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BOSTON  MEDICAL  LIBRARY        -^  ^ 

IN  THE 
HIANCIS  A.  (fpJJNTWAY 

UBBARY  OF  MEDICINB 

BRITISH    JOURNAL 


HOMCEOPATHY. 


EDITED  BY 
J.  J.  DRTSDALE,  M.D.,  K.  E.  DUDGEON,  M.D., 

RICHARD  HUGHES,  L.R.C.P. 


TOL  XXXIL 


in  oasTis  mnrie,  eh  ddbhs  LtsBKria,  in  omnstrs  chabitas. 


LONDON: 

HENBT  TUBNER  &  CO.,  77,  FLEET  STREET,  E.G.; 

MANCHESTER:  41,  HCCADILLT. 


lOKWCUUCIT. 


CONTENTS  OP  No.  CXXVII. 

PAQS 

PHOSPHO&US  IN  N£U&AL6IiL  .1 

CASES   OF   LEAD   POISONING    FROM    WELL  WATER.      BY   DR.   J.    W.   VON 

TUNZELM/LNN       ........      17 

WALDENBUR6>S  EXPERIMENTS  ON  ANIMALS  APPLIED  TO  HUMAN  TUBER- 
CULOSIS AND  PULMONARY  CONSUMPTION  .82 

A  REVIEW  OF  HAHNEMANN'S  'INSTRUCTION  FOR  SURGEONS  RESPECTING 

VENEREAL  DISEASES.'    BY  W.  B.  A.  SCOTT,  M.D.  EDIN.    .  .66 

ON  THE  PATHOGENESY  OF  ACONITE,  WITH  CLINICAL  OBSERVATIONS.     BY 

J.  H.  NANKTVBLL-  M.R.C.S.,  YORK  .70 

CASE  OF  COLIC  SIMIJLATING  PAINTER'S  COLIC.  WITH  OPISTHOTONOS,  AND 

OTHER  CASES.    BY  DR.  E.  C.  HOLLAND    .  .79 

NOTES  ON  RE-VACCINATION.    BY  CHARLES  H.  BLACKLEY,  M.R.C.S.  ENG.       .      90 

REVIEV7S. 

MEMOIR  OF  SIR  JAMES  Y.  SIMPSON,  BART.    BY  J.  DUNS,  D.D..  F.R.S.E.  .    lU 

THE  SIMPLICITY  OF  LIFE:  AN  INTRODUCTORY  CHAPTER  TO  'PATHOLOGY.* 

BY  RALPH  RICHARDSON,  M.A.,  M.D.  .166 

THE  BATHS  AND  WELLS  OF  EUROPE,  THEIR  ACTIONS  AND  USES,  WITH 
NOTICES  OF  CLIMATIC  RESORTS  AND  DIET  CURES.  BY  JOHN  MAC- 
PHERSON,  M.D.  .166 

OPHIDIANS:  ZOOLOGICAL  ARRANGEMENT  OF  THE  DIFFERENT  GENERA, 
INCLUDING  VARIETIES  KNOWN  IN  NORTH  AND  SOUTH  AMERICA,  THE 
EAST  INDIES,  SOUTH  AFRICA,  AND  AUSTRALIA,  8u.    BY  S.  B.  HIGGINS,  S.A.    168 

PRACTICAL  NOTES  OK  THE  NEW  AMERICAN  REMEDIES.  BY  R.  TUTHILL 
MASSY.  M.D.  .169 

TAKING  COLD  (THE  CAUSE  OF  HALF  OUR  DISEASES) :  ITS  NATURE,  CAUSES, 
PREVENTION.  AND  CURE:  ITS  FREQUENCY  AS  A  CAUSE  OF  OTHER  DIS- 
EA8£S»  AND  THE  DISEASES  OF  WHICH  IT  IS  A  CAUSE,  WITH  THEIR  DIA- 
GNOSIS AND  TREATMENT.     BY  JOHN  W.  HAYWARD,  M.D..  M.R.C.S.,  L.S.A.    160 

FHY810L0GIC0-PATH0L0GICAL  BASIS  OF  THE  MATERIA  MEDICA.    BY  W.  H. 

BURT,  MJ>.  .161 

ACTION  DES  MEDICAMENTS  HOM(EOPATHlQUES.  OU,  ELEMENTS  DE  PHAR- 

MAOODYNAMIQUE.    PAR  LE  DR.  RICHARD  HUGHES  .164 

CLINICAL  RECORD     .  .166 

MISCELLANEOUS. 
On  liilbiiteiimalDoMi,17S.— Gofloo  and  itoUae8,188.— HomcDopaihyaBd  "Scientific  Medieiiie,"189. 
Booxa  RxcxiTxo,  193. 


CONTENTS  OP  No.  OXXVIII. 

THE  CLIMATE  OF  MADEIRA  IN  THE  TREATMENT  OF  PHTHISIS  AND  OTHER 

AFFECTIONS  OF  THE  RESPIRATORY  ORGANS.  BY  W.  B.  A  SCOTT,  M.D.  .  19S 
ON  THE  TREATMENT  OF  SOME  SKIN  DISEASES.  BY  DR.  CLOTAR  MULLER  .  386 
THE  CYPHER  REPERTORY.    BY  DR.  RICHARD  HUGHES  .344 

THE  TREATMENT  OF  TYPHOID  FEVER  BY  COLD  BATHS  .360 

A   CALL  UPON   ALL  HOMCEOPATHIC  PHYSICIANS  FOR  THE    PROVING    OF 

MEDICINES  UPON  HEALTHY  MEN  AND  ANIMALS  .366 

PHYSIOLOGICAL  ACTION  OF  ACETATE  OF  COPPER     .  .360 

BINZ  AND  ANSTIE  ON  BROMIDE  OF  POTASSIUM  .    37i 

ON    THE  NAIVETE   INHERENT   IN   GERMAN   HOMCEOPATHY.     A   CRITICAL 

MEDPTATION.    BY  DR.  J.  KAFKA.  PRAGUE  .376 

ON  CERTAIN  PATHOLOGICAL  POINTS  OF  INTEREST.    BY  EDWARD  T.  BLAKK, 

M.D.,  OF  REIGATE  .381 

CASES  ILLUSTRATIVE  OF  DISEASE  OF  THE  URINARY  ORGANS.      BY  HENRY 

HARRIS,  ESQ..  M.R.C.S.      .  .396 

SPECIFIC  MEDICATION  IN  RELATION  TO  SURGERY.    BY  DR.  W.  S.  CRAIG,  OF 

SCARBOROUGH  .304 

CASES  FROM  THE  LONDON  HOMCEOPATHIC  HOSPITAL.    BY  DR.  MACKECHNIE    S30 

REVIEWS. 

THE  SPECIFIC  ACTION  OF  DRUGS  ON  THE  HEALTHY  SYSTEM:  AN  INDEX  TO 
THEIR  THERAPEUTIC  VALUE.  AS  DEDUCED  FROM  EXPERIMENTS  ON 
MEN  AND  ANIMALS.  BY  ALEX.  G.  BURNESS,  MB.,  CM.,  UNIV.  ABERU. : 
AND  F.  T.  MAVOR,  M.R.C.V.S.  !    834 

BOERICKE  AND  TAFEL'S  QUARTERLY  BULLETIN  OF  MEDICAL  LITERATURE    8S8 

MISCELLANEOUS. 

Tozieology  of  the  PoiMm  of  Tarions  Fangi,  348.— On  Sulphide  of  PotaMinm,  Snlphide  of  Sodiam, 
and  Snlphide  of  Calcinm,  bj  Sydney  Ringer,  MJ).,  368.— Liquor  Sodn  Chlorats  in  Metror- 
rhagia, sas.— Cbipa  from  the  Workahops  of  the  '*  Sccret-caae  "  Practittonen»  by  Dr.  Hirsch, 
Piagne,  864. 

CUNICAL  RFXX)RD     .  .  .  \    870 

OnrruABT :  Dr.  Bemhard  Hinchel  and  Dr.  Edward  Acworth,  883. 

Britiflh  HomcBopathie  Congreaa,  888. 

Boon  RSCBITBD,  SSi. 


CONTENTS  OP  No.  CXXIX. 

PA  OB 

OZONE  JLND  ANTOZOKE.    BY  W.  B.  A.  SCOTT,  M.D.      .  .886 

ON  THE  ACTION  OP  IBON.    BY  KOBERT  T.  COOPER.  M.D.T.C.D.  .    409 

RABIES  MEPHITICA.    BY  THE  REV.  HORACE  HOVEY,  M.A.     .  .    44S 

HAHNEMANN'S  EARLIEST  DISCIPLES.    DISCOURSE  BY  DR.  LORBACHEB,  OF 

LEIPSIC,  ON  THE  119th  ANNIVERSARY  OF  HAHNEMANN'S  BIRTH  .    4S1 

(ENANTHE  CROCATA  ,    U9 

NOTE  TO   "EXAMINATION  OF  HAHNEMANN'S  PATHOGENESIS   OF   BELLA- 
DONNA."   BY  DR.  RICHARD  HUGHES  .475 
ON  SOME  CASES  OF  HEMOPTYSIS.    BY  DR.  HERBERT  NANKIVELL   .              .    488 
ON  SOME  POINTS  IN  THE  THERAPEUTICS  OF  APOMORPHIA  AND  CHLORAL. 

BY  D.  DYCE  BROWN,  MJL.,  M.D.  .497 

ADDRESS  AT  CLOSE  OF  SESSION  187S-4.    BY  DR.  BAYES,  VICE-PRESIDENT      .    617 

REVIEWS. 

BOSNNINGHAUSEN'S  HOM(EOPATHIC  THERAPEU  OF  INTERMITTENT  AND 
OTHER  FEVERS.  TRANSLATED.  WITH  THE  ADDITION  OF  NEW  REME- 
DIES. BY  A.  KORNIXERFER,  M.D.  .681 

ANNUAL  RECORD  OF  HOMCEOPATHIC  LITERATURE.    1878.    EDITED  BY  C.  G. 

RAUB,  M.D.,  ASSISTED  BY  FIFTEEN  OTHERS  .684 

THE  SCIENCE  AND  ART  OF  SURGERY.  COMPILED  FROM  STANDARD  ALLO- 
PATHIC  AUTHORITIES,  AND  ADAPTED  TO  HOMCEOPATHIC  THERAPEUTICS. 
BY  E.  C.  FRANKLIN,  M.D.  .636 

C.  HERING'S  MATERIA  MEDICA;  WITH  A  PATHOLOGICAL  INDEX  .    688 

THE  HAHNEMANN  MATERU  MEDICA.    PART  III,  CONTAINING  BELLADONNA, 

BY  DR.  R.  HUGHES  .  .643 

L'HOMCEOPATHIE  PROUVEE  PAR  SE8  ADVERS AIRES.    PAR  DR.  FLABSCHOEN    643 

ON    THE    UNIVERSALITY    OF    THE    HOMOSOPATHIC    LAW   OF  CURE.      BY 

CHARLES  NEIDHARD.  M.D.,  kc.    .  .643 

JOURNALS  OF  THE  QUARTER  .643 

CLINICAL  RECORD     .  .684 

MISCELLANEOUS. 

Britiah  Homosopathie  CongreUf  666.— Bazaar  in  aid  of  the  Fanda  of  tke  London  Honunopathic 
Hospital.  567.— Caaea  of  Ringworm  treated  by  Oleate  of  Mercmnr,  by  Leonard  Cane,  M.B. 
and  B.S.  Lond.,  670. — Case  of  Diabetes  Mellitoa,  nnder  the  care  of  Mr.  Kennedy,  678. 

OBiruAKY :  Dr.  George  N.  Eppi ,  674. 

ComKESPONDXif CK :  Letter  from  W.  B.  A.  Soott,  676. 

Books  Rxcxivxd.  676 . 


CONTENTS  OF  No.  OXXX. 

HINDOO  MEDICINE.    BY  W.  B.  A.  SCOTT,  M.D.  .677 

CASES  OF  ZINC  POISONING.    BY  J.  W.  VON  TUNZELMANN.  M.D.  .    610 

HAHNEMANN'S  PATHOGENESIS  OF  FERRUM  .614 
THE  PATHOGENESIES  OF  THE  '*  CHRONIC  DISEASES."     BT  DR.  RICHARD 

HUGHES  .681 

DR.  RUSSELL  REYNOLDS  BEfX)RE  THE  BRITISH  MEDICAL  ASSOCIATION  .    638 

LUPUS  AND  ITS  TREATMENT.    BY  EDWARD  T.  BLAKE,  M.D.,  OF  REIGATE  .    848 

REVIEWS. 

UEBER  DIE  INCOMPETENZ  DER  BEWEISE  FUB  UND  WIDER  DIE  HOMOO- 
PATHIE  GEGENUBER  DER  CONDITIO  SINB  OVA  NON  UM  DIE  GANZE 
BOM(EOPATHISCH£  8TREITFRA6E  ZU  LOSEN.    VON  VESPASUN  V.  GRU- 

A  SYSTEM  OF*  SURGERY.    BY  *WM.  TOD  HELMUTH,  m!d.  *  !    880 

THE  STEPPING-STONE  TO  HOMOSOPATHY  AND  HEALTH.    BT  DR.  RUDDOCK .    87 
JOURNALS  OF  THE  QUARTER  .  .883 

MISCELLANEOUS. 

Relations  of  the  Press  towards  HomoBopaths,  741. 

ConHBSPOHDSNCS :  Letter  from  C.  Neidhard,  758.— Letter  from  Washington  Epps,  767. 

Books  Rkcsitkd,  768. 

1rdkx,759. 

Appsndi  :— Pathogenetic  Record,  by  Dr.  Bkkkidqx. 


THE 


BRITISH   JOURNAL 


09 


HOM(EOPATHY. 


PHOSPHORUS  IN  NEURALGIA. 

In  the  October  number  of  the  Practitioner  Mr.  J. 
AshburtoQ  Thompson  continues  his  remarks  on  the  powers 
of  Phosphorus  in  neuralgia^  and  mentions  several  prepara- 
tions as  having  been  employed  by  him  with  varying  suc- 
cess. Among  others  he  instances  six  cases  of  neuralgia 
treated  with  Zinc  phosphide.  *^  This  preparation  is  said/'  he 
writes,  ''  to  contain  one  fourth  of  its  weight  of  pure  Pho$' 
phoruSy  of  which  only  a  half  is  available  for  therapeutic 
purposes.^'  What  he  means  by  that  is  not  clear  to  us ; 
we  would  be  inclined  to  think  that  the  whole  dose  of  the 
medicine  given  was  available  for  therapeutic  purposes,  but 
as  Zinc  phosphide,  not  in  any  way  as  Phosphorus,  which  is 
quite  a  different  thing.  However,  let  that  pass ;  there  are 
other  things  that  strike  us  in  this  notice  of  Zinc  phosphide. 
The  writer,  it  seems,  '^  inadvertently  prescribed  a  quantity 
equivalent  to  ijl^nd  of  a  grain  "  in  two  cases.  One  of  these 
was  a  young  lady  suffering  frpm  chronic  gastritis,  the  other 
a  young  man  debilitated  by  excessive  mental  work ;  neither 
of  them  had  ever  had  neuralgia,  though  one  of  them  had  a 
neuralgic  sister,  so  might  be  ''  a  favourable  subject  for  the 
disease.^'     The  sequel  shows  that  the  other  was  an  equally 

VOL.  XZXII^  NO.  CXXVII. JANUARY,  1874.  A 


2  Phosphorus  in  Neuralgia, 

favourable  subject  for  neuralgia^  though  no  family  predis- 
position is  recorded  of  her. 

These  two  non-neuralgic  persons  then,  after  taking  respec- 
tively seven  lind  nine  doses  of  this  minute  quantity  of  Zinc 
phosphide,  ''complained  of  severe  frontal  headache  accom- 
panied by  frequent  stabs  of  pain^  apparently  darting  from 
before  backwards  to  the  occipital  region^  but  intracranial, 
and  not  attended  by  any  disturbance  of  sensation  in  the 
scalp/'  Then  follows  the  very  curious  denouement :  ''  Under 
a  dose  equivalent  to  ygth  of  a  grain  of  Phosphorus  both 
patients  very  quickly  recovered,  and  have  had  no  return  of 
pain.  These  are  the  only  two  cases  in  which,  under 
favourable  circumstances  of  experiment,  I  have  observed  any 
apparent  confirmation  of  the  homoeopathic  hypothesis,  and 
I  will  not  attempt  to  explain  these  phenomena  from  that 
point  of  view.  But  since,  after  its  first  prescription  by  Dr. 
Badcliffe^  the  use  of  Phosphorus  in  neuralgia  was  practi- 
cally reintroduced  to  notice  under  auspices  of  homoeopathy, 
it  may  not  be  out  of  place  to  remark  here  that  it  holds  no 
more  distinguished  a  place  in  the  Homoeopathic  Phartna^ 
copcna  than  the  other  thirty-and-odd  drugs  which  are  there 
recommended  in  the  treatment  of  this  disease.'^ 

There  are  several  statements  in  this  passage  which  appear 
to  us  to  require  comment. 

And,  first,  we  would  observe  that  no  conclusion  can  be 
drawn  relative  to  the  effects  of  Phosphorus  from  the  admi- 
nistration of  Zinc  phosphide  or  even  of  Sodium  hypophos- 
phiie.  Neither  can  the  cure  of  symptoms  caused  by  the 
,\{nd  of  a  grain  of  a  drug  by  the  j^th  of  a  grain  of  the 
same  drug  be  regarded  as  either  a  real  or  an  apparent  con- 
firmation of  the  "homoeopathic  hypothesis.*'  What  Mr. 
Thompson  apparently  fails  to  perceive  is  that  the  production 
of  neuralgia  in  patients  not  subject  to  that  affection  by  a 
drug  which  has  the  power  of  curing  similar  neuralgia 
occurring  spontaneously,  as  some  of  his  cases  prove  it  to 
possess,  is  a  real  and  not  at  all  an  apparent  confirmation  of 
the  truth  of  the  homoeopathic  therapeutic  maxim,  similia 
similibus  curaniur.  What  Mr.  Thompson  means  by  the 
''  homoeopathic  hypothesis  ''  we  do  not  know,  the  maxim 


Phosphorus  in  Neuralgia,  3 

being    merely  a    therapeutic    rule    and    not    a    hvpotkesis 
at  all. 

Again^  he  might  have  known  that  no  one  neuralgic 
remedy  in  the  Homoeopathic  Pharmacopoeia  holds  a  more 
distinguished  place  than  another.  Every  one  is  equally 
distinguished  for  the  cure  of  its  own  peculiar  form  of 
neuralgia.  This  is  one  of  the  most  frequent  errors  of  the 
allopathic  sect^  treating  names  in  place  of  individual  forms 
of  disease.  If  there  are  thirty- and -odd  drugs  used  accord- 
ing to  the  homoeopathic  method  for  neuralgia  they  are  for 
the  treatment  of  thirty-and-odd  forms  of  neuralgia^  and  the 
form  produced  on  the  healthy  by  each  of  these  gives  the 
guide  to  the  form  spontaneously  occurring  it  is  capable  of 
curing.  To  his  great  surprise  Mr.  Thompson  made  an 
accidental  proving  of  the  Zinc  phosphide,  and  had  he  care- 
fully noted  the  pathogenetic  effects  developed  they  would  have 
surely  guided  him  to  the  form  of  neuralgia  for  which  the 
drug  is  curative.  That  Zinc  phosphide  is  not  indicated  for 
the  same  cases  as  Phosphorus  is  shown  by  one  of  his  own 
cases^  No.  35^  which  was  fruitlessly  treated  with  the  former 
remedy^  but  rapidly  yielded  to  the  latter.  Mr.  Thompson 
would  have  conferred  a  real  benefit  on  therapeutics  had  he 
Bet  himself  to  differentiate  the  forms  of  neuralgia  for  which 
Phosphorus  and  Zinc  phosphide  are  respectively  indicated. 

Mr.  Thompson  is  mistaken  in  supposing  that  Dr.  Bad- 
cliffe  was  the  first  to  prescribe  Phosphorus  in  neuralgia,  even 
admitting,  which  we  are  not  the  least  disposed  to  do,  that 
his  prescription  of  Sodium  hypophosphite  was  equivalent  to  a 
prescription  of  Phosphorus,  Long  before  Dr.  Radcliffe  \^as 
a  doctor,  and  long  before  Phosphorus  had  been  proved  by 
Hartlaub,  it  had  been  successfully  used  in  neuralgia  by 
physicians  of  the  old  school. 

It  may  interest  our  readers  to  give  here  a  slight  sketch 
of  the  employment  of  Phosphorus  in  neuralgia  by  both 
schools. 

Kunckel  {Chem.  Anmerk,,  Erfurt,  1721)  was  probably  the 
first  that  used  Phosphorus  for  curative  purposes.  He  gave 
it  in  the  form  of  pills,  and  lauds  its  strengthening  and  pain- 
subduing  properties.     Thirty  years  later  we  find  a  notice  of 


4  Phoftphorus  in  Neuralgia. 

Phosphorus  as  a  remedial  agent  in  an  inaugural  treatise  hj 
J.  O.  Mentz^  Dissertatio  inavg,  medica  de  Phosphori  loco 
medicifUB  assumpti,  virtute  medica^  aliquot  casibus  singu- 
laribus  confrmata,  Vittemberg,  1751. 

The  singulares  casus  alluded  to  are  mostly  of  malignant 
fevers^  some  petechial.  Various  allopathic  practitioners  have 
confirmed  the  utility  of  Phosphorus  in  such  casea^  and  it  is 
well  known  to  homceopathists  as  a  sovereign  remedy  in 
typhus.     But  this  by  the  way. 

We  shall  now  give  some  cases  from  allopathic  authors  of 
the  cure  of  neuralgias  of  the  head  by  means  of  Phosphorus. 
The  first  case  is  one  by  Dr.  Lobenstein  von  Lobel  from  the 
22nd  vol.  of  Horn's  Archiv,  which  is  given  in  full  detail 
in  the  2nd  vol.  of  Frank's  Magazin  (from  which  we 
translate)  and  in  a  more  condensed  form  in  Sorge's  PhoS' 
phor. 

The  author  (Dr.  L.  v.  L.),  a  thin,  delicate,  and  highly  irritable 
subject,  had  had  an  attack  of  podagra  in  January,  1805,  which 
was  cured  in  six  weeks.  He  remained  well  for  two  years,  with 
the  exception  of  a  violent  headache  that  used  to  torture  him  for 
a  day  at  a  time.  It  was  not  produced  by  anything  he  ate,  nor 
by  mental  fatigue,  but  came  on  without  any  assignable  cause. 
It  did  not  always  attack  the  same  part,  but,  on  the  contrary, 
always  chose  a  new  spot,  which  was  sometimes  the  forehead, 
sometimes  the  occiput,  &c.  Where  the  pains  were  most  severe 
the  part  swelled  and  caused  the  most  intolerable  pain  when 
touched.  His  mind  became  so  weak  that  he  could  not  do  the 
simplest  intellectual  work,  and  the  lefl  eye  was  so  affected  by 
the  pain  that  he  could  no  longer  see  things  distinctly — although 
no  change  was  perceptible  in  the  eye  itself.  He  considered  his 
ailment  to  be  a  transient  arthritic  headache.  [The  name  is,  of 
course,  of  no  importance,  except  as  it  led  the  patient  to  use  a 
farrago  of  anti-arthritic  remedies  without  benefit.]  He  rubbed 
his  head  several  times  a  day  with  Camphorated  spirit  and  dosed 
himself  with  Bad,  ealam,  arom,,  Tinet,  Ouaiac^  and  Laudanum. 
At  the  same  time  he  avoided  all  intellectual  work  and  bodily 
exertion  and  took  frequent  tepid  baths.  Still  the  headache 
always  returned,  and  that  notwithstanding  that  the  doctor 
employed  many  other  external  and  internal  remedies  and  was 


Phosphorus  in  Neuralgia.  5 

frequenilj  prescribed  for  bj  other  doctors.  At  first  the  headaches 
seemed  to  get  better,  he  had  no  attack  for  a  fortnight,  but  thej 
then  unexpectedly  returned  in  great  intensity,  and  each  succes- 
sive attack  seemed  to  be  worse  than  the  preceding  one.  Thej 
also  became  more  frequent  and  lasted  longer  ;  whereas  formerly 
they  had  come  on  only  once  or  twice  a  week  and  lasted  only  one 
day,  now  they  occurred  every  two  days  and  lasted  without  cessa- 
tion from  two  to  three  days.  With  the  headache  were 
associated  eructations,  eitreme  weariness  of  the*  limbs,  a  con- 
fased  empty  feeling  in  the  head,  low  spirits,  ill  humour,  and 
gloominess ;  the  hair  fell  out,  he  had  violent  pain  in  the  loins 
after  the  attacks ;  the  pulse  was  extremely  slow  (45) ;  the  urine 
pale,  watery,  of  a  disgusting  sweet  smell ;  appetite  unaffected, 
except  during  the  attacks,  when  he  felt  disgust  at  all  food,  thirst, 
restlessness,  and  such  a  feeling  of  anxiety  that  he  could  neither 
lie,  stand,  nor  walk. 

In  this  state  of  things  he  took,  every  two  hours,  from  twenty 
to  twenty-eight  drops  of  the  following  mixture: — Fhosphor,,, 
gr.  iv,  JEth,  Sulph.y  Jss,  01.  Oaryophyll.^  9ss. 

After  the  third  dose  he  experienced  agreeable  warmth 
throughout  the  body,  frequent  passing  of  water,  cheerfulness, 
indeed  an  indescribable  joyf ulness ;  the  pulse  rose ;  the  intoler- 
able aching  pain  in  the  head  changed  to  a  dull  headache; 
inclination  to  rest.  There  was  moist  skin  all  over  the  body  and 
perspiration  on  the  head ;  he  slept  quietly  through  the  night  and 
next  morning  felt  wonderfully  refreshed.  His  head  was  quite 
free  from  pain,  the  weary  feeling  was  gone,  the  appetite  good. 
He  now  took  twenty-five  drops  of  the  Phosphorus  mixture  on 
sugar  every  three  hours.  The  following  day  indescribable  good 
temper  and  cheerfulness,  and  agreeable  warmth  throughout 
the  body.    The  headache  now  ceased  entirely  for  a  long  time. 

Six  weeks  afterwards  he  got  a  severe  chill,  beginning  with 
such  a  general  rigor  as  if  he  was  going  to  have  a  febrile  paroxysm. 
At  the  same  time  nausea,  uncommon  weariness,  and  return  of 
the  usual  headache  with  great  severity.  He  took  the  above 
preparation  of  Phosphorus  in  doses  of  thirty  drops  on  sugar. 
After  the  first  dose  he  felt  nothing  but  warmth  throughout  the 
body ;  half  an  hour  after  the  second  dose  he  fell  into  a  refreshing 
sleep  that  lasted  five  hours.  On  waking  he  found  himself  in  a 
profuse  perspiration>  free  from  headache,  quite  well,  and  with 


6  Phosphorus  in  Neuralgia. 

good  appetite.  After  waking  he  passed  red  pellucid  urine, 
smelling  of  sulphur,  which,  after  standing  two  hours,  deposited  a 
thick,  white,  slimy  sediment.  The  medicine  was  continued  in 
the  dose  of  twentj-five  drops  every  two  hours,  from  the  18th  to 
the  29th  of  January,  and  from  that  time  the  patient  never  had 
an  attack  of  his  most  prostrating  headache. 

Dr.  Lobstein  wrote  a  work^  entitled  Recherches  ei 
observations  sur  le  phosphore,  ouvrage  dans  lequel  on  fait 
connaitre  les  effets  extraordinaires  de  ce  remede  dans  le  traite' 
ment  de  differentes  maladies  internes,  1815. 

Among  the  cases  given  in  this  work  is  the  following  one 
of  periodical  headache,  which  seems  to  have  been  of  a 
typical  neuralgic  character,  though  it  is  not  described  more 
minutely  than  Mr.  Thompson's  cases.  We  translate  from 
Frank's  Magazin,  vol.  iii,  p.  875. 

A  lady,  SBt.  28,  of  very  excitable  nervous  character,  was 
subject  to  a  violent  headache,  chiefly  located  in  the  forehead 
over  the  orbit,  and  coming  on  about  every  ten  days.  She  had 
taken  many  remedies  from  many  medical  men  and  from  the 
author  without  much  benefit.  She  vtow  got  the  following  pre- 
scription : — Phosphorus,  gr.  iv ;  JEth.  Sulph.,  Jss  ;  01.  CaryophylL, 
gtt.  X.  To  take  twenty-five  drops  on  the  commencement  of  an 
attack  and  the  same  dose  two  hours  later. 

One  hour  after  the  first  dose  there  was  manifest  improvement ; 
the  attack  lasted  only  three  quarters  of  an  hour.  'So  more 
medicine  imtil  the  occurrence  of  the  next  attack,  when  the  same 
remedy  was  used;  the  attack  was  much  slighter,  lasted  only 
a  quarter  of  an  hour  and  never  afterwards  recurred. 

The  following  case  by  Dr.  Lobenstein  von  Lobel,  quoted 
by  Sorge  from  Horn's  Archiv,  is  interesting  in  several 
points  of  view. 

A.  H — ,  tet.  G5,  a  market  porter,  had  for  three  years  suffered 
off  and  on  from  a  violent  one-sided  headache.  His  sight  too 
gradually  became  impaired  until  he  became  quite  blind.  The 
headache  increased  and  along  with  it  there  came  violent 
trembling  in  the  right  arm,  the  same  side  on  which  his  headache 
was.  There  was  also  great  debility,  so  that  he  could  not  raise 
himself  up  and  complained  of  cold  all  over.     Amaurosis  was 


Phosphorus  in  Neuralgia,  7 

munistakeable.  He  had  a  dull  eqiiinting  look,  the  pupils  were 
much  dilated,  insensible  to  light  and  oval-shaped ;  the  come» 
were  transparent,  and  there  was  no  trace  of  inflammation  or 
redness.  He  had  not  the  faintest  perception  of  light,  was 
mach  depressed  in  spirits,  and  talked  much  about  dying. 

On  the  17th  April,  1807,  I  prescribed  Phosphortts,  gr.  iv; 
j^iheris,  Jss.  Mix.  From  twenty-fire  to  thirty  drops  every  two 
hours,  and  alcoholic  embrocations. 

On  the  27th  April  he  got  out  of  bed  for  the  first  time,  he  was 
cheerful  and  animated,  the  headache  had  not  returned,  the 
trembling  of  the  arm  was  quite  gone,  but  the  eyes  were  not 
altered.  Owing  to  nausea  and  burning  in  the  stomach  in  the 
beginning  of  May  the  Phosphorus  had  to  be  discontinued  for 
some  days,  but  was  again  taken  until  the  9th  of  June,  and 
an  ethereal  solution  of  Phosphorus  was  rubbed  on  the  eyelids 
and  forehead. 

On  the  10th  June  the  patient  was  dismissed  perfectly  and 
permanently  cured.  He  could  never,  however,  read  again,  although 
he  saw  pretty  well,  and  nothing  abnormal  could  be  observed  in 
his  eyes. 

In  spite  of  the  meagreness  of  the  details  of  the  ease  it 
seems  to  have  been  one  of  fully-developed  glaucoma. 
Several  other  cases  of  a  similar  character  are  recorded 
which  iseem  to  show  the  power  of  Phosphorus  for  the  cure 
of  this  disease.  We  may  give  in  this  place  a  very  striking 
one  from  the  practice  of  the  same  physician.  It  is  given 
in  full  in  Frank's  Magazin. 

A  poor  fellow,  the  usher  in  a  village  school,  after  great  exer- 
tions and  over-heating  himself  in  the  autumn  of  1805,  contracted 
an  inflammation  in  his  eyes  with  almost  unbearable  headache 
and  photophobia,  which  were  sadly  aggravated  by  his  occupa- 
tion of  teaching  and  unsuitable  domestic  remedies.  In  the 
autumn  of  1806,  after  the  battle  of  Jena,  he  had  to  pass  eight 
days  and  nights  in  a  wood  in  the  open  air  with  insuf&cient 
clothing  and  scanty  food,  whereby  his  malady  was  much 
increased,  and  the  exposure  he  had  undergone  brought  on  diar- 
rhoea and  a  low  fever  that  came  on  every  day  about  4  p.m.  In 
this  miserable  condition  he  was  brought  to  Dr.  L —  on  the 
10th  November,  1806.     The  tarsi  were  swollen,  red,  and  very 


8  Phosphorus  in  Neuralgia. 

painful,  the  eyelashee  had  aknost  all  fallen  out  firom  ulceration, 
the  conjunctiva  was  studded  oyer  with  small  ulcers,  the  whole 
eye  resembled  a  lump  of  flesh  sprinkled  oyer  with  white  spots, 
neither  pupil  nor  iris  could  be  seen.  The  patient  complained  of 
yiolent  burning  pains  in  the  eyes ;  he  could  not  distinguish  any 
object,  he  could  only  distinguish  Ught  from  darkness.  From 
the  eyes  there  flowed  a  dear  acrid  water  that  caused  a  kind  of 
herpetic  eruption  on  the  cheek.  In  addition  there  was  great 
general  debility,  anorexia,  pains  in  the  bowels,  especially  in  the 
umbilical  region;  constant  diarrhooa  with  hectic  fever,  pulse 
small,  contracted,  scarcely  to  be  felt ;  body  emaciated  and  miser- 
able ;  voice  trembling ;  tongue  clean  in  the  centre,  bluish  stripes 
on  its  sides  that  extend  to  the  root  of  the  tongue.  At  first  the 
general  health  was  restored  by  a  generous  diet  and  appropriate 
medicines,  the  herpetic  eruption  on  the  cheeks  and  the  chronie 
ophthalmia  were  abo  removed,  chiefly  by  locsil  remedies,  such  as 
JPrecipUate  ointment^  &c.  By  the  9th  of  December  the  sclerotic 
was  quite  clean  and  white  as  alabaster,  the  cornea  no  longer  dim 
but  clear  as  crystal ;  in  short,  the  eyes  were  completely  freed 
from  inflammation,  and  the  iris  and  pupil  were  distinctly  visible. 
All  the  structures  of  the  eye  appeared  to  be  perfectly  normal. 
The  pupil  had  a  brownish-black  appearance,  but  there  was  no 
trace  of  milkiness  or  whitish  appearance  in  it.  Many  remedies, 
both  internal  or  external,  were  administered,  but  without  doing 
any  good.  On  the  27th  March  he  got  the  following  prescription 
— Fhospk.,  gr.  iii,  solve  in  Naphth.  Vitriol.  (,^her),  Jss, 
add  01.  Valer,  dest,  9ss,  d.  s.,  from  twenty-five  to  sixty  drops 
every  three  hours,  the  dose  being  increased  by  three  drops  every 
three  days.  At  the  same  time  the  forehead,  eyelids,  and  cheeks 
were  rubbed  three  times  a  day  with  an  embrocation  of  Balsam, 
Fit,  Sqff^.y  Jss ;  Spir,  Sal,  Ammon,  Oaust,  5j  i  ^^'  Chamomil. 
dest,j  9j  ;  Spir,  Fin,  rect,^  Jss.  But  this  embrocation  could  not 
be  considered  as  of  much  avail,  as  similar  and  even  stronger 
embrocations  had  been  used  during  the  whole  treatment. 
Neither  is  much  importance  to  be  attached  to  the  medicated 
warm  baths  that  were  used  at  first  every  other  day  and  after- 
wards every  day.  After  using  the  Photphonis  for  twelve  days 
it  bad  to  be  left  off  for  some  days  on  account  of  nausea.  The 
patient  declared  that  the  light  appeared  bright  and  he  could  see 
the  Bun  shining  better,  but  he  could  not  distinguish  any  object. 


Phosphorus  in  Neuralgia,  9 

Soon  after  this  he  often  felt  a  painless  itching  on  the  eyelids  and 
ejeball.  Some  days  later  the  doctor  yisited  his  patient^  who  of 
his  own  accord  had,  since  last  report,  been  taking  the  medicine 
in  the  dose  of  from  se?enty  to  seventy.five  drops  every  three 
hours.  He  now  could  actually  see,  though  not  very  clearly. 
Objects  appeared  to  him  as  if  enyeloped  in  a  black  veil,  and  he 
could  not  distinguish  colours ;  the  pupils,  that  were  previously 
immovable,  now  contracted  as  in  healthy  eyes,  and  the  previous 
inanimate  look  was  quite  gone.  From  this  time  he  got  daily 
seventy-five  drops  of  the  phosphorus  solution  three  times  a  day, 
besides  the  embrocatioa  and  a  daily  bath.  After  twelve  days  the 
patient  came  to  the  doctor  alone ;  he  could  now  see  perfectly 
and  could  distinguish  colours  accurately,  only  objects  appeared 
larger  than  natural.  The  JPhospharus  was  now  left  off  and  some 
mild  stimul^ts  administered  for  a  short  time,  particularly 
Valerian  in  combination  with  aromatics.  In  May  the  patient 
was  again  able  to  take  a  situation  as  schoolmaster. 

It  is  not  very  clear  what  was  the  precise  character  of  the 
amaurosis  in  this  case^  but  although  details  are  wanting  for 
establishing  an  exact  diagnosis,  it  is  probable  that  the  real 
nature  of  the  affection  was  glaucoma.  The  author  himself 
calls  it  a  weakness  of  the  nerve  of  the  eye,  but  some  of 
the  symptoms  he  enumerates  point  rather  to  the  disease  we 
have  mentioned.  The  dilated  insensible  pupils  of  a 
brownish-black  colour,  with  the  perfectly  transparent  cornea 
and  the  previous  inflammatory  symptoms^  all  seem  to  point 
to  a  glaucomatous  affection.  We  are  the  more  confirmed  in 
our  opinion  as  to  the  power  of  Phosphorus  in  glaucoma  by 
the  following  case^  which  is  related  in  the  Ally,  horn, 
Zeiiungy  vol.  xxii^  by  our  old  friend  the  late  Dr.  Weber^  of 
Hanover.  We  make  no  apology  for  giving  it  at  length 
here  as  it  bears  also  upon  the  neuralgic  question. 

William  M — ,  of  Hanover,  »t.  24,  taU,  thin,  small-boned,  pale- 
complexioned,  of  reflective  disposition;  especially  disposed  to 
dwell  upon  his  malady ;  had  suffered  for  two  years  almost  unin- 
terruptedly from  headaches,  often  only  one-sided,  the  character  of 
which  was  aching  in  temples  and  forehead,  unaltered  by  movement 
or  rest.  Sensation  of  ebullition  in  the  head,  with  pale  suffering 
expression  of  features.    The  pains  in  the  head  are  increased  by 


10  Phosphortis  in  Neuralgia. 

the  slightest  pressure  of  the  hat.  Constant  stuffed  nose ;  con- 
tinued burning  in  the  eyes,  which  have  a  peculiar  brightness ; 
small  appetite ;  after  taking  ever  so  little  and  digestible  food, 
immediate  diarrhoea.  Four  years  ago  had  twice  in  succession  the 
itch,  which  was  rapidly  cured  by  a  grey  ointment  (Mercurial?), 
Since  that  time  the  above-described  malady  has  gradually 
developed  itself.  From  the  21st  August  to  the  14th  September 
he  got  Tinct.  suiph.  8  or  12,  a  dose  every  third  night.  On  the 
latter  date  the  report  was,  the  burning  in  the  eyes  worse. 
Upon  falling  asleep  at  night,  frequent  deceptions  of  vision,  sparks 
before  the  eyes,  shooting  pains  through  the  eyes,  appearance  of 
flashes  of  lightning,  the  pain  of  head  somewhat  diminished. 
Prescrip.  Bell,  6,  two  drops  every  other  day.  On  the  28th 
September,  I  find,  from  my  notes,  that  I  prescribed  Nux  vom,  3, 
one  drop  per  diem ;  but  I  have  omitted  to  state  my  reason  for  so 
doing.  2nd  October. — Very  great  weight  of  head,  throbbing,  beat- 
ing  and  pressure,  worst  in  the  left  temple,  and  almost  intolerable ; 
Calear,  carb.  6.  15th  October. — Burning  and  great  heat  in  eyes ; 
pains  in  head  somewhat  less ;  Tinct,  sulph,  16.  24th  October. — 
Somewhat  better ;  he  again  got  Tinct,  stUph,  24  until  the  25th 
November.  He  now  complained  of  loose  motions  once  or  twice 
a  day.  This  he  had  suffered  from  for  upwards  of  a  year.  By 
day  flickering  before  eyes.  In  the  evening,  when  it  was  dark, 
flashes  before  the  eyes,  violent  burning  and  transient  shoots  in 
them ;  sometimes  it  seemed  to  him  as  if  he  was  looking — even 
when  his  eyes  were  shut — into  a  sea  of  fire,  or  into  a  large  vessel 
full  of  glaring  red  molten  iron.  What  led  me  for  this  to  pre- 
scribe Petroleum  3  I  cannot  now  remember.  On  the  3rd 
December  the  patient  complained  of  more  pain  in  the  eye  than 
ever ;  moreover,  the  deceptions  of  light  were  seen  by  day,  though 
not  so  frequently  as  at  night.  The  eyes  were  so  sensitive  to 
light  that  for  several  days  he  was  unable  to  work.  At  the  same 
time  he  was  deathly  pale.  If  he  made  his  room  dark  the 
appearances  of  light  became  more  pronounced,  and  they  in- 
creased with  the  pains  towards  evening  until  far  into  the  night, 
were  of  such  intensity  that  he  feared  they  would  drive  him  mad. 
For  several  weeks  past  I  had  noticed  in  the  eye,  in  addition  to 
unusual  brightness,  a  slight  pale  reddish  colour  of  the  sclerotic, 
especially  in  the  external  canthi.  Being  much  concerned  about 
the   poor  fellow,  I  read  all  the  medical  works  and  periodi- 


Phosphorous  in  Neuralgia.  1 1 

cals  I  could  lay  bands  on ;  but  I  could  not  find  any  record 
of  a  similar  case.  I  came  upon  a  passage  to  this  effect : — 
^  When  the  motions  are  pappy  or  constantly  diarrhc^ic,  Phosphorus 
is  indicated."  This  led  me  to  the  careful  study  of  Phosphorus^ 
and  I  found  that  it  was  capable  of  producing  the  other  symptoms 
of  my  patient.  I  found  in  its  pathogenesis  the  peculiar  headache, 
the  pains  in  the  eyes,  the  congestions  and  ebullitions  in  the  head  ; 
in  short  I  found  that  if  ever  I  had  a  patient  who  was  precisely  ad  apted 
for  Phosphorus  this  was  one.  I  gave  Tine,  phosph,  ^,  gtt.  xz,  in 
5j  of  Alcohol,  and  directed  him  to  take  six  or  eight  drops  of  this 
every  morning  on  an  empty  stomach.  Under  this  the  morbid 
condition  improved  rapidly,  and  in  a  fortnight  or  three  weeks  all 
the  pains  in  the  eyes,  together  with  the  photopsia  and  the  head- 
aches— ^the  last  not  entirely — were  gone.  I  was  unable  to 
remove  entirely  the  slight  remains  of  the  head  pains  by  means  of 
other  remedies. 

The  above  is  a  graphic  description  of  the  first  stage  of 
glaucoma,  and  the  effects  of  Phosphorus  in  checking  it  are 
very  satisfactory.  It  is  worthy  of  remark  that  Hahnemann 
mentions  glaucoma  as  one  of  the  diseases  for  which  Phos.  is 
specially  indicated  (CA.  ifr.,  vol.  ii). 

But  to  return  to  our  proper  subject — the  cure  of 
neuralgia  by  Phosphorus,  Our  homceopathic  literature^  as 
might  be  expected,  abounds  in  cases  illustrative  of  the 
curative  power  of  Phosphorus  in  neuralgia.  An  exquisite 
example  of  prosopalgia  in  a  lady  of  thirty-five  cured  by 
Phosphorus  6  after  several  other  remedies  had  been  em- 
ployed in  vain,  is  related  in  vol.  vii  of  this  Journal,  p.  490, 
by  Dr.  Ker. 

The  following  cases  are  referred  to  in  Sorgo's  work  : 

A  farmer,  st.  44,  accustomed  to  exposure  to  all  kinds  of  wind 
and  weather,  got  a  severe  chill  two  years  previously,  and  since  then 
has  been  a  great  sufferer.  He  suffers  from  severe  pains  in  the 
head  like  a  kind  of  stupefaction,  with  rush  of  blood  and  pulsation 
in  the  head.  Pale,  unhealthy,  earthy  complexion,  shooting  and 
drawing  in  the  malar  bones,  now  on  one  side,  now  on  the  other, 
especially  violent  after  exposure  to  cold  (a  kind  of  prosopalgia). 
Blue  borders  round  the  eyes;  eyes  deeply  sunk  in  the  head. 
Frequent    bleeding   of  the    gums ;    toothache   often ;    a    chill 


12  Pho9phorus  in  Neuralgia. 

accompanying  the  faceache,  and  accumulation  of  saliya  on  the 
same  eide  of  the  mouth ;  he  has  to  spit  constantly.  Frequent 
eructations  with  pain  and  fermentation  in  the  stomach.  In- 
difference to  food ;  still  he  can  eat  pretty  well  when  he  sits 
down  to  table.  Spirits  cause  burning  in  the  stomach,  and 
tobacco,  which  he  used  to  smoke  all  day  long,  makes  him 
immediately  sick.  Pain  in  the  bowels,  with  rumbling  of  the 
belly  almost  incessant.  He  is  sometimes  quite  distended  with 
flatulence.  Two  painless  diarrhooic  stools  every  day.  Urine 
with  brickdust-coloured  sediment.  Frequent  coryza.  Bheu- 
matic  pain,  tensive  drafting  and  tearing  in  the  limbs  here  and 
there,  alternating  with  the  pain  in  head.  A  chill  is  what  does 
him  most  harm,  and  rouses  up  all  his  morbid  symptoms. 
Weariness,  bruised  feeling,  heaviness  and  weakness  of  all  limbs ; 
he  cannot  walk  far  without  fatigue.  All  exercise  has  such  an 
etfect  on  him  that  he  sinks  down  quite  exhausted.  Sleep  good ; 
spirits  always  bad ;  melancholy,  anxious,  and  hypochondriacal.* 

He  got  Fhospharm  (dilution  not  mentioned).  This  acted  so 
well  that  in  four  weeks  he  was  able  to  walk  twenty  miles  to  see 
me.  He  was  in  high  spirits,  his  pains  having  completely 
vanished.  Head  all  right,  spirits  cheerful,  appetite  good,  and  he 
again  relishes  his  tobacco.  Seen  half  a  year  afterwards,  he  was 
still  quite  well,  and  assured  the  doctor  that  his  powders  had 
restored  his  youth.  (Oaspary,  Ann.  d.  Mom,  Klin.^  Bd.  Ill, 
p.  30.) 

A  man,  sst.  80,  of  robust  frame,  had  suffered  for  eight  years 
from  faceache,  for  which  numerous  allopathic  remedies  had  been 
tried  in  vain.  As  a  last  resort  it  was  proposed  to  cut  the  nerve 
through ;  but  before  submitting  to  this  he  thought  he  would  try 
homcBopathy.  The  commencement  of  the  disease  eight  years  ago 
seems  to  have  been  a  chill  he  got  while  in  the  army.  Since  then 
he  has  been  troubled  almost  constantly  with  it;  it  sometimes 
leaves  him  for  a  few  hours — seldom  for  several  days.  His 
symptoms  are  as  follows  :  Vertigo  on  rising  in  the  morning ;  it 
seems  then  that  the  blood  rises  to  the  head.  For  this  he  has 
had  many  bloodlettings,  purgatives,  <&c.,  without  relief.  Itching 
over  the  left  temple  and  side  of  the  face.  Tension  in  the  skin 
of  the  fSekce  on  the  left  side.  Face  puffed  and  pale.  Dull  tearing 
in  the  whole  of  the  left  cheek;  dull  painful  drawing  on  the 


Phosphorus  in  Neuralgia,  13^ 

upper  jaw  of  the  left  side  as  far  as  the  root  of  the  nose.  Pains 
and  stitches  in  the  cheek,  proceeding  from  the  left  upper  mazillay 
extending  to  the  maxillary  joint  and  to  behind  the  ear.  Acute 
pain  on  opening  the  mouth  through  the  whole  of  the  left  side 
of  the  face.  With  the  exception  of  these  pains  his  health  was 
good.  He  got  a  dose  of  Phosphorus  (quantity  not  specified). 
For  the  first  two  days  after  taking  the  medicine  the  pains 
were  much  worse ;  but  after  a  week  they  became  slighter,  and 
by  the  end  of  the  fortnight  they  were  quite  gone.  Seen  two 
years  afterwards,  he  still  remained  quite  well,  though  he  had 
been  frequently  exposed  to  cold.  (Gaspary,  Ann,  d,  Horn.  Klin.y 
III,  410.) 

A  gamekeeper,  set.  36,  had  always  enjoyed  good  health  until  a 
few  months  ago,  when  he  got  a  severe  chill  by  falling  into  the 
water  and  haying  to  remain  a  considerable  time  in  his  wet 
clothes.  From  this  time  he  was  ill,  and  tried  first  all  sorts  of 
domestic  remedies  without  effect,  and  then  he  put  himself  under 
a  physician.  He  prescribed  almost  every  remedy  in  the  pharma- 
copoBia,  with  the  effect  of  making  him  worse.  He  got  so  bad  that 
he  was  confined  to  the  house,  and  could  no  longer  follow  his 
occupation.  His  symptoms  were  as  follows: — ^Heaviness  and 
pain  in  the  whole  head  ;  he  is  unable  to  think,  and  he  is  often  as 
giddy  as  if  he  had  been  drinking.  Drawing  and  aching  in  the 
forehead ;  drawing,  shooting  pain  through  the  whole  of  the  right 
side  of  the  face  from  the  temple  to  the  chin.  Drawing  in  all  the 
teeth ;  disgusting  taste.  The  mouth  is  always  full  of  mucus  and 
saUva  which  he  must  constantly  spit  out.  Eructation  after 
eating  and  drinking.  Pressure  and  full  feeling  in  the  stomach, 
which  is  tender  to  the  touch.  Pains  in  bowels,  loose  motions ; 
pains  in  loins  and  limbs  ;  tearing  and  drawing  here  and  there  in 
the  limbs,  and  stitches  behind  skin  and  fiesh.  He  could  do 
nothing  on  account  of  weariness  and  weakness  of  limbs.  Beaten 
feeling  and  coldness  throughout  the  body.  He  cannot  bear  the 
open  air.  Laziness  and  sleepiness;  he  wishes  to  lie  down 
constantly.  Sleep  full  of  dreams.  Low  spirits,  irritability,  very 
restless  and  anxious,  tendency  to  weep. 

He  got  one  dose  of  Phosphorus  (quantity  not  stated).  Aggra* 
yation  for  the  next  two  days.  On  the  third  day  he  was  better, 
and  he  continued  to  improve  from  day  to  day,  so  that  in  four 


14  Phosphorus  in  Neuralgia. 

weeks  he  was  quite  well,  and  could  resume  his  occupation.  He 
needed  no  further  treatment.  (Gasparj,  Ann,  d.  Horn,  Klin.^ 
Ill,  428.) 

A  man,  set.  39,  who  had  hitherto  been  always  weak  after  mental 
worry,  suffered  for  a  year  from  jerking,  tearing  pains  in  the  teeth 
and  cheek  of  the  left  side  that  extended  on  the  forehead  into  the 
right  temple.  Left  cheek  swollen.  The  pain  is  aggravated  by 
taking  anything  cold  in  the  mouth,  by  cold  air,  by  drawing  in 
cold  air,  by  cold  wet  weather ;  amelioration  by  warmth.  He  is 
always  chilly,  perspires  rarely  ;  has  furred  tongue  ;  complains  of 
pressure  on  the  chest ;  has  frequent  cold  in  the  head,  with  fetid 
smell  and  sneezing,  with  occasional  watery  discharge  from  the 
nose.  Nux,  vom,  6  and  200  and  Sulph,  30  did  little  or  nothing 
to  relieve  the  patient.  Two  doses  of  Phosphorus  30  on  two 
successive  days  cured  him  completely  and  permanently.  (Hau- 
stein,  Prager  Med,  Monatschrift,  iv,  193.) 

A  woman,  sat.  74,  had  suffered  for  ten  years  from  tearing  and 
shooting  pain  in  the  right  cheek  up  into  the  head.  Aggravation 
from  speaking,  eating,  and  swallowing.  Tendency  to  perspiration, 
weariness,  vertigo,  so  that  she  could  hardly  walk  without  falling. 
Phosphorus  2,  a  dose  every  day,  for  twelve  days,  did  little  good. 
More  good  was  effected  by  twenty-eight  drops  of  Phos.  1  in  two 
ounces  of  water,  two  teaspoonfuls  per  diem.  A  complete  cure 
was  effected  by  from  fourteen  to  eighteen  drops  of  undiluted 
Tinct  phos.  in  water.     {Allg,  Horn,  Ztg.,  xxxiv,  p.  328.) 

A  man,  set.  60,  had  suffered  for  several  years  from  faceache,  for 
the  cure  of  which  he  had  all  the  teeth  in  his  lower  jaw  drawn 
without  benefit.  The  symptoms  were — violent  tearing  beginning 
in  the  gums  of  the  lower  jow,  then  grovring  worse  and  extending 
over  the  upper  maxilla  into  the  fossa  infraorbitalis.  The  attacks 
are  brought  on  by  speaking,  eating,  or  the  slightest  touch,  and 
last  several  hours ;  at  the  same  time  tearing  in  the  top  of  the  head, 
noise  in  the  ears,  feeling  of  tension  in  the  cheek,  as  if  the  mouth 
could  not  be  properly  opened.  Four  doses  of  Phos,  (strength 
not  mentioned),  one  every  five  days,  cured  him  completely. 
(Schindler,  PraJct,  Beitr.^  ii,  6.) 

Instances    of   the    remedial    power    of    Phosphorus    in 


Phosphorus  in  Neuralgia,  15 

nenral^a  of  head  and  face  taken  from  homoeopathic  litera- 
tare  might  be  adduced  to  almost  any  extent.  Space  will 
only  allow  us  to  quote  a  few  more. 

Charles  A — ,  ®t.  26,  a  labourer,  was  admitted  18th  January, 
1869,  with  a  headache  which  he  has  had  for  five  years,  the  pain 
ahooting  from  one  temple  to  the  other,  and  at  times  flying  through 
to  the  occiput,  coming  on  at  irregular  intervals,  but  generally 
brought  on  by  stooping  his  head  ;  is  worse  in  front  of  the  head. 
The  paroxysms  are  preceded  by  dimness  of  sight,  and  accompanied 
by  a  feeling  of  sickness.  Not  subject  to  pains  in  any  other  part 
of  the  body.  Food  appears  to  him  not  to  digest  properly,  and 
his  appetite  is  very  indifferent;  does  not  relish  anything. 
Bowels  are  irregularly  confined  and  relaxed ;  relaxation  for  a  day 
or  two,  and  then  constipation  for  a  week.  Prescribed  JPhos,, 
3rd  dec. 

January  28th.-^Certainly  better;  headache  very  slight  and 
wholly  confined  to  the  forehead.  Bowels  have  acted  regularly, 
no  dimness  of  sight.     Continue. 

February  1st. — Once  or  twice  during  the  week  has  had  a  severe 
headache;  but  in  other  respects  very  much  improved.  Con- 
tinue. 

17th. — Well  in  every  respect ;  has  not  had  any  headache. 
Dismissed  cured.  (Dr.  E.  Cooper,  Monthly  Som,  Rev,,  vol.  xiv/ 
p.  272.) 

Fanny  C — ,  set.  26,  a  thin,  spare  woman,  was  admitted  11th 
August,  1869,  having  suflered  six  months*  intense  pain  in  face 
and  head.  Darting  pains  in  different  parts  of  the  face,  beginning 
in  uncertain  places;  worst  when  exerting  herself  and  when 
nursing,  which  she  is  doing  just  now.  The  pains  move  about 
every  month,  and  are  generally  protracted  and  very  severe  when 
they  commence  at  night,  as  well  as  when  she  is  eating,  at  which 
time  the  face  is  very  tender ;  but  the  tenderness  does  not  con- 
tinue long  after.  Gums  not  sore;  but  teeth  decaying  rapidly. 
Much  flatulence  and  weak  feeling  on  the  chest.  Bowels  regular 
and  tongue  clean ;  urine  rather  thick.     Phos,  30  dec. 

25th. — Her  face  has  not  been  so  painful,  but  her  chest  is 
extremely  weak.  The  darting  pains  much  relieved  in  violence, 
but  not  yet  well.    Is  never  kept  awake  by  them  now.     Continue. 

September  1st. — Very  much  better ;  has  scarcely  felt  any  pain, 


16  Phosphorus  in  Neuralgia. 

and  chest  is  much  stronger.  A  slight  aching  on  right  side  over 
liver.  Sacch,  lact,  for  a  week,  then  Phos,  30  for  a  week.  Did  not 
make  her  appearance  any  more.  (Dr.  B.  Cooper,  Jfcfoa/A.  Horn, 
Bev.,  xiv,  273.) 

On  the  24th  September,  1854, 1  was  called  to  see  Mrs.  E.  B — , 
CBt.  20;  blue  ejes,  light  hair,  short  stature,  thin.  When  six 
months  pregnant  she  was  taken  one  day,  while  getting  dinner, 
with  severe  pains  in  her  stomach,  appearing  in  paroxysms,  con- 
tinuing in  the  same  form  for  three  days.  In  a  few  hours,  after 
leaving  the  stomach,  the  same  kind  of  pain  appeared  in  her  left 
temple,  extending  to  the  eye,  teeth,  and  side  of  head.  The  pains 
were  described  like  sticking  the  parts  with  a  knife,  and  were  so 
severe  as  to' make  her  wholly  beside  herself.  Severity  of  the 
pains  seemed  to  be  the  great  characteristic  point  in  the  case. 
For  one  year  she  had  been  under  the  care  of  three  physicians  at 
different  times — one  homoBopath  and  two  allopaths — without 
reliefl  Bemedies  given  not  known.  The  birth  or  nursing  of  her 
child  had  no  apparent  influence  in  changing  the  nature  of  the 
pains.  She  had  no  belief  that  she  oould  be  cured.  She  got 
Pho8,  80,  a  dose  every  six  hours.  The  first  dose  relieved  the 
pains  entirely.  Up  to  this  day  (1869)  she  has  never  ex- 
perienced any  similar  pains.  {Am,  Jour,  JSom,  Mat.  Med,,  ii, 
p.  243.) 

These  instances  will  suffice  to  show  that  Phosphorus  has 
been  recognised  and  employed  as  a  remedy  in  neuralgia  by 
adherents  of  both  schools  certainly  long  before  Dr.  Rad- 
cliffe  employed  in  such  eases  the  Sodium  hypopJiosphite, 
While  like  most  remedies  brought  into  use  in  the  old  school 
practice  it  was  soon  fbrgotten^  it  has  always  retained  its 
proper  place  as  a  neuralgic  remedy  in  the  practice  of  those 
who  acknowledge  the  homoeopathic  principle  as  a  guide  in 
the  treatment  of  disease.  The  reason  of  this  is  sufficiently 
obvious.  The  allopathic  sect,  disdaining  a  knowledge  of  the 
pathogenetic  effects  of  a  drug  as  a  guide  for  its  administra- 
tion in  disease,  have  no  method  for  determining  the  eicact 
cases  for  which  it  is  suitable.  They  consequently  rely  on 
the  crudest  empiricism.  Some  accident  or  caprice  has  led  ' 
them  to  try  a  drug  in  a  disease.  If  it  succeed  they  imme- 
diately set  about  administering  the  same  drug  in  every  case 


Ca9e9  of  Lead  Poisminfffrwn  Well  Water.  17 

of  the  same  disease  that  presents  itself,  though  the  cases 
may  widely  differ  from  one  another  in  character  while 
called  by  the  same  nosological  name.  Failure  here  is 
inevitab]^.  To  .take  the.  instance  of  neuralgia  and  Pho$' 
phorus,  l^is  drug  is  applicable  to  only  a  given  kind  of 
neuralgia,  and  if  administered  indiscriminately  to  all  cases 
of  neuralgia  it  needs  must  fail  to  cure  some,  and  thus  its  the- 
rapeutic powers  are  discredited,  and  it  falls  into  disgrace  as 
rapidly  as  it  rose  into  favour.  Such  has  been  the  process 
pursued  by  Mr.  Thompson.  He  has  been  lucky  to  meet 
with  so  many  cases  for  which  tbe  drug  is  suitable,  and 
probably  he  is  indebted  to  what  is  understood  by  the 
genius  epidemicus  for  the  nearly  simultaneous  appearance 
of  a  number  of  cases  of  neuralgia  curable  by  Phosphorus. 
We  venture  to  predict,  however,  that  if  he  goes  on  in  this 
kind  of  fashion  he  will  soon  meet  with  an  equally  numerous 
series  of  cases  of  neuralgia  in  which  Phosphorus  will  be 
useless. 

.  In  our  school  we,  escape;  those^  fljiCtuatioAs  of  ^opihioUs 
with  respect  to  the  value  of  drugs  for  which  our  opponents 
are  so  distinguished.  The  provings  on  the  healthy  teach 
us  the  precise  forms  of  disease  in  which  each  drug  must  be 
used,  and  with  the  sure  foundation  of  pathogenetic  know- 
ledge we  are  independent  of  accident  and  caprice  in  the 
selection  of  our  remedies,  and  run  little  danger  of  discre- 
diting valuable  drugs  by  ignorantly  administering  them  in 
unsuitable  cases. 


CASES    OP    LEAD   POISONING    FROM    WELL 

WATER. 

By  Dr.  J.  W.  von  Tunzelmann. 

Having  recently  had  some  serious  cases  of  lead  poison- 
ing under  my  care,  which  occurred  under  circumstances 
where  one  would  not  have  expected  to  find  such  a  delete- 
rious agency  at  work,  viz,  from  well  water  having  become 

VOL.  XXXII,  NO.  CXXVIl. ^JANUABY,  1874.  B 


18  Cases  of  Lead  Poisoning  from  Well  Water, 

impregnated  with  lead  to  a  dangerous  extent^  I  report  them, 
as  they  may  be  interesting  to  others.  I  sent  an  abstract  of 
them  soon  after  their  occurrence  to  the  Medical  Times 
and  Gazette/f^  as  I  considered  it  my  duty  to  inform  my 
colleagues  (of  the  profession  as  a  whole)  in  this  neighbour- 
hood, of  what  I  found  to  have  been  going  on  unperceived 
for  some  time.  The  chief  interest  of  these  cases  to  us  as 
homoeopathic  physicians  consists  in  the  assistance  which  I 
derived  from  our  law  of  healings  in  its  practical  working, 
in  arriving  at  a  correct  diagnosis  before  any  very  serious 
mischief  had  occurred. 

Case  1.  Diplopia. — I  was  requested  at  the  end  of  ^ 
April,  this  year^  to  see  Miss  A — ,  set.  23,  who  had  suffered 
for  some  days  from  a  troublesome  affection  of  the  eyes ;  she 
could  not  see  anything  distinctly,  objects  appeared  double^ 
except  when  she  was  quite  close  to  them.  She  appeared 
to  be  in  very  good  health  otherwise,  complaining  only  on 
being  closely  questioned  of  lassitude,  and  a  weary  feeling 
in  the  back,  hardly  amounting  to  pain ;  there  was  also  a 
tendency  to  constipation,  but  it  was  not  troublesome ;  there 
was  no  headache,  no  pain  in  the  eyes,  and  no  photophobia. 
The  only  constitutional  state  that  was  amiss  was  a  tendency 
to  relaxed  throat  in  damp  weather.  The  catamenia  were 
generally  two  or  three  days  before  the  time,  but  otherwise 
normal.  The  mother  of  this  patient,  accustomed  to  act  on 
her  own  responsibility^  as  there  has  not  been,  till  quite 
lately,  a  resident  homoeopathic  physician  at  Wimbledon, 
had  given  her  Gelseminum,  on  the  recommendation,  I  believe, 
of  Dr.  Buddock,  in  one  of  his  domestic  works ;  it  had  not 
produced  any  effect,  I  could  not  satisfy  the  anxious 
questionings  of  the  mother  as  to  the  cause  of  the  ailment. 
Miss  A —  was  fond  of  study  and  had  been  learning  German 
diligently,  and  therefore  it  might  have  been  partly  owing  to 
fatigue  of  the  eyes  and  brain,  but  as  there  was  no  photo- 
phobia, that  did  not  satisfy  me,  though  I  could  not  suggest 
any  other  cause  for  this  state  of  things.  I  gave  her 
Belladonna  3,  and  as  all  the  solanaceae  produce  diplopia  iu 

•  Med.  I%me9  and  GoMeUe,  September  27th,  1873. 


Jy  Dr.  J.  TF.  von  Tunzelmann.  19 

large  doses,  I  was  at  least  acting  by  rule^  to  which  we  are 
Bometimes  reduced  in  obscure  cases. 

I  saw  her  again  in  three  days^  and  had  studied  her  case 
meanwhile:  there  was  no  improvement  and  I  gave  her 
Conium,  as  Con.  produces  diplopia  as  a  pathogenetic  symp- 
tom,  and  it  is  also  an  excellent  remedy  in  hysteria,  and  for 
lack  of  evidence  I  could  only  regard  this  diplopia  as  a 
sympathetic  hysterical  symptom.  She  took  Conium  in 
different  dilutions  for  ten  days,  and  as  there  was  no 
perceptible  improvement,  and. there  was  an  opportunity  of 
sending  her  to  Hastings  with  a  relative,  I  recommended  the 
change  and  also  advised  Mrs.  A —  to  let  her  daughter  have 
the  benefit  of  the  advice  of  a  homoeopathic  physician  of 
eminence  at  Brighton,  under  whose  care  a  sister  of 
my  patient  had  recently  been  while  at  school  there. 
Phosph.  was  recommended,  in  alternation  with  iVu^  vomica, 
and  these  medicines  were  taken  for  some  time,  and 
apparently  with  some  benefit,  but  as  the  change  had  to  be 
taken  into  account  also  it  was  hard  to  tell  what  share  the 
medicines  had  in  the  improvement.  She  was  away  for 
three  weeks,  and  on  returning  continued  the  medicines, 
but  as  no  further  improvement  took  place,  I  recommended 
after  three  weeks  another  change,  and  she  went  to  Chisel- 
hurst,  still  continuing  the  same  medicines,  except  that  after 
a  while  Ignatia  was  substituted  for  Nux  vom.,  as  she  had 
began  to  suffer  from  headache.  She  remained  at  Chisel- 
hurst  for  three  weeks,  and  on  returning  was  able  to  report 
a  very  distinct  improvement.  While  at  Chiselhurst  she 
had  been  able  to  drive  a  pony  phaeton,  4hich  she  could  not 
do  at  Hastings,  showing  that  the  vision  was  decidedly  im- 
proved. The  improvement  did  not  progress  after  her 
return,  the  medicines  were  therefore  discontinued,  and 
Phosph.  acid  alone  given  for  a  time,  on  account  of  the 
continuance  of  excessive  lassitude.  While  I  had  been 
relieved  of  the  immediate  responsibility  of  the  ,case  I  had 
still  been  considering  it  carefully,  and  I  felt  convinced 
from  the  persistence  of  this  one  symptom,  while  the  general 
health  was  not  amiss  in  any  particular  way,  not  more  than 
we  constantly  find  in  young  ladies  of  the  present  day,  that 


20  Cases  of  Lead  Poisoning  from  Well  Water ^ 

there  was  some  hitherto  undiscovered  influence  at  work 
which  was  producing  it.  I  was  strongly  inclined  to  give 
Plumbum^  as  that  is  one  of  the  medicines  which  produces 
ambylopia  more  markedly  perhaps  than  any  other  of  the 
medicines  whose  action  is  of  sufBiciently  long  duration  to  be 
relied  on  in  chronic  cases^  but  I  felt  that  I  ought  to  be 
quite  sure  before  giving  it  that  lead  was  not  the  cause  of 
this  ailment.  I  therefore  questioned  Mr.  A— >  about  the  water 
supply  of  the  house^  thinking  that  as  it  lay  at  a  distance  of 
about  200  yards  from  the  main  road,  possibly  the  water 
^  which  supplied  the  house  was  conveyed  to  it  by  a  leaden 
pipe  from  the  main  in  the  road ;  but  I  learned  that  the 
house  had  a  well  from  which  all  the  drinking  water  was 
derived^  and  I  therefore  came  to  the  conclusion  that  I  was 
not  on  the  right  track,  and  I  turned  my  attention  to  the 
paper  hangings  of  the  house^  as  arsenic  produces  amaurosis 
with  all  the  minor  symptoms  in  that  direction.  One  paper 
was  found  in  the  dining  room  which  was  of  a  dark  green 
colour  (a  flock  paper) ;  it  had  been  up  for  sixteen  years,  and 
on  being  analysed  by  Dr.  Williamson  of  University  College, 
was  reported  to  contain  arsenic  in  considerable  -  quantity. 
I  expected  this  from  the  colour  of  the  paper,  but  as  the 
pathogenetic  symptoms  of  Arsenic  which  have  been  observed 
in  cases  of  poisoning  from  arsenical  paper,  have  all  been 
more  or  less  of  an  inflammatory  character  I  did  not  feel  at 
all  sure  that  the  ailment  would  cease  on  removing  the 
paper.  Its  removal  was,  however,  decided  on,  as  the  family 
did  not  relish  the  thought  of  inhaling  poison  any  longer. 
Meanwhile  I  had  been  attending  a  case  of  a  different 
nature,  not  far  off  (about  a  quarter  of  a  mile),  one  which 
gave  me  still  more  anxiety,  and  which  I  will  now  relate,  as 
it  became  the  key  to  this  one. 

Case  2.  Icterus  satuminus.  -^I  was  requested,  on  June 
11th,  this  year,  to  see  the  cook  in  one  of  the  best  houses  in 
the  outskirts  of  Wimbledon,  who  had  been  ill  for  three 
weeks ;  she  vomited  constantly,  not  being  able  to  retain  any 
food ;  there  was  also  constant  nausea,  and  even  when  no 
food  was  taken,  there   was  still  frequent  vomiting  of  a 


^  ♦ 


by  Dr,  J.  W.  von  Tunzelmann.  21 

greenisli  watery  fluid.  She  had  been  taking  different 
homoeopathic  medicines^  given  to  her  by  a  member  of  the 
family,  without  any  relief.  The  skin  had  a  yellowish  tint, 
the  conjanctiyas  were  also  decidedly  yellow;  the  tongue 
furred,  the  mucus  on  its  posterior  part  very  yellow ;  she 
complained  of  a  horrible  taste  in  her  mouth ;  there  was  no 
abdominal  pain  (neither  at  the  epigastrium  nor  in  either 
hypochondriac  region) ;  there  was  no  tenderness  in  the 
region  of  the  liver,  even  on  strong  percussion,  and  the 
region  of  hepatic  dulness  was  not  increased — the  abdomen, 
in  fact,  appeared  in  every  respect  normal  except  that,  after 
retching,  she^sometimes  felt  slight  pain  in  the  lower  part  of 
it^  evidently  of  a  myal^c  nature,  from  fatigue  of  the  abdo-/ 
minal  muscles ;  the  bowels  were  very  confined,  not  having 
acted  for  several  days,  and  I  was  told  that  this  was  her 
great  constitutional  trouble.  The  case  was  puzzling,  as 
there  was  no  definite  symptom  but  the  vomiting,  which  was 
very  frequent,  and  she  was  extremely  debilitated.  I  gave 
her  Lachesis  6,  which  I  had  by  me,  as  another  of  the  snake 
poisons  {Crotalus)  has  been  found,  in  the  Southern  States 
of  America,  to  be  one  of  the  most  efficacious  medicines  in 
the  homoeopathic  treatment  of  yellow  fever,  in  which 
malady  persistent  vomiting  is  one  of  the  gravest  symptoms 
(in  fatal  cases  of  snake-bite  vomiting  is  often,  though  not 
always,  a  prominent  symptom) ;  claret  and  water,  and  beef 
tea  (cold),  in  small  quantities,  were  ordered.  On  the 
following  day  I  found  her  decidedly  better,  the  vomiting 
being  much  less  frequent,  She  continued  to  improve  for 
two  or  three  days,  so  as  to  be  able  to  take  a  little  fish  (sole), 
but  whatever  she  took  came  np  after  a  while ;  she  also 
vomited  very  much  in  the  nighty  especially  the  early  morning 
(this  was  so  constant  throughout,  and  as  she  took  no 
nourishment  in  the  night,  from  her  great  aversion  to  it,  it 
showed  very  plainly  that  the  vomiting  was  irrespective  of 
the  presence  of  food  in  the  stomach).  What  could  it  be? 
Other  medicines  were  now  given  for  three  or  four  days, 
Mercurius  salubilis  6,  Ntuc  vom,  8,  Bryonia  3,  but  without 
any  good  result ;  then  Hydrastis  3  was  given,  which  checked 
the  vomiting  greatly,  and  after  its  continued  use  for  some 


22  Cases  of  Lead  Poisoning  from  WeU  VTatef, 

days,  the  bowels  began  to  act,  and  soon  acted  once  a  day^ 
She  was  all  this  time  only  taking  beef  tea  (cold)  and  water 
as  a  drink^  as  I  did  not  think  that  the  claret  agreed  with 
her ;  she  sometimes  took  a  little  bread  and  gravy,  and  once 
or  twice  tried  a  little  fishi  and  also  a  small  piece  of  mntton, 
but  as  any  solid  food  that  she  took  was  vomited,  she  dis- 
continued this.     She  improved  gradually  until  July  21,  the 
vomiting  ceasing,  and  nausea  only  remaining,  so  that  I 
expected  to  be  able  to  take  leave  of  her  shortly,  but  on  the 
23rd  a  message  came  to  me  with  a  note  from  her  mistress^ 
stating  that  the  vomiting  had  returned  {in  the  night)  •     I 
sent  her  Tartar  emetic  6,  and  when   I  saw  her  on  the 
following  day  found  that  she  was  better,  but  the  bowels 
were  relaxed  (they  had  acted  three  times)  and  there  was  a 
good  deal  of  rumbling  in  them.     I  gave  her  China  1 ;   she 
improved,  but  still  the  vomiting  continued,  and  she  became 
so  weak  that  I  was  obliged  to  give  her  champagne  which 
she  relished  greatly,  and  did  not  vomit ;  she  lived  on  it  for 
three  or  four  days,  taking  literally  nothing  else  in  the  way 
of  nourishment   (she  took  about  half  a  bottle  a  day).     I 
tried  to  get  her  to  take  a  little  beef  tea,  but  it  always  made 
her  sick ;  after  four  or  five  days,  however,  she  ceased  to 
relish  the  champagne,  but  she  was  stronger,  and  began  to 
take  spoonfuls  of  beef  tea,  but  still  there  was  so  much 
nausea  that  she  took  very  little,  so  that  I  told  her  I  should 
be  obliged  to  give  it  to  her  by  injection,  as  I  could  not  let 
her  get  weaker  than  she  already  was  if  I  could  help  it ; 
this  horrified   her  greatly,  and  she  began  to  take   more 
(about  a  teacupful  each  day)  for  a  few  days,  and  improved 
steadily.     On  August  6th  there  had  been  no  vomiting ;  on 
the  9th  also  she  was  still  free  from  it,  but  complained  of  a 
loss  of  power  in  her  hands,  so  that  she  could  scarcely  do 
anything  with  them.     All  this   time  the  patient  had  not 
been  confined  to  bed,  though  obliged  to  lie  on  the  bed  the 
greater  part  of  the  day  on  account  of  excessive  debility.     I 
had  been  studying  her  case  carefully  and  anxiously,  looking 
over   the   medicines  suggested  by  our   repertories    [after 
China  1  she  took  Podophyllum  1,  and  then  again  Lach.  6, 
as  she  never  lost  the  excessive  nausea,  and  there  was  still 


hy  Dr.  J.  W.  von  Tunzelmann.  23 

the  yellowish  tint  of  the  face  and  of  the  conjunctivae^  and 
the  yellow  mucus  on  the  posterior  part  of  the  tongue].  I 
found  that  Plumbum  was  so  strongly  marked  in  corre- 
spondence to  most  of  her  symptoms  that  I  referred  to 
Pereira*s  Materia  Medica,  and  found  that  her  case  corre- 
sponded exactly  with  his  description  of  lead  jaundice;  she 
had  the  fcetor  of  the  breath  mentioned  by  Pereira  as  a 
symptom  of  lead  poisoning  so  strongly  that  a  fellow  servant 
who  slept  in  the  same  room  with  her  told  her  mistress  that 
ahe  could  scarcely  endure  it.  The  paralytic  weakness  of 
the  arms,  of  which  she  now  complained,  is  such  a  well- 
known  symptom  of  lead  poisoning  among  painters,  that  I 
felt  it  must  be  a  case  of  lead  jaundice  and  therefore 
examined  her  gums ;  they  showed  the  ''  blue  line  **  along 
the  alveolar  border  more  plainly  than  I  ever  saw  it  in  a 
hospital  patient :  that  was  proof  positive.  I  therefore  took 
home  some  of  the  drinking  water  furnished  by  a  well  in 
the  house,  and  testing  it  with  a  solution  of  sulphuretted 
hydrogen,  found  that  the  water  became  of  a  distinctly 
brownish  tint,  showing  the  presence  of  lead.  The  water 
was  of  such  remarkable  purity  in  appearance  that  it  was 
the  last  thing  that  one  would  have  suspected,  i  priori,  of 
being  the  cause  of  this  illness.  As  the  case  was  so  grave 
I  took,  for  satisfaction,  a  specimen  of  the  water  to  Dr. 
Frankiand,  of  the  Boyal  College  of  Chemistry,  who  tested 
it,  and  stated  in  his  report  about  it  as  under  : 

^ROTAL  Ck)LI.SOB  ov  Chxmistbt  ; 

"  Mt  BSls  Sib, — I  have  tested,  qnalitatiTely ,  the  sample  of  water  which  you 
left  with  me,  imd  find  that  it  contains  so  mnch  lead  as  to  render  it  quite  unfit 
for  domestic  use.  "  Belieye  me,  yours  very  truly, 

(Signed)        **  £.  Fbakkland. 

"Dr.  VOK  TnirzBLicAirN." 

Dr.  Frankiand  has  since  then  determined  the  quantity  of 
lead  in  the  water  of  the  well  (as  drawn  from  the  pump  of 
the  adjoining  house,  which  is  supplied  by  the  same  well), 
about  which  he  reports  as  under  : 


24  CaseM  of  Lead  PoUoninp  from  Well  Water, 

"  14^  Laxcabteb  Qatb,  Htdb  Vksx,  W. ; 
AnguMt  2^k,  1873. 
**  M T  DUB  SiBr-The  Munple  of  water  eontaiiu  1*547  grain  of  lead  per 
imperial  gallon.  "  Yovri  Tery  tmlj, 

(Signed)  '*  &  Fbaxxluts. 

"  Dr.  JOB  Ttrvziufmr/' 

The  use  of  this  water  was  stopped,  and  I  did  not  see  the 
patient  again,  as  she  soon  after  this  went  to  Brighton  for 
six  weeks  for  a  change. 

October  18th. — ^This  piftient  has  now  returned  from 
Brighton  and  is  quite  well,  better  (as  might  have  been  ex- 
pected) than  before  her  illness. 

To  return  now  to  Case  1. — Having  discovered  lead  in 
the  water  of  a  well  in  one  house,  I  was  naturally  led  to 
test  the  drinking  water  in  the  house  where  my  patient 
with  diplopia  lives ;  I  had  not  done  so  before,  as  I  had 
never  heard  of  well  water  having  become  impregnated  with 
lead ;  and  Dr.  Frankland  told  me  that  although  he  has  to 
examine  specimens  of  water  by  the  hundred  he  has  never 
been  consulted  about  contamination  of  well  water  with 
lead  before.  Lead  was  found  in  the  water  of  this  well 
nearly  to  the  same  amount  as  in  the  water  of  the  other 
well,  and  this  explained  not  only  the  diplopia,  but  also  the 
excessive  languor  from  which  Miss  A —  had  been  suffering. 
LacheM  6  was  given,  and  the  family  going  to  the  Lakes, 
I  did  not  see  my  patient  for  six  weeks. 

October  18th. — ^This  patient  has  just  returned  from 
her  trip  to  the  north,  her  eyes  are  now  quite  well ;  she  is 
only  reminded  of  her  former  trouble  by  an  occasional 
ftloggiBhuess  of  adaptation  in  them. 

Case  8.  Bheumaiism,  Palpitation,  8^c. — The  mother  of 
this  young  lady,  subject  to  rheumatic  pains  (muscular)  for 
some  years  (they  have  lived  in  this  house  for  sixteen  years), 
has  also  latterly  suffered  a  good  deal  from  palpitation,  with 
such  a  distressing  craving  for  air,  especially  at  night,  that 
during  the  warm  weather  she  was  obliged  to  keep  both 
the  door  and  window  of  her  bedroom  open,  becoming  in 
consequence  deaf  from  getting  a  cold  in  her  ears.     (This 


by  Dr,  «/.  TV.  von  Tunzelmann.  25 

ease  makes  a  very  good  proving  of  lead,  giving  some  of  the 
less  firequently  observed  symptoms.)  Different  medicines 
were  prescribed  for  this  palpitation,  bnt  no  medicine  con- 
tinued to  afford  relief  long ;  Lachesis  5  relieved  her  con- 
siderably at  last ;  after  taking  it  for  a  few  days  she  com- 
plained of  vague  symptoms  of  indigestion,  and  Niw  vom. 
3  was  given  by  day,  the  Lachesis  being  still  continued  at 
night,  and  she  improved  considerably. 

Aug.  14th. — ^Was  sent  for  this  day  on  account  of  con- 
siderable aching  pain  in  the  back  (lumbar  region,  with 
lassitude,  and  the  secretion  of  a  large  quantity  of  watery 
urine,  on  the  surface  of  which  a  pellicle  had  been  observed, 
after  standing  (the  same  had  been  noticed  about  a  year 
previously  and  occasionally  since  then).  I  had  not  then 
tested  the  water  of  the  well,  but  did  so  the  same  day  and 
found  lead  in  it,  as  before  said.  The  pellicle  which  formed 
on  the  urine  passed  by  this  patient,  on  examination  the 
next  day  (a  small  specimen  having  been  obtained),  was  found 
to  be  of  pearly  whiteness  (it  looked  exactly  like  spermaceti), 
with  a  distinct  metallic  lustre ;  it  left  a  greasy  mark  on 
the  paper  in  which  it  had  been  wrapped,  i.  e.  fatty  matter 
mixed  with  lead,  in  some  form.  This  fact  is  of  extreme 
importance  as  showing  how  the  kidneys  excrete  this  mineral 
poison.  A  specimen  of  the  urine  was  examined  the  next 
day;  colour  natural;  reaction  acid,  but  not  strongly  so; 
spec.  grav.  1022 ;  no  albumen ;  on  standing  for  an  hour, 
deposits  a  light  flaky  sediment  (one  fourth),  showing  under 
the  microscope  only  a  few  granules  (mucous),  and  a  solitary 
cell  of  renal  epithelium,  containing  several  fatty  globules. 
I  could  not  find  another,  but  even  this  one  suggests  that 
the  lead  was  excreted  as  an'oleo-stearate  of  lead,  inclosed  in 
cells  which,  becoming  detached,  convey  their  contents  into 
the  bladder,  retaining  their  vitality  sufficiently  long  not  to 
burst  till  after  micturition  has  taken  place ;  then  chemical 
action  coming  into  play,  the  lead  is  precipitated  (as  a 
sulphide*)  and  the  fatty  acids,  rising  to  the  surface,  on 
account  of  their  lightness,  become  solidified  on  the  cooling 

*  Galena,  the  natire  snlpHde  of  lead,  has  all  the  appearance  of  a  metal ;  it 
IB  not  unlike  platinum,  being  somewhat  darker  than  lead  (in  its  pure  state). 


26  Cases  of  Lead  Poisoning  from  WeU  tFater, 

of  the  urine  from  98^  (the  temperature  of  the  body)  to  the 
temperature  of  the  atmosphere  (at  that  time  about  70^)^ 
possibly  becoming  lime  salts  at  the  same  time  that  the  lead 
becomes  a  sulphide ;  the  precipitated  lead  adhering  to  them. 
In  private  practice  one  cannot  get  a  specimen  of  this  nature 
in  sufficient  quantity  for  satisfactory  examination^  but  if  any 
of  my  colleagues  who  are  hospital  physicians  should  meet 
with  a  similar  case,  this  pellicle  might  be  collected  in  suffi- 
cient quantity  to  be  examined  by  an  analytical  chemist. 
This  was  evidently  an  attack  of  renal  congestion^  a  patho- 
genetic effect  of  the  lead  taken^  for  several  years^  in  the 
drinking  water,  and  an  effort  of  the  system  to  rid  itself  of 
the  poison.  Arsenicum  6  was  prescribed^  and  it  relieved 
the  back  somewhat,  but  I  advised  the  lady  not  to  take  it 
except  the  distress  should  be  excessive,  as  it  was  better  not 
to  interfere  with  the  process  of  elimination. 

The  water  of  the  well,  I  need  hardly  say,  was  not  used 
after  it  had  been  found  to  contain  lead.  The  lady  went  to 
the  Lakes  after  this,  so  that  I  did  not  see  her  again  for  six 
weeks.  She  took  Cantharis  6  with  her,  in  case  the  pain  in 
the  back  (lumbar  region),  with  its  concomitant  symptoms 
of  great  languor  and  malaise,  should  be  suchas  to  require 
relief. 

Oct.  18th. — Mrs  A —  is  very  much  better,  but  still  not 
quite  free  from  pain  in  the  back ;  the  quantity  of  urine  ex- 
creted is  also  still  such  as  to  be  inconvenient  at  night. 

The  weakness  of  the  arms  is  still  felt  at  times,  but  not 
enough  to  require  a  course  of  Iodide  of  Potassium  to 
dissolve  the  remaining  lead  out  of  the  system. 

Case  4.  Anasarca  and  Paralysis.^— In  the  adjoining 
house  to  the  one  where  the  case  of  lead-jaundice  occurred, 
I  was  requested,  in  February  of  this  year  (1873),  to  prescribe 
for  the  housekeeper,  who  had  swollen  ankles;  they  had 
been  in  that  state  for  three  or  four  weeks  ;  she  had  a  sallow 
complexion ;  she  complained  of  nausea,  but  otherwise 
appeared  in  good  health.  The  anasarca  extended  about 
halfway  up  the  legs.  The  urine  was  examiiied,  but  nothing 
abnormal  was  found  in  it — it  was  quite  free  from  albumen. 
Arsenicum  6  was  prescribed,  and  in  about  two  months  the 


bjf  Dr.  /.  W.  von  Tunzelmann.  27 

ainasarca  was  quite  reduced ;  during  that  time  she  com- 
plained occasionally  of  much  pain  in  the  upper  part  of  one 
leg,  and  on  examination  distinct  varicosis  was  found  (none 
existing  about  the  ankles)  :  this  swelling  of  the  principal 
cutaneous  vein  at  the  back  of  the  right  leg  had  only  existed 
for  a  short  time  (two  or  three  weeks),  and  Hamamelis  3 
reduced  it  in  about  three  weeks : — ^AU  this  time  it  was  un- 
known to  me  that  there  was  anything  wrong  in  the  water 
of  the  house,  and  I  think  it  shows  the  strength  of  Arsen.,  in 
a  therapeutic  point  of  view,  that  it  should  reduce  distinct 
anasarca^  owing,  I  have  no  doubt,  to  the  lead  in  the  water, 
though  the  water  was  still  taken.  The  anasarca  returned 
in  about  six  weeks,  and  was  again  subdued  by  Arsenicum  6 
in  about  a  month.  Soon  after  that  the  discovery  of  the 
presence  of  lead  in  the  water  of  the  well  was  made  (the 
house  is  a  semi-detached  one,  a  common  well  supplying  it 
and  the  adjoining  house,  where  the  case  of  lead  jaundice 
occurred).  Four  days  after  the  use  of  the  water  had  been 
stopped  she  was  suddenly  seized  with  a  loss  of  power  in 
her  hands,  one  morning,  while  attending  to  her  household 
duties  (she  had  awoke  in  the  night  with  a  feeling  of  numb- 
ness in  them).  I  was  sent  for  in  great  haste,  the  lady  of 
the  house  thinking  that  her  servant  had  been  seized  with  a 
paralytic  stroke  (the  symptoms  would  have  made  me  uneasy 
too  had  I  not  then  known  of  the  existence  of  lead  in  the 
water,  which  they  had  been  drinking  for  three  years).  I 
told  the  lady  that  I  did  not  expect  her  servant  would  become 
much  worse  (the  use  of  the  poisoned  water  having  been 
stopped),  and  this  proved  to  be  the  case.  Lachesis  6  was 
given,  and  on  the  following  day  there  was  some  improve- 
ment in  the  arms,  but  she  complained  of  a  numbness  in  the 
legs  as  well.  She  continued  the  LacJiesis  for  three  or  four 
days,  and  then  took  Phos.  6,  for  a  few  days,  improving 
gradually,  and  in  about  a  fortnight  ceased  to  be  under  treat- 
ment, slight  neuralgia  only  being  at  times  felt  in  the  legs 
(it  was  for  this  that  Phos.  was  given). 

Cask  5.  Chronic  enteriiis, — Mrs.  B — ,  the  mistress  of 
the  last  patient,  consulted  me  frequently  (from  the  middle 
of  February,  when  I  commenced  to  attend  the  family)  on 


28  Cases  of  Lead  Poisoning  from  Well  Water ^ 

accoant  of  troublesome  and  constant  diarrhcBa,  at  times 
accompanied  with  a  good  deal  of  abdominal  pain^  and 
sometimes  with  veiy  much  tenesmus.  She  had  liyed  in 
India  for  about  twelve  years^  and  had  there  had  dysentery^ 
which  seemed  to  account  for  the  ailment.  Various 
medicines  were  given^  without  permanent  benefit,  except 
that  Merc.  corr.  6  stopped  the  tenesmus,  and  Ars.  6  kept 
the  diarrhoea  in  check.  Puis.  3  also  gave  relief  several 
times,  but  still  the  bowels  generally  acted  three  or  four 
times  a  day,  the  stools  being  quite  liquid  j  no  blood  was 
passed,  but  mucus  sometimes.  About  the  time  that  the 
discovery  of  the  presence  of  lead  in  the  water  was  made,  she 
had  begun  to  sufier  more  continuous  abdominal  pain. 
Improvement  commenced  as  soon  as  the  use  of  the  poisoned 
wfiter  was  stopped;  Puis.  3  had  to  be  given  for  about 
three  weeks,  else  the  looseness  returned,  but  with  that,  in 
small  doses,  the  bowels  began  to  act  naturally  (once  a  day) 
and  continued  to  do  so  except  when,  either  from  fatigue  or 
a  chill,  a  slight  return  of  the  old  malady  came  on. 

Case  6.  Tabes  saturnina. — Master  H.  B— ^,  set.  12,  the 
youngest  son  of  Mrs.  B — ,  was  put  under  my  care  in  the 
middle  of  February  this  year  on  account  of  the  remains  of 
a  severe  bronchial  catarrh  (for  which  he  had  been  treated 
by  a  physician  from  town).  I  found  a  tall  boy,  very  thin, 
in  fact  so  emaciated  that  I  feared  I  had  to  do  with  a  case 
of  confirmed  tuberculosis.  On  examining  his  chest  I  found 
that  there  was  evidence  of  consolidation  in  the  left  apex, 
but  as  no  breaking  up  of  lung  tissue  had  occurred,  I  hoped 
that  he  might  still  be  brought  round,  though  appearances 
were  very  much  against  a  favorable  issue  of  the  case. 
There  was  some  loose  cough,  but  not  much  expectoration  ; 
Hepar  sulph.  6  checked  this,  and  the  boy  improved 
gradually,  but  being  very  weak,  (Quinine  1  was  the  medicine 
chiefly  used  after  the  cough  had  ceased ;  constipation  was 
a  troublesome  symptom  and  Nux  vom.  3  had  to  be  fre- 
quently given ;  meat  three  times  a  day  and  wine  were  also 
found  necessary.  The  constipation  increased  to  such  an 
extent  notwithstanding  the  medicine,  and  careful  dietetic 


by  Dr,  J.  W.  van  Ttmzelmann.  29 

management  (brown  bread,  fruit,  &c.),  that  fissure  of  the 

anus  took   place,  although  the  bowels  acted  nearly  eyery 

day.     I  need  not  dwell  long  on  this  case,  but  will  only  say 

that  as  soon  as  the  use  of  the  poisoned  water  was  stopped, 

the  improvement  was  so  rapid  that  in  a  month  he  looked 

almost  as  if  nothing  had  ever  been  amiss.     The  peculiarity 

of  the  state   of  his   chest   was   that  although   there  was 

distinct  consolidation  in  one  apex,  and  the  appearance  of  its 

commencing  in  the  other,  there  was  no  r&le,  moist  or  dry, 

and  very  little  cough.     When  I  first  attended  him,  and 

while  the  poisoned  water  was  being  used,  there  was  scarcely 

any  rising  of  the   upper   left   chest   on   inspiration   (the 

respiration  being  very  harsh,  almost  bronchial),  but  soon 

after  pure  water  had  been  used  in  the  house,  the  chest 

began  again  to  expand,  and  the  respiration  became  puerile. 

I  have  no  doubt  that  with  care  the  lung  will  quite  recover 

itself.     The  family  has  left  Wimbledon^  so  that  I  cannot 

report  the  final  issue  of  this  case.    It  seems  to  me  that  this 

was  a  case  of  pathogenetic  consolidation  of  lung  tissue  fi:oin 

the  continued  use  of  lead  in  the  drinking  water. 

Casb  7.  Hamqpiysis  and  eptstaxis.^^'Mx.  N.  B — ,  »t. 
22,  an  elder  brother  of  the  last  patient^  came  to  me  in  the 
middle  of  February,  informing  me  that  he  had  coughed  up 
blood  for  three  days,  having  lost  altogether  about  half  a 
pint.  I  was  anxious  about  his  having  come  to  me,  having 
walked  a  distance  of  two  miles,  but  he  said  that  he  was 
accustomed  to  walking,  and  it  did  not  fatigue  him.  I 
examined  his  chest  and  nothing  very  distinct  could  be 
detected,  except  that  the  respiration  was  very  feeble  in 
both  apices ;  he  had  no  cough. 

I  gave  him  Arnica^  but  he  did  not  continue  under  my 
care,  not  having  any  confidence  in  homoeopathy ;  he  con- 
sulted Dr.  Sieveking,  who  put  him  on  Iron  and  Quinine,  and 
he  improved  quickly,  in  fact  there  was  nothing  amiss  with 
his  health  to  all  appearance  beyond  a  weak  action  of  the 
lungs,  especially  the  left.  He  continued  under  Dr.  Sieve- 
king's  care  for  about  six  weeks,  and  after  the  first  fortnight 
was  allowed  to  walk  four  miles  a  day,  showing  that  it  was 


80  Cases  of  Lead  Poisoninp  from  Well  Water, 

not  an  ordinary  case  of  incipient  phthisis ;  he  could  have 
walked  twelve  miles  with  pleasure,  he  told  me.  He  was 
very  fond  of  rowing,  and  being  out  a  whole  day  with  a  friend 
about  a  month  after  having  left  off  treatment,  got  a  fresh 
attack  of  spitting  of  blood,  again  without  cough.  I  did 
not  see  any  of  the  expectoration,  but  he  told  me  that  his 
nose  bled  at  the  same  time.  This  was  evidently  from  the 
exertion,  but  he  had  no  pain  in  his  chest,  and  no  cough ; 
there  was  a  distinct  shade  of  dulness  in  the  right  apex  (the 
left  being  the  first  affected).  I  gave  him  Arnica,  and  after 
keeping  quiet  for  a  fortnight  he  was  allowed  to  walk  as 
usual.  Soon  after  this  the  state  of  the  drinking  water  was 
discovered.  He  looked  pale  and  rather  emaciated  until  the 
poisoned  water  was  stopped,  but  after  that  improved  so 
rapidly  that,  in  about  six  weeks,  one  would  scarcely  have 
known  him  to  be  the  same  young  man.  I  examined  his 
chest  then,  and  there  was  still  feeble  respiration  in  the  left 
apex,  but  otherwise  no  appearance  of  phthisis. 

I  have  related  these  two  cases,  as  they  seem  to  me  to  be 
purely  pathogenetic  in  nature,  and  singular  in  the  gradual 
production,  in  both  cases,  of  an  organic  lesion,  such  as  was 
capable  of  being  detected  by  the  ordinary  means,  of  physical 
diagnosis.  I  ought  to  add  that  phthisis  exists  in  the 
family  on  the  father's  side,  but  remotely.  There  are  two 
other  sons — one,  the  eldest,  had  consolidation  of  one  apex 
about  ten  years  ago,  while  at  a  military  college,  but  is  now 
robust  and  well ;  another  brother,  younger  than  my  patient 
with  haemoptysis,  is  an  oflScer  in  the  army  and  in  good 
health.  The  family  tendency  seems  to  be  only  sufficient 
to  have  determined  the  action  of  the  lead  chiefly  to  the 
lungs. 

Remarks, — ^I  am  not  aware  that  Lachesis  has  ever  before 
been  used  as  a  remedy  for  incipient  lead  paralysis.  I  have 
found  it  to  be  most  effectual  in  the  cases  in  which  I  have 
tried  it.  I  first  used  it  about  twelve  years  ago,  in  the  case 
of  a  dispensary  patient,  a  painter,  who  came  to  me  with 
^'  wrist-drop,"  which  had  existed  for  a  few  days,  and  he  had 
been  obliged  to  give  up  work  in  consequence  of  it ;  it  was 


by  Dr»  J.  W.  von  Tuimelmann.  31 

my  first  case.  I  gave  him  LachesU  6,  from  my  general 
recollection  of  the  fatal  effects  of  snake-poison,  viz.  that 
death  in  snake-bite  takes  place  from  asphyxia^  caused  by 
paralysis  of  the  muscles  of  respiration.  It  was  an  experi- 
ment, but  it  proved  to  be  a  crucial  one ;  the  man  returned 
in  a  week  so  much  improved  that  I  was  quite  astonished^ 
expecting  after  my  experience  of  the  tediousness  of  this 
complaint  in  hospital  patients  under  the  best  ordinary  treat- 
ment, that  it  would  be  weeks  before  he  would  be  able  to 
work  again ;  he  returned  to  work  in  the  foUowing  week, 
and  did  not  come  to  me  again,  which  I  have  no  doubt  he 
would  have  done  if  he  had  had  occasion  to  do  so. 

In  the  case  of  commencing  lead  paralysis  which  I  have 
now  related  (Case  4)  the  improvement  was  equally  rapid. 
The  same  might  be  said  of  the  relief  afforded  to  the 
asthmatic  suffering  of  Case  3.  These  different  facts,  taken 
together,  seem  to  point  to  Lachesis  as  a  valuable  medicine 
in  some  of  the  conditions  produced  by  lead  poisoning,  i.  e., 
paralysis  and  asthmatic  suffering,  with  palpitation  of  the 
heart.  The  lead  jaundice  was  also  distinctly  benefited  by  it, 
and  would  have  been  still  more  so,  I  have  no  doubt,  had  the 
patient  not  been  taking  the  solution  of  lead  at  the  same 
time.  None  of  our  books  mention  lead  paralysis,  except 
Hempel  in  his  Lectures  on  the  Homoeopathic  Materia 
Medica ;  he  says  there,  under  Oleander,  that  Hahnemann 
recommends  it  in  lead  palsy.  This  is  not  definitely  stated 
in  the  French  translation  (1834)  which  I  have  by  me, 
though  it  might  be  implied  from  the  following  statement, 
'^  dans  certaines  paralysies  sans  douleurs  .  .  .  .  le  laurier 
rose  est  si-non  un  moyen  propre  &  procurer  la  guerison  com- 
plete, du  moins  un  remede  intercurrent  indispensable  \"  this 
is  certainly  not  very  encouraging  I  If  I  should  have  another 
case  of  lead  paralysis,  and  Lachesis  (or  Crotalus)  failed  me,  I 
should  be  inclined  to  try  Apis,  an  allied  remedy  and  a 
natural  analogue  of  the  serpent  poisons.  I  say  this  on  the 
strength  of  the  record  of  a  fatal  case  of  bee-sting  related 
by  Dr.  Strong,  of  Boss,  in  the  September  number  of  the 
Monthly  Horn,   Review  for  this    year  (1873*).     A  woman 

*  M<mtMy  HomoBOpatMo  Seview,  voL  xvii,  p.  569. 


82       Waldenbyrg*$  Experiments  on  Animals  applied  to 

was  stung  on  the  33rd  of  May  ;  on  the  28th  she  said  to  a 
friend,  who  called  to  see  her,  '^  I  have  lost  the  use  of  my 
hands ;"  she  complained  also  of  her  feet^  that  she  had  lost 
the  use  of  them.  On  the  30th  was  seen  by  another  neigh- 
bour, dying  :  "  her  nails  had  turned  purple,  her  eyes  and 
mouth  were  open,  and  she  was  labouring  very  hard  for 
breath  [i.  e.,  death  from  asphyxia,  as  in  fatal  cases  of  snake- 
bite. J.  W.  V.  T.]  ;  she  died  in  about  half  an  hour. 
After  her  death  I  looked  into  her  mouth  and  found  the 
back  part  of  her  throat  very  much  swollen.  I  think  she 
was  suffocated.  I  do  not  think  she  could  swallow.  A 
surgeon  by  order  of  the  coroner  examined  her  body,  and 
found  traces  of  several  stings  on  the  back  of  her  neck. 
The  veins  of  the  neck  and  throat  were  very  much  swollen 
and  discoloured.  This  is  much  more  definite  than  any- 
thing given  by  C.  Hering,  valuable  as  his  treatise  on  Apis 
is.  The  only  pathogenetic  symptom  in  the  direction  of 
paralysis  which  I  can  find  is  S.  877,  '^  Eingenommenheit 
des  linken  Armes.'^  It  was  developed  in  himself,  on  taking 
the  poison  of  one  bee,  in  fifteen  minutes ;  he  does  not  say 
how  long  it  continued,  but  from  the  way  in  which  it  is 
recorded  in  the  proving  it  was  evidently  only  a  vague  and 
passing  sensation. 


WALDENBURG'S  EXPERIMENTS  ON  ANIMALS 
APPLIED  TO  HUMAN  TUBERCULOSIS  AND 
PULMONARY  CONSUMPTION. 

(Contimtedfrom  Vol  XXXI,  p.  483.) 

We  have  now  to  consider  the  proofs  derived  from 
ETIOLOGY  in  support  of  my  theory. 

The  causes  of  phthisis  and  of  tuberculosis  have  hitherto 
been  usually  divided  into  the  constitutional  and  the 
occasional.  The  former  were  always  placed  in  the  front 
rank,  whilst  the  latter  were  kept  in  the  back  ground,  some* 


Human  TuAerculosia  and  Pulmonai^j  Comumption.       33 

times  more,  sometimes  less  so,  according  to  the  views 
which  were  held  respecting  the  disease.  Those  who  regarded 
phthisis  as  an  inflammatory  affection  could  not  but  take 
oc^nixance  of  the  immediate  or  exciting  causes,  such  as 
taking  cold^  &c.,  whereas,  on  the  other  hand^  those  who 
looked  upon  tuberculosis  as  a  new  formation  had  to  consider 
such  influences  as  unimportant. 

We  now  recognise  only  the  essential  causes,  that  is  to 
say,  those  tsLCtors  and  affections  which  occasion  the  taking 
up  of  fine  foreign  particles  into  the  blood.  The  consti- 
tutional causes  coincide  in  part  with  the  essential^  but  with 
this  difference  that,  according  to  my  views,  it  is  not  the 
constitution  bat  the  already  existent  constitutional  disease 
which  is  the  causal  force ;  in  other  words,  tuberculosis 
results  not  from  the  phthisical  or  the  scrofulous  habit,  but 
£rom  existent  phthisis  (cheesy  pneumonia),  or  from  scrofala 
(cheesy  lymph  glands).  The  constitutional  abnormality  is 
the  first  instigator  to  the  primary  disease  (phthisis,  scrofula, 
caseous  inflammations  of  divers  organs),  and  therefore 
stands  in  an  indirect  relation  only  to  the  secondary  affection, 
i.  e.  true  tuberculosis. 

The  exciting  causes  are  similarly  circumstanced. 
Under  this  head  come  cold,  excesses,  residence  in  vitiated 
air,  bad  and  deficient  food,  mental  emotions,  excessive 
exertion,  &c.  They  cannot,  according  to  my  theory,  directly 
excite  tuberculosis,  with  the  exception,  perhaps,  of  living  in 
foul  air;  but  they  can  very  easily  develop  the  primary 
affection,  and  then  tuberculosis  arises  afterwards.  Cold, 
excess,  over-exertion,  and  the  like,  set  up  catarrh  and 
pneumonia,  which  leave  behind  cheesy  products,  and  in  this 
way  generate  tuberculosis  subsequently.  The  same  causes 
may  likewise  arrest  menstruation,  start  an  haemoptysis,  &c., 
and  thus  lay  the  foundation  of  tuberculosis,  or  bad  air, 
deficient  nourishment,  &c.,  bring  on  scrofula,  from  which 
tuberculosis  originates  later.  Accordingly,  the  causae 
occasionales  are,  to  my  thinking,  by  no  means  unimportant ; 
they  are  the  exciters,  not  of  tuberculosis  itself  but  of  the 
primary  diseases  that  lead  to  its  development. 

Let  us  now  review  seriatim  the  different  primary  affec- 

VOL.  XXXII,  NO.  CXXVII. ^JANUARY,  1874.  C 


34       fValdenburg's  Eopperiments  on  Animals  applied  to 

tions    which    are   followed    more   or    less    frequently    by 
tuberculosis. 

1.  Pneumonia. — It  will  not  be  necessary  to  enlarge  on 
this  subject  here,  because  in  an  earlier  part  of  my  work  I 
fully  discussed  the  important  part  which  cheesy  pneumonia 
plays  in  the  production  of  tuberculosis,  and  also  because  it 
is  a  well-established  fact  that  nothing  is  more  common  than 
the  combination  of  both  acute  and  chronic  tuberculosis  with 
cheesy  pneumonical  products.  We  know  that  cheesy 
pneumonia  both  alone  and  when  associated  with  tuberculosis 
constitutes  by  far  the  most  frequent  form  of  pulmonary 
consumption.  We  also  know  that  the  pulmonary  inflam- 
mation which  paves  the  way  for  phthisis  need  not  be  a 
special  kind  from  the  firsts  but  that  even  simple  croupous 
or  catarrhal  pneumonia  may  run  on  to  caseation,  and  thus 
lead  to  phthisis.  I  have  pointed  out  in  a  former  discussion 
that  the  constitutional  cause  of  phthisis  is  not  tuberculosis, 
but  cheesy  pneumonia  solely ;  whilst  the  most  common 
exciting  causes,  such  as  cold,  excess,  over-exertion,  &c., 
likewise  point  to  cheesy  pneumonia^  as  has  just  been  stated. 

The  historical  sketch  of  the  doctrines  held  respecting 
pulmonary  consumption  which  forms  the  introductory 
portion  of  my  work  plainly  teaches  us  that  the  inflamma- 
tory origin  of  this  disease  was  admitted,  without  the  least 
doubt  being  expressed  about  it,  by  the  majority  of  writers 
from  Hippocrates  down  to  our  own  time.  This  doctrine 
was  first  shaken  by  Bayle  and  Laennec,  but  was  again 
stoutly  upheld  by  other  authorities,  including  Broussais, 
Andral^  Cruveilhier^  Beinhardt,  &c.  The  disbelief  on  this 
matter  was  based  on  the  recognition  of  miliary  tubercle  as  a 
specific  formation,  and  on  the  fusion  of  cheesy  deposits 
(infiltrated  tubercle)  with  true  tubercles.  We  who  now 
regard  miliary  tubercle  as  a  secondary  non-specific  growth, 
and  oppose  the  fusion  just  referred  to,  give  our  support  to 
the  old  dogma  that  most  cases  of  phthisis,  t.  e.,  those 
beginnipg  with  cheesy  pneumonia,  have  an  inflammatory 
origin, 

2.  ScROFULOsis. — This  is  one  of  the  most  common 
causes  of  tuberculosis,   although  rarer  than   cheesy  pneu- 


Human  Tuberculosig  and  Pulmonary  Consumption.       35 

moiiia.  The  connexion  of  tuberculosis  and  of  phthisis  with 
scrofulosis  was  a  recognised  doctrine  for  more  than  a 
ceutury^  and  the  two  morbid  processes  were  almost  regarded 
as  one  and  the  same.  This  view  was  doubtless  based 
chiefly  on  anatomical  structure^  especially  on  the  cheesy 
condition  of  scrofulous  glands  being  analogous  to  that  of 
the  lung  nodules,  or  ''tubercles''  of  phthisis.  Clinical 
observation  also  taught  that  this  connexion  undoubtedly 
exists;  for  the  strong  tendency  of  scrofulous  persons  to 
become  phthisical  is  a  matter  of  every  day  experience.  This 
clinical  fact  will  always  remain  uncontested,  although  the 
theories  explaining  it  may  undergo  ever  so  many  changes. 

A.  Hirsch^  comparing  the  geographical  distribution  of 
scrofulosis  and  of  phthisis,  arrives  at  the  conclusion  that 
''  in  tbe  great  majority  of  localities  where  scrofulosis  prevails 
consumption  also  occupies  a  very  conspicuous  place  in  the 
mortality ;  whilst^  on  the  other  hand,  in  districts  which  are 
exempt  from  it,  consumption  of  the  lungs  is  little,  if  at  all 
known."* 

It  should  be  understood  that  tuberculosis  and  phthisis 
follow  not  only  the  fully  developed  conditions  of  scrofulosis, 
but  also  when  there  is  merely  swelling  and  caseation  of  the 
lymph-glands.  The  ancients  were  familiar  with  this  fact, 
and  it  has  been  corroborated  both  by  recent  experience 
and  by  the  post-mortem  researches  lately  carried  out  with 
reference  to  Buhl's  theory.  The  celebrated  F.  Hoffmann 
reports  several  cases  in  which  phthisis  originated  after  the 
sudden  resorption  of  the  contents  of  cervical  glands.f 

My  theory  explains  the  connexion  between  -tuberculosis 
and  scrofulosis  in  the  simplest  manner ;  they  stand  to  one 
another  in  the  relation  of  cause  to  effect.  I  do  not  resort 
to  the  indefinite  hypothesis  of  a  general  cachexia^  or  one 
common  to  both,  and  still  less  do  I  attempt  to  make  the 
two  morbid  processes  identical.  But  I  defend  Buhl's 
teaching  that  tuberculosis  following  scrofulosis  takes  place 
from  the  direct  resorption  of  the  cheesy  matter  contained  in 

*  Sandbuek  der  l^atoritch-Oeographitehen  Pathologie,  Bd.  II,  p.  97. 
t  ObfervatUmM  twr  la  Natwre  et  U  Traitemewt  de  la  PKtliuie  JPuImonaire, 
Tome  If  p.  99. 


86       fValdenburg^s  Experiments  on  Animals  applied  to 

the  lympb-glands.  Yet  I  do  not  think,  as  he  doeSy  that  this 
matter  contains  any  kind  of  virns,  my  own  opinion  being 
that  the  indispensable  and  only  sufficient  condition  for  tuber- 
cular infection  is  the  resorption  of  detritus,  ».  e.  the  corpus- 
cular elements  in  cheesy  masses.  Scrofulosis  is  not  a 
specific,  virulent,  or  contagious  disease ;  its  matter  when 
taken  up  into  the  circulation  acts  in  no  way  differently  from 
the  finely  divided  corpuscular  particles  of  non-scrofulous 
deposits. 

In  order  that  scrofulosis  may  produce  tuberculosis,  it  is 
necessary  not  only  that  cheesy  or  degenerated  lymph-glands 
be  present,  but  also  that  they  should  be  situated  in  imme- 
diate contact  with  blood-vessels.  If  the  glands  are  sur- 
rounded with  a  fibrous  and  non-vascular  capsule,  there  ia 
very  little  danger  of  resorption,  and,  consequently,  of  tuber- 
cular infection. 

Moreover,  as  the  admission  of  true  corpuscular  elements 
into  the  blood  is  essential,  according  to  my  theory,  for  the 
production  of  tuberculosis,  it  is  easy  to  explain  why  under 
different  conditions  a  resorption  may  be  quite  innocuous. 
For  instance,  if  a  tumefied  or  inflamed  gland  in  which  no 
cheesy  matter  has  as  yet  been  found  is  resorbed,  say  by 
Iodine,  the  result  is  ascribed,  according  to  the  prevailing 
opinion,  to  the  elements  having  undergone  fatty  degenera- 
tion and  liquefaction.  But  if  these  elements  are  already 
shrivelled  up  in  consequence  of  caseous  metamorphosis,  they 
are  less  capable  of  passing  through  a  complete  fatty  and  liques- 
cent process ;  they,  therefore,  either  remain  in  the  organism 
as  deposits  unless  expelled^  or  enter  the  circulation  through 
open  blood-vessels,  or  through  lymph-vessels.  Resorption 
of  the  former  masses  does  not  convey  any  foreign  particles 
into  the  blood,  and  is,  therefore,  free  from  danger ;  whereas, 
when  the  latter  are  resorbed,  the  blood  gets  loaded  with 
foreign  stuff,  and  the  organs  in  which  this  stuff  is  stored 
fall  into  disease. 

Not  only  acute  general  miliary  tuberculosis,  but  also 
subacute  and  chronic  local  tuberculosis  follow  scrofulosis, 
and  that  whether  the  cheesy  glands  are  situated  in  the  neck, 
the   mediastinum,   the   mesentery,  or    in  any  other    part. 


Human  Tuberculosis  and  Pulmonary  Consumption,       87 

Hence  the  phthisis  of  scrofulous  persons  is  in  most  cases 
really  dependent  on  tuberculosis^  but  there  is  no  denying 
that  it  may  also  begin  and  end  as  cheesy  pneumonia. 
Indeed,  it  is  quite  common  for  such  persons  to  have  a  pre- 
disposition to  catarrh  and  to  inflammations  of  the  respiratory 
organs.  The  inflammatory  products  in  the  lungs  may^  in 
certain  circumstances^  become  caseous,  and  so  set  up  phthisis 
either  alone  or  combined  with  tuberculosis.  Besides^  my 
experiments  proved  that  purulent  inflammation  in  different 
organs  can  be  excited  by  inoculation,  in  addition  to  true 
tubercles;  and  therefore  it  is  possible  that  cheesy  pneu* 
monical  deposits,  as  well  as  tuberculosis,  may  be  developed 
as  the  direct  result  of  the  resorption  of  scrofulous  matter. 

Again,  the  last-mentioned  experimental  facts  compel  us 
to  consider  whether  the  simple  inflammatory  affections  of 
scrofulous  subjects  are,  or  are  not,  in  certain  conditions, 
secondary  and  due  to  the  resorption  of  cheesy  matter  in 
lymph-glands.  I  refer  to  obstinate  cutaneous  eruptions, 
inflammation  of  bones  and  of  joints,  troublesome  eye  affec- 
tions, ftc.  Such  cases  are,  no  doubt,  generally  primary,  and 
swollen  glands  secondary  ;  but  there  are  also  many  instances 
in  which  the  glands  become  tumefied  and  caseous  after  an 
inconsiderable  inflammation  of  the  skin  or  of  the  mucous 
membrane,  which  soon  recedes ;  then  at  a  much  later  period 
serious  mischief  makes  its  appearance  in  various  organs. 
Here  we  are  at  liberty  to  refer  the  latter  morbid  process  to 
the  same  long-standing  cachexia  from  which  the  former  and 
less  severe  affections  originated,  an  explanation  hitherto 
regarded  as  the  only  correct  one ;  or  we  may  consider  it 
as  caused,  in  part  at  least,  by  resorption.  Let  us  not  come 
to  a  too  hasty  decision  on  this  important  question,  but 
rather  let  us  try  to  solve  the  problem  by  the  aid  of  numerous 
and  searching  experiments. 

I  have  already  in  a  former  division  of  my  work  dis- 
coursed upon  the  nature  and  constitutional  causes  of  scrofu- 
losis.  The  tendency  of  the  glands  to  caseation  may  be 
traceable  to  an  inherited  abnormality  in  the  structure  of 
the  lymphatic  system.  But  undoubtedly  scrofulosis  can 
also  be  acquired.     Bad  air  and  insufficient  or  unsuitable 


88        Waldenburg* $  Erperimenis  on  Aninuds  applied  to 

food  stand  foremost  amongst  the  conditions  which  produce 
it;  whilst  living  in  small  ill-ventihited,  dark,  and  over- 
crowded dwellings  is  the  most  common  canse  of  its  acquire- 
ment. It  is  surely  an  interesting  fact  that  I  have  observed 
the  occurrence  of  scrofulous  kinds  of  disease  in  animals 
under  similar  drcomstauces.  I  was  obliged^  it  is  true,  to 
leave  the  question  open  whether  inoculation  in  animals 
contributed  essentially  to  visceral,  skin,  and  bone  affections 
or  whether  the  extaiial  conditions  alone  were  sufficient. 
Still,  it  is  probable  that  the  cutaneous  puncture  gave  at 
least  the  impulse  to  the  general  changes,  but  whether  really 
from  resorption  of  detritus,  or  from  simple  setting  np  of 
inflammatory  irritation,  remains  undecided. 

I  must  pause  here  a  little  to  consider  the  practically 
important  question  as  to  the  hurtfulness  of  vaccination. 
Opponents  of  this  measure  maintain  that  besides  other 
diseases  it  is  especially  scrofula  which  is  transmitted  by 
vaccination.  According  to  my  theory,  scroiiilosis  is  neither 
a  contagious  nor  a  specific  disease ;  therefore,  I  emphatically 
deny  the  possibility  of  transmitting  any  scrofulous  virus 
whatever  from  one  individual  to  another.  It  is  another 
matter  if  we  ask  whether  vaccination  is  ever  able  to  scro- 
fulise  a  child  which  has  been  vaccinated  indifferently  from  a 
scrofulous  or  a  non-scrofulous  vaccinifer.  As  the  experi- 
ments on  which  my  views  rest  are  not  yet  concluded,  and 
as  very  many  doubts  still  remain^  I  do  not  wish  my  opinions 
to  be  accepted  save  with  great  reserve.  I  believe,  then, 
that  vaccination  may  be  an  exciting  cause  in  bringing  forth 
scrofulosis  in  children  who  already  possess  the  inherited 
predisposition  to  the  disease ;  but  in  this  case  any  other 
sort  of  small  wound^  a  trifling  catarrh,  &c.,  may  have  a 
similar  action,  and  therefore  vaccination  cannot  be  singled 
out  as  the  essential  morbific  agent.  Indeed  the  most  in- 
significant glandular  swelling  can  remain  quiescent  and  under- 
go caseation  where  the  liability  exists.  It  is  also  possible 
that  vaccination  gives  the  accidental  impulse  to  the  outbreak 
of  scrofulosis,  when  the  child  lives  amidst  the  external  in- 
jurious influences  which  are  wont  to  occasion  the  acquired 
disease.     I  have  often  seen  children  suffer  a  long  time  from 


Human  Thiberculosis  and  Pulmonary  Consumption.       39 

slight  skin  eruptions  after  vaccination^  but  these  always 
completely  vanished  in  the  course  of  a  few  weeks ;  if  they 
did  not^  there  was  evidence  of  a  disposition  to  scrofulosis, 
either  acquired  or  inherited  from  constitutionally  diseased 
parents.  Hence  it  is  idle  to  talk  of  an  essential  pemicious- 
ness  in  vaccination^  at  least  in  comparison  with  the  great 
benefits  it  confers. 

One  other  point  is  worth  mentioning.  Although  vaccina- 
tion with  pure  clear  lymph  is  without  any  danger^  yet  the 
use  of  turbid  lymph  which  contains  corpuscular  elements, 
t.  e.  pus  and  blood-cells,  is  perhaps  not  altogether  beyond 
suspicion.  Attention  has  been  repeatedly  drawn  to  this 
topic,  and  a  warning  sounded  against  such  lymph.  Whether 
or  not  those  cases  in  which  obstinate  skin  eruptions,  slight 
disorders  of  weeks'  duration.  Sec,  have  been  observed  to 
follow  vaccination,  were  traceable  to  this  cause,  must  be 
determined  by  more  numerous  investigations  than  I  have 
been  able  to  institute.  It  will  therefore  be  seen  that  many 
knotty  points  remain  to  be  unravelled, 

8.  HiBMOPTYsis. — Up  to  the  beginning  of  this  century 
no  one  had  any  doubt  as  to  haemoptysis  being  one  of  the 
most  frequent  causes  of  phthisis.  This  opinion,  however, 
was  abandoned  by  most  men  through  the  authority  of 
Laennec,  who  maintained  that  where  haemoptysis  apparently 
ushers  in  phthisis  latent  tubercles  are  then  in  existence, 
and  that  it  is  never  the  cause  but  always  the  consequence 
of  an  already  present  tuberculosis.  It  cannot  be  denied 
that  he  was  led  to  these  views  principally  from  theoretical 
considerations.  His  doctrine  that  tubercle  is  a  specific 
new  formation  was  irreconcileable  with  haemoptysis  being 
a  cause,  and  hence  he  had  recourse  to  another  interpretation, 
but  no  one  can  possibly  assent  to  it  whose  observations  are 
made  in  a  candid  and  impartial  spirit,  uninfluenced  by  the 
bias  of  a  foregone  conclusion. 

Our  forefathers  were  excellent  observers,  and  the  experi- 
ence they  acquired  deserves  a  much  higher  appreciation 
than  some  have  thought  proper  to  give  it  in  recent  times. 
They  were  not  equipped  with  objective  instruments  for 
physical  diagnosis,  and  were  thrown  back  on  subjective  symp- 


40       fFaldeniurg's  Experiments  on  Animals  applied  to 

toms  solely ;  they  had  thei^fore  a  keener  perceptivity  than  is 
poBsessed  by  those  who  often  treat  such  symptoms  as  of  sub- 
ordinate impoftance  in  consequence  of  relying  upon  objective 
methods  of  investigation.  Can  any  keen-eyed  and  impartial 
observer  deny  that  many  cases  of  haemoptysis  occur 
saddenly  in  persons  who  are  quite  well  ?  Why  should  it  be 
here  assumed  for  the  sake  of  a  theory  that  there  must  have 
existed  a  tuberculosis  which  was  previously  altogether  un- 
noticed? I  have  often  enough  seen  perfectly  robust  individuals 
who  enjoyed  sound  healthy  or  at  least  who  manifested  no  abnor- 
mal condition^  become  suddenly  attacked  with  haemoptysis, 
whereupon  all  the  symptoms  of  phthisis  followed,  and  I 
could  bring  forward  many  striking  proofs  of  the  fact. 

The  following  appears  to  me  to  explain  the  causal  rela- 
tion between  haemoptysis  and  phthisis.  My  experiments 
convinced  me  that  fresh  blood  in  the  air-passages  is  able  to 
set  up  inflammation  of  the  pulmonary  structures.  The 
same  thing  occurs  in  man  as  well  as  in  animals,  numer- 
ous observations  having  convincingly  proved  that  bronchitis 
and  pneumonia  are  easily  lighted  up  if  blood  flows  down  into 
the.  trachea  after  tracheotomy.  Why,  then,  should  we  not 
venture  to  think  that  blood  which  gets  into  the  lung  with- 
out tracheotomy,  but  is  directly  effused  there,  can  likewise 
act  as  an  irritant  and  excite  inflammation  ?  Have  we  not 
observed  dry  cough,  perhaps  also  dyspnoea,  pyrexia,  and  all 
the  symptoms  of  pneumonia,  make  their  appearance  a  few 
days  after  most  attacks  of  haemoptysis  ?  If  we  once  admit 
that  pneumonia  can  be  produced  by  haemoptysis,  then  the 
possibility  of  the  pneumonical  products  undergoing  caseation, 
followed  by  phthisis  and  tuberculosis,  must  be  conceded. 

I  believe,  therefore,  that  haemoptysis  may  appear  in 
a  person  perfectly  healthy,  and  either  be  destitute  of 
results,  as  I  have  often  seen,  or  lead  to  bronchitis  and 
circumscribed  pneumonia.  The  products  of  the  latter  dis- 
eases become  caseous  and  induce  acute  or  chronic  phthisis, 
with  or  without  tuberculosis,  especially  in  those  who  possess 
the  phthisical  habitus.*     The  question  remains  for  the  pre- 

*  Here  follows  a  case  of  Andral's  iUostrating  the  above  remarks.  It  is  the 
less  necessary  to  reprodoce  it  in  this  place*  since  clinical  facts  are  rapidly 
accumulating  in  verification  of  the  author's  deductions. — Q.  M. 


Human  TSibercuhsis  and  Pulmonary  Consumption,       41 

sent  undecided  as  to  the  occurrence  of  true  tuberculosis 
after  bsemoptysis  from  the  direct  resorption  of  degenerated 
or  shriTclled  blood-corpuscles^  without  the  intervention  of 
caseous  pneumonia.  Yet,  whilst  regarding  haemoptysis  as 
a  cause  of  phthisis^  it  is  perhaps  scarcely  necessary  to  add 
that  I  do  not  consider  every  haemoptysis  of  phthisical  per- 
sons as  a  primary  affection ;  on  the  contrary,  my  opinion 
is  that  the  most  frequent  attacks  are  not  the  causes,  but 
the  consequences  of  more  or  less  advanced  phthisis  due  to 
ulceration  of  the  lung.  But  even  secondary  effusions  of 
blood  may,  according  to  the  modern  point  of  view,  lead  to 
further  pneumonical  deposits  and  to  fresh  tubercular  erup- 
tions* Lastly,  haemoptysis  may  appear  like  epistaxis  in 
persons  of  delicate  constitution  as  an  expression  of  the 
existing  cachexia,  and  then  be  the  forerunner  of  phthisis. 
In  such  cases  haemoptysis  is,  no  doubt,  an  outcome  of  the 
phthisical  habit,  but  afterwards  the  immediate  cause  of 
phthisis  itself. 

4.  Bronchitis. — It  is  an  undisputed  fact  that  phthisis 
very  frequently  begins  with  the  symptoms  of  simple  bron- 
chial catarrh^  but  it  is  questionable  if  the  latter  is  always  the 
result  of  existent  tubercle,  or  of  tubercle  in  course  of  forma- 
tion as  Laennec  teaches.  On  this  point  I  side  with  Laennec's 
opponents,  who,  whilst  admitting  that  such  symptoms  are 
very  frequently  caused  by  phthisis  and  tuberculosis,  also 
hold  that  a  simple  bronchitis  excited,  for  instance,  by  catch- 
ing cold,  may  end  in  phthisis,  especially  where  the  liability 
is  present.  Laennec's  views  are  based  on  the  theory  that 
tubercle  is  a  specific  new  formation.  The  reasons  for  this 
theory,  which  is  contradicted  by  impartial  observation,  fall 
to  the  ground  along  with  the  theory  itself.  When  a  case 
presents  bronchitic  symptoms  without  alteration  of  the  per- 
cussion note^  I  contend  that  simple  bronchitis  only  exists ; 
whereas,  according  to  the  other  theory,  latent  tubercles  not 
yet  discoverable  by  physical  examination  must  be  present. 
Neither  of  us,  it  is  true,  can  bring  forward  positive  evidence 
in  support  of  our  respective  views,  nor  does  the  conflict  of 
opinion  between  us  admit  of  adjustment,  but  it  will  be 
conceded  that  he  places  an  arbitrary  interpretation  on  the 


42        IValdtnburg^s  Experiments  on  Animals  applied  to 

phenomena  observedy  whilst  his  opponents  are  in  harmony 
with  views  which  have  long  prevailed,  and  assume  as  pre- 
sent only  what  they  are  in  a  condition  to  substantiate  by 
objective  proofs. 

Bronchitis  may  run  on  to  phthisis  where  cheesy  products 
are  developed  and  break  down;  usually,  however,  it  is 
succeeded  by  catarrhal  pneumonia  which  leads  to  phthisis, 
and  afterwards  to  tuberculosis. 

5.  Larynobal  Affections. — ^The  relation  of  these  dis- 
eases to  phthisis  is  of  no  slight  importance.  It  has  been 
held  since  Laennec  that  they  are  always  secondary, 
and  that  tubercles,  either  manifest  or  latent,  must  in  all 
cases  precede  them.  This  view  has  been  almost  uncontested 
up  to  the  latest  date,  although  Andral  and  others  pro- 
nounced against  it,  and  although  it  seems  to  be  at  variance 
with  impartial  experience.  I  myself  used  to  go  about  my 
observations  as  faithfully  as  any  one  could  possibly  do,  but 
very^  soon  numerous  cases  occurred  to  me  which  I  did  not 
know  how  to  reconcile  with  a  belief  in  the  accepted  creed. 
For  many  years,  and  long  before  Villemin  published  his 
experiments,  I  was  convinced  that  this  doctrine  could  not 
lay  the  least  claim  to  general  validity.  Having  for  a  con- 
siderable period  practised  as  a  specialist  in  diseases  of  the 
respiratory  organs,  I  had  abundant  opportunities  of  observ- 
ing^ cases  of  beginning  phthisis.  Amongst  them  were 
many  with  the  throat  afifected,  but  not  the  smallest  trace  of 
anything  wrong  in  the  chest  could  be  discovered  by  the 
most  searching  physical  exploration.  The  disease  had 
begun  at  once  with  hoarseness,  followed  by  pains  in  the 
throat,  whilst  cough  either  appeared  long  afterwards,  or 
was  entirely  absent,  except  in  the  form  of  slight  hawking. 
Laryngoscopic  examination  usually  disclosed  either  ulcer- 
ation in  the  larynx,  or  perichondritis  of  the  arytenoid 
cartilage,  or  of  the  epiglottis.  The  recent  cases  were  cured 
by  local  applications,  but  the  majority,  especially  when 
the  cartilages  were  involved,  defied  every  treatment.  I  have 
seen  the  throat  lesion  increase  both  in  intensity  and  in  ex  ten- 
sity, and  pulmonary  symptoms  gradually  come  on,  such  as 
progressive  dulness  of  the    percussion    note,   troublesome 


Human  TSiberculons  and  Pulmonary  Consumption.       43 

coDgh,  and  dyspnoea;  at  last  pyrexia  supenrened^  and 
death  became  inevitable  from  laryngeal  and  pulmonary 
consomption. 

The  objection  may,  of  course^  be  made  that  at  the  time 
when  laryngitis  appeared,  latent  tubercles  were  already  pre- 
sent iu  the  lungs  and  had  escaped  detection.  I  cannot 
rebut  this  ?iew  by  any  counter-proofs,  but  I  should  like  to 
ask  the  question,  why  should  we  prefer,  out  of  respect 
to  an  hypothesis  whose  foundations  are  now  sapped,  to  sup- 
pose that  there  is  something  latent  and  non-demonstrable 
in  an  objective  condition,  instead  of  admitting  the  existence 
of  that  only  which  is  presented  to  us  by  rigorous  exami- 
nation ? 

I  am  persuaded  that  even  the  least  attentive  physician 
will  be  able  to  make  observations  similar  to  my  own,  and 
perhaps  has  already  done  so,  although  more  or  less  biassed 
by  dogmatic  teaching.  As  to  the  fact  itself,  there  cannot, 
I  think,  be  any  doubt ;  yet  the  interpretations  placed  upon 
it  may  vary.  My  own  theory  appears  to  me  to  be  more 
simple  and  to  have  an  older  historical  claim  than  Laennec's, 
and,  moreover,  is  not  prejudiced  by  any  foregone  conclu- 
sions. 

Nor  is  the  kind  of  interpretation  of  slight  importance  in 
practice.  According  to  my  views  every  inveterate  laryn- 
gitis, especially  the  ulcerative,  is  a  very  serious  disease,  but 
I  think  that  if  we  succeed  in  curing  it  in  the  early  stage 
a  subsequent  phthisis  and  tuberculosis  is  prevented.  Oppo- 
nents, however,  console  themselves  in  every  eventuality 
with  the  ''  non  possumus  '^  argument.  If  laryngitis  leads 
to  the  development  of  phthisis,  the  latter  was  originally 
present  in  the  latent  form,  and  consequently  its  cure  would 
have  been  impossible  in  all  cases.  If,  on  the  other  hand, 
the  affection  is  cured,  it  was  only  simple  laryngitis,  and 
therefore  the  favorable  result  might  have  been  presupposed 
even  from  inactive  treatment. 

Well,  then,  how  is  it  that  laryngitis  leads  to  phthisis  ? 
I  think  in  the  following  ways :  Firstly,  by  simple  exten- 
sion of  the  inflammatory  process  to  the  bronchi  and  lungs, 
in    which   cheesy    pneumonical   products    are     developed. 


44        Waldenburg*8  Experiments  on  Animals  applied  to 

Secondly,  by  dropping  down  of  purulent  secretion  into  the 
bronchi  where  inflammatory  products  are  directly  engen- 
dered. I  have  already  published  the  report  of  a  case  of 
this  kind.*  A  man  who  suffered  from  perichondritis  and 
deep  ulceration  of  the  larynx^  followed  by  pulmonary  symp- 
toms, died  of  stenosis  and  o&dema  glottidis,  and  the  post- 
mortem revealed  several  disseminated  pneumonical  deposits 
in  the  lung,  besides  the  laryngeal  mischief.  Professor 
Virchow,  to  whom  I  showed  the  preparation,  expressed  the 
opinion  that  these  deposits  were  in  all  probability  induced 
by  the  purulent  secretion  from  the  laryngeal  ulcer  flowing 
downwards,  and  this  explanation  was,  in  truth,  the  only 
satisfactory  one.  As  simple  pneumonia  was  owing  to 
ulcerative  laryngitis  in  this  case,  so  cheesy  pneumonical 
deposits  may  be  developed  in  others,  and  iu  this  way  lung 
phthisis  be  secondary  to  laryngeal  phthisis.  Thirdly,  true 
tnberculosis  may  be  excited  without  the  previous  production 
of  caseous  pneumonia  by  resorption  of  detritus  from 
ulcerative  laryngitis,  or  from  perichondritis  which  usually 
ends  in  abscess  and  ulceration.  Further  clinical  observation 
can  alone  determine  which  of  these  three  occurrences  is  the 
most  common. 

I  have  considered  primary  ulcerative  laryngitis  as  an 
idiopathic  and  not  as  a  tubercular  affection,  but,  in  my 
opinion,  it  occurs  only  exceptionally  in  persons  who  are 
quite  strong,  and  is,  as  a  rule,  the  expression  of  a  delicate 
constitution,  or  of  a  disposition  to  obstinate  catarrhs  and 
especially  to  follicular  ulceration.  Then  laryngitis  is  the 
first  manifestation  of  the  constitutional  abnormality,  and 
in  this  sense  plays  the  same  part  as  cheesy  pneumonia  and 
haemoptysis  do  in  other  cases. 

The  secondary  laryngitides  which  appear  in  the  course  of 
phthisis  are  much  more  common  than  the  primary  kinds 
occurring  in  a  phthisical  person,  and  are  not  by  any  means 
always  of  a  tubercular  character.  I  have  often  seen  simple 
laryngeal  catarrh^  indistinguishable  from  ordinary  catarrh, 
and  curable  sooner  or  later  by  local  agents,  set  in  during 
the  progress  of  consumption.    'Even   true   laryngeal  ulcer- 

•  Allgem.  Med,  CentrdUti^,,  101, 102.    1865. 


Human  Tubereulosis  and  Pulmonary  Consumption.       45 

ation  complicating  phthisis  is  not  always  due  to  miliary 
tubercles^  for  we  may  be  dealing  with  simple  follicular  ulcers. 
I  have,  in  certain  conditions^  seen  such  secondary  ulcers 
healed,  though  seldom  completely  so.  Secondary  laryngitis 
is  not  caused  iu  every  instance  by  generalised  tuberculosis, 
t.  e.  by  resorption  of  detritus  from  pneumonical  deposits, 
but  by  the  sputa  thrown  up  from  the  lungs  irritating  and 
inflaming  the  laryngeal  mucous  membrane. 

I  have  been  obliged  to  content  myself  with  merely  touch- 
ing upon  these  different  questions.  It  is  to  be  hoped  that 
their  great  importance  will  act  as  a  spur  to  further  thorough 
researches. 

6.  PcjRULENT  Inflammations. — It  is  an  acknowledged 
fact  that  these  diseases  are  frequently  associated  with 
tuberculosis. 

(a.)  Pleuriiis  tcith  purulent  secretion  is  especially  and  most 
commonly  followed  by  tuberculosis.  It  is  not  necessary  to 
qnote  examples  and  authorities  in  support  of  this  statement, 
because  the  fact  itseif  is  beyond  contradiction,  although  the 
way  in  which  it  has  been  explained  is  open  to  dispute. 
Some  have  considered  the  tuberculosis  as  due  partly  to  the 
same  cachexia  which  originated  the  pleuritis,  and  partly  to 
another  acquired  from  the  lingering  course  of  the  latter  dis- 
ease. This  view,  it  must  be  admitted,  is  a  mere  makeshift, 
a  cloak  for  ignorance  concerning  the  nature  and  causes  of 
tuberculosis,  and  should  be  discarded  now  that  a  definite 
and  concrete  doctrine,  that  of  absorption,  has  been  put 
forth  in  its  place.  That  resorption  can  satisfactorily  explain 
the  occurrence  of  tuberculosis  after  purulent  plearitis  is  a 
thesis  which  does  not  require  much  discussion.  We  know 
that  tuberculosis  frequently  supervenes,  especially  when  the 
empyema  has  persisted  for  a  long  period,  and  when  the 
secretion  has  not  been  evacuated  either  spontaneously  or 
by  thoracentesis,  so  that  inspissation  has  taken  place.  The 
tubercular  outbreak  usually  occurs  on  the  side  opposite  to 
the  empyema ;  here,  the  activity  of  the  lung's  functions  is 
much  increased,  a  large  amount  of  blood  circulates  through 
the  lung,  and  for  these  reasons,  perhaps,  resorption  is  easily 
effected.      On  the  other  hand,  the  lung  on   the  diseased 


46        1Valdenburff*s  Experiments  on  Animals  applied  to 

side  is  compressed,  faQCtioaally  torpid,  and  Separated  from 
the  secretion  by  a  more  or  less  thickened  false  membrane. 
Whether  the  empyema  mast  necessarily  contain  cheesy 
masses,  or  whether  pus  as  such  is  sufficient  for  the  produc- 
tion of  tuberculosis,  is  at  present  undetermined.  Of  course 
those  pleuritides  which  occur  during  tuberculosis  or  phthisis, 
whether  of  a  true  tubercular  or  of  an  inflammatory  nature, 
should  not  be  confounded  with  the  pleuritis  which  causes 
tuberculosis. 

(b,)  Another  precursor  of  tuberculosis,  though  a  rarer 
one  than  the  last  mentioned,  is  purulent  peritonitis,  especially 
when  it  runs  a  chronic  course  and  the  purulent  exudation 
becomes  thickened  and  cheesy.  Here  the  neo-membrane 
of  the  peritoneum  and  its  immediate  vicinity  are,  at  first 
and  usually  the  seat  of  tubercular  formations;  it  is  only 
later,  if  at  all,  that  the  process  becomes  generalised.* 

(c,)  In  the  same  way,  tuberculosis  follows  caseous  inflam^ 
mation  of  the  urinary  and  generative  organs.  Two  striking 
instances   of  this   occurrence   are    mentioned     by    C.    E. 

Hoffmann.t 

''  In  the  first  case,  chronic  inflammation  of  the  urinary 
passage,  consequent  upon  repeated  claps,  made  its  appear- 
ance at  first  in  the  posterior  part  of  the  urethra  and  in  the 
bladder,  and  extended  to  the  kidneys ;  the  serious  mischief 
thus  caused  was  followed  by  miliary  tubercles  in  the  lungs 
and  the  liver.  In  the  other  case  the  patient  had  first 
disease  of  the  bladder  and  chronic  inflammation  of  the 
testes,  then  the  inflammation  spread  to  the  kidneys,  and  at 
a  much  later  period  miliary  tubercles  appeared  in  the 
lungs.'' 

{d.)  Tuberculosis  has  also  frequently  been  observed  after 
inflammation  of  joints,  particularly  the  hips.  Portal  reports 
two  cases  of  coxitis  and  one  of  so-called  spontaneous 
luxation  of  the  thigh,  in  which  phthisis  supervened.     In  the 

*  The  author  qnotei  in  extemo  the  particalan  of  a  case  recorded  hy  C.  S. 
Hoffman  in  the  DmUchet  Jrokio  /.  KUn,  Med,,  III,  1867,  p.  108;  bat  it  is 
too  long  to  be  reproduced  here. — O.  M. 

t  Ibidem,  pp.  83  and  91. 


Human  Tuberculosis  and  Pulmonary  Consumption.        47 

former  cases  there  was  no  external  discharge  of  pus. 
Again,  some  cases  of  typical  miliary  tuberculosis  have 
recently  been  under  observation,  whilst  coxitis  was  still 
recent,  at  the  clinic  of  Professor  Langenbeck.  His  assistant. 
Dr.  Busch,  intends  to  publish  the  report  shortly.  Phthisis 
is  much  more  frequent  when  protracted  suppuration  has 
been  established  in  the  course  of  coxitis,  and  is  usually 
ascribed  to  cachexia.  In  such  cases  it  will  have  to  be 
determined  whether  we  are  dealing  with  true  tuberculosis 
or  with  simple  phthisis  (cheesy  pneumonia)^  and  also 
whether  or  not  the  lymph-glands  are  in  a  state  of  caseous 
degeneration,  because  it  is  only  by  instituting  a  comparison 
between  all  the  factors  that  we  can  discover  the  cause  of 
phthisis.  If  true  tuberculosis  be  present,  then  it  is  refer- 
able to  the  resorption  of  shrivelled  pus-corpuscles  from  the 
affected  joints  or  of  cheesy  matter  from  lymph  glands  ;  if 
simple  phthisis,  then  the  constitutional  abnormality  will  be 
specially  taken  into  account,  although  there  is  a  possibility 
that  it  also  may  have  originated  from  resorption. 

{e.)  Chronic  abscesses.  —  Chronic  abscesses,  especially 
when  connected  with  caries  of  bone,  stand  on  the  same 
footing  as  joint  inflammation,  and  in  this  respect  caries  of 
the  petrous  bone  is  pre-eminently  hurtful.  The  latter  is 
usually  considered  as  tubercular,  but,  as  Troeltsch  justly 
insists,  without  trustworthy  evidence  being  advanced  to 
support  such  a  view.  The  cheesy  masses  which  are  found 
in  the  cells  of  the  petrous  bone  can  be  ascribed  more  simply 
to  purulent  inflammation  than  to  a  tubercular  process  ;  and 
it  is  urged  by  Troeltsch  that  chronic  otorrhoea  usually 
precedes  the  bone  disease,  and  that  the  latter  is  entirely 
caused  by  neglect  of  the  former.  The  experience  of  aurists 
who  have  a  rich  field  for  observation  goes  to  show  that  a 
large  proportion  of  persons  sufi^ering  from  chronic  otorrhoea 
die  from  tuberculosis,  and  that  the  tubercles  are  situated 
very  frequently  or  exclusively  in  the  membranes  of  the 
brain.  The  relation  between  caries  of  this  bone  and 
meningeal  tuberculosis  was  too  striking  to  be  regarded  as 
accidental.     Accordingly  Troeltsch  some  years  ago  arrived 


48        Waldefdnar^g  Experhnents  om  Amimmh  applied  to 

at  an  independent  interpretation  which  hannoniaes  tolerably 
well  with  Bnhl's  theory  and  my  own«* 

It  follows  from  all  this  eridence  that  toberenlosis  very 
frequently  makes  its  appearance  as  a  seocmdaiy  disease  after 
pnmlent  inflaromation,   and  that  it  does  so  especially  in 
those  cases  where  the  pus  cannot  be  discharged  externally, 
and   is  therefore   retained  in  the  organism.     My   theory 
explains  the  phenomena  in  the  simplest  way ;  they^jMin^lva- 
to  the  resorption  of  shrivelled  pus-c^*^- — ' 
detritns.     Whether  the  retains 
nceessity   be   caseous  in  order 
a    problem    which   awaits  solu 
researches. 

7.  '*  Typhus  ''  and  thb  Acuti 
has  at  all  times  been  not  unfreqt 
of  ''typhus''   fevers  and  the  ac 
measles.     This   fact  is    in    com) 
theory.     The  former  affections 
the  lymph-glands  or  ulcers  in  the  1 
ment  of   the  mesenteric  glands, 
points  of  tuberculosis.     The  latt 
quently  complicated  with  bronchit. 
catarrhal  pneumonia  or  circumsc. 
ration,  and  thus  induce  phthisis 
excite  glandular  swellings  which  b 
tuberculosis  follows  from  resorptiot 
the  same  footing  as  the  acute  exan. 

8.  Ulcer  op  the  Stomach. — D 
tion  to  the  frequent  complication 
organ  with  tuberculosis.     It  is  not 
fact  also  into  harmony  with  my  vie 
abnormal  elements  are  resorbed  fron 

explanation  applies  to  those  rare   •  ^^ 

ulceration,  especially  of  the  stomach  ^owel^  in  which 

tuberculosis  appears  secondarily,  according  to  the  observa- 
tions of  Diettrich  and  of  Martins.    It  is,  however,  a  matter 

*  Waldenbnrg  gives  Troeltsch's  views,  bufc  it  is  onneoessary  to  publish  them 
in  this  phuw. — G.  M. 


Human  Tuberculoris  and  Pulmonary  Consumption.      49 

for  farther  inquiry  whether  we  are  here  dealing  with  true 
tubercalosis  or  with  caseous  pneumonia. 

9.  Diabetes  mellitus. — This  disease  is  one  of  the  most 
frequent  antecedents  of  phthisis.  Phthisis  then  depends 
usually  on  cheesy  pneumoniayfor  diabetic  patients  are  disposed 
to  inflammation^  andj  it  is  very  likely  that  the  considerable 
loss  of  fluid  which  is  constantly  going  on  is  the  chief  reason 
why  the  purulent  products  become  cheesy.  If  cheesy 
deposits  are  present^  tuberculosis  arises,  of  course,  as  a  con- 
secutive disease.  But  it  is  still  an  open  point  whether 
or  not  primary  miliary  tuberculosis  appears  directly  in 
diabetes,  without  the  intervention  of  cheesy  pneumonia. 
The  observations  hitherto  made  are,  in  my  opinion, 
insuflicient  to  solve  the  problem,  because  in  published 
reports  phthisis  is  generally  confounded  with  tuberculosis. 
If  the  question  be  answered  affirmatively,  we  can  explain  the 
fact  by  saying  with  Dittrich,  that  the  regressive  metamor- 
phosis of  the  tissues  is  abnormally  increased^  and  that  the 
degenerated  elements  are  resorbed  into  the  blood  in  the 
corpuscular  form. 

This  explanation  would  be  all  the  more  plausible  if  it 
should  be  proved  that  tuberculosis  frequently  results  from 
an  enforced  "  Banting-Cur,''  in  which  rapid  reduction  of 
the  weight  of  the  body  occurs  within  a  short  time.  The 
reports  communicated  up  to  this  day,  as  far  as  they  are 
known  to  me^  are  much  too  inexact  to  enable  me  to  arrive  at 
an  opinion  as  to  their  credibility,  and  especially  as  to 
whether  they  have  reference  to  simple  phthisis  or  to  tuber- 
culosis. 

10.  Suppression  of  Habitual  Discharges,  &c. — The 
moderns  not  only  deny,  but  smile  at  the  opinion  that 
phthisis  and  tuberculosis  are  caused  by  the  arrest  of  dis- 
charges, the  healing  of  ulcers,  &c. ;  and  yet  it  was  Enter- 
tained by  the  most  eminent  and  experienced  authors  up  to 
the  beginning  of  this  century,  including  Morton,  Sauvages, 
CuUen,  and  by  Portal,  and  Schiinlein  more  recently.  Portal, 
for  instance,  refers  to  the  frequent  occurrence  of  phthisis 
after  the  healing  of  skin  eruptions,  under  the  name  of 
'^  phthisis  exanthematica/'     He  also  speaks  of  '^  phthisis 

VOL.  XXXII,  NO.  CXXVII.— JANUARY,  1874,  D 


50        Waldenburg^i  Experiment$  on  Animals  applied  to 

metastatica''  as  the  oonaequence  of  drying  np  old  absoessea 
in  any  part  of  the  body^  and  of  qniekly  healing  chronic 
nloersy  iasnea,  pumlent  torfaoea  prodnoed  by  vesicatories, 
kc.,  whether  the  core  of  these  lesions  is  brought  about 
spontaneously  or  by  medical  treatment. 

And  Schonlein  classified  tuberculosis,  according  to  its 
causes,  into  the  following  forms:— -(1)  simple  pulmonary 
tubercle;  (2)  menstrual  tubercle,  with  its  variety,  puerperal 
tuberde ;  (3)  tubercle  from  cold  drinks ;  (4)  exanthematic 
tubercle :  (5)  impetiginous  tubercle ;  (6)  arthritic  tubercle ; 
(7)  inherited  tubercle.  I  am  far  from  assenting  to  these 
views  in  their  full  scope,  but  I  should  like  to  obtain  for 
them  an  unprejudiced  examination  with  the  aid  of  all  the 
means  of  research  at  our  command. 

I  shall  now  review  the  individual  factors  on  which  our 
predecessors  laid  the  most  weight. 

(a.)  Suppression  of  the  caiamenia. — ^This  usually  takes 
place  in  the  course  of  phthisis,  most  frequently  in  the  advanced 
stage,  more  rarely  soon  after  the  onset  of  the  disease,  and 
is  always  a  ^'  signum  mali  ominis.'^  This  fact  was  not  less 
known  to  our  ancestors  than  to  ourselves ;  surely,  therefore, 
they  did  not  refer  to  such  cases  when  they  maintained  that 
phthisis  arises  in  consequence  of  suppressed  menstruation.  In 
reality,  we  cau  take  into  account  only  those  instances  in|which 
cessatio  mensium  traceable  to  any  cause  whatsoever  brings 
on  the  disease  in  previously  healthy  persons.  The  following 
notes  illustrate  this  point  :-7-Frau  G — ,  aet.  29,  family 
quite  healthy,  mother  still  living,  father  robust  and  died  of 
apoplexy.  Patient  has  always  been  strong  and  healthy ; 
has  had  two  children,  the  youngest  is  two  and  a  half  years 
old.  Of  late  menstruation  has  been  somewhat  irregular, 
but  has  never  stopped.  In  August,  1867,  at  a  time  when 
the  period  was  expected,  she  took  a  cold  bath  for  the  first 
time  in  her  life.  On  returning  home  after  the  bath  she 
noticed  a  few  drops  of  vaginal  blood,  but  no  more  came ; 
menstruation  was  arrested  at  its  commencement  and  has 
not  since  made  its  appearance.  Some  time  afterwards  dry 
cough  set  in,  slight  at  first  and  gradually  getting  worse, 
lo  the  middle  of  December  she  became  hoarse,  and  at  a 


Human  Tuberctdosis  and  Pulmonary  Consumption.      51 

later  period  lost  her  Toice ;  then  followed  high  fever^  night 
sweats,  and  excessive  wasting.  On  February  17th,  1868, 
percussion  gave  marked  dulness  at  both  apices,  where  there 
were  also  lond  bronchial  breathing  and  metallic  rattles. 
Examination  with  the  laryngoscope  disclosed  perichondritis 
of  the  arytenoid  cartilages  and  ulceration  of  the  larynx. 
In  these  circumstances  all  treatment  proved  useless,  and  the 
patient  died  on  February  28th. 

There  can  scarcely  be  the  least  doubt  that  in  this  case 
the  suppressio  mensium  produced  by  the  cold  bath  at  the 
menstrual  period  was  the  cause  of  the  subsequent  phthisis 
and  tuberculosis.  In  this  patient  there  was  no  hsemonfhage 
from  the  lungs  in  any  part  of  her  illness.  In  many  persons 
suppressed  menstruation  brings  on  haemoptysis,  especially 
where  a  disposition  to  bleeding  or  the  phthisical  habit 
exists. 

Haemoptysis  may  then  be  the  point  of  departure  of  a 
later  phthisis.  We  frequently  observe  that  persons  who 
are  already  phthisical  are  disposed  to  haemoptysis  at  the 
menstrual  period,  when  menstruation  is  delayed  or  scanty — 
a  fact  which  has  a  close  analogy  to  those  cases  of  primary 
haemoptysis  which  introduce  phthisis  after  suppressed 
catamenia. 

(p.)  The  tendency  of  chlorotic  patients  to  become 
phthisical  is  beyond  doubt.  Here  also,  in  at  least  many 
cases,  secondary  phthisis  may  be  ascribed  to  retentio 
mensium,  but  the  conditions  are  too  complicated  and  the 
causes  too  obscure  to  enable  us  to  enter  at  present  into  the 
details,  except  with  great  reserve. 

(c.)  The  suppression  of  habitual  hitmorrhoidal  flux  may 
also  lead  to  phthisis:  On  this  matter  I  have  no  experience 
of  my  own,  but  this  much  I  have  frequently  observed,  that 
arrest  of  bleeding  from  the  haemorrhoidal  arteries  excites 
various  chest  and  abdominal  complaints,  increases  existent 
bronchial  and  pharyngeal  catarrh,  creates  oppression  of  the 
chest,  &c.,  and  that  all  these  symptoms  disappear  when  the 
bleeding  returns.  I  have  also  often  observed  that  bleeding 
piles  give  temporary  relief  in  phthisis,  but  in  some 
cases  no  effect  is  produced  on  the  disease.     Further  obser« 


52        Waldenburg*8  ETperimenU  on  Animals  applied  to 

▼ations  must  be  made  as  to  whether  Ticarious  haemoptysis^ 
or  direct  phthisis  and  tuberculosis  can  originate  from  sup- 
pressed haemorrhoidal  bleeding. 

(d.)  The  suppression  of  the  lochia  and  the  sudden  suppress 
sion  of  the  milk  secretion  are  still  more  problematical  causes 
of  phthisis.  Exact  observations  on  these  points  are  still 
wanting  and  wanted. 

(e.)  The  suppression  of  long-coniinued  eruptions  of  the  skin 
was  r^arded  by  old  authors  as  one  of  the  most  important 
causes  of  phthisisi  and  in  this  respect  is  discussed  at  length 
by  Portal.*  The  modern  incredulity  as  to  suppressed  skin 
eruptions  leading  to  phthisis  finds  no  slight  support  in  the 
fact  that  ''  itch ''  was  formerly  included  amongst  the 
exanthems  which  induce  metastasis.  We  know  now  that 
itch  and  many  other  exanthems  are  purely  local  and 
parasitic  diseases,  and  therefore  the  metastasis  of  such  dis- 
eases we  rightly  consider  as  "  ein  nonsens.^'  Nevertheless, 
there  is  a  considerable  number  of  skin  affections  which 
were  once  confounded  with  itch^  and  which  undoubtedly  owe 
their  existence  to  dyscrasia  and  not  to  parasites. 

(/.)  The  healing  of  fistuta-in^ano. — On  this  point  my 
own  experience  accords  with  that  of  the  ancientS|  and  I 
remember  two  cases  particularly  in  which  phthisis  appeared 
in  previously  healthy  persons  shortly  after  recovery  from 
fistula.     (Notes  too  long  for  translation,  O.  M.) 

In  both  casesy  it  seems  to  me  that  the  relation  of 
phthisis  to  the  cure  of  fistula  can  scarcely  be  a  matter 
of  doubt.  Both  patients  had  already  reached  an  age  when 
phthisis  is  not  a  very  common  disease,  at  least  a  phthisis 
running  so  rapid  a  course  as  in  the  first  case.  Besides, 
both  had  been  previously  quite  well  in  their  respiratory 
organs.  In  the  first  case  the  furuncular  eruption  at  the 
beginning  of  the  attack  may  not  be  destitute  of  significance 
in  making  the  correctness  of  the  causative  relation  still 
more  probable.  The  second  case  is  one  of  the  most 
interesting  and  gratifying  in  my  practice  on  account  of  its 
complete  cure  when  all  the  symptoms  of  pulmonary  and 

*  Observatiom  tur  la  Nature  et  le  Traitemeni  de  la  Phthisis  Pulmonaire, 
tome  I»  p.  317. 


Human  Tvberculosis  and  Pulmonary  Consumption.      53 

laryngeal  phthisis  were  present.  I  ascribe  the  result  partly 
to  local  treatment^*  but  chiefly  to  an  issue  in  the  arm  that 
I  bad  made  in  view  of  the  cause  which  produced  the  disease. 
It  is  also  interesting  from  its  showing  the  alternation 
of  phthisis  with  gout^  a  form  of  the  disease  which  used  to 
be  designated  '^  phthisis  arthritica/'  I  have  likewise  seen 
several  other  cases  of  fistula-in-ano  preceding  phthisis,  but 
I  am  not  in  possession  of  positive  facts  respecting  their 
development  and  termination.  I  have  also  frequently 
observed  anal  fistula  in  developed  phthisis,  but  I  do  not 
remember  that  it  exercised  an  essential  influence  on  the 
progress  of  the  lung  disease. 

Modern  surgeons  frequently  deny  that  the  operation  for 
fistula  is  a  cause  of  phthisis.  We  may  conclude  from  this 
that  phthisis  follows  the  operation  in  a  certain  number  of 
cases  only,  but  by  no  means  in  all.  Even  the  kind  of 
operation,  whether  by  cutting,  or  galvano-caustic,  &c.,  may 
not  be  without  some  influence  on  the  result,  since  resorp- 
tion of  detritus  from  the  surface  of  the  flstula  may  be 
facilitated  by  the  one  operation  and  rendered  difficult  by 
the  other.  Besides,  operators  often  quickly  lose  sight  of  their 
patients  and  learn  nothing  of  their  subsequent  internal 
maladies. 

(jr.)  The  suppression  of  chronic  perspirations,  especially 
affecting  the  feet,  was  formerly  regarded  as  one  of  the 
antecedents  of  phthisis.  Portal  reports  a  case  in  which 
phthisis  appeared  and  ended  fatally  after  the  violent  arrest  of 
chronic,  offensive,  and  copious  sweating  in  the  axilla  by 
means  of  alum  applied  locally.  Swelling  of  the  arms  preceded 
the  phthisis. 

I  must  once  more  lay  stress  on  the  declaration  that  I 
do  not  give  my  unqualified  adhesion  to  the  foregoing  views 
of  the  older  authors :  but  it  seems  to  me  that  their  experi- 
ence deserves,  and  even  urgently  demands,  an  impartial 
examination.  We  have  therefore  henceforth  to  collect  new 
and  exact  observations  with  regard  to  setiology.  The 
principal   point   will  be  to    determine  in    individual  cases 

*  Brashing  the  larynx  with  nitrate  of  silver  and  inhaling  the  spray  of  an 
alnm  solution. — Q.  M. 


54  WaUembmrg'M  Erpfrimemis  <m  AjnmaU^  ^e. 

whetber  pbthias  appearing  after  the  aboTe-mentioned  dia- 
eaaes  depends  on  simple  cbeesy  pneumonia  or  on  miliary 
tnbeicalosia. 

Tbe  finegping  examples  of  metastatie  pbtbisis  or  tuber- 
culosis are  easily  explained  by  my  tbeory.  In  some  cases 
we  perbaps  find  cbeesy  lympb-glands,  as  wbere  cbronic  skin 
eruptions  bsTC  pre-existed,  or  some  otber  kind  of  cbeesy 
deposit,  sudi  as  pus  collected  in  an  abscess.  In  otbers, 
Ticarious  bsmorrbage  may  be  at  tbe  foundation  of  pbtbisis, 
as  after  suppressio  mensium  ;  wbilst  in  anal  fistula  we  may 
bare  to  do  witb  resorption  firom  tbe  wound.  But  tbere  are 
also  cases  in  wbicb  none  of  tbese  explanations  avail,  and 
we  are  tbrown  back  on  tbe  ancient  doctrine  tbat  in  certain 
circumstances  tbe  products  of  regressive  metamorpbosis  are 
regularly  eliminated  by  ulcers,  eruptions,  &c,  and  that  when 
these  vents  are  suddenly  closed  tbe  products  in  question 
are  retained  in  the  body,  and  set  up  disease  in  tbe  organs 
in  wbicb  they  are  deposited.  Such  an  hypothesis  must 
appear  to  be  almost  incredible  as  long  as  suppuration  and 
excretion  are  r^arded  as  the  local  operations  of  tissues. 
But  now  that  Cohnbeim's  researches  bring  us  back  to  the 
old  opinion  tbat  pus  is  separated  from  the  blood,  the 
supposition  is  by  no  means  far-fetched  that  foreign  and 
perhaps  morbid  products  also  may  be  separated  from  the 
blood  along  with  pus  through  the  channel  of  suppurating 
surfaces.  This  doctrine  stamps  the  apparently  local  disease 
as  a  general  one,  and  explains  both  the  difficulty  of  curing 
it  and  the  disadvantage  of  its  sudden  suppression. 


55 


A  REVIEW  OP  HAHNEMANN'S  'INSTRUCTION 
FOR  SURGEONS  RESPECTING  VENEREAL 
DISEASES/* 

By  W.  B.  A.  Scott,  M.D.  Edin. 

NoNi  of  the  writings  of  Hahnemann  appears  to  me 
better  calculated  to  induce  practitioners  of  the  old  school  to 
give  at  least  a  hearing  to  the  great  master's  doctrines  than 
the  treatise  on  venereal  diseases  by  the  discoverer  of 
homoeopathy.  In  the  year  when  this  work  was  first  pub- 
lished (1789)  Hahnemann  had  not  as  yet  thrown  down  the 
gauntlet  to  the  adherents  of  the  old  system  (if,  indeed^  an 
incoherent  mass  of  heterogeneous  theories  deserved  the 
name  of  a  system),  nor  had  he  reached  the  doctrine  of 
infinitesimal  doses  which  is  still  believed  by  many 
ignorant  persons  to  be  the  essence  of  homoeopathy,  and 
which,  from  its  startling^  and,  at  first  sight,  paradoxical 
character  is^  doubtless,  apt  to  deter  many  inquirers  from 
the  very  threshold  of  the  investigation.  We  have  here 
simply  a  learned^  modest  and  ingenuous  treatise  on  a  too 
common  disease,  in  which  the  author  is  shown  to  be  at 
least  on  a  level  with  the  highest  authorities  of  his  own  day 
in  etiology,  pathology,  and  diagnosis ;  while,  in  respect  of 
treatment,  he  has  anticipated  nearly  all  the  improvements 
which  have  since  his  time  been  gradually  and  in  spite  of 
much  opposition  introduced  into  the  soudisant  **  regular  ^' 
practice.  This  being  the  case^  it  is  surely  worth  while  at 
least  to  pause  and  consider  whether  it  may  not  be  possible 
that  the  man  who,  in  1789,  '^  with  something  of  prophetic 
strain,'^  preached  amid  the  scorn  of  his  contemporaries  the 
doctrines  universally  received  in  1873,  may  not  in  1810 
(the  year  of  the  publication  of  the  Organon)  have  taught 
much  which  the  future  will  confirm,  and  which  it  will  one 
day  be  the  acknowledged  reproach  of  the  present  age  to 
have  condemned  unheard.     If  a  traveller  should  find  on  his 

•  Leipzig,  1789.    Translated  by  B.  £.  Dudgeon,  M.D.,  in  Hahnemann's 
Writingt, 


56    Hahnemann's  Instruction  respecting  Venereal  Diseases^ 

arriTal  at  each  sncces^siye  stage  of  his  joomej  that  it,  as 
well  as  those  preceding,  has  been  accurately  described  by 
one  who  has  prerioosly  traTersed  the  same  roate^  sorely 
snch  a  diacoTery  would  afford  at  least  a  primd  fade  ground 
for  beliering  that  his  predecessor's  descriptions  of  the  stages 
which  still  lie  before  him  are  worthy,  if  not  of  blind  and 
implicit  confidence,  at  any  rate  of  careful  examination. 
And  this  appears  to  us  to  be  no  inapt  parallel  to  the  case  of 
Hahnemann  and  his  opponents  of  the  present  day.  One 
by  one  most  of  our  founder's  doctrines  hare  established  and 
maintained  their  ground,  some  eren  during  his  own  life- 
time, but  the  greater  part  since  his  decease.  Bloodletting, 
mercurial  salivation,  the  monstrous  treatment  of  gastric 
acidity  by  the  antipathic  administration  of  alkalis  (compare 
Drs.  Binger  and  Buckheim),  prescriptions  compounded  of  as 
many  ingredients  as  the  famous  dish  in  Aristophanes,  the 
practice  of  suffocating  a  fever-patient  in  a  hot  and  airless 
room,  and  denying  him  even  the  cup  of  cold  water  which  he 
craves,  *'  heroic "  treatment  generally,  lai^  doses,  the 
**  reducing ''  system,  together  with  many  other  absurdities 
against  which  Hahnemann  entered  his  honest  and  courageous 
protest  in  a  minority  of  one,  are  now,  happily,  things  of  the 
past ;  and  the  once  celebrated  treatises  which  extolled  them 
have  been  deservedly  relegated  in  vicum  vendentem  thus  et 
odores.  But  while  this  is  the  case,  the  wise  old  physician 
who  alone,  or  all  but  alone,  protested  against  these  modes 
of  procedure  more  than  three  quarters  of  a  century  ago,  in 
the  midst  of  obloquy,  derision,  and  neglect,  has  been 
studiously  ignored  by  the  very  men  who  have  obtruded  on 
the  world  his  discoveries  as  their  own,  and  who  may  be 
said  to  hold  their  fame,  wealth,  and  professorial  chairs  on 
the  all  but  expressed  condition  of  ignoring  or  vilifying  the 
genius  the  results  of  whose  labours  they  pirate.  The  pro- 
fessional forefathers  of  the  "  regular "  school  acquired  for 
themselves  an  unenviable  notoriety  by  abusing  Harvey  and 
Jenner,  and  some  still  living  took  part  in  the  disgraceful 
persecution  of  Dr.  EUiotson  by  the  authorities  of  a  college 
well  known  for  the  loudness  and  frequency  of  its  professions 
of  unlimited  toleration  ;  but,  to  do  the  ''  regulars  ''  of  the 


by  Dr.  W.  B.  A.  Scott.  57 

present  day  jastice^  it  must  be  acknowledged  that,  in  these 
instances^  they  are  now  doing  their  best  to  (metaphorically) 
build  the  sepulchres  of  the  prophets  whom  their  fathers 
blasphemed.  A  harder  fate  has  befallen  Hahnemann. 
While  his  doctrines  and  discoveries  have  been  shamelessly 
plagiarised^  being  in  most  cases  adopted  no  less  generally 
than  those  which  deservedly  rendered  the  names  of  Harvey 
and  Jenner  immortal^  his  fame  has  been  left  unvindicated 
save  by  his  professed  disciples ;  even  the  tardy  tribute  of 
posthumous  praise  has  been  denied  him,  and  his  conscien- 
tious followers  are  held  up  to  scorn  by  the  very  men  who 
disingenuously  practise  what  they  honestly  profess,  and 
labour  under  the  reproach  of  belonging  to  a  school  ab  initio 
condemned  by  the  '^  regulars/'  no  notice  being  taken  of 
the  very  essential  qualification  that  what  the  homoeopathic 
school  was  condemned  for  in  initio  is,  in  most  respects, 
precisely  what  the  "  advanced  regulars  '*  now  find  it  con- 
ducive to  the  gaining  of  university  chairs,  public  confidence 
and  remunerative  practice  loudly  to  proclaim  as  discoveries 
of  their  own.  We  propose,  therefore,  to  give  a  short  notice 
of  Hahnemann's  treatise  on  venereal  diseases,  an  able 
translation  of  which  by  Dr.  Dudgeon  may  be  found  in  that 
gentleman's  edition  of  Hahnemann's  Lesser  Writings. 

To  begin  with  the  preface.  There  is  little  to  notice  here 
beyond  Hahnemann's  liberal  acknowledgment  of  indebtedness 
wherever  such  was  due  (in  which  the  vast  extent  of  his 
reading  becomes  apparent)  the  modesty  which  leads  him  to 
compare  his  own  labours  not  to  ''  stone  blocks ''  in  the 
temple  of  science,  but  rather  to  *^  small  stones  to  fill  up 
intervening  spaces,"  and  to  disclaim  all  pretensions  to  high 
reputation ;  and  the  ingenuousness  with  which,  in  an  age 
and  country  fertile  in  occult  remedies  and  secret  modes  of 
cure,  he  details  every  step,  not  only  of  his  treatment,  but 
even  of  the  method  of  preparing  the  celebrated  '^  mercurius 
solubilis ''  which  still  goes  by  his  name  in  treatises  on 
chemistry.  It  may,  perhaps,  be  worth  while  to  remark  in 
passing  that  here  (p.  6)  and  elsewhere  he  uses  the  term 
''  white  precipitate ''  in  the  sense  of  a  mixture  ^f  calomel 
and  corrosive  sublimate,  not  in  that  of  the  amido-cbloride 


58    Hahnemann's  Instruction  respecting  Venereal  Diseases, 

of  mercary  which  is  its  present  acceptation.  The  directions 
he  here  gives  for  the  preparation  of  his  ^*  soluble  mercury/' 
though  minute  and  indicative  of  the  most  conscientious 
patience  and  care,  need  not  be  further  referred  to,  as 
they  were  subsequently  superseded  by  a  more  convenient 
method. 

N.B. — It  may  be  as  well  to  state,  for  the  benefit 
of  any  allopathist  who  may  condescend  to  read  these 
pages,  that  the  ''  mercurius  solubilis "  does  not  derive  its 
name  from  being  soluble  in  water  (which  it  is  not),  but 
from  its  free  solubility  in  many  organic  acids.  This 
explanation  may  appear  superfluous ;  but  Hahnemann  was  a 
good  deal  stronger  in  chemistry  than  most  of  his  opponents, 
and  the  same  may  without  either  vanity  or  the  profession 
of  anything  beyond  the  most  superficial  attainment  be  said 
of  many  of  his  successors. 

In  his  introduction  Hahnemann  more  than  once  gives 
some  occasion  of  triumph  to  his  adversaries,  as  he  expresses 
his  agreement  with  Hunter  in  some  doctrines  which 
subsequent  experience  has  shown  (we  think  conclusively)  to 
be  erroneous.  These  are,  (1)  that  the  virus  of  syphilis  and 
that  of  gonorrhoea  are  identical ;  (2)  that  the  sole  difierence 
between  syphilis  and  gonorrhoea  consists  in  this ;  viz.  that 
in  the  latter  the  virus  is  brought  in  contact  with  portions 
of  the  body  devoid  of  epidermis,  while  in  the  former  it  is 
inoculated  on  cutaneous  surfaces.  (Hahnemann's  own 
meaning  would  have  been  better  expressed  by  saying  that 
in  gonorrhoea,  which  he  regarded  as  a  purely  local  disease, 
the  virus  merely  acted  locally  on  a  sensitive  surface,  but 
that  in  syphilis  it  was  absorbed  into  the  system.  He  him- 
self maintains  that,  even  in  the  urethra,  gonorrhoeal  dis- 
charge may  convert  an  open  fissure  into  a  chancre  ;  (3) 
that  there  is  no  such  disease  as  congenital  syphilis,  properly 
so  called  y  and  that  neither  the  milk,  semen,  breath, 
perspiration,  nor  urine  of  a  syphilitic  patient  is  capable  of 
conveying  the  disease  either  in  its  primary  or  secondary 
form.  Now,  it  has  of  late  years  been  pretty  clearly  shown, 
(1)  that,  iif  spite  of  Pope's  well-known  line,  "  time  "  never 
has  **  matured  a  clap  to  pox ;"   (2)  that  pure   gonorrhoeal 


by  Dr.  W.  B.  A.  Scott.  59 

matter  taken  from  a  patient  not  labouring  under  coexisting 
syphilis  will  fwt  by  inoculation  produce  a  true  chancre  ;'  (3) 
that  a  primary  chancre  may  exist  on  a  mucous  as  well  as  on 
a  cutaneottft  surface  (e.  ff,  in  the  urethra,  and^  in  some  dis- 
graceful cases,  on  the  lips^  kc.),  the  failure  to  recognise 
which  may  have  occasioned   Hunter  to  imagine  he  was 
dealing  with  pure  gonorrhoeal  matter,  when  in  reality  the 
patient  from  whom  he  procured  it  had  been  simultaneously 
affected  with  a  urethral  chancre  ;  (4)  that  cases  of  true  con- 
genital syphilis  do  really  occur ;  that  is  to  say,  cases  where 
the  foetus  has  been  infected  in  utero  or  the  ovum  by  the 
aemen^  when  no  local  symptoms  (as  chancres)  were  present 
in  the  maternal  passages,  such  as  might  have  caused  inocu- 
lation to  take  place  during  parturition  ;  (5)  that  a  mother 
may  thus  be  infected  through  her  own   child ;  and   (6), 
though  this  is  less  certain,  that^  in  rare  cases,  syphilis  may 
possibly    be  communicated  to  an  infant  from  a  syphilitic 
wet-nurse.     Let  us,  therefore,  freely  concede  to  our  oppo- 
nents that   on  these   points  Hahnemann  was   not  better 
informed  than  Hunter,  but  shared  the  errors  of  the  most 
distinguished  pathologist  of  his  age,   whom  the  allopathic 
sectarians  (with  much  presumption)  claim  as  a  professional 
father.     It  appears,  in  fact,  that,  for  once,  the  founder  of 
homceopathy  was  not  materially  in  advance  of  the  highest 
authority  among  his    medical    confreres.     Our   opponents 
are  heartily  welcome  to  make  the  most  of  this  concession ; 
they  need  all  they  can  get. 

These  views  of  Hunter  which  Hahnemann  was  led  to 
adopt  were  the  cause  of  his  following  a  somewhat  unfortu- 
nate method  in  laying  out  the  plan  of  his  subject.  He 
divides  bis  treatise  into  two  parts ;  the  first  part  he  sub- 
divides into  two  classes,  and  each  class  again  into  two 
divisions  ;  the  second  part  is  distributed  into  five  divisions, 
or  sections.  In  the  first  part  he  treats,  in  the  first  class, 
of  '*  idiopathic  local  venereal  affections  on  secreting  surfaces 
of  the  body  destitute  of  epidermis;^'  of  this,  the  first 
division  deals  with  primary  gonorrhoea,  and  the  second 
division  with  its  sequelsa ;  in  the  second  class,  he  treats  of 
"  idiopathic  local  venereal  affections  on  parts  of  the  body 


60    Hahnemann's  Instruction  respecting  Venereal  Diseases, 

provided  with  epidermis ;''  the  first  divisioD  of  this  describes 
chancre,  and  the  second  division  gives  an  account  of  bubo. 
The  second  part  treats  wholly  of  the  diagoosis,  nature,  and 
treatment  of  syphilis, — ^understanding  by  this  term*  what  is 
now  called  constitutional  syphilis.     Now,  while  this  distri- 
bution of  the  subject    has  the  advantage  of   enabling   us 
more    readily   to  contrast  the  corresponding  stages  of  the 
two  chief  forms  of  lues  venerea^  we  have  admitted  above 
that  (in  our  opinion)  the  principle  on  which  the  classification 
was  founded   (viz.  Hunter's)  has  been  shown  to  be  erro- 
neous ;    to  which  must  be  added  that  it  labours  under  the 
serious  drawback  of  making  no  sufiSciently  well-marked  dis- 
tinction between  the  hard  and   soft  chancre,  terming  both 
alike,  as  also  gonorrhoea  "  local  venereal  affections.^'     It  is 
true  that    at    §  270    Hahnemann   says,    "  the    earlier  a 
chancre  breaks  out  after    infection  the  more  is  it  disposed 
to  inflammation  ;  the   later   it  appears,   the  more  readily 
will    the  blood  be  inoculated  by  the  poison   and  the  lues 
venerea  produced ;''  and  in  §§  266—268  he  recognises  the 
greater  tendency  to  sphacelus  observable  in  certain  chancres, 
but  he  seems  to   consider  this  latter  phenomenon  at  any 
rate  due  to  the  individual  diathesis  of  the  patient,  which  is 
doubtless  true  in  part,  but  probably  not  the  whole  truth. 
These  remarks  of  his,  however,  which  we  have  just  referred 
to,    may   serve  to   show    how,    even  when    misled    by    a 
specious  prevalent  theory,  Hahnemann's  singular  acuteness 
and  solid  judgment  did  not  often  sufler  him  to  be  drawn 
astray  in  matters  of  practice  or  observation. 

When,  leaving  the  formal  distribution  of  the  various 
parts  of  this  treatise,  we  examine  the  manner  in  which 
Hahnemann  has  handled  the  details  of  his  subject^  we 
shall  find  small  room  for  criticism,  at  any  rate  in  the 
matter  of  treatment,  and  sufficient  ground  for  surprise  and 
eulogy.  In  Hahnemann's  description  of  primary  gonorrhcea, 
§§  12 — 53,  we  have  the  stages  of  its  earlier  and  later  pro- 
gress vividly  and  accurately  detailed  ;  the  relation  between 
the  subjective  and  objective  symptoms  clearly  set  forth  ;  the 
concomitant  phenomena  (such  as  chordee  and  sympa- 
thetic bubo)  well  pointed  out ;  and  the  disastrous  sequelae^ 


by  Dr.  W.  -B.  A.  Scott,  61 

fistula  perinaei,  prostatitis^  balanitis^  orchitis,  spermatocele, 
and  so  forth,  not  merely  indicated,  but  correctly  referred  to 
their  most  frequent  causes^  viz.  improper  treatment,  in- 
temperance, coition,  over-heating,  chills,  &;c.,  Hahnemann 
also  points  out  that  the  inflammation  of  Cowper's  glands 
which  so  frequently  leads  to  fistula  perinsei  is  probably 
due  to  extension,  and  not  to  metastasis  of  the  original 
inflammation.  He  is,  perhaps,  wrong  in  denying  the 
occurrence  of  true  metastasis  in  some  cases  of  gonorrhoeal 
ophthalmia  (§  35  and  note),  and  he  missed  what  is  probably, 
after  all,  its  most  usual  cause,  owing  to  his  having  adopted 
the  theory  maintained  by  the  leading  pathologists  of  his 
own  day,  viz.  that  gonorrhoea  is  a  merely  local  disease. 
But  it  is  with  great  justice  that  he  goes  on  to  remark,  ''  there 
is  certainly  a  sympathy  known  to  exist  between  the  visual 
organs  and  the  genital  apparatus.'^  •  This  is,  well  exemplified 
by  the  myopia  and  dimness  of  sight  which  are  such  con- 
stant results  of  the  habit  of  masturbation ;  and  a  striking 
instance  of  sympathy  between  the  visual  and  urinary 
apparatus  is  presented  by  the  frequent  concurrence  of 
diabetes  and  cataract.  Possibly  the  coincidence  of  these 
phenomena  may  admit  of  some  explanation  on  the  theory  of 
polar  or  rather  bipolar  development  which  has  been  so  well 
illustrated  by  Professor  Laycock  {Mind  and  Brain,  vol.  ii). 
With  regard  to  treatment.  The  treatment  pursued  by 
Hahnemann  in  1789  was  as  nearly  as  possible  identical 
with  that  universally  adopted  in  1873.  After  remarking 
that  mild  cases  of  gonorrhoea  will  not  unfrequently  get 
well  spontaneously,  Hahnemann  orders  frequent  ablution 
of  the  penis ;  abstinence  from  spirituous  liquors,  spices^  and 
salt  meat ;  prescribes  a  mild,  chiefly  vegetable  diet  with  the 
free  use  of  cooling  and  diluent  drinks ;  and  directs  the 
following  anodyne  and  astringent  injection  to  be  used ; 
Plumb.  Acei.  gr.  iij  ;  Opii  pulv.  gr.  iij  ;  8p.  jEth.  Nit.  5ss ; 
Aq.  5]>  ^^^  bowels  meanwhile  (if  necessary)  being  kept  open 
by  means  of  clysters.  It  is  to  be  particularly  remembered 
that  this  simple  and  rational  treatment  was  here  proposed  not 
(as  one  would  at  first  imagine)  within  the  last  fifteen  or  twenty 
yearsi  but  at  a  time  when  the ''  regular  "  treatment  consisted 


62    Hahnemann's  Instruction  respecting  Venereal  Diseases^ 

in  ''  frequent  venesectionB  and  the  administration  of  large 
quantities  of  Mercury,  Scammony,  Nitre,  Agaric"  &c.,  and 
it  would  be  a  great  injustice  to  Hahnemann  if  we  were  to 
omit  to  mention  that  in  §  84  he  points  out  the  great  dangers 
attending  the  use  of  copaiba^  cubebs^  and  balsams  in 
general^  in  the  inflammatory  stage  of  gonorrhoea,  though 
(§  88)  he  admits  their  value  after  all  irritability  has  ceased 
— a  point  which  has  only  been  duly  adverted  to  by  the  bulk  of 
the  allopathic  sectarians  within  the  last  few  years.  Most 
of  us  can  remember  the  time  when  the  administration  of 
strong  injections  together  with  liberal  doses  of  copaiba  and 
cubebs  was  as  much  the  rule  in  the  ordinary  treatment  of 
gonorrhoea  as  the  administration  of  quinine  is  (and  with 
perfect  propriety)  the  rule  in  a  large  proportion  of  cases  of 
ague.  Hahnemann  also  condemns  in  terms  of  becoming 
reprobation  the  infernal^  doctrine  then  (and  it  is  to  be 
feared,  even  now)  believed  in  and  acted  on  by  some,  viz. 
that  a  patient  afiected  with  gonorrhosa  should  seek  his  cure 
by  means  of  having  connexion  with  a  pure  virgin,  a  detes- 
table counsel  which  probably  took  its  rise  from  the  fact  having 
been  observed  that  an  obstinate  gleet  is  at  times  cured  by 
an  act  of  coition. 

Some  may  think  that  Hahnemann  is  guilty  of  an  incon- 
sistency in  condemning  the  use  of  Mercury  in  the  treat- 
ment of  gODorrhosa  (§  67),  while  in  §  125  he  advises  local 
fumigations  of  Cinnabar  in  gonorrhoeal  ophthalmia,  but  we 
must  recollect  that  in  the  latter  case  he  is  speaking  of  what 
he  regards  as  a  mere  blennorrhoeic  ophthalmia,  a  purulent 
conjunctivitis,  consequent  indeed  upon  gonorrhoea,  but  not 
itself  of  a  venereal  character.  (See  §  35  and  note  iv.) 
Hence  the  topical  application  of  the  mineral  seems  to  be 
ordered  rather  for  the  sake  of  the  local  stimulation  it  pro- 
duces than  for  its  specific  action  as  an  antisyphilitic. 
Again^  ill  §  1^1  he  recommends  the  exhibition  of  a  few 
doses  of  soluble  Mercury  in  cases  of  orchitis  resulting  from 
a  suppressed  gonorrhoea!  discharge,  but  this  admits  of  a 
ready  explanation  either  on  the  supposition  that  he  orders 
it  simply  on  account  of  the  resolvent  and  discutient  action 
of  the  drug,  or  because  he  is  of  opinion  that  in  such  cases 


by  Dr.  W.  B.  A.  Scott.  63 

(as  in  those  of  severe  posthitis  referred  to^  §  126)  ''  the  dis- 
ease has  penetrated  deeper/'  and  developed  into  a  trae 
syphilitic  affection  (in  the  modern  sense  of  that  word) — a 
not  unlikely  occurrence  on  Hunter's  supposition  of  the 
identity  of  the  gonorrhoeal  and  syphilitic  virus,  and  such 
as  might  readily  happen  (on  that  hypothesis),  owing  to  the 
infection  of  an  open  fissure  in  the  urethra  by  gonorrhoeal 
matter  (cf.  §  191).  This  also  explains  his  recommendation 
of  soluble  Mercury  in  cases  of  obstinate  gonorrhoeal  gleet, 
where  he  directs  the  administration  to  be  continued  till  the 
mercurial  fever  (not  salivation)  is  clearly  set  up.  Such 
passages  as  these  also  clearly  demonstrate  that  while 
Hahnemann  himself  persists  in  calling  gonorrhoea  a  purely 
local  disease^  he  was  nevertheless  well  aware  that  consti« 
tutional  venereal  symptoms  might  in  some  cases  supervene, 
though  we  believe  him  to  have  been  mistaken  in  the  way 
he  explains  their  occurrence.  Although  misled  by  the 
doctrines  of  Hunter  as  to  theory^  we  can  see  that  his  own 
sagacity  kept  him  from  any  serious  error  in  the  more  im- 
portant departments  of  practice  and  diagnosis.  We  may 
now  pass  from  this  section  of  the  treatise^  merely  remarking 
that  his  classification  of  the  different  forms  of  gleet  is 
peculiarly  fortunate;  closely  resembling,  and  in  some  re- 
spects even  excelling  that  adopted  by  high  authorities  at  the 
present  day.  He  arranges  them  thus :  (1)  gleet  from 
irritability ;  (2)  from  local  or  general  weakness ;  (3)  from 
habit ;  (4)  from  urethral  ulcers ;  (5)  from  stricture  of  the 
urethra ;  and  he  displays  great  acuteness  in  the  direc- 
tions he  gives  for  the  diagnosis  and  treatment  of  each 
variety. 

We  have  already  expressed  our  opinion  that  in  the 
second  section  of  this  part  of  his  work  Hahnemann  does 
not  sufficiently  clearly  recognise  or  indicate  the  difference 
between  hard  and  soft  chancres ;  while  at  the  same  time 
we  showed  that  he  incidentally  pointed  out  some  of  the 
chief  distinguishing  features  of  these  two  varieties^  thus 
evincing  his  practical  recognition  of  the  distinction.  It  is 
worthy  of  remark,  that  from  the  description  he  gives  of 
chancre  (§  260)  he  seems  to  have  been  more  fiamiliar  with 


G4    Hahnemann  $  Instruction  respecting  Venereal  Diseases, 

the  Hunterian  than  with  the  soft  chancre,  an  experience 
directly  at  Tariance  with  that  of  sui^eons  of  the  present 
day,  at  least  in  Britain,  since  he  insists  strongly  on  the 
hardness  of  the  base  ;  and  this  may  perhaps  explain  his  so 
firmly  maintaining  that  all  chancres  (at  least  according  to 
his  own  observation)  are  followed  by  constitutional  infec- 
tion unless  treated  with  mercury.  As  we  before  dissented 
from  the  doctrine  of  the  identity  of  the  gonorrhoeal  and 
syphilitic  virus,  so  here  again  we  freely  acknowledge  our 
conviction  that  on  this  other  point  also  Hahnemann  was  in 
the  wrong.  Stilly  it  must  be  remembered  that  even  in  the 
present  day  many  allopathic  sectarian  surgeons^  and  some 
of  them  of  the  highest  eminence,  are  here  at  one  with 
Hahnemann ;  and  it  will,  perhaps,  long  remain  an  open 
question  whether  the  appearance  of  a  hard  or  a  soft  chancre 
does  not  depend  on  the  constitution  of  the  patient,  his 
personal  habits,  the  mode  of  treatment  to  which  he  has 
been  subjected  and  so  forth,  rather  than  on  any  specific 
difierence  in  the  nature  of  the  infecting  virus.  Hahne- 
mann's remarks  upon  the  modifications  in  the  appearance 
of  the  chancre  according  to  its  seat  and  rapidity  of  develop- 
ment (§§  258  and  261 — 264  and  270),  the  diathesis  of  the 
patient  (§§  265 — 267),  as  well  as  his  description  of  the  nor- 
mal course  it  runs  up  to  maturity  (§  260),  are  such  as 
might  well  find  a  place  in  any  treatise  on  the  same  subject 
written  at  the  present  day.  Like  Ricord  he  regards 
venereal  bubo  as  simply  a  chancre  occurring  in  a  lymphatic 
gland,  but  (in  our  opinion)  he  goes  too  far  when  he  says  that 
probably  not  a  single  case  ever  occurred  where  the  local 
treatment  of  chancre  did  not  give  rise  to  bubo.  Indeed  he 
qualifies  this  assertion  in  a  note  to  page  97,  where  he 
admits  that  ^'  Girtanner's  caustic  alkali  "  may  be  successfully 
used  locally — a  fact  which  he  seeks  to  explain,  however,  by 
suggesting  that  this  may  have  a  specific  anti-venereal 
power,  and  so  destroy  the  poison  at  its  seat.  And  it  is  also 
to  be  remembered  that  the  strongest  caustic  with  which  he 
was  familiar  for  this  purpose  seems  to  have  been  nitrate  of 
silver  (§  276),  and  of  this  substance  were  employed  in  all 
cases  to  cauterize  soft  chancres,  it  would  usually  be  found 


by  Dr.  W.  B.  A.  Scott.  66 

wholly  iaefficient  as  a  means  of  eradication,  while  the  local 
irritation  it  would    set  up  would    be  extremely  likely   to 
cause  the  appearance  of  sympathetic  buboes.     In  the  case 
of   genuine    Uunterian    chancre  it  would,    of   course^    be 
entirely  useless,  unless,  indeed,   we  are  to  believe  in  those 
extremely  rare   and    doubtful  cases  where  a  chancre  has 
been    professedly  destroyed  on  its  first  appearance  by  the 
abortive  treatment,  without  the  supervention   of  secondary 
symptoms.     To  this  Hahnemann  refers  with  hesitation  in 
§  277.     In  §  368  Hahnemann  admits  the  occasional  but 
very  rare  occurrence  of  that  vexed  subject  of  contention^ 
the  "  bubon  d'embl^e.^'     But  without  further  considering 
such  questions  on  this  head  as    are   rather    of  a   purely 
scientific  than  a  practical  interest,  let  us  proceed  to  com- 
pare Hahnemann's  treatment  with  that  common  in  his  own 
day  and  until  much  later  times,  and  we  shall  be  struck 
with  the    singular  sagacity  with    which    he    detected  the 
errors  of  the  system   then  prevalent    and    anticipated    so 
many  of  the  subsequent  modern  improvements. 

Yery  soon  after  the  appearance  of  syphilis  in  Europe^  in 
1483,  physicians  seem  to  have  discovered  that  they  possessed 
in  Mercury  a  specific  antidote  to  this  retributive  scourge. 
Accordingly,  this  medicine,  in  some  form  or  other^  seems  to 
have  entered^  more  or  less,  into  all  the  anti-venereal  nos- 
trums of  the  16th,  17th,  and  18th  centuries.  Then,  as  now, 
it  was  administered  in  three  ways :  by  the  mouth,  by 
inunction,  and  in  the  form  of  vapour.  But  so  uncertain 
was  the  strength  of  different  specimens  even  of  the  same 
preparation ;  so  widely  did  the  various  medicaments  differ 
from  one  another  in  respect  of  the  amount  of  the  mineral 
they  contained ;  so  liable  were  they  to  und^go  important 
changes  from  time  and  exposure  to  air;  and  lastly,  so 
little  was  the  real  action  or  the  true  therapeutic  value  of 
the  drug  understood,  that  perhaps  more  harm  than  good 
was  done  by  its  employment.  No  symptom  short  of  pro- 
fuse salivation  was  held  to  indicate  that  the  system  was 
really  under  the  influence  of  Mercury.  Not  aware  that  by 
pushing  the  use  of  the  drug  so  far  its  beneficial  action 
was  obstructed  if  not   wholly  lost,  those  preparations  were 

VOL,  XXXII,  NO,  CXXVII.— JANVAEY,  1874.  B 


66  Hahnemann^ $  Instruction  respecting  Venereal  Diseases^ 

the  most  highly  esteemed  which  were  found   to   saiirate 
most  certainly,  most '  rapidly,  and  most  severely.     In   time 
theories  came  to   be  formed  upon  the  subject,  and  much 
learned  folly  was  talked  about  elimin<nting  the  Tims  from 
the  system  by  means  of  copious  artificial  evacuations  sach 
as  this.     Having  persuaded  their  patients  (and,  we  trust, 
themselves)    that   after    sufficiently  long  and    sufficiently 
severe  salivation   (duly  accompanied,  of  course,  by  our  old 
friends  bloodletting,  emetics,  drastic  purgatives,  and  deple* 
tory   measures    in  general)    the     disease   was    assuredly 
worked  out  of  the  system,   physiciaus  readily  induced  the 
unhappy  sufferers  to  submit  to  this  treatment,  and  wisely 
took  the  preliminary  precaution  of  burning  off  the   tell- 
tale chancres  which  otherwise  would  have  remained  to  bear 
witness  to  the  continued  presence  of  the  patient's  disease 
and  the  futility  of  their  own  modes  of  practice.   Hahnemann, 
on  the  contrary,   considering  the  presence  or  spontaneous 
removal  of  the  chancre   a  valuable   diagnostic  mark  of  the 
continuance  or  departure  of  the  disease,  directs  that  no 
local  applications  whatever  (unless  for  the  sake  of  cleanli- 
ness) be  employed,  but  that  soluble  Mercury  be  given  by 
the  mouth,  in  larger  or  smaller  doses  as  might  be  necessary, 
until  a  distinct,  even  severe,  accession  of  mercurial  fever  set 
in,  and  by  this  means  he  found  that  in  a  few  weeks  nearly 
all  the  chancres  took  on  a  healthy  action,  and  healed  of 
themselves.     He  seldom  had  occasion  to  use  more  than 
twelve  grains  of  the  drug  during  the  whole  course  of  treat- 
ment, and  yet  the  disease  was  finally   eradicated  from  the 
system.     He  found  success  to  depend,  not  on  the  quantity 
of  Mercury  administered,  but  on  the  intensity  of  the  mer- 
curial fever  set  up.     He  deprecated  the  use  of  depletory 
measures,  and   directed  that  the  patient  should  be  put  on 
precisely  the  same  moderately  nutritious,  but  unstimulating 
diet  as  is  prescribed  now-a-days.     He  dwells  at  length  in 
the  second  part   on    the    importance  of  attending  to  the 
patient's    general  health    and    individual  diathesis    before 
giving  mercury  at  all,  and  the  relation  these  considerations 
bear  to  the  question  of  the  doses  in  which  the  drug  should 
be  fidpoimst^red.     He  speaks  pf  tjie  non-merguriHl  iinti* 


by  Dr.  W.  B.  A.  Scott.  67 

venereal  preparations  (§§  541 — 562)  in  the  very  terms  in 
which  they  are  spoken  of  by  the  chief  authorities  of  the 
present  day,  and  although  he  would  now  be  censured  by 
many  for  condemning  mercurial  inunction  in  toto,  he  is 
unquestionably  right  in  asserting  that  we  can  never  be 
sure  how  much  of  the  drug  really  enters  the  system  by 
this  method.  In  fact^  the  present  advocates  of  this  mode  of 
administering  Mercury  chiefly  employ  it  in  the  case  of 
infants,  when  it  is  often  difficult  to  administer  it  otherwise^ 
and  who,  strange  to  say,  seem  less  liable  to  ill  effects  from 
an  overdose  of  this  drug  than  adults.  He  directs  that 
buboes,  if  opened  at  all,  be  opened  by  means  of  Poiassafusa 
rather  than  by  the  knife;  a  point  insisted  upon  at  the 
present  day  by  Professor  Erichsen  in  all  cases  where  the  in- 
teguments are  much  thinned  or  undermined  {Science  and 
Art  of  Surgery^  4th  edition,  p.  580).  His  remarks  upon 
the  nature  and  treatment  of  the  ordinary  local  and  consti- 
tutional symptoms  occurring  during  the  progress  of  the 
disease,  or  as  sequelae  (§§  636 — 647),  might  be  transferred 
with  little  if  any  alteration  to  the  pages  of  a  treatise  on  a 
similar  subject  published  at  the  present  day.  Especially 
valuable  and  striking  are  his  remarks  upon  the  prevention 
of  the  disagreeable  effects  of  Mercury,  Part  II,  8rd  division, 
cap.  iii,  in  particular  §  600,  where  he  inculcates  the  frequent 
necessity  of  a  tonic  treatment,  and  this  at  a  time  when 
contemporary  practitioners,  with  the  Montpellier  school  at 
their  head,  sought  to  avert  untoward  consequences  by  means 
of  hot  baths,  starvation,  violent  purgatives  and  bloodletting. 

It  is  worthy  of  remark  that  in  ^  448  Hahnemann  admits 
the  occurrence  of  syphilitic  affections  of  the  lungs,  although 
even  in  much  later  times  the  possibility  of  syphilis  attacking 
the  internal  viscera  was  strenuously  opposed  even  by  Sir 
Astley  Cooper,  and  it  is  only  quite  recently  that  the 
syphilitic  origin  of  visceral  gummata,  &c.,  has  been  fully 
recognised.  Dr.  C.  B.  Ker,  in  an  able  article  on  syphilis 
{Brit.  Jour.  Horn.,  Ap.,  1878),  has  called  attention  to  this. 
We  must  also  add  that  the  infecting  character  of  venereal 
condylomata,  which  Hahnemann  maintained  in  opposition 
to  Hunter^  has  been  now  f^\r\y  established, 


fiS  Hahnemann's  Jnttrvctiop  restpeciin^  Venereal  Duemses, 

Our  task  is  done ;  we  hare  shown  that  in  this  tieatiae 
Hahnemann  plainly  appears  to  be  on  no  qoestion  of  patho- 
logy inferior  to  the  leading  pathologists  of  his  age ;  while 
on  some  points  (e.  g.  the  infectious  natore  of  Yenereal 
condylomata)  he  was  in  advance  of  Hnnter;  and  in  his 
assertion  of  the  venereal  source  of  some  pulmonary  affections 
he  was  in  advance  even  of  so  much  more  recent  an  authority 
a.H  Sir  Astley  Cooper.  We  have  shown  how  closely  his 
treatment  of  gonorrhoea  and  constitutional  syphilis^  as  well 
as  of  the  true  or  Hnnterian  chancre^  approximated  to  that 
of  the  roost  advanced  school  of  the  present  day.  The 
error^  if  it  is  an  error^  of  identifying  the  virus  of  syphilis 
with  that  of  gonorrhoea  he  shared  with  Hunter ;  and  the 
chief  points  in  his  practice  which  contrast  with  that  of  the 
present  ''  regulars  *'  are  (1)  the  universal  prohibition  of  the 
employment  of  caustics  in  cases  of  chancre;  and  (2)  the 
adoption  of  soluble  Mercury  in  preference  to  other  mercurial 
preparations.  With  regard  to  the  first  of  these,  few  now 
venture  to  cauterise  even  a  soft  chancre  without  the  simul- 
taneous internal  administration  of  Mercury,  thus  plainly 
admitting  the  great  risk  of  constitutional  infection  attendant 
on  this  mode  of  procedure ;  and  as  regards  the  second  point 
our  increased  knowledge  of  chemistry  has  no  doubt  enabled 
us  to  prepare  many  other  forms  of  the  drug  free  from  the 
impurities  which  led  Hahnemann  to  reject  them ;  but  it 
would  still  be  well  worth  the  time  and  trouble  of  any 
courageous  surgeon  attached  to  one  of  our  larger  hospitals 
to  give  a  trial  to  the  Merc,  aoL  He  need  not  run  any 
very  great  risk  if  he  takes  the  simple  precaution  of  pre- 
scribing  the  drug  under  some  other  name. 

We  should  have  liked  to  dwell  shortly  upon  Hahne- 
mann's remarks  on  '  the  mercurial  fever — the  first  of  the 
'*  drug-diseases  "  which  seems  to  have  attracted  his  notice — 
in  which  we  may  clearly  see  the  germ  of  the  system  which 
twenty-one  years  later  attained  such  a  splendid  development 

in  the  Organon.     The  words  "  the  mercurial  fever 

by  extinguishing  the  venereal  irritation  through  the  instru- 
mentality of  the  specific  irritation  excited/'  §  887^  acquire  a 
peculiar  interest  when  read  iu  the  light  of  Hahnemann's 


by  Dr.  fV.  B.  A.  Scott.  69 

subsequent  discoveries^  and  there  are  many  passages  scat- 
tered throughout  this  treatise  which  must^  to  the  homoeo- 
pathic reader^  clearly  enough  indicate  the  dawning  of  the 
universal  law  of  cure  upon  the  mind  of  his  great  master. 
But  we  have  already  encroached  too  far  upon  the  space  due 
to  the  more  valuable  communications  of  our  colleagues^  and 
must  now  draw  our  article  to  a  close. 

Before  concluding,  however,  we  must  express  our  hope 
that  none  of  our  remarks  upon  the  adoption  of  the  doctrines 
of  Hahnemann  into  the  *^  regular  '^  practice  will  be  misunder- 
stood. We  rejoice  even  at  their  unacknowledged  adoption, 
and  esteem  it  a  happy  thing  that  suffering  humanity  should 
now  enjoy  the  beneficial  results  of  our  founder's  discoveries^ 
even  though  they  should  ever  remain  in  ignorance  of  their 
benefactor,  who  has  long  since  passed  beyond  the  reach  of 
earthly  censure  or  applause.  So  long  as  the  true  doctrines 
are  received  and  acted  upon,  we  count  it  a  very  small 
matter  whether  their  votaries  are  ostensibly  followers  with 
us  or  not.  While  by  their  daily  practice  they  pay  the 
highest  of  all  possible  compliments  to  our  system,  we  can 
afford  to  smile  at  their  harmless  vituperation,  and  to  dis- 
regard the  favourite  witticism  of  some  among  their  number, 
that  *'  a  homoeopathist  must  be  either  a  knave  or  a  fool.'' 
We  have  no  wish  to  return  railing  for  railing,  and  we 
have  neither  the  skill  nor  the  inclination  to  rival  our 
opponents'  proficiency  in  the  objurgatory  dialect  of  the  stable- 
yard  and  the  fish-market.  Nor  is  it  our  desire  to  lay  to 
the  charge  of  the  bulk  of  the  dominant  party  the  ribaldry 
of  a  few  comparatively  obscure  provincial  practitioners,  or 
the  disingenuousness  of  some  deservedly  eminent  medical 
teachers.  We  gladly  believe  that  many,  especially  among 
the  junior  members  of  the  "  regular  "  school,  who,  with- 
out acknowledgment  of  indebtedness,  practise  our  system, 
do  so  in  pardonable  ignorance  of  its  true  discoverer,  as  all 
information  upon  this  head  was  studiously  withheld  from 
them  during  their  hospital  and  collegiate  course.  With 
all  such  it  is  our  wish  to  co-operate  in  perfect  cordiality, 
recognizing  no  spirit  of  emulation  or  rivalry  save  that  of 
which   shall  best  serve  the  interests  of  suffering  mankind. 


7(J  On  the  Pathogenesy  of  Aconite, 

With  those  alone  do  we  refuse  to  associate  who  knowingly 
parade  our  doctrines  as  discoveries  of  their  own,  and  for 
the  sake  of  money,  position,  or  fame  consent  to  vilify  or 
ignore  the  real  author.  Such  among  our  opponents  can 
expect  nothing  at  our  hands  save  indignant  exposure  and 
richly  merited  contempt. 


ON   THE   PATHOGENESY   OF   ACONITE,   WITH 

CLINICAL  OBSERVATIONS. 

By  J.  H.  Nankivell,  M.R.C.S.,  York. 

{Continued from  Vol.  XXXI,  p,  427.) 

Upper  Extremities.  ''Trembling  of  the  hands  and  arms  ; 
pains  in  the  arms  and  fingers;  numbness  and  lameness  of 
the  left  arm^  which  scarcely  permits  the  hand  to  stir.  The 
arms  hang  down  powerless  as  if  paralysed  by  blows.  The 
arms  feel  chilly  and  insensible/' 

Trembling,  numbness,  lameness,  as  if  paralysed;  these 
terms  seem  to  fall  naturally  into  one  category  and  mark 
the  depressing  power  of  the  drug  when  large  or  often 
repeated  small  doses  of  it  have  been  taken.  In  such  a 
state  of  things  the  muscles  lose  their  tone,  and  are  in  the 
first  stage  of  automatic  uncontrolled  action.  The  vaso- 
motor nerves  have  failed  to  keep  up  their  full  influence  on 
the  arteries  they  supply,  and  thus  in  a  morbid  circle  the 
nerves  themselves  cease  to  receive  that  quantum  of  blood 
which  is  required  for  the  exercise  of  normal  healthy 
functions  :  hence  we  arrive  at  a  stage  when  a  form  of 
ansesthesia  obtains  and  but  little  power  is  left  in  the 
aflfected  extremities.  The  "  clinical  observations  '^  of  Aconite 
do  not  afford  us  any  confirmation  of  the  above  signs  or 
symptoms,  but  doubtless  they  have  been  met  with  in  practice, 
and  been  combated  with  Aconite.  I  have  not  anv  case  in 
point  to  record  from  my  own  experience. 


hy  Mr.  J,  H,  NankivelL  7\ 

''Tearing  in  the  arms  from  the  shoulders  to  the  wrist- 
joints  and  the  fingers,  scarcely  even  felt  except  during 
movement,  with  blueness  of  the  hand  during  the  paroxysm 
of  pain.  Pain  as  if  contused  in  the  shoulder-joint  (also  the 
hip-joint)  after  sleep,  as  if  he  had  been  lying  on  too  hard  a 
conch ;  the  pain  is  felt  only  during  movement.  Pain  in  the 
shoulder,  it  feels  as  if  it  would  drop.  Swelling  of  the 
deltoid  muscle,  which*  when  touched  feels  painful  as  if 
bruised.  Stitches  in  the  shoulder  and  the  upper  arm 
(they  are  sometimes  drawing)/' 

In  the  first  sentence  we  have  a  remarkable  symptom,  viz. 
venous  engorgement  accompanying  acute  pain;  an  opinion 
of  Rau's  may  throw  some  light  upon  this  point :  he  main- 
tained that  Aconite  influenced  the  arterial  but  had  no  direct 
action  on  the  venous  system^  and  that  the  result  was  a 
stasis  in  this  portion  of  the  circulating  vessels  and  hence  a 
passive  engorgement  of  the  capillaries.  Aconite  seems  to 
elect  the  upper  extremity  for  some  of  its  most  marked 
effects  ;  thus  we  find  '^  Sense  of  contusion  of  shoulder-joint 
and  even  swelling  of  deltoid,^'  but  Bonninghausen  has 
recorded  ''  a  laming  pain  in  the  arms  and  bones  without 
swelling/'  The  symptoms  in  their  entirety  bear  a  close 
resemblance  to  those  of  chronic  rheumatism  as  affecting 
aged  people* 

*'  Drawing  pains  in  elbow^joints,  weight  and  debility  of  the 
forearms  as  far  as  the  fingers,  which  feel  as  if  gone  to  sleep 
when  taking  hold  of  anything.  Pain  in  the  forearm  as 
after  a  violent  blow.  Drawing  (with  sense  of  tearing  and 
sticking)  in  the  forearms  and  their  bones ;  movement  excites 
the  pains.  Feeling  of  lameness  in  the  right  forearm  and 
hand,  especially  when  writing,  going  off  by  moving  the 
part  strongly.'' 

It  has  been  before  remarked,  that  the  expression  ''  as  if 
gone  to  sleep "  or  "  numb  tingling  "  is  one  of  the  most 
characteristic  symptoms  of  Aconite,  and  the  expression 
'^  compare  with  Arnica  ^'  is  constantly  suggested  during  our 
study  by  such  phrases  as"  after  a  blow."  We  may  be 
pretty  sure  if  this  description  of  a  pain  by  a  patient  had 
led  us  into  the  routine  of  giving  Arnica  and  the  effect  if 


72  On  the  Pathogenesy  of  Aconite, 

any  had  disappointed  us  that  we  might  with  every  pro- 
priety give  Aconite. 

It  is  perhaps  worthy  of  notice  that  the  last  two  sen- 
tences are  antagonistic  in  one  of  their  conditions  as  to  the 
effect  of  movement;  in  the  first  pain  is  caused^  in  the 
other  it  is  allayed.  The  last  sentence  is  well  worth  bearing 
in  mind,  as  the  lameness  complained  of  is  by  no  means 
rare  amongst  persons  much  engag^  in  literary  composi- 
tion. 

"  Crampy  contractive  pain  in  the  hand  and  fingers^  some- 
times accompanied  with  stitches.  Tearing  and  paralysing 
drawing  in  the  wrists.  Numbness^  icy  coldness^  and  insen- 
sibility (deadness)  of  one  hand.  Cool  sweat  of  the  palms 
of  the  hands.  Swelling  of  the  hands^  with  frequent 
paroxysm  of  cough^  and  good  appetite.  Drawings  jerking 
pain  in  the  thumbs ;  pain  in  the  thumbs  as  if  sprained  and 
lame.  When  bending  the  fingers^  violent  stitches  dart 
through  the  wrist-joint  to  the  elbow-joint.  Tingling  pain 
in  the  fingers  even  while  writing.'' 

It  will  not  be  necessary  to  make  much  comment  on  this 
quotation  because  most  of  the  troubles  are  like  those  before 
glanced  at,  the  site  and  sphere  of  them  only  being  different. 
We  may  conclude  for  the  most  part  that  the  same  provers 
who  had  stitches  in  the  fingers^  tingling^  tearing,  fee.,  had 
also  like  affection  in  the  region  of  the  humerus.  **  Icy 
coldness  of  one  hand  ''  is  backed  by  '^  Icy  coldness  of  both 
hands"  in  the  Oest.  Zeitschrift,  but  Bonninghausen  in  the 
three  (only)  symptoms  he  records  respecting  the  upper 
extremity  has  *"  Hot  hands  with  cold  feet."  Were  it  not 
impious  and  disloyal  to  say  so  or  think  so,  the  sentence 
beginning  "  Swelling  of  the  hands ''  might  be  reckoned 
an  incongruous  one,  the  pathological  relations  being  not 
very  evident. 

(From  the  Oest.  Zeitschrift.) 

^'  Stinging  and  pricking  in  the  arms  and  fingers.  Jacti* 
tation  of  the  arms.  Shooting  stitches  in  the  left  shoulder. 
^Drawing,  tearing  pain  in  the  shoulder -Joint.  Violent 
drawing  and  tearing,  with  a  feeling  of  lameness  in  the  head 


by  Mr.  /.  H.  NankivelL  73 

of  the  left  humerus.  Lameness  and  stiffness  of  the  outer 
side  of  the  right  upper  arm.  Frequently  recurring  pinch- 
ing as  with  dull  pincers  in  some  parts  of  the  left  arm/^ 

It  is  highly  probable  that  the  stinging  and  stitching 
sensations  have  their  seat  in  minute  fibres  of  nerves^  not  in 
the  larger  trunks  and  main  branches^  and  for  the  most  part 
are  subcutaneous.  Jactitation  is  trembling  in  a  magnified 
degree.  The  sentences  describing  acute  pain  about  the 
shoulder-joint  seem  to  mark  deep-seated  lesion^  and  it  would 
appear  from  the  asterisk  and  italics  have  been  notably  cured 
by  Aconite.  With  regard  to  lameness  and  stiffness  of  the 
limb,  the  cases  which  most  commonly  have  been  treated  by 
me  with  these  features  have  been  those  of  pseudo-paralysis 
in  women^  about  the  age  of  fifty,  in  whom  the  catamenial 
periods  have  become  very  irregular  in  their  return  or  have 
ceased  altogether.  Aconite  and  Lachesis  help  this  form  of 
disease. 

*"  Drawing f  tearing  pain  in  the  elbow-joint.  Acute  pain 
in  the  right  forearm  along  the  tendon  of  the  flexor  digiti 
minimi,  increased  by  movement.  Drawingy  tearing  pain  in 
the  forearm.  Prickings  in  the  joints  of  the  forearm.  In- 
sensibility of  the  palms  of  the  hands.  Icy  coldness  of  the 
hands.  Drawing,  tearing  pain  in  the  wrist-joint  and  fingers. 
dot  pricking  in  the  tips  of  the  fingers  at  night.'^ 

With  the  exception  of  ordinary  rheumatic  pains,  espe- 
cially in  elderly  people  who  have  worked  hard  for  many 
years  whilst  exposed  to  cold  and  wet,  I  do  not  remember  many 
cases  of  disease  which  were  at  all  parallel  to  the  above. 
But  of  such  as  I  allude  to  a  few  might  be  described  were 
they  not  so  miserably  common.  The  effects  produced  have 
been  some  stiffness  and  immobility  of  the  shoulder-joint, 
likewise  of  the  elbow,  rarely  with  deformity.  But  in  the 
wrist  and  fingers  one  often  is  called  upon  to  prescribe  for 
tendons  glued  to  their  sheaths,  bursal  and  other  enlarge- 
ments, lamentable  distortion  in  the  joints  of  the  fingers 
which  have  become  twisted  hither  and  thither ;  and  un- 
happily the  pains  which  caused  or  accompanied  these  lesions 
have  not  ceased  when  the  laming  effect  has  been  produced. 
Neither  with  Aconite  nor  any  other  remedy  are  we  able,  iu 


f4i  On  the  Paihogentsy  of  Aconite, 

this  chronic  condition  of  things,  to  effect  anything  better  ihatl 
slight  palliation. 

It  boots  little  to  say  that  had  these  patients  been  at  an 
earlier  period  subjected  to  common  sense  or^  as  we  call  it, 
homoeopathic  treatment,  our  blessed  drug  Aconite  would 
have  helped  them  very  much. 

Lower  Limbs.  '^  After  sitting  the  thighs  and  legs  feel 
lame  and  weak.  Tensive  pressure  in  the  thighs  as  if  a 
tight  bandage  were  drawn  around  them,  with  great  weak- 
ness when  walking.  Weakness  in  the  region  of  the  head 
of  the  femur  and  inability  to  walk,  owing  to  an  indescrib- 
able intolerable  pain  as  if  the  head  of  the  femur  had  been 
crushed,  particularly  after  lying  down  and  sleeping.  Numb- 
ness and  lameness  in  the  left  thigh.'' 

The  two  first  sentences  of  the  above  quotation  are  not 
very  suggestive  of  clinical  comment,  the  tight-bandage 
sensation  being  one  of  rare  occurrence,  albeit  well  de- 
serving to  be  kept  in  mind.  For  the  rest,  although  the 
passages  do  not  point  clearly  and  unmistakeably  to  what 
we  understand  by  the  expression  hip-joint  disease,  I  shall 
take  this  opportunity  of  subjoining  a  few  remarks  on  that 
subject,  and  though  when  one  sees  in  every  town  of  any 
importance  strumous  children  in  whom  one  of  the  lower 
extremities  has  been  dislocated  at  the  hip-joint  by  the  slow 
process  of  scrofulous  inflammation  and  suppuration,  the 
question  naturally  arises,  Are  there  no  means  hitherto  dis- 
covered, in  allopathic  or  homoeopathic  modes  of  treatment, 
whereby  such  a  direful  calamity  might  be  more  frequently 
averted  than  it  hitherto  has  been?  And  there  is  also 
another  interesting  question  connected  with  it,  viz.  By 
what  strange  cause  does  it  befal  that  double  hip-joint  disease 
is  unknown  ?  It  might  have  been  reasonably  presupposed 
that,  when  one  joint  has  been  destroyed,  and  the  limb  of 
which  it  formed  a  part  has  become  suspended,  and  doomed 
to  be  a  mere  pendulous  crippled  extremity,  the  other  limb, 
having  to  bear  the  whole  weight  of  the  body  almost  con- 
stantly, and  at  a  great  disadvantage,  would  soon  become 
hors  de  combat  also.  For  whoever  has  noticed  a  case  of 
this  sort  with  single  crutch,  or  crutch  and  stick,  may  well 


in/  Mr.  J.  H.  Nankivetl.  76 

be  astonished  at  the  rapid  and  nimble  rate  at  which  the 
child  will  get  over  the  groand^  and  at  each  step^  if  so  it 
may  be  called  (for  the  motion  is  more  like  yaalting  with  a 
pole),  coming  down  to  the  ground  with  a  shock  and  jerk  of 
a  very  pronounced  kind. 

If  hip-joint  disease  were  always  treated  very  early 
and  according  to  reasonable  indications,  the  success  we 
should  meet  with  would  be  far  greater  than  it  ever  yet  has 
been.  As  an  illustration  of  what  I  mean  the  following  sad 
case  may  be  recorded : 

Many  years  since  a  poor  man  brought  to  me  his 
daughter,  set.  10,  and  stated  that  she  was  suffering  from  an 
inflammation  of  the  right  knee^  but  it  was  very  eyident  that 
there  was  disease  of  the  hip-joint  of  the  same  side.  I 
mentioned  the  nature  of  the  disease,  and  prescribed  for  the 
child^  and  requested  the  father  to  come  to  me  again  in  a 
week^  and  directed  that  the  limb  should  be  kept  in  a  state  of 
entire  rest.  I  saw  nothing  further  of  the  man  for  several 
months^  when  he  came  again,  bringing  the  little  girl  with 
him,  and  expressed  his  extreme  sorrow  that  he  should  have 
listened  to  other  advisers,  who  confirmed  him  in  his  first 
opinion^  that  the  knee  was  the  principal  part  affected,  if  not 
the  only  one;  there  had  been  suppuration  of  the  joint, 
and  the  child  was  lamed  for  life. 

Soon  after  this  event,  another  patient,  in  an  early  stage 
of  this  disease,  a  boy  of  nine  years,  came  under  treatment 
in  good  season^  and  the  parents  being  intelligent  and 
trustful,  the  disease  entirely  subsided  in  six  weeks.  Aconite 
and  Belladonna  being  administered  internally,  and  Bellas 
donna  lotion  assiduously  applied  to  the  joint. 

"  Unsteadiness  of  the  knees,  they  totter  and  give  way  in 
walking ;  tearing  of  the  knees,  as  with  a  jerk  in  the  inner 
side ;  drawing  in  the  right  leg,  and  the  region  of  the  tendo 
Achillis  extending  as  far  as  the  heel ;  the  legs  feel  heavy ; 
the  legs  and  feet  feel  numb,  and  go  to  sleep ;  pain  in  the 
tarsal  joints,  accompanied  with  despairing  thoughts  and 
the  dread  of  death.^' 

Bonninghausen  gives  ''  want  of  power  in  the  hip  and 
knee-joints.^'     The  first  condition  given  in  the  text  of  our 


76  On  the  Pathogencsy  of  Aconite, 

Materia  Medica  I  have  never  had  to  treat,  except  in  a 
man^  aet.  26,  who  had  suffered  some  degree  of  paralysis  of 
the  lower  extremities  when  a  child.  The  attack  was 
believed  to  be  doe  to  severe  convulsions  when  teething  was 
going  on  in  a  painfdl  manner ;  there  was  also  some  distor- 
tion of  the  ankle-joints.  The  poor  fellow  on  one  occasion 
slipped  and  fell,  at  the  same  time  the  extensor  muscles  of 
the  thigh  contracted  so  violently  that  both  ligaments  of 
the  patellse  snapped  asunder ;  nor  was  there  ever  after  any 
good  repair  of  these  structures.  The  man  was  sadly 
crippled,  and  could  only  walk  by  aid  of  crutches. 

The  other  symptoms  enumerated  are  met  with  commonly 
enough  in  practice,  with  the  exception  of  the  last,  in  which, 
strangely  enough,  there  is  found  extreme  mental  depres- 
sion, with  affection  of  the  tarsal  joints.  There  can  be 
little  doubt  that  this  combination  must  have  been  an  acci- 
dental one. 

''  Coldness  of  the  feet,  extending  as  far  as  the  malleoli^ 
with  sweat  of  the  toes  and  soles  of  the  feet.  Coldness  of  the 
feet,  particularly  the  toes.  Sensation  in  the  malleoli  as  if 
a  bandage  were  drawn  tightly  around  them  early  in  the 
morning.  Excessive  pain  in  the  malleolus,  diminished  by 
pressing  upon  the  part.'^ 

This  passage  scarcely  demands  any  remark.  The  dia- 
phoretic property  of  Aconite  is  felt,  no  doubt,  in  the  ex- 
tremities. It  would  seem  that  the  malleoli  are  especially 
subject  to  the  influence  of  our  drug.  The  pathogenesy 
does  not  suggest  to  my  mind  any  clinical  experience. 

(Prom  the  Oest.  Zeiischrift.) 

**  Trembling  of  the  lower  extremities.  The  lower  extre* 
mities  totter.  They  are  in  constant  motion.  Drawing 
pains  in  the  hip-joint  during  movement.  Drawing  pains 
in  the  lower  extremities ,  especially  in  the  joints.  Drawing 
in  the  aponeurosis  of  the  lower  extremities.  Drawing, 
tearing  pain  in  the  thigh.^'  Trembling  and  tottering  cor- 
respond with  and  confirm  the  original  observation  in  the 
Materia  Medica,  viz.  ''  unsteadiness  and  tottering  of  the 


by  Mr,  J.  H,  Nankivell,  77 

knees/'  For  this  want  of  power  in  the  lower  extremities 
it  is  highly  probable  that  Aconite  will  not  be  found  in 
practice  to  be  the  most  useful  remedy^  and  that  it  will 
require  the  help  of  others^  such  as  Arnica^  Belladonna, 
Laurocera9U8,  Secale  comuiumy  &c. 

Certainly  in  rickety,  badly-nourished  children,  and  in 
the  weakness  of  the  extremities,  as  old  age  approaches^ 
Aconite  would  be  a  bad  crutch  to  lean  upon  ;  but  doubtless 
there  are  other  conditions  resembling  the  above^  and  secon- 
dary or  consecutive  to  certain  morbid  states^  in  which  Aconite 
may  be  tried  with  good  effect;  and  the  sentence  which 
follows  in  the  text  will  afford  us  a  fair  example  of  such 
primary  affections  as  may  lead  to  or  be  accompanied  by 
marked  and  distressing  debility  in  the  lower  extremities. 
Such  pains  as  are  designated  drawing  or  tearing  may  at 
least  be  set  down  in  the  category  of  rheumatic.  Class  5th 
of  pains  gives  in  its  picture  fifteen  shades  or  varieties 
of  such  aches,  such  differentiation  marking  the  various 
sensations  complained  of.  My  conclusion  is  this  :  that  our 
drug  would  be  a  reliable  agent  in  the  primary  and  secondary 
states  of  rheumatic  or  arthritic  disorder. 

"  Soreness  of  the  thighs  when  touching  them.  Cold 
creeping  on  the  inner  side  of  lower  extremities,  and  dramng, 
tearing  pain  in  the  knee-joint.  Tension  in  the  patella^ 
hindering  walking.  Aching  pain  in  the  patella  and  tendo 
A  chillis ;  aching,  gnawing  pain  in  the  patella.  Stitches  in 
the  left  knee.  Icy  coldness  of  the  knees,  alternating  with 
shooting  stitches.^' 

The  first  sentence  describes  a  simile  of  a  very  common 
affection,  viz.  rheumatism  of  the  skin.  The  second  is. 
analogous  to  the  miserable  numbness  and  lameness  felt  on 
the  outer  side  of  the  extremity  in  the  first  onslaught  of 
'^  cold  sciatica,"  and  both  of  these  have  their  similes  also 
in  the  Aconite  working;  and,  briefly,  the  remaining 
sentences  have  their  disease-reflections  most  distinctly 
defined  in  different  stages  or  degrees  of  rheumatic  dis- 
tempers. 

''  Sensation  as  if  the  hamstrings  were  shorter  than  usual. 
Fain  in  the  calves  as  after  a  cramp.     The  feet  heavy  as 


78  On  the  Pathogenesy  of  Aconite. 

lead.  The  toes  of  the  right  foot  go  to  sleep  while  walking. 
Hot  pricking  in  the  toes  at  night/' 

These  pathogenesies  are  so  like  those  which  have  pre- 
ceded that  it  is  not  necessary  to  do  much  more  than 
record  them.  In  natural  disease  as  dispart  from  medicinal 
disease^  the  doubles  of  the  above  have  been  over  and  over 
again  noticed  by  every  physician  of  experience^  and  one 
would  have  thought  that  the  wonderful  correspondence 
which  may  be  noticed  between  drug  pathogenesies  in  gene- 
ral and  actual  diseases,  would  long  ere  this  have  convinced 
all  men  of  the  truth  of  our  law  of  similia  similibus. 

Looking  at  the  last  sentence  from  a  pathological  point 
of  view  we  may  read  amongst  other  things  congestions  of 
tendinous  sheaths  and  bursee,  and  perhaps  myalgy  from 
vascular  engorgements,  and  different  sensations  in  the 
feet  characterised  by  more  or  less  perversion  of  nervous 
power. 

That  Aconite  has  the  capacity  in  an  eminent  degree  of 
causing  ansesthesia  in  the  organism  has  been  amply  proved 
by  experiment^  and  that  it  would  antagonise  such  a  state  of 
things  when  caused  by  natural  disease  no  person^  no 
physician  who  has  escaped  from  the  trammels  of  prejudice, 
can  possibly  entertain  the  shadow  of  a  doubt. 

Sleep.  ^'He  feels  drowsy,  heavy  in  the  limbs,  even 
during  a  walk,  especially  in  the  afternoon  and  after  a  meal ; 
frequent  yawning  and  stretching  of  the  limbs.'' 

I  believe  that  this  drug  has  some  direct  influence 
in  procuring  sleep^  and  that  its  modits  operandi  renders 
it  infinitely  preferable  to  Opium,  but  it  is  to  be  re- 
membered that  its  soporific  effect  is  most  commonly  con- 
nected with  or  rather  is  the  result  of  its  bland  and 
blessed  operation  in  soothing  and  allaying  pains  originating 
from  an  inflammatory  cause.  The  action  of  this  drug  upon 
the  capillary  circulation  generally  is  something  marvellous, 
and  the  rapidity  with  which  it  takes  effect  is  not  less  so. 
The  local  effects  mentioned  in  the  text  are  all  in  keeping 
with  the  central  torpor,  and  the  passage  reads  as  if  the 
prover  was  under  the  full  influence  of  the  drug. 

It  is  not  Qut  of  plac9  h§re  to  remark  bow  invaluable  i^ 


Case  of  Colic  simulating  Painter^s  Colic,  79 

Aconite  in  all  cases  of  an  apoplectic .  character  in  which 
extreme  drowsiness  is  a  prominent  symptom ;  indeed  ia  the 
incipient  stages  of  such  a  grave  malady  Aconite  should  be 
trusted  to  in  preference  to  Opium.  If  there  is  marked 
somnolency  and  therewith  a  full  energetic  beat  of  the 
heart,  with  throbbing  of  the  carotid  and  temporal  arteries, 
then  indeed  we  may  place  the  greatest  reliance  in  the 
working  of  Aconite. 

(To  he  continued.) 


CASE  OP  COLIC  SIMULATING  PAINTER^S  COLIC, 
WITH  OPISTHOTONOS  AND  OTHER  CASES, 

By  Dr.  E.  C.  Holland. 

(Read  before  the  British  Homoeopathic  Society.) 

On  the  26th  of  Febrnary,  1862,  1  received  a  very  urgent 
telegram  from  Mr.  Reed,  requesting  me  to  come,  by  first 
train,  to  King's  Lynn  to  see  a  patient  in  consultation  with 
him.  On  arriving  at  Lynn,  Mr.  Reed  met  me  at  the 
station  and  detailed  to  me  the  particulars  of  the  patient's 
case,  which  were  dreadful  enough ;  but  very  far  short  of  the 
actual  condition  in  which  I  found  the  patient.  He  had 
been  ill  two  days^  sufi^ering  from  the  most  frightful  abdo- 
minal spasms.  The  abdomen  was  as  hard  as  a  stone,  not 
very  tympanitic,  but  the  recti  muscles  drawn  up  into 
knots,  nearly  as  large  as  my  fist.  There  had  been  no 
alvine  evacuation  for  two  days,  and  no  urine  had  been 
passed  for  eighteen  hours.  The  countenance  was  expres- 
sive of  the  greatest  anxiety,  and  the  face  and  forehead 
bedewed  with  a  cold  clammy  perspiration ;  pulse  very  feeble, 
but  not  particularly  quick.  When  the  spasms  came  on, 
which  was  about  every  three  minutes,  vomiting  of  a  blackish, 
grumous  Quid  took  place^  atten^e^  wi^h  deadly  faintness, 


80  Case  of  Colic  simulating  Painter^s  Colic, 

Sometimes  the  body  would  become  so  arched  backwards  as  to 
form  a  semicircle^  and  so  sadden  aud  violent  was  the  action 
as  almost  to  throw  him  from  his  bed.  The  patient  was  lying 
flat  on  his  back  with  extended  legs ;  and  pressure  with  the 
hand  flat  imparted  some  amount  of  relief,  but  this  was  very 
transient.  Mr.  Reed  has  been  most  unremitting  in  his 
attention  to  the  case^  and  had  adopted  every  means  that 
would  present  themselves  to  the  most  experienced  and 
judicious  physician.  Copious  enemata  had  been  used,  with 
the  effect  of  only  bringing  away  one  or  two  small  lumps^ 
which  were  very  hard  and  of  a  greyish  colour^  but  no  relief 
to  the  pain  followed.  Fomentations  had  been  applied^  but 
were  unavailing  in  imparting  any  degree  of  relief.  Aconite, 
Belladonna,  Nux,  Cocculus,  Colocynth,  and  Mercurvus 
corroaivus  and  Opium,  which  had  been  given  in  succession, 
were  equally  useless  so  far  as  diminishing  the  acuteness  of 
the  patient's  sufferings  were  concerned.  Never  did  I 
witness  snch  extreme  agony  in  any  case,  and  such  was  the 
horror  aud  distress  of  the  father  of  the  patient,  that  he 
begged  us  "  for  God's  sake "  to  relieve  his  son  by  any 
means^  even  "  if  it  put  him  out  of  the  world"  After  a  most 
scrutinising  inquiry  as  to  whether  he  might  have  drank 
cider  made  on  a  lead  press,  whether  there  had  been  any 
painting  going  on  on  the  premises,  or  whether  any  of  the 
water  pipes  were  corroded,  and  he  might  have  been  drink- 
ing water  impregnated  with  lead,  we  could  not  arrive  at  a 
satisfactory  solution  of  the  cause  of  this  exaggerated  state  of 
symptoms  so  closely  allied  to  lead  poisoning,  though  many 
symptoms  were  wanting  to  complete  the  picture.  In 
Devonshire  I  had  met  with  three  such  cases,  clearly  trace- 
able to  cider  impregnated  with  lead,  all  of  which  terminated 
fatally. 

It  was  exceedingly  difficult  to  form  a  correct  pathological 
diagnosis;  but  whatever  might  have  been  the  cause,  Mr. 
Reed  and  I  considered  it  very  desirable  in  the  first  place  to 
introduce  a  catheter  and  evacuate  the  bladder.  The 
catheter  was  used,  but  there  was  no  urine. 

Then  as  to  the  treatment.  It  was  of  no  use  to  go  over 
the  same  ground  which  Mr.  Reed  had  so  fully  carried  out^ 


by  br.  E.  C.  Hollarid.  8 1 

And  the  only  medicine  whose  symptoms  produced  an  ana- 
logue of  our  patient^s  case  appeared  to  me  to  be  Lead.  I 
happened  to  have  some  Acetate  of  Lead  3^  in  my  case^  and 
we  administered  a  dose  at  once  and  mixed  some  more  to  be 
taken  in  teaspoon  doses  every  ten  minutes  if  the  symptoms 
were  urgent.  At  the  same  time  I  explained  to  the  young 
man's  father  that  it  would  be  advisable  for  Mr.  Reed  to 
leave  the  house  and  not  see  the  patient  for  three  or  four 
hours^  as^  in  his  intense  anxiety  to  relieve  his  sufferings 
he  might  be  induced  to  fly  from  one  medicine  to  another, 
and  that,  consequently,  none  would  have  a  fair  trial.  It 
was  with  difficulty  that  I  could  get  Mr.  Reed  to  assent  to 
this  plan,  as  the  patient's  father  was  one  of  the  most 
influential  men  in  Lynn ;  and  the  allopathic  doctors,  with 
their  usual  generosity,  were  bruiting  all  over  the  town  that 
the  patient  was  allowed  to  die  without  anything  being 
done  for  him.  However,  I  prevailed  at  last,  and  just  as  I 
was  leaving  the  house  a  message  came  to  us  that  the  patient 
was  suffering  much  more  severely  than  he  had  done  at  all. 
We  determined,  notwithstanding,  to  continue  the  medi- 
cine, and  I  took  my  leave  and  returned  home,  dreading 
what  report  might  reach  me  in  the  morning  as  to  the  con- 
dition of  my  patient.  To  my  surprise  and  intense  delight, 
on  reaching  my  house,  I  found  a  telegram  in  these  words : 
"  Thank  God  !  my  son  has  had  no  pain  since  you  left ; 
particulars  by  post." 

It  appears  that,  after  the  exacerbation  of  suffering  soon 
after  taking  the  first  dose  of  the  medicine,  he  fell  asleep 
and  slept  for  many  hours.  On  waking,  the  bowels  were 
copiously  relieved  of  immense  quantities  of  the  same  scyba- 
lous formations ;  the  bladder  acted  well  and  on  the  fol- 
lowing day  he  left  his  bed*feeling  quite  well,  and  his 
recovery  of  strength  was  rapid.  I  have  never  been  able  to 
satisfy  my  mind  as  to  the  real  pathological  condition  that 
this  case  exhibited;  and  after  a  perusal  of  the  details 
which  I  have  given  (too  lengthy  I  fear)  I  must  leave  it  to 
some  wiser  heads  than  mine,  many  of  which  are  to  be 
found  amongst  the  members  of  the  British  Homoeopathic 
Society,  to  determine. 

VOL.  XXXII,  NO.  CXXVII. JANUARY,  1874.  F 


82  Ca$e  of  Colic  rimulaiing  Painter^s  Colic, 

That  it  was  not  peritonitis  or  enteritis  appears  to  me  to 
be  clearly  proved  by  the  toleration  of  pressure  and  the  pain 
being  lessened  by  it,  independent  of  the  paroxysmal  charac- 
ter of  the  pain  and  the  total  absence  of  fever.  That  it  was 
not  painter's  colic  may  be  inferred  firom  the  extinction  of 
all  the  symptoms  soon  after  the  first  spasm  following  the 
administration  of  Lead.  Nor  am  I  aware  that  scybala  in 
the  colon  wonld  give  rise  to  the  opisthotonos  and  suspen- 
sion of  the  secretion  of  urine.  But  whatever  the  nature  of 
the  disease  I  think  the  cure  may  be  undeniably  attributed 
to  the  Acetate  of  Lead,  confirmatory  of  the  niiom,  post  hoc^ 
ergo  propter  hoc. 

I  have  met  with  some  very  interesting  cases  of  disease  of 
the  bladder  which  have  been  entirely  cured  by  homoeo- 
pathic treatment,  though,  from  their  long  antecedent  dura- 
tion, they  proved  somewhat  intractable  and  a  long  course 
of  treatment  was  necessary.  I  will  trouble  the  Society 
with  two  only,  the  features  of  which  appeared  most 
uupromising  and  one  of  which  had  been  under  allopathic 
treatment  for  six  years,  and  was  considered  to  be  in  a  hope* 
less  state. 

The  patient  had  been  a  book-keeper  in  a  factory,  but 
was  obliged  to  relinquish  his  position  about  nine  months 
before  I  saw  him.  He  had  been  a  remarkably  robust  man, 
but  presented  a  most  pitiable  appearance  when  I  visited 
him  on  November  29th,  1863. 

He  had  lost  all  power  of  retaining  his  urine,  which  was 
continually  dribbling  from  him,  attended  with  the  most 
terrible  burning  of  the  urethra  and  an  incessant  expulsive 
effort  on  the  part  of  the  bladder.  About  every  quarter  of 
an  hour  he  voided  about  a  tablespoonful  of  urine  and  a 
muco-purulent  matter  generally  mixed  with  blood.  He  had 
constant  pain  in  the  region  of  the  bladder,  and  occasionally 
the  right  testis  would  be^forcibly  drawn  up  to  the  pubes, 
causing  agonising  pain  which  extended  throughout  the  penis. 
His  pulse  was  very  quick,  but  feeble.  He  had  a  parched, 
dry  tongue  and  constant  thirst.  Occasionally  he  was 
delirious.  I  think  I  never  saw  such  extreme  emaciation,  and 
altogether  his  condition   was   such   that  I  entertained   no 


by  t>r.  E.  C.  Holland.     *  83 

hope  of  bis  recovery.  I  directed  warm  fomentations  to  be 
applied  to  the  abdomen^  and  bis  diet  to  consist  of  good 
beef  tea  thickened  with  pearl  barley^  occasionally  to  take 
milk  and  potash  water^  but  no  stimulants,  and  the  penis 
was  to  rest  on  a  large  soft  sponge^  which  was  frequently  to 
be  washed  in  warm  water.  With  some  difficulty^  on 
account  of  the  pain  it  produced^  I  introduced  a  medium 
catheter  and  thoroughly  washed  out  the  bladder  with  warm 
water,  repeating  the  operation  night  and  morning.  After 
the  first  impression  of  pain  from  the  use  of  the  catheter, 
this  proceeding  afforded  the  greatest  possible  relief.  I 
prescribed  Arsen,  S^,  and  Cantharides  2^,  a  teaspoonful 
of  each  mixture,  about  half  a  drop  for  a  dose,  to  be  taken 
alternately  every  quarter  of  an  hour.  The  next  day  I 
found  him  somewhat  easier  and  he  had  passed  a  better 
night,  and  looked  less  anxious.  This  plan  was  adhered-  to 
till  the  morning  of  December  4th  with  gradual  amelioration 
of  the  symptoms  ;  the  strangury  was  considerably  relieved 
and  more  urine,  and  of  a  more  healthy  character,  was  dis- 
charged. From  this  date  the  bladder  was  injected  only 
once  a  day  and  the  same  medicine  continued  at  intervals 
of  two  hours.  The  appetite  being  somewhat  better,  a  little 
chicken  was  allowed  at  dinner,  and  the  beef  tea  every  three 
hours.  Matters  progressed  favorably  till  the  11th,  when 
a  copious  blenorrhosal  discharge  from  the  urethra  set  in 
and  the  ardor  urinse  greatly  increased.  Still  the  calls  to 
urinate  were  much  less  frequent  and  the  quality  of  the 
secretion  better  and  more  copious.  Cannabis  V  was 
substituted  for  Caniharides  with  manifest  relief,  and  the 
Arsenicum  was  _  discontinued.  The  general  condition  of 
the  patient  was  much  improved.  On  the  23rd  the  aspect 
of  affaira  was  much  more  promising,  the  discharge  had 
considerably  abated  and  the  patient  expressed  himself  as 
feeling  much  better  in  all  respects.  He  was  now  able  to 
take  a  mutton  chop,  and  I  allowed  him  a  little  sherry  and 
water,  which  was  to  be  discontinued  if  the  urinary  diffi* 
culties  increased. 

On  January  2nd,  1864,  the  patient  was  so  much  better  in 
all  respects  that  I  allowed  him   to  take  half  a  pint  of 


S4  Case  of  Colic  simulating  Painler^s  Colic, 

porter  at  dinner^  which  in  a  few  days  materially  improved 
his  strength.  He  had  now  an  excellent  pulse^  the 
countenance  had  lost  all  its  hippocratic  expression,  and  he 
had  occasion  to  pass  water  only  once  in  three  hours,  and 
every  trace  of  mucus  had  disappeared  under  the  use  of 
Thuja  and  Sulphur  for  the  next  two  months.  He  became 
convalescent  and  was  removed  to  the  seaside  the  latter  part 
of  March,  where  he  rapidly  gained  flesh  and  strength. 

On  the  14th  of  May  I  received  a  letter  from  him  in 
which  he  says,  '^  /  can  now  make  water  as  well  as  any 
man  and  think  I  must  have  gained  more  than  a  stone  and 
a  half  in  weight.  If  you  have  no  objection,  I  shall  return 
to  my  office  next  month.'^  I  have  seen  the  patient  frequently 
since,  and  should  not  have  recognised  him  as  the  same 
person. 

•The  next  case  that  I  describe  was  one  of  chronic  in- 
flammation of  the  mucous  membrane  of  the  bladder, 
occurring  in  an  Independent  minister.  The  patient  was 
at  a  hydropathic  establishment,  and  I  was  telegraphed  for 
to  see  him  on  November  3rd,  1871.  I  found  him  sufiering 
most  acutely  from  retention  of  urine,  and  was  told  that, 
on  the  previous  day,  a  medical  man  in  the  neighbourhood 
had  been  sent  for,  but  could  not  succeed  in  passing  a 
catheter.  Soon  afterwards  a  hospital  surgeon  was  tele- 
graphed for,  and  he  succeeded,  though  not  without  great 
difficulty,  in  introducing  one. 

The  patient  was  67  years  of  age,  and  had  suffered,  more 
or  less,  for  years  from  difficulty  in  passing  water.  His 
present  symptoms  were  constant  but  ineffectual  efforts  to 
urinate,  only  a  few  drops  passing  at  a  time,  and  followed 
by  a  quantity  of  acrid  bloody  mucus,  which  caused  him  to 
scream  from  the  intensity  of  the  pain  it  occasioned.  He 
was  sadly  reduced  in  flesh  and  strength;  tongue  dry; 
pulse  feeble,  but  not  much  accelerated ;  sallow  complexion ; 
great  pain  on  pressure  over  the  pubes,  and  violent  pain  in 
the  glans  penis.  Evacuations  from  the  bowels  quite 
flattened,  and  a  vast  amount  of  pain  in  the  anus  and  peri- 
neum on  passing  fseces.  On  examination  per  rectum  I 
found  the  prostate  gland  enormously  enlarged,   and    ex- 


by  Dr.  E.  C.  Holland.  85 

quisitely  tender,  presenting  to  the  finger  the  feeling  of  a 
large  accumulation  of  matter  being  there.  I  ordered 
fomentation,  vhich  had  been  freely  used  previously,  and 
injected  the  bladder  with  warm  water.  Gave  Cannabis 
every  two  hours. 

On  the  7th  the  symptoms  were  unchanged,  exceptiug 
that  more  blood  was  passed,  and  the  desire  to  pass  water 
every  half  hour.  Terebinihina  V  was  ordered  every  hour, 
to  drink  freely  of  barley  water,  or  potass  water  and  milk. 

14th. — Pain  very  severe;  micturition  more  frequent; 
more  mucus  and  less  blood.      Copaiba  1^  every  hour. 

22nd. — No  improvement,  and  thinking  it  desirable  to 
see  him  every  day,  I  desired  that  he  should  be  removed  to 
Sath,  which  was  accordingly  done.  He  bore  the  railway 
journey  better  than  I  could  have  expected,  but  his  suffer- 
ings were  very  great.  In  succession  I  gave  him  Cantharis, 
Pulsatilla^  Berberis,  and  Thuja,  but  with  very  little  relief  to 
his  symptoms,  which  continued  of  the  same  severe  cha- 
racter till  February  6th,  1872,  when  I  prescribed  Chima" 
phila  1%  to  be  taken  in  drop  doses  every  hour. 

On  the  18th  there  was  no  improvement,  and  I  then 
gSkvefive  drops  of  the  pure  tincture  every  two  hours.  The 
effect  was  marvellous ;  his  bladder  began  to  act  well ;  the 
urine  quite  healthy ;  no  trace  of  mucus,  and  he  rapidly 
regained  his  usual  health.  He  writes  to  me  from  Hert- 
fordshire to  say  that  he  is  quite  well,  and  able  to  preach 
every  Sunday ;  sometimes  twice  in  the  day. 

I  will  now  describe  two  'cases  of  chronic  dyspepsia 
occurring  in  clergymen,  which  illustrate  the  great  value  of 
Argentum  nitricum,  where  the  brain  and  nervous  centres 
are  sympathetically  affected. 

The  first  is  that  of  an  old  and  venerable  clergyman 
residing  in  Norfolk,  and  whom  I  have  lately  seen  in  the 
enjoyment  of  excellent  health.  For  several  years  he  had 
been  in  declining  health,  and  at  his  age  (78)  despaired 
of  getting  better,  particularly  as  many  medical  men,  whom 
he  had  consulted  in  London  and  the  provinces,  assured 
him  that  his  heart  was  so  seriously  affected  that  it  was 
only  a  question  of  time  bow  long  he  might  live.     He  had 


86  Case  of  Colic  simulating  Painier^s  Colic, 

always  been  very  much  opposed  to  homoeopatby,  but  by 
the  advice   of  his  frieuds,  who  were  desirous  that  nothing 
should  be  left    untried^  he  was  induced  to  consult  me  on 
August  8th,  1868.      I  found  him  exceedingly  depressed  in 
spirits,  having  had  a  consultation  of  three  medical  men  on 
his  case  that  morning,  all   of  whom  had  given  the  .same 
adverse   prognosis.       His  general    aspect    would   indicate 
serious  organic  mischief.       His  pulse   was  very  fluttering 
and   extremely  intermittent,  averaging   about   140  beats  in 
the  minute.     The  tongue  was  loaded  with  a  brown  fur,  and 
very  dry.     He  had  constant   eructations   of  a  foetid  cha- 
racter ;  great  dryness  of  the  throat,  and  a  feeling  of  suffo- 
cation,   chiefly    at    night,    when    reclining;    total    loss    of 
appetite  and  extreme  nausea,  with  feeling  of  anxiety,  and 
trembling  in  the  epigastrium,  sometimes  acute  pain  in  that 
region.     The  bowels  very  variable,  though    generally  re- 
laxed, and  a  great  amount  of  mucus  in  the  evacuations. 
Some  di£Sculty  in  urinating,  sometimes  with  a  sharp  pain, 
extending  to  the  anus ;  occasional  cough,  particularly  after 
a  meal,   and   most  violent  palpitation   of  the   heart,  with 
dyspnoea.     I  could  not  detect  that  there  was  any  disease 
of  the  heart,  but  imagined  it  to  be  afiectcd  sympathetically 
with  a  very  disturbed  state  of  the  digestive  organs.     He 
had  taken  Ntuv,  prescribed  by  one  of  the  doctors  he  had 
consulted.     I  ordered  Argent.  7iit.  3^,  in  drop  doses,  three 
times  a  day  for  a  week. 

On  the  15th  of  August  he  came  to  me  again,  and  was 
wonderfully  better ;  and  on  the  29th  all  his  bad  symptoms 
were  gone,  together  with  the  cardiac  irritation,  and  he 
considered  himself  quite  well.  From  that  time  to  this  he 
has  enjoyed  excellent  health. 

The  other  case  to  which  I  have  referred  was  a  Dorset- 
shire clergyman,  who  consulted  me  in  March,  1872.  He 
had  been  ill  nearly  three  years,  and  had  given  up  all 
clerical  duty  for  upwards  of  two  years.  Being  a  cousin  of 
a  former  president  of  the  London  College  of  Physicians, 
under  whose  care  he  had  been  from  the  commencement  of 
his  illness,  and  who  had  given  a  most  unfavorable  prognosis 
of  his  case,  he  was  not  very  sanguine  that   any  system  of 


by  Dr.  E.  C.  Holland.  87 

treatment  would  be  attended  with  more  than  temporary 
relief.  He  was  40  years  of  age^  and  had  for  many  years 
been  the  subject  of  biliary  derangement.  I  found  him 
exceedingly  depressed  in  spirits;  his  complexion  very 
sallow ;  tongue  greatly  loaded  ;  constant  eructation ;  great 
sensitiveness  on  pressure  over  the  liver  and  stomach; 
bowels  very  constipated ;  violent  palpitation^  and  extreme 
irregularity  of  the  heart's  action ;  constant  desire  to  sigh, 
to  relieve  the  feeling  of  oppression  of  the  right  side; 
appetite  entirely  gone.  I  prescribed  six  doses  of  Bryonia 
2%  a  drop  night  and  mornings  and  then  Argent,  nit.  8^  one 
drop  three  times  a  day,  and  requested  him  to  come  again 
in  three  weeks. 

On  the  8th  of  April  I  received  a  most  satisfactory  letter 
in  which  he  says,  ^'  It  gives  me  great  pleasure  to  inform 
yon  that  since  T  began  your  treatment  a  most  marked 
improvement  has  taken  place  iu  my  general  condition,  aud 
I  have  not  felt  so  well  for  many  years.'' 

My  patient  attended  the  May  meetings  in  London  the 
following  month,  and  every  one  who  knew  him  congratu- 
lated him  on  his  energy,  and  the  visible  improvement  in 
his  health.  His  cousin — the  ex -president  of  the  College 
of  Physicians — was  amazed  at  his  improvement,  and,  patting 
him  on  the  back,  said,  "  You  did  quite  right  to  try  homceo- 
pathy,  as  our  system  had  failed  ;  those  gentlemen  have 
opened  our  eyes  to  many  important  matters  in  the  treat- 
ment of  disease." 


Discussion  on  Dr.  E.  C.  Holland^ s  paper. 


Dr.  Edwabd  Blakb,  whilst  thanking  Dr.  Holland  for  a  capital 
paper,  could  not  quite  comprehend  the  recti  ahdominales  being 
spasmodically  contracted  in  opiBthotonos ;  was  it  not  a  case  of 
emprosthotonos  ?  Dr.  Blake  nad  seen  opisthotonos  result  from 
the  passage  of  renal  calculus.  The  bladder  case,  No.  1,  seemed 
to  him  an  instance  of  gonorrhoea  repressed  by  the  treatment,  or 
by  mistimed,  active,  astringent  injections.  In  support  of  this 
view  he  drew  the  attention  of  the  meeting  to  the  significant  fact 


88  Case  of  Colic  simulating  Painter  s  Colic, 

of  improyement  setting  in  after  the  reproduction  of  the  discharge. 
Such  remedies  as  Atropine,  Colocynth,  Hamamelis  and  Thuja,  aided 
by  the  use  of  the  hot  hip  bath,  would  have  occurred  to  his  mind. 
In  connection  with  the  prostate  case,  Dr.  Blake  would  mention 
that  in  the  instance  of  a  certain  aged  dignitary  in  the  Church, 
who  suffered  sadly  from  an  enlarged  and  irritable  prostate,  he 
had  afforded  great  relief  by  Niue  3'  internally  combined  with  the 
use  of  cacoa-butter  suppositories  containing  i  gr.  of  Strychnia. 
When  the  symptoms  of  irritation  had  passed  away  a  long  course 
of  Baryta  carhonica  was  prescribed.     This  drug  exerts  a  specific 
influence  on  the  hypertrophied  prostate  with  the  advantage  of 
toning  the  degenerated  cardiac  wall  so  commonly  complicating 
these  cases.     Dr.  Blake  thought  Argentum  an  admirable  remedy 
most  undeservedly  neglected.     Bemedies  are  useful  in  proportion 
to  the  sharpness  of  the  lines  which  bound  their  action.    The 
peculiar  value  of  silver  and  its  salts  lies  in  the  fact  that  their 
sphere  of  operation  is  so  well  defined.     Dr.  Clotar  MiiUer  has 
said  that  the  heart  and  stomach  are  the  chief  ^otn^^  d*aitaqu€  of 
Argentum.    If  to  these  be  added  the  spinal  cord  his  generalisa- 
tion may  be  freely  endorsed.    Dr.  Blake  had  to  thank  his  friend 
Mr.  Clifton,  of  fforthampton,  for  drawing  his  attention  to  the 
value  of  this  drug  in  certain  forms  of  headache.     Mr.  Cliflton 
employed  it  with  success  in  the  frontal  headache  of  business  men. 
Dr.  Blake  had  found  it  of  good  service  in  the  headaches  and 
dyspepsia  which  are  induced  by  mental  agitation,  nursing  the 
sick,  &c.     He  had  found  it  of  value,  too,  in  the  after  effects  of 
sunstroke.      Graves,  of  Dublin,  who  struck  empirically  on  so 
many  pieces  of  pure  homoeopathy,  was  in  the  habit  of  adminis- 
tering \  gr.  of  tne  Nitrate  every  two  or  three  hours  for  conges- 
tive hysterical  headache.     He  adds, "  I  have  found  it  invaluable 
not  only  in  the  headaches  of  hysterical  young  women  but  in 
those  of  men,  particularly  the  habitual  stomach  headache,  to 
which  delicate  and  literary  men  are  so  subject."     Dr.  Blake  did 
not  think    that    these    were    true  "stomach  headaches,"  but 
instances  of  cerebral  dyspepsia.    The  headache  of  Argentum  is 
dull,  pressive,  persistent,  and  it  encircles  the  calvarium  like  a 
wreath.     The  tongue  has  a  silvery  coating  more]  dense  than  the 
transparent  white  of  Arsenic,  not  as  cream-like  as  that  of  Tartar 
emetic. 

Dr.  Abthub  Clifton,  in  the  case  of  abscess  of  prostate,  has 
seen  Baryta  given  by  Dr.  Sharp  with  great  success. 

Dr.  Wtld  said  the  first  of  Dr.  Holmnd's  cases  seems  to  him  to 
have  been  one  of  spasm  from  hard  scybala  and  from  incarcerated 
flatus,  or  possibly  of  intussusception.  Acetate  of  Lead  under  any 
of  these  circumstances  was  an  excellent  medicine  to  select. 

Mr.  Ekgall  said  that  amongst  the  medicines  which  he  had 
found  most  useful  was  one  which  was  not  mentioned  in  the 
remedies  employed  in  the  cases  of  inflammation  of  the  bladder 
narrated,  and  this  was  Liquor  potasses.    The  first  case  in  which 


by  Dr.  E,  C.  Holland.  89 

he  tried  it  waa  that  of  a  ladj,  and  was  a^roost  intense  one ;  pus 
as  indicated  by  the  microscope  was  secreted  in  great  abundance, 
and  such  was  the  irritable  state  of  the  bladder  that  the  patient 
was  constantly  trying  to  urinate.  In  this  case,  finding  his  own 
efforts  unayailing,  he  consulted  Dr.  £idd,  who  passed  a  catheter, 
as  stone  was  feared  to  exist.  This  was  not  found  to  be  the  case, 
and,  therefore,  he  advised  an  increase  of  the  Cantharis,  This 
resulted  in  blood  being  mixed  with  the  pus,  so  this  was  dis- 
continued and  other  medicines  and  means  used,  but  these  failing 
he  tried  the  Liquor  potassa  in  five-drop  doses.  In  a  .short  time 
improyement  took  place,  and  she  made  an  excellent  recovery,  and 
has  continued  well  ever  since.  In  another  case,  when  our  usual 
remedies  had  failed,  the  Liquor  potassa  was  of  the  greatest  use, 
although  in  this  case  it  was  not  until  the  dose  had  been  consider- 
ably increased  to  ten  or  fifteen  drops  that  the  beneficial  action  of 
the  medicine  took  place.  At  the  present  time  a  patient  who  had 
been  under  various  treatments  for  an  irritation  at  the  orifice  of 
the  urethra  (for  which  he  had  been  sounded,  fearing  stone  in  the 
bladder)  reports  himself  as  much  better.  Another  case  he  might 
mention  of  practical  importance.  This  was  one  of  tenesmus  of 
the  bladder  in  which  the  ordinary  means  failed,  but  the  patient  at 
last  took  a  dose  of  Castor  oil,  and  after  the  passage  of  a  large 
quantiW  of  fseces  the  tenesmus  ceased. 

Dr.  Bates  said  that  it  was  always  a  great  disadvantage  to  be 
obliged  to  discuss  a  paper  in  the  absence  of  the  writer,  since  there 
are  many  points  which  the  writer  alone  can  elucidate.  He, 
however,  knew  some  of  the  particulars  of  two  of  the  cases  related, 
having  heard  them  related  oy  Dr.  Holland  more  than  once,  and 
having  also  heard  Dr.  Beed,  of  Lynn,  mention  the  first  case.  The 
case  was  one  of  either  colic  or  of  intussusception,  and  it  is  very 
possible,  from  the  sudden  relief  experienced  after  a  terrible 
accession  of  -pain,  that  Dr.  Hamilton  may  be  right  in  suggesting 
that  the  relief  experienced  was  from  the  sudden  yielding  of  the 
obstruction,  but  that  relief  followed  so  shortly  after  the  administra- 
tion of  the  Plumbum  that  we  may  fairly  infer  that  the  Flumhum 
had  a  decided  influence  in  obviating  the  spasm.  The  patient  was  a 
young  man  who  had  certainly  suffered  for  many  hours  before 
Dr.  Holland  was  summoned,  and  many  more  hours  must  have 
elapsed  before  he  could  reach  the  patient ;  many  medicines  and  all 
the  usual  adjunctive  means  had  been  used  by  a  skilful  practitioner 
before  Dr.  Holland's  arrival,  but  no  good  result  appeared  until  the 
administration  of  the  Flumhum,  Dr.  Holland's  remarks  as  to 
the  desirability  of  avoiding  too  active  anxiety  for  the  instantaneous 
action  of  remedies  and  the  consequent  too  frequent  change  of 
medicines  in  the  face  of  acute  disease  are  well  worth  attention. 
Time  is  an  element  in  the  cure  of  all  disease,  and  the  rapid 
changing  from  one  medicine  to  another  often  frustrates  all  cura- 
tive intention.  Dr.  Bayes  had  also  seen  the  old  clergyman  whose 
case  was  detailed  by  Dr.  Holland,    His  heart  had  been  sympathe- 


90  Note$  on  Re'Vaccinaiion, 

ticallj  disturbed  in  ita  action  bj  stomach  difficolties.  AUopatiiic 
diagnosis  had  been  at  fault,  and  Dr.  Holland's  more  aceunte 
diagnosis  had  enabled  him  to  cure  a  disease  readilj  which  had 
been  wrongly  pronounced  incurable. 


NOTES  ON  KE. VACCINATION. 
By  Charles  H.  Blacklet^  M.R.C.S.  Eng. 

(Bead  before  the  British  Homceopathie  Society.) 

In  the  years  1864  and  1865^  in  consequence '  of  the 
presence  of  smallpox  in  the  neighbonrhood  of  Manchester, 
I  had  occasion  to  re-vaccinate  a  number  of  children  and 
adults;  and  again  in  the  epidemic  of  1871  a  much  larger 
number  were  re-vaccinated  by  me.  In  the  first  period 
from  60  to  80  patients  passed  through  my  hands^  and 
in  the  latter  period  from  250  to  300.  These  varied  in 
age  from  six  years  up  to  eighty,  and  were,  as  a  matter  of 
course,  in  different  conditions  of  health  and  of  very  varied 
constitutions. 

In  ordinary  vaccinations  I  had  often  noticed  a  marked 
difference  in  the  action  of  lymph  of  the  same  kind  and 
quantity,  and  it  occurred  to  me  that  it  might  be  useful  to 
ascertain  the  cause  of  the  different  amount  of  irritation 
produced  in  different  cases.  It  seemed  to  me  quite  pos- 
sible for  this  to  be  due  either  to  an  extra  degree  of  suscepti- 
bitity,  to  the  extent  of  surface  laid  bare,  to  the  quantity 
of  lymph  applied,  or  to  all  of  these  combined. 

In  private  practice  the  number  operated  upon  at  one 
time  is  rarely  large  enough  to  enable  us  to  make  experi- 
mental observations  from  which  we  can  draw  trustworthy 
conclusions;  and  indeed  in  the  present  state  of  opinion 
upon  the  subject  of  vaccination  anything  which  has  the 
appearance  of  pure  experiment  on  children  would  in  most 
instances  be  strenuously  objected  to,  however  harmless  it 
might  be.  A  good  opportunity,  however,  for  making 
observations  upon  re-vaccinated  patients  did  occur  in  1864 


by  Mr.  Charles  H.  Blackley.  91 

and  1865^  and  although  at  the  time  these  were  commenced 
I  had  no  expectation  of  being  able  to  make  other  observa- 
tions by  way  of  comparison^  if  such  an  opportunity  did 
occur,  it  seemed  to  me  quite  possible  to  determine  whether 
the  degree  of  susceptibility  varied  in  different  years  in  the 
subjects  re-vaccinated.  It  also  seemed  possible  to  ascertain 
the  relative  number  of  those  operated  upon,  in  whom  the 
susceptibility  to  the  action  of  lymph  was  perfectly  exhausted 
by  a  previous  vaccination. 

Although  the  two  periods  named  have  furnished  as 
favorable  an  opportunity  as  may  perhaps  ever  occur  for 
making  such  inquiries  as  those  I  have  indicated,  I  do  not 
know  that  I  can  answer  any  of  the  questions  suggested  in 
as  complete  and  satisfactory  a  manner  as  I  should  wish. 

I  have,  however,  thought  it  worth  while  to  record  my 
experience  on  these  and  other  points  connected  with  re- 
vaccination,  so  as  to  be  able  to  compare  notes  with  some  of 
my  colleagues. 

At  different  times  several  methods  of  preserving  lymph 
were  tried,  namely,  by  keeping  it  in  capillary  tubes,  on  slips 
of  glass,  on  ivory  points,  and  lastly  on  slips  of  paper.  The 
capillary  tubes,  in  which  the  lymph  was  kept  moist,  proved 
with  me  wasteful  and  uncertain ;  and  from  the  experience 
obtained  on  these  occasions  I  do  not  think  moist  lymph 
keeps  as  well  as  dry  lymph.  From  the  circumstance  also 
that  in  using  this  there  is  always  a  small  portion  left  in  the 
tube  which  no  ordinary  force  can  drive  out,  it  is  a  wasteful 
method  of  using  lymph.  For  ordinary  use  I  prefer  the 
ivory  points,  and  have  found  that  when  [these  are  quickly 
and  carefully  dried,  if  they  are  tightly  corked  up  in  a 
small  glass  tube  and  excluded  from  the  light,  the  lymph 
will  often  be  found  to  be  active  at  the  end  of  four  months. 

The  paper  alluded  to  above  was  used  to  enable  me  to 
determine,  with  some  slight  approach  to  accuracy,  the 
relative  quantity  of  lymph  applied  in  those  cases  I  wished 
to  have  under  observation.  A  strip  of  highly  glazed  thick 
cream-wove  note-paper,  two  lines  wide,  was  charged  with 
lymph  on  one  surface  by  being  drawn  across  a  vaccine 
vesicle  after  the  lymph  had  been  made  to  flow  by  puncturing 


92  Notei  on  Re-  Vaccination, 

it  on  the  eighth  day.  By  allowing  this  to  dry  and  then 
drawing  it  across  the  vesicle  again  a  layer  of  lymph  of 
double  the  thickness  a  single  charge  would  give  was  placed 
on  one  surface.  Some  of  the  strips  of  paper  had  a  single 
and  some  a  double  charge  given  to  them.  In  using  these 
a  piece  two  lines  long  was  cut  off  and  laid  on  the  abraded 
spot  after  being  moistened.  Where  I  wished  to  apply  a  single 
charge  of  lymph  to  the  arms  of  different  individuals  whilst 
this  was  quite  moist  a  piece  of  the  paper  two  liues  square  was 
charged  with  the  fresh  lymph  as  it  flowed  and  was  applied 
to  the  abraded  surface^  which  latter  was  made  as  nearly  as 
possible  to  correspond  to  the  size  of  the  paper. 

When  a  double  charge  was  applied  the  first  square  of 
paper,  after  being  allowed  to  remain  on  the  abraded  spot  for 
a  given  length  of  time,  was  removed  and  another  piece, 
freshly  charged^  was  applied.  Small  squares  of  thin  ivory 
were  used  in  a  similar  manner,  but  on  the  whole  I  prefer 
the  paper. 

The  object  of  this  mode  of  proceeding  was  to  ascertain  what 
difference  there  was  in  the  amount  of  susceptibility  in  dif- 
ferent individuals  and  also  to  determine  whether  the  degree 
of  irritation  varied  according  to  the  quantity  of  lymph 
applied  to  an  abraded  surface  of  a  given  area.  It  was  for 
the  time  being  assumed  that  the  power  of  vaccine  lymph 
did  not  vary  when  used  whilst  fresh.  No  attempt  was 
made  to  determine  the  difference  which  small  variations  in 
the  quantity  of  lymph  used  would  make  in  the  effect  pro- 
duced. 

The  abrasion  of  a  portion  of  the  skin  so  as  to  lay  bare,  in 
each  case^  an  area  of  exactly  the  same  dimensions — or,  in 
other  words,  an  area  supplied  with  a  similar  number  of 
capillary  vessels — proved  to  be  an  exceedingly  difficult 
task.  So  difficult  indeed  was  it  that  only  a  very  moderate 
approach  to  uniformity  could  be  attained.  The  lancet  was 
the  instrument  which  in  most  cases  had  to  be  used.  In 
some  of  the  cases,  however,  where  I  wished  to  be  as  exact 
as  possible  in  the  size  of  the  area  operated  upon,  and  where 
the  patients  were  liberal  enough  to  permit  the  use  of  a 
novel  apparatus,  the  cuticle  was  punctured  by  a  small  instru^. 


by  Mr.  Charles  H.  Btacktey.  93 

ment  formed  by  having  a  number  of  needles  laid  together 
so  that  the  points  spread  over  an  area  the  size  of  the  squares 
of  paper  mentioned  above^  but  this  method  I  found  was  very 
uncertain.  The  application  of  Cantharides  to  a  small  por- 
tion of  the  skin  might  have  given  uniform  results^  but  I 
believe  that  the  use  of  this  substance  would  have  been 
attended  with  the  risk  of  inducing  a  greater  amount  of 
inflammatory  action  than  could  be  easily  controlled. 

As  I  shall  have  to  show  further  on^  it  is  not  so  much  the 
quantity  of  lymph  applied  as  the  more  or  less  perfect  manner 
in  which  the  capillaries  are  laid  bare  that  determines  the 
degree  of  inflammatory  action. 

In  both  the  periods  named  I  was  myself  a  patient^  so  that 
I  had  the  opportunity  of  studying  some  of  the  phenomena 
alluded  to  a  little  more  closely  than  I  otherwise  could  have 
done.  The  average  quantity  of  lymph  used  for  one  vesicle 
was  about  j^th  of  a  grain  (estimated  as  dry  lymph)^  but  I 
have  found  that  so  small  a  quantity  as  3^th  of  a  grain  would^ 
if  used  whilst  fresh^  produce  a  full-sized  vesicle ;  but  if  the 
lymph  is  diluted  I  believe  it  is  possible  to  make  a  much 
smaller  quantity  than  this  to  suffice. 

In  operating  with  the  lancet  a  slip  of  thin  wood,  in  the 
centre  of  which  an  opening  two  lines  square  had  been  made, 
was  pressed  upon  the  arm,  and  the  lancet  was  drawn  across 
the  skin  shown  in  this  opening  a  given  number  of  times  so  as 
to  penetrate*the  cuticle  with  lines  crossing  each  other  at  right 
angles.  With  a  little  care,  and  by  using  a  sharp  lancet, 
tolerably  even  results  could  be  obtained.  Slipf  of  paper 
perforated  in  a  similar  manner  answered  equally  as  well  as 
the  wood,  but  were  of  course  not  permanent.  The  squares 
of  paper  charged  as  previously  described  were  applied  to 
these  abraded  spots. 

In  the  first  period  the  number  of  persons  on  whom  a 
normal  vesicle  was  formed  was  very  small.  I  believe  not 
more  than  four  out  of  the  whole  number,  and  in  not  one 
instance  do  I  remember  the  vaccine  fever  being  set  up. 

The  irritation  generally  commenced  in  a  very  few  hours 
after  the  lymph  had  been  applied,  but  in  some  cases  it  would 
not  be  felt  for  two  or  three  days.  In  the  latter  case  the  irrita- 


94  Notes  on  Re-  Vaccination, 

lion  was  generally  more  severe  and  more  widely  spread^ 
and  indeed  made  a  nearer  approach  to  the  ordinary  course  of 
a  primary  vaccination  than  is  usually  seen  in  re-vaccination. 
In  most  instances  the  vesicles^  if  such  they  might  be  called^ 
arrived  at  maturity  on  the  fourth  or  fifth  day,  and  in  some 
few  cases  as  early  as  the  third  day. 

A  curious  circumstance  occurred  in  my  own  case  in  this 
first  period.  I  re-vaccinated  myself  with  fresh  lymph  at 
the  same  time  that  three  or  four  others  were  operated  upon^ 
but  whilst  in  these  cases  vesicles  of  a  more  or  less  perfect 
character  were  formed,  no  effect  was  produced  upon  me. 
I  concluded  from  this  that  in  all  probability  I  was  not 
susceptible^  and  that  I  had  to  thank  the  vaccination  of  my 
childhood  for  this  immunity.  In  about  four  weeks,  how- 
ever, I  tried  the  operation  again  with  lymph  obtained  from 
another  child,  and  found  that,  although  the  vesicles  were 
very  imperfect,  I  was*  still  susceptible  to  the  action  of 
lymph.  In  two  other  instances  I  have  known  the  same  thing 
to  occur.  In  one  of  these  the  patient  was  suffering  from 
a  slight  feverish  attack  of  an  indefinite  character,  but  of 
which  I  was  not  aware  at  the  time  I  vaccinated. 

From  these  cases  I  conclude  that  there  may  be  a  condition 
of  the  organism  which  at  times  renders  the  patient  unsus- 
ceptible to  the  action  of  lymph  for  the  time  being,  whilst 
there  are  other  patients  who  are  susceptible  to  the  action  of 
one  lymph  and  not  to  another.  Of  the  exact  nature  of  the 
condition  which  gives  these  results  I  can  offer  no  explana- 
tion, and^t  is  important  to  mention  here  that  it  is  only 
in  re-vaccinated  cases  that  this  condition  has  been  seen. 

In  this  first  period  fully  one  fourth  of  those  operated 
upon  seemed  to  be  quite  insusceptible  to  the  action  of  vaccine 
lymph ;  whilst  about  an  equal  number  were  very  slightly 
susceptible.  In  all  these  cases  it  was  the  rule  to  make  two 
abrasions,  and  curiously  enough  whilst  one  vesicle  would,  in 
some  cases,  be  more  or  less  perfect,  the  other  would  be 
quite  abortive  although  both  abrasions  had  been  treated  in 
exactly  the  same  manner.  In  some  few  cases  a  single 
charge  of  lymph  was  applied  to  one  abrasion,  whilst  a 
double  one  was  applied  to  the  other,  but  not  in  any  case 


by  Mr,  Charles  H.  Blackky,  95 

could  I  say  that  the  degree  of  inflammatory  action  bore  an 
exact  relation  to  the  quantity  of  lymph  applied.  In  one 
instance  no  difiference  was  perceptible. 

In  1871  the  number  of  successful  cases  was  much 
greater  than  in  1864  and  1865.  Whilst  in  the  latter  period 
not  less  than  one  in  four  proved  to  be  entirely  insusceptiblci 
in  the  former  period  not  more  than  one  in  ten  seemed  to 
be  so.  In  some  cases  the  susceptibility  seemed  to  be  very 
small  indeed^  but  in  others  the  vesicles  were  as  well-formed 
as  in  any  primary  vaccination.  In  these  cases  it  would 
have  been  interesting  to  have  tried  whether  the  lymph 
would  have  afforded  as  complete  protection,  if  used  for  other 
patients^  as  that  obtained  from  a  primary  vaccination.  The 
feeling  that  it  was  my  duty  to  do  that  which  I  knew  would 
give  the  most  complete  protection  prevented  me  trying  any 
experiments  of  this  kind ;  but  I  do  not  doubt  that  lymph 
obtained  in  this  way  would  be  quite  efficacious. 

In  primary  vaccinations  there  is,  as  every  one  knows^  a 
period  of  quiescence^  so  far  as  external  signs  are  concerned, 
between  the  insertion  of  the  lymph  and  the  formation  of 
the  vesicle.  In  first  vaccinations  this  period  may  extend 
to  the  seventh  or  eighth  day;  in  re-vaccination  it  is 
generally  much  shorter,  rarely  going  beyond  the  second  or 
third  day,  and  sometimes  not  lasting  more  than  twenty-four 
hours.  This  stage  of  incubation  was  longest  in  those  cases 
which  were  most  severe,  and  in  which  the  vesicle  approached 
most  nearly  to  the  character  of  the  vesicle  of  a  primary 
vaccination ;  but  I  could  not  say  that  this  period  of  quies- 
cence was  as  long  in  any  case  as  it  usually  is  in  the  latter. 

In  some  cases  sores  were  formed  which  kept  up  a  constant 
discharge  of  thin  puriform  lymph  for  ten  days  or  a  fortnight 
after  the  usual  period  of  healing  was  past.  In  two  of  these 
cases  there  had  been  a  previous  attack  of  syphilis,  and  in 
these  the  wound  enlarged  to  quite  double  the  size  of  the 
vesicle  first  formed ;  rendering  it  necessary  to  have  them 
dressed  with  a  stimulating  lotion  before  the  healing  process 
would  commence.  Had  it  not  been  that  twenty-five  to 
thirty  other  patients  were  re-vaccinated  along  with  the  two 
mentioned  above,  and  in  whom  no  untoward  appearances 


96  Kot€$  on  Re- Vaccination ^ 

were  seen,  I  should  hare  been  inclined  to  suspect  that  the 
Ijmph  used  was  unhealthy^  and  this  leads  me  to  obserre 
that  in  some  cases  of  primary  yaccination,  where  I  hare 
known  that  a  specific  taint  has  existed  in  one  or  other 
parent,  I  hare  had  similar  trouble  with  the  Taccination  in 
the  child. 

As  a  role  those  who  were  full  fleshed  or  inclined  to 
obesity  suffered  more  severely  than  those  of  spare  habit, 
but  some  even  of  the  latter  had  a  smart  febrile  attack.  In 
one  case  this  was  attended  with  a  slight  tendency  to 
delirium.  In  my  own  case  the  vesicles  began  to  appear  in 
about  forty-eight  hours  after  the  lymph  had  been  applied, 
and  at  the  end  of  the  fourth  day  I  began  to  have  a  sense 
of  chilliness,  with  aching  pains  in  the  spine  and  weariness 
over  the  whole  body.  The  sleep  was  fitful  and  disturbed 
for  a  couple  of  nights.  The  vesicles  were  small  and  not 
very  perfectly  developed  and  arrived  at  maturity  on  the 
sixth  day.  For  about  two  days  the  arm  ir&s  very  painful 
and  tender  to  the  touch.  During  the  night  the  pain  and 
burning  sensation  around  the  abrasions  were  quite  severe 
enough  to  keep  one  awake  if  the  arm  was  not  kept  elevated  a 
little  above  the  body  and  in  an  easy  position.  After  the 
seventh  day  the  symptoms  gradually  abated,  but  there  was 
one  symptom  which  in  my  case  was  the  first  to  appear  and 
the  last  to  depart.  I  allude  to  the  peculiar  stinging  sensa- 
tion felt  in  or  around  the  abraded  spots.  This  was  so 
sharp  and  sudden  at  times  that  one  forgot  all  about  the 
vaccination  and  grasped  the  arm  suddenly  in  order  to  get 
rid  of  it.  I  believe  that  this  sensation  is  very  common 
amongst  those  who  have  been  re- vaccinated,  for  I  found  on 
inquiry  that  a  very  large  number  of  my  patients  com- 
plained of  the  same  thing.  My  reason  for  drawing  attention 
to  it,  however^  is  to  mention  that  as  it  lessened  in 
intensity  iu  the  area  affected  by  the  vaccination  it  seemed 
to  spread  itself  over  the  whole  of  the  upper  and  lower 
limb  of  the  same  side.  The  sensation  was  at  times 
felt  in  the  foot  or  the  hand  so  distinctly  that  it  seemed 
almost  as  if  it  might  be  the  prelude  to  partial  anaesthesia. 

It  was  often  very  troublesome  long  after  the  vaccinated 


iy  Mr.  Charles  H.  Blackley.  Qf 

spots  had  healed  and  it  was  not  until  about  four  months  had 
elapsed  that  it  ceased  to  be  felt. 

In  two  cases  where  the  vesicles  were  moderately  large 
and  well  formed  the  patients  were  said  to  have  had  small- 
pox ;    one  of  these  was  in  his    seventy-eighth    year^  the 
other   in    her  thirtieth    year.     In   neither  case^  however^ 
could  I  discover  marks  of  the  disease.     In  another  case  I 
think  there  could  be  no  doubt  about  the  patient    having 
had  an  attack  of  smallpox,  although  no  marks  were  to  be 
found.     This  patient  was  fifty-eight  years  of  age  and  had 
taken  the  disorder,  when   very  young,  from  a  sister  who 
was  passing  through  an  attack  at  the  time  and  who  is  still 
very  distinctly  pitted.     In  this  instance  the   vesicles  were 
large    and    well  formed ;    the  limb  was  very  painful  and 
much  swollen  in  the  upper  part,  and   altogether  this  case, 
like   my    own,    presented   a   remarkable    example   of  the 
different  degree  of  susceptibility  there  is  at  different  periods, 
for,  without  knowing  that  the  patient  had  had   smallpox,  I 
vaccinated  him  in  1865  and    again    in    1871.     The    first 
vaccination  scarcely  took  any  effect ;    the  second  one,  as  I 
have  shown  above,  was  very  successful. 

In  1871  I  had  a  patient  under  my  care  who  was 
phthisical.  At  the  time  smallpox  was  said  to  be  very 
prevalent  in  the  village  in  which  he  lived,  which  was  about 
eight  miles  from  Manchester. 

I  strongly  urged  upon  him  as  well  as  upon  all  the  mem- 
bers of  his  family  the  necessity  of  being  re-vaccinated,  but 
as    they    had    imbibed    the  extreme  notions  of  the  anti- 
vaccinationists,  they  objected  to   have  the  operation  per- 
formed.    Early  in  1872  I  received  a  message  informing  me 
that  they  had  smallpox  in  the  house,  and  requesting  me  to 
go  over  to  see  the  phthisical  patient.     Engagements  which 
I  could  not  set  aside  prevented  me  going  over  until  the 
following  day.     When  I  arrived  I  found  that  one  daughter 
had  been  attacked  and  had  recovered,  but  a   second   and 
younger  one  whose  illness  had  commenced  only  eight  days 
before    had    died    a   few  hours  before   I    arrived.        The 
medical  man  who  had  been  in  attendance,   probably   know- 
ing the  strong  antipathy  the  family  had  to  vaccination,  had 

VOL.  XXXII,  NO.  CXXVH, JANUARY,  1874.  Q 


98  Notes  on  Re-  Vaccination^ 

not  urged  it  upon  them,  and  coDsequently  nothiog  had  been 
done.  The  question  they  wished  me  now  to  decide  was^ 
whether  I  would  still  re-vaccinate  the  phthisical  patient  who 
was  then  in  the  last  stage  of  the  disease  and  conldj  at 
most^  live  only  a  few  weeks  probably.  I  decided  to  re-vacci- 
nate at  once^  and  I  did  so  for  the  following  reasons : — In 
the  first  place  the  patient  had  been  exposed  to  almost 
direct  contact  with  two  cases  of  smallpox,  one  of  which 
was  of  the  confluent  kind,  and  if  unfortunately  an  attack 
had  come  on  in  his  case  it  would  have  added  immensely  to 
his  sufferings  without  in  any  sensible  degree  retarding  the 
progress  of  the  malady  from  which  he  was  suffering.  In 
the  second  place  if  the  patient  had  taken  the  disorder  he 
would  have  furnished  a  fresh  centre  of  infection  as  well  as 
a  means  of  concentrating  the  poison. 

The  change  of  opinion  which  the  death  of  one  member 
of  the  family  had  wrought  made  the  surviving  members 
just  as  anxious  about  re-vaccination  as  they  were  in- 
different to  it  before,  and  having  sufficient  lymph  with 
mc  I  re-vaccinated  four  of  the  family  before  I  left  the 
house;  namely,  the  father,  mother,  and  two  sons,  one  of 
whom  was  my  phthisical  patient.  Another  sou,  who  lived 
some  distance  away,  came  over  and  was  re-vaccinated  before 
he  went  to  the  house  two  days  after.  On  the  fifth  day 
four  out  of  the  number  sickened,  and  I  was  requested  to 
see  them  again.  I  found  the  pulse  in  each  case  much 
quickened  ;  there  was  pain  in  the  head  and  back,  with  nausea 
and  a  thickly  coated  tongue.  It  appeared  as  if  the  vaccina- 
tion was  too  late,  although  in  each  of  the  first  four 
cases  a  tolerably  distinct  vesicle  had  formed,  which, 
though  small  and  imperfect,  showed  that  the  lymph 
had  in  some  degree  taken  effect.  Notwithstanding  this  I 
made  up  my  mind  I  was  going  to  have  a  troublesome  time 
of  it. 

At  the  end  of  about  thirty-six  hours,  however,  three  out 
of  the  number  took  a  sudden  turn  for  the  better,  and 
along  with  this  it  was  noticed  that  iu  these  cases  one  or 
two  vesicles  had  begun  to  form  on  the  wrists,  on  the  alae 
nasi,  and  on  the  forearms.     These,  though  not  more  than 


by  Mr,  Charles  H.  Btactcley.  99 

two  lines  in  diameter,  became  quite  normal  in  character 
and  passed  through  the  usual  changes,  but  this  they  did  in 
a  much  shorter  time  than  is  usual  in  ordinary  attacks  of 
smallpox ;  and  the  most  noticeable  feature  in  the  cases 
was  that  iffter  the  eruption  had  come  fairly  out  the 
patients  seemed  to  have  gone  at  one  bound  from  a 
state  of  serious  illness  to  comparative  health.  My 
phthisical  patient  was  one  of  the  three  and  seemed  to  suffer 
less  than  the  other  two,  but  as  he  was  suffering  from 
hectic  fever  at  the  time,  this  probably  masked  some  of  the 
symptoms  which  appeared  more  prominently  on  the  other 
two  cases. 

The  fourth  patient,  a  youth  of  about  twenty-one,  did  not 
go  on  so  favorably.  In  his  case  the  symptoms  became 
much  more  severe;  the  eruption  came  out  more  tardily, 
but  ultimately  he  passed  safely  through  a  somewhat  severe 
attack  of  semi*confluent  smallpox.  I  learned  on  inquiry  that 
this  patient  had  been  very  much  attached  to  the  sister  who 
had  died,  and  that  he  had  spent  a  good  deal  of  his  time  at 
her  bedside  during  her  illness.  I  was  curious  to  know  what 
would  be  the  effect  of  the  development  of  the  natural  pock 
on  the  very  imperfect  vaccine  vesicles  which  had  already 
formed.  A  cluster  of  pocks  that  came  out  close  to  the 
latter  encroached  so  much  upon  these  that  they  were 
soon  completely  buried,  as  it  were,  beneath  the  cluster. 
The  son  who  lived  away  from  home  escaped  entirely, 
although  he  was  constantly  going  in  and  out  of  the  house 
for  three  days  after  being  re-vaccinated. 

All  these  patients  were  said  to  have  been  vaccinated  in 
infancy.  In  three  of  them  cicatrices  were  very  perceptible 
— ^the  one  who  had  the.  severe  attack  of  smallpox  was 
amongst  the  number.  In  one  the  cicatrices  were  very 
small,  and  in  the  remaining  one  they  are  not  to  be  seen. 

Sir  Thomas  Watson,  when  quoting  Mr.  Marson,  says,  that 
if  a  Yaccinated  patient  inhale  the  germ  of  variola  on  any 
given  day  re-vaccination  will  not  be  effectual  in  preventing 
an  attack  of  smallpox  if  delayed  beyond  four  days.  In 
reference  to  the  cases  cited  above,  the  question  naturally 
occurs  to  which  of  the  two  vaccinations  was  the  modification 


100  Notes  an  Re-  Vaccination^ 

leen  in  three  of  the  eases  doe  ?  The  experienoe  deriyed 
from  these  is  too  limited  to  allow  ns  to  draw  final  concla- 
mons  from  it,  bat  I  think  it  is  highly  probable  that  the 
modification  was,  in  each  case,  dne  to  the  presence  of  the 
lymph  recently  introduced,  and  that  the  seyeie  attack  of 
smallpox  which  did  occnr  in  the  one  patient  was  caused  by 
a  larger  dose  of  the  poison  being  inhaled.  Whatever  view 
be  taken  of  the  matter  I  should,  by  the  experience  gained 
in  these  instances,  if  placed  in  the  like  circumstances  again, 
be  encouraged  to  adopt  the  same  course. 

In  some  of  the  cases  which  came  under  my  care  in  1871 
I  noticed  a  peculiarity  which  we  do  not  always  see  in  first 
vaccinations,  namely,  that  beyond  the  areola  there  was  an 
effusion  into  the  subcutaneous  cellular  tissue  which  was 
evidently  not  inflammatory.  It  was  in  fact  simple  cedema, 
and  pitted  on  pressure  just  as  (edematous  swellings  do.  In 
two  or  three  instances  this  gave  rise  to  a  curious  appear- 
ance of  the  limb.  The  swelling  was  greatest  at  the  spot 
where  the  abrasions  had  been  made  and  gradually 
diminished  towards  the  elbow,  causing  the  upper  part  of  the 
limb  to  have  somewhat  of  an  inverted  pyriform  appearance. 
At  the  part  nearest  the  elbow  the  limb  was  scarcely,  if  at 
all,  above  the  normal  size^  but  curiously  enough  the  part  of 
the  forearm  just  below  the  elbow  was  considerably  swollen 
by  this  non-inflammatory  efinsion  into  the  subcutaneous 
tissue.  My  chief  reason  for  drawing  attention  to  this 
matter  is  to  notice  that  along  with  true  inflammatory  action 
we  may  have,  beyond  the  inflamed  area,  efinsion  such  as 
that  named  by  what  appears  to  me  to  be  simple  reflex 
action. 

The  swelling  in  the  upper  part  of  the  limb  might  have 
been  produced  by  the  continuity  of  the  action  set  up  by  the 
introduction  of  lymph.  The  swelling  in  the  forearm,  how- 
ever, could  only  have  been  produced  in  one  of  two  ways, 
namely,  either  by  the  gravitation  of  the  fluid  effused  in  the 
upper  arm,  or  by  reflex  action.  If  the  swelling  had  been 
caused  by  the  gravitation  of  the  fluid,  this  would  have  been 
greatest  at  the  most  dependent  part.  It  was  not  so,  how- 
ever;  and  we  must  therefore  conclude  that  it  must  have 


by  Mr.  Charles  H.  Blackley,  101 

been  due  in  greater  part,  if  not  entirely,  to  reflex  action.  It 
is  true  it  might  have  been  caused  by  a  temporary  want  of 
power  in  the  absorbents,  but  even  in  this  case  it  must  have 
been  due  to  reflex  action.  How  far  this  kind  of  action  may 
«  be  seen  to  occur  in  idiopathic  inflammations  of  tlie  iutegn- 
ment  I  am  not  prepared  to  say,  and  it  would  be  beyond  the 
scope  of  this  paper  to  attempt  to  discuss  the  matter,  but  I 
am  inclined  to  think  that  in  some  cases  of  erysipelas  of  the 
head  and  face,  and  also  in  cases  where  strongly  acting 
counter-irritants  are  used  it  may  become  a. source  of  great 
danger  even  where  the  inflammation  is  not  very  extensive 
or  severe. 

As  previously  shown  the  symptoms  produced  in  1864 
and  1865  were  mild.  In  1871  these  were  more  severe ; 
the  number  of  persons  susceptible  to  the  action  of  lymph 
was  larger  than  in  the  first  period,  whilst  at  the  same  time 
the  vesicles  produced  in  many  cases  were  to  all  appearance 
normal.  And  it  should  be  noted  that  this  was  not  the  case 
only  with  those  who  were  advanced  in  years,  and  in  whom 
the  protective  influence  of  a  first  vaccination  might  have 
been  supposed  to  be  exhausted.  Neither  were  these  results 
seen  only  in  those  instances  where  the  effect  of  the  primary 
vaccination  had  been  doubtful.  In  one  case  where  the 
cicatrices  from  the  first  vaccination  were  large,  and  where 
the  patient  was  not  more  than  seven  years  of  age,  the 
vesicles  produced  by  re-vaccination  were  large  and  well 
formed.  In  another,  who  was  twelve  years  of  age,  the 
same  thing  occurred.  Then,  again,  some  of  those  who 
were  revaccinated  in  1864  or  1865  were  again  operated 
upon  in  1871,  and,  although  the  operation  was  performed 
with  the  same  amount  of  care  on  each  occasion,  the  symp- 
toms were  more  severe  in  the  latter  than  in  the  former 
period. 

Along  with  the  facts  stated  above  we  find  smallpox  more 
prevalent  and  more  virulent  in  1871  than  in  1864 ;  and  if 
we  were  to  draw  our  conclusions  from  this  last-named 
circumstance  only,  we  might  say  that  the  smallpox  virus 
had  increased  in  quantity  or  in  power  and  thus  had  given 
ris^  to  the  epidemic  we  had  in  1871.     The  facts  I  have 


102  Notes  on  Re'Vaccination, 

brought  forward  above^  however^  seem  to  point  to  a  different 
couclusion.  We  have  seen  that  lymph  produced  in  1871 
an  effect  which  corresponded  closely  with  the  increased 
prevalence  and  virulence  of  smallpox ;  and  seeing  that 
vaccine  lymph  and  the  virus  of  smallpox  are  probably  dis- 
tinct bodies  and  derived  from  different  sources^  unless  we 
believe  that  both  have  undergone  the  same  change^  we  must 
suppose  that  the  cause  of  the  different  effects  produced  lies 
in  the  different  conditions  of  the  human  organism  at  the 
two  periods. 

I  do  not  know  if  nosologists  would  call  this  a  change  of 
type  in  disease,  but  if  it  is  not^  I  think  it  is  closely  allied  to 
it.  The  change^  however,  is  not  in  the  exciting  cause  of 
the  disease,  but,  if  the  facts  given  have  been  correctly 
observed,  it  is  in  the  condition  of  the  organism  affected. 
Formerly  I  was  very  sceptical  with  regard  to  the  possibility 
of  change  of  type  in  disease,  but  now  I  must  confess  that  it 
does  not  seem  at  all  impossible  for  such  a  change  to  occur. 
And  again,  if  it  is  a  fact  that  the  body  may,  by  the  acquire- 
ment of  some  peculiar  condition  or  quality,  become  more 
susceptible  to  the  action  of  certain  causes  of  disease,  may  it 
not  be  that  a  change  in  an  opposite  direction  is  possible,  and 
that  by  the  continued  operation  of  this  change  a  disease, 
which  has  at  one  time  been  common,  may  entirely  disappear 
for  a  time  ? 

It  is  generally  supposed  that  large  cicatrices  are  the  sigA 
of  a  high  degree  of  insusceptibility  to  the  action  of  vaccine 
lymph,  and  therefore  to  the  contagion  of  smallpox.  I  have 
shown  that  in  some  cases  where  the  cicatrices  were  large 
the  second  vaccination  took  vigorously.  From  these  cases 
I  infer  that  a  large  cicatrix  is  a  sign  of  great  susceptibility 
having  existed  at  some  time,  but  that  this  high  susceptibility 
has  been  always  exhausted  by  the  primary  vaccination  is 
at  least  doubtful. 

Another  notable  circumstance  to  which  1  have  previously 
alluded  was  that  whilst  an  increase  in  the  quantity  of  lymph 
did  not  in  a  proportionate  degree  increase  the  irritation, 
the  extension  of  the  surface  to  which  the  lymph  was  applied 
increased  the  inflammatory  action  quite  out  of  proportion  to 


by  Mr.  Charles  H.  Blackley.  103 

the  surface  abraded.  Whether  this  increase  of  action 
would  give  a  greater  amount  of  protective  influence  I  can- 
not sav^  but  I  do  not  think  it  would  be  at  all  difficult  to 
produce  very  dangerous  symptoms  by  applying  lymph  to  a 
comparatively  small  surface  of  skin  from  which  the  cuticle 
had  been  completely  removed. 

One  other  matter  I  must  allude  to  before  I  close  my 
remarks — one  of  the  most  potent  arguments  against  com- 
pulsory vaccination — is^  that  this  may  be  the  means  of  trans- 
mitting disease.  It  cannot  now  be  doubted  that  disease 
may  be  transmitted  in  this  way,  and  whilst  some  of  the 
more  ultra  of  the  opponents  of  vaccination  offer  no  effectual 
substitute  and  would  return  to  the  old  regime  under  which 
smallpox  was  left  to  follow  its  destructive  course  unchecked, 
it  never  seems  to  have  occurred  to  them  that  whilst  doing 
so  they  would  not  lessen  the  evil  they  deprecate  so  much, 
but  on  the  contrary  would  rather  increase  it. 

As  it  has  never  been  shown  that  smallpox  can  be  gene- 
rated de  novo,  the  virus  of  this  disease  roust  come  through 
and  from  the  same  source  as  vaccine  lymph^  and  if  disease 
may  be  conveyed  by  the  latter  it  is  equally  possible  for  it 
to  be  conveyed  by  the  former.  If  the  protoplasm  of  vaccine 
lymph  may  be  impressed  with  the  stamp  of  disease  so  may 
the  protoplasm  of  smallpox;  but  there  is  a  very  important 
difference  in  the  circumstances  under  which  the  two  bodies 
do  their  work  when  they  do  operate.  In  the  one  case  we  have 
a  choice  in  the  quality  and  can  control  the  quantity  used  ; 
whilst  in  the  other  we  have  no  control  whatever^  and  at  the 
same  time  we  are  entirely  ignorant  of  the  source  from  which 
the  virus  comes.  Smallpox  has  well  earned  the  title  of 
being  one  of  the  greatest  scourges  that  has  ever  afflicted 
the  human  race,  and  if  the  statements  of  the  opponents  of 
vaccination  were  more  strictly  true  than  they  sometimes  are 
I  should  still,  for  the  reasons  I  have  given  above,  prefer  to 
use  the  protective  influence  of  both  primary  and  secondary 
vaccination. 


94  Notes  on  Re^  Vaccination, 

tion  was  generally  more  severe  and  more  widely  spread^ 
and  indeed  made  a  nearer  approach  to  the  ordinary  course  of 
a  primary  vaccination  than  is  usually  seen  in  re- vaccination. 
In  most  instances  the  vesicles,  if  such  they  might  be  called, 
arrived  at  maturity  on  the  fourth  or  fifth  day,  and  in  some 
few  cases  as  early  as  the  third  day. 

A  curious  circumstance  occurred  in  my  own  case  in  this 
first  period.  I  re-vaccinated  myself  with  fresh  lymph  at 
the  same  time  that  three  or  four  others  were  operated  upon, 
but  whilst  in  these  cases  vesicles  of  a  more  or  less  perfect 
character  were  formed,  no  e£fect  was  produced  upon  me. 
I  concluded  from  this  that  in  all  probability  I  was  not 
susceptible,  and  that  I  had  to  thank  the  vaccination  of  my 
childhood  for  this  immunity.  In  about  four  weeks,  how- 
ever, I  tried  the  operation  again  with  lymph  obtained  from 
another  child,  and  found  that,  although  the  vesicles  were 
very  imperfect,  I  was*  still  susceptible  to  the  action  of 
lymph.  In  two  other  instances  I  have  known  the  same  thing 
to  occur.  In  one  of  these  the  patient  was  suffering  from 
a  slight  feverish  attack  of  an  indefinite  character,  but  of 
which  I  was  not  aware  at  the  time  I  vaccinated. 

From  these  cases  I  conclude  that  there  may  be  a  condition 
of  the  organism  which  at  times  renders  the  patient  unsus- 
ceptible to  the  action  of  lymph  for  the  time  being,  whilst 
there  are  other  patients  who  are  susceptible  to  the  action  of 
one  lymph  and  not  to  another.  Of  the  exact  nature  of  the 
condition  which  gives  these  results  I  can  offer  no  explana- 
tion, and^t  is  important  to  mention  here  that  it  is  only 
in  re-vaccinated  cases  that  this  condition  has  been  seen. 

In  this  first  period  fully  one  fourth  of  those  operated 
upon  seemed  to  be  quite  insusceptible  to  the  action  of  vaccine 
lymph ;  whilst  about  an  equal  number  were  very  slightly 
susceptible.  In  all  these  cases  it  was  the  rule  to  make  two 
abrasions,  and  curiously  enough  whilst  one  vesicle  would,  in 
some  cases,  be  more  or  less  perfect,  the  other  would  be 
quite  abortive  although  both  abrasions  had  been  treated  in 
exactly  the  same  manner.  In  some  few  cases  a  single 
charge  of  lymph  was  applied  to  one  abrasion,  whilst  a 
double  one  was  applied  to  the  other,  but  not  in  any  case 


by  Mr.  Charles  H.  Blackky,  95 

could  I  say  that  the  degree  of  inflammatory  action  bore  an 
exact  relation  to  the  quantity  of  lymph  applied.  In  one 
instance  no  difference  was  perceptible. 

In  1871  the  number  of  successful  cases  was  much 
greater  than  in  1864  and  1866.  Whilst  in  the  latter  period 
not  less  than  one  in  four  proved  to  be  entirely  insusceptible^ 
in  the  former  period  not  more  than  one  in  ten  seemed  to 
be  so.  In  some  cases  the  susceptibility  seemed  to  be  very 
small  indeed^  but  in  others  the  vesicles  were  as  well-formed 
as  in  any  primary  vaccination.  In  these  cases  it  would 
have  been  interesting  to  have  tried  whether  the  lymph 
would  have  afforded  as  complete  protection,  if  used  for  other 
patients,  as  that  obtained  from  a  primary  vaccination.  The 
feeling  that  it  was  my  duty  to  do  that  which  I  knew  would 
give  the  most  complete  protection  prevented  me  trying  any 
experiments  of  this  kind ;  but  I  do  not  doubt  that  lymph 
obtained  in  this  way  would  be  quite  efficacious. 

In  primary  vaccinations  there  is,  as  every  one  knows,  a 
period  of  quiescence,  so  far  as  external  signs  are  concerned, 
between  the  insertion  of  the  lymph  and  the  formation  of 
the  vesicle.  In  first  vaccinations  this  period  may  extend 
to  the  seventh  or  eighth  day;  in  re- vaccination  it  is 
generally  much  shorter,  rarely  going  beyond  the  second  or 
third  day,  and  sometimes  not  lasting  more  than  twenty-four 
hours.  This  stage  of  incubation  was  longest  in  those  cases 
which  were  most  severe,  and  in  which  the  vesicle  approached 
most  nearly  to  the  character  of  the  vesicle  of  a  primary 
vaccination;  but  I  could  not  say  that  this  period  of  quies- 
cence was  as  long  in  any  case  as  it  usually  is  in  the  latter. 

In  some  cases  sores  were  formed  which  kept  up  a  constant 
discharge  of  thin  puriform  lymph  for  ten  days  or  a  fortnight 
after  the  usual  period  of  healing  was  past.  In  two  of  these 
cases  there  had  been  a  previous  attack  of  syphilis,  and  in 
these  the  wound  enlarged  to  quite  double  the  size  of  the 
vesicle  first  formed ;  rendering  it  necessary  to  have  them 
dressed  with  a  stimulating  lotion  before  the  healing  process 
would  commence.  Had  it  not  been  that  twenty-five  to 
thirty  other  patients  were  re-vaccinated  along  with  the  two 
mentioned  above,  and  in  whom  no  untoward  appearances 


106  Notes  on  Re^  Vaccination , 

vaccination  was  adopted.  The  size  of  the  vaccine  pustule 
depends  upon  the  size  of  the  blister,  and  in  young  infants  care 
must  be  taken  to  apply  a  very  small  portion  of  the  Empl<tst. 
eanth.  He  once  vaccinated  three  infants  with  lymph  whicn  was 
a  day  or  two  too  old,  having  become  opaque  and  semi-purulent ; 
the  subsequent  vesicles  went  through  their  stages,  but  after- 
wards formed  troublesome  sloughing  sores.  He  mentioned  that 
in  1871  he  vaccinated  a  couple  of  his  cows  in  their  ears,  and  was 
disappointed  at  finding  no  symptom  there  of  the  vaccination 
having  taken  effect ;  but  on  the  eighth  day  his  man  came  and 
asked  him  to  look  at  the  cows,  as  their  teats  were  so  bad  he 
could  hardly  milk  them.  He  was  surprised  to  find  numerous, 
fully-developed,  cow-pock  pustules  over  the  udders  and  teats, 
whilst  the  spot  where  the  lymph  had  been  introduced  was  an 
almost  invisible  scratch.  He  remembered  the  case  'of  a  surgeon 
who  had  a  very  troublesome  form  of  eczema  of  the  face,  which 
had  resisted  all  treatment.  He  was  once  vaccinating  an  infant, 
the  child  struggled,  and  throwing  up  its  hand  knocked  the  ivory 
point  into  the  operator's  nose.  He  was  re- vaccinated !  a  fine 
pustule  formed,  and  with  its  disappearance  the  eczema  also  dis- 
appeared. 

Dr.  Wtld  said  re-vaccination  statistics  proved  that  only 
a  very  small  proportion  of  the  population  who  had  been 
vaccinated  in  infancy  were  attacked  by  smallpox,  and  of  those  so 
attacked  only  four  or  five  per  cent.  died.  This  being  the  case, 
and  seeing  that  secondary  vaccination  was  often  followed  by 
eruptions  over  the  body  and  frequently  by  erysipelas,  we  should 
pause  before  rashly  re-vaccinating  in  all  directions  ;  at  the 
same  time  re-vaccination  was  undoubtedly  an  additional  protec- 
tion against  smallpox.  With  regard  to  primary  vaccination  the 
statistics  of  the  Smallpox  Hospital  demonstrated  in  February, 
1871,  that  of  those  attacked  by  smallpox  only  five  per  cent, 
perished  if  vaccinated,  while  forty-one  per  cent,  perished  if  not 
vaccinated.  In  the  face  of  such  statistics  it  was  shameful  to  find 
a  few  educated  medical  men  denouncing  the  practice  of  vaccination 
in  the  coarsest  and  most  claptrap  language.  Syphilis,  no  doubt,  had 
occasionally  been  communicated  by  vaccination;  but  the  skin 
eruptions,  which  not  unfrequently  followed  vaccination  among 
the  enfeebled  children  of  the  lower  orders,  and  so  alarmed  them, 
were  rarely  syphilitic ;  they  were  generally  only  such  skin  erup- 
tions as  were  firequently  developed  during  teething,  and  often,  no 
doubt,  caused  by  the  irritation  of  teething  which  was  contempora- 
neous with  the  vaccination.  Even  granting  that  the  eruptions 
were  excited  by  the  vaccination,  this  was  not  necessarily  an  evil, 
as  skin  eruptions  were  frequently  safety  valves  against  fits  or 
other  internal  diseases.  The  fact  that  45,000,000  died  of  small- 
pox during  the  18th  century  should  arrest  the  clamour  made  by 
the  ignorant  or  the  demagogue  against  the  practice  of  vaccination. 
Dr.  Wyld  was  in  the  habit  of  scraping  the  cuticle  and  then 


by  Mr.  Charles  H,  Blackley.  107 

applying  the  vaccine  to  the  denuded  aur&oe.  By  this  process 
no  blood  was  drawn,  and  the  operation  was  so  gentle  that  few 
infants  cried  under  it.  The  drops  and  even  s^ams  of  blood 
frequently  exhibited  at  the  public  vaccinations  not  only  inter- 
fered with  the  success  of  the  operation,  but  painfully  impressed 
the  spectators,  and  in  their  minds  was  an  argument  against 
vaccination.  The  extravagant  cry  against  vaccination  has  done 
this  good :  it  has  stirred  up  the  profession  to  look  more  carefully 
to  the  gualitv  of  the  vaccine  matter,  and  as  Government 
compels  all  to  be  vaccinated.  Dr.  Wyld  thought  that  G-ovemment 
should  guarantee  a  supply  of  pure  vaccine  either  from  the  heifer 
or  otherwise. 

Dr.  CoopsB. — If  we  are  to  have  a  paper  upon  vaccination  at  a 
homoeopathic  society  there  is  no  one  we  could  select  for  investi- 
gating the  subject  better  qualified)  for  the  task  than  tic. 
Slaekley;  his  painstaking  and  observant  papers  upon  hay 
asthma  in  recent  numbers  of  the  British  Journal  of  Homooopathy 
sufficiently  show  this.  Mr.  Blackley  possesses  that  patience  and 
keen  discrimination  that  eminently  nt  him  for.  the  inquiry.  I 
could  wish,  however,  that  we  approached  the  subject  more  as 
homoBopaths ;  as  such  we  possess  certain  theories  of  the  actions  of 
substances  upon  the  economy  that  we  ought  to  put  in  force  when 
we  come  to  investigate  such  a  matter  as  that  of  vaccination. 
Hence  the  primary  question  for  us  is  to  consider  what  the  pro- 
perties are  of  the  vaccine  lymph  upon  the  economy ;  viewed  in  a 
homoeopathic  point  of  view  it  is  unscientific  to  suppose  that  the 
lymph  has  but  one  property  and  that  the  protecting  against 
smallpox ;  and  that  our  principles  do  not  belie  us,  but,  on  the  con- 
trary, that  there  is  every  reason  to  suppose  that  the  lymph 
possesses  strong  medicinal  properties,  besides  its  counteracting 
power  over  smallpox,  is  evident  from  the  cases  of  obstinate 
eczema  reported  some  time  since  in  the  British  Medical  Journal^ 
and  which,  after  resisting  alll  ordinary  means  of  cure,  succumbed 
to  the  action  of  vaccine  lymph  introduced  after  the  usual  fiishion. 
And  thus,  as  we  find  very  often  the  introduction  of  vaccine 
lymph  into  the  system  to  be  followed  by  very  intractable  forms 
of  eczema,  so  we  also  find  that  for  equally  intractable  forms  of 
the  disease  it  furnishes  us  with  the  best  means  of  cure  we  can 
exhibit.  Nor  need  we  listen  to  those  who  assert  that  they 
have  been  vaccinators  for  years  and  yet  have  never  seen  any 
untoward  results  to  ensue.  At  a  recent  meeting  of  the  Clinical 
Society,  Jonathan  Hutchinson  administered  a  very  proper  rebuke 
to  a  gentleman  who  made  a  boast  of  this  kind — "  x  es,'*  said  he, 
*'  ana  had  you  vaccinated  these  children  who  are  now  suffering 
from  vaccino-syphilis  you  would  be  making  the  same  assertion, 
for  the  person  who  vaccinated  them  had  no  idea  of  its  occurrence 
until  I  pointed  it  out  to  him."  Dr.  Wyld's  assertion,  though 
in  compliance  with  received  opinion,  is  by  no  means  proved, 
namely,  that  it  is  the  globule  of  blood  intermingled  with  the 


lOS  Notei  m  Re'Vaedmaium, 

lymph  and  not  the  1  jmph  iteelf  that  is  the  carrier  of  infection ; 
thifl  as  well  as  many  other  matters  connected  with  raccination 
requires  farther  investigation ;  and  it  certainly  follows  from  our 
principles  that  however  protective  against  smallpox  the  vaccine 
Ijmph  may  be,  it  yet  is  too  powerful  a  substance  to  trifle  with 
and  ought  not  to  be  introduced  indiscriminately  into  human 
bodies,  but  rather  that  some  selection  ought  to  be  made.  As 
showing  the  Bpecific  action  of  the  lymph,  a  case  occurred  under 
my  care  in  Southampton,  where  a  young  lady  had  been  suffering 
from  year  to  year  with  debility  attended  with  constantly  re- 
curring pricking  pains  in  the  left  side  of  the  chest.  When  the 
smallpox  epidemic  came  she  was  vaccinated  three  or  four  times 
without  its  taking,  and  the  last  time  a  slight  redness  appeared  on 
the  arm,  nothing  more ;  but  ever  since,  whether  from  vaccination 
or  not,  her  health  has  become  completely  restored  and  the  pains 
have  left  altogether.  This  would  seem  to  show  that  the  intro- 
duction of  the  lymph  without  any  subsequent  vesicular  forma- 
tion may  affect  the  system.  And  why  should  it  not  ?  It  is 
one  thing  to  obtain  its  prophylactic  properties,  for  which 
the  vesicTe  seems  necessary,  and  quite  another  to  secure  its 
other  medicinal  properties. 

Dr.  Hale  described  his  method  of  vaccinating,  which  was 
simply  by  gently  remo?ing  the  cuticle  with  the  edge  of  the 
lancet,  taking  care  to  avoid  drawing  blood,  and  then  rubbing  the 
point  over  the  denuded  surface.  In  this  way  he  had  often  vacci- 
nated infants  even  while  asleep.  In  confirmation  of  Mr. 
Kyngdon's  experience  on  the  experiment  upon  a  cow,  when 
Dr.  Bale  vaccinated  one  of  his  children,  not  only  was  there  the 
usual  normal  vesicle  on  the  arm,  bat  a  perfect  vesicle  appeared 
on  the  loins  simultaneously  with  those  on  the  arm,  showing  that 
the  system  generally  was  thoroughly  under  the  influence  of  the 
vaccine  virus.  The  question  of  immunity  from  infection  is  a 
difficult  one  upon  which  to  lay  down  any  positive  law  ;  some 
people  are  sure  to  contract  infection  whenever  exposed  to  it, 
others  resist  it  and  escape ;  we  can  only  account  for  such  a 
diflerence  by  the  differing  idiosyncrasies  of  individuals.  Dr. 
Hale  dissents  from  Dr.  Yeldham's  opinion,  and  considers  that 
during  an  epidemic  of  smallpox  we  ought  to  give  people  the 
chance  of  increased  immunity  by  re-vaccination ;  now,  although 
there  were  sufficient  evidence  of  previous  successful  vaccination, 
and  knowing  as  we  do  that  in  the  human  subject  there  is  a  com-^ 
pleto  metamorphosis  of  all  the  tissues  every  seven  years,  it  is 
reasonable  to  suppose  that  the  preservative  effect  of  vaccination 
mat/  be  dissipated  in  that  time.  Beferring  to  the  theor}'  of  the 
change  of  type  in  disease,  if  it  meant  that  which  is  observed  in 
specific  fevers,  he  was  quite  ready  to  admit  it,  but  if  applied  to 
acute  inflammations  he  entirely  rejected  such  a  theory,  which 
was  now  wellnigh  exploded  in  the  profession.  During  the 
late  epidemic  of  smallpox  a  correspondent  of  the  Zancet  had 


ty  Mr.  Charies  H.  Blackiey.  \6^ 

• 
commnnicated  some  very  remarkable  results  of  tHe  treatment  of 
smallpox  by  re-yaccination  in  the  earlj  stage.  Dr.  Hale  some 
years  ago  had  given  Vaccinia  in  smallpox,  but  with  apparently 
negative  results,  but  were  he  now  called  upon  to  treat  smallpox 
he  should  feel  very  much  inclined  to  try  the  effect  of  vaccination 
as  a  remedial  measure,  hoping  thereby  to  at  least  modify  the 
disease.  Dr.  Hale  regretted  that  no  anti-vaccination  speaker 
had  apjpeared  amongst  them  on  this  occasion,  not  only  to  be 
discomnted,  but  that  it  might  be  seen  what  unanimity  there 
existed  in  the  Society  in  favour  of  vaccination,  and  he  looked 
upon  the  present  opposition  to  vaccination,  if  not  positively 
criminal  at  least  most  mischievous,  in  causing  and  spreading  au 
ignorant  prejudice  in  the  minds  of  the  poor. 

Dr.  Dunesoir  said.  Dr.  Hale  regretted  there  was  no  anti- 
vaccinator  present,  but  he  should  not  have  talked  so  confidently, 
for  he  (Dr.  Dudgeon)  acknowledged  himself  to  be  an  anti- 
vaccinator  if— and  there  is  much  virtue  in  an  "if" — ^if  the 
experiments  of  Dr.  von  Kaczkowski  recorded  in  a  late  number  of 
the  BrUish  Journal  of  SomoBopathy  should  be  corroborated  and 
proved  correct.  Should  Dr.  Kaczkowski's  observations  prove 
true  then  vaccination,  as  ordinarily  performed,  must  fall  to  the 
ground,  and  we  should  protect  our  patients  effectually  £rom 
smallpox  and  cure  them,  should  they  accidentally  get  the  disease, 
by  doses  of  the  6th  dilution  of  Fariolinvm,  The  paper  they  had 
heard  read  that  night  testified  to  the  thorough,  conscientious, 
and  intelligent  manner  in  which  the  author  had  gone  about  his 
investigations,  and  was  marked  by  those  eminent  qualities  of 
patient  research  and  unwearied  diligence  that  were  so  con- 
spicuous in  Mr.  Blackley's  admirable  work  on  hay  fever  that  had 
wrung  from  our  opponents  of  the  allopathic  school  the  most 
hearty  expressions  of  commendation.  But  though  Mr.  Blackley's 
experiments  and  observations  were  excellent,  as  far  as  they  went, 
they  were  of  course  insufficient  to  settle  the  various  questions 
he  had  raised;  much  greater  experience  is  still  required.  He 
found  that  Mr.  Blackley's  argument  for  the  superior  safety  of 
vaccination  over  natural  smallpox  with  regard  to  the  reception 
by  the  inoculated  poison  of  syphilis  might  not  be  altogether  satis- 
factory to  the  anti-vaccinator,  because,  though  there  could  be  no 
doubt  that  protoplasm  was  conveyed  into  the  system  by  the 
operation  of  vaccination,  there  was  no  evidence  that  a  person  who 
caught  smallpox  by  infection  took  any  of  the  smallpox  patient's 
protoplasm  (in  which  the  syphilitic  taint  was  said  to  be  contained) 
into  his  system.  He  thought  that  some  cases  that  were  thought 
to  be  syphilitic  infection  might  not  in  reality  be  such,  and  that 
the  phenomena  developed,  though  resembling  syphilis,  might  often 
be  of  a  much  more  innocent  character.  Two  years  ago  two 
patients  came  to  him  from  widely  different  parts  of  the  country, 
one  a  girl  of  ten,  the  other  a  lady  of  forty,  both  of  whom  had 
been  re-vaccinated  some  months  previously,  and  on  whom  the 


1 10  Notes  on  IZe-  Vaccination^ 

yaccioated  spots  presented  the  exact  appearance  of  true  Hun- 
terian  chancre.  He  treated  them  with  wet  lint  and  small  doses 
of  Mercurius  virus,  and  in  a  week  or  two  the  sores  were  healed, 
and  up  to  this  time  no  perceptible  morbid  effects  had  followed, 
except  that  the  ladj  had  a  sort  of  serpiginous  eruption  on  the 
forearm  of  the  yaccinated  arm,  which  soon  went  off.  He  con- 
cluded that  these  sores^  though  they  looked  syphilitic,  could  not 
have  been  truly  syphilitic,  though,  of  course,  he  might  be  mistaken 
in  this.  His  experience  of  yaccination  and  smaupox  in  his  own 
person  differed  from  Dr.  Yeldham's.  He  was  originally  yacci- 
nated successfully  in  1820,  re-yaccinated  unsuccessfully  in  1831, 
had  a  smart  attack  of  smallpox  in  1838,  tried  to  yacdnate  himself 
in  1864  without  effect,  and  was  successfully  yaodnated  in  1871, 
the  yaccination  running  a  regular  course  and  leaying  two  well- 
marked  cicatrices.  He  thought  the  method  of  yaccinating  by 
the  pin-head-sized  blister  was  generally  followed  by  bad  inflam- 
mation of  the  arm.  He  preferred  scratching  with  a  lancet  and 
inserting  the  matter  from  iyory  points.  Ignorant  people  were 
often  much  alarmed  by  obserying  the  occurrence  of  eruptions  of 
yarious  kinds  on  their  children  after  yaccination.  ^But  such 
eruptions  occurred  frequently  after  any  exanthematous  feyer  and 
were  not  brought  into  the  system  by  the  yaccination,  but 
brought  to  the  surface  by  the  peculiar  febrile  disease. 

Mr.  Enoall  said,  One  of  the  most  important  things  was  the 
purity  of  the  lymph  employed  in  yaccmation;  and,  for  this 
reason,  he  thought  the  use  of  either  the  thread  or  the  paper 
referred  to  was  objectionable,  as  there  was  a  risk  of  taking  up 
some  of  the  blood ;  that  this  was  obyiated  by  the  use  of  the 
capillary  tubes,  for  in  these  if  anything  but  pure  lymph  existed, 
it  was  made  eyident  to  the  sight.  Unuke  some  of  the  speakers, 
the  points  had  uniformly  failed  with  him,  but  the  use  of  lymph 
taken  from  the  arm  in  the  tubes  (with  one  exception)  had  always 
succeeded.  This  one  failure  he  attributed  to  tne  quantity  being 
too  small,  as  a  repetition  of  the  process  produced  ^ood  yesicles. 
His  mode  of  yaccinating  differed  somewhat  from  those  already 
mentioned.  He  broke  off  the  ends  of  the  tube  and  blew  the 
lymph  upon  the  arm,  which  formed  a  globule  of  lymph,  into  the 
centre  or  which  he  placed  the  lancet  and  made  the  scratch,  taking 
care  not  to  cause  any  blood  to  flow.  By  this  means  he  caused 
no  pain  to  the  child,  excluded  the  air  from  the  wound,  and 
secured  the  immediate  absorption  of  the  lymph.  The  super- 
fluous lymph — ^if  any — could  then  be  taken  up  oy  the  tube  and 
be  blown  upon  the  other  part  where  the  second  scratch  would 
haye  to  be  made.  He  generally  used  two  tubes,  each  of  which  he 
•had  preyiously  supplied  with  the  quantity  necessary  for  one 
puncture.  By  this  procedure  he  got  a  healthy  yeside,  which  he 
thought  was  not  chained  when  blistering  of  the  cuticle  was  first 
employed,  since  in  the  latter  case  there  would  be  two  actions  set 
up, — ^that  of  the  blistering  yesicle,  and  that  of  the  yaccine  yirus. 


by  Mr.  Charles  H.  Blackley.  Ill 

Now,  that  of  the  blistering,  it  had  been  shown  (if  too  much  were 
uBed),  would  produce  swelling  of  the  whole  arm,  which  pure 
vaccine  virus  alone  does  not  produce ;  and,  therefore,  the  action 
of  the  blistering  is  stronger  than  that  of  the  vaccine  virus,  and 
must  modify  it  accordingly.  Even  when  this  swelling  is  not 
produced  there  are  still  the  two  actions  going  on,  which  must 
modify  in  some  degree  the  result ;  hence,  he  thought  that  the 
lymph  from  such  vesicle  could  not  represent  normal  vaccine 
lymph,  and  from  such  causes  might  arise  those  failures  which 
were  so  rife.  Again,  the  object  aimed  at  should  be  the  introduc- 
tion of  the  lymph  into  the  absorbent  system  in  such  manner  that 
the  result  might  be  due  solely  to  its  influence.  Therefore,  he 
thought  that  an  incision  made  deeper  than  just  to  indicate  by  the 
presence  of  a  red  line  that  the  absorbents  were  reached  was 
objectionable,  because,  as  each  tissue  has  its  specific  inflammation 
the  deeper  the  cut  the  more  likelihood  for  these  several  struc- 
tures to  be  involved,  and  (as  in  the  case  before  cited)  other 
modifying  inflammations  to  be  set  up.  This  might  also  be  the 
case  with  the  irritation  produced  by  the  points  acting  as  local 
irritants.  If  these  deeper  structures  were  involved,  and  another 
action  set  up,  this  would  manifest  itself  in  a  deeper  cicatrix ;  and 
therefore  he  was  of  opinion  that  a  deep-seated  cicatrix  did  not 
indicate  protection  so  well  as  one  which  indicated  that  the 
absorbento  alone  had  been  reached. 

Dr.  Dbuby  called  attention  to  some  coloured  drawings  of 
arms,  showing  the  effects  of  re-vaccination ;  one,  that  of  a  butler, 
that  had  the  appearance  of  rupia.  In  this  case  the  vaccination 
apparently  called  into  action  disease  that  was  lurking  in  the 
system.  Another  drawing  was  that  of  a  bad  arm  following 
vaccination,  the  remarkable  feature  of  which  was  that  the  lady 
was  attacked  with  smallpox  several  weeks  after,  but  .before  the 
arm  was  quite  well.  The  arm  of  a  young  woman,  said  to  have 
bad  smallpox  when  two  years  old,  went  through  the  stages  of 
vaccination  perfectly ;  this  was  done  with-  vaccine  four  removes 
from  the  cow.  Dr.  Drury  said  that  in  vaccinating  he  always 
adopted  the  nick  mode  of  scratching  the  arm  with  a  lancet,  and, 
if  possible,  rubbing  in  the  fresh  lymph  ofl*  his  lancet,  either  direct 
{torn  a  child  or  from  a  tube.  Failing  such  a  supply  he  rubbed 
in  the  dry  points,  and  when  vaccine  was  scarce  naa  more  than 
once  used  one  point  to  do  two  places.  He  was  aware  that  at  the 
Smallpox  Hospital  Mr.  Marson  always  liked  to  vaccinate  in  five 
places.  He  very  much  questioned  if  one  small  place  took  if  the 
system  was  not  as  effectually  protected,  and  that  the  real  advan- 
tage of  a  number  of  places  was  to  secure  a  good  supply  of  lymph 
and  to  ensure  a  successful  operation  if  possible.  As  regarded  the 
size  of  the  cicatrix  he  thought  far  too  much  importance  was 
attached  to  it;  the  operation  might  have  been  perfectly  suc- 
cessful when  only  a  small  one  was  to  be  found,  while  a  large 
cicatrix  might  result  from  the  arm  being  allowed  to  get  rubbed 


112  Noles  on  Re'Vaccinaiion^ 

and  ulcerated.    As  regarded  the  risks  of  re-vaccination  tbere 
was  no  doubt  that  in  a  certain  number  of  cases  bad  arms  were  to 
be  expected,  but  the  fact  that  the  same  lymph  was  used  in 
several  cases  without  any  such  result  following  showed  that  the 
vaccination  merely  called  out  mischief  ready  to  show  itself  on 
provocation.     Of  course,  it  was  possible  that  disease  might  be 
conveyed  by  the  lymph,  but  the  facts  that  he  had  mentioned 
showed  that  it  was  not  the  cause  in  the  majority  of  cases.     Bad 
arms  were  not  often  seen  after  first  vaccination,  and  in  the  cases 
where  eruptions  appeared,  on  careful  inquiry,  it  could  oflen  be 
ascertainea  that  some  eruption  had  appeared  before  vaccination, 
or  that  any  connection  with  vaccination  was  very  remote.     As  a 
large  number  of  children  came  under  his  observation ,  he  took 
some  trouble  to  inquire  about  these  matters  when  cases  came 
before  him  where  vaccination  was  blamed.      A  gentleman,  who 
had  suffered  from  eczema,  applied  to  him  to  be  vaccinated ;  he 
told  him  that  he  could  not  guarantee  that  the  operation  might 
not  be  followed  b^  a  return  of  his  attack,  his  patient  preferred 
this  risk  to  the  nsk  of  taking  smallpox ;  the  result  was  one  of 
the  most  severe  attacks  of  eczema  he  had  ever  seen.      His  prac- 
tice was  to  advocate  vaccination,  while  he  strongly  objected  to 
its  being  made  compulsory ;  he  did  not  think  that  the  contro- 
versy for  and   against  vaccination  had  been  carried  on  with 
fairness  by  either  its  friends  or  its  opponents.     He  wished  to 
point  out  one  peculiarity  of  the  recent  epidemic  of  smallpox, 
which  was  this,  that  formerly  children  who  had  been  vaccinated 
were  almost  absolutely  safe  from  an  attack  of  smallpox  till  the 
age  of  fourteen,  as  strongly  insisted  on  by  the  late  Dr.  George 
Gregory  and  Dr.  Copland,  whereas  in  the  last  epidemic  vacci- 
nated children  had  not  this  same  universal  protection. 

Dr.  J.  Galley  Blacexet  begged  to  add  his  testimony  to  the 
value  of  vaccination,  both  primary  and  secondary.  During  the  epi- 
demic of  smallpox  in  Liverpool  in  1871  out  of  150  cases  which  had 
passed  through  his  hands  the  speaker  only  remembered  one  fatal 
case,  where  there  was  distinct  evidence  of  vaccination  having  been 
previously  properly  performed,  whilst  in  those  who  had  been  re- 
vaccinated  not  a  single  case  of  smallpox  occurred.  He  thought 
that  the  protective  influence  certainly  diminished  with  lapse  of 
time,  and  instanced  three  cases  of  smallpox  occurring  in  one 
family.  The  first,  a  child  of  three  months  old  who  had  not  yet 
been  vaccinated,  had  a  most  severe  attack  of  confiuent  smallpox 
and  died ;  the  second  was  a  boy  of  seven  who  had  been  success- 
fully vaccinated  in  infancy ;  in  this  case  the  attack  was  a  remark- 
ably mild  one,  whilst  in  the  third  case,  which  was  that  of  a  girl  of 
fourteen,  who  also  had  been  vaccinated  in  infancy,  the  attack 
was  much  more  severe,  but  terminated  favorably.  Beferring  to 
the  question  of  the  transmission  of  disease  by  means  of  vaccina- 
tion, Dr.  Blackley  thought  this  had  been  very  much  exaggerated, 
as  well*authenticated  cases  were  really  very  rare.    As  to  the 


Ify  Mr.  Charles  H,  Blackley,  113 

mode  of  transmisBioD,  we  had  as  yet  no  proof  that  the  hlood- 
Gorpascles  alone  were  the  agents,  there  being  just  as  great  a 
probability  in  favour  of  the  lymph  itself  being  the  vehicle.  In 
concluaion,  the  speaker  expressed  his  preference  for  the  ivory 
points,  which  when  used  to  a  scarified  surface  seldom  failed. 

Dr.  Bates  (Vice-President)  said  that  he  had  wished  to  add  a 
few  remarks  to  those  already  expressed^  but  that  owing  to  the 
lateness  of  the  hour  he  would  only  express  the  satisfaction  which 
he  felt  at  the  turn  the  discussion  had  taken,  as,  although  many 
different  opinions  had  been  expressed  as  to  the  best  mode  of 
preserving  lymph  and  of  vaccinating,  yet  there  was  perfect 
unanimity,  on  the  part  of  all  the  members  present,  as  to  the 
valae  of  vaccination  as  a  prophylactic  against  smallpox. 


VOL.  XXXII^  NO.  CXXVIl.— -JANUARY,  1874.  tt 


REVIEWS. 


Memoir  of  Sir  James  Y,  Simpson,  Bart.  By  J,  Duns, 
D.D.,  P.R.S.E.,  Professor  of  Natural  Science,  New 
College,  Edinburgh. 

Ever  since  the  death  of  Sir  James  Simpson  the  profes* 
sion,  and  indeed  the  general  public,  have  been  eagerly  look- 
ing forward  to  some  biography  which  should  give  a  fair 
Tiew  of  the  life,  labours,  and  character  of  that  distinguished 
man.  It  was  reasonably  anticipated  that  the  career  of  one 
who,  from  comparative  obscurity,  had,  in  virtue  of  his  own 
genius  and  diligence,  come  "  to  stand  before  kings  rather 
than  before  mean  men  '^ — whose  name  had  become  a 
household  word  in  thousands  of  families,  the  members  of 
which  had  shared  the  blessings  of  that  anesthetic  which 
his  labours  principally  contributed  to  bring  into  common 
use — who,  while  by  general  consent  facile  princeps  in  his 
own  special  department,  had  yet  found  time  to  linger  in 
nearly  every  province  of  the  healing  art,  and  in  each  had 
left  imperishable  traces  of  his  presence  behind  him — who 
had  thrown  considerable  light  upon  the  interesting  but 
obscure  subject  of  medical  antiquities — who,  during  nearly 
thirty  years,  had  lectured  to  perhaps  the  most  numerously 
attended  medical  class  in  the  University  of  Edinburgh,  and 
who  in  private  life  attracted  the  admiration  and  warm 
personal  regard  of  the  thousands  with  whom  his  princely 
hospitality  brought  him  into  contact,  must  necessarily 
interest  not  his  professional  brethren  alone,  but  also  those 
of  the  community  at  large  who  had  profited  by  his  benevo- 
lence, industry,  and  skill,  and  indeed  all  who  find  pleasure 


Memoir  of  Sir  James  Y.  Simpson,  115 

in  the  spectacle  of  labour  and  genius  obtaining  their  due 
meed  of  competence  and  fame.  Most  persons,  indeed,  must 
have  feared  that  the  narrative  of  the  numerous  and  acri- 
monious controversies  into  which  Sir  James  Simpson  had 
plunged  from  time  to  time,  which  would  be  inevitable  in 
any  biography  professing  to  give  a  fair  representation  of 
his  life,  must  recall  much  which  it  would  be  better  for  his 
fame  to  bury  in  oblivion.  But  the  story  of  those  very  con- 
troversies, if  fairly  related,  however  much  to  be  regretted 
for  the  reason  we  have  just  mentioned,  would  still  have 
formed  a  most  important  chapter  in  the  history  of  medicine, 
and  so  have  lent  an  additional  interest  to  the  biography 
itself. 

Neither  the  medical  profession  nor  the  general  public, 
however,  have  much  cause  to  congratulate  themselves  upon 
the  specimen  of  biography  with  which  Dr.  Duns  has  favoured 
them  in  fulfilment  of  such  anticipations.  In  some  respects, 
indeed.  Dr.  Duns  appears  to  possess  eminent  qualifications 
for  the  labour  of  love  he  has  undertaken.  A  warm  admirer, 
and,  for  many  years,  an  intimate  personal  friend  of  Sir 
James  Simpson — with  abundant  materials,  as  he  himself 
assures  us,  placed  in  his  hands,  and  being,  moreover,  a 
resident  in  the  city  which  was  the  scene  of  his  hero's  chief 
labours  and  the  centre  of  his  fame, — presumably,  too, 
acquainted  with  many  of  Sir  James  Simpson's  opponents  as 
well  as  of  his  supporters — we  anticipated  from  Dr.  Dans  not 
merely  an  interesting  account  of  the  life  of  this  eminent  man, 
but  also  a  fair  representation  of  both  sides  of  the  memorable 
disputes  which  took  up  so  large  a  portion  of  his  time,  which 
might  easily  have  been  produced  by  giving  characteristic 
and  well-chosen  extracts  from  the  voluminous  records  of 
these  controversies  still  existing  in  print.  Of  course,  as  Dr. 
Duns  is  not  himself  a  medical  man,  it  was  not  to  be 
expected  that  he  should  be  able  to  throw  any  new  light  on 
the  respective  merits  of  the  controversialists;  but  it  was 
quite  within  his  power  to  have,  at  least,  exercised  impar- 
tiality by  allotting  equal  space  to  both  sides,  and  the  advice 
of  medical  friends  might  have  guided  his  choice  of  the  par- 
ticular documents  or  portions  of  such  to  be  selected.     Dr. 


Il6  Reviews, 

Dans,  however^  has  taken  qnite  a  different  view  of  the 
matter^  and  unmistakably  hints  in  his  preface  that  he 
regards  the  nature  of  his  own  training  and  studies  as 
entitling  him  to  lay  down  the  law  on  medical  subjects  with 
no  small  authority — a  privilege  of  which  he  does  not 
scruple  frequently  to  avail  himself.  We  learn  from  the 
title-page  that  Dr.  Duns  is  Professor  of  Natural  Science 
(which  we  are  informed  means  Natural  History)  in  New 
College^  Edinburgh.  How  the  study  of  zoology  and  com- 
parative anatomy  is  to  enable  any  one  to  deliver  ex  cathedra 
opinions  (of  any  value)  upon  acupressure,  homoeopathy^  and 
anaesthetics,  we  confess  we  are  at  some  loss  to  discover. 
But  this  is  not  all.  In  his  accounts  of  all  Sir  James  Simpson's 
numerous  controversies  Dr.  Duns  seems  to  have  been  guided 
solely  by  his  own  prejudices  as  to  the  selections  he  makes 
from  contemporary  documents^  and  this  has  led  him  to  the 
simple  and  ingenious  contrivance  of  finding  room  for  copious 
extracts  from  his  hero's  arguments  by  means  of  ignoring  all 
the  refutations  and  allegations  brought  forward  by  his 
opponents.  It  is  true  Dr.  Duns  is  so  far  impartial  as  to 
take  small  pains  to  disguise  Sir  James  Simpson's  insolent 
and  acrimonious  pertinacity,  but  he  salves  all  this  by  con- 
tinually remarking  that  great  indeed  must  have  been  the 
provocation  which  could  have  induced  such  a  man  to  use 
such  language,  without,  as  a  rule,  stating  what  the  provoca- 
tion was.  We  do  not  in  the  least  restrict  these  remarks  to 
the  account  Dr.  Duns  gives  of  the  celebrated  *^  homoeo- 
pathy ''  controversy — although,  indeed,  it  is  the  ridiculous 
misrepresentations  and  transparent  absurdities  there  brought 
forward  which  first  induced  us  to  select  this  biography  as  the 
subject  of  an  article  in  this  Journal — ^for  they  equally  apply 
to  his  narrative  of  the  disputes  with  the  Edinburgh  Senatus 
and  with  Professors  Syme^  Miller  and  Lister,  as  we  shall  see 
when  we  come  to  examine  the  book  in  detail. 

Little  can  be  said  in  favour  of  the  literary  or  scientific 
merits  of  this  biography.  We  have,  for  example,  the 
occurrence  of  the  Scotticism  ''  would ''  where  '^  should '' 
ought  to  find  place,  and  the  work  presents  several  instances 
of  incorrect  spelling,  as  ''maxas''  for  ''moxas,''  *'Barnsby" 


Memoir  of  Sir  James  Y.  Simpson,  117 

Cooper  for  ^'Bransby''  Cooper,  Dr.  "Bennef'  for  Dr. 
"  Bennett/'  &c.  And  in  one  place  Dr.  Duns  actually  goes 
out  of  his  way  to  contradict  a  statement  quoted  by  Sir 
William  Hamilton  from  St.  Augustine,  to  the  eflfect  that  if 
the  bodies  of  certain  centipedes  or  myriapods  be  divided, 
the  segments  will  for  some  time  continue  to  move  indepen« 
dently,  a  fact  we  should  have  supposed  sufficiently  familiar 
to  any  professor  of  natural  history,  and,  indeed,  to  every- 
body, as  it  is  one  of  which  schoolboys  are  in  the  habit  of 
giving  daily  practical  demonstrations,  in  no  laudable  spirit 
of  curiosity. 

But  it  is  time  for  us  to  approach  the  real  object  of  the 
ensuing  pages,  which  is  to  give  a  very  brief  notice  of  Sir 
James  Simpson's  life,  entirely  extracted  from  the  biography 
before  cis,  with  a  more  detailed  account  of  the  famous 
'*  homoeopathy "  controversy  in  which  he  played  so  noto- 
rious a  part.  Bearing  in  mind  this  latter  object,  we  shall 
also  examine,  though  more  cursorily.  Sir  James  Simpson's 
controversies  (to  give  them  no  harsher  name)  with  the 
Edinburgh  Senatus,  Professors  Syme,  Miller,  and  Lister,* 
and  the  opponents  of  chloroform ;  chiefly  as  affording  illus- 
trations of  the  spirit  in  which  he  carried  on  disputes  of  any 
kind,  so  that  wc  may  be  the  better  enabled  to  estimate  his 
ferocious  attack  upon  homoeopathy  at  its  true  value,  and 
criticise  it  accordingly.  It  is,  of  course,  no  part  either  of 
our  duty  or  our  intention  to  offer  any  remarks  on  the 
portion  of  Dr.  Duns's  work  which  specially  deals  with  Sir 
James  Simpson's  moral  and  religious  character.  We  are 
quite  willing  to  believe  that  in  this,  the  highest  of  all  con- 
siderations. Sir  James  Simpson  was  unimpeachable ;  and, 
even  had  we  thought  otherwise,  it  would  have  afforded  us 
no  pleasure  to  blacken  the  memory  of  a  gifted  and  indus- 
trious man.  Such  distasteful  work  we  leave  to  our  cynical 
contemporary  the  Medical  Times  and  Gazette,  which  scur- 
rilous periodical  assailed  the  spotless  fame  of  the  late 
Professor  Henderson,  almost  before  he  had  been  laid  in  his 
grave,  with  mendacious  insinuations  of  selfishness  and 
dishonesty. 


118  Reviews. 

James  Young  Simpson  was  born  at  Bathgate,  Linlith- 
gowshire,  on  the  7th  of  June^  1811,  the  descendant  of  a 
line  of  ''small  farmers'-^  who  had  long  lived  in  that 
county.  His  father,  David  Simpson,  born  in  the  same 
town,  had  for  some  years  worked  as  a  journeyman  baker  in 
London,  Glasgow,  and  Leith,  and  in  the  year  1810  settled 
in  his  native  place  in  the  same  line  of  business.  Besides 
his  youngest,  the  subject  of  this  biography,  whom  paternal 
fondness  always  regarded  as  the  genius  of  the  family,  David 
Simpson  had  six  other  sons  and  one  daughter.  His  third, 
son,  Alexander,  who  succeeded  to  his  business^  and  ulti- 
mately rose  to  the  position  of  banker  in  his  native  town, 
was  the  kind  and  generous  supporter  of  James  Simpson 
during  his  youth  while  he  needed  aid ;  and  it  is  gratifying 
to  have  to  record  that  this  liberality  was  not  forgotten  or 
unrequited  by  the  younger  brother  when,  in  later  years,  he  had 
risen  to  well-earned  opulence  and  fame.  Indeed,  some  of  the 
most  pleasing  passages  in  this  biography  are  those  which  de- 
scribe the  affectionate  intercourse  and  mutual  helpfulness  of 
the  various  members  of  Sir  James  Simpson's  family.  After 
going  through  the  usual  curriculum  at  the  parish  school  at 
Bathgate,  James  Simpson  entered  the  University  of  Edin- 
burgh in  1825,  where,  for  two  years,  he  attended  the  classes 
of  Greek,  humanity,  and  mathematics,  without,  however, 
gaining  much  distinction.  He  commenced  his  professional 
studies  in  1837,  and  during  his  first  medical  session  he  also 
took  the  classes  of  natural  and  moral  philosophy.  In  later 
years  he  was  accustomed  to  speak  of  his  attendance  on  the 
arts  classes  as  having  been  very  useful  to  him  through  life, 
which  makes  it  the  more  surprising  that  we  find  him,  in 
1867,  disparaging  classical  education,  in  a  strain,  however, 
displaying  considerably  more  zeal  than  knowledge.  In 
1880  he  obtained  his  surgical  diploma,  and  in  1832  gradu- 
ated at  Edinburgh  as  M.D.  He  then  became  candidate 
for  the  situation  of  parish  surgeon  to  the  small  village  of 
Inverkip,  a  post  which,  fortunately  for  himself  and  his 
profession,  he  failed  to  obtain.  Shortly  after  he  became 
assistant  to  Professor  John  Thomson,  who,  we  are  informed, 
had  been  struck  with  the  excellence  of  Simpson's  inaugural 


Memoir  of  Sir  James  Y,  Simpson.  119 

dissertation ;  and  it  was  while  he  held  this  situation  that 
he  resolved  to  devote  himself  to  that  department  of  practice 
in  which  he  snbsequently  acquired  such  distinction.  He 
wrote  several  papers  on  professional  subjects,  which  attracted 
so  much  attention  abroad  as  well  as  at  home^  that  they 
were  translated  into  German,  French,  and  Italian.  He 
became  a  member  of  the  Royal  Medical  and  Royal  Physical 
Societies  of  Edinburgh,  of  both  which  he  was  later  elected 
president.  In  1835  he  was  enabled^  by  his  brother's 
liberality,  to  accompany  Dr.  D.  Maclagan  on  a  tour  of 
study  and  observation  through  London,  Paris,  Brussels, 
and  Antwerp.  In  1836  he  was  elected  corresponding 
member  of  the  Medical  Society  of  Ghent,  and  in  the  same 
year  he  obtained  the  post  of  house-surgeon  to  the  Edinburgh 
Lying-in  Hospital.  Next  year  he  was  appomted  interim 
lecturer  on  pathology  at  the  University,  as  that  enlightened 
body — the  Edinburgh  Town  Council — ^had,  with  their  wonted 
o£Scionsness^  raised  a  clamour  against  Professor  Thomson 
on  account  of  some  ridiculous  charges  they  b&d  managed 
to  trump  up  concerning  him ;  and  in  1838  he  commenced 
his  first  course  of  lectures  on  midwifery  as  an  extra-mural 
teacher.  It  is  right  to  add  that  both  his  obstetric  and 
pathological  courses  were  largely  attended,  and  his  students 
publicly  testified  their  sense  of  the  value  of  his  prelec- 
tions. 

Thus  far  things  seem  to  have  gone  smoothly  enough, 
on  the  surface  at  any  rate ;  but  from  this  time,  until  Sir 
James  Simpson's  death,  we  shall  have  to  force  our  way 
through  an  uninterrupted  series  of  rancorous  and,  too  often^ 
discreditable  contentions.  These  may  be  said  to  date  from 
the  summer  of  1889,  when  Dr.  Hamilton  resigned  the 
chair  of  midwifery ;  and,  as  an  illustration  of  the  temper 
in  which  Simpson  was  likely  to  encounter  any  slight  or 
opposition,  we  may  extract  the  following  anecdote,  which 
refers  to  the  same  year,  and  is  here  reproduced  in  the  words 
of  Dr.  Duns : 

''  Dr.  Simpson  and  Dr.  Lewins  were  conversing  together 
in  the  reading  room  of  the  College  of  Physicians 
Soon  after,  the  conversation  turned  to  an  anonymous  letter 


120  Retriews. 

that  had  lately  appeared  in  the  newspaper  on  Qaeen's 
College^  Ireland.  '  What  a  precious  piece  of  humbug !' 
said  Lewins^  in  reference  to  a  remark  of  Simpson's  on 
another  matter.  Turning  to  Lewins,  and  looking  him  full 
in  the  face,  he  said,  '  That  was  a  scandalous  and  lying 
article  in  the  Observer ;  I  hope  you  were  not  the  author  of 
it.'  "  As  Lewins  was  the  author,  and  as  Simpson  clearly 
showed  by  his  manner  that  he  knew,  or,  at  least,  suspected 
this  to  be  the  case,  we  are  not  surprised  to  learn  that  the 
result  of  this  classical  colloquy  was  a  threatened  duel, 
which  was,  however,  fortunately  averted  by  the  friendly 
interposition  of  Dr.  Handyside  and  others. 

Upon  the  resignation  of  the  chair  of  midwifery  by  Pro* 
sessor  Hamilton,  Drs.  Lee  and  Kennedy,  as  well  as  several 
others  of  lessiuote,  offered  themselves,  together  with  James 
Simpson,  as  competitors  for  the  vacant  professorship.  The  two 
former  of  these,  at  any  rate,  were  men  of  European  celebrity, 
mature  age,  and  long  experience.  Not  unreasonably,  there 
was  a  strong  feeling  among  many  of  the  professors  and  others 
that  the  claims  of  these  were  preferable  to  Simpson's.  Mr, 
Syme,  in  particular,  seems  to  have  exerted  himself  strongly 
in  favour  of  one  of  Simpson's  rivals,  a  fact  which  Simpson 
seems  never  either  to  have  forgotten  or  forgiven.  Sir 
Charles  Bell  also  expressed  himself  to  the  effect  that,  in  a 
case  like  the  one  under  consideration,  regard  ought  rather 
to  be  paid  to  the  duration  of  a  candidate's  professional 
career,  and  the  amount  of  his  experience  as  a  teacher,  than 
to  the  mere  number,  or  even  character,  of  personal  testi- 
monials from  friends  and  others,  the  supply  of  which,  of 
the  most  flattering  nature,  is  generally  found  to  be  equal  to 
the  demand.  Of  these  latter  documents  Dr.  Simpson 
seems  to  have  possessed  abundance,  and  he  had,  as  we  have 
seen,  other  more  solid  recommendations.  But  Dr.  Duns 
feels  it  his  duty  to  comment  very  severely  on  Sir  Charles 
Bell's  very  sensible  remarks,  and  to  adminster  no  small 
dose  of  flattery  to  the  Town  Council  for  their  remarkable 
sagacity  in  disregarding  them.  It  is  a  happy  thing  that, 
in  the  present  instance,  the  result  justified  their  choice ; 
that   Sir  Jam^s  Simpsou   did   not  prove   another  Monro 


Memoir  of  Sir  James  Y.  Simpson.  121 

tertius,  and  that  his  election  over  the  heads  of  his  seniors 
did  not  turn  out  to  be  an  electioneering  blunder^  like  that 
which  installed  Christopher  North  in  the  chair  of  moral 
philosophy  in  preference  to  Sir  William  Hamilton. 

Dr.  Simpson's  chief  claims  were  as  follows  : — he  had  for 
one  session  delivered  an  extramural  course  of  lectures  on 
midwifery  with  considerable  applause ;  he  had   also^  for  a 
time^  discharged  the  duties  of  interim  lecturer  on  pathology 
at  the  university ;  he  was  the  author  of  several  articles  on 
obstetrical  subjects  which  had  been  deemed  worthy  of  trans- 
lation into  various  continental  languages;  he  had  written 
an  article  on  *'  Hermaphroditism  '*  for  Todd's  Cyclopedia  of 
Anatomy  which  gained  much  commendation ;  he  had  been 
chosen  a  member  of  the  Medical  Society  of  Ghent ;  he  was 
president  and  honorary  member  of  the  Royal  Medical  Society 
of  Edinburgh^  and  member  of  the  Royal  Physical  Society 
in  that  city ;  and^  lastly^  he  had  a  not  inconsiderable  and 
daily  increasing  obstetric  practice.     On  the  other  hand^  he 
was  only  twenty-nine  years  of  age^  and  hardly  eight  years 
had  yet  elapsed  since  his   graduation ;    while    among  his 
opponents  were  veteran  obstetricians^  with  claims  to  con- 
sideration  greatly  superior   to    his    own.     Dr.    Simpson's 
success  may,  in  part,  be  attributed  to  the  confusion  arising 
from  the  appearance  upon  the  scene  of  a  considerable  number 
of  competitors^  many  of  whom  withdrew  before  the  close  of 
the  contest ;  partly  to  the  energetic  canvass  of  himself  and 
his  friends ;    partly  to  the  influence  of   Ritchie  and   the 
whig  party^  who,  fearing  Simpson  might  contest  the  chair 
of  pathology   with   their  candidate  Dr.  W.  Thomson^   or 
otherwise  obstruct  that  appointment,  were  anxious  so  to 
provide  for  him  as  to  render  this  impossible;    and  partly 
to  a  rumour  (true  or  false)   that  Dr.  Kennedy,  in  spite  of 
his  attainments  and  experience,  was  not  a  fluent  lecturer. 
However  this  may  be,  we  have  now  every  cause  to  rejoice 
in  the  result  of  the  election,  and  we  can  only  regret  that 
Dr.  Simpson  should  so  strongly  have  resented  Mr.   Syme's 
opposition  as  to  maintain  a  lifelong  quarrel  with  the  dis- 
tinguished  surgeon,  and  even  to  visit  the  sins  of  the  father- 
in-law  on  the  head  of  the  son-in-law  by  ei^teadiug  his 


122  Reviews. 

hostility  to  Professor  Lister.  It  might  have  been  hoped 
that  honest  self-gratulation  wonld  have  got  the  better  of 
vindictive  feelings^  more  especially  as,  during  the  very  heat 
of  the  *conte8t,  Dr.  Simpson,  fortunate  alike  in  love  and 
strife,  was  united  to  his  cousin,  Miss  Jessie  Grindlay,  to 
whom  he  had  been  for  some  time  attached,  and  who  survived 
him  only  a  few  days.  His  angry  feeling  towards  Mr. 
Syme  appears  the  less  justifiable  when  we  remember  the 
active  part  Dr.  Simpson  himself  subsequently  took  in  the 
election  to  several  medical  professorships  in  the  University 
of  Edinburgh. 

He  had  scarcely  been  installed  in  his  professorship  before 
he  was  offered  the  deanship  at  a  meeting  of  the  Medical 
Faculty.  Something  in  the  manner  in  which  the  offer  was 
made  seems  to  have  irritated  Dr.  Simpson's  remarkably 
keen  sensibilities,  and  he  accordingly  declined  the  proffered 
dignity,  in  terms  which  Professor  Graham  regarded  as 
tantamount  to  giving  the  lie  direct  to  every  one  present. 
Simpson  at  first  tried  to  make  matters  up  by  assuring 
Professor  Graham  by  letter  that  he  (Professor  Graham)  was 
"  one  of  the  very  last  members  of  the  Medical  Faculty 
whose  good  opinion  he  (Dr.  Simpson)  would  be  willing  to 
forfeit,''  but  considering  the  terms  Dr.  Simpson  was  now 
on  with  his  colleagues,  this  assurance  did  not  amount  to 
very  much.  As  Professor  Graham  failed  to  receive  this 
gushing  appeal  with  becoming  bnthusiasm.  Dr.  Simpson 
wound  up  the  correspondence  (and,  we  presume,  the  inti- 
macy) with  an  extraordinary  letter  in  which  he  blusters  a 
good  deal  about  the  '^  dignity  of  a  gentleman,''  and  kindly 
informs  Professor  Graham  that  he  (Professor  Graham)  is 
ignorant  of  the  laws  of  courtesy. 

Professor  Simpson's  first  session,  no  less  than  those 
which  followed,  was  a  complete  success.  This  is  ascribed 
by  Dr.  Duns  to  his  genial  bearing,  earnestness  of  manner, 
felicity  of  illustration,  forcible  and  lucid  style,  and  to  his 
'' pleasant  talk  and  sallies  of  quiet  humour."  We  could 
wish  Dr.  Duns  had  not  felt  it  necessary  to  allude,  even  in 
such  euphemistic  terms,  to  this  latter  element  of  popularity, 
as  it  recalls  to  the  mind  of  all  former  Edinburgh  students. 


Memoir  of  Sir  James  Y.  Simpson.  128 

at  leasts  a  featnre  in  their  old  teacher's  didactic  and  coUo- 
qnial  style  which  his  friends  might  well  wish  obliterated. 
It  is  only  too  notorious  that  the  license  Sir  James  Simpson 
permitted  himself  to  take^  in  the  selection  of  anecdotes  and 
digressions  wherewith  to  enli?efi  his  disquisitions  on  a 
subject  only  too  likely  to  suggest  indecorous  allusions^  was 
pushed  to  an  extreme  very  unbecoming  in  one  of  his 
talents  and  attainments.  But  on  this  we  have  no  wish  to 
dwell.  It  is  more  pleasing  to  refer  to  the  enlightened  and 
active  part  he  took^  about  this  time^  in  the  discussion  as  to 
whether  the  chair  of  general  pathology  should  be  abolished^ 
in  which  he  argued,  alike  earnestly  and  conyincingly^  in 
favour  of  its  continuance.  He  fortunately  gained  his 
pointy  and  to  his  success  on  this  occasion  the  University 
and  the  profession  are  indebted  for  the  valuable  services  of 
the  late  Professor  Henderson,  who  was  elected  to  this  chair^ 
in  succession  to  Dr.  Thomson,  in  1842.  It  is  curious  to 
find  that  Simpson  was  thus  the  indirect  means  df  procuring 
a  university  chair  for  the  very  man  whom,  a  few  years  later, 
he  laboured  in  conjunction  with  Syme  to  deprive  of  every 
medical  appointment  and  to  chase  out  of'  professional 
society. 

But  to  return.  From  this  time  until  the  year  1847 
Professor  Simpson's  career  presents  little  of  interest  to  the 
general  public.  He  seems  to  have  taken  much  interest  in 
the  Free  Church  controversy,  then  at  its  height,  and 
indulged  his  archseological  tastes^  by  the  publication  of 
a  valuable  memoir  entitled  Antiquarian  Notices  of  Leprosy 
and  Leper-houses  in  Scotland  and  England.  His  fame  and 
fortune  were  now  progressing  pari  passu,  which  seems  to 
have  kept  him  in  such  good  humour,  that,  beyond  a  squabble 
with  Dr.  Radford,  and  a  somewhat  more  serious  assault  upon 
Professor  Syme  (whom  he  accused  of  making  *'  disingenuous 
and  untrue  statements '' — ^*  deliberate  mis-statements  " — 
''  assertions  which  he  knew  to  be  quite  false,''  and  *'  which 
had  no  foundation  in  truth ;"  and  of  possessing  a  *'  morbid- 
appetite  for  railing "  (save  the  mark  \),  and  other  un- 
gracious  deeds  and  attributes),  we  have  little  characteristic 
to  record,  until  the  last-named  year  (in  which  he  was  made 


121  Reviews. 

Queen's  physician  for  Scotland)  brought  him  again  into  the 
field  upon  the  famous  "anaesthesia  "  controversy. 

Tiie  production  of  aniestbesia  during  the  performance  of 
painful  operations  seems  to  have  engaged  the  attention  of 
the  medical  profession  from  the  earliest  times.  We  find 
the  use  of  niaudragora  for  this  purpose  referred  to  by 
Aretxus^  Cclsus,  Dioscorides^  and  others;  and  in  the 
thirteenth  century  Hugo  of  Lucca  and  Theodoric  described 
a  "  spongia  somnifera ''  which  they  deemed  available  to 
this  end.  The  use  of  sulphuric  ether  was  suggested  by 
Richard  Pearson  in  1795,  and,  five  years  later,  Sir 
Humphry  Davy  proposed  the  inhalation  of  nitrous  oxide 
gas,  which  has  of  late  years  been  revived.  Ambrose 
Par^  in  the  sixteenth  century,  and  Dr.  Jloore  in  1784, 
had  attempted  to  produce  local  aneesthesia  by  compres-, 
sion  of  the  implicated  nerves.  But  for  some  inscrutable 
reason  the  subject  seems  to  have  been  dropped  from  time  to 
time,  until  in  1846  the  use  of  sulphuric  ether  was  intro- 
duced in  America  by  Dr.  Morton,  a  dentist  at  Boston,  or, 
as  some  allege,  by  Dr.  Jackson.  But,  prior  to  the  labours 
of  Dr.  Simpson,  the  use  of  any  form  of  anaesthetic  seems, 
in  modern  times  at  least,  to  have  been  limited  to  those 
about  to  undergo  surgical  operations.  When  Simpson 
proposed  to  extend  the  practice  to  obstetric  cases  he  had, 
therefore,  to  dispose  of  various  preliminary  objections  before 
demonstrating,  or  endeavouring  to  demonstrate,  the  supe- 
riority of  chloroform  to  ^y  other  form  of  anaesthetic. 

The  alleged  objections  were  of  three  kinds — religious, 
moral,  and  medical.  The  opponents  who  maintained  the 
first  class  of  objections  urged,  not  without  some  plausibility, 
that,  as  the  pains  of  childbirth  were  denounced  on  tho 
daughters  of  Eve  as  part  of  the  primeval  curse,  any  en- 
deavour to  avert  them  was  an  impious  attempt  to  defy  the 
sentence  of  the  Creator.  This  allegation  the  Rev.  Dr. 
Chalmers  was  inclined  to  treat  with  contempt.  Simpson, 
on  the  other  hand,  and  his  colleague.  Sir  Robert  Christison, 
in  a  more  becoming  spirit,  endeavoured  to  demonstrate  its 
unsoundness.  The  act  of  disobedience  in  Paradise  entailed 
labour  on  man  no  less  than  parturient  pangs  on  woman, 


Memoir  of  Sir  James  Y.  Simpson.  125 

If,  therefore,  we  are  justified  in  endeavouring,  by  means  of 
mechanical  or  other  contrivances,  to  alleviate  that  portion 
of  the  curse  which  lights  upon  the  stronger  sex,  it  seems 
strange  that  we  should  be  accused  of  impiety  if  we  try  to 
mitigate  the  far   heavier   doom  pronounced  on   the  other 
section  of  humanity,  whose  tenderness  and  helplessness  call 
for  more  rather  than  for  less  indulgence.     Other  replies 
were  made,  in  which  the  force  of  the  original  words  in  the 
Hebrew  text  was  dwelt  on ;  but  upon  this  we  have  neither 
the  learning  nor  the  time  to  enter.     On  moral  grounds,  it 
was  urged    that   abandoned   persons  might   employ  anaes- 
thetics for  licentious  or  other  criminal  purposes ;  but  it  may 
fairly  be  hoped  that  judicious  legislation  will  prevent  this 
disaster,  and  it  seems  hard  to  deprive  multitudes  of  a  price- 
less boon  lest  a  few  individuals  should  be  found  so  wicked 
as  to  abuse  it.       On   medical   grounds,  it  was  asserted  (1) 
that  the  administration  of  anaesthetics  during  labour  favoured 
the  occurrence  of  post-partum  haemorrhage  and  puerperal 
convulsions;    (2)   that  it  caused   cessation  of  the  natural 
efforts   made   by   the   patient    to    aid  the  passage  of   the 
child ;  ftnd  (3)  that  it  might  exert  an  unfavorable  influence 
upon  the  child's  health.     The   first  and   second  of  these, 
objections  have  been  amply  refuted  by  general  experience ; 
as  regards  the  third,  we  confess  we  should  hesitate  to  give 
a  very  decided  opinion.     That  after  a  labour,  during  which 
chloroform  or  aether  has  been   administered,  the  child  can 
fail  to  come  into  the  world  saturated  (so  to  speak)  with  the 
drug,  seems  to  us  a  simple  impossibility ;  as,  although  it  is 
quite  true  that  the  child  does  not  breathe  until  the  head  at 
any  rate  is  born,  still  it  is  diflQcult  to  conceive  how  the 
vessels  of  the  placenta  can  miss  absorbing  the  vapour  given 
off  by  those  of  the  uterus.     We  own  we  should  like  to  see 
a  large  statistical  table  giving  some  history  of  1000  or  2000 
children    at  whose   birth  anaesthetics  were    employed,    in 
contrast   with   that  of  a   similar    number  at  whose   birth 
recourse  was  not  had  to  such  means.     We  do  not  attach 
much  importance  to  the  fears  some  timid  people  express 
about  the  use   of  chloroform  in   cases  where  cardiac   or 
pulmonary  disease  is  present,  as  we  think  Professor  Erich- 


126  Remetos. 

sen  has  satisfactorily  shown  that  to  such  (in  surgical  cases  at 
any  rate)  the  pain  of  the  operation  where  insensibility  is 
not  produced  is  much  more  dangerous  than  any  effects 
arising  from  careful  administration  of  the  drug^  and  we 
know  this  to  have  been  the  opinion  of  Sir  James  Simpson^ 
and  to  be  that  of  his  successor,  in  obstetric  cases  also. 

To  Sir  James  Simpson  is  due  the  high  praise  of  having 
not  only  manfully  fought  the  battle  of  anaesthetics  in 
general^  but  also  of  having  been  the  first  to  employ 
chloroform  in  midwifery,  and  even  the  first  publicly  to  teach 
and  consistently  to  have  recourse  to  the  use  of  any  such 
alleviations  in  that  department  of  practice.  He  was  not, 
indeed,  in  any  sense,  the  discoverer  of  chloroform,  as  Dr. 
Duns  absurdly  calls  him,  for  this  drug  was  first  prepared  by 
Soubeiran  in  1831,  analysed  for  the  first  time  by  Dumas  in 
1885,  and  first  proposed  as  an  anaesthetic  by  Mr.  Waldie, 
of  Liverpool,  who  suggested  its  use  to  Simpson  himself,  in 
1846,  or  the  beginning  of  1847.  It  is  unfortunate,  there- 
fore, that  Simpson,  in  vindicating  to  himself  the  fame  he  so 
well  deserved,  should,  at  all  times,  have  seemed  to  put 
forward  claims  to  an  honour  to  which  he  had  no  real 
pretensions;  but  we  are  willing  to  hope  that  the 
seeming  disingenousness  was  more  apparent  than  real,  and 
we  can  readily  pardon  him  if,  in  the  justifiable  exultation 
he  must  have  felt  at  having  been  the  happy  instrument  of 
disseminating  such  a  boon  amongst  mankind,  his  language 
was  not  always  sufficiently  guarded.  Sir  James  Simpson 
well  deserves  a  place  beside  Jenner,  and  inasmuch  as  the 
tortures  of  the  operating  theatre  and  the  lying-in  room  far 
exceed  those  of  ordinary  disease,  and  have  now  by-  Simpson's 
means  been  all  but  annihilated,  we  do  not  scruple  to  rank  his 
name  with  that  of  Hahnemann  as  a  benefactor  to  mankind, 
though  not,  of  course,  as  a  philosophical  physician. 

The  account  Dr.  Duns  gives  us  of  this  famous  contro- 
versy is,  as  usual,  one-sided,  partial,  and  inaccurate,  and  he 
manifests  an  intolerance,  strange  in  one  of  his  profession, 
towards  all  those  who  did  not  at  once  abandon  the  religious 
class  of  objections.  He  has  favoured  us  with  long  screeds 
from  Simpson's  correspondence  which  were  wholly  uncalled 


Memoir  of  Sir  James  Y.  Simpson.  127 

for ;  andj  but  for  an  accidental  letter  to  which  no  particular 
notice  is  drawn,  Mr.  Waldie^s  name^  so  far  as  we  can  find, 
would  have  been  ignored. 

In  1848^  Dr.  Simpson  was  invited  to  remove  to  London, 
and  promised,  in  the  event  of  his  complying,  the  chair  of 
midwifery  at  St.  Bartholomew's.  Having  the  fate  of  Sir 
Charles  Bell  before  his  eyes,  he  remained  in  Edinburgh,  like 
a  sensible  man.  In  1849,  he  described  the  celebrated ''  air- 
tractor  '^  which  still  goes  by  his  name.  Shortly  afterwards^ 
he  appears  to  have  had  some  misunderstanding  with  Prof. 
Miller,  which  lasted  longer  .than  might  have  been  expected 
between  men  who  had  once  been  such  close  friends.  But 
it  seems  to  have  been  so  marked  thatj  in  1850,  Simpson 
haying  personal  occasion  for  surgical  assistance^  sent  for 
his  old  enemy  Syme,  and  overlooked  his  old  friend  Miller. 
Dr.  Dans,  indeed,  would  have  us  believe  that  this  strange 
act  of  Simpson's  was  the  occasion  of  the  coldness,  and 
insists  that  Mrs.  Simpson^  for  some  absurd  whim  of  her 
own,  henpecked  her  husband  into  discarding  Miller  in 
Syme's  favour,  in  spite  of  his  own  better  judgment ;  but 
this  story,  being  in  the  highest  degree  improbable,  extremely 
nncomplimentary  to  Mrs.  Simpson,  and  not  very  flattering 
to  her  husband's  manliness  or  common  sense,  we  may  pass 
by  as  unworthy  of  attention. 

We  now  come  to  the  "  tug  of  war,"  the  famous  '*  homoeo- 
pathy "  controversy,  which  really  deserves  to  be  prefaced  by 
a  Homeric  invocation  were  not  such  strains  beyond  the 
reach  of  our  humble  ability.  Its  rise  was  as  follows : — 
Professor  Henderson,*  feeling  it  his  duty  to  practise  his 

*  It  is  Qimeoesiary  here  again  to  ref ate  an  absurd  slander,  revived  after 
Henderson's  death  by  the  Medical  Times  and  Gazette  (April  20th,  1872),  to 
the  effect  that  his  conversion  to  homoBopathy  was  the  result  of  experiments 
with  a  box  of  globules  given  him  by  Simpson,  and  which  was  subsequently 
found  to  have  been  so  tampered  with  as  to  invalidate  any  conclusions  drawn 
from  its  Tue.  This  fable  was  fully  exposed  by  Dr.  Pope  in  his  speech  at  the 
dinner  in  aid  of  the  funds  of  the  London  Homoeopathic  Hospital,  2drd  April, 
1872.  It  is  deeply  to  be  regretted  that  Simpson  himself  tried  to  maintain 
this  supposition,'  though  weU  aware  of  its  groundlessness.  This  is  but  one  of 
those  numerous  instances  of  disingenuousness  which  form  so  dark  a  blot  upon 
Simpfon's  character. 


128  Reviews, 

profession  for  the  benefit  of  his  patients^  and  not  merely  so 
as  to  promote  the  interest  of  a  narrow-minded  medical 
clique,  and  having  heard  and  seen  much  of  the  good 
effected  by  the  homoeopathic  system,  devoted  a  considerable 
portion  of  his  time  to  the  patient  study  of  the  Organon 
and  other  of  Hahnemann's  writings^  and  to  personal  trial  of 
the  effects  of  homceopathic  medicines.  The  result  in  his 
case,  as  in  that  of  every  candid  and  intelligent  investigator, 
was  an  assured  conviction  of  the  truth  of  the  great  law 
similia  simililms  curaniur.  As  Henderson  was  no  profi- 
cient in  the  convenient  form  of  casuistry  which  enables 
medical  teachers  of  more  recent  times  to  practise  and  even 
to  inculcate  homoeopathic  doctrines,  and  yet  so  to  mask 
their  deeds  and  utterances  as  to  retain  their  stipends,  the 
natural  consequence  of  his  honest  declaration  of  his  con* 
victions  was  his  summary  ejection  from  the  chair  of  clinical 
medicine  and  from  his  post  as  physician  to  the  Royal 
Infirmary  together  with  the  loss  of  nearly  all  bis  patients. 
By  way  of  driving  Henderson  to  utter  destitution.  Professor 
Syme,  to  his  lasting  disgrace,  even  sought  to  chase  him  out 
of  the  chair  of  pathology,  as  if  a  physician's  views  upon 
pharmaco-dynamics  were  likely  to  affect  his  descriptions  of 
specimens  of  morbid  anatomy  or  his  accounts  of  the  course 
of  any  pathological  process.  This  infamous  attempt  failed, 
as  we  all  know ;  still,  not  the  less  did  Simpson  feel  it  his 
duty  to  address  the  following  masterly  allocution  to  the 
Medico-Chirurgical  Society  of  Edinburgh,  according  to  the 
report  of  the  Monthly  Journal  of  Medical  Science  .- 

''For  one.  Dr.  Simpson  rejoiced  that  the  colleges  had 
taken  up  the  subject  and  set  the  matter  on  its  right  footing 
by  making  the  question  of  meeting  homoeopathists  not  a 
question  longer  left  to  the  responsibility  and  importunities 
of  individuals,  but  a  question  which  the  profession  had  fixed 
and  settled  in  their  corporate  capacity. 

''  The  resolutions  of  the  colleges  would,  he  believed,  be 
doubly  useful  by  not  only  determining  for  the  future  the 
proper  line  of  duty  of  the  profession  towards  homoeopathists, 
but  by  showing  also  to  the  homoeopathists  their  exact 
position  in  relation  to  the  profession.     ...     In  passing, 


99 


Memoir  of  Sir  James  Y,  Simpson,  12& 

therefore^  and^  it  is  to  be  hoped^  unanimously,  such  a 
measure  as  that  proposed  by  Mr.  Syme,  we  .  .  .  show 
our  anxiety  to  be  rid  of  the  professional  presence  {sic)  of 
homoeopathists  in  all  our  institutions  by  showing  them  our 
determination  to  be  rid  of  them  in  those  places  from  which 
we  have  an  undoubted  right  of  enforcing  their  exchision/' 

Now,  we  are  sorry  to  interrupt  such  a  flow  of  oratory, 
but  we  should  very  much  like  to  know  what  the  distinction 
is  between  "  homoeopaths  '*  and  the  "  profession/'  '*  The 
profession/'  in  common  parlance,  is  taken  to  mean  the  body 
of  members  of  the  medical  profession,  just  as  ''the  cloth 
is  used  as  a  synonym  for  the  clergy,  and  the  ''  trade 
signifies  the  body  of  booksellers  and  publishers.  Member- 
ship of  the  medical  profession  is  constituted  by  the  pos- 
session of  a  legally-recognised  diploma  or  licence  to  practise 
medicine  or  surgery,  obtained  after  due  examination,  and 
has  nothing  whatever  to  do  with  the  dipldme's  views  about 
pharmacodynamics  or  anything  else.  Even  could  an  M.D. 
or  M.B.C.S.  now  be  found  who  practised  bloodletting 
in  pneumonia  or  administered  carbonate  of  soda  in  cases  of 
gastric  acidity,  he  would  still  remain  a  member  of  "  the 
profession,^'  however  much  he  might  deservedly  sink  in  the 
opinion  of  Dr.  Sydney  Ringer  and  of  all  other  sensible 
men.  We  do  not  even  deny  such  membership  to  the 
editor  of  the  Medical  Gazette.  A  homoeopathist,  again,  is 
one  who  holds  certain  doctrines  as  to  the  action  of  drugs, 
and  "  professional "  in  the  acceptation  we  are  considering 
means  belonging  to  the  medical  profession ;  hence  there 
are  professional  and  non-professional  homoeopathists,  as  Dr. 
Henderson  and  Archbishop  Whately,  just  as  there  are 
professional  and  non-professional  allopaths,  as  the  late  Dr. 
Pritchard  and  the  Rev.  Dr.  Duns ;  or  professional  and  non- 
professional stump  orators,  as  Sir  James  Simpson  and  Mr. 
Odger.  Hence,  to  speak  of  homoeopathists  or  any  other 
"  ists,''  in  contradistinction  to  "  the  profession,''  is  to  be 
guilty  of  what  logicians  call  a  ^ ''  cross-division.''  But 
Simpson  next  expresses  his  desire  to  be  rid  of  the  ''  pro- 
fessional presence "  of  the  homoeopathists.  How  is  this  ? 
How  on  earth  can  these  reprehensible  beings  have  a  "  pro- 

VOL.  XXXII,  NO.  CXXVII.— -JANUARY,  1874,  I 


180  Reviews, 

fessional "  presence  at  all  according  to  Simpson^s  new  style 
of  nomenclature^  since  they  are  thereby  excluded  from  the 
profession  altogether  ?  Moreover,  the  "  undoubted  right  ^' 
to  exclude  a  medical  man  from  a  society  into  which  he  has 
been  duly  elected  merely  on  account  of  his  views  on  a 
particular  scientific  question  is,  to  say  the  least  of  it,  very 
open  to  dispute.  Could  the  Royal  Medical  Society,  for 
instance!  ^j^^^  ^^^^  ^^  ^^^  members  merely  because  he  held 
either  the  cellular  or  the  molecular  origin  of  animal  tissues 
in  opposition  to  the  opinion  of  the  majority  of  his  col- 
leagues ?  But  to  return  to  Simpson's  address.  "  He  held 
that  no  men  or  set  of  men  could  in  any  degree  aid  in 
effecting  the  cultivation  and  advancement  of  medical  science 
and  knowledge,  who  entertained  principles  such  as  those 
which  form  the  basis  of  the  homoeopathic  belief.  We 
were  as  much  justified  in  asking  those  who  had  taken 
up  a  belief  in  the  follies  of  Hahnemann  and  his  Organon 
to  withdraw  from  our  Society  as  a  Christian  community 
would  be  justified  in  expelling  those  of  its  members  who 
came  to  believe  in  the  follies  of  Joe  Smith  and  the  Mormon 
Bible.  These  two  heresies^  the  homeopathic  and  the  Mor- 
monite,  appeared^  in  fact,  to  have  many  points  in  common, 
though  the  one  belonged  to  medicine,  and  could  only  pro- 
perly be  judged  of  by  physicians,  and  the  other  belonged  to 
theology,  and  could  only  be  properly  judged  of  by  clerical  men. 
They  were  both  equally  wild.  Some  homoeopathists  profess 
Hahnemann  to  have  been  inspired ''  (Name !  name  !)  ^'  as 
the  Mormonites  hold  Smith  to  have  been.  Both  heresies 
were  extending,  it  was  true,  but  that  was  no  evidence  of 
the  value  of  either/' 

On  comparing  this  tirade  with  that  which  preceded  we 
feel  tempted  to  exclaim  with  Sir  Andrew  Aguecheek, 
*'  Why,  this  is  the  best  fooling,  when  all  is  done."  *'  No 
man  can  aid  in  the  advancement  of  medical  knowledge  who 
holds  the  homoeopathic  belief.'^  Yet  Hahnemann  himself 
deprecated  bloodletting  more  than  a  quarter  of  a  century 
before  Skoda  and  Prof.  Hughes  Bennett  were  ever  heard 
of ;  was  the  first  to  suggest  Camphor  in  the  treatment  of 
cholera ;    decried  the   antiphlogistic    system    while  it  was 


Memoir  of  Sir  James  Y.  Simpson,  131 

still  the  rage  all  over  Europe ;  proposed  Lead  for  some 
forms  of  constipation^  and  Arsenic  for  certain  varieties  of 
enteritis,  when  all  the  thanks  he  got  was  to  be  laughed  at 
for  his  pains   during  his  life^  and  to  have  his  discovery 
pirated  nearly  thirty  years  aftei;  his  death ;  and,  to  crown 
all^  anticipated  Simpson's  own  proposals  for  hospital  reform 
before  Simpson  himself  was  born  ! !     "  Homoeopathy  and 
Mormonism  have  many  points  in  common/'     Well^  Bishop 
Copleston  tells  us  that  the  perception  of  analogies  is  the 
greatest  proof  of  genius.     If  the  discovery  of  similitudes 
vhere   none  such  exist   be    also    a  proof  of  high  natural 
endowments,  then  the  soul   of  Simpson  must  indeed   be 
allowed  to  have  been  more  brilliantly  illuminated  than  any 
other  which  has  as  yet  vouchsafed  to  animate  this  '^  body 
of  our  humiliation/'     "  Homoeopathy  and  Mormonism  are 
both  wild/'     Of  course  we  ourselves  deny  the  first  half  of 
this  assertion ;    but,  even  if  we  accepted  it  in  its  fullest 
extent,  we  should  still  be  unable  to  perceive  that  any  very 
striking  similitude  or  analogy  was  established  between  two 
objects  by  the  fact  of  their  possessing  the  attribute  of  '^  wiid- 
ness^'   in  common.     The  practice  of  mercurial  salivation 
was  *'  wild  ;^'  bloodletting  was   very   "  wild  "  indeed ;  the 
doctrine  of  *^  contraria  contrariis,''  &c.,  is,   if  possible,  still 
"  wilder,'^  yet  none  of  these  vagaries  is  indissolubly  asso- 
ciated in  our  mind  with  the  attempt  of  the  Earl  of  Essex  to 
seize  the  City  of  London,  which  we  take  to  have  been  one 
of  the  *'  wildest "  freaks  on  record.     We  fear  we  are  very 
far  inferior  to  Sir  James  Simpson   in  the  ready  perception 
of  analogies.     But,  if  such  a    soaring  imagination  could 
condescend  to  details^  we  should  feel  disposed  to  ask ;  What 
doctrine  in  Mormonism  corresponds  to  the  law  of  similars 
in  homoeopathy  ?     What  subordinate  article  of  belief,  even, 
in  that  creed,  corresponds  to  the  so-called  law  of  infinitesimal 
doses,  held  as  a  subordinate  doctrine  by  the  majority  of 
homoeopaths  ?  We  are  not  very  learned  in  the  opinions  of  the 
Mormonites,  in  spite  of  Mr.  Hepworth  Dixon's  commend- 
able   diligence ;  but    we  have  been  given  to  understand 
that  the  principid  article  of  the  Mormonite  creed  has  some- 
thing to  do   with  one  or  more  wonderful  inscriptions  on 


i32  Reviews. 

certain  metallic  plates  said  to  have  been  found  no  one 
exactly  knows  where^  and  to  have  disappeared  no  one 
exactly  knows  whither.  What  on  earth  has  this  to  do  with 
the  law  of  similars  7  And  to  compare  subordinate  articles 
of  belief.  We  hope  we  are  doing  our  Mormonite  friends 
no  injustice  in  supposing  their  most  characteristic  subordi- 
nate doctrine  has  to  do  with  certain  rules  concerning  the 
conjugal  state,  which  have  not  been  found  to  square  very 
completely  with  the  legal  maxims  of  most  civilised  countries. 
What  in  the  name  of  wonder  has  all  this  to  do  with  infini- 
tesimal doses  ?  Do  the  Mormonites  enjoin  matrimony  to 
be  taken  in  infinitesimal  doses  ?  If  so,  they  are  a  much 
maligned  community.  But,  it  seems,  ''^the  followers  of 
Joe  Smith  believe  him  to  have  been  inspired,^'  and  the 
followers  of  Hahnemann  believe  the  same  of  their  master. 
The  second  part  of  this  assertion  is  not  true,  to  begin  with ; 
but  that  is  a  small  matter.  No  one  asserts  Hahnemann 
to  have  been  inspired,  except  in  that  vague  sense  in  which 
people  speak  of  Tennyson,  or  Macaulay,  or  Cicero,  or 
Demosthenes,  or  Homer,  having  been  inspired.  But  sup- 
posing some  enthusiastic  follower,  in  an  outburst  of  gratitude 
for  benefits  received  under  homoeopathic  treatment,  had 
used  the  term  in  a  more  literal  acceptation ;  what  then  ? 
Does  that  prove  Hahnemann  himself  a  visionary,  and  his 
other  followers  fools  ?  A  lady  of  our  acquaintance,  who,  a 
short  time  before,  had  enjoyed  the  benefit  of  chloroform  on  an 
"  interesting  occasion,^'  assured  us  that,  in  her  opinion.  Sir 
James  Simpson  ought  to  have  been  made  King  of  England. 
Was  Sir  James,  therefore,  a  traitor,  and  are  all  who  employ 
chloroform  conspirators  ? 

"  The  extension  of  a  belief  is  no  proof  of  its  value.'' 
Indeed  I  Not  a  conclusive  one,  we  grant,  as  witness  Mor« 
monism  itself  twenty  years  ago,  though  we  doubt  whether 
it  is  extending  now.  But  the  fact  of  Christianity  having 
extended  widely,  surely,  and  even  rapidly  in  the  face  of 
obloquy  and  persecution,  is  generally  alleged  as  at  least 
a  subsidiary  proof  of  its  divine  origin  and  therefore  of  its 
truth ;  and  homoeopathy  has  encountered  obloquy  and  per- 
secution   enough  with  a  vengeance,    as  this    very  speech 


Memoir  of  Sir  James  Y,  Simpson.  188 

of  Simpson's  shows^  and  yet  it  has  extended  to  such  a 
d^ree  that  whereas  in  1837  there  were  only  four  homoeo- 
pathic physicians  in  the  United  Kingdom^  in  1873  there  are 
between  eighty  and  ninety  in  London  alone.  In  point  of 
fact,  the  permanent  extension  of  any  system  is  not  a  bad 
proof  of  what  may  be  called  its  relative  truths  so  far  as  it 
goes.  Mohammedanism  is  often  adduced  as  an  instance  to 
the  contrary,  but  we  think  that  in  reality  it  makes  for  our 
assertion  rather  than  against  it.  Defective  as  is  the  religion 
of  Mahomet^  we  have  good  reason  for  believing  it  superior  to 
the  Sabsean  Fire-worship,  and  even  the  extremely  debased 
forms  of  Judaism  and  so-called  Christianity,  which  that 
conqueror  overthrew. 

Dr.  Simpson  proceeds,  "  It  has  been  alleged  that  we 
have  no  confession  of  faith  in  medicine — no  standard  by 
which  we  can  possibly  judge,  as  clerical  bodies  do,  of  the 
amount  of  error  and  deviation  of  those  members  of  the 
profession  who,  from  time  to  time,  may  choose  to  set  at 
nought  the  common  principles  of  that  profession.  But  we 
have  a  standard  of  faith,  and  a  confession  by  which  we  can 
judge  such  men,  namely,  the  standard  of  Common  Sense/' 
We  shall  offer  no  comments  of  our  own  upon  this  passage, 
but  shall  merely  contrast  it  with  an  extract  from  the  writings 
of  Archbishop  Whately : 

''  Since,  therefore,  each  gives  the  preference  to  unassisted 
common  sense  only  in  those  cases  where  he  himself  has 
nothing  else  to  trust  to,  and  invariably  resorts  to  the  rules 
of  art  iJoherever  he  possesses  the  knowledge  of  them,  it  is 
plain  that  mankind  universally  bear  their  testimony,  though 
unconsciously  and  often  unwillingly,  to  the  preferableness 
of  systematic  knowledge  to  conjectural  judgments  J^ 

Dr.  Simpson  proceeds  to  dwell  at  some  length  on  the 
subject  of  infinitesimal  doees,  but  as  we  shall  advert  to  this 
when  we  come  to  the  consideration  of  his  Homceopathy  Mis- 
represented, we  shall  pass  it  over  for  the  present,  and  pro- 
ceed to  a  passage  near  the  end  of  his  speech.  Alluding  to 
homoeopathic  chemists,  Simpson  says,  "  he  did  not  know  the 
number  of  drugs  that  homoeopathists  used,  but  he  did  not  sup- 
pose that  they  exceeded  350  or  300  separate  articles  (!)     Hq 


134  Reviews. 

was  not  aware  what  a  grain  of  each  might  cost^  but  he  sup- 
posed not  above  a  penny  or  two^  at  most^  on  the  average. 
And  one  single   grain    .......  would   of  course   be 

sufficient  during   ahy  one  druggist's  lifetime  ....  for  a 

whole  universe.  A.  homoeopathic  apothecary's  stock  in 
trade,  therefore^  could  not  well  exceed  a  few  shillings,  and 
need  not  require  renewal  during  the  longest  lifetime.      And 

yet  these  same  dilutions  seem  convertible into 

annual  incomes  sufficient  for  the  maintenance  of  three 
thriving  drug  establishments.'' 

All  this  discovers  total  ignorance  of  the  very  elements  of 
homoeopathic  pharmacy.  In  the  first  place,  a  separate 
pestle  and  mortar  are  required  for  nearly  every  drug^  for 
purposes  of  trituration.  Next^  the  processes  of  trituration, 
succussion^  &c.^  and  especially  of  preparing  any  individual 
required  trituration  or  dilution,  can  only  be  entrusted  to 
most  skilful  and  experienced  hands,  and  require  the  ex- 
penditure of  a  very  great  deal  of  time  and  trouble ;  while^ 
owing  to  the  extreme  delicacy  of  homoeopathic  preparations, 
the  slightest  carelessness,  or  even  unavoidable  accident,  will 
often  cause  injury  to  a  large  quantity  of  material,  rendering 
it  necessary  to  throw  it  away^  after  much  time  and  labour 
havel)een  bestowed  upon  it.  So  that  homoeopathic  drugs, 
as  usually  prepared^  are  really  very  costly  indeed ;  and  the 
apothecaries  (using  this  word  in  its  Scotch  acceptation)  who 
may  well  excite  our  envy  are  the  allopathic  druggists,  who 
have  nothing  more  refined  to  deal  with  than  ordinary 
mother  tinctures  and  native  powders,  and  yet  have  the  con- 
science to  charge  the  uniform  rate  of  one  shilling  and  nine- 
pence  apiece  for  bottles  of  physic,  the  average  actual  money 
value  of  which  could  not  by  the  most  extravagant  estimate 
be  adjudged  at  one  penny  farthing. 

But  it  is  perhaps  unfair  to  judge  Simpson  by  a  speech 
evidently  composed  in  haste^  and  we  trust  repented^  though 
not  detracted,  at  leisure.  Let  us,  therefore,  proceed  to  ex- 
amine the  summary  with  which  Dr.  Duns  favours  his 
readers  of  the  contents  of  the  once  celebrated,  though  now, 
happily,  forgotten  treatise,  which  may  fairly  be  supposed  to 
express  Simpson's  deliberate  and  mature  convictions. 


Memoir  of  Sir  James  F.  Simpson.  185 

Dr.   Simpson  (we  are  informed)  shows  (1)   "  that  both 
the  profession  on  the  one  hand^  and  Hahnemann  himself  on 
the  other,  utterly   repudiate  the  compatibility  of  the  two 
systems^  homoeopathy  and  scientific  medicine^  the  principles 
and  practice  of  which  are  as  much  opposed  to  each  other  as 
light  to  darkness,  virtue  to  vice ;  thus  exposing  the  knavery 
of  those  who  profess  to  believe  in   and  to  practise   both." 
If  for  the  words  "  scientific  medicine^'  we  substitute  "  allo- 
pathy "  which  is  what  Simpson  here  means^  we  are  ready 
to  greet  this  dictum  with  rapturous  applause,  the  more  so 
as  it  is  almost  a  transcript  of  the  words   of  Hahnemann. 
As  in  the  first  member  of  the  first  clause  of  the  sentence 
"  homoeopathy  "  is  the  antecedent^  "  light  "  and  '*  virtue  " 
occupying  the  same  relative  place  in  the  first  member  of 
the  second  clause  ;  while  '^  scientific  medicine  "  (which  we 
have  seen  to  mean  allopathy)  and  "  darkness  and  vice  "  are 
corresponding  consequents^  we  learn  that  homoeopathy  is  to 
be  duly  exalted  to  the  regions  of  illumination  and  righteous- 
ness, and  its  antagonist  to  be  relegated   to  the  mansions 
of  obscurity  and  guilt.     This  is  precisely  our  own  opinion, 
and  we  are  grateful  to   Simpson  for  having  expressed  it  so 
forcibly  and  succinctly  for  us.     We  fully  accord,  moreover, 
with  the  censure  passed  upon  the  conduct  of  those  who  try 
to  unite  two  antagonistic  systems ;  though,  out  of  respect 
to  the  feelings  of  certain  distinguished  medical  professors  of 
the  present  day,  and  having  the  fear  of  an  action  for  damages 
on  account  of  defamation  of  character  before  our  eyes,  we 
should  prefer  to  substitute  the  term  "  disingenousness  *' 
for  "knavery/^     However,    if    these    gentlemen    do   not 
object,  it   is  certainly  no  business  of  ours  to  interfere. 
*'  Let   the  galled  jade  wince,  our  withers  are  un wrung." 
No  one  was  more  severe  than   Hahnemann  himself  upon 
those  whom  he  termed  "  bastard  homoeopaths."     The  term 
'^  scientific  medicine  '*  as  applied  to  allopathy  is,,  of  course, 
absurd.     No  system  can  be  called  scientific  which  is  not 
based   upon  some    principle  and   does  not  recognise  the 
working  of  certain  laws.     But  the  profession,  sometimes 
even  the  boast,  of  the  allopaths  is,  that  their  system  is  one 
of  pure  empiricism.     ''  There  can   be  no  doubt,"  said  Dr. 


186  Reviews. 

Stokes^  ''  that  medicine  requires  to  be  put  on  a  much  more 
scientific  basis  than  it  at  present  possesses  ;  it  is  now  simply 
empiricism,  and  that  empiricism  is  onlj  valuable  and  use- 
ful because  it  is  wielded  by  thoughtful  men/'  Sir  John 
Forbes  saysj  medical  treatment  is  '^  neither  precise  in  its 
indications,  direct  in  its  action,  nor  positive  in  its  result/' 
One  of  our  teachers  used  to  glory  in  the  practice  of  medi* 
cine  being  confessedly  empirical,  because,  as  he  alleged,  we 
are  not  yet  sufficiently  advanced  to  reduce  it  to  a  scientific 
system.  Much  in  harmony  with  this  is  the  assertion  of 
Kurt  Sprengel,  one  of  the  greatest  modern  historians  of 
medicine,  who  tells  us  *'  scepticism  in  medicine  is  the  top- 
stone  of  the  science ;  and  it  is  the  wisest  part  to  regard  all 
opinions  with  indifference,  and  to  adopt  none/' 

In  the  year  1847,  Professors  Gairdner  and  Hughes 
Bennett  declared  that  if  any  one  could  demonstrate  the 
inutility  of  bleeding  in  pneumonia  they  would  cease  to 
believe  in  any  medical  theory  whatever.  Yet  the  latter  of 
these  gentlemen  before  many  years,  with  praiseworthy 
candour,  came  forward  as  the  strenuous  opponent  of  blood- 
letting altogether,  and  we  are  glad  he  has  lived  to  see  the 
whole  medical  profession  unanimously  adopt  his  views.  So 
much  for  the  ''  scientific  "  character  of  allopathy  I 

The  next  thing  we  are  told  Simpson  proved  was  (2) 
''that  Hahnemann  himself  very  rarely,  if  ever,  adminis- 
tered to  his  patients  anything  but  small  grains  of  sugar  j 
and  he  confessed  he  did  this  for  the  purpose  of  keeping  up 
in  his  patient's  mind  the  firm  belief  that  each  powder  con- 
tains a  dose  of  some  medicine.  This,  indeed,  was  long 
known  to  the  profession,  and  an  account  of  it  appeared  more 
than  twelve  months  ago  in  the  Court  Journal,^' 

By  inserting  the  words  "if  ever,"  Simpson  becomes 
obnoxious  to  the  charge  of  wilful  and  deliberate  falsehood, 
as  he  thereby  suggests  that  a  doubt  may  be  felt  whether 
Hahnemann  ever  actually  administered  any  medicinal  drug, 
whereas  no  one  who  has  read  any  of  Hahnemann's  works 
can  entertain  such  a  doubt  for  an  instant.  As,  however, 
it  clearly  appears  that  Simpson  never  read  the  Organon 
or  {^n^  other  of  Hahnemapn's  writings,  with  the  smalks^ 


Memoir  of  Sir  James  Y,  Simpson.  187 

attention  or  understanding,  but  seems  to  have  contented  him- 
self with  the  rechauffes  served  up  at  secondhand  by  that 
great  medical  authority  the  Court  Journal^  we  gladly  acquit 
him  of  any  charge  heavier  than  that  of  ^^  answering  a  matter 
before  he  heareth  it/'  Hahnemann's  use  of  Saccharum 
lactis  was  precisely  the  same  as  that  of  bread  pills  or  syrup 
of  saffiron  by  the  allopaths  ;  with  the  advantage  in  his  favour 
of  employing  a  really  inert  material,  whereas  saffron  some- 
times exerts  a  powerful  (but  unsought)  action.  Every 
physician,  whether  homoeopath  or  allopath,  will  acknowledge 
that  if  he  is  forbidden  to  employ  '^  placebos/'  he  may  as 
well  give  up  practice  altogether. 

We  are  next  told  (3)  ^'  that,  except  at  Vienna,  homoeopathy 
is  now  comparatively  little  heard  of  in  Germany  and  France, 
and  that  notwithstanding  Leipzig  is  the  head-quarters  of 
this  doctrine,  the  homoeopathic  hospital  in  that  city,  a 
small  house  in  the  suburbs,  contains  only  eight  beds,  of 
which  Mr.  Lee,  who  lately  visited  it^  found  only  two  or 
three  occupied,  and  it  was  never  sanctioned  by  any  individual 
of  eminence  in  the  profession." 

"  Homoeopathy  is  little  heard  of  in  Germany  or  in  Prance," 
and  this  is  used  as  an  argument  to  discredit  it.  Dr.  Simpson 
had  informed  the  Medico-Chirurgical  Society  that  homoeo- 
pathy was  ^*  extending  "  somewhere  or  other,  but  that  this 
was  no  proof  of  its  truth.  Here  we  are  told  that  the  fact 
of  its  not  spreading  is  a  proof  of  its  vanity.  Poor  homoeo- 
pathy seems  in  a  sad  plight.  If  it  disseminates  itself,  that's 
nothing  to  the  purpose,  but  only  makes  it  the  more  like 
Mormonism.  If  it  does  not  disseminate  itself  it  is  at  once 
shown  to  be  good-for-nothing.  This  is  soniething  like  the 
game  ^f  ''  Heads  I  win,  and  tails  you  lose."  But  we  have 
strong  ^*  historic  doubts  "  as  to  the  truth  of  Simpson's  asser- 
tion that  *^  homoeopathy  was  little  heard  of  in  Germany  and 
Prance."  We  have  not  got  the  statistics  of  1851  before  us, 
but  this  year  (1873)  we  find  there  are  265  homoeopathic 
practitioners  in  Germany  and  upwards  of  400  in  Prance ; 
and  if  these  have  all  sprung  up  during  the  last  twenty-two 
years,  it  speaks  well  for  the  recent  progress  of  the  school. 
>Ioreover  w^  should  like  \p  ]^now  fpr  what  reasoa  Leipzig 


138  Reviews, 

is  called  the  ^'  head-quarters  '^  of  homoeopathy.  Is  it  because 
Hahnemann  was  banished  thence  by  the  apothecaries? 
We  know  of  no  other  title  it  possesses  to  the  honour 
assigned  it. 

We  are  next  told  (4)  "  that  the  theory  of  homoeopathy  is 
never  carried  out  in  practice^  and  indeed  never  can  be  from 
the  natural  impossibility  of  doing  so."     That  the  theory  of 
homoeopathy  is    rarely^   if   ever,   perfectly  carried    out    in 
practice  is,  we  fear,  indisputable ;  and  it  is  perhaps  impos- 
sible  for  fallible  human  nature  in  any  particular  case  to 
insure  the  absolute  homoeopathicity  of  the  selected  drug. 
It  is  still  more  deeply  to  be  lamented  that  the  theory  of 
Christianity  is  never  perfectly  carried  out  in  practice,  and 
we  apprehend  its  complete  fulfilment  is  a  "  natural  impos- 
sibility "  to  fallen  humanity.     Yet  neither  Simpson  nor  his 
biographer  would,  we  imagine,  have  held  this  any  disparage- 
ment of  its  value,  but  the  reverse ;  and  assuredly  he  who 
aims  at  the  lofty  mark  of  the  '^  prize  of  our  high  calling  " 
will,  even  if  he  fail,  at  least  shoot  far  above  the  man  who 
contents  himself  with  a  lower  object.     And  so,  though  our 
approach  towards  perfect  homoeopathicity   may  be  but  an 
asymptotical  progress  after  all,  yet  we  are  on  the  right  path, 
and  our  every  step  is  a  step  in  advance,  which  brings  its  own 
rich  reward.     As  a  matter  of  experience,  we  see,  that,  while 
we  guide  ourselves  by  the  homoeopathic  law,  every  new  fact 
learned  of  pharmacodynamics  adds  its  portion  of  certainty 
to  our  practice,  and  contributes  its  share  towards  the  forma- 
tion of  a  complete  system.     To  the  allopath,  as  we  have 
seen,  such  remains  merely  an  isolated  fact,  reducible  to  no 
law,  and  only  accidentally,  if  at  all,  valuable  in  practice. 
Surely  a  theory,  the  only  fault  of  which  is  that  its  perfect 
realisation  is  beyond  our  power,  is  at  least  preferable  to  no 
theory  at  all — especially  when  every  step  towards  its  realisa- 
tion, however  far  it  may  fall  short,  is  found  by  practical 
experience  to  be  an  actual  gain ;  and  for  confirmation  of 
the  assertion  that  the  allopaths  are    entirely  destitute  of 
theory  or  law  to  guide  their  actions,  we  need  only  refer  to 
the  words  of  Dr.  Stokes  quoted  above. 

Next  (5),   ^'Although  different   effects  are  theoretically 


memoir  of  Sir  James  Y.  Simpson,  139 

said  to  be  produced  by  different  dilutions^  yet  homoeopathists 
themselves  confess  to  effects  quite  the  same  from  all  dila- 
tions/' Why,  of  course  they  do,  in  different  individuals,  or 
even  in  the  same  individual  in  different  physical  conditions. 
Using  language  in  its  ordinary  acceptation,  we  may  say 
that  very  different  effects  are  produced  by  two  drops  and 
two  drachms  of  Tincture  of  Opium,  Yet  it  may  be  a  ques- 
tion, or  in  fact  it  hardly  is  a  question,  whether  two  drachms 
of  Laudanum  would  have  had  more  effect  upon  the  late  Mr. 
De  Quincy  than  two  drops  upon  a  child  of  eight  years  old. 
-Age,  habitual  use  of  a  drug,  sex,  occupation,  periodical 
physical  conditions  (as  the  menstrual  period  in  woman), 
habitSj  position  in  life,  inherited  or  acquired  peculiarities, 
climate,  and  especially  idiosyncrasy ;  all  these  exert  so 
powerful  and  diverse  an  influence  on  different  individuals 
and  on  the  same  individual  at  different  times,  that  it  would 
have  been  a  miracle  if  '^  effects  quite  the  same  had  *'  not 
'^  been  obtained  from  all  dilutions '/'  that  is  to  say,  if  it  had 
not  been  necessary,  in  different  cases,  to  employ  different 
dilations  in  order  to  produce  the  same  effect. 

(6)  ''  The  supposed  statistical  evidence  in  favour  of 
homoeopathic  practice  is  founded  on  false  and  disingenuous 
returns/'  This  is  mere  assertion,  and  admits  of  being 
retorted  on  our  opponents  with  perfect  fairness.  Nowadays, 
so  far  as  we  have  ourselves  seen,  laudable  pains  really  are 
taken  to  secure  tolerably  accurate  hospital  returns;  but 
two  and  twenty  years  ago^  whatever  may  have  been  the  case  in 
homoeopathic  hospitals,  the  reports  of  allopathic  hospitals^  at 
any  rate,  were  notorious  for  their  scandalous  carelessness  and 
inexactitude,  not  to  say  mendacity. 

Perhaps  the  best  reply  to  this  allegation  will  be  afforded 
by  a  simple  and  precise  enunciation  of  the  facts  upon  which 
the  statiatics  of  the  homoeopaths  and  allopaths  were 
founded,  in  reference  to  the  comparative  mortality  and 
duration  of  pneumonia  in  the  two  methods  of  treatment, 
since  this  was  selected  as  the  battle-ground.  It  is  true 
that  as  we  now  know  pneumonia  to  be  a  disease  which 
normally  tends  to  a  spontaneous  cure,  it  is  not  the  one  we 
should  prefer  at  the  present  day  in  support  of  homoeopathic 


140 


Reviews. 


claims;  still  the  following  table,  rightly  understood,  will 
amplv  demonstrate  the  perfectly  ingenuous  character  of  the 
homoeopathic  statistics,  and  the  power  of  our  mode  of  treat- 
ment in  lessening  the  mortality  and  shortening  the  dura- 
tion of  this  disease — not  only  as  compared  with  the 
murderous  bloodlettings  and  ^*  tartarizations  "  of  the 
ordinary  school,  but  even  with  the  more  judicious  ^'  expec- 
tant "  treatment  of  Dietl. 


Ilendenon  and. 
Tessier ■    llonueop. 


o 

2; 


50 


p 
S 


S 


V 


Dtctl 
Louii 


Expect.     1 189     7-4 


p.  c. 

18 


s 

> 
o 
.e 

< 


00 


4> 


l%«  I'm  O 

10  O        Js 

•     I  -I  Oi— ^ 


2  ap    2  *>        T. 
S       «S       o     h^   "'^  ^^ 


p.  c.ip.  c 


50 


AUop. 


78  369 


Oonilland  1  Ditto,  coup 

i  lur  coup 
bleedings 


Toylor,  WaUhe, 
and  Peacock 


} 


AUop. 


75 


1333 


140  30-7 


975 
193 


238 


3S 


p.  c 
50 


p.  c.dnvRdavs  p.  c. 
41     50    11 G  8'  i  20 

I        I        i 
—     —     28    91 


B 

6 


o 


I 


61     — 


18     — 


39     —    933 


p.  c.'p 
10 


10 
6 


10 


146   34 

I 

U4   18 


Now,  with  regard  to  the  above  table  we  must  note  (1) 
the  homoeopathic  cases  were  unselected,  being  taken  in  suc- 
cession as  they  occurred  in  the  case-books ;  (2)  among  the 
'^  complicated  "  homcBopathic  cases  are  eiffht  in  which  pre- 
viously enfeebled  and  deteriorated  health  are  specially  noted ; 
(3)  although  the  proportion  of  female  patients,  as  well  as  of 
those  in  whom  the  upper  lobe  was  affected,  is  smaller  than 
that  in  some  allopathic  statistics  (as  in  those  of  Andral  and 
Grisolle),  this  fact  loses  all  weight  as  an  objection  when  we 
remember  that  such  cases  are  stated  by  Louis,  Grisolle, 
and  Briquet  to  be  more  fatal  only  on  account  of  the 
advanced  age  at  which  they  commonly  appear.  Hence,  as 
the  average  of  the  ages  in  the  homoeopathic  cases  is  con- 
siderably above  that  of  the  allopathic,  the  circumstance 
becomes  unimportant;  (4)  in  the  homoeopathic  cases  the 
duration  of  the  disease  is  reckoned  from  the  commence- 
ment till  the  subsidence  even  of  the  physical  signs,  whereas 
Louis  only  reckons  it  until  the  patient  is  so  far  recovered 
a?  to  l^e  $ible  to  tak^  UQurishing  food }  and  Bonillaud^  still 


Memoir  of  Sir  James  Y,  Simpson,  l4i 

more  nnsatisfactorily^  only  includes  the  time  ''until  the 
characteristic  signs  of  pneumonia  and  fever  have  almost  dis- 
appeared^ and  when  he  had  begun  to  give  some  bouillons ;'' 
(5)  Louis  purposely  excludes  forty-six  cases  which  had 
occurred  in  his  practice  along  with  the  seventy-eight  given^ 
because  in  these  pneumonia  had  occurred  in  unfavorable 
circumstances,  such  as  previous  bad  health;  and^  in  the 
seventy-eight  cases,  he  himself  tells  us  "  all  were  in  a  state 
of  perfect  health  at  the  time  when  the  first  symptoms  of 
the  disease  began  " — in  the  homoeopathic  cases  one  third 
bad  been  in  bad  health  previous  to  the  pneumonia ;  (6)  it  is 
true^  the  instances  of  double  pneumonia  are  less  numerous 
in  the  homoeopathic  than  in  the  allopathic  cases^  but  then 
it  is  to  be  remembered  that,  by  the  acknowledgment  of 
Bouillaud  himself,  this  untoward  complication  was  con- 
stantly the  result  of  the  venesection  resorted  to  in  the 
ordinary  treatment,  so  that  the  comparative  rarity  of  its 
occurrence  under  Tessier  is  a  credit  and  not  a  disparage- 
ment to  his  mode  of  practice.  To  these  observations  on 
the  above  table  we  may  add  the  following  statement  of 
Dietl :  "  the  average  duration  of  pneumonia  treated  by 
venesection  is  85  days — by  Tartar  emetic  28-9  days,  and 
by  the  expectant  method  28  days"  i.  e,  16  days  longer  than 
under  homoeopathy. 

Simpson  objected  to  the  cases  of  Tessier,  that,  as  one 
died  of  erysipelas  which  began  12  days  after  the  pneumonia 
was  cured,  and  two  others  (according  to  his  statement,  but 
only  one  according  to  the  truth)  died  of  consumption  before 
leaving  the  hospital  (although  three  months  after  the  pneU' 
monia  had  been  cured),  these  cases  ought  to  have  been 
counted  as  fatal,  and  would  have  been  so  in  the  returns  of 
allopathic  hospitals.  But,  as  Henderson  justly  remarks, 
we  are  not  comparing  the  homoeopathic  cases  with  crude 
hospital  returns,  but  with  the  discriminating  statements  of 
individual  physicians,  who  knew  perfectly  well  when  their 
patients  died  of  pneumonia,  and  when  of  some  other  disease 
which  had  no  connection  with  it.  Another  objection 
Simpson  brings  forward  is,  that  as  six  of  the  homoeopathic 
patients  had  been  bled  prior  to  the  homceopathic  treatment, 


142  Reviews. 

the  bloodletting  must  have  benefited  these  cases,  and  so  dis" 
qualified  them  from  bearing  testimony  to  the  efficacy  of 
homoeopathy,  Simpson  little  thought  when  he  uttered  this 
silly  cavil  that  the  day  was  not  far  distant  when  the  fact  of 
these  six  recovering  in  spite  of  having  been  bled  would  be 
considered  an  additional  feather  in  the  cap  of  homoeopathy. 

Dr.  Henderson  remarks^  with  perfect  fairness^  that  as 
the  superiority  of  homoeopathy  to  allopathy  in  the  treat- 
ment of  pneumonia  in  carefully  recorded  cases  like  the 
above  is  nearly  the  same  as  that  reported  by  Fleischmann 
in  his  practice  on  a  much  larger  scale^  we  are  entitled  to 
assume  that  in  these  latter  cases  homoeopathy  possessed  no 
unfair  advantage  in  the  nature  of  the  cases  under  treatment. 
And  while  he  admits  that  a  larger  proportion  of  incurable 
organic  diseases  may  resort  to  the  old  allopathic  hospitals 
than  was  at  that  time  to  be  found  in  homoeopathic  institu- 
tions^ he  truly  observes  that  any  disadvantage  under  which 
the  former  thereby  labour  is  more  than  compensated  by  the 
diminished  proportion  of  their  cases  of  acute  inflammation 
which  Simpson  himself  was  forced  to  acknowledge  recovered 
under  homoeopathic  treatment.  With  these  remarks  we 
leave  it  to  our  readers^  judgment  to  determine  whether  the 
homoeopaths  or  the  allopaths  lie  most  open  to  the  charge  of 
having  cooked  their  statistics.* 

But  we  are  informed  (7)  '^  that  all  attempts  to  obtain 
physical  proofs  f  either  of  the  activity  or  even  of  the  exist- 
ence of  the  drugs  said  to  be  contained  in  the  infinitesi- 
mal doses  have  failed.  Homoeopathists  have  not  been 
able  to  show  by  the  highest  magnifying  powers  of  the 
solar  microscope^  by  the  magnetoscope^  or  new  magnetic 
indicator,  or  by  any  other  means,  the  existence  of  the 
smallest  quantity  of  medicine  in  any  of  their  preparations. 
The  magnetoscope  has,  however,  revealed  much  that  one 
would  scarcely  have  expected  to  exist,  of  the  effects  and 
vagaries  of  human  credulity.^' 

If  any  proof  were  wanting  to  show  that  Simpson  had 

*  See  Henderson's  SomoBopathy  Fairly  Sepresented. 
t  Beyond  a  limit  of  dilution,  which  varies  as  chemistry  and  phyucs  ad- 
vance.— Ed. 


Memoir  of  Sir  James  Y,  Simpson.  l43 

never  read  any  one  of  Hahnemann's  chief  works — such  as 
the  Organon  which  he  prates  so  much  about — with  ^the 
smallest  attention^  these  sentences  we  have  just  transcribed 
would  furnish  it  in  abundance.  Does  not  Hahnemann 
expressly  state,  does  not  every  one  of  his  followers  openly 
acknowledge^  that  no  chemical  or  physical  proof  whatever 
can  possibly  be  given  of  *'  the  existence  of  the  drugs  said  to 
be  contained  in  the  infinitesimal  doses/'  and  that  the 
dynamic  activity  of  the  drag  will  respond  to  none  but  its 
own  appropriate  test^  the  physiological  ? 

At  present  in  spite  of  the  new  weapon  of  spectrum 
analysis^  the  physiological  test  still  prevails  over  the  chemi- 
cal and  physical  in  delicacy,  and  quantities  of  matter  which 
have  no  appreciable  action  either  on  chemical  reagents 
or  on  the  spectroscope  may  be  found  to  act  on  living 
matters  and  although  from  the  mutual  interactions  of  many 
chemical  and  physical  properties  it  may  sometimes  happen 
that  the  one  may  be  tested  by  the  other^  an  example  of 
which  is  afforded  by  the  use  of  the  solar  spectrum  in  chemical 
analysis^  still  we  are  by  no  means  warranted  in  demanding 
that  every  ''  dynamis ''  in  each  of  those  three  great  divi- 
sions shall  necessarily  reveal  itself  at  the  bidding  of  another 
taken  from  a  different  class.  Hgpce  we  have  no  reason 
whatever  to  expect  chemical  or  physical  evidence  of  the 
presence  of  a  vital  ''  dynamis/'  All  the  evidence  of  this 
which  we  have  a  right  to  demand  is  its  own  special  and 
appropriate  evidence^  namely,  the  physiological ;  and  this 
we  have  in  abundance^  while  every  day's  experience  of 
medical  practice  furnishes  it  in  still  more  copious  and  in- 
creasing store. 

All  these  are  elementary  facts,  familiar  to  every  tyro 
in  homoeopathy ;  not,  indeed^  that  the  so-called  *'  law  of 
infinitesimal  doses  "  is  the  characteristic  of  homoeopathy,  as 
some  persons  equally  ignorant  of  Oreek  and  medicine 
absurdly  suppose,  but  because  the  facts  on  which  it  is  based 
formed  no  small  portion  of  the  teaching  of  Hahnemann, 
and  have  exerted  a  powerful  influence  no  less  on  the  mode 
of  practice  than  on  the  fame  and  fortune  of  his  successors. 
No  professional  homoeopathist,  therefore,  would  have  wasted 


l4ii  Uevieios. 


his  time  over  *'  solar  microscopes^  magnetoscopes^  new  mag- 
netic indicators/'  &c.^  seeking  to  demonstrate  by  their 
means  a  fact  which  did  not  come  within  the  province  of 
their  cognizance^  any  more  than  he  would  have  sought  to 
ascertain  the  taste  of  a  new  fruit  by  placing  a  fragment  of 
it  in  his  ear^  or  the  colour  of  a  piece  of  cloth  by  putting  it 
in  his  mouth.  Every  student  of  the  writings  of  Hahne- 
mann must  have  been  well  aware  that  even  could  he  have 
possessed  himself  of  Sam  Weller's  famous  "  double  million 
magnifying  gas  microscope  of  hextry  power"  he  would 
still  have  failed  to  perceive  by  its  aid  that  which  is 
physiologically  and  not  microscopically  discerned.  And  if 
Simpson  or  any  of  his  friends  busied  themselves  with  fthe 
magnetoscope  with  any  such  absurd  intentions,  expectations, 
or  belief,  why,  then  it  is  our  happy  lot  cordially  to  agree 
with  that  gentleman^s  assertion,  that  the  instrument  in 
question  '^  has  revealed  much  that  one  would  scarcely  have 
expected  to  exist  of  the  effects  and  vagaries  of -human 
credulity.*' 

Haying  thus  attacked  some  of  the  details  of  homoeo- 
pathic practice,  Simpson  next  proceeds  to  assail  the  homoeo- 
pathic law.  We  confess  this  appears  to  us  a  singular 
course  of  procedure  on  that  gentleman's  part.  He  places 
a  number  of  subordinate  details,  of  greater  or  less  impor- 
tance, at  the  head  of  the  table,  and  then  drags  in  the 
general  principle  at  the  tail  end,  like  the  poor  relations 
who  serve  as  refreshers  after  a  dinner  party.  But  as 
dutiful  disciples  of  Hahnemann  we  are,  no  doubt,  bound  .to 
greet  the  law  of  homoeopathy  with  ^  becoming  reverence 
wherever  we  fall  in  with  it,  so  let  us  see  what  Simpson 
has  found  to  allege  concerning  this  matter. 

(8.)  ''  That  there  is  no  foundation  whatever  for  the  lead- 
ing principle  of  homoeopathy,  Hmilia  similibtis  curantur, 
except  that  which  is  grounded  on  a  gross  perversion  of 
medical  facts  J* 

We  are  more  accustomed  to  speak  of  ^'laying  "  than  of 
"  grounding  *'  a  foundation,  but  as  we  are  not  at  present 
concerned,  with  Simpson's  peculiar  style  of  English  compo- 
sition, we  may  let  this  pass.     But  we  should  rerily  like  to 


Memoir  of  Sir  James  Y,  Simpson,  145 

know  whether^  if  Simpson  were  now  alive,  he  would  still 
adhere  to  the  above  ridiculous  statement.  The  list  of 
illustrations  of  the  truth  of  the  homoeopathic  law  that 
might  be  culled  from  old  medical  literature  and  from  recent 
allopathic  writings  is  so  large  that  to  give  a  tithe  of  them 
would  more  than  fill  all  our  space.  We  need  merely  refer 
the  reader  to  those  collected  by  Hahnemann  in  his  Organon 
and  elsewhere^  and  scarcely  a  treatise  on  homoeopathy 
is  to  be  found  that  do^s  not  add  from  orthodox  sources  to 
these  illustrations.  One  of  the  best  known  of  these  colleo* 
tions  of  old  school-corroborations  of  the  homoeopathic  law  is 
the  appendix  to  Dr.  Keith's  pamphlet.  Some  recent  works 
by  allopathic  authorities  add  immensely  to  this  sort  of 
evidence.  Dr.  Sydney  Ringer's  excellent  Manual  of  TherO' 
peutics  is  one  of  the  classbooks  specially  recommended  by 
Sir  Robert  Christison  to  his  students,  and  we  are  there 
taught  (1)  that  the  well-known  emetic,  Ipecacuanha,  is 
the  specific  for  many  kinds  of  vomiting ;  (2)  that  Iodine 
produces  coryza,  lachrymation,  frontal  headache,  &c.  (in 
fact,  the  condition  familiarly  known  as  ''iodism^'),  and  that 
it  is  precisely  in  the  treatment  of  such  afiections  that  the 
administration  of  Iodine  is  found  useful ;  these  may  serve  as 
specimens,  but  the  book  is  full  of  illustrations  and  corro- 
borations of  the  homoeopathic  law.  Dr.  Thorowgood  loudly 
asserts  the  value  of  Arsenic  in  the  treatment  of  gastro- 
enteritis, and  seems  to  plume  himself  greatly  on  what  he 
supposes  to  be  his  own  discovery.  Sir  Thomas  Watson,  in 
his  Lectures  on  the  Principles  and  Practice  of  Physic,  deems 
the  claims  of  Strychnia  to  be  employed  in  the  treatment  of 
tetanus  well  worthy  of  attention,  and  admits  that,  if 
successful,  it  would  be  an  instance  of  cure  according  to 
the  Hahnemannic  law.  Dr.  Symonds,  in  his  article  on  tetanus 
in  the  Cyclopedia  of  Medicine^  expresses  his  concurrence 
in  this  opinion  of  Sir  Thomas  Watson,  and  adds,  that,  as 
OU  of  Turpentine  has  been  known  to  produce  a  discharge 
of  bloody  urine,  it  might  rationally  be  administered  in  a 
case  of  spontaneous  hsematuria.  These  illustrations  of  the 
truth  of  the  doctrine  similia  similibus  curantur  are  pro- 
duced ex  abunduntid  from  the  results  of  modem  teaching 

VOL.  XXXII,  NO.  CXXVII. JANUARY,   1874.  K 


146  Reviews. 

among  professed  allopaths,  and  they  offer  themselves  in  such 
troops  that  the  only  di£Sculty  is  to  make  a  selection.  We 
should  very  much  like  to  be  informed  on  what  **  gross  per- 
version of  medical  facts"  the  "  foundation  "  they  afford  to 
the  ^'  leading  principle  of  homoeopathy  ''  is  supposed  to  be 
*'  grounded/' 

But,  after  all,  the  strongest  proofs  of  all  are  to  be  found 
in  experiments  specially  performed  for  the  purpose,  and  not 
mere  chance  blunderings,  as  are  mostly  the  illustrations 
obtained  from  allopathic  sources  before  or  since  Hahne- 
mann's discovery.  Proper  homoeopathic  treatment  by 
medicines  chosen  in  accordance  with  careful  homoeopathic 
provings  is  the  real  test,  and  it  is  to  that  we  refer  scientific 
men.  Any  one  who  pretends  to  judge  of  the  truth  or 
falsity  of  the  homoeopathic  law  without  making  systematic 
and  conscientious  trials  of  this  sort  is  no  true  man  of  science, 
and  his  judgments  are  worthless. 

We  now  come  to  the  last  of  Simpson's  allegations,  which 
is  as  follows :  (9)  ^^That  the  writings  and  the  practice  of  diffe- 
rent homoeopathists  are  so  full  of  contradictions  and  incon- 
sistencies that  it  is  impossible  either  to  harmonise  or  reconcile 
them  except  on  an  hypothesis  fatal  to  their  pretensions.'^ 

All  those  who  are  in  the  least  familiar  with  religious  pole- 
mics must  have  met  with  an  argument  identical  in  principle 
with  the  above  urged  usque  ad  nauseam  in  opposition  to  the 
^'  pretensions  '^  of  Christianity ;  and,  as  further  allusion 
to  so  momentous  a  subject  would  be  unbecoming  in  this 
place,  let  us  try  to  realise  the  results  to  which  we  should 
be  led  if  such  an  argument  were  allowed  any  great  weight  in 
purely  secular  matters. 

Hughes  Bennett,  Virchow,  Huxley,  Schultze,  and  Schlei- 
den  and  Schwann,  hold  widely  differing  views  on  many  phy- 
siological questions;  tj^erefore  physiology  is  ''but  a  name.'' 
Lord  Macaulay  and  Mr.  Froude  regard  King  Henry  the 
Eighth  with  very  different  eyes ;  therefore  no  such  monarch 
ever  reigned.  Max  Miiller  and  Professor  Blackie  are  at 
loggerheads  on  most  mythological  points ;  therefore  the 
study  of  mythology  ought  to  be  abandoned.  It  is  gene- 
rally  believed  that  the   blood   circulates,   but  some    have 


Memoir  of  Sir  James  Y.  Simpson,  147 

asserted  and  some  have  denied  this  circulation  to  be  effected 
by  means  of  a  ft^  afronte  in  addition  to  the  vis  a  tergo 
resalting  from  the  cardiac  contractions ;  therefore  no  cir* 
culation  takes  place  at  all.  And  to  come  nearer  home, 
Simpson  would  have  done  well^  before  bringing  out  this  ninth 
thesis^  to  bethink  himself  of  the  wise  old  proyerb,  "  Those 
who  live  in  glass  houses  ought  not  to  throw  stones.*'  If  dis- 
crepancies in  the  teaching  and  inconsistencies  in  the  modes 
of  practice  of  the  adherents  of  any  system  are  to  be  held 
fatal  to  its  ^*  pretensions/'  what  in  the  world  is  to  become 
of  the  '*  pretensions  '^  of  allopathy,  or  "  scientific  medicine/' 
as  Simpson  calls  it  on  the  lucus  a  non  lucendo  principle  ? 
What  are  we  to  think  of  the  very  different  light  in  which 
Simpson  and  Prof.  Lister  regarded  the  use  of  carbolic  acid  ? 
What  are  we  to  think  of  the  differences  of  opinion,  ex- 
pressed with  exemplary  plainness  of  speech,  but  somewhat 
defective  courtesy,  as  to  the  value  of  chloroform  ?  How 
about  the  disputes  raging  in  the  allopathic  camp  about  the 
use  of  Mercury^  whether  as  a  cholagogue,  sialogue,  or  anti- 
syphilitic^  and  even  as  to  the  propriety  of  its  being  ever 
administered  under  any  circumstances  at  all  ?  What  con- 
clusion are  we  to  draw  from  the  controversies  regarding 
Bromide  of  Potassium,  Digitalis^  Belladonna,  Copaiba, 
Cubebs,  Sarsaparilla,  the  entire  class  of  so-called  antispas- 
modics, as  Valerian,  Assafcetida,  ^c.,  Cod-liver  Oil,  Taraxa^ 
cum,  Podophyllin,  Benzoic  acid,  Sarracenia  purpurea,  OH' 
banum,  (iuinine,  and  nearly  every  other  drug  contained  or 
not  contained  in  the  British  Pharmacopada  ?  And  even, 
to  narrow  the  sphere  of  debate  to  the  mere  question 
of  one  single  circumstance  in  the  treatment  of  one  soli- 
tary disease,  what  are  we  to  infer  from  the  endless  dis- 
putes about  the  influence  of  climate  in  the  treatment  of 
phthisis  ?  Some,  especially,  thoughlnot  exclusively  of  the 
less  advanced  school,  are  still  louo^in  their  praises  of  a 
warm  climate;  others,  as  Dr.  Buj*gess,  think  a  cold  is 
better,  and  they  are  by  no  means  unable  to  show  some 
primd  facie  reason,  at  least,  for  their  omiion ;  a  third  set^ 
ably  represented  by  Dr.  Liedbeck  of  *tockholm,  recom- 
mends mountain-tops,  on  the  sufficiently  plausible  allegation 


148  Reviews. 

that  the  rarefaction  of  the  air  at  such  altitudes  compels  the 
patient  to  make  deep  inspirations  in  order  to  obtain  a  dc^e 
supply  of  oxygen  each  time  he  breathes,  and  thereby  tends  to 
strengthen  and  expand  the  pulmonary  organs ;  a  fourth 
advocates  valleys  in  preference^  as  iu  such  localities,  owing 
to  the  condensation  of  the  air^  a  more  copious  supply  of 
oxygen  is  obtained  without  undue  overaction  of  the  respira- 
tory muscles  or  stretching  of  the  weakened  lung ;  a  fifth 
recommends  a  dry  atmosphere^  as  aiding  the  evaporation 
from  the  lungs ;  a  sixth  insists  upon  a  moist  air  as  less 
irritating ;  and  a  seventh,  of  which  Prof.  Hughes  Bennett 
may  be  taken  as  the  distinguished  head^  thinks  the  ques- 
tion of  climate  of  very  little  importance  in  the  treatment  of 
the  disease  we  are  speaking  of.  Besides  all  this,  the  whole 
question  of  oKone  opens  a  wide  field  of  discussion,  which 
our  readers  would  find  more  tedious  than  instructive.  Yet 
all  these  are  merely  questions  of  our  own  day ;  if  we  were 
to  look  into  the  history  of  medicine^  and  call  to  remem- 
brance all  the  contentions  of  the  '^  methodists,^'  the  "  pneu- 
maticks^"  the  ''  dogmatists "  and  other  ancient  sects,  the 
task  would  be  endless.  And  no  doubt  all  this  has  led  to 
great  scepticism  in  theoretical  matters,  as  well  as  nihilism 
in  practice,  among  the  more  enlightened  adherents  of  the 
allopathic  school,  as  well  as  to  great  disparagement  of  the 
profession  in  the  eyes  of  the  public.  We  fear  it  must  be 
admitted  that,  in  all  ages,  the  most  enlightened  and  saga- 
cious men  have,  as  a  rule,  been  precisely  those  who  held  the 
art  of  the  physician  in  the  lowest  contempt.  Juvenal, 
Erasmus,  Montaigne,  Moliere,  Voltaire,  Heinrich  Heine, 
SmoUett  (himself  a  medical  man).  Fielding,  and  in  our  own 
days,  Williamson,  Frankland,  and,  among  popular  writers, 
Charles  Beade — men  of  very  different  countries,  ages,  and 
general  character — ^yet  agree  in  this.  All  this  has  naturally 
produced  a  feeling  of  disappointment  and  despondency 
among  the  adherents  of  the  "  advanced  school  "  in  allo- 
pathy. Such  are  quite  ready  to  renounce  and  deride  the 
doctrines  of  "  orthodox "  medicine,  and  we  might  have 
gained  nearly  all  of  them  as  coadjutors  of  our  own,  were  it 
not  that  despair  of  success  has  bred  in  many  an  apathy  of 


Memoir  of  Sir  James  Y.  Simpson.  149 

mind  which  is  a  very  unfavorable  preparation  for  the  in- 
vestigation of  any  new  system  which  may  present  itself  to 
them.  They  "  are  ready  to  say,  Who  will  show  us  any  good?" 
and  not  indisposed  to  charge  those  with  presumption  who  pro- 
fess to  have  discovered  a  law  where  all  before  found  nought 
but  confusion.  A  precisely  similar  accusation  was  foreseen 
and  deprecated  by  Lord  Bacon,  as  likely  to  be  brought 
against  himself  for  the  claims  he  made  in  behalf  of  his 
"  new  philosophy.^'  And  as  the  course  which  Hahnemann 
pursued  in  the  investigation  of  his  great  law  was  identi- 
cally that  which  Bacon  laid  down  as  essential  to  all  philo- 
sophical investigation ;  as  Hahnemann's  great  doctrine  was 
no  lucky  guess  or  chance  discovery,  but  the  result  of  long 
observations,  carefully  made  and  accurately  reasoned  upon ; 
not  founded  on  a  few  disconnected  phenomena  or  instances^ 
but  duly  established  by  "  solitary,"  *'  migrating,'^  "  con- 
spicuous," "  clandestine,"  "  similar,"  ''  singular,"  "  deviat- 
ing," and  ''  bordering  "  instances,  and  instances  "  of  power ;" 
verified  and  corrected  by  "  instances  of  the  cross ;"  and, 
both  during  and  since  his  own  lifetime,  illustrated  and  con- 
firmed by  ^'  instances  of  the  lamp,"  the  followers  of  Hahne- 
mann have  an  equal  right  with  those  of  Bacon  to  require 
their  opponents  to  cast  away  their  idols  of  the  tribe,  the 
theatre,  the  market-place,  and  the  cave,  and  examine  with 
patient  and  unbiassed  attention  the  doctrines  which  have 
been  attested  by  so  much  endurance  and  such  noble 
sacrifices. 

We  find  that  we  have  devoted  so  much  space  to  the 
examination  of  this  celebrated  oontrovery,  that  we  must  pass 
in  rapid  review  the  remaining  incidents  and  contentions  of 
Simpson's  laborious  and  varied  career.  We  shall,  there- 
fore, forbear  to  dwell  upon  an  outbreak  of  hostilities  between 
Miller  and  Simpson  in  1852,  and  the  much  more  pleasing 
account  of  Simpson*s  splendid  hospitality  and  friendly 
intercourse  with  such  men  as  Channing,  Eyre,  Betzius  and 
Churchill,  which  Dr.  Duns  inserts  under  the  same  year. 
In  1853,  he  published  a  paper  on  the  supposed  utility  of 
inunction  with  Cod-liver  oil  in  phthisical  cases — a  practice 
which  Dr.  Bennett  has  since  shown  to  be  of  doubtful  value. 


150  Review.9, 

In  the  same  year  be  published  Notes  on  some  Ancient  Greek 
Vases,  the  subject  having  been  suggested  to  him  by  acci- 
dentally noticing  the  Lycium  of  Musseus  at  the  British 
Museum.  On  1st  of  March,  1853,  he  was  elected  foreign 
associate  of  the  French  Academy  of  Medicine^  though  not 
without  some  opposition ;  and  as  we  have  said  so  much  of 
Simpson's  disputatious  temper^  and  but  too  frequent  want  of 
courtesy  and  even  candour,  we  have  real  pleasure  in  being 
able  to  record  of  him  that  about  this  time  he  undertook  a 
generous  defence  of  his  old  antagonist  Syme  against  the 
unfounded  aspersions  of  Mr.  Hester^  at  a  meeting  of  the 
Provincial  Medical  Association  at  Oxford.  Perhaps,  after 
his  estrangement  from  Miller,  Simpson  may  have  become  in 
some  measure  reconciled  to  Syme,  with  whom  he  had 
warmly  co-operated  in  the  persecution  of  Henderson ;  but 
the  reconciliation  was  certainly  not  lasting,  and  probably 
not  very  deep,  which  makes  his  voluntary  interference  on 
Syme's  behalf  all  the  more  creditable.  He  interested  himself 
warmly  in  the  election  of  Edward  Forbes  to  the  chair  of 
natural  history  in  1854,  and  after  that  distinguished 
naturalist's  death  strove  inefifectually  to  have  Agassiz 
appointed  as  his  successor.  He  also  laboured,  but  without 
success,  to  have  Dr.  Hughes  Bennett  appointed  to  the  chair 
of  practice  of  physic  on  Alison's  retirement  in  1855,  and  no 
less  exerted  his  influence  to  the  utmost  of  his  power  when 
the  chemistry  chair  fell  vacant  in  1858.  With  regard  to 
this  subject  we  beg  to  express  our  entire  concurrence  with 
the  remark  of  his  biographer,  which  we  here  transcribe : 
'^  When  we  remember  how  bitterly  he  felt  and  how  earnestly 
he  resented  the  interference  of  some  of  his  colleagues  in  his 
own  election,  we  may  wonder  that  he  ever  ventured  to  take 
any  step  in  these  matters  fitted  to  create  even  the  slightest 
suspicion  of  interference  on  his  part.'' 

In  1856,  Simpson  published  a  paper  entitled.  Was  the 
Roman  Army  provided  with  Medical  Officers  ?  In  the 
same  year  he  had  the  honour  of  attending  the  Empress  of 
the  French  in  bis  professional  capacity,  and  also  received 
from  the  French  Academy  the  Monthyon  prize  of  2000 
francs    for   '^  most  important    services  done  to  humanity/' 


Memoir  of  Sir  James  Y,  Simpson.  151 

He  took  au  active  sLare^  together  with  Dr.  Alexander  Wood 
io  the  discussions  at  the  time  of  the  passing  of  the  famous 
"  Medical  Act,  1858/*  We  next  hear  of  a  squabble  with  Mr. 
Syme,  in  which  that  gentleman  applied  the  terms  *'  false  and 
calumnious  '^  to  a  statement  of  Dr.  Simpson's,  and  before 
the  summer  of  1860  our  indefatigable  professor  had 
published  three  quartos  on  archaeological  subjects.  In 
1860  and  at  various  times  afterwards  he  wrote  upon  a 
subject  which  has  since  become  almost  as  indissoluble 
associated  with  his  name  as  chloroform  itself,  viz.,  acupres- 
sure. As  the  advantages  of  this  haemostatic  process  over 
the  ligature  in  many  cases  where  it  is  admissible  are  now 
generally  admitted,  such  as  its  rendering  isolation  of  the 
end  of  the  vessel  unnecessary,  the  smaller  likelihood  of 
subsequent  mortification,  and  the  lower  degree  of  inflamma- 
tion excited,  &c.,  it  is  a  pity  that  Mr.  Syme  allowed 
himself  to  speak  slightingly  of  the  author  of  the  work  on 
Acupressure,  if  not  of  the  method  itself,  even  although  in 
the  first  fervour  of  a  new  idea  Simpson  unquestionably 
spoke  of  his  operation  as  being  more  widely  applicable  than 
it  has  really  proved.  Mr.  Syme  even  went  so  far  as  to 
tear  up  Simpson's  pamphlet  in  the  presence  of  his  students, 
and  a  long  and  bitter  course  of  wrangling  began.  It  was 
of  course  natural  enough  that  Simpson  should  have  resented 
such  unseemly  conduct  on  the  part  of  his  antagonist,  but 
we  regret  to  have  to  add  that  in  1867,  when  Syme's  son-in- 
law.  Professor  Lister,  introduced  Carbolic  acid  to  the  notice 
of  the  profession.  Sir  James  Simpson  used  every  means  to 
depreciate  the  antiseptic  and  to  disparage  the  proposer  of 
it,  actuated  no  doubt  in  part  by  apprehension  lest  the 
introduction  of  a  really  perfect  antiseptic  (if  this  should 
prove  such)  should  interfere  with  the  universal  adoption  of 
acupressure  in  preference  to  the  ligature,  on  which  he  had 
set  his  heart,  but  also,  we  fear,  by  the  rancorous  feelings 
he  permitted  himself  to  indulge  towards  Professor  Lister's 
father-in-law. 

On  8rd  January,  1866,  Earl  Russell  communicated  to 
Simpson  the  Queen's  offer  of  a  baronetcy,  which  he  accepted 
in  due  course ;  so  during  our  few   remaining   pages    Dr. 


152  Reviews, 

Simpson  disappears  and  Sir  James  will  take  his  place.  In 
1867,  Sir  James  delivered  a  lecture  on  "  Modem  and 
Ancient  Languages/'  at  Granton.  This  discourse  seems  to 
have  been  very  much  of  a  richauffi  of  Mr.  Lowe's  tirade 
against  classical  education  at  the  Royal  Institution  a  few  days 
before.  We  have  the  usual  flourish  about  Greek  and  Latin 
being  dead  languages,  and  the  utterly  inaccurate  statement 
that  in  many  schools  in  England  they  were  the  only  languages 
taught.  Whatever  might  have  been  the  case  some  years 
previously^  such  an  assertion  was  notoriously  untrue  in 
1867,  but  the  ignorance  of  the  Scotch  concerning  English 
education  is  amazing ;  perhaps  also  the  converse  is  hardly 
less  surprising.  Sir  James  insisted  that  if  a  knowledge  of 
the  classics  were  really  favorable  to  the  acquirement  of  a 
good  literary  style^  this  would  exclude  all  ladies  from  author- 
ship^ forgetting  apparently  or  else  being  ignorant  of  the 
fact  that  '^  George  Eliot,''  Mrs.  Browning,  and  even  Mrs. 
Hemans  were  excellent  classical  scholars ;  of  the  first  we 
may  happily  still  speak  in  the  present  tense.  Amongst 
'^ eminent  authoresses"  who  did  not  acknowledge  Greek  and 
Latin  to  be  requisite  in  order  to  write  English  he  cites  the 
authoress  of  that  singular  production  Oswald  Cray,  a  writer 
who  has  the  best  of  all  reasons  for  refusing  to  make  any 
such  acknowledgment.  Then  we  have  the  threadbare 
assertion  that  if  the  works  of  Horace,  Ovid,  Juvenal,  and 
Martial,  had  originally  been  published  in  England,  their 
sale  would  have  been  stopped  by  authority.  But  however  this 
may  be,  a  generation  which  buys  by  the  score  editions  of 
tenth-rate  sensation  novels  redolent  of  nothing  but  murder, 
adultery,  and  seduction,  and  provides  itself  with  copies  of 
Mr.  Swinburne's  poems  by  the  thousand,  has  no  right  to 
quarrel  even  with  the  second  and  ninth  satires  of  Juvenal, 
or  to  be  very  severe  upon  "  all  those  naughty  epigrams  of 
Martial."  The  fact  that  Juvenal,  for  example,  wrote  in 
Italy  1800  years  ago,  and  that  he  did  not  *'  originally 
publish  in  England  "  in  the  present  day,  is  precisely  his 
justification.  Even  in  England,  too,  conventional  ideas  of 
propriety  are  very  fleeting  things.  A  hundred  years  ago, 
one  of  the  most  religious  of  English  poets  read  Jonathan 


Memoir  of  Sir  James  Y.  Simpson.  153 

Tfild  aloud  for  the  delectation  of  an  evangelical  old  lady. 
Nowadays^  whatever  may  be  the  nature  of  our  daughters*  or 
sisters'  private  studies^  we  are  all,  as  a  rule,  extremely 
proper  about  the  books  we  quote  in  their  presence.  We 
are  far  from  decrying  such  decorous  precautions — they  would 
be  highly  commendable  could  we  but  suppose  they  afforded 
any  trustworthy  indication  of  our  private  acts  and  thoughts. 
And  a  hundred  years  hence,  in  all  probability,  our  descen-. 
dants  will  encase  the  legs  of  their  drawing-room  chairs  in 
neat  little  trousers,  and  ask  a  lady  whether  she  prefers  the 
pectoral  region  or  the  crural  members  of  a  partridge.  Very 
likely  in  that  Saturnian  era  similar  objections  will  be  brought 
against  Spenser  and  Milton  to  those  which  Sir  James 
Simpson  and  others  have  seen  fit  to  bring  against  the 
greatest  satirist  the  world  ever  saw. 

In  1868,  the  principalship  of  the  University  of  Edin- 
burgh having  fallen  vacant  by  the  death  of  Sir  David 
Brewster,  a  strong  effort  was  made  to  procure  it  for  Sir 
James  Simpson ;  but  the  Court  of  Curators,  unwilling  to 
break  through  long  prescription,  and  finding  no  precedent 
for  selecting  the  Principal  from  the  Medical  Faculty, 
conferred  the  vacant  o£Sce  upon  Sir  Alexander  Grant. 

In  this  brief  sketch  of  Sir  James  Simpson's  life  we  have 
necessarily  omitted  much  which  in  a  more  detailed  account 
it  would  be  unpardonable  not  to  particularise.  For  ex- 
ample, we  have  said  nothing  about  his  proposals  for  hospital 
reform^  little  about  his  various  papers  on  obstetric  subjects, 
and  hardly  anything  about  his  numerous  charities  and 
genial  bearing  in  private  life.  All  these  are  sufficiently 
present  to  the  minds  of  those  who  knew  him,  and  to 
strangers  the  curt  mention  of  them  which  alone  the  limits 
of  a  review  permit  must,  perforce,  be  uninteresting.  It 
only  remains  to  tell  that^  after  a  painful  illness,  Sir  James 
died  on  the  6th  of  May,  1870,  and  was  buried  at  Warriston 
Cemetery — the  offer  of  a  public  funeral  in  Westminster 
Abbey  having  been  declined. 

However  imperfectly  Dr.  Duns  has  performed  his  task, 
it  is  impossible  for  any  ''  Civis  Academise  Edinensis "  to 
read  this   biography  without  very  strong   and  very  mixed 


154  Reviews. 

emotions.  As  we  turn  over  its  pages  and  recognise  on  each 
some  familiar  name^  past  days  seem  to  come  back,  and  for 
a  moment  we  can  almost  fancy  we  are  again  among  our  old 
friends  and  teachers.  But  we  are  quickly  reminded  how 
heavy  a  hand  death  has  laid  upon  the  brilliant  circle  which 
but  lately  graced  our  alma  mater.  During  the  last  seven 
years  four  of  the  brightest  lights  even  in  that  splendid 
constellation  have  been  quenched  in  the  darkness  which 
awaits  us  all ;  and  although  we  are  very  far  indeed  from 
insinuating  that  the  distinguished  successors  of  Henderson, 
Goodsir,  Syme,  and  Simpson  are,  in  any  sense,  unworthy 
representatives  of  those  who  immediately  preceded  them, 
we  may  well  be  pardoned  if  a  natural  feeling  of  sadness 
comes  over  us  when  we  remember  that  so  many  of  our  old 
instructors  have  passed  away  from  the  society  which  they 
contributed  so  much  to  adorn.  Of  Henderson  it  may 
safely  be  asserted  that  none  ever  listened  to  him  as  a 
teacher  who  did  not^  ere  long,  come  to  love  him  as  a  friend ; 
and  although  some  few  may  have  been  chilled  or  repelled 
by  the  thoughtful  gravity  of  Goodsir,  none  who  really  knew 
him  could  fail  to  prize  the  genuine  kindness  and  Christian 
worth  which  were,  perhaps,  at  times  hidden  from  the 
superficial  by  his  characteristic  reserve.  Notwithstanding 
Syme's  sarcastic  and  even  bitter  disposition,  there  was 
below  the  surface  a  fund  of  native  benevolence,  the  effects 
of  which  many  of  his  students,  whose  welfare  he  was  ever 
ready  to  promote,  have  had  gratefully  to  acknowledge  in 
after  life.  And  while  we  cannot  but  remember  with  regret 
the  rancour,  discourtesy,  and  even  disingenuousness,  which 
too  often  disgraced  Simpson  as  a  controversialist,  and  the 
intolerant  and  persecuting  spirit  he  uniformly  displayed 
towards  those  who  differed  from  him,  we  are  bound,  in 
fairness,  to  set  against  all  this,  not  only  his  almost 
incredible  industry,  the  versatility  of  his  genius,  and  his 
practical  usefulness,  but  also  his  many  acts  of  unostenta- 
tious benevolence,  his  strong  family  affection,  and  his  active 
friendship  towards  many  a  struggling  aspirant  who  had  no 
claims  to  his  notice  except  those  of  poverty  and  distress. 
We  are  sorry  to  be  compelled  to  do  the  ungracious  act 


The  Simplicity  of  Life,  by  Dr.  Ralph  Richardson.    155 

of  exposing  Simpson  again  after  his  deaths  but  Dr.  Duns's 
biography  has  left  us  no  choice.  It  is  strange  that  a 
learned  divine  of  that  Free  Kirk  of  Scotland,  of  which 
both  Simpson  and  Henderson  were  members — Henderson 
indeed  occupying  a  conspicuous  position  as  elder — should 
have  failed  to  perceive  without  any  telling  that  Henderson 
would  not  have  sacrificed  name^  and  fame^  and  money,  and 
repose  for  the  sake  of  advocating  the  claims  of  homoeopathy 
to  be  considered  a  great  truth  in  medicine,  had  it  been  the 
grotesque  chimera  represented  in  Duns's  pages  on  Simpson's 
authority.  Surely  any  man  of  sense  might  have  perceived 
that  the  sole  real  point  at  issue  between  the  supporters 
and  opponents  of  homoeopathy  is  simply  the  experimental 
point,  is  the  principle  true  or  not  when  tried  ?  Henderson 
thought  it  right  to  make  the  trial  before  bearing  public 
witness  for  or  against  it.  A  religious  man  as  he  was, 
he  had  the  fear  of  the  ninth  commandment  before  his 
eyes,  and  was  accordingly  solicitous  not  to  bear  false 
witness.  How  does  a  divine  excuse  Simpson,  who,  without 
one  single  trial,  testified  publicly  that  his  colleague  had 
spoken  falsely  ? 


The  Simplicity  of  Life :  an  introductory  Chapter  to  '  Patho- 
logy.^ By  Ralph  Richaroson,  M.A.,  M.D.  London  : 
H.  K.  Lewis.     Pp.  118. 

Wb  are  truly  rejoiced  to  see  the  appearance  of  this  work, 
which  is  the  first  instalment  of  a  new  edition  of  Fletcher^a 
Pathology.  The  author  is  an  old  pupil  of  Fletcher's,  and 
possesses,  besides  the  published  works  of  that  distinguished 
physiologist,  notes  of  his  lectures,  and  will  therefore,  we 
hope,  be  able  to  add  much  valuable  matter  from  that  source. 
About  two  years  ago  he  wrote  to  Dr.  Drysdale,  as  the 
surviving  Editor  of  Fletcher  s  Pathology,  asking  if  there 
was  any  intention  of  publishing  a  second  edition,  adding 
that  he  contemplated  doing  so.     Dr.   Drysdale  replied  that 


156  Reviews, 

he  was  unable  to  undertake  the  task,  and  expressed  his 
gratification  at  hearing  of  Dr.  Bchardson's  intention.  The 
present  volume  contains  chiefly  a  transcription  of  Fletcher's 
chapter  on  life  in  the  Rudiments  of  Physiology ^  preceded 
by  some  introductory  matter  comparing  it  with  the  ideas 
prevalent  now,  especially  those  of  Oull,  Huxley,  and  Beale, 
which  he  judges  on  Fletcher's  principles.  On  some  points 
we  are  not  j^uite  at  one  with  him  respecting  the  nature 
of  force  and  its  relation  to  the  animal ;  e.  g.y  he  objects  to 
the  expression  of  force  being  *^  stored  up ''  in  plant 
products  to  be  consumed  in  animals,  while  we  think  that, 
properly  understood,  this  is  quite  correct.  But  we  are  all 
the  same  unspeakably  gratified  that  the  doctrines  of  Fletcher, 
which  we  have  so  long  endeavoured  to  bring  into  the  promi- 
nence they  deserve^  should  now  be  brought  forward  by  other 
independent  disciples.  We  look  forward  with  eagerness  to 
the  future  parts^  and  if  the  author  brings  the  public  to  apply 
Fletcher's  doctrines  to  the  physiological,  pathological,  and 
therapeutic  knowledge  of  the  day,  he  will  be  doing  incal- 
culable service.     We  have  to  notice  one  omission.     In  the 

• 

appendix  he  gives  extracts  from  Dr.  Drysdale's  first  part  of 
Life  and  Equivalence  of  Force,  selected  on  some  principle  we 
fail  to  discover,  but  he  omits  to  put  marks  showing  that  the 
quotations  are  not  consecutive.  The  meaning  is  therefore 
not  what  Dr.  Drysdale  intended.  The  second  part^  in 
which  reference  to  Fletcher  is  made,  is  not  alluded  to  in 
this  volume. 


The  Baths  and  Wells  of  Europe,  their  actions  and  uses, 
taiih  notices  of  Climatic  Resorts  and  Diet  Cures.  By 
John  Macfherson,  M.D.  Second  Edition.  London : 
Macmillan,  1878. 

m 

This  is  a  nice  little  book,  not  by  any  means  an  exhaus- 
tive treatise  on  the  baths  and  wells  of  Europe,  but  useful 
to  the  practitioner  by  giving,  in  a  few  words,  the  leading 


The  Baths  and  Wells  of  Europe^  by  Dr.  Macpherson.  167 

cbaracteristics  of  the  waters  of  the  different  mineral  sources, 
and  the  maladies  for  which  they  are  indicated.  It  is  a  pity 
the  author's  plan  did  not  admit  of  his  saying  all  he  had  to 
say  about  each  source  at  one  place,  for  it  is  rather  tiresome 
to  have  to  refer  to  two  and  often  to  three  different  parts  of 
the  work  for  the  information  we  seek  respecting  some 
particular  mineral  water.  A  more  convenient  plan  for  the 
construction  of  such  a  work  would,  we  think,  be  to  give  the 
watering  places  in  their  alphabetical  order,  say  all  that  was 
to  be  said  about  each  under  its  own  heading,  and  supply 
complete  indices  of  the  leading  chemical  character  of  the 
springs  and  of  the  diseases  for  which  they  are  recommended. 
However,  we  must  be  content  with  what  we  have,  and 
there  is  no  doubt  Dr.  Macpherson's  little  book,  which  has 
already  got  to  a  second  edition,  supplies  a  want  often 
felt  by  the  busy  practitioner  in  this  country,  and  we  can 
heartily  recommend  it  as  a  sort  of  remembraDcer  for  the 
physician,  but  not '  as  a  work  that  can  supersede  special 
treatises  on  the  various  sources,  though  these  again  usually 
err  on  the  side  of  excessive  laudation  of  the  healing  virtues 
of  the  sources  they  treat  of. 

The  second  edition  omits  the  very  full  table  of  contents 
that  adorned  the  first  edition.  We  cannot  conceive  the 
author's  object  in  making  this  alteration,  and  would  advise 
him  in  subsequent  editions  not  only  to  restore  the  table  of 
contents,  but  to  insert  the  page  after  each  particular  subject 
mentioned.  A  book  like  this,  which  is  essentially  a  work 
of  reference,  cannot  be  too  liberally  supplied  with  indices 
for  enabling  us  to  refer  in  a  moment  to  the  subject  we  wish 
to  re%4  about. 

We  notice  that  Dr.  Macpherson  is  guilty  of  the  common 
English  error  of  spelling  Interlaken,  Interlachen.  The 
word  is  a  compound  of  two  Latin  words,  inter  and  laciis, 
betwixt  the  lakes,  and  is  pronounced  and  written  Inter- 
laken ;  it  has  nothing  to  do  with  the  German  word  lachen, 
to  laugh,  though  a  German  would  undoubtedly  laugh  to 
hear  it  pronounced  Interlachen. 


158  Reviews, 


Ophidians :  Zoological  Arrangement  of  the  different  genera, 
including  varieties  knovm  in  North  and  South  America, 
the  East  Indies,  South  Africa,  and  Australia,  Their 
Poisons  and  all  that  is  known  of  their  nature.  Their 
Galls  as  antidotes  to  the  snake  venom.  Pathological, 
tojncological,  and  microscopical  facts;  together  with 
much  interesting  matter  not  hitherto  published.  By  S.  B. 
HiooiNS,  S.A.^  Honorary  Member  of  the  Hom(Bopathic 
Institute  of  the  United  States  of  Colombia.  New 
York  :  Boericke.     London  :  Turner,  1873. 

This  is  a  little  book  with  a  big  title.  Small  though  it 
be  there  is  a  great  deal  in  it  that  might  have  been  as  well 
left  out.  A  great  portion  of  the  book  is  taken  up  with 
descriptions  derived  chiefly  from  the  standard  works  of 
Gunther,  Baird,  and  Oirard,  of  all  the  snakes  venomous 
and  innocuous  of  all  the  four  or  five  quarters  of  the  globe^ 
and  with  bare  enumerations  of  cases  of  snake  bites  from  the 
works  of  Fayrer,  Russell,  and  others. 

There  are  also  descriptions  of  all  the  plants  and  secret 
remedies  used  in  various  countries  as  specifics  against  snake 
bites. 

A  great  deal  of  this  might  have  been  well  omitted  in  a 
little  book  professing  to  give  an  account  of  a  new  antidote 
for  snake  bites^  and  much  more  might  have  been  said  about 
the  antidote  itself  and  proofs  given  of  its  efiicacy.  There  is, 
too,  a  great  want  of  method  in  the  arrangement  of  the  book, 
so  that  it  is  a  matter  of  considerable  difficulty  to  find  the 
various  parts  that  possess  an  interest  for  us  by  virtue  of 
their  novelty  or  of  their  bearing  on  the  subject  of  snake 
bites  and  their  treatment. 

Mr.  Higgins  has  long  resided  in  the  United  States  of 
Colombia,  a  country  very  prolific  in  poisonous  snakes.  He 
became  acquainted  with  the  methods  adopted  by  the  curers 
of  snake  bites,  and  learned  that  the  bile  of  poisonous  snakes 
entered  into  the  composition  of  most  of  their  vaunted  anti- 
dotes. 

The  idea  occurred  to  him  to  try  the  efi'ects  of  the  ad- 


On  the  New  American  Remedies,  by  Dr,  71  Massy.  159 

xniuistration  of  the  bile  of  the  snake  that  imparted  the  poi- 
sonous bite^  and  this  treatment  he  assures  us  he  has  found 
perfectly  successful,  and  he  sajs  it  has  been  largely  adopted 
by  the  ''  curers  "  and  medical  men  of  Colombia. 

His  mode  of  preparing  the  antidote  is  to  take  the  bile 
from  the  gall-bladder  of  the  snake  shortly  after  it  has  cast 
its  skin,  when  the  virtues  of  the  bile  are  most  developed. 
One  drop  of  this  bile  to  ten  drops  of  alcohol,  strong  wine, 
or  spirits^  is  the  proportion  for  his  tincture.  For  the  treat- 
ment of  bites  five  to  ten  drops  of  this  tincture  are  to  be 
mixed  with  a  tumblerful  of  water,  and  a  tablespooiiful  given 
every  five,  ten,  fifteen,  or  twenty  minutes.  He  also  makes 
a  crucial  incision  in  the  wound,  and  bathes  the  limb  in  hot 
water  in  which  are  a  few  drops  of  the  tincture  of  bile.  He 
warns  against  giving  too  much  of  the  bile,  for  though  it  will 
remove  the  symptoms  of  venom-poisoning  it  may  kill  the 
patient  from  its  own  poisonous  properties. 

It  may  be  worth  the  vi  hile  of  those  resident  in  countries 
where  venomous  serpents  abound  to  try  Mr.  Higgins'  simple 
mode  of  treatment,  for  which  purpose  all  that  would  be 
necessary  would  be  to  have  tinctures  of  the  bile  of  the 
various  poisonous  reptiles  of  the  country  prepared,  and  have 
recourse  to  the  bottle  corresponding  to  the  snake  that  has 
inflicted  the  bite. 

Mr.  Higgins  identifies  the  Lachesis  of  Dr.  Hering's 
celebrated  proving  with  the  Lachesis  trtganocephaliAS  or 
Curucuca  of  Dutch  Guiana,  the  Conanaconchi  or  Bushmaster 
of  British  Guiana,  and  denies  that  it  is  the  Craspodocephalus 
lanceolatus  or  Fer-de- lance,  which  he  says  is  a  native  of 
Martinique. 


Practical  Notes  on  the  New  American  Remedies.  By  B. 
TuTHiLL  Massy,  M.D.  Second  Edition,  enlarged. 
London :  E.  Gould  and  Son. 

We  must  apologise  to  Dr.   Massy  for  having,  through 
inadvertence,   neglected  to    notice  this    book  on  its  first 


160  Reviews. 

appearance.  That  it  has  reached  a  second  edition  in  a 
short  time  is  sufficient  evidence  of  its  usefulness.  It  is 
best  described  as  a  supplement  to  the  usual  domestic 
practices^  adding  to  the  older  stock  of  homcdopathic  reme- 
dies therein  mentioned  our  recent  importations  from  America. 
It  is  written  in  a  chatty  and  somewhat  desultory  style : 
but  contains  a  great  deal  of  useful  information.  It  hardly 
serves  as  an  epitome  of  Dr.  E.  M.  Hale's  book  for  practi* 
turners,  as  it  makes  no  attempt  at  a  physiological  and 
therapeutic  study  of  the  ''  New  Remedies/'  but  for  amateurs 
it  is  all  that  they  could  desire. 

We  note  one  point  requiring  correction,  p.  15.  *'  Words 
ending  in  in  or  ine  denote  the  alkaloids  of  the  drugs  whose 
name  they  bear.''  This  might  be  correct  as  regards  medi- 
cines in  general,  but  would  mislead  if  understood  of  the  ''New 
Remedies."  ApocytUn,  Gelsemin,  Macrotin,  8cc,,  are  not 
alkaloid  "  active  principles  "  like  Atropine ;  they  are  pre- 
parations purporting  to  contain  all  the  active  ingredients 
of  each  plant,  divested  of  woody  fibre  and  such  like  inert 
matters. 

We  recommend  Dr.  Massy's  little  volume  to  all  whom 
circumstances  force  into  amateur  prescribing,  but  who  are 
unable  to  master  larger  works. 


Taking  Cold  {the  cause  of  half  our  diseases) :  its  Nature, 
Causes,  Prevention,  and  Cure ;  its  frequency  as  a  cause 
of  other  diseases,  and  the  diseases  of  which  it  is  a  cause, 
with  their  diagnosis  and  treatment.  By  John  W. 
Haywabd,  M.D.,  M.R.C.S.,  L.S.A.  Fourth  Edition/ 
enlarged  and  improved.     London  :  Turner,  &  Co. 

This  work  originally  appeared  some  years  ago  as  a  much 
smaller  volume.  It  was  then  entirely  devoted  to  the  sub- 
ject of  "  taking  cold  "  as  the  most  frequent  causes  of  illness 
and  to  the  recommendation  of  Aconite  as  the    one  specific 


On  the  Materia  Medica,  161 

remedy  for  this  casualty.  Its  scope  is  more  enlarged^  to 
take  in  the  diseases  of  which  ''  taking  cold'^  is  a  cause^  with 
their  diagnosis  and  treatment.  This  addition  has  rather 
spoilt  the  structure  of  the  title^  as  may  be  seen  above^  but 
it  has  enhanced  the  valu^  of  the  book.  It  is  now  one  of 
the  best  manuals  we  have  of  the  treatment  of  acute  diseases^ 
so  far  as  this  can  be  safely  conducted  by  amateur  hands. 
We  think  that  both  doctor  and  patient  will  have  reason  to 
be  thankful  to  Dr.  Hayward  if  he  can  impress  upon  all  who 
follow  homoeopathy  the  primary  importance  of  Aconite  in 
these  disorders.  If  every  one  who  has  ^'J;aken  cold/'  and 
feels  himself  growing  ill  in  consequence,  would  take  this 
medicine  until  his  doctor  could  see  him,  time  would  always 
be  gained,  and  not  uncommonly  an  arrest  of  further 
progress  procured. 


Phyriologieo^Pathological  Basis  of  the  Materia  Medica. 
By  W.  H.  BtTBT,  M.D.  652,  West  Washington  Street, 
Chicago,  111. 

Undbr  this  heading  (which  seems  to  English  eyes  to 
specify  rather  too  much)  Dr.  Burt  (known  hitherto  as  an 
indefatigable  prover  of  **  new  remedies,"  and  as  the  author 
of  a  '  Characteristic  Materia  Medica '  already  reviewed  in 
these  pages*)  has  sent  us  a  chart  of  the  Materia  Medica, 
&shioned  for  hanging  up  in  our  studies.  It  is  arranged 
upon  the  following  theory : — ''  All  medicines  have  for  their 
starting-point  or  centre  of  action  the  nervous  centres^  either 
animal  or  organic.  Those  that  have  this  centre  of  action 
in  the  animal  (cerebro-spinal)  nervous  system  are  the  true 
remedies  for  acute  and  sub-acute  diseases ;  and  those  that 
have  this  centre  of  action  in  the  organic  (ganglionic) 
nervous  system  are  the  true  remedies  for  sub-acute  and 
chronic  diseases.''  Under  one  or  other  of  these  headings 
all  our  medicines  (with  some  new  ones  of  which  we  have  never 

•  Vide  voL  zxviii,  p.  178. 
VOL.  XZXII,  NO.  CXZVII. JANUARY,   1874.  L 


162  Reviews, 

heard)  are  arranged^  and  they  are  farther  subdivided 
according  to  the  tissues  or  organs  specialty  affected  by 
them.  Dr.  Burt  considers  that  this  classification  ''  is  as 
much  a  science  as  Similia,  in  fact  it  is  the  completion  of 
that  great  law/^ 

We  wish  we  could  endorse  his  sanguine  estimate.  But 
facts  compel  us  to  allege  that  this  "  physiologico-patho- 
logical  basis  of  the  Materia  Medica''  has  itself  no  basis 
in  physiology  or  pathology^  and  is  wellnigh  valueless 
practically. 

In  the  first  place,  there  is  no  foundation  for  the  sharp 
distinction  here  made  between  the  cerebro-spinal  and  the 
ganglionic  centres,  as  the  nervous  system  respectively  of 
animal  and  organic  life.  In  Bichat's  time  this  «eemed  to 
be,  and  perhaps  was,  a  brilliant  generalisation,  but  physio- 
logy has  since  left  it  far  behind.  The  ganglionic  nervous 
system  is  now  recognised  as  mainly  vaso-motor,  and  in  such 
additional  functions  as  it  subserves  its  influence  is  always 
directed  upon  muscular  fibre,  as  in  the  heart,  uterus,  iris^ 
and  so  forth.  It  has  no  direct  influence,  so  far  as  is  known, 
upon  nutrition  and  secretion  ;  if  there  are  any  ^*  trophic  " 
nerves,  they  are  cerebro-spinal.  Moreover,  the  two  systems 
(if  such  they  be)  have  so  many  points  of  contact  that  it  is 
impossible  to  draw  a  hard  and  fast  line  between  them. 
The  pupil  can  be  dilated  by  irritating  either  the  spinal  cord 
or  the  cervical  ganglia  j  and  so  with  the  blood-vessels  of 
various  parts,  with  the  heart,  and  with  the  intestines.  The 
*'  great  sympathetic  '^  is  rather  a  supplement  to  the  cerebro- 
spinal system  than  a  system  by  itself;  its  sphere  is  not 
''  organic  life,''  which  could  go  on  (as  it  does  in  plants) 
excellently  well  without  it,  but  involuntary  muscular  fibre. 

It  is  impossible,  therefore,  to  find  a  physiological  basis 
for  the  Materia  Medica  in  the  action  of  drugs  on  the  cerebro- 
spinal or  ganglionic  centres  respectively.  As  a  rule,  most 
medicines  which  influence  the  musculo-motor  act  also  on 
the  vaso-motor  functions.  We  ourselves  should  go  farther^ 
and  say  that  the  majority  of  medicines  have  no  neurotic 
power  at  all,  and  act  directly  on  the  tissues  or  organs  they 
influence.     But  this  is  only  theoretical,  and  our  criticism 


On  the  Materia  Medico.  163 

of  Dr.  Bart  is  limited  to  comparing  his  hypothesis  with  the 
facts  of  the  case. 

Its  illusory  character  becomes  still  more  evident  when 
we  consider  its  pathological  assumptions.  We  begin  here 
by  eliminating  the  unfortunate  word  '^  sub-acute  "  introduced 
by  Dr.  Burt  as  a  sort  of  middle  ground  between  acute  and 
chronic  disease,  which  may  belong  to  either.  This  is  surely 
a  misconception.  When  we  speak  of  '^  acute "  disease  as 
distinct  from  chronie,  we  mean  by  ''acute''  that  it  is 
recent  in  origin  and  rapid  in  course.  But  when  we  speak 
of  "  sub-acute "  we  are  using  the  word  "  acute "  in  its 
proper  sense  of  sharp,  and  we  simply  mean  "  mild.'' 
However,  putting  aside  this  error  (which  does  not  touch  the 
essence  of  the  matter),  we  have  before  us  the  theory  that  all 
acute  disease  originates  in  the  cerebro-spinal  centres,  and 
all  chronic  disease  in  the  ganglionic.  Now,  even  were  we  to 
admit  (which  we  should  be  very  indisposed  to  do)  that  all 
dfseases  are  primarily  neuroses,  no  such  classification  of 
them  can  be  considered  tenable.  Diabetes  is  essentially  a 
chronic  disease ;  but  if  it  have  a  nervous  origin,  this  is 
fonnd  in  the  floor  of  the  fourth  ventricle.  Pericarditis  is 
an  acute  disease ;  what  warrant  have  we  for  supposing  any 
cerebro-spinal  starting-point  for  it?  If  is  needless  to 
multiply  instances ;  the  theory  is  entirely  without  founda- 
tion. 

So  far,  then,  as  Dr.  Burt's  chart  embodies  a  new  and 
anibitious  classification  of  the  Materia  Medica,  we  must 
pronounce  it  valueless.  But  its  grouping  of  the  medicines 
according  as  they  act  on  the  mucous  or  serous  membranes, 
the  glands,  bones,  skin,  &c.,  is  an  attempt  in  an  important 
direction,  and  may  often  be  helpful  in  comparison  and 
choice.  It  is  beautifully  printed,  and,  were  such  errors  as 
•' Lachnan^es,"  '^Na^a,"  "  CAancalagua,"  "  Eleterium," 
*'  Mephittta,"  and  Petelea"  corrected,  would  be  externally 
unexceptionable. 


]64  Reviews, 


Action  des  Medicaments  HomceopathiqueSg  ch,  Elimenis  de 
Pharmaeodynamique.  Par  le  Dr.  Ricbikd  Hughes  ; 
traduit  de  I'ADglais  et  annot^  par  le  Dr.  I.  Oubrin 
Mensyillb,  Chevalier  de  la  Legion  d^Honneur,  &c. 
Bailli^re. 

We  can^  of  course,  odIj  notice  the  fact  of  the  appearance 
of  this  translation ;  but  we  may  add  that  it  seems  excel- 
lently done. 


165 


CLINICAL   RECORD. 


l^ea^msni  of  Uleeration,  Meningitii^  and  OonjunetiviHa. 
By  Thsodobx  B.  Bbotghib,  M.B.,C.M.y  of  Liverpool. 

I  PBOPOSB  in  this  paper  to  consider  three  subjects,  yiz.  ulcera- 
tion, meningitis,  and  conjunctiyitis,  and  to  illustrate  these  bj  a 
series  of  cases  which  have  come  under  mj  obseryation  in  practice. 

The  great  resources  which  homoeopathy  affords  ns  in  the 
treatment  of  these  diseases,  and  the  brilliant  results  which  follow 
the  sncoessful  application  of  the  indicated  medicines,  are  one  of 
the  many  triumphs  which  we  may  justly  claim  for  the  principles 
we  profess,  and  allow  us  to  bear  with  equanimity  the  illiberal 
attacks  of  our  allopathic  brethren.  To  the  eyes  of  the  uninitiated 
the  speedy  cure  of  some  of  the  malignant  forms  of  ulceration 
appear  almost  miraculous,  and  to  the  practitioner  they  afford 
encouragement  to  perseYere  in  the  treatment  of  what  may  seem 
beyond  the  power  of  human  skill.  The  first  subject  to  which  I 
will  allude  is  ulceration. 

To  meet  some  of  the  malignant  forms  of  ulceration  requires 
often  on  the  part  of  the  surgeon  the  nicest  discrimination,  and 
the  exact  differential  diagnosis  of  the  remedies,  as  many  medicines 
may  apparently  apply,  yet  be  quite  unsuitable  to  the  case  which 
he  has  under  treatment. 

I  think  you  will  also  find  that  in  some  cases  you  must  resort  to 
certain  local  applications  to  assist  or  bring  about  the  healing 
process,  although  I  am  confideiat  that  as  we  master  the  exact 
application  of  our  homoBopathic  remedies,  we  will  rarely  have 
to  resort  to  extraneous  helps. 

The  question  which  naturally  occurs  is,  What  is  ulceration,  and 
how  does  it  occur  P  It  is  a  solution  of  continuity  with  loss  of 
substance,  and  is  brought  about  by  congestion  or  inflammation  in 


166  Clinical  Record. 

the  part,  accompanied  by  exudation  of  liquor  Banguinis,  hence 
nutrition  is  suspended,  the  part  becoming  weakened  and  softened, 
and  the  substances  thrown  out  likewise  producing  pressure,  mole- 
cular death  takes  place,  ulceration  ensuing.  Ulceration  is  more 
common  in  the  cellular  and  adipose  tissue  than  in  muscles, 
tendons,  ligaments,  nerves,  or  blood-vessels,  and  I  would  now 
verj  briefly  allude  to  some  principles  which  apply  to  all  the 
varieties  of  ulceration  we  may  be  called  on  to  treat. 

Locally,  we  must  endeavour  to  subdue  inflammation,  for  until 
this  is  accomplished  no  reparative  process  can  go  on;  again, 
position  and  rest  of  the  part  is  of  great  benefit,  in  order  that 
congestion  or  determination  of  blood  may  not  take  place. 

Constitutionally,  nourishing  diet,  especially  food  easily  assi- 
milated, and  a  certain  amount  of  stimulant  in  some  cases,  is  of 
essential  benefit. 

Having  thus  briefly  alluded  to  general  treatment,  I  will  now 
proceed  to  consider  one  of  the  most  malignant  forms  we  may 
have  to  deal  vrith,  viz.,  the  phagedenic  form  of  ulceration  ;  and 
I  will  show  the  nature  and  treatment  of  this  ulcer  by  cases  which 
have  occurred,  in  my  own  experience. 

A  girl  st.  12  came  to  me  with  an  ulcer  situated  beneath  the 
inferior  maxilla  of  the  left  side.  On  examination  the  ulcer 
showed  first  as  to  the  edges.  They  were  ragged,  of  a  dark  livid 
red  colour,  some  parts  everted,  some  inverted.  The  granulations 
were  dark,  livid,  red,  irregular,  elevated,  depressed,  and  painful. 
Discharge  was  ichorish,  scalding,  and  very  acrid.  There  was  also 
great  irritability  of  system,  and  the  child  was  very  much 
emaciated.  1  prescribed  Kali  hick.  3,  a  dose  every  three  hours ; 
beef  tea,  sherry  wine,  and  plenty  of  arrowroot,  to  be  continued  for 
five  days.  I  also  ordered  Camph.  0,  morning  and  evening,  to  quiet 
the  nervous  irritability  of  the  system.  On  seeing  her  at  the  end 
of  this  period  no  improvement  had  taken  place,  but  the  child  had 
better  rest  at  night,  owing  probably  to  the  Camphor.  1  next 
ordered  Mere.  oor.  8,  every  three  hours,  for  five  days. 

At  the  end  of  this  time  she  again  came  to  say  there  was  no 
improvement.  The  ulcer  was  apparently  spreading,  aud  I  was 
afraid  lest  it  would  open  into  the  carotid.  As  there  might  probably 
be  a  syphilitic  congenital  cause,  although  I  could  get  no  history 
of  syphilis,  I  prescribed  Nitric  ctcid  1,  one  drop  every  three  hours. 
At  the  end  of  a  week  there  was  a  marked  improvement,  which 


Ulceration,  Meningitis,  and  Conjunctivitis.  167 

happilj  continued^  till  at  the  end  of  three  weeks  the  ulcer  com- 
pletely healed  ap,  and  nothing  was  visible  except  a  white  scar. 

The  second  case  to  which  I  will  allude  occurred  in  a  child  aged 
three.  The^ulcer  in  this  case  was  situated  a  little  to  the  inner 
side  of  the  left  nipple,  and  the  history,  as  £ar  as  1  could  gather  it 
was  that  an  abscess  had  formed  some  time  back,  and  burst,  dis- 
charging matter,  but  had  not  healed  up.  On  examination  I  found 
it  presented  all  the  characters  of  a  phagedaanic  ulcer,  accompanied 
with  great  nervous  irritability,  thirst,  and  looseness  of  the  bowels. 
I  prescribed  Ara,  8,  a  dose  every  three  hours,  beef  tea,  arrowroot, 
and  a  dessert  spoonful  of  brandy  to  be  given  during  the  day ; 
Camphor  d  morning  and  evening.  On  seeing  the  child  four  days 
after  the  ulcer  looked  rather  healthier,  but  there  was  a  good  deal 
of  prostration,  the  looseness  of  bowels,  however,  being  better. 
I  ordered  Lachesis  6  for  five  days.  On  seeing  the  patient  there 
was  decided  improvement,  though  it  still  looked  suspicious ; 
Laehesis  to  be  continued,  and  at  the  end  of  a  fortnight  from 
this  time  it  was  quite  healed  up. 

Another  form  of  ulceration  which  is  often  met  with  is  the 
indolent  ulcer.  This  ulcer,  as  you  know,  generally  occurs  about 
the  middle  period  of  life^  and  is  of  a  very  obstinate  character, 
being  healed  with  the  greatest  difficulty.  A  rather  interesting 
case  came  under  my  treatment  in  a  man  set.  49,  who  consulted  me 
about  an  ulcer  situated  at  the  anterior  internal  aspect  of  the  tibia. 
He  had  suffered  for  some  jears  from  this  ulcer,  and  had  tried 
various  doctors  and  various  remedies,  such  as  HoUoway's  ointment, 
Ac.t  but  without  success.  He  said  he  believed  he  had  spent 
£200,  having  taken  Blue  pills  and  Sarsaparilla  ad  infinitum,  and 
he  wished  me  to  try  and  heal  this  very  expensive  ulcer.  On 
examination  I  found  the  edges  deep,  hard,  and  excavated,  the 
granulations  pallid,  and  the  discharge  thin  and  sanious.  The  first 
point  to  be  attended  to  was  to  clean  the  sore,  and  afterwards 
stimulate  the  granulations.  I  ordered  him  to  poultice  the  ulcer 
for  forty-eight  hours  with  a  poultice  made  of  oatmeal  and  butter- 
milk, which  is  about  the  best  drawing  poultice  you  can  get.  As. 
there  was  no  doubt  some  disease  of  the  bone  existed,  I  ordered  him 
SUic.  5,  every  three  hours,  and  after  the  poultice  was  removed  to 
use  simple  water  dressings  for  a  week,  also  to  take  a  pint  of  stout 
during  the  day.  At  the  end  of  this  period  1  saw  him  again  and 
found  the  sore  much  healthier  looking,  but  still  not  so  clean  as  I 


168  Clinical  Record. 

desired.  I  ordered  the  poultice  to  be  contioued  for  a  d«y  or  two ; 
Silic.  to  be  continued.  On  seeing  him  again  in  a  week  it  looked 
much  better,  and  I  ordered  Kali  bieh.  gr.  1,  AqwB  ^yi,  to  be 
applied  to  the  ulcer,  at  the  same  time  I  encircled  it  with  plaster 
to  keep  up  some  pressure  and  diminish  the  size.  Week  after 
still  improving ;  continue  treatment.  On  seeing  him  at  the  end 
of  this  period  he  complained  of  a  certain  boring  pain  iii  the  part. 
I  resolved  now  to  try  Aur,  6,  and  Carbolic  acid  lotion  for  a  fort- 
night. When  I  again  saw  him  the -ulcer  was  almost  healed;  but 
as  one  or  two  of  the  granulations  were  rather  pallid,  I  touched 
them  with  Sulphate  of  Capper,  and  prescribed  Sulph.  d  for  ten  days. 
On  seeing  him  again  the  ulcer  was  quite  healed,  and  he  felt  in 
remarkably  good  health.  I  told  him  to  keep  the  leg  firmly 
bandaged  from  the  foot  upward ;  and  the  last  time  I  saw  him  he 
had  no  signs  of  a  return  of  his  old  enemy. 

The  only  other  form  of  ulceration  to  which  it  will  be  neces- 
sary to  allude  is  the  inflamed  ulcer;  and  I  will  illustrate  its 
nature  and  treatment  by  a  case  which  lately  occurred  to  me. 

A  young  man  got  scalded  in  the  neck,  and  got  some  liniment 
applied  to  the  part,  which  eased  the  pain,  but  a  nasty  sore  resulted. 
On  examination  the  part  was  red,  inflamed,  and  swollen,  with 
a  thick  offensive  discharge  streaked  with  blood,  and  great  pain  ; 
in  fact,  showing  all  the  signs  of  an  inflamed  ulcer.  I  ordered 
Aeon,  P,  one  drop  every  three  hours,  and  a  lotion  of  rectified 
spirits  and  water  to  be  applied  externally.  On  seeing  him  three 
days  after,  the  inflammation  had  greatly  subsided,  but  the  thick 
discharge  still  continued,  accompanied  with  a  burning  feeling.  He 
was  ordered  Are,  1,  gtt.  z,  Aquce  Ji^i  a  dessert-spoonful  every 
three  hours,  and  at  the  end  of  ten  days  he  was  quite  cured. 

Before  passing  on  to  consider  the  next  subject,  I  would  remark 
that  I  am  confident  the  true  curative  sphere  of  the  treatment  of 
all  malignant  ulcers  lies  in  the  acid  group  of  medicines. 

The  next  subject  to  which  I  will  refer  is  meningitis,  and  I  will 
show  its  nature  and  treatment  by  two  very  successful  cases  which 
occurred  in  practice  during  the  past  year. 

The  first  case  occurred  in  a  boy  a&t.  13.  The  history  of  the 
case  was  that  the  boy  received  a  blow  on  the  right  temple,  the 
result  of  a  fall  against  the  edge  of  a  fender.  He  complained  a 
few  days  after  of  pain  in  his  head,  and  appeared  to  be  restless. 
He  was  then  seen  by  an  allopath,  who  ordered  some  mixture, 


Ulceration,  Meningitis,  and  Conjunctivitis.  169 

bnt  with  no  good  result.    His  mother  then  consulted   a  more 
emineit  allopath,  who  ordered  a  blister  at  the  back  of  his  neck. 
The  only  effect  resulting  from  this  treatment  was  the  formation 
of  a  large  sore  which  did  no  good,  and  the  boy  continued  to  get 
worse.    The  mother  then  at  the  end  ot  the  tenth  day  asked  me  to 
see  the  boy.     I  found  him  sitting  in  an  armchair  looking  pale, 
but  occasionally  a  hot  flush  passed  over  his  face,  skin  hot  and 
dry,  pulse  wiry  and  jerky,  tongue  whitish,  and  inclined  to  be 
side.    On  asking  him  where  he  had  pain  he  put  his  hand  to  his 
head,  complaining  of  pain  nowhere  else,  but  seemed  to  be  irri- 
table and  disinclined  to  answer  questions.     I  carefully  examined 
the  head,  but  could  detect  no  depression.     Taking  the  history 
into  consideration,  and  the  different  symptoms,   I  diagnosed 
meningitis.    I  ordered  the  boy  to  be  put  to  bed,  and  his  diet  to 
consist  of  milk  and  water,  as  being  the  most  unstimulating.     I 
prescribed  Arnica  P,  and  Aeon,  1,  every  three  hours.    On  seeing 
him  the  next  day  no  improvement  had  taken  place.     Continued 
the  same  treatment  for  five  days,  but  with  no  success.    I  then 
ordered  Bell,  1',  for  four  days,  but  with  no  benefit.    The  boy 
continued  to  get  worse,  and  began  to  get  rather  deaf,  and  could 
with  great  difficulty  be  roused.   On  the  eighth  day  I  ordered  Brif, 
1',  and  continued  this  till  the  twelfth  day,  with  a  dose  of  Arnica 
every  day  when  I  saw  him.     He  continued  to  get  worse,  and  on 
the  thirteenth  day  was  almost  insensible,  quite  deaf,  and  sleepless. 
From  these  signs  I  was  convinced  effusion  had  taken  place  above 
the  arachnoid  membrane,  and  being  desirous  of  sharing  the  respon- 
sibility with  some  one,  I  determined  on  having  a  consultation.    I 
requested  a  medical  friend  on  whose  sound  judgment  and  skill  I 
could  place  every  reliance  to  see  the  case  with  me.    We  both 
agreed  as  to  the  nature  of  the  case,  and  determined  on  prescribing 
lod.  1,  and  Ver(U.  tiride  P,  every  two  hours  in  altematiDn,  the 
hair  to  be  cut,  and  hot  cloths  applied  to  the  head.     On  seeing 
him  next  day  he  had  slept  rather  better.    This  line  of  treatment 
was  continued  till  the  twenty-seventh  day,  when  he  was  quite 
sensible,  but  rather  weak.    During  that  critical  period  I  always 
when  seeing  him  gave  a  dose  of  Arnica,  but  under  the  lod.  and 
Ferai,  vir,  treatment  the  effusion  completely  disappeared.     I 
then  gave  him  Sulph.  0  for  ten  days,  afterwards  following  it  up  by 
China  1',  and  at  the  end  of  six  weeks  he  was  quite  convalescent, 
and  able  to  move  about.    I  then  ceased  my  attendance,  having 


170  Clinical  Record. 

ordered  him  to  be  Bent  to  the  country  as  soon  as  convenient  to 
bis  parents.  I  have  seen  him  often  since,  and  a  stronger  or 
more  intelligent  boy  it  would  be  difficult  to  find. 

The  next  case  occurred  in  a  girl  »t.  11.  The  history  of  this 
case  was  that  the  child  had  fidlen  against  a  table,  and  two  or  three 
days  afterwards  complained  of  pain  in  the  head.  The  parents  did 
not  consider  this  of  any  consequence ;  but  the  child  continued  to 
get  worse  and  inclined  to  lie  down,  and  was  very  restless.  About 
ten  days  from  this  period  of  receiving  the  blow  the  parents  asked  me 
to  see  the  child.  On  seeing  her  I  carefully  examined  for  any 
depression,  but  none  was  to  be  detected.  She  showed  all  the 
signs  described  in  the  last  case,  the  deafness  being  also  well 
marked.  From  the  history  and  the  signs  present  I  diagnosed 
a  case  of  meningitis,  with  incipent  effusion.  Warned  by  my 
previous  experience,  I  determined  to  strike  at  the  disease  at  once, 
and  prescribed  lod,  1  and  Verai,  viride  1',  every  two  hours  in 
alternation,  the  hair  to  be  cut,  and  hot  cloths  applied  to  the  head  ; 
the  diet  to  consist  of  mUk  and  water.  This  treatment  was 
pursued  for  nine  days,  at  the  end  of  which  period  she  was  quite 
sensible.  I  then  prescribed  Sulpk.  0  for  ten  days,  following  it 
up  with  ChifM  1',  and  at  the  end  of  a  month  she  was  quite 
convalescent  and  robust. 

I  would  now  make  a  few  observations  on  the  treatment  and 
what  appears  to  me  to  be  the  guiding  points  in  diagnosis.  In 
the  first  place  be  sure  the  lodium  you  obtain  is  pure  and  of  the 
strength  you  order.  The  first  which  I  ordered  was  as  clear  as 
water,  and  its  medicinal  properties  were  equal  to  the  200th  dilu- 
tion so  eloquently  recommended  by  a  London  practitioner. 
What  I  obtained  personally  was  of  a  bright  red  colour,  and  its 
action  was  most  decided ;  and  as  life  or  death  often  hangs  on  the 
purity  of  the  drug,  it  behoves  us  to  be  very  careful  to  obtain  the 
exact  strength  we  consider  to  be  necessary.  In  the  second  place 
the  diet  should  consist  of  milk  and  water,  as  any  stimulating 
diet,  such  as  beef  tea,  will  precipitate  the  dormant  effusion.  In 
the  third  place,  hot  cloths  to  the-  head  are  of  infinite  advantage, 
soothing  the  patient  and  procuring  that  needful  sleep  which 
enables  nature  to  restore  the  diseased  organ  to  its  former  vigour. 
In  the  fourth  place,  it  is  highly  necessary  to  have  an  intelligent 
nurse  always  with  the  patient,  as  he  may  turn  over  on  his  fiice 
and  become  asphyxiated. 


Ulceraiwn,  Meningitis^  and  Cofffunctivitis.         171 

The  guiding  points  in  diagnosis  appear  to  me  to  be  the  follow- 
ing : — ^riz.,  Ist.  The  history  of  a  blow  or  a  fall ;  no  depression  on 
examination,  all  the  pain  complained  of  situated  in  the  head.  In 
the  second  place,  the  gradual  deyelopment  of  the  symptoms.  In 
the  third  place,  when  effusion  has  taken  or  is  about  to  take 
place,  the  deyelopment  of  dea&ess  gradually  increasing.  In  the 
fourth  place,  you  often  find  the  patient  lying  on  the  ba<^  or  side  ; 
torn  him  round  and  you  will  inyariably  find  him  resume  his  old 
position,  a  look  of  irritation  rapidly  passing  oyer  his  features.  It 
now  naturally  occurs  to  lis,  with  what  may  this  disease  be  con- 
founded ?  It  may  be  wrongly  diagnosed  for  concussion  or  com- 
pression.   How  are  we  to  distinguish  these  ? 

In  concussion  and  compression  the  mental  operations  are 
suspended*  In  meningitis  they  are  not  exercised ;  temper  is  irrit- 
able. Pupils  in  concussion  are  not  fixed ;  in  compression^/Sd^^J; 
in  meningitis  generally  contracted.  Bespiration  in  concussion 
feeble,  silent ;  in  compression  slow,  stertorous  snoring ;  in  menin- 
gitis unaffected.  The  alimentary  canal  in  concussion,  no  swal- 
lowing, involuntary  movements  of  the  bowels ;  in  compression,  no 
swallowing,  constipation ;  in  meningitis  the  alimentary  canal  is 
unaffected. 

Haying  thus  briefly  alluded  to  the  leading  distinctions  of  these 
diseases  I  would  pass  on  to  the  consideration  of  my  next  subject, 
conjunctivitis,  glancing  also  at  ulceration  of  the  cornea  ;  and,  as 
before,  I  would  illustrate  these  subjects  by  some  cases  which  I 
have  lately  treated. 

Conjunctivitis  is  one  of  those  diseases  which  the  practitioner 
is  continually  called  on  to  treat,  especially  in  children.  You  may 
see  the  patient  at  first  when  there  is  simple  inflammation  of  the 
conjunctiva,  or  at  a  later  stage  where  muco-purulent  discharge 
exists.  In  the  first  stage  you  may  speedily  cure  the  disease  by  a 
course  of  Bell,,  while  in  the  second  stage  you  must  resort  to  a 
different  mode  of  treatment. 

A  child  aged  five  was  brought  to  me  with  what  the  mother 
termed  sore  eyes.  On  examination  I  found  the  conjunctiva 
deeply  congested  and  inflamed,  and  the  child  very  sensitive  of 
light.  The  mother  informed  me  that  the  child's  eyes  were  glued 
together  in  the  morning.  I  prescribed  Bell,  2  every  three  hours, 
to  be  continued  four  days,  and  a  plain  bread  poultice  on  the  eyes 
at  night.     On  seeing  the  child  at  the  end  of  this  time  the  con- 


172  Clinical  Record. 

gestion  had  disappeared,  but  a  naatj  maco*paruleiit  discharge 
existed.  I  now  ordered  Mere,  ear,,  8,  every  two  hours,  and  saw 
the  child  again  in  four  days.  There  was  no  decided  improve- 
ment, and  I  now  ordered  a  lotion  of  Tannin  grs.  x,  Aqua  Jiii ; 
the  lotion  to  be  used  three  times  a  day.  Mere.  car.  8  to  be  con. 
tinned.  On  seeing  the  patient  four  days  after  it  was  much 
better,  and  in  sixteen  days  quite  cured. 

I  will  now  relate  two  cases  of  ulceration  of  the  cornea.  I 
may  remark  that  there  are  two  varieties  of  this  form,  viz.,  ulcera- 
tion of  the  proper  substance  of  the  cornea,  and  ulceration  of  the 
conjuDctiva  comeaB,  and  you  find  these  both  require  different 
treatment,  because  the  treatment  that  applies  to  one  is  totally 
useless  for  the  other. 

A  girl,  »t.  19,  asked  my  advice  about  a  speck  which  was 
situated  on  the  right  eye.  On  examination  I  found  a  superficial 
ulcer  of  the  cornea.  She  only  complained  of  a  feeling  of  some- 
thing on  the  eye,  and  a  certain  amount  of  dryness.  I  prescribed 
Fadophyllum  8,  three  times  daily,  and  at  the  end  of  a  fortnight 
she  was  quite  cured,  and  nothing  was  visible  on  the  eye.  I 
believe  that  in  ulceration  of  the  conjunctiva  comeie  Fodophyllwn 
is  specific. 

A  young  man  consulted  me  about  something  which  was 
situated  in  his  left  eye.  He  had  been  under  allopathic  treatment 
for  some  time,  but  with  no  benefit.  He  complained  of  a  sensa- 
tion of  sand  lodged  in  the  eye,  and  occasionally  violent  stitches. 
On  examination  I  found  an  ulcer  situated  in  the  cornea  proper. 
1  prescribed  An.^  2  trit.,  every  three  hours  for  a  week.  On 
seeing  him  I  found  that  the  feeling  of  sand  in  the  eye  was  gone 
and  also  the  violent  stitches,  but  no  improvement  otherwise.  I 
now  ordered  Fodoph.  8  every  three  hours,  for  a  week,  but  with 
no  benefit.  I  then  .ordered  Mere.  car.  8  every  three  hours,  and 
dusted  in  a  little  CkUomel  with  a  camel's-hair  brush,  and  asked 
him  to  come  and  see  me  every  third  day.  I  continued  this  treat- 
ment for  about  seventeen  days,  when  the  ulcer  had  almost  dis- 
appeared. I  then  prescribed  Sulph.  6  morning  and  evening,  and 
at  the  end  of  six  weeks  from  the  commencement  of  the  treatment 
he  was  quite  cured. 


Cerebral  Ejphaustion  from  Over -work,  178 


Ofirehral  JExkaiution  or  Break-down  from  Over^study, 

By  Dr.  Dbtsdalb. 

In  conseqiience  of  the  mental  hard  work  required  in  training 
for  the  professiotu)  or  TTniyersitj  honours,  we  irequentlj  meet 
with  a  greater  or  leas  break-down  of  the  cerebral  faculties,  so 
that  the  patient  is  unable  to  endure  continued  application  to 
business  of  luaj  kind,  and  in  consequence  becomes  nervous  and 
depressed.  If  this  continues  long  he  falls  into  desultory  habits, 
becomes  hypochondriac,  and  stands  a  fair  chance  of  being  thrown 
out  in  the  race  for  life  altogether.  In  these  cases  and  in  other 
nervous  diseases  I  have  observed,  and  find  the  same  remark  made 
by  Brown-Sequard,  that  it  is  better  not  to  go  on  long  advising 
total  rest  and  abstinence  from  business,  with  frequent  change  of 
air  and  scene  &c.,  all  of  which  are  essential  at  first,  but  we  must 
oounsei  the  return  to  a  moderate  amount  of  steady  responsible 
daQy  occupation.  To  this  and  the  usual  hygienic  roles  we  must 
add  steady  perseverance  in  specific  treatment  with  medicine 
chosen  in  accordance  with  the  homoeopathic  law.  Often  we  do 
not  get  the  opportunity  of  a  full  trial  of  steady  persever- 
ance in  homoBopathic  treatment,  as  these  patients  are  change- 
able and  full  of  whims ;  so  they  go  from  one  physician  to  another 
and  give  no  plan  a  fair  trial. 

But  sometimes  we  meet  with  sufficient  success  at  the  first  to 
induce  the  patient  to  continue  the  treatment.  The  following  is 
a  case  which  may  serve  for  encouragement  both  to  ourselves  and 
similar  patients. 

A  young  clergyman  broke  down  in  studying  some  years  ago 
and  was  attacked  with  extreme  restlessness,  fits  of  drowsiness, 
headache,  ^.,  so  that  he  was  obliged  to  give  up  all  work  for 
nearly  four  years.  Then  he  improved  so  that  he  was  able  to 
undertake  duty  about  a  year  ago,  but  has  since  gradually 
become  affected  with  the  following  symptoms,  so  that  he  fears 
he  must  give  up  work  again.  On  6th  of  June,  1873,  he  com- 
plained of  great  excitability,  and  on  the  least  surprise  or  mental 
emotion  he  is  seized  with  tremor  all  over,  and  palpitation.  He 
has  frequent  headaches  characterised  by  a  dull  throbbing  all 
over  the  head,  worse  at  night,  especially  after  being  in  company 


174  Clinical  Record. 

at  a  close  room.  Lobs  of  memory ;  bowels  costive^  and  if  two 
days  confined  he  has  dull  headache  and  general  oppression.  The 
sleep  is  usuallj  heavy  and  unrefreshing,  but  after  the  least 
excitement  he  often  lies  awake  for  hours  with  restless  fatigued 
feeling  and  itching  of  the  skin  here  and  there.  Buzzing  in  one 
ear.  Fits  of  melancholy  and  causeless  depression^  and  he  fancies 
he  has  all  sorts  of  diseases. 

He  was  ordered  two  drops  of  the  Ist  dec,  dilution  of  SabadiUa 
night  and  morning  daily,  and  two  grains  of  the  1st  centes. 
trituration  of  Platina  at  noon  every  second  day. 

On  the  drd  of  July  he  stated  that  the  bowels  were  opened 
naturally,  the  excitability  and  headache  were  less ;  no  buzzing  in 
the  ear  and  the  causeless  fear  was  relieved.  Other  symptoms 
the  same. 

Prescription  •  four  drops  of  Anaeardimm  1  cent,  night  and 
morning  daily ;  two  grains  of  Ist  dec.  trituration  of  Sanionine  at 
noon  every  second  day. 

On  6th  August  he  was  better  of  all  the  symptoms  and  com- 
plained only  that  his  memory  and  intellectual  powers  were  stQl 
too  easily  upset  by  work.  Mthma  tHfnapium  \  drop  of  the  pure 
tincture  night  and  morning  every  second  day. 

On  the  10th  October  he  reported  that  he  was  perfectly  well 
and  had  been  so  for  the  last  few  weeks. 


175 


MISCELLANEOUS. 


Ok  iNFnnTisiMAL  Doses. 

To  the  Editors  of  the  <  BritUh  Journal  of  HofMeopathy,* 

Obktlemsn, — Possibly  the  appeals  lately  made  by  Dip.  Black 
and  others  for  experimentation  with  what  may  be  c^ed  reason- 
able doses  of  drugs  homcBopathically  indicated  may  be  helped 
forward  by  serious  consideration  of  the  following  statement  of 
facte  which  probably  not  one  in  a  hundred  of  our  practitioners 
has  fairly  looked  in  the  face. 

The  first  centesimal  dilution  of  a  drug  contains  ordinarily  one 
hundredth  of  a  drop  of  the  mother  tincture,  or  one  hundredth  of 
a  grain  of  the  crude  substance.  As  all  further  dilutions  are 
made  by  adding  ninety-nine  drops  of  Spirit,  vini  to  one  drop  of 
the  dilution  below,  the  second  dilution  wiU  contain  one  ten 
thousandth  of  the  original  drop  or  grain,  the  third  one  millionth 
and  so  on.  And  the  simple  rule  results  that  in  order  to  know 
what  fraction  of  the  mother  tincture  or  crude  drug  we  haye  in 
any  dilution,  it  is  necessary  only  to  place  double  that  number  of 
ciphers  after  unity  as  the  denominator  of  a  fraction  with  unity 
for  its  numerator. 

As  an  instance  take  the  8rd  centesimal.  After  the  figure  I 
add  six  ciphers  for  the  .denominator,  and  write  1  for  the 
numerator  thus  r,Tny^,TnnF>  ^^  ^^^  millionth. 

It  will  therefore  be  seen  that  the  fraction  which  will  represent 
the  quantity  of  the  actual  drug  contained  in  the  thirtieth  dilu- 
tion of  any  medicine  will  be  one  identical  with  that  given  for  the 
3rd,  except  that  in  place  of  six  ciphers  there  will  be  sixty. 

Dilution  No.  3  as  aboye  shown  contains  one  part  of  the 
drug  in  one  million  parts  of  the  Spirit,  vini ;  and  when  we  get  to 
dilution  No.  6  the  quantity  of  spirits  of  wine  to  each  drop  of  the 
drug  will  have  mounted  up  not  to  the  double  of  the  million^  be  it 


176  Miscellaneous. 

observed,  bnt  to  a  billion  of  drops,  that  is,  to  a  million  millions,  a 
proportion  inconceivably  large. 

In  truth  as  soon  as  dilation  has  gone  beyond  No.  3  or  the 
millionth,  the  mind  fails  to  grasp  the  figures  which  represent 
the  proportion  of  the  diluent. 

I  have  said  that  sixty  ciphers  must  find  place  in  the  denomi- 
nator of  the  fraction  which  will  represent  the  quantity  of  a  drop 
in  the  dOth  dilution,  but  some  of  our  physicians  are  using 
the  200th  dilution  (or  suppose  themselves  to  be  using  it),  and 
for  the  fraction  representing  the  quantity  of  any  drug  which  the 
200th  dilution  would  contain  four  hitkdbkd  oifhsbs  would  be 
necessary. 

Has  any  serious  thought  been  given  to  this  P 

Perhaps  the  following  may  help  some  to  think. 

The  pharmacopoBia  gives  76,800  as  the  number  of  minims  in  a 
gallon.  Say  that  there  are  10,000  drops  in  a  gallon,  for  we  can 
afford  to  cast  in  any  number  of  odd  thousands  or  millions  without 
affecting  appreciably  the  stupendous  aggregates  with  which  we 
have  to  deal.  Sixty  ciphers  in  the  denominator  represent  the 
80th  dilution;  strike  off  four  of  these  and  the  remaining 
fifty-six  with  the  unit  preceding  them  will  represent  the  namber 
of  gallons  of  spirits  of  crude  wine  with,  which  a  single  drop  or 
grain  of  any  drug  must  be  mixed  in  order  to  give  the  said  30th 
dilution.  . 

Now,  as  this  number  of  gallons  is  altogether  beyond  conception 
as  a  mere  statement  of  figures,  consider  the  following. 

If  a  person  were  to  drink  a  gallon  of  water  every  second  for 
one  year,  the  quantity  drank  would  be  31,536,000  or  say 
32,000,000  gallons.  If  for  a  million  of  years  a  million  of  gallons 
were  drank  every  second,  the  thirty-two  would  be  followed  by 
only  eighteen  ciphers.  But  all  this  quantity  woiild  be  simply  as 
nothing  in  comparison  with  the  amount  needed  to  mix  with  a 
single  drop  or  grain  of  any  drug  in  order  to  form  the  30th 
dilution. 

I  have  not  the  data  for  the  calculation,  but  I  question  whether 
the  whole  bed  of  the  Thames  from  its  source  to  the  sea  contains 
the  quantity  of  water  that  would  be  needed  to  mix  with  a  single 
grain  of  any  drug  in  order  to  turn  the  whole  into  the  200th  dilu- 
tion. 

Think  of  one  grain  of  common  salt  or  one  drop  of  aconite  mixed 


On  Infinitesimal  Doses.  177 

with  all  the  water  in  the  Thames,  and  one  drop  (or  a  million 
gallons  if  you  like)  of  this  mixture  given  with  any  expectation  of 
possible  effect. 

Becollect  that  if  for  millions  of  millions  of  years  the  patient 
were  erery  second  to  swallow  millions  of  millions  of  gallons,  he 
could  not  succeed  in  getting  into  his  stomach  the  millionth  part 
of  a  drop  or  grain  of  any  mother  tincture  or  crude  drug. 

Can  any  mistake  be  shown  in  this  ?  If  not  what  answer  has 
any  sane  man  who  deals  in  these  dilutions  (delusions  had  almost 
slipped  from  my  pen)  ? 

I  am  not  suggesting  that  these  dilutions  cannot  easily  be  made 
with  very  small  quantities  of  the  diluting  fluid  ;  ninety-nine  drops 
for  each  dilution,  if  only  any  one  could  be  trusted  to  have  made 
them.  What  I  desire  to  call  attention  to  is  the  quality  of  the 
drug  contained  in  the  30th  (not  to  say  the  200th)  dilution, 
supposing  them  honestly  prepared. 

I  trust  that  you  and  your  readers  will  feel  that  this  is  a 
matter  to  be  most  seriously  dealt  with* 

K  those  who  are  in  the  habit  of  prescribing  one  drop  of  a  vast 
river  with  which  at  its  source  one  grain  of  a  drug  was  mixed  have 
no  other  ground  to  rest  on  than  thin  &llible  judgment  as  to 
what  seemed  to  be  results,  the  allopath  who  gives  his  scruples 
and  drachms  has  far  more  justification  when  he  asks  you  to 
rely  on  his  experience  as  sufficient  evidence  that  he  beneficially 
affects  the  course  of  disease  by  his  treatment.  In  his  case  it 
may  be  admitted  that  effects  of  some  kind  will  be  produced,  and 
the  only  question  will  be  whether  they  are  curative.  In  the 
case  of  the  high  dilutionist,  the  first  question  will  be  as  to  the 
possibility  of  any  fractional  part  being  forthcoming  of  the 
evidence  which  ordinary  intelligence  must  require  before  it  can 
assent  to  what  is  so  utterly  inconceivable. — fours,  &c.,  N. 

[We  think  our  anonymous  correspondent  can  hardly  be  fully 
acquainted  with  homoeopathic  literature  if  he  thinks  that  the  mere 
numerical  aspect  of  dilation  has  not  been  repeatedly  presented. 
But  we  give  place  to  his  remarks,  as  it  may  be  useful  from  time  to 
time  to  bring  the  facts  before  the  busy  practitioner.  We  are 
under  the  impression  that  the  above  statement  considerably 
underrates  the  bulk  of  the  total  mass  required  to  dilute,  to  ensure 
the  attenuation  within  the  30th.  We  have  likewise  a  novelty  in  our 

TOl4^XXXII^  NO.  CXXVII. ^JANUARY,  1874.  M 


178  Miscellaneous, 

correspondent's  letter  in  that  he  writes  out  at  length  the  denomi- 
nator of  the  fraction  corresponding  to  the  200th  dilution,  but  we 
have  not  space  to  reproduce  it,  as  it  occupies  43-|  inches  at  the 
rate  of  9*17  ciphers  to  the  inch. 

We  fear  our  correspondent  is  rather  sanguine  as  to  the  effect 
that  the  mere  statement  of  these  facts  must  have  on  rational  beings 
having  any  influence  on  high  dilutionists,  for  we  find  no  longer  ago 
than  August,  1872,  Dr.  H.  Hartlaub  writing  thus :  "  In  homoeo- 
pathj  it  is  not  with  small  doses  that  we  have  to  do,  but  with 
immaterial  doses  i  these  are  the  peculiarity  of  homoeopath  j,  and  it 
is  these  which  place  a  boundary  between  what  belongs  to  homceo- 
pathy  and  what  is  foreign  to  it."  And  again :  ^*  The  homceo- 
pathic  preparation  of  medicines  has  for  its  object  not  the  dilu- 
tion nor  the  decomposition  of  the  matter,  but  the  removal  of  it 
altogether^  And  again :  '*  To  constitute  true  homoeopathy  we 
reckon  not  only  the  simile  strictly  according  to  the  proving  on 
the  healthy,  as  well  as  single  medicines  without  any  foreign 
admixture,  but  also  the  immaterial  dose,  which  is  that  without 
which  the  total  mass  has  neither  spirit  nor  life.  With  this  spirit 
and  life  of  the  medicine  stands  or  falls  the  spirit  and  life  of  the 
whole  of  homoeopathy  '*  {Allgem,  Rom,  Zeitungy  August,  1872). 
Against  ideas  like  this  what  avail  all  the  wealth  of  facts  and 
reasoning  offered  to  us  by  physics,  chemistry  and  physiology  P 
We  can  only  protest  against  and  repudiate  the  pretentious  pre- 
sumption of  such  dreamers  to  put  forward  their  silly  speculations 
as  the  creed  of  the  homoeopathic  school.  It  is  almost  sufficient 
to  quote  one  paragraph  from  Hahnemann  to  dispose  of  these  pre- 
tensions. In  the  Organon,  6th  edit.,  p.  288,  we  find  the  following 
words  addressed  to  those  who  doubt  the  possibility  of  the  action  of 
the  ordinary  homoeopathic  dilutions :  "  They  may  learn  from  the 
mathematician  that  a  substance  when  divided  into  ever  so  many 
parts  still  contains  in  the  smallest  imaginable  part  some  of  the 
substance,  and  the  smallest  imaginable  part  cannot  cease  to  be 
some  portion  of  this  substance  and  thus  cannot  possibly  become 
nothing ' '  [i,  e.-  immaterial] . 

But  as  the  old  vague  notions  of  spiritual  essences  as  the  cause 
of  the  properties  or  qualities  of  things,  and  the  possibility  of 
a'  separation  of  those  spiritual  essences  from  the  matter  to 
which  they  were  supposed  to  be  attached  by  a  not  insoluble 
bond,  may  still  lie  at  the  root  of  that  credulity  and  want 
of  true  philosophical  method  which  is  conspicuous  in  dealing 


On  Infinitesimal  Doses.  179 

with    the    '' potency"   question    by   all    so-called    high    dilu- 
tioniflts,  it  may  be  well  to  say  a  few  words  on  the  subject  in  its 
old  form  and  in  the  newer  one  of  a  "  force  "  supposed  to  be 
capable  of  being  set  free.    Hahnemann  unfortunately  for  a  time 
feU  into  the  chemical  blunder  of  supposing  that  OautHcum  was  the 
'*  principle  of  causticity  "  which  was  detached  from  an  alkali  and 
held  in  combination  for  the  time  by  an  indifferent  substance. 
Sut  this  was  speedily  recognised  as  an  error.     Nevertheless  a 
similar  idea  of  the  possible  detachment  of  the  specific  virtue  of 
medicine  from  the  material   substance   still  apparently  haunts 
some  minds,  and  against  that  it  is  impossible  to  argue  if  those  who 
believe  it  hold  the  doctrine  that  the  properties  of  matter  reside 
in  superadded  immaterial  essences.     From  these,  however,  we  can 
only  demand  rigid  proof  of  the  action  of  each  dilution  by  ordinary 
experiment.    What  can  we  know  about  immaterial  essences  and 
the  effect  of  dilution  upon  them  ?    Can  you  dilute  an  immaterial 
substance  ?     And  if  you  could,  what  good  or  harm  could  it  do  P 
But  to  those  who  talk  of  "  medicinal  force  "  capable  of  transference 
and  transformation  we  can  hold  a  different  language,  and  tell 
them  beforehand  that  the  whole  idea  lies  in  mere  confusion  and  mis- 
apprehension of  the  meaning  of  the  word  force.     It  is  only  com- 
mon force-— in  all  probability,  merely  motion  either  molar  or  mole- 
cular of  the  particles  of  matter — which  is  capable  of  transference 
and  transformation,  while  the  specific  properties  which  distinguish 
one  kind  of  matter,  whether  simple  or  compound,  from  another, 
are  inherent  in  the  matter  itself  and  incapable  of  being  either 
detached  from  it  or  being  manifested  by.  any  other  kind  of  matter. 
All  the  specific  powers  of  medicine  with  which  it  is  our  business 
to  deal  belong  to  these  inherent  intransferable  properties,  and 
consequently  can  only  be  manifested  while  some  portion  of  the 
actual  material  is  present.     However  little  of  this  specific  action  of 
a  substance  be  required  it  is  necessary  that  matter   must  be 
divisible  to  the  extent  of  the  dilution  that  may  be  in  question. 
But  there  are  very  strong  reasons  for  holding  the  finite  divisibility 
of  matter,  and  of  late  Sir  W.  Thomson  has  given  good  grounds 
for  supposing  that  the  size  of  the  ultimate  atom  may  be  ascertained 
approximately  and  that  far  below  our  higher  dilutions. 

Ghiudin  has  calculated  the  size  of  the  ultimate  particles  of 
matter  on  different  data  from  those  used  by  Thomson,  and  come 
to  much  the  same  conclusion.  In  illustration  he  states  that 
in  a  sphere  of  ordinary  matter  the  size  of  a  pin*s  head  the  num- 


180  Miscellaneous. 

ber  of  chemical  atoms  amounts  to  eight  thousand  trillions,  or 
8000,000000,000000,000000;  and  thus  to  count  the  number  of 
distinct  metallic  particles  in  the  head  of  a  pin,  at  the  rate, 
mentallj,  of  a  thousand  millions  each  second,  would  take  250,000 
years.  Here  we  haye  ample  room  and  rerge  enough  for  supply- 
ng  millions  of  distinct  particles  to  eyery  square  inch  of  the  body 
from  a  single  grain  of  any  of  our  ordinary  lower  attenuations,  if 
only  they  were  equally  distributed.  But  it  is  differeut  with 
respect  to  the  dilutions  above  the  trillion th ;  for  if  the  above 
calculations  are  approximatively  correct,  if  we  imagine  one  grain 
divided  equally  among  a  trillion  drops  of  water,  then  each  drop 
will  contain  one  atom  or  indivisible  particle.  How,  then,  if  you 
put  one  drop  into  ninety-nine  fresh  drops  of  water  ?  We  shall 
then  have  one  particle  in  100  drops  of  water,  and  if  you  wish  to 
dilute  that  again  in  the  same  way,  there  must  be  ninety-nine 
chances  to  one  that  the  next  phial  will  contain  none  of  the 
substance.  It  cannot  be  certainly  said  that  the  limit  of  size  is 
reached  at  the  trillionth ;  but  it  seems  certain  that  some  such 
limit  must  exist  probably  not  fiur  beyond  it. 

If  such  calculations  are  near  the  truth,  then  the  distance 
between  the  molecules  must  become  so  great  that  the  chance  of 
some  one  of  the  series  of  our  dilutions  having  none  of  the  matter 
at  all  must  ere  long  be  reached,  though  at  what  point  that  result 
is  reached  it  may  be  impossible  to  say.  This  would  throw  a 
doubt  and  uncertainty  on  all  experiments  with  high  dilutions,  for 
the  20th,  or  SOth,  or  50th,  &c.,  might  in  one  batch  contain  some, 
in  another  none  of  the  matter  at  all.  This  may  be  illustrated 
more  palpably  by  referring  to  the  particles  of  organic  matter 
which  are  the  causes  of  contagious  diseases.  If,  as  is  now  most 
probable,  these  consist  of  living  matter,  then  that  is  not  soluble,  but 
however  small  can  only  be  held  in  suspension,  and  therefore  not 
equally  diffusible  at  all.  Let  us  now  suppose  one  particle  of 
smallpox  matter,  the  smallest  portion  capable  of  propagating  the 
disease,  thrown  into  drinking  water  actually  drunk  on  any  day 
which  all  the  inhabitants  of  London  had  an  equal  chance  of 
swallowing.  Then  it  is  plain  that  it  is  about  three  millions  to 
one  against  any  particular  individual  getting  the  smallpox, 
supposing  all  were  susceptible,  and  the  particle  escapes  all  other 
chance  of  having  its  efficacy  destroyed.  If  matter  is  not  more 
divisible  than  calculated  by  Sir  W.  Thomson  and  Ghiudin,  this 


On  Infinitesimal  Doses.  181 

illuBtration  gives  but  a  faint  idea  of  the  enarmous  chance  against 
the  efficacy  of  the  highest  dilutions.  But  when  we  add  to  that 
all  the  other  uncertainties  engendered  bj  the  impurities  of 
materials,  and  possibiUtj  of  error  in  manipulation  in  the  prepara- 
tion, those  in  dispensing,  and  beyond  that  the  still  greater 
diances  of  neatraUzation,  loss,  and  destruction  in  the  secretions 
and  fluids  of  the  b6dy  before  the  extremely  attenuated  portion  of 
matter  can  come  into  contact  with  the  living  matter  on  which  it 
is  finally  to  act,  then  we  shall  begin  to  understand  the  extreme 
uncertainty  that  must  cling  to  the  action  of  all  highly  diluted 
medicinesy  even  granting,  what  we  by  no  means  grant,  that  the 
doee  of  a  well-chosen  homoeopathically  specific  medicine  can  never 
be  too  small  to  efiect  a  cure.  Our  conclusion  from  these  a  priori 
considerations  would  be  that,  although*  possibly  the  higher  dUu- 
tions  might,  in  singular  instances,  efiect  cures,  they  would  be 
quite  unsuitable  for  ordinary  practice,  and  that  ii^  proportion  to 
the  liability  of  error,  all  experimentation  with  them  must  be 
conducted  on  a  larger  scale  and  under  far  more  rigid  conditions 
of  proof  than  with  the  lower  and  more  massive  doses.  Now,  it  is 
not  the  case  that  the  so-called  experiments  with  the  high  dilutions, 
i.e.,  50th,  200th  and  upwards,  have  been  made  by  men  of  proved 
capacity  for  such  delicate  investigation,  by  men  who  have  at  the 
same  time  knowledge,  skill,  and  patience  in  the  diagnosis  and 
treatment  of  disease  according  to  the  known  methods,  and  who 
have  only  advanced  by  slow  steps  from  one  well-ascertained  stage 
to  another.  The  contrary  rather  has  been  conspicuously  evident, 
and  men  of  possibly  small  experience  with  the  3rd  and  6th  dilu- 
tion have  leaped  at  abound  to  the  inconceivable  height  of  the  200kh 
on  the  slenderest  evidence.  The  whole  thing,  in  fact,  was  begun 
in  a  blunder  or  fraud  by  Jenichen,  not  a  medical  man  at  all,  and 
has  been  carried  on  with  a  levity  and  disregard  of  the  solemn 
responsibiUties  of  the  physician  which  has  repeatedly  caused  us  to 
blush  with  shame.  Few  things  have  retarded  the  progress  of 
what  is  true  in  the  homoeopathic  doctrines  than  this  whole  unfor- 
tunate episode  of  the  high  dilutions. 

We  do  not  mean  to  say  that  the  question  of  the  relative  effi- 
ciency of  the*  dilutions  above  and  below  the  3rd  centesimal  has 
been  altogether  left  to  the  desultory  experiments  of  private 
practice,  for  some  systematic  series  of  experiments  have  been 
undertaken  by  the  Vienna  Hospital  physicians ;  but  they  are 


182  Miscellanetms, 

still  incomplete,  and  the  question  has  not  been  settled;  for 
althongb,  as  a  rule,  greater  saccess  has  been  attained  in  hospital 
practice  under  the  lower,  though  still  infinitesimal,  dUntions  than 
when  the)  15th  centesimal  was  uniformlj  giren,  jet,  on  the  other 
hand,  Watzke,  a  man  of  rare  obser?ing  powers,  as  well  as  solid 
judgment,  found  that  in  the  provings  on  the  healthy  certain 
symptoms  were  evoked  by  the  dilutions  which  were  not  observed 
when  the  drug  was  given  in  the  immediate  fractions  of  the  drop 
or  grain.  He  has  candidly  stated  the  facts  in  1848,  and  also  that 
he  has  had  cures  with  dilutions  above  3rd  centesimal ;  but  the 
subject  was  evidently  to  him  still  open  to  further  experiment 
before  positive  conclusions  should  be  drawn ;  and  he  certunly 
did  not  draw  any  conclusion  favorable  to  the  practical  use  of 
higher  dilutions  as  a  rule, — a  fact  that  may  be  seen  by  reference 
to  his  much  more  recent ''  One  Day  of  my  Practice  "  published 
» in  this  Journal  some  years  ago. 

The  statistical  reports  of  Eidherz,  in  1862,  also  give  coun- 
tenance to  the  belief  that  the  6th  or  9th  centesimal  dilution 
acted  more  favorably  in  pneumonia  than  the  lower,  though  still 
infinitesimal  dilutions. 

The  paper  published  by  Dr.  Bajes  some  time  ago,  in  which  he 
gave  the  doses  usually  prescribed  by  our  colleagues  in  this 
country,  proves  very  little  beyond  the  fact  that  most  of  the 
British  practitioners  have  accepted  the  common  opinion  first 
imported  into  this  country  along  with  homceopathy,  viz.,  that 
low  dilutions  are  best  for  acute  diseases,  and  high  dilations  for 
chronic  diseases.  This  opinion  does  not  seem  to  be  founded  on 
any  series  of  comparative  trials,  and  we  are  at  a  loss  to  account 
for  its  general  acceptance  except  on  the  ground  that  it  was 
authoritatively  put  forward  by  some  writers  who  first  secured  the 
attention  of  the  profession.  Almost  every  new  convert  adopted 
it  and  passed  some  years  of  his  professional  life  without 
questioning  its  truth.  It  is  evident  from  the  statistics  collected 
by  Dr.  Bayes  that  many  have  remained  in  this  stage  of  their 
first  impressions,  and  have  continued  to  repeat,  like  parrots,  the 
opinion  they  .first  adopted  on  the  authority  of  others.  Some 
have  indeed  cast  aside  the  trammels  of  authority,  and  have  dis- 
covered that  this  rule  for  the  dose  has  no  foundation  in  practical 
experience,  but  most,  as  is  evident  from  Dr.  Bayes'  statistics, 
have  remained  fossilised  in  the  notions  they  originally  adopted, 


Guaco  and  its  uses,  183 

and  amid  the  busy  exigiencies  of  their  practical  life  have  appa- 
rentlj  lost  the  power  to  throw  off  the  routine  habits  and  ideas 
thej  started  with.  Thus  it  happens  that  statistics  of  the  practice 
of  homoBopathists  in  this  country  show  an  overwhelming  majority 
still  practising  in  the  way  they  first  learned  to  practise,  who  have 
had,  perhaps,  neither  the  time  nor  the  inclination  to  obtain  fresh 
experience  for  themselves,  but  have  been  only  too  willing  to 
accept  a  rule  which  comes  recommended  to  them  by  its  apparent 
simplicity  and  by  what  they  deemed  to  be  respectable  authority. 
Every  one  conversant  with  recent  homceopathic  literature  knows 
that  this  supposed  rule  for  the  dose  is  not  true,  but  it  is  equally 
clear  that  the  true  rule  for  the  dose  has  not  yet  been  discovered. 
—Eds.] 


Gh^aeo  and  its  Uses;.* 

This  species  of  twining  plant  grows  wild  in  the  fields  of  New 
Granada  and  Yenezuela,  and  is  met  with  usually  in  glens,  at  the 
margin  of  rivers,  and  sometimes  (ittached  to  the  boundaries  of 
gardens. 

No  one  knows  when  the  Indians  and  negroes  of  Santa  F6  first 
employed  it  as  an  antidote  against  the  venom  of  snakes.  This 
property  was  kept  secret  amongst  them  until  1788,  when  Senor 
Mutis  discovered  it  by  an  artifice.  Ten  years  later  he  thus 
wrote  to  Senor  Zea :  "  Nobody  in  this  place  dies  of  snake  bite. 
Horses,  sheep,  ^.,  are  cured  as  well  as  man  when  there  is  an 
opportunity  of  giving  them  guaco  juice." 

When  the  negroes  wish  to  guard  against  snake  bite,  and  to  be 
able  to  carry  snakes  about  them  with  impunity,  they  resort  to 
inoculation.  They  make  six  incisions — two  in  the  hands,  two  in 
the  feet,  and  one  on  each  side  of  the  chest.  The  juice  is 
extracted  £rom  guaco  leaves  and  put  into  the  incisions,  after  the 
manner  of  vaccination.  Previous  to  the  operation  two 
spoonfuls  of  juice  are  swallowed.  It  is  advisable  for  the  initiated 
person  to  take  the  juice  every  month  for  five  or  six  days; 
because  if  this  be  omitted  for  some  time,  his  vulnerability  returns 
and  a  fresh  inoculation  will  be  necessary. 

•  Translated    from    La  Beforma  M^iea,  Oct  81st,  1878,  by  George 
Moore^  M.D. 


181  MUcellaneoui, 

Am  tbe  plant  drops  its  leaves  in  the  dry  season,  and  as  the 
pure  juice  from  them  cannot  be  preserved  many  days  without 
undergoing  decomposition,  the  following  preparation  must  be 
made  for  future  use.  Take  the  leaves  only  and  squeeze  out  the 
juice  through  linen ;  put  it  at  once  into  a  bottle  containing  an 
equal  quantity  of  spirit ;  shake  this  mixture  well  together,  then 
cork  the  bottle  and  let  it  rest  for  eight  days.  At  the  end  of  this 
time  all  the  sediment  has  £dlen  to  the  bottom,  and  the  dear 
tincture  remaining  above  is  decanted  into  another  bottle,  which 
should  be  tightly  corked  to  keep  its  contents  in  good  condition 
for  use  when  wanted.  The  tincture  is  applicable  to  the  same 
purposes  as  the  pure  juice,  except  that  the  latter  is  alone  fitted 
for  inoculation. 

Applicationt, — 1.  For  snake  bite,  three  large  spoonfuls  of  the 
pure  juice  are  to  be  taken  immediately,  and  at  the  same  time  a 
cataplasm  of  the  powdered  leaves  is  to  be  applied  to  the  wound. 
These  are  to  be  repeated  every  day  until  the  patient  is  well.  If 
nothing  but  the  prepared  guaco  is  at  hand,  he  should  have  three 
spoonfuls  of  it,  and  it  should  be  rubbed  into  the  bite,  repeating 
these  measures  as  with  the  pure  juice  and  the  cataplasm. 
L^ger  doses  are  required  for  horses,  cattle,  and  other  animals. 

2.  The  same  treatment  should  be  adopted  against  the  bites  of 
the  scorpion  (alacran)  and  those  of  dogs  and  other  rabid 
animals,  continuing  in  the  latter  case  for  forty  days. 

8.  In  rheumatism  and  gout  give  daily  two  spoonfuls  of  the 
pure  juice  or  of  the  tincture,  and  rub  the  painful  part  with  one  or 
other  of  these  forms  of  the  drug,  or  apply  a  cataplasm. 

4.  For  the  injuiries  due  to  mechanical  violence,  apply  the 
same  treatment  for  a  few  days,  with  the  difference  that  the  dose 
should  be  three  spoonfuls. 

5.  When  the  catamenia  are  suspended,  two  spoonfuls  should 
be  taken  every  day  until  the  case  is  cured.  The  same  treatment 
is  required  for  other  obstructions  of  the  abdominal  viscera  and 
for  liver  disease.  In  the  latter  disease  we  should  also  apply 
cataplasms  of  the  leaves  over  the  right  hypochondrium,  or  rub  in 
the  tincture. 

6.  He  who  suffers  from  chronic  and  refractory  ulcers  should 
take  daily  three  or  four  spoonfuls  of  the  pure  juice  or  of  the 
tincture,  and  also  put  cataplasms  of  the  leaves  <)n  the  ulcers,  or 
dress  them  with  the  tincture. 


Guaco  and  its  uses,  185 

?.  The  treatment  of  tetanus  conBiats  in  lapping  cloths 
Batniated  with  the  tincture  round  the  jaws  and  head  of  the 
patient,  and  in  giving  three  spoonfnls  of  the  same  preparation  or 
of  the  pure  juice,  repeating  the  dose  as  is  done  with  opium  in 
like  cases.  In  spasm  of  the  stomach,  give  four  spoonfuls  of  the 
juice,  or,  better  still,  of  the  tincture,  and  apply  the  above 
mentioned  cloths  to  the  region  of  the  stomach. 

8.  In  ''  la  6tica,"  t.  0.,  hectic  fever,  consumption,  give  an  infu- 
sion of  the  leaves,  made  with  hot  water. 

9.  For  asthma;,  use  the  same  measures  as  are  described  in  the 
fifth  paragraph. 

10.  In  tertians  and  all  fevers  with  chills,  four  spoonfiils  of  the 
tincture  or  of  the  pure  juice  should  be  administered  at  the 
beginning  of  the  rigor,  and  continued  in  equal  doses,  fastbg,  for 
a  month. 

11.  The  author  of  the  memoir  from  which  some  of  tbese 
remarks  are  drawn  does  not  say  how  Ouaco  is  tq  be  employed  as 
a  vermifuge.  In  my  opinion  we  should  give  the  pure  juice,  or 
the  tincture,  in  doses  of  one  spoonful  for  children  and  two  for 
adults,  fasting. 

12.  In  order  to  cure  hemicrania  radically  it  is  necessary  to 
give  fasting  two  spoonfuls  of  the  juice,  or  of  the  tiucture,  and  as 
mucb  more  a  little  before  meals. 

13.  For  toothache,  some  of  the  juice  or  the  tincture  should 
be  rinsed  in  the  mouth,  and  applied  on  cotton  to  the  painful 
part. 

Cases. — Chioeo  has  proved  successful  in  so  many  different  dis- 
eases, that  if  every  case  were  referred  to  it  would  be  necessary  to 
write  a  treatise ;  hence,  I  shall  here  confine  myself  to  the  most 
remarkable  of  those  which  the  aforesaid  memoir  contains,  and  to 
few  of  the  many  which  have  come  under  my  own  more  immediate 
notice. 

1.  In  1828,  a  servant  of  the  Sras  Martinez  was  bitten  in  the 
hand  by  a  coral  snake.  The  tincture  was  given  and  within  eight 
days  she  was  perfectly  well.  The  same  remedy  cured,  in  1830, 
a  servant  of  General  Juan  de  Escalona.  She  was  bitten  in  the 
finger  by  a  snake  of  unknown  species,  and  was  under  treatment 
for  three  days.  Sr.  Antonio  Bodriguez,  who  had  caused  himself 
to  be  inoculated  with  Gfuaco,  was  on  such  familiar  terms  with  the 
most  venomous  snakes,  that  he  had  always  some  of  them  in  his 


186  Miscellaneous. 

house,  in  his  clothes  trunk,  and  eren  in  his  hed.  On  (me  oeca- 
sion  he  carried  a  rattlesnake  in  the  crown  of  his  hat,  and  some 
friends  to  whom  he  showed  it  haring  irritated  it,  it  hit  him  in  the 
head  when  the  hat  was  pat  on,  hut  without  the  least  bad  result. 
Inoculated  persons  acquire  a  certain  power  over  snakes,  as  is 
pro? ed  bj  what  frequently  took  place  in  the  district  of  Argua 
where  two  boys  who  had  been  inoculated  bj  Seuor  Benites  used  to 
go  out  into  the  fields,  catch  snakes,  and  return  playing  with 
theuL 

2.  The  author  of  the  memoir  does  not  mention  any  instances 
of  the  bite  of  the  alecran,  nor  has  anything  reached  me  through 
other  channels. 

8.  According  to  the  statement  of  the  late  Br.  Cristobal 
Mendoza,  G-oyemor  of  Venezuela,  four  negroes  were  bitten  by  a 
rabid  dog.  Three  of  them  were  treated  by  the  usual  remedies 
and  died  of  hydrophobia ;  the  fourth  was  treated  with  Chtaco 
and  escaped.  Senora  Porte,  sister-in-law  to  Oeneral  Juan  de 
Escalono,  and  her  servant  were  bitten  by  a  rabid  dog.  Both  at 
once  took  daily  three  spoonfuls  of  pUre  Quaco  juice,  applying  it 
also  to  the  wounds,  and  continued  this  for  forty  days.  They  did 
not  fall  victims  to  this  terrible  disei^e.  Sr.  Pedro  AlcaU  was 
bitten  in  the  arm  by  a  mad  dog  and  escaped  by  virtue  oi 
Quaeo  treatment.  It  must  be  noted  that  two  of  the  dogs  just 
mentioned  bit  various  animals  all  of  which  died  rabid.  Last 
year  and  this  hydrophobia  has  been  very  rife  amongst  dogs  in 
the  whole  province,  and  Qtmco  has  been  increasingly  employed 
with  the  best  results.  I  have  been  assured  that  for  this  reason 
the  English  Consul  has  written  to  London  some  interesting 
accounts  of  the  virtues  of  this  plant. 

4.  A  woman,  named  Serafnia,  sufiered  from  rheumatiBm  for 
ten  years,  and  became  crippled  by  it.  She  then  took  Guaeoy 
which  restored  her  health  and  the  use  of  her  limbs,  and  I  have 
seen  her  walking  along  the  street  without  difficulty.  A  trust- 
worthy person  informed  the  author  of  the  memoir  that  a  foreigner 
whom  the  gout  had  crippled  was  so  thoroughly  cured  by  Ouaco 
that  shortly  after  his  recovery  he  made  a  jouruey  on  foot  from 
this  city  to  Guavia,  and  that  the  complaint  did  not  return. 

6.  A  child  of  Cdrlos  Mendoza  fell  irom  the  second  story  of  the 
house  into  the  court  below  and  was  badly  injured  in  the  face  and 
all  over  the  body.    Cataplasms  of  the  leayes  were  applied  to  the 


Guaco  and  its  uses.  187 

woondB  and  contusions,  and  the  pure  juioe  was  given  internallj, 
with  success. 

6.  Sras  Martinez,  who  has  been  already  referred  to,  had  a 
sh&Te  suffering  from  arrest  of  the  catamenia.  A  complete  cure 
was  effected  bj  the  treatment  mentioned  above  in  the  fifth 
paragraph. 

7.  The  late  D.  Francisco  Espejo  delates  that  a  disease  of  the 
liver,  which  had  afflicted  him  for  a  long  time,  having  brought  him 
into  a  desperate  condition  in  the  judgment  of  his  physicians,  a 
negro  cured  him  with  drinks  of  Guaco  juice  and  cataplasms  of  thtf 
leaves  put  over  the  Uver/  A  slave  attacked  with  the  same  disease 
was  given  up  by  her  physician,  who  said  she  could  not  survive 
five  days  more.  Guaco  was  employed  as  in  the  previous  case  and 
succeeded  in  restoring  her  health  sO  completely  and  so  quickly 
that  at  the  end  of  a  month  she  returned  to  Work  and  laboured  on 
a  par  with  the  other  slave. 

8.  Senor  Pedro  Edwards  cured  one  of  his  slaves  who  had 
suffered  for  four  years  from  a  sctofulous  Ulcer  in  the  neck,  by 
giving  the  juioe  and  applying  cataplasms  of  the  leaves. 

9.  Col.  Diezo  Yallenilla  states  that  in  Gumana,  his  country,  no 
one  dies  of  tetanus  and  spasm  of  the  stomach  when  Guaco  is  used 
according  to  the  directions  given  in  the  seventh  paragraph.  I  do 
not  know  if  this  remedy  has  been  employed  in  our  city  in  such 
cases,  which  are  rarely  met  with. 

10.  A  slave  of  Senor  Feliciano  Falacios  had  all  the  symptoms 
of  consumption  resulting  Arom  suspended  menstruation,  and  was 
cured  with  an  infusion  of  the  leaves  prescribed  by  an  Indian^ 

11.  A  slave  of  Col.  Francisco  Abendano  was  afflicted  with 
asthma  and  had  a  severe  attack  of  rheumatism.  Guaco  was 
administered  for  the  latter,  and  it  cured  both  diseases.  The  wife 
of  Dr.  F.  Javier  Yaney  gave  the  tincture  to  a  slave  who  was  an 
asthmatic,  and  obtained  the  best  results. 

12.  Senor  Pedro  Edwards,  already  cited,  cured  a  Spaniard  of  a 
tertian  fever  contracted  in  the  Antilles,  by  giving  Quaco  for  a  few 
days. 

13.  The  author  of  the  Memoir  does  not  mention  any  specific 
cases  of  worms,  but  it  is  a  fact  that  many  persons  who  have 
resorted  to  Guaco  for  other  reasons  have  destroyed  these 
parasites. 

14.  Senor  Eduardo,  a  frequent  sufferer  from  violent  hemicrania, 
got  rid  of  it  by  taking  Guaco  tincture. 


188  Miscellaneous. 

Hypodermic  Injections  of  Filtered  water  to  Believe  Pain,* 

la  the  September  number'  of  the  Art  MSdiealy  Dr.  Jouaset 
reports  cases  treated  by  him  at  the  Hdpital  St.  Jacques.  la 
three  of  these  cases  he  made  i^  of  hypodermic  injections  of 
filtered  water  in  the  treatment  of  the  symptom  pain. 

Ci.Sfl  1. — G-.  L — ,  fbt.  37,  stone-cutter,  was  admitted  on 
January  11th,  and  discharged  ^arch  210th.  He  was  suffering 
from  pleuritis  when  admitted,  and  while  in  the  hospital  he  got  an 
attack  of  acute  rheumatism. 

Up  to  February  18th  patient  was  treated  with  Acon.^  Oanth.^ 
KaU,  Mang.f  Ohin,^  Sul.,  Mere.  soh»  and  on  this  day  there  was 
considerable  amelioration,  especially  of  the  fever ;  the  pulse  had 
fallen  to  84  since  some  di^ys ;  at  this  stage  we  (Dr.  Jousset) 
made  some  hypoderpiic  injections  of  simple  water;  the  paias 
diminished  very  perceptibly  and  the  patient  was  at  last  able  to 
sleep. 

The  pulse  having  fallen  to  72,  the  pains  having  abated,  the 
subcutaneous  injections  of  filtered  ^ater  hmng  several  times 
Btopped  attacks  of  pain,  the  Quinine  was  replaced  by  Ohin.,  3 
trit.,  this  by  Sulph.  12.,  and  the  pleuritic  exudation  being  pretty 
well  absorbed,  the  patient  was  ^charged  on  March  2Qth  at  hia 
own  request. 

Case  2. — M.  T — ^  a  man  let.  SS8,  was  admitted  on  February 
11th,  suffering  from  gouty  i^rthritis  confined  to  the  right  shoulder. 
The  pain  is  very  violent,  the  patient  can  make  no  use  whatever 
of  his  arm,  the  joint  is  red,  hot,  and  swelled. 

On  Saturday,  January  16th,  we  made  an  injection  of  water 
simply  filtered ;  twenty-five  minutes  thereafter  the  patient  felt 
himself  greatly  relieved,  and  at  night  he  got  a  little  sleep. 

On  Sunday,  the  next  day,  we  made  another  similar  injection ; 
after  which  the  patient  could  readily  move  his  arm,  and  he  slept 
well  the  following  night. 

On  Monday  we  made  a  third  and  last  injection.  Ever  since  the 
joint  had  been  perfectly  free,  and,  moreover,  his  sleep  has  been 
excellent.  Hypodermic  injections  of  filtered  water  exercise  an 
incontestable  action  on  the  symptom  pain^  but  here  it  is  only 
right  to  mention  that  China^  3  trit,  had  already  begun  to  effect 
improvement. 

•  From  the  AH  MSdieal.    Extracted  by  Dr.  Burnett. 


Hommopatky  and  "Sdentific  Medicine/^  189 

Case  3. — A  woman  suffering  from  intercostal  nenralgia.  She 
was  subjected  to  subcatatieous  injections  of  filtered  water ;  these 
injections  relieved  her,*  but  one  of  them  caused  a  subcutaneous 
abscess. 

Dr.  Jousset  concludes  thus  :  '*  Let  us  for  a  moment  recur  to 
this  question  of  the  hypodermic  injection  of  water  as  a  means  of 
combating  the  symptom  paiii.  This  method  at  first  seemed  to 
UB  so  yeiy  paradoxical  that  w^  most  unwillingly  consented  to  try 
an  experiment  with  it.  The  donclusions  which  we  have  been 
enabled  to  arriye  at  from  a  consideration  of  the  three  cases  in 
which  we  tried  *the  experiment  may  be  thus  stated.  Both  in  the 
rheumatic  and  in  the  gouty  a^hntia  the  pain  was  incontestably 
relieved  after  such  injection.  In  the  case  of  intercostal  neuralgia 
the  pain  was  not  only  not  relieved,  but  the  fourth  or  fifth  injec- 
tion resulted  in  an  abscess  of  the  size  of  a  walnut.  We  have 
therefore  the  fact  of  the  relief  of  the  pain  of  arthritis  by  the 
injection  of  water,  a  fact  which  thus  far  appears  inexplicable,  "f 


HomoBopathif  and "  Scientific  Medicine" 

Thb  following  passage  occurs  in  the  Address  delivered  by 
Prof  Humphrey,  of  Cambridge,  at  the  late  annual  meeting  of  the 
British  Medical  Association. 

''The  physiologically  antagonistic  influences  of  atropia  and 
physostigma,  and  the  fact  that  a  poisonous  dose  of  the  one  may 
be  given  with  impunity  if  the  other  is  administered  along  with 

*  There  is  a  discrepancy  with  regard  to  the  result  of  the  injection  in  the 
case  of  the  intercostal  nenralgia.  Thus,  on  p.  162,  Dr.  Joasset  says,  "  Ces 
injectiones  la  aoulagh'ent,  <f-c."  ».  e,,  these  injections  relieved  her.  But  on  p. 
174  he  says, "  Dans  le  cas  de  n^vralgie  intercoetale  oh  ce  moyen  a  ^t^  applique 
U  8  ^  ineffleaeo  contre  la  donlenr,  Ac,"  i  e„  in  the  case  of  intercostal 
neuralgia  in  which  this  means  was  adopted,  it  was  imjfieaeuHu,  Ac. 

t  I  think  it  is  to  he  explained  hy  the  well-known  action  of  puie  water  on 
protoplasm,  upon  which  it  acts  as  a  strong  stimulus,  causing  it  to  hecome 
contracted  and  finally  to  lose  its  irritahility.  According  to  J.  Buike, "  distilled 
water  acts  as  one  of  the  most  violent  poisons  to  muscular  and  nervous 
suhstances  "  (Fhysiolopie,  p.  118).  The  cause  is  prohably  the  great  capacity 
for  imbibition  possessed  by  pure  water.  Thi»  acting  in  excess  becomes  a  force 
first  stimulating  then  destroying  the  very  complex  molecules  of  the  living 
matter.  This  action  of  pure  water  seems  not  to  have  been  hitherto  sufficiently 
considered  in  the  method  of  hypodermic  injection. — J.  Dbtbdalb. 


190  Miscellaneous. 

it,  seem  to  open  a  prospect  that  really  cnratiTO,  that  is,  antidotal 
agents  may  be  discovered,  not  simply  for  drugs,  but  for  the 
effects  induced  by  drugs,  and  also  for  the  changes  which  consti- 
tute disease ;  and  the  observation  that  morphia,  chloroform,  and 
some  other  substances  produce  different  and  sometimes  opposite 
effects,  according  to  the  doses  in  which  they  are  given,  renders  it 
not  improbable  that  poisonous  agents  may,  in  some  instances,  be 
antidotal  to  themselves,  and  that  the  word  '  homoeopathy '  may 
be  rescued  from  its  position  as  the  expression  of  a  fallacy,  and 
may  yet  take  its  place  in  the  etymology*  of  scientific 
medicine.'^ 

Professor  Humphrey  is  a  man  of  thought  and  science.  But 
his  qualities  seem  to  fail  him  here,  confused  in  the  ''lumen 
madidum  "  which  the  prejudice  against  homoeopathy  never  fails 
to  diffuse.  Let  us  analyse  his  paragraph  into  its  component 
propositions. 
1st.  Antidotal  agents  are  the  really  curative  ones. 
2nd.  Some  substances  are  found  to  produce  opposite  effects, 
according  to  the  dose  in  which  they  are  given. 

8rd.  Hence  it  may  be  that  in  some  instances  a  small  dose  of  a 
poisonous  agent  may  antidote,  i.  e.,  cure,  the  effect  of  a  large 
dose  of  the  same,  or  a  like  change  when  occurring  in  disease. 

4th.  This  would  truly  be  *'  homoeopathy/'  and  such  practice, 
denoted  by  this  appropriate  name,  would  take  its  place  unques- 
tioned in ''  scientific  medicine.*' 

What,  then,  is  the  "  faUacy  "  of  which  this  word  is  at  present 
the  expression?  Simply  this, — that  a  methodus  medendi  con- 
fessedly applicable  to  certain  cases,  and  here  suggested  as 
possibly  of  wider  range  than  we  at  present  know,  is  asserted  by 
some  to  be  of  universal  application  within  its  own  sphere, — such 
assertion  being  based  upon  experiment  and  observation  carried 
on  widely  and  continuously  since  the  beginning  of  this  century. 
Wherein  is  the  "  fallacy  "  here  ?  The  induction  may  be  disproved 
or  superseded ;  but  at  the  most  it  can  only  be  demonstrated  to 
be  partial ;  there  is  no  "  fallacy  "  about  it.  To  assume  it  as 
already  discredited  is  surely  unworthy  of  a  man  of  Prof. 
Humphrey's  reputation.  He  should  rather,  by  precept  and 
example,  encourage  those  who  look  up  to  him  to  "  prove  all 
things  "  in  medicine,  before  they  allow  themselves  to  "  hold  fast 

•  We  suppose  Prof.  Hampbrey  means  "  vocabulary." 


Hamceopaihy  and  "Scientific  Medicine/'  191 

that  which  is  good."  Which  is  the  more  philosophical  course, 
to  test  such  a  method  by  experiment,  or  to  reject  it  as  a 
*'  fallacy  ?*'  All  we  are  doing  is  to  adopt  the  former  course, 
allowing  the  doctrine  to  dominate  our  practice  just  so  far  as  it 
becomes  verified  by  fact,  and  no  farther.* 

But,  alas!  Professor  Humphrey  could  Aot  recommend  this 
more  philosophical  course,  even  if  he  approved  of  it.  He  would 
be  imperilling  the  future  career  of  his  pupils.  Let  us  recall  the 
following : 

"  On  the  4th  of  d'anuary^  1856,  under  the  presidency  of  Profes- 
sor Cruveilhier,  were  expelled  from  the  Anatomical  Society  of  Paris 
with  the  unanimous  consent  of  the  members, '  Drs.  J.  P.  Tessier, 
Gabalda,  Fredault,  and  Jousset,  as  authors  of  homoeopathic 
publications,  and  M.  W —  an  account  of  an  infamous  and 
felonious  act  already  punished  by  the  law/  *'  (See  VArt  MSdical, 
December,  1873.)  Such  a  concatenation  would  seem  to  bear 
with  it  its  own  shame.  But  it  is  to  be  feared  that  such  expulsion 
well  expresses  the  medical  mind  of  Great  Britain  at  the  pFesent 
day.  The  name  of  Beith  has  to  be  added  to  those  of  Tessier  and 
Henderson  as  instances  of  the  utter  intolerance  of  the  most 
liberal  and  honest  investigation,  if  its  results  happen  to  tend  in 
a  certain  direction.  Who  then  can  dare  to  advise,  and  who 
dare  to  imitate,  the  "rescue"  which  Professor  Humphrey 
anticipates  ?  Suppose  it  leads,  as  it  has  already  led  in  the  case 
of  such  men  as  these,  to  a  conviction  that  no  rescue  is  needed, 
and  that  the  word  "  homceopathy  "  is  even  now  the  expression  of 
no  fallacy,  but  of  a  large  body  of  ascertained  and  sifted  truth. 
Were  Professor  Humphrey  himself  to  follow  (as  he  need  not  be 
ashamed  of  following)  Tessier  and  Henderson  to  this  conclusion, 
his  place  in  Cambridge  would  know  him  no  more.  He  would 
doubtless  be  above  any  such  terrors  when  Truth  invited  him.     But 

*  A  good  instance  of  the  comparatiye  fraitfulness  of  sach  a  course  is  seen 
in  the  case  of  the  action  of  Ekiu  on  the  skin.  In  the  London  Medical  Beeord 
of  Aug:  27th,  Dr.  Ringer  cites  from  the  New  York  Medical  Journal  some 
ohsenrations  on  the  power  of  BJmu  toxicodendron  and  Rhut  venenata  to 
inflame  the  skin.  The  facts  are  recorded :  hut  there  they  remain  ahsolntelj 
barren.  To  us,  onjthe  contrary,  who  use  the  method  of  Hahnemann,  they  have 
long  ago  suggested  the  use  of  the  Shnt  in  such  cutaneous  affections,  and  with 
the  distinguished  success  to  which  we  all  can  testify.  Which  is  the  Medicine 
of  the  future,  that  which  can  utilize  all  pathogenetic  facts,  or  that  to  which 
at  leaat  one  half  of  them  has  no  signification  P 


192  Books  received. 

can  he  tolerate  their  existence  ?  Can  he  doubt  their  benumbing 
effects  on  weaker  minds  P  Is  it  not  time  that  he,  and  such  as  he, 
spoke  out  for  liberty  of  thought  and  removal  of  disabilities  in 
medical  as  in  political  lifeP  Is  it  not  time  for  withdrawing 
the  unjust  stigma  which  rests  upon  those  whose  only  fault  is 
their  free  carrying  out  of  the  very  investigations  which  have 
raised  the  hopes  here  expressed  ? 


BOOKS    RECEIVED. 


Oompulsofy  Faeeinaiion:  its  Wickedness  to  the  Poor.  By 
J.  J.  Gaeth  Wilkinson.    London :  Pitman. 

Sir  James  Paget  on  Changes  produced  hy  Vaccination, 

Disasters  from  Vaccination,     By  Edwabd  Ballabd,  M.D. 

On  the  Evil  Oonsequences  ^Impure  Vaccination^  By  Edwasd 
HAroHTON,  A.B.,  F.C.D.,  KD.,  M.E.C.S.B.,  &c. 

The  Danger  and  Injustice  of  Compulsory  Vaccination. 

Vaccination  and  the  Vaccination  Act.  By  Bev.  Mitnsxfobd 
Allen. 

On  the  Best  Method  of  Medicating  Pilules.  By  Isaac  C. 
Thompson. 

Annual  Record  of  Homceopathic  Literature  for  1873.  By  C. 
Qt.  Raub,  M.D.     Boericke  and  Tafel,  New  York. 

Albany  Weekly  Times,  Nov.  27,  1878. 

The  Dublin  Journal  of  Medical  Science. 

The  New  Zealand  Homceopathic  Gazette. 

The  Monthly  Homceopathic  Beview. 

The  Hahnemannian  Monthly. 

The  American  Homoeopathic  Observer. 

The  Western  Homoeopathic  Observer. 

The  Chicago  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy. 

United  States  Medical  and  Surgical  Journal. 

The  Western  Homosopathic  Observer. 

The  New  England  Medical  Gazette. 

The  American  Journal  of  Homoeopathic  Materia  Mediea. 

JSl  Criterio  Medico, 

BibUothhque  Homoeopathique. 

The  Calcutta  Journal  qf  Medicine. 

The  Food  Journal. 

The  Chemist  and  Druggist. 

The  New  York  Journal  of  Homoeopathy. 

The  Sanitarian. 

The  Medical  Union. 

Compendio  di  Materia  Mediea  Pura.    Par  Dr.  B.  Dadxa. 


THE 


BRITISH   JOURNAL 


ov 


HOMCEOPATHY. 


THE  CLIMATE  OP  MADEIRA,  IN  THE  TREAT- 
MENT  OP  PHTHISIS'  AND  OTHER  APPEC 
TIONS  OP  THE  RESPIRATORY  ORGANS. 

By  W.  B.  A.  Scott,  M.D. 

LiTTLJB  more  tban  a  quarter  of  a  century  ago  the  Island 
of  Madeira  was^  unquestionably,  the  fayourite  winter  resort 
of  all  phthisical  invalids  from  this  country  whose  resources 
and  circumstances  permitted  them  to  visit  so  distant  a 
shore.  The  writings  of  Sir  James  Clark,  Dr.  Gourlay,  Sir 
Thomas  Watson,  Dr.  Scott  Alison,  and  many  others,  all 
described  the  climate  of  Madeira  as  that  which  was  incom- 
parably better  suited  than  any  other  to  consumptive 
patients.  The  sufferers  themselves,  in  many  cases,  echoed 
the  encomiums  bestowed  on  that  beautiful  island  by  their 
medical  advisers,  and  the  prevailing  opinion  of  the  public, 
no  less  than  that  of  the  profession,  rose  so  high  in  its 
favour  that  a  visit  of  longer  or  shorter  duration  to  that 
favoured  spot  was  deemed  an  all  but  infallible  cure  for 
consumption  in  its  eaHier  stages,  a  certain  means  of 
securing  prolonged  existence,  or,  at  least,  euthanasia,  at  a 
more  advanced  period,  and  an  effectual  prophylactic 
measure  in  cases  where  the  disease  indicated  its  approach 

VOL.  XXXII,  NO.  CXXVIII. APRIL,  1874.  N 


194  The  Climate  of  Madeira  in  PhihUU,  ^e., 

by  premonitory  symptoms^  without  having  as  yet  estab- 
lished itself  in  the  constitution. 

A  very  different  opinion  on  this  subject  prevails  at  the 
present  day.  The  name  of  Madeira,  indeed,  is  still  found 
in  works  dealing  with  medical  climatology,  but  it  occurs 
merely  as  one  among  a  host  of  others,  and  to  which  no 
special  recommendation  is  accorded ;  while  our  more  accu- 
rate knowledge  of  the  topographic,  thermometric,  baro- 
metric, hygrometric,  and  other  physical  conditions  of  the 
various  health  resorts  now  in  vogue  has  enabled  us  to 
institute  comparisons  between  them  with  greater  precision, 
and  has  led,  in  many  cases,  to  very  unexpected  results.  It 
will  be  an  interesting  task  to  endeavour  to  find  out  the 
causes  of  this  former  popularity,  in  which  we  shall  readily 
perceive  the  reasons  of  its  subsequent  decline,  while,  at  the 
same  time,  we  shall  be  doing  a  good  service  both  to  the 
island  itself  and,  what  is  of  far  greater  consequence,  to 
the  interests  of  suffering  humanity,  if  our  investigation 
shall  enable  us  to  point  out  the  nature  of  the  cases  to 
which  the  climate  of  Madeira  is  likely  to  prove  of  real 
benefit. 

In  order  to  understand  the  circumstances  under  which 
Madeira  acquired  the  high  reputation  it  formerly  enjoyed 
as  a  resort  for  phthisical  invalids^  it  is  necessary  to  bear 
distinctly  in  mind  the  views  entertained  until  a  compara- 
tively recent  period  upon  the  etiology,  pathology,  and 
treatment  of  phthisis.  This  formidable  disease  was  sup- 
posed to  be  chiefly,  if  not  entirely,  confined  to  damp,  cold, 
and  variable  climates,  and  its  origin  was  mainly  ascribed  to 
these  hygrometric  and  thermometric  conditions.  It  was 
imagined  to  be  a  local  disease  affecting  the  lungs,  at  least 
primarily,  and  even  in  some  cases  to  run  its  course  without 
materially  implicating  any  other  organ.  The  former  of 
these  ideas  derived  some  confirmation  from  the  general 
pulmonaiy  symptoms,  as  cough,  dyspnoea,  sanguineous  and 
purulent  expectoration,  and  so  forth,  while  the  latter  seemed 
to  be  supported  by  the  fact  that  in  some  cases  death  super- 
vened without  the  previous  occurrence  of  the  profuse 
diaphoresis,  troublesome  sickness,  and  colliquative  diarrhoea. 


by  Dr.  W.  B.  A,  Scoti.  195 

ivhich^  Bingly  or  in  combination^  characterise  in  general 
the  progress  of  consumption.  In  fact^  these  latter 'symp- 
toms, as  well  as  those  of  hectic,  were  accounted  for  as 
results  of  the  *' inflammatory '^  condition  set  up  by  the 
progress  of  the  local  disease^  and,  therefore,  to  be  met  by 
the  disastrous  antiphlogistic  remedies  then  in  fashion,  which 
have  more  deaths  to  answer  for  than  the  most  fiercely- 
contested  tenets  of  political  or  religious  persecution. 
Accordingly,  when  the  disease  had  fully  declared  itself,  the 
quick  pulse  and  high  temperature  were  held  to  indicate 
"-inflammation,"  and  immediate  recourse  was  had  to  the 
'^regular''  sanguinary,  nauseating,  and  debilitating  mea- 
sures which,  repeated  sufficiently  often,  safely  conducted 
the  patient  to  the  grave,  leaving  the  survivors  with  the 
consoling  assurance  that  every  weapon  of  the  therapeutic 
armoury  had  been  employed  strictly  according  to  rule,  in 
combating  the  foe;  but  in  this  particular  case  had  failed  to 
baulk  the  destroyer  of  his  prey.  Now,  it  is  evident  that 
under  this  mode  of  treatment  every  accidental  and  tempo- 
rary aggravation,  such  as  a  trifling  attack  of  intercurrent 
catarrh  or  bronchitis,  which  was  supposed  to  call  for 
medical  interference,  must,  on  account  of  the  infatuated 
measures  adopted,  have  been  succeeded  by  marked  loss  of 
strength  and  increase  of  all  the  unfavourable  symptoms. 
It  was  observed  that  catarrhal  or  bronchitic  affections  often 
took  their  rise  from  cold  or  variations  of  temperature,  and 
as  it  was  to  the  supervention  of  these  i^ffections  themselves, 
and  not  to  the  inappropriate  measures  adopted  for  their 
relief,  that  the  physicians  of  the  day  ascribed  the  aggrava- 
tions of  the  primary  disease,  they  argued,  with  much 
plausibility,  that  by  transporting  the  patient  to  a  warm  and 
equable  climate  he  would  be  placed  in  the  most  favourable 
circumstances  for  obtainitig  an  arrest  or  suspension,  if  not 
a  final  cure,  of  his  malady.  Moreover,  as  in  those  days 
comparative  sanitary  statistics  hardly  existed,  and  as  it  was 
noticed  that  coughs  and  colds  were  more  common  am9ngst 
ourselves  in  winter  than  in  summer,  and  frequently  took 
their  rise,  even  during  mild  weather,  from  rash  transitions 
firom  a  heated  room  to  the  open  air,  it  was  hastily  and 


196  The  Climate  of  Madeira  in  Phthisis^  ^c, 

erroneously^   but  not  altogether   unreaaonably^  concluded, 
that  phthisis  was  peculiarly  a  disease  of  cold  and  change- 
able climates^  having  its  origin  in  these  atmospheric  condi- 
tions, and  that  therefore  a  temporary  or  permanent  sojourn 
in  more  favoured  regions  might  not  only  mitigate  or  heal 
the   disease  in  those  actually  attacked^  but  even   avert  it 
altogether  from  others  on  whom  it  had  not  as  yet  laid  its 
destroying  hand.      As  might  have  been  expected,  no  cases 
of  consumption  which  fell  under  medical  treatment  in  this 
country  at  the  time  we  are  considering  ever  by  any  chance 
recovered,  and  the  not  infrequent  instances  of  spontaneous 
cure  in  such  as  had  been  so  fortunate  as  to  escape  this 
ordeal  were  unhesitatingly  declared  to  have  been  cases  of 
bronchitis.     The  story  goes  that  an  Irishman  once  com- 
plained  to   a  school  committee  of  the   undue   favouritism 
shown  by  the  master  to  one  of  the  pupils  aft  the  expense 
of   his    (the   complainant's)    son.       "Why/'   said  Paddy, 
*^  sure   an'   the   master  asked   how  many    commandments 
there  were,  an'  my  boy  tould  him  there  was  a  hundhred, 
and,  bedad,  the  scoundhrel  let   toother  boy  go  above  him 
who  wouldn't  own  to  more  than  ten  I"     And  just  as  the 
indignant  son  of  Erin  thought  that  a  schoolboy's  deserts 
were  in  direct  proportion  to  the  number  of  moral  obliga- 
tions whose  authority  he  acknowledged,  so  physicians  of  the 
old  school  were  naturally  persuaded  that  a  patient's  chances 
of  recovery  were  directly  proportional  to  the  number  and 
activity  of  the  artificial  methods  employed  in  combating  the 
disease.     Armed   with  mercurial  and  antimonial  draughts 
in  the  one  hand,  and  with  lancets,  cauteries,  and  scarifiers 
in  the  other,  like  Queen  Eleanor  with  the  dagger  and  the 
bowl,  they  naturally  felt  that  if  they  failed  to  destroy  the 
interloper   who   had   taken    unlawful   possession    of  their 
patient,  and  whose  mazy  windings  they  had  so  studiously 
tracked,  it  must  be  on  account  of  her  being  invincible,  and 
loudly  denied  the  possibility  of  a  spontaneous  and  gradual 
disappearance  of  their  detested  rival.     Yet  there  is  every 
reason  to  believe  that  fair  Rosamond  died  in  the  course  of 
nature,  and  it  is  still  more  certain   that  the  formidable 
ailment,  of  which  we  have  so  ungallantly  taken  that  objec- 


by  Dr.  W.  B.  A.  Scott.  197 

tionable  younp^  lady  as  a  type  in  our  allegory,  frequently 
enough  departed  of  itself,  when  not  rendered  fatal  by 
"  heroic "  measures.  It  was  not  strange,  however,  that 
the  physicians  of  the  day,  finding  the  impotence  of  their  art 
as  a  means  of  cure,  should  have  laid  the  fatality  of  the 
disease  to  the  account  of  nature  rather  than  to  that  of  their 
own  malpractice,  lind,  therefore,  sought  for  prophylactic 
naeans  when  possible,  or,  when  too  late  to  apply  these, 
prescribed  such  measures  as  might  diminish  the  chances  of 
the  untoward  complications  they  so  much  dreaded. 
Ai^aing  on  the  insufficient  premises  we  have  above  re- 
ferred to,  they  supposed  the  requirements  to  be  best  met 
by  a  warm  and  equable  climate,  and  this  can  assuredly  no- 
where be  found  in  greater  perfection  than  in  the  Island  of 
Madeira.  We  need  not  be  surprised,  therefore,  that  they 
fondly  deemed  they  had  at  last  found  the  true  Atlantis  in 
this  western  isle. 

During  the  latter  years  of  the  last  century  and  the  early 
part  of  the  present,  Madeira  was  so  fortunate  as  to  possess 
an  eminently  judicious  British  physician,  in  the  person  of  the 
late  Dr.  William  Gourlay,  whose  book  upon  the  island  is,  in 
a  medical  point  of  view,  very  much  the  best  which  appeared 
previously  to  Dr.  W.  W.  Ireland's  articles  in  the  Medico^^ 
Chirurffical  Journal  of  Edinburgh  in  the  summer  of  1869., 
Dr.  Grourlay,  indeed,  remarked  that  no  disease  was  of  more 
common  CKX^urrence  than  phthisis  among  the  Madeiranese 
themselves,  and  thus  at  once  refuted  the  unfounded  notion 
that  this  malady  is,  in  any  sense,  exclusively  or  even 
characteristically  a  denizen  of  cold  or  variable  climates. 
He  also  observed  that  it  ran  a  more  rapid  course  among 
the  natives  in  Madeira  than  among  the  English  at  home. 
In  fact.  Dr.  Oourlay's  is  nearly  the  only  medical  work  on  this 
subject  which  can  be  described  as  having  been  written  with 
a  thoroughly  honest  intention,*  as  the  publications  of  Dr. 

*  We  do  not,  of  coarse,  extend  this  censure  to  the  remarks  of  Sir  James 
Clark  (who,  hy  the  way,  tells  us  he  had  never  himself  visited  the  island,  hut  took 
his  facts  from  information  supplied  him  by  others),  but  to  the  works  named  in  the 
text,  as  well  as  to  an  ostentatious  pamphlet  by  a  Mr.  Mackenzie  Blozam  (who, 
however,  was  not  a  medical  man),  which  contains  an  equal  display  of  ignorance, 
presumption,  and  discourtesy ;  together  with  some  others  of  like  character. 


198  The  aimate  of  Madeira  in  Phthisis,  ^., 

Lnnd  and  others  are  little  better  than  professional  adrer- 
tisements,  and  the  foolish  brochure  giyen  to  the  public  two 
or  three  years  ago  by  Dr.  Grabham  scarcely  deserved  even 
the  contemptuous  exposure  it  received  from  one  of  the 
Scottish  medical  journals.  Notwithstanding  his  acknow- 
ledgment of  the  frequency  and  fatality  of  phthisis  amon^ 
the  natives^  however,  Dr.  Oourlay  was  of  opinion  that  the 
climate  of  Madeira  was  eminently  suitable  for  consumptive 
patients  from  other  countries,  especially  £ngland ;  and 
whether  these  two  opinions  are  correct  or  not,  we  homoeo- 
paths are  the  very  last  people  in  the  world  to  maintain  that 
they  are  incompatible,  as  the  allopaths  are,  of  course, 
bound  to  do  if  they  have  the  smallest  regard  to  consistency. 
Dr.  Oourlay  found  ample  reason  to  be  satisfied  with  the 
results  of  his  own  practice,  and  no  wonder,  for  it  seems  to 
have  been  judicious  in  an  eminent  degree,  and  would  do 
little  discredit  to  one  of  his  own  school  at  the  present  day. 
He  tells  us  thaf  he  found  violent  remedies  of  any  kind  badly 
bome^  so  that  his  measures  were,  as  a  rule,  of  the  mildest 
character  ;  he  rarely,  if  ever,  had  recourse  to  bloodletting, 
substituting  for  this  the  administration  of  digitalis — a 
formidable  drug^  indeed,  aud  one  the  action  of  which  is 
even  now  imperfectly  understood,  but  still,  Hyperion  to  a 
Satyr  as  compared  with  the  murderous  operation  it  re- 
placed.  Under  this  enlightened  treatment  we  are  not  sur- 
prised to  find  that  many  recoveries  took  place,  and  these, 
when  contrasted  with  the  uniform  fatality  of  all  cases  of 
this  disease  which  fell  under  the  treatment  of  physicians  in 
England  at  that  time,  naturally  led  the  patients  to  endorse 
the  favorable  verdict  of  the  profession,  and  to  join  loudly 
in  the  praises  of  an  island  which  they  had  found  so  lovely 
a  place  of  sojourn,  and  where  many  of  them  had  received 
marked  and  permanent  physical  benefit. 

The  reputation  thus  acquired  bond  fide  was  (we  fear,  at  ^ 
times,  disingenuously)  defended  in  pamphlets  and  other 
publications  by  the  various  British  physicians  practising 
in  the  island.  Of  late  years  the  dispute  has  assumed  a 
specially  acrimonious  character,  owing  to  the  interests,  not 
only  of  the  doctors,  but  of  the  tradesmen  and  landlords. 


by  Dr.  W.  B.  A.  Scott.  199 

having  become  Beriously  prejudiced  both  by  the  establish- 
ment of  so  many  other  sanatoria  of  equal  or  /superior  merit 
and  easier  access,  and  by  the  general  migration  of  the  pre- 
viously resident  English  after  the  vine  disease  of  1852 
having  rendered  all  these  persons  dependent  to  a  great 
extent  upon  the  chance  influx  of  winter  visitors.  Accord- 
ingly, as  is  the  case  in  most  valetudinarian  resorts,  we  find 
that  many  of  the  English  who^  having  originally  visited  the 
island  for  medical  reasons^  have  since  deemed  it  expedient 
to  adopt  it  as  their  permanent  abode,  and  whose  interests 
have  in  consequence  become  associated  with  its  prosperity, 
are  loud  in  maintaining  all  its  old  claims  as  a  sanatorium, 
in  real  or  assumed  ignorance  of  the  fact  that  many  of  these 
claims  have  been  utterly  invalidated  by  the  progress  of 
science,  and  other  results  of  the  march  of  time.  It  now 
becomes  our  duty  to  lay  before  our  readers  as  accurate  and 
comprehensive  a  description  of  the  island  as  is  consistent 
with  the  limits  of  an-  article,  and  to  consider  this,  in  con- 
nection with  the  altered  views  which  our  extended  know- 
ledge of  pathology  and  therapeutics  has  introduced  as  to 
the  causes,  nature,  and  treatment  of  phthisis. 

The  island  of  Madeira  is  situated  between  the  degrees  of 
82°  49'  and  82'' 87'  north  latitude,  and  16^89'  and  If  17' 
west  longitude,  its  greatest  length  and  breadth  being  about 
thirty  and  twel?e  miles  respectively.  It  lies  about  800 
miles  from  the  African  coast,  and  a  steamer  performs  the 
voyage  from  Funchal,  its  chief  town,  to  Teneriffe  in  twenty- 
four  hours.*  Cr.  Ireland  remarks,  ''  Like  the  Azores  and 
Canaries,  the  whole  island  is  obviously  of  volcanic  origin, 

*  It  OQght  to  be  mentioned  in  this  place,  that  as  Lisbon  is  the  only  town  on 
the  continent  of  Europe  to  which  there  Ib  any  direct  communication,  an 
invalid  who  shall  select  Madeira  as  hia  place  of  winter  resort  will  find  himself 
virtually  compelled  to  remain  in  the  island  until  he  returns  to  England, 
whether  the  climate  suits  him  or  not;  as  the  stormy  passage  to  Lisbon,  and 
subsequent  fatigaing  railway  journey  across  Portugal,  part  of  Spcdn  and 
France  in  the  depth  of  winter,  ought  certainly  not  to  be  hazar^pd  by  any  one 
whose  condition  is  such  as  to  require  change  of  climate  at  all.  Lisbon  itself 
has  no  claims  whatever  as  a  sanatorium,  and  now-a-days  would  never  be 
thought  of  as  such,  except  from  its  having  been  the  death-place  of  Doddridge 
and  Fielding,  who  resorted^hlther  in  vun  pursuit  of  health. 


200  The  Climate  of  Madeira  in  PAiMsis,  ^., 

formed  partly  by  npbeayals,  bat  nuunly  by  gooeeasiTe 
deposits  of  igneous  rocks/'  This  ia  sbown  by  the  existeooe 
of  laya  and  trachytes,  of  recent  date,  together  with  trap 
and  basalt^  belonging  to  the  secondary  and  tertiary  strata. 
Dr.  Ireland  continues,  ''  The  backbone  of  the  island,  whose 
loftiest  peaks  are  about  6000  feet  high,  slopes  towards  the 
sea  both  on  the  north  and  south  aspect.  Madeira  is, 
indeed,  one  mountainous  range  surrounded  by  the  ocean ; 
nothing  but  hill,  precipice,  and  ravine,  scarcely  any  lerel 
ground,  and  no  sea  beach,  save  at  one  or  two  points  where 
a  powerful  surf  rolls  about  large  pebbles  which  it  has 
detached  from  the  surrounding  rocks.''  Owing  to  its 
mountainous  structure  the  island  presents  a  great  variety  of 
climates,  snow  being  sometimes  found  on  the  summits 
during  the  winter  time,  while  at  Funchal  the  thermometer 
very  rarely  indeed  falls  below  53^  or  54°,  this  mild  tempera- 
ture being  due,  in  part,  to  the  town  having  a  southern 
aspect.  It  is  with  the  town  of  Funchal  itself  we  are 
principally  concerned,  as  it  is  the  sole  residence  of  invalids, 
except  for  a  few  months  during  the  spring  and  summer, 
when  accommodation  can  be  obtained  at  a  village  in  the 
north  of  the  island.  This  is  much  to  be  regretted,  as  the 
more  bracing  atmosphere  of  the  northern  shore  would  prove 
far  more  beneficial  to  a  large  class  of  consumptive  patients 
than  the  warm,  equable,  and  consequently  debilitating 
climate  of  Funchal.  At  present,  however,  this  can  hardly 
be  remedied,  as  their  remoteness  from  medical  aid,  and 
even  from  the  supply  of  the  most  ordinary  conveniences 
and  necessaries,  renders  the  northern  districts  unsuitable 
for  an  invalid's  residence.  The  rainfall  at  Funchal  is  about 
thirty  inches,*  and  the  most  frequent  showers  occur  during 
October,  December,  January,  and  February,  when  the 
rain  often  descends  in  torrents;  but  as  these,  although 
violent,  are  rarely  of  long  duration,  and  as,  from  the 
nature  of  the  soil  and  pavement,  the  streets  dry  quickly,  it 
is  but  seldom  that  an  invalid  needs  to  keep  indoors  for  an 

a  The  rainfall  at  Malta  is  15  in. ;  at  Algiers,  86  in. ;  at  Malaga,  16'6  in. ;  at 
Underdiff  in  the  Isle  of  Wight  2848  in.;  at  Nice,  86  in.;  at  Paris,  48  in. 


by  Dr.  W.  B.  A.  Scott.  201 

entire  day  from  this  cause.*  The  number  of  days  on 
which  rain  falls  in  the  course  of  the  year  is  said  to  be 
about  eighty-eight,  but  this  is  thought  by  some  to  be 
increasing,  owing  to  the  reintroduction  of  the  cultivation  of 
the  sugar-cane  on  the  failure  of  the  vines  in  1852. 
Whether  this  event  has  really  increased  the  rainfall  may  be 
a  matter  of  doubt,  but  there  can  be  no  question  that  the 
constant  irrigation  the  canes  require  must  materially 
increase  the  vapour  suspended  in  the  atmosphere.  This 
vapour,  by  in  part  condensing  after  sunset,  combined  with 
the  insular  situation,  and  the  protection  from  northerly 
winds  afforded  by  the  range  of  hills  behind  Funchal, 
doubtless  contributes  to  the  equability  of  the  temperature 
and  the  small  thermometric  variation  between  day  and 
night  (which  in  winter  is  often  scarcely  'perceptible),  but  it 
also  adds  to  the  debilitating  nature  of  the  climate.  This 
dampness  was  at  one  time  overlooked,  perhaps  owing  to 
the  frequent  absence  of  dew  which  results  from  the  small 
nightly  depression  of  temperature,  but  its  existence  no 
longer  admits  of  question.  Not  only  do  clothes,  books, 
&c.,  become  mildewed  and  steel  instruments  rusty,  but  the 
hygrometer  places  the  matter  beyond  controversy.  The 
observations  of  Heineken  and  Barral  with  this  instrument 
give  us  an  average  of  4*5  grains  of  aqueous  vapour  to  the 
cubic  foot,  equivalent  to  saturation  at  58^.  Colonel 
Azevedo  gives  us  4*6  grains,  or  saturation  at  53'5^.  Mr. 
White  gives  us  6  grains,  or  saturation  at  56^.  Compared 
with  this  we  have  all  over  Scotland  3^2  grains,  or  satura- 
tion about  44*5^,  and  at  Torquay  3*1  grains,  or  saturation 
at  44^.  If  we  strike  an  average  between  the  thermometric 
observations  of  Heineken,  White,  Barral,  and  Azevedo^  we 
get  the  following  mean  temperatures  for  the  seven  months 
which  chiefly  concern  invalids: — October,  69'89®;  No- 
vember,   65-40°;    December,    6188°;    January,    6082°; 

*  King  Charles  II  used  to  say  that  in  no  country  which  he  had  ever  ^ited 
was  it  possible  to  spend  so  many  hours  of  so  many  days  in  the  open  air, 
thronghont  the  entire  year,  as  in  England.  He  would  certainly  not  have  said 
this  had  he  chanced  to  have  ever  resided  in  Madeira. 


202  The  Climate  of  Madeira  in  Phihisis,  ^c, 

February,  61-46°;  March,  6235°;  April,  65-81^*  The 
extreme  range  of  temperature  between  and  on  the  various 
days  and  nights  during  these  months  is  thus  given  firom 
observations  at  the  Boyal  Observatory,  Punchal,  (when 
translated  from  the  Centigrade  to  the  Fahrenheit  scale): 
October,  171°;  November,  15-8°;  December,  221°; 
January,  158°;  February,  216°;  March,  15-6°;  April, 
15*6°.  We  may  see  from  these  statistics  that,  in  point  of 
equability  of  temperature,  Madeira  is  superior  to  almost 
any  other  invalid  station  with  the  exception,  perhaps^  of 
Malaga.  Dr.  Burgess  endeavoured  to  impugn  this,  but  he 
was  misled  by  statistics  taken  during  two  very  exceptional 
seasons.     The  amount  of  ozone  seems  to  be  at  any  rate  I 

not  above  the  average,  and  the  barometric  height  averages 
about  thirty  inches.  The  town  of  Funchal  enjoys  a  night 
and  morning  sea  breese,  and  the  only  cold  wind  is  the 
northerly,  from  which  it  is  in  a  great  degree  sheltered.  A 
dry,  hot,  east  wind,  called  Leste,  blows  at  times  from  the 
African  shore,  which  is  very  trying  to  invalids,  and, 
indeed,  most  unpleasant  even  to  those  in  robust  health; 
but  the  frequency  of  this  has  been  much  exaggerated.  It 
rarely  blows  in  the  winter  time,  which  is  the  season  for 
visitors,  and,  indeed,  between  March,  1869,  and  April, 
1870,  and  again  from  October,  1870,  till  February,  1871, 
during  which  periods  the  present  writer  resided  at  Madeira, 
he  can  only  call  to  mind  one  occasion  (and  that  in  the 
hottest  part  of  summer)  on  which  he  felt  any  serious 
inconvenience  from  this  rare  but  troublesome  visitor. 

It  is  almost  needless  to  say  that  the  island  is  lovely  in 
the  extreme,  a  bright  gem  of  the  ocean,  which  seems  to 
realise  all  that  poets  have  ever  dreamed  of  a  possible  Ogygia 
or  Atlantis.     The  outline  of  the  mountain  tops,  as  seen 

*  That  U  to  say,  an  average  temperature  of  nearly  64^  during  these  months. 
This  may  be  compared  with  the  following  list  which  refers  to  the  same 
months :  Algiers,  56*91^ ;  Cape  Town,  67^  j  Malaga,  64*41^ ;  Mentone,  about 
48"" ;  Nice,  46*38° ;  F^u,  about  48° ;  Queenstown,  44*1° ;  Torquay,  44° ;  Under- 
did, 41*89° ;  Folkestone*  41'76°.  8o  far  as  the  anerage  temperaktre  is  con- 
cerned, any  of  these  would  in  all  probability  be  preferable  for  most  Britiah 
phthisical  patients.  Unless  in  advanced  casei^  64°  is  unquestionably,  as  a 
rule,  too  high  for  patients  from  Kngland. 


by  Dr.  W.  B.  A.  Scott.  203 

from  some  little  distance  at  sea,  is  bold,  rugged,  and 
striking  in  the  highest  degree,  somewhat  recalling  the  Isle 
of  Arran,  but  grander  and  more  characteristic.  In  some 
parts  the  cliffs  descend  perpendicularly  into  the  water  from  a 
height  of  many  hundred  feet,  while  in  others  there  are 
gradual  slopes  or  terraces  richly  clothed  with  the  vegeta* 
tion  both  of  the  temperate  regions  and  of  the  tropics. 
Nearly  every  variety  of  landscape  is  here  presented,  fertile 
valleys,  barren  peaks,  yawning  ravines,  and  long  ranges  of 
more  open  country  covered  with  noble  trees.  But  owing 
to  the  very  same  steep  and  mountainous  structure  of  the 
country  which  lends  to  it  so  many  attractions,  two  of  the 
leading  charms  of  English  scenery,  namely,  lakes  and 
rivers,  are  wanting.  The  bougainvillia,  the  oleander,  the 
clematis,  camellias,  roses,  passion  flowers,  and  jessamines, 
are  seen  in  rich  profusion }  and  among  fruits  there  is  the 
delicious  banana  to  be  had  all  the  year  round,  and  in  their 
seasons  there  are  (besides  such  English  fruits  as  peaches, 
nectarines,  strawberries,  cherries,  pears,  apples,  plums,  and 
so  forth)  grapes,  oranges,  mangoes,  loquats,  guavas,  pome- 
granates, lemons,  prickly  pears,  and,  best  of  all,  the 
exquisite  custard  apple.  Again,  the  island  is  perfectly  free 
from  all  venomous  reptiles,  and  is  very  sparingly  visited  by ' 
mosquitoes ;  the  only  annoyances  of  this  kind  are  cock- 
roaches and  centipedes,  which  attain  a  large  size,  and  are 
certainly  more  numerous  than  could  be  desired. 

Owing  to  the  comparatively  recent  period  at  which 
Madeira  was  peopled*  the  island  presents  no  objects  of 
antiquarian  interest,  but  many  charming  excursions  can  be 
made  in  a  hammock  or  on  horseback  within  an  accessible 
distance  from  Funchal;  and,  notwithstanding  the  hilly 
character  of  the  district,  there  is  one  perfectly  level  road 
extending  several  miles  from  the  western  extremity  of  the 
town,  admirably  suited  for  invalids,  either  walking  or 
riding.  The  boarding-houses  are,  on  the  whole,  well 
situated,    most   of    them   being   near   the   sea,    but    one 

*  Madeira  was  discovered  by  the  Portagneee  in  1419,  and  colonised  by  them^ 
shortly  afterwards.    It  derived  its  name  from  the  abundance  of  trees  (Portug. 
ICadeiraaawood)  observed  in  the  island. 


204  The  Clunaie  of  Madeira  im  Phthisis,  ifc, 

(Hollway's)  is  bailt  at  an  elevation  of  several  handred  feet^ 
so  that  it  enjoys  the  advantage  of  a  much  more  bracing 
temperature.  It  has,  however^  the  drawback  of  possessing 
scarcely  any  level  walks  in  its  neighbourhood  suitable  for 
invalids.  The  charges  are  not  unreasonable ;  a  bedroom^ 
with  the  use  of  the  general  sitting-room^  a  liberal  and 
even  luxurious  boards  with  attendance,  lights,  &c.y  may  be 
obtained  at  the  rate  of  from  forty  to  fifty  dollars  monthly  ; 
that  is  to  say,  £8  6s.  8d.  to  JElO  Ss.  4d.  This  does  not,  of 
course,  include  wine.  Washing,  4s.  2d.  to  5s.  per  month. 
Hire  of  horse  and  man.  Is.  9d.  per  hour ;  hammock  or 
carro  (a  sort  of  sledge  drawn  by  two  oxen)  Is.  3d.  per 
hour.  The  price  of  provisions  generally  is  far  more  mode- 
rate than  in  England.  Meat  and  eggs  not  more  than  half 
the  price ;  vegetables  and  butter  a  good  deal  cheaper  than 
with  us ;  fruit  may  be  obtained  at  an  almost  nominal  price  ; 
milk  and  bread  about  the  same  as  at  home ;  and,  although 
we  might  have  expected  the  price  of  cloth  to  be  high,  as  it 
requires  to  be  imported  and  is  subject  to  a  heavy  duty,  still, 
owing  to  the  cheapness  of  labour  in  Madeira,  a  suit  of 
clothes  does  not  cost  more  there  than  in  London.  House 
rent  is  remarkably  cheap.  The  writer  well  knows  a  house 
containing  eight  or  nine  good  rooms,  situated  in  a  fair-sized 
garden,  and  provided  with  the  usual  offices  and  out-houses, 
which  is  let  for  less  than  £26  a  year.  Servants'  wages  may  be 
stated,  as  a  rule,  at  about  half  the  amount  paid  in  England. 

Funchal  is  provided  with  a  Portuguese  and  also  an 
English  library,  reading-rooms,  billiard-rooms,  a  Portuguese 
club,  and  one  or  two  more  such  places  of  public  resort ;  a 
military  band  plays  once  or  twice  during  the  week  in  the 
passeio  or  square.  There  are  not  many  evening  amuse- 
ments, except  private  entertainments,  but  this  is  hardly 
an  objection  so  far  as  invalids  are  concerned. 

It  is  to  be  regretted  that,  with  so  many  attractions, 
Madeira  possesses  so  many  and  so  great  drawbacks,  as,  in 
our  opinion  at  least,  far  more  than  counterbalance  all  that 
can  be  said  in  its  favour.  Among  the  lesser,  but  by  no 
means  trifling,  inconveniences  may  be  instanced  the  nature 
of  the  pavements  in  Funchal.     Instead  of  smooth    flag 


by  Dr.  W.  B.  A.  Scoit.  205 

stones  being  employed  tbese  are  constructed  of  oval 
pebbles  or  small  stones^  rather  larger  than  an  egg>  inserted 
perpendicularly^  with  the  somewhat  pointed  extremities 
projecting  a  considerable  distance  above  the  level  of  the 
soil,  which  are  extremely  painful  to  the  feet  of  walkers  at 
ail  times,  besides  being  excessively  slippery  after  rain. 
They  have,  however,  the  advantage  of  drying  quickly. 
Again,  the  streets^  though  far  less  odoriferous  than  those  of 
many  continental  towns,  at  times  contrast  unfavourably  in 
this  respect  with  those  of  favourite  English  watering-places. 
The  heat  of  the  sun  is  most  overpowering,  though  not  so 
oppressive  as  at  Lisbon,  and  the  difference  between  the  tempe- 
ratnre  in  the  sun  and  that  in  the  shade  is  far  greater  even  in 
proportion  than  with  us.  Much  has  beeu  said  in  praise  of 
the  equability  of  the  temperature,  and  it  is,  indeed,  uniform 
in  no  common  degree.  But  from  this  very  cause,  com- 
bined with  the  atmospheric  moisture,  it  is  debilitating  and 
depressing  to  an  extent  only  realisable  by  those  who  have 
experienced  it,  and  which  exerts  a  most  unfavourable  influ- 
ence on  most  natives  of  England  or  other  more  bracing 
regions,  and  the  children  of  such  even  if  born  in  the  island.* 
As  a  rule  cod-liver  oil  can  only  be  taken  in  greatly 
diminished  doses,  if  at  all ;  and,  notwithstanding  the 
unblushing  effrontery  of  a  physician  practising  in  the 
island,  wlio  assures  his  patients  this  is  of  no  consequence, 
every  one  who  is  entitled  to  have  an  opinion  on  the  sub- 
ject is  well  aware  that  this  analeptic  is  of  far  more  benefit 
to  consumptive  patients  than  any  climatic  treatment  what- 
soever   or   wheresoever.f       The    injurious    effects   of   the 

*  This  fact,  which  is  ao  obvioas  to  the  most  casual  observer  as  to  have 
forced  itself  on  the  attention  of  the  present  writer  before  he  had  been  many  days 
in  the  ialand,  was  first  distinctly  pointed  oat  by  Dr.  Ireland  in  the  pamphlet 
so  often  referred  to  above,  though  it  might  have  been  easily  inferred  from  Dr. 
Qonrlay's  observations.  It  is  a  striking  proof  of  the  disingednoosness  of  those 
interested  in  the  defence  of  Madeira  that  it  should  have  been  so  long  concealed. 
Dr.  Qiabham  has  even  the  coolness  to  assert  the  direct  contrary.  Even  in 
England  the  comparatively  equable  temperatures  of  such  places  as  Torquay  and 
Ventnor  are  not  found  very  favorable  to  children ;  and  at  Malaga,  which  vies 
with  Madeira  in  point  of  equability,  the  infant  mortality  is  nearly  43  per  cent, 
during  the  first  five  years. 

t  Dr.  Chambers  says,  "  To  find  the  easiest  assimilated  oil,  and  to  prepare 


206  The  Climate  of  Madeira  in  Phthisis,  ^c., 

climate  are  painfully  exemplified  io  the  cases  of  nearly  all 
the  children  born  in  the  island  of  British  parent^.  They 
are  in  general  poor,  nervous^  dyspeptic,  scrofulous  little 
things.*  In  the  next  place,  as  there  is  but  little  society  of 
an  agreeable  character  among  the  residents,  such  of  the 
invalids  as  care  about  maintaining  their  own  self-respect  are 
compelled  to  form  a  little  clique  of  their  own.  Nqthin^ 
can  possibly  be  more  undesirable  than  this.  Cowper  com- 
plains that — 

"  Some  men  employ  their  health  (an  ugly  trick) 
In  making  known  how  oft  they  have  been  aick, 

the  digestion  for  the  absorption  of  the  oil,  are  the  main  problems  in  the  care  of 
consumption." 

*  The  remarks  of  Dr.  Ireland  in  his  pamphlet  on  Madeira,  regarding  this 
question  of  equability  of  temperature,  are  well  worth  quoting :  "  It  appears  to 
me,  from  actual  experience,  that  warm  air,  ever  at  about  the  same  tempera- 
ture, has  a  relaxing  effect  upon  the  frame,  diminishes  the  appetite,   and 
depresses  the  spirits.    Dr.  Combe,  whose  favorable  opinion  on  Madeira  is  so 
often  cited,  remarks, '  the  climate  is  somewhat  relaxing  from  its  humidity  and 
equable  temperature,  and  in  summer  most  be  so  to  a  still  greater  degree.' 
My  experience  in  India,  and  especially  at  Eoussooli,  has  convinced  me  that 
patients  do  not  recover  well  dmrin^  an  equable  temperature,  and  that  a  con- 
eiderable  range  during  the  dag  and  night  is  of  advantage  to  most  oonstiiutions. 
Dr.  E.  Smith,  in  his  thoughtful  work  called  OycUeal  Changes,  has  pointed 
out  with  great  clearness  the  effects  of  those  variations  of  temperature  which 
we  call  seasons,  and  their  influence  in  keeping  up  the  balance  of  vital  forces, 
actions,  and  re-actions,  necessary  to  health,  and  although  it  is  no  doubt  true 
that  sick  persons  must  often  be  guarded  against  what  would  do  them  good  in 
ordinary  health,  even  in  pulmonary  cases   the  advantage  of  equability  of 
temperature  has  been  much  overrated.    'Theoretically  speaking,'  says  Dr. 
Walshe, '  steadiness  of  the  temperature  from  day  to  day  with  but  slight  noc- 
turnal fall  of  the   thermometer,  ranks  as  a  very  important  condition,  but 
pracUealUf  it  turns  out  to  he  eomparativelg  insignificant.    For  these  climates, 
Egypt  and  Australia,  which  furnish  from  time  to  time  the  most  striking  ex- 
amples of  the  arrest  of  phthisis  in  individuals  of  the  Saxon  and  Celtic  races 
of  North  Europe,  are  glaringly  deficient  in  this  element  of  theoretical  success ' 
{Diseases  of  the  Lungs,  1860).    It  can  scarcely  fail  to  strike  an  attentive 
observer  how  readily  an  unusual,  though  apparently  insignificant,  variation 
of  the  thermometer,  especially  if  it  be  accompanied  by  wind,  causes  colds  and 
rheumatisms  amongst  those  who  have  been  some  time  in  Funchal.     This  has 
already  been  noticed  hg  Dr,  A,  Combe  in  Madeira,  and  the  same  remark  has 
been  made  hg  A.  von  Swnboldt  in  a  similar^  equable  climate   in  South 
America^*    (The  italics  are  our  own.) 


by  Dr.  W.  B.  A.  Scoit.  207 

And  give  vi»  in  reoitalB  of  diiease, 
A  doctor's  trouble,  bat  without  the  fees; 
Belate  how  many  weeks  they  kept  their  bed. 
How  an  emetic  or  cathartic  sped,  &c/' 

Bat  if  this  is  tiresome  to  a  listener  in  health,  it  becomes 
most  prejudicial  when  all  the  interlocutors  are  invalids.  A 
comparison  of  pulmonary  Yomicse,  haemoptyses,  purulent 
eipectorationsy  cough,  pleuritic  pains^  crapulous  diarrhoeas 
and  acid  yomitings,  on  the  part  of  the  sufferers  themselves, 
18  about  the  most  effectual  means  that  could  possibly  be 
devised  for  aggravatting  and  perpetuating  these  untoward 
symptoms.  But  it  is  difiicult  to  find  much  desirable 
society.  The  resident  Portuguese  are,  as  a  rule,  profligate 
in  the  extreme^  and  but  few  among  them  are  persons  of 
much  intelligence  or  attainment.  The  Romish  priests  live, 
in .  too  many  cases,  in  open  concubinage,  with  a  reckless- 
ness of  observation  greater*than  can  easily  be  found  else- 
where, and  among  the  laity  the  practice  of  systematic 
seduction  is  carried  to  an  extent  of  which  we  in  England, 
with  all  our  faults,  are,  happily,  almost  unable  to  form 
a  conception.  Portuguese  gentlemen  appear  in  public  with 
their  mistresses  without  the  smallest  hesitation,  and  an 
English  maid-servant,  if  at  all  good-looking,  is  almost 
certain  to  come  to  destruction.  Unnatural  vices  are 
practised  with  little  regard  to  secrecy  by  the  lower  classes, 
and  even,  it  may  be  feared,  by  some  persons  of  higher  posi- 
tion. The  condition  of  the  lower  orders  generally  is  one 
of  the  utmost  ignorance,  vice,  and  poverty,  although  their 
natural  levity  and  the  clemency  of  the  climate  prevent  their 
offering  so  conspicuous  a  spectacle  of  distress  as  might  have 
been  anticipated.  But  still,  their  moral,  physical,  and 
intellectual  degradation  must  be  exceedingly  depressing  to 
all  visitors  who  are  not  so  selfishly  absorbed  in  the  con- 
sideration of  their  own  viscera  as  to  be  utterly  regardless  of 
the  welfare  of  their  fellow  creatures.*  Among  the  natives 
we  find  nearly   every  kind  of  scrofulous  affection,  rheu- 

*  The  annual  mortality  of  the  natives  of  Fnnchal  is  1  in  88*9 ;  in  France  it 
is  only  1  in  44*5,  and  in  England  and  Scotland  still  leas,  being  1  in  46  and  1 
in  49  respeetiTely. 


208  The  Climate  of  Madeira  in  Phthisis,  ^c, 

matism^  phthisis,  low  and  intermittent  fevers,  pneamonia, 
and  a  considerable  yariety  of  skin  diseases;  among  these 
latter  occur  cases  of  elephantiasis ;  but  Dr.  Gourlay  tells  us 
that  this  disgusting  malady  is  not  here  attended  with  the 
unseemly  but  too  common  accompaniment  of  satyriasis-^' 
a  most  fortunate  circumstance^  considering  what  is  the 
actual  condition  of  morals  in  the  island;  with  this  addi- 
tional incentive  Funchal  would  not  be  long  in  rivalling 
the  Cities  of  the  Plain.  Even  among  the  British  residents 
the  greatest  dircuraspection  is  necessary  before  forming 
anything  approaching  to  au  intimacy ;  because  too  many  of 
them  have  become  so  habituated  to  the  contemplation  of 
the  state  of  things  in  Madeira,*  that  they  have  ceased  to 
regard  with  becoming  indignation  the  most  selfish  and 
degrading  of  all  vices,  which,  though  they  may  not  them- 
selves practise,  they  are  but  too  ready  to  condone  in  others, 
especially  in  such  as  are  of  good  position.  It  is  strange 
and  pitiful  to  behold  many  who  are  fond  of  displaying  their 
religious  zeal  by  ridiculing  the  professed  faith  of  the  country 
of  their  adoption,  and  dwell  with  much  complacency  on  the 
imaginary  *'  persecutions  "  they  or  their  friends  have  under- 

*  It  is  scarely  necessarj  to  say  that  all  this  is  merely  general,  and  has  no 
fersanal  reference. 

"  Why,  who  cries  out  on  pride 
That  can  therein  tax  any  priyate  party  ? 
Doth  it  not  flow  as  hngely  as  the  sea 
Till  that  the  very  very  means  do  ebh  P 
What  woman  in  the  city  do  I  name 
When  that  I  say  the  city-woman  bears 
The  cost  of  princes  on  unworthy  shoulders  P 
Who  can  come  in  and  say  that  I  mean  her 
When  such  a  one  as  she  such  is  her  neighbour  P 
Or  what  is  he,  of  basest  function. 
Who  says  his  bravery  is  not  on  my  cost 
(Thinking  that  I  mean  him),  but  thereby  suits 
His  folly  to  the  mettle  of  my  speech  P 
There  then ;  how,  what  then  P     Let  me  see  wherein 
My  tongue  hath  wronged  him ;  if  it  do  him  right 
Then  he  hath  wronged  himself;  if  he  be  free, 
Why,  then,  my  taxing  like  a  wild  goose  flies 
Unclaimed  of  any  man." 

As  Tou  Like  It,  Act  ii,  Scene  7. 


by  Dr.  W.  B.  A.  Scott.  209 

gone  for  conscience'  sake,  who  yet  are  not  asbamed  to  conrt 
with  the  most  servile  assiduity  the  society  of  those  whose 
impure  and  licentious  lives  would  revolt  any  person  of 
average  moral  feelings  whether  Catholic  or  Protestant^ 
Christian  or  infidel.  But,  unhappily,  too  many  who  are 
most  edifying  to  listen  to  on  nice  points  of  theological 
doctrine,  and  to  whom,  in  a  religious  point  of  view,  any  one 
suspected  of  heretical  pravity  is  an  abomination,  feel  little 
abhorrence  for  vices  which  neither  afPect  their  social  status 
nor  their  breeches  pocket — perhaps  actuated  by  the  notion 
that  too  rigorous  a  regard  .  to  matters  of  mere  morality 
which  concerned  even  the  '^  poor  heathen/'  to  say  nothing 
of  heretics  and  infidels,  might  be  justly  suspected  of 
savouring  of  nndua  contempt  for  Gospel  liberty,  and 
smacked  in  some  measure  of  a  servile  adherence  to  the  law 
of  works.* 

We  may  conclude  our  description  of  Madeira  with  the 
remark  that,  it  is  an  island  which  Nature  has  lavished  her 
utmost  bounty  to  bless,  and  man  has  done  his  best  to 
desecrate. 

"  Strange,  that  where  Nature  loved  to  trace, 
As  if  for  gods,  a  dwelling  place,  ,    . 

There  man,  enamoured  of  distress, 
Shoidd  mar  it  into  wilderness. 
And  trample,  bmte-like,  o'er  each  flower 
That  aska  not  one  laborious  hour, 
Nor  claims  the  culture  of  his  care, 
And  sweetly  woos  him  but  to  spare ! 
Strange,  that  where  all  is  peace  beside 
There  man  should  riot  in  his  pride. 
And  lust  and  rapine  wildly  reign 
To  darken  o'er  the  fair  domain ! 
It  is  as  though  the  fiends  prevailed 
Against  the  seraphs  they  assailed^ 
And,  fixed  in  Heavenly  thrones,  should  dwell 
The  freed  inheritors  of  HelL 
So  soft  the  scene,  so  formed  for  joy. 
So  curst  the  tyrants  who  destroy  1" 

*  It  is  fair  to  remark  that,  in  one  respect^  the  conduct  of  the  natives  con- 
trasts favorably  with  our  own — they  are  certainly  more  temperate,  as  is 
usually  the  case  in  wine-countries ;  but  as  the  English  have  borrowed  so  many 
darker  vices  from  their  entertainers,  so  they  now  seem  to  be  in  a  fair  way  of 
repaying  the  obHgation  by  imparting  to  the  latter  that  of  intemperance. 
VOL.  XXZII,  NO.  CXZVIII. ^APRIL^  1874.  O 


210  The  Climate  of  Madeira  in  Phthisis,  ifc. 

It  is  now  time  that  we  should  direct  our  attention  to 
the  subject  of  phthisis  itself^  and  examine  what  informa- 
tion modem  researches  afford  us  respecting  its  origin, 
nature,  and  treatment. 

Until  a  few  years  ago  the  word  phthisis   (unless  other- 
wise specialised  by  some  such    adjective  as   abdominalis) 
was  used  as  a  synonym  for  pulmonary  tuberculosis;    or, 
in  other  words«  the  morbid  condition   familiarly  known  as 
consumption  was  supposed  to  arise  from  invasion  and  subse- 
quent destruction,  to  a  greater  or  less  extent,  of  the  lun^ 
tissue  by  tuberculous  matter.     But  pathologists  were  by^ 
no  means  agreed  as  to  the  nature  of  tubercle  itself.     The 
name  was  at  first  applied  to  that  which  is  now  known  as 
miliary  tubercle,  namely,  small,  rounded,  nodular  masses, 
resembling  a  millet  seed,  and  about  the  size  of  a  pin's  head. 
As,   however,  Lebert   was  of  opinion  that  tubercle  is    a 
product  sm  generis,  and  that  its  presence  in  the  lungs  is  the 
characteristic  lesion  of  phthisis,  the  name  of  tubercle  was 
extended  to  the  opaque  yellow  masses,  varying  in  size  from 
that  of  a  pin's  head  to  that  of  a  pea,  and  in  consistency 
from  a  soft  to  a  firm  and  dry  and  even  calcareous  body, 
which  were  frequently  found  associated  with  miliary  tubercle 
in  the  lungs  of  those  who  had  died  from  phthisis.     Hence  a 
distinction  was  drawn  between  grey  or  miliary,  and  yellow 
tubercle.     Further,    owing   to    the   supposition   that   this 
morbid  process  was  of  a  specific  nature,  the  etymology  of 
the   word  tubercle  was  wholly  disregarded,   and  the  term 
came  to  be  applied  to  any  deposit  of  a  "  cheesy ''  character, 
so    far  resembling  the  preceding  as  to  have    a    tendency 
under  some  circumstances  to  harden  and  dry  up,  and  under 
others  to  suppurate.     Hence,  pneumonic  consolidations  fell 
under  this  designation.     Lebert  thought  the  characteristic 
of    tubercle   to    be   little,    hard,    shrivelled,    translucent, 
nucleolated  nuclei,  of  a  greyish  colour,  insoluble  in  acetic 
acid,   which    renders   their   outline   more   distinct.     Prof. 
Hughes  Bennett  adopted  a  nearly  similar  definition,  adding 
that  these  bodies  are  completely  dissolved  by  fixed  alkalies, 
and  partially  by  ammonia.     He  lays  special  stress  upon  their 
nuclear  character,  because  some  had  erroneously  supposed 


by  Dr,  W.  B.  A.  Scott,  211 

them  to  be  cells^  but  Dr.  Bennett  very  justly  pointed  out 
that  one  of  the  leading  distinctions  between  the  pathology 
of  tubercular  and  cancerous  products  is,  that^  while  the 
former  hxenuclear,  incapable  of  reproduction,  and  therefore 
only  susceptible  of  increase  by  additional  deposition  from 
without,  the  latter  are  cellular^  and,  being  capable  of  repro- 
duction, thus  multiply  themselves  from  within,  thereby 
imparting  to  cancer  its  malignant  character.  The  question 
of  the  inflammatory  or  non-inflammatory  nature  of  tubercle 
was  eagerly  discussed,  but,  in  the  ignorance  then  prevalent 
as  to  the  essential  character  of  inflammatioti,  it  degenerated, 
ia  a  theoretical  point  of  view,  very  much  into  a  matter  of 
mere  logomachy.  In  fact,  even  at  the  present  day,  notwith- 
standing the  researches  of  Burden  Sanderson,  Virchow, 
Cohnheim,  Waller,  Addison,  and  others,  a  good  deal  of 
uncertainty  still  prevails  on  this  subject;  one  of  their 
doctrines  at  least,  viz.  that  of  the  extravasation  of  leucocytes, 
being  stoutly  opposed  by  Prof.  Bennett  and  his  followers. 
However,  in  a  practical  point  of  view,*  the  question  was 
far  more  important  some  years  ago  than  it  is  now,  because 
"  inflammation  ''  was  then  the  signal  to  bring  together  all 
the  forces  of  depletion  and  antiphlogisticism,  and  as  un- 
happily the  inflammatory  view  of  the  origin  of  tubercle  was 
that  which  long  found  most  favour,  we  have  seen  above  that 
most  phthisical  patients  who  were  so  unfortunate  as  to  fall 
into  the  hands  of  physicians  speedily  died,  from  the 
inhuman  treatment  to  which  they  were  subjected. 

With  regard  to  the  origin  of  tubercle  there  was  much 
dispute.  OuUiver  and  Vogel  maintained,  in  opposition  to 
Lebert,  that  in  the  earlier  stages  nucleated  cells  were  to  be 
found  in  tubercular  matter.  Van  der  Eolk,  while  admitting 
the  nuclear  character  of  tubercle  corpuscles,  supposed  them 
to  be  nuclei  resulting  from  the  disintegration  of  the  bron- 
chial and  pulmonary  epithelial  cells,  a  view  which,  as  Prof. 

*  It  is  tme  that  there  is  an  increase  of  the  nntritive  activity  of  the  cellolar 
elements  in  an  inflamed  part,  hnt  at  the  same  time  there  is  a  degradation  of  the 
products.  Hence,  so  fir  from  dehilitating'  the  patients  by  autimonials,  leeches, 
and  other  old-fashioned  contrivances,  we  often  require  even  to  administer 
•timulanU  in*  addition  to  nutritions  diet. 


212  The  Climate  of  Madeira  in  Phthisis,  ifc, 

Bennett  observes,  appears  to  be  negatived  hj  the  fact  of 
their  occurrence  in  tissues  destitute  of  epithelium^  as  in  the 
substance  of  the  brain.  Virchow  considered  them  to  be  the 
result  of  endogenous  cell  formation,  but  thought  their  cells 
might  belong  either  to  epithelial  or  to  fibrous  tissue. 
Among  the  chief  medical  authorities  in  this  country,  how- 
ever, the  carefully  elaborated  doctrines  of  Prof.  Bennett 
may  be  said  ultimately  to  have  in  general  found  moat 
favour.  They  may  be  summarised  as  follows :  tubercle  is 
an  albuminous  morbid  product,  characterised  by  the 
presence  of  certain  nuclei,  and  containing  earthy  phos- 
phates, together  with  small  quantities  of  fibrin  and  fat  ; 
it  is  incapable  of  spreading  by  reproduction,  but  rather 
tends  to  break  down  slowly  into  abortive  corpuscles ;  very 
liable  to  ulceration  and  disintegration,  but  much  less  so  to 
absorption ;  and  it  commonly  makes  its  first  appearance  iu 
the  lympathic  glands,  and  occurs  generally  between  the 
periods  of  dentition  and  adult  age,  being  almost  always 
preceded  by  derangements  of  the  prima  via.  Prof. 
Bennett  thus  distinguishes  tubercular  from  simple  inflam- 
matory exudation  which  attacks  all  tissues  and  all  ages 
indiscriminately,  and  is  either  chronic,  forming  adhesive 
products,  or  acute,  forming  rapidly  growing  temporary  cell 
products  which  are  speedly  excreted  by  the  emunctories ;  and 
from  cancerous  exudation,  which  commonly  occurs  in  adults, 
attacks  glands  primarily  and  lymphatics  only  secondarily, 
and  is  characterised  by  an  abundance  of  cells  having  the 
power  of  self-development. 

But  within  the  last  seyen  or  eight  years  all  our  ideas 
regarding  phthisis  and  tubercle  have  again  been  thrown  into 
uncertainty.  In  the  first  place,  it  was  demonstrated  that 
many  cases  presented  most  of  the  physical  signs  of  what 
was  regarded  as  phthisis  in  which  no  tubercle  was  discovered 
at  the  autopsy,  and,  next,  it  was  shown  that  in  cases  of 
''  galloping  consumption,"  or  acute  tuberculosis,  while 
miliary  tubercle  was  found  scattered  over  all  the  viscera, 
the  injury  to  the  lungs  was  often  so  slight  that  it  was 
impossible  to  attribute  the  fatal  result  to  the  pulmonary 
lesion.     The   miliary  tubercle  in  cases   of  acute  general 


by  Dr.  W.  B.  A.  Scott.  218 

tuberculosis  was  found  equally  studding  the  lungs^  kidneys, 
liver^  spleen,  peritoneum  and  pia  mater,  and,  what  was  very 
remarkable,  in  the  first  of  th^se  situations  it  did  not  appear 
to  be  the  result  of  exudation  into  the  air-vesicles,  but 
assumed  the  form  of  little  nuclear  formations  in  the  fibrous 
tissue  of  the  lung  itself,  viz.  in  ihe  walls  of  the  air-cells  and 
the  peri-bronchial  tissue;  in  the  adenoid  perivascular 
fibrous  sheath  of  the  capillaries,  and  in  the  subpleural 
fibrous  tissue.  Burdon  Sanderson  has  shown  that  these 
only  occur  where  adenoid  tissue  is  normally  present,  and  in 
all  probability  they  usually  consist  of  a  hypertrophy  of  that 
structure. 

This  disease  (acute  tuberculosis)  runs  its  course  in  from 
one  to  four  weeks,  and  is  accompanied  by  a  fever  closely 
resembling  typhoid,  but  more  intermittent.  It  was  in- 
geniously suggested  that  the  deposition  of  tubercle  here 
very  closely  resembled  the  development  of  the  eruption  in 
eruptive  fevers,  and  that  it  was,  therefore,  likely  to  be 
infective^  i.  6.,  the  result  of  toxsemia  or  blood  infection  ;  and 
it  was  ascertainbd  by  experiment  that  this  or  an  analogous 
disease  could  be  artificially  produced  by  the  inoculation  of 
diseased  gland  structure,  but  especially  by  means  of  intro- 
ducing portions  of  ''  eheesy ''  pneumonic  products.*     From 

*  Dr.  Green  i^^tsthology  and  Morbid  Anaton^  p.  161)  remarks — "These 
caMfl  of  artificial  tubercaloeiB,  however,  differ  from  the  natural  disease  in  this 
respect — ^that  most  of  the  disseminated  lesions  in  the  long^  and  in  other  aoUd 
orgoHta  (He)  are  not  miUary  tuberelesy  hut  consist  of  nodnhir  and  diffuse  in- 
flammatory growths,  which,  like  the  tnhercle,  quickly  become  caseous."  This 
is  certainly  rather  an  important  difference,  especially  as  (p.  S4)  Dr.  Green  tella 
us  these  cheesy  masses  *'  indicate  merely  that  the  histological  elements  have  this 
fatty  metamorphosis,  and  under  no  circumstances  are  they  in  themselves  evidence 
of  any  one  particular  form  of  morbid  growth"  However,  for  our  purpose  this 
does  not  very  much  matter,  as,  in  the  first  place,  it  is  almost  impossible  now- 
adays to  make  out  what  different  writers  mean  by  tubercle,  and,  secondly,  there 
ean  be  no  doubt  that  a  histolytic  disease  of  the  lungs  may  arise  from  absorption 
of,  and  subsequent  poisoning  by,  these  *'  cheesy  "  masses,  whatever  their  origin. 
The  use  of  setons.  Dr.  Green  informs  us,  will  produce  this  artificial  disease. 
Now,  Themison  (the  founder  as  some  suppose  of  that  eminently  judicious  allo- 
pathic sect  called  "Methodists")  was  remarkable  for  his  heroic  employment 
of  setons  in  phthisical  cases.  We  are,  therefore,  not  surprised  to  find  that 
when  Juvenal  was  casting  about  for  some  hyperbolical  expression  to  signify  a 


214  The  Climate  of  Madtira  in  Phthisis,  ^c, 

hence  it  baa  been  inferred  that  the  disease  commonly  arises 
from  the  absorption  of  masses  of  **  cheesy  "  matter^  whether 
the  result  of  old  pneumonic  processes  in  the  lungs^  or  of 
amyloid  or  other  degeueration  elsewhere.  This  conclusioa 
may  be  said  to  be  now  tolerably  firmly  established. 

The  absence  of  true  tubercle  in  many  cases  of  miners' 
and  fibroid  phthisis,  together  with  the  fact  that  destruction 
of  the  substance  of  the  lungs  may  result  from  the  retro- 
grade metamorphosis  of  simple  pneumonic  products  in  an 
unhealthy  constitution,  and  from  various  other  causes,  as 
gangrene,  &c.,  has  induced  Professor  Sanders,  of  Edinburgh^ 
to  include  under  the  name  of  pulmonary  phthisis,  in  strict 
accordance  with  its  etymology,  all  diseases  capable  of  pro- 
ducing cavities  or  destruction  in  the  pulmonary  tissue. 
While  this  definition  is  convenient  in  some  respects,  it  will 
be  at  once  seen  that  it  brings  under  one  general  designation 
a  vast  number  of  diseases  differiug  in  the  mode  of  treatment 
appropriate  to  each,  no  less  than  in  their  respective  etiology 
and  pathology.  It  therefore  becomes  necessary  for  our 
present  purpose  to  ascertain  which  of  all  these  varieties  it 
is  which  is  said  to  prove  fatal  to  one  eighth  part  of  the  whole 
population  of  Great  Britain,  and  which,  par  excellence, 
is  popularly  known  as  consumption  or  decline.  A  very 
little  investigation  will  suffice  to  convince  us  that  it  is  the 
disease  treated  of  by  Professor  Bennett  in  his  admirable 
treatise  on  pulmonary  consumption,  and  the  real  causes, 
nature,  and  treatment  of  which  that  gentleman  has  perhaps 
done  more  than  any  other  living  physician  to  elucidate. 
We   shall,  therefore,  now    give    a    summary  of   Professor 

ooonilesg  multitude,  he  selected  the  phnuie  "  Quot  ThemUon  a^rot  amUunno 
occiderit  uno."  Probably  Sir  James  Simpson  would  have  alleged  this  was  an 
instance  of  homoeopathic  practice  on  the  part  of  Themison.  It  is,  no  doubt, 
marvellously  like  the  style  of  homceopathic  practice  adopted  by  the  allopaths 
when  they  profess  to  be  "  giving  homoeopathy  a  fair  trial,"  in  order  to  refute 
that  system  by  means  of  secret  trickery  and  cooked  statistics,  as  in  the  case 
of  Andral ;  but  it  bears  about  as  much  resemblance  to  the  practice  of  Hahne- 
mann as  the  professional  demeanour  of  Sir  James  Simpson  bore  to  the  conduct 
of  a  gentleman,  or  that  "  bellicose  professor's "  garbled  misrepresentation  of 
the  doctrines  of ,  the  Otyanan  to  a  candid  and  intelligent  reader's  oonoep> 
tion  of  the  same. 


by  Dr,  W.  B.  A.  Scott.  215 

Sennett's  doctrines  on  this  subject^  together  with  a  short 
sketch  of  the  process  by  which  he  was  led  to  adopt  them^ 
and  conclude  by  showing  their  bearings  together  with  that 
of  the  theories  we  have  been  discnssing^  upon  the  climatic 
treatment  of  phthisis^  formerly  so  much  in  vogne. 

Professor  Bennett^  as  is  well  known,  was  one  of  the 
first  to  point  out  that  consumption,  so  far  from  being  a 
necessarily  fatal  disease,  is  one  which  presents  numerous 
instances  of  spontaneous  cure,  towards  which  it  at  all  times 
has  a  marked  natural  tendency.  This  discovery  was^  as 
nsoal,  greeted  with  ignorant  and  derisive  contempt  by  the 
aUopaths,  who  lost  no  time  in  lavishing  upon  one  of  the 
acutest  physicians  of  the  dny  the  same  unmeaning  ribaldry 
and  invective  which  that  anile  community  or  its  grand- 
mothers had  drivelled  against  Harvey,  Sydenham,  Jenner, 
Hahnemann,  and  ^lliotson  in  former  years.  But  Professor 
Bennett^s  new  doctrine,  unlike  those  of  his  opponents,  was 
no  baseless' d  priori  theory,  spun  from  the  substance  of  a 
mind  alike  devoid  of  the  knowledge  gained  from  acquaint- 
ance with  the  thoughts  of  other  men  and  the  wisdom  which 
dwells  with  such  as  are  attentive  to  their  own.  It  was  the 
result  of  observation,  of  the  "  actual  experiment/'  '^  interro- 
gation of  nature/'  and  so  forth,  about  which  such  a  clatter 
is  kept  np  nowadays  by  persons  wholly  devoid  of  the 
originality  and  attainments  necessary  to  put  them  in 
practice.  Professor  Bennett  had  long  been  impressed  with 
the  not  uncommon  but  isolated  cases  of  real  or  imagined 
recovery  from  phthisis  in  all  stages,  and,  with  his  usual 
candour,  industry,  and  acuteness,  instead  of  voting  such 
cases  impossible  because  opposed  to  the  dogmas  of  an  effete 
superstition,  he  at  once  set  about  investigating  whether 
they  were  really  authentic,  and,  if  so^  on  what  principles 
they  were  to  be  accounted  for.  He  ascertained  that  the 
facts  were  unquestionable;  and  that  just  as  the  disease  had 
been  invariably  preceded  by  some  circumstancei^  either  in 
the  patient's  own  constitution  or  in  his  surroundings 
leading  to  mal-assimilation  of  food  (not  of  necessity  from 
poverty,  it  might  arise  from  many  other  causes,  as  over- 
work, anxiety,  mental  distress,  too  luxurious  living,  insuffi- 


216  The  Climate  of  Madeira  in  Phthisis,  ^c, 

cient  exercise^  impure  air^  ^')^  bo  he  found  recoyery  to  be 
in  all  cases  preceded  by  the  restoration  of  the  due  discharge 
of  the  digestive  functions.*  The  introduction  of  the  stetho-> 
scope  by  Laennec  had  at  first  tended  to  confirm  the  belief 
in  the  incurability  of  consumption,  by  more  distinctly 
reyealing  the  serious  organic  nature  of  the  accompanying 
pulmonary  lesion.  It  was  impossible  to  suppose  that  a 
cavity  in  the  lungs  could  be  filled  up  with  new  pulmonary 
tissue,  or  that  a  portion  of  lung  substance  which  had  for 
years  been  consolidated  and  metamorphosed  could  be  re- 
generated and  resume  its  normal  functions.  But  Professor 
Bennett  discovered  that  this  was  by  no  means  necessary, 
that  if  further  disintegration  and  additional  deposition  of 
tubercle  be  prevented,  and  the  system  be  brought  to  a 
healthy  condition,  cavities  would  quickly  contract  and 
cicatrise ;  cretaceous  or  cheesy  pfiasses  become  encysted  in 
a  firm,  fibrinous  covering,  and  any  loose  purulent  matter 
be  got  rid  of  by  expectoration.  Then  the  portion  of  lung 
which  still  retained  its  normal  structure,  even  if  very  small 
in  amount,  would  amply  serve  all  respiratory  purposes  by 
means  of  quickened  breathing,  and  perhaps  expansion.  A 
case  occurred  at  the  Royal  Infirmar^  of  Edinburgh,  Feb- 
ruary 8,  1844,  which  triumphantly  ratified  these  conclusions. 
We  give  it  in  Professor  Bennett's  own  words : — '*  John 
Keith,  set.  60,  a  teacher  of  languages,  was  admitted  into 
the  Royal  Infirmary,  February  8,  1844,  in  a  state  of  coma, 
and  died  an  hour  afterwards.     On  examination  the  mem- 

*  It  ii  due  to  the  memory  of  the  late  Dr.  Stewart^  the  "  physician-miniBter 
of  Erskine,"  to  mention  that  he  had,  some  years  previonsly  to  the  lahoars  of 
Dr.  Bennett,  pointed  ont  the  necessity  of  the  analeptic  treatment  in  phthisis. 
With  no  more  specific  analeptics  than  heef -steaks  and  stout,  the  rev.  gentleman 
effected  numerous  cures,  both  in  his  own  parish  and  in  more  distant  parts, 
to  which  he  was  often  summoned  on  account  of  his  well-earned  fame.  Like 
Melampus,  he  obtained  the  hand  of  one  of  his  fair  patients  as  the  rich  reward 
of  his  successful  treatment  of  her  case.  He  was,  perhaps,  the  first  to  point 
out  that  the  ridiculous  "coddling"  system  so  much  in  favour  with  most 
patients,  and  even  recommended  by  some  physicians  who  have  more  regard  to 
,  their  patient's  personal  approbation  and  the  guineas  resulting  therefrom,  than 
to  the  oonscientiouB  discharge  of  their  own  duties,  is  wholly  out  of  place  in 
the  treatment  of  this  disease. 


by  Dr.  W.  B.  A.  Scott.  217 

branes  of  the  brain  at  the  base  were  found  unusnally  con- 
gested^  and  covered  with  a  considerable  exudation  of 
recently  coagulated  lymph,  here  and  there  mingled  with 
bloody  extravasation  The  apex  of  the  right  lung  presented 
a  remarkable  cicatrix,  consisting  of  dense,  white  fibrous  tissue, 
varying  in  breadth  from  one  fourth  to  three  fourths  of  an 
inch,  and  measuring  about  three  inches  in  length.  The 
pleural  surface  in  its  neighbourhood  was  considerably 
puckered.  On  making  a  section  through  the  lung  parallel 
with  the  external  cicatrix,  the  substance  immediately  below 
presented  linear  indurations  of  a  black  colour,  together  with 
fine  cretaceous  concretions,  varying  in  size  from  a  pin's 
head  to  that  of  a  large  pea.  The  surrounding  pulmonary 
substance  was  healthy.  The  apex  of  the  left  lung  was  also 
strongly  puckered,  and  contained  six  or  seven  cretaceous 
concretions,  each  surrounded  by  a  blacky  dense,  fibrous 
cyst." 

The  history  was  as  follows : — ''  Keith^  in  early  life,  was 
in  very  indifferent  circumstances,  and  supported  himself  as 
a  writer.  At  the  age  of  twenty^two  or  twenty^three  he 
laboured  under  all  the  symptoms  of  a  deep  decline  and  his  life 
was  despaired  of.  About  this  time  he  was  lost  sight  of  by 
his  friends ;  but  it  was  afterwards  ascertained  that  he  had 
become  a  parish  schoolmaster  in  the  west  of  Scotland,^'  not  in 
Madeira  or  Egypt,  ^^and  that  his  health  hadbeen  reestablished. 
He  returned  to  Edinburgh  six  years  before  his  death,  and 
endeavoured  to  gain  a  livelihood  by  teaching  Latin  and 
French.  He  succeeded  but  very  imperfectly,  and  fell  into 
dissipated  habits.  Latterly  he  had  become  subject  to 
attacks  of  mania,  apparently  the  result  of  drink.  It  was 
after  an  unusually  severe  attack  of  this  kind  that  he  was 
brought  into  the  Infirmary,  where  he  died  in  the  manner 
previously  described. 

''  This  case  points  out  the  following  important  facts : 
1st.  That  at  the  age  of  twenty-two  or  twenty-three  the 
patient  had  a  tubercular  ulcer  in  the  right  lung,  the  size  of 
which  must  have  been  very  considerable  when  the  contracted 
cicatrix  alone  was  three  inches  long.  2nd.  That  tubercular 
exudations  existed  at  the  apex  of  the  left  lung.     3rd.  After 


218  The  Climate  of  Madeira  in  Phthisis,  ffc, 

receiTing  the  appointment  of  a  parish  achoolmaster,  after 
changing  his  residence  and  occupation,  while  his  social 
condition  was  greatly  improved^  these  symptoms  dis- 
appeared. We  may  therefore  infer  that  it  was  about 
this  period  that  the  excavation  on  the  right  side  healed  and 
cicatrisEedy  while  the  tubercular  exudations  on  the  left  side 
were  converted  into  cretaceous  masses,  and  so  rendered 
abortive.  It  demonstrates,  4thly,  That  when  at  a  more 
advanced  age  he  again  fell  into  bad  circnmstances,  and 
even  became  a  drunkard,  tubercular  exudations  did  not 
return,  but  that  delirium  tremens  was  induced,  with  single 
exudations  on  the  membranes  of  the  brain^  of  which  he 
died.''  So  complete  and  permanent  was  the  cure  so  far 
as  phthisis  is  concerned. 

Professor  Bennett's  views  derived  further  confirmation 
from  every  case  which  came  under  his  notice,  some  of  the 
most  characteristic  of  which  are  given  in  extenso  in  the 
work  from  which  the  above  extract  is  taken.     The  results 
at    which    he    arrived    may   be    thus    summarised.      The 
characteristic  lesion  of  pulmonary  consumption  consists  in 
an  exudation  of  low  type  into  the  lungs^  which  assumes  the 
form  of  tubercle,  being  at  first  miliary,  but,  if  long  continued, 
exhibiting  the  *^  cheesy ''  form  ;  this  substance  is  incapable 
of  self-reproduction,  and  hence  only  susceptible  of  increase 
by  additions  from  without  by  fresh  exudation  of  the  im- 
poverished liquor  sanguinis ;  it  may  run  any  of  the  three  fol- 
lowing courses — (1)  it  may  be  absorbed  to  a  greater  or  less 
extent,  the  residue  becoming  encapsuled  in  a  firm  fibrous 
sheath,  the  walls  of  which  in  process  of  time  contract  and 
coalesce,  through  absorption  of  the  contents,  until  a  cicatrix 
of  dense  connective  tissue  is  all  that  remains  to  tell  of  the 
previous  lesion.     This  is  a  favorable  termination ;  or  (2) 
the  animal  matter  may  be  entirely  absorbed,  and  the  cal- 
careous salts  be  left  in  the  form  of  mineral  concretions  of 
larger  or  smaller  size,  which  also  become  encapsuled  as  the 
preceding,  and  thereby  innocuous ;    or  (3)   through   fresh 
deposition  of  tubercular  matter  and  its  subsequent  retro- 
grade metamorphosis,  the  lung  tissue  may  become  deprived 
of  its  proper  blood^supply,  owing  to  pressure  on  the  vessels 


"  by  Dr.  W.  B.  A.  Scott.  219 

by  the  adventititious  substance,  and  also  be  broken  down 
and  caused  to  suppurate  by  the  presence  of  the  products 
of  retrograde  tubercular  metamorphosis.  Thus  cavities  are 
formed  which  may  either  (a)  increase  in  size,  until  the 
patient  falls  a  victim  to  a  prolonged  and  severe  haemoptysis, 
owing  to  implication  of  a  large  vessel,  or  more  commonly 
succumbs  to  the  hectic  and  debility  engendered  by  pro- 
longed suppuration ;  or  else  (6)  a  fibrous  capsule  may  form 
around  the  cavity,  which  ere  long  contracts,  leaving  the 
patient  perfectly  well. 

It  is  thus  seen  that  of  the  four  possible  terminations  of 
phthisis^  viz.  partial  absorption  and  cicatrisation,  calci- 
fication and  cicatrisation,  the  indefinite  extension  and 
suppuration  of  pulmonary  vomicse,  and  the  encapsuling  and 
subsequent  contraction  of  the  same,  one  only,  the  third, 
is  necessarily  fatal,  and  the  circumstances  in  which  it  is 
likely  to  occur  are  precisely  those  which  give  rise  to  the 
disease  in  the  first  instance;  that  is  to  say^  a  state  of 
cachexia  or  mal-nutrition. 

This  cachectic  condition  Professor  Bennett  found  to 
consist  in  a  want  of  due  assimilation  of  fatty  principles. 
The  fact  that  during  the  progress  of  phthisis  fatty  matters 
are  frequently  deposited  in  the  liver  and  certain  other 
viscera,  in  no  way  militates  against  this  conclusion^  because 
in  these  cases  the  adipose  formations  occur  as  a  result  of 
the  secondary  digestion,  or  of  the  specific  secretion  of 
individual  glands,  and^  "  as  such,  are,  per  se,  incapable  of 
being  reabsorbed  or  of  affording  nutrition.  In  short,  such 
fat  must  undergo  those  changes  and  that  elaboration  which 
the  digestive  functions  produce  before  it  can  be  made 
available  for  the  formation  of  go6d  blood,  which  in  its  turn 
is  only  a  preliminary  step  to  healthy  nutrition,^'  {Pulm.  Con, 
p.  35).  It  is  very  important  to  bear  this  fact  in  mind  in 
inquiring  into  the  climatic  treatment  of  phthisis,  as  this 
useless  and  even  injurious  form  of  fatty  deposition  is  just 
the  result  most  likely  to  ensue  upon  the  administration  of 
oleaginous  principles  in  warm  climates,  as  we  learn  from 
the  common  occurrence  of  ''  fatty  liver "  in  those  who 
have  resided  in  hot  countries,  and  from  the  practice  of  those 


220  The  Climate  of  Madeira  in  Phthisis,  ifc, 

who  feed  up  Strasburg  geese  in  order  that  rich  gluttons, 
whg  do  not  care  at  what  pain  to  others  they  gratify  their 
own  debauched  palates,  may  be  enabled  to  gorge  upon 
diseased  livers  in  the  form  of  p&t^  de  foie  gras.  Hence  we 
see  that  a  warm  climate  is  likely  to  prove  unfavorable  to 
the  proper  assimilation  of  the  oleaginous  substances  which 
form  so  necessary  a  part  of  the  diet  of  a  consumptive 
patient. 

Next,  as  to  the  treatment.  The  ordinary  articles  of 
diet  supply  all  the  necessary  fatty  principles,  but  not  always 
in  a  form  readily  taken  up.  For  instance,  the  oleaginous 
particles  in  ordinary  adipose  tissue  are  contained  in  a 
cellular  sheath,  which  must  first  be  dissolved  before  the 
contents  can  be  assimilated.  Besides,  as  either  beef  or 
mutton  fat  remains  solid  at  ordinary  temperatures^  it  is 
likely  to  prove  of  a  heavy  and  indigestible  character,  even 
although  it  may  be  liquefied  at  the  temperature  of  the 
interior  of  the  body.  Expressed  vegetable  oils  are  free 
from  these  disadvantages,  but  such  nearly  universally  ex^rt 
a  cathartic  or  other  specific  action.  But  in  cod-liver  oil, 
f.  e,y  the  oil  expressed  from  the  sliced  fresh  livers  of  the  cod 
fish,  we  have  a  combination  of  all  the  required  qualities, 
together  with  the  presence  of  minute  quantities  of  Phos- 
phoruSy  Iodine^  and  Bromine^  just  the  very  drugs  which  are 
homcBcpathic  to  the  disease.  Professor  Bennett,  we  regret 
to  say,  in  spite  of  his  originality,  is  still  pervaded  with  so 
much  of  the  "  odor  quo  semel  est  imbutus  recens "  as  to 
think  the  proportion  of  these  elements  too  small  to  exert 
any  influence  one  way  or  the  other,  but  we  know  better  ! 

The  appropriate  '^analeptic''  for  phthisis  having  thus 
been  found  (we  do  not  say  that  the  ''  dynamic ''  action  of 
other  drugs  may  not  be  necessary,  notwithstanding  the 
Iodine  and  Bromine)^  the  next  desideratum  is  to  order  the 
patient^s  regimen  in  such  wise  that  the  oil  may  be  best 
assimilated.  Now,  the  circumstances  universally  favorable 
to  digestion  are  pure  air,  sufficient  exercise,  and  a  mind 
cheerful  and  at  ease.  The  last  of  these  it  is  not  in  human 
power  to  minister,  but  it  is  hardly  likely  to  be  promoted  by 
expatriating  a  patiBut  to  a  distance  of  1100  miles  from  his 


by  Dr.  W.  B.  A.  Scott.  221 

firiends,  where  a  fortnight  at  least  necessarily  elapses  between 
writing  a  letter  and  receiving  a  reply.     Exercise  is  specially  . 
needful  to  the  due  assimilation  of  fatty  aliment ;   a  warm^ 
eqaable  climate,    with  a  high  saturation  point,  and  conse- 
qaently,/7ar  excellence  a  debilitating  and  enervating  climate,  is 
BOt  very  likely  to  predispose  to  exertion,  and  perfectly  certain 
to  produce  copious  and  weakening  diaphoresis  if  any  exercise 
be  taken.     Further,  as  a  liberal  supply  of  oxygen  is  espe- 
cially requisite  in  the  case  of  persons  on   a  fatty  diet,  it  is 
reasonable  to  conclude  that  the  condensation  of  that  vital 
agent  in  a  moderately  cold  atmosphere,  by  causing  a  greater 
amount,  bulk  for  bulk,  to  be  inhaled  at   each  inspiration^ 
must  prove  more  beneficial- than  the  smaller  quantity  which  a 
respiration  of  equal  extent  inhales  in  a  warm,  and  therefore 
expanded  and  rarefied,  atmosphere.     Lastly,  a  high  satura- 
tion point  prevents  sufficient  elimination  of  watery  vapour 
from  the  lungs,and  it  is  to  be  remembered  that  it  is  the  actual, 
not  the  relative,  humidity  of  the  atmosphere  which  is  here  in 
question.     For  example :    an   atmosphere  at  46^  with    a 
saturation    point   at   44°  is  very  damp  indeed  relatively, 
having  only  V*  of   dryness,   but  as  respired  air  is  raised 
nearly  to  the  temperature  of  the  body  in  its  course  through 
the  air-passages,  there  will  be  60°  or  more  to  be  saturated 
before  it  leaves  the  lungs,  and  hence  much  more  pulmonary 
evaporation  can  take  place  than  in  an  atmosphere  of  64° 
with  a  saturation  point  of  54°,  although  we  have  here  10° 
of  dryness  instead  of  only  1°^  so  that  the  relative  humidity 
may  be  described  as  less.     Furthermorei  we  find  consump* 
tion  all  but  unknown  in  Newfoundland  and  Labrador,  and 
four  times  more  common  at  Marseilles  than  at  Stockholm ; 
also,  it  is   notorious   that  many  if   not  most  consumptive 
patients  stand  the  dry  cold  of  the  Hudson^s  Bay  territory 
perfectly  well,  often  with  actual  benefit ;  so,  as  this  question 
of  temperature  is  shown  to  have  nothing  to  do  with  the 
production  of  phthisis,  and  every  process  of  reasoning,  no 
less  than  observation,  leads  us  to  suppose  that  warmth  is  by 
no  means  conducive  to  its  cure,  we  have  no  hesitation  in 
ratifying  the  verdict  which  Professor  Bennett  has  delivered 
as  the   result   alike  of   his   studies   and  of  his  extensive 


222  The  Climate  of  Madeira  in  Phthisis,  ^c, 

experience^  that  "  with  proper  care  and  treatment  phthisis 
may  be  arrested  in  this  country  much  more  frequently  than 
was  formerly  supposed^  and  that  there  is  no  reason  to 
belieye  that  such  arrestment  is  more  common  in  Madeira, 
Egypt,  or  Italy,  than  in  Edinburgh  or  London/'* 

It  may,  perhaps,  be  objected  that  the  discovery,  to  which 
we  alluded  above,  of  the  deposition  of  tubercle  in  acnte 
tuberculosis  being  of  an  infective  character,  and  the  result 
of  retrograde  metamorphosis  of  ^'  cheesy  **  pneumonic  pro- 
ducts, seems  to  point  to  a  mild  climate  as  the  most  favor- 
able, as  there  can  be  no  doubt  that  pneumonia  is  often 
caused  by  cold.  But,  in  the  first  place,  acute  tuberculosis 
is  a  totally  different  disease  from  the  one  under  considera- 
,tion;  and,  secondly,  it  results  not  from  an  attack  of  inter- 
current pneumonia  occurring  in  a  duly  nourished  frame,  but 
from  the  morbid  degeneration  of  old  pneumonic  products 
in  a  debilitated  constitution.  If  assimilation  be  only  properly 
effected,  no  disease  is  more  easily  treated,  or,  in  fact, 
requires  less  treatment,  than  pneumonia.  In  such  cases 
the  disease  will  run  its  natural  course ;  the  exudation  will 
pass  through  its  normal  stages,  and  will  finally  become 
absorbed  and  its  products  be  duly  eliminated  by  the 
natural  emunctories  instead  of  remaining  behind  as 
^'  cheesy  ''  deposits.  So  that  the  great  preventive  of  acute 
tuberculosis  is  due  attention  to  nutrition  ;  when  it  has 
once  fairly  set  in  it  usually  runs  its  course  in  from  one  to 

*  The  only  Btatistics  of  any  value  relating  to  the  efPects  of  the  climate  of 
Madeira  in  the  treatment  of  phthisis  are  those  giving  the  results  of  the 
celebrated  Brompton  experiment.  Twenty-seven  cases  were  sent  out  a  few 
years  ago  by  the  Brompton  Hospital,  with  the  following  results : — 2  returned 
improved,  7  slightly  improved,  12  neither  better  nor  worse,  5  were  made 
worse,  and  1  died.  See  Dr.  Thorowgood's  treatise  on  the  CUmatic  Treatment 
of  Cofuumption.  The  statistics  of  Dr.  Lund,  even  if  we  were  to  suppose  them 
accurate,  give  no  better  results  than  are  constantly  obtained  in  England  with 
the  improved  treatment  of  modem  times,  and  Dr.  Schultze  has  committed 
himself  to  so  many  extravagant  theories  as  must  tend  to  cUscredlt  any  of 
his  conclusions.  For  example,  he  asserts  Cod-liver  oil  to  be  of  no  value  in  the 
treatment  of  phthisis;  maintains  that  this  disease  will  be  revealed  by 
Hutchinson's  spirometer  when  percussion  and  auscultation  have  failed  to  detect 
it;  gives  the  death  rate  of  Great  Britain  as  1  in  60,  and  the  deaths  from 
phthisis  in  Britain  as  1  in  5.    See  Dr.  Ireland's  pamphlet. 


by  Dr.  W.  B.  A.  Scott.  228 

four  or  six  weeks,  so  as  to  render  banishment  to  a  remote 
island  impossible^  even  supposing  this  were  capable  of  pro- 
ducing the  smallest  benefit  in  such  cases,  which  it  con- 
fessedly is  not.  Where  such  ''cheesy^'  deposits  already 
exist  without  acute  tuberculosis  having  as  yet  declared 
itself,  let  due  attention  be  paid  to  bringing  about  a  state  of 
general  eucrasia,  and  these  untoward  reliquise  will  speedily 
become  encapsuled  and  harmless.  These  general  hygienic 
and  dietetic  measures  are  the  same  as  those  above  de- 
scribed. 

Sut  while  the  climate  of  Madeira  is,  as  we  have  seen, 
little  likely  to  prove  beneficial  in  phthisical  cases,  we  know 
of  none  more  admirably  adkpted  for  such  more  local  respi- 
ratory afi'ections  as  laryngitis  and  chronic  bronchitis. 
Here  its  warm,  moist,  equable  temperature  is  just  the  very 
thing  to  be  desired.  In  all  these  respects  it  is  far  superior 
to  the  climate  of  Torquay,  Queenstown,  Jersey,  Mentone, 
Hyeres,  Nice,  Rome,  Naples,  or  any  other  invalid  resort 
with  the  statistics  of  which  we  are  acquainted;  and  al- 
though the  climate  of  Malaga  may,  perhaps,  vie  with  that 
of  Madeira  in  point  of  equability,  stilly  the  accommodation 
of  that  town  is  described  as  being  so  very  inferior  (for  here 
we  cannot  speak  from  personal  knowledge)  that  the  island 
must  unquestionably,  all  things  considered,  bear  off  the 
palm.  Besides,  the  humidity  of  the  atmosphere  in  Madeira 
is,  in  such  cases,  a  positive  advantage,  and  furthermore 
renders  the  island  likely  to  prove  highly  salutary  to  most 
asthmatic  patients.  Some  really  remarkable  and  well- 
authenticated  cures  of  gangrene  of  the  lungs,  as  that  of 
Dr.  Dyster,  are  also  recorded  to  the  credit  of  Madeira. 
Elderly  persons  in  general  are  likely  to  enjoy  this  genial 
climate,  and  certainly  could  find  no  lovelier  spot  for  their 
closing  years ;  and  cases  of  hopelessly  advanced  phthisis 
may  sometimes  be  transported  thither  with  some  hope 
of  euthanasia,  but  this  is  not  a  very  certain  result  of  the 
experiment. 

A  permanent  residence  in  the  island,  in  the  case  of  those 
who  have  families,  entails  a  necessary  separation  from  their 
children,  not  merely  on  account  of  the  climate  being  highly 


224  The  Climate  of  Madeira  in  PhlkUis,  ifC., 

pemidons  to  these  latter,  bat  for  the  mach  weightier  reasons 
that  there  are  no  means  of  education,  and  that  the  moral 
and  social  influences  are  deleterious  in  the  last  degree. 
Those  among  the  children  of  British  residents  who  are 
not  sent  home  for  their  education  grow  up  utterly  un- 
taught, speaking  a  sort  of  hideous  mongrel  patois 
bearing  about  as  much  resemblance  to  refined  English 
as  it  does  to  Low  Dutch  ;  and  their  ideas,  as  Dr.  Johnson 
was  so  ungallant  as  to  say  of  the  sentiments  of  a  lady  of 
Boswell's  acquaintance,  are  ^'  very  fit  for  a  brothel." 

Considering  the  reception  accorded  to  Dr.  Ireland's 
temperate  and  unanswerable  pamphlet  by  those  whose  peca- 
niary  or  professional  interests  Vere  in?olved  in  the  reputa- 
tion of  Madeira,  we  have  little  doubt  that  if  our  article 
shall  fall  under  the  notice  of  such  persons  it  will  be  the 
signal  for  a  burst  of  insular  indignation,  expressed  in  terms 
which  are  likely  to  be  a  good  deal  more  forcible  than 
elegant.  Few,  indeed^  in  the  island  took  the  trouble  of 
reading  so  calumnious  a  production  as  Dr.  Ireland^s  publi- 
cation, and,  even  if  they  had  done  so,  still  fewer  were 
capable  of  understanding  it.  But  all  felt  themselves  fully 
qualified  to  join  in  a  universal  bray  of  terrified  cupidity  and 
injured  self-esteem.  A  physician  practising  in  the  island 
hit  upon  the  truly  ingenious  and  economical  device  of 
writing  a  letter  to  the  Guardian,  assuring  the  editor  and 
readers  of  that  periodical  that  all  English  visitors  to 
Madeira  might  rest  satisfied  that  their  spiritual  wants 
would  be  attended  to  in  the  most  efficient  manner,  and  in 
every  variety  of  style,  by  the  British  chaplains  of  different 
denominations  resident  in  the  island.  We  can  from  oar 
own  personal  knowledge  affirm  that  this  assurance  is  strictly 
true,  as  the  gentlemen  who  now  officiate  in  that  capacity 
would  adorn  any  sacred  office  to  which  they  might  be 
appointed.  But  as  the  typical  valetudinarian  is,  unhappily, 
a  very  selfish  and  not  over  spiritually-minded  specimen  of 
humanity,  we  fear  the  medical  gentleman^s  interesting  piece 
of  religious  statistics  was  contributed  mainly  with  the  view 
of  acting  as  the  vehicle  of  the  gratuitous  advertisement  of 
the  island  itself,  and  of  one  at  least  of  the  distinguished 


On  the  Treatment  of  some  Skin  Diseases.  225 

sons  of  ^sculapius^  who  favour  that  fortunate  locality  with 
the  benefit  of  their  learned  services.  If  our  article  shall 
call  forth  a  second  advertisement  of  similar  character  we 
shall  wish  the  latter  all  success  for  the  sake  of  those 
interested^  but  as  we  have  been  rigidly  careful  to  make  no 
statement  in  the  course  of  our  remarks  which  will  not  bear 
the  strictest  investigation^  we  stand  in  no  fear  of  criticism^ 
and  however  many  exploded  vagaries  may  be  trumped  up 
in  maintenance  of  theories  long  since  discarded^  we,  at 
least,  shall  assuredly  not  cry  peccavi.  And  as  we  do  not 
understand  that  the  echoes  of  the  Madeiranese  outcry  were 
so  distinctly  audible  in  this  country  as  to  disturb  Dr. 
Ireland's  well-eamed  nocturnal  repose  with  their  thunder, 
or  to  distract  the  attention  of  the  editor  of  the  Edinburgh 
MedicO'CMrurffical  Journal  from  his  important  labours^  we 
take  our  leave  of  the  subject  of  Madeira^  satisfied  with 
having  spoken  the  truths  and  with  the  consolatory  assurance 
that  as  any  counter-statements  must  be  destitute  of 
foundation  in  fact^  so  remote  provincial  vituperation  is 
impotent  of  harm. 


ON  THE  TREATMENT  OP  SOME  SKIN  DISEASES. 

By  Dr.  Clotar  Mullee.* 

The  Leipzic  Homoeopathic  Dispensary^  with  which  I 
have  been  connected  as  ordinary  medical  ofiicer  for  a  long 
series  of  years^  has  brought  under  my  observation  a  rich 
array  of  exanthematic  diseases.  Ip  some  kinds  of  these 
diseases  I  believe  I  have  observed  in  my  frequent  treatment 
of  them  a  certain  steadfastness  in  the  occurrence  of  certain 
results.  I  therefore  do  not  hesitate  to  give  a  resumS  of  my 
observations  and  deductions  respecting  them  with  all  caution. 
These  will  doubtless  be  comparatively  few  in  number 
if  I  confine  myself  to  what  seems  to  me  the  necessary 

^It^temaiianaU  Sam.  JPresse,  vr,  1. 
VOL.  SXXlly  NO.  CXXVIII. ^APRIL,  1874.  P 


226  On  the  Treatment  of  some  Skin  Diseases, 

limits.  Not  that  the  number  of  cures  effected  was  so  very 
small,  although  these  must  be  regarded  as  not  very 
numerous  compared  with  the  number  of  cases  treated, 
owing  to  the  difficulty  of  exercising  any  control  over  the 
patients  frequenting  a  dispensary.  Bat  in  conformity  with 
the  special  object  of  this  communication  I  must  pass  over 
all  those  curative  results  even  of  a  striking  and  decisive 
character  which  only  occurred  in  single  cases  and  were  not 
confirmed  on  the  occurrence  of  analogous  circumstances. 
In  like  manner  no  notice  can  be  taken  here  of  all  those 
cures  where  the  curative  medicine  was  chosen  not  exda* 
sively  or  chiefly  with  reference  to  the  exanthematotts  symp- 
toms, but  with  reference  to  the  general  morbid  phenomena,, 
whether  these  were  the  consequence  or  the  cause  of  the 
skin  affection.  For  in  the  great  multiph'city  of  these 
morbid  symptoms,  which  may  be  present  in  the  most 
various  forms  of  exanthemata,  the  skin  symptoms  them- 
selves have  little  or  no  influence  on  our  selection  of  the 
drug,  and  it  would  be  incorrect  to  infer  that  the  same 
remedy  would  again  be  useful  in  the  same  form  of  skin 
disease  if  the  general  morbid  symptoms  that  determined 
the  selection  were  not  likewise  present.  In  the  present 
short  communication,  I  repeat,  I  shall  confine  myself  to 
the  few  constant  curative  results  obtained  in  certain  forms 
of  exanthemata,  in  which  that  which  determined  the  selec- 
tion was  found  in  the  skin  symptoms  themselves^  and, 
consequently,  I  was  able  to  repeat  the  curative  experiment 
with  the  medicine  in  the  same  cases  of  skin  diseases,  and 
others  may  now  test  the  matter  for  themselves. 

Limiting  myself  thus,  I  shall  not  enter  into  the  question 
of  the  constitutional  or  local  nature  of  skin  diseases,  nor 
as  to  whether  Hahnemann's  psora  theory  should  be 
accepted  fully  or  with  limitations,  or  entirely  rejected. 
But  I  may  be  allowed  to  make  a  few  general  observations 
on  this  latter  point  suggested  by  a  postscript  by  Dr.  Siiss- 
Hahnemann  to  Dr.  E.  Blake's  paper  translated  in  the  first 
volume  of  the  Internationale  Horn.  Presse. 

Whether  Hahnemann,  if  he  had  become  aware  of  the  exist- 
ence of  the  Acarus  scabiei,  would  have  treated  the  itch  with 


i 


by  Dr.  Clotar  MuOtr.  227 

external  remedies  cannot  be  determined  by  the  views  he 
has  enunciated  in  his  writings  respecting  parasitical  diseases. 
In  this  I  quite  agree  with  his  grandson;  but  the  question 
is  rather  an  idle  one.  It  is,  however,  certain  that  a  know- 
ledge of  the  acarus  would  have  caused  Hahnemann  to 
modify  his  psora  theory  as  far  as  regards  the  nomenclature 
of  those  skin  diseases  which  he  believed  to  constitute  the 
prominent  signs  and  essential  symptoms  of  the  psora 
dyscrasia.  If  he  specially  reckoned  the  itch  among  these, 
and,  indeed,  firequently  used  the  terms  "  psora ''  and 
''itch'^  as  synonyms,  he  would  certainly,  on  recognising 
the  essential  character  of  the  acarus  itch,  have  either 
excluded  it  entirely  from  the  list  of  psoric  symptoms  or 
only  admitted  it  in  a  modified  manner.  But  this  would 
assuredly  have  in  no  way  militated  against  the  psora  theory 
itself,  or  against  the  maxim  that  skin  diseases  are  of  a 
constitutional  and  not  a  local  nature.  For  in  a  certain  and 
strictly  scientific  sense  the  acarus  itch  does  not  belong  to 
the  cutaneous  diseases  or  exanthemata  at  all,  but  can  only 
become  such  in  consequence  of  neglect  or  long  duration, 
like  the  affections  caused  by  the  head  and  body  louse.  If, 
in  consequence  of  our  present  knowledge  of  the  acarus,  we 
will  accustom  ourselves  to  separate  the  idea  of  the  acarus 
itch  completely  from  psora  and  to  substitute  for  the  latter 
some  dyscrasia  more  in  accordance  with  our  present  patho* 
logical  views,  such,  for  example,  as  scrofnlosis,  then 
no  valid  objection  can  be  raised  against  Hahnemann's  psora 
theory  and  its  main  consequences.  No  one  will  deny  that 
the  skin  diseases  of  the  so-called  scrofulous  are  of  a  com* 
pletely  constitutional  character,  that  their  imprudent  sup- 
pression by  external  desiccating  remedies  is  frequently 
attended  with  danger  and  is  always  useless  in  respect  to  the 
cure  of  the  dyscrasia.  Moreover,  it  is  well  known  that  the 
scrofulous  dyscrasia  finds  its  chief  subjects  in  the  children 
or  .descendants  of  syphilitic  parents,  and  hence  may  be 
regarded  as  an  outcome  or  development  of  syphilis  or 
sycosis,  therein  agreeing  with  Hahnemann's  dictum  re- 
specting the  three  sources  of  all  chronic  diseases. 

If  then,  according  to  my  view,  we  are  not  justified  in 


228  On  the  Treatment  of  some  Skin  Diseases, 

rejecting  Hahnemann's  paora  theory  as  an  obaolete  idea  or 
even  as  an  absurdity,  and  in  asserting  that  the  homoeo- 
pathy of  the  ptesent  day  ignores  it,  so,  on  the  other  hand, 
the  orthodox  followers  of  Hahnemann's  homoeopathy  should 
guard  themselves  against  asserting  too  much  and  obsti- 
nately holding  to  the  letter  of  his  doctrine.  I  will  not 
here  speak  of  the  antipathy  to  the  local  treatment  of  the 
acarus  itch,  i.  e.  of  the  .destruction  of  the  skin  vermin  by 
the  direct  application  of  remedies,  for  such  one-sidedness 
and  obstinacy  can  only  be  accounted  for  by  a  deliberate 
shutting  of  the  eyes  to  undoubted  facts.  But,  besides  the 
acarus  itch,  there  are  evidently  other  skin  diseases  which, 
at  least  at  their  commencement,  and  ere  they  have  lasted 
too  long,  are  of  a  purely  local  nature  and  may  certainly, 
and  without  any  injurious  effects,  be  removed  by  external 
remedies  or  by  the  knife,  and  I  do  not  here  refer  merely 
to  warts,  callosities,  corns,  horns,  certain  encysted 
tumours,  Sec.,  but  also  to  exanthemata  strictly  so  called. 
Certain  cutaneous  affections,  as  favus,  condylomata,  prurigo, 
lupus,  &c.,  can  hardly  ever  be  removed,  radically  and  per- 
manently, without  the  aid  of  external  remedies,  and  the 
danger  of  producing  more  serious  diseases  by  cures  of  this 
kind  is,  on  the  one  hand,  exaggerated  and  merely  supposi- 
titious, and  on  the  other,  if  it  really  exists,  as  it  does  in 
all  constitutional  and  particularly  in  exuding  skin  diseases, 
generally  owing  to  other  causes  and  processes.  For 
when,  after  the  sudden  disappearance  of  an  exanthema 
other  disturbances  of  the  health  ensue,  this  is  not  always  a 
proof,  as  some  partizans  of  the  psora  theory  allege,  that  the 
former  supposed  constitutional  malady  is  now  driven  to 
another  organ  and  has  undergone  a  dangerous  aggravation, 
but  even  when  the  latter  disease  stands  in  causal  relation 
to  the  suppressed  skin  disease  this  relation  is  usually 
limited  to  the  imprudent  and  sudden  suppression  of  a 
secretion  to  which  the  organism  has  become  habituated. 
In  iUnstration  of  this  I  may  refer  to  the  precautions  with 
which  in  former  days  issues  that  had  been  kept  long  open 
were  healed  up,  because  it  too  often  happened  that  after 
the  sudden  suppression  of  the  accustomed  suppuration  evil 


by  Dr.  Chtar  Midler,  229 

effects  were  observed.  No  one  will  serionsly  contend  that 
the  artificial  suppuration  kept  up  by  the  pea  was  a  consti- 
tutional (psoric)  affection,  which  after  its  suppression  in  the 
arm  flared  up  in  a  worse  form  in  an  internal  organ.  It  is 
precisely  the  same  case  with  many  of  the  so-called 
metastases  after  the  removal  of  skin  diseases.  Hence  it 
follows,  in  my  humble  opinion,  that  though  it  is  doubtless 
yeiy  irrational  and  blameable  to  suppress  quickly  skin 
diseases,  especially  such  as  exude  freely,  even  though  they 
may  be  of  purely  local  nature,  by  means  of  external  desic* 
eating  remedies,  still,  it  is  not  correct  to  infer  that  the 
diseases  that  subsequently  occur  are  direct  metastases,  t.  e, 
new  and  more  dangerous  forms  of  the  dyscrasia  that  was 
previously  confined  to  the  skin. 

In  what  I  have  said  I  do  not  mean  to  curtail  too  much 
the  number  of  skin  diseases  depending  on  constitutional 
dyscrasia,  far  less  to  account  for  the  danger  of  rapid  curing 
merely  by  the  suppression  of  accustomed  secretions.  On 
the  contrary,  I  think  there  can  be  no  doubt  that  besides 
the  scrofulous  and  syphilitic  exanthemata  there  are  many 
other  real  constitutional  skin  affections  whose  appearances 
and  disappearances  stand  in  direct  alternating  connection 
and  in  direct  causal  relation  with  often  dangerous 
maladies.  In  this  category  we  must  reckon  some  appa- 
rently unimportant  eruptions  without  any  discharge,  as,  for 
example,  the  usually  dry  insignificant  hsemorrhoidal  erup- 
tion round  the  anus,  &c.  All  I  contend  for  is  that  here 
as  elsewhere  in  medicine  we  must  draw  distinctions  and 
not  estimate  all  exanthemata  alike.  Just  because  I  would 
wish  to  see  the  Hahnemannic  psora  theory  maintained,  and 
not  heedlessly  sacrificed  to  the  prevalent  hypermaterialism, 
I  am  anxious  that  it  should  be  rightly  understood  and 
kept  within  its  legitimate  bounds.  I  hope  these  few  lines 
may  serve  as  my  humble  contribution  to  this  object. 

Scabies  and  Prurigo, 

These  two  exanthemata  are  certainly  far  from  being 
identical,  but  they  not  only  frequently  occur  simultaneously. 


230  On  the  Treatment  of  some  Skin  Diseases^ 

but  they  have  also  this  in  common  that  both  are  ezdaaiFely 
caused  by  external  local  influences  on  the  skin,  the  itch  hy 
acari,  and  prurigo  chiefly  by  want  of  cleanliness,  lice,  dis- 
charges, scratching,  dust,  and  other  cutaneous  irritants. 
The  treatment  of  both  will  consequently  be  in  many  cases 
the  same ;  for  even  the  acarus  itch  generally  requires  some 
subsequent  treatment  after  the  acari  have  been  killed,  for 
even  on  those  parts  of  the  skin  where  no  acari  existed 
(their  chief  seat  being  betwixt  the  fingers  and  on  the  wrist) 
we  find  secondary  and  sympathetic  eruptions  (papulce, 
vesiculse,  or  impetigo). 

In  the  dispensary  I  generally  use  for  killing  the  acarus 
soft  soap,  which  I  direct  to  be  well  rubbed  into  all  the 
affected  spots  for  three  successive  nights  and  only  washed 
off  the  following  morning.  If  this  does  not  suffice,  then  I 
order  a  watery  solution  of  styrax  to  be  used  in  the  same 
way.  This  is  cheap,  it  leaves  behind  it  no  penetrating 
odour,  nor  does  it  cause  any  permanent  stain  on  the  linen. 
In  very  obstinate  cases  these  rubbings  must  be  repeated 
after  a  week  or  a  fortnight,  but  this  is  generally  because 
the  first  rubbing  was  not  performed  with  sufficient  energy. 
At  the  same  time  I  give  internally  Sulphur  or  Mercury. 
The  choice  betwixt  these  two  remedies  is  rather  difficult ; 
the  common  saying  that  the  characteristic  eruption  of 
Sulphur  is  papular  while  that  of  Mercury  is  vesicular  does 
not  settle  the  matter,  for  in  many  cases  both  forms  of  erup- 
tion occur  mingled  together  in  one  person  and  besides  these 
not  unfrequently  pustules.  In  prurigo,  and  particularly  in 
itch,  the  external  form  of  the  local  eruption  is  of  no  great 
consequence ;  it  often  depends  on  purely  external  and 
accidental  circumstances,  and  Hebra  is  not  far  wrong  when 
he  says,  **  The  exanthema  of  itch  depends  on  the  length  of 
the  finger  nails.''  In  most  cases,  but  especially  in  old  and 
neglected  itches,  I  begin  by  giving  Sulphur,  from  three  to 
five  drops  of  the  tincture  night  and  morning.  If,  after  ten 
days,  that  is  to  say,  seven  days  after  the  last  rubbing-in, 
there  is  no  diminution  of  the  eruption,  and^  particularly  of 
the  itching,  then  I  give  Mercurius  eolabUis,  as  much  of  the 
8rd  trit.  as  will  lie  on  the  point  of  a  penknife  in  a  tea- 


by  Dr.  Clotar  Mutter.  231 

spoonful  of '  water  every  night  and  morning ;  at  the  same 
time,  if  the  acari  appear  to  be  not  all  destroyed^  I  direct 
three  more  rabbings-in  of  soap  or  styrax.  If  the  eruption 
is  from  the  very  first  generally  vesicular,  or  set  thickly 
with  vesicles  and  pustules^  or  if  the  patient  has  already 
been  treated  with  sulphur  ointment  and  baths,  then  I  give 
Mercurius  at  once.  I  am  unfortunately  unable  to  give  a 
precise  differential  diagnosis  for  the  employment  of  Sulphur 
and  Mercury  founded  on  the  essential  differences  in  the 
local  and  general  symptoms  of  both  remedies,  for  the  chief 
characteristics  of  itch  are  possessed  by  both  remedies  in 
equal  degree.  Among  these  chief  characteristics  (passing 
over  the  local  peculiarities  of  the  eruption)  I  include  par- 
ticularly the  aggravation  of  the  itching  at  night  and  in  the 
heat  of  the  bed  and  the  general  irritability  of  the  skin, 
which,  by  scratching  on  one  spot^  spreads  over  almost  the 
whole  surface  and  is  thereby  aggravated  to  the  utmost. 

Under  this  treatment  many  cases  are  quickly  and  per^ 
fectly  cured,  and  I  have  never  observed  that  so-called 
metastases  and  bad  effects  occurred  in  those  cured  either 
immediately  or  later.  Still  very  many  cases  remain  un« 
cured  after  a  longer  or  a  shorter  treatment.  This^  how- 
ever^ I  must  attribute  less  to  the  insufficiency  of  the 
treatment  prescribed  than  to  the  unfavorable  conditions 
surrounding  dispensary  patients.  For,  apart  from  the 
circumstance  that  the  frictions  are  generally  performed  in  a 
very  careless  and  imperfect  manner^  the  living  together  of 
whole  families  in  a  confined  space,  and  especially  the 
sleeping  of  several  children  together  or  with  their  mothers, 
forms  a  constant  source  of  new  infection  by  the  acari,  so 
that  it  constantly  happens  that  a  child  who  has  been  freed 
&x>m  the  acari  by  the  rubbings-in^  will  be  infected  anew  a 
few  days  afterwards  by  the  bed  or  body  linen.  We  must 
also  take  into  consideration  the  numbers  of  those  who  do 
not  return  to  report  whether  they  have  been  cured  or  not. 
These  certainly  constitute  disadvantages  enough  to  explain 
the  fact  that  the  percentage  of  cures  of  itch  patients  is  very 
small^  and  that  the  results  of  the  treatment  are  apparently 
unfavourable.      I    have   consequently    often    had    serious 


232  On  the  Treatment  of  some  Skin  Diseases, 

thoughts  of  excluding  all  itch  patients  from  the  dispei 
and  sending  them  to  the  town  hospital,  where  the  enforced 
isolation  of  the  infected  would  at  all  events  prevent  the 
further  propagation  of  the  infection  to  other  members  of 
the  family. 

Of  all  skin  diseases  the  treatment  of  prurigo  is  one  of 
the  most  unsnccessfnl  and  unsatisfactory.  In  the  first 
place,  the  disease  itself  is  very  obstinate,  and,  moreover, 
the  greater  number  of  the  injurious  influences  that  cause, 
or  at  least  keep  it  up,  in  dispensary  patients  are  difficult  or 
impossible  to  be  removed.  The  greatest  cleanliness,  and 
the  most  careful  attention  to  the  skin,  are  here  the  chief 
promoters  of  the  cure.  The  main  remedy  here  is  Sulphur, 
to  which  Graphites  is  to  be  preferred,  when,  as  often 
happens  in  children,  large  raw  places,  destitute  of  epi- 
dermis, occur.  If  the  prurigo  is  complicated  with  eczema, 
impetigo,  and  ecthyma,  I  employ  Mercurius  and^  Anti- 
monium  crudum.  Besides  these  Croton  is  particularly 
recommended,  but  to  me  it  appears  that  this  remedy  is 
more  suitable  for  pruritus.  In  prurigo  of  the  anus  not 
caused  by  ascarides  Lycopodium  is  indicated ;  in  prurigo 
pudendi  Mercurius  and  Antimonium.  If  the  eruption  about 
the  anus  is  caused  by  ascarides  Ignatia  is  often  of  use,  at 
all  events  for  the  itching  that  disturbs  the  sleep  of  chil- 
dren, but  in  order  to  remove  this  itching  and  eruption 
permanently  it  is  necessary  to  remove  the  worms  by  means 
of  clysters.  Of  late  I  have  used  with  good  effect  an  injec- 
tion of  infusion  of  walnut  leaves,  which  is  not  so  repulsive 
as  the  disgusting  smelling  clysters  of  onions  and  garlic,  and 
yet  is  equally  efficacious. 

For  pruritus  (hyperaesthesia  of  the  skin,  which,  to  be 
sure,  in  many  cases  is  owing  to  local  derangements  of 
the  skin)  I  employ  pretty  much  the  same  internal  reme- 
dies as  for  prurigo,  only  that  here  I  prefer  the  higher 
dilutions  of  Sulphur  (30).  I  have  also  sometimes  seen 
good  results  in  such  cases  from  Arsenic  and  Croton  ;  these 
have,  however,  been  generally  but  transient  in  pruritus 
senilis,  a  very  obstinate  disease.  In  this  disease  careful 
attention  to  skin  cleanliness  is  required  and  the  removal  of 


by  Dr.  Clotar  Muller.  238 

all  exciting  causes,  as  parasites,  dirt,  irritating  and  highly- 
spiced  food,  the  use  of  spirits,  &;c. 

I  would  call  attention  to  the  employment  of  Chelido" 
fdum  in  the  pruritus  of  icteric  patients;  its  pathogenesis 
shows  some  very  characteristic  indications. 


Psoriiuis. 

There  are  three  remedies  from  which  I  have  not  only 
frequently,  but  almost  always,  seen  good .  effects  in  this 
most  obstinate  skin  disease.  The  chief  of  these  is  Arsenic. 
With  this  remedy  alone  I  have  cured  very  many,  and 
among  these  the  most  severe  cases  radically ;  some  of  these 
had  persisted  for  years,  and  resisted  almost  every  variety  of 
treatment.  I  have  never  met  with  psoriasis  in  any  other 
than  a  chronic  form,  and  I  do  not  understand  how  Blake 
and  Siiss  can  recommend  Mercuritis  for  acute  psoriasis,  nor 
do  I  find  that  Hebra  or  other  dermatologists  anywhere 
mention  an  acute  form. 

This  most  decided  efiScacy  of  Arsenic  in  psoriasis  must, 
if  the  homoeopathic  law  of  similarity  be,  in  other  respects,  the 
proper  indication  for  the  choice  of  the  remedy,  finds  its 
corroboration  also  in  the  local  skin  symptoms  which  this 
medicine  has  produced  in  provings  on  the  healthy  or  in 
cases  of  poisoning ;  and  this  is  doubtless  to  a  certain  extent 
the  case.  We  cannot,  to  be  sure,  expoct  to  find  complete 
identity,  but  only  indications  and  analogies  in  the  essentials 
and  characteristics  of  this  cutaneous  affection.  Such  are 
the  following  Arsenic  symptoms  which  I  extract  from  our 
Materia  Medica. 

Dry,  parchment-like,  cold,  livid  skin ;  dirty  earthy  colour 
of  the  skin ;  spots  here  and  there  on  the  skin ;  yellow 
spots  on  the  chest;  discoloured  spots;  scaling  and  des- 
quamation of  the  skin ;  spots  and  scabby  eruption  on  the 
skin  $  papular  eruption  that  falls  off  in  scales. 

It  will  be  observed  that  the  correspondence  is  not  very 
striking,  by  no  means  so  much  so  as  it  is  between  other 
remedies  and  diseases ;  Arsenic  is  deficient  in  some  symp- 


284  On  the  Treatment  of  some  SHn  Diseases, 

toms  which  appear  to  be  extremely  essential  and  character* 
istic  of  psoriasis.  Such  are  the  continual  desquamation 
of  true  white  epidermis  scales  on  a  hyperaemic^  superficially- 
infiltrated  cutis  (ground,  the  almost  invariable  round  shape 
of  the  spots  and  the  marked  predilection  of  psoriasis  for  the 
elbows  and  knees  and  the  neighbouring  parts  of  the 
extremities,  and  for  their  extensor  sides.  Whether  this 
merely  superficial  resemblance  of  the  skin  symptoms  of 
Arsenic  with  psoriasis  be  owing  to  the  shortcomings  of  our 
prorings  and  observations  or  to  some  other  cause,  this  much 
is  certain,  that  the  curative  action  of  this  remedy  in  most 
cases  was  very  evident.  Usually,  in  the  course  of  a  week 
or  two,  an  amelioration  of  the  exanthema  was  observed ; 
still,  no  doubt,  in  old  cases  a  considerable  time  (two  to 
three  months)  was  often  required  to  efiect  a  complete  cure. 
I  usually  prescribed  the  Arsenic  in  the  6th  centesimal 
dilution;  in  very  obstinate  cases  also  in  the  Srd^and  2nd 
centesimal  triturations. 

I  may  further  mention  that  in  old  cases  of  psoriasis 
especially,  the  indication  for  Arsenic  is  to  be  found  in  the 
general  morbid  symptoms,  particularly  in  the  dyspepsia,  the 
emaciation,  the  corporeal  debility,  and  the  disposition  to 
diarrhoea. 

More  significant  is  the  correspondence  of  Mercurius  in 
its  skin  symptoms  with  psoriasis,  although  here  also,  it 
must  be  confessed,  the  commonest  and  most  characteristic 
mercurial  exanthema  does  not  exhibit  the  peculiarities  of 
psoriasis.  It  is  well  known  that  the  mercurial  exanthema 
chiefly  afiects  the  form  of  eczema  and  ulceration.  The 
following  cutaneous  symptoms  may  be  adduced  as  being  the 
principal  ones  pointing  to  psoriasis : 

Skin  dirty  yellow,  rough,  and  dry ;  scaly  dry  eruption 
(Flechten) ;  eruption  of  small,  red,  not  inflamed  elevations, 
whose  apices  become  scaly  and  white  on  the  left  arm ;  red, 
round,  scaly  spots,  one  inch  in  diameter,  on  the  forearm 
and  wrist;  rough  skinned,  partly  reddish,  partly  whitish 
leprous-like  spot  on  the  left  zygoma ;  dry,  elevated, 
burning,  itching,  leprous  spots  all  over  the  body,  especially 
on  the  legs,  arms,  wrists,  and  hands,  and  even  betwixt  the 


by  Dr.  Clotar  MUller.  235 

fingers ;  leprous  spot  on  right  forearm,  which  becomes 
roaDdj  causes  the  skin  to  peel  off,  and  itches  voluptuously ; 
those  parts  of  the  skin  thkt  remain  free  from  impetigo 
mercurialis  become  rough,  dry,  somewhat  chapped,  and 
peel  off  in  the  form  of  white  bran-like  scales,  especially  on 
the  hairy  parts,  on  the  scalp,  in  the  whiskers,  in  the  eye- 
brows, leaving  the  face  free ;  deep  chaps,  like  cuts,  on  the 
hands  and  fingers,  especially  on  their  inner  side,  looking 
raw  and  bloody  in  their  bottom  and  painful  (psoriasis 
palmaris  ?). 

MercmiuB  is  specially  iigidicated  for  psoriasis  occurring  in 
a  syphilitically  infected  system ;  it  is  well  known  as  a 
pretty  frequent  form  of  syphilid.  But  even  in  cases  where 
there  was  no  syphilitic  complication  I  have  sometimes 
found  Mercurius  of  use  where  Arsenic  was  of  none,  or  at 
least  only  caused  transient  amelioration.  I  think  I  have 
noticed  this  to  be  particularly  the  case  where  the  psoriasis 
was  mainly  concentrated  in  the  lower  extremities ;  it  strikes 
me  that  in  the  last  three  or  four  years.  I  have  been  obliged 
to  resort  more  frequently  to  this  remedy,  whereas  formerly 
Arsenic  was  more  generally  and  efficaciously  employed. 

I  generally  gave  the  8rd  or  2nd  trituration  of  Mercuriue 
MoluUlis,  less  frequently  Merc,  precip.  ruber. 

Lastly,  Sepia  presents  some  highly  characteristic  skin 
symptoms  for  psoriasis,  particularly  the  following : 

The  epidermis  scales  off  painlessly  in  larger  or  smaller, 
generally  roundish  spots,  especially  on  the  hands  and  fingers ; 
yellowish-brown  spots  about  a  square  inch  in  size  round  the 
neck,  which  scale  off  when  rubbed;  lentil-sized  brown 
spots  on  the  elbows  and  round  about  leprous-like  skin; 
itching  discharge  at  the  b^ck  of  both  elbows  ;  desquama- 
tion of  the  skin  of  both  palms ;  ring-shaped  desquamation 
of  the  skin. 

In  spite  of  these  in  many  respects  characteristic  indica- 
tions I  do  not  believe  that  Sepia  can  be  considered  a  real 
specific  for  psoriasis  like  the  other  two  medicines,  and  I 
have  never  observed  really  curative  effects  from  its  use  in 
old  highly-developed  cases  of  this  disease,  especially  when 
the   desquamation  was  great  and  thick,  and  complicated 


236  On  the  Treatment  of  some  Skin  Diseasea, 

with  considerable  infiltration  of  the  skin.  On  the  other 
handy  I  have  often  seen  good  effects  from  its  employment 
in  cases  where  a  much  thinner,  bran-like  desquamatioa 
took  place  on  yellowish-red  spots,  cases  which  might, 
perhaps,  be  more  appropriately  considered  as  pityriasis, 
lichen  drcumscriptns,  or  other  allied  exanthematons  forms. 
In  all  those  cutaneous  spots  characterised  by  a  yellowish 
coloration.  Sepia  is  known  to  be  a  chief  remedy,  and  the 
presence  of  tUs  symptom  frequently  constitutes  a  par- 
ticular indication  for  its  employment  in  many  diverse  forms 
of  disease* 

On  the  other  hand,  I  have  never  seen  any  marked 
curative  effect  from  Clematis,  whose  skin  symptoms  show 
much  similarity  to  psoriasis,  nor  yet  from  Lycopodiwn. 
The  last-named  remedy  has  sometimes  proved  curative  in 
the  80th  dilution  in  pityriasis. 


Eczema, 

Of  the  various  kinds  of  eczema,  the  eczema  chronicum  is 
that  which  occurs  most  frequently  in  dispensary  practice 
and  its  most  frequent  seat  is  on  the  legs  and  the  scalp. 
Eczema  of  the  legs  is  one  of  the  most  obstinate  and 
troublesome  forms  of  this  exanthema,  for  it  is  often  the 
cause  of  extensive  ulcers  on  the  leg,  almost  as  often  as 
varicose  veins,  the  two  diseases  being  often  complicated 
with  one  another, 

I  have  already  mentioned  that  Merctarius  is  the  chief 
representative  of  eczematous  eruptions,  and  I  must  add 
that  according  to  my  experience  it  is  also  their  chief 
remedy,  especially  when  they  occur  on  the  extremities,  and 
particularly  on  the  lower  limbs.  The  only  remedy  that  is 
of  nearly  equal  value  in  such  cases  is  Sulphur,  But  in  all 
cases  of  pure  eczema  I  prefer  Mercurius,  In  this  disease  I 
have  often  effected  comparatively  rapid  amelioration  and 
cure  in  the  most  diverse  cases  where  there  was  considerable 
infiltration  and  where  at  the  same  time  the  patient^s  cir- 
cumstances would  not  allow  of  any  lying  up.     Only  in 


by  Dr.  Clotar  MiUler.  237 

those  cases  where  there  is  considerable  swelling  and 
varicose  dilatation  or  extensive  ulceration  is  Sulphur  my 
chief  remedy.  In  my  lengthened  experience  of  this  very 
common  affection  in  dispensary  practice  I  have  found  no 
remedy  equal  to  Sulphur  in  such  cases.  Though  I  have 
seen  occasional  curative  results  from  Mercuriua,  LacheHs, 
Hamamelis^  Graphites^  and  Pulsatilla^  in  ulcers  of  the  legs, 
I  always  resort  to  Sulphur.  It  is  remarkable  how  rapidly 
it  often  causes  amelioration,  and  above  all  how  quickly  it 
removes  the  intolerable  burning  pain.  And  this  it  does  under 
the  most  unfavorable  external  circumstances  which  permit  of 
no  release  from  a  standing  posture^  in  compositors,  printers, 
cooks,  &c.,  and  even  where  any  adequate  cleanliness  and 
bandaging  of  the  ulcer  is  impossible.  There  is  hardly 
any  possibility  of  employing  any  of  the  external  adjuvants 
that  are  of  so  much  use  in  the  treatment  of  ulcers  of  the 
leg;  a  horizontal  position  of  the  limb  or  strapping  the  ulcer 
with  sticking  plaster  is  never  attainable.  The  utmost  that 
can  be  done  is  to  apply  linen  rags  spread  with  beef  suet, 
and,  perhaps,  a  cold  water  compress  at  night.  Although 
in  some  cases  under  these  unfavorable  circumstances 
Sulphur  30  will  display  its  power,  I  now  almost  invariably 
give  from  3  to  6  drops  of  the  undiluted  tincture  of  Sulphur 
every  night  and  mornings  because  I  have  seen  the  most 
rapid^  marked^  and  certain  effects  from  this  dose. 

I  will'  not  here  detail  the  cutaneous  symptoms  of  3fer- 
curius  that  point  to  eczema^  for  these  are  given  so  fully 
and  lucidly  in  our  Materia  Medica  (vide  Noack  and 
Trinks'  Handbuchy  vol.  ii),  to  which  I  refer  the  reader  for 
each  individual  form  of  the  disease. 

Mercurius  is  not  nearly  such  a  sovereign  remedy  for 
eczema  on  the  hairy  parts  of  the  head  (tinea  capitis)^  which 
is  very  frequent  among  children  here  and  generally  occurs 
in  combination  with  eczema  impetiginodes  with  swelling  of 
the  lymphatic  glands.  In  this  affection  Rhus  toxicodendron 
is  the  chief  remedy,  as  it  is  also  in  most  facial  eruptions  if 
they  are  of  the  eczema  or  lichen  form  and  not  too  strongly 
complicated  with  impetigo  or  running  on  to  ulceration. 
When  this  last  is  the  case  Mercurius   and  Sulphur  are 


288  On  the  Treatment  of  some  Skin  Diseases, 

again  to  be  preferred^  the  former,  especiaUy  in  impetigo 
on  and  behind  the  ear.  Bat  I  have  seen  no  good  effects 
firom  Rhus  in  favus.  This  disease  is  generally  very  obsti- 
nate, and  requires  a  careful  external  treatment  with  fre- 
quent ablutions  with  soap  and  water  and  moistening  of  the 
scabs  with  oil.  The  best  internal  remedies  are  Spongia^ 
Graphites,  and  Cotyledon. 

Ecsema  mbrum  of  the  face  is  also  a  very  obstinate 
disease.  Not  only  is  the  burning  and  itching  of  it  ex- 
tremely tiresome  and  the  serous  secretion  often  so  copions 
that  it  trickles  down  the  face  (especially  in  the  case  of 
women  afker  confinement  and  after  weaning),  but  the 
relapses  every  six,  eight,  or  fourteen  days,  are  very  difficult 
to  be  prevented.  At  least  I  have  never  seen  any 
decided  effects  from  Rhus,  Apis,  Euphorbiutn,  or  jRamiit* 
cuius. 

In  ecsema  scroti  and  pudendi,  Aurum,  Graphites,  Rhodo* 
dendron,  and  Petroleum  are  particularly  recommended,  but 
I  must  confess  that  I  have  never  seen  much  effect  from 
these  remedies,  and  I  have  much  greater  confidence  in 
Mercurius  and  Sulphur. 

Lastly,  I  will  mention  that  according  to  my  experience 
eczema  is  one  of  those  exanthemata,  the  sudden  cure  of 
which,  whether  it  occur  spontaneously  or  by  the  incautious 
use  of  external  remedies,  is  not  unfrequently  followed  by 
serious  affections  of  internal  organs,  and  we  sometimes  see 
chronic  diseases  relieved  or  even  disappear  on  the  occur- 
rence .of  eczema.  Hence,  we  require  to  be  cautious  in  the 
employment  of  external  remedies,  especially  in  cases  of  the 
latter  description.  Whether  this  proves  the  true  constitu- 
tional character  of  eczema  or  whether  the  metastases  are 
only  to  be  ascribed  to  the  suppression  of  the  profuse  secre- 
tion that  accompanies  the  eczema,  the  difference  of  which  I 
have  already  alluded  to  above,  I  am  unable  to  determine. 
In  young  children  I  have  several  times  observed  serious 
meningitis  follow  the  spontaneous  rapid  drying  up  of  moist 
eruptions  on  the  face  and  head,  but  my  impression  is  that 
this  drying  up  has  usually  been  rather  the  effect  than  the 
cause  of  the  meningitis.     I  have  not  unfrequently  observed 


by  Dr.  Clotar  MUUer.  289 

alternating  exacerbations  of  asthmatic,  cardiac,  and  pul« 
monary  disease  and  chronic  eczema  of  the  legs. 


Herpes, 

The  various  forms  of  herpes,  as  phlyctenodes,  circinatns^ 
and  zoster,  are  generally  curable  by  Mercurius  and  Sulphur, 
and  in  some  cases  by  Rhus,  Ranunculus,  Graphites,  Arsenic, 
Sec.  Many  of  these  exanthemata  get  well  without  medi- 
cine, as,  for  example,  herpes  labialis  in  acute  diseases 
(generally  inflammatory  afi^ections  of  the  lungs)  and  herpes 
preputialis.  On  the  other  hand,  herpes  zoster  is  often  a 
Tcry  disagreeable  affection  on  account  of  the  excessively 
severe  burning  pain,  and  the  frequently  persistent  inter- 
costal neuralgia.  Rhus,  Mercurius,  Arsenic,  Dulcamara, 
are  particularly  recommended  for  zoster,  and  their  skin 
symptoms  all  present  a  certain  resemblance  to  this  peculiar 
cutaneous  disease.  However,  I  cannot  say  that  I  have  ever 
seen  any  very  decided  curative  action  from  any  of  these 
remedies.  Whichever  of  these  remedies  I  have  given  the 
affection  would  run  its  course,  sometimes  quicker,  some- 
times slower,  sometimes  with  more,  sometimes  with  less, 
burning  pain.  I  have  most  confidence  in  Mercurius.  I 
have  seldom  had  to  treat  the  secondary  neuralgic  pains,  and 
never  in  any  great  severity  (perhaps  this  may  be  owing  to 
the  remedies  I  have  used  ?) ;  Dolichos  pruriens  and  Zincum 
are  recommended  for  it. 

Herpes  of  the  fingers  frequently  occurs,  that  looks  very 
innocent,  bnt  is  attended  with  excessive  itching ;  sometimes 
lasts  long,  and  is  apt  to  produce  injurious  effects  on  the 
nails  and  joints.  I  have  generally  found  Ranunculus 
bulbosus  in  the  6th  or  3rd  dilution  to  be  of  service. 

On  the  whole,  the  herpetic  exanthemata,  in  comparison 
with  the  eczemata,  are  usually  slighter  affections,  and 
frequently  get  well  of  themselves.  So-called  metastatic 
secondary  diseases  are  seldom  or  perhaps  never  observed 
after  them.  On  the  other  hand,  the  pemphigus  of  new- 
bom  infants  is  often  very  obstinate  and  even  dangerous.     I 


240  On  the  Treatment  of  some  Skin  Diseases^ 

have  seen  some  cases  where  new  blisters  constantly  broke 
out^  developing  with  extreme  rapidity  into  raw  exuding 
spots  the  size  of  the  hand.  What  with  the  constant 
screaming^  the  refusal  of  food,  fever,  and  complete  sup- 
pression of  the  urinary  secretion,  the  little  patients  were  so 
reduced  that  death  seemed  imminent.  I  gave  several 
remedies,  such  as  Apis,  Urtica,  Cantharis,  Lycopodium,  the 
disease  at  length  took  a  favorable  turn,  but  I  am  unable  to 
say  whether  any  one  of  the  remedies,  far  less  which  of 
them,  contributed  to  the  favorable  result.  Probably  warm 
baths,  and  alleviation  of  the  burning  pain  by  supplementing 
the  loss  of  the  epidermis  by  the  artificial  aid  of  cotton-wool, 
dusting  with  starch-flour  or  the  like,  did  most  to  promote 
the  cure. 

Urticaria, 

In  the  case  of  dispensary  patients,  whose  visits  are 
almost  invariably  very  irregular,  it  is  very  difficult  to  deter- 
mine what  effect  the  prescribed  remedies  have  on  the 
temporary  or  radical  disappearance  of  the  exanthema.  The 
nettlerash  appears  on  one  spot  of  the  skin  and  perhaps 
vanishes  soon  to  reappear  after  a  short  time  on  the  same  or 
another  spot.  It  is  only  in  the  case  of  chronic  urticaria  that 
it  would  be  possible  to  establish  the  action  of  remedies  with 
certainty  were  it  not  that  the  patients  are  too  apt  to  cease 
attendance  when  they  have  obtained  some  alleviation,  for 
they  do  not  think  the  malady  important  enough  to  subject 
themselves  to  a  lengthened  treatment  in  order  to  obtain  a 
radical  cure.  Moreover,  the  cure  of  nettlerash  is  to  a 
great  extent  dependent  on  the  avoidance  of  various  local 
and  general  exciting  causes,  which  is  a  matter  of  great 
difficulty  with  dispensary  patients.  In  the  chronic  form 
that  is  liable  to  burst  out  after  any  dietetic  error  or  after 
any  overheating  or  mental  excitement  I  have  generally 
employed  Apis,  Clematis,  Dulcamara^  Copaiba,  and  Urtica, 
but  without  any  marked  result;  in  acute  cases  Aconite 
sometimes  seemed  to  have  a  favorable  effect,  at  all  events  on 
the  troublesome  itching. 


by  Dr.  Clotar  MuUer.  241 


Acne,  Impetigo,  and  Lupus. 

In  that  most  obstinate  affection  acne,  which  in  the  form 
of  acne  punctata  faciei  so  frequently  attacks  young  girls  and 
boysj  I  have  for  many  years  tried  various  remedies.  I 
have  sometimes  seen  decided  good  effects  from  high  dilu- 
tions of  Belladonna  and  Pulsatilla,  but  very  often  no  effect 
at  all.  Latterly  I  have  generally  employed  Sulphur,  and 
direct  the  affected  parts  of  the  face  to  be  washed  at  night 
with  the  undiluted  tincture.  When  large  pustules  appear 
here  and  there  I  prescribe  Aniimonium  tartaricum  or  crudum. 
Of  all  remedies  Tartar  emetic  is  most  decidedly  and  mark- 
edly specific  to  impetiginous  and  erythematous  eruptions. 
I  may  refer  here  not  only  to  its  well-known  property  of 
causing  a  pock-like  exanthema  when  rubbed  on  the  skin, 
but  also  to  the  various  pustular  eruptions  caused  by  its 
internal  administration  which  are  recorded  in  our  Materia 
Medica.  Antimomum  crudum  alone  displays  a  similar 
marked  resemblance  in  its  skin  symptoms,  and  doubtless  it 
would  do  this  in  a  still  greater  degree  were  not  its  proving 
so  imperfect  and  incomplete.  This  may  also  be  the  reason 
of  its  rare  administration  and  neglect  by  us,  which  I  regret 
much,  as  latterly  I  have  frequently  witnessed  its  extra- 
ordinary efficacy  in  affections  of  the  skin  and  respiratory 
tubes.  I  have  reason  to  think  that  Antimonium  crudum  is 
an  invaluable  remedy  in  all  cutaneous  affections  where 
pustules^  pocks  or  furuncular  excrescences,  or  pimples  and 
boils,  arise  primarily  or  secondarily,  especially  when  at  the 
same  time  there  is  severe,  continued  pricking  itching  of 
the  skin,  and  after  rubbing  tenderness  and  soreness.  These 
indications  for  Antim,  crud,  may  occur  in  the  most  various 
forms  of  exanthema,  in  eczema,  prurigo,  scabies,  acne, 
impetigo,  ecthyma,  &c.,  and  in  my  opinion  always  furnish 
a  particular  indication.  They  may  appear  on  any  portion 
of  the  skin,  but  specially  call  for  Antim.  when  they  occur  on 
the  face  or  genitals.  I  may  particularly  mention  an 
impetiginous  eruption  on  the  scrotum  that  is  by  no 
means  uncommon   and  is  very   tiresome   and   obstinate. 

VOL.  XXUI,  NO.  CZXVII].— APBIL^  1874.  Q 


242  On  the  Treixtmeni  of  some  Skin  Diseases, 

Moreover^  some  of  the  symptoms  of  Antinumy  lead  me  to 
infer  that  it  may  be  of  use  in  certain  cases  of  Inpus^ 
namely,  when  the  suppurative  destruction  and  loss  of  sub- 
stance is  not  far  advanced ;  at  least,  prominent  among  the 
symptoms  of  Antimony  we  find  the  obstinate  lumps,  boils, 
and  pimples  so  characteristic  of  lupus,  and  not  less  so  the 
disposition  to  discoloured  gangrenous  suppuration  of  the 
upper  connective  tissue.  I  have  not  at  the  present  moment 
any  clinical  experience  of  the  efficacy  of  Antimony  in  such 
affections^  but  I  shall  employ  it  whenever  an  opportuoity 
presents  itself. 

As  regards  the  treatment  of  lupus  it  is  not  altogether  with- 
out favourable  results.  Arsenic  and  Mercurius  are  sometimes 
strikingly  efficacious,  sometimes^  however,  not  at  all.  I 
have  given  Kali  bichrom,  and  Condurango  too  seldom  to  be 
justified  in  forming  conclusions  respecting  them.  For 
about  seven  months  I  have  had  under  treatment  a  girl  of 
seventeen  who  has  had  this  horrible  disease  for  ten  years, 
and  in  whom  it  has  already  produced  the  most  cruel  devasta- 
tion. The  left  eye,  the  nose,  and  the  upper  lip  are  com- 
pletely destroyed ;  the  lower  lip  is  so  far  destroyed  that  the 
incisor  teeth  are  laid  bare  to  their  roots  and  are  quite 
loose.  Since  the  employment  of  Mercury  the  destructive 
process  in  the  orbit  and  the  root  of  the  nose  has  come  to  a 
stand  and  become  almost  dry,  and  the  pains  in  the  lower 
lip  have  almost  ceased. 

In  order  to  show  how  numerous  are  the  cases  of  exanthe* 
matous  disease  in  our  dispensary  I  subjoin  a  tabular 
risumi  of  the  cases  treated  in  1872  and  the  results  of  the 
treatment. 


by  Dr.  Clotar  Miiller, 


248 


^ 

'i 

•s^ 

8 

• 

o 

3 

•BS 

^ 

i 

16 

1 

1 

Only  c&xz 
once. 

Chtoiged  1 
treatmc 

1 

G 

'5 

Acne .... 

2 

2 

C 

4 

••1 

1 

Cnutalactea 

4 

1 

•  •  • 

1 

1 

•  •  • 

III 

1 

Eczema 

46 

12 

7 

7 

14 

••• 

••• 

6 

ElepbantiaBiB 

1 

•  •  ■ 

1 

•  •■ 

•  •• 

•  II 

••• 

••• 

EroBiones  . 

4 

3 

•  •• 

1 

1  •• 

••• 

•  •• 

••• 

Ezysipelaa. 

20 

3 

1 

9 

6 

•  •  • 

••• 

1 

SyphUides  . 

2 

■  •  • 

••• 

1 

1 

•  •• 

••• 

»•• 

Fayos 

2 

■  •  ■ 

•  •• 

•  •  • 

2 

•  •• 

lit 

•11 

Herpes 

17 

4 

•  t* 

6 

6 

.  •  • 

... 

1 

—    zoeter 

2 

1  •• 

••  • 

2 

•  •  > 

•  • « 

••• 

••• 

Impetigo   . 

40 

7 

4 

13 

7 

•  •• 

III 

9 

Xnteitrigo  . 

4 

•«■ 

••  • 

2 

••• 

••• 

I II 

2 

Lichen 

1 

••• 

•»» 

1 

t*a 

••• 

••• 

••1 

Lnpiu 

5 

•  t  • 

•  •  • 

2 

1 

••• 

*•• 

2 

Mentagra  . 

1 

••• 

«•■ 

••• 

1 

••• 

••• 

•t« 

IGliaria 

4 

••• 

•  •  • 

2 

2 

••• 

••• 

■•( 

Morbilli 

8 

6 

*•  • 

t«« 

2 

1 

*•• 

•t* 

PemphigOB 

1 

1 

■  •  • 

«  •  • 

« •  • 

•  •  t 

III 

•It 

KtjrriasiB  . 

6 

1 

1 

2 

•  •  • 

•  •  • 

••• 

2 

IVorigo      • 

43 

9 

6 

10 

13 

t  !• 

III 

5 

Pmntns 

4 

1 

1 

1 

•  ■  • 

•  •• 

III 

1 

Psoriaffls 

16 

3 

8 

8 

8 

•  •• 

III 

4 

Bhagades  . 

1^ 

•  •  • 

••• 

1 

•  •  • 

•  ■• 

I  •• 

II* 

«      Scabies 

66 

14 

2 

12 

23 

2 

i«« 

3 

Scarlatina  . 

3 

1 

•  •• 

1 

1 

(It 

1 1* 

itt 

Strophulus 

1 

•  •  • 

•  •  • 

•  •  i 

1 

•i« 

••• 

lit 

'nnea  capitis 

26 

6 

1  •  • 

6 

14 

•«• 

III 

1 

Urticaria    . 

12 

3 

2 

6 

2 

III 

••• 

•II 

Varicella    . 

3 

1 

•  •• 

2 

••• 

.It 

•11 

1 1  * 

Variola 

2 

1 

•  •• 

•  *  • 

••  • 

III 

1 

III 

348 

77 

30 

96 

104 

3 

1 

89 

I  should  mention  that  in  the  third  column  (''  improved  '^) 
all  those  cases  which  did  not  present  themselves  in  the 
dispensary  after  their  complete  cure  must  be  included ;  and 
in  like  manner  under  the  head  of  '^  discontinued '^  there 
must  always  be  a  considerable  proportion  of  cured^  s», 
indeed,  we  are  often  made  aware  when  they  subsequently 
present  themselves  for  other  affections. 

The  case  of  elephantiasis  occurred  in  a  man  of  sixty, 
in  whom,  in  consequence  of  chronic  ulcers  of  the  legs  of 
many  years'  standing  (originating  in  eczema),  there  was 
developed  immense  infiltration  of  the  whole  surrounding 
skin  with  considerable   thickening  and  desquamatioui   so 


244  The  Cypher  Repertory, 

that  the  whole  leg  and  foot  formed  a  thick  shapeless  mass, 
which  certainly  justified  the  above  diagnosis.  Under  the 
use  of  Sulphur  and  Arsenic  marked  improyement  took  place ; 
unfortunately  the  patient  ceased  attendance  after  some 
time. 


THE  CYPHER  REPERTORY. 
By  Dr.  Richabd  Hughes. 

The  appearance  of  a  fresh  instalment  of  the  Repertory 
of  the  HaJinemann  Publishing  Society^*  for  which  we  are 
indebted  to  the  industry  of  Dr.  Herbert  Nankiyell^  induces 
me  to  say  a  few  words  on  the  subject  of  repertories  in 
general^  and  of  this  one  in  particular. 

It  must  be  obvious  to  any  one  who  considers  the 
subject,  that  there  are  two  conceivable  modes  of  working 
the  homoeopathic  method,  of  following  the  rule  *'  Let  likes 
be  treated  by  likes.'^  The  one  may  be  called  the  a  priori 
mode,  the  other  the  &  posteriori.  The  former  infers  from 
the  pathogenetic  action  of  any  substance  what  will  be  the 
morbid  conditions  in  which  it  should  prove  curative.  It 
tests  the  inference  by  practice,  and  gains  therefrom  addi- 
tional indications  for  the  distinctive  choice  of  the  remedy. 
It  finally  obtains  a  specific,  t.  e.  a  medicine  definitely 
related  to  a  certain  form  or  stage  of  a  known  malady, 
which  when  it  encounters  it  will  certainly  modify  or  extin- 
guish. The  d  posteriori  mode,  on  the  other  hand,  begins 
with  disease  instead  of  drugs.  It  is  that  which  we  adopt 
when,  having  examined  a  case,  we  consult  our  pathogenetic 
records  to  see  what  medicine  has  caused  similar  symptoms 
in  the  healthy.  Our  future  progress  here  tnay  be  as  in  the 
former  way  of  proceeding ;  but,  more  commonly,  the  fre- 

*  A  Itepertofyg  or,  Sif Hematic  Arrati^emeni  and  Andl^tU  of  ike  Somao* 
paihie  Materia  Mediea,  Part  VI,  containing  Stools  and  Rectom.  By  Dr. 
Herbert  KankivelL    London:  Turner.    New  York:  Boericke  and  Taf eL 


by  Dr.  Richard  Hughes.  245 

qaent  adoption  of  this  plan  results  in  its  exclusive  use^  to 
the  disregard  of  the  other  mode  of  working. 

I  have  myself  been  an  habitual  follower  and  adyocate  of 
the  ii  priori  mode  of  homoeopathising ;  and  what  work  I 
have  been  able  to  do  in  the  field  of  Materia  Medica  has 
been  directed  towards  its  furtherance.  Nor  do  I  >cea8e  to 
maintain  that  it  is,  whenever  practicable^  the  best  manner 
of  proceeding.  It  sends  the  student  forth  ready  equipped 
for  his  work  yithout  cumbersome  apparatus  of  books  of 
reference.  It  harmonises  with  all  advance  in  physiology 
and  pathology,  for  it  tends  to  make  of  pharmaco-dynamics 
a  companion  and  analogous  science.  Nor  need  it  be 
deficient  in  the  individualisation  which  is  the  special 
merit  of  the  other  plan.  If  only  the  medicines  be  studied 
in  their  minute  detail  as  well  as  their  broad  outline,  they 
may  be  a  priori  adapted  not  only  to  genera  but  to  species, 
not  only  to  species  but  to  individuals.  As  a  matter  of 
fact,  nearly  all  our  best  specifics — the  remedies  which  are 
the  glory  and  the  power  of  homoeopathy— have  been  gained 
in  this  way. 

But  it  is  nevertheless  true  that  such  a  plan  alone  does 
not  suffice  for  the  exigencies  of  practice.  The  chief  diffi- 
culty in  working  it  arises  from  the  form  of  our  Materia 
Medica.  The  i  posteriori  method  was  evidently  Hahne- 
mann's ideal ;  and  the  arrangement  of  his  pathogeneses  in 
the  form  of  a  schema  of  disconnected  symptoms  had  view 
thereto.  If  every  case  is  to  be  treated  by  writing  down  its 
symptoms  in  anatomical  order,  and  then  finding  what 
medicine  has  produced  all,  or  the  greatest  number,  or  the 
most  characteristic  of  them,  then  the  form  adopted  answers 
every  purpose.  That  it  is  impossible  to  form  any  ct  priori 
notion  of  the  medicine,  or  to  see  in  its  effects  any  true 
pictures  of  disease,  is  of  no  consequence  upon  this  system. 
The  only  faculty  to  be  exercised  upon  the  Materia  Medica 
is  that  of  memory.  Now,  as  we  know  many  of  our  medi- 
cines only  from  the  pathogeneses  with  which  Hahnemann 
and  his  like-minded  followers  have  furnished  us,  we  can 
work  with  them  ouly  upon  his  plan.  We  should  never 
use    them    i  priori ;     but     when    seekiug   for   a   simile 


246  The  Cypher  Reperttm/^ 

to  fit  a  given  case^  every  now  and  then  we  come  upon 
them. 

It  is  for  this  latter  purpose  that  repertories  are  indis- 
pensable. A  repertory,  as  its  name  implies^  is  a  means  of 
finding  that  to  which  it  belongs.  It  is  simply  an  index  to 
the  Symptomen-Codex^  which  shall  save  us  the  turning  over 
every  page  in  search  of  that  which  we  want.  But  an  index 
may  be  a  good  or  a  bad  one.  It  is  good  in  proportion  as 
it  is  copious^  as  by  repeating  each  topic  in  every  element 
of  which  it  consists  it  insures  immediate  success  in  con- 
sulting it.  Dr.  Nankivell  himself  has^  years  ago,  demon- 
strated the  superiority  in  this  respect  of  the  Repertory  of 
the  Hahnemann  Publishing  Society  over  the  others  avail- 
able to  English  readers.*  I  would  refer  those  interested 
in  the  subject  to  his  article,  and  it  is  needless  to  repeat 
his  arguments  here.  One,  however,  may  be  added.  The 
other  repertories  (Hempel's^  and  Hull's  and  Curie's  Jahr) 
date  some  twenty  years  back ;  and  hence  contain  none  of 
the  medicines  which  have  been  added  to  our  stock  since 
that  time.  The  English  Repertory^  as  it  has  fairly  been 
called,  adopts  all  new  remedies  as  it  goes  on.  Its  first  list 
(I860)  contained  328  medicines;  its  second  (1859) — some 
being  omitted — 301 ;  and  now  Dr.  Nankivell  has  added 
(mainly  from  Hale's  and  Mure's  collections)  eighty-two 
more. 

As  this  work  is  hardly  so  well  known  as  it  deserves  to 
be,  a  brief  account  of  its  history  and  progress  may  be  given 
with  advantage. 

The  Hahnemann  Publishing  Society  was  founded  in 
1848.  Its  object  was  to  supply  to  physicians  practising 
homoeopathy  works  of  real  value,  the  expense  of  whose 
publication  would  be  too  great  a  risk  to  be  undertaken  by 
private  enterprise.  Dr.  Dudgeon  at  once  ofiered  to 
prepare  for  it  ''  a  systematic  arrangement  of  the  homoeo- 
pathic Materia  Medica.''  This  offer  being  accepted,  there 
appeared  from  his  pen  in  1850  a  volume  of  some  600  pages, 
entitled  The  Pathogenetic  Cyclopadia ;  a  systematic  arrange^ 
ment  and  analysis  of  the  Homceopathic  Materia  Medica. 

*  BrU,  Jowm,  of  Sim.,  xziy,  278. 


by  Dr.  Richard  Hughes.  247 

Fart  I^  containing  the  symptoms  of  the  Disposition^ 
Mind^  and  Head.  This  work  is  of  priceless  valne ;  and  I 
for  one  conld  have  wished  that  the  subsequent  parts  had 
been  fashioned,  bulk  notwithstanding^  on  the  same  plan. 
It  is  arranged  in  sections  with  certain  general  headings. 
The  symptoms  as  they  occur  in  the  original  provings  are 
arranged  under  these,  the  medicines  being  placed  in  alpha- 
betical order.  To  each  section  is  appended  a  minute 
analysis  of  its  contents^  the  medicities  being  arranged 
as  to  precise  character,  circumstances  of  aggravation  and 
amelioration^  and  concomitants.  The  iSnding  of  the 
required  medicine  is  thus  rendered  certain  and  easy. 

After  an  interval  of  nine  years,  there  appeared  a  volume 
called  on  its  cover  "  A  Kepertory ;  or  systematic  arrange- 
ment and  analysis  of  the  Homoeopathic  Materia  Medica. 
Parts  I  and  11^  containing  Preface;  Introduction,  by 
Drs.  Drysdale  and  Atkin;  Eyes/ by  Dr.  Dudgeon;  Ears, 
by  the  same ;  and  Nose  and  Smell,  Face  and  Neck,  Teeth 
and  Gums,  by  Drs.  Drysdale  and  Stokes.''  On  its  title 
page,  however,  it  is  styled  ''  A  Repertory  of  the  Materia 
Medica  Pura :  forming  vol.  ii  of  the  Pathogenetic  Cyclo- 
paedia.'' In  the  preface  we  are  informed  that  a  special 
committee  of  the  society  was  formed  in  1868  ''for  the 
purpose,  if  possible,  of  devising  a  plan  for  completing  the 
Pathogenetic  Cyclopsedia  in  a  less  voluminous  form  than 
that  adopted  in  the  first  volume.''  The  result  was  the  work 
whose  first  instalment  was  now  published.  A  third  and 
fourth  part  appeared  in  the  course  of  the  same  year,  con- 
taining ''  Mouth  and  Tongue  ,•  Throat ;  Appetite,  Taste, 
and  Digestion ;  Acidity^  &c. ;  Nausea  and  Vomiting ;  and 
Stomach;"  by  Drs.  Drysdale  and  Stokes.  1861  saw  a  fifth 
part,  concluding  the  Stomach,  and  adding  thereto  the  Abdo- 
men, by  Drs.  Drysdale,  Stokes,  and  Hay  ward.  Then 
its  progress  was  arrested,  until  in  the  present  year  we 
received  from  Dr.  Nankivell  the  sixth  part  now  before  us. 

A  good  deal  of  difference  appears  in  the  arrangement  of 
this  second  volume  of  the  Pathogenetic  Cyclopaedia.  The 
sections  are  commonly  six  in  number.  The  first  comprises 
"Character,"  "Pains,"  ''Degree,  Locality,  and  Direction 


248  The  Cypher  Repertory^ 

of  Pains ;''  the  seeond, ''  Conditions  of  Pains  \*  the  thirds 
'*  Concomitants  of  Pains  /'  the  fourth^  "  Coarae  and  Pro- 
gress of  Symptoms;''  the  fifths  '^ Peculiar  Symptoms;" 
the  sixth,  ''Anatomical  B^ons.'^  Some  modifications 
haye  been  introduced  into  subsequent  portions  of  the 
work  (as,  for  instance,  in  Part  YI,  ''  Stools  and  Diarrhoea  " 
take  the  place  of  "  Pains  ") ;  but  substantially  this  is  the 
order  adopted. 

But  the  distingnishing  feature  in  this  repertory  is  that 
every  symptom  i$  given  entire  under  every  aspect  in  which  it 
could  posribbf  present  itself.  This  had  already  been  noted 
by  Jahr  as  desirable  and  eyen  necessary ;  but  renounced  as 
impracticable,  since  he  had  calculated  that  if,  upon  an 
ayerage^  only  four  points  of  yiew  of  each  symptom  were 
giyen,  the  number  of  necessary  repetitions  is  so  great,  that 
for  a  repertory  worked  on  this  plan,  forty-eight  thick 
octayo  yolumes  would  be  required.  The  difficulty  has  been 
surmounted  in  the  English  Repertory  by  the  use  of  cypher. 
A  system  of  symbols  has  been  deyised  for  the  yarious 
elements  of  the  symptoms — Roman  numerals  for  ''  pains '' 
and  English  for  their  ''  conditions,''  English  letters  for  their 
'^degree,  locality,  and  direction/'  and  Greek  for  their 
''  concomitants,"  and  so  forth.  By  means  of  these  a  whole 
symptom' may  be  expressed  within  the  compass  of  little 
more  than  the  abbreyiations  of  the  medicines  ordinarily 
used  in  repertories.  Thus — ^in  Chapter  '^  Teeth  and 
Gums,"  Phosphorus;  ''continued  tearing  and  boring  of 
one  molar  tooth,  worse  by  touch  or  chewing,"  appears  as 
"  Mo.  Pho.  1^.  V^  VI*.  11—60."  Accordingly,  the  600 
pages  which  were  required  in  the  first  yolume  for  the 
"  Disposition,  Mind,  and  Head "  haye  sufficed  in  the 
second  for  all  the  categories  of  Hahnemann's  scheme  from 
"  Eyes  "  to  "  Stools." 

I  am  not  disposed  to  pass  any  criticism  on  this- adoption 
of  cypher.  It  has  unquestionably  hindered  (to  say  the 
least)  the  acceptance  of  the  work ;  and  yet  complaint  would 
probably  haye  been  greater  still  if  any  approach  to  Jahr's 
forty-eight  yolumes  had  been  made.  Dr«  Nankiyell,  in  the 
article  to  which  I  bay^  referred,  has  well  shown  that  the 


by  Dr.  Richard  Hughes.  249 

cypher  is  not  an  essential  part  of  the  repertory^  that 
the  latter  can  be  used  while  it  is  ignored.  It  is  only 
essential  to  the  completeness  of  the  view  of  each  symptom 
in  every  place  where  it  is  found ;  and  such  completeness 
must  often  save  greater  trouble  than  that  involved  in 
mastering  the  meaning  of  the  symbols. 

I  have  too  little  practical  acquaintance  with  repertory- 
making  to  criticise  Dr.  NankiveU^s  work.*  My  one 
thought  is  to  congratulate  English-reading  homoeopathists 
that  in  it  our  best  index  to  the  Materia  Medica  is  resumed. 
I  hope  that  the  Hahnemann  Publishing  Society  will  now 
find  workers  to  press  on  the  undertaking  to  its  conclusion. 
When  Dr.  Allen's  complete  collection  of  the  Materia 
Medica  itself  shall  have  been  published^  the  two  will  stand 
side  by  side  and  complementary^  to  represent  Hahnemann's 
homoBopfithy  as  it  now  stands.  Whether  the  homoeopathy 
of  the  future  may  not  be  something  better  is  a  point  on 
which  I  have  opinions^,  but  which  I  will  not  here  discuss, 

[Note  bt  Db.  Dbysbalb. — It  has  been  a  subject  of  regret 
for  some  time  that  my  esteemed  fiiend  and  colleague.  Dr. 
Hughes,  does  not  fuUy  share  the  opinion  of  Dr.  Dudgeon  and 
myself  on  the  supreme  importance  of  having  an  accurate  and 
complete  catalogue  of  the  symptoms  of  our  Materia  Medica.  The 
Cipher  Bepertory  purports  to  be  this  and  nothing  more; 
and,  moreover,  it  is,  as  yet,  the  only  practicable  plan  aiming  at 
that  object.  But  in  recommending  it  I  declioe  to  allow  myself 
to  be  placed  in  the  above  ^  posteriori  category  ;  nor  do  I  admit 
that  Hahnemann  is  rightly  placed  therein.  On  the  contrary,  he 
belongs  to  the  a  priori  category,  for  the  knowledge  of  the  special 
symptoms  is  essential  to  the  a  priori  method,  just  as  semeiology  is 


*  The  following  remark  has  been  commnnicated  tx>  me  by  one  well  qnalified 
to  express  an  opinion : — **  In  the  concomitant  pains  of  stool  there  is  no  coUec- 
tiye  of  pains  before,  during,  or  after  stool.  So,  to  find  all  the  pains  before 
stool,  we  have  to  look  through  all  varieties  and  classes  of  pains  occupying 
twelve  columns.  This  is  a  serious  omission.  Also  here^  and  in  some  other 
rubrics,  there  is  a  heading  '  Pains  so  stated/  with  complete  adjuncts  of  con- 
ditions and  concomitants;  a  useless  and  misleading  heading,  instead  of  which 
we  should  always  have  a '  collective.' " 


250     T%e  Treatment  of  Typhoid  Fever  by  Cold  Baths. 

an  eraential  part  of  pathology.  The  proper  division  of  partieB 
seems  to  me  to  be  that  given  by  Dr.  Hughes  in  his  paragraph  on 
the  a  priori  method,  viz.  with  those  who  follow  it  in  a  broad, 
general,  and  more  or  less  vagoe  manner,  and  those  who  adapt  iti^ 
not  only  to  genera,  but  also  to  species  and  individaals,  leaving  out 
the  a  posteriori  altogether  as  a  mere  abnse  of  the  homoBopathic 
principle.  It  is  only  those  persons  in  the  second  division  who 
wiU  ever  obtain  the  full  benefit  of  the  homoDopathic  law,  and  that 
only  through  the  means  of  an  accurate  catalogue  of  the  symp- 
toms of  a  sufficiently  large  and  sufficiently  well-proved  Materia 
Medica.  With  respect  to  the  preference  of  Dr.  Hughes  for  the 
plan  of  the  Fathogenetie  Oyelopadiaj  it  is  not  shflfed  by  Dr. 
Dudgeon  himself,  who  is  now  occupied,  in  conjunction  with 
Dr.  Stokes,  in  supplementing  it  with  an  analysis  after  the 
manner  of  the  Cypher  BepertoryJ] 


THE  TREATMENT  OF  TYPHOID  FEVER  BY 

COLD  BATHS, 

The  cold-bath  treatment  of  diseases  attended  by  increased 
temperature  has  become  such  a  recognised  therapeutic 
method,  and  its  results  have  been  everywhere  found  to  be 
so  successful,  that  no  system  of  medicine  can  afford  to 
neglect  this  mode  of  treatment. 

As  tepresentatives  of  progressive  medicine,  it  is  our  duty 
to  avail  ourselves  of  every  improvement  in  therapeutics^ 
whencesoever  it  may  come.  As  long  as  our  treatment  of 
diseases  remains  imperfect,  so  long  shall  we  seek  to 
diminish  its  imperfections  by  all  the  aids  that  accident  or 
science  may  offer  to  us.  The  success  of  our  treatment  of 
typhoid  and  other  febrile  diseases  attended  by  a  great  rise 
of  temperature  is  not  so  absolute  as  to  prevent  us  desiring 
some  adjuvant  to  the  merely  medicinal  treatment  that  may 
diminish  still  further  the  percentage  of  our  fatal  cases ;  and 
such  an  adjuvant  is  apparently  offered  to  us  in  the  now 
fashionable  cold-bath  treatment  of  fevers. 


The  Treatment  of  Typhoid  Fever  by  Cold  Baths.     251 

One  of  the  earliest  accounts  of  this  treatment  will  be 
found  in  tbe  Lancet  of  December  Slst^  1870^  where  Dr.  O. 
Fehrsen  gives  an  account  of  the  treatment  of  the  fever- 
stricken  soldiers  of  the  French  and  German  armies  in  the 
Stadtkrankenhaus  of  Dresden. 

A  paper  by  Dr.  C.  Liebermeister,  of  Basely  in  No.  31  of 
Volkmann's  Sammlung  kliniacher  Vortrdge^  gives  us  a 
detailed  account  of  the  treatment  pursued  in  the  Basel 
Hospital^  and  som&historical  account  of  the  treatment,  which 
we  are  happy  to  be  able  to  lay  before  our  readers  en  rSsumS, 

Until  a  very  recent  period  it  was  generally  supposed 
that  fever  was  in  some  manner  a  wholesome  effort  of  nature 
to  throw  off  some  morbid  materies  from  the  system.  This 
opinion  was  held  by  the  most  illustrious  names  in  medicine^ 
as  Asclepiades,  Campanellaj  Van  Helmont,  Sydenham^ 
Stahl^  Boerhaave,  &c. 

Since  it  has  been  shown  that  the  increased  temperature 
in  fever  is  owing  to  a  more  rapid  combustion  of  material^ 
and  as  in  febrile  diseases  the  appetite  and  digestive  system 
are  usually  deficient^  it  is  evident  that  the  temperature  can 
only  be  kept  up  by  the  consumption  of  the  tissues  of  the 
body ;  hence  the  febrile  process  began  to  be  looked  upon  as 
something  the  reverse  of  wholesome. 

But  it  has  now  also  been  satisfactorily  shown  that  the 
increase  of  temperathre  in  the  organism  is  accompanied  by 
destruction  of  the  organs  themselves^  and  it  has  been  found 
that  when  the  temperature  rises  above  a  certain  point,  this 
destruction  is  complete  and  unmistakable^  so  that  the 
integrity  of  the  organs  cannot  be  restored^  and  the  patient 
must  die.  The  destruction  or  disorganisation  varies  ac- 
cording to  the  organ.  In  all  organs  it  is  a  real  parenchy- 
matous degeneration  that  accompanies  this  extreme  tem- 
perature; the  liver^  heart,  kidneys,  brain,  are  each  dis- 
organised in  their  several  manners. 

This  having  been  recognised  as  the  inevitable  effect  of  a 
certain  elevation  of  temperature,  it  seemed  desirable  to 
check  the  tendency  to  elevated  temperature  in  fever,  and 
so  prevent  the  disastrous  effects  that  are  owing  to  increased 
temperature  alone. 


252     The  Treatment  qf  T^fphaid  Fever  by  Cold  Bathe. 

It  is  well  known  that  in  the  end  of  last  oentnry  Dr. 
James  Carrie  attained  a  remarkable  degree  of  soooess  in 
the  treatment  of  exanthematic  typhns  and  scarlet  fever  by 
means  of  cold  water  donches.  Bat  though  his  method 
was  so  snccessfol,  it  foand  bat  few  imitators^  and  was 
almost  forgotten  until  the  success  of  Priessnits  with  his 
cold  water  cure  brought  Carrie's  method  to  remembrance. 
It  is  certain,  however,  that  Priessnitz  and  his  disciples 
did  not  commonly  employ  their  method  in  casies  of 
fever, 

Ernst  Brand,  of  Stettin,  in  1861,  wrote  a  book  in  which 
he  vaunted  the  success  of  the  cold  water  cure  in  typhus. 
But  his  recommendation  fell  dead  on  the  ear  of  the 
profession. 

It  was  not  till  the  work  of  Bartels  and  Jiirgensen,  of 
Kiel,  was  published  in  1866,  that  attention  was  roused  to 
the  efficacy  of  the  cold-bath  treatment  in  lowering  the 
temperature  in  fevers,  and  thereby  obviating  the  ill-effects 
of  the  elevated  temperature.  These  careful  observers 
showed  that  cold  baths  could  be  given  not  only  with  im- 
punity, but  with  immense  advantage,  as  often  as  the  elevated 
temperature  rendered  them  necessary.  They  showed  that 
the  abstraction  of  heat  from  the  patient  should  be  carried 
out  persistently  day  and  night  as  often  as  the  temperature 
as  shown  by  the  thermometer  applied  to  the  axiUa  reached 
or  exceeded  39^  C.  It  sometimes  happened  that  as  many  as 
twelve  baths  had  to  be  given  in  twenty-four  hours,  and 
that  one  patient  had  to  get  200  baths  in  the  course  of  his 
disease. 

The  results  of  this  treatment  were  exhibited  by  the 
statistics  of  typhus  abdominalis  in  the  Kiel  Hospital.  From 
1850  to  1861  there  were  treated  380  cases  by  the  ordinary 
methods,  of  whom  51  died,  showing  a  mortality  of  15*4  per 
cent.  From  1863  to  1866  there  were  160  cases  treated 
by  the  cold-bath  system,  of  whom  only  5  died  =  8*1  per 
cent. 

In  Basel,  where  the  abdominal  typhus  is  extremely 
frequent  and  maligpiant,  the  success  obtained  in  the 
hospital  by  the  cold-bath  treatment  was  equally  striking. 


The  freatment  of  Typhoid  f^ever  by  Cold  Baths.     258 

Up  to  1865  the  treatment  was  the  ordinary  expectant 
treatment.  In  1865^  cold  baths  were  employed  to  some 
extent^  bnt  as  a  rule  only  once^  very  seldom  twice  a  day. 
But  Dr.  Liebermeister,  having  read  Bartels  and  Jiirgensen's 
book  in  1866^  adopted  the  full  cold-bath  system  administered 
by  these  gentlemen.  The  result  is  evident  from  the  following 
table: 

I.  Ordinary  treatment. 


Year9,              Typhm-oasee. 

2)i6d. 

Mortaliiy. 

1843— 18S3        ...        444 

•. . 

136 

30*4  pei 

'cent 

X854r~1869        ...        643 

« •• 

172 

26-7 

If 

1860-1864        ...        681 

... 

162 

25-7 

>» 

II.  Imperfect  antipyretic  treatment. 

From  begiimmg  of 

■» 

1865  to  Sept  1866    ...        982 

••• 

169 

16*2 

99 

III.  Complete  antipyretic  treatment.* 

Sept  1866  to  1867    ...        839 

*•• 

33 

9-7 

» 

1868    ...        181 

... 

11 

61 

» 

1869    ...        186 

•*• 

10 

6*4 

f» 

1870     ...        139 

... 

10 

7-2 

If 

*  A  paper  by  Dr.  Behier,  in  the  Febroary  number  of  the  PraoHHoner, 
enablee  ns  to  add  to  the  atatistics  snpplied  by  Dr.  Liebermeister  of  the  cold- 
bath  treatment  of  typhoid. 

Brand  treated  m  1868,    171  cases,  of  whom  1  died. 

1870-1,  89  „  0    „ 

El^nard     „     at  Lyons,  12  „  0    „ 

In  the  Leipzic  hosptal  from  1861  to  1867, 1178  cases  were  treated  by  the 
old  methods,  of  whom  213  died«18-l  per  cent  From  1868  to  1872,  261 
cases  were  treated  by  odd  baths,  with  18  deathsB7-2  per  cent 

Mortality  with  treatment        Mortality  with  treatment 
withont  batbB.  with  baths. 

Jfirgensen  .  •    16*4  per  cent.  3*1  per  cent 

Ziemssen  and  Immermann  .    30*2       „  7*6        „ 

Liebermeisterand  Hagenbach    26*2        „  9*7        „ 

Riegel    .  .  .20*0        „  4*3        „ 

Stohr     .  .  *    20-7        •,  0*6        ^ 


254     T%e  treatment  of  Tifphoid  Fever  by  Cold  Baths. 

This  striking  result  of  the  cold-bath  treatment  of  typhoid^ 
whereby  the  mortality  was  reduced  to  nearly  a  fonrth  of 
what  it  had  been  nnder  the  ordinary  expectant  treatment^ 
was  confirmed  by  the  experience  of  the  hospitals  of  Munich^ 
Erlangen,  Wiirzburgi  Niirnberg,  Greifswald^  Jena^  Halle^ 
&c.,  and  there  can  be  no  donbt  that  it  is  a  powerful 
remedial  means  that  should  not  be  neglected  in  the  treat- 
ment of  typhoid  whereyer  it  may  occur. 

But  it  is  not  only  in  typhoid  that  the  cold-bath  treat- 
ment is  of  use.  It  has  been  employed  with  success  ia 
typhoid  pneumonia,  in  scarlatina,  measles,  the  premonitory 
fever  of  variola,  puerperal  fever,  pleurisy,  meningitis 
cerebro-spinalis  epidemica,  &c. 

The  temperature  of  the  water,  in  the  bath  should  be 
20^  C.  or  lower.  The  same  water  may  be  used  for  one 
patient  repeatedly.  The  bath  may  stand  in  the  patienf  a 
room  ready  for  use,  and  he  should  remain  in  it  for  ten 
minutes  at  a  time.  The  attendants  should  be  instructed  to 
take  the  temperature  in  the  axilla  every  two  hours,  and 
whenever  they  find  it  89^  or  upwards  they  should  put  the 
patient  into  the  bath  for  ten  minutes,  then  lift  him  out, 
wrap  him  up  in  a  dry  sheet,  and  let  him  rest  for  a  time  on 
the  bed  before  putting  on  his  night  shirt. 

Very  weak  patients  should  have  the  water  rather  warmer 
(24^  C),  and  may  remain  in  it  a  shorter  time  (seven  or  five 
minutes). 

Such  is  the  cold-bath  treatment  now  so  extensively 
employed,  especially  on  the  Continent^  in  the  treatment  of 
febrile  diseases  with  a  high  temperature  of  the  body.  It 
promises  to  be  a  useful  auxiliary  to  the  best  medicinal 
treatment  of  such  diseases,  and  though  like  much  of  the 
medication  of  the  so-called  ''  rational ''  school,  it  is  a  mere 
treatment  of  a  symptom,  the  increased  temperature  of  the 
body,  yet  that  should  not  prejudice  us  against  it,  for  it  is 
precisely  this  increase  of  temperature  that  constitutes 
the  great  danger  in  typhoid  by  the  parenchymatous  dege- 
neration it  is  liable  to  produce.  If  by  the  use  of  cold  baths 
we  can  effectually  ward  off  this  by  no  means  insignificant 
peril,  we  shall  afford  to  our  specific  remedies  BapHria,  Rhus, 


On  the  Proving  (ff  Medicines.  255 

Arsenicum,  Phosphorus^  and  others^  all  the  more  scope  for 
exerting  on  the  essence  of  the  disease  those  curative  effects 
which  would  be  rendered  nugatory  by  the  disorganisation 
that  attends  the  elevated  temperature. 

Dr.  Liebermeister  does  not  trust  entirely  to  the  anti- 
pyretic action  of  cold  water  in  the  treatment  of  typhoid^ 
but  seeks  to  aid  it  by  the  administration  of  large  doses  of 
Quinine,  DiffUalis,  or  Veratrum,  remedies  which  are  not  to 
he  compared  in  efficacy  with  the  medicines  which  the 
homoeopathic  principle  of  selection  furnishes  us  with. 


a  gall  upon  all  homceopathic  physi- 
clAlNs  for  the  proving  op  medicines 
upon  healthy  men  and  animals.* 

HoM(EOPATHT  cau  ouly  fulfil  her  task  of  curing  men  and 
animals  of  their  diseases  in  proportion  as  she  more  or 
less  thoroughly  tests  the  medicines  as  to  the  artificial 
diseases  which  they  are  capable  of  producing  on  the  healthy 
organism.  She  takes  her  stand  solely  qn  the  ground  of 
these  '^  provings  ;'^  and  according  as  they  are  sparingly 
carried  on  or  discontinued^  so  her  living  power  of  pro- 
gressive development  comes  to  a  standstill. 

How  could  any  one  ever  think  of  effecting  a  homoeo- 
pathic cure  in  cases  where  similar  diseases  have  never  been 
produced,  either  in  healthy  animals  or  healthy  men,  by 
provings  of  the  remedies  ?  How  could  any  one  hope^  on  a 
return  of  any  given  disease,  as^  e.g.,  Asiatic  cholera^  to 
become  each  time  more  surely  master  of  the  disease^  if  he 
does  not  constantly  prove  more  rigorously  the  remedies 
hitherto  used  for  cholera,  and  all  the  medicines  most  nearly 
related  to  them  ?  "  Prove  more  rigorously,''  what  does 
that  mean  ? 

The  means  of  determining  almost  all  morbid  symptoms 

*  "Stom  iibe  InUffMHbHale  hom6op(Uki&che  Presse, 


266  On  the  Proving  of  Medicines, 

have  multiplied  with  the  progress  of  the  natural  sciences. 
Not  one  of  these  means  should  be  overlooked  or  even 
imperfectly  employed  in  our  provings  of  medicine. 

1.  All  physical  methods  of  examination  (auscultation, 
percussion^  laryngoscopy,  &c.)  should  be  called  to  our  aid 
with  the  greatest  rigor  and  precision. 

2.  Every  chemical  examination  of  organic  matters  that 
have  undergone  morbid  changes  should  be  made  with  the 
aid  of  aU  the  methods  placed  at  our  disposal  through  the 
advance  of  chemistry,  methods  aiming  at  the  most  precise 
determination  of  their  internal  chemical  constitution. 

8.  The  pathologico-anatomical  new  formations  (morbid 
neoplasms)  ought  to  be  examined  and  determined  with  the 
utmost  exactitude  by  macroscopic  and  microscopic  observa- 
tion. 

The  highest  aim  that  any  praver  of  a  given  medicine  can 
propose  to  himself  is  to  produce  by  the  mutual  action  of 
that  medicine  and  his  healthy  body  a  well-defined  totality 
of  morbid  action,  or  else,  in  case  he  should  himself  be  not 
perfectly  healthy  or  too  feeble  for  the  purpose,  it  must  be 
that  of  other  heal  thy 'i^  persons  placed  under  his  immediate 
inspection,  or,  at  the  very  least,  that  of  some  healthy 
animal. 

Morbid  symptoms  that  are  perfectly  isolated,  provided 
only  they  be  accurately  determined,  in  case  only  one 
prover  was  in  a  condition  to  incur  such  symptoms,  are 
welcome  with  a  fully  adequate  recognition  of  their  value  as 
fragments  of  a  totality  of  which  others  will  avail  themselves 
in  order  to  complete  the  '^  picture ''  of  the  artificial 
disease. 

In  Vienna  the  medicines  selected  for  proving  will  be 
tried  upon  animals  in  various  localities.  Approved  zoolo- 
gists, chemists,  and  histologists  have  promised  their  advice 
and  aid  in  the  experiments  to  be  conducted  by  skilled 
provers  of  medicine. 

Whoever  has  a  mind  to  see  for  himself  the  procedure  in 
the  production  of  artificial  diseases  by  given  medicines  on 

*  For  which  purpose  also  women,  single  and  married^  and  also  children,  are 
desirable. 


On  the  Proving  of  Medicines,  257 

healthy  animals,  or^  at  least,  will  associate  himself  as  an 
observer  and  registrar  of  all  morbid  symptoms  exhibited 
by  animals  under  proving^  an  opportunity  is  offered  espe^* 
cially  at  the  Pesth  University,  in  the  homoeopathic  insti- 
tute, for  the  production  of  artificial  disease. 

Directions  for  the  provers  of  medicines  respecting  the 
diseases  which  they  produce  are  to  be  found  in  vol.  i  of  the 
Journal  of  tfie  Society  of  Austrian  Homoeopathic  Physicians^ 
edited  by  Dr.  J.  O.  Miiller  (Vienna,  1857).  They  have 
been  elaborated  into  a  whole  out  of  the  previous  admirable 
results  of  the  Vienna  Proving  Society  by  a  select  com- 
mittee. We  recommend  this  article  to  the  attentive  consi- 
deration of  all  those  who  are  in  a  position  to  undertake  for 
the  first  time,  without  any  preliminary  practice,  the  physio- 
logical proving  of  any  given  medicine  on  themselves,  on 
others,  or  on  animals. 

We  propose  Cuprum  metallicum  as  the  first  medicine  to 
be  proved,  in  consideration  of  all  that  has  occured  in  Europe 
this  year  in  cases  of  cholera ;  and,  this  proving  being  com- 
pleted, the  next  in  order  will  be  Cuprum  aceiicum,  then 
C.  sulphuricum,  and,  lastly,  C  arsenicosum,  in  proportion- 
ably  longer  or  shorter  periods,  and  with  constant  compara- 
tive retrospect  of  the  results  of  the  Cuprum  metallicum 
proving. 

The  centesimal  triturations  of  the  metallic  copper  are, 
immediately  after  their  preparation,  and  again  before  they 
are  administered  to  the  provers,  examined  microscopically 
both  as  to  the  number  and  the  fineness  of  the  metallic 
particles  reduced  by  each  trituration  with  milk-sugar,  and 
the  results  formed  into  a  table  to  be  afterwards  added 
to  the  printed  account  of  the  proving.  The  dilutions  of  the  * 
same  are  next  examined  in  like  manner  with  the  microscope, 
or,  in  case  this  no  longer  indicates  any  copper,  by  spectrum 
analysis ;  and  the  result  of  this  examination  is  faithfully 
and  accurately  published  in  tables  afterwards. 

The  preparations  of  the  medicines  to  be  proved  are  sent, 
■•**^  the  most  exact  account  of  the  process,  from  Dr. 
Willmar  Schwabe's  homoeopathic  central  depdt,  Leipsic,  to 

VOL.  XXXII,  NO.  CXXVIII. APRIL,  1874.  R    . 


258  On  the  Proving  of  Medicines. 

every  prover^  at  the  cost  of  the  Society^  without  charge^  or, 
in  case  he  wishes  it^  to  be  paid  for  afterwards. 

The  medicines  selected  for  proving  by  the  Central  Society 
from  time  to  time  will  be  kept  there,  in  all  triturations  and 
dilutions  on  the  centesimal  scale,  ready  for  the  optional 
selection  of  the  prover. 

The  results  of  proving  are  to  be  sent  to  the  chief  editor 
of  the  International  Hommopathic  Press^  Dr.  Clotar  Miiller, 
Leipsic  (No.  5,  Budolfstrasse). 

On  behalf  of  the  Central  Society  of  Homoeopathic 
Physicians  of  Germany,  Vienna,  August  10th,  1873. 

Dr.  Ebnst  Hilarius  Faolich,  Vienna. 
Prof.  Dr.  FaANE  Hausmann,  Pesth. 


The  -following  observations  by  Dr.  Koeszler  at  the  forty- 
first  meeting  of  the  Central  Homoeopathic  Society  of 
Germany,  held  at  Vienna  in  August  last,  form  a  fitting 
addendum  to  the  above  appeal.  We  take  the  report  of  the 
speech  from  vol.  87  of  the  AUg,  Horn.  Zeitung, 

GehtiiBMEN, — I  will  call  your  attention  to  a  subject  with 
which  not  only  our  interests  but  the  interests  of  homoBopathy  are 
most  intimately  connected,  and  which  is  deserving  of  our  most 
careful  consideration;  I  mean  the  question,  Why  are  we  novo 
getting  to  few  yov/ng  physicians  to  join  our  ranks  ? 

The  discussion  of  this  question,  the  elucidation  of  the  causes  of 
this  unhappy  circumstance,-  is  by  no  means  new ;  we  have  often 
talked  it  over,  but  without  properly  comprehending  and  demon- 
strating the  real  fiEtcts  of  the  case,  and  without  being  able  to 
indicate  remedial  measures.  It  cannot  be  denied  that  noted 
homoeopaths  have  given  weighty  reasons  in  explanation  of  the 
unfavourable  position,  and  likewise  alleged  the  possibility  of 
altering  it;  yet  they  have  not  chosen  the  starting-point 
proper  to  a  consideration  of  this  earnest  question.  Those 
numerous  and  enthusiastic  fighters  in  the  van  of  homoeopathy 
that  were  brought  over  in  consequence  of  the  defects  of  the 
dominant  school,  and  by  the  practical  success  of  the  Hahne- 
mannian  doctrine,  and  who  studied  homoeopathy  and  bore  their 


On  the  Proving  of  Medicines.  259 

part  in  founding  the  school,  .worked  with  holy  zeal  at  the 
development  of  our  method,  but  they  divided  themaelyes  from 
the  yery  beginning  into  two  different  parties — ^into  the  absolutely 
dogmatic  with  a  dynamic  basis;  and  into  the  speculative- 
rational  with  a  material  basis. 

The  former  became  and  remained  dogmatic,  and  regarded  all 
that  had  been  done  in  homceopathy,  including  the  Materia  Medica 
J^ura,  as  complete  and  not  to  be  touched  by  unholy  hands; 
the  latter  entered  on  the  path  of  sifling  and  examining  the 
collected  materials. 

Now,  we  must  all  admit  that  the  so-called  Materia  Medica 
JPifra  is  indeed  the  comer  stone,  but  not  the  crowning  one  of 
the  edifice.  The  sifting  and  sorting  and  the  after-provings  were 
not  carried  on  in  an  exact  scientific  way  either ;  hence  they  were 
unable  to  attract  the  attention  of  scientific  thinkers ;  and  since 
these  efforts  could  not  even  satisfy  the  workers  themselves,  they 
flagged  and  finally  ceased.  The  want  of  firesh  men  coincides 
with  this  period  of  the  historical  development  of  homoBopathy ! 

But  time  advances;  we  enter  upon  a  new  phase  of  the 
historical  development  of  the  immortal  idea  of  Hahnemann: 
this  is  the  era  of  exact  scientific  experiment. 

The  Organon^  the  Materia  Medica^  constitutes  now,  as  then, 
the  basis  of  our  school ;  but  it  is  necessary  that  it  be  understood 
and  explained  in  accordance  with  the  present  state  of  science,  and 
that  by  the  exact  method  of  the  present  time — by  scientific 
experiment. 

But  what  is  this  exaet  method  ?  It  is  the  practical  application 
and  utilisation  of  all  those  aids  which  modem  natural  science 
offers  in  proving  our  drugs  on  the  healthy,  i,  e.,  a  most  extensive 
strictly  sciehtifically  carried-out  method  in  the  provings  of  reme- 
dies as  morbifijc  agencies  with  a  correlative  comparison  of  the 
natural  diseases  at  the  bedside.  For  this  purpose  we  must  make 
use  of  experimental  pathology,  pathological  physiology  and 
histology,  chemistry,  &c.,  in  the  study  of  our  Materia  Medica, 
just  as  is  done  in  the  study  of  the  natural  diseases.  Taking  this 
as  a  starting-point,  homoBopathy  in  Hungary  has  acquired  her  two 
professorships,  and  that  one  for  Materia  Medica  with  a  proper 
experimental  institution  attached,  and  the  other  for  homoeopathic 
drdcal  instruction.  For  the  successful  development  of  homcBO- 
pathy  which  is  now  showing  itself  in  creating  a  young  generation, 


260         Pkyriological  Action  of  Acetate  of  Copper. 

iheie  two  professonhips  are  absolutely  neoeflsarj — one  conditions 
the  other,  one  completes  the  other.  These  are  the  workshops  in 
which  the  young  physicians  of  the  modem  school  must  be 
taught  the  ideas  that  represent  our  school  by  the  &cte  obtained 
firom  nature's  scientific  experiments. 

Now-a-days  the  young  physician  can  no  longer  be  converted 
into  a  belieying  therapeuticist  by  the  cut-and-dried  post  hoc  ergo 
propter  hoe;  only  in  the  way  just  indicated  is  it  possible  to 
procure  for  homoBopathy  numerous  firmly-convinced  adherents, 
and  to  develop  homosopathy  in  a  strictly  scientific  sense,  and  to 
conquer  a  place  of  honour  for  it  amongst  the  natural  sciences. 
(Cheers.) 

With  us  in  Hungary,  where,  under  the  direction  of  Professor 
Hausmann,  the  Institute  for  Materia  Medica  is  for  the  experi- 
mentation in  artificial  drug-diseases ;  where,  under  the  direction 
of  Professor  Bakody,  the  homosopathic  hospital  exists  as  adjunct  to 
the  artificial  diseases ;  where,  therefore,  the  demands  of  modem 
science  are  satisfied  in  the  lectures  of  these  two  professors,  there 
has  arisen  such  a  lively  interest  for  homceopathy  that  we  can 
already  speak  of  a  considerable  increase  in  the  number  of  new 
homoeopathic  physicians. 

Wherever  homoeopathy  has  established  itself  our  endeavour 
must  be  to  advance  in  like  manner ;  we  may  not  put  up  with  a 
little,  dispensary,  or  with  some  clinical  wards,  or  with  a  professor* 
ship  for  everything;  no,  we  must  have  homceopathy  in  its 
entirety,  for  then  victory  is  certain  and  the  future  ours.  (G-reat 
cheering.) 


PHYSIOLOGICAL     ACTION      OF     ACETATE     OF 

COPPER.* 

Thaoitgh  the  kindness  of  Professor  Joseph  Buchner^  of 
Munich,  we  have  received  a  valuable  inaugural  dissertation 
by  Adolf  Carl  Kock,  delivered  at  Munich  in  1872,  con- 
taining very  precious  information,   which  we  wish  to  com* 

•  Jfmis  Zeiiiehri/tfUr  Mom.  KUmk,  Bd.  17.  Nos.  20  &  21. 


Physiological  Action  of  Acetate  of  Copper.         261 

municate  to  our  readers  in  an  extract ;  though  compressed  in 
form  yet  substantially  complete. 


I.  Poisoning  Cases. 

a.  Scheuchzer  gives  an  account  of  a  Swiss  monastery 
where  the  monks  suffered  from  constant  colic^  retchings 
bilious  vomitings  loss  of  appetite^  constipation^  flatulence, 
heartburn^  pain  in  the  limbs,  tightness  of  the  chest,  and 
even  paralysis.  He  found  that  the  kitchen  utensils  were  of 
copper^  badly  or  not  at  all  tinned,  and  some  of  brass,  were 
very  dirty ;  and  in  these  all  sorts  of  food,  acids  included^ 
were  boiled. 

b.  Schodius  saw  in  the  case  of  a  gardener,  who  had 
eaten  fish  cooked  with  salt  and  oil  in  a  copper  vessel, 
vomitings  bloody  stools,  and  death.  Lanzoni  observed, 
after  eating  rice  out  of  a  copper  vessel^  vomiting,  colic,  and 
delirium. 

c.  Strack  saw  in  four  children,  who  ate  beans  cooked  in 
a  copper  vessel,  retching  followed  by  vomiting,  continued 
diarrhoea,  pale  face^  swooning,  and  colic. 

d.  Fabas  relates  that  ^  family  of  six  were  ill  after  eggs 
cooked  with  sorrel  and  butter  in  a  copper  vessel.  All  six 
had  constant  vomiting  and  diarrhoea,  convulsive  movements, 
cramp  and  violent  pain  in  the  abdomen,  and  were  benefited 
by  taking  oil  and  mucilaginous  remedies. 

e.  A  boy  fell  into  violent  convulsions  after  eating,  on 
board  ship^  some  peas  which  had  stuck  to  the  bottom  and 
sides  of  a  large  copper.  Soon  after  a  serious  disease  broke 
out  in  the  whole  crew,  with  colic,  vomiting,  purging^  and 
swooning.  The  ship  surgeon  took  it  for  cholera,  but  it 
passed  off  when  the  dirt  in  the  copper  was  discovered  and 
removed.     Thus  says  Ramsay. 

/.  Two  men  died  after  eating  food  prepared  in  a  copper 
vessel  imperfectly  tinned;  for  an  hour  they  suffered  the 
most  violent  pains  in  the  stomach,  with  vomiting  and 
tenesmus.  The  intestines,  says  Portal,  were  swollen, 
with  erosions  in  several  places,  especially  in  the  small-guts; 


262         Physiological  Action  of  Acetate  of  Copper. 

the  pylorus  and  duodenum  were  even  gangrenous;  the 
rectum  perforated  in  two  places. 

g.  In  Fahner's  Beitrdge  zur  praktischen  und  gericht" 
lichen  Medizin  we  read  as  follows : — "  A  girl^  st.  18, 
who  ate  beans  boiled  in  a  copper  vessel,  soon  lifter  experi- 
enced nausea,  vomiting,  pain  in  the  abdomen,  convulsions, 
and  loss  of  consciousness.  Six  hours  after,  oil  and  milk, 
with  oyster-shell  powder,  were  prescribed  internally,  with 
emollient  poultices.  The  pain  and  vomiting  ceased;  yet 
the  girl  complained  of  an  unusual  paralytic  sensation  in  the 
arms  and  legs.  Bloodletting  was  ordered,  with  Spirit  of 
Hartshorn,  afterwards  Nitre  and  Opium.  Her  face  was 
hippocratic ;  the  abdomen  painful  and  tumid ;  soon  after 
she  died.  The  skin  was  yellow,  the  mouth  fast  closed, 
eyes  half  open,  nails  blue ;  the  stomach  inside  was  green 
and  much  inflamed,  especially  at  the  pylorus  :  it  contained 
green  mucous  masses ;  several  gangrenous  specks  in  the 
cardiac  portion ;  the  mesentery  was  tender  and  much 
inflamed;  the  intestines  contained  green  fluid  and  green 
faeces  in  several  places ;  the  liver,  inflamed  on  its  sharp 
rim ;  bladder  empty,  almost  inflamed ;  gall  bladder  also 
rather  inflamed ;  lungs  and  heart  full  of  thick  blood ; 
oesophagus  much  inflamed.  There  are  very  full  symptoms 
of  men  who  had  swallowed  verdigris ;  in  some  cases  in- 
advertently, in  others  from  despondency  or  for  the  purpose 
of  suicide. 

h.  Pyl  tells  us  of  a  girl,  set.  24,  that  had  swallowed 
four  ounces  of  verdigris,  who  died  in  sixty  hours  with 
frequent  vomiting,  colic,  diarrhoea,  and  convulsions.  The 
post-mortem  showed  yellow  skin,  the  body  stiff,  mouth 
fast  closed,  eyes  half  open,  nails  blue,  mesentery  soft 
and  inflamed ;  intestines  stained  green,  inflamed,  here  and 
there  gangrenous  j  pylorus  green,  inflamed,  gangrenous, 
contracted  like  cartilage  in  some  places  of  the  size  of  a 
crown ;  faeces  green ;  intestines  here  and  there  inflamed, 
and  gangrenous  all  the  way  to  the  rectum ;  liver  inflamed 
on  the  sharp  rim ;  gall  bladder  somewhat  inflamed  ; 
heart  and  blood-vessels  distended  with  blood  'Uot  in  a  fluid 
ftate. 


Physiological  Action  of  Acetate  of  Copper.         263 

t.  Daval  describes  a  similar  case,  with  the  same  symp- 
toms^ of  a  soldier^  who  swallowed  1^  oz.  of  verdigris  in 
4  oz.  of  water  from  despondency.  Vomiting,  coliCj  and 
purging ;  convulsions^  tetanic  contraction  of  all  the 
limbs^  &c. 

k,  Orfila  describes  a  case  of  copper  poisoning  with  4 
drachms,  by  a  man.  Violent  pain  in  the  abdomen,  copions 
stool  and  vomiting.  Mucilage,  milk^  and  emollient  clysters 
prescribed.  In  three  hours  his  countenance  was  sad,  with 
deep-sunken  eyes,  moist  tongue,  and  clammy  mouth. 
Hawking^  coppery  eructation,  violent  thirst,  loss  of  appetite, 
liext,  vomiting  of  green  masses ;  and  shortly  after  jaundice 
act  in.  Three  stools  brought  alleviation  and  sleep.  The 
day  after^  countenance  calm,  tongue  greyish^  mouth 
clammy^  with  coppery  taste, '  yellow  skin ;  the  vomiting 
stopped ;  abdomen  very  sensitive  to  pressure^  pulse  regular, 
head  heavy^  with  slight  deafness.  After  Vichy  water  with 
whey,  and  emollient  clysters,  four  greyish  stools.  The 
day  after,  felt  unwell,  with  thirst  and  dark-red  urine. 
Hext  day  jaundice  disappeared,  appetite  returned ;  weak- 
ness alone  remained. 

It  would  lead  us  too  far  to  specify  all  the  cases  which 
presented  the  characteristic  action  of  this  salt.  It  is, 
however,  well  seen  from  the  individual  instances  here 
selected  out  of  all  that  Drouard,  Orfila,  and  Smith  tell  us 
in  abundance,  we  may  infer  that  this  poison  causes  death 
within  twenty-four  hours,  if  the  dose  amounted  to  1  to 
1^  gramme ;  that,  on  the  contrary,  death  ensued  in  two 
hours  if  it  was  a  larger  dose  ;  further,  that  if  the  verdigris 
was  taken  in  a  solid  form,  or  dissolved  in  water,  the  first 
symptoms  appeared  in  ten  minutes. 


II.    EZPERIMSNTS  ON  AnIMALS. 

1.  Pigeons. 

a.  Having  tied  the   oesophagus  of  a  healthy  pigeon,  I 
injected  0*1  gramme  of  neutral  Acetate  of  Copper  into  the 


264         Physiological  Action  of  Acetate  of  Copper. 

crop^  dissolved  in  2  grammes  of  water.  In  a  few  minutes 
began  violent  oft-repeated  retchings^  shivering  all  over  the 
body ;  soon  after,  greenish-grey  faeces  passed,  next,  straining 
to  vomit,  then  more  green  faeces ;  quick  respiration, 
growing  constantly  louder ;  violent  shivering  and  wavering 
of  the  whole  body ;  till,  in  a  few  minutes  more,  the  bird 
collapsed;  continued  opening  and  shutting  of  the  bill  with 
very  laborious  breathing ;  then  death. 

Post-mortem. — The  crop,  which  contained  some  grains  of 
barley,  exhibited  a  blue  fluid ;  a  thin  membrane  of  a 
greenish-blue  was  easily  drawn  off  from  the  underlying 
muscular  coat;  oesophagus  coloured  blue  outside;  in  the 
glandular  stomach  was  a  bluish-green  greasy  mass;  intes- 
tines much  reddened,  the  vessels  strongly  injected,  showing 
themselves  dichotomous ;  on  some  spots  the  red  is  dark ; 
the  lower  intestines  filled  up  with  white  greasy  mass; 
kidneys  distended  with  blood  ;  liver  brownish-red,  very  full 
of  blood,  as  also  the  lungs ;  the  spinal  cord  seems  to  be 
affected ;  at  least,  hyperaemia  of  its  sheath  is  unmistakable. 

b.  Having  tied  the  oesophagus  of  a  perfectly  healthy  and 
very  lively  pigeon,  I  injected  0*5  gramme  of  neutral  Acetate 
of  Copper  into  the  crop,  dissolved  in  2  grm.  of  water.  This 
bird  was  as  lively  as  ever,  just  as  if  nothing  had  happened. 
In  about  half  an  hour  there  came  on  retching,  but  with  no 
effect ;  soon  after,  it  lost  its  equilibrium,  and  tumbled 
about,  but  got  up  again ;  at  last  shivering  set  in,  and  the 
bird  collapsed  and  flapped  out  its  wings  constantly,  as  if 
trying  in  vain  to  raise  itself,  and  so  continued  for  half  an 
hour ;  breathing  was  now  quick,  but  not  so  distressing  as  in 
the  first  case ;  the  eyelids  opened  and  shut  by  turns ;  the 
respiration  became  a  mechanical  catching  at  the  air,  and 
she  let  her  head  fall  to  the  ground  and  died. 

Post-mortem. — ^The  crop  as  in  the  previous  case;  the 
mucous  membrane  of  the  upper  intestines  thrown  off  easily, 
a  greenish  greasy  coat,  in  the  middle  third,  strongly 
injected;  the  lower,  of  the  normal  colour.  Kidneys  and 
liver  as  in  Case  1.  The  veins  leading  from  the  intestines 
contain  dark  blood  in  abundance ;  heart  full  of  liquid  dark 
red  bloody  lungs  hyperaemic,  yet  the  trachea  uninjured. 


Physiological  Action  of  Acetate  of  Copper,         265 

c.  I  injected  a  well-fed  pigeon^s  crop  with  1  gramme  of 
neutral  Acetate  of  Copper  dissolved  in  15  grm«  of  water. 
The  head^  bill^  and  eyes  betrayed  discomfort^  by  constant 
movements;  shortly  commenced  efforts  at  vomiting  and 
convulsions,  soon  followed  by  actual  vomiting.  The 
breathing  was  accelerated  and  distressing ;  yellowish-white 
faeces  passed,  then  liquid,  and  then  green  containing 
copper ;  respiration  became  audible,  the  bird  shivered,  sat 
on  the  ground,  and  jerked  with  its  wings ;  this  I  took  for 
convulsions,  because  this  symptom  was  constantly  aggra- 
vated, so  that  a  cramp-like  jerking  of  the  muscles  was 
unmistakable,  especially  those  of  the  wings. 

The  eyes  were  fixed  and  the  head  often  quivered ;  this 
bird  snatched  at  the  air ;  and,  quite  exhausted  from  want  of 
breath  and  from  shivering,  let  its  head  sink  and  died,  two 
.hours  after  the  injection  of  the  poison. 

Post-mortem. — Crop,  oesophagus,  and  stomach  as  in  the 
two  first  cases.  Mucous  membrane  of  the  intestines  quite 
eroded  and  softened,  and  peels  off  in  bluish-green  bits, 
especially  in  the  duodenum.  Kidneys  and  liver  hypersemic, 
the  envelope  (peritoneum)  of  both  greenish.  The  bronchial 
tubes  look  green,  as  well  as  their  continuation  imbedded  in 
the  lungs.  The  inner  surface  of  the  larynx  much  eroded, 
with  a  bluish  membrane  sticking  to  its  inner  parietes. 
The  blood-vessels  of  the  brain  exhibited  much  blood,  whilst 
the  brain  itself  was  normal.  The  investing  membrane  of 
the  spinal  cord  less  full  of  blood  than  in  the  previous  cases. 
Fluid  dark  red  blood  in  the  heart ;  which,  on  long  exposure 
to  the  air,  became  bright  red. 

d.  A  fourth  pigeon,  after  its  oesophagus  was  tied  and  2 
grammes  of  Acetate  of  Copper  in  18  grammes  of  water  were 
injected  into  the  crop,  remained  quiet  for  about  five 
minutes,  when  a  gurgling  of  fluid  was  heard  in  the  crop ; 
the  breathing  at  once  became  diflScult,  so  that  the  whole 
body  began  to  shiver ;  this  grew  worse  and  worse,  and  she 
seemed  anxious  to  vomit,  but  did  not  succeed.  Hard 
fseces  then  passed.  The  bird  kept  catching  at  the  air,  the 
eyelids  opened  wide,  with  the  pupils  fixed  and  motionless. 
The  whole  body  shivered;  a  convulsive  twitching  of  the 


266         Physiological  Action  of  Acetate  of  Copper, 

muscles  was  perceptible,  and  also  an  alternate  dilatation 
and  contraction  of  the  pupils;  respiration  kept  getting 
weaker^  the  muscles  seemed  quite  paralysed.  The  pigeon 
fell  on  its  side,  and  soon  died. 

Post-mortem, — Throat  somewhat  reddened,  contained 
mucus ;  oesophagus  bore  no  signs  of  erosion  or  inflamma* 
tion,  crop  filled  with  blue  liquid.  The  part  of  the 
oesophagus  above  the  ligature  yellowish-white  outside, 
without  any  particular  injection  of  the  vessels.  The  glan- 
dular and  muscular  stomach  filled  with  a  greenish-blue 
fluid,  but  nowhere  inflamed  or  eroded.  The  intestinal 
canal  covered  with  numerous  dichotomised  vessels,  and  is 
greenish  blue;  its  inner  coat  showed  no  inflammation. 
The  kidneys  when  cut  open  emitted  dark  red  blood ;  so  also 
the  spleen.  Liver  very  dark,  containing  much  blood ; 
heart  filled  with  black  fluid  blood,  the  coronary  vessels 
quite  distended  with  blood.  Lungs  scarlet  and  very  full  of 
blood  when  cut  up;  the  membranes  of  the  brain  covered 
with  vessels  tolerably  full;  on  cutting  through  the  brain 
specks  of  blood  are  seen,  and  the  sheaths  of  the  spinal  cord 
also  contain  much  blood. 


2.  RabbUs. 

From  the  experiments  carefully  tried  upon  two  rabbits 
the  following  instructive  symptoms  presented  themselves  v 

a.  A  rabbit  was  subcutaneously  injected  with  0*06 
gramme  of  Acetate  of  Copper  dissolved  in  4  grammes  of 
water  for  five  days  in  succession.  No  symptoms.  From 
sixth  to  eleventh  day  1^  centigramme.  No  symptoms. 
From  twelfth  to  fifteenth  day  '3  centigrammes.  The 
animal  has  lost  its  sprightliness ;  it  steps  slowly  and  with 
difficulty,  generally  remains  sitting  in  one  place,  and  seems 
to  have  lost  appetite,  whilst  it  drinks  more.  From  sixteenth 
to  twenty-second  day  6  centigrammes.  Its  pace  becomes 
still  more  difficult,  almost  dragging  the  hind  feet;  daily 
amount  of  urine  diminished,  and  traces  of  copper  discovered 
in   it  by  testing;    much   thirst   and   sleepiness;   sudden 


Phyriohffical  Action  of  Acetate  of  Copper.         267 

starting  and  sbivering  all  over.  Two  days  after  12  centi- 
grammes daily ;  extreme  langour  and  emaciation.  On  the 
upper  part  of  each  fore  leg^  close  to  the  chesty  two  boils 
are  visible,  and  can  be  felt  as  ronnd  doughy  bodies,  clearly 
defined;  the  right  hind  foot  drawn  in  spasmodically,  the 
left  dragging  behind.  Traces  of  albumen  in  the  urine, 
which  is  scanty.  On  the  twenty-fifth  day  18  centigrammes 
in  1  gramme  of  water  injected.  Walking  very  wearisome ; 
left  fore  foot  drawn  inwards  and  disabled ;  total  loss  of 
appetite ;  shivering  all  over ;  here  and  there  more  severe, 
like  an  ague  fit ;  head  always  moving  from  before  back- 
wards ;  respiration  very  quick ;  faeces  no  longer  compact 
and  globular,  but  soft  and  long ;  albuminous  urine.  On 
the  twenty-sixth  day  24  centigrammes.  The  animal  lay  with 
chest  and  belly  on  the  ground ;  the  head  sinks,  but  is  raised 
again  now  and  then  and  falls  back  to  the  ground ;  respira- 
tion very  rapid,  mechanical  convulsive  gasping;  constant 
jerking  and  shivering  of  the  whole  body ;  eyes  closed  ;  no 
urine.  On  the  twenty-seventh  day  I  found  it  lying  dead  in 
the  same  position,  only  rather  turned  to  the  right,  in  a 
semifluid  green  pus  which  it  had  probably  thrown  up,  whilst 
the  hind  feet  and  belly  were  wet  with  liquid  faeces. 

Post-mortem^ — Under  the  skin  where  the  punctures  were 
made  there  were  dark  green  hard  cicatrices  adhering  to  the 
muscle ;  the  two  boils  on  the  fore  legs  exhibited  a  green 
mucous  mass,  an  exudation  of  the  inflammation  caused  in 
the  skin  and  cellular  tissue  by  the  injection;  muscles 
anaemic  and  thin;  lungs  hyperaemic  in  a  slight  degree; 
heart  fall  of  clotted  blood,  with  the  septum  of  the  left 
ventricle  four  times  as  thick  as  the  right ;  liver  very  large, 
full  of  blood,  and  very  firm ;  gall  bladder  full,  and  dark 
green.  The  scalpel,  in  dividing  the  liver,  crepitated,  so 
that  one  was  clearly  aware  of  meeting  with  some  resistance, 
with  a  crackling  sensation,  as  if  the  scalpel  was  passing 
over  a  number  of  slender  threads  which  had  to  be  cut 
through ;  the  surface  of  the  section  was  uneven,  as  was  still 
more  manifest  from  treatment  with  nitric  acid;  stomach 
and  intestines  normal;  the  former  small,  and  moderately 
full  of  food ;   duodenum  stained  green  with  bile ;   caecum 


268         Physiological  Action  of  Acetate  of  Copper. 

fall  of  thin  fseces;  rectam  quite  empty;  bladder  mode- 
rately fall ;  spleen  Tery  hypersemic,  small,  and  shaped  like 
a  leech.  Kidneys  externally  pretty  large,  not  particolarly 
fall  of  blood  when  cat ;  showed  under  a  microscope  that 
the  arinary  canals  were  filled  with  an  immense  quantity  of 
little  granules,  which  were  fatty  degenerations  of  epithelimn 
detached  from  the  canals;  the  membranes  of  the  spinal 
cord  were  somewhat  hypersemic,  those  of  the  bndn  normal. 

b,  A  rabbit  was  subcutaneously  injected  with  8  milli- 
grammes of  Acetate  of  Copper.     No  symptoms.     Next  day 
10  milligrammes;  on  three  following  days  1^  centigramme ; 
on  the  last  of  these  days  there  was  a  jerking  of  the  fore 
foot  during  and  little  after  the  injection.     From  the  sixth 
day  to  the  ninth  3  centigrammes ;  the  animal  is  surprisingly 
quiet,  keeps  sitting  in  the  same  place,  and  eats  very  little. 
From    tenth   to  sixteenth   6  centigrammes.     Emaciation, 
little  appetite,  much  thirst ;  great  weariness,  slow  walking, 
traces  of  copper  in  the  urine.     The  two  next  days  12  centi- 
grammes in  1  gramme  of  water ;  the  anterior  joint  of  the 
left  fore  foot  convulsively  drawn  in,  so  that  the  animal 
walks  on  this  side  as  if  it  were  broken ;  the  attempt  to 
straighten  it  is  difficult,  and  it  immediately  resumes  its 
contracted  form.      On  the  left  upper  arm,   close  to  the 
chest,  a  boil  is  to  be  felt ;  the  anterior  joint  of  the  left  hind 
foot  is  drawn  back,  and  this  foot  drags  in  walking ;  faeces 
not  so  compact  as  before,  but  more    doughy ;    urination 
suppressed ;  the  urine  was  rendered  turbid  by  nitric  acid. 
Nineteenth  day  18  centigrammes.     Extreme  emaciation ; 
the  animal  keeps  sitting  in  the  same  place,  and  turns  away 
from  food ;  inspiration  frequent ;  often  stretches  its  neck 
upwards   as   if    catching   at    the    air.       Twentieth     day 
24   centigrammes    given.      Want    of    breath    is     clearly 
indicated  ;  the  thorax  rises  and  falls  so  quick  that  it  looks 
like  a  shivering  of  the  whole  body ;    the  head  is  raised 
aloft  and  falls  again  to  the  ground ;  the  right  fore  foot  is 
stretched  forwards,  the  animal  falls  with  its  chest  on  the 
ground,  rocks  from  side  to  side,  and  dies  on  the  left  amidst 
frequent  jerkings. 

Post'mortem. — Skin  and  muscle  in  the  same  plight  as  in 


Physiological  Action  of  Acetate  of  Copper.         269 

the  first  case ;  lungs  on  the  two  lower  lobes  normal ;  the 
other  lobes  externally  dark  red^  almost  brown ;  when  cut 
through  a  little  blood  issued^  but  more  froth  and  serous 
fluid ;  heart,  in  both  ventricles  and  both  auricles^  contained 
congealed  black  blood ;  the  septum  of  the  left  ventricle  was 
notably  thicker  than  that  of  the  right.  The  vessels  of  the 
retina  much  injected.  The  stomach,  containing  some 
remains  of  food,  exhibited  nothing  abnormal,  nor  did  the 
intestines,  which  were  full  of  liquid  faeces ;  liver,  not 
particularly  large  and  hypersemic,  showed  as  in  the  first 
case ;  the  scalpel  met  with  resistance  in  cutting  it,  accom- 
panied by  crepitation,  and  the  external  appearance  led,  as 
in  the  above  instance,  to  the  conclusion  that  the  liver  was 
certainly  '^  granulated /'  spleen  somewhat  larger  than  in 
the  first  case;  bladder  not  overfull.  The  membranes  of 
the  spinal  cord  were  here  also  hypersemic,  and  the  cord 
itself  on  section  showed  insignificant  specks  of  blood; 
kidneys  somewhat  larger  as  to  external  form,  and  when  cut 
open  not  so  pale  as  in  the  first  case ;  still  there  was  the 
same  evidence  in  the  urinary  canals  of  cells  subjected  to 
fatty  degeneration. 

3.  Dogs. 

As  I  could  not  myself  institute  experiments  and  observa* 
tions  for  want  of  subjects,  I  adduce  some  instances  to 
complete  my  subject,  which  lead  to  conclusions  respecting 
the  characteristic  phenomena  of  the  action  of  Acetate  of 
Copper, 

a.  Drouard  gave  a  dog  15  grains  of  this  salt ;  in  half  an 
hour  he  made  vain  attempts  to  vomit,  and  passed  much  by 
stool  day  and  night;  great  weakness  preceded  his  death, 
which  followed  in  twenty-eight  hours.  Stomach  exhibited 
ecchymosis  here  and  there ;  duodenum  hypersemic ;  in  the 
jejunum  extensive  extravasation. 

b.  He  injected  \  grain  into  the  jugular  of  a  strong  dog  ; 
at  the  moment  movements  of  chewing  and  swallowing ;  in 
a  quarter  of  an  hour  he  vomited.  On  the  third  day  he 
kept  quiet  and  languid,  and  his  limbs  appeared  generally 


270         Physiological  Action  of  Acetate  of  Copper. 

paralysed.     Fourth  day  he  died  with  violent  rftle  and  diffi- 
culty of  breathing. 

c.  Hillefield  gave  a  dog  1  scrapie  JSs.  viride  in  water ;  at 
once  violent  retching  set  in^  with  frequent  urination.  In 
an  hour  and  a  half  he  ate  flesh,  and  soon  after  drank 
water ;  in  two  hours  retching  and  convulsive  breathing  set 
in ;  the  next  three  days  passed  with  constant  retching  and 
spasmodic  cough. 

d.  He  gave  16  grains  to  a  dog,  vomiting  of  greenish 
mucus  at  once  set  in ;  in  a  quarter  of  an  hour  he  breathed 
with  difficulty  and  pain,  and  whined  at  times ;  in  half  an 
hour  he  lay  stretched  out,  hardly  breathing ;  began 
retching  and  soon  after  died. 

Post-mortem. — Lung  here  and  there  sugillated,  full  of 
mucus  and  air ;  heart-blood  black,  stomach  full  of  food, 
blackish-red  inside  and  contracted  in  small  plaits,  intestines 
healthy. 

e.  Orfila  made  several  experiments  with  Acetas  cupri  on 
various  dogs,  and  found  that  frequent  vomiting  of  a  blue 
mass,  followed  by  ineffectual  retching,  difficult  breathings 
irregular  quick  pulse,  and  often  general  paralysis  followed ; 
almost  always  the  animals  suffered  from  violent  jerking 
movements  a  few  moments  before  death ;  general  stiffness 
took  place,  with  tetanic  kicks  and  mucus  at  the  lips. 
Immediately  after  death  the  muscles  were  no  longer  irri- 
table; mucous  membrane  of  the  stomach  lined  with  a 
bluish  hard  almost  wrinkled  coat ;  under  this  it  was  rose 
coloured;  trachea  and  its  branches  full  of  white  froth, 
lungs  crepitant,  spotted  with  rose  colour. 


From  these  experiments  on  animals  of  three  species,  of 
different  age  and  sex,  in  most  varied 'ways  and  doses  and 
from  the  consideration  of  the  symptoms  of  men,  where 
through  neglect  of  cooking-vessels  or  suicidal  intention,  the 
deleterious  effects  of  verdigris  were  brought  to  light,  the 
following  properties  may  be  inferred. 

1.  The  neutral  Acetate  of  Copper  certainly  attacks  the 
abdominal  ganglia  of  the  sympatheticus  and  vagus ;  affects 


Physiological  Action  of  Acetate  of  Copper,         271 

the*  stomach,  liver,  and  spleen;  causes  violent  thirst, 
nausea,  loss  of  appetite,  emaciation,  retching,  and  actual 
vomiting ;  pain  in  the  bowels,  colic,  diarrhea,  suppressed 
secretion  of  bile,  and  biliary  stasis  proceeding  to  cirrhosis 
of  the  liver  and  jaundice  (I,  g  and  A). 

2.  Its  action  on  heart  and  lungs  is  such  that  the 
muscles  of  the  left  side  of  the  heart  become  hypertrophied 
after  long  action  of  the  poison,  though  only  in  a  moderate 
d^;ree ;  the  kidneys  are  also  attacked,  so  as  to  exhibit  in  a 
comparatively  short  time  albumen  and  deficiency  of  urine. 
In  this  respect  Cuprum  is  allied  to  Arsenicum  and  Aurum ; 
whilst  Phosphofrus  produces  albuminous  urine  by  congestion 
of  the  right  heart.  From  the  post-mortem  results  in 
the  lungs  (which  were  but  slightly  hypersemic  and  often 
quite  normal),  no  conclusion  can  be  formed  of  any  specific 
action.  As  to  the  symptoms  of  dyspnoea,  tightness  of  the 
chest,  hindrance  of  breathing  even  to  sufibcation,  catching 
at  the  air,  convulsive  ^respiration,  frequent  and  audible, — 
all  these  must  be  regarded  as  the  effect  of  Cuprum  on 
the  innervation. 

8.  The  main  effect  of  the  poison  is,  however,  certainly 
the  seizure  of  the  motor  nerves ;  convulsions  of  the  limbs, 
with  reactionary  languor,  weakness  and  paralysis  of  them 
and  of  the  whole  body ;  also  cramp  in  the  abdomen  and  its 
muscles;  on  the  brain  it  seems  to  have  no  influence,  at 
least  not  in  all  cases;  but  it  has  certainly  on  the  spinal 
cord  and  its  investing  membrane,  which  were  found  partly 
altered ;  in  this  last  respect  it  is  allied  to  Stramonium, 
Atropine,  and  Argent,  nitricum,  but  quite  opposed  to 
Arsenicum,  which  attacks  the  nerves  of  sensation. 

*  The  symptoms  of  parts  in  actual  contact  with  the  poison,  as  stomach, 
intestines,  tztemal  skin,  &c.,  cannot  be  reckoned  here  as  characteristic 
symptoms,  since  they  appeared  in  greater  or  less  intensity,  accor<ting  to  the 
power  of  resistance  in  the  several  animals,  and  in  proportion  presented  degrees 
of  local  action  varying  from  mere  detachment  of  the  epithelium  to  erosion  and 
gangrenous  infliunmation. 


272 


BINZ  AND   ANSTIE  ON  BROMIDE    OF 

POTASSIUM. 

The  articles  by  Binz  and  Anstie  in  the  January  number 
of.  the  Practitioner  are  very  instructive.  After  the  great 
experience  with  it  of  late  in  the  imperfect  and  unsystematic 
way  usual,  it  appears  to  be  a  salt  of  not  great  power^ 
probably  not  more  active  as  a  poison  than  common  salt ;  and 
its  more  obvious  action  seems  to  be  as  a  mild  narcotic  acting 
chiefly  on  the  reflex  action  of  the  spinal  cord^  with  slightly 
hypnotic  power.  It  is  for  these  purposes  chiefly  given 
and  with  the  usual  results  of  a  fashionable  drug  used  by  un- 
scientific^ merely  professional  hands^  at  first  unduly  lauded, 
and  then  producing  the  customary  disappointment.  But 
there  are  some  things  that  remain  and  it  is  singular  to  look 
at  what  these  are.  The  drug  was  first  introduced  by  Dr. 
Locock  on  account  of  its  supposed  primary  action  in  depress- 
ing the  sexual  nerves  and  function.  But  in  Binz^s  paper 
here,  p.  10^  we  find  the  experiments  of  Laborde  thus  narrated. 
He  took  ninety-four  grains  each  time. 

*' Within  an  hour  he  felt  a  general  sensation  of  well- 
being  and  of  calm  which  incited  to  sleep;  the  latter, 
however,  was  but  half  established,  so  to  speak,  and  in  this 
half  sleep  there  soon  came  on,  especially  if  he  was  lying  on 
his  bed^  a  more  or  less  intense  sexual  excitement,  according 
to  the  circumstances — an  excitement  which  was  habitually 
accompanied  by  erection  and  emission ;  this  act,  of  which 
there  is  always  perfect  consciousness,  almost  always  wakened 
him.     .     .  Finally,  sleep  is  definitely  established,  but 

with  more  difficulty  or  less  rapidity  than  when  emission  does 
not  take  place.^' 

To  this  Binz  remarks  only,  ''Thus  K,  br.  is  also  an 
aphrodisiac.     What  manysidedness  !'^ 

And  on  this  Anstie  makes  no  remark  at  all  except 
apparently  inadvertently  in  a  parenthesis  which  is  very 
significant  in  spite  of  him  ;  for,  as  usual,  Anstie  evades  the 
difficult  points  in  pharmaco-dynamics.     He  dares  not  give 


Binz  and  Anstie  an  Bromide  of  Potassium.         273 

the  true  explanation  of  the  many  homosopathic  actions  of 
medicines^  so  he  keeps  discreet  silefnce.  The  conclusion  of 
Binz  is  that  the  whole  therapeutic  action  of  K,  br,  has  been 
exaggerated,  and  that  it  is  of  very  little  value,  and  that 
the  good  it  happens  to  do  is  solely  on  account  of  the  potash 
it  contains.  Hereupon  Anstie  writes  an  article  intended 
to  confute  that  dictum  by  the  English  experience.  The 
main  body  of  this  is,  we  find,  liVtle  more  than  a  transcript  of 
B.  Reynolds'  well-known  articles  on  the  use  of  it  in  epilepsy, 
in  some  cases  of  which  he  pronounces  it  curative  in  doses 
of  four  to  forty  grains  daily.  On  this  Anstie  gives  the 
result  of  the  experience  of  himself  and  Dr.  Hughlings 
Jackson,  and,  alas  1  they  both  agreed  that  neither  of  them 
had  ever  seen  an  example  of  a  cure  of  epilepsy  by  it.  It 
can  mitigate  the  number  and  severity  of  the  fits,  as  anybody 
now  knows,  but  cure  never. 

Both  of  them  have  great  doubts  if  it  has  any  efiect 
as  a  hypnotic  in  the  miscellaneous  forms  of  insomnia. 
Anstie  then  says  for  himself,  ''As  regards  sleeplessness  from 
emotional  causes  {with  the  exception  of  the  insomnia  produced 
by  sexual  excitement  with  exhatistion),  I  am  not  convinced 
on  the  whole  that  K,  br.  is  distinctly  remedial''  (p.  22).'!' 

This  is  very  remarkable  indeed.  The  original  discovery 
of  K.  br.  was  empirical  from  its  calming  aexu^  excitement 
and  the  diseases  arising  from  it,  and  of  course  it  was  assumed 
such  influence  was  from  its  primary  action.  But  now  by 
more  extended  proving  it  turns  out  this  is  one  of  its  true 
specific  actions  and  is  really  homoeopathic.  At  the  same 
time,  the  really  slight  narcotic  action  or  reflex  actions  in  the 
healthy  were  turned  to  account  allopathically,  and  after  twenty 
years'  experience  it  is  confessed  to  have  failed  to  cure  by 
means  of  them ;  whereas  the  only  action  which  still  holds  its 
ground  as  curative,  as  admitted  involuntarily  by  Anstie,  is  the 
homoeopathic  action.  This  is  of  the  more  specific  character 
only  discovered  by  long  proving,  for  the  specific  susceptibility 
is  not  always  developed,  and  thus  the  careless,  unsystematic, 

*  To  the  above  testimony  of  Anstie  may  be  added  what  he  says  on  Nbu~ 
ralgia : — "It  is  singolarly  efficacioas,  bat  in  a  comparatively  limited  nomber 
of  cases ;  the  majority  of  these  are  instances  of  some  form  of  sexual  worry." 

VOL.  XXXII,  NO.  CXXVIII. ^AF&IL,  1874.  S 


274        Binz  and  Anstie  on  Bromide  of  Potassium* 

haphazard  proving  does  not  reach  it.  There  is  another  specific 
action  now  found,  viz.,  the  rash  or  acne  on  the  skin^  and 
on  this  R.  Eeynolds  gives  a  most  significant  remark,  '^  the^ 
rash  or  acne  on  the  skin  which  is  occasionally  seen  is  not 
determined  by  the  quantity  of  the  Bromide  that  is  taken. 
I  have  seen  it  after  a  few  doses  of  five  grains  each,  and  it 
has  been  absent  in  many  cases  where  thirty  grains  have  been 
taken  three  times  daily  for  six  or  even  twelve  months." 

Thus  it  is  not  one  of  the  common  actions  which  may  be 
produced  at  will  by  merely  giving  enough  of  it,  but  it  is  one 
of  the  peculi&r  actions  which  requires  the  presence  of  the 
special  susceptibility  to  bring  it  out— one  of  the  idio-dyna- 
mic  class  as  named  by  Dr.  Madden,  and  it  is  in  them  that 
the  more  specific  curative  actions  of  medicines  lie,  and  as 
such  is  almost  independent  of  dose.  We  have  repeatedly 
verified  the  curative  effect  of  K,  br,  in  this  fofm  of  acne 
to  two  or  three  grain  doses*  Thus  the  only  two  diseases  in 
which  K.  br,  holds  its  ground  as  a  really  curative  drug  are 
the  two  in  which  the  specific  and  homoeopathic  actions  are 
synonymous.* 

Besides  these  two  no  doubt  there  are  other  diseased 
states  in  which  iC.  br.  is  truly  curative,  and  if  they  are 
closely  studied  we  have  no  doubt  they  wiU  be  also  found 
to  be  homoeopathic.  The  analysis  of  Dr.  Clouston's 
experience  in  a  lunatic  asylum  shows  the  merely  palliative 
action  of  the  drug  in  epileptic  fits,  and  no  cure  is  reported, 
although  there  was  some  permanent  amendment  in  some 
cases,  while  others  were  actually  worse  after  the  palliative 
effect  had  subsided. 

To  weigh  the  real  value  of  the  drug  when  used  for  its 
merely  primary  or  allopathic  action  we  need  be  in  no  difficulty* 
We  are  quite  ready  to  acknowledge  the  degree  in  which  it 
may  *^  do  good  '^  to  the  patient  by  calming  refiex  spinal 
irritation  for  the  time  even.  No  doubt  there  are  circum- 
stances where  such  a  drug  may  benefit  the  health  by  warding 
off  the  immediate  evils  of  the  succession  of  fits,  and  in  default 
of  true  cures  this  is  not  a  means  to  be  despised  or  withheld. 
The  best  way  to  picture  the  matter  to  ourselves  is  to  com- 

*  See  vol.  zxTiii,  p.  807,  of  this  Journal. 


On  the  NmveU  inherent  in  German  Homceopathy.   276 

pare  it  to  the  effect  of  a  mild  purgative  like  Rhubarb  or 
Aloes  in  constipation ;  by  meand  of  this  from  time  to  time 
we  can  ward  off  many  serious  evils,  although  we  do  notoure 
the  tendency  to  constipation,  and  in  default  of  that  the 
occasional  purgative  is  a  smaller  evil  than  the  manifold 
secondary  disturbanee  from  inaction  of  the  colon. 

But  we  should  not  be  satisfied  with  that,  and  always  aim 
at  the  radical  and  true  specific  cures.  But  as  long  as  men 
are  hindered  by  subsidiary  personal  motives  from  fairly  and 
philosophically  discussing  all  the  possible  actions^  homoso* 
pathic  as  well  as  other,  of  medicines,  it  is  impossible  that 
there  can  be  any  important  or  philosophical  discussion  of 
the  subject  between  ourselves  and  the  adherents  of  the 
dominant  school.  And  yet  the  time  has  surely  gone  by 
when  our  opponents  can  afford  to  treat  us  as  unworthy  of 
professional  courtesy  when  almost  every  improvement  that  has 
of  late  years  been  effected  in  old-school  therapeutics  has  been 
merely  a  *'  crib  '^  from  the  practice  of  the  school  they  despise 
in  words  but  in  fact  sincerely  admire,  if  imitation  be  'a  sign 
of  admiration. 


ON    THE    NAIVETE    INHERENT    IN    GERMAN 
HOMCEOPATHY.*    A  CRITICAL  MEDITATION. 

By  Dr.  J.  Kafka,  Prague. 

The  attentive  observer  is  sometimes  disagreeably  sur- 
prised when,  in  speeches,  magazine  reports,  new  books,  or 
original  articles,  he  gets  to  hear  or  read  expressions, 
opinions,  and  views  which  are  in  direct  antagonism  with 
the  judgment,  experience,  and  aims  of  the  modern  school, 
betray  a  character  of  mere  childish  innocence,  nay  even  of 
inconsiderate  rashness,  and  expose  themselves,  partly  through 
one-sidedness,  partly  through  false  conclusions,  or  mere 
deficiency  of  the  judicial  faculty ;    and  all  this  from  men 

•  AU^.  Somctop.  Zeiimg,  Bd.  Ixxxvu,  No.  26. 


276    On  the  Natveti  inherent  in  Crerman  Hommopathy, 

at  whose  hands  he  expected  energy,  solidity,  conscientious- 
ness and  scientific  progress ! 

It  is  really  sorrowful  and  disheartening  to  see  how  those 
who  are  rich  in  experience  and  natural  gifts  (and  to  a 
certain  extent  belong  to  the  class  who  gwe  the  tone),  yet 
partly  yenerate  tradition,  partly  disallow,  intentionally  or 
unintentionally,  the  progress  of  modem  times,  get  into 
contradiction  with  themselves,  or  with  the  positive  experi- 
ence of  others,  and  thus  damage,  whether  they  know  it  or 
not,  that  very  homoeopathy  whose  banner  they  fancy  they  are 
waving  aloft. 

In  my  report  of  this  year's  assembly  of  the  Central 
Homoeopathic  Society  at  Vienna  (No.  12  of  this  serial)  I  ex* 
pressed  my  astonishment  that  the  president.  Dr.  Gerstel, 
spoke  in  favour  of  maintaining  the  '*  conservative  stand* 
point "  in  homcsopathy. 

Before  he  reached  this  stage  in  his  peroration  he  had 
expatiated  on  the  ''  value  of  practical  medicine,*'  and  said 
that  it  is  therapeutic  medicine  alone  that  gives  value  to  the 
theoretic  studies,  which  (apart  from  the  collateral  sciences) 
consist  essentially,  mainly,  entirely,  of  nosology  (including 
diagnosis)  and  the  knowledge  of  the  Pharmacopoeia. 

Of  Hahnemann's  own  ^^  Arzneimittellehre  ^'  which  he 
most  truly  called  "  MonumefUum  are  perenmus*^  he  said, 
en  passant,  that  this  treasury  of  science  first  received  its 
infinite  appreciation,  nay  its  very  consecration  to  the  service 
of  therapeutics,  through  the  method  at  the  same  time  dis- 
covered by  Hahnemann  on  the  path  of  experience  and 
observation  how  this  real  knowledge  of  the  action  of  medicines 
should  be  brought  ijito  combination  and  due  appreciation  with 
the  permanent  positive  sciences,  pathogenesy  and  pathology, 
t.  6.,  with  diagnosis,  in  order  to  the  real  cure  of  the 
patients. 

This  practical  point  of  connexion  between  pathology  and 
materia  medica,  this  nucleus  of  therapeutic  science,  is  the 
fundamental  law  of  healing  discovered  by  Hahnemann, 
''  similia  similibus."  It  is,  said  Gerstel,  the  electric  spark 
which  elevates  medicinal  action  to  the  rank  of  curative 
action  in  the  morbid  organism.     So  far  I  am  in  full  accord- 


I 


by  Dr.  J.  Kafka.  277 

ance  with  our  honoured  presideDt ;  for^  as  I  long  ago  sought 
to  make  good,  our  knowledge  of  the  morbific  action  of  the 
medicines  (t.  e.  of  our  materia  medica)  depends  on  our 
knowledge  of  pathology  and  diagnosis ;  because  we  are 
always  directed  to  the  comparison  between  medicinal  and 
natural  diseases,  only  in  order  to  find  out  their  mutual 
resemblances  and  difierences. 

Hence  follows  the  necessity  for  all  unprejudiced  persons, 
who  would  systematically  understand  and  duly  value  the 
homoeopathic  Materia  Medica,  to  be  first  thoroughly  con- 
versant with  those  indispensable  branches,  pathology,  patho- 
genesy,  and  diagnosis,  i.  e.,  they  should  be  first  regularly 
trained  and  accomplished  physicians,  and  then  take  homoeo- 
pathy in  hand.  In  his  further  deductions  respecting  the 
importance  and  value  of  our  Materia  Medica,  and  of  the  law 
of  similitude,  which  are  announced  as  the  only  actual  bases 
of  homoeopathic  curation.  Dr.  Gerstel  at  last  comes  to  the 
conclusion  '^that  we  retrograde  so  much  the  more, 
under  the  reproach  of  ignorance  and  indecision,  in  propor- 
tion as  we  accommodate  ourselves  to  the  views  of  the  domi- 
nant school,  and  are  willing  to  give  up  the  Mat.  Med. 
Pura  as  the  foundation  of  our  curative  indications,  in  order 
to  substitute  in  exchange  the  evidences  formulated  in  clinical 
practice." 

These  words  of  Dr.  Weber  at  Dursburg  (compare  Bd.  86 
Allff.  Horn.  Zeit.,  No.  4),  on  which  Gerstel  supports  him- 
self and  which  he  sets  forth  as  his  own  view,  stand  in  glaring 
contradiction  to  his  own  propositions  above  quoted,  and 
form  as  it  were  k  parody  on  my  *'  progressive  tendencies,''  in 
which  I  defined  the  physiological  school  as  the  very  heart 
and  soul  of  the  totality  of  auxiliary  sciences  which  embrace 
medicine  as  a  whole,  and  I  incessantly  stood  up  for  its 
appropriation  by  us.  According  to  my  idea,  the  physio- 
logical school  is  the  very  groundwork  of  the  whole  circle 
of  theoretic  medicine,  and  is  the  common  property  of  all 
therapeutic  schools ;  who,  all  alike,  seek  to  utilise  it  for 
their  curative  purposes,  according  to  their  respective 
judgments,  principles,  and  views.  It  ought  not  to  be 
identified  with  allopathic  therapeutics    in   particular,  for 


278    On  the  Naheie  inherent  in  Gemuin  Hommqpathy, 

allopathy  represents  not  only  the  densest  conseryatism,  the 
chronic  dependence  on  tradition  and  prejudice,  self-satis- 
faction with  delusive  effects,  with  nnprofitable  narcotising, 
depletion,  and  enfeebling  of  the  constitution,  &c.,  but  she 
is  '  to  the  highest  degree  intolerant  towards  us  "  into 
the  bargain ;"  and,  in  her  grandeur  and  high-mightiness, 
wilfully  overlooks  our  splendid  results,  wHich  she  explains 
without  exception  as  *'  spontaneous  recoveries/'  It  never 
could  enter  the  thoughts  of  any  educated  and  scientific 
homoeopath  to  lean  on  the  '^  indications  "  of  allopathy  and 
value  them  for  the  purposes  of  our  therapeutics.  The 
physiological  school  has  nothing  in  common  with  these 
excrescences  of  the  old  medicine ;  but  teaches  us  to  know 
the  natural  laws  under  which  the  various  functions  of  the 
human  body  take  place,  gives  us  an  insight  into  the 
phenomena  which  occur  in  health  and  disease,  and  leads 
us  on  those  ways  which  show  the  possibility  of  a  good  re- 
sult, both  in  a  physiological  point  of  view  and  also  that  of 
pathology  and  organic  chemistry. 

These  are  the  true  acquisitions  of  the  physiological  school, 
the  indisputable  signs  of  progress  in  every  sense,  which  the 
hommopathic  physician  has  to  appropriate  to  himself^  and  to 
utilise  for  his  curative  purposes.  These  alone  have  I  tried 
to  avail  myself  of  in  my  treatment ;  and  have,  from  this 
true  standpoint,  ranked  homoeopathy  with  the  physio- 
logical school,  not  with  the  allopathic  therapeutics. 

Unfortunately,  there  is  still  a  great  mistake  prevalent  as 
to  the  meaning  of  the  "  Physiological  school,'^  by  which 
expression  many  of  us  understand  allopathy  itself  I  Where* 
fore  there  were  many,  and  even  the  late  highly  gifted 
Trinks,.who  were  alarmed  at  the  title  "homoeopathic  treat- 
ment on  the  foundation  of  the  physiological  school,'^  by  which 
I  understand  not  allopathy,  but  the  newest  advance  of 
recent  times  in  the  sciences  that  lend  their  aid  to  universal 
medicine.  Unfortunately,  my  honoured  friend  Oerstel 
belongs  to  the  category  of  those  who  are  caught  by  this 
error,  otherwise  he  would  not  possibly  have  quoted  the 
above  words  of  Weber's  with  approbation. 

Naif  in  the  highest  degree  seems  to  me  the  grand  finale 


by  Dr.  J.  Kafka.  279 

of  Dr.  Gersters  gala-speech,  in  which  he  emphatically  saya, 
^  The  newer  researches  of  medical  science  ought  to  accommo- 
date themselTes  to  homoeopathy ;  they  ought  not  to  pay 
homage  to  their  actual  progress  in  homoeopathy,  and  they 
ahonld  not  assume  a  conservative  attitude  towards  her  V^ 
The  newest  researchea  in  medical  science  are  purely  object 
tive ;  they  follow  no  therapeutic  direction,  but  simply  attend 
to  the  matter  on  which  they  are  treating.  Much  does 
pathological  anatomy  trouble  itself  about  curing  the 
^'  subject  V*  If  it  ever  does  so,  it  is  in  general  only  to 
expose  the  blunders  of  the  dominant  therapeutic  school^  as 
was  the  case  long  ago  in  Berlin,  Vienna,  Prague,  and  even  in 
London  and  Paris,  where  the  clinical  professors  regularly 
found  themselves  more  or  less  on  a  warlike  footing  with 
the  post-mortem  class.  The  physiologist,  the  histologist, 
the  microscopist,  the  chemist,  nay  even  the  pathologist,  the 
biologist,  the  epidemiologist,  &c.,  follow^  thetr  own  path 
without  any  regard  to  curation.  On  the  contraiy  it  is  the 
necessany  task  of  therapeutics  to  estimate  precisely  the 
lessons  of  these  departmental  sciences,  and  to  utilise  them 
for  their  own  curative  purposes.  That  method  of  treatment 
alone  rests  on  the  modern  standpoint,  and  possesses  stability 
which  appropriates  the  lessons  of  universal  medicine,  and 
supports  itself  on  them,  not  on  tradition  or  caprice. 

Much  we  care  whether  our  opponents  are  giving  up  their 
conservative  standpoint  or  sticking  to  it  I  We  have  to  care 
for  ourselves  and  our  future,  for  the  permanence,  the  diffu- 
sion, and  genuine  scientific  development  of  homoeopathy. 
If  we  abide  on  the  old  standpoint  handed  down  to  us  by 
Hahnemann,  without  sharing  the  profits  of  the  modern 
acquirements  in  pathology,  physiology,  nosogeny,  diagnosis 
with  all  its  aids,  microscopy,  &c.,  then  the  future  of  homoeo- 
pathy is  very  questionable,  and  its  recognition  by  the 
scientific  world  can  never  be  expected.  As  long  as  the 
psora,  metastasis,  and  dynamization  theories  keep  flitting 
about  in  our  brains,  so  long  are  we  occupying  ourselves 
merely  with  the  outer  coverings  of  the  symptoms,  and  not 
paying  at  the  same  time  due  regard  to  the  pathological 
processes,  and  so  long  are  we  seeking  power  in  the  smallness 


280    Oft  the  Natveie  Inherent  in  Gertnan  Hamaopathy. 

and  DOt  in  the  snitability  and  correct  choice  of  the  doses ; 
on  the  other  hand,  as  long  as  we  do  ,not  occupy  ourselves 
with  the  cognisanoe  and  differential  diagnosis  of  the  diseases 
and  only  cultivate  that  of  the  remedies,  so  long  are  we  not 
justified  in  announcing  our  therapeutic  system  as  a  rational 
one,  intelligible  and  accessible  to  all  educated  physicians. 
Homoeopathy  groans  under  dogma  as  well  as  under  con- 
servatism ;  she  sighs  under  the  pressure  of  one-sidedness, 
and  gasps  under  the  shackles  of  restriction ;  nor  will  she 
ever,  in  such  ''  form ''  as  this,  be  able  to  lay  claim  to  uni- 
versal esteem  and  recognition. 

Conservatism  is,  as  Dr.  Oerstel  described  it,  the  death- 
knell  of  homoeopathy  I  The  old  wHl  die  off  one  by  one, 
and  the  young  will  turn  away  with  aversioQ  from  our 
method,  glorious  and  blessed  as  it  is.  The  young  are  other* 
wise  led  and  otherwise  schooled  than  by  conservatism.  We 
must  work  and  live  amongst  the  principles  of  modem  medi^ 
cine  as  a  whole,  and  turn  them  to  account  far  our  doctrine. 
That  is  what  I  understand  by  ^*  Progress  ;**  for  I  am 
incessantly  pressing  it  on  my  homoeopathic  colleagues  that 
it  is  only  by  progress  that  our  method  of  cure  will  ever 
grow  in  vitality,  and  thus  be  in  a  condition  to  maintain 
itself  for  the  coming  generation,  to  overspread  the  wide 
world,  and  dispense  blessings  to  its  utmost  limits. 


281 


ON  CERTAIN  PATHOLOGICAL   POINTS  OF 

INTEREST. 

By  Edward  T.  Blake^  M.D.,  of  Reigate. 

(Read  beftxre  the  British  HomcBopathic  Society.) 

I.  Sublingual  Ulceration  in  Hooping-coUgh. 
II.  F)requency  of  Follicular  Pharyngitis, 
III.  jEtiokjigy  of  Sunstroke  and  Hay-fever. 

» 
Mb.  President  and  GEKTLEMEN,-^It  is  my  purpose  first 

to  consider  a  peculiar  pathological  condition  coexistent* 
with  a  very  ordinary  disease  always  endemic  in  some  part 
of  this  country^  which  has^  strange  to  say^  escaped  the 
observation  of  physicians  till  within  a  comparatively  recent 
period.  I  allude  to  ulceration  beneath  the  tongue  occur- 
ring in  the  course  of  hooping-cough. 

You  are  aware  that  MacCall  has  pointed  out  the  existence 
of  the  sublingual  sore  of  pertussis.  The  observation  was 
made  during  the  winter  of  1869-70,  when  MacCall  found 
ulceration  present  in  111  out  of  252  children  attacked 
with  hoopingi^cough,  t.^.,  in  more  than  44  per  cent.  The 
affection  varied  in  degree  from  a  mere  abrasion  to  a  deep 
fissure  with  a  grey  or  yellowish  surface^  and  often  bleeding 
daring  or  after  a  paroxysm.  In  105  of  the  111  it  was 
situated  in  front  of  the  frsenum ;  in  4  out  of  the  other  6  its 
varying  position  was  accompanied  by  some  abnormal  dis- 
position of  certain  teeth. 

He  considered  it  to  be  due  to  the  rubbing  of  the  tongue 
against  the  latter  in  the  act  of  coughing.  He  looks  upon 
it  as  a  valuable  diagnostic  sign  in  cases  where  the  cough  is 
not  heard  by  the  physician.* 

Unfortunately  for  the  probability  of  the  explanation 
afforded  by  Dr.  MacCall^  children  rarely  cough  with  their 
tongues  extruded^  and  it  is  quite  an  anatomical  impossibility 

•  Glasgow  Medical  Journal,  1871,  iii,  172. 


282      '    On  certain  Pathological  Pointn  of  Interest, 

to  bring  the  frsenam  into  contact  with  the  teeth.  Dr. 
MacCall  was  mistaken  when  he  hailed  his  observation  as 
a  discoverjTi  for  as  early  as  the  year  1844  the  association  of 
these  phenomena  was  observed  and  discussed  by  Amelung, 
Brach,  Braun,  Leirsch,  Schmidt,  Zitterland^  and  others. 
Then  come  Gamborini's  observations,  and  many  other 
writers  on  this  subject  followed  in  his  wake ;  chief  amongst 
them  may  be  named  Messrs,  Charles  and  Bouchut.*  I 
have  said  that  MacCall  thinks  the  ulceration  useful  in 
differentiating  this  disease ;  in  my  own  experience  the 
sublingual  ulcer  is  of  too  uncertain  occurrence  to  be  a 
diagnostic  sign  of  much  value.  In  the  two  towns  Reigate 
and  Bedhill  I  had  last  year  6  cases  of  this  tedious  disorder^ 
1  only  had  the  nicer ;  it  was  as  large  as  a  pea ;  it  had  a 
'  yellow  base  and  was  seated  in  the  centre  of  the  frsenum. 
During  the  present  winter  18  cases  have  up  to  this 
date  fallen  to  my  share ;  of  these  again  8  only  have  exhibited* 
ulceration  of  the  fnenum,  2  others  had  ulceration  of 
lips  and  tongue.  I  should  much  like  to  hear  the  results 
of  your  own  observations  on  this  point.  Apart  from 
its  pathological  interest,  to  the  physician  who  employs  the 
symptomatic  clue  to  thread  the  intricate  labyrinth  of 
Therapeia,  when  present,  this  sign  will  lead  him  to  a  greater 
accuracy  in  the  selection  of  his  remedy.  He  will  think  of 
such  medicaments  as  Agaricus,  Bovista,  Carb.  veg.  Causticum, 
Graphites,  Kali  carb,^  Lycopodium,  Natrum  Carbonicum, 
Nitric  add,  Nux  moschata.  Phosphorus,  Bichromate  of 
Potash^  and  Iodine,  including  its  potassic  and  mercurial 
compounds.f     These  have  been  observed  to  produce  sub- 

•  Boachnt,  BuU.  de  VAcad,  de  Paris,  1858-9,  et  J<mr,J%r  Kinder  Kramk- 
heiien,  1866-6,  et  TraiU  Prat,  de  Mcdad.  dee  Nouveau-iUs.  Charles,  Dee 
UleeraHone  de  la  LoHffue  dame  la  CoqmeUiehe;  also  in  art.  "  Coqueluclie*" 
2hMe.  Diet,  de  MSd,  et  de  Chirurff,  I  am  indebted  to  my  friend  Dr.  Cooper 
for  the  early  literatare  of  this  disease. — ^E.  T.  B. 

t  As  to  the  ordinary  remedies  of  the  disorder  nnder  consideration,  it  most 
have  stmck  all  my  hearers  forcibly  how  lamentably  all  come  short  in  certain 
cases.  I  have  seen  decidedly  better  results  in  the  spasmodic  stage  from 
MephUie  puiorine,  the  flnid  of  the  pole-cat  (for  which  we  are  indebted  to 
Keidhard),  than  from  the  time-hononred  bnt  uncertain  Droeera,  When 
spasmodic  symptoms  predominate.  Trousseau's  favourite  remedy.  Sulphate  of 
Copper,  is  followed  by  good  results. 


£y  Dr.  Edward  T.  Blake.  288 

lingual  symptoms   in  addition  to  a   cough   more   or  less 
spasmodic  and  continued  in  character. 

Agaricus^  which  gives  under  tongue  symptoms  '^  small 
painful  ulcer,  by  the  side  of  the  fraenum  of  the  tongue 
on  the  ninth  day.  After  18  coryza  symptoms  we  have  as 
regards  resemblance  to  the  cough  of  pertussis  :  "  frequently 
returning  sensation  of  tickling  in  the  larynx;  which  induces 
short  and  frequently  repeated  coughing.^' 

Bovista,  We  find,  under  this  rarely-used  medicine,  ''  red, 
little  spot  on  the  firamum  lingua^  which  is  painful  to  the 
touch.*'  There  are  cough  symptoms;  but  they  belong 
essentially  to  the  pharynx  and  occur  accordingly  in  the 
morning. 

Carbo  eegetabHis  has  been  employed  afl  a  remedy  in  the 
course  of  pertussis  \  we  find  ''  crampy  pain  in  the  left  side  of 
the  root  of  tongue/' 

There  are  28  coryza  symptoms. 

Of  the  68  symptoms  under  **  throat  and  respiratory 
organs/'  one  is  '^  with  retching ''  and  one  with  "  vomiting 
and  retching,  aggravated  in  the  evening/' 

Under  CauHicum  we  have  '^  soreness  upon  and  under 
tongue  and  in  palate/'  After  16  *^  coryza  symptoms  "  we 
find  under  larynx : — *'  Cough  and  retching  with  difiSculty  of 
breathing ;  frequent,  dry,  short,  and  hacking  cough,  rarely 
accompanied  by  a  discharge  of  mucus;  dry,  hollow  cough, 
five  or  six  fits  at  a  time,  with  a  feeling  of  soreness  in  the 
interior  of  the  larynx  in  a  space  like  a  band,  every  fit  of 
cough  causing  a  pain  and  almost  arresting  the  breathing/' 

Graphites  gives  '*  burning  vesicles  on  the  lower  surface  of 
the  tongue,"  and  ''whitish,  painful  ulcer  on  the  lower 
surface  of  the  tongue/' 

Plumbago  was  credited  by  Hahnemann  with  the  power 
of  producing  no  less  than  80  symptoms  of  ''  catarrh  "  and 
''  coryza,''  besides  5  different  ''  coughs,"  none  of  which, 
however,  resembles  the  classic  cough  of  pertussis. 

Kali  carbonicum,^  we  have  a  much  more  promising  remedy, 

*  Becker,  of  Muhlhansen,  gives  a  rather  singular  but,  I  fear,  not  very 
practical,  indication  for  the  employment  of  this  remedy  in  pertussis,  viz., 
pityriasis  over  npper  extremities  and  scalp,  with  dry  hair.    C.  Heriug  holds 


284  On  certain  Pathological  Points  of  Interest, 

one  indeed  that  already  holds  a  post  in  onr  programme  of 
treatment  of  pertussis.  Its  proving  gives  *'  soreness  of  the 
frtenutn  lingtut*^  [the  soreness  is  produced  apparently  by  a 
vesicle,  for  the  characteristic  buccal  symptom  is]  *'  vesicle 
with  burning  pain/' 

There  are  18  ''  coryza  "  symptoms,  and  when  I  tell  you 
that  there  are  over  half  a  hundred  ''  cou^h  **  symptoms, 
you  will  pardon  my  not  quoting  them.  Suffice  it  to  say 
that  one  of  those  symptoms  is  **  accompanied  by  nausea ''  and 
two  are  with  *'  vomiting ;"  resembling  so  far  the  especial 
explosion  of  hooping-cough. 

Lycopodium  presents,  in  its  proving,  a  slight  resemblance 
to  the  phenomena  of  pertussis  :  **  ulcer  under  the  tongue, 
being  very  troublesome  when  talking  or  eating.''  There 
are  24  ''  coryza  symptoms ''  [rather  above  the  average  I]  J 
one  only  of  all  the  ''  cough ''  symptoms  presents  reflex, 
gastric  contractions,  '^  titillation  with  cough  with  retching.'' 
(I  do  not  know,  I  must  frankly  confess,  what  to  mak^  of 
a  symptom  like  this :)  '^  nightly  cough  affecting  the  stomach 
and  the  diaphragm  (?  how),  mostly  previous  to  the  rising 
of  the  sun." 

Natrum  carbonicum  has  **  pustule  near  the  frsenum.'^ 
Hahnemann  records  no  less  than  33  catarrhal  symptoms 
under  this  remedy.  They  coincide  with  the  earlier  stages 
of  hooping-cough. 

Nitric  acid,  it  is  well  known,  causes  ulceration  of  the  oral 
cavity  generally.  There  is  quite  the  usual  modicum  of 
*'  coryza "  symptoms,  26  in  fact,  and  they  are  well  pro- 
nounced. This  drug  undoubtedly  enjoys,  like  most  of  its 
compounds  with  the  mineral  bases,  a  specific  action  on  the 
larynx. 

Of  the  86  ''  cough "  symptoms,  one  is  connected  with 
*'  vomiting  "  and  one  mast  be  given  in  detail,  "  concussive 
cough,  in  the  night,  the  breathing  being  frequently  arrested, 

this  drag  in  high  esteem  for  certain  forms  of  booping-oough,  especially  when 
agg.  from  8  to  5  a.m.  is  present.  Bcenninghansen  affirms  that  he  adminis- 
tered it  with  complete  success  in  an  epidemic  where  an'  early  symptom  was 
**  pnffing  of  upper  eyelid.** 


by  Dr.  Edward  T.  Blake.  285 

as  in  hooping-cough,  accompanied  by  stitches  in  the  chesty 
sore  throat  and  fever .^^ 

Nux  moschaia.  In  Hall's  large  Jahr  (1848),  we  see 
'^  bright-red  shining  elevations  resembling  mucous  glands 
below  thefranum  lingua,  somewhat  larger  than  millet-seeds/' 
Three  symptoms  of  "  coryza." 

The  seven  cough  symptoms  do  not  resemble  hooping- 
coagh ;  they  point  more  to  the  dry^  brassy^  ringings  reflex 
cough  of  the  hysterical  subject. 

Phosphorus  gives  ''pain  and  prickling  in  the finenum, 
apparently  subjective  sensations.  This  drug  has  'Womiting 
connected  with  "  cough,''  but  it  is  "  sourish  vomiting 
during  the  cough,"  whereas  the  vomiturition  of  pertussis 
occurs  at  the  close  of  the  paroxysm. 

Our  old  friend,  Drosera,  gives  "  whitish  ulcer  on  the  tip 
of  the  tongue." 


if 

99 


Follicular  Pharyngitis. 

A  disease  of  an  adjacent  organ,  to  the  consideration  of 
which  I  will  next  ask  your  attention.  The  literature  of  the 
new  faith  teems  with  examples  of  the  cure  of  chronic  disease, 
but  of  follicular  inflammation  of  the  pharynx  we  see  little, 
and,  excepting  in  the  more  recent  serials,  nothing ;  indeed, 
I  am  not  aware  that  any  of  our  body,  besides  Hughes  and 
Meyhofier,  has  honoured  this  prevalent  and  persistent 
pathological  condition  with  distinct  notice. 

Kleinert,  in  vol.  xx  of  the  British  Journal  of  HomceO' 
pathy,  in  a  paper  distinguished  by  originality  of  thought  and 
disfigured  by  a  perfectly  paradisiacal  innocence  of  pathology, 
relates  some  interesting  cases  of  follicular  disease  under  the 
comprehensive  title  "  Laryngeal  Catarrh."  His  remedies 
are  Acid,  nitric,  Ambra,  Argentum,  Carbo  veg.,  Causticum, 
Eupion,  Hepar,  Mangan.  acet.,  Merc,  Phos.,  Selenium, 
Stram.,  Verb.*  Hartmann  does  not  condescend  to  recognise 
the  existence  even  of  this  disorder. 

*  Oddly  enough  Dr.  Kleinert  did  not  appear  to  employ  ITali  hieh.,  thoogli 


286  On  certain  Pathological  PahUs  of  Interest, 

The  reason  of  this  remarkable  neglect  is  twofold  :  On  the 
one  hand  physicians  are  rarely  consulted  for  this  symptom 
when  it  stands  alone,  and  if  graver  signs  eoexist,  the  pharyn- 
geal complication  is  lost  sight  of  in  the  mHange  of  pheno- 
mena^ more  urgent  or  at  the  least  more  interesting.  On 
the  other  hand^  the  disorders  of  the  pharynx  rec^ved  little 
attention  before  the  researches  of  Garcia,  Torek  and  Ciermak, 
initiated  in  the  year  1855,'!'  shed  upon  an  adjacent  region  sncfa 
a  flood  of  new  light,  light  both  literal  and  figurative. 

As  far  as  my  own  experience  goes,  I  have  encountered 
this  affection  most  firequently  in  two  classes  of  the  com- 
munity, viz.,  in  clergymen  and  in  nursing  mothers.  The 
association  is  apparent — debility. 

In  Meyhoffer's  admirable  work  on  The  Chronic  Diseasee 
of  the  Organs  .of  Respiration,  treating  of  follicular  laryngitis 
(which  I  have  never  myself  seen  without  accompanying  and 
probably  antecedent  pharyngitis),  he  gives  as  causal  agents : 
'^  over-exertion  of  voice,  oral  respiration,  local  irritants  as 
tobacco-smoke,  alcoholic  drinks,  spices  and  the  inspiration 
of  chemical  vapours.^'  To  these  I  will  add  such  predis- 
ponents  as  dyspepsia,  starvation  and  depressing  mental 
emotions,  in  fact  every  debilitating  circumstance ;  but  above 
alT  these  we  must  place  those  constant  catarrhs  which  ever 
afflict  the  resident  in  a  humid  and  fickle  dimatcf 

As  evidence  of  the  prevalence  of  pharyngeal  lesions  even 
in  a  sheltered  valley  noted  for  the  dryness  of  its  air,  I  will 
give  you  the  result  of  some  careful  observations  recorded  by 
myself  in  the  March  of  the  year  that  has  just  passed 
(1878). 

I  had  the  curiosity,  during  one  week,  to  scrutinise  the 
pharynges  of  all  the  patients  who  came  to  my  consulting- 
room. 

that  drug  had  been  even  then  flgaring  in  English  clinical  literature  for  four- 
teen years. 

*  I  do  not  here  speak  of  Liston's  earlier  nse  of  the  laryngeal  mirror  in  1840, 
because  that  is  a  matter  of  historic  rather  than  of  clinical  interest. 

t  Conversation  in  a  carriage  has  a  peculiarly  irritating  eflfect  on  the  voice 
of  f oUicolar  subjects,  and  it  is  not  easy  to  append  any  satisfactory  explanation 
to  this. 


by  Dr.  Edward  T.  Blake.  287 

From  the  23rd  to  the  29th  of  March,  both  daj^  inclusive, 
I  examined  forty^-nine  throats ;  of  these  thirteen  wer^  males. 

Now,  I  think,  gentlemen,  you  will  be  surprised  when  I 
tell  you  that  in  so  enormous  a  proportion  as  forty-two  to 
seven  there  was  some  distinct  deviation  from  the  standard  of 
health  I  In  nearly  every  instance  that  deviation  took  the  form 
of  engorged  follicles.  It  is  interesting  to  note  that  though 
this  disorder  formerly  enjoyed  a  masculine  designation^ 
Angina  Ckricorumy  as  a  matter  of  fact  it  is  divided  with 
remarkable  impartiality  between  the  two  sexes ;  for  whilst 
{^  or  85  per  cent.,  of  men  suffered,  §i,  or  8j6  per  cent.,  oi  the 
women  were  victims ;  showing  even  a  slight  preponderance 
on  ihe  female  side.* 

One  sixth  only  of  all  patients  enjoyed  the  possession  of  a 
typically  sound  pharynx. 

It  is  di£Scult  to  follow  numerical  values  mentally,  bo  I 
will  briefly  tabulate  thus : 


Fharyn^^feal  affection  . 
Healthy  throats . 


J^eepective  totals 
Total  .       . 


Men, 

Women, 

11 

••• 

81 

2 

••• 

5 

18 

••• 

86 

I 

•«    i' 

49 

The  remedy  from  the  use  of  which  I  have  seen  the 
greatest  amount  of  success  is  the  Yellow  Iodide  of  Mercury ; 
the  salt  containing  two  equivalents  of  Iodine  has  not 
appeared  to  me  to  be  followed  by  results  so  favorable. 
The  next  medicinal  agent  in  order  of  clinical  value  ie  Kali 
Uchromicum. 

I  have  seen  good  eflects  from  Hamamelis  V  in  the  sub« 
acute,  from  Capsicum  8'  in  the  chronic  venous  congestion 
so  frequently  seen  in  conjunction  with  follicular  lesion. 
Nux  is  useful  when  the  mucous  membrane  is  brick-red,  and 

*  Follicnlar  pharyngitis  is  nearly  always  present  in  the  subjects  of  pulmo- 
nary, yesicnlar  emphysema.  Dr.  Henry  Bennett  has  pointed  out  how  frequently 
pelvic  congestion  in  women  is  associated  with  a  relaxed  state  of  the  pharyngeal 
mucous  membrane. 


28&  On  certain  Pathologieal  Points  of  Interest, 

the  mouth  is  tore^  or  when  peine  congestion  complicates 
the  case. 


Insolatio  and  Hap'/ever, 

We  will  now^  gentlemen^  pass  to  the  consideration  of  two 
diseased  conditions  which,  widely  separated  as  they  may  be 
in  their  manifestations^  are  yet  at  times  allied  as  to  their 
aetiology — I  speak  of  sunstroke  and  hay-fever. 

It  wonld  be  no  novelty  to  assert  that  both  these  morbid 
states  may  be  induced  by  the  impinging^  under  certain 
circumstances^  of  the  rays  of  the  sun  on  the  surface  of  the 
body.  They  have  been  said  to  owe^  in  some  instances,  a 
common  origin  to  the  hbat  of  the  sun ;  but  I  ask  you, 
have  we  not  rather  ignored  the  share  that  another  factor 
concerned  may  claim  in  the  production  of  these  pheno- 
mena? 

We  must  not  forget  that  the  solar  beams  contain  pencils 
of  yellow  or  light  rays  as  well  as  pencils  of  blue  or  chemical 
rays. 

Why  may  not  over-stimulation  by  light  be  accredited  as 
the  cause,  knowing  as  we  do  that  no  amount  of  heat* 
without  light  will  so  disturb  the  economy  ? 

In  an  exhaustive  monograph,  composed  in  a  truly  scien- 
tific spirit,  and  displaying  peculiar  powers  of  patient  in- 
vestigation, one  of  our  body  has  recently  given  to  us  the 
valuable  results  of  years  of  thought  and  observation  on  the 
subject  of  hay-asthma.  When  I  had  the  pleasure  of 
perusing  this  classic  contribution  to  the  scant  litera- 
ture of  hay-fever,  with  a  feeling  of  extreme  admiration 
for  the  minute  care,  the  paticfnt  research,  betrayed  by 
its  style,  came  a  sensation  of  surprise  that  its  author 
should    have    dropped    into    the    beaten    track    of    attri* 

*  There  it  a  disease  induced  by  over-ftimnlation  with  chemical  or  bine  rays* 
Yiz.  the  moon-stroke  of  India.  It  is  characterised  by  hepatic  congestion  and 
an  impaired  state  of  the  memory.  I  have  nnder  my  care  a  lady  who^  after  a 
moonlight  walk,  experiences  diminished  heart-action  and  marked  moacnlar 
prostration — ^niootism  minna  the  nanaea. 


'     by  Dr.  Edward  T.  Blake.  289 

bating  this  disease  to  the  heat  rather  than  to .  the  liffhi  of 
the  son. 

At  p.  677  of  vol.  XXX  of  the  British  Journal  of  Homeo- 
pathy Mr.  Blackley  says  : — '*  Many  patients  have  thought 
that  exposure  to  the  heat  of  the  sun  has  made  their  attacks 
more  severe/'  Again^  ''  Dr.  Bostock  had  the  symptoms 
more  severely  developed  whenever  he  ventured  into  the 
open  air  whilst  residing  at  Bamsgate ''  (whose  atmosphere 
is  likely  to  be  as  free  from  pollen  as  any  in  great  Britain)  ; 
and  again,  ^*  Dr.  Phoebus  notices  that  exercise,  especially 
that  of  a  fatiguing  nature  (in  other  words,  outdoor  exercise), 
canses  exacerbations.''  Dr.  Smith,  p.  258,  loc.  cit.,  thinks 
that  great  heat  and  strong  light  induce  or  aggravate  the 
symptoms. 

Mr.  Blackley  explains  all  these  by  the  fact  that  when 
patients  are  in  the  open  air  they  inhale  more  pollen.  This 
MAT  be  so ;  but  another  explanation  perhaps  lurks  behind. 
They  are  certainly  more  exposed  to  the  direct  rays  of  light 
emanating  from  the  sun.  Mr.  Blackley  does,  indeed,  at 
p.  253,  tsike  up  the  question  of  light  as  a  causative  agent, 
but  he  dismisses  it  so  summarily  as  nearly  to  amount  to  a 
patting  oat  of  court. 

Whilst  Bostock,  Oeorge  Moore,  Pirrie,  and  Smith  have 
supported  the  heat  theory,  Phoebus  alone  definitely  advo- 
cated the  view  that  light  might  be  the  chief  disturbing 
cause. 

May  not  the  whole  question  of  hay-asthma  be  condensed 
and  formularised  thusf — Given  a  hypertBsthetic  condition  of 
the  nerves  distributed  to  the  skin  or.  to  the  ophthalmo-respi* 
ratory  tracts  then  any  irritant^  local  or  reflex,  its  nature 
determined  by  the  special  idiosyncrasy  of  each  particular 
individual,  shall  induce  an  attack. 

We  shall  never  discover  which  is  the  precise  sinner, 
because  all  in  turn  are  sinners,  because  every  patient  has  his 
own  peculiar  bite  noire  always  ready  to  pounce  on  him  in 
seasons  when  his  resisting  power  stands  at  a  minimum. 

For  convenience  we  class  all  under  the  comprehensive, 
but  incorrect,  terms  '^  hay-fever/'  and  *'  hay-asthma ;" 
there    is   no    doubt    that    even   in    the    same    individual 

VOL.  XXXII,  NO.  CXXYIII. APBIL,  1874.  T 


290  On  certain  Pathohgical  Points  of  Interest, 

different  exciting  causes  will  induce  the  same  result, 
whether  we  style  that  result  musk-asthma,  pollen-asthma, 
solar  asthma,  or  ipecacuanha-asthma.* 

It  is  well  known  that  some  persons  are  prone  to  have 
a  sneezing  fit  on  passing  from  the  shade  suddenly  into  the 
full  blaze  of  sun.  May  not  this  be  a  kind  of  incipient  or 
rudimentary  hay-asthma  T 

I  always  direct  my  patienta  who  are  predisposed  to  sun- 
stroke or  hay-fever  to  wear  on  the  head  during  summer  a 
white  covering,  lined  with  some  black  materia),  that  any 
light  rays  which  escape  reflection  from  the  white  surface 
may  be  absorbed  by  the  dark  lining. 

The  remedies  that  I  ha?e  found  most  useful  in  the 
treatment  of  insolatio  are  Glanoin,  Lachesis,  Nux  vomica,  and 
Arffentum, 

It  might  seem,  gentlemen,  to  demand  some  apology  that 
this  New  Year's  dish  offered  for  your  discussion  should  be 
such  a  medical  mixture*--such  a  veritable  pathological 
Olla  podrida  ! 

However  this  may  be,  it  has  given  me  much  pleasure  to 
prepare  it  for  you,  and  now  I  heartily  invite  you,  one  and 
all,  to  begin  the  attack.  Use  your  knives  with  a  will,  but 
spare— -spare  me  your  teeth  ! 

This  night  I  crave,  my  brethren,  from  you  no  happier 
fate  than  befalls  the  oyster — ^to  be  swallowed  without  being 
bitten  I 


Di8cu$9um  on  Dr.  Edward  T.  Blake's  paper. 

Mr.  KTironoir  had  never  observed  the  sublingual  ulcers  spoken 
of  by  Dr.  Blake,  and  would  ask  him  at  what  period  of  the  disease 
he  saw  th^m.  Speaking  of  the  treatment  of  buccal  ulcers,  he  once 
had  an  obstinate  case  of  ulcer  in  the  fauces  which  ultimately 
healed  rapidly  under  Ac.  Jluor,  6.  He  could  not  agree  with  Dr. 
Blake  that  hay-asthma  could  be  induced  by  the  heat  and  bright 
light  of  the  solar  rays  acting  on  the  cutaneous  nerves ;  for  this 
theory  is  completely  upset  by  the  fact  that  sufferers  from  the 

*  One  ftict  has  latterly  been  presBed  upon  my  notice,  that  this  disorder  is  of 
much  more  frequent  occurrence  thim  is  usually  supposed  by  us. 


by  Dr.  Edward  T.  Blake.  291 

afiection  UBuallj  lose  all  tlie  distresBing  Bjmptoms  on  going  out 
to  aea^  where  we  know  that  the  sun*8  rays  are  more  powerful 
and  more  ''burning"  than  on  land.  He  knew  the  ease  of  a 
gentleman  who  invariablj  had  a  sharp  attack  of  hay-asthma  on 
touching  or  coming  near  a  dead  deer.  As  regards  treatment, 
many  years  ago  he  made  a  tincture  of  the  flowers  of  Anthoxanthum 
odoratum^  and  used  it  empirically  for  this  affection,  sometimes 
with  marked  success,  so  much  so  that  Mr.  Kendall,  the  homodo- 
pathic  chemist  at  Exeter,  had  such  numerous  applications  for 
"  Mr.  Kyngdon*s  remedy  for  hay-fever  "  that  he  used  to  sell  it  to 
allopathic  chemists^ and  others  by  the  pint  and  quart;  but 
latterly  he  had  almost  given  up  its  use  and  employed  very 
successfully  Sulph.  tod.  3.  This  remedy  is  very  homoaopathic  to 
faay-«sthma,  and  the  trituration  of  it  by  the  chemist  usually  brings 
on  a  sharp  attack  of  its  prominent  symptoms. 

Dr.  VxBKOK  fiiLL  said  he  had  never  noticed  ulceration  under 
the  tongue  in  any  case  of  hooping-cough  that  had  been  in  his 
care.  In  one  very  severe  instance  a  species  of  complete  chemosis 
came  on  during  the  convulsive  stage,  which  he  attributed  to 
strain.  He  fancied  the  ulcers  of  the  soft  tissues  under  the 
tongue  mentioned  by  Dr.  Blake  and  other  observers  might  be 
due  to  the  same  cause;  at  all  events,  he  (Dr.  Yernon  Bell) 
scarcely  considered  such  exceptional  occurrences  any  clue  to 
treatment.  As  to  follicular  pharyngitis  he  thought  it  very  pro- 
bable that  such  an  affection  existed  mr  more  firequently  than  was 
suspected,  but  it  was  seldom  brought  under  the  observation  of 
meaical  men  until  it  had  become  moderately  bad.  In  his  (Dr. 
Vernon  Bell's)  experience  the  disorder  was  certainly  not  confined 
to  clergymen  or  to  those  who  greatly  exercised  the  voice,  for  it 
was  even  more  frequent  among  the  classes  exposed  to  sudden 
atmospheric  changes  and  to  noxious  particles  floating  in  the 
air.  He  had  met  one  very  obstinate  example  of  the  latter  in  the 
case  of  a  photographer.  But  whatever  the  proximate  causes  might 
be  he  had  no  doubt  about  two  remote  predisposing  causes — dis- 
orders of  the  stomach  and  a  peculiar  proclivity  of  the  pharyngeal 
membrane  to  morbid  action,  which  had  not  yet  been  satisfactorily 
explained.  The  medicine  in  which  he  most  confided  was  JTimt 
vomica  in  the  earlier  degrees  of  the  inflammation.  The  green 
Iodide  qfy  and  other  combixuitions  of,  Mercury  and  Ferroeyanide 
qfPotassium,  with  an  exclusive  dietary,  he  believed  to  be  neces- 
sary in  almost  every  severe  case.  The  inhalation  of  Iodine  he 
almost  always  used,  but  this  and  other  local  applications  were  of 
subsidiary  service,  and  could  not  be  relied  upon  for  a  permanent 
cure  in  the  absence  of  systematic  and  radical  measures.  So  much 
might  be  urged  for  aud  against  Dr.  Edward  Blake's  supposed 
causes  of  '*  sun-stroke  hay-fever"  that  he  (Dr.  Yernon  ^ell) 
could  not  offer  any  opinion  which  would  be  of  value  to  the 
Society. 

Dr.  Hale  could  not  agree  with  Dr.  Blake's  statement  that 


292  On  certain  Pathological  Points  of  Interest, 

follicular  phaiyngitis  had  not  been  sufficiently  observed  bj  prac- 
titioners ;  for  his  own  part,  Dr.  Hale  bad  recognised  and  treated 
such  a  condition  of  the  pharyngeal  mucous  membrane  for  years, 
and  had  met  with  a  large  percentage  of  cases  so  affected.  He 
had  found  Biniodide  of  Mercury  one  of  the  best  remedies.  Folli- 
cular deposits  are  generally  met  with  in  strumous  cases,  and  their 
presence  always  led  him  to  examine  carefully  for  the  existence  of 
tubercular  deposits  in  other  organs,  especially  in  the  lungs.  The 
case  of  a  clergyman  who  had  been  a  patient  of  Dr.  Hale*a  for 
many  years  illustrated  the  importance  of  this  connection.  This 
patient  had  not  only  the  follicular  deposit  in  the  pharynx  as  a 
chronic  condition,  but  from  exposure  to  a  chill  after  preaching 
suffered  from  an  attack  of  subacute  laryngitis  of  the  follicular 
kind,  involving  the  vocal  cords,  necessitating  complete  rest  of  the 
vocal  organs.  Dulness  on  percussion  over  the  apex  of  the  right 
lung,  where  congestion  with  haemoptysis  had  occurred  under  Dr. 
Hale's  care  twenty  years  before,  caused  grave  suspicions  of 
tubercle,  but  happily  under  a  course  of  medicine  consisting  of 
Biniodide  of  Mercury  5^  Iodide  of  Potassium  3,  and  lodiutn  3, 
with  Cod-liver  Oil  and  sea  air,  complete  restoration  of  voice  and 
removal  of  the  physical,  signs  of  lung  disease  followed  the 
treatment.  Mr.  Kyngdon  had  quite  demolished  Dr.  Blake's 
theory  of  light  as  the  factor  in  producing  hay-asthma.  There 
were,  nevertheless,  some  remarkable  physiological  effects  pro- 
duced by  the  non-luminous  rays  in  the  solar  spectrum  which  Dr. 
Hale  suggested  would  form  an  intereHting  subject  for  inquiry. 
Referring  to  the  effects  of  sunstroke  Dr.  Hale  mentioned  a  case 
of  painful  interest  to  him  where  chronic  inflammation  of  the 
membranes  of  the  brain  and  spinal  cord  had  its  origin  in  sun- 
stroke. Dr.  Hale  described  a  remarkable  case  in  which,  owing  to 
the  idiosyncrasy  of  the  patient,  the  smell  of  horses  or  of  a  stable 
produced  most  violent  attacks  of  asthma  resembling  the  symp- 
toms of  hay-asthma.  Dr.  Hale  had  tried  with  some  effect  the 
Tincture  of  Anthoxanthum  odoratum  in  hay-asthma,  but  it  is 
probable  any  stimulating  vapour  would  act  as  a  palliative. 

Mr.  Enoall  said  that  amongst  other  remedies  there  was  one 
which  he  thought  would  be  of  use  in  follicular  pharyngitis  on 
account  of  its  action  on  the  mucous  membrane.  This  was  the 
local  use  of  Glycerine.  He  had  tried  it  in  the  form  of  gargle 
with  great  benefit  in  cases  of  deafness  from  the  closure  of  the 
Eustachian  tube.  He  had  been  led  to  use  it  for  this  purpose 
from  observing  the  effect  of  it  upon  the  mucous  membrane  of  the 
nose  in  a  case  of  congenital  closure  of  the  lachrymal  canal.  In 
this  case  from  the  time  of  the  child's  birth  the  canal  was  so 
obstructed  that  a  large  tumour  formed  in  the  sac  which  he  feared 
would  have  ended  in  fistula.  After  several  medicinal  means  had 
failed  he  ordered  the  internal  nostril  to  be  moistened  with  diluted 
Glycerine  by  means  of  a  hair-pencil ;  after  persisting  in  this  for  a 
few  days  the  distension  of  tne  sac  suddenly  disappeared ;   and 


by  Dr.  Edward  T.  Blake.  293 

although  many  monthB  had  now  passed  it  had  remained  perfectly- 
cured.  As  to  the  hay-fever,  he  did  not  think  that  light  could  be 
the  cause  of  it.  The  body  was  not  exposed  to  its  influence, 
being  clothed ;  the  face  was  the  only  part  exposed,  as  the  head 
was  protected  by  a  natural  or  by  an  artificial  covering.  As 
regards  "  clergyman's  throat,"  he  found  that  one  efficient  means 
of  cure  was  to  teach  the  natural  use  of  the  voice,  as  the  cause  of 
it  in  most  cases  is  undue  tension  and  too  prolonged  use  of  the 
organs  forming  the  voice  through  lack  of  sufficient  rest  by  way  of 
pauses.  Let  the  patient  be  made  to  read  and  this  fault  is  easily 
discovered.  By  directing  him  how  to  read  and  speak  so  as  to 
ensure  a  momentary  rest,  between  the  words  if  the  case  is  very 
bad,  or  between  the  sentences  in  less  severe  cases,  the  cure  could 
be  effected.  It  is  a  common  error  with  speakers  and  readers  to 
suppose  that  in  order  to  be  heard  the  voice  should  be  loud.  The 
best  way  to  ensure  this  is  the  distinct  articulation  of  every  word  ; 
and  the  greater  the  distance  to  be  reached  the  slower  should  the 
utterance  be,  and  the  more  marked  the  necessary  emphasis. 

Dr.  KiDi)  said  follicular  pharyngitis  is  often  a  very  chronic 
disease..  He  had  found  much  help  in  its  treatment  from  the  use 
of  Antimanium  tartaricum  according  to  a  suggestion  of  our  dear 
and  much  valued  friend  Dr.  H.  B.  Madden  some  years  ago.  The 
usual  dose  he  (Dr.  Kidd)  gave  was  five  grains  of  the  second 
decimal  trituration  on  the  tongue  at  bedtime  every  night  for  a  few 
weeks.  He  had  in  other  cases  found  Ferri  sulph.y  five  drops  of 
the  first  decimal  dilution  three  times  a  day,  very  helpful.  Of  all 
local  remedies  he  had  found  table  salt  (Chloride  of  Sodium)  in  Git/- 
eerine  and  water,  used  by  the  spray- producer,  most  effectual,  two 
drachms  of  table  salt  dissolved  in  two  ounces  of  Qlycerine  and 
four  ounces  of  water  used  twice  or  three  times  a  day.  The 
Chloride  of  Sodium  he  considered  to  have  a  specific  effect  on  the 
follicles,  improving  their  secretion.  As  to  the  pathology  of  hay- 
fever  and  hay-asthma  Dr.  Kidd  quite  agreed  with  Mr.  Blackley 
as  to  the  pollen  theory.  In  simple  hay  coryza  with  sneezing  he 
had  found  Nux  v.,  four  to  six  drops  three  or  four  times  a  day, 
most  effectual.  In  hay -asthma  for  twelve  or  fifteen  years  he 
had  used  Arsenic  with  singularly  good  result ;  the  first  centesimal 
dilution  about  three  to  four  drops  three  or  four  times  a  day,  or 
Fowler's  solution  the  same  dose.  In  the  treatment  of  hay-coryza 
and  hay-asthma  a  most  important  aid  he  considered  to  b^  to 
endeavour  to  blunt  the  sensibility  of  the  mucous  membrane. 
Por  this  purpose  for  many  years  he  had  prescribed  half  an  ounce 
liquid  Extract  of  Opium  blended  into  a  cream  with  an  ounce  of 
beef  marrow  used  three  or  four  times  a  day.  The  effect  of  this 
was  most  beneficial. 

Mr.  Pope  (Vice-President,  in  the  Chair)  said  that  they  had 
all  much  reason  to  feel  obliged  to  Dr.  Blake  for  the  suggestive 
paper  he  had  read,  as  well  as  for  the  interesting  discussion  to 
which  it  had  led.     The  ulcer  under  the  tongue  to  which  Dr. 


294  On  certain  Pathological  Points  of  Interest, 

Blake  bad  referred  bad,  be  tbougbt,  been  alleged  to  be  a  pre- 
monitory  symptom  of  measles,  as  well  as  of  boopiog  cough. 
He  bad  looked  for  it  on  several  occasions  in  botb  forms  of 
disease,  but  bad  never  observed  it,  and  believed  that  where  it 
bad  been  noticed  it  was  a  mere  coincidence  and  not  of  any  im- 
portance as  a  diagnostic  indication.  With  regard  to  the  etiology 
of  bay-fever,  Mr.  Pope  thought  that  the  evidence  as  to  its 
dependence  upon  floating  pollen  bad  been  so  fully  and  clearly  set 
forth  by  Mr.  Blackley  in  bis  recent  work  on  the  subject,  that  at. 
present  it  was  incontestable.  It  had  been  shown  that  whenever 
other  circumstances,  such  as  heat  and  light,  for  example,  to  the 
influence  of  wbicb  bay-fever  had  been  ascribed  by  some,  had 
been  supposed  to  excite  an  attack  of  the  disease  pollen  had  also 
been  present ;  and  further,  it  bad  also  been  shown  that  in  the 
absence  of  pollen  these  other  circumstances  did  not  give  rise  to 
the  symptoms  of  this  painful  illness.  If  pollen  was  the  cause 
of  tbe  disease,  it  seemed  hopeless  to  attempt  to  cure  it,  in  the 
correct  sense  of  that  term.  As  long  as  the  poison  was  being 
inhaled,  bo  long  would  the  patient  sufler.  All  that  was  left  to 
us  to  do  was  to  palliate.  Of  the  various  means  of  palliation 
suggested  that  named  by  Dr.  Eidd  of  a  mixture  of  fat  and  opium 
seemed  to  him  the  most  promising.  In  reference  to  a  remark 
about  the  Iodide  of  Sulphur  he  would  state  that  a  very  fair 
proving  of  it  by  Dr.  Eelsall  would  be  found  in  an  early  volume 
of  the  Monthly  Homaeopathie  Bemew  (vol.  ii,  p.  154).  The  medi- 
cines known  as  "  American  Bemedies  "  had  been  spoken  of  some- 
what disparagingly.  He  was  afraid  that  there  was  only  too  much 
reason  for  doubting  their  value.  He  believed  that  the  cause  of 
the  disappointment  which  had  been  met  with  in  using  them  was 
due  to  tne  indications  for  prescribing  them  having  been,  in  too 
many  instances,  purely  empirical.  Their  information  regarding 
them  was  only  partly  derived  from  physiological  experiments. 
On  this  source  they  could  rely,  and  it  they,  in  studying  the 
works  of  Dr.  Hale,  restricted  themselves  to  the  provings  be  bad 
recorded,  and  ignored,  as  at  least  doubtful,  all  the  empirical 
notions  of  the  so-called  Eclectics  and  others  of  tbe  same  class 
be  had  unfortunately  mixed  up  with  them,  the  remedies  he  had 
introduced  to  their  notice  would  prove  of  great  service.  It  was 
when  they  were  non-bomcBopatbic  that  these  medicines  bad  led 
them  astray,  not  in  cases  wnere  they  were  bomcBopathic.  Mr. 
Pope  concluded  by  expressing  the  pleastire  with  which  be  bad 
beard  that  Dr.  Cooper  nad  a  proving  of  tbe  Chlorate  of  Soda  in 
bis  desk. 

Dr.  Blake,  in  reply,  observed  that  epithelioma  of  the  tongue 
bad  been  spoken  of  by  Dr.  Cooper.  Dr.  Blake  had  tried  tbe  much 
vaunted  chromic  acid  in  a  case  where  the  submaxillary  glands 
were  involved,  and  it  had  failed  as  all  remedies  do  fail  when  that 
is  the  case.  Dr.  Blake  considered  carcinoma  lingu®  to  be 
primarily y  f .  e,  before  gland  invasion,  essentially  a  local  disease 


On  Disease  of  the  Urinary  Organs.  295 

quite  amenable  to  local  treatment.    He  had  seen  many  cases  dis. 
appear  under  Mydrastis,  but  always  used  locally  as  weU  as  inter- 
nally.  He  thought  that  syphilis  lingua  was  often  called  carcinoma. 
In  connection,  with  the  allusion  to  the  use  of  lunar  caustic  by 
one  of  the  speakers,  it  is  interesting  to  note  that  Argentum  is  ad- 
ministered internally  by  homoeopaths  for  one  form  of  follicular 
throat.     In  reply  to  Mr.  Kyngdon,  Dr.  Blake  said  that  it  was 
during  the  spasmodic  stage  that  sublingual  ulceration  had  been 
obserred.     It  was  quite  a  mistake  to  suppose,  as  observed  by 
Drs.  Hale  and  Kyngdon,  that  hay-asthma  did  not  occur  on  board 
ship  ;  it  was  a  problem  to  the  ezclusLve  pollen  school  to  explain 
it,  they  had  been  compelled  to  such  ingenious  explanations  as 
that  pollen  might  be  carried  over  the  sea  in  "dust  clouds,"  or 
that  hay  might  be  on  board  to  feed  the  cows !    Dr.  Blake  would 
remind  Dr.  Hale  that  it  was  at  the  sea-side,  in  the  Island  of 
Thanet,  that  Dr.  Bostock  fell  a  victim  to  this  besetting  calamity, 
where  he  was  not  in  the  way  of  pollen  from  grass.      When 
insolatio  produces  profound  disturbance  of  the  nutritive  function, 
as  in  the  sad  case  of  his  own  child  detaUed  by  Dr.  Hale,  more 
was  to  be  hoped  from  Argentum  and  its  salt  than  any  other 
known  remedy.      Anthoaimthum  might  be  a  remedy  in  some 
cases,  but  to  the  homoeopathic  it  should  be  employed  in  just 
those  cases  which  simulate  asthma  from  hay,  but  are  not  caused 
by  pollen  irritation.     In  Mr.  Kyngdon's  interesting  instance  it 
is  quite  possible  that  the  disturbing  cause  was  an  emanation 
from  the  scrotal  follicles  of  the  deer.    You  know  that  musk  will 
induce  asthma  in  certain  persons,  and  it  was  unnecessary  to 
remind  the  members  how  nearly  allied  are  the  Moschidad  and  the 
Cervidffi. 


CASES  ILLUSTRATIVE  OF  DISEASE  OP  THE 

URINARY  ORGANS. 

By  Henrt  Harris  Esq.^  M.R.C.S. 

(fiead  before  the  Britbh  HonMBopathio  Sodety.) 

The  first  case  I  have  to  bring  before  the  Society  to 
i^igbt  I  have  called  tubercular  disease  of  prostate.  It  ia 
not  my  intention  to  preface  it  with  any  remarks  upon  the 
nature  of  the  disease  it  professos  to  illustratej  but  to  let  it 


296  On  Diseases  of  the  Urinary  Organs, 

tell  its  own  tale,  and  at  the  close  point  out  the  grounds 
upon  which  I  found  my  diagnosis. 

W.  C — ,  set.  32^  a  strongly  built  man,  five  feet  eleven 
inches  in  height,  and  weighing  fourteen  stone,  in  early  life 
a  bookbinder,  latterly  a  gas  inspector.  Comes  of  a  con« 
sumptive  family,  but  has  always  had  good  health  with  the 
exception  of  occasional  attacks  of  gout  in  the  feet. 

At  the  end  of  the  year  1870  he  consulted  me,  com- 
plaining of  an  increased  frequency  of  micturition^  with 
some  little  pain  after  passing  water,  which  was  occasionally 
tinged  with  blood,  or  perhaps  it  would  be  more  correct  to 
say  contained  streaks  of  blood.  The  urine  on  examination 
appeared  to  be  normal,  with  the  exception  that  it  contained 
a  rather  larger  quantity  of  mucus  than  .  is  usual.  He 
received  Terebinthina  and  Belladonna,  and  in  a  fortnight  all 
the  symptoms  were  removed.  He  remained  free  from  any 
trouble  till  January,  1873,  on  the  27th  of  which  month  he 
again  came  under  treatment  for  the  same  symptoms  but  in 
an  aggravated  form.  The  water  at  this  time  contained  a 
considerable  quantity  of  muco-pus^  very  little  albumen,  no 
casts,  and  varied  much  in  character  on  different  days.  The 
pain  was  mainly  at  the  commencement  and  after,  micturi- 
tion. Thinking  it  possible  he  might  be  suffering  from 
calculus  I  carefully  sounded  him,  but  failed  to  find  a  stone. 
This  examination  did  not  appear  to  cause  much  pain.  On 
the  24th  of  February  he  had  an  attack  of  gout,  which 
yielded  in  a  day  or  two  to  Bryonia  and  Colchicum.  At 
the  beginning  of  March,  as  no  satisfactory  progress  had 
been  made,  he  by  my  advice  took  another  opinion ;  an 
examination  by  catheter  was  made,  which  gave  excessive 
pain  and  was  followed  by  rigors.  No  stone  was  discovered, 
but  a  roughened  sensation  at  the  neck  of  the  bladder  was 
felt ;  examination  per  rectum  revealed  no  enlargement,  and 
-  but  slight  tenderness  of  prostate.  The  case  was  pro- 
nounced one  of  cystitis.  The  treatment  recommended  was 
steadily  pursued  till  the  end  of  the  month  without  any 
benefit  accruing.  At  this  period  I  noticed  that  the  patient 
was  losing  flesh  and  had  him  weighed  on  the  2nd  of  April ; 
he  weighed  12  stone^  he  was  weighed  each  week  up  to  the 


by  Mr,  Henry  Harris.  297 

9th  Angast^  when  his  weight  was  9  stone  10  lbs. ;  the 
decrease  was  steady  and  uniform  and  appeared  quite 
uninfluenced  by  any  of  the  circumstances  of  his  illness. 
On  the  5th  of  May  he  saw  a  physician  in  consultation 
with  me;  by  this  time  his  countenance  had  acquired  a 
haggard  worn  look,  «nd  he  complained  of  a  dull  aching 
pain  immediately  above  the  pubes.  The  urine  now  con- 
tained more  pus^  but  still  no  casts,  and  there  had  not  for 
some  time  been  any  blood  passed.  The  opinion  given  was 
that  it  was  a  case  of  cystitis  depending  probably  on  some 
malignant  disease  of  bladder.  No  chest  mischief  could  at 
this  time  be  detected.  On  the  25th  of  August  the  bowels 
which  up  to  that  time  had  been  confined  became  much 
relaxed,  and  continued  so  in  spite  of  medicines  for  ten 
days;  this  greatly  prostrated  him,  he  also  now  began  to 
sufier  from  nausea,  vomiting  and  pain  at  stomach  after 
food^  and  for  the  first  time  complained  of  distress  in  the 
lumbar  region. 

At  the  end  of  November  another  attack  of  diarrhoea 
occurred  and  was  accompanied  by  such  excessive  prostra- 
tion that  the  patient  and  his  friends  were  counting  the 
hours  of  his  life,  and  it  seemed  impossible  that  he  could 
last  from  day  to  day.  After  taking  two  doses  of  Apis  the 
diarrhoea  stopped,  the  appetite,  which  had  completely  failed, 
returned,  and  the  patient  recovered  sufficient  strength  to 
move  about  the  house  and  even  to  go  out  for  a  short  walk. 
When  the  diarrhoea  ceased  the  bowels  again  became  much 
confined,  the  motions  now  assuming  quite  a  new  character, 
being  hard  round  lumps  coated  with  blood  and  slime, 
causing  great  pain  in  passing.  An  examination  by  rectum 
which  gave  excessive  pain  revealed  no  enlargement,  but 
intense  tenderness  in  the  region  of  the  prostate.  The 
improvement  lasted  for  a  fortnight,  when  the  appetite  again 
failed,  and  he  lost  his  newly  acquired  strength.  At  the 
banning  of  last  mouth  cough  came  on  and  I  found  some 
dulness  over  the  upper  part  of  the  right  lung,  by  the 
middle  of  the  month  this  had  increased,  and  the  cough  was 
now  accompanied  by  a  greenish  expectoration  streaked  with 
blood.     Up  to  the  present  time  the  emaciation   has  con- 


298  On  Diieaaes  of  the  Urinary  Organs, 

tinued  to  progress^  so  that  now  he  lies  a  perfect  skeleton. 
Takes  but  little  food^  which  is  more  often  vomited  than 
retained^  bowels  much  confined,  and  when  relieved  the 
motions  are  hard  balls  with  much  blood  and  pus,  water 
scanty,  depositing  about  one  third  of  muco-pus,  sp.  gr. 
1012^  acid^  the  deposit  insoluble  in  acetic  acid.  The 
state  of  the  lung  is  much  the  same,  the  cough  not  very 
troublesomCi  profuse  night  perspirations,  and  hectic  fever 
night  and  mornii^. 

I  believe  this  to  be  a  case  of  tubercular  disease  com- 
mencing in  the  upper  part  of  the  prostate,  extending  from 
there  to  the  bladder  and  kidnev,  and  now  invading  the  lower 
half  of  the  prostate  and  causing  ulceration  into  the  rectum. 
I  had  fully  expected  before  the  time  for  reading  this  paper 
arrived  that  I  should  have  been  able  to  verify  my  diagnosis 
by  a  post-mortem  examination;  failing  that  I  will  state 
briefly  the  reasons  which  have  led  me  to  this  conclusion. 
That  it  is  tubercular  disease  I  think  the  family  history,  the 
excessive  wasting,  the  comparative  absence  of  pain,  and  the 
occurrence  at  the  close  of  symptoms  of  pulmonary  phthisis, 
prove  or  at  least  make  it  exceedingly  probable.  That  its 
primary  seat  was  the  prostate  and  its  course  that  I  have 
described  is  evidenced  to  my  mind  by  the  following  facts : 
that  the  pain  at  the  commencement  of  the  disease  was 
always  referred  to  the  position  of  the  prostate,  and  was 
accompanied  by  the  passing  of  streaks  of  blood,  which  as 
the  disease  progressed  ceased^  the  gradual  increase  of  the 
purulent  deposit  with  the  supra-pubic  pain  showed  its 
extension  to  the  bladder,  and  the  lumbar  pain  and  gastric 
disturbance  its  further  progress  to  the  kidney,  while  the 
ulceration  into  rectum  proves  the  last  step  of  the  process. 

Sir  Henry  Thompson  in  his  work  on  prostatic  disease, 
speaks  of  tubercular  affection  of  that  gland  as  very  rare,  and 
instances  but  eighteen  recorded  cases.  He  also  says  that  it 
probably  never  is  limited  to  the  prostate  and  that  the  kidney 
is  generally  its  primary  seat,  next  to  that  the  testicle ;  in  my 
case  for  the  reasons  I  have  given,  I  believe  it  commenced 
in  the  prostate,  and  there  has  been  no  sign  of  any  affection 
of  the  testicle. 


by  Mr,  Henry  Harris.  299 

Dr.  Roberts,  speaking  of  tubercle  of  the  kidney,  says, 
that  in  males  it  not  nnfrequently  affects  also  the  genital 
organs;  and  most  frequently  the  prostate,  but  that  in  the 
female,  tubercular  diseases  of  the  urinary  do  not  spread  to 
the  genital  organs,  and  vice  versd. 

Hitherto  I  have  not  mentioned  the  treatment  pursued, 
for  no  medicine  seemed  to  have  any  influence  in  stopping 
the  progress  of  the  disease.  The  list  is  a  long  one,  and 
includes  most,  I  had  nearly  said  all  the  remedies  which  are 
credited  with  an  action  on  the  bladder  and  prostate  or  on 
the  tubercular  diathesis.  The  temporary  rally  after  the  use 
of  ^pis  almost  made  me  hope  that  I  had  found  the  specific 
medicine,  though,  having  at  that  time  fully  made  up  my 
mind  as  to  the  nature  of  the  disease,  I  could  not  endorse  the 
sanguine  expectations  of  the  patient's  friends  ;  its  failure  to 
continue  forced  me  to  conclude  that  it  was  a  post  and  not  a 
propter  hoe  fact,  and  in  this  idea  I  am  confirmed,  for  I 
find  Dr.  Roberts  recording  an  almost  similar  instance 
of  sudden  improvement  in  a  woman  apparently  dying  of 
tubercle  in  the  kidney,  for  the  occurrence  of  which  improve- 
ment he  confesses  himself  quite  unable  to  account.  The 
medicine  which  always  appeared  to  me  to  cover  most  of  the 
symptoms  and  to  be  most  indicated  by  the  location  of  the 
disease  was  Tkuja.  I  tried  it  in  various  dilutions,  but  without 
result ;  had  I,  however,  another  case  to  treat,  I  should  give 
that  medicine  a  more  extended  trial  at  an  earlier  stage 
of  the  disease,  should  I  be  so  fortunate  as  to  recognise 
the  malady  with  which  I  had  to  cope  sooner  than  I  did  in 
this  instance. 

My  next  case  is  one  of  hsemorrhage  from  the  urethra 
with  expulsion  of  fibrinous  cast.  In  the  evening  of  the  7th 
of  March  last  I  was  summoned  to  visit  a  man,  who  the 
messenger,  his  brother,  stated  had  come  home  about  an 
hour  previously  bleeding  profusely  from  the  urethra,  and 
had  passed  just  before  he  started  to  fetch  roe  a  mass  looking 
at  first  sight  like  a  globular  lump  of  flesh  about  an  inch  or 
an  inch  and  a  half  in  diameter.  Directing  the  man  to  be 
placed  on  hi^  back  and  ice  to  be  applied  to  the  genitals,  I 
promised  to  follow  as  quickly  as  possible.     On  washing  the 


800  On  Diseases  of  the  Urinary  Organs, 

lump  from  grit  I  found  after  the  clotted  blood  had  separated 
from  it  that  it  consisted  of  a  fibrinous  cast,  resembling  in 
shape  more  closely  than  anything  else  a  segment  of  a  ball 
enema  with  the  tube  attached  ;  the  circular  part  was,  as  before 
stated,  about  an  inch  and  a  half  in  diameter,  whilst  the  pipe 
was  about  an  inch  in  length  and  of  the  diameter  of  a  wheat 
straw  ;  its  structure  was  evidently  fibrinous.  I  much  regret 
that  I  have  not  now  the  specimen  by  me,  but  at  the  time  I 
did  not  think  of  bringing  the  case  before  this  society,  and 
I  gave  it  to  a  professional  friend  to  exhibit  at  the  Pathological 
Society. 

On  my  arrival  at  the  house  I  found  the  patient,  a  man 
about  thirty,  lying  on  his  back,  perfectly  blanched,  pulse 
very  slow  and  thready,  countenance  expressive  of  great 
terror  ^nd  anxiety ;  the  bleeding  had  been  in  a  measure 
checked  by  the  application  of  the  ice,  but  blood  was  still 
dripping  from  the  urethra.  I  at  once  passed  a  No.  12  silver 
catheter  into  the  bladder,  and  noticed  that  the  water  which 
came  through  the  instrument  was  unstained  with  blood. 
The  pressure  of  the  instrument  almost  immediately  stopped 
the  haemorrhage.  I  fastened  the  catheter  in,  cautioning 
the  patient  to  lie  perfectly  still  on  his  back  and  to  have  the 
ice  applied  if  the  bleeding  recurred.  I  left  him  Arnica  and 
China  to  take  alternately^  The  next  morning  I  found  that 
there  had  been  no  more  haemorrhage,  and  on  removing  the 
instrument  the  urine  passed  per  urethram  was  only  slightly 
tinged  with  blood.  He  was  kept  quiet  in  bed  for  two  or 
three  days  and  made  a  good  recovery.  The  history  given 
by  him  was  as  follows :  that  a  week  before  the  evening  I 
saw  him  **  he  was  larking/'  to  use  his  own  words,  with  a 
woman  previous  to  having  connection  with  her,  when  a 
sudden  gush  of  blood  from  the  urethra  took  place ;  this  lasted 
some  ten  minutes  and  then  ceased.  Four  days  after,  under 
similar  circumstances,  there  was  a  recurrence  of  the  haemor- 
rhage, but  in  a  slighter  degree.  On  that  evening  on  which  I 
saw  him  he  was  walking  to  his  home  at  Brixton,  and  whilst 
crossing  St.  James's  Park  had  an  erection,  and  at  once  there 
was  again  a  rush  of  blood  from  the  penis;  this  continued 
till  he  reached  home  and,  increasing  in  quantity,  they  sent 


by  Mr.  Henry  Harris,  301 

for  me.  Of  the  amount  of  blood  lost  it  is  difficult  to  form 
an  estimate,  but  it  must  have  been  very  considerable,  as  it 
continued  for  more  than  two  hours,  and  the  bed  and  bedding 
were  quite  saturated.  Neither  on  passing  the  catheter  nor 
by  subsequent  examination  along  the  whole  course  of  the 
urethra  could  I  find  any  tender  spot^  and  I  confess  that  I 
have  not  been  able  to  decide  to  my  own  satisfaction  the 
source  nor  the  real  cause  of  the  haemorrhage.  The  man  at 
the  time  was  suffering  from  a  slight  gleet  for  which  he 
subsequently  came  under  treatment  and  soon  recovered.  I 
ordered  him  to  abstain  at  least  for  a  time  from  all  sexual 
excitement,  and  I  think  for  a  little  while  he  obeyed  the 
injunction,  but  being  of  a  very  erotic  temperament  he  soon 
lapsed  into  his  former  habits,  but  had  not  when  I  last 
heard  of  him,  a  month  or  two  since^  had  any  return  of  the 
haemorrhage. 

The  last  case  with  which  I  shall  trouble  you  to-night 
will  be  stated  in  a  very  few  words,  h.  young  man  who 
had  been  under  treatment  for  gonorrhoea  returned  in  about 
a  month  with  a  profuse  crop  of  warts  on  the  glans  penis  and 
prepuce,  the  largest  being  of  the  size  of  a  pea ;  he  was 
ordered  a  lotion  of  Thuja  0  and  Thuja  1st  centesimal  in- 
ternally ;  at  the  end  of  the  week  he  reported  himself  much 
the  same.  Medicine  and  lotion  repeated ;  at  the  end  of 
the  second  week  there  was  still  the  same  report.  I  now 
swept  the  surface  of  the  warts  with  strong  Nitric  acid  and 
gave  him  Nitric  acid  1st  centesimal^  internally  ;  on  his  next 
visit  the  largest  of  the  warts  were  reduced  in  size,  but  the 
number  was  not  diminished.  The  treatment  was  repeated  for 
another  week^  but  still  very  slight  progress  was  made.  I  then 
gave  him  the  Thuja  lotion  again  and  Thuja  12  internally.  At 
the  end  of  the  first  week  of  this  treatment  many  of  the  small 
warts  had  disappeared  and  the  larger  ones  were  reduced  in 
size.  Thuja  12  was  repeated  but  without  the  lotion ;  next 
time  a  very  marked  improvement  was  manifest ;  the  whole 
of  the  warts  save  the  largest  were  quite  gone  ;  he  received 
another  week's  medicine  and  ceased  to  attend.  He  has 
since  been  under  treatment  for  another  attack  of  gonorrhoea, 
and  tells  me  that   all  the  warts  had  entirely  disappeared 


302  On  DiseoBCB  of  ihe  Urinary  Organs  ^ 

before  he  finished  hk  last  medictiie.  This  case  is  so  slight 
in  itself  that  I  should  not  have  brought  it  before  70a  but 
that  it  appeared  to  me  to  have  some  bearing  oq  the  mach- 
yesed  Question  of  the  curative  dose. 


Discussion  on  Mr,  Henry  Harris's  ptg^er. 


Dr.  Bakstosd  had  a  case  very  like  Mr.  Harris's  first  case  with 
this  important  difference,  that  there  were  no  tubercles  in  the 
prostate.  The  subject  was  an  aged  clergyman.  The  bladder  was 
very  irritable;  the  urine  drawn  off  by  catheter  night  and 
morning.  Oannabis  sativa  1  materially  relieved  him  and  pro* 
longed  his  life,  although  the  vesical  paralysis  was  not  cured.  He 
has  found  Ckmnahis  indica  f  in  one-orop  doses  more  efficacious  in 
curing  acute  gonorrhoBa  than  Oannahis  sativA  ^,  but  in  gleet  he 
has  still  more  confidence  in  Bals.  copaiba,  of  which  he  orders 
two  or  three  drops  of  a  saturated  alcohoHc  solution  three  or  four 
times  daily. 

Dr.  YAUOHAV-HroHEs  said  that  cases  of  tubercular  hyper- 
trophy of  the  prostate  must  be  very  rare ;  he  had  never  met  with 
sucn  pure  ana  simple.  He  was  of  opinion  that  Mr.  Harris's 
patient  had  tubercular  deposits  in  the  submucous  tissue,  uid  that 
these  spots  ulcerated  through  to  the  surface  and  discharged  a 
matter,  more  or  less  purulent,  bloody,  and  sanious,  which  gave 
rise  to  excessive  irritation  in  the  bladder,  prostate,  and  urethra. 
Dr.  Vaughan-Hughes  considered  that  the  hsmorrhage  from 
the  urethra  during  violent  and  long-continued  erection  arose 
from  an  ulcer  in  some  part  of  the  urethral  mucous  membrane 
becoming  suddenly  torn  up  by  the  rapid  expansion  of  the  erec- 
tile tissues. 

Dr.  DuDCHBOK  was  not  quite  satisfied  from  Mr.  Harris's 
description  of  his  first  case  that  the  disease  was  really  tubercle 
of  the  prostate.  In  that  case  would  there  not  have  been  enlarge- 
ment of  the  gland  ?  It  seemed  to  him  that  the  disease  might,  in 
the  absence  of  confirmatory  evidence  on  the  dissecting  table,  be 
assumed  to  be  chronic  cystitis  with  ulceration.  As  the  parent 
had  not  yet  died  he  might  yet  derive  some  advantage  from 
Argentinn  niiricum,  which  had  not  apparently  been  yet  given  by 
Mr.  Harris. 

Dr.  Bates  thanked  Mr.  Harris  for  the  very  interesting  cases 
BO  clearly  and  well  related.  Urinary  hiemorrhage  was  oflmi  a 
very  obscure  affection.  Latterly  he  (Dr.  Bayes)  had  treated  two 
such  cases,  both  of  great  severity ;  one  progressed  favorably,  but 
the  other  proved  fatal.  The  first  of  these  two  cases  came  under 
his  treatment  about  twelve  months  ago ;  he  had  been  up  till  then 
under  allopathic  treatment.    There  were  frequently  recurring 


by  Mr.  Henry  Harris.  303 

hsmorrhages  of  very  considerable  extent,  and  in  addition  to  clots 
passed  on  such  occasions  masses  of  villous  growth,  some  of  con- 
siderable size,  were  occasionally  to  be  detected  in  the  urine.   The 
microscope  showed  their  structure,  and  a  very  good  specimen  is 
to  be  seen  'among  the  preparations  at   St.  George's  Hospital. 
The  urine  was  always  loaded  with  albumen  and  a  very  consider- 
able   quantity    of    blood-corpuscles,    pus-corpuscles,    epithelial 
scales,  &c.,  were  always  present.     He  (Br.  Bayes)  imn[iediately 
withdrew  all  alcoholic  stimulants,  and  slow  improvement  set  in 
under  a  course  of  hom<Bopathic  remedies.     Fresh  hsemorrhages 
occaaonally  recurred  (but  less  frequently  than  before),  and  a 
very  severe  attack  came  on  in  May,  the  patient  being  at  that 
time  in  Bournemouth  under  Dr.    NankivelPs  immediate  care. 
The  bladder  became  distended  with  clots,  and  Dr.  Nankivell 
washed  it  out  very  skilfully.     After  this  the  patient  returned  to 
London.     The  urine  still  albuminous  and  loaded  with  pus,  still 
containing  at  times  villous  growth.     He  (Dr.  Bayes)  now  gave 
him  small  doses  of  Sulpho-carbolate  of  Lime,  a  grain  three  times 
a  day,  and  under  this  and  the  careful  meeting  of  symptoms  by 
other  remedies  the  pus  speedily  disappeared,  the  urine  lost  its 
albumen  and  became  more  natural  in  composition,  the  patient 
gradually  assumed  a  healthful  aspect,  and  appears  well.     No 
fresh  haemorrhage  (worthy  of  the  name)  has  appeared  during 
eight  months,  and  were  it  not  for  the  occasional  appearance  of  a 
small  clot  in  the  urine  the  patient  might  be  pronounced  well. 
The  second  case  alluded  to  was  that  of  an  officer.     When  he 
(Dr.    Bayes)   first  saw  him   he  was  completely   exsanguined, 
suffering  much  alsof  from  dysuria  and  irritable  bladder  to  so  great 
a  degree  as  to  force  urination  every  twenty  minutes,  day  and 
night.     There  was  no  considerable  hemorrhage,  but  the  urine 
was  loaded  with  pus  and  albumen.    The  pain  was  so  urgent  that 
the  patient  took  large  and  repeated  doses  of  Morphia,  but  still 
no  longer  interval  of  sleep  than  twenty  minutes  to  half  an  hour 
was  yielded.    A  course  of  homosopathic  medication  relieved  the 
urgent  symptoms,  and  the  patient  was  enabled  to  sleep  two  or 
three  hours  at  a  time ;  so  marked  was  the  improvement  for  a  time 
that  the  patient  and  his  friends  became  very  sanguine  of  ultimate 
recovery.      The .  pus  and  albumen  nearly   disappeared   under 
SulphO'Carholate  of  Lime,  but  suddenly  paralysis  of  the  bladder 
set  in.     A  surgeon  was  called  in  who  very  skilfully  used  the 
catheter,  but  this  brought  on  passive  hsBmorrhage.  Constitutional 
symptoms  set  in,  aphthous  ulceration  of  mouth  and  throat  fol- 
lowed, and  diarrhcea  and  lienteria  ended  the  patient's  sufferings. 
There  had  been  at  one  time  great  pain  and  discomfort  in  the 
prostate  gland,  but  this  was  permanently  relieved  by  a  few  doses 
of  Aconite  1.     In  both  these  cases  the  effect  of  many  of  our 
medicines  was  well  marked ;  and  he  (Dr.  Bayes)  may,  at  some 
future  time,  give  the  details,  but  the  point  he  wished  to  bring 
forward  at  this  time  was  the  beneficial  action  of  small  doses  of 


804  Specific  Medication  in  relation  to  Surgery, 

StdphO'Carholate  of  Lime  in  ftrresting  disorganization,  and, 
perhaps  (in  the  first  case),  in  destroying  or  controlling  the 
development  of  growths  of  loose  organisation  within  the  urinary 
cavities. 

Mr.  HA.BBIS,  in  reply,  said  that  he  was  by  no  means  pre- 
judiced in  favour  of  his  diagnosis  of  the  first  case,  and  should  be 
pleased  if  its  favorable  issue  showed  that  he  was  mistaken.  He 
would  gladly  avail  himself  of  Dr.  Dudgeon's  suggestion  as  to  the 
use  of  Argenti  nitras^  though  he  feared  the  case  was  now  too 
far  advanced  for  any  treatment  to  be  of  much  benefit.  Dr. 
Yaughan-Hughes  had  suggested  that  the  tubercular  deposit 
might  be  in  the  submucous  tissue ;  that  no  doubt  was  possible, 
but  Mr.  Harris  was  of  opinion  that  it  was  really  in  the  gland 
structure  itself.  Tubercular  disease  may  exist  without  any 
hypertrophy  at  the  beginning ;  it  is  said  there  is  sometimes  a 
slight  enlargement,  but  as  the  disease  progresses  the  gland  really 
diminishes  in  size.  In  this  case  there  is  certainly  no  hyper- 
trophy, nor  has  there  been  at  any  time  any  difficulty  in  getting 
rid  of  the  urine.  That  the  hemorrhage  in  the  second  case  was 
not  due  to  stricture  nor  to  ulcer  in  urethra  is  shown  by  the  fact 
that  a  No.  12  catheter  was  passed  without  difficulty  and  without 
pain.  The  last  case  was  not  brought  forward  as  a  striking  cure 
of  warts,  but  simply  to  show  that  a  cure  appeared  to  be  effected 
by  Tht^a  12,  a  similar  result  not  having  followed  the  use  of 
tnat  drug  in  the  first  dilution. 


SPECIFIC  MEDICATION    IN  ftELATION  TO 

SURGERY. 

By  Dr.  W.  S.  Craig^  of  Scarborough. 

(Read  before  the  British  Homosopatbic  Society.) 

HoM(EOPATHY  being  a  system  of  therapeutics  is  more 
intimately  related  to  the  practice  of  physic  than  to  surgery^ 
and  consequently  homoeopathic  practitioners  have  a  tendency 
to  cultivate  medicine  to  the  neglect  of  surgery.  The 
teaching  of  Hahnemann  exerted  an  influence  in  the  same 
direction  since  he  inculcated  the  desirability  of  curing  the 
external  manifestation  of  diseases  from  within  bv  medicine 
rather  than  attacking  them  from  without.     While  acknow- 


by  Dr.  W.  S.  Craig.  805 

ledging  the  valae  of  ibis  teaching,  it  is  a  question  whether 
we  do  not  often  trammel  ourselves  unnecessarily  by 
endeavouring  to  avoid  surgical  interference  when  it  would 
very  much  expedite  the  cure  and  even  increase  the  efficacy  of 
the  medicinal  treatment.  I  think  I  have  seen  prolonged 
attempts  to  remove  paronychia,  naevi,  wens^  ganglia^  and 
Tarious  external  tumours  with  medicine,  which,  I  am 
sure,  would  have  been  materially  expedited  without  detri- 
ment by  judicious  surgical  assistance.  It  is  also  desirable 
that  homoeopaths  should  maintain  their  status  as  competent 
surgeons,  the  more  so  that  their  command  of  the  homoeo- 
pathic therapeutics  gives  an  immense  advantage  in  carrying 
surgical  and  obstetrical  cases  to  a  successful  issue.  The 
rapidity  and  precision  with  which  inflammatory  reactions 
and  other  complications  in  operative  surgery  are  controlled 
by  the  homoeopathic  medicines,  are  very  striking  when 
contrasted  with  the  indirect,  disturbing,  and  exhausting 
remedies  in  ordinary  use.  Of  this  I  had  a  gratifying 
experience  some  time  ago,  in  the  case  of  a  rather  severe 
accident  which  came  under  my  care.  A  farmer,  while 
superintending  a  thrashing  machine,  had  his  clothes  caught 
by  the  horizontal  revolving  shaft ;  he  was  whirled  round  the 
shafts  and  struck  violently  ou  the  ground  with  each  revolu* 
tion.  .He  was  bruised  all  over  and  sustained  a  com- 
minuted compound  fracture  of  the  right  forearm,  and  a 
fracture  of  the  right  tibia  and  fibula.  I  amputated  the  arm 
a  few  inches  below  the  elbow,  and  adjusted  the  leg  in  sand* 
bag  aplints.  The  action  of  Arnica  in  removing  the  ecchy* 
mosis  was  very  striking,  and  the  immediate  effect  of  Aconite 
and  Belladonna  in  cheeking  the  reactionary  fever,  with  a 
tendency  to  erysipelas  of  the  face,  was  most  satisfactory. 
Within  eight  days  the  patient  was  able  to  sit  up  in  a  chair 
and  write  a  letter  with  his  left  hand.  It  is  my  object  to 
direct  your  attention  to  the  satisfactory  results  of  a  eom<- 
bination  of  homoeopathy  with  surgery,  confining  myself  to 
such  operations  as  should  be  within  the  scope  of  every  general 
practitioner. 

For  example,  diseases  of  the  rectum  are  the  source  of 
many  alarming  and  obscure  derangements  of  the  health, 

VOL.  XXXII,  NO.  CXXVIII. ^AFRIL,  1874.  U 


806         Specific  Medication  in  relation  to  Surgery, 

and  we  frequently  meet  with  patients  suffering  from  these 
diseases  who  have  run  the  gauntlet  of  medical  treatment  of 
all  sorts  without  relief.  Direct  surgical  interference  is 
absolutely  necessary,  and  this,  agsiiu,  must  be  supple- 
mented by  specific  medication,  directed  towards  the  re- 
moval of  the  hepatic  congestion  which  underlies  the  morbid 
condition  of  the  bowel. 

The  following  cases  will  illustrate  my  meaning. 

Many  years  ago  I  was  called  to  see  a  widow  lady,  set.  38, 
reported  to  be  dying  from  disease  of  the  heart.  I  found 
her  propped  up  in  bed,  excessively  pale  and  oedematous. 
The  heart  was  visiby  agitated,  but  auscultation  disclosed 
no  sign  of  organic  disease.  The  urine  was  free  from 
albumen,  and  there  was  no  history  of  menorrhagia,  or  anj 
other  haemorrhage,  to  account  for  the  evident  anemia.  Inquiry 
as  to  the  existence  of  piles  or  loss  of  blood  at  stool  was 
met  with  a  decided  negative,  nevertheless  I  determined  to 
examine  the  bowel,  when  I  found  two  vascular  tumours 
bleeding  on  being  touched,  which  I  could  not  hesitate  to 
regard  as  the  immediate  source  of  the  whole  serious  train  of 
symptoms.  After  an  unsuccessful  attempt  to  remove  them 
by  mediciue,  the  piles  were  destroyed  by  ligatures  passed 
through  their  base  and  tied  each  half  separately.  On  the 
separation  of  ligatures  a  course  of  China,  Nux  vom.,  Card, 
veg.,  and  Lycopodium  removed  the  oedema  and  completely 
restored  the  chylo-poietio  functions.  Her  restoration  to 
health  was  rapid  and  permanent.  This  is  a  very  simple 
case  and  was  appreciated  much  beyond  its  deserts,  but  the 
credit  of  the  cure  would  have  been  lost  to  homoeopathy  if  I 
had  exhausted  the  patience  of  the  sufferer  in  my  attempt  to 
cure  her  with  medicine  alone. 

Last  summer  a  gentleman,  set.  82,  was  brought  into  my 
consulting  room  in  a  state  of  syncope  from  hsemorrhage 
from  the  bowel.  He  had  been  under  the  care  of  a  homoeo- 
pathic medical  man  for  several  months,  reputedly  for  disease 
of  the  heart.  The  heart  exhibited  no  evidence  of  disease 
beyond  functional  irritation.  Examination  of  the  bowel 
revealed  two  large  bleeding  haemorrhoids.  These  were 
removed  by  ligature,  after  which  all  other  symptoms  rapidly 


by  Dr.  W.  8.  Craig.  307 

yielded  to  homoeopathic  treatment,  and  in  a  few  weeks  he 
returned  home  restored  to  perfect  healthy  a  result  which  could 
not  have  been  attained  by  medicine  alone. 

The  Rev.  J.  H — ,  «t.  49,  had  perceived  a  steadily  increas- 
ing failure  of  strength.  He  looked  robust^  but  in  spite  of  a 
florid  complexion  a  certain  pallor  and  waxiness  about  the  lips 
became  apparent.  His  breathing  on  rising  even  a  gentle  ascent 
was  laboured  and  distressing,  and  he  was  alarmed  by  occasional 
sudden  loss  of  memory  and  threatened  fainting.  Several 
medical  friends  who  were  interested  in  his  health  carefully 
examined  him,  and  in  succession  undertook  the  treatment  of 
the  case.  He  was  sent  twice  to  a  hydropathic  establishment 
and  took  lengthened  rest  and  withdrawal  from  duty,  but  with- 
out any  lasting  benefit.  The  diagnosis  of  his  condition  was 
never  satisfactorily  determined  till  in  despair  I  examined  the 
rectum^  and  found  a  very  large  internal  hsemorrhoid  which 
bled  freely  on  being  touched.  The  patient  admitted 
that  he  had  for  years  occasionally  observed  blood  with  the 
stools,  but  as  he  had  been  led  by  his  allopathic  physicians  to 
regard  it  as  salutary,  he  had  never  given  much  attention  to 
the  matter.  After  the  removal  of  the  tumour^  and 
under  the  action  of  Podophyllum  and  Sol.  Soda  Chloral.,  a 
critical  diarrhoea  set  in,  with  great  relief  to  the  portal  con- 
gestion, followed  by  the  disappearance  of  all  the  anxious 
symptoms. 

A  condition  of  congestion  and  erosion  of  the  mucous 
lining  of  the  rectum  is  frequently  met  with,  not  amounting 
to  distinct  haemorrhoids^  and  yet  causing  many  local  and 
sympathetic  discomforts.  The  medicines  which  I  have  found 
of  most  service  are  Merc.  corr.  and  Nilric  add,  but  the 
cure  is  greatly  expedited  by  the  application  of  strong  Nitric 
acid  to  the  eroded  surface.  The  distressing  pain  of  spasm 
of  the  sphincter  associated  with  fissure  in  ano  is  effectually 
cured  by  introducing  the  two  index  fingers  within  the 
tightened  ring  of  muscular  fibre,  and  steadily  overcoming 
the  contraction.  Ignatia  is  useful  in  preventing  the  return 
of  the  spasm,  but  I  have  never  been  able  to  remove  it  with 
medicine  alone. 

The  treatment  of  scirrhus  of  the  breast  by  medicines 


808  Specific  Medication  in  relation  to  Surgery, 

alone  is  not  encouraging,  and  the  mere  surgical  removal  of 
the  tumour  is  almost  invariably  followed  by  the  reappear* 
ance  of  the  disease  in  the  cicatrix  or  in  some  other  part. 
I  have  been  much  gratified  by  observing  the  power  of  a 
steady  course  of  Sanguinaria  Canadensis  in  preventing  the 
return  of  the  disease.  I  have  notes  of  six  caises,  all  of  whom 
are  at  this  time  alive  and  well,  in  which  I  removed  the 
breast,  and  followed  up  the  operation  with  a  course  of 
Sanguinaria,  Of  course  the  cases  were  selected  as  suitable 
for  operation,  that  is  to  say,  the  disease  had  not  extended  to 
the  axillary  glands  nor  involved  the  skin.  In  every  case 
the  entire  breast  was  removed,  and  adhesion  by  first  inten- 
tion was  almost  uniformly  secured  by  the  sustained  pressure 
of  a  large  sponge  wrung  out  of  Infusion  of  Marygolds  bound 
over  the  dressing  of  the  wound. 

Mrs.  N.  Nt — ,  set.  54,  had  observed  a  tumour  of  the  left 
breast  slowly  increasing  for  the  last  tbree  years.  There 
was  much  shooting  pain  in  the  swelling,  which  was  hard 
and  defined  ;  the  tumour  was  not  adherent,  the  breast  being 
moveable.  No  swelling  in  axilla  and  no  nodules  in  the 
skin.  The  patient  was  very  stout ;  nevertheless,  under  the 
influence  of  chloroform,  the  whole  mamma  was  excised,  and 
the  wound  was  mopped  out  with  a  solution  of  Chloride  of 
Zinc,  10  grains  to  the  oz.  A  dressing  of  Infusion  of  Calen* 
dula  and  a  large  new  sponge  wrung  out  of  the  same  lotion 
was  applied.  The  wound  healed  by  first  intention  through- 
out, the  slight  local  inflammation  being  checked  at  once  by 
Belladonna.  The  patient  took  Tinct.  Sanguinaria  Can.  3x 
for  some  months,  and  after  three  years  there  is  no  appear- 
ance  of  any  return  of  the  disease.  I  need  not  multiply  the 
reportof  cases  so  simple  and  uniformly  successful  both  as  to  the 
operation  and  the  prevention  of  the  return  of  the  disease. 

I  may,  however,  state  that  in  each  case  upon  which  I 
have  operated,  examination  of  the  tumour  after  excision  left 
no  doubt  as  to  its  being  true  scirrhus. 

I  have  found  Sanguinaria  Can.  of  the  greatest  service  in 
removing  a  painful  enlargement  of  the  whole  breast  which 
frequently  occurs  at  the  climacteric  period,  which  often 
occasions  much  anxiety  and  apprehension  ;  but  if  there  is  no 


by  Dr.  W.  S.  Ocaig.  809 

defined  nndeus  m  the^  mass  it  speedily  disappears  under 
the  use  of  the  drug.  But  if  a  defined  tumour  exists, 
neither  Sanguxnaria  nor  any  other  medicine  that  I  know  of 
will  benefit  the  patient,  unless  the  nidus  of  the  disease  is 
remoyed  surgically. 

The  improved  methods  of  performing  ovariotomy  and  the 
strikingly  improved  results  of  the  operation  are  among  the 
triumphs  of  modern  surgery.  Still  the  operation  is  most 
formidable,  and  patients  will  not  willingly  submit  to  it 
until  they  are  driven  to  extremes.  Tapping  is  so  readily 
performed,  and  is  so  free  from  pain  or  alarm,  that  we  are 
frequently  urged  to  resort  to  it  when  as  yet  the  patient  is 
not  convinced  of  the  necessity  of  excision.  But  tapping 
has  fallen  into  disrepute  since  it  is  found  to  be  not  abso- 
lutely free  from  danger,  and  at  best  it  affords  but  a  tempo- 
rary relief  from  the  dropsical  encumbrance.  I  am  satisfied 
from  observation  that  Apis  tnel.,  taken  internally  after  the 
operation,  has  considerable  power  in  checking  the  reaccumn- 
lation  of  the  fluid. 

In  1856,  M.  N — ,  aet.  24,  unmarried,  had  observed  a 
tumour  in  the  abdomen  gradually  increasing  in  size  for 
eighteen  months.  It  was  a  firm  swelling  lying  towards  the 
left  side  of  the  umbilicus,  and  from  its  situation  and  appear- 
ance was  evidently  an  ovarian  tumour.  Various  homoeo- 
pathic remedies  were  used  without  any  evident  result.  I 
then  tapped  and  withdrew  about  eight  quarts  of  straw- 
coloured  fluid,  the  abdomen  was  carefully  bound,  and  Apis 
meL  prescribed  to  be  taken  internally  three  times  a  day. 
There  was  no  return  of  the  swelling  for  two  years,  when  I 
again  tapped  and  withdrew  six  quarts  of  a  similar  fluid,  after 
which  she  resumed  the  Apis  meL  After  some  years  she 
married,  and  though  she  has  had  no.  children,  she  is  well 
and  free  from  any  signs  of  the  disease. 

Miss  E.  J — ,  set.  7'Z,  had  an  ovarian  tumour  on  her  left 
side.  Her  physician^  a  skilful  homoeopath,  had  failed  to 
make  any  impression  upon  the  disease  with  medicine,  and 
requested  me  to  tap.  About  five  quarts  of  fluid  were  with- 
drawn and  the  abdomen  carefully  supported  with  a  bandage, 
and  she  took  Apis  mel.  for  a  length  of  time.     She  died  six 


810         Specific  Medication  of  relation  to  Surgery, 

years  afterwards  of  bronchitis.  A  post-mortem  exami- 
nation  was  permitted,  when  we  found  the  cyst  shrivelled 
to  the  size  of  a  walnut  and  attached  by  a  pedicle  to  the 
ovary. 

In  cases  therefore  where  the  patient  cannot  reasonably 
be  expected  to  bear  ovariotomy^  or  declines  to  run  the  risk, 
I  would  recommend  tapping  in  conjunction  with  the  use  of 
Apis  mellifica. 

In  conclusion,  whilst  I  readily  admit  the  power  of  the 
antipsorics  to  influence  peripheral  morbid  lesions,  yet  I 
submit  that  it  is  safe  and  often  desirable  to  supplement 
the  curative  action  with  surgical  assistance. 


Discussion  on  Dr.  W.  S.  Craig* s  paper. 

Dr.  Wtld  did  not  see  how  tapping  could  be  of  use  in  any 
ovarian  tumour  unless  it  were  hyarous  and  unilocular.  He  had 
at  present  under  treatment  an  abnormal  tumour  diagnosed  by  the 
first  authority  in  London  to  be  multilocular  ovarian  tumour ^  and  a 
good  case  for  the  operation  for  removal.  Under  the  use  of 
Silicea  6  twice  a  day  aod  other  remedies,  together  with  daily 
'medical  rubbing  with  Olive  oil,  the  health  of  the  patient  has 
much  improved,  and  the  tumour,  which  was  gradually  increasing, 
has  decidedly  decreased  under  six  weeks'  treatment.  Twenty  years 
ago,  while  treating  a  woman  for  lar^e  ovarian  tumour,  it  most 
fortunately  burst  and  discharged  itself  by  the  vagina.  The  case 
made  a  perfect  recovery  and  is  well  up  to  the  present  day,  there 
being  no  recurrence  of  the  tumour. 

Dr.  Hale  doubted  whether  Dr.  Craig  had  sufficiently  discrimi- 
nated between  the  cases  of  hsamorrhoids  requiring  operatioa  and 
those  which  were  curable  by  medicine  uone.  In  the  great 
majority  of  cases  Dr.  Hale  had  succeeded  in  curing  basmorrhoids 
by  medicine  alone,  and  in  the  few  cases  in  which  he  had  advised 
an  operation  there  was  either  prolapsus  of  the  hsemorrhoidal 
tumour  during  the  exercise  of  walking,  riding  on  horseback,  or 
standing  (prolapsus  during  defecation  only  he  did  not  consider 
demanded  operation),  or  there  was  heemorrhage  which  medicines 
failed  to  control,  and  which  was  reducing  the  strength  of  the 
patient.  Under  those  two  conditions  Dr.  H.  had  seen  the 
most  happy  results  following  operation  either  by  ligature,  the 
Scraseur,  or  the  clamp  and  the  actual  cautery,  according  to  the 
nature,  shape,  or  situation  of  the  hsemorrhoid.  Dr.  Hale  men- 
tioned the  case  of  a  gentleman  who  had  become  ansemic  to  an 


by  Dr.  W.  S.  Craig.  311 

alarming  extent  from  very  slight  but  daily  recurring  hssmorrhage 
during  defsBcation,  going  on  for  many  months,  caused  by  a  small 
vascular  polypiform  tumour,  which  was  removed  by  the  clamp 
and  cautery  with  arrest  of  the  haemorrhage  and  complete  restora- 
tiom  of  health.     In  cases  of  fissure  of  the  anus  he  thought  opera- 
tion with  the  knife  the  quickest  and  most  effectual  moae  of 
treatment,  but  he  had  at  present  a  case  under  his  care  of  super- 
ficial fissure  external  to  the  sphincter,  which  he  was  treating  by 
dilatation  by  means  of  a  large  hougie  well  smeared  with  Calendula 
ointmenty  and  with  every  prqspect  of  cure.     Dr.  Hale  had  been 
often  consulted  about  non-malignant  irritable  tumours  of  thebreast ; 
in  such  cases  he  had  invariably  found  they  yielded  to  Qmium.     He 
related  a  case  of  fibrous  tumours  of  the  uterus  at  present  under 
treatment,  the  characteristic  feature  of  which  is  that,  although 
there  are  frequently  recurring  attacks  of  a  secretion,  which  is 
partly  coagulated  blood  and   partly  serum  deeply  tinged  with 
blood,  the  general  health  and  strength  of  the  patient  are  very 
slightly  affected,  the  most  distressing  symptom  being  a  fearful 
dread  of  fatal  flooding.     There  are  two  tumours  attached  to  the 
fundus,  the  left  very  mobile,  and  neither  of  them  fortunately 
pressing  to  any  extent  upon  the  rectum  or  bladder.     Has  given 
several  medicines,  amongst  the  rest  the  Finca  major,  suggested  by 
Dr.  Meadows,  but  without  any  very  satisfactory  result.  A  suspicion 
of  polypi  in  utero  was  dispelled,  for  upon  two  examinations  no 
polypus  was  found. 

Dr.  CooPEB  stated  that  it  was  very  desirable  that  we  should,  as 
homoeopathic  physicians,  cultivate  the  art  of  surgery  as  much  as 
possible,  but  unfortunately  the  means  at  our  disposal  were  far  too 
limited  to  accomplish  this  satisfactorily.  Dr.  Cooper  did  not 
think  Dr.  Craig's  inference  as  to  the  prophylactic  properties  of 
Sanguinaria  over  cancer  of  the  breast  after  removal  could  be 
justified  upon  such  insufficient  data.  Cancerous  tumours  of  the 
breast  frequently  do  not  return  after  operation,  and,  except  the 
evidence  ot  a  large  number  of  cases  be  taken,  the  non-recurrence 
of  these  tumours  could  not  be  accepted  as  exemplifying  the 
beneficial  effects  of  the  medical  treatment.  As  to  piles,  save  in 
very  exceptional  cases,  we  ouoht  to  be  able  to  cure  them  with 
medicines  alone.  Those  who  are  worse  educated  than  we  find  no 
difficulty  in  treating  an  ordinary  case  of  piles — ^he  referred  to  the 
herbalists,  a  class  from  whom  we  might  derive  many  a  wrinkle. 
If  operation  must  be  resorted  to  there  is  none  he  had  seen  com- 
parable to  that  of  the  actual  cautery  applied  by  catching  up  the 
piles  with  Henry  Smith's  protected  clamp,  and  applying  a  good, 
large,  red-hot  iron,  which,  when  applied  to  the  mucous  surface 
only,  never  causes  any  pain.  Dr.  Cooper  was  surprised  at  no 
reference  having  been  made  to  Rhatania,  a  remedy  of  established 
repute  in  homoeopathy  for  fissure  of  the  rectum.  In  reply  to  Dr. 
Hale,  asking  for  a  remedy  to  arrest  the  haemorrhage  from  a  fibrous 
tumour  of  the  uterus,  Dr.  Cooper  advised,  on  Dr.  McClintock's 


812  Specific  Medication  in  relation  to  Surgery y 

recommendation,  a  trial  of  Chloride  of  Calcium,  Dr.  Yaughan- 
Hnghesy  who  spoke  afterwards,  referred  to  some  points  of  treat- 
ment in  regard  to  epithelioma  of  the  breast,  and  Dr.  Cooper 
wished  to  know  if  this  was  a  very  common  affection,  to  which 
Dr.  Hughes  gave  an  affirmative  repl  j. 

Dr.  Whesleb,  after  congratulating  Dr.  Craig  upon  the  brevity 
and  practical  character  of  the  paper,  spoke  of  the  unadvisability 
of  delay  in  resorting  to  surgical  interference,  in  many  cases, 
where  instant  action  was  requisite,  and  illustrated  his  remarks  by 
mentioning  a  case  of  abscess  of  the  ischio-rectal  fossa,  which^ 
from  delay  in  operating,  had  resulted  in  a  most  severe  fistula  in 
ano,  and  consequent  disgrace  to  homoeopathy  and  suffering  to  the 

Satient.  He  quite  agreed  with  Dr.  Hale  in  the  importance  <^ 
istinguishing  between  cases  of  h»morrhoids  suitable  for  medical 
treatment  alone  and  those  where  surgical  interference  must  be 
resorted  to,  and  illustrated  his  remarks  by  two  cases  in  point, — one 
of  a  sailor  in  Australia,  in  whicb  the  attack  was  acute,  inflamma- 
tory, and  bleeding,  and  where  hot  fomentation  and  Nux  vom. 
and  Aconite  alone  sufficed  for  the  cure.  In  another  case  of 
more  chronic  character,  the  hemorrhoid  was  about  the  size  of 
a  large  walnut  and  could  not  be  returned.  In  this  case  the 
clamp  and  actual  cautery  was  used  and  the  sore  dressed  with 
Carbolic  oil  and  wet  bandages,  and  the  cure  was  perfect.  In 
reference  to  tumours  of  the  breast  Dr.  W.  remarked  that  there 
always  appears  an  element  of  doubt  in  those  cases  of  reputed 
scirrhus  which  are  operated  on  and  do  not  return.  There  are  so 
many  benign  tumours  of  the  breast  which  can  be  removed  by 
medical  means  alone.  Several  cases  of  apparent  cancer  of  the 
breast  have  entirely  disappeared  under  the  external  and  internal 
use  of  Hydrastis, 

Mr.  Habmab  Smith  observed  that  he  had  attended  two 
surgical  cases  lately  in  which  medicine  given  according  to  the 
homoBopathic  law  had  been  the  instrument  of  cure.  The  first 
case  was  that  of  a  ladT>  about  forty  years  of  age,  married,  and 
having  had  a  family,  who  bad  consulted  him  about  a  tumour  of 
the  breast,  which  very  much  disquieted  her,  as  .she  feared  that  it 
was  of  a  malignant  nature.  It  bad  increased  rapidly  from  the 
size  of  a  horsebean  to  that  of  a  small  orange.  It  was  hard  and 
lobulated,  but  scarcely  hard  enough  for  scirrhus.  The  pain  was 
lancinating,  severe  at  times,  but  bearable.  It  was  increased  after 
tiie  least  handling  of  the  tumour,  and  also  was  exasperated  at  the 
menstrual  periods.  The  rapid  growth,  the  circumbtance  last 
mentioned,  the  limited  hardness,  the  tenderness,  and  the  bearable 
character  of  the  pain,  he  thought  justified  him  in  assuring  the 
patient  that  it  was  not  scirrhus, «  conclusion  which  the  subse- 
quent history  of  the  case  confirmed.  It  was  treated  vnth 
Mydrastis  lotion,  and  Hydrastis  and  Phytolacca  were  given  inter- 
nally. Under  this  treatment  it  dwindled  and  nearly  disappeared. 
After  a  time,  however,  it  returned  and  was  as  hard  as  berore.    It 


by  Dr.  W,  8,  Craig.  818 

waa  then  treated  with  Phytolaeea  alone  (drop  doses  of  the 
mother  tincture),  and  with  a  yery  weak  l(9Cion  of  the  same 
tincture  (half  a  drop  to  each  dressing).  This  time  the  tumoi^r 
disappeared  so  mocD  more  rapidly  than  hefore  that  he  was  con- 
vinced that  the  cure  was  entirely  due  to  the  Phytolaeea.  The 
last  time  he  examined  the  breast  there  was  no  hardness  to  be 
felty  and  no  tenderness  on  pressure,  and  the  patient  had  passed 
her  monthly  period  without  any  return  of  the  pain.  He  had 
also  found  the  therapeutic  virtue  of  Phytolaeea  in  threatened 
abscess  and  other  affections  of  the  mammary  gland.  In  a  second 
patient,  who  was  still  under  treatment,  a  naSal  polypus  had  been 
in  a  few  weeks  greatly  reduced  in  size  by  Tht^a  taken  internally 
and  applied  to  the  part  affected.  The  polypus  had  nearly  plugged 
up  the  nostril,  but  was  now  reduced  to  the  size  of  a  pea,  and 
looked  like  a  small  wart.  He  had  also  visited  a  patient  on  his 
way  to  the  meeting,  the  credit  of  whose  cure  he  could  scarcely 
claim  for  homoeopathy  unless  the  beneficial  action  of  Merewry  in 
inflammation  of  the  joints  could  be  so  reckoned,  which  he 
supposed  in  strictness  it  might  be.  The  patient  was  a  youth 
who  had  fallen  and  hurt  his  knee,  and  got  effusion  under  the 
patella  with  much  tenderness  on  pressure  and  pain  on  movement. 
He  (Mr.  S.)  had  first  ordered  hot  fomentations,  then  cold  lotions 
with  Calendula,  but  there  was  no  improvement.  He  then  applied 
the  Ceratum  Sydraryyri  Comp,  of  the  P.  B.  (Scott's  ointment) 
spread  on  linen  rag,  an  application  which  he  had  often  used  with 
advantage  in  the  old  practice,  on  the  plan  recommended  by  the 
late  Mr.  Scott,  of  the  London  Hospital.  Over  the  rag  he  applied 
strips  of  plaster  and  a  bandage,  then  kept  the  joint  at  rest  by  a 
pasteboard  splint,  and  was  pleased  on  calling  to-day  to  find  the 
pain  and  swelling  gone,  and  the  patient  able  to  walk  without 
difficulty. 

Dr.  Yaughak-Huohes  remarked  that  it  waa  well  known  the 
fissured  anus  was  kept  from  healing  by  the  passage  of  feces  over 
the  denuded  and  ulcerated  surface,  and  he  had  resorted  to  the 
plan  of  washing  out  the  rectum  daily,  and  then  injecting  an  ounce 
of  Carbolie  oil  (1  to  10)  and  leaving  it  in  the  bowel,  where  it  was 
retained  with  great  comfort,  so  that  at  the  next  evacuation  no 
fsculent  matter  came  into  contact  with  the  fissure.  As  a 
supplement  to  this  proceeding  he  would  scrape  the  surface  of  the 
ulcer  with  his  nail,  and  thus  get  a  raw  healthy  basis,  and  this  he 
would  sometimes  paint  over  with  a  solution  of  Nitrate  of  Silver 
(1  to  20).  He  had  not  resorted  to  the  use  of  the  knife  for  a  long 
time.  He  once  cured  in  three  months  a  very  bad  case  of  fistula 
in  ano  (in  which  the  lady  said  she  would  die  rather  than  that  a 
knife  should  touch  her).  The  rectum  was  perseveringly  washed 
'  out  daily,  and  the  fieces  were  thus  cut  off  from  entering  the 
internal  aperture  of  the  abscess,  and  through  the  external  skin 
opening  a  solution  of  Chloride  ofZine  was  injected  by  means  of 
a  stopcock  syringe  attached  to  a  small  elastic  catheter.    Thus 


314  Specific  Medieaiion  in  relation  to  Surgery^ 

the  cavity  was  cleansed  dailj,  and  it  ^radoall j  healed  np  from 
the  fimdua.  Merc.  cor.  and  Arsenic  2>^  are  the  remedies  usaallv 
employed  internally  by  him.  Within  the  Ust  twenty-five  years 
Dr.  y.  H.  had  removed  a  goodly  number  of  scirrhous  growths, 
but  he  could  not  venture  to  say,  even  under  the  most  fiivourable 
circumstances,  that  they  did  not^  one  and  all,  return  sooner  or 
later.  Still  it  was  of  the  utmost  importance  sometimes  that  life 
should  be  prolonged  for  a  year  or  two,  and  he  did  not  hesitate  to 
use  the  knife.  When  a  tumour  did  not  return  he  felt  sure  that 
it  was  not  really  malignant,  but  of  a  fibroid  or  at  the  worst  of  an 
epitheliomic  character. 

Mr.  Pope  said,  that  while  he  believed  it  was  true  that  he  was 
the  best  surgeon  who  was  the  least  indebted  for  his  success  to  the 
use  of  the  knife^  he  thought  that  it  was  equally  true  that  in  the 
early  history  of  homeopathy  evil  had  been  done  by  too  often 
relying  on  medicine  when  the  knife  had  been  really  required.  It 
was,  no  doubt,  a  fact  that  many  cases,  where  surgical  interference 
would  otherwise  have  been  demanded^  were  curable  by  medicine 
alone,  when  that  medicine  was  homceopathically  indicated.  But 
still  there  were  only  too  many  where  this  was  not  the  case.  Of 
late  years  this  fact  had  become  more  generally  recognised,  and 
their  buainess  now  was  to  establish  clearly  the  line  of  demarca- 
tion between  those  cases  which  could  be  treated  medicinally  and 
those  which  required  the  surgeon's  knife.  Cases  of  piles,  of  fissure 
in  ano,  and  of  cancer  of  the  breast  were  among  those  which  they 
required  to  consider  carefully  from  such  a  point  of  view.  With 
regard  to  piles  there  were  many  instances  of  this  troublesome 
disorder  of  a  purely  functional  character  that  yielded  well  to 
medicine.  On  the  other  hand,  there  were  cases  of  chronic  enlarge- 
ment of  the  veins  which  gave  an  immense  amount  of  discomfort 
to  the  patient  that  no  medicine  could  do  more  than  imperfectly 
palliate,  while  the  pain  and  suffering  could  only  be  entirely 
removed  by  one  or  other  of  the  methods  Dr.  Craig  had  alluded 
to.  While,  again,  in  those  cases  of  bleeding  piles  where  a  great 
drain  was  going  on  and  undermining  the  health  of  the  patient, 
he  could  see  no  advantage  to  be  derived  irom  waiting  for  the 
specific  action  of  a  medicine  when  other  means  of  remedying 
them  at  once  were  at  hand.  Tumours  of  the  breast  afforded 
another  illustration.  In  one  class  where  there  was  a  hard  and  may 
be  suspicious  growth  in  the  mamma,  Gonium  was  undoubtedly 
curative.  These,  however,  were  not  cases  of  true  cancer.  Their 
nature  had  been  described,  and  their  remedy  pointed  out  many 
years  ago,  by  Sir  Astley  Cooper,  who  invariably  gave  the  Extract 
of  Oonium  in  a  pill  with  the,  at  that  time,  invariable  Blue  pill  in 
combination.  He  (Mr.  Pope)  had  frequently  read  in  homoeo- 
pathic journals  of  eases  of  cancer  of  the  breast  cured  by  Conium, 
lu  all  such  instances  he  believed  the  diagnosis  had  been  at  fiiult. 
Small  as  had  been  his  confidence  in  the  remedial  power  of  medi- 
cine over  scirrhus  of  the  breast,  he  would  never  again  advise  the 


by  Dr.  W,  S.  Craig.  315 

removal  of  the  disease  by  operation  until  a  fair  trial  had  been 
made  of  the  Hydrastis  Canadensis.  In  one  such  case,  which  bore 
all  the  marks  of  true  scirrhus,  he  had  seen  recovery  take  place. 
He  had  felt  so  confident  of  the  scirrhous  nature  of  the  tumour  in 
this  instance  as  to  have  recommended  its  removal  by  the  knife. 
While  the  patient  was  endeavouring  to  reconcile  herself  to  an 
operation  he  gave  her  the  Hydrastis,  said  the  result  was  that  the 
pain  left,  the  retracted  nipple  again  appeared,  and  the  hard 
swelling  became  imperceptible.  He  had  been  much  impressed 
by  the  result  of  treatment  in  this  instance,  the  more  so,  perhaps, 
as  it  was  entirely  unexpected.  That  the  cases  Dr.  Craig  had 
related  were  true  specimens  of  scirrhus,  had  been  verified  by  the 
microscope ;  and  the  non -reproduction  of  the  disease,  which 
usually  occurred  within  eighteen  months  of  operation,  might,  he 
thought,  be  fairly  attributed  to  the  8anguUiaria  used  by  Dr. 
Craig.  At  all  events,  it  was  of  great  importance  to  know  that 
they  had  medicinal  measures  worthy  of  some  degree  of  confidence 
in  these  very  anxious  cases. 

Dr.  Yeldhah  urged  the  absolute  necessity  of  examining  the 
anus  and  rectum  in  reputed  cases  of  piles.  He  had  seen  many 
sad  mistakes  occur  from  the  omission  of  this  simple  procedure : 
cancer  of  the  rectum,  attended  with  the  protrusion  of  granular 
growth,  treated  as  cases  of  piles.  He  had  seen  several  cases  of 
itching  eczema  ani  treated   for  piles,  on  the  ifse  dixit  of  the 

Eatient.  He  made  it  a  rule  never  to  treat  a  case  of  piles,  if 
e  could  possibly  avoid  it,  without  ocular  and,  if  necessary, 
manual  examination.  The  advantage  of  this  was  immense.  Some 
time  since  he  saw  a  gentleman  from  the  country  who  had  been 
attended  two  years  for  bleeding  piles.  He  had  never  been 
examined.  On  examination  a  bleeding  point  on  an  internal  pile 
was  instantly  detected.  Two  applications  of  Nitric  acid  stopped 
the  bleeding,  and,  with  proper  medicines,  cured  the  pile.  In 
recent  piles,  medicines,  as  a  rule,  were  alone  necessary,  and  in 
some  chronic  ca^es  too.  In  all  cases  they  did  good.  Those  on 
which  he  relied  were  the  mother  tinctures  of  Sulphur,  Nux 
vomica,  and  Hydrastis,  chiefly.  Some  cases  demanded  the  addi- 
tion of  other  measures.  Of  these  he  found  the  application  of 
Nitric  acid  the  most  frequently  available.  He  applied  it  with  a 
glass  rod.  When  confined  to  the  mucous  membrane  it  was 
nearly,  in  some  cases  quite,  painless.  It  not  only  stopped 
bleeding,  but  under  its  action  the  pile  shrunk  and  ultimately 
disappeared.  He  agreed  with  Dr.  Hughes  that  it  was  rarely- 
necessary  to  incise  fissure  in  the  anus.  The  object  to  be  had  in 
view  in  the  treatment  was  to  protect  the  ulcer  from  the  contact  of 
faeces,  which  irritated  the  nerves  and  caused  the  agonising  spasm 
for  hoiirs  after.  He  efi*ected  this  by  the  introduction  of  the 
finger,  immediately  before  and  after  evacuating,  well  charged 
with  lard.  As  regarded  afiections  of  the  breast,  he  knew  that 
cases  of  fibrous  tumour  were  sometimes  removed  as  cancerous 


316  Specific  Medication  in  relation  to  Surgery , 

disease.  A  lady  friend  of  his  once  had  undergone  such  an  opera- 
tion. He  knew  her  to  have  sereral  hard  fibroas  lamps,  feeling 
like  so  manj  small  eggs,  moveable  under  the  skin  of  the  breast, 
for  manj  years.  A  surgeon  removed  them  ;  they  had,  of  coarse, 
not  recumd,  but  she  had  been  in  weak  health  ever  since  the 
operation,  now  some  yebrs.  The  chief  diagnostic  signs  of  trae 
cancer  were  its  irregular  nodulated  condition,  and  intense 
hardness.  Fibrous  tumours  were  smoother,  more  uniform  in 
shape,  and  somewhat  elastic.  The  constitutional  conditi<m  of  the 
two  diseases  was  also  generally  different.  As  to  the  treatment 
of  wounds,  whilst  he  fully  admitted  the  great  value  of.  Calendyla 
as  a  topical  application,  and  employed  it  where  wet  dressings 
were  necessary,  as  in  open  ulcers  and  the  like,  he,  on  the  other 
hand,  greatly  preferred  dry  dressings  in  all  cases  where  they 
were  admissible,  such  as  cases  of  fresh  and  incised  wounds,  and 
the  like.  Warmth  and  moisture,  conditions  unavoidable  when 
lotions  were  applied  to  a  limb  and  enveloped  in  bandages,  inevit- 
ably favoured  decomposition  of  discharges  from  wounds,  and 
prevented  healthy  granulation  and  union.  Dry  dressings  of 
cotton-wool  and  lint  had  no  such  effect,  but,  on  the  contrary,  by 
excluding  the  access  of  air,  and  water  moisture,  and  infecting 
germs,  they  tended  to  prevent  decomposition  and  to  promote 
healthy  action ;  under  these  dressings,  pus  even  was  benign  and 
unirritating.  In  incised  wounds,  whether  from  accident,  or  from 
amputations  of  limbs,  the  breast,  &e.,  the  plan  was  to  bring  the 
'  cut  edges  together  with  silver  sutures  (never  with  thread),  wash 
the  blood  away  arotmd  the  wound,  wipe  it  thoroughly  dry,  apply 
a  layer  of  cotton-wool  or  lint,  and  a  roller,  and  let  these  remain 
undisturbed  as  long  as  possible.  He  would  give  an  example.  A 
few  days  ago  a  gentleman,  occupying  offices  over  his  consulting 
rooms,  in  attempting  to  draw  the  cork  of  a  bottle  of  wine  in  the 
old-fashioned  way,  burst  the  bottle  between  bis  knees  and  cut  his 
hand  and  thigh  fearfully.  The  end  of  the  forefinger  of  the  left 
hand  was  nearly  severed ;  a  large  piece  of  fiesh  was  scooped  out 
between  the  forefinger  and  thumb,  and  hung  by  a  piece  of  skin 
only;  and  a  deep  wound  of  three  inches  long  was  inflicted 
diagonally  in  the  thigh,  immediately  across  the  femoral  artery. 
Had  there  not  been  a  considerable  layer  of  fat  this  vessel  would 
inevitably  have  been  wounded.  Keeping  the  arm  in  an  elevated 
position  for  a  few  minutes  till  bleeding  ceased,  and  having  ascer- 
tained that  there  were  not  pieces  of  glass  in  the  wounds,  he 
(Dr.  Y.),  without  washing  the  blood  away,  for  blood  was  the  best 
of  all  lotions,  replaced  the  piece  of  detached  flesh,  applied  pledgets 
of  dry  lint  to  it  and  the  cut  finger,  and  kept  them  m  position  by 
light  rollers  of  lint.  Three  silver  sutures  were  inserted  in  the 
lips  of  the  femoral  wound,  and  it  was  covered  and  bandaged  in 
like  manner.  This  was  on  Monday  afternoon.  The  dressings 
were  allowed  to  remain  undisturbed  till  Saturday  afternoon.  On 
removing  them  the  union  was  perfect  in  every  place. '  The  sutures 


by  Dr.  W.  S.  Craig.  317 

were  removed,  a  little  lint  and  Spermaceti  (dnttnent  applied,  and 
the  ease  was  ended.  He  did  not  think  such  satisfactory  results 
would  have  followed  the  application  of  moist  dressings.  He 
might  add  that  the  perfect  comfort  of  the  parts  was  his  guide  in 
leaving  the  dressings  undisturbed  ;  had  there  been  pain  he  would 
have  removed  them  earlier. 

Dr.  Watbok  wished  to  call  attention  to  the  value  of  Oonium  in 
tumours  of  the  breast.  One  case,  that  of  a  young  girl  who  had 
sustained  a  severe  contusion  of  the  left  breast,  resulting  in  a  swelling 
freely  movable,  but  hard,  the  size  of  a  small  walnut,  was  eom- 
pletely  cured  in  fourteen  days  by  Conium  in  pilules,  to  his  surprise 
and  great  gratification,  as  he  feared  it  might  lead  to  scirrhus. 
He  had  also  seen  scirrhus  of  the  breast  removed  in  an  old  lady 
of  71,  arising  from  contusion,  by  enucleation  with  Chloride  of  Zinc 
and  Hjfdrattis,  with  perfect  success.  This  case  was  pronounced 
scirrhus  by  the  most  eminent  allopathic  surgeon  of  the  day.  Dr. 
Watson  had  effected  a  cure  of  fistula  in  &no  with  Iodide  of 
Calcium,  and  had  often  proved  the  value  of  Hamamelie  supposi* 
tories  in  hjemorrhoids. 

Dr.  Dbuby  waa  much  pleased  to  see  Dr.  Craig  at  the  meeting. 
It  always  added  much  to  the  value  of  a  paper  when  the  author 
could  read  it  himself  and  so  do  full  justice  to  his  subject. 
Besides  this  it  was  always  pleasant  to  see  members  from  the 
country,  a  personal  acquaintance  being  in  every  way  an  advan- 
tage, new  friendships  were  formed,  and  instead  of  our  knowledge 
being  confined  to  knowing  a  man  by  his  writings,  a  shake  of  the 
hand  helped  to  strengthen  the  tie  that  bound  our  body  together. 
He  was  glad  to  hear  what  Dr.  Craig  had  said  of  Samguinaria,  that 
being  a  medicine  that  he,  Dr.  Drury,  had  much  confidence  in  in 
properly  selected  cases,  while  Conium,  Hydrastis,  and  other 
remedies  might  each  in  turn  prove  serviceable  in  alleviating  the 
suffering  or  retarding  the  progress  of  cancer.  Dr.  Drury  had 
heard  with  regret  the  manner  in  which  caustics  had  been  spoken 
of.  It  was  a  delusion  to  speak  of  them  as  cures  for  cancer ;  he 
did  not  believe  in  the  cure  of  a  single  case  of  cancer  by  such 
means,  but  what  he  particularly  wished  to  protest  against  was 
the  fact  that  gentlemen  occasionally  got  up  and  deliberately  re- 
commended an  allopathic  course  of  treatment  much  in  the  same 
way  as  they  would  do  if  speaking  in  an  allopathic  society,  doing 
so  without  necessity  and  quite  as  a  matter  of  course.  'Circum- 
stances might  justifv  a  departure  from  starict  homceopathic  prac- 
tice, and  if  the  good  of  the  patient  demanded  it  the  physician 
should  be  as  free  and  fearless  in  this  as  anything  else,  but  to 
persistently  select  and  recommend  allopathic  practice  in  a 
homoeopathic  society,  as  a  rule,  was  open  to  very  grave  censure.  It 
so  happened  that  some  time  ago  a  student  from  one  of  the  allo- 
pathic hospitals  was  regularly  watching  his  practice  in  the 
diseases  of  children ;  he  invited  him  to  be  present  at  a  pieeting  of 
the  Society.    It  so  happened  that  it  was  an  evening  when  it  was 


318  Specific  Medication  in  relation  to  Surgery, 

desirable  that  the  meeting  should  terminate  early,  so  that  there 
were  not  manj  speakers.  One  gentleman  advocated  a  regular 
allopathic  line  of  treatment,  which  he  found  most  convenient  in 
his  own  practice.  Dr.  Drury  blamed  himself  very  much  for  not 
rising  at  the  time  to  protest  against  such  teaching,  as,  unfortu- 
nately, the  result  was  that  his  young  friend  had  entirely  ceased 
attending,  feeling,  no  doubt,  that  if  what  he  heard  was  common 
amongst  the  homoeopaths,  there  was  nothing  to  be  gained  by  his 
forsaking  University  or  King's  College. 

Dr.  Bates  (Vice-President)  said  that  it  appeared  to  him  that 
the  expressed  object  of  Dr.  Craig's  paper  had  been  somewhat 
overlooked  by  the  gentlemen  who  had  spoken  upon  it  and  had 
been  misinterpreted  by  most.  Dr.  Craig  had  brought  four  very 
interesting  classes  of  disease  under  notice,  viz.  haemorrhoids, 
fissured  anus,  cancer,  and  ovarian  tumour,  but  he  did  not  bring 
these  diseases  forward  with  the  view  of  discussing  their  medical 
treatment,  but  to  show  how  far  specific,  i.  e,  homoeopathic,  treat- 
ment, even  after  it  had  failed  to  cure  the  disease,  could  never- 
theless complete  the  restoration  of  the  patient  after  surgery  had 
been  brought  in  aid.  It  was  to  be  assumed  that  the  cases 
brought  forward  by  Dr.  Craig  had  resisted  the  curative  power  of 
medicine  and  that  he  had  had  recourse  to  the  knife  as  a  last 
resource,  but  then  specific  medicine  came  in  usefully  to  prevent 
a  recurrence  of  the  ailment.  This  appeared  to  be  the  author's 
object,  especially  with  regard  to  cancer,  in  which  disease  a  return 
of  the  malignant  tumour  was  the  rule  under  simple  surgery; 
whereas  Dr.  Craig  had  found  that  no  such  return  of  cancer  was 
to  be  feared  if  the  patient  was  placed  under  appropriate  specific 
treatment  after  the  operation.  No  homoeopathic  practitioner 
could  doubt  that  by  far  the  greater  number  of  cases  of  hiemor- 
rhoids  can  be  cured  by  homoeopathic  medication  ;  such  cures  are 
in  our  constant  daily  experience,  but  where  no  such  tendency  to 
cure  follows  appropriate  medication  nothing  remains  but  to 
operate  and  the  operation  must  not  be  delayed  too  long,  but  after 
the  operation  specific  medicine  may  complete  the  cure  by 
checking  all  tendency  to  their  new  formation.  It  was  singular 
that  none  of  the  speakers  had  alluded  to  one  of  the  most  power- 
ful means  in  the  cure  of  haemorrhoids,  viz.  the  external  and 
internal  use  of  Hamamelia,  But  in  piles  the  state  of  the  health 
of  the  patient  demands  our  first  care,  as  this  afiection  is  very 
generally  only  an  expression  of  functional  disturbance,  and  is  t'^ 
be  removed  by  restoring  functional  balance.  He  (Dr.  Bayes) 
liever  found  it  needful  to  have  a  case  of  fissure  of  the  anus 
operated  on.  Within  the  past  fortnight  it  had  been  his  good 
fortune  to  see  two  patients  who  had  readily  recovered  from  this 
painful  afiection  and  who  remained  well.  He  had  for  a  long  time 
adopted  a  method  in  some  respects  similar  to  those  named  by 
Dr.  Yaughan- Hughes  and  Dr.  Yeldham.  He  directed  his 
patients  to  inject  two  or  three  ounces  of  Olive  oil  every  morning 


by  Dr.  fF.  ,S.  Craig.  319 

before  the  usual  time  of  evacuating  the  bowels,  and  in  addition 
he  also  ordered  an  ointment  of  Hydrastis  Canadensis,  ten  grains 
to  the  ounce.  This  ointment  is  to  be  spread  on  a  narrow  strip  of 
lint  and  introduced  by  means  of  a  pen-stick  within  the  anus  every 
night,  and  to  be  allowed  to  remain  there  with  the  free  end 
hanging  out.  As  to  the  constitutional  treatment  of  cancer,  both 
Sof^inaria  and  Hydrastis  are  most  useful.  He  (Dr.  Bayes) 
had  formerly  expressed  an  opinion  as.  to  the  action  of  the  latter 
remedy  (in  a  paper  read  before  the  Society),  which  his  subse- 
quent experience  tended  to  confirm,  viz.  that  Hydrastis  does  not 
exert  anv  specific  influence  over  cancer,  but  that  it  induces  a 
healthy  runctional  state  in  the  glands  and  that  this  checks  the 
development  of  cancer  and  so  to  say  starves  the  morbid  growth. 
As  bearing  somewhat  on  these  subjects,  Dr.  Bayes  would  again 
take  the  opportunity  of  drawing  attention  to  the  power  of  Sutpho- 
carbolate  of  Lime  in  checking  the  formation  of  pus  and  in 
arresting  the  development  of  morbid  growths  when  given  in  very 
small  doses. 

Dr.  Cbaio,  in  replying,  thanked  the  President  for  reminding 
the  meeting  that  the  object  of  the  paper  was  not  to  supplant  all 
attempts  at  cure  by  homoeopathic  means  by  immediate  recourse 
to  surgical  interference,  but  rather  to  show  the  propriety  of 
supplementing  the  former  bv  the  latter  when  there  was  need. 
He  reiterated  the  advice  of  Dr.  Yeldham  to  all,  particularly 
young  practitioners,  to  institute  an  examination  of  the  parts  in 
diseases  of  the  rectum,  and  thus  avoid  grievous  mistakes  in 
diagnosis.  He  thanked  the  Society  for  their  kindly  acceptance 
of  so  simple  a  paper  and  for  the  very  suggestive  discussion 
arising  thereon. 


820 


CASES  FROM  THE  LONDON  HOMCEOPATHIC. 

HOSPITAL. 

By  Dr.  Mackechnie. 

Thb  interest  of  the  following  group  of  cases  is  greatly 
increased  by  thei;r  pathological  relationship. 

The  first  case^  one  of  '^  land-scurvy/'  was  manifestly 
inflaenced  by  the  medicine  employed,  for  hygienic  and 
dietetic  measures  alone  would  not  have  ensured  recovery  in 
so  short  a  space  of  time.  At  the  same  time  that  medicine 
would  not  have  obtained  a  cure  without  the  hygienic  means 
employed  is  evident  enough. 


Scorbutus. 

E.  J — ,  set.  20,  housemaid,  was  admitted  on  October  8rd, 
1871,  suffering  from  an  eruption  all  over  the  body,  but 
especially  on  the  extremities,  and  accompanied  by  great 
languor  and  debility.  The  eruption  is  of  a  purplish  colour 
in  small  spots  or  patches. 

On  admission  we  find  that  her  illness  has  been  coming 
on  for  some  months.  She  has  been  living  in  a  house 
where  the  kitchen  is  ver^  dark  and  dose.  Has  not  cared 
mpch  for  her  food  and  has  been  troubled  with  frequent 
heartburn  after  food.  Has  eaten  little  or  no  vegetable  food, 
chiefly  because  she  found  that  heartburn  was  sure  to  follow 
the  use  of  potatoes,  and  there  was  seldom  any  other  vege- 
table to  be  had. 

On  inquiry  I  find  she  has  noticed  her  skin  to  be  very 
liable  to  bruise  from  the  slightest  causes  for  some  weeks 
past,  and  also  that  the  gums  bleed  readily.  Upon  examina- 
tion they  look  spongy  and  dark  coloured.  The  patient  is 
thin  and  delicate-looking,  with  dark  n^arks  under  the  eyes. 
She  complains  of  dyspnoea  in   going  up  stairs.     The  cata- 


by  Dr.  Mackechnie.  821 

menia  have  been  occurring  about  every  three  weeks,  and 
have  been  decidedly  more  profuse  than  usual^  painless^  last- 
ing seven  days,  and  followed  by  much  prostration.  The 
pulse  is  96,  but  there  is  no  suspicion  of  feverishness ;  hands 
and  feet  chilly.  She  has  beeu  troubled  much  with  severe 
pains  in  various  parts  of  the  body,  especially  the  face  (appa* 
rently  neuralgic  in  character).  The  blotches  and  patches  on 
the  skin  are  purple  in  colour,  and  tend  to  run  together* 
They  are  accompanied  by  a  good  deal  of  itching  after  they 
have  been  out  for  a  day  or  two.  Sleep  is  good ;  rather 
heavy,  but  she  does  not  wake  refreshed.  Sight  has  been 
very  weak  of  late,  and  she  is  troubled  with  dizziness  and 
vertigo  after  she  has  been  exerting  herself  for  a  time. 
Palpitation  of  heart  with  any  exertion^  and  frequently  with- 
out. On  examination  I  find  some  bruit  at  the  cervical 
veins,  not  constant,  however,  most  heard  when  standing. 
Bowels  are  very  constipated,  acting  only  every  third  or 
fourth  day  with  much  difficulty.  She  was  ordered  first 
diet  with  the  juice  of  half  a  lemon  a  day.  For  medicine 
she  had  Sulphur  ^,  a  drop  three  times  a  day. 

October  7th. — Reports  the  skin  much  the  same,  some 
fresh  patches  having  come  out,  especially  on  the  lower  ex- 
tremities. The  bowels  are  acting  once  a  day,  but  with 
difficulty ;  otherwise  much  the  same. 

11th. — Decidedly  improving,  the  patches  dying  away, 
the  itching  ceased.  Feels  herself  much  more  comfortable^ 
though  still  rather  wea)&.  Bowels  acting  every  day  with 
moderate  ease;  spirits  greatly  improved. 

14th. — The  eruption  almost  entirely  disappeared.  There 
has  not  been  any  fresh  appearance  for  a  week.  The  bowels 
acting  moderately  well.  She  feels  so  much  better  that  she 
was  at  her  own  request  dismissed  with  strict  directions  as 
to  her  regimen  and  hygiene^  and  ordered  a  continuance  of 
the  Sulphur. 

It  seems  to  me  that  this  case  was  sufficiently  marked^  and 
the  recovery  was  sufficiently  rapid,  to  say  that  the  latter  was 
due  to  something  more  than  the  hygienic  and  dietetic  treat- 
ment^ which  are  notoriously  slow  in  their  operation ;  and  I 
am  inclined  to  think  that  we  may  attribute  it  in  a  great 

VOL.  XXXII,  NO.  CXXVIII. APRIL,  1874.  X 


322       Ca9e$from  the  Ixmdon  Hcmmopathie  Hospital, 

meamire  to  the  medicine,  althongfa  this  was  selected  in 
accordance  only  with  the  concomitant  symptoms  of  the 
malady,  Tiz.,  with  the  constipation  and  the  itching  of  the 
skin. 

Purpmra  h^tmorrkagica. 

J.  O — f  enf^eer's  assistant,  st.  80,  admitted  September 
28th,  1869,  SQ&ering  with  hemorrhagic  troubles.  Has 
generally  enjoyed  good  health,  but  seven  years  ago  was  laid 
up  with  acute  rheumatism,  firom  which  he  recovered  with- 
out any  ill  consequences  remaining  perceptible  to  himself. 
Is  on  admission  rather  thin,  and  is  very  weak  with  an 
anxious,  worn  expression  of  countenance.  Appetite  gene- 
rally very  moderate,  has  been  not  so  good  of  late.  Has  eaten 
a  good  deal  of  fish,  especially  fresh  fish ;  does  not  ever  eat 
much  fresh  vegetables,  and  has  of  late  taken  less  than  usual. 
Seven  months  ago  had  a  severe  attack  of  epistaxis,  and  at 
the  same  time  coughed  up  a  considerable  quantity  of  dark- 
coloured  clotted  blood,  followed  in  fourteen  days  by  some 
red  spots  on  the  hands  and  wrists  of  the  sixe  of  flea-bites  ; 
these  gradually  extended  to  the  arms,  and  thence  to  the 
trunk,  while  he  became  very  much  out  of  health  and 
very  weak.  Cannot  give  any  account  of  the  treatment 
which  was  then  employed.  He  recovered,  however,  but 
has  ever  since  been  troubled  with  occasional  attacks  of 
epistaxis.  Seven  weeks  ago  had  a  severe  attack  of  diarrhoea 
which  lasted  two  days,  and  daring  which  he  passed  a  large 
quantity  of  (florid  ?)  blood  with  the  stools.  Has  remained 
very  weak  ever  since,  ^  and  the  present  eruption  began  to 
make  its  appearance  almost  immediately  after.  There  are 
a  great  number  of  purpuric  spots  over  the  legs  and  arms  and 
a  few  on  the  trunk  ;  they  vary  from  the  size  of  a  mere  point 
to  that  of  a  split  pea,  and  a  few  which  are  even  larger  appear 
to  have  arisen  from  the  coalescence  of  some  of  the  latter. 
He  has  also  here  and  there  some  ecchymoses  which  seem  to 
have  occurred  from  very  trivial  causes.  He  complains  of 
aching  in  the  limbs  and  of  being  very  easily  fatigued.  Sleep 
not  good,  being  much  broken,  and  not  refreshing. 


by  Dr.  Mackechnie,  328 

The  gums  show  no  signs  of  haemorrhage  at  present. 
Tongue  clean;  appetite  moderately  good  ;  complains  of  con- 
stant thirst ;  bowels  regular^  urine  rather  pale  coloured. 
There  is  slight  tenderness  noticed  on  pressure  over  the 
lumbar  regions.  The  hepatic  dulness  normal ,  splenic  ditto. 
Sespiratory  sounds  good ;  heart  sounds  normal.  Complains 
of  dyspnoea  on  ascending  stairs  or  with  a  very  moderate 
amonnt  of  exertion.     Spirits  are  very  much  depressed. 

On  admission  he  was  put  under  the  influence  of  Arsenicum 
8^  a  drop  to  be  taken  three  times  a  day.  He  was  put  upon 
the  first  diet  with  two  ounces  of  lemon  juice  and  a  pint  of 
beer  per  diem. 

On  October  5th  he  complained  of  a  good  deal  of  heat 
and  soreness  about  the  principal  seats  of  the  purpuric  spots^ 
which  latter^  however^  had  been  lessening  slightly,  and  one 
of  the  legs  looked  much  less  intense  in  colour  as  a  whole, 
but  upon  examining  closely  I  found  there  was  somewhat  of 
a  blush  (erythematous)  over  the  part  where  the  eruption  was 
thickest,  and  the  patient  was  complaining  of  some  headache, 
and  had  not  slept  so  well  the  last  night  or  two.  Belladonna 
8',  two  drops  three  times  a  day. 

7th. — The  erythematous  condition  has  subsided.  The 
pnrpura  is  lessening.  Complains  of  feeling  very  weak; 
takes  and  enjoys  his  food,  but  is  troubled  with  flatulence 
shortly  after,  with  much  abdominal  rumbling.  Under 
these  circumstances  he  was  put  upon  China  8^,  two  drops 
three  times  a  day. 

From  this  time  the  case  continued  steadily  to  improve ; 
there  was  no  return  of  the  erythematous  condition,  while  the 
pnrpura  gradually  subsided,  and  he  was  dismissed  on  the 
22nd  October  cured. 

Erythema  nodosum. 

The  next  case,  that  of  M.  A.  G — ^  a  housemaid,  est.  25^ 
is  characteristic,  though  considerably  difierent  from  either 
of  the  others.  She  is  a  fair,  thin-skinned,  rather  delicate* 
looking  girl.'  Has  been  getting  out  of  health  for  some 
months,    feeling    easily   fatigued,    languid,    and    mentally 


824       Cuses  from  the  London  Hommopathic  Hospital^ 

depressed.  Has  latdy^  for  some  weeks,  though  she  seems 
very  uncertain  as  to  its  duration,  noticed  an  eruption  which 
affects  her  principally  on  the  extremities,  but  has  lately 
affected  the  trunk  also.  It  occurs  at  first  in  the  shape  of 
patches  of  about  the  size  of  a  split  pea  or  bean.  They  are 
slightly  elevated,  red  in  colour,  and  raised  a  little  above  the 
surrounding  surface,  and  itch  and  burn  like  the  sting  or  bite 
of  an  insect;  do  not  disappear  but  become  purplish  in 
colour  and  are  very  slow  in  subsiding,  the  irritation  ceasing 
long  before  the  spot  disappears;  fresh  ones  making  their 
appearance  here  and  there  to  keep  up  the  supply.  She  is 
unable  to  give  any  account  of  the  reasons  of  her  present 
illness.  £[as  lived  well,  and  appears  to  have  kept  up  the 
balance  between  animal  and  vegetable  food  well.  Has  very- 
little  out-door  eiercise.  The  countenance  is  pale,  sallow^ 
with  dark  marks  under  the  eyes,  and  an  anxious  expression. 
The  temperature  is  good.  Pulse  74.  Complains  of  general 
aching  pains,  which  trouble  her  most  when  at  rest,  and 
especially  at  night.  Has  occasional  headache  affecting  her 
in  the  morning,  generally  passing  off  after  breakfast.  The 
catamenia  have  not  occurred  for  several  months.  Has 
palpitation  of  the  heart,  which  she  feels  under  any  exertion. 
On  auscultation  the  heart  sounds  are  found  to  be  natural, 
and  the  cardiac  dulness  within  its  natural  limits.  No 
cough,  but  is  liable  to  colds,  which  generally  eventuate  in 
cough. 

Was  admitted  on  December  2nd,  1870,  and  had  Arsenicum 
8rd,  drop  three  times  a  day.  She  was  ordered  first  diet, 
to  which  was  added  in  a  day  or  two  four  ounces  of  port  wine 
a  day. 

Under  this  treatment  a  certain  amount  of  improvement 
occurred,  though  it  was  so  slight  that  on  December  14th  I 
thought  it  well  to  try  another  dilution  of  Arsenicum,  and 
ordered  the  12th  to  be  given  three  times  a  day.  Under 
this  the  patient  remained  much  the  same,  but  on  the  21st 
she  was  suffering  much  with  headache,  the  head  having  a 
sense  of  fulness  with  heat,  aggravated  by  movement.  The 
catamenia  occurring  with  pelvic  pains  and  scanty  dischai^e, 
frc,  the  house  surgeon  ordered  Belladonna  V  to  be  taken 


by  Dr.  Mackechnie.  325 

as  frequently  as  required.  On  the  23rd  the  head  was 
greatly  relieved  and  the  catamenial  discharge  had  ceased, 
this  having  been  its  first  appearance  for  several  months. 
The  eruption  was  much  the  same.  She  is  complaining 
much  of  severe  rheumatic  pains  which  wander  from  limb  to 
limb^  and  are  most  troublesome  at  night  when  warm  in 
bed.  These  pains  have  been  somewhat  relieved  by  the 
limbs  being  bandaged  tightly.  The  appetite  continues  very 
bad.  The  bowels  are  constipated.  The  urine  normal. 
Tongue  clean. 

Rhus  toancodendron  6^  a  drop  three  times  a  day^  was  then 
ordered,  and  from  that  time  a  decided  and  speedy  improve- 
ment set  in.  The  eruption  then  apparent  gradually  faded 
away,  while  there  was  little  or  no  fresh  appearance  of  spots 
occurring.  At  the  same  time  the  general  health  rapidly 
improved.  The  appetite  began  to  improve  and  the  pains  to 
subside,  while  the  headache  generally  disappeared. 

On  January  1st  I  find  reported  "  vertiginous  on  going 
out  to-day .^^  Some  headache  afterwards.  "  Appetite 
good.''     The  eruption  improving. 

3rd.-; — "  Still  improving.'*  "  Vertigo  ceased."  •*  No  head- 
ache."    "  Strength,  improving." 

7th. — She  has  been  improving,  but  when  going  out 
yesterday  seems  to  have  taken  cold.  Nasal,  fluent  catarrh 
with  some  sneezing,  and  soreness  of  the  margins  of  the 
nostrils.     Mercurius  3  was  given  every  four  hours. 

On  the  8th,  at  her  own  request,  she  was  dismissed 
''greatly  relieved,"  to  continue  as  an  out-patient,  the 
eruption  having  nearly  disappeared,  and  being  manifestly  in 
rapid  progress  towards  cure. 

£.  P — ,  a  servant,  set.  35,  was  admitted  June  17th,  1871, 
giving  the  following  history.  Has  generally  had  good 
health,  but  for  the  last  two  months,  and  more  especially  the 
last  month,  she  has  been  feeling  weak  and  poorly,  while 
her  appetite  has  been  failing  her.  No  special  dyspeptic 
symptoms. 

The  first  symptoms  noticed  were  some  unsteadiness  in 
walking,  staggering  gait,  vertigo,  trembling  of  the  legs,  ftc. 


326       Cases  from  the  London  Hommc^athic  Hospital, 

She  gradually  got  worse  until  the  15thj  when  she  found  she 
could  no  longer  stand  on  her  feet  on  account  of  the  paio 
and  stiffness  there  and  in  all  the  joints  of  the  legs.  Upoa 
examining  the  limbs  she  found  the  shins  covered  with 
an  eruption  of  light  red  spots  very  sparsely  scattered, 
aching  and  somewhat  sore  to  touch.  These  were  followed 
by  others,  and  at  present  they  are  pretty  thickly  spread  over 
the  whole  of  the  lower  extremities  where  they  appear  to  be 
still  coming  out.  The  spots  vary  somewhat  in  colour 
according  to  the  length  of  time  they  have  been  out,  fading 
under  pressure,  and  the  older  ones  being  the  darker.  They 
are  all  slightly  raised  above  the  surrounding  surface,  and  are 
sore  to  touch,  especially  those  on  the  tibia.  The  bowels 
were  sluggish,  acting  every  or  every  other  day ;  evacuations 
light  coloured  and  scybalous.  The  urine  natural,  rather 
copious.  She  complains  of  frequent  headache^  frontal 
vertigo,  and  confusion  of  sight,  especially  in  the  open  air,  and 
on  suddenly  rising  up  to  the  standing  position.'  Sleep  has 
been  disturbed  and  broken  of  late  and  full  of  unpleasant 
dreams,  with  difficulty  in  getting  to  sleep  again.  Pulse  at 
wrist  96,  rather  full  but  soft. 

Aconite  1  was  prescribed,  a  drop  every  three  hours. 
First  diet  and  beer,  one  pint  a  day,  was  ordered. 

19th. — Much  the  same,  does  not  think  many  fresh  spots 
have  made  their  appearance  since  she  came  in.  In  other 
respects  is  very  much  the  same. 

She  complains  that  beer  does  not  agree  with  her.  Bella^ 
donna  1%  a  dtof  every  three  hours,  was  ordered.  Diet  the 
same  except  that  she  was  to  have  claret  ^iv  in  place  of  the 
.  beer. 

21st. — Better  decidedly.  The  pain  in  the  joints  much 
less;  the  spots  not  so  red  nor  so  tender.  Head  better, 
and  slept  better  last  night. 

24th. — 'Continuing  to  improve.  Feels  sure  no  more 
spots  have  appeared,  and  the  limbs  are  altogether  easier  as 
well  as  the  head.  Appetite  better  than  it  has  been  for  a 
long  time. 

28th. — She  was  still  further  improved,  and  on  July  3rd 
she  was  discharged  quite  cured. 


by  Dr,  Mackechnie.  827 


Chhrdsis. 

The'  foUowiDg  differ  considerably  from  the  foregoing 
cases  on  account  of  the  absence  of  any  eruption  or  petechial 
mark^  the  only  *point  of  resemblance  being  that  there  is 
manifestly  in  all  of  them  an  unhealthy  condition  of  the 
blood  and  consequently  of  the  containing  vessels.  The 
patient  J.  B — ,  whose  case  I  have  to  narrate  to  you  now,  is 
a  rather  tall,  delicate* looking  girl  with  very  pale  complexion, 
white  lips,  &c,  suggesting  at  once  the  idea  of  chlorosis. 
The  skin  is  white  and  clear  looking,  while  the  hair  is  dark. 
Has  lived  for  some  time  in  Bermuda,  where  she  had  a  bad 
attack  of  yellow  fever  in  1856.  Has  never  bad  jaundice. 
Has  been  resident  in  England  for  three  years.  Has 
been  failing  in  health  the  last  fourteen  months,  but  has 
been  really  ill  for  about  two  months,  during  which  time 
she  has  been  rapidly  losing  strength,  and  her  digestive 
powers  have  failed  very  much.  She  now  suffers  very 
frequently  from  pain  in  the  stomach,  with  vomiting  on 
moving  suddenly  or  violently.  The  food  only  is  ejected  on 
these  occasions. 

She  complains  of  very  frequent,  nearly  constant  pain  in 
the  chest  and  shoulders.  The  catamenia  have  been  regular 
though  very  scanty,  until  the  last  six  weeks,  since  when 
they  have  not  recurred.  Has  never  had  jaundice.  On 
admission  she  was  markedly  anemic,  with  a  yellowish  tinge 
in  the  complexion  ;  is  very  thin,  has  a  worn  and  anxious 
expression.  Suffers  frequently  from  headache  affecting  the 
frontal  and  temporal  regions.  Frequently  is  troubled  with 
vertigo,  affecting  her  most  when  walking  or  standing  for  any 
length  of  time.  Sleep  is  moderately  good.  The  chest 
appears  healthy.  No  cough.  Heart's  action  rather  irre- 
gular and  decidedly  excitable.  On  auscultation  found  slight 
murmur  with  the  second  sound,  heard  most  at  the  base  and 
along  the  large  vessels,  especially  in  right  carotid,  while 
there  was  a  venous  bruit  to  be  heard  in  the  neck  on  both 
sides.  The  abdomen  I  found  moderately  healthy,  and  more 
generally  resonant  than  normal.     The  liver  was  within  its 


828       Cases  from  the  London  Homoeopathic  Hospital^ 

normal  limits^  nor  could  I  find  any  evidence  of  enlargement 
of  the  spleen.  These  circumstances  made  me  conclude  that 
I  had  a  simple  case  of  chlorosis  to  deal  with^  and  not  of 
leucocythemia,  as  I  was  at  first  disposed  to  consider  it,  the 
patient  having  suffered  formerly  from .  yellow  fever.  The 
bowels  had  been  constipated  of  late,  but'  were  generally 
quite  regular. 

Sulphur  6  was  ordered  to  be  taken  three  times  a  day. 
The  first  diet  was  ordered  with  four  ounces  of  claret.  She 
continued  nnder  this  medicine  for  a  week  with  little  change 
except  that  the  bowels  acted  rather  more  easily,  but  the 
stools  were  of  very  pale  colour,  as  if  wanting  in  bile,  and 
the  patient  was  complaining  of  pyrosis  occurring  very  shortly 
after  the  principal  meals.  China  3^  was  ordered,  a  drop 
every  four  hours. 

13th. — Is  feeling  decidedly  better,  with  less  pain,  and 
less  dyspncea  in  moving  rapidly.  The  stools  are  more 
regular,  but  still  pale  coloured.  Tastes  her  food  for  a  long 
time  after  eating  it. 

17th. — Sore  throat,  but  no  evidence  of  inflammation  in 
throat  on  inspection.  The  pain  in  the  throat  is  relieved  for 
a  time  by  swallowing.  Complains  again  of  shooting  pains 
through  the  shoulders.  Pulse  92.  Belladonna  3'  was  given 
every  four  hours.  * 

20th. —  Reported  better.  Tongue  and  throat  pale  coloured 
and  relaxed.  Has  some  cough,  which  is,,  however,  easy  and 
rather  loose.  The  appetite  is  very  bad.  The  bowels  are 
regular,  and  the  stools  of  much  better  colour. 

24th. — Reported  still  better.  Appetite  better.  The 
bowels  regular.  Cough  much  less.  Complains  much  of 
tired,  aching  pains  in  the  limbs,  when  they  are  hanging 
down.  A  great  deal  of  thirst  with  dryness  and  soreness  of  the 
throat.     Arsenicum  8  was  ordered,  a  drop  every  four  hours. 

27th. — The  report  is  very  much  the  same  except  that 
the  colour  of  the  lips  is  improving ;  the  patient  feels  stronger, 
and  the  appetite  is  mending. 

February  3rd. — Constant  aching  in  the  legs,  which, 
however,  do  not  swell.  Dryness  of  the  nares  and  throat 
continues. 


by  Dr.  Mackechnie.  329 

17tli. — Still  complaining  of  the  aching  of  the  lower 
extremities.  Feet  perspiring  much  at  night,  and  the 
perspiration  is  of  an  nnpleasant  odour.  There  are  no  vari- 
cosities. Graphites  80  was  ordered^  a  drop  three  times 
a  day. 

23rd. — The  report  is  "  improving  decidedly/'  The 
aching  of  the  limbs  much  better.  The  feet  are  perspiring 
much  less.  The  dryness  of  the  throat  gone.  The  anaemic 
condition  is  greatly  improved.  The  colour  of  the  lips  is 
much  better,  though  the  cheeks,  &c.,  do  not  show  much  as 
yet.  The  catamenia  appeared^  though  very  scantily,  on 
the  14th  instant,  being  a  mere  show  and  lasting  little  over 
thirty-six  hours,  but  it  was  a  great  relief  to  the  patient, 
and  she  requested  to  be  dismissed  to  be  under  treatment 
as  an  out-patient,  but  whether  she  has  so  continued  I  am 
not  aware.  She  was  manifestly  in  the  way  to  improve,  the 
symptoms  breaking  down  one  by, one  before  the  treatment 
adopted. 

J.  W — ,  «t.  19',  female  servant,  was  admitted  February 
14th,  1871,  giving  the  following  history.  Got  wet  and 
caught  cold  in  the  month  of  August  last,  since  which  time 
she  has  not  menstruated.  Catamenia  had  always  occurred 
r^ularly  before  that  time.  Whether  she  lias  been  subjected 
to  treatment  is  not  reported.  The  patient  is  moderately 
fat,  but  the  complexion  is  very  pale,  the  lips  showing  the 
pallor  very  much  and  the  conjunctivae  being  very  blue. 
Complains  of  feeling  the  cold  very  much,  and  of  a  constant 
feeling  of  fatigue  and  general  weakness.  Continual  head- 
ache and  aching  in  the  back.  Palpitation  of  the  heart  and 
difficulty  of  breathing  with  the  least  exertion.  The  pulse 
was  normal,  except  in  being  very  compressible.  The 
tongue  was  clean  and  the  bowels  regular.  PubaiiUa  S\  a 
drop  three  times  a  day. 

22nd. — Complaining  much  of  severe  pain  in  right  side  of 
the  chest  in  taking  a  deep  breath.  There  was,  however,  no 
cough,  and  auscultation  showed  that  there  was  no  derange- 
ment in  the  internal  organs.  There  was  severe  pain  on  the 
same  side  from  some  decayed  teeth.     TemporaJ  headache. 


330       Ca$e$  from  the  London  Hommopathic  Hospital, 

with  severe  shootiDg  pain.  Tongue  pale  and  flabbj. 
Ranunculus  bulb.  S^,  a  drop  to  be  taken  every  four  hoars. 

25th. — Is  much  improved  as  to  the  plenro-dynic  paiD, 
which  is  nearly  gone.  The  head  also  better.  Appetite 
good.  The  bowels  constipated^  not  having  acted  for  five 
days.  Nux  vomica  Si*,  a  drop  to  be  taken  every  four 
hours. 

March  Ist. — Beported  to  have  been  improving  in  general 
condition  until  yesterday,  when  she  was  attacked  with  severe 
headache,  with  heat  of  the  head,  flashing,  &c.,  aggravated  by 
movement  and  light.  Bowels  still  constipated.  Belladonna 
8^  8^^-  j  every  two  hours. 

5th. — ^Much  better.  Still  suffers  from  headache  in  the 
morning,  but  it  does  not  last,  nor  is  it  of  the  same  character. 
The  flushing  and  heat  of  the  head  are  gone.  There  is  still 
some  vertigo.  The  bowels  are  acting  spontaneouslv. 
Appetite  good.  No  signs  of  the  catamenia  occurring. 
Pulsatilla  3^,  a  drop  every  four  hours. 

8th. — ^The  condition  generally  improving ;  takes  her  food 
better  than  she  has  done  for  months.  Continue  Pulsatilla. 
No  other  medicine  was  required,  and  on  the  18th  there  was 
some  appearance  of  the  catamenia,  very  scanty,  and  lasting 
only  a  day  or  two,  but  the  patient  felt  so  much  \pspirited 
by  the  occurrence  that  she  requested  to  be  dismissed,  and 
was  allowed  to  depart,  taking  some  Pulsatilla  with  her  to 
continue  under  its  influence. 

M.  L — ,  aet.  24,  nursemaid.  Admitted  February  7th, 
stating  that  she  has  suffered  from  weakness,  palpitation 
of  the  heart,  and  general  &ilure  of  strength  for  the 
last  year.  Has  suffered  from  pain  in  the  right  flank  for 
the  last  siic  weeks.  Is  complaining  now  of  tenderness 
in  the  right  side.  Pain  at  the  back  of  the  head. 
Shooting  pain  through  the  temples.  Dyspnoea  with  the 
least  exertion.  Anaemic  bruit  audible  over  the  cervical 
vessels.  Catamenia  very  irregular,  and  very  scanty  when 
they  do  occur.  Leucorrhoea  remaining  after  their  cessation. 
Countenance  very  pale,  the  lips,  especially  inside,  are  very 
anaemic  looking.     The  tongue  pale  and  flabby.     Appetite 


by  Dr.  Mackechnie.  381 

very  bad^  eructaiions  after  food^  and  tasting  6f  it.  Pulsatilla 
8^  a  drop  three  times  a  day^   first  diet.. 

11th. — Feels  rather  better  in  all  respects. 

14th. — Not  so  well.  Nausea  after  food.  Severe  head- 
ache^ with  shooting  pains  in  occiput  and  temples. 

17th.*— Nausea  gone.  Appetite  returning.  Tongue 
clean.  Pulse  small  and  somewhat  frequent.  Complaining 
of  pain  and  soreness  in  right  flank^  with  tenderness  to 
pressure. 

22nd. — Improving.  Pain  in  side  less.  Appetite  con- 
tinues to  improve.  Bowels  acting.  Complaining  of  shoot- 
ing pain  in  the  dorsal  region  of  back. 

25th. — Continuing  to  improve.  Some  pain  in  cardiac 
region.     Continue  Pulsatilla. 

March  1st. — Feeling  much  better.  Some  sharp  catching 
pain  occasionally  in  left  hypochondrium.  Complexion 
greatly  improved.  She  was  dismissed  at  her  own  request^ 
wishing  to  go  back  to  her  situation. 


Bronchitis  and  ckranic  metritis. 

L.  R— >-^  servant^  set.  39,  admitted  January  18th^ 
stating  that  for  several  winters  she  has  been  subject  to  a 
cough,  recurring  as  soon  as  the  cold  weather  sets  in.  Always 
appears  to  arise  in  an  attack  of  cold  from  exposure^  but 
remains  behind^  after  the  other  symptoms  disappear^  until 
moderately  warm  weather  sets  in.  Sputa  generally  yellow, 
sometimes  rather  frothy  and  copious ;  they  have  been  occa- 
sionally streaked  with  blood ;  cough  very  frequent,  most  at 
night  and  morning,  and  aggravated  by  any  change  of 
temperature.  Sharp  pains  at  the  upper  part  of  the  chest, 
especially  the  left  side.  In  this  spot  there  is  some  tender- 
ness to  pressure.  The  percussion  sounds  are  dear,  but 
there  are  all  sorts  of  moist  r&les  to  be  heard  over  the  whole 
upper  part  of  the  chest.  The  voice  is  at  present  very  hoarse, 
and  the  larynx  is  tender  to  pressure.  There  is  some  pain 
in  swallowing.     Complaining  of  pains  in  head  and  in  the 


S32       Cases  from  the  London  Homoeopathic  Hospital. 

back.  Appetite  is  moderately  good.  Tong^ue  clean.  Bowels 
regular.  Catamenia  regular.  Belladonna  I,  a  drop  every 
two  hours.     Cold  water  compress  to  the  neck. 

21  St. — Hoarseness  decidedly  less,  but  the  throat  is  still 
much  inflamed  and  sore.  The  fauces,  &c.,  are  of  a  dark 
red  colour.  Feels  as  though  there  were  a  sore  spot  in  one 
point  in  the  throat,  with  occasionally  a  sharp  pricking  sensa- 
tion. The  cough  continues  much  the  same,  but  often  wakes 
her  at  night;  the  sputa  are  greyish.  Lachesis  12  to  be 
taken  three  times  a  day.     Continue  the  compress. 

28th. — Improving  greatly.  The  throat  is  much  better, 
though  the  fauces  are  still  dusky  in  colour  and  there  is  a 
feeling  of  dryness  in  one  spot  in  the  throat.  Cough  con- 
tinues in  the  day,  and  especially  night  and  morning.  The 
expectoration  is  much  less.  Bryonia  3^,  a  drop  three  times 
a  day. 

February  4th. — Still  improving,  but  the  cough  is  still 
dry,  and  violent  in  paroxysms.  On  examination  found  the 
uvula  elongated  and  the  velum  relaxed.  Kali  carb.  12 
three  times  a  day. 

On  the  8th  I  find  Carbo  veget^  was  prescribed,  but  no 
notes  of  the  patient's  condition. 

15th. — Patient  has  been  progressing  well  till  last  night, 
when  the  pain  in  the  chest  returned.  Pulse  98.  Head- 
ache.    Aconite  3,  a  drop  every  four  hours. 

17th. — Head  and  back  both  painful.  Cough  much  the 
same.  Expectoration  copious,  greyish,  difficult  to  raise. 
Lumpy,  acrid,  mucous  leucorrhoea.     Repeat  Lachesis. 

21st. — The  leucorrhoea  continuing,  and  becoming  still 
more  acrid,  causing  a  feeling  of  scalding.  She  was  examined 
by  Dr.  Leadam,  who  reported  a  state  of  chronic  metritis  with 
ulceration  of  the  os  uteri.  Other  symptoms  were  improving. 
Mercurius  corros,  3,  three  times  a  day. 

March  4th. — ^The  leucorrhoea  much  improved.  Bowels 
constipated,  acting  every  second  or  third  day,  with  the  stools 
of  natural  size.  Thinks  she  has  contraction  of  the  rectum 
on  account  of  severe  pain  and  throbbing  occurring  at  times. 
Has  never  had  haemorrhoids  to  her  knowledge,  but  has  had 
fissure  of  the  anus  twice  (?).     Has  always  very  little  control 


by  Dr,  Mackechnie.  333 

over  the  actions  of  the  bowels.  Aloes  3^  three  times  a 
day. 

15th. — Feels  better  in  most  respects.  The  constipation 
continues.  There  is  desire  for  stool^  but  she  dreads  the 
pain  following  the  action. 

18th. — Better^  except  that  the  constipation  continues. 
The  leucorrhosa  less  and  much  more  bland.  The  action  of 
the  bowels  is  extremely  painful^  the  pain  continuing  for  a 
long  time  after.     Aloes  3^  was  continued. 

21st. — Better.  The  leucorrhoea  gradually  subsided^  and 
with  it  the  pain  in  the  rectum  lessened  so  that  the  bowels 
acted  each  day^  although  there  was  much  pain  after. 
Throat  is  at  times  irritable^  causing  paroxysms  of  barking 
choky  cough. 

28th. — The  improvement  was  progressive,  and  the  uterine 
and  rectal  trouble  were  so  far  improved  that  she  was 
dismissed  at  her  own  request  much  relieved. 


S34 


REVIEWS. 


T^Ae  Specific  Action  of  Drugs  on  the  Healthy  System :  an 
index  to  their  therapeutic  value,  as  deduced  from  experu' 
ments  on  men  and  animals.  By  Alex.  &•  Burness, 
M.B.,  CM.,  Univ.  Aberd. ;  and  P.  T.  Mayor, 
M.K.C.V.S.,  President  Central  Veterinary  Society, 
London :  Bailliere. 

The  appearance  of  the  above  volome  was  heralded  with 
the  following  statement  in  advertisement : — 

"  The  object  .of  this  work  is  threefold — 

'^  1.  To  point  out  that  each  drug,  when  introduced  into 
the  system^  acts  upon  some  special  parts  or  tracts,  in  virtue 
of  its  physical,  chemical,  or  dynamical  properties. 

^^  2.  That  the  therapeutic  value  of  each  drug  is  to  be 
determined  by  ascertaining  the  symptoms  produced,  and 
the  parts  influenced  by  it,  when  introduced  into  the  healthy 
animal  system. 

*'  8.  That  while  a  toxic  dose  will  effect  such  changes  in 
a  part  as  to  unfit  it  for  any  vital  action,  a  lesser  dose 
applied  to  a  diseased  part  will,  by  removing  that  state  of 
combination  of  the  elements  which  excited  diseased  action, 
enable  the  normal  process  of  nutrition  to  restore  the 
healthy  constitution/' 

It  was  very  easy  to  see  that  this  was  homoeopathy  with 
the  name  left  out.  The  above  propositions  embody  the 
three  supports  of  our  tripod — the  relation  of  similitude  (at 
least  as  far  as  seat  goes),  the  proving  of  medicines  on  the 
healthy,  and  the  reduction  of  the  dose  below  the  level  of 
physiological  action.  We  naturally  looked  forward  with 
some  interest  to  the  appearance  of  such  a  work. 


Action  of  Drugs  on  the  Healthy  System.  335 

It  has  DOW  been  out  for  some  two  months^  and  has 
receWed  a  full  review  in  our  Monthly  contemporary.  As 
nearly  all  our  readers  will  have  seen  the  account  of  it 
given  there^  we  do  not  propose  to  go  over  the  same  ground 
again^  but  briefly  to  state  our  impressions  as  to  the  signifi- 
cance and  value  of  the  book. 

1.  Its  importance  as  a  sign  of  the  progress  of  our  ideas 
has  been  somewhat  discounted  by  Dr.  Ringer's  Handbook. 
Stilly  Dr.  Burness  makes  an  advance  upon  his  predecessor. 
The  one  gives  his  homoeopathic  applications  of  drugs  simply 
as  empirical  fragments ;  with  the  other  they  are  advanced 
as  instances  of  principles  which  are  homoeopathic  in  every- 
thing but  name.  We  shall  be  curious  to  see  what  treat- 
ment Dr.  Burness  and  his  book  receive  from  the  medical 
journals..  If  they  are  tolerated^  on  what  ground  can  our 
ostracism  be  suffered  to  continue  ? 

2.  As  to  the  value  of  the  work,  we  are  divided  in 
mind.  It  is  of  course  a  cause  for  rejoicing  that  hom- 
oeopathy should  find  any  utterance  within  the  rigidly- 
guarded  portals  of  the  sect  which  at  present  usurps  the 
title  of  scientific  medicine;  and  we  must  not  complain  if 
its  accents  are  somewhat  lisping  and  broken.  We  are  not 
inclined  to  enter  at  present  on  the  question  of  casuistry 
whether  the  guilt  is  the  greater  on  the  part  of  those 
who  persecute  truth  or  those  who  deny  or  conceal  it 
from  motives  of  self-interest.  It  is,  indeed,  disgraceful 
that  Dr.  Burness  should  succumb  to  the  temptation  to 
conceal  the  name  of  homoeopathy^  but  the  disgrace  belongs 
far  more  to  the  leaders  and  the  mouthpieces  of  the  profes- 
sion, who  alone  can  withdraw  the  ban  under  which  the 
school  of  Hahnemann  is  placed.  We  cannot  expect  a  new 
recruit  and  humble  private  to  incur  their  odium  by  striking 
ont  a  different  course.  But  we  could  have  wished  that  this 
first  essay  of  the  kind  had  had  more  to  recommend  it  in 
point  of  style^  arrangement,  and  presentation  (to  say 
nothing  of  orthography  and  punctuation).  The  patho- 
genetic effects  of  the  several  drugs,  and  the  diseases  they 
are  reputed  to  benefit,  are  huddled  together  in  such  a 
manner  that  they  make  no  distinct  impression  on  the  mind. 


336  Reviews. 

The  former^  moreover,  are  so  mixed  up  with  chemical 
explanations^  often  of  the  most  hypothetical  character,  that 
they  fail  of  their  own  effect  as  undoubted  facts ;  and  this 
is  besides  the  loss  they  sustain  by  standing  unsupported  by 
any  cited  authority.  The  cases,  also^  given  at  the-  end  to 
illustrate  what  the  authors  "  mean  by  specific  treatment/' 
are  fa^  too  briefly  and  vaguely  stated  to  have  any  weight 
with  those  to  whom  the  method  is  new  and  unwelcome. 
Altogether,  we  have  serious  fears  that  little  good  will  come 
of  Dr.  Burness'  undertaking.  Its  manner  is  not  up  to  the 
old  school  mark,  and  its  matter  would  hardly  be  iadjudged 
valuable  from  a  homoeopathic  standpoint.  He  would  have 
done  better,  we  think,  to  have  published  a  brief  essay  on 
the  homoeopathic  principle  expressed  in  his  own  words,  and 
to  have  deferred  treatment  of  special  pharmacodynamics  till 
greater  maturity  had  been  reached. 

We  give  a  specimen  medicine  to  show  how  the  work  is 
done ;  and  from  this  our  own  readers  may  judge  whether 
or  no  the  book  is  likely  to  be  useful  to  themselves.  Its 
original  material^  in  the  shape  of  some  experiments  on 
horses  by  Mr.  Mavor,  has  of  course  its  value,  and  will 
receive  its  due  incorporation  into  our  pathogeneses, 

IODINE,  AND  IODIDE  OF  POTASSIUM. 

PHTBIOLOeiCAX  EfFXOTB. 

Iodine  in  a  full  dose,  produces  coryza,  frontal  headache, 
lachrymation,  injection  of  the  conjunctivfe,  dryness  of  the  throat, 
irritation  of  the  air-passages,  with  cough  and  dyspnooa.  The 
following  effects  have  been  induced  by  the  use  of  Iodine,  viz. 
Impaired  digestion,  emaciation,  sweating,  diarrhoea,  and  hectic 
fever,  salivation,  and  wasting  of  the  mammae  and  testes. 

Catarrh  of  nasaT  membrane  and  frontal  sinuses,  dry  cough, 
hoarseness,  aphonia»  and  chronic  inflammation  of  the  throat, 
inflammation  of  the  serous  membrane,  with  eflusion,  eruption  on 
the  skin  of  an  erythematous,  papular,  and  pustular  character, 
tremor,  twitching  and  convulsive  movements,  terminating  in 
paralysis,  derangement  of  sensation,  deranged  vision,  partial 
deafness,  and  depression  of  spirits. 

Headache,  sense  of  fulness,  giddiness,  drowsiness,  with  epistaxis. 


Action  of  Drugs  on  the  HeaUhy  Sy$tem.  337 

tumiiltuoufl  action  of  the  heart,  intermittent  pulse,  weakness, 
I088  of  appetite  and  yomiting,  in  some  cases  saliyation  and 
BorenesB  of  themouth. 

The  physiological  effects  produced  hy  Iodide  of  Potamtm  are 
analogoas  to  those  produced  by  Iodine ;  in  a  full  dose  it  causes 
nausea,  yomiting,  pain  and  heat  in  the  stomach,  and  purging, 
sometimes  diuresis,  but  does  not  act  so  energetically  as  free 
Zodme.  It  sometimes  causes  salivation  and  increased  secretion 
£rom  the  nasal  and  conjunctival  membranes,  headache  and 
-wakefulness.  It  is  soon  eliminated  from  the  system  even  when 
given  in  large  doses  ;  hence  the  dose  often  requires  to  be 
repeated  to  produce  the  physiological  effects. 

IODINE. 

Spsoifio  Actiok. 

Both  the  effects  produced  by  this  agent  iu  the  healthy  body, 
and  in  various  diseases,  indicate  that  its  action  is  primarily  on 
the  blood,  hence  on  the  fluids  of  the  body.  It  acts  in  virtue  of 
its  chemical  properties,  abstracting  hydrogen  and  uniting  with 
bases,  appearing  in  the  urine  and  other  secretions,  as  hydriodic 
acid,  iodine  and  iodate ;  also  upon  the  glands,  and  the  mucous  and 
aerous  membranes  in  the  process  of  elimination. 

IODIDE  OP  POTASSIUM.    . 

As  this  salt  is  very  soluble,  it  is  soon  absorbed  into  the  blood, 
and  therefore  acts  less  on  the  stomach,  &c.  It  diffuses  readily 
and  is  soon  eliminated  by  the  urine.  On  account  of  its  physical 
properties,  it  will  cause  endosmose  of  the  serum  of  the  blood,  or 
W4se  versd,  according  to  the  degree  of  concentration  of  the  solution 
given.  It  is,  however,  probably  soon  decomposed  after  introduction 
mto  the  stomach. 

Thbsapbutic  Uses. 

The  vapour  of  Iodine  is  useful  in  corysa,  catarrh,  chronic  bron- 
chitis, bronchorrhcsa,  diphtheria,  laryngitis,  spasmodic  asthma, 
and  in  salivation. 

Is  Ebstobatiyb  Dosbs. 

Indicated  in  scaly  diseases  of  the  skin^  as  lepra,  psoriasis.    In 

VOL.  XXXII^  NO.  CXXVill. ^ilPRIL^  18f4.  Y 


838  Reviews. 

chronic  enlargement  of  the  liyer,  in  the  diarrhoaa,  Tomiting,  and 
hectic  of  phthisis ;  in  chronic  cutaneous  eruptions,  especially  in 
BcrofuloHS  children,  chronic  rheumatism ;  in  inflammation  of  bones 
or  periosteum,  the  consequence  of  sjphilis ;  in  chronic  rheumatic 
arthritis. 

Iir  Phtsiolooicaii  Doses. 

In  tabes  mesenterica,  in  mammary,  ovarian,  and  uterine  tumours^ 
and  bronchocele. 

IODIDE  OP  POTASSIUM. 

Ik  Esstoratits  Doses. 

Indicated  in  articular  rheumatism,  dropsies,  hydrocele,  peri- 
osteal nodes  due  to  syphilis,  in  secondary  or  tertiary  syphilis,  in 
lead  poisoning,  and  coryza. 

In  Phtsiologioal  Doses. 

Indicated  in  scrofula,  chronic  diseases  connected  with  indura- 
tion and  enlargement  of  various  organs,  also  to  promote  the 
absorption  of  effusions. 

Exteenal  Uses. 

In  chronic  rheumatism,  gout,  pleurisy,  synovitis,  bronchocele, 
lupus,  myalgia,  indurated  glands,  erysipelas,  and  as  an  injection 
in  hydrocele,  white  swelling,  ovarian  tumours  (after  being  tapped), 
large  abscesses,  &c. 


Boericke  and  TafeV$  Qudrterly  Bulletin  of  Medical  Litera- 
ture.  No.  II,  February,  1874.  New  York  and  Phila- 
delphia. 

This  useful  account  of  homoBopathic  literature  is  in  the 
present  quarter  of  no  ordinary  interest.  It  has  several 
times  given  intimations  of  a  forthcoming  complete  collec- 
tion of  existing  provings,  under  the  auspices  of  Dr.  Allen, 
of  New  York.  The  number  now  before  us  contains  the 
prospectus  and  plan  of  publication  of  this  work,  with  a 
specimen  medicine.    Jt  will  be  of  interest  to  our  readers 


Quarterly  Bulletin  of  Medical  Literature.         389 

that  we  give  them  an  account  of  the  former,  and  of  im- 
portance to  the  cause  of  homoeopathy  that  we  critically 
examine  the  latter. 

1.  Messrs.  Boericke  and  Tafel  propose  to  publish  an 
Encyclapadia  of  Homceopathic  Materia  Medica,  It  is  to 
be  all  that  Jahrs  Symptomen-Codex  (long  out  of  print) 
was  in  its  time,  brought  down  to  the  present  day  by  the 
incorporation  of  all  new  provings^  and  on  an  improved 
plan.  The  terms^  &c.,  of  issue  are  stated  by  the  pub- 
lishers thus : — 

"  We  intend  to  issue  the  work  in  volumes  of  640  pages  each, 
size  of  page  and  type  to  be  like  sample,  at  the  price  of  {6.00,  and 
mail  issue  no  less  than  two  volumes  per  year,  most  likely  three,  as 
we  would  like  to  see  the  whole  work  completed  in  1876. 

''  Physicians  subscribing  in  advance  for  the  whole  work  will 
receive  the  volume  at  $5.00,  substantiaUy- bound  in  cloth. 

*'  It  is  impossible  to  state  in  advance,  with  certainty,  how  many 
such  volumes  will  comprise  the  whol^  work,  but  to  judge  firom  the 
present  state  of  the  MSS.,  we  should  think  that  five  or  six 
volumes  will  complete  the  whole. 

"  It  will  readily  be  perceived  that  this  is  a  great  enterprise, 
entailing  much  labour  and  a  large  outlay  of  money.  In  justice 
to  ourselves,  and  in  justice  to  subscribers,  who  will  have  a  claim 
to  an  assurance  that  the  work  will  be  carried  through  to  its 
completion,  we  desire  to  have  it  understood  that  we  cannot  com- 
mence publication  until  we  have  a  subscription  list  containing 
the  names  of  not  less  than  tivb  hukdbsi)  subscbibebs.  While 
this  number  of  subscriptions  will  fall  very  far  short  of  the  actual 
cost  and  outlay,  it  will  suffice  to  assure  us  that  the  profession 
appreciates  our  efforts ;  it  will  suffice,  too,  to  place  the  publica- 
tion upon  a  satisfactory  financial  basis. 

"  To  contribute  your  share  then  towards  expediting  the  con- 
summation of  this  most  important  work,  send  in  your  signature 
AT  OK  OB  ;  don't  put  it  off;  there  may  be  too  many  who,  although 
favourable  to  the  enterprise,  neglect  sending  in  their  names, 
thinking  that  a  work  so  much  needed  will  certainly  receive  the 
required  number  of  subscribers  without  them,  and  thus  the  whole 
may  be  retarded. 

"  If  there  are  more  than  one  physician  in  one  place,  it  will  be 


340  Reviewi. 

of  advantage  if  thej  order  their  yolames  sent  in  one  package,  as 
it  will  diminiali  cost  of  transportation,  and  books  sent  per  express 
arriye  in  better  condition  than  when  ordered  to  be  sent  by  mail. 

''  A  full  list  of  subscribers  will  be  appended  to  the  first  volume 
of  the  work,  after  the  publication  of  which  the  subscription  list 
will  be  closed,  and  no  more  subscriptions  of  $5.00  per  volume 
will  be  received,  but  the  regular  retail  price  of  $6.00  will  be 
charged. 

"Subscriptions  should  be  addressed  to  Bobbicke  &  Tafel, 
145,  Grand  Street,  N.  Y.,  635,  Arch  Street,  Philadelphia,  or 
their  agents,  Henbt  Tubnbb  &  Co.,  77,  Fleet  Street,  London.'* 

Now  it  is  quite  certain  that^  whatever  be  the  execution 
of  this  worky  it  is  of  indispensable  value  to  every  medical 
man  practising  homoeopathically ;  and  we  hope  that  it  may 
receive  the  support  it  deserves.  It  will  be  no  credit  to 
this  country  if  a  large  proportion  of  the  five  hundred  sub- 
scribers required  do  not  come  therefrom. 

2.  But  though  the  work  have  this  necessary  value^  even 
if  it  were  no  better  done  than  was  Jahr's  ;  yet  it  is  of  the 
highest  importance  for  the  repute  and  spread  of  our  system^ 
and  for  the  benefit  of  the  patients  for  whose  aid  the  patho- 
geneses are  designed^  that  they  shall  be  presented  in  the 
best  conceivable  form.  For  this  cause  we  turn  with  the 
utmost  interest  to  the  specimen  medicine  furnished  us, 
which  is  Aconite. 

Dr.  Allen's  ''  Introduction ''  had  beat  speak  for  itself. 

"  The  following  symptomatology  of  Aconite  has  been  compiled 
from  the  resumes  of  Hahnemann  and  the  Austrian  Society,  both 
of  which  have  been  carefully  retranslated  and  compared  with  Dr. 
Dudgeon's  compilation  in  the  Hahnemann  Materia  Mediea^ 
Fart  I ;  to  these  have  been  added  all  other  provings  that  we  have 
been  able  to  discover,  and  also  many  valuable  symptoms 
from  cases  of  poisoning.  It  has  been  the  aim  of  the  editor  to 
make  it  complete  and  accurate;  symptoms  have  been  carefuUy 
preserved  as  given  by  the  provers  and  have  been  divided  as  little 
as  possible.  All  of  the  symptoms  given  by  Hahnemann  are 
retained,  though  a  few  have  been  corrected  as  indicated  by  Dr. 
Hughes  in  the  Month.  Horn.  Rev,  Some  of  Hahnemann's  symp- 
toms, derived  from  clinical  cases  or  poisonings,  have  by  some  been 


Quarterly  Bulletin  of  Medical  Literature.  341 

considered  unreliable — as  for  example  moBt  of  Grreding*8  Bjmp- 
toms  (Aconite  No.  12) ;  but  though  symptoms  so  obtained  are 
often  treacherous,  Hahnemann  seemed  to  possess  the  keen  percep- 
tion  of  the  master  mind,  for  it  is  found  that  these  symptoms  are 
remarkably  corroborated  by  those  obtained  from  provings  on  the 
healthy :  a  few  are,  however,  put  in  brackets,  but  none  are  omitted. 
It  will  be  noticed  that  the  small  numbers  after  the  symptoms 
refer  to  the  authorities ;  such  reference  will,  it  is  believed,  enhance 
the  value  of  the  work  without  adding  materially  to  its  bulk.    The 
symptoms  are  numbered  by  tens  in  order  to  facilitate  reference. 
Four  grades  of  symptoms  are  noted ;  the  italics  denote  repeatedly 
observed,  or  in  any  way  important,  symptoms  ;  the  stars  denote 
Tenfications ;  the  heavy,  full-faced  type  denotes  repeated  verifi- 
cations (symptoms   of  the   highest  importance).     A  very  few 
clinical  symptoms  are  reluctantly  admitted,  and  these  only  because 
they  have  been  repeatedly  verified.     We  must  remember  that  no 
accurate  system  of  therapeutics  can  ever  rest  on  a  clinical  basis ; 
the  elements  of  uncertainty  are  too  numerous,  and  the  experience 
of  centuries  has  clearly  demonstrated  the  futility  of  the  attempt. 
Pathological  names  and  clinical  hints  are  omitted  and  referred  to 
repertories,  clinical  guides,  works  on  practice,  or  commentaries 
on  the  Materia  Medica. 

*'  Arrangement — The  usefulness  of  the  work  depends  very 
materially  upon  a  convenient  and  uniform  arrangement  of  the 
symptoms  under  the  several  rubrics.  In  doing  this,  two  principal 
aims  have  been  kept  in  view  ;  Jirstf  objective  and  subjective  symp- 
toms; and  second,  excitement  and  depression  of  function  or 
sensation.  The  mental  symptoms  have  all  been  grouped  in  a 
way  to  give  first  excitement,  and  lastly  stupor,  and  not  variations 
of  any  special  mental  function  by  itself,  since  the  effect  of  the 
drug  (in  this  case  at  least)  is  general  and  not  special.  The  head 
symptoms  comprise  general  head  symptoms,  as  vertigo,  dull 
sensations,  sharp  sensations ;  then  localized  sensations  in  forehead 
and  temples,  vertex  and  parietals,  and  occiput;  then  external 
head.  In  the  eyes,  first,  objective  (the  general  appearance,  move- 
ments, &c.)  ;  then  sensations  from  the  external  to  the  internal ; 
and  lastly  ywfi^um. 

''  Under  general  symptoms  we  find,  first,  objective  appearances, 
spasms,  twitches,  &c. ;  then  paralysis ;  then  cold  and  heat ;  then 
sensations,  dull  (aching,  drawing,  burning,  bursting,  constrictive, 


842  Review9. 

throbbing,  Ac.) ;  then  sharp  (shooting,  cntting,  &c) ;  then 
peculiar  pains.  This  arrangement  seems  to  me  the  most  simple, 
and  hence  the  most  useful ;  it  involves  no  theory  and  causes  no 
confusion. 

"  In  italicizing  and  starring  symptoms,  great  care  will  be  taken 
to  refer  to  all  clinical  verifications,  from  the  earliest  period  of 
homoeopathic  literature.  Dr.  Carroll  Dunham  has  very  generously 
consented  to  furnish  verifications  from  his  own  experience,  and  a 
like  offer  has  been  made  by  many  of  my  colleagues  in  the  profes- 
sion. Dr.  Hering  has  very  kindly  supplied  several  valuable 
notes  of  errors  (typographical  and  others)  found  in  the  original 
provings. 

''  The  editor  expects  the  valuable  aid  of  Dr.  Biehard  Hughes, 
of  England,  who  has  liberally  offered  to  verify  or  correct  (in 
the  London  libraries)  the  citations  found  in  Hahnemann's 
provings. 

^*  We  regret  to  announce  that  Dr.  8.  A.  Jones  has  found  it 
necessary  (on  account  of  recent  changes  in  business)  to  withdraw 
from  this  work.  Dr.  Fanning* e  work  on  Hahnemann's  provings 
has  also,  for  the  present  at  least,  been  suspended.  The  retire- 
ment of  these  gentlemen  throws  the  sole  responsibility  upon  the 
editor,  through  whose  hands  the  work  will  pass.  The  amount 
of  labour  requisite  for  a  work  of  this  character  is  obviously  very 
great,  but  the  urgent  need  of  it  is  so  very  pressing,  that  the 
editor  has  presumed  to  undertake  it  with  the  assistance  of 
several  who  are  in  various  ways  interested  with  him.  We 
shall  be  glad  to  receive  any  unpublished  provings  or  clinical 
verifications  from  any  member  of  the  profession,  as  we  desire 
the  work  to  be  as  complete  and  reliable  as  possible. — ^T.  F. 
Allbk,  M.D.'* 

The  several  points  here  touched  upon  will  come  before 
us  as  we  examine  the  features  of  the  article  itself. 

Firsts  as  to  material ;  to  which  Dr.  Allen's  four  opening 
sentences  refer.  That  he  should  add  to  the  two  great 
provings  of  Aconite  we  possess — ^those  of  Hahnemann  and 
of  the  Austrian  Society — any  later  provings  on  record^  and 
cases  of  poisoning,  only  entitle  him  to  our  thanks.  But 
we  hold  the  "  on  record  "  to  be  a  sine  qud  non  here.  We 
may  take  the  symptoms  furnished  by  Hahnemann  on  his 


Quariesly  BfjUletin  of  Medical  Literature.         843 

own  authority ;  but  we  cannot  so  deal  with  "  H.  N.  S., 
40l;h  dil.  ;  T.  C.  D.,  60th  dil./'  which  are  Dr.  Allen's 
39th  and  40th  specified  sources.  In  the  absence  of  any 
detailed  account  of  such  experiments  which  might  enable  us 
to  weigh  their  value^  it  is  simply  nil;  and  they  are  rather 
a  weakness  to  the  collection. 

A  still  more  important  matter  is  the  treatment  of  the 
symptoms  cited  by  Hahnemann  from  authors.  •  Dr.  Allen 
promises  that  these  shall  be  "  verified  or  corrected  '^  from 
the  original  sources.  But  unless  this  is  allowed  to  be 
done  with  a  bolder  hand  than  the  editor's  own  the  result 
will  be  very  ineffective,  and  the  opportunity  will  be  lost 
for  removing  one  of  the  most  crying  faults  of  our  Materia 
Medica.  Dr.  Allen  speaks  of  using  the  revised  list  of  the 
cited  symptoms  of  Aconite  which  appeared  in  the  Monthly 
HomcBopathic  Review  for  November,  1873.  He  cannot 
bring  himself  to  omit  any ;  but  he  has  bracketed  a  few 
(t.  e.  marked  them  as  doubtful)  and  corrected  a  few  more^ 
as  indicated  in  that  article.  We  have  nothing  to  say 
against  the  substitution  of  bracketing  for  expunging^ 
though  we  ourselves  should  have  preferred  the  more 
thorough  course.  But  when  we  consider  that  Hahnemann 
himself  bracketed  every  sjmptom  of  his  provers  that  oould 
not  be  considered  decisively  genuine,*  surely  such  marks 
should  not  be  omitted  where  any  symptom  is  decisively 
doubtfol  (not  to  say  non-genuine).  Thus: — S.  251  of 
Hahnemann's  proving  is  '^  profuse,  tenacious^  yellowish 
leucorrhoea.^'  The  article  in  the  Monthly  Review  tells  us 
that  this  discharge  coincided  with  the  disappearance  of  a 
considerable  swelling  in  the  left  iliac  region,  for  which  a 
patient  was  being  treated  with  Aconite,  The  inference 
seems  plain  that  this  could  not  be  a  pathogenetic  effect  of 
the  drug ;  yet  Dr.  Allen  leaves  it  unbracketed.  Again, 
the  symptom  following  (252)  is  also  expunged  in  the 
revised  list  given  in  the  article.  It  is — "  Bage,  at  the 
time  of  the  appearance  of  the  menses/'  It  occurred  in  a 
maniac,  who  was  being  treated  for  indurated  cervical  glands 
by  Aconite ;  and  surely  her  furor  might  well  appear  at  the 

*  Preface  to  first  vol.  of  Mat.  Med.  Futa,  8rd  edit 


844 


Reviews. 


time  of  the  catamenial  nisus,  without  its  occurrence  being 
set  down  as  the  efi'ect  of  the  medicine  she  was  taking.    Yet 
'  this  symptom  too  stands  in  Dr.  Allen's  list  without  anj 
note  of  its  dubiousness. 

This  (to  our  minds)  mistaken  tenderness  is  defended  on 
the  ground  that  though  symptoms  obtained  upon  patients 
"  are  often  treacherous,  Hahnemann  seemed  to  possess  the 
keen  perception  of  the  master  mind^  for  it  is  found  that 
those  symptoms  are  remarkably  corroborated  by  those 
obtained  from  provings  on  the  healthy/'  Where  there  is 
no  decisive  evidence  one  way  or  the  other,  such  perception 
and  corroboration  might  fairly  avail.  But  in  the  face  of 
such  facts  as  those  stated  above,  *'  perception "  has  no 
place;  and  in  these  instances  at  least  corroboration  is 
wanting.  No  other  woman  but  this  maniac  was  furious 
while  taking  Aconite  at  the  appearance  of  her  catamenia ; 
no  other  than  this  sufferer  from  ovarian  tumours  had  pro- 
fuse, tenacious,  yellowish  leucorrhoea. 

One  other  weak  element  in  Dr.  Allen's  collection 
consists  of  the  ^'  very  few  clinical  symptoms  "  which  he  has 
**  reluctantly  admitted."  The  grounds  of  his  reluctance, 
which  he  goes  on  to  state,  are  substantial  enough;  but 
there  is  a  further  reason  which  should  convert  it  into  an 
absolute  refusal.  These  "  clinical  symptoms  "  (i»  e.  symp- 
toms which  have  disappeared  in  the  sick  while  the  medicine 
was  being  taken)  have  no  place  whatever  in  the  HofntBO'^ 
paihic  Materia  Medico,  which  is  a  collection  of  pure 
pathogenetic  effects  from  which  the  rule  similia  simUibue 
euraniur  may  be  worked.  Hahnemann  never  admitted 
them ;  and  we  hope  that  Dr.  Allen  may  set  his  face  against 
the  practice. 

We  come  now  to  the  arrangement  of  the  material  hitherto 
described,  which  gives  Dr.  Allen  1656  symptoms  (Hahne- 
mann has  but  541).  It  is  to  be  regretted  that  these  could 
not,  as  in  the  Materia  Medica  Pura  and  Chronic  Diseases, 
stand  one  under  another  separately ;  but  exigencies  of  space 
compel  their  being  printed  continuously.  Another  expe- 
dient towards  this  end,  and  one  involving  less  sacrifice,  is 
the    representing    the    authority    for   or    subject    of  each 


Quarterly  Bulletin  of  Medical  Literature.         845 

symptom  by  a  Dumber.  This  is  a  great  improvement  upon 
Hempers  total  omission  of  such  information^  which  Hahne- 
mann so  assiduously  gives.  The  result  is  that  the  whole 
1656  symptoms  take  up  only  twenty-nine  octavo  pages  of 
fair-sized  type^  which  is  just  the  number  occupied  (with 
but  slight  differences  of  page  and  print)  by  Hahnemann's 
541. 

At  the  outset  we  have  a  list  of  provers  and  authorities. 
Of  this  we  note  the  great  paucity  of  information  given. 
To  be  told^  that  the  first  nineteen  names  belong  to  Hahne- 
mann's Materia  Medica  Pura  is  enough :  but  ^*  Austrian 
provings "  is  a  very  insufficient  heading  for  the  next  six- 
teen. We  should  have  been  informed  that  these  are  to  be 
found  in  vol.  i  of  the  Oesterreichiscke  Zeitung.  And  so 
with  the  '^  additional  provings.''  Where  are  Jousset's.and 
West's  to  be  found  7  We  know  not;  and  there  are  many 
who  would  not  recognise  the  sources  indicated  as  Schneller 
and  J.  C.  Peters.  Again,  surely  the  information  which  has 
been  collected  and  presented  in  the  articles  on  Aconite  in 
the  Oesterreichiscke  Zeitung,  in  the  Hahnemann  Materia 
Medica,  and  in  the  Monthly  Review,  regarding  the  sources 
of  the  cited  symptoms  in  Hahnemann's  pathogenesis, 
should  be  given  (however  briefly)  here.  "Greding"  and 
"  Stoerck  "  convey  no  idea  to  the  mind  ;  but  a  catalogue  of 
the  patients  to  whom  they  gave  Aconite,  and  who  had  the 
symptoms  selected^  is  full  of  illumination.  Then  also  we 
are  told  that  '*  toxicological  symptoms  are  marked  with  ^." 
If  this  were  in  addition  to  a  reference  to  their  source,  the 
information  conveyed  by  it  would  be  useful ;  and  it  is  so 
in  the  poisonings  used  by  Hahnemann.  But  to  authenticate 
a  symptom  simply  by  a  t,  without  any  other  reference, 
cannot  be  commended ;  and  this  occurs  very  frequently  in 
Dr.  Allen's  collection  (e,g.,  eight  times  in  the  first  fifty 
symptoms).  Lastly,  we  miss  Hahnemann's  introduction  to 
the  medicine,  as  also  his  notes  to  several  of  his  symptoms. 
If  the  former  is  inconsistent  with  the  compressed  plan  of 
the  work,  the  latter  at  any  rate  must  be  retained,  as  indis- 
pensable to  the  understanding  of  his  statements. 

Coming   now    to   the   body  of  the  pathogenesis, — the 


SA6  StvitwMm 

fMrincipIes  on  which  the  qrmptoms  are  ordered  are  explained 
by  l>r.  Allen,  and  seem  very  good.     They  apply,  however, 
to  the  intimate  stmcture  of  the  schema.     Its  lai^  outline 
is  that  of  Hahnemann,  as  he  altered  it   for  his  Cknmie 
Diseases,  t .  e.  putting  the  mental  and  moral  symptoms  first 
instead  of  last.      We  cannot  complain  of  this ;  thongb  we 
do  think  that  the  time  has  arrived  for  a  revision  of  some 
parts  of  the  Hahnemannian  order.     We  refer  especially  to 
making     it     more     consistently    anatomico  -  physiological 
throughout  (''  fever/'  for  instance,  is   a  pathological  head- 
ing) ;   and  to  breaking  up  the  chapter  "  generalities  '^  into 
certain   defined   sections.     But  this  is  only  a  suggestion. 
The  indications  given  by  asterisks  and  variations  of  type 
will  doubtless  be  valuable  to  students ;  and  another  useful 
addition  from  the  editor  is  a  chapter  of  conditions  of  a^ra- 
vation  and  amelioration.    We  wish  he  had  also  given,  where 
the  records  enable  him    so   to   do,  references   firom   one 
symptom  to  another,  to  show  connection  and  coincidence. 
This  is  carried  out  largely  in  Dr.  Hering's  monographs ; 
and  the  same  end  is  obtained  by  a  system  of  grouping  in 
the  Hahnemann  Materia  Medica, 

Our  criticism  of  Dr.  Allen's  work  has  necessarily  taken 
the  form  mainly  of  fault  finding.  But  we  gladly  end  with 
the  more  grateful  task  of  expressing  the  great  obligation 
under  which  homoeopathy  will  be  to  him  if  he  carry  through 
the  labour  of  which  the  pathogenesis  of  Acowiie  is  an  earnest 
and  sample.  It  exhibits  such  industry  and  research,  so 
much  thought  and  knowledge ;  it  is  such  a  complete 
collection  of  all  that  is  known  of  the  physiological  action  of 
the  drug,  that  to  have  a  whole  Materia  Medica  like  it  will 
be  the  greatest  boon  we  have  received  since  Hahnemann's 
pen  fell  from  his  hands.  We  hope  that  Dr.  Allen  will  feel 
our  animadversions  only  as  additional  evidence  of  our  interest 
in  and  appreciation  of  his  work ;  and  that  he  will  enhance 
its  value  by  giving  them  his  unprejudiced  consideration. 
Let  us  briefly  sum  up  what  we  recommend  : — 

1.  That  the  materials  of  the  collection  shall  consist  only 
of  such  provings^  &c.^  as  are  on  record.     If  anything  exist 


Quarterly  Bulletin  of  Medical  Literature.         347 

irorthy  of  note  yet  unpublished,  let  it  be  printed  in  one  of 
our  journals^  and  then  cited  therefrom. 

2.  That  the  bracketing  and  correcting  (where  necessary) 
of  the  symptoms  taken  by  Hahnemann  from  authors  be 
done  with  the  utmost  thoroughness. 

3.  That  no  mere  "  clinical  symptoms^'  be  admitted. 

4.  That  full  information  be  given  at  the  outset  as  to  the 
authorities  for  and  subjects  of  the  symptoms,  as  by  Dr. 
Hering,  and  in  the  Hahnemann  Materia  Medlca. 

5.  That  each  subject  of  overdosing  or  poisoning  shall  be 
numbered  and  referred  to  separately^  as  are  the  provers ;  and 
the  circumstances  of  the  case  briefly  stated. 

6.  That  all  natural  groups  of  symptoms  be  preserved 
(where  we  have  the  original  records)  by  references  between 
the  component  elements  of  such  groups  in  the  several 
places  where  they  occur. 

One  word  in  conclusion.  It  must  be  borne  in  mind  that, 
although  we  need  such  a  work  as  this — ^a  new,  fuller,  and 
better  Jahr, — it  is  not  our  only  or  even  our  chief  desideratum 
as  regards  the  Materia  Medica.  We  want  monographs  on 
medicines,  in  which  they  receive  exhaustive  study  and 
presentation  in  all  their  aspects  and  relations.  No  one 
man  can  do  more  than  a  few  of  these  in  his  lifetime ;  and 
therefore  we  want  numerous  workers.  We  hope  that  the 
Hahnemann  Publishing  Society  may  no  longer  have  to  call 
for  such  in  vain. 


848 


MISCELLANEOUS. 


Ihxioology  of  the  Poitan  qfvarioui  Fungi* 

1.  Agabicub  MUBOABirS  {lAnfUBi). 

Setting  aside  the  oldest  relevant  obaervations  on  aooount  of 
their  defectiyeness,  let  us  observe  that  Paulus,  from  various 
poisonings  with  the  fly  mushroom,  cites  the  following  STmptoms : 
— ^Nausea,  vomiting,  fainting,  anguish,  prostration,  and  stupor,  a 
sensation  of  constriction  of  the  trachea.  Some  of  the  patients 
had  cutting  pain  in  the  abdomen.  After  emetics  the  fungus  was 
ejected  upwards  and  downwards  along  with  bloodj  masses. 

Yadrot  observed  in  some  French  soldiers  who  were  poisoned : 
anguish,  choking,  burning  thirst,  violent  pains  in  the  abdomen ; 
small,  irregular  pulse,  cold  sweat,  cyanosis  of  the  face,  general 
shivering,  tympanites  of  the  abdomen,  very  effusive  stools.  The 
coldness  and  cyanosis  of  the  extremities,  delirium,  and  extremely 
violent  pain  continued  uninterruptedly  till  death,  which  occurred 
the  next  night.    Emetics  saved  some  from  death. 

Fricker  relates  that  a  child  of  sixteen  months  had  eaten  some 
fly  mushroom  raw ;  very  rapidly  there  set  in  a  deathlike  sleep,  in 
which  the  pupils  were  dilated  and  insensible  to  light ;  the  face 
puffed  up,  pale,  and  bluish  about  the  eyes,  nose  and  mouth ;  pulse 
small  and  irregular ;  slight  twitching  all  over  the  body,  and  slight 
distortion  of  the  upper  extremities  set  in. 

Elrombhols  communicates  the  history  of  a  day-labourer,  aged 
50,  who  drank  a  decoction  of  twenty-four  of  these  AgaHd  for  an 
(edematous  swelling  of  the  feet.  Soon  after  he  vomited  often, 
and  violently,  and  had  many  diarrhooic  stools;  complained  of  violent 
pain  in  the  abdomen,  fell  into  an  unconscioas  state,  and  soon 
died.  In  cases  of  slight  poisoning  only  staggering  as  from  drink, 
with  vertigo  and  inclination  to  vomit. 

Of  late  years,  some  observations  were  published  in  France, 
which  deviate  somewhat  from  the  above.    In  October,  1859,  six 

•  Neue  ZeiUehHftfgr  Horn,  Klmik.,  Bd.  18,  No.  19. 


Toxicology  of  the  Poison  of  various  Fungi.         849 

officers  ate  a  dish  of  Agarieus  musearius.  In  six  hours  vomiting 
set  in,  soon  followed '  by  colic»  and  then  by  convalsions,  and  a 
Bensation  of  heat  in  the  epigastrium,  consciousness  intact  till 
death. 

The  experiments  by  various  hands  on  animals  are  valuable. 
The  most  careful  ones  are  those  of  Krombholz.  Cats,  dogs,  birds, 
frogs,  &c.  He  sometimes  used  decoctions  of  the  fungus  in  milk, 
flometimes  the  expressed  juice,  which  he  introduced  into  the 
stomach.  In  two  cases  injections  under  the  skin  of  the  back. 
Sesults  as  follows : 

In  general,  during  the  experiments,  or  at  most  within  fifteen 
minutes,  the  first  symptoms  set  in.  With  small  doses,  the  animals 
were  sad  and  their  faces  betrayed  uneasiness.  In  most  cases 
vomiting  followed,  or  frequent  stools,  or  both  at  once ;  whereupon 
the  animals  recovered  in  from  half  to  one  hour.  "With  larger  doses 
violent  attacks  ensued,  quickest  and  most  violent  after  injecting 
the  cellular  tissue.  As  constant  symptoms  were  observed,  restless- 
ness, fear,  trembling,  vertigo,  staggering  as  from  drink,  dilatation  of 
the  pupils,  sight  impaired  or  destroyed,  dulness  of  all  the  senses, 
breathing  rapidly  and  heavily,  but  towards  the  end  slowly  and 
painfully ;  twitching  of  the  cer?ical  muscles ;  palsy  soon  setting  in, 
especially  of  the  hinder  part  and  hinder  extremities.  Less 
constant  symptoms  were,  increased  and  involuntarily  evacuations 
(vomiting,  stool,  and  urine)  and  salivation.  The  least  constant 
were  exalted  sensitiveness  previous  to  stupefaction,  dread  of 
water  (hydrophobia),  and  violent  thirst.  In  two  cases  death 
ensued  with  general  convulsions  ;  in  most  of  the  others  quietly . 
Beports  post-mortem  are  very  sparing. 

In  three  patients  of  Yadrot's  was  found  a  considerable  accu- 
mulation of  fetid  gas  in  the  stomach  and  bowels,  whose  mucous 
membranes  showed  signs  of  more  or  less  inflammation  and  gangre- 
nous spots  (extravasation  ?)  In  some  places  that  of  the  small 
intestines  quite  destroyed.  In  a  fourth  subject  the  liver  was 
also  considerably  swollen,  and  the  gall  filled  with  thick,  dark  bile. 

In  Krombholz's  case,  the  post-mortem  exhibited  severe  con- 
gestion of  blood  in  the  spinal  cord,  brain,  and  its  membranes, 
lungs,  the  right  side  of  the  heart,  the  liver,  and  kidneys  ;  striking 
congestion  also  in  the  whole  of  the  venous  system,  with  black  thick 
blood.  The  mucous  membrane  of  the  alimentary  canal  reddened 
here  and  there,  but  with  no  trace  of  softening  or  destruction. 


350  Miscellaneous. 

Wolf  found  in  a  girl  of  6,  who  was  found  dead  tvrelve  hours 
after  eating  this  fungus,  numerous  death  spots,  teeth  tight 
clenched,  pupils  much  dilated ;  abdomen  distended,  sphincter  ani 
open.  No  important  changes  in  the  cranial  cayitj ;  the  fauc^ 
trachea,  and  (esophagus  not  inflamed.  Heart  fiabbj  and  relaxed, 
with  some  blood  in  the  right  side,  none  in  the  left-  Stomach 
much  distended,  pale,  with  a  bluish  spot  about  one  centimetre 
diameter  on  the  lesser  curvature;  the  tunica  intima  in  the 
pyloric  portion  rosy  red,  yet  no  peculiar  inflammation ;  the  inner 
parietes  of  the  stomach  pale,  yery  thick,  coated  with  U>agh 
mucus. 

Krombholz,  in  his  experiments  on  animals,  found  after  death 
(besides  abnormal  distribution  of  the  blood)  great  redness  of  the 
mucous  membranes,  prominence  of  the  eyes,  contraction  and  empti- 
ness of  the  intestines,  excess  of  bile  in  the  gall,  yiscosity  and 
blackness  of  the  blood.  Less  constant  symptoms  were  redness 
of  the  buccal  canity  and  the  salivary  glands.  In  warm-blooded 
animals  the  blood  half  coagulated ;  in  cold-blooded,  quite  fluid ; 
serous  exudation  in  the  cavities,  and  prominence  of  the  ab- 
domen. 

2.  AoABicus  Phalloides  (Fries). 

The  cases  of  poisoniug  with  this  fungus  (the  Knollen-Blatter- 
pilz)  appear  to  have  occurred  more  frequently  than  with  the 
Agaricus  muscarius,  partly  because  its  action  is  more  intense, 
partly  because  it  is  so  easily  mistaken  for  the  commonly  esteemed 
Champiffnon.^ 

In  these  cases,  symptoms  precisely  corresponding  with  cholera 
are  constantly  observed.  Girard  makes  a  prominent  remark 
that  even  the  quantity  of  the  stools  adds  to  this  resemblance ; 
equally  constant  are  the  cardialgia,  and  colic  of  the  most  violent 
kind,  with  pain  of  the  head,  tormenting  thirst  which  can  not  be 
quenched  because  drink  at  once  brings  on  vomiting ;  cool  skin, 
cold  sweat,  coldness  and  cyanosis  of  face  and  extremities,  tym- 
panites of  the  abdomen,  shivering  of  the  whole  body,  anguish,  and 
fainting  fits. 

Urination  in  most  cases  strikingly  diminished,  at  times  wholly 

*  This  being  a  perfectly  vagae  term,  the  botanical  name  should  have  been 
added*    It  may  mean  Agarioua  arcades,  which  is  the  English  "  Champignon.'* 


Toxicology  of  the  Poistm  of  various  Fungi.  351 

• 

sappressed.  The  pulse  is  described  as  extraordinarily  small,  hardly 
perceptible;  and  the  pulsation  of  the  heart  as  very  feeble. 
Sometimes  jaundiced  tin^  of  the  skin  and  pains  in  the  liver.  In 
Bome  cases  consciousness  is  undisturbed,  in  others  stupe&ction 
and  sopor ;  often  convulsions,  sometimes  partial,  sometimes  gene- 
ral, and  even  trismus  and  tetanus.  Maschka  found  by  post- 
mortem the  following  phenomena,  in  seven  cases.  No  trace  of 
stiffening  afber  death  ;  pupils  considerably  dilated,  reddish  froth 
of  small  bubbles  in  the  bronchial  tubes,  blood  in  all  the  vessels 
and  the  right  heart,  fluid,  and  of  a  dark  cherry -brown  colour ; 
fatty  degeneration  of  the  liver  in  three  cases,  gall-bladder  mode- 
rately filled,  mucous  coat  of  stomach  and  intestines  covered  with 
thick,  tough,  reddish-brown  mucus.  Ecchymosis  and  suggilla- 
tion  at  the  fundus  of  the  stomach  only  in  two  cases.  Bladder  in 
all  cases  so  full  that  it  reached  nearly  to  the  navel,  parenchy- 
matous organs  more  or  less  hypersBmic,  and  full  of  numberless 
ecchymoses,  most  of  which  are  in  the  integument,  scr  also  the 
pericardium,  and  the  serous  covering  of  the  heart  itself. 

3.  Boletus  Satanab  (Lenz). 

One  of  the  most  dangerous  fungi  is  the  one  named  by  Lenz 
Boletus  satanas,  a  variety  of  B.  luridus.  The  most  renowned 
German  mycologists  have  been  brought  to.  the  brink  of  the 
grave  by  eating  this  fungus.  But  it  is  just  their  experience  we 
have  to  thank  for  authentic  descriptions  of  the  poisoning  as  pre- 
sented below  in  the  notes  of  those  naturalists.  These  also  permit 
us  to  prognosticate  this  remedy  as  a  valuable  simile  in  cholera. 
The  first  symptoms  of  poisoning  occur  very  soon,  from  two  to  six 
hours  after,  and  consist  of  a  general  feeling  of  indisposition, 
burning  and  scraping  in  the  gullet,  vertigo,  and  nausea.  Vomit- 
ing soon  ensues,  and  is  often  repeated  even  long  after  the  stomach 
is  emptied,  so  that  nothing  comes  up  but  an  excessively  bitter 
fluid,  the  ejected  matter  not  unfrequently  mixed  with  blood  ;  the 
vomiturition  is  accompanied  with  violent  pains  in  the  bowels, 
whilst  the  body  is  covered  with  cold  sweat;  diarrhoea  super- 
venes, with  very  violent  colic  and  tenesmus,  fasces  often  mixed 
with  blood ;  later  on  the  cold  in  the  extremities  is  accompanied 
with  extremely  painful  cramp  in  the  muscles  of  the  limbs,  e.  g. 
the  calves  of  the  legs;  the  strength  fails  entirely;  the  pulse 


352  Miacellaneout. 

becomes  small,  and  hardly  perceptible;  thirst  unquenchable, 
great  prostration  and  fainting  fits,  without  exception.  Unfor- 
tunatelj,  there  are  no  post-mortem  reports. 

# 

4.  €hnu»  BussiTLiL. 

In  regard  to  this  genus,  where  there  is  great  confusion  of 
names,  there  is  but  one  detailed  account  fiimished  bj  Alphons 
Barrelet,  of  a  case  of  poisoning  with  R.  fasten.  The  symptoms 
which  occurred  in  the  course  of  six  days  after  eating  the  broiled 
fungus  were,  nausea,  pains  in  the  bowels,  vomiturition,  actual 
vomiting,  diarrhoea,  coldness  of  the  extremities,  cyanosis  of  the 
£B«e.  Pupils  sometimes  normal,  sometimes  dilated,  sometimes 
contracted,  continued  shivering  of  the  limbs  (sometimes  inter- 
rupted by  spasmodic  contraction)  proceeded  to  general  clonic 
spasms,  with  entire  loss  of  consciousness,  involuntary  urination, 
the  pulse  at  first  small  and  contracted  and  84  per  min.,  rose  afl;er 
emetics  and  sinapism  to  100,  and  then  sank  to  80.  On  the  third 
day,  consciousness  returned,  the  patient  hears  well,  but  is  quite 
blind  ;  the  muscular  spasms  abate  gradually,  the  anguish  of  death 
and  dyspncea  disappear ;  hallucinations  set  in  for  three  days  ;  then 
a  pseudo-erysipelas  on  the  elbow,  and  numerous  furunculi  all  over 
the  body,  but  especially  on  the  scapula  and  the  small  of  the  back. 
Got  well  in  two  or  three  weeks. 

Tbeatmskt  of  Fufgus-poibokikg. 

Experience  teaches  us  that  the  fungi  yield  with  great  difficulty 
and  very  slowly  to  the  digestive  powers,  their  remains  have  been 
observed  in  the  f»ces  two  days  after  eating  them,  and,  according 
to  very  many  observations,  fragments  but  little  altered  have  been 
vomited  up  on  the  second  and  third  and  once  on  the  sixth  day ! 
The  treatment  of  the  poisoned  has  therefore  to  strive  afber  a  dis- 
charge of  the  ingesta  by  vomiting  and  purging,  in  order  to  satisfy 
tbe  causal-indication  :  and  this  so  much  the  more,  as  a  favourable 
result  may  be  hoped  for  even  in  late  stages.  The  choice  of  the 
emetic  can  not  be  a  matter  of  indifierence,  and  requires  so  much 
the  more  consideration,  because  in  many  cases  (chiefly  as  it 
appears  with  the  A,  muscarius)  spontaneous  vomiting  entirely  fails, 
and  then  the  artificial  inducement  of  it  is  very  difficult,  owing  to 
spasms  of  the  cardia  and  (esophagus.    In  some  cases  thirty-six 


The  Sulphides  of  Potassium,  Sodium,  and  Calcium.     353 

grains  of  Tartar  emetic  were  administered  without  effect.  It 
deserves  to  be  mentioned  on  this  point  that  not  un&equentlj 
mechanical  means,  such  as  touching  the  fauces  with  a  feather 
moistened  in  oil,  and  pressure  on  the  abdomen,  have  been 
attended  with  success.  The  stomach-pump  has  been  used  by 
Paddie  in  seyeral  cases  with  effect.  Amongst  antidotes,  the  only 
Bfure  one  is  Atropine,  whose  striking  effects  have  been  noticed  in 
detail  in  the  former  article.  Also  vinegar  and  citron-juice  are 
sometimes  useful,  as  well  as  common  salt.  Oallio  aeid  (G-arbsaure) , 
and  lod.  kali,  which  were  recommended  by  one  party  proved 
utterly  useless. 


On  Sulphide  of  Potassium,  Sulphide  of  Sodium,  and  Sulphide  of 

Calcium, 

By  Stdket  Eikgeb,  M.D.,  Professor  of  Therapeutics  in  TJniver- 
sity  CoUege,  and  Physician  to  University  College  Hospital. 

I  wish  to  call  attention  to  the  value  of  sulphides,  present  in 
many  natural  waters,  in  abscesses,  boils,  and  scrofulous  sores. 
The  influence  of  the  group  on  the  suppurative  process  is  easily 
made  manifest.  Thus  when  Sulphide  of  Potassium  or  Calcium  is 
administered,  a  thin,  watery,  unhealthy  discharge  becomes  at 
first  more  abundant,  afterwards  diminishing,  and  throughout 
continues  thicker  and  healthier,  possessing  indeed  the  characters 
of  "  laudable "  pus.  The  condition  of  the  sore  improves  cor- 
respondingly, and  its  healing  is  promoted. 

The  sulphides  appear  often  to  arrest  suppuration.  Thus  in 
inflammation  threatening  to  end  in  suppuration  they  reduce  the 
inflammation,  and  avert  the  formation  of  pus.  This  effect  is 
manifested  when  sulphur  compounds  are  employed  locally  in  acne 
indurata ;  but  further  on  I  shall  speak  more  in  detail  concerning 
their  employment  in  this  eruption.  The  influence  of  this  group 
is  still  more  conspicuous  after  the  formation  of  pus.  They 
then  considerably  hasten  maturation,  whilst  at  the  same  time 
they  diminish  and  dreumscribe  the  inflammation.  They  promote 
the  passage  of  the  pus  to  the  surface  and  the  evacuation  of  the 
abscess.  Their  efficacy  may  be  frequently  demonstrated  in  cases 
of  the  following'  kind.     An  unhealthy  child,  from  six  to  twelve 

VOL.  XXXII^  NO.  CZXVIII. APRIL,   1874.  Z 


854  Miscellaneous, 

months  old,  eaffen  from  a  slight  sore  throat,  perhaps  occurring 
in  scarlet  fever  or  measles.  The  sore  throat  produces  consider- 
able enlargement  of  the  glands  behind  the  angle  of  the  jaw. 
The  swelling,  of  stonj-hardness,  may  be  sufficiently  large  to 
interfere  with  swallowing  and  to  push  the  head  on  one  side. 
Suppuration  takes  place,  but  is  yery  deep-seated,  and  for  a  long 
time  there  is  neither  redness  of  the  skin  nor  fluctuation,  and  the 
pus  yery  slowly  makes  its  way  to  the  surface,  so  that  a  fortnight, 
three  weeks,  or  even  a  month  may  elapse  before  the  abscess 
bursts,  or  is  fit  to  be  opened,  when  a  deep  hole  is  left,  with  con- 
siderable induration  around  it.  The  pain  and  constitutional 
disturbance  are  so  great  that  the  child  sometimes  dies  ;  and  even 
if  this  termination  is  averted,  the  deep  discharging  hole  heals  very 
slowly  owing  to  the  indurated  and  unhealthy  state  of  the  adjacent 
tissues.  If  a.tenth  of  a  grain  of  Sulphide  of  Calcium,  mixed  with  a 
grain  of  Su^ar  ofMUk,  is  given  in  such  a  case  every  hour  or  two 
hours,  the  results  are  most  striking.  The  swelling  becomes 
smaller,  the  pus  reaches  the  surface  in  four  or  five  days,  and  when 
it  is  evacuated  leaves  a  benign  wound  which  quickly  heals.  The 
effects  of  these  remedies  are  equally  conspicuous  in  mammary 
abscesses,  although  in  rare  instances  they  appear  temporarily  to 
increase  the  pain — a  remark  which  seems  sometimes  to  hold  good 
with  respect  to  boils.  But  as  a  rule  the  pain  is  speedily  miti- 
gated. Singular  to  say,  I  have  found  these  remedies  of  much  less 
use  in  forwarding  the  maturation  and  expulsion  of  pus  in  indolent 
buboes,  but  my  experience  of  their  use  in  buboes  has  been  but 
small. 

It  may  be  urged  that  it  is  difficult  to  imagine  how  these  reme- 
dies can  produce  effects  so  different  and  apparently  opposite  as 
the  dispersion  of  inflammation  in  one  case  and  the  expulsion  of 
pus  in  another;  but  poultices  and  hot  fomentations  certainly 
possess  the  property  both  of  subduing  inflammation  and  of  pre- 
venting suppuration,  and  in  other  cases  of  hastening  considerably 
the  evacuation  of  pus. 

In  boils  and  carbuncles  these  remedies  yield  excellent  results. 
A  tenth  of  a  grain  of  Sulphide  of  Calcium,  given  every  two  or 
three  hours,  generally  prevents  the  formation  of  fresh  boils,  while 
it  lessens  the  ipflammation  and  reduces  the  area  of  the  existing 
boils,  and  quickly  liquefies  the  core,  so  that  its  separation  is 
much  more  speedy,  thus  considerably  curtailing  the  course  of  the 


The  Sulphides  of  Potassium,  Sodium,  and  Calcium.     355 

boil.  Where  the  skin  is  not  yet  broken,  and  the  slow-separating 
core  therefore  not  jet  exposed,  the  sulphides  often  convert  the 
boil  into  an  abscess,  so  that  on  bursting  pus  is  freely  discharged 
and  the  wound  at  once  heals.  These  remedies  meanwhile  im- 
prove the  general  health,  removing  that  debility  and  malaise 
ordinarily  so  markedly  associated  with  these  eruptions.  In  some 
cases,  however,  as  in  the  deep-seated  boils  and  abscesses  of 
diabetes,  they  are  powerless.  In  carbuncles  the  sulphides  will 
generally  be  found  equally  serviceable,  melting,  as  it  were,  the 
core  into  healthy  pus,  and  so  quickly  expelling  the  dead  and 
otherwise  slow-separating  tissue.  In  abscesses  and  carbuncles  it 
is  useful  to  apply  Belladonna  over  the  inflamed  part  to  reduce 
inflammation  and  allay  pain.  The  skin  should  be  thickly 
smeared  with  equal  parts  of  Belladonna  and  Glycerine,  and  over 
this  a  poultice  applied,  renewing  the  Belladonna  each  time  the 
poultice  is  changed.  Poultices,  however,  being  liable  to  bring 
out  a  fresh  crop  of  boils,  one  of  the  following  plans  should  be 
adopted  :  Smear  Belladonna  ointment  some  distance  round  but  not 
over  the  boil,  and  then  apply  a  poultice,  the  greasy  application 
thus  protecting  the  neighbouring  tissues.  Or,  still  better,  apply 
a  Belladonna  or  Opium  plaster  on  leather,  with  a  hole  the  size  of 
the  boil,  around  the  swelling,  and  through  the  opening  smear 
Olycerine  and  Belladonna,  covering  all  with  a  small  poultice.  The 
leather  plaster  efficiently  protects  toe  surrounding  skin  and 
averts  the  production  of  fresh  boils. 

I  have  thought  it  worth  while  to  mention  these  useful  plans  of 
protecting  the  boil ;  but  it  is  scarcely  necessary  to  observe  that 
whilst  investigating  the  effects  of  sulphides  I  have  employed 
them  alone,  or  at  most  sometimes  using  only  a  poultice.  The 
good  effects  of  sulphides  are  conspicuous  in  certain  scrofulous 
Bores  not  uncommonly  seen  ,in  children.  Scrofulous  children 
during  the  first  few  months  are  sometimes  subject  to  indolent 
abscesses  in  the  cellular  tissue  which  run  a  very  slow  indolent 
course.  At  first  only  a  small  hard  substance  is  observable,  no 
larger  than  a  pea,  under  the  skin,  which  is  of  natural  colour,  and 
movable  over  it.  The  small  substances  next  suppurate  and 
gradually  enlarge,  the  skin  becomes  adherent  to  them,  and 
changes  in  colour  to  red  or  even  violet,  while  sometimes  in  their 
neighbourhood  the  smaller  vessels  become  enlarged  and  even 
varicose.    They  may  grow  to  the  size  of  a  florin,  and,  when 


356  MiiceilaneouM. 

maturated  feel  soft  and  boggy.  After  a  time  a  small  circular 
openiug  appears,  not  larger  perhaps  than  a  pin's  head,  through 
which  escapes  a  thin  unhealthy  pus.  If  deep  seated,  as  on  the 
buttocks,  or  in  fat  children,  there  may  be  very  little  or  no  dis- 
coloration of  the  skin.  The  chief  noticeable  character  then  is 
the  small  sharply-cut  opening,  as  if  a  piece  had  been  punched 
out.  These  formations  follow  one  another,  and  may  continue  to 
distress  the  child  for  months  or  years.  In  mild  cases  a  few  only 
may  form,  whilst  in  severe  cases  there  may  be  at  one  time  ten  or 
a  dozen  in  different  stages  of  development.  'When  they  heal 
they  leave  a  white,  sharply  defined,  but  not  deeply  depressed 
scar.  On  the  administration  every  hour  or  two  of  a  tenth  or 
twentieth  of  a  grain  of  Sulphide  of  Oalcium  the  following  effects 
occur : — New  formations  seldom  appear,  although  for  months  or 
years  the  child  may  have  been  infested  with  them.  Many  of  the 
abscesses,  especially  in  a  very  early  stage  of  development,  dry  up 
and  disperse,  others  generally  speedily  come  forward  and  dis- 
charge their  contents,  the  pus  being  laudable,  instead  of  thin  and 
unhealthy.  The  abscesses  already  in  an  open  state  improve, 
their  pus  becoming  healthier,  and  the  wound  healing  speedily. 

In  some  cases,  in  addition  to  these  subcutaneous  formations,  the 
bones  also  become  affected.  The  phalangeal  bones  of  the  hand 
are  most  frequently  attacked,  but  not  uncommonly  the  metacarpal, 
and  more  rarely  the  metatarsal.  Where  the  phalangeal  bones 
are  affected,  one  or  several  of  the  fingers  become  nodose.  For  a 
long  time  the  skin  remains  pale  and  freely  movable,  but  after  a 
time  suppuration  ensues,  when  the  swelling  increases,  the  skin 
becomes  red  and  painful,  and  after  a  time  slowly  softens  at  one 
point,  remaining  boggy  for  a  considerable  time  before  the  abscess 
opens  naturally.  Then  generally  a  little  bone  separates,  or  in 
bad  cases  the  whole  of  the  shaft  comes  away,  leaving  the  epiphyses 
behind.  When  an  opportunity  occurs  to  examine  these  bones 
before  suppuration  sets  in,  the  shaft  is  considerably  enlarged,  very 
pale,  and  the  cancellous  structure  infiltrated  with  a  straw-coloured 
firm  substance,  whilst  the  epiphyses  and  their  cartilages  are 
healthy.  Even  an  affection  so  severe  as  this  may  be  considerably 
benefited  by  sulphides.  •  Thus  before  suppuration  has  set  in,  or 
whilst  it  has  made  little  way,  they  often  remove  the  swelling, 
though  large  doses  may  be  required.  After  much  suppuration, 
their  good  effects  depend  in  a  great  measure  on  the  amount  of 


The  Sulphides  of  Poiassium^  Sodium,  and  Calcium.     857 

the  disease  of  the  bone.  If  the  whole  shaft  becomes  necrosed, 
of  course  the  sore  will  not  heal  till  this  has  been  got  rid  of ;  but 
suppuration  often  occurs  and  yet  but  little,  or  perhaps  none,  of 
the  bone  dies.  In  such  a  case  the  sulphides  hasten  the  expul- 
sion of  the  pus,  and  if  the  skin  is  already  broken  before  they  are 
employed,  they  improve  the  character  of  the  wound  and  the 
discharge,  and  the  sore  heals,  leaving  a  sunken  scar  adherent  to 
the  bone,  whilst  the  finger  slowly  assumes  its  natural  proportions. 
Large  indolent  abscesses  may  form  on  the  back  of  the  hands  or 
feet.  These  are  similarly  affected  by  the  sulphides.  Whilst 
these  remedies  are  thus  influencing  locally  these  strumous  forma- 
tions and  abscesses,  the  child's  health  greatly  improves,  although 
failing  previously,  in  spite,  perhaps,  of  the  administration  of  Cod* 
liver  oil  and  Steel  toine.  That  the  improvement  is  due  to  the 
sulphide  is  shown  by  the  fact  that  the  amendment  occurs  where 
only  this  drug  is  administered.  On  prematurely  discontinuing 
the  sulphide,  fresh  formations  are  apt  to  appear,  especially  on 
the  occurrence  even  of  a  slight  illness ;  indeed,  a  severe  illness 
will  often  excite  a  few  fresh  abscesses,  in  spite  of  the  sulphides. 

Ther  sulphides  appear  to  me  to  exercise  a  very  beneficial  in- 
fluence in  suppurating  scrofulous  glands  in  the  neck.  Here 
again  they  hasten  the  elimination  of  the  pus,  and  subsequently  the 
cheesy  scrofulous  matter.  After  the  abscesses  have  burst,  and 
continued  slowly  discharging  a  scanty,  unhealthy  pus,  and  when 
the  edges  of  the  sores  have  become  much  thickened  and  indurated, 
these  remedies  render  the  discharge  more  abundant,  thick,  creamy, 
and  healthy,  considerably  hasten  the  evacuation  of  the  scrofulous 
matter,  which  prevents  the  healing  of  the  wound,  and  at  the 
same  time  soften  the  round  indurated  edges,  so  that  the  sore 
heals  much  more  speedily.  If  small  doses  appear  to  affect  these 
sores  but  little,  larger  doses,  as  half  a  grain  or  a  grain,  should  be 
given  several  times  a  day,  or  even  every  two  hours.  I  need 
hardly  say  that  to  compass  the  results  described  the  treatment 
must  be  continued  several  weeks,  for  it  is  vain  to  expect  them  to 
occur  in  a  few  days,  when  the  sores  have  been  discharging  perhaps 
for  months  or  even  years. 

The  topical  effect  of  Sulphur  ointmefU^  or  of  an  Ointment  of 
ike  Hypoehlorite  of  Sulphur^  or,  still  better,  of  the  Iodide  of 
Sulphur  of  the  FharmacopoBia,  is  most  marked  on  acne  indnrata 
and  acne  rosacea.    Here,  again,  the  effects  are  twofold,  and  even 


358  Miscellaneoui. 

opposite,  according  to  the  stage  of  the  eruption.    If  applied  at 
the  very  commencement  of  the  eruption,  as  soon  as  the  little  hard 
knot  is  felt  under  the  skin,  further  deyelopment  is  arrested  and 
the  hardness  speedily  disappears.     For  instance,  if  smeared  OTer 
the  hardness  just  before  going  to  bed,  in  the  morning  scarcely 
any  induration  will  be  felt,  though  after  a  time,  perhaps  from 
exercise,  or  the  irritation  from  washing,  much  of  the  hardness  may 
return,  to  be  again  removed  by  a  renewed  application  of  the 
ointment,  so  that  in  two  or  at  most  three  days  a  papule  that 
threatened  to  become  of  considerable  size  may  be  completely 
dispersed.     When,  however,  the  nodule  has  advanced  further, 
and  suppuration  has  set  in,  then  the  effects  of  the  ointment  are 
much  like  those  of  sulphides,  administered  internally,  on  boils. 
The  ointment  hastens  maturation,  limits  the  swelling  and  hard- 
ness, and  thus  considerably  curtails  the  duration  of  the  eruption. 
Nay,  iiirther,  if  rubbed  over  the  skin  it  appears  to  check  the 
formation  of  the  acne  spots.    If  rubbed  over  the  nose   and 
neighbouring  parts  of  the  face  in  acne  rosacea  its  effects  are  often 
striking.     Not  only  does  it  act  as  in  acne  indurata,  but  the 
hardened,  swollen  tissues  become  softened  and  reduced  to  a  more 
natural  state.     I  have  found  the  Iodide  of  Sulphur  likewise  useful 
in  bromic  acne,  reducing  the  eruption,  or  at  least  considerably 
lessening  the  size  of  each  spot.     In  acne  the  ointment  should  be 
thickly  smeared  over  the  eruption  night  and  morning. 

Any  one  who  gives  the  sulphides  a  fair  trial  in  the  foregoing 
cases  will,  I  feel  confident,  have  reason  to  be  gratified  with 
the  result — Lancet j  February  2l8t,  1874. 

To  read  the  above  in  the  pages  of  our  old  enemy  the  Lancet 
almost  took  away  our  breath.  It  is  nothing  but  a  homoeopathic 
clinical  lecture  on  our  very  own  medicine,  Hepar  tulphurisy  with 
the  omission  of  the  word  *'  hom(Bopathic,"-and  the  thin  veil  of 
Sulphide  of  Calcium  used  to  conceal  the  more  ordinary  homcno- 
pathic  appellation  Hepar,  How  comes  it  that  the  Lancet^  which 
still  wages  fierce  war  against  homodopathy,  admits  a  pure  piece 
of  homoBopathic  practice  into  its  columns,  provided  the  author 
has  made  no  actual  confession  of  a  belief  in  homoBopathy,  and  no 
verbal  mention  is  made  of  the  hated  system?  Had  our  late 
illustrious  colleague.  Professor  Henderson,  written  an  article  on 
Hepar  in  connexion  with  the  suppurative  process,  or  with  boils 


The  Sulphides  of  Poiasrium,  Sodium,  and  Calcium.     859 

and  carbancles,  he  ooold  Bcarcely  have  said  anything  different 
from  what  the  Professor  of  Therapeutics  in  University  College  has 
Baid ;  but  had  he  sent  such  a  paper  to  the  Lancet,  can  any  one 
doubt  that  it  could  have  been  insultingly  rejected  ? 

It  must  be  very  mortifying  to  Professor  Sydney  Binger  to 
find  that  the  sole  credit  of  the  discovery  of  the  curative  action  of 
Hepar  wlpkurie  in  suppurative  processes  is  not  left  to  his 
peaceable  enjoyment.  In  the  very  next  number  of  the  Zaneet^ 
Dr.  Thorowgood,  whose  frequent  rediscoveries  of  well-known 
homcBopathic  remedies  would  be  surprising  did  we  not  know  the 
source  whence  he  derives  his  information,  claims  to  have  used 
Hepar  eulph.  in  diseases  attended  with  suppuration  for  ten  years ; 
and  Dr.  Burness,  who  has  Just  published  a  book  of  homoeopathic 
principles  and  practice,  without  the  name,  expresses  his  con- 
currence with  what  Dr.  Binger  says  about  Separ^  and  testifies 
that  he  has  frequently  used  it  in  similar  cases.  We  subjoin  the 
letters  of  those  two  **  allopathic  '*  practitioniBrs,  which  will  be 
found  highly  amusing  to  all  convers^t  with  homoeopathic 
practice. 

Medioxkal  IJsb  oe  Csbtaim  Sttlfuides'. 
To  the  Editor  of  The  Lancet: 

Sib, — ^Dr.  Binger  has  done  good  service  in  bringing  into 
prominent  notice  the  use  of  certain  sulphides  in  diseases 
attended  with  suppuration. 

About  ten  years  ago  I  had  under  my  care  a  child  afflicted  with 
unhealthy  strumous  ulcerations  in  the  neck  and  other  parts  of 
the  body.  The  sores  had  thickened  edges ;  and,  in  some,  a  small 
greenish  slough  formed.  There  was  no  evidence  of  syphilitic 
taint.  Ood-liver  oil  and  Iodide  of  Iron  had  no  curative  action, 
but  on  haif-grain  doses  of  Sulphide  of  Calcium  in  water  a  very 
striking  amendment  took  place. 

I  have  found  the  Sulphuretted  potash  of  the  B.P.  an  admirable 
remedy  in  many  cases  of  glandular  suppuration.  In  follicular 
tonsillitis,  also,  I  have  employed  this  salt  with  highly  satis- 
factory results.  One  grain  can  be  made  into  a  pill,  with  a  drop 
of  Oil  of  Anise  added  as  an  effectual  means  of  overcoming  the 
abominable  odour  of  the  salt.  When  made,  the  piU  may  be 
coated  with  Ethereal  solution  ofTolu;  this  will  not  only  conceal 
the  smeU,  but  will  prevent  the  contained  sulphide  absorbing 
oxygen  and  becoming  an  inert  sulphate. 


860  MisceUaneaus. 

M.  Tuy,  of  PariB,  preparet  eapeiiles  containing  the  Sulphu- 
retted potash.  In  these  the  salt  is  perfectly  protected  from  the 
air,  and  in  this  form  the  drug  is  readily  given  to  the  most 
fastidioos  of  patients.  The  capsules  that  I  have  seen  and  used 
were  obtained  from  Messrs.  Corbyn,  and  imported  by  that  house 

frtnn  Paris. 

I  am,  Sir,  obediently  yours, 

JoHV  C.  Thobowgood,  M.D.  Lend., 

Lecturer  on  Materia  Medica  at  Middlesex  HoepitaL 

To  the  Editor  of*  The  Lancet: 

81B, — Your  issue  of  February  2l8t  contains  an  article  by  Dr. 
Sydney  Binger  on  the  Sulphides  of  Potassium,  Sodium,  and 
CkUeiwn,  in  which  he  refers  to  the  power  of  these  agents  to 
control  suppuration,  and  states  that  he  has  found  them  to  be 
valuable  agents  in  the  treatment  of  boils,  carbuncles,  scrofulous 
glands,  and  many  skin  diseases.  With  his  statement  I  fully 
concur,  having  frequently  used  the  sulphides  in  the  treatment  of 
similar  cases  with  great  success.  But  however  interesting  and 
curious  these  facts  may  be  of  themselves,  I  think  more  valuable 
instruction  may  be  derived  from  them  if  we  seek  to  ascertain  bow 
and  why  they  are  such  valuable  therapeutic  agents  in  the 
treatment  of  the  special  affections  alluded  to,  and,  having  gained 
this  knowledge,  we  will  then  have  a  scientific  basis  on  which  to 
found  our  treatment.  Therefore,  having  this  object  in  view,  I 
trust  you  will  allow  me  to  quote  the  following  remarks  from  my 
work  on  the  Speoifie  Action  of  Thugs,  where  I  premise  that  the 
full  therapeutic  value  of  any  drug  is  only  to  be  obtained  by  first 
ascertaining  its  physiological  action.  Now,  as  regards  the  sul- 
phides, when  swallowed  in  a  full  dose  they  are,  to  a  certain 
extent,  decomposed  by  the  free  acid  in  the  stomach,  sulphuretted 
hydrogen  is  evolved,  and  some  of  the  effects  produced  are  due  to 
this  gas — ^viz.,  an  acid  taste  in  the  mouth,  burning  pain  in  the 
throat  and  stomach,  dry  cough  (sometimes  vomiting  and  purging), 
feeble  pulse,  faintness,  convulsions,  or  a  state  of  sopor.  But  in 
smaller  doses,  frequently  repeated,  they  produce  an  ansBmic  con- 
dition, with  general  nervous  depression.  Applied  ezterni^y  they 
cause  a  papular  or  vesicular  eruption,  and  it  is  well  known  that 
the  sulphides,  like  Suiphur,  are  eliminated  by  the  skin  in  the 
form  of  sulphuretted  hydrogen. 

Now  these  facts  indicate  that  the  specific  action  of  these 


I 

The  Sulphides  of  Potassium,  Sodium,  and  Calcium.     861 

agents  is  upon  the  skin  and  mucous  membrane  in  the  process  of 
elimination,  and  also  to  a  certain  extent  upon  the  blood-corpuscles 
(the  secondary  effects  being  due  to  the  changes  produced  in  the 
nature  and  quality  of  the  vital  action  of  these  parts).  We 
naturally  infer  that  the  therapeutic  actions  of  these  agents  will 
be  on  the  same  tracts,  and  hence  we  are  led  to  use  them  in  such 
affections  as  chronic  catarrh,  follicular  sore  throat,  chronic  bron- 
chitis, abscesses,  scrofulous  glands,  and  many  skin  diseases ;  also 
to  improTe  the  eondition  of  scrofulous  children  suffering  from 
indolent  abscesses,  but  in  these  cases  we  give  a  less  dose  than  a 
physiological  one — viz.  a  restorative  dose. 

We  can  thus  remove  the  sulphides  from  the  list  of  empiric 
remedies,  having  facts  at  our  disposal  to  account  for  their  remedial 
action,  for  I  have  indicated  that  given  in  a  physiological  dose  they 
influence  certain  specific  parts ;  and  daily  experience  (^.y.,  the 
cases  communicated  by  Dr.  Sydney  Binger)  confirms  the  truth  of 
the  inference  that  in  a  restorative  dose  they  will  beneficially  influ- 
ence the  same  parts  when  deranged,  and  this  they  do  either  by  in 
some  manner  altering  the  nature  and  quality  of  the  vital  action  of 
the  parts  or  by  removing  the  state  of  combination  of  the  elements 
which  excite  diseased  action,  and  thus  enabling  the  normal 
powers  of  nutrition  to  restore  the  healthy  constitution ;  and  this 
I  consider  applies  not  only  to  the  sulphides  but  also  to  every 
other  drug.  Now  in  reference  to  the  dose  mentioned  by  Dr. 
Sydney  Binger — viz.,  one  tenth  of  a  grain  every  two  or  three 
hours — I  consider  the  quantity  quite  sufBcient,  and  this  for  two 
reasons.  1st.  because  the  sulphides  are  comparatively  insoluble 
and  slowly  diffusible  salts,  hence  require  to  be  given  in  small 
and  repeated  doses  to  ensure  their  being  absorbed  into  the  system, 
for  if  a  large  dose  be  given  at  once  it  may  pass  through  the  intes- 
tinal canal  before  it  can  be  changed  into  a  condition  necessary 
for  absorption;  moreover,  by  giving  small  and  repeated  doses 
we  can  keep  the  system  longer  under  the  influence  of  the  drug. 
2nd.  A  small  dose  is  indicated  because  we  wish  the  restorative 
action  of  a  drug  on  a  part  whose  functions  are  deranged,  and 
not  its  physiological  action,  at  least  in  the  cases  mentioned 
above. 

I  remain,  Sir,  your  obedient  servant, 

Alex.  G.  Busitbss,  M.B.,  &c. 

Qreen  Street,  GroBvenor  Square ;  2drd  Feb.,  1874. 


862  Miscellaneous. 

How  then  does  the  case  stand  ?  A  paper  on  the  homosopathic 
treatment  of  a  disease — and  we  have  aeeti  manj  such  in  all  the  allo- 
pathic periodicals  of  late — ^is  published  in  a  journal  that  affects  to 
despise  and  condemn  homoeopathy,  and  because  the  word  "  homoeo- 
pathj  "  does  not  occur  in  it  the  editor  puts  it  forth  as  sound 
allopathic  practice.  This  procedure  reminds  us  of  the  dodge  of 
the  priest  of  oH  who  ate  his  fiit  capon  on  an  abstinence  day 
with  an  easy  conscience  after  pronouncing  over  it  the  miracle- 
effecting  worda  Jiatpisets,  But  simple  onlookers  did  not  see  that 
the  fowl  was  changed  into  a  fish  in  consequence  of  the  Latin 
adjuration,  nor  do  we  see  that  homoDopathy  becomes  allopathy 
because  it  appears  in  the  pages  of  the  Lancet  The  fact  is  that 
the  medical  trades-union  and  its  periodical  organs  hare  conspired 
to  ignore  homoBopathy  as  it  really  is,  and  to  continue  to  mis- 
represent it  as  the  ridiculous  caricature  that  was  drawn  of  it 
twenty  or  thirty  years  ago,  by  persons  of  no  reputation,  such  as  the 
author  of  Homoeopathy  Unmasked,  This  conspiracy  effectually 
deters  the  great  body  of  the  medical  profession  from  reading  our 
works  or  periodicals,  and  so  they  have  no  idea  that  the  articles 
cooked  up  for  them  by  the  Lancet  and  its  allopathic  contem- 
poraries are  often  merely  very  good  homoeopathy  with  this  word 
omitted.  We  are  defenceless  against  this  trades-union  plot,  but 
its  existence  is  clear  and  should  incite  all  among  us  who  are 
capable  to  lend  a  helping  hand  to  the  completion  of  the  thera- 
peutic portion  of  the  Bepertory,  which  will  show  what  homoso- 
pathy  really  is,  and  will,  we  hope,  deter  these  allopathic  daws  from 
decking  themselves  with  our  feathers. 

But  what  are  we  to  say  of  Professor  Sydney  Ringer  and  his 
frequent  appearances  in  the  character  of  a  rechawffewr  of  trite 
bits  of  homoeopathic  practice  on  an  allopathic  dish?  ''Flat 
burglary  as  ever  was  committed,"  no  doubt  it  is  ;  but  we  cannoi 
help  being  amused  at  the  unconsciousness  of  the  professor  that  he 
is  doing  anything  wrong  in  thus  appropriating  the  labours  of 
others  without  a  word  of  acknowledgment,  and  at  the  simplicity 
of  his  medical  brethren  who  look  upon  him  as  a  wonderfuUy 
original  therapeutic  genius. 


Liquor  Sadie  Chloraia  in  Metrorrhagia,  368 


Liquor  Soda  Okhratm  in  Metrorrhagia, 

The  following  letter  has  been  received  by  Dr.  Cooper,  and  we 
have  pleasure  in  publishing  it,  as  it  is  an  allopathic  testimony  to 
the  efficacy  of  the  treatment  recommended  by  him  in  this  Journal, 
yol.  XXX,  p.  683. 

'*  Ebtsxhbd  Colleagub, 

''I  am  happy  to  be  able  to  send  you  the 
details  of  two  cases  in  which  I  have  successfully  employed  the 
Liquor  Soda  CMorattB  which  you  had  the  kindness  to  send  me.  A 
third  case  in  which  I  prescribed  it  I  unfortunately  lost  sight  of. 
I  admit  that  two  cases  prove  little,  though  they  were  successes, 
but  I  have  no  doubt  that  the  employment  of  this  remedy  in  future 
«»e8  which  may  offer,  and  reapecting  which  I  shall  keep  you  in- 
formed,  will  confirm  the  hopes  you  entertain  of  this  medicine,  and 
encourage  you  in  the  unwearied  and  laborious  researches  which 
yon  are  making  in  order  to  be  able  to  construct  a  complete  history 
of  this  medicine. 

"  Obs.  I.  Mile.  N.  V — ,  aet.  39,  weak  constitution,  lymphatic 
temperament.  For  several  years  past  she  has  suffered  from 
chloro-aniemia  and  leucorrhoBa.  Catamenia  abundant,  lasting  from 
eight  to  nine  days ;  clots  appear  in  the  discharge.  Every 
catamenial  period  is  preceded  and  followed  for  several  days  by 
the  sensation  of  a  weight  low  down  in  the  pelvis,  as  if  all  would 
be  forced  out  at  the  vulva,  with  pains  extending  to  the  kidneys, 
back,  and  mamm»,  especially  the  left.  The  general  treatment 
(consisting  chiefly  of  chalybeates,  nourishing  diet,  good  hygienic 
conditions,  &c.,  together  with  astringent  vaginal  injections), 
though  it  produced  a  good  effect  on  the  general  state,  had  but 
little  influence  on  the  catamenia,  which  remained  as  profuse  as 
before.  I  now  had  recourse  to  the  Liquor  Soda  OKlorata,  The 
first  time  I  prescribed  seven  drops  in  fifty  grammes  of  water 
three  times  a  day,  on  the  fifth  day  of  the  menstrual  flux,  and  the 
foUowing  day  the  discharge  had  completely  stopped.  On  the  two 
following  catamenial  periods  the  same  remedy  was  given  on  the 
fifth  day,  but  in  the  dose  of  five  drops  only,  and  the  same  success- 
ful result  was  obtained.  At  the  following  period  I  did  not  give 
your  remedy  at  all ;  the  menses  followed  almost  normally,  without 
clots,  and  lasted  only  seven  days,  quite  insignificant  the  last  two 


364  Miscellaneous. 

dajB.  I  may  add  that  the  weight  she  comphuned  of  in  the  pelns 
did  not  occur  after  the  second  administration  of  this  remedy.  It 
IB  true  that  in  the  interval  between  the  catamenial  periods  Miss 
Y —  continued  to  take  the  steel  medicine,  but  I  think  it  is  without 
doubt  that  it  was  the  Liquor  Soda  CMoratw  alone  that  arrested 
these  discharges,  which  may  be  termed  hiemorrhagic. 

'*  Obs.  II. — Mme.  E — ,  set.  40,  six  years  married,  mother  of  fire 
childr^i,  the  youngest  of  whoi&  is  two  years  old.  Bobust  consti- 
tution, nervous  temperament.  This  lady  came  to  ask  my  advice 
for  her  menses,  which  she  said  lasted  eight  days  and  are  always 
very  copious.  This  has  been  the  case  for  two  months.  A  month 
ago  they  were  just  the  same.  Since  then  she  constantly  com- 
plains of  discomfort  in  the  lower  part  of  the  abdomen,  feeling  of 
a  weight,  with  shooting  pain  in  back.  The  only  treatment  I 
recommended  was  six  drops  of  the  Liq,  Sod.  Chlor.,  to  be  taken 
in  three  times  as  above,  and  the  foUowiug  morning  all  the  dis- 
charge had  ceased.  This  uncomfortable  feeling  went  off  gradually, 
and  a  week  later  she  was  quite  well.  Since  then  her  catamenia 
have  been  normal. 

**  I  allow  you  sir,  to  make  what  use  you  like  of  these  observa- 
tions, if  you  think  them  worth  anything,  and  beg  to  remain 

"  Yours  truly, 

"  Alph.  BosLAirnTs,  M.D. 

"  Menlebeke,  West  Flanders,  Belgium ;  15th  Oct.,  1873." 


OhipMfrom  the  Workshops  of  the  "  Seeret-ease  "  Practitioners.* 

By  Dr.  Hibsoh,  Prague. 

A  mighty  fruitful  field  for  the  worshipful  company  of  disease- 
makers  is  furnished  without  restriction  by  the  so-called  '*  secret 
cases.*'  From  year  to  year,  and  day  by  day,  we  find  the  announce- 
ment of  these  gentry  in  the  journals — "  Complete  cure,  speedy 
and  certain."  This  is  promised  with  a  bold  front,  yet  practically 
complete  illness,  speedy  and  certain,  is  the  result  of  this  treatment. 
As  Leichtenberg  says  he  never  saw  a  genial  fellow  who  smoked 
tobacco ;  any  one  might,  if  this  were  true,  receive  as  a  settled 
point  that  the  great  Sicord  was  never  a  smoker,  for  to  that  grand 
idea  which  he  has  especially  cultivated,  of  charming  away  a 
•  Nette  Zeitfur  Rom.  Klimk.,  Bd.  18,  No.  19,  Oct.,  1873. 


"  Secrtt-case*^  Practitioners.  365 

gonorrbcea  in  due  form  with  a  few  injections,  the  character  of 
geniality  cannot  be  refused !  For  my  part  I  cannot  help  think- 
ing that  this  inTODtion  is  far  more  genial  than  even  that  of  a  breech- 
loader !  For  whilst  the  work  of  destruction  carried  on  by  the 
latter  is  only  temporary,  and  finds  full  employment  principally  in 
time  of  war,  we  see  the  injecting  apparatus  taken  in  hand  with 
never  ceasing  activity. 

2.  Whilst  in  the  latter  invention  it  is  at  once  publicly  known 
what  percentage  of  victims  fall  a  prey  to  it,  and  what  mischief  it 
produces, ''  the  secret-case  "  doctor  has  this  great  advantage  that 
he  settles  the  business  quietly  and  confidentially.  The  party 
concerned  comes  to  tbe  doctor  with  one  secret  complaint  and 
very  frequently  steals  away  from  him  with  Another  still  more 
secret. 

8.  The  destructive  mangling  work  of  the  breech-loader  is  limited 
solely  to  the  individual  sufferers,  whereas  the  skill  of  the  other 
even  succeeds  in  transmitting  to  others  the  se^ds  of  disease  and 
pain. 

It  certainly  requires  on  the  part  of  these  doctors  a  very  elastic 
conscience  or  a  very  limited  intellect  either  to  ignore  the  highly 
mischievous  effects  of  their  work,  or  else  really  not  tb  per- 
ceive it. 

When  we  observe  for  years,  with  attentive  eyes,  the  conduct 
of  these  doctors  and  the  consequences  of  it  in'  general,  the  idea 
forces  itself  involuntarily  upon  us  that  a  higher  providence 
has  furnished  two  sorts  of  advocates  for  men  when  visited  with 
sickness, — ^the  one  are  destroying  angels,  the  other  guardian 
angels.  The  answer  to  the  question  which  are  playing  these 
respective  parts  I  leave  to  the  judgment  of  my  respected 
readers. 

And  now  let  me  adduce  some  cases  in  illustration  of  the 
above. 

Mr.  B — ,  »t.  24,  the  only  son  of  a  landed  proprietor,  of 
slender  build  and  rather  delicate  constitution,  lively,  excitable 
temperament  and  highly  developed  intellect,  was  studying  juris- 
prudence at  Prague,  and  was  on  the  point  of  preparing  for  his 
first  public  examination,  when  he  unfortunately  contracted  gonor- 
rhoea; whilst  a  still  greater  misfortune  was  that,  trusting 
to  the  seductive  promises  of  the  advertising  specialists,  he 
had  recourse  to  one  of  them.     Fast  enough  were  daily  injections 


866  Miicettaneoui. 

tried  for  a  whole  week,  but  not  bo  faat  did  the  promised  "  speed  j 
cure"  proceed.  In  spite  of  frequent  changes  in  the  solution 
injected,  each  gradually  stronger,  and  in  spite  of  the  internal 
exhibition  of  medicated  capsules,  electuaries,  and  that  the  whole 
anti-gonorrhoeic  apparatus  that  was  brought  into  play,  one  could 
not  get  to  any  end  of  the  relapses  that  kept  setting  in  ever  and 
anon  without  any  fault  on  the  part  of  the  patient. 

At  last  the  inguinal  region  began  to  grow  rather  sensitive. 

Incredible  as  it  may  appear,  yet  I  pledge  my  word  of  honour 
in  asserting  that,  in  the  course  of  the  seven  following  weeks, 
with  constantly  increasing  development  of  buboes,  two  boxes 
of  Sublimaie  pilU  were  administered,  and  a  complete  course  of 
ointment  had  to  be  gone  through ;  and  all  this  on  account  of  an 
originally  simple  gonorrhosa ! 

Happily  the  parents,  who  lived  habitually  in  the  country,  now 
came  to  Prague.  Indescribable  was  their  horror  on  finding 
their  son  lying  in  bed,  the  picture  of  woe.  Pale  and  hollow- 
cheeked,  with  deep-sunken  eyes,  there  he  lay,  reduced  to  a 
skeleton ;  with  tears  in  his  eyes  he  made  confession  of  the  above. 
The  parents,  accustomed  for  years  to  the  cautious  homcBopathic 
practice  of  Dr.  Seegen,  since  removed  to  Vienna,  at  once  resolved 
to  call  in  a  homosopathic  physician,  and  the  choice  then  fell 
upon  me. 

It  was  not  the  hard,  red,  and  highly  sensitive  buboes  (at  least 
as  large  as  half  an  egg  cut  lengthwise)  that  alarmed  me  at  mj 
first  visit,  but  the  total  prostration  of  the  patient,  the  general 
emaciation,  the  empty  pulse,  the  complete  loss  of  appetite,  the 
greatly  disturbed  sleep,  and  lastly  the  copious  night-sweats, — these 
symptoms  it  was  that  warned  me  to  go  to  work,  in  settling  the 
prognosis,  with  considerable  caution.  As  to  my  treatment,  I 
must  remark  imprimis  that,  for  a  long  course  of  years,  that  has 
continued  essentially  the  same  in  such  cases ;  and  this  my  persis- 
tency in  the  same  mode  of  treatment  ought  to  give  clear  evidence 
that  the  results  obtained  by  it  were  always  satisfactory. 

Above  all,  I  found  it  expedient  for  the  patient  at  once  to  set 
aside  the  application  of  ice  incessantly  to  the  inflamed  swelling, 
as  prescribed  by  the  previous  medical  attendant;  and  to 
exchange  it  for  well-covered,  stimulant,  cold  compresses,  to  be 
changed  as  soon  as  they  got  duly  warmed. 

The    internal  remedy  was  NUrie  add,  in  the  8rd  decimal 


"  Secret-case  '*  Practitioners.  867 

dilation,  three  times  a  daj,  one  drop  in  a  tablespoonful  of  water. 
Under  this  treatment,  within  three  days  the  sensitiveness  of  the 
baboes  had  diminished  considerably,  but  the  swelling  not  at  all. 
I  now  had  the  poultice  covered  with  a  compress  bandage,  acting 
at  first  very   lightly  ;  this  consisted  of  a  double-sided  fracture- 
bandage  without  hip-spring,  which  the  patient  bore  very  well,  as 
all  such  patients  do ;  if  it  be  applied  at  the  right  time,  and 
sufficiently  slack  to  begin  with,  within  two  or  three  days  at 
furthest,    during    which    the    bandage    has    to    be    gradually 
tightened  a  little,  such  patients  find  a  very  material  alleviation, 
and  gain  an  advantage  not  to  be  undervalued,  viz.,  that  they  can 
now  move  without  pain,  and  are  soon  able  to  walk  without  any 
inconvenience.     And  such  was  the  case  with  our  patient,  whose 
appetite  began  to  revive,  and  sleep  was  much  improved  after  this 
treatment,  and  the  further  use  for  two  days  of  the  Nitric 
acid.     Of  course  the  cold  compress,  covered  with  dry  lint,  was 
regularly  continued,  and  its  application  was  very  easily  managed 
by  a  little  lifbing  of  the  bandage  on  one  side ;  and  afterwards 
with  a  little  practice  the  heated  compress  that  had  served  its 
turn  was  drawn  out  over  the  bandage,  and  the  fresh  cold  one 
slipped  in,  without  requiring  the  bandage  to  be  slackened,  but 
only  the  abdomen  to  be  slightly  drawn  in.     After  five  days' 
treatment  I  allowed  him  to  leave  his  bed,  whereupon  in  conse- 
quence of  weakness  he  at  first  always  experienced  vertigo  and 
was  soon  obliged  to  sit  down ;  yet  this  disappeared  entirely  in 
three  or  four  days,  after  which  he  gradually  took  stronger 
nourishment  and  also  some  beer,  by  which  the  perspiration  was 
considerably  diminished.    And  what  of  the  buboes  P    They  were 
flattened,  quite  painless,  and  only  a  little  reddened  where  the 
bandage  had  pressed  them ;  yet  even  those  places  could  be 
touched  and  even  strongly  pressed  without  his  complaining  of 
the  slightest  pain.     Patient  could  also  attend  to  his  studies 
again  all  day  long.     And  now  he  pul;  the  question  to  me  quite 
timidly, — ^whether  I  believed  that  in  nine  days  he  would  not  be 
physically  capable  of  going  up  for  his  public  examination,  for 
which  he  thought  he  was  quite  prepared,  and  it  would  be  very 
disagreeable  to  him  to  have  to  apply  for  a  postponement  of  it. 
In  consideration  of  the  striking  improvement  already  attained  in 
the  general  health  of  the  patient,  and  of  the  very  favourable 
change  observable  in  the  local  ailment,  since  the  inflammation 


368  MiMcettanew. 

waa  all  gone,  ao  that  there  waa  do  longer  anj  fear  of  the  aappa- 
ration  whidi  waa  once  imminent  (and  beeidea,  there  aeemed  to 
be  fairlj  in  proceea  an  absorption  of  the  infiltration),  I 
thought  I  conld  replj  to  lua  qaeation  in  the  affinnati?e ;  yet  I 
pat  in  the  remark  that,  up  to  thia  point,  the  core  was  not  yet  bj 
any  means  complete,  and  that  he  would  have  to  go  on  for  st 
least  fourteen  days  with  the  cold  compieas  (only  not  to  be 
changed  so  often),  to  keep  the  bandage  on,  and  eontinue  taking 
the  medicine,  aa  there  would  probably  be  at  least  so  long  to 
wait  before  the  local  curatiTe  process  would  be  thoroughly 
completed.  Fiye  daya  before  going  up  for  his  public  examina- 
tion I  allowed  him  at  first  to  drive  out  for  an  hour  or  two,  and 
then  to  take  a  walk  without  the  least  distress,  either  from 
walking,  sitting,  or  rising  up.  He  looked  better  from  day  to 
day ;  and  after  getting  well  through  the  examination,  there  was 
nothing  more  to  desire.  The  glandular  swellings  were  entirely 
levelled,  and  considerably  less ;  yet  there  was,  on  the  right  side,  a 
very  scanty  discharge  of  fiuid  resembling  pus  (without  pain), 
through  an  orifice  no  larger  than  a  pin's  head ;  which  however 
soon  dried  up,  and  was  scarcely  perceptible. 

In  the  fifth  week  of  homoBopathtc  treatment  the  cure  of  these 
buboes  was  completed.  I  cannot  say  whether  they  were  more 
sympathetic  or  more  mercurial ;  they  were,  at  any  rate,  called 
into  existence  by  the  skill  of  the  great  healer. 

But  one  would  be  doing  shameful  injustice  to  these  specialist 
gentlemen  if  one  should  fancy  that  they  are  only  capable  of 
producing  buboes ;  their  skill  is  by  no  means  so  narrowly  limited, 
it  extends  still  further,  as  we  may  perceive  from  the  following 


A  gentleman,  married  six  years,  had  taken  a  business  journey, 
and  was  obliged  to  stay  some  time  in  Vienna.  Here,  one  evening 
after  the  business  of  the  day  was  concluded,  he  forgot  his 
marriage  vows,  and  a  few  days  after  made  the  very  un- 
welcome discovery  that  he  had  contracted  gonorrhcea.  G^reat, 
very  great  was  his  perplexity,  for  in  ten  to  twelve  days  at  latest 
he  had  to  return  home.  So  he  soon  resolved  to  betake  himself 
to  the  leading  practitioner  for  "  secret  cases,*'  and  besought  him 
earnestly  to  give  speedy  relief.  This  he  obtained,  in  part,  for  in 
six  days  the  gonorrhcea  was  removed  by  several  injections ;  but  a 
surprise  again  awaited  him  at  home,  for  the  first  lawful  coitua 


"  Secret-case  "  Practitioners*  869 

brought  the  gonorrhoea  once  more  to  view.  Now  he  had 
recourse  to  one  of  the  most  renowned  specialists  in  Prague,  whose 
earnest  exertions  had  again  the  success  of  considerably  diminish- 
ing the  gonorrhoBay  but  at  the  same  time  brought  on  an  exquisite, 
acute,  and  excessivelj  painful  catarrh  of  the  bladder,  accompanied 
with  feverish  excitement.  This  disorder  also  was,  chiefly  by  local 
anodyne  meal  poultices,  and  tepid  sitz  bath,  so  far  alleviated 
that  the  violent  pains  gradually  abated,  and  thb  only  remaining 
subjective  symptoms  were  a  frequent  urgency  to  pass  water,  and 
a  burning  sensation  in  the  urethra ;  but  to  this  a  new  objective 
one  was  added,  viz.,  that  mucous  masses,  becoming  day  by  day 
more  considerable,  accumulated  at  the  bottom  of  the  utensil,  and 
accordingly  the  acute  catarrh  had  passed  into  a  chronic  one ; 
which,  after  it  had  obstinately  resisted  allopathic  treatment  for 
three  months^  I  was  asked  to  cure. 

From  all  the  history  of  the  case  reported  to  me  as  above 
it  was  perfectly  clear  that  in  consequence  of  highly  inappropriate 
medical  treatment  the  original  inflammatory  exQJitement  of  the 
mucous  lining  of  the  urethra  had  been  transferred  to  that  of  the 
bladder,  and  that  incorrect  management  of  the  acute  catarrh  of 
that  organ  had  only  rendered  it  chronic.  The  urine  exhibited  to 
me  in  a  tolerably  tall  glass  of  about  nine  centimetres  diameter 
was  for  two  thirds  of  its  depth  pretty  clear  and  light  yellow ;  still, 
at  the  bottom  of  the  glass  was  seen  a  thick,  yellowish-white 
collection  of  mucus,  which,  after  slowly  emptying  the  contents, 
rolled  out  in  lumps,  whilst  the  remainder  drew  out  into  ropes. 
The  fact  that  he  complained  of  violent  burning  when  he  passed 
water  (always  in  a  thin  stream)  rendered  it  advisable  to  examine 
the  passage  with  a  bougie,  by  which  the  absence  of  stricture  was 
ascertained.  Yet  during  this  examination  a  remarkable  tender- 
ness, probably  indicating  erosion  of  the  mucous  membrane  at  the 
vesical  opening  of  the  urefchra,  could  not  escape  notice.  I  began 
treatment  with  Pulsatilla  6,  and  as  he  was  compelled  to  remain 
at  home  the  greater  part  of  the  day  owing  to  frequent  urgency  to 
urinate,  he  took  it  in  water,  two  teaspoonfuls  every  three  hours. 
When  I  repeated  my  visit  in  two  days,  I  learnt  that  the  said 
urgency  was  less  frequent,  and  no  longer  so  cruelly  violent ;  yet 
the  burning  pain  of  urination  remained  as  before,  and  the  same 
was  true  of  the  quantity  of  mucus  deposited  in  the  urine  glass. 
Just  the  same  story  was  told  after  taking  Pulsatilla  for  several 

VOL.  ZXXII^  NO.  CXXVIII. ^APRIL^  1874,  A  A 


370  CUnical  Record. 

days,  and  the  burning  (naj,  aometimes  catting)  pain  in  tbe 
urethra  waa  particularlj  marked.  Now  came  OatUkaridetyJ^Mx 
vamieaf  and  JShUphw  in  anccession,  jet  the  pains  remained  con- 
Btantly  the  same,  till  at  last  I  lighted  on  Kali  biehrom,^  after 
which,  within  two  days,  the  pain  was  strikingly  diminished,  and 
had  nearly  disappeared  in  a  week  after ;  but  the  deposit  of  mucus 
all  the  time  underwent  no  diminution,  and  now  an  accurate 
testing  of  the  condition  of  the  urine  showed  that  it  waa 
when'  first  passed  turbid,  as  if  intimately  mixed  with  the 
mucus,  and  not  until  the  second  or  third  hour  did  the  thick 
masses  settle  to  the  bottom.  Bed  test-paper  was  coloured  blue, 
and  also  the  smell  of  the  urine  was  sharply  ammoniacal.  a  pheno- 
menon to  be  explained  by  the  fact  that  the  copious  mucus  of  the 
bladder  was  decomposing  the  elements  of  the  urine.  In  sucees- 
sion  now  Duleamara,  Calcarea  earbon.y  and  Natrum  carbon,  were 
given,  from  the  two  last  of  which,  and  especially  (Me.  carh.,  a 
favourable  effect,  viz.  manifest  diminution  of  the  mucous  secretion, 
could  be  observed.  The  observation  of  this  determined  me  to 
give  the  patient  a  wineglass  of  the  WOdung  Spa  water,  which  is 
so  extremely  rich  in  Carbonate  of  lAme^  every  night  and  morning. 
The  essential  service  rendered  by  this  calcareous  spa  was  soon 
manifested;  and  that  not  only  in  the  visible  diminution  of 
mucus  (and  thus  too  in  the  abatement  of  ammoniacal  odour),  but 
also  in  the  complete  disappearance  of  the  burning  pain.  After 
taking  the  Wildung  water  for  barely  four  weeks,  the  patient  was 
at  last  perfectly  cured. 


CLINICAL    RECORD. 


Thloipi  bursa  paetorU  in  Metrorrhagia. 
By  Dr.  BAFnnssQUB.* 

Last  year  I  received  a  letter  from  fingland,  sent  by  one  of  my 
patients,  a  young  widow,  whose  state  of  health  caused  her  great 
alarm.  She  informed  me  that  three  months  previously  she  had 
had  an  attack  of  icterus  of  no  great  severity,  and  that  for  two 

•  BmU.  de  la  Soe.  M4d.  Horn,  de  S^raneel 


Thlaspi  bursa  pastoris  in  Metrorrhagia.  371 

months  she  had  suffered  from  a  continual  discharge  which  came 
on  after  the  menses.  t 

She  had  been  treated  without  success  for  this  discharge  by 
seyeral  medical  men,  who  had  given  her  among  other  remedies 
OaeculuSy  StdphuTy  and  Oonium,  They  had  also  strongly  recom- 
mended the  use  of  generous  wines,  but  not  being  accustomed  to 
them  she  felt  all  the  worse  for  them.  She  suffered  much  &om 
pain  in  the  region  of  the  right  ovary  extending  to  the  knee  ;  her 
stomach  and  bowels  were  frequently  deranged,  she  lost  her 
strength,  and  fell  off  visibly.  She  desired  to  return  to  France, 
but  feared  she  might  not  be  able  to  stand  the  journey  but  be  laid 
up  somewhere  on  the  road. 

Judging  that  the  climate,  the  treatment,  and  the  regimen  she 
was  subjected  to  were  unsuitable  for  her,  I  encouraged  her  to 
undertake  the  journey.  She  accomplished  it  happily,  but  the 
catamenia  appeared  as  soon  as  she  arrived,  and  did  not  leave  off 
until  the  sixth  day.  I  then  gave  Ferr.  met,  24,  three  globules  in 
half  a  tumbler  of  water,  to  be  taken  until  the  following  day. 

The  effect  was  favourable,  no  loss,  only  some  pinchings  in  tho 
abdomen  and  small  of  the  back.    I  continued  the  Ferr.  met. 

The  third,  day  there  occurred  pains  in  the  stomach  and  two 
^ilious  motions ;  the  liver  was  tender,  pulse  84.  I  gave  internally 
Ars.  12,  but  as  the  pains  in  the  stomach  went  oBf  whilst  the 
diarrjioda  increased,  I  had  recourse  to  Verat.,  and  the  symptoms 
subsided,  the  pulse  &lling  to  72. 

Then,  that  is  to  say,  six  days  after  the  cessation  of  the 
catamenia,  not  two  days  as  formerly,  what  the  patient  called  a 
loBB  of  blood,  such  as  had  occurred  in  England,  recommenced.  It 
was  in  reality  a  very  profuse  leucorrhoea,  to  which  the  name  was 
very  inappropriate,  as  it  was  of  a  chocolate-brown  colour  and  very 
fetid. 

Examination  with  the  speculum  showed  the  neck  of  the  uterus 
swollen,  but  not  ulcerated ;  I  could  only  detect  slight  granula- 
tions and  the  presence  of  some  viscid  clots  of  a  dark  colour. 

This  case  required  a  methodical  and  long-continued  treatment ; 
I  reckoned  that  three  months  at  least  would  be  required,  as  well 
as  great  patience  and  perseverance  on  the  part  of  patient  and 
doctor. 

I  shall  not  go  into  details  of  the  daily  treatment,  which  lasted 
in  fact  three  months  and  ended  in  complete  cure.    I  will  briefly 


872  CHnical  Record. 

pass  it  in  review  in  order  to  oome  to  and  to  roooinmend  to  yoa 
the  remedy  to  which  I  attribute  the  greatest  share  in  the  aao- 
ceasful  reaojlta. 

I  had  to  treat  a  delicate  iropreMionable  woman,  very  much 
weakened  but  very  docile  and  punctual  in  taking  her  medicine. 

During  the  first  month,  according  aa  there  were  pains  in  the 
abdomen,  with  difficulty  of  passing  water,  or  tumefieiction  of  tiie 
liver,  and  a  tendency  to  early  recurrence  of  the  catamenia,  I  had 
recourse  to  Bell.  12  and  200,  Nux  vom.  12,  Sahim.  3  and  f,  huitly  to 
Ereoeoi.  12,  which  removed  a  painful  sensation  of  general  swelling 
worse  in  the  evening  than  in  the  morning. 

I  thus  arrived  at  the  return  of  the  catamenia  and  the  com- 
mencement of  the  second  month,  with  a  noteworthy  amendment 
of  the  general  health,  but  with  little  decrease  of  tiie  discharge  or 
alteration  of  its  character.  It  usually  reappeared  one  or  two  days 
after  the  cessation  of  the  menstruation,  at  first  slight  and  li^t 
coloured,  but  gradually  very  abundant  and  very  dark,  sometimes 
continuously,  sometimes  in  gushes ;  I  waited  for  it  in  <Mrder  to 
employ  a  remedy  which  has  never  as  far  as  I  know  been  employed 
by  us  except  in  cases  of  true  metrorrhagia,  but  with  which  I  had 
made  some  successful  trials,  in  consequence  of  remembering  that 
it  is  employed  by  country  people  against  various  kinds  of  fluxes. 
This  is  the  Thlaepi  hwr$a  paetoru^  of  which  there  are  several 
varieties.  This  cruciferous  plant  is  astringent  and  its  use  is 
unattended  with  danger  even  in  considerable  doses. 

As  soon  as  a  discharge  at  first  light  coloured,  hardly  darker  than 
pale  cafi^  au  lait,  commenced  to  grow  darker  and  more  copious,  I 
gave  Thlaep.  hure.  poet.,  6  drops  of  the  6th  dilution  in  100  gnunmes 
of  water,  a  spoonful  every  three  hours. 

The  following  day,  which  was  the  19th  of  the  month,  the  dis- 
charge grew  pale  and  lessened,  the  following  day  it  stopped,  but 
the  patient  complained  of  colic  and  pinching  in  the  stomach ;  the 
2lBt,  in  spite  of  the  medicine  being  continued,  the  pains  in  the 
stomach  had  ceased,  the  discharge  had  not  returned ;  it  was  the 
same  on  the  23rd,  but  the  Hver  became  tender,  with  accompanying 
pains  in  the  groins  and  right  leg,  and  the  following  night,  23rd — 
24ith,  was  marked  by  increase  of  the  pains,  then  bilious  stools  and 
general  uneasiness ;  the  24th,  finding  the  tongue  furred,  the  liver 
enlarged,  the  stomach  tender  and  sunk,  I  had  recourse  to  Mere, 
eol,  12. 


Thlaspi  buna  pastoris  in  Metrorrhagia.  373 

The  following  day  tKe  discharge  returned  and  the  general  state 
less  satisfactory  ;  there  was  a  sensation  of  fatigue  with 
trembling  and  rigor. 

I  resolved  not  to  have  again  recourse  to  TT^laspi  before  the 
following  month,  and  to  employ  the  interval  until  the  next 
menstrual  period  in  fortifying  and  giving  tone  generally  and 
locally  to  the  patient. 

I  made  h^  take  oold  drinks  every  morning  and  inject  cold 
water,  also  to  take  Seoale  earn,  8  and  ^,  one  cisntigramine  in 
100  grammes  of  water. 

These  remedies  appeared  to  me  necessary,  the  cervix  was 
swoU^Di  and  sofb,  there  was  some  slight  difficulty  in  passing  water, 
the  introduction  of  the  injecting  tube  was  paiilful,  the  strength 
was  fiuling,  and  the  pain,  which  from  the  right  groin  had  passed 
into  the  lefb,  did  not  allow  of  carrifige  exwcise. 

In  the  end  I  obtained  a  marked  amendment,  and  several  times 
the  leucorrhcBal  discharge  diminished  sensibly,  and  even  stopped 
for  some  time,  but  it  a^ain  became  more  copious,  deeper  coloured. 
And  more  fetid  than  ever  as  the  eatamenia  approached. 

During  the  fortnight  previous  to  this  appearance  I  gave,  with- 
out paying  attention  to  the  discharge,  first  Mrr.  met,  in  the  first 
trituration,  then  China  ^,  80  drops  in  800  grammes  of  water,  a 
spoonful  every  hour. 

The  catamenial  discharge  was  copious  and  dark  coloured. 
Two  days  after  its  cessation,  on  the  appearance  of  a  discharge 
resembling  the  washings  of  meat,  and  in  spite  of  tbe  sensitiveness 
of  the  liver  and  some  pains  in  the  right  leg  down  to  the  foot,  I 
prescribed  Thlaspi  0, 10  drops  in  200  grammes  of  water. 

The  discharge  immediately  diminished  and  stopped  after  three 
days. 

I  continued  the  Thlaspi  in  the  6th  dilution  this  time  and  per- 
sisted in  its  use ;  at  the  end  of  ten  days,  reckoning  from  the 
cessation  of  the  eatamenia,  the  patient,  who  had  not  quitted  her 
house  in  the  evening  for  more  than  two  months,  felt  so  well  that 
she  ventured  to  dine  out. 

Witb  the  exception  of  an  interruption  of  forty-eight  hours  to 
give^^^»^.  for  fcitigue  of  the  voice,  I  insisted  on  the  continu- 
ance of  Thlaspi  until  the  reappearance  of  the  eatamenia,  only 
diminishing  the  frequency  of  the  dose. 

The  eatamenia  came  on  at  the  accustomed  time,   but  the 


874  Clinical  Record. 

diBcharge  did  not  return  and  has  not  recurred  for  eight  months. 
On  the  contrary,  the  Luiy  has  gained  greatly  in  strength,  and 
the  good  health  she  enjoys  sets  off  her  natural  beauty. 

[Non  BT  Db.  Dudgeck. — ^With  all  deference  to  Dr. 
Bafinesque,  whose  treatment  in  this  case  was  crowned  with 
success,  I  would  venture  to  differ  from  him  in  respect  to  his 
pathology  of  the  disease  here  described.  I  do  so  with  the  more 
confidence,  as  I  belieye  the  patient  was  for  some  time  under  my 
own  treatment.  She  had  not  a  slight  but  a  seyere  attack  of 
icterus,  with  great  pain  and  tenderness  of  the  liver,  and  during 
all  the  three  months  I  attended  her  she  betrayed  unmistakeable 
symptoms  of  congestion  of  and  imperfect  circulation  through  the 
liver.  The  metrorrhagia — ^for  it  was  a  real  metrorrhagia  and  not 
at  all  like  any  leucorrhoea  I  have  ever  seen — was  evidently  owing 
to  a  congested  condition  of  the  uterus,  which  again  appeared  to 
me  to  be  a  secondary  effect  of  the  congested  condition  of  the 
liver.  Whether  the  cure  was  due  to  the  Thlaspi  or  to  the 
change  of  climate  and  regimen,  and  the  tonic  treatment  previous 
to  the  last  catamenial  period,  I  will  leave  to  the  reader's  own 
judgment.] 


Chronic  BronchitU, 

Cabs  1. — A  married  lady,  aged  thirty  years,  experienced  a 
tickling  sensation  in  the  bronchial  tubes,  which  she  believed  to  be 
the  result  of  inhaling  some  irritating  vapour  from  the  atmosphere. 
The  tickling  caused  a  cough  which,  at  first,  was  unattended  with 
expectoration,  but  the  tickling  and  inclination  to  cough  did  not 
subside  as  she  anticipated,  and  the  irritation  of  the  mucous  mem- 
brane increased  until  it  settled  into  a  chronic  inflammation.  She 
then  began  to  expectorate  a  white,  frothy  mucus,  attended  with 
no  pain  except  from  severe  paroxysms  of  coughing.  At  this  stage 
the  case  came  under  our  treatment.  Our  first  prescription  was 
Hepar  iulph.  6th  attenuation,  in  water,  a  table-spoonful  twice  a 
day.  After  two  days  there  was  a  change  in  the  expectoration, 
but  the  cough  remained  about  the  same,  and  she  expectorated  a 
yellowish,  tough  phlegm.     Phosphorus  6th,  a  few  drops  in  half  a 


Chronic  Bronchitis.  375 

glass  of  water,  a  dessert-spoonful  three  times  a  day,  was  pre- 
scribed. She  took  this  remedy  for  three  days,  and  derived 
apparently  considerable  benefit.  The  cough  was  less  severe,  and 
the  expectoration  £ree,  but  unchanged,  in  colour.  She  coughed 
mostly  in  the  morning.  Continued  Phosphorus  30th,  after  the 
same  manner,  for  several  days,  and  there  was  considerable  miti- 
gation. The  cough  and  expectoration  were  less,  and  for  several 
days  she  continued  to  improve.  But,  it  being  late  in  the  fall,  and 
much  changeable  weather,  she  contracted  a  slight  cold,  and  had  a 
relapse,  and  now  the  cough  changed  ifrom  the  morning  to  the 
evening  and  night,  and  came  on  in  paroxysms.  The  expectora- 
tion also  changed  colour,  and  she  complained  of  an  indistinct, 
deep-seated  pain  in  the  bronchial  tubes.  Lycopodiwny  6th 
attenuation,  was  given  in  water  in  the  same  way,  and  during  the 
next  twenty-four  hours  there  was  a  slight  improvement.  The 
indistinct  pain  was  removed,  and  the  paroxysms  of  coughing 
were  less  exhausting  and  frequent,  and  the  expectoration,  though 
the  same  in  character,  was  less.  Lyeopodium  30  continued. 
During  the  next  four  days  she  continued  to  improve.  The  cough 
had  mostly  disappeared,  and  the  signs  of  complete  recovery  were 
quite  satisfactory.  The  appetite  was  fair,  and  the  strength  but 
little  impaired.  She  continued  better  for  some  weeks,  and  then 
had  a  relapse ;  coughed  much  during  the  night,  and  with  little 
expectoration.  Hyoseyamus  6th  was  given  in  water,  as  the  reme- 
dies before  mentioned,  and  the  cough  at  night  ceased  altogether, 
and  she  rested  well. 

She  had  frequent  relapses  during  the  winter,  and  each 
seemed  to  be  of  a  different  character,  and  called  for  a  cor- 
responding remedy.  At  the  menstrual  periods,  she  coughed 
much  at  nights,  and  the  expectoration  was  of  a  greenish 
colour.  Pulsatilla  6th  invariably  relieved  the  cough  at  these 
times. 

When  the  winter  was  far  advanced,  and  the  March  winds  set 
in,  she  was  attacked  acutely  with  the  cough  again,  and  was  much 
prostrated  under  its  influence.  The  expectoration  was  of  a 
muco-purulent  character,  and  very  copious,  and  her  appetite  was 
somewhat  impaired.  Guve  Stannum  6th  dilution  at  first,  and 
afterwards  the  30th,  two  doses  daily.  Under  this  treatment,  she 
improved  rapidly  until  the  warm  weather  set  in,  after  which 
recovery  was  complete,  with  the  exception  of  the  predisponent 


376  Clinical  Record. 

left  in  the  system,  and  she  remained  quite  well  until  the  oold  ood 
changeable  weather  late  in  the  fiill,  when  there  was  a  palpable 
indication  of  the  return  of  the  disease.  Looking  forwazd  to  a 
winter  of  severe  suffering,  she,  with  her  husbitnd,  spent  the 
winter  in  Florida,  and  by  this  means  she  escaped  the  severe 
relapses  which  were  sure  to  be  her  lot  in  the  frigid  climate  of  the 
north.  In  the  spring  after  the  weather  became  warm,  she 
returned  home  and  remained  well  ever  after  for  several  years. 
This  case  presents  an  argument  in  iavonr  of  the  influence  of 
protracted  warm  weather  in  effecting  the  cure  of  chronic  bron- 
chitis. 

Cabb  2. — A  preacher  of  the  Society  of  Friends  took  a  severe 
cold,  which  greatly  affected  the  mucous  lining  of  the  bronchial 
tubes,  and  it  terminated  in  a  stubborn  case  of  chronic  bron- 
chitis, which  persisted  in  spite  of  treatment  from  early  flail  till 
the  warm  weather  of  the  succeeding  spring.  For  two  successive 
winters  he  had  been  treated  allopathically  with  cough  syrups  and 
expectorants,  which  only  palliated  the  severity  of  the  disease. 
Not  deeming  it  practicable  to  repair  to  a,  warmer  climate,  he 
concluded  to  hazard  another  winter  at  his  home  in  Eastern 
Pennsylvania.  He  was  much  better  during  the  summer,  and 
until  the  fall,  when  a  recurrence  of  his  disease  was  inevitable. 
Being  called  upon  to  take  charge  of  his  case,  we  found  him, 
September  10th,  suffering  greatly  frt>m  suffocative  cough  and 
copious  expectoration  of  tough  white  viscid  mucus ;  quite  weak 
and  emaciated,  with  swoUen  feet.  Sambueus  3rd  was  our  first 
prescription,  to  be  given  in  drop  doses,  in  water,  every  three 
hours.  He  felt  better  after  taking  the  remedy  twenty-four 
hours,  and  continued  in  the  same  way  until  September  25th,  not 
improving  under  the  Sambuctu  beyond  a  certain  point;  and 
having  at  times  considerable  suffocation  from  the  accumulation  of 
mucus  and  cough,  Fhogphorw  6th  was  given  in  drop  doses, 
repeated  every  three  hours,  for  several  days.  The  improvement 
was  very  marked  under  this  remedy  up  to  a  certain  point,  and 
here  he  remained  stationary.  The  cough  somewhat  troublesome 
and  the  difficulty  of  sneezing  was  extreme.  His  appetite  was 
indifferent.  Tart,  emetic  6th  was  given  in  drop  doses,  in  water, 
for  twenty-four  hours,  after  which  expectoration  was  effected 
without  difficulty  and  there  was  a  return  of  appetite  and  the 
cough  became  different.    It  was  a  short,  hacking  cough,  without 


Chronic  Bronchitis.  377 

Boffocation,  but  exceedingly  annoying  both  day  and  night. 
Sulphur  in  the  third  trituration  was  given  daily  for  a  week,  at 
the  dose  of  which  he  was  in  all  respects  better,  with  improved 
etrengih  and  a  good  appetite ;  and  with  exercise  in  the  open  air, 
and  great  care  to  keep  himself  well  clothed,  he  passed  the  cold 
season  with  but  little  cough,  in  comparative  ease  and  comfort, 
and  the  following  season  be  was  able  to  attend  to  business.  By 
the  employment  of  homoeopathic  remedies  to  ward  off  approaching 
attacks,  be  passed  the  succeeding  winter  in  the  same  comfortable 
way.  This  man  was  an  esteemed  member  of  the  Society  of 
Friends,  and  in  all  respects  a  model  of  temperance.  For  four 
years  he  braved  the  storms  of  winter,  and  ultimately  regained  his 
health  so  perfectly  that  he  went  out  in  all  weathers  without 
experiencing  the  slightest  injury ;  and  he  maintained  that  the 

Sulphur  was  the  curative  remedy  in  his  case. 

#  •  ♦  *  « 

Cabb  4. — A  clergyman  of  the  Unitarian  denomination  was  the 
victim  of  a  congenital  bronchial  cough,  with  little  or  no  expectora- 
tion until  he  had  reached  adult  age.  Coughing  apparently  was 
so  fixed  in  his  constitution  that  it  made  a  part  of  it.  Whether 
this  cough  depended  on  a  chronic  congenital  inflammation  or  not 
we  are  unable  to  say ;  but  one  thing  was  evident,  that  the  cough 
was  a  necessity,  and  with  this  gentleman  was  a  standard  of 
health,  so  often  did  this  cough  excite  the  sympathy  of  friends, 
that  from  week  to  week  anodyne  cough  preparations  were  pressed 
upon  him  to  repress  it.  But  whenever  a  measure  of  the  kind  was 
brought  to  bear  to  suspend  the  cough  he  invariably  became  sick, 
and  suffered  much  until  his  cough  returned.  After  he  attained 
the  age  of  twenty-one  years,  and  while  yet  a  pupil  at  the 
university,  he  for  the  first  time  coughed  up  some  mucus  streaked 
with  Uood,  but  this  was  after  violent  exercise  in  the  gymnasium; 
We  prescribed  Arnica  for  his  relief,  and  were  not  disappointed. 
After  taking  the  remedy  one  or  two  days  he  was  cured  of  the 
expectoration,  but  the  cough  was  what  it  had  been  up  to  that 
event.  The  cough  could  be  temporarily  suppressed  by  an  effort 
of  the  will.  At  the  age  of  twenty-three  he  left  the  university  and 
was  trained  for  the  pulpit ;  at  the  age  of  twenty-five  he  was 
installed  as  pastor  of  the  first  Unitarian  Society  of  S — ,  and 
preached  regularly  every  Sunday  for  seven  years.  By  an  effort 
of  the  wUl  he  could,  in  the  main,  control  his  cough  when  speaking. 


878  Clinical  Record. 

but  be  was  compelled  to  indulge  in  a  complete  paroxysm  a  abort 
time  after  eacb  effort. 

At  tbe  concluflion  of  tbe  seyen  jeara  it  was  found  that  hiB 
bealth  reinained  much  the  same,  and  be  neither  grew  better  nor 
worse  from  tbe  exercise  of  bis  voice  in  elocution;   and  everj 
time  an  attempt  was  made  to  smother  his  cough,  or  suspend  it 
by  the  action  of  a  sedative,  be  was  made  sick,  and  remained  bo 
until  bis  cough  returned,  and  then  he  invariably  found  himself 
in  a  normal  state  of  health  for  him.     From  tbe  age  of  thirty-two 
he  began  to  expectorate  freely.     At  first  mucus  from  tbe  mem- 
branous lining  of  the  bronchial  tubes,  and  this  pre-expectoration 
attended  every  effort  of  coughing.      Phapkorus  3rd  was  given  in 
drop  doses  several  times  a  day.    This  remedy,  like  those  taken 
by  him    before,   did  not  palliate  his  cough,  but  it  seemed  to 
diminish  the  expectoration  for  a  time,  and  then  it  returned  in 
another  form.    The  sputum  was  tinged  and  streaked  with  blood, 
and  appeared  to  be  a  mixture  of  mucus  and  blood.     He  at  the 
same  time  looked  pale  and  was  exceedingly  debilitated.     China 
was  now  given  in  the  8rd  dilution  in  water,  ten  drops  to  a  gill, 
and  a  dessert-spoonful  every  two  hours,  which  gave  temporary 
relief  to  all  the  symptoms  except  the  cough.     After  taking  the 
China  his  cough  seemed  to  assume  an  asthmatic  character,  for 
which   Ipecac,   was  prescribed,  and  relief  of  the  asthma  was 
followed  by  the  same  old  cough,  purulent  expectoration,  which 
was  very  copious  and  exhausting  to  vitality.     He  rallied  again 
under  the  use  of  Galcarea,  and  afterwards  Fcrrum  met.y  and  was 
able  to  labour  quite  regularly  until  thirty-seven  years  of  age,' 
coughing  and  expectorating  moderately  all   the  time,  when  a 
sudden  development  of  worse  features  of  the  disease,  in  the  form 
of   quick  consumptioQ,  terminated  hi^  life.     The  interesting 
features  of  this  case  are  the  imperative  necessity  for  the  cough, 
and  tbe  action  of  remedies  in  changing  the  character  of  the 
expectoration. 

Cass  5. — A  cure  of  chronic  bronchitis  after  an  attack  of 
measles.  The  subject  was  seventeen  years  of  age  when  she  was 
attacked  with  measles  of  a  severe  type,  with  excessively  severe 
cough,  which  manifested  itself  several  days  before  the  eruption 
appeared.  Tbe  cough,  in  a  great  measure,  subsided  when  the 
eruption  was  tbe  most  marked.  It  is  worthy  of  mention,  how- 
ever, that  the  eruption  was  unusually  tardy  in  making  its  appear- 


Chronic  Bronchitis.  379 

ance.  After  recovery  from  the  measles,  a  bronchial  cough 
rejnained  as  a  sequel.  She  coughed  most  when  lying  down,  and 
expectorated  considerably ;  complained  of  chilliness  and  rigors 
down  the  back,  and  also  of  pain  in  the  head,  with  more  or  less 
fever  every  day.  Belladonna  6th  was  prescribed,  with  satisfac- 
tory results ;  the  pain  in  the  head  ceased,  the  chilliness  and 
rigors  disappeared,  and  the  cough  was  less  painful ;  expectoration 
of  mucus  continued.  Observing  that  the  cough  was  aggravated 
on  lying,  and  better  when  sitting  up,  gave  Hyoacyamus  6th,  at 
intervals  of  two  hours,  and  continued  the  remedy  for  several 
days,  but  with  little  benefit.  Changed  to  Ipeeae.,  and  afterwards 
to  JBuUatilla^  but  little  change  for  the  better.  Gave  Phosphorus 
6th  and  30th  for  several  days,  and  the  cough  changed  from  its 
humid  character  to  a  racking  cough,  and  considerable  soreness  of 
the  chest.  After  this  change,  gave  Dioscorea  6th  in  drop  doses 
in  water,  repeated  at  intervals  of  two  hours,  and  she  began 
immediately  to  improve  from  day  to  day  until  the  cough  dis- 
appeared entirely,  and  she  was  able  to  lie  down  with  ease.  She 
soon  recovered  her  normal  health  and  strength. 

Cask  6. — A  gentleman,  aged  thirty-one,  had  a  severe  attack  of 
pneumonia,  and  was  treated  by  an  allopathic  physician.  A 
cough  remained  after  the  pneumonia  passed  off,  which  settled 
into  a  chronic  form,  and  for  six  months  he  was  treated  vnth 
cough-  mixtures  and  expectorants,  from  which  but  little  benefit 
was  derived.  A  temporary  palliation  at  best  was  all  that  could 
be  claimed  for  this  resort.  Not  deriving  any  permanent  benefit 
from  this  treatment,  he  was  induced  to  try  homoBopatby.  The 
case  presented  the  following  symptoms : — A  dry  bronchial  cough, 
which  for  most  of  the  time  was  quiet  during  the  night,  but  came 
on  in  the  morning  in  paroxysms,  and  continued  at  frequent 
intervals  during  the  day.  Every  time  a  paroxysm'  occurred  the 
head  would  ache  as  if  it  would  split.  The  coughing  each  time 
was  attended  with  soreness  and  heat  of  the  chest,  but  seldom 
with  perceptible  fever.  Bryonia  3rd,  ten  drops  in  half  a  glass  of 
water  was  given  in  teaspoonful  doses,  and  repeated  immediately 
after  each  paroxysm.  The  residt  of  this  prescription  was 
decidedly  favorable.  The  cough  became  less  painful,  and  was  un- 
attended with  the  pain  in  the  head,  and  more  or  less  expectora- 
tion followed,  which  at  first  was  frothy  and  white.  Bryonia  30th 
was  then  given  for  three  or  four  days,  at  intervals  of  two  hours. 


880  Clinical  Record. 

The  patieiit  continued  to  oongh  and  expectorate  raaem,  some- 
what frothy  and  white,  without  further  mitigation.  L^eapodmm 
was  substituted  for  the  Bryomi^y  a  dose  three  times  a  day.  After 
four  days  the  expectoration  changed  to  a  thick  yellow  sputum, 
while  the  cough,  not  painful,  continued,  and  evinced  no  signs  of 
disappearing.  Stamnum  30  th  was  substituted  for  the  LifeopO' 
dium,  and  a  drop  to  a  dessert-spoonful  of  water  was  given  half  an 
hour  before  each  meaL  The  cough  became  better  under  the  use 
of  this  remedy,  but  there  was  a  tendency  to  chilliness,  and  fever, 
aod  night  sweats,  for  which  Oarbo  peffetabilis  was  prescribed,  and 
to  be  administered  in  the  same  form  as  directed  for  Stantimm. 
The  patient  found  great  relief  from  this  remedy,  and  seemed  to 
be  rapidly  improving,  until  a  fresh  cold  aggravated  the  oough  to  a 
degree  that  brought  on  hsmorrhage,  from  the  rupture  of  a  small 
vessel,  and  for  this  HamamelU  Virqinioa  was  prescribed  with 
salutary  effects;  the  hemorrhage  ceased,  the  abrasion  healed, 
and  the  consequent  soreness  was  no  longer  felt.  There  was  a 
gradual  improvement  from  this  time,  and  recovery  was  the 
result. — Dr.  A.  E.  Sicall,  United  Statu  Medical  amd  Smyioal 
Journal,  January,  1874. 


Oancer  of  the  Beetum, 

Mrs.  GK— ,  of  Franklin,  N.  H.,  aged  thirty^one,  married, 
of  nervo-bilious  temperament,  having  formerly  enjoyed  good 
health,  and  belonging  to  a  family  free  from  scrofulous  and 
hereditary  diseases,  became  iU  in  March,  1878.  The  symptoms 
at  first  were  pain  in  the  stomach  and  lower  portion  of  the  abdo* 
men,  with  obstinate  nausea  and  considerable  thirst.  There  was 
also  present  a  constipated  condition,  and  in  one  instance  the 
patient  fiunted  while  at  stool  foom  the  severity  of  the  pain  during 
evacuation.  An  allopathic  physician  was  called,  and  under  his 
treatment  the  pain  and  nausea  subsided  at  the  end  of  a  week, 
and  the  patient  was  comparatively  comfortable  for  a  fortnight, 
whf  n  they  returned  worse  than  ever,  salivation  being  added  to 
the  list,  and  for  two  months  the  most  **  heroic  "  treatment  fiuled 
to  give  relief.  The  pain  again  ceased  for  a  short  time,  the 
salivary  discharge  continuing,  and  decided  symptoms  of  debility 
presenting  themselves.    Again  the  pain  and  nausea  appeared. 


Cancer  of  the  Rectum.  881 

which  resiflted  treatment;  emaciatioii  rapidly  progressed,  the 
strength  failed  greatlj,  the  patient  becoming  so  weak  as  to  require 
to  be  moved  in  bed  by  assistants,  in  the  most  careful  mannto. 
Meanwhile  the  bowels  had  become  moire  regular,  but  thirst 
continued  uninterruptedly. 

Up  to  this  time  she  had  been  treated  by  several  allopathic 
physicians^  the  treatment  largely  consisting  of  cathartic  and 
narcotic  medicines,  and  the  diagnosis  being  intrauterine  abseete, 
the  regular  attendant  regaling  the  family  each  day  with  a  minute 
description  of  the  size  the  abscess  had  attained,  and  the  probable 
quantity  it  would  discharge  when  it  burst.  Among  those  who 
were  called  to  the  case  waa  a  professor  of  surgery  in  two  different 
"  regular  "  schools,  and  he  agreed  with  both  the  diagnosis  and 
treatment  of  the  other  physicians. 

Palling  to  find  relief  from  the  means  employed,  the  patient  at 
this  time  (August  14th)  came  under  the  care  of  Br.  E.  L.  Styles^ 
a  homoeopathic  physician  of  Hartford,  Yt.  The  symptoms 
present  were  those  above  enumerated,  ~- prostration,  emaoiationy 
thirstp  distress  and  pain  in  lower  portion  of  abdomen,  nausea, 
profuse  salivation,  &c.  The  latter  symptom,  which  was  very 
troublesome,  yielded  promptly  to  Lobelia,  During  his  first  visit. 
Dr.  S.  examined  the  patient  with  a  speculum,  and  failed  to  find  any 
evidence  of  uterine  disease,  and  hence  the  presumption  was  that 
the  seat  of  trouble  must  be  in  the  bowels.  Arsenicum  and  Nux 
vomica  were  prescribed,  and  in  four  days'  time  the  patient  was 
again  visited  by  Dr.  Styles,  and,  while  in  the  house,  a  profuse 
discharge  of  blood  occurred,  patient  sinking  at  the  time  to  the 
point  of  syncope,  and  grave  doubts  being  felt  as  to  her  ability  to 
rally.  The  hnmorrhage  was  very  profuse, — about  three  quarts, 
with  shreds  and  pieces  of  flesb-like  material  interspersed. 

Being  summoned  by  telegraph,  I  visited  the  patient  in  con- 
sultation, and  after  examining  the  vessel  my  decided  impression 
waa  that  a  miscarriage  had  occurred  at  some  former  time,  and 
the  placenta  had  now  been  expelled.  A  vaginal  examination 
showed  this  opinion  to  be  erroneous,  when  a  digital  exploration 
of  the  rectum  revealed  a  ragged  mass,  some  three  or  four  inches 
aboTC  the  anus,  at  least  half  as  large  as  a  hen's  egg,  quite 
sensitive  to  the  touch,  and  from  which  the  h»morrhage  had 
evidently  proceeded,  the  profuse  discharge  having  been  checked 
by  the  administration  of  Ohituh  and  the  use  of  an  injection  of 


382  Clinical  Record. 

Hamamelit,  directed  bj  Dr.  S.  before  mj  arriyal.  Bealising  the 
importance  of  a  correct  diagnoflis,  some  of  the  fibres  were 
collected  and  safely  enclosed  in  a  bottle  for  future  examination, 
and  the  patient  was  left  with  Arsenicum  3  and  China  3  in  alter- 
nation every  half  hour  until  improvement  manifested  itself,  the 
interval  between  the  doses  to  be  then  increased,  and  the 
injections  of  Hamamelie  to  be  continued.  A  micrpscopie 
examination  of  the  shreds  showed  very  plainly  the  true  cancer 
cells,  and  also  the  hair-like  appearances  noticeable  in  some  casesy 
and  the  conclusion  was  that  we  had  a  fibro-cellular  cancer  of  the 
rectum  to  deal  with.  To  avoid  any  possible  mistake,  fibres  were 
sent  to  two  other  physicians  (one  of  them  a  brother  of  the 
professor  who  had  seen  the  patient),  and  after  careful  micro- 
scopic examinations  they  both  pronounced  the  case' to  be  cancer. 
The  case  was  now  left  in  the  hands  of  Dr.  Styles,  my  opinion 
being  unhesitatingly  given  that  the  patient  could  not  possibly 
recover ;  and,  from  Dr.  S.'s  note- book,  I  will  give  the  subse- 
quent treatment,  and  the  result. 

The  Anenicum  and  China  were  continued  for  one  week,  an 
occasional  intercurrent  dose  of  Carbo  veg,  3  being  administered, 
and  under  this  treatment  the  patient  gradually  improved,  having 
but  one  subsequent  hemorrhage,  and  that  but  slight.  Qrdphitee 
6  was  next  prescribed,  three  powders  daily  (the  Hamamelie 
injections  being  continued),  and  one  powder  per  day  of  Lachesie 
12  was  also  administered. 

Improvement  continued  under  this  treatment  for  about  two 
weeks,  when  the  patient  seemed  to  come  to  a  stand-still,  but  was 
well  enough  to  be  removed  to  her  father's  home  in  Quechee, 
Yt.,  a  distance  of  over  forty  miles,  her  former  allopathic  attend- 
ants, however,  freely  expressing  the  opinion  that  she  would 
not  return  alive.  A  powder  of  Sulphur  200  was  next  given,  and 
Iodine  of  Arsenic  3  prescribed,  three  powders  daily.  This 
treatment  was  continued  for  three  weeks,  with  an  occasional 
dose  of  Sulphur  200,  after  which  Phosphoric  acid  3  was  adminis- 
tered twice  per  day  for  a  fortnight,  when  the  patient  was  suf- 
ficiently well  to  return  to  her  home  on  the  12th  day  of  October, 
two  months  after  she  adopted  homoeopathic  treatment.  At 
this  time  she  was  well  enough  to  do  light  house-work,  and  has 
continued  to  steadily  improve,  without  medicine^  being  now 
aparently  in  her  usual  health.    On  the  1st  of  October  an  exami- 


British  Hommopathic  Congress.  383 

nation  showed  that  the  caDcerouB  mass  had  been  completely 
absorbed^  a  slight  induration  only  remaining,  and  from  present 
indications  the  disease  is  entirely  cured.— Br.  G-alXiIKOEB,  New 
^Ingland  Med.  Oaz.,  Eeb.  18th,  1874. 


OBITUARY. 


Db.  Bebkhabb  Hibschel,  of  Dresden. 

At  the  age  of  fifty-nine  Dr.  Hirschel,  the  learned  editor  of  the 
Neue  2jeitschrifijur  Motndop.Klinih,  died  most  unexpectedly  of 
strangulated  hernia  on  the  15th  of  January.  He  was  the  author  of 
numerous  works  on  homoBopathy  apd  other  subjects,  and  will  make 
a  blank  in  the  ranks  of  German  homoeopathists  that  will  not 
easily  be  filled  up.  The  journal  he  edited  so  long  and  so  ably  will . 
he  continued  under  the  editorship  of  his  nephew,  Dr.  Edmund 
Iiewi. 

Dr.  Edwabd  Acwobth. 

We  regret  to  have  to  announce  the  death  of  our  colleague  Dr. 
Acworth,  which  took  place  at  his  residence  at  Hayward's  Heath 
on  the  17th  March,  after  a  short  illness,  at  the  age  of  sixty-four. 
Though  we  differed  from  the  deceased  on  some  subjects,  which 
will  be  fresh  in  the  remembrance  of  our  readers,  we  have  • 
always  been  ready  to  acknowledge  the  charm  of  his  literary  style, 
and  to  regret  that  these  differences  should  have  lost  to  our  pages 
a  continuation  of  those  brilliant  articles  on  homoeopathic  sub- 
jects, many  of  which  are  to  be  found  in  our  earlier  volumes. 


British  Homoeopathic  Congress. 

The  Congress  for  this  year  is  fixed  to  take  phice  in  the  large 
board-room  of  the  London  HomcBopathic  Hospital,  Great  Ormoud 
Street,  on  Thursday,  the  4th  June.  The  Congress  will  open  at 
half-past  10  o'clock,  and  in  order  to  accommodate  provincial  mem- 
bers arriving  by  early  train,  the  President  will  not  commence  his 
address  till  11  o'clock.  Various  papers  of  interest  have  been  offered, 
and  those  selected  by  the  Committee  will  probably  be  announced 
in  the  Monthly  Homoeopathic  Review  of  May.  It  is  hoped  that 
the  Congress  will  be  well  attended,  aud  that  many  of  our  foreign 


384  Booh  reeewed. 

colleagaes  will  honour  it  wil^  thinr  presence.  Hie  memhen  of 
Congreas  will  dine  together  the  same  daj  at  ''The  Fkll  Mall,'*  in 
Waterloo  Phu». 


BOOKS    RECEIVED. 


BdnninghauietCt  HomcBOpathic  Tkerapeia  of  Ini&rmitteiU  and 
other  Fever*.  Tranislated  with  the  addition  of  new  remedies  bj 
A.  KoKKDOXBFXB,  M.D.  Boericko  and  Tafel,  New  York  and 
Philadelphia,  1878.    8vo,  pp.  223. 

C  Hering*9  Materia  Mediea^  with  a  Pathologieml  Index^  yoL  i. 
Boericke  and  Tafel,  New  York,  1873. 

Petition  to  Hie  JSxeellenej/  John  A.  Dixy  Governor  of  the  State 
of  New  York,  and  the  Honorable  the  Membere  of  the  Senate, 

A  Memorial  of  David  James,  M.D, 

1$  it  the  Tenieney  of  Homaopathie  Treatment  to  len^hen  Hwnum 
JAfe  ?  Experience  of  the  Atlantic  Mutual  Life  Assurance  Cbm* 
pony, 

Birmingham  Hospital  Bepori  for  1873. 

Apoplexy  not  a  Disease,  bj  En.  A.  Murphy,  MJD.,  Glere- 
land. 

Notes  on  Electro-Swrgery,  by  Ed.  A.  Mubpht,  M.D.,  Chicago, 
1874. 

The  Hot  Springs  of  Wishaden,     B j  Dr.  W.  Magdebubg. 

The  Dublin  Journal  of  Medical  Science, 

The  New  Zealand  HomoBopathic  Gazette, 

The  Monthly  Honueopathic  Beview, 

Hie  Hahnemofinian  Monthly. 

The  American  Homoeopathic  Observer, 

The  Western  Homoeopathic  Observer. 

The  Chicago  Medical  Investigator, 

The  North  American  Journal  of  Homoeopathy. 

United  States  Medical  and  Surgical  Journal, 

The  Western  Homoeopathic  Observer, 

The  New  England  Medical  Gazette, 

The  American  Journal  of  Homoeopathic  Materia  Medica, 

El  Criterio  Medico. 

BibUoth^que  Homoeopathique, 

The  Calcutta  Journal  of  Medicine, 

The  Food  Journal, 

The  Chemist  and  Druggist, 

The  New  York  Journal  of  Homoeopathy. 

The  Sanitarian. 

The  Medical  Union. 

Compendio  di  Materia  Medica  Bura.    Par  Dr.  B.  Dadx^ 


TH£ 


BRITISH   JOURNAL 


OF 


HOKEOPATHY. 


OZONE    AND   ANTOZONE. 
By  W.  B.  A.  Scott,  M,D. 

An  opinioQ  has  prevailed  widely  amongst  most  nations^ 
alike  in  modern  and  ancient  times^  that  a  storm  of  light- 
ning, especially  if  accompanied  by  a  fall  of  the  so-called 
thunderbolt^  is  followed  by  a  more  or  less  distinctly  per- 
ceptible sulphurous  odour.  So  ancient  and  widely  spread 
is  this  belief  that  the  expression  of  it  has  found  its  way 
into  the  earliest  poetry  which  has  come  down  to  us ;  thus 
we  find  frequent  allusion  made  to  this  phenomenon  by 
Homer  : 

'Oc  8'8d  VTTO  wXriyrig  irarpog  Aioq  i^Ephry  Bpvg 
wpoppiZog,  Stivfj  Si  Oedov  ylyv^rai  oSfiii 
IS  avrifc*     tov  S*ovTr(p  i\H  OpacFog  8c  kev  JSijTat 
iyyvc  iwv*     \aXETrog  Si  Atoc  fisyaXoio  K€pavv6g' 

Orthodox  philosophers,  however,  with  their  wonted  reluct- 
ance to  acknowledge  the  occurrence  of  any  phenomenon 
which  does  not  admit  of  explanation  on  principles  known  to 
themselves  at  the  time,  and  feeling  certain  that  there  was 
no  actual  generation  or  combustion   of  sulphur  upon  such 

VOL.  XXXI  I,  NO.  CXXIX. JULY,  1874.  B  B 


886  Ozone  and  Aniozane, 

occasions^  got  rid  of  the  difficulty  by  their  customary 
expedient  of  denying  the  alleged  fact  which  had  given  rise 
to  it^  just  as  their  predecessors  had  denied  the  existence  of 
the  antipodes  on  account  of  the  impossibility  of  reconciling 
such  with  their  views  of  natural  philosophy.  Accordingly^ 
they  maintained  that  the  multitude,  misled  by  the  resem- 
blance in  colour  between  the  flash  of  the  thunderbolt  and 
the  flame  of  sulphur,  had  imagined  the  existence  of  the 
smell  which  the  optical  resemblance  of  the  former  suggested 
to  them.  But  time  has  shown  that  the  multitude  was 
right,  and  the  orthodox  philosophers,  as  usual,  totally  wrongs 
as  to  the  matter  of  fact ;  while,  as  might  have  been  expected, 
the  multitude  was  mistaken  in  the  inference  as  to  the  pre- 
sence of  sulphur,  and  the  philosophers,  as  it  happened, 
were  for  once  right  in  the  premisses  which  led  them^  by  a 
false  process  of  reasoning,  to  deny  the  existence  of  the 
smell.  The  actual  discovery  of  ozone,  therefore,  is  of 
unknown  antiquity,  and  can  be  attributed  to  no  one 
person  in  particular;  its  source,  nature,  and  properties, 
however^  have  only  been  investigated  within  the  last  ninety 
years. 

In  the  present  article  I  shall  to  a  great  extent  follow  the 
method  adopted  by  Dr.  C.  B.  Fox  in  his  admirable  and 
exhaustive  treatise  on  Ozone,  a  work  to  which  I  wish 
here  to  make  my  acknowledgment  of  general  and  particular 
indebtedness,  once  for  ali^  as  I  should  be  involved  in  con- 
stant and  wearisome  repetition  were  1  to  make  separate 
references  to '  that  learned  and  ingenious  writer  regarding 
every  detail  in  respect  to  which  I  am  indebted  to  him  for 
valuable  instruction.  The  whole  profession  is  under  a  deep 
obligation  to  Dr.  Fox  for  the  untiring  industry  with  which 
he  has  sought  and  brought  together  all  the  various  memoirs 
and  monographs  upon  this  important  subject,  which  lie 
scattered  and  all  but  inaccessible  through  difierent  English, 
German,  French,  Italian  and  American  Reviews,  Journals, 
and  Proceedings  of  Scientific  Societies  ;  the  skill  with  which 
he  has  extracted  what  is  most  valuable  in  each ;  the 
patience,  care,  and  ingenuity  displayed  in  his  original 
researches,  and  the  felicity  with  which   he  has   condensed 


by  Dr.  W.  B.  A.  Scott.  387 

and  arranged  the  whole  within  the  limits  of  the  moderate** 
sized  yet  comprehensive  and  interesting  volume  with  which 
he  faToured  the  scientific  world  some  months  ago. 

Osone,  or,  as  it  has  been  variously  called,  electrified 
oxygen,  allotropic  oxygen,  nascent  oxygen,  and  active  oxygen, 
each  of  which  names  has  a  special  propriety  of  its  own, 
was  first  brought  before  the  notice  of  philosophers  by  Van 
Marum  in  1785,  who  observed  that  oxygen  through  which 
electric  sparks  had  been  passed  acquired  thereby  a 
peculiar  odour,  and  also  the  power  of  acting  upon  metallic 
mercury. 

At  the  beginning  of  the  present  century  Cavallo  observed 
that  oxygen  thus  treated  acquired  the  power  of  purifying 
decomposing  organic  matter,  and  he  used  it  to  correct  the 
foetor  of  foul  ulcers.  In  1826  Dr.  John  Davy  recognised 
the  existence  of  this  principle  in  the  air,  and  in  1839 
Schonbein  found  that  an  odour  resembling  that  described 
by  Van  Marum  was  emitted  at  the  positive  pole  during 
the  decomposition  of  water  by  voltaic  electricity.  The 
same  distinguished  chemist  showed  that  this  odour  was  due 
to  a  peculiar  body  which  he  called  ''  ozone  '^  from  its  most 
striking  characteristic,  and  not  merely  to  the  action  of 
electricity  on  the  sense  of  smell,  as  was  previously  supposed 
by  some,  or  to  the  influence  of  minute  particles  of  gold 
or  platinum  detached  by  the  electric  current,  as  had  been 
maintained  by  De  la  Bive,  which  latter  hypothesis  Schon- 
bein proved  untenable  by  showing  that  ozone  can  be  pre- 
pared by  simply  exposing  phosphorus  to  the  action  of 
oxygen  in  the  presence  of  moisture.  At  first,  however, 
Schonbein  inclined  to  the  erroneous  supposition  that  ozone 
was  a  body  which,  together  with  hydrogen,  entered  into  the 
composition  of  nitrogen,  and  so  little  was  its  real  nature 
understood  at  this  time,  that  Osann  regarded  it  as  a  com- 
pound  containing  nitrogen.  In  1845,  however,  Marignac 
and  De  la  Rive  refuted  both  these  theories,  by  showing 
that  ozone  could  be  prepared  from  water  under  circum- 
stances which  excluded  the  possibility  of  nitrogen  being 
present,  and  they  expressed  their  conviction  (which  coin- 
cided with  that  of  Berzelius)   that  ozone  is  simply  an  alio- 


388  Ozone  and  Antozone, 

tropic  form  of  oxygen.     This  view  was  strenuously  opposed 
by  Scbonbeio,  who  next  maintained  it  to    be  a  compound 
of  oxygen  and  hydrogen  containing  one  more  atom  of  the 
former  than   exists  in  Theuard's   peroxide^  and   therefore 
to  be  represented  O.N.HOg,  or  N.N.HgOg.     He  afterwards 
changed  his  mind^  and  declared  ozone  to  be  identical  with 
peroxide  of  hydrogen^  in  which  opinion  he  was  supported  by 
Professor  Williamson.     The   researches  of  Becquerel  and 
Frdmy  in  1852  proved  that  oxygen  can  be  wholly  converted 
into  o2one,  even  when  no  hydrogen   is  present,    by  means 
of  causing  the  ozone  to   be  absorbed^  pari  passu  with  its 
formation,  by  mercury  or  iodide  of  potassium,  thereby  con- 
firming the  doctrine  of  Marignac,  De  la  Rive,  and  Berzelius, 
that  ozone  is  merely  an   allotropic  form  of  oxygen.      But 
now  a  new  question  was  started ;  were  there  not  two  kinds 
of  ozone  ?  or,  rather,  was  not  the  term  ''  ozone ''  applied  to 
two  wholly  distinct    substances?    Baumert  replied  in  the 
affirmative,   maintaining  that  the  ozone  resulting  from  the 
electrolysis  of  water  is  some  oxide  of  hydrogen,  while  that 
obtained    from    oxygen   by    means    of   phosphorus  or  the 
passage  of  the  electric  spark  is  simply  an  allotropic  modifi- 
cation   of     that    element.       This    theory,   however,     was 
overthrown  in  1856  by  Andrews  and  Tait,  whose  conclu- 
sions    were    confirmed    by    Soret    and    von     Babo,    who 
clearly     demonstrated    the    identity     of    ozone,    however 
prepared. 

During  these  investigations  the  truth  of  the  common 
opinion  that  a  smell  resembling  that  of  sulphur,  or^  at 
least,  a  peculiar  odour  sui  generis  nearly  allied  to  it, 
is  really  perceptible  during  electrical  disturbances  of  the 
atmosphere  (and  also  that  this  odour  is  caused  by  the 
formation  of  ozone),  was  triumphantly  demonstrated  by  the 
two  following  facts:  (1)  Buchwalder,  whose  servant  had 
been  killed  at  his  side  by  lightning  in  a  small  tent  in  which 
they  were  seated,  and  who  had  noticed  a  peculiar  and  very 
powerful  odour  at  the  time  of  the  accident,  happening  to 
enter  Schoubeiu^s  laboratory  one  day  when  the  great 
chemist  was  experimenting  with  ozone,  remarked  that  the 
odour  which  filled  the  apartment  was  identical  with   that 


by  Dr.  W.  B,  A.  Scott.  389 

which  he  had  perceived  at  the  time  of  the  unfortunate 
occurrence  just  described  ;  and  (2)  Schonbein  recognised 
the  identity  of  the  odour  with  that  of  which  he  had  himself 
been  sensible  during  a  thunderstorm  on  the  Jura. 

The  ultimate  identity  of  ozone  and  oxygen  having  been 
established,  the  question  next  arose,  what  particular 
molecular  or  atomic  arrangement,  or  what  other  allotropic 
modification  of  the  element  is  it  which  causes  it  to  manifest 
itself  under  these  different  conditions  ?  In  1858  Ciausius 
suggested  that  in  ordinary  oxygen  the  atoms  might  be 
combined  in  pairs  as  molecules,  while  in  ozone  they  might 
exist  in  a  free  state.  This  somewhat  improbable  hypothesis 
he  subsequently  abandoned.  But  in  the  same  year  Schon- 
bein led  him  to  adopt  a  theory  which^  although  hardly  in 
accordance  with  subsequent  discoveries,  well  deserves  to  be 
mentioned  at  some  length,  on  account  of  its  extreme  beauty 
and  ingenuity^  and  also  as  having  been  the  means  of  calling 
the  attention  of  the  scientific  world  to  the  subject  of 
antozone. 

This  chemist  found  that  peroxide  of  lead  was  formed  by 
the  action  of  peroxide  of  hydrogen  on  plumbic  acetate.  He 
also  observed  that  when  the  plumbic  peroxide,  thus  formed, 
was  subjected  to  the  continued  action  of  peroxide  of 
hydrogen,  both  peroxides  were  reduced,  with  the  formation 
of  water  and  protoxide  of  lead  and  the  simultaneous  evolu- 
tion of  free  oxygen.  He  sought  to  explain  this  curious 
phenomenon  by  the  ingenious  and  probably  correct  hypo- 
thesis that  the  oxygen  exists  in  an  opposite  condition  of 
electric  polarity  in  the  two  peroxides^  being  negative  in  the 
lead  salt  and  positive  in  the  peroxide  of  hydrogen.  He 
found  that  a  similar  process  of  reduction,  together  with  the 
evolution  of  free  oxygen,  ensued  when  permanganate  of 
potash  was  treated  with  peroxide  of  hydrogen, — a  pheno- 
menon which,  of  course,  admitted  of  the  same  explanation 
as  the  preceding.  This  suggested  to  him  the  notion  that 
there  might  exist  both  a  negative  and  a  positive  form  of 
oxygen,  which  he  named  respectively  ozone  and  antozone, 
and  which  by  their  union  constitute  ordinary  oxygen.  In 
ozone  he  conceived  a  positive  atom  of  oxygen  to  lie  between 


390  Ozone  and  Antozone, 

two  negative,  and  in  antozone  a  negative  to  lie  between  two 
positive  atoms.     It  will  be  at  onee  seen  that  this  hypothesis 
involves  the  simultaneous   production  of   a  corresponding 
amount  of  antozone  whenever  ozone  is  formed.    Schonbein, 
moreover^  considered  that  one  or   other    of  the  bodies  is 
formed  whenever  oxygen  enters  into  combination  with  any 
substance  whatever^   and  he   accordingly  classed  all  com- 
pounds containing  oxygen  under  two  heads;  viz.  ozonides, 
or  those  which  contain  the  negative  variety  of  oxygen,  of 
which   the   typical    representatives    are    permanganic    and 
chromic  acids  and  the  peroxides  of  manganese,  silver,  lead, 
cobalt,  nickel,  bismuth  and  iron,  all  of  which  he   believed 
to    liberate  chlorine   from    its    compounds    and    to    turn 
guaiacum   paper   blue;    and  antozonides,  or    those  which 
contain  oxygen  in  the  positive  state,  typified  by  peroxide  of 
hydrogen  and   the  peroxides  of  the  alkalies  and  alkaline 
earths,   which    do    not   exhibit  either  of  the    last-named 
reactions. 

Applying  the  results  of  his  investigations  to  physiology, 
Schonbein  maintained  that  the  blood-corpuscles  resolved 
the  oxygen  of  the  air  into  its  oppositely  polarized  con- 
stituents ozone  and  antozone;  adding  that  the  former 
was  consumed  in  various  oxidizing  processes  within  the  body, 
and  that  the  latter  was  in  part  transformed  by  the  blood- 
corpuscles  into  ozone,  and  the  remainder  into  peroxide  of 
hydrogen  by  combining  with  the  water  of  the  blood.  This 
transformation  of  antozone  into  ozone  by  the  action  of  the 
blood  he  supported  by  showing  that  tincture  of  guaiacum  is 
only  coloured  blue  by  peroxide  of  hydrogen  (i.  e.  by 
antozone  water  according  to  Schonbein's  hypothesis),  when 
blood-  or  pus-corpuscles  are  present.  However,  it  must  be 
remembered  that  many  other  substances  besides  ozone 
impart  a  blue  colour  to  guaiacum.  Schonbein  further 
maintained,  in  support  of  the  existence  of  antozone  as  a 
distinct  body  from  ozone,  that  the  former  could  be  produced 
by  rubbing  a  piece  of  Bavarian  fluor  spar,  which,  according 
to  him,  produced  a  different  odour  from  that  of  ozone  ;  but 
in  this  he  seems  to  have  been  mistaken,  since  Schrotter,  on 
the  contrary,  not  only  pronounced  the  odours  identical,  but 


by  Dr.  W.  B.  A.  Scott.  391 

farther  showed  that  the  product  thus  obtained  liberates 
iodine  from  iodide  of  potassium. 

In  support  of  the  views  of  Schoiibein,  Meissner,  in  1863, 
showed  that  if  a  stream  of  electrified  oxygen  be  passed 
through  Water^  a  cloud  or  mist  will  appear  in  the  receiver 
into  which  it  is  conducted,  the  production  of  which  he 
attributed  to  the  influence  of  a  substance  which  he  named 
''  atniiaM>ne^"  and  which  was  afterwards  shown  to  be 
identical  with  Schonbein's  antozone.  He  succeeded  in 
isolating  this  by  passing  a  stream  of  electrified  oxygen 
through  a  solution  of  iodide  of  potassium  which  absorbs  all 
the  ozone,  while  the  emerging  gas  produced  a  dense  white 
mist  after  being  led  through  a  vessel  containing  water.  By 
these  discoveries  Meissner  sought  to  explain  the  formation 
of  clouds  in  the  atmosphere,  regarding  these  bodies  as  an 
aggregate  of  antozone  or  '^  atmizone  '^  aqueous  vapour.  To 
the  influence  of  atmizone  he  also  attributed  the  formation 
of  coal-smoke  and  tobacco-smoke,  as  well  as  the  fumes  of 
phosphorus  and  gunpowder. 

Those  who  maintained  the  existence  of  antozone  as  a 
distinct  body  from  ozone  were  of  opinion  that  the  former 
is  destitute  of  the  power  of  oxidizing  such  bodies  as 
phosphorus  and  pyrogallic  acid,  or  of  liberating  iodine  from 
iodide  of  potassium,  while  it  is  readily  soluble  in  water, 
which  it  converts  into  peroxide  of  hydrogen.  Ozone  has 
diametrically  opposite  properties.  Babo  and  Weltzien,  how- 
ever, and  subsequently  Nasse  and  Engler,  observing  that 
**  atmizone  '^  or  antozone  is  only  produced  when  ozone 
suffers  decomposition  from 'the  action  of  water^  and  that 
ozone  and  antozone  are  not  formed  simultaneously  when 
dry  oxygen  is  subjected  to  the  action  of  electricity,  as  must 
necessarily  be  the  case  on  Schonbein's  hypothesis  of  their 
constitution,  came  to  the  conclusion  that  the  doctrine  of 
the  existence  of  any  distinct  substance  as  antozone  is 
erroneous,  and  that  the  phenomena  of  which  it  is  the 
supposed  cause  are  due  to  the  difi'usion  of  peroxide  of 
hydrogen  through  air  or  oxygen,  thus  completely  over- 
turning Schonbein's  ingenious  hypothesis.  Brodie  coincides 
in  this  yiew.     In  support  of  it  Nasse  and  Engler  showed 


392  Ozone  and  Aniozone^ 

(I)  that  when  a  current  of  electrified  oxygen  is  passed 
through  a  tube  containing  dry  zinc-sodium  (which  absorbs 
ozone,  but  has  no  action  at  all  upon  the  so-called  antozone) 
and  then  passed  through  water,  no  mist  or  yapour  is 
produced,  thus  demonstrating  that  ozone  and  antozone  are 
not  simultaneously  formed ;  (2)  that  when  a  stream  of 
electrified  oxygen  is  conducted  through  a  tube  containing 
chloride  of  calcium  (which  absorbs  antozone  but  does  not 
aSect  ozone),  and  then  passed  through  water,  clouds  still 
appear  in  the  receiver,  which  could  not  be  the  case  if  their 
existence  depended  on  the  presence  of  antozone;  (3)  that 
all  the  tests  of  the  so-called  antozone  are  identical  with 
those  of  peroxide  of  hydrogen.  Even  Meissner  has 
recently  qualified  the  assent  he  formerly  gave  to  Scbon- 
bein's  hypothesis,  which,  although  it  has  still  a  few  sup- 
porters, is  daily  losing  ground ;  and  it  may  now  be 
considered  as  at  least  provisionally  established  that  the 
antozone  of  Schonbein,  the  atmizone  of  Meissner,  and  the 
peroxide  of  hydrogen  of  Thenard  are  identical.  Babo, 
indeed,  is  of  opinion  that  the  cloud-forming  power  depends 
on  the  presence  of  nitrogen,  but  this  appears  to  have  been 
sufficiently  refuted  by  Meissner  himself. 

Dismissing  Schonbein's  antozone  from  our  consideration, 
it  is  now  necessary  that  we  should  inquire  into  the  volu- 
metric relations  of  ozone  and  oxygen,  the  modes  of 
preparing  the  former  body,  the  circumstances  which  modify 
its  production,  and  its  distinctive  properties ;  and  also 
endeavour  to  substitute  some  valid  theory  of  its  constitu- 
tion, since  Schonbein's  ingenious  hypothesis  seems  no 
longer  tenable. 

Ozone  may  be  prepared  in  at  least  seven  different  ways : 
(1.)  By  passing  electric  sparks  through  air  or  oxygen, 
or  by  the  inductive  influence  of  a  series  of  sparks  passed 
along  the  outer  surface  of  the  tube  containing  the  gas. 
This  latter  is  the  preferable  modification  of  the  method  we 
are  now  considering,  because  the  passage  of  the  actual 
spark  destroys  a  large  portion  of  the  ozone  as  soon  as  it  is 
formed.  Sparks  an  inch  long  generate  twice  as  much 
ozone  as  those  of  one  sixth  of  an  inch.     It  is  a  curious 


by  Dr.  W,  B.  A.  Scott.  393 

fact  that  the  form  and  coTering  of  the  containing  tube 
exert  an  immense  influence  on  the  amount  of  ozone 
produced  by  this  method.  Thus^  the  production  of  ozone 
in  a  row  of  parallel  uncovered  tubes  is  nil ;  when  these  are 
coated  and  fastened  together  with  a  thin  covering  of  wax 
the  quantity  produced  is  appreciable ;  it  is  increased  when 
lateral  glass  wings  are  affixed  to  the  tube,  still  further 
augmented  when  sealing-wax  supports  are  added  to  the  glass 
wings^  and  Teaches  its  maximum  when  the  tubes  are 
provided  with  thick  glass  wings  with  sharp  angular  edges. 
When  the  angles  of  these  wings  are  rounded  off  the 
production  of  ozone  falls  to  nil,  but  it  is  again  formed  in 
abundance  on  the  angles  being  restored.  These  facts, 
however  strange,  seem  to  be  perfectly  well  established  by 
Meissner's  experiments. 

(2.)  Ozone  may  be  prepared  by  the  electrolysis  of 
acidulated  water,  when  it  appears  at  the  negative  pole. 

(3.)  By  placing  a  piece  of  phosphorus  half  covered  with 
tepid  water  in  a  vessel  of  air.  The  phosphorus  ought  to  be 
removed  after  two  hours  at  latest,  as  it  then  begins  to 
absorb  a  portion  of  the  ozone  it  had  previously  formed. 

(4.)  By  the  action  of  strong  sulphuric  acid  upon 
permanganate  of  potash,  a  method  judiciously  recommended 
by  Dr.  Fox  when  the  formation  of  this  body  is  desired  for 
the  purification  of  the  atmosphere  in  hospitals  and  theatres. 
(5.)  By  dispersing  water  in  a  pulverized  form  through 
the  air,  as  the  electricity  generated  by  the  vaporisation  of 
the  water  dust  converts  a  portion  of  the  atmospheric  oxygen 
into  ozone. 

(6.)  By  the  introduction  of  a  heated  glass  rod  into  a 
mixture  of  air  and  ether-vapour. 

(7.)  By  exposing  almost  any  ether  or  essential  oil  to  the 
action  of  light  and  air.  Dr.  Day,  of  Geelong,  recommends 
that  ethers  thus  ozonized  should  be  employed  to  disinfect 
the  clothes,  bedding,  bandages,  &c.,  of  the  sick  in  hospitals. 
A  convenient  method  of  producing  ozone  in  hospital  wards, 
&c.,  is  to  heat  a  platinum  wire  to  incandescence  by  means 
of  a  Bunsen's  coil. 

The  theory  of  the  constitution  of  ozone,  as  also  that  of 


394  Ozone  and  Antozone^ 

the  Tolumetric  relations  subsisting  between  that  body  and 
oxygen,  seem  now  to  be  established  on  a  tolerably  secure  basis 
by  the  labours  of  Andrews  and  Tait,  supplemented  by  those 
of  Sorel.  The  first-named  physicists  observed  that  while 
only  a  small  proportion  of  the  oxygen  experimented  with 
could  be  converted  into  ozone  at  one  time,  a  certain  reduc- 
tion of  the  volume  of  the  gas  attends  the  formation  of 
each  successive  portion  of  this  substance.  By  the  applica- 
tion of  heat  the  ozone  was  reconverted  into  oxygen,  and 
the  total  volume  of  the  gas  resumed  its  first  dimensions. 
They  found  that  100  volumes  of  oxygen,  when  acted  on  by 
the  electric  sparky  contracted  to  92  volumes,  with  the 
formation  of  ozone;  and,  strange  to  say,  when  the  ozone 
thus  formed  was  absorbed  by  mercury^  92  volumes  of 
oxygen  still  remained.  This  process  was  continued,  the 
residual  92  volumes  were  ozonized  and  therebv  reduced  to 
84*82  volumes,  the  ozone  thus  formed  again  taken  up  by 
mercury,  and  still  84*82  volumes  of  oxygen  remained 
behind.  This  latter  phenomenon  seemed  inexplicable,  but 
Dr.  Odling  accounted  for  the  formation  of  the  gas  by  the 
supposition  that  the  molecule  of  ozone  contains  three  atoms 
of  oxygen,  and,  since  the  molecules  of  all  gases  are  equal 
in  volume,  was,  therefore,  half  as  dense  again  as  the 
molecule  of  oxygen,  which  contains  only  two  atoms. 
Hence,  when  the  100  volumes  of  oxygen  contracted  to 
92  volumes  with  formation  of  ozone,  what  took  place  was 
thi» : — 1  molecule,  16  volumes,  or  2  atoms  of  oxygen  united 
with  half  a  molecule,  8  volumes,  or  1  atom  of  oxygen  to 
form  1  molecule,  two  atoms,  or  16  volumes  of  ozone, 
thereby  diminishing  the  total  bulk  of  the  gas  by  8  volumes, 
i.  e.  reducing  the  100  volumes  to  92  volumes.  A  similar 
process  occurred  with  each  successive  formation  of  ozone. 
Odling  further  suggested  that  when  the  gas  is  acted  upon 
by  mercury  it  is  only  the  third  atom  of  the  oxygen  con- 
tained in  the  molecule  of  ozone  which  is  absorbed  by  the 
metal,  the  remaining  two  atoms  being  liberated  as  free 
oxygen,  and  the  total  volume  of  the  gas,  accordingly, 
remaining  unchanged.  This  theory  was  confirmed  by 
Soret,   who,  by   using  oil  of  turpentine  as  the  absorbent 


by  Dr,  W.  B.  A.  Scott.  895 

(which  takes  up  the  whole  molecule  of  ozone),  found  that 
only  76  volumes  were  left  of  the  92  volumes  of  ozonised 
oxyp^en — a  result  which  exactly  fulfils  the  necessary  condi- 
tions of  Odling's  hypothesis.  Odling's  doctrine  may^ 
therefore,  be  considered  as  tolerably  well  established,  even 
although  in  1872  MM.  E.  and  P.  Thenard  were  disposed  to 
impugn  it,  on  account  of  the  results  of  some  experiments 
they  had  instituted  upon  ozone  with  sulphate  of  indigo  and 
arsenious  acid.  Did  space  permit,  I  think  it  would  not  be 
very  difScult  to  show  that  these  results  may  be  explained 
in  a  way  perfectly  reconcilable  with  Odling^s  hypothesis, 
while  the  explanation  offered  by  Thenard  himself  seems 
both  indefinite  and  hardly  sufficient  to  account  for  the 
phenomena  he  observed. 

The  presence  of  ozone  in  the  atmosphere,  which  is  still 
doubted  by  Frankland,  was  called  in  question  by  Dumas, 
Thenard,  and  others,  more  especially  by  M.  Cloez,  who 
showed  that  the  reaction  with  starch  and  iodide  of  potas- 
sium can  be  produced  by  chlorine,  bromine^  nitrogen,  and 
acetic  and  formic  acids,  alone  or  in  combination.  This  led 
B^rigny,  in  1865,  to  propose  the  question  of  the  existence 
of  atmospheric  ozone  to  the  French  Academy,  who  ap- 
pointed a  committee  to  investigate  this  interesting  subject. 
In  the  name  of  this  committee  M.  Fremy  denied  the 
presence  of  ozone  in  the  atmosphere,  as  he  considered  the 
oxidation  of  metallic  silver  to  be  its  sole  conclusive  test, 
and  this  reaction  he  was  unable  to  obtain.  He  subse- 
quently endeavoured  to  show  that  whilst  ozone  must 
constantly  be  formed  in  the  atmosphere  by  thunderstorms, 
its  existence  could  be  but  momentary  ;  since  the  same 
electrical  disturbances  must  produce  nitric  acid,  which 
would  destroy  the  ozone  as  soon  as  produced. 

Houzeau  had  satisfactorily  demonstrated  the  uncertainty 
of  the  iodide  of  potassium  and  starch  test  several  years 
before,  and  had  substituted  in  its  stead  the  alkalinization 
of  a  weak  solution  of  iodide  of  potassium,  which  he  conclu- 
sively proved  could  be  effected  only  by  ozone  or  peroxide 
of  hydrogen.  The  further  investigations  on  this  subject 
which  he  was  led  to  make  by  the  publications  of  Cloez  in 


396  Ozone  and  Afttozone, 

1861^  and  by  the  subsequent  denial  of  the  existence  of 
atmospheric  ozone  by  Fr^my  on  the  part  of  the  French 
Academy  in  1865,  only  served  to  confirm  his  previous 
conclusions,  while  he  demonstrated  the  unsuitableness  of 
the  metallic  silver  test  by  showing  that  this  substance  can 
only  be  oxidized  by  ozone  when  that  body  is  present  in 
comparatively  large  quantities.  He  further  showed  that 
ozone  might  really  exist  constantly  in  the  air  notwith- 
standing its  acknowledged  instability,  since  the  generation 
of  it  is  incessant,  and  its  stability  much  augmented  (as 
is  the  case  with  many  other  bodies)  by  its  state  of 
dilution. 

Absolute  certainty  as  to  the  existence  of  atmospheric 
ozone  was  not,  however,  obtained  even  thus,  since  peroxide 
of  hydrogen  (as  well  as  ozone)  possesses  the  power  of 
alkalinizing  a  solution  of  iodide  of  potassium.  This  source 
of  ambiguity  was  to  some  extent  removed  by  the  protoxide 
of  thallium  test  proposed  by  Schonbein,  although,  as  the 
presence  of  carbonic  acid  interferes  with  this  reaction,  it  is 
more  applicable  to  laboratory  than  to  meteorological  pur- 
poses. This,  together  with  the  researches  of  Andrews, 
Huizinga,  and  Gorup-Besanez,  has  now  established  beyond 
reasonable  doubt  the  presence  of  ozone  in  the  atmosphere. 

As  Schonbein  proved  that  antozone, ''  atmizone,''  or  per- 
oxide of  hydrogen  (which  we  have  seen  to  be  identical)  is 
formed  to  a  greater  or  less  extent  simultaneously  with  ozone 
in  most  of  the  reactions  by  which  the  latter  is  prepared ; 
as  it  is  also  produced  by  the  slow  combustion  of  various 
organic  and  inorganic  substances ;  and  as  in  Russia  it  has 
been  demonstrated  to  exist  in  snow-water,  its  presence  also 
in  the  atmosphere  may  now  be  deemed  established,  it  may 
be  distinguished  from  ozone  by  the  fact  that  it  only  has  the 
power  of  alkalinizing  a  solution  of  iodide  of  potassium  in  the 
presence  of  carbonic  acid^  but  its  most  distinctive  test  is  its 
power  of  further  oxidizing  the  protoxide  of  lead. 

The  more  or  less  frequent  occurrence  of  ozone  in  the 
atmosphere  having  been  thus  established,  we  must  next 
inquire  at  what  times  it  is  present,  and  what  circumstances 
determine  its  scarcity  or  abundance. 


by  Dr.  W.  B.  A.  Scott.  897 

Mr.  Lowe  aeems  to  have  proved  that  ozone  is  always 
present  in  larger  or  smaller  amounts^  and  Mr.  Smyth  main- 
tained that  the  variation  in  quantity  is  trifling.  In  this 
latter  conclusion,  however,  Mr.  Smyth  appears  to  have  been 
mistaken,  since  it  has  been  found  to  be  present  in  very 
small  relative  amounts  when  northerly  winds  prevail.  Mr. 
Smyth's  mistake  probably  arose  from  the  great  velocity  of 
the  current  of  air  which  he  passed  over  his  iodized  starch 
test-papers — a  circumstance  which,  as  we  shall  see  in  the 
sequel,  materially  affects  the  result.  Its  amount  is  likewise 
small  when  the  air  is  much  contaminated  with  the  products 
of  decomposing  organic  matter,  but  in  such  circumstances 
errors  may  have  crept  into  the  calculations  owing  to  the 
ozone  having  been  absorbed  as  soon  as  it  was  formed.  From 
the  results  of  observations  in  seventy  difi^erent  localities  we 
find  that,  in  a  majority  of  cases,  the  maximum  occurs  in 
February  and  May,  and  the  minimum  in  July  and  October. 
Frestel  maintains  that  there  are  two  seasons  of  maximum 
intensity,  a  greater  and  a  less,  and  two  corresponding 
minima.  The  greater  maximum  and  lower  minimum 
occur  respectively  about  the  vernal  equinox  and  summer 
solstice;  the  lower  maximum  and  higher  minimum  about 
the  autumnal  equinox  and  winter  solstice.  Reslhulber 
thinks  the  conditions  producing  a  maximum  are  low  tem- 
perature and  barometric  pressure,  damp  atmosphere,  dull 
overcast  sky,  and  much  snow,  while  a  minimum  is  produced 
by  a  warm  temperature  with  mean  barometric  pressure,  clear 
sky,  dry  atmosphere,  and  thunderstorms.  The  Rouen 
observations  give  the  mean  of  the  first  three  months  of  the 
year  as  22,  that  of  the  next  three  as  56,  the  next  three  as 
37,  and  the  last  three  as  19.  But  this  summer  maximum  . 
seems  to  be  explained  by  the  presence  of  large  forests  in 
the  immediate  neighbourhood,  the  ozone-producing  effects 
of  which  are  necessarily  greater  in  summer  owing  to  the 
increased  activity  of  the  vegetative  processes  during  that 
period — an  explanation  which  probably  also  applies  to 
Versailles  and  such  other  places  aq  exhibit  a  summer  instead 
of  a  spring  or  winter  maximum.  For  the  majority  of 
observers  have  found  ozone  more   abundant  in  winter  than 


898  Ozone  and  Antozone, 

in  summer ;  perhaps  they  failed  to  make  sufficient  allowance 
for  the  fact  that  a  larger  quantity  is  consumed  during  the 
hot  season,  owing  to  the  increased  amount  of  organic 
impurities  in  the  air.  Scoutetten,  moreover,  asserts  that 
the  heat  in  summer  raises  the  ozone  to  the  upper  regions  of 
the  air,  but  it  is  difficult  to  see  why  it  should  be  elevated 
iu  larger  proportion  than  the  other  gases.  There  seems 
little  doubt  that  ozone  is  more  abuadant  by  night  than  by 
day,  the  greater  and  lesser  maxima  occurring  at  sonrise  and 
sunset  respectively  (owing,  perhaps,  to  the  precipitation  of 
dew  at  these  periods),  and  the  minimum  about  noon. 
Regarding  the  interval  between  9  a.m.  and  9  p.m.  as  day, 
and  the  remaining  twelve  hours  as  night,  the  amount  of 
ozone  in  the  former  is  to  that  in  the  latter  in  the  propor- 
tion of  183  to  286. 

It  might  i  priori  be  expected  that  in  foggy  weather  much 
electricity  and  ozone  would  be  produced  from  the  mutual 
friction  of  the  particles  of  water  suspended  in  the  atmo- 
sphere, but  in  the  present  state  of  our  knowledge  we  cannot 
positively  assert  this  to  be  the  case.  The  conditions 
determining  the  production  of  electricity  and  ozone  appear 
to  be  identical ;  since  both  reach  their  maximum  with  a 
low  temperature,  moderate  degree  of  humidity,  in  elevated 
localities,  and  at  sunrise  and  sunset.  Another  striking 
point  of  coincidence  is  that  cloth  will  not  dye  when  no 
ozone  is  present,  and  the  effect  of  thunderstorms  in 
favouring  the  action  of  dyers'  mordants  is  well  known. 
Thunderstorms,  halos,  auroras,  hail,  and  snow  cause  an 
increase  of  ozone  when  the  barometer  is  falling,  but  accord- 
ing to  Moffat  the  amount  is  diminished  when  the  glass  is 
t  rising.  This  latter  statement,  however,  requires  confirma- 
tion. 

Much  difference  of  opinion  prevails  as  to  the  effect  of 
the  direction  and  force  of  winds  in  the  production  of  ozone. 
Dr.  Moffat  endeavours  to  establish  the  simultaneity  of  the 
periods  of  maximum  and  minimum  ozone  production  with 
those  of  the  greatest  and  least  intensity  of  phosphoric 
luminosity ;  i.  e.,  with  the  times  when  the  southern  and 
northern  winds  respectively  prevail.     A  majority  of  observa- 


by  Dr.  fV.  B.  A.  Scott.  899 

tioDs  assigns  the  maximum  to  west  and  south-west  winds^ 
yet  at  Bouen  we  have  it  with  north-east,  perhaps  owing  to 
the  presence  of  forests  in  that  direction.  The  truth  seems 
to  be  that  the  observations  at  any  particular  place  are  so 
materially  influenced  by  the  nature  of  the  surrounding 
country,  the  direction  in  whicli  the  sea  lies^  the  proximity 
of  forests,  or,  on  the  other  hand,  of  marshes  or  putrescent 
organic  matter,  in  any  special  quarter,  that  it  is  only  by 
comparing  with  the  minutest  care  a  series  of  observations 
made  in  a  very  large  number  of  different  localities,  paying 
strict  r^ard  the  while  to  the  circumstances  just  mentioned 
and  many  others,  that  we  can  hope  to  come  to  any  satis- 
factory conclusion.  Berigny  goes  so  far  as  to  assert  that 
the  force  and  direction  of  the  wind  are,  in  themselves,  quite 
unimportant  ;  whereas  Prestel,  probably  with  greater 
justice,  thinks  both  these  circumstances  of  consequence,  but 
especially  the  latter. 

We  learn  from  the  observations  of  Berigny  and 
Decharmes  that  the  quantity  of  ozone  present  in  the 
atmosphere  varies  directly  as  the  cloudiness  of  the  sky ;  a 
maximum  is  reached  with  cirro-strati  and  a  minimum  with 
cirro-cumuli ;  and  the  higher  the  clouds  the  greater  the 
amount  of  ozone.  The  quantity  of  ozone,  moreover,  varies 
inversely  as  tlie  barometric  pressure,  as  might  have  been 
anticipated  from  the  fact  that  a  low  barometric  pressure 
coincides  with  the  occurrence  of  rain  or  storms,  both  of 
which  are  favorable  to  the  production  of  ozone.  A 
similar  explanation  may  perhaps  account  for  the  alleged 
abundance  of  ozone  at  the  periods  of  new  and  full  moon. 
It  seems  also  to  be  present  in  large  ainount  during  eclipses 
and  at  the  time  of  the  passage  of  asteroids.  The  influence 
of  earthquakes  is  disputed. 

The  general  conclusion  at  which  Dr.  Fox  arrives  is  that 
ozone  exists  in  large  amount  during  spring  and  winter, 
because  these  are  the  seasons  of  rain,  snow,  hail,  storms, 
and  cold.  Summer  and  autumn  presenting  diametrically 
opposite  meteorological  conditions,  and  being,  furthermore, 
seasons  during  which  the  atmosphere  is  contaminated  with 
the    maximum   of  decomposing   organic  matter,  owing  to 


400  Ozone  and  Antozone, 

their  high  temperature  stimulating  every  form  of  chemical 
activity^  are  characterised  by  the  presence  of  a  minimum  of 
ozone. 

Speaking  generally,  ozone  is  more  plentiful  on  mountain 
tops  than  in  valleys,  at  the  coast  than  inland,  in  the 
country  than  in  town,  and  in  welUdrained  cities  than  in 
those  in  which  sanitary  precautions  are  neglected.  In 
manufacturing  towns  a  slight  elevation  of  situation  is  not 
attended  with  an  increased  amount  of  ozone,  because  the 
noxious  vapours  have  a  tendency  to  ascend.  The  annual 
mean  is  higher  at  SiUoth  on  the*  Solway  than  at  any  other 
place  where  observations  have  been  recorded,  while  Lyons, 
on  the  other  hand,  has  earned  the  unenviable  soubriquet  of 
''  the  town  without  ozone/' 

The  sources  of  atmospheric  ozone  appear  to  be  (1)  elec- 
trical disturbances,  as  thunderstorms,  &c. ;  (2)  the  conden- 
sation in  their  northerly  course  of  the  heated  equatorial 
aerial  currents;  (3)  the  phosphorous  oxidation  of  the 
noctilucene  or  excretory  product  of  certain  medusae^ 
infusoria,  and  other  marine  animal  organisms,  which  has 
been  shown  by  Panari  and  Phipson  to  be  the  cause  of  the 
phosphorescence  of  the  sea ;  (4)  the  electrisation  of  oxygen 
escaping  from  aqueous  solution,  and  of  that  secreted  or 
given  off  by  plants,  and  disengaged  in  chemical  action  ;  and 
(5)  more  especially  that  given  off  from  salt  water,  which 
is  electrified  not  merely  by  its  escape  from  solution,  but 
also  by  the  disengaging  of  the  various  salts  left  behind  by 
the  water  evaporating  from  the  surface. 

It  is  of  great  importance,  and,  at  the  same  time,  ex- 
ceedingly difficult,  to  determine  the  amount  of  ozone,  as 
distinguished  from  that  of  other  oxidizing  and  purifying 
principles,  present  in  the  air  at  any  given  time  and  place. 
The  following  are  among  the  chief  tests  which  have  been 
adopted  with  the  view  of  solving  this  interesting  problem : 
(1)  Iodide  of  potassium,  which  is  only  useful  as  a  means  of 
ascertaining  the  sum  of  purifying  principleg  contained  in 
the  air,  but  fails  to  determine  the  amount  of  ozone  as 
distinct  from  the  rest;  a  reddish*brown  is  produced  by 
liberation  of  iodine ;   (2)  red  litmus  paper  in  a  solution  of 


by  Dr.  W.  B.  A.  Scott,  401 

iodide  of  potassium ;  this  is   the  only  trustworthy  ozone 
test^  and  has  hitherto  been  solely  used  by  French  chemists ; 
here^  in  proportion  as  iodine  is  liberated^  potash  is  formed, 
which^  of  course,  restores   the  original  blue  colour  of  the 
litmus;  (3)  pure  silver^  which  is  oxidized  by  ozone  when 
the  latter  is  present  in  considerable  amount,  and  (4)   sul- 
phate of  protoxide  of  manganese,  which  is  further  oxidized 
under  similar  circumstances ;  but  neither  of  these  tests  is 
sufficiently  delicate  for  the  estimation  of  atmospheric  ozone, 
the  quantity  of  which  is,  even  when  at  its  maximum,  very 
small;    (5)   oxide  of  thallium,    useless    for    meteorological 
purposes,  since  its  indications  are  destroyed  by  the  carbonic 
acid   present  in    the    atmosphere ;     (6)    the    formation   of 
acetate    of  copper    from    copper    and    acetic    acid, — too 
laborious  a   method  to  be  practically   useful;    (7)    black 
sulphide  of,  lead^  which  is   oxidized  by   ozone   (but    also, 
unfortunately,  by  some  of  the  oxides  of  nitrogen)  into  the 
colourless  sulphate ;   (8)   guaiac  resin,  which  ozone  renders 
blue,  but  this  reaction  also  occurs  under  the  sole  influence 
of  light ;  (9)  indigo,  which  is  bleached ;  and   (10)  certain 
fungi,  as  boletus  luridus,  which  are  coloured  blue  by  ozone ; 
and  (11)  the  celebrated  starch  and  iodide  of  potassium  test, 
which  has  been  chiefly  used  hitherto.     This  last  is,  how- 
ever^   open    to    all    the    following    objections:  —  1.     The 
chemicals  are  often  impure,  the   iodide  of  potassium  con- 
taining some  carbonate,  or  an  excess  uf  free  iodine.    2.  The 
paper  often  gives  rise  to   error,   being   impregnated   with 
lime,  silica,  oxide  of  iron,  &c. ;  and  yet,  common  writing 
paper,  with  all  these  and  other  contaminations^  is  used  by 
Mr.  Molfat,  and   recommended   by   the  British  Meteoro- 
logical    Society  !     3.  A    certain   amount  of  the  liberated 
iodine  is  converted  into  iodic  acid.     4.  The  force  of  the 
wind  is  another  fruitful   cause   of  error,    as   manifestly  a 
much  larger   amount  of  air    must   come  into   momentary 
contact  with  the  test-paper  during  a  gale  than  during  a 
calm,  and  the  papers  will  therefore  register  the  action  of  a 
greater   quantity    of   ozone,   when    the   actual    percentage 
present  in  any   given  bulk   of  air   may    even  have    been 
actually  smaller.    This  may  be  in  a  great  measure  obviated 

VOL.  XXXII,  NO.  CXXIX. JULY,  1874.  cc 


402  Ozone  and  Antozone, 

by  Bsing  Mr.  Morton  Festing's  excellent  form  of  ''  ozone- 
cage/'  6.  Excessive  humidity  and  a  high  temperature 
interfere  with  this  test  by  causing  evaporation  of  the 
iodine;  while  (6)  long  exposure  to  air  and  light  causes 
bleaching;  this  effect  is  also  produced  by  (7)  sulphurous 
acid^  the  product  of  coal  combustion^  and  a  constant 
impurity  in  the  atmosphere  of  large  towns.  8.  The  pre- 
valence of  what  has  been  called  a  "  true  antozone  period/' 
generally  coincident  with  a  north  wind,  also  affects  the 
test^ — but  this  subject  requires  elucidation.  Ozone,  more- 
over, seems  to  exert  some  imperfectly  understood  action  on 
the  starch  itself,  besides  liberating  the  iodine  from  the 
iodide  of  potassium.  Add  to  all  this  the  defective  cha- 
racter of  ozonometers,  their  varying  scales  of  division,  the 
difference  between  various  observers  in  their  power  of 
distinguishing  shades  of  colour,  errors  which  have  resulted 
from  differences  in  the  quarter  of  the  compass  to  which  the 
tests  were  exposed,  differences  of  elevation,  &c.,  and  when 
we  remember  that  this  starch  and  iodide  of  potassium  test 
is  that  which  has  been  by  far  the  most  generally  used,  we 
shall  not  be  surprised  to  meet  with  the  following  desponding 
results : 

1.  According  to  Dr.  Richardson,  the  tests  for  atmospheric 
ozone  are  very  unsatisfactory. 

2.  According  to  Professor  Heaton,  the  greater  number  of 
the  observations  thereon  are  worthless. 

8.  According  to  Boehm,  tests  prepared  alike  give  different 
results. 

4.  According  to  Scoresby  Jackson,  all  the  ozonometric 
methods  which  have  been  proposed  are  more  or  less  objec- 
tionable. 

5.  According  to  Cloez,  ozonometric  observations  are 
utterly  destitute  of  any  value. 

6.  According  to  Parkes,  the  uncertainty  of  the  whole 
subject  forbids  us  to  draw  any  conclusions  thereon. 

7.  According  to  Admiral  Fitzroy,  no  clear  and  satis- 
factory results  have  been  obtained. 

8.  According  to  Dr.  Stark,  ozonoscopes  merely  register 
the  amount  of  moisture  present  in  the  air. 


by  Dr.  W.  B.  A.  Scott.  408 

9.  According  to  the  Scottish  Meteorological  Society 
(January  14th,  1869),  no  noieans  whatever  have  yet  been 
devised  for  the  estimation  of  ozone.  Under  such  circum- 
stances it  need  not  astonish  us  that  the  beneficial  or  dele- 
terious effects  of  ozone  upon  the  animal  economy  in  curing 
or  causing  disease  of  any  kind,  the  share  it  takes  in 
spreading  or  destroying  the  infection  of  contagious  disorders, 
and  the  part  it  plays  in  renovating  the  atmosphere,  are  all 
still  as  vigorously  debated  as  the  influence  of  climate  in 
phthisis,  the  action  of  bromide  of  potassium,  and  the  patho- 
logy and  treatment  of  diabetes. 

The  chief  "air-purifiers''  are  ozone,  nitrous  acid,  and 
peroxide  of  hydrogen.  The  sum  of  these  three  may 
be  measured  by  the  amount  of  iodine  liberated  from  a 
solution  of  pure  neutral  iodide  of  potassium.  *  In  order  to 
ascertain  this,  slips  of  moderately  thick  Swedish  filtering- 
paper  must  be  dipped  in  a  solution  of  the  above  salt, 
strength  about  15  per  cent,  then  carefully  dried  and  kept 
in  a  dark  place,  not  exposed  to  air.  When  used,  one  or 
more  of  these  slips  must  be  placed  in  an  ozone-box  through 
which  a  current  of  air  of  known  velocity  is  drawn  by  an 
aspirator  for  the  length  of  time  determined  on,  and,  as 
moisture  favours  volatilisation  of  the  liberated  iodine,  they 
must  be  as  much  as  possible  protected  by  means  of  several 
layers  of  wire  gauze,  further  corrections  of  this  source  of 
error  being  drawn  from  the  hygrometric  readings.  The 
slip  (or  slips)  of  paper  is  then  removed  and  carefully  com- 
pared with  the  chromatic  scale.  Next,  as  a  portion  of  the 
liberated  iodine  is  often  oxidized  into  iodic  acid  which  gives 
no  indication  of  its  presence  by  colorisation,  this  must  be 
decomposed  by  means  of  tartaric  acid  spray,  and  the  slip 
again  compared  with  the  chromatic  scale. 

If,  however,  we  require  to  ascertain  the  amount  of  pure 
ozone  present  in  the  atmosphere,  we  must  resort  to  the 
celebrated  iodized  litmus  test,  which  was  some  time  ago 
suggested  by  Bernays  and  Hornidge,  but  first  actually 
employed  by  Houzeau.     It  is  thus  conducted  : 

Slue  litmus  having  been  boiled  in  distilled  water,  the 
solution  is  allowed  to  stand  for  twenty-four  hours ;  then 


404  Ozone  and  Antozone, 

decanted^  and  divided  into  two  equal  parte.     One  of  these  is 
reddened  by  means  of  the  smallest  possible  amount  of  pure 
sulphuric  acid^  and  then  mixed  with  the  other.  The  whole  is 
again  divided,  one  part  reddened  hj  a  similar  addition  of 
sulphuric  acid,  and  mixed  with  the  other ;  this  process  is 
again  and  again  repeated  until  a  persistent  vinous  red  hue 
is  obtained,  the  stability  of  which  is  ascertained  by  a  mark 
caused  by  it  not  becoming  blue  on  drying.      This  solution 
is  allowed  to  stand  and  then  filtered.     It  ought  to  contain 
one  seventy-fifth  part  by  weight  of  the  dry  extract.     Care 
must  be  taken  to  secure  the  precise  vinous  red  tint,  as  any 
undue  excess  of  acid  (which  produces  a  hue  resembling  that 
of    the    skin    of   an    onion)    renders   the    test    much    less 
delicate.     The  very  slight  excess  of  acid  always  present  is 
useful,  as  it  prevents  the  formation  of  iodate  of  potash.     In 
this  are  to  be  dipped   the  slips  of  Swedish  filtering-paper 
described  above;  but  the  solution  of  iodide  of  potassium  ought 
to  contain  only  about  1  per  cent,  of  the  salt.     If  a  slip  of 
the  paper  impregnated  with  litmus  be  dipped  into  this  latter 
and  exposed  to  the  air,  the  ozone,  if  present,  will  liberate  a 
portion  of  the  iodine  from  the  iodide  of  potassium,  replacing 
it    in   combination   with    the   potassium,  thereby   forming 
potash.     The  alkalinity  thus  produced  will  be  appreciable 
by  the  depth  of  the  blue  tint  assumed  by  the  litmus  paper, 
which  is  thus  a  quantitative  test  indicating  the  amount  of 
ozone  present  in  the  atmosphere.     The  chief  source  of  error 
in  this  test  arises  from  the  fact  that  the  reddened  litmus  has 
a  tendency  to  assume  a  more  or  less  bluish  tinge  in  damp 
air,  even  apart  from  the  influence  of  ozone,  owing  to  fermen- 
tative changes  set  up  in  the  drug  itself  by  moisture.     More- 
over, the  test  is  not  quite  so  delicate  as  could  be  wished  ; 
but  still  it    not    merely  furnishes    incomparably  the  best 
means  hitherto  known  of  estimating  atmospheric  ozone,  but, 
in  the  present  state  of  our  knowledge,  it  is  the  sole  trust- 
worthy method  at  our   disposal.     Smyth^s  ozone  box,  as 
modified    and  improved  by   Dr.    Fox,  seems  at  once  the 
simplest  and  the  best  receptacle  for  the  test-papers  during 
the  experiment.     It  is  described   and  delineated  pp.  262 
and  264  of  that  gentleman's  treatise  on  ozone^  and  at  p. 


by  Dr,  W,  B,  A.  Scoti.  405 

^5  of  the  same  work  he  gives  a  diagram  and  description 
of  the  whole  apparatus  that  he  employs  in  his  experiments. 
It  would  be  useless  to  attempt  any  description  of  these  here 
\rithout  the  aid  of  diagrams^  and  I  have  already  lingered 
too  long  on  this  part  of  the  subject.  We  may  now  reason- 
ably hope  that^  with  the  aid  of  these  improved  methods  and 
apparatus^  Dr.  Fox  and  other  sagacious  and  accurate 
observers  will  ultimately  succeed  in  rescuing  this  much 
▼exed  subject  of  ozone  from  its  present  unfortunate  position 
as  one  of  the  opprobria  chemuB, 

At  present,  regarding  the  subject  from  a  medical  point 
of  view,  it  must  be  confessed  that  even  after  the  labours  of 
such  men  as  Berzelius,  Schonbein,  De  la  Rive,  Fr^my, 
Williamson,  Baumert,  Andrews,  Tait,  Soret,  Faraday, 
Houzeau,  Scoutetten,  and  numerous  others,  extending  over  a 
period  of  nearly  thirty  years,  we  can  say  but  very  little 
which  is  either  definite  or  positive. 

The  relation  between  ozone  and  cholera  epidemics  is  as 
yet  undetermined.  In  London,  during  the  epidemic  of 
1854,  Glaisher  found  the  normal  amount  of  ozone  in  dis- 
tricts where  deaths  from  cholera  were  numerous,  and  no 
ozone  whatever  in  districts  where  not  a  single  death  occurred 
from  this  disease.  The  observations  of  Seitz,  at  Munich, 
during"  the  same  year  are  in  harmony  with  those  of  Glaisher. 
Similarly,  Dr.  Day,  of  Geelong,  found  an  abundant  ozonic 
reaction  around  the  houses  of  cholera  patients.  In  the 
United  States,  during  1851,  Peter  was  unable  to  trace  any 
connection  between  the  absence  or  presence  of  ozone  and 
the  prevalence  of  cholera,  and  in  this  negative  opinion  he  is 
supported  by  £.  Boeckel,  of  Strasburg,  Strambio  of  Milan, 
and  one  set  of  observations  by  Simonin  of  Nancy.  More- 
over, Fournet  maintained  that  in  Lyons,  the  '^  city  without 
ozone/'  cholera  is  not  more  frequent  or  severe  than  elsewhere, 
and  the  negative  view  is  further  supported  by  Petenkofer 
and  Schifferdecker.  Dr.  Moxon  thinks  that  the  prevalence 
of  simple  diarrhcsa  is  increased  by  the  preponderance  of 
ozone.  On  the  other  hand,  the  observations  of  Smallwood 
in  Canada  ;  those  of  Cook  in  Bombay,  extending  from  1863 
to    1865 ;  those    of   Moffat    at    Newcastle   in    1863,   and 


406  Ozone  and  Antozone^ 

throughout  England  and  Wales  in  1866,  and  those  of 
Simonin  at  Nancy  in  1855,  all  favour  the  supposition  that 
the  times  of  the  appearance  and  prevalence  of  cholera 
coincide  with  those  of  the  absence  or  deficiencv  of  ozone. 
Billard,  of  Corbigny,  thinks  that  the  diminution  of  ozone  is 
the,  first  cause  of  a  chloera  epidemic.  The  views  of  these 
observers  are  further  supported  by  experiments  at  Berae, 
Marseilles,  and  Berlin.  I  have  endeavoured  to  sum  up  the 
evidence  on  both  sides  as  fairly  as  I  can^  but  who  shall 
decide  when  such  doctors  disagree  ? 

Next,  as  regards  catarrhal  aflPections.  Schonbein  has 
demonstrated  that  catarrh  can  be  set  up  in  animals  by 
forcing  them  to  breathe  air  largely  impregnated  with  ozone, 
and  Mr.  Blackley  has  observed  a  condition  closely  resem- 
bling hay-fever  to  be  thus  produced.  At  the  same  time, 
the  amount  of  ozone  present  in  the  atmosphere  is,  even 
when  at  its  maximum,  wholly  insufficient  to  give  rise  to  any- 
such  morbid  states  in  a  previously  healthy  subject,  while  it 
is,  of  course,  amply  abundant  to  cure  any  existing  disease  to 
which  it  is  homoeopathic.  Accordingly,  we  learn  from  the 
results  of  observations  by  Seitz  at  Munich  that  the  number 
of  cases  of  catarrh  decreases  in  proportion  as  the  amount  of 
atmospheric  ozone  increases.  The  observations  of  Seitz  are 
corroborated  by  those  of  Dr.  W.  W.  Ireland,  at  Umballa, 
and  Mr.  Harris  at  Worthing.  It  is  true  that  Heidenreich, 
E.  Boeckel,  and  Spongier  hold  a  diametrically  opposite 
opinion,  and  affirm  that  the  period  of  a  catarrhal  epidemic 
is  coincident  with  that  of  an  excess  of  atmospheric  ozone ; 
while  Faber,  Wunderlich,  Schifferdecker,  T.  Boeckel  and 
others  deny  that  any  connection  whatever  exists  between 
these  periods.  But  it  must  be  remembered  that  many 
influences  contribute  to  the  production  of  ozone,  and  that 
these  influences  act  in  different  proportions  in  different 
places.  Among  the  most  powerful  and  widely  distributed 
of  these  agencies  are  cold  and  damp,  and  since  the  maximum 
of  atmospheric  ozone  is  on  all  sides  admitted  to  be  wholly 
insufficient  to  produce  catarrh,  it  is  only  reasonable  to  assign 
the  comtemporaneity  of  periods  of  high  ozonic  reaction  and 
catarrhal  epidemics  to  the  influence  of  cold  and  damp  in  pro- 


by  Dr.  W.  B.  A.  Scott.  407 

daciDg  bothy  while,  from  the  premisses,  it  is  absolutely  im- 
possible that  the  latter  should  be  caused  by  the  former;  we 
ought  rather  to  say  both  have  a  common  origin.  We  may^ 
therefore,  fairly  suppose  that  at  Munich,  Umballa,  and 
Worthing,  other  ozone-producing  agents  have  a  more  influ- 
ential share  than  cold  and  damp  in  the  generation  of  ozone, 
when  compared  with  the  part  they  take  in  some  other 
localities,  and  hence  may  justly  claim  the  observations  of 
Seitz,  Ireland^  and  Harris,  as  illustrations  of  the  homoeo- 
pathic law ;  at  least  the  discrepant  results  of  Heidenreich 
and  others  are  manifestly  no  refutation  of  it,  while  a  nega- 
tive conclusion^  such  as  that  of  Faber  and  others,  is  pro- 
yerbially  difficult  of  proof,  and  from  its  antagonism  to  that  of 
both  the  other  sets  of  observers  is  primd  facie  at  any  rate 
likely  to  be  unsound.  The  observations  of  Seitz^  Ireland, 
and  Harris,  regarding  this  seem  to  be  illustrative  not  only  of 
the  truth  of  the  homoeopathic  law,  but  also  of  the  fact  that 
quantities  of  a  therapeutic  agent  the  effects  of  which  are 
inappreciable  in  health  may  still  prove  curative  in  disease 
when  administered  according  to  the  law  of  similars.  In 
the  catarrhal  stage  of  phthisis  a  residence  at  the  seaside 
(where  ozone  abounds)  is  often  beneficial — probably  another 
illustration  of  homoeopathy,  and  certainly  tending  to  confirm 
the  former. 

The  fact  that  air  impregnated  with  less  than  3,509.060  ^^  ^^^ 
bulk  of  ozone  purifies  its  own  volume  of  air  loaded  with 
the  effluvia  of  four  ounces  of  highly  putrid  meat  demonstrates 
the  strongly  disinfectant  power  of  ozone  in  all  cases  where 
infection  depends  on  decomposing  organic  matter;  while 
the  circumstance  that  air  containing  only  t,s5s.q5q  ^^  ^^^  ^^^ 
bulk  of  ozone  possesses  a  distinct  ozonic  smell  may  stagger 
those  who  deride  so-called  infinitesimal  doses. 

Contrariety  between  the  actions  of  large  and  small  doses 
is  well  exemplified  by  the  fact,  that  while  a  country  air 
with  a  fair  proportion  of  ozone  is  favorable  to  vegetation, 
air  strongly  impregnated  with  ozone  retards  the  growth  of 
plants. 

There  is   no    conclusive   evidence    to   show    that  ozone 


408  Ozone  and  Antozane, 

destroys  marsh  miasm,  or  has  any  relation  whatever  to 
malarial  diseases.     This  question  is  still  subjudice. 

Ozone  is  said  to  hare  been  in  excess  during  some  diph- 
theria and  smallpox  epidemics,  and  while  certain  skin- 
diseases  prcTailed,  while  a  deficiency  has  been  noted  during 
epidemics  of  continued  and  relapsing  fever,  scarlatina, 
typhus  and  measles.  It  is  also  said  to  have  been  deficient 
in  places  where  the  cattle  plague  raged  with  peculiar 
severity,  and  likewise  just  before  the  occurrence  of  the 
potato  disease  at  CuUoden.  These  two  latter  statements 
require  confirmation. 

Peroxide  of  hydrogen,  or  the  "  antozone ''  of  Schonbein, 
as  we  are  all  aware,  was  some  years  since  proposed  as  a  remedy 
for  diabetes  when  administered  in  ethereal  solution ;  but 
the  early  hopes  it  raised  have  not  been  realised,  and  Dr. 
Tanner  finds  it  impossible  to  administer  the  remedy  during 
any  great  length  of  time  on  account  of  the  violent  sickness 
it  occasions.  It  is  difficult  to  see  how  it  could  act  other- 
wise than  as  a  mere  palliative  in  this  disease,  or  rather 
could  do  anything  more  than  disguise  or  conceal  its  most 
characteristic  symptom  by  artificially  burning  away  the 
sugar  before  the  same  finds  its  way  into  the  urine.  No 
relation  has  yet  been  shown  to  exist  between  the  symptoms 
of  diabetes  and  those  produced  by  peroxide  of  hydrogen 
(Schoobein's  ''antozone). 


I 

99 


1  subjoin  in  conclusion  a  list  of  the  questions  to  which 
Dr.  Fox  hopes  that  our  improved  methods  of  ozonometiy 
may  one  day  enable  ourselves  or  our  descendants  to  furnish 
satisfactory  answers  : 

1.  What  are  all  the  sources  of  atmospheric  ozone? 

2.  How,  and  under  what  circumstances,  isjt  formed  7 

3.  What  is  its  precise  action  on  animals  and  plants  ? 

4.  Has  an  excess  or  deficiency  of  ozone  any  effect  upon 
the  public  health  ? 

5.  If  so,  what  is  the  nature  of  that  influence? 

6.  What  connection  has  the  amount  of  ozone  with  the 
presence  of  epidemics  ? 


On  the  Action  of  Iron,  409 

7.  Does  ozone  oxidize  only  one  or  all  the  organic  atmo- 
spberic  impurities  ? 

At  present  I  fear  we  can  only  reply  to  all  these  interro- 
gations with  the  dying  words  of  Goethe  and  the  prayer  of 
Ajax. 


ON  THE  ACTION  OP  IRON. 

By  Robert  T.  Cooper,  M.D.,  T.C.D  * 

It  has  always  appeared  to  me  that  we  confine  our 
provings  to  an  unnecessary  extent  to  the  healthy,  and  that 
in  doing  so  we  have  practically  impeded  the  progress  of 
medicine,  for  although  it  is  quite  true  that  we  cannot  turn 
our  patients  into  provers  we  can  yet  watch  with  great 
advantage  the  way  in  which  drugs  affect  them,  and,  by 
observing  care,  can  in  this  way  learn  a  great  deal  of  pure 
drug  action.  Aggravations  will  occur,  however  minute  our 
doses  may  be,  and  a  little  patient  inquiry  is  all  that  in 
many  cases  is  required  to  determine  whether  these  aggra- 
vations are  pure  or  not.  According  to  my  experience  the 
range  of  action  of  each  drug  can  be  divided  into  depart- 
ments which  have  certain  index  lines  or  characteristic 
symptoms  leading  to  them ;  and  knowing  the  one  the  other 
can  be  the  more  readily  committed  to  memory.  Thus, 
taking  chloro-ansemia  as  a  department  in  the  action  of 
iron,  the  true  specific  indications  for  the  Iron  will  be  the 
symptoms  of  this  affection;  or,  again,  supposing,  as  we 
intend  to  shoF  this  evening,  that  Iron  produces  irritability 
of  fibre  marked  by  painlessness,  we  have  only  to  discover 
the  symptoms  of  this  irritability  to  arrive  at  characteristic 
indications  for  Iron,  and,  by  the  one,  to  fix  the  other  in 

*  This  paper,  originally  intended  to  be  read  at  an  evening  meeting  of  the 
British  HomcBopathic  Society,  is  published  in  its  present  form,  as  it  was  found 
impossible  to  compress  the  matter  of  it  within  a  compass  sufficiently  narrow 
to  admit  of  after  discussion. 


410  On  the  Action  of  Iron, 

memory.  The  irritability  will  be  the  department  or  condi- 
tion of  system;  its  symptoms  the  index  lines.  The 
investigation  of  the  remedy  must  in  this  way  proceed  pari 
passu  with  that  of  the  disease,  and  the  effect  will  be  a 
mutual  clearing  away  of  obscurities. 

The  morbific  influences  at  work  in  the  production  of 
disease  must  be  acknowledged,  and  the  resulting  symptoms 
must  be  classified  in  a  different  manner  from  what  they  are 
now  before  we  can  attain  to  any  geueral  simplification  of 
our  methods  of  treatment.  Hahnemann  dimly  fore- 
shadowed this  when  he  divided  chronic  disease  into  psora, 
syphilis,  and  sycosis ;  but  Rademacher  came  nearer  to  the 
truth  in  supposing  the  existence  of  an  epidemic  constitu- 
tion varying  in  its  nature  and  its  required  modes  of 
treatment. 

We  can  safely  say  that  there  are  present  in  drugs, 
diseases,  atmospheres,  and  individuals,  peculiarities  that 
modify  and  cause  to  vary  the  course  disease  will  assume, 
and  all  these  must  be  allowed  for  in  enunciating  laws  that 
aim  at  the  systemisation  and  simplification  of  treatment. 

The  pertinence  of  these  remarks  will  be  apparent  as  we 
proceed.  You  will  remember  that  I  read  a  paper  before 
you  on  the  action  of  Iron  some  seven  years  ago,  in  which 
stress  was  laid  upon  its  vesical  action,  and  testimony  borne 
to  its  effects  upon  irritability  of  the  neck  of  the  bladder, 
the  characteristic  symptom  of  which  I  was  the  first  to 
show  could  arise  independently  of  a  calculus;  ti  constant 
and  pressing  desire  to  urinate  during  the  daytime  only. 
If  you  afterwards  followed  me  through  the  pages  of  the 
British  Journal  of  Hommopathy  you  must  have  seen  in  my 
articles  upon  diseases  of  the  bladder  how  beautifully  this 
symptom  was  developed  in  Rademacher's  provings.  As  we 
proceed  we  intend  to  prove  that  it  forms  but  one  symptom 
of  a  condition  of  system  characterised  throughout  by  irri- 
tability of  fibre  without  much  accompanying  pain. 

Fanny  G — ,  a  single  woman,  of  thirty-four,  of  delicate 
arterial  complexion,  had  ulcerated  womb  four  years  before 
coming  under  treatment,  succeeded  by  bearing  down,  aggra- 


by  Dr.  Robert  T.  Cooper.  '  411 

vated  by  standing  erect;  dry  cough  worse  at  night  and  in 
the  morning,  each  paroxysm  of  which  increases  the  forcing 
down.  Pain  in  the  stomach  through  to  the  back,  and  pain 
in  the  lower  back  going  up  to  the  shoulders,  both  which  are 
worse  before  the  monthly  period.  Period  too  profuse ;  no 
leucorrhoea  ;  other  functions  natural. 

There  are  several  circumstances  connected  with  this  case 
that  point  to  Iron  as  the  appropriate  remedy.  First  of  all,  to 
what  do  the  symptoms  point  ?  there  is  a  cough  worse  at 
night  and  in  the  morning ;  there  is  then  a  bearing  down  of 
the  womb  aggravated  each  time  she  coughs ;  there  are  ante- 
catamenial  pains  and  increased  menstrual  flow,  but  beyond 
these  symptoms  no  disturbance  of  the  general  health ;  in  a 
word,  an  irritability  existed  in  the  neck  of  the  womb 
the  remnant  of  a  former  congestion,  and  this  irritability 
caused  a  greater  flow  of  blood  to  the  ovario-uterine  region 
at 'each  catamenial  period  than  would  normally  occur,  as  we 
see  by  the  back  and  left  side  pains,  and  a  similar  kind  of 
irritability  existed  in  the  mucous  membrane  of  the  larynx, 
giving  rise  to  cough ;  there  is,  in  fine,  an  absence  of  all 
Bjmptoms  but  those  that  might  be  explained  by  the 
existence  of  a  tendency  to  irritability  throughout  the 
system,  selecting  as  its  site  the  larynx  and  the  neck  of  the 
womb^  parts  that  are  markedly  acted  upon  by  Iron. 

This  affection,  this  painless  irritability,  I  must  look  upon 
as  a  distinct  and  independent  disorder  as  classifiable  and  as 
uniform  as  neuralgia,  myalgia,  or  any  other  variety  of 
chronic  disease,  and  we  ought  to  have  an  accurate  know- 
ledge of  its  symptoms,  as  it  constitutes  a  very  important 
department  among  the  specific  spheres  of  Iron, 

Our  patient  after  taking  Phosphate  of  Iron  in  the  first 
decimal  trituration  presents  herself  next  week,  and  we 
report — the  pain  in  the  left  side  under  the  ribs  through  to 
the  back  remains,  and  she  has  to  undo  her  clothes  from  a 
swelling  of  the  stomach,  worse  after  standing ;  the  monthly 
period  has  passed  by  with  much  less  pain,  the  cough  has 
quite  gone,  and  the  bearing  down  nearly  gone. 

You  see,  therefore,  that  the  irritation  at  the  neck  of  the 
womb  is  relieved,  and  that  the  cough  has  gone,  and,  from 


412  On  the  Action  of  Iron, 

the  ante-catamenial  sacral  pain  having  been  lessened,  we 
may  assume  a  diminution  of  the  exalted  hypenemia  of 
OTuIation,  while  the  pain  in  the  left  side  and  sense  of  dis- 
tension shows  that  some  catamenial  ovarian  distress  remains  ; 
this  pain  by  the  following  week  had  almost  entirely  left,  and 
except  for  some  cardiac  palpitation  during  the  week  she  was 
quite  well. 

We  have  from  this  case  forcing  down  of  the  womb  agyra- 
vated  by  a  hacking  laryngeal  cough,  with  tendency  to  visceral 
hypermmia  ;  in  the  present  instance  an  increase  of  the  normal 
catamenial  hyperemia. 

Pray  do  not  be  too  critical  as  to  the  diagnosis,  or  I  shall 
have  to  give  you  an  explanatory  paper  much  more  tedious 
than  this. 

The  case  is  etiologically  interesting  in  this  way :  the 
irritability  of  the  uterine  cervix  arose  not  from  any  previous 
miscarriage  or  bad  confinement,  but  independently  of  blood 
loss,  in  this  respect  forming  a  marked  contrast  to  the  Soda 
chlorata  cases  recently  published  by  me  in  the  British  Journal 
of  HomcBopathy, 

Now  attend  to  the  next  case. 

Charlotte  O — ,  aged  twenty-eight,  of  a  brownish-yellow 
complexion,  suffered  for  a  year  from  the  following  symp- 
toms : — She  had  been  married  two  years,  without  children, 
when  she  began  to  suffer  with  pains  under  the  heart,  worse 
when  lying  down,  feels  as  if  the  heart  were  ready  to  burst, 
lower  chest  and  stomach  swell  very  much,  a  great  deal  of 
headache  during  the  day,  but  not  coming  on  at  fixed  hours. 
Is  very  low-spirited,  and  feels  very  weak,  and  suffers  from 
such  an  acute  pain  across  the  lower  part  of  the  back  as  to 
oblige  her  to  fall  back  when  rising  in  the  morning.  Very 
much  sacral  and  left  submammary  pain  before  the  monthly 
illnesses,  and  the  period  is  scanty  but  regular.  Appetite  is 
very  bad ;  bowels  confined ;  tongue  clean. 

For  these  symptoms  I  gave  Sepia  in  the  12th  dilution, 
and  with  marked  effect.  She  felt  herself  much  better,  but, 
after  taking  it,  bearing- down  pains,  described  as  being  in 
the  womb,  came  on  with  a  slight  leucorrhoeal  discharge. 


by  Dr.  Robert  T.  Cooper.  413 

The  back  pain  and  constipation  remained  unchanged^  and 
there  is  present  what  she  hitherto  neglected  to  mention, 
and  which  has  troubled  her  for  some  months — a  constant 
desire  to  pass  water  during  the  day  especially,  but  dis- 
tressing her  also  at  night,  along  with  a  pain  over  the  left 
ovary,  worse  on  pressure,  increased  each  time  she  makes 
water. 

I  now  gave  Ferrum phosphor,  in  the  1st  decimal  trituration, 
the  action  of  which  was  succeeded  by  removal  of  the  constant 
desire  to  urinate  and  disappearance  of  the  leucorrhoeal 
discharge ;  for  the  next  week  she  remained  without  medi- 
cine, and  the  back  pain  came  on  again,  but  altogether 
disappeared  on  returning  to  the  Ferrum. 

This  we  regard  as  a  case  of  ovarian  irritation  on  the  left 
side  producing  the  ovarian,  submammary^  and  sacral  pain, 
and  of  irritation  in  the  lining  membrane  of  the  neck  of  the 
womb. 

I  would  be  unable  to  describe  on  paper  all  my  reasons 
for  making  this  diagnosis;  but  remember,  there  was  con- 
stant desire  to  make  water  chiefly  during  the  day,  but  at 
night  as  well ;  this  in  itself  might  have  arisen  from 
irritation  of  the  neck  of  the  badder,  but  I  took  it  not  to  be 
so  from  the  absence  of  any  uncomfortable  feeling  about  the 
lower  part  of  the  bladder.  Well,  granting  this,  the  Sepia 
ought  to  act  upon  the  seat  of  the  disease — the  lining 
membrane  of  the  neck  of  the  womb — and  ought  to  subdue 
it  at  once,  or^  causing  aggravation,  to  drive  it  to  the  outside 
of  the  OS  uteri,  and  increase  the  bearing  down  and  bring  on 
leucorrhoea;  and  this  aggravating  effect  is  precisely  what 
we  find  to  take  place  after  its  administration;  so  that 
this  case  would  teach  us  that  S^ia  acts  upon  the  lining 
membrane  of  the  cervix,  probably  between  the  internal  and 
external  os  uteris  an  irritation  of  which  may  occasion 
constant  urination  and  also  reflex  pain  in  an  already 
irritated  ovary. 

You  may  argue  that  the  ovary  was  the  seat  of  the 
occasioning  irritation,  the  oriffo  mali  in  fact^  a  view  of  the 
case  that  I  am  not  inclined  to  dispute,  and  you  may  also 


414  On  the  Action  of  Iron, 

pronounce  that  bad  the  Sqria  been  continued  it  alone 
would  have  sufficed  to  effect  a  cure;  but  the  feature  of 
interest  for  the  present  investigation  is  this,  that  after 
giving  Sepia  we  get  precisely  the  bearing-down  pain  of 
Iron,  an  acute  and  very  uncomfortable,  but  not  exactly  a 
painful,  bearing  down — a  bearing  down  that  lacks  that 
violent  burning  pain  we  find  to  call  for  Arsenic  and  other 
remedies.  It  is  this  bearing  down  that  indicates  Iron  when 
miscarriage  threatens  and  which  Iron  infallibly  subdues. 

If  any  symptom  of  the  Materia  Medica  is  worthy  of 
being  remembered  this  is,  for  you  can,  without  a  possibility 
of  failure,  arrest  a  miscarriage  by  giving  Iron  when  such  a 
symptom  is  present.  Only  let  me  give  you  this  caution : 
administer  it  in  miscarriage  cases  in  the  mildest  potency 
possible,  which  in  my  experience  is  the  sixth  or  the  third. 
In  the  case  reported  the  leucorrhoea  is  passed  by  unnoticed^ 
as  I  attribute  it  simply  to  the  local  action  of  Sepia,  and 
that  it  would  have  left  even  if  Iron  had  not  been  given. 

It  is  very  characteristic  of  the  tracheal  cough  of  Iron 
that  it  manifests  a  tendency  to  strain  distant  parts,  and  to 
keep  up  irritation  in  them  should  such  be  present ;  thus, 
in  our  first  case  we  find  that  the  womb  was  affected — the 
bearing  down  increased — each  time  the  patient  coughed  ;  at 
other  times  we  find  that  it  is  the  bladder,  at  others  the 
rectum,  and  at  others,  and,  perhaps,  most  frequently,  the 
stomach.  The  cough  is  often  worse  on  going  from  a  cold 
air  into  a  warm  one,  and  vice  versd,  but  this  is  not  always 
so,  and  an  absence  of  such  peculiarity,  were  we  not  on  our 
guard,  might  mislead  us  and  divert  our  attention  to  other 
and  less  appropriate  selections. 

We  now  come  to  another  case,  that  of  William  D — , 
set.  53,  a  moderately  stout  man,  who  was  admitted  under 
treatment  the  17th  February,  1873.  He  had  suffered  all 
the  winter  from  a  cold  succeeded  by  a  cough,  and  the 
symptoms,  instead  of  leaving  him^  seemed,  when  he  placed 
himself  under  treatment,  to  be  getting  worse;  the  cough 
troubled  him  most  at  night,  in  the  morning  after  getting 
up,  and  during  the  daytime  after  meals;  it  caused  him  to 


by  Dr,  Robert  T.  Cooper.  415 

spit  up  and  to  Tomit  a  great  deal  of  white  phlegm^  and  to 
preyent  him  from  keeping  anything  heavier  than  bread  and 
milk  on  his  stomach ;  he  describes  the  stomach  as  being 
weak^  and  the  whole  system  appears  in  a  debilitated  state ; 
he  becomes  covered  with  a  cold  shivering  perspiration  when 
at  work.  He  suffers  from  flatulence,  and,  since  yesterday, 
has  had  diarrhoea  and  pains  in  the  abdomen  as  if  empty, 
with  total  want  of  appetite.  Sleep  natural ;  taste  good  ; 
urine  clear. 

Now  observe  the  efl«ct  of  Phosphate  of  Iron  in  the  1st 
decimal  upon  this  case.  During  the  first  week  all  these 
symptoms  subsided ;  the  cough  did  not  disturb  him  except 
on  waking  in  the  morning,  when  a  good  deal  of  phlegm 
would  come  up ;  the  food  remained  on  his  stomach,  and  he 
had  no  flatulence  or  diarrhoea  and  no  shivering  perspira- 
tions. 

The  Iron  was  continued  during  the  next  (third)  week 
with  the  effect  of  increasing  the  cough,  and  bringing  on  the 
sickness  and  discharge  of  phlegm.  During  the  fourth 
week  he  remained  without  medicine ;  the  Iron  previously 
given  was  allowed  to  act,  and  he  got  perfectly  well  though 
still  subject  to  accumulation  of  phlegm  in  the  mouth. 

In  previous  articles,  especially  in  those  on  Diseases  of  the 
Bladder,  I  have  pointed  out,  and,  for  aught  I  know  or  care, 
have  been  the  first  to  do  so,  what  a  very  irritating  drug 
Iron  is,  and  how  frequently  it  occasions  aggravation  of  its 
indicated  symptoms ;  if  this  peculiarity  be  lost  sight  of  it 
would  be  much  better  not  to  prescribe  Iron  on  homoeopathic 
principles  in  any  case ;  its  effects  ought  to  be  expected, 
and  met  when  they  appear  by  a  discontinuance,  change  of 
potency,  or  cessation  of  the  drug ;  for,  as  before  remarked, 
its  truly  homoeopathic  aggravation  does  credit  to  Hahne- 
mann's Organon. 

Carroll  Dunham,  duriug  his  recent  visit  to  England,  told 
me  that  he  had  cured  many  cases  of  irritation  of  the  neck 
of  the  bladder  and  prostate  with  the  Phosphate  of  Iron  in 
1st  decimal  form  according  to  my  suggestions;  and  he 
instanced  one  case,  that  of  a  gentleman  suffering  from  a 
very  severe  attack  of  this  affection,  where  this  preparation  of 


416  On  the  Action  of  Iron, 

the  Iron  was  followed  by  most  distressing  aggravatioQi  and 
where  even  a  discontinuance  of  the  remedy  did  not  prove 
sufficient  and  resort  had  to  be  made  to  a  higher  potency ; 
this  I  can  quite  understand. 

The  case  we  are  now  studying  shows  an  exacerbation  of 
the  cough  and  sickness  from  a  prolonged  employment  of 
the  Ferrum,  and  a  cessation  of  the  medicinal  aggravation 
from  discontinuing  it. 

Just  call  to  mind  the  original  symptoms  and  deny  if  yon 
can  that  an  attendant  would  have  been  justified  in  pro- 
nouncing it  to  be  influenza,  gastric  catarrh^  diarrho&a,  or 
indigestion,  just,  in  fact,  as  the  humour  took  him.  Our 
present  nomenclature  is  framed  on  too  narrow  a  basis  to 
adapt  itself  satisfactorily  to  chronic  complaints ;  it  is  often 
the  means  of  getting  us  into  hot  water  with  those  inquisi- 
tive and  fidgetty  old  ladies  who  possess  the  detestable  habit 
of  obtaining  a  second  opinion  on  the  sly.  Paracelsus  hit  the 
mark,  in  our  humble  estimation,  when  he  proposed  to  have 
conditions  of  system  named  from  their  specifics,  as  Morbus 
helleborinus,  &c.  The  case  reported  is  an  aggravated 
example  of  the  painless  irritability  of  fibre,  a  term  less 
open  to  misconception,  and  more  comprehensive  and 
distinctive  for  purposes  of  description  and  treatment  than 
any  of  the  above;  as  Morbus  ferruginus  it  would  quite 
comport  with  Faracelsian  nomenclature. 

The  patient  first  takes  cold,  then  this  cold  brings  on  a 
laryngeal  cough,  and  this,  in  its  turn,  induces  irritability 
and  weakness  of  the  stomach  indicated  by  sickness,  the  food 
does  not  digest  and  he  becomes  weak,  discharge  of  phlegm 
from  the  stomach,  abdominal  pains  and  diarrhoea  ensue. 

The  progress  of  the  irritability  from  the  larynx  to  the 
stomach,  in  the  stomach  producing  irritability  and  weakness 
with  discharge  of  phlegm,  the  irritability  travelling  down 
and  inducing  intestinal  irritation  evidenced  by  pain  and 
diarrhoea,  all  show  that  what  at  first  is  a  very  trivial  ailment 
may  in  time  become  a  very  serious  disease ;  and  it  is  these 
apparently  trivial  prodromata  which,  though  sent  to  herald  a 
coming  storm,  are  so  likely  to  obtain  insufficient  considera- 
tion at  our  hands;  they  constitute  a  subject  of  study  that  must 


by  Dr.  Robert  T.  Cooper.  417 

have  attention  directed  to  it  before  accuracy  in  treatment, 
in  prognosis,  and  in  diagnosis  can  be  obtained.  Irritation 
cannot  long  exist  on  a  mucous  surface  without  an  exfolia- 
tion of  epithelium  and  discharge  of  secretion,  and  so  catarrh 
conies  to  be,  in  such  cases,  indicative  of  Iron. 

We  get  from  this  case  as  sympathetic  of  irritability  of 
fibre,  laryngeal  cough  cattsing  weakness  and  irritabilily  of 
the  stomach,  indicated  at  first  by  gulping  up*  of  food,  and 
then  by  actual  vomiting ,  induced  more  particularly  by  a  meat 
diet,  with  catarrhal  discharge ;  diarrhoea  and  abdominal 
pains,  the  last  two  being  symptoms  of  a  late  stage  of  the 
disorder. 

The  next  case  yoo  may  term  remittent  dyspepsia,  or  with 
Dyce  Duckworth  {Brit.  Med.  Journal,  December  27th, 
1873)  nightly  dyspepsia,  if  you  wish ;  but  the  painless 
irritability  with  its  well-marked  and  unmistakable  epi- 
phenomeua  embraces  both  these. 

Anne  H — ,  set.  35,  a  dark-haired  plethoric  subject, 
menstruated  at  fifteen,  married  six  years,  and  without 
children,  has  been  ill  four  months  with  attacks  of  indiges- 
tion, which  have  been  getting  increasingly  worse ;  they 
come  on  very  irregularly ;  within  the  last  month  she  has 
been  in  a  very  bad  state  of  health,  besides  having  had  three 
of  those  indigestion  fits.  They  come  on  in  the  middle  of 
the  night  with  sickness  and  diarrhoea  and  pains  in  the 
limbs,  and  for  the  last  three  months  her  face  has  been 
covered  with  a  red  lichenous  eruption.  Her  tongue  pre- 
sents the  white  fur  of  dyspepsia,  and  she  suffers  from 
acidity ;  there  are  occasional  pains  in  both  hips  and 
constant  facial  flushings.  The  monthly  period  is  true  to 
time  but  is  scanty,  and  always  preceded  by  a  good  deal  of 
white  discharge. 

Being  evidently  of  a  temperament  indicating  iron  I 
inquired  as  to  cough,  and  found  that  she  had  a  dry  cough 
every  winter,  a  very  troublesome  one,  and  that  this  cough 

*  The  preliminaiy  galping  np  is  assumed  from  evidence  afforded  by  many 
other  cases ;  it  is  impossible  to  extract  every  important  particular  from  the 
same  patient. 

VOL.  XXXII,  NO.  CXXIX. JULY,  1874.  D  D 


418  On  the  Action  of  Iron, 

caused  urination,  especially  so  at  tlie  catarneuial  epoch ; 
aUo^  that  there  was  a  frontal  headache  with  the  cough  and 
tightness  on  the  chest. 

The  cough,  therefore,  must  be  put  down  as  a  shaking 
cough  ;  it  affected  parts  remote  from  the  larynx,  caused 
sudden  contraction  of  the  diaphragm,  with  the  chest  and 
abdominal  muscles,  and  thus  impelled  the  blood  to  the 
head ;  caused  contraction  of  the  muscular  coat  of  the 
stomach,  and  thus  induced  gulping  up  of  food ;  caused  con- 
traction of  the  fundus  vesicae^  and  thus  relaxation  of  the 
sphincter  and  forcible  expulsion  of  urine  ;  it  was  an  trrt- 
tating  cough  and  transmitted  its  irritation  to  the  stomach, 
causing  vomiting,  and  to  the  bowels  causing  diarrhoea,  and 
it  coexisted  along  with  hip  pains  and  pre-catamenial  leucor- 
rhoea,  flushings,  and  lichenous  facial  eruption — ^showing 
probably  hepatic  and  uterine  congestion. 

For  these  symptoms  she  was  ordered  Ferrum  muriaticum^ 
in  the  12th,  and  the  next  week  the  report  was  very  favor- 
able ;  she  felt  better  and  lighter,  sickness,  diarrhoea,  cough, 
and  tightness  on  the  chest  had  left,  flushings  were  better 
and  the  hip  pains  had  gone,  but  she  complains  of  sleeping 
heavily  and  of  waking  with  a  severe  crushing  pain  across  the 
forehead  which  goes  away  after  breakfast  less ;  the  eruption 
and  leucorrhosa  are  both  better,  but  the  tongue  is  still 
coated. 

For  the  succeeding  thr^e  weeks  she  remained  without 
medicine,  and  though  she  had  one  or  two  roughish  days 
with  coated  tongue  and  other  threatening  symptoms^  with 
this  exception  she  continuously  improved  and  left  the  dis- 
pensary perfectly  well. 

Observe,  in  this  case  there  was,  as  we  have  said^  slight 
congestion  of  the  womb  indicated  by  hip  pains,  leucorrhoea 
before  the  period,  and  the  flushings.  Mark,  too,  that  the 
period  has  never  been  much,  the  blood  would  seem  to  be 
thrown  in  upon  the  system — a  marked  indication  for  the 
smallest  doses  possible  of  Iron;  the  greatest  care  ought  to 
be  taken  when  administering  the  drug  in  the  presence  of 
such   a  feature.      The  blood  «>find8  its  way  into  the  venous 


by  Dr.  Robert  T.  Cooper.  419 

plexuses  of  the  abdomeu^  turgescing  the  liver,  as  we  see  from 
the  florid  complexion^  the  licheaous  eruption,  and  abdo- 
minal distress,  and  into  the  chest,  causing  tightness,  and  up 
to  the  head,  causing  frontal  headache,  and  this  internal 
overflow  is  facilitated  by  the  sudden  contraction  of  the 
muscular  structures  throughout  the  body,  and  all  this  existing 
along  with  the  hacking  cough  leave  no  doubt  as  to  the 
appropriateness  of  Iron, 

In  such  cases  as  these^  where  a  regulation  of  the  blood - 
current  is  required,  I  can  quite  understand  an  ordinary 
allopathic  dose  of  Iron  inducing  suddeu  cerebral  congestiou 
with  an  immediately  fatal  result.* 

So  that  if  we  find  symptoms  of  visceral  congestion 
throughout  the  body — internal  overflow  as  we  have  termed 
it — and  along  with  this  a  hard,  dry,  hacking,  laryngeal 
cough,  we  may  be  sure  that  we  have  to  deal  with  a 
typical  case  of  painless  irritability  of  the  fibre,  and  that  it 
calls  for  the  smallest  possible  doses  of  Iron. 

William  H — ,  set.  45,  a  brewery  worker,  sufiers  from  a 
bad  cough,  with  difficulty  of  breathing  and  hoarseness  ;  the 
cough  succeeded  an  attack  of  measles  that  he  had  seven 
years  ago  and  which  has  left  him  in  indiflerent  health  ever 
since.  Dry  spasmodic  cough,  chiefly  at  night,  preventing 
sleep  and  eased  by  bringing  up  phlegm,  rambles  in  his 
sleep,  and  sufiers  from  a  frontal  headache  when  he  coughs 
and  when  getting  up  in  the  morning.  Appetite  is  very 
bad ;  tongue  coated  with  a  soft  fur ;  bowels  regular. 

On   10th  February,   1873,  he   was  ordered   Tinct.  Ferr. 

*  The  testimony  of  allopathic  writers  substantiates  this  assertion.  Barnes, 
in  his  work  npon  the  Di»ea$9i  of  Women,  p.  96,  art.  Htnnorrhagea  (Uterine), 
says : — "  Hamorrhage,  especiaUj  the  active  form,  is  followed  by  a  stage  of 
reaction  of  erythism,  which  has  been  not  inaptly  termed  hemorrhagic  fever. 
The  pulse  is  quickened,  the  skin  is  warm  and  dry,  there  is  intense  beating 
headache,  restlesBness,  hypersesthesia  manifested  in  general  irritability,  and 
morbid  sensitiveness  to  light  and  sound.  In  this'  condiiion  it  it  a  wrioui 
elimieal  error  to  administer  Iron.**  And  so  it  is  if  given  in  an  ordinary 
allopathic  dose ;  but  if  given  in  dilution,  the  Iron  becomes  pre-eminently  the 
spedflc  remedy.  This  is  one  of  the  many  cases  where  the  homcBopatbic  physi- 
cian is  obliged  to  part  company  with  the  old-school  follower. 


420  On  the  Action  of  Iron, 

Muriatici,  gtt.  z,   Aqtue,  y^y   misce.      Capiat,   gtt.   y,    in 
Aqud  ter  in  die. 

By  the  17th  February  be  was  much  improvedy  the 
ranabling  in  sleep  had  ceased,  the  headache  had  left,  but 
the  hoareeiieRS  was  worse.  Small,  deep-coloured,  purpuric 
spots  with  intense  irritation  day  and  night  have  come  upon 
the  shins ;  and  he  is  suffering  from  a  very  bad  attack  of 
diarrhoea,  quite  an  unusual  thing  for  him  to  have,  with  heat 
and  burning  at  the  anus  night  and  day,  rectal  straining 
and  extreme  urgency  to  evacuate  the  bowel,  especially 
after  coughing — the  motion  will  come  with  the  cough  if  he 
does  not  run  off  to  stool ;  aggravation  from  drinking 
warm  things^  especially  cocoa. 

Every  one  of  these  symptoms  is  characteristic  of  Iron; 
the  only  doubt  would  be  about  the  peculiar  purpuric  spots, 
and  these  we  leave  for  further  inquiry. 

We  now  put  the  patient  on  the  30th  dilution  of  Ferrum 
murtaticum,  and  this  brings  improvement  with  it ;  the  diar- 
rhoea gradually  ceased  during  the  week;  hoarseness  the 
same.  To  go  back  to  ten  drops  of  Ferrum  muriaticum  as 
above.  This  again  aggravated  ;  the  diarrhoea,  this  time, 
with  tightness  across  the  abdomen  just  below  the  navel, 
came  on,  and  great  irritation  set  in  in  the  skin  of  the  legs 
without  any  spots  appearing,  the  cough  lessened^  and  the 
hoarseness  and  dyspnoea  remained  the  same. 

During  the  next  week  we  put  him  upon  the  Ist  decimal 
of  Phosphate  of  Iron  and  with  manifest  effect ;  the  dyspnoea 
and  voice  at  once  improved,  the  tightness  across  the  navel 
went  away,  and  he  felt  altogether  much  better.  Yet 
symptoms  of  aggravation  can  be  noticed;  the  cough,  espe- 
cially in  the  morning,  has  come  back  again  and  retching 
comes  on  after  taking  warm  cocoa ;  these  cease  on  dis* 
continuing  the  Iron,  came  on  again  when  we  resumed  it, 
and  again  cease  when  left  without  medicine.  When  he 
discontinued  attending,  after  being  two  months  under  treat- 
ment, he  was  quite  well. 

We  have  then  from  this  case  some  very  strikingly  cha- 
racteristic symptoms  of /ron ;  first,  there  is  the  full  plethoric 


by  Dr.  Robert  T.  Cooper.  421 

habit — this  indicates  Iron  in  homoBopathic  doses.  Give,  in 
such  a  case,  tangible  doses,  and,  as  our  patient  exemplified. 
Iron  will  be  sure  to  aggravate;  we  have  then  frontal 
headache  very  bad  at  night,  increased  when  he  coughs  (from 
sudden  rush  of  blood  to  the  head),  and  on  getting  up  in 
the  morning  j  we  have  disturbance  of  the  brain  in  sleep, 
"a  rambling  in  sleep,'^  and  we  have  a  spasmodic  irri^ 
tative  cough.  As  aggravation  from  the  muriate  tinc- 
ture^ we  get  irritable  rectum  amounting  almost  to  dysentery, 
and  in  unison  with  a  similar  condition  I  have  shown  Iron 
to  produce  upon  the  neck  of  the  bladder ;  we  have  new 
symptoms  in  the  dyspnoea,  and  the  tightness  below  the  navel — 
this  being  symptomatic  of  an  extension  of  irritation  from 
the  rectum  to  the  mesentery ;  and  then  we  get  aggravation 
from  warm  food,  especially  from  warm  drinks,  as  cocoa,  ^c. 
The  lesion  Iron  produces  upon  the  bladder  and  rectum — 
the  lesion  present  in  parts  affected  with  this  painless 
irritability — is  of  a  compound  nature ;  there  is  weakness 
associated  with  irritability  and  spasm  ;  irritability,  plus 
paresis,  plus  spasm.  And  we  may  further  formulate : 
excess  of  irritability,  of  spasm,  or  of  both  of  these,  over 
weakness,  calls  for  small  doses ;  excess  of  paresis  over  one 
or  both  calls  for  large  doses.  The  patient^s  description  of 
bis  symptoms  to  all  intents  and  |)urposes  serves  as  a  suffi- 
cient criterion  of  the  character  of  the  predominant  lesion. 

We  must  now  prepare  ourselves  for  fresh  inquiry  into  a 
department  of  the  action  of  Iron  that  with  what  has  gone 
before  will  demonstrate  beyond  question  that  Iron  more 
than  deserves  the  proud  position  it  has  always  enjoyed  as  a 
remedial  agent ;  and  it  is  a  matter  of  great  pleasure  to  me 
to  have  been  the  humble  instrument  to  wrest  it  from  the 
unenlightened  beliefs  that  surrounded  its  employment  and 
that  caused  some  of  even  homoeopathic  physicians  to 
desert  the  very  principles  they  held  sacred  and  to  join  in 
with  those  antiquated  views  they  professed  to  repudiate  and 
disavow.  It  is  not  a  little  remarkable  that  even  Teste 
should  have  made  use  of  such  words  as  these :  ^'  It  seems 
to  me  that  all  the  various  symptoms  that  Iron  is  capable  of 
curing  depend  upon  the  same  general  disease,  chlorosis.'' 


422  On  the  Action  of  Iron, 

A  moment's  reflection  would  have  convinced  Teste  that  such 
an  assertion  was  altogether  short  of  the  truth  ;  his  remarks 
upon  the  symptom-producing  effects  of  Ferrum  magneticum 
afford  abundant  proof  of  this. 

Marian  6 — ,  set.  47,  ill  three  weeks  with  what  she 
considers  a  dreadful  irritation  and  suffocative  feeling  in  the 
throaty  and  occasional  cough^  bringing  with  it  hard  lumps  of 
phlegm  ;  very  much  palpitation  of  the  heart  and  constant 
sickness,  cannot  keep  a  particle  of  meat  on  her  stomach  {jnde 
case  of  William  D — ,  p.  414).  Hips  and  back  ache,  and  she 
suffers  from  piles.  Bowels  and  monthly  period  regular; 
tongue  clean. 

The  1st  decimal  of  the  Phosphate  at  once  checked  the 
gulping  up  of  food,  and  enabled  her  to  digest  mept;  but 
the  throat  became  worse,  more  choky,  and  the  lymphatics 
on  both  sides  of  the  neck  became  swollen.  For  this 
symptom  I  changed  the  preparation  of  Iron  to  the  Muriate 
Tincture  of  the  British  Pharmacopceia,  of  which  a  drop 
diluted  was  given  every  day.  This  swollen  state  of  the 
lymphatics  I  had  always  heretofore  looked  upon  as  an 
indication  for  this  preparation  of  the  metal,  but  looking 
back  upon  the  case,  and  taking  into  consideration  the 
experience  I  have  had  with  Iron  and  its  preparations,  I 
unhesitatingly  pronounce,  and  this  from  overwhelming 
evidence,  that  the  swelling  of  the  lymphatics  as  well  as  the 
increase  of  the  swollen  state  of  the  throat,  was  produced  by 
transitory  aggravation  of  the  phosphate,  nor  am  I  prepared 
to  admit  that  the  cessation  of  this  effect  under  the  influence 
of  the  Muriate  establishes  sufiicient  proof  to  the  contrary, 
for  it  is  not  unlikely  that  as  with  Mercfiry  so  with  Iron, 
alteration  in  the  preparation  of  the  metal  will  subdue 
previous  drug  effects.  Other  causes  may  have  contributed 
to  the  production  of  these,  symptoms,  as,  tor  example,  cold, 
but  that  the  Iron  determined  the  glandular  implication  I 
maintain  to  be  most  probable,  and  it  is  this  symptom, 
whether  produced  by  Iron  in  the  above  case  or  not,  that 
opens  up  the  new  field  of  inquiry. 

We  get  from  the  case  not  a  simple  laryngeal  irritation. 


by  Dr.  Robert  T.  Cooper.  423 

remember,  but  an  irritation  with  a  suffocative  feeling,  and 
we  have  a  cough  bringing  with  it  hard  lumps  of  phlegm  ; 
and  then  we  get^  though  there  is  no  record  of  how  the  Iron 
affected  them,  hip  pains  and  piles^  indicating  visceral 
(pelvic)  congestion.  All  these  are  indicative  of  the  same 
affection,  painless  irritability  of  fibre. 

We  frequently  meet  with  influenzas  where  the  prevailing 
symptoms  are^  a  sense  of  soreness  of  the  throat,  a  harsh  dry 
cough^  with  expulsion  of  small  lumps  of  viscid  phlegm^  an 
irritative  feeling  throughout  the  entire  system^  and  where 
on  either  side  of  the  neck,  but  especially  on  the  left,  the 
lymphatic  chains  are  tender  and  tumefied  ;  such  we  have 
known  to  be  very  frequent  up  till  middle  age,  and  to  be 
invariably  accompanied  by  great  physical  depression.  These 
influenzas  can  be  arrested  with  the  greatest  possible  certainty 
by  administering  homoeopathic  doses  of  the  Muriate  and 
Pemitrate  of  Iron,  and  I  have  always  regarded  the  condition 
of  the  lymphatics  as  the  distinguishing  feature  demanding 
Iron;  it  is,  indeed,  a  most  valued  keynote  for  the  adminis- 
tration of  this  drug.  I  have  used  these  preparations  with 
success,  and  therefore  wish  to  record  the  fact,  but  am 
fully  aware  that,  theoretically,  the  Iodide  of  Iron  ought  to 
be  preferred.  The  indication,  though  only  observed  in 
clinical  practice,  is  partly  corroborated  in  our  provings 
wliere  we  get  long -lasting  swelling  of  the  cervical  glands, 
and  it  only  requires  us  to  be  assured  that  these  cervical 
glands  were  the  lymphatic  glands  and  the  matter  will  be 
beyond  dispute.  Supposing  therefore  this  observation  of 
ours  to  be  a  correct  one,  and  that  preparations  of  Iron,  to 
wit,  the  Muriate,  Pemitrate,  and  Phosphate  (the  Phosphate 
pathogenetically)  act  upon  the  lymphatic  glands,  is  there  any 
well- recognised  pathological  afl*ection  characterised  by  tume- 
faction of  them  ?  We  have  found  certain  forms  of  in- 
fluenza to  be  so,  but  is  there  no  more  substantive  disease 
than  it  where  swollen  lymphatics  obtain,  and  where  Iron 
may  prove  specific  ?  Let  us  work  this  matter  out.  Given 
the  lymphatics  of  the  neck  enlarged,  in  what  condition  may 
we  expect  to  find  the  bronchial,  pharyngeal,  tracheal,  and 
laryngeal  lymphatics?     It  may  not  necessarily  follow  that 


424  On  the  Action  of  Iron, 

they,  too,  will  be  turgid,  but  is  it  not  extremely  likely  that 
these  will  sympathise  with  the  neighbouring  lymphatic 
tracts?  And,  if  so,  have  we  not  an  explanation  of  the 
suffocative  feeling  in  the  throat  with  irritation,  and  if  lower 
down  a  similar  condition  prevails  and  exercises  pressure 
upon  the  bronchial  tubes,  will  it  not  induce  congestion  by 
hindering  free  circulation  of  blood  through  the  lung  tissue, 
and  thus  cause  to  be  thrown  upon  the  heart  such  a  strain 
as  will  induce  palpitation,  and  such  irritation  in  the  bronchial 
mucous  membrane  as  will  induce  secretion  of  mucus,  tight- 
ness of  the  chest  and  difficulty  of  breathing,  such  as  we  found 
exemplified  in  William  H — ^s  case  p.  419  ?  But  let  us  clearly 
understand  our  position  ;  what  I  claim  for  Iron  from  clinical 
observation  is  not  that,  as  the  proving  informs  us,  it  produced 
long-lasting  swelling  of  the  cervical  glands,  but  simply  aud 
solely  that  its  preparations  are  demanded  where  we  find  on 
either  side  of  the  neck,  as  the  result  of  cold,  a  swelling, 
tenderness,  and  sometimes  even  a  slight  redness  (lympha- 
denitis) along  the  lymphatic  chain  of  glands ;  and  inferen- 
tiaily  we  are  supposing  that  this  morbid  condition  may 
extend  itself  along  these  lymphatic  tracts,  and  follow  them 
in  their  course  down  the  bronchial  tubes. 

Enlargement  of  the  bronchial  glands  as  a  separate  affec- 
tion is  a  well-recognised  pathological  condition.  It  has 
been  referred  to  by  Dr.  Harrison,  of  Dublin,  in  his  work 
on  the  Anatomy  of  the  Arteries,  but  for  an  account  of  its 
less  obvious  and  incipient  condition  I  am  indebted  to  a  paper 
that  was  read  before  the  medical  section  of  the  British  Medical 
Association  in  London,  in  August,  1873,  by  Noel  Gueneau 
de  Mussy,  Physician  to  the  Hdtel  Dieu,  Paris.  From  this 
paper  we  copy  the  following  very  instructive  remarks. 

*'  Almost  all  the  diseases  of  the  respiratory  organs  may  be 
complicated  with  enlargement  of  the  bronchial  glands ;  and 
very  often  this  enlargement  unites  its  phenomenal  expres- 
sion with  that  of  other  affections,  and  can  claim  a  part  in 
the  modifications  of  the  respiratory  murmur,  and  of  the 
resonance  of  the  chest  observed  in  these  diseases. 

^'  Of  course,  the  signs  of  the  bronchial  adenopathy  are 


by  Dr.  Robert  T.  Cooper.  425 

geDerally  to  be  found  in  the  region  corresponding  to  the 
bronchial  glands,  behind  the  upper  part  of  the  manubrium 
of  the  sternum^  the  sterno-clavicular,  and  the  first  sterno- 
costal joints^  and  the  inner  part  of  the  two  first  intercostal 
spaces.  Behind,  the  laminae  of  the  first  four  dorsal 
vertebrae  correspond  to  the  same  organs. 

**  When  these  glands  are  enlarged^  you  can  find  in  those 
points  a  sound  duller,  higher  than  natural,  generally  duller 
on  one  side  than  on  the  other^  with  impaired  elasticity. 
With  these  modifications  of  the  resonance,  often  very  per- 
ceptible^ you  may  find  weakness,  roughness  of  the  respiratory 
murmur  in  the  whole  of  a  lung,  if  the  main  bronchial  tube 
be  compressed,  or  in  a  part  of  it,  if  one  only  of  the  secou* 
dary  bronchial  divisions.  This  weakness  of  respiration, 
often  very  evident  in  parts  where  the  sound  is  normal  and 
no  alteration  of  tissue  is  to  be  suspected,  which  is  not 
at  all  uncommon,  cannot  be  explained  satisfactorily  without 
the  interference  of  bronchial  pressure.  This  weakness  is 
usually  connected  with  acuteness  of  the  respiratory  sound 
and  protracted  expiration.  Near  the  origin  of  the  bron- 
chial tubes  a  ruugh,  sibilant,  or  rubbing  sound  is  pretty 
often  to  be  heard.  In  the  same  point  there  often  may  be 
heard  an  expiratory  souffle  resounding  over  a  more  or  less 
large  extent,  which  is  nothing  else  than  the  tracheal  sound 
transmitted  by  the  enlarged  glands.  It  may  be  heard 
behind^  near  the  spinal  column ;  in  front,  near  the  sternum  ; 
with  this  peculiarity,  that  sometimes  the  movement  of  the 
body  may  modify  this  sound,  by  changing  the  relation  of 
the  trachea  with  the  surrounding  parts.  I  observed  this 
alteration  of  the  tracheal  souffle  in  a  remarkable  degree, 
lately,  in  a  female  patient  in  my  wards  at  the  Hdtel  Dieu. 
The  souffle  was  very  strong  when  she  lifted  her  head  up, 
and  the  trachea  was  closely  applied  against  the  convex 
surface  of  the  cervical  spine ;  it  disappeared  when  she  bent 
her  head  forward,  and  the  connection  between  the  trachea 
and  the  enlarged  glands,  which  conducted  the  sound,  was 
relaxed.  For  many  weeks  I  could,  according  to  the  posi- 
tion of  the  neck,  produce  the  souffle,  or,  on  the  contrary, 
make  it  disappear.     The  cough,  usually  the  consequence  of 


426  On  the  Action  cf  Irorij 

the  bronchial  adenopathy,  ia  drj,  obstinate,  sometimes 
attended  with  a  long  whistling  inspiration,  as  in  hooping- 
cough.  This  hooping-oough-like  character  has  been 
pointed  out  as  belonging  to  the  most  advanced  degree  of 
this  disease  by  all  the  physicians  who  have  written  on  this 
affection.  It  may  be  observed  in  its  mildest  forms,  and 
depends  very  probably  on  the  connection  of  the  enlarged 
glands  with  the  pneumogastric  nerve.  I  dare  not  assert 
that  this  peculiar  character  in  hooping*cough  is  always  the 
result  of  the  enlargement  of  these  glands ;  but  I  found  all 
the  signs  proper  to  this  condition  in  some  cases  of  hooping- 
cough,  namely,  in  those  which  may  be  called  chronic;  and 
this  complication  seems  to  me  to  explain  satisfactorily  the 
unusual  circumstance  of  an  indefinite  duration  in  a  conta- 
gious   disease    like    hooping-cough,    assimilable    in    many 

.  respects  to  the  eruptive  fevers.  Everybody  knows  that  the 
cough  may  retain  its  character  sometimes  for  several  years; 
and  in  a  case  of  this  description,  lasting  for  two  years,  I 
observed  the  physical  signs  of  the  bronchial  adenopathy. 
I  have  noticed  that  the  cough  may  disappear  in  some 
chronic  cases,  although  all  the  signs  of  the  bronchial 
adenopathy  have  persisted. 

*^  The  next  symptom  to  be  observed  is  a  slight  degree  of 

'  dyspnoea,  sometimes  recurrent,  and  assuming  an  asthmatic 
form,  or  only  perceptible  when  the  patient  is  making  an 
exertion,  or  when  some  accidental  congestion  'increases  the 
swelling  of  the  glands.  I  have  seen,  under  such  circum- 
stances, a  depression  of  the  skin  above  the  superior 
extremity  of  the  sternum,  at  each  inspiration,  as  in  cases 
where  some  obstacle  prevents  the  free  access  of  air 
to  the  lungs.  The  dilatation  of  the  corresponding 
side  of  the  chest  is  also  diminished,  as  can  be  ascer- 
tained by  a  little  instrument  which  I  have  called  a 
pneumometer,  which  serves  to  measure  the  relative  degree 
dilatation  of  both  sides  of  the  chest.  This  instrument  is 
composed  of  a  spring  supporting  a  dial  with  a  graduated 
index.  On  each  side  of  the  dial  is  a  string,  which  serves 
both  to  fix  the  instrument  in  the  required  position,  and 
also  to  measure  the  breadth  of  the  chest. 


by  Dr.  Robert  T.  Cooper.  427 

''  This  morbid  condition  of  the  glands  explains  certain 
cases  of  aphonia.  I  have^  on  two  occasions  in  my  practice, 
met  with  cases  of  aphonia  accompanied  by  all  the  physical 
signs  of  bronchial  adenopathy  on  one  side  ;  and  from  these 
circumstances  I  diagnosed  a  paralysis  of  the  vocal  chord  of  the 
corresponding  side^  due  to  a  compression  of  the  inferior 
laryngeal  nerve  ;  which  diagnosis  was  afterwards  verified  by 
a  laryngoscopic  examination. 

^*  In  one  case,  the  bronchial  adenopathy  seemed  to  me 
accountable,  in  a  young  boy,  for  an  unrestrainable  vomiting, 
attended  with  dyspnoea,  which  lasted  for  two  years.  Many 
treatments  had  been  unsuccessfully  employed  to  master  this 
affection.  I  prescribed  Labourboule  waters,  half  a  glass 
four  times  a  day,  a  plaster  with  Belladonna  to  be  applied 
on  the  pit  of  the  stomach,  and  Tincture  of  Iodine  on  the 
chest;  and  under  this  treatment,  directed  principally 
against  the  enlargement  of  the  bronchial  glands,  the  patient 
was  quite  cured. 

"  I  do  not  wish  to  describe  the  symptoms  of  the  most 
advanced  degrees  of  this  affection,  which  are  well  known, 
when  large  tumours  press  on  the  veins,  the  trachea,  the 
cssophagus,  and  produce  cynauosis,  oedema  of  the  superior 
parts,  congestion  of  the  brain,  dysphagia,  and  sometimes 
asphyxia. 

*'  These  periods  of  this  affection  which  I  have  studied 
here  are  more  amenable  to  treatment  than  those  of  more 
advanced  stages.  The  mineral  waters,  containing  chloride 
of  sodium  and  arseniate  of  soda,  such  as  those* of  Labour- 
boule, or  chloride  of  sodium  and  iodine,  as  Kreuznach, 
Salies,  and  Salins,  and,  in  certain  cases,  sulphurous  springs, 
may  be  efficaciously  prescribed.  The  use  of  Iodine  inter- 
nally and  externally  is  also  indicated. 

**  This  condition  of  the  lymphatic  glands,  to  which  I 
have  alluded,  may  be  observed  at  every  age ;  it  may  com- 
plicate a  great  number  of  affections,  such  as  measles, 
hooping-cough,  typhoid  fever,  bronchitis,  pleurisy,  pneu- 
monia, tubercular  induration  of  the  lungs,  and  accounts  for 
many  auscultatory  phenomena  which  I  had  been  previously 
at  a  loss  to  explain.''' 


428  On  the  Action  of  Iron^ 

It  is  to  us  very  obvious  that  the  vomiting  spoken  of  above 
was  due  to  want  of  retentive  power  in  a  stoniach  sympa- 
thising with  the  irritated  condition  of  other  parts,  probably, 
as  Gueneau  de  Mussy  says,  with  the  bronchial  glands,  and  that 
were  the  syaiptoms  given  in  full,  the  cough  and  suffocative 
feeling  which  we  have  in  Marian  G — 's  case,  p.  421,  would 
have  established  the  identity  of  the  enlisting  lesions  in  both ; 
and  though  we  do  not  wish  to  deny  that  the  Iodine  may 
have  effected  the  cure,  it  is  yet  quite  as  possible  that  the 
curative  agent  was  the  Belladonna — a  Belladonna  plaster 
will  prevent  vomiting  in  obscure  cases  which  nothing  else 
seems  to  touch. 

It  is  also  obvious  to  us  that  the  hoarseness  and  weakness 
of  voice  in  William  H — 's  case,  not  to  mention  other  cases 
also,  may  have  pointed  to  a  like  lymphatic  engorgement;  in 
his  case  the  whistling  inspiration  was  remarkably  evident, 
though  we  have  not  reported  it.  We  cannot  procure  the 
almost  positive  proof  that  dull  percussion  affords  of  there 
being  enlarged  glands  present  in  the  examples  adduced  in 
this  paper,  for  the  matter  did  not  occur  to  us  when  reporting 
them  ;  but  fortunately,  we  are  dealing  with  an  affection 
whose  symptoms  are  uniform  and  can,  therefore,  be  easily 
recognised.  All  the  symptoms  Noel  Gueneau  de  Mussy 
apportions  to  tumefaction  of  the  bronchial  glands  in  the 
stage  he  refers  to  are  to  be  met  with  to  a  less  degree,  and 
presumably  at  an  earlier  stage  of  engorgement  in  our 
cases,  and  the  additional  symptoms  we  have  observed  are 
fairly  attributable  to  our  giving  a  fuller  narrative  of  the 
patient's  sufferings.  If  we  are  right  in  our  surmise  it 
will  be  necessary,  as  elucidating  the  etiology  of  painless 
irritabilit}',  to  inquire  into  the  cause  of  the  coexistent 
lymphatic  complication ;  it  is  this  that  gives  us  a  clue  to 
the  whole  nature  of  the  affection  ;  and  having  done  this  we 
will  have  the  important  fact  to  discuss,  namely,  that  Iron 
acts  upon  the  lymphatic  system.  The  existence  of  angio- 
leucitis  must  be  taken  as  evidence  of  the  presence  of 
impure  material  in  the  system,  in  what  form  we  have  no 
means  of  judging ;  only  we  know  that  it  occurs  after  inter- 
ference  has  taken  place  with    the    process  of  absorption 


by  Dr.  Robert  T.  Cooper.  429 

going  on  throughout  the  system,  and  that  it  is  more 
frequent  at  some  seasons  than  at  others. 

It  is  not  difScuIt  to  suppose  that  all  the  symptoms  we 
have  indicated  as  characterising  this  affection  may  be  due 
to  the  introduction  of  impure  material  into  the  venous 
currents  by  means  of  the  thoracic  duct.  Burdon  Sander- 
son^ Fox,  and  others  have  proved  the  formation  of  a  kind 
of  tubercle  in  the  lungs  and  other  organs  of  guinea-pigs  by 
exciting  suppuration  beneath  the  skin,  showing  how  mani- 
festly the  entire  system  is  affected  through  the  instru- 
mentality of  vitiated  substances  introduced  into  the 
absorbent  system ;  and  that  this  is  the  cause  of  the  symp- 
toms indicating  Iron,  at  least  of  those  we  have  referred  to^ 
is  to  our  mind  perfectly  plain.  Iron  is  not  without  some 
homoeopathic  relationship  to  erysipelas  and  also  to  rheu- 
matic fever^  whether  accompanied  by  debility  or  not^  as^ 
indeed^  to  other  diseases  of  the  zymotic  class  for  which  of 
late  years  it  has  been  recommended  ;  but  its  relationship  to 
these  is  at  best  but  roughly  homoeopathic  and  so  they  require 
to  have  large  doses  of  the  drug. 

That  the  introduction  of  infectious  material  is  the  cause 
of  painless  irritability  is  shown  by  its  frequent  occurrence 
after  specific  fevers^  but  particularly  after  measles.  We 
met  with  a  case  some  time  ago  in  a  girl  of  twenty,  who 
had  had  measles  at  the  age  of  five  years  followed  by  a  hard 
dry  cough,  very  annoying  at  night  and  whenever  she  went 
into  a  warm  room  ;  also  very  bad  in  the  morning  on 
getting  up,  and  at  any  hour  after  sitting  long  there  was  a 
stitching  pain  between  the  shoulders,  great  inclination  to 
take  cold  and  obstinate  confinement  of  the  bowels — all  of 
which  symptoms  are  particularly  important.  Enlarged  bron- 
chial glands,  according  to  Oueneau  de  Mussy,  are  affected  by 
the  position  of  the  head ;  when  it  is  held  well  up  a  souffle 
can  be  heard^  for  the  trachea  comes  to  be  applied  to  the 
convex  surface  of  the  cervical  spine  which  disappears  when 
the  head  is  bent  forward.  In  our  patient  we  find  the 
cough  aggravated  by  warmth  (at  night  in  bed  and  in  a 
warm  room),  when  getting  up  in  the  morning,  and  after 
sitting  down — presumably  with  the  head  bent  forward,  as 


430  On  the  Action  of  Iron, 

the  girl  was  a  dressmaker;  and  as  all  these  influences 
would  have  the  same  effect  and  relax  the  mucous  mem- 
brane we  take  it  that  the  mucous  surface  is  then  more 
susceptible  to  the  irritation  of  the  adjoining  glands;  this 
will  not  hold  good  in  every  case,  for  there  are  coughs, 
as  before  remarked,  calling  for  Iron  that  are  increased  bjr 
going  into  a  cold  air  after  being  in  a  warm  one. 

With  this  patient  the  Ist  decimal  completely  failed  to 
subdue  the  cough,  and  we  were  obliged  to  resort  to  a  five- 
grain  dose  of  the  pure  powder  of  Phosphate  of  Iron^  which 
we  ordered  to  be  taken  dry  every  night  and  morning, 
and  this  very  soon  removed  the  cough,  brought  about 
natural  action  of  the  bowels,  and  arrested  the  inter-scapular 
pain. 

It  will  be  seen  that  the  dose  differs  from  that  required 
in  all  Our  other  cases ;  it  would  seem  that  the  phosphate  in 
substance  was  required  to  arrest  what  we  may  suppose  to 
have  been  a  long-lasting  change  in  the  gland  substance. 
We  might  argue  that  the  deeper  seated  the  lesion  the 
greater  the  dose ;  the  more  superficial  the  irritation  the 
less  the  dose ;  but  unhappily  we  cannot  lay  down  rules  so 
easily,  and  the  lesson  we  ought  to  learn  is  not  to  express 
ourselves  too  positively  as  to  the  relative  superiority  of 
either  high  or  low  dilutions. 

It  is  known,  alas  too  well  I  to  every  physician  that  the 
physical  signs  of  pneumonic  phthisis  may  be  absent,  and 
yet  that  if  in  a  young  girl  there  be  a  long-lasting  liability 
to  take  cold  with  a  constant  hacking  cough,  which  has 
been  present  from  childhood,  and  that  with  these  the 
cataraenia  be  scanty,  the  much  dreaded  consumption  roust 
be  expected.  Now  it  is  reasonable  to  suppose  that  a 
chronic  cuugh  like  this  did  not  take  origin  and  owe  its 
obstinacy  to  some  profounder  lesion  than  a  simple  irrita- 
bility of  the  laryngeal  mucous  membrane  inducing  spasm; 
even  assume  the  presence  of  irritability  of  the  pneumo- 
gastric  or  its  branches,  such  must  have  been  kept  agoing  by 
some  deep-seated  lesion,  and  what  more  likely  to  occasion 
it  than  a  tumefied  state  of  the  tracheal  and  bronchial 
lymphatics  ? 


by  Dr.  Robert  T.  Cooper.  431 

When  looking  over  notes  taken  from   Professor  Banks' 
Lectures  on  the  Practice  of  Medicine  in  the  University  of 
Dublin  I  was  very  much  struck  by  his  laying  special  stress 
upon  a  spasmodic  cough  causing  vomiting  of  food  as  being 
highly  indicative  of  the  commencement  of  the  first  stage  of 
phthisis  pulmonum^  and   we  all  know  that   even  indepen- 
dently of  our  individual  investigations  this  symptom   has 
been  universally  looked  upon  among  us  as  a  characteristic 
one  of  Irof%.     It  is  something   to  know   that  a  physician 
like  Dr.    Banks  has  watched  and  traced  up  this  identical 
symptom^  unaffected  as  it  would  be  by  non-specific  medica- 
tion, and  has  found  tuberculisation  of  the  lungs  to  follow 
directly  in  its  wane.     It  is  no  trivial  gain^  therefore,  to  be 
able  to  arrest  this  cough,  and  to  abort  the  morbific  condi- 
tion from  which  it  arises,  which  condition  we  believe  to  be 
an  irritability  of  the  mucous    membrane,  kept  agoing  by 
infected  material  deposited  in  the  neighbouring  absorbent 
glands.     The  importance  of  our  position   is   not  that  we 
have  shown  it  possible  for  a  spasmodic  cough  to  be  followed 
by  phthisis,  but  that  the  actual  cough  of  Iron,  the  cough 
with    vomiting    of   food,   not  alone  may  be  succeeded  by 
phthisis,  but  that  it  is  in  reality  symptomatic  of  the  initiatory 
stage  of  this  curse  of  mankind. 

Referring  again  to  William  H — 's  case  it  is  to  be  observed 
what  defined  and  palpable  laryngeal  symptoms  were  pre- 
sent; there  was  hoarseness  and  sense  of  tumefaction,  a 
suffocative  feeling,  or,  as  he  described  it,  difficulty  of 
breathing.  Dr.  George  Johnson,  in  the  British  Medical 
Journal,  January,  1874,  expresses  the  opinion  that  '^  there 
is  good  reason  to  believe  that  disease  beginning  in  the 
larynx  is  a  frequent  determining  and  exciting  cause  of 
disease  in  the  lungs.'^  During  the  last  ten  years,  since  I 
have  learnt  to  use  the  laryngoscope,  I  have  seen,  both  in 
hospital  and  in  private  practice,  a  large  number  of  cases  in 
which  chronic  disease  beginning  in  the  larynx  has  been 
followed  by  tubercular  disease  of  the  lungs.  These  cases 
come  under  the  designation  laryngeal  phthisis.^  This 
painful  and  fatal  malady  often  begins  with  a  neglected  cold. 
The  sore  throat  and  hoarseness  excited  by  exposure  to  cold 


432  On  the  Action  of  Iron^ 

and  wet  remain  for  weeks  and  months;  there  is  cough 
with  mucous  expectoration ;  perhaps  some  pain  and  diffi- 
culty in  swallowing;  and  there  may  be  more  or  less  stridor 
on  deep  inspiration. 

*'  Looking  at  the  larynx  with  the  mirror  the  most 
characteristic  appearance  consists  of  a  pale,  doughy,  cede- 
matous  thickening,  with  or  without  ulceration.  In  some 
cases  the  swelling  of  the  mucous  membrane  remains  for 
months  without  the  occurrence  of  ulceration.  In  the 
earlier  stages  of  this  laryngeal  affectiou  there  is  no  e?idence 
of  pulmonary  disease. 

'*  Haring  closely  observed  a  large  number  of  these  cases,  I 
have  gradually  arrived  at  the  conclusion  that  the  pulmonary 
disease  is  a  more  or  less  direct  result  of  the  pre-existing 
laryngeal  affection. 

'*  It  is  possible  that  the  morbid-infecting  materials  from 
an  ulcer  in  the  larynx  may  be  carried  directly  by  the 
inspiratory  current  of  air  into  the  interior  of  the  lungs, 
and  there  set  up  disease.'' 

This  he  mentions  as  one  mode  of  production  of  puU 
monary  from  laryngeal  disease,  the  other  being  through 
the  medium  of  the  lymphatics  and  blood-vessels ;  and  he 
cites  a  case  of  ulceration  of  the  tympanic  cavity  which  was 
followed  by  enlarged  lymphatics  below  the  damaged  ear, 
after  which  basic  consolidation  of  the  corresponding  lung 
showed  itself. 

We  have  not  proved,  but  is  it  not  extremely  likely,  that 
in  such  cases  as  William  H — 's,  where  the  irritation  and 
fulness  of  the  throat  had  existed  so  long,  there  may 
ensue  laryngeal  ulcerative  process,  leading  to  pulmonary 
complication  by  direct  infection  by  means  of  the  inspira- 
tory current  or  by  transmission  of  infection  through  the 
absorbents  ;  for  it  is  certain  that  such  irritation  as  existed 
in  the  larynx  would  be  in  time  quite  capable  of  inducing  a 
local  ulceration. 

And  again,  let  us  reflect  that  the  symptoms  in  William 
H — 's  case,  and  the  cough  in  the  case  of  the  dressmaker, 
arose  from  measles.  Now  a  cough  cannot  continue,  or,  which 
is  much  the  same  thing,  a  superficial  irritation  cannot  exist, 


by  Dr.  Robert  T.  Cooper.  438 

upon  a  macous  surface  in  a  girl  from  five  years  old  till 
twenty  without  there  being  present  some  substantive  lesion 
to  account  for  it;  so-called  functional  derangements  are 
becoming  more  and  more  things  of  the  past  as  morbid 
pathology  comes  more  to  be  studied.  We  have  suggested 
that  the  derangement  in  cases  like  this  may  be  a  bronchial 
adenopathy  either  induced  by  the  imperfect  elimination^  and 
therefore  retention^  of  the  morbilloos  poison  in  the 
absorbent  glands,  or  produced  during  the  continuance  of 
the  febrile  state  by  the  unnatural  strain  brought  to  bear 
upon  them.  It  will  be  interesting  to  see  how  far  the 
supposition  of  there  being  enlarged  glands  present  in  such 
cases  comports  with  all  we  know  of  measles,  and^  first, 
what  is  the  character  of  the  cough  of  measles?  It  is 
frequent,  occurs  in  parotysms,  is  often  accompanied  with 
hoarseness,  is  short  and  barking,  is  often  accompanied  by 
constriction  across  the  chest,  by  diarrhcea,  and  sometimes 
by  ischuria  (Aitken,  Prac.  of  Medicine,  vol.  i,  p.  457). 
The  cough  is  sequential  to  an  irritation,  which,  at  first 
attacking  the  conjunctival  and  nasal  mucous  membrane 
and  giving  rise  to  lachrymation,  coryza,  and  sneezing, 
extends  itself  to  the  larynx  and  trachea,*  and  that  its 
influence  is  deeper  seated  than  the  mere  superficies  of  the 
mucous  membrane  is  evident  from  cases  in  which  after  the 
eruption  has  subsided  we  find  structures,  such  as  the 
lymphatic  glands,  upon  which  the  irritation  had  presumably 
settled  during  a  continuance  of  the  febrile  condition,  to 
become  swollen  and  take  on  suppuration  or  even  to  become 
the  seat  of  caseous  deposit. 

"  In  strumous  patients  measles  may  end  in  the  develop-* 
ment  of  miliary  tubercles  in  the  lungs,  increHsing  cough, 
emaciation,  and  a  harsh  dry  skin  being  the  symptoms  of 
such  an  untoward  result.  The  catarrhal  affection  during 
the  desquamative  stage  forms  generally  the  connecting  link 
with  the  sequelte  of  measles ;  and  the  cough  often  remains 
for  weeks  or  months  (might  we  not  say  for  years? — B.T.C.) 
after  desquamation  is  over,  and  grows  worse  from  the  most 
trifling  causes.  It  may  depend  on  simple  bronthial 
catarrh,  or  on  severe  disease  of  the  luUgs.     The  nature  of 

VOL.  XXXII,  NO.  CXXIX. JULY,  1874.  E  E 


434  On  the  Action  of  Iron, 

that  disease,  however,  is  not  always  tabercle,  but  more 
often  a  caseous  transformation  and  disintegration  of  the 
products  of  lobular  pneumonia^  with  caseous  degeneration  of 
the  bronchial  glands,  one  of  the  most  common  complications 
of  measles  "  ( A.itkeu^  op.  cit.,  p.  461).  So  that  the  evidence 
of  pathology  fully  justifies  the  supposition  of  there  being 
present  degenerated  bronchial  (and  tracheal)  glands  in 
cases  of  chronic  cough  coming  on  after  measles,  which 
degeneration  the  Phosphate  of  Iron  would  seem  to  have 
dissipated  in  the  case  of  the  dressmaker  and  in  that  of 
William  H— . 

But  we  go  even  farther  when  we  assert  that  measles  is 
the  acute  form  of  the  condition  we  understand  by  the  term 
painless  irritability  of  fibre,  and  that  Iron  is  indicated  for 
what  we  may  assume  to  be  the  full  and  first  effects  of  the 
poison,  namely,  the  measles  itself,  and  for  the  lesser  symp- 
toms it  may  leave  behind,  and  also  for  symptoms  the  poison 
of  measles  may  occasion  in  those  fortified  from  its  typical 
effects  by  their  having  had  the  disease  at  a  former  period. 
The  poison  of  measles,  I  hold,  as  also  that  of  scarlatina, 
modifies  the  epidemic  constitution  of  disease.  Thus,  a 
greater  number  of  sore  throats  prevail  during  epidemics  of 
scarlatina  than  at  other  times,  and  sometimes  we  can  trace 
the  origin  of  these  to  the  infection  of  the  atmosphere  of 
the  fever  chamber;  so  with  erysipelas,  pysemia,  and 
puerperal  and  typhoid  fevers,  they  prevail  side  by  side  at 
one  and  the  same  time.  And  I  have  observed  that  during 
the  prevalence  of  measles  the  painless  irritability  of  fibre 
is  unusually  frequent ;  it  would  even  seem  that  the  irri- 
tability of  the  larynx  and  of  the*  neck  of  the  bladder  were 
an  indication  of  the  poison  of  measles  pervading  the  atmo- 
sphere, as  is  hypersemic  and  ulcerated  sore  throat  of  the 
prevalence  of  scarlet  fever.  I  do  not  deny — indeed,  facts 
seem  to  show — that  the  poison  either  of  measles  or  of  scar- 
latina may  produce,  or,  we  will  say,  lead  to  one  and  the 
same  grave  zymotic  diseases;  but  these  resulting  diseases 
will  be  characterised  by  differences  so  subtle  that  while 
their  symptoms  alone  may  not  teach  us  the  remedy,  an 
acquaintance  with  the  prevailing  miasm  will  lead  to  the 


by  Dr.  Robert  T.  Cooper,  435 

discovery  of  the  specific.  Acting  upon  this  supposition^  I 
prescribed  a  short  time  since  for  a  young  lady  whose  eyes 
were  affected  with  conjunctival  irritation,  lachrymation,  and 
increasing  myopia.  Acomtumy  Belladonna,  Arsenicum,  and 
(I  believe)  Euphrasia  had  been  givei»  in  vain.  Assuming 
my  theory  to  be  justly  founded,  that  a  specific  relationship 
existed  between  the  dynamic  action  of  Iron  and  that  of  the 
poison  of  measles,  I  prescribed  infinitesimal  doses  of  the 
Muriate  Tincture  of  Iron,  and  with  complete  success ;  the 
irritation  lessened  and  finally  ceased  altogether,  and  after 
some  weeks  natural  vision  became  restored.  Analogy 
would  lead  to  the  supposition  of  Iron  being  prophylactic 
against  measles,  a  particular  determinable  only  by  extensive 
and  accurate  statistical  evidence.  My  own  .observations 
would  goto  show,  but  they  are  too  few  and  not/8u£Sciently 
accurate  to  prove,  that  small  doses  of  /ron  hasten  the 
development  of  the  rash  of  measles,  lessen  the  congestion 
of  the  head,  subdue  the  cough,  and  diminish  the  ten- 
dency to  lung  complication.  After  what  had  passed  it  is 
almost  unnecessary  to  say  that  the  doses  in  which  Iron 
should  be  given  in  measles  ought  to  be  very  minute,  so  as  to 
guard  against  aggravation;  and  that  there  are  many  symptoms 
which  might  arise  in  an  attack  of  measles^  and  which  would 
call  for  other  remedies,  such,  for  instance^  as  Aconite, 
Arsenicum,  Hyoscyamus,  Pulsatilla,  &c.,  in  preference  to 
Iron,  we,  as  students  of  Hahnemann,  must  be  aware. 

I  have  observed  in  several  instances  that  patients 
suffering  from  painless  irritability  of  fibre  are  members  of 
the  same  family ;  thus^  I  have  known  mother  and  child, 
brother  and  sister,  and  father  and  son,  to  be  liable  to  its 
peculiar  effects,  so  that  it  would  seem  that,  as  in  tubercu- 
losis, an  hereditary  disposition  to  the  affection  can  exist ; 
in  whatever  direction,  therefore,  we  look  its  phthisical 
characteristics  are  manifest,  and  warrant  the  assertion  that 
it  is  often  the  incipient  stage  of  this  formidable  scourge. 

Gueneau  de  Mussy  points  out  that  engorgement  of  the 
bronchial  glands  may  aggravate  or  even  be  the  primary  cause 
of  asthma ;  and  if  we  look  at  an  article  on  asthma  in  the 
same  number  of  the  British  Medical  Journal  by  Dr.  Berk- 


436  On  the  Action  of  Iron, 

hart,  Assistant-Physician  to  the  Victoria  Park  Hospital  for 
Diseases  of  the  Chesty  we  find  him  concluding  by  saying 
that  asthma  is  a  symptom  dependent  upon  deficient 
elasticity^  preventing  the  expiratory  forces  overcoming  any 
obstacle  to  free  expiration ;  and  that  pressure  from  anj 
cause  (as  tumefied  glands  would  produce)  may  constitute 
such  obstacle,  and  lead  to  a  reduction  of  the  expiratory 
forces  of  the  bronchial  muscular  tissue,  and  by  acting  upon 
these  glands  it  is  evident  that  Iron  may  come  to  be  indicated 
in  asthmatical  cases,  and  such  we  may  suppose  to  have  been 
the  cause  of  the  dyspncea  in  Mrs.  O — 's  case. 

That  Iron  is  homoeopathically  related  to  some  of  the 
sequelse  of  measles  we  have  proved  beyond  a  doubt ;  that  it 
is  likewise  in  relationship  to  many  of  the  symptoms  of  the 
original  afiection  is  equally  certain ;  that  the  chief  pulmonary 
complications  accompanying  and  following  measles  arise 
primarily  from  implication  of  the  bronchial  glands,  a  con- 
dition for  which  Iron  is  appropriate  when  incipient  as  well 
as  when  chronic ;  that  influenzas  accompanied  by  lympha- 
denitis showing  upon  the  neck  most  positively  call  for  Iron, 
and  that  it  is  probable  the  lymphatic  complication  may  not 
appear  on  the  neck  and  yet  exist  along  the  course  of  the 
larynx  and  trachea,  giving  rise  to  hard,  hacking  cough,  and 
equally  indicative  of  Iron,  and  that  unarrested  this  con- 
dition proves  a  most  fruitful  source  of  tubercular  deposit  in 
the  lung,  and  probably  also,  from  the  tendency  of  the  irri- 
tability to  attack  internal  parts,  in  other  viscera  as  well ; 
that  the  peculiar  irritability  to  which  it  is  related  is  as  much 
a  septicsemic  disease  as  are  the  better  known  affections  of 
this  class,  viz.  erysipelas,  pyaemia,  hospital  gangrene,  &c. ; 
that  as  the  symptoms  of  it  are  easily  determinable  from  the 
first,  our  being  familiarised  with  these  symptoms  will  enable 
us  to  guard  in  time  against  the  serioua  consequences  that,  if 
it  remained  unarrested,  might  ensue  ;  that  its  prevalence  at 
any  one  season  of  the  year  will  enable  us  to  determine  the 
nature  of  the  epidemic  constitution  of  disease  then  present ; 
that  appearing  at  the  commencement  of  any  season  of 
the  year  it  will  warn  us  of  the  nature  of  the  epidemic  we 
may  expect  to  follow,  and  at  the  end  of  a  season  of  epi- 


by  Dt.  Robert  T.  Cooper.  487 

demic  may  afford  proof  of  the  nature  of  the  diseases  that 
have  prevailed. 

la  looking  back  upon  what  we  have  written  upon  the 
action  of  Iron,  our  only  fear  is  that  the  indications,  we  have 
given  for  its  administration  may  be  abused,  and  that  Iron 
may  be  given  for  coughs  where  it  is  not  called  for ;  and 
though  we  ourselves  have  no  difficulty  in  applying  our  indi- 
cations in  practice,  it  is  yet  extremely  difficult  so  to  convey 
the  information  we  want  to  on  paper  as  to  prevent  any 
misapprehension  arising.  We  therefore  again  lay  stress 
upon  the  assertion  that  the  coughs  and  vesical  irritabilities 
for  which  Iron  is  appropriate  will  be  found  more  frequently 
present  when  epidemics  of  measles  are  about,  and  therefore 
in  the  autumn  and  winter  months  than  at  any  other  time 
of  year ;  its  glandular  iuflammations  are  all  characterised 
by  a  sharpness  and  sensitiveness  of  the  tissues  involved  that 
places  Iron  midway  between  Belladonna  and  Arsenicum. 
The  points  of  variation  between  the  conditions  produced  by 
Iron  and  those  produced  by  some  other  drugs  are  so  fine  and 
subtle  as  to  render  the  paper  description  of  them  im- 
possible ;  but,  fortunately,  they  are  easily  recognisable  in 
practice. 

We  have  omitted  mentioning  another  part  of  the 
system  which  is  subject  to  irritability  calling  for  Iron — this 
is  the  walls  of  the  aorta.  I  have  had  a  very  striking  case 
related  to  me  from  the  practice  of  Dr.  McDowel,  of  the 
Richmond  Hospital,  in  Dublin,  where  Iron  proved  imme- 
diately remedial  in  this  distressing  affection.  The  pathology 
of  aortic  irritability  when  it  attacks  the  outer  walls  of  the 
vessel  would  seem  to  be  the  form  that  specially  calls  for /ran,  for 
the  external  coats  are  seldom  inflamed^  '^  except  when  inflam- 
mation or  ulceration  of  the  adjoining  lymphatic  glands,  the 
trachea  or  other  neighbouring  organs,  extends  into  the  aorta.'' 
(Aitken,  on  the  authority  of  Niemeyer.) 

The  throat  symptoms  of  Iron  must  be  distinguished 
from  those  that  characterise  Belladonna^  MercurtM,  Baryta 
carboniea ;  these  seem  to  affect  the  upper  part  of  the  throat 
more  than  the  lower ;  still,  Iron  is  nearly  associated  with 
them,  but  more  so  with  Alumina,  Arnica,  and  Ipecacuanha. 


438  On  the  Action  of  Iron, 

It  is  extraordinarji  Snelling  remarks  {vide  HulPs  Jdhr. 
art.  Alumina),  that  Alumina  is  not  more  frequently  used 
in  chronic  affections  if  we  take  into  consideration  the 
careful  proving  it  has  been  submitted  to.  We  would  ask 
particular  attention  to  Testers  observations  upon  this  drug. 
He  assures  us  that  he  has  seen  a  few  doses  excite  and 
maintain  for  two  months  in  succession  a  tearing  cough, 
every  paroxysm  of  which  was  accompanied  by  involuntary 
emission  of  urine^  which  reduced  the  patient  to  despair. 
Upon  this  Peters^  with  barefaced  effrontery,  remarks  that 
<<  every  physician  in  full  practice  must  have  met  with  such 
cases  in  which  no  Alumina  had  been  given/'  All  the  more 
reason,  one  would  think,  for  a  believer  in  the  law  of  similars 
to  look  upon  the  symptom  as  an  important  one.  Peters, 
without  being  aware  of  it,  proceeds  to  furnish  us  with 
evidence  proving  the  correctness  of  Teste's  observation,  for 
he  goes  on  to  say  that  Alumina  is  homcsopathic  to  the  dry, 
irritating  cough  which  occurs  in  the  first  stage  of  phthisis 
from  scrofulous  irritation  of  the  pharyngeal  and  laryngeal 
mucous  membrane — just  what  we  might  suppose,  allowing 
that  it  produces  the  cough  Teste  says  it  does. 

Seeing  that  Alumina  is,  in  all  probability,  among  the 
remedies  for  this  painless  irritability,  we  may  expect,  should 
this  relationship  be  confirmed,  that  it  will  exert  an  anti- 
dotal effect  over  Iron — this,  however,  we  have  not  verified. 

As  the  opportunity  may  not  occur  again,  we  feel  sure 
our  readers  will  excuse  us  in  stepping  out  of  our  way  to 
quote  a  case  in  which  Alumina  exerted  most  decided 
beneficial  effects  in  chronic  lead  poisoning.  Through  what 
channel  the  lead  was  introduced  into  the  system  in  the  case 
in  question  did  not  appear  evident.  The  patient,  a  woman 
whose  age  was  fifty-three,  and  the  subject  of  regular  cata- 
menial  flow,  was  affected  with  manifest  wrist-drop  on  both 
sides  with  swollen  finger-joints,  swollen  knee  on  the  right 
side,  and  with  liability  of  the  feet,  even  the  soles,  to  swell;  the 
digestive  system  was  good,  except  for  attacks  of  biliousness 
and  occasional  but  severe  sickness.  The  limbs  were  weak^ 
and  always  became  swollen  after  walking.  The  only 
history  we  could  obtain  was  that  sixteen  years  ago  she  had 


by  Dr.  Robert  T.  Cooper.  439 

liad  an  attack  of  colic  and  cramp  in  the  legs^  from  which 
she  imperfectly  recovered ;  and  one  year  ago,  and  from  no 
cause  she  could  account  for,  a  still  worse  attack  presented 
itself  with  pains  in  the  back  and  all  over  the  body,  severe 
colic  and  tingling  in  the  fingers,  followed  by  loss  of  use  of 
her  hands.  The  gums  receded  from  the  teeth,  which  were 
dropping  out  when  I  saw  her ;  the  dental  discoloration  was 
but  faintly  observable.  In  this  case  the  2nd  decimal 
trituration  of  Alumina  removed  the  numbness  of  the  hands^ 
strengthened  the  legs,  and  diminished  the  swelling  in  the 
feet  ;  the  hands,  however,  were  still  weak  when  I  was 
leaving  Southampton,  after  being  under  Alumina  for  two 
months. 

It  struck  me  as  very  remarkable  the  rapid  improvement 
that  took  place  in  a  case  so  chronic  as  this,  and  where  the 
lead  had  so  completely  ingrained  itself  upon  the  system ; 
the  patient  had  been  for  a  long  time  treated  at  the  Boyal 
South  Hants  Infirmary  without  relief. 

The  importance  of  showing  that  Iron  exerts  a  positive 
effect  upon  the  lymphatic  system  will  be  apparent  now  that 
we  come  to  discuss  its  heematosic  action.  All  observers 
admit  that  between  the  lymphatic  system  and  chloro- 
ansemic  conditions  there  exists  a  very  intimate  connection. 
Yirchow  suspected,  from  finding  the  spleen  so  frequently 
enlarged,  that  the  affection  he  termed  leucaemia  owed  its 
origin  to  some  alteration  in  the  functional  activity  of  the 
lymphatic  glands;  and  other  observers  have  proved  the 
possibility  of  such  an  occurrence  by  demonstrating  that  one 
of  the  functions  of  these  glands  is  the  regulation  of  the 
cellular  constituents  of  the  blood.  Yirchow  brought  forward 
cases  where  an  increase  in  the  colourless  elements  of  the 
blood  was  met  with  as  a  coincidence  of  simple  hypertrophy 
of  the  lymphatic  glands.  Since  that  time  this  important 
function  of  the  lymphatics  has  been  confirmed  and  illus- 
trated by  various  authors,  by  Bennett  and  others ;  but  it 
remained  for  Eolliker  to  furnish  us  with  anatomical  proof 
of  this,  supported  by  which  Briicke^  Donders^  and  other 
well-known  physiologists  have  expressed  themselves  unani- 
mously in  favour  of  the  hypothesis  that  the  elements  of  the 


440  On  the  Action  of  Iron, 

lymphatic  glands  go  over  into  the  chyle  and  lymph.  (From 
Kolliker's  Microscopic  Anatomy ^  p.  512.) 

Professor  Draper,  of  New  York  {Human  Physiology,  p. 
118),  describes  the  mesenteric  glands  as  the  original  place 
of  formation  of  the  blood^^cells,  and  states  that  the  cells 
become  perfected  in  the  circulation  of  the  blood. 

Now,  it  is  evident  that  if  we  prove  nothing  more  than 
that  Iron  is  indicated  where  the  lymphatic  glands  are 
swollen  and  tender,  we  have  done  little  more  than  sub- 
stantiate what  this  inquiry  has  over  and  over  again  brought 
to  light,  the  exceedingly  obvious  similarity  existing  between 
the  action  of  Iron  and  that  of  Arsenic,  for  we  know  that 
the  curative  sphere  of  the  latter  comprehends  within  it 
many  diseases  in  which  the  lymphatic  glands  are  known  to 
be  involved  ;  for  example,  tabes  mesenterica,  in  which  oom> 
plaint  the  Iodide  of  Arsenic  acts  with  surprising  efficiency. 
But  if  we  compare  the  systemic  actions  of  these  two  reme- 
dies in  contradistinction  to  their  local  actions  we  must  be 
struck  by  the  very  great  and  obvious  curative  differences 
we  find  between  them ;  so  much  so  that  we  are  compelled 
to  look  to  something  beyond  the  mere  structural  alteration 
effected  in  the  lymphatic  glands  themselves,  and  to  assume 
the  production  of  alteration  in  the  constituents  of  the  blood 
itself  for  a  hypothetical  explanation  of  the  phenomena.  I 
am  of  opinion — an  opinion  that  remains  for  the  chemist  to 
confirm  or  disallow — that  the  affinity  existing  between  Iron 
and  Sulphur  has  much  to  do  with  its  remedial  virtues  in 
chlorosis;  that  its  action  is,  by  reason  of  homceopathic 
relationship,  in  the  first  place,  dynamic,  setting  to  right  the 
perverted  function  of  the  lymphatic  glands  themselves,  and 
facilitating  transudation  through  the  capillary  walls ;  and,  in 
the  second  place,  chemical,  adding  iron  particles  to  the 
blood  and  uniting  with  Sulphur ;  however,  I  put  this 
forward  as  mere  hypothesis,  and  as  being  unsupported  by 
any  reliable  testimony*  Still  it  is  a  fact  that  we  find  that 
most  of  the  metals  seem  to  unite  with  StUphur  in  the  tissues  ; 
witness  the  black  dental  discoloration  of  Lead,  and  the 
greenish  discoloration  of  Copper ;  look  how  Iron  blackens 
the  stools,  and  how  Sulphur  does  so  too,  showing  that  they 


by  Dr,  Robert  T.  Cooper.  441 

continue  to  exert  within  the  body  that  affinity  we  know 
them  to  possess  outside  of  it ;  and  even  the  black  discolora* 
tion  of  the  skin  produced  by  Nitrate  of  Silver  is  probably 
owing  to  the  formation  of  a  sulphide  of  the  metal ;  but  all 
other  metals  would  appear  to  differ  from  Iron  in  that  in 
abstracting  the  Sulphur  the  resulting  combination  exerts  a 
deleterious  rather  than^  like  it^  a  beneficial  effect  upon  the 
process  of  cell-formation  within  the  lymphatic  system ;  they 
render  the  blood  poorer  in  oxidized  materials  while  Iron 
enriches  it,  and  even  in  health  (up  to  a  certain  point) 
arterialises  it. 

In  studying  Iron^  on  the  principles  of  specific  medicine, 
we  musty  save  in  the  chloro-ansemic  department  of  its 
actioui  shut  out  from  view  all  former  acquaintance  with  the 
drug  as  we  knew  of  it  in  our  allopathic  days;  we  must  take 
it  in  hand  as  though  we  had  met  with  it  for  the  first 
time;  as  though,  in  fact,  it  were  a  stranger  with  whom 
we  had  had  but  limited  dealings,  otherwise  we  can  never 
learn  its  true  specific  action.  It  is  from  supposing  that 
strong  solutions  of  Iron  can  be  given  by  the  wineglassful 
without  producing  any  medicinal  effects  that  we  have  come 
to  look  upon  it  as  a  mere  tonic^  and  as  almost  useless  for 
the  purposes  of  specific  medication,  whereas  the  very 
reverse  is  the  truth,  and  Iron  ought  to  be  placed  among  the 
most  useful  homceopathic  remedies  we  possess,  a  possession 
as  cheap  as  it  is  valuable,  all  but  as  common  fts  clay,  and 
yet  more  precious  than  gold. 

We  must  not  conclude  this  article  without  referring  to 
the  hepatic  and  nephritic  action  of  Iron ;  in  hypersesthesia 
of  the  liver  and  kidney  Iron  will  be  called  for ;  it  will  be 
found  an  indispensable  remedy  where  the  kidneys  seem  to 
act  very  quickly,  and  where  drink,  especially  warm  drink,  of 
any  sort  passes  off  as  light-coloured  and  watery  urine  so 
soon  as  it  is  imbibed ;  so,  also,  where  the  liver  is  tender 
and  dull  right  side  pain,  with  sharp  aggravating  cough,  is 
complained  of,  and  where  the  larger  bowel  shows  its 
sympathising  effect  by  discharging  a  small  quantity  of 
blood  at  each  stool,  or  where  it  takes  on  a  similar  morbid 
condition  to  that  existing  in  the  liver,  and  discharges  its 


442  Rabies  Mephilica, 

contents  either  as  water  or  as  undigested  food  immediately 
after  meals,  especially  again  after  warm  food^  as  warm 
cocoa  or  tea ;  in  these  incipient  inflammations  Iron  acts 
with  surprising  rapidity;  it,  in  fact,  renders  the  organ  it 
exerts  an  influence  upon  impatient  of  its  contents;  the 
words  impatience  and  irritability  being  expressive  both  of 
the  mental  and  bodily  condition  of  those  patients  whose 
affections  require  its  specific  action.  The  brain  is  thrown 
into  precisely  the  same  condition  of  hyper-excitability  as 
the  liver  and  kidneys,  the  bowel,  womb,  and  bladder ;  there 
may  be  a  dull  heavy  pain  across  the  forehead^  which  is 
always  worse  on  getting  up  in  the  morning,  but  except  for 
this  and  a  feeling  of  uncomfortable  heat^  no  pain  exists  with 
the  affection  we  are  considering ;  the  brain  rejects  impres- 
sions, or  tries  to  do  so,  as  they  are  thrown  upon  it,  and 
everything  causing  excitement  in  it  is  unpleasant  and  irri- 
tating beyond  what  is  usual ;  in  all  this  we  see  a  resem- 
blance to  Belladonna,  but  the  skilful  student  of  the  Materia 
Medica  will  have  no  difficulty  in  choosing  between  them. 


RABIES  MEPHITICA  * 

By  the  Rev.  Horace  Hovby,  M.A. 

Mt  subject  concerns  alike  medical  science  and  natural 
history.  For  while  proving  the  existence  of  a  new  disease, 
some  singular  facts  will  be  brought  to  light  about  a  familiar 
member  of  the  American  fauna.  It  is  cruel  to  add  aught 
to  the  odium  already  attached  to  the  common  skunk 
{Mephitis  mephiiica,  Shaw;  M.  chinga^  Tiedmann),  but, 
clearly,  he  is  as  dangerous  as  he  is  disagreeable.  In  a 
wild  state  he  is  by  no  means  the  weak,  timid,  harmless 
creature  commonly    described   by   naturalists,   although  it 

*  From  the  American  Journal  of  Science  and  Arts,  May,  1874. 


by  Rev.  Horace  Hovey.  443 

is  said  that  if  disarmed  of  his  weapons  of  defence  while 
young  he  may  be  safely  domesticated. 

A  peculiar  poison  is  sometimes  contained  in  the  saliya  of 
animals  belonging  to  the  canine  and  feline  families,  the 
production  of  which,  it  has  been  generally  supposed^  is  limited 
to  them.  Other  animals  of  the  same  or  of  different  species 
may  be  inoculated  with  this  virus^  the  result  being  a 
mysterious  malady  which  men  have  observed  from  the  days 
of  Homer  and  Aristotle,  but  which  has  never  been  either 
cured  or  understood.  This  frightful  disease  has  been 
called,  from  its  origin,  Rabies  canina,  and  from  one  of  its 
symptoms,  hydrophobia.  Probably  it  is  not  communicable 
by  any  species  but  those  with  which  it  originates.  A  few 
instances  have  been  recorded  to  the  contrary ;  but  they 
were  so  imperfectly  observed  as  merely  to  stimulate  us  to 
further  investigation.  It  is  stated  by  the  best  medical 
writers  (e.  ff.  Watson,  Gross,  and  Aitken)  as  an  undeniable 
fact  that  no  instance  is  known  of  hydrophobia  having  been 
communicated  from  one  human  being  to  another,  although 
many  patients,  in  their  spasms,  have  bitten  their  attendants. 
An  interesting  case,  but  inconclusive,  being  the  only  one  of 
its  kind,  is  reported  by  M.  Ouillory,  in  which  an  aged  man 
experienced  spontaneous  hydrophobia  {Bulletin  of  Belgian 
Academy,  Nov.  8th,  1871). 

In  such  exceptional  instances  there  may  have  been 
previous  inoculation,  unnoticed  or  forgotten ;  for  the  least 
particle  of  this  deadly  poison  will  be  efficient,  and  yet  it  is 
always  tardy  in  its  period  of  incubation. 

The  facts  now  collated  will  show,  it  is  thought,  one  of  two 
things — either  that  the  hydrophobic  virus  is  both  generated 
and  communicated  by  some  of  the  MustelidiS,  as  well  as  the 
Felida  and  Canida,  or  else  that  a  new  disease  has  been 
discovered,  which  generally  resembles  Rabies  eaninay  while 
differing  from  it  specifically.  My  judgment  favours  the 
latter  opinion  decidedly,  for  reasons  to  be  adduced ;  and 
accordingly  I  may  name  this  new  malady,  from  the  animal 
in  whose  saliva  it  is  generated, 


441  Rabies  Mephitica, 


Rabies  Mephitica. 

Tbe  varieties  of  mephitis  are  notorious  for  the  singular 
battery  with  which  they  are  provided  by  nature.  It  consists 
of  two  anal  glands,  from  which,  by  the  contraction  of  sub- 
caudal  muscles,  an  offensive  fluid  can  be  discharged  in 
thread-like  streams  with  such  accuracy  of  aim  as  to  strike 
any  object  within  fifteen  feet.  This  secretion  is  either 
colourless  or  of  a  pale  yellow  hue.  It  is  phosphorescent ; 
viewed  from  a  safe  distance,  its  discharge  looks  like  a  puflT 
of  steam  or  white  smoke.  Its  odour  is  far  more  persistent 
than  that  of  musk.  If  too  freely  inhaled  it  causes  intense 
nausea,  followed  by  distressing  gastric  cramp.  In  minute 
doses  it  is  said  to  be  a  valuable  anti-spasmodic.  If  so, 
why  not  experiment  with  it  as  a  cure  for  hydrophobic  con- 
fulsions  7  It  is  not  known  what  the  effect  would  be  of 
injecting  this  fluid  beneath  the  skin.  Interesting  results 
might  be  attained  by  any  one  who  was  willing  in  behalf  of 
science  to  investigate  further  in  this  inviting  path.  There 
certainly  seems  to  be  some  connection  between  it  and  the 
disease  under  consideration ;  for  in  every  instance  the  rabid 
skunk  has  either  exhausted  his  mephitic  battery,  or  else 
has  lost  the  projectile  force  by  which  it  is  dischau^ed. 
Perhaps  the  secretion  is  only  checked  by  the  feverish  state 
of  the  system.  Possibly  there  may  be  a  causative 
connection  between  this  inactivity  of  the  anal  glands  and 
the  generation  of  malignant  virus  in  the  glands  of  the 
mouth. 

An  adventure,  while  on  a  summer  tour  amid  the  Rocky 
Mountains,  first  called  my  attention  to  the  novel  class  of  facts 
about  to  be  presented.  Our  camp  was  invaded  by  a  noo- 
turnsl  prowler,  which  proved  to  be  a  large  coal-black  skunk. 
A^nxious  to  secure  his  fine  silky  fur  uninjured,  I  attempted 
to  kill  him  with  small  shot  and  failed.  He  made  churac- 
teristic  retaliation,  and  then,  rushing  at  me  with  ferocity, 
he  seized  the  muzzle  of  my  gun  between  his  teeth.  Of 
course  the  penalty  was  instant  death.  An  experienced 
huuter  then  startled  us  by  saying  that  the  bite  of  this 


by  Rev,  Horace  Hovey.  445 

animal  is  invariably  fatal^  and  that  when  in  apparent  perfect 
health  it  is  always  rabid.  He  resented  our  incredulity  and 
confirmed  his  statement  by  several  instances  of  dogs  and 
men  dying  in  convulsions  shortly  after  having  been  thus 
bitten. 

On  mentioning  this  adventure  to  H.  B.  Payne^  M.D.,  who 
had  been  camping  with  miners  near  Canon  City,  Colorado, 
he  said  that  at  night  skunks  would  come  into  their  tent, 
making  a  peculiar  crying  noise,  and  threatening  to  attack  them. 
His  companions,  from  Texas  and  elsewhere,  had  accounts 
to  give  of  fatal  results  following  the  bite  of  this  animal. 

Since  returning  to  Kansas  City,  I  have  had  extensive 
correspondence  with  hunters,  taxidermists,  surgeons,  and 
others,  by  which  means  the  particulars  have  been  obtained 
of  forty-one  cases  of  Rabies  mephitica  occurring  in  Virginia, 
Michigan,  Illinois,  Kansas,  Missouri,  Colorado,  and  Texas. 
All  were  fatal  except  one,  that  was  the  case  of  a  farmer 
named  Fletcher,  living  near  Oainsville,  Texas,  who  was 
twice  bitten  by  3f.  macroura,  yet  recovered  and  is  living 
still.  On  further  inquiry  it  was  found  that  he  was  aware 
of  his  danger,  and  used  prompt  preventive  treatment. 
Another  case  was  alleged  to  be  an  exception — that  of  a 
dog  which  was  severely  bitten  in  a  long  fight  with  a  skunk, 
but  whose  wounds  healed  readily  and  without  subsequent 
disease.  It  seems,  however,  that  this  dog  afterwards  died 
with  mysterious  symptoms  like  those  of  hydrophobia  in 
some  of  its  less  aggravated  forms. 

Instead  of  burdening  this  article  with  a  mass  of  circum- 
stantial details,  a  few  cases  only  will  be  given,  best  fitted  to 
show  the  peculiarities  of  the  malady,  and  those  are  pre- 
ferred that  are  located  on  the  almost  uninhabited  plains  of 
Western  Kansas,  because  there  the  mephitic  weasels 
would  be  least  liable  to  be  inoculated  with  canine  virus. 

A  veteran  hunter,  Nathaniel  Douglas,  was  hunting 
bufialo,  in  June,  1873,  fourteen  miles  north  of  Park's  Fort. 
While  asleep  he  was  bitten  on  the  thumb  by  a  skunk. 
Fourteen  days  afterwards  singular  sensations  caused  him  to 
seek  medical  advice ;  but  it  was  too  late,  and  after  convul- 
sions lasting  for  ten  hours  he  died.      This  case  is  reported 


446  Rabies  Mephiiica, 

by  an  eye-witness^  Mr.  E.  S.  Love,  of  Wyanditte,  Kansas, 
who  also  gives  several  similar  accounts. 

One  of  the  men  employed  by  H.  P.  Wilson,  Esq.,  of 
Hayes  City,  Kansas,  was  bitten  by  a  skunk  at  ni^ht  while 
herding  cattle  in  the  plains.  About  ten  days  afterwards  he 
was  seized  with  delirium  and  fearful  convulsions,  which 
followed  each  other  until  death  brought  relief.  Mr. 
Wilson  also  reports  other  cases,  one  of  which  is  very  recent. 
In  the  summer  of  1878  a  Swedish  girl  was  bitten  by  a 
skunk  while  going  to  a  neighbour's  house.  As  the  wound 
was  slight  and  readily  cured  the  affair  was  hardly  thought 
worthy  of  remembrance.  But  on  January  24th,  1874^  the 
virus,  which  had  been  latent  for  five  months,  asserted  its 
power.  She  was  seized  with  terrible  paroxysms ;  large 
doses  of  Morphine  were  administered,  which  ended  both  her 
agony  and  her  life. 

In  October,  I87I,  a  hunter  on  Walnut  Creek,  Kansas, 
was  awakened  by  having  his  left  ear  bitten  by  some  animal ; 
seizing  it  with  his  hand,  he  found  it  to  be  a  skunk,  which 
after  a  struggle  he  killed,  but  not  until  his  hand  was  pain- 
fully punctured  and  lacerated.  He  presented  himself  for 
treatment  to  Dr.  J.  H.  Janeway,  army  surgeon  at  Fort 
Hayes,  from  whom  I  have  the  facts.  The  wounds  in  the 
hands  were  cauterized,  much  to  the  man's  disgust,  who 
thought  simple  dressing  sufficient.  He  refused  to  have  the 
wound  in  the  ear  touched,  and  went  to  Fort  Harker,  to 
consult  Dr.  R.  C.  Brewer.  Twelve  days  after  the  latter 
reported  that  his  patient  had  died  with  hydrophobic  symp- 
toms. Another  hunter  in  the  fall  of  1872  applied  to  Dr. 
Janeway  to  be  treated  for  a  bite  through  one  of  the  alse  of 
the  nose.  He  had  been  attacked  by  a  skunk  while  in  camp 
on  the  Smoky  River,  two  nights  previous.  He  had  been 
imbibing  stimulants  freely  and  was  highly  excited  and 
nervous.  A  stick  of  nitrate  of  silver  was  passed  through 
the  wound  several  times.  He  was  kept  under  treatment 
for  two  days,  when  he  left  to  have  a  '^  madstone  "  applied. 
He  afterwards  went  home  to  his  ranch  and  died  in  convul- 
sions twenty-one  days  from  the  time  he  was  inoculated. 

I  give  but  one  more  of  the  cases  reported  to  me  by 


by  Rev,  Horace  Hovey,  447 

Dr.  Janeway.  In  October^  1871,  he  was  called  to  see  a 
young  man  living  in  a  '^  dug-out ''  a  few  miles  from  the 
fort.  He  had  been  bitten  by  a  skunk^  seventeen  days 
previous,  in  the  little  finger  of  the  left  hand.  His  face 
was  .flushed  and  he  complained  that  his  throat  seemed  to 
be  turning  into  bone.  On  hearing  the  sound  of  water 
poured  from  a  pail  into  a  tin  cup,  he  went  into  convulsions 
that  followed  each  other  with  rapidity  and  violence  for 
sixteen  hours,  terminating  in  death.  This  man's  dog  had 
also  been  bitten,  and  it  was  suggested  that  he  had  better 
be  shut  up.  He  chanced  at  the  time  to  be  in  the  hog  pen, 
and  he  was  confined  in  that  enclosure.  Ere  long  he  began 
to  gnaw  furiously  at  the  nails  and  posts  of  the  pen,  and  to 
bite  the  hogs,  until  the  by-standers,  convinced  that  he  was 
mad,  ended  the  scene  by  shooting  all  the  animals  in  the 
pen. 

It  is  evidently  the  opinion  of  Dr.  Janeway  that  the 
malady  produced  by  mephitic  virus  is  simply  hydrophobia. 
Should  he  be  correct,  then  all  that  is  established  by  these 
facts  would  be  this,  viz.,  that  henceforth  the  varieties  of 
Mephitis  must  be  classed  with  those  animals  that  sponta- 
neously generate  poison  in  the  glands  of  the  mouth  and 
communicate  it  by  salivary  inoculation.  From  this,  as  a 
starting-point,  we  might  go  further  and  see  a  solution  of 
the  whole  mystery  of  hydrophobia  in  the  theory  that  this 
dread  malady  primarily  originates  with  the  allied  genera  of 
M^hitis  puiorius  and  Mtistela,  widely  scattered  over  the 
earth,  being  from  them  transferred  to  Felida  and  Canida, 
and  other  families  of  animals. 

And  then  if  it  could  be  proved,  experimentally,  that  the 
characteristic  mephitic  secretions  contained  an  antidote  for 
the  virus  of  the  saliva  we  should  have  the  whole  subject 
arranged  very  beautifully.  I  am  favoured  by  Dr.  M.  M. 
Shearer,  Surgeon  in  the  6th  U.  S.  Cavalry,  with  notes 
from  his  case-book,  of  font  cases  in  which  persons  have 
died  from  the  bite  of  the  skunk  ;  and  he  also  mentions 
additional  instances  reported  to  him  by  other  observers. 
He  thinks  there  is  a  marked  difference  between  the  symp- 
toms of  this  malady  and  those   of  hydrophobia.      I   shall 


448  Rabies  Mephiiica^ 

refer  to  this  testimony  again,  but  pause  for  a  moment  to 
notice  his  final  conclusionsi  from  which^  original  and 
interesting  as  they  are^  I  must  dissent.  He  says — **  I 
regard  this  virus  as  being  as  peculiar  to  the  skunk  as  the 
▼enom  of  the  rattlesnake  is  to  that  creature,  and  not  an 
occasional  outbreak  of  disease  as  the  astus  veneris  of  the 
wolf  or  the  rabies  canina/'  Singular  as  this  theory  may 
seem^  it  is  not  wholly  without  support*  It  is  remarkable 
that  of  all  the  cases  thus  far  reported  to  me^  there  is  but 
one  instance  of  recovery.  It  is  stated  in  fFatson*s  Physic 
(yol.  iy  p.  615)  that  of  one  hundred  and  fourteen  bitten  by 
rabid  wolves  only  sixty-seven  died ;  and  of  those  bitten  by 
rabid  dogs  the  proportion  is  still  less.  But  mephitic 
inoculation  is  a  sure  death.  Then,  again^  it  is  to  be 
observed  that  the  only  peculiarity  noticeable  in  these  biting 
skunks  is  the  arrest  of  their  effluvium.  They  approach 
stealthily,  while  their  victims  are  asleep,  and  inflict  the 
deadly  wound  upon  some  minor  member^— the  thumb,  the 
little  finger,  the  lobe  of  the  ear,  one  of  the  al»  of  the  nose. 
How  different  from  the  fierce  assault  of  a  mad  dog  !  how 
subtle  and  snakelike  I  It  may  be  remarked  also  that  dogs 
are  generally  as  cautious  and  adroit  in  attacking  these 
odious  animals  as  they  are  in  seizing  venomous  snakes. 
But  we  must  remember,  on  the  other  hand,  that  thousands 
of  skunks  are  killed  annually,  partly  as  pests  and  partly  for 
the  fur  trade ;  and  it  is  incredible  that  an  animal,  whose 
ordinary  bite  is  as  venomous  as  that  of  a  rattlesnake, 
should  so  seldom  resort  to  that  mode  of  defence  if  it  be 
his.  The  resulting  disease  resembles  hydrophobia  more 
than  it  does  the  effect  of  ophidian  venom.  But  here,  as 
observed  at  the  outset,  the  likeness  is  only  generic,  while 
specifically  there  are  marked  differences.  These  have  pur- 
posely been  kept  in  the  background  until  now,  and  in 
giving  a  differential  diagnosis  I  shall  avoid  repetitious 
details,  and  combine  facts  gathered  from  many  sources  with 
the  close  and  accurate  observation  which  Dr.  Shearer  has 
put  at  my  disposal. 

1.  The  period  of  incubation  is  alike  in  Rabies  canina 
and  Rabies  mephiiica :  that  is,  it  is  indefinite,  ranging  from 


by  Bev»  Horace  Hovey.  449 

ten  days  to  twelve  months^  with  no  opportunity  meanwhile 
for  subsequent  inoculation.  But  during  the  incubatiye  period 
of  R.  mephitica  no  perceptible  changes  take  place  in  the 
constitution  as  in  hydrophobia.  In  only  one  instance  was 
there  unusual  nervousness^  and  that  might  have  been  due 
to  alcohol.  In  every  case  where  there  was  time  for  it  the 
wonnds  healed  over  smoothly  and  permanently^  and  in 
several  instances  not  even  a  scar  was  visible.  In  no  case  was 
there  the  recrudescence  of  the  wound  always  seen  in  hydro- 
phobia; indeed,  there  were  even  so  few  premonitions  of 
any  kind  that  in  most  instances  the  attendant  physicians 
themselves  supposed  the  ailment  to  be  simple  and  trivial^ 
until  the  sudden  and  fearful  convulsions  came  on  to  baffle 
all  their  skill. 

2.  Characteristic  pustules  form^  in  hydrophobia^  beneath 
the  tongue  and  near  the  orifices  of  the  submaxillary  glands 
(see  Aitken,  Science  and  Practice  of  Medicine,  vol.  i, 
p.  663).  These  were  not  reported  in  a  siqgle  case  of  it. 
mephitica.  Dr.  Shearer  looked  for  them  carefully  in  all  his 
cases,  but  did  not  find  them. 

8.  The  specific  action  of  hydrophobic  virus  affects  the 
eighth  pair  of  cranial  nerves  and  their  branches^  especially 
the  (esophageal  branchy  the  result  being  great  difficulty 
in  swallowiug ;  and  the  motor  nerve  of  the  larynx^  caus- 
ing sighing,  catching  of  the  breathy  and  difficulty  in 
expelling  the  frothy  mucus  accumulated  in  the  throat. 
These  invariable  accompaniments  of  JR.  canina  are  usually 
wanting  in  R.  mephitica,  the  exceptions  being  in  the  case 
of  the  Swedish  girl,  who  complained  of  pain  in  her  chest ; 
and  the  young  man.  Dr.  Janeway's  patient,  whose  constric- 
tion of  the  throat  was  decided,  as  well  as  his  sensitiveness  to 
water.  Dr.  Shearer's  patients  had  no  such  trouble. 
A  taxidermist,  who  had  seen  four  dogs  die  from  R. 
mephitica,  in  Michigan,  says  they  did  not  seem  to  have 
any  fear  of  water,  or  other  signs  which  he  had  supposed 
were  characteristic  of  JR.  canina.  Ordinary  hydrophobia, 
again,  is  marked  by  constant  hyperaesthesia  of  the  skin, 
so  that  the  slightest  breath  of  air  will  precipitate  convul- 
sions.     But  in  R,  mephitica  fanning  the  face  affords  relief, 

VOL.  ZXXII^  NO.  CXXIX.<^«'JULT,  1874.  vv 


460  llabies  Mephitiea. 

and  even  cloths  dipped  into  water  and  laid  on  the  forehead 
were  soothing. 

4.  In  hydrophobia  the  perceptions  are  intensified^  so 
that  the  deaf  are  said  to  have  their  hearing  restored ;  the 
papils  are  strongly  dilated,  imparting  to  the  eyes  a  wild 
glaring  expression ;  the  spasms  are  tonic,  f .  e.  steady  and 
oontinnons ;  the  pnlse  is  feeble,  and  delirium  is  occasionally 
relieved  by  Incid  intervals.  But  the  symptoms  are  wholly 
different  in  JR.  mephitica;  there  is  oscillation  of  the  pupil, 
the  spasms  are  clonic,  t.  e.  marked  by  rapid  altemate  con- 
traction and  relaxation  of  the  muscles;  small  but  wiry 
radial  pulse  and  rapid  carotids ;  positive  loss  of  perception 
and  volition  throughout,  until  delirium  ends  in  persistent 
unconsciousness,  simultaneously  with  cold  perspiration  and 
relaxation  of  the  sphincters. 

51  The  mode  of  death  is  by  asthenia  in  both  forms  of 
rabies ;  but  in  22.  canina  the  frightful  struggles  of  nature 
to  eliminate  the  poison  are  more  prolonged  than  in 
jR.  mephitica,  and  in  the  latter  they  may,  on  occasion,  be 
still  further  abridged  by  the  use  of  Morphine,  which  has  no 
narcotic  effect  upon  the  former  even  in  the  largest  doses 
and  injected  into  the  veins. 

I  have  thus  endeavoured  to  describe,  and  also  to  explain, 
these  strange  and  painful  phenotnena.  I  must  leave  the 
reader  to  form  his  own  decision,  only  hoping  that  some  one 
may  be  induced  to  follow  this  pioneer  work  in  a  new 
path  by  further  and  more  able  investigations  of  his  own« 


45l 


HAHNEMANN'S  EARLIEST  DISCIPLES. 

Discourse  by  Dr.  Lorbacheb,  of  Letpsic,  on  the  119/A 
anniversary  of  Hahnemann's  birth. 

[The  interest  that  attaches  to  a  great  man^  the  founder 
of  a  new  philosophy^  a  new  religion  or  a  new  system  of 
medicine^  extends  in  a  minor  degree  to  his  immediate 
followers  and  associates,  and  we  have  pleasure  in  laying 
before  our  readers  a  translation  of  this  notice  of  the  early 
disciples  and  companions  in  labour  of  the  founder  of  homoeo- 
pathy, as  it  forms  a  fitting  sequel  to  the  previous  account  by 
the  same  author  of  Hahnemann  himself,  which  we  gave  in 
a  former  number.— -Eds.] 

At  the  two  last  festivals  of  this  Society  on  this  anniver- 
sary I  attempted  to  lay  before  you  a  brief  sketch  of  our 
master  as  the  propagator  of  the  new  truth  discovered  by 
him,  and  as  the  reformer  of  medicine.  But  a  master 
requires  followers  and  disciples  in.  order  to  obtain  the 
extension  and  recognition  of  his  doctrine ;  he  must  find 
men  who  accept  it  without  preconceived  prejudice  and 
subject  it  to  an  impartial  proof,  who,  when  convinced  of  its 
truth,  have  the  courage  to  defend  it  with  all  their  power, 
and  willingly  to  submit  to  the  martyrdom  that  awaits  them. 
Let  us  this  day,  on  which  we  celebrate  the  119th  birthday  of 
Hahnemann,  devote  a  little  time  to  the  consideration  of 
how  it  fared  with  him  in  this  respect. 

At  the  period  when  he  first  promulgated  Us  new 
doctrine  medicine  languished  in  the  fetters  of  the  oppressive 
Galenic  dogmatism.  The  attempts  of  some  illustrious  men, 
such  as  Paracelsus,  Hoffmann,  Stahl  and  others  to  break 
these  bonds  had  been  productive  of  no  permanent  results. 
The  university  chairs  were  occupied  by  the  partisans  of  the 
Galenic  dogmas  that  had  held  sway  in  medicine  for  centu- 
ries. They  zealously  endeavoured  to  allow  no  doubt  to 
disturb  them,  to  crush  at  once  in  the  bud  every  heretical 
doctrine  that  might  arise.    Owing  to  the  innate  indolence  of 


4lSi  Hahnemanris  Earliest  Disciptes, 

most  men^  which  prevents  all  independent  thought  and  keeps 
them  from  inquiring  into  the  rational  grounds  of  things, 
which  makes  it  appear  more  comfortable  for  them  to  swim 
with  the  stream  and  to  worship  public  opinion^  which 
Schoppenhauer  has  so  accurately  characterised^  it  was 
inevitable  that  the  disciples  of  ^scnlapius  educated  at  our 
colleges  were  all  given  to  swear  in  verba  magistri,  and  to  per- 
secute with  orthodox  fanaticism  all  who  thought  differently. 
This  is  a  phenomenon  which^  be  it  remarked  en  passant, 
may  be  observed  even  at  the  present  day. 

Thus  Hahnemann  with  his  novel  doctrine  found  himself 
opposed  to  a  dose  phalanx.  But  undismayed,  actuated  by 
a  profound  conviction  of  the  truth  of  his  newly  discovered 
doctrine,  influenced  by  compassion  for  the  sufferings  of  his 
fellow  creatures,  to  whom  he  was  anxious  to  bring  its 
blessings,  he  boldly  entered  the  lists  and  proclaimed  his 
discovery  to  the  world.  At  first  the  words  of  this  man, 
whose  reputation  for  learning  was  generally  acknowledged, 
excited  some  attention,  and  Hufeland  opened  to  him  the 
pages  of  his  Journal,  the  most  important  medical  periodical 
of  the  day,  and  offered  him  an  opportunity  for  laying  the 
foundations  of  his  doctrine.  Hufeland  himself  seemed  not 
indisposed  to  subject  it  to  a  trial,  and  he  was  unable  to 
deny  that  there  was  some  truth  in  it.  But  when  a  nearer 
inspection  revealed  its  reformatory,  I  may  almost  say  its 
revolutionary  character,  when  it  was  perceived  that  its 
acceptance  would  lead  to  the  complete  overthrow  of  the  old 
and  already  shaky  edifice  of  Galenic  medicine,  and  that  a 
complete  rebuilding  would  be  necessary,  a  general  anathema 
was  hurled  at  it,  and  the  novel  heresy  was  combated  with 
every  possible  weapon.  That  under  these  circumstances 
none  of  the  disciples  of  the  true  faith  dared  to  investigate 
the  subject  more  closely,  and  to  subject  it  to  experimental 
proof,  is  hardly  to  be  wondered  at. 

Thus  it  was  that  for  a  long  time  Hahnemann  stood  alone 
in  his  defence  of  the  new  doctrine.  It  was  not  until  1812, 
when,  after  a  wandering  life  full  of  vicissitudes,  he  settled 
down  in  Leipsic,  and  endeavoured  by  lecturing  in  the 
university  to  make  medical  students  acquainted  with  his 


iy  Dr.  Larbacher,  453 

Organon,  that  he  succeeded  in  gaining  a  few  disciples,  who 
assisted  him  with  his  drug-provings,  which  till  then  he  had 
only  been  able  to  institute  on  himself  and  the  members  of 
his  own  family.     Who  were  these  men  ? 

Fortunately  one  of  them.  Dr.  Franz  Hartmann,  who  in 
many  ways  has  rendered  great  services  to  homceopathy, 
has  given  us  in  the  38th  and  89th  vols,  of  the  AU^. 
horn,  Zeitung  not  only  their  names  but  also  a  detailed 
biography  of  almost  all  of  them,  and  furnished  us  with  such 
a  life-like  picture  of  the  life  and  work  in  Hahnemann's 
first  circle  of  disciples,  that  it  is  easy  for  us  to  place  our- 
selves in  spirit  in  their  midst  and  to  get  an  accurate  idea  of 
its  various  component  members.  Without  reckoning 
Hahnemann's  own  son  Friedrich,  a  gifted  but  somewhat 
fantastic  character,  who  stood  faithfully  by  his  father's  side 
and  gave  evidence  of  great  polemical  power  in  his  refuta- 
tion of  Hecker's  attack  on  homoeopathy,  but  seems  not  to 
have  formed  any  close  alliance  with  his  father's  other 
disciples,  and  like  a  meteor,  after  a  short  and  brilliant 
career,  disappeared,  and  left  no  trace  behind ;  there  were 
ten  of  his  followers  who  remained  closely  attached  to  him 
and  constituted  his  first  society  of  provers;  their  names 
are  Stapf,  Gross,  Homburg,  Franz,  Wislicenus,  Teuthom, 
Herrmann,  Riickert,  Langhammer,  and  Hartmann.  We 
may  leave  out  of  consideration  Teuthom  and  Herrmann, 
who  seem  to  have  been  inconsiderable  personages,  and  of 
whose  appearance  as  homoeopathic  physicians  nothing  is 
known.  If  we  examine  the  others  more  closely  we  find 
that  they  were  young  men,  some  of  them  still  medical 
students,  who,  without  having  formed  any  independent 
judgment  on  the  subject  for  themselves,  were  animated  by 
the  personal  influence  of  Hahnemann  and  by  the  enthusiasm 
they  observed  in  him  for  the  new  doctrine.  They  lent  him 
their  services  for  his  drug-provings,  and  in  consequence  of 
thescj  as  also  of  the  brilliant  cures  effected  by  the  master, 
together  with  their  own  practical  experiments,  they  acquired 
that  firm  conviction  of  the  truth  of  the  doctrine  that 
enabled  them  to  encounter  courageously  the  persecutions 
they  were   subjected  to.      When   we    consider  what  is 


454  Hahi\emaim*B  Earliest  Disciples, 

implied  in  the  persecution  by  one's  colleagues  by  ridicule 
and  contempt^  in  being  shunned  like  the  plague^  we  can  see 
how^  to  use  Hartmann's  expression,  they  had  to  deny  them* 
selves  many  of  the  pleasures  and  enjoyments  of  youth  in 
order  to  carry  out  their  resolutions  in  regard  to  the  proving 
of  medicines,  and  we  cannot  fail  to  award  to  these  men 
their  due  meed  of  admiration. 

Of  these,  as  far  as  we  can  learn,  Homburg  and  Stapf 
were  the  two  who  first  became  closely  connected  with 
Hahnemann.  Homburg  is  represented  to  us  as  a  man  of 
great  gifts,  of  extraordinary  practical  talent,  which  gave 
him  much  certainty  in  the  diagnosis  of  disease,  as  well  as 
in  the  discovery  of  the  right  remedy,  so  that  he  soon  ob« 
tained  the  repute  of  a  successful  practitioner.  But  he  was 
deficient  in  refinement  /*  his  boyish  manners,  as  well*  as  his 
disrespectful  behaviour,  especially  towards  all  opponents  of 
homcBopathy-— he  spared  neither  professor  nor  medical 
authoritieB-*«reated  for  him  many  enemies  and  drew  upon 
him  much  persecution,  whereby  the  latter  part  of  his  life  was 
much  embittered,  and  may  have  been  in  some  respects 
unfavorable  to  the  spread  of  homoeopathy.  And  yet  I  am 
not  prepared  to  say  that  occasionally  a  rude  attack  at  the 
proper  time  may  not  be  more  effectual  in  advancing  a 
cause  than  a  delicate  diplomacy.  At  all  events,  Homburg 
by  his  contributions  to  the  provings  of  medicines,  as  well 
as  by  his  mode  of  directing  the  attention  of  students  to 
homoeopathy,  has  rendered  permanent  service  to  our  cause. 

The  most  important  of  Hahnemann's  earliest  disciples 
was  undoubtedly  Stapf.  Endowed  with  brilliant  talents,  a 
wealth  of  knowledge,  and  personal  amiability,  he  was  the 
active  and  vivifying  element  in  the  small  circle,  for  which 
his  peculiar  and  somewhat  mercurial  vivacity  and  his 
sparkling  wit  eminently  qualified  him.  That  both  the 
above-named  qualifications  remained  to  him  in  a  high 
degree  in  advanced  life  I  had  an  opportunity  of  becoming 
personally  convinced  of  during  a  visit  I  paid  to  him  at 
Naumburg.  The  hours  I  passed  in  his  company  are 
among  the  pleasantest  recollections  of  my  life.  A  firm 
friendship  which  nothing  could  disturb  bound  him  to  his 


by  Dr.  Lorbacher.  455 

master  to  the  end.  By  his  participation  in  the  provings  of 
medicines  and  the  great  number  of  accurate  and  reliable 
symptoms  he  contributed^  as  well  as  by  his  Archiv  and  the 
number  of  scientific  articles  he  furnished  towards  the 
foundation  and  establishment  of  the  new  doctrine,  he  has 
raised  a  lasting  monument  to  his  memory. 

Next  to  him  stands  Oross^  an  apparently  unsympathetic 
and  cold  character^  of  unattractive  appearance^  of  a  hypo- 
chondriacal  and  dreamy  nature.  A  nearer  acquaintance 
showed  him  to  be  possessed  of  energy  and  industry,  a 
warm-hearted  man  for  the  cause  and  to  his  friends.  As  a 
drug-prover  he  occupies  one  of  the  foremost  places.  By 
his  participation  in  the  editing  of  the  Archiv  and  AUff. 
homr  Zeiiunfff  as  also  by  his  other  literary  works  whether 
of  a  defensive  or  didactic  character^  he  has  earned  a  perma- 
nent title  to  our  remembrance.  In  his  practice  he  held 
firmly  to  the  precepts  tof  the  master,  with  whom  he  re^- 
mained  in  friendly  intercourse  to  Ih6  end  of  his  life, 
notwithstanding  the  serious  difibretices  thai  arose  betw^n 
Hahnemann  and  most  of  his  disciples ;  though  he  netet 
hesitated  to  oppose  him  in  matters  ott  which  he  believed 
Hahnemann  to  be  in  the  wroDg.  A  peculiar  trail  in  his 
character  was  that  he  always  espoused  new  ideas  with  seal, 
and  came  forward  with  his  views  Upon  them  before  he  had 
subjected  them  to  a  thorough  and  repeated  proofs  I  will 
only  here  allude  to  isopathy  and  the  high  potencies.  The 
consequence  of  this  was  that  he  drew  down  on  himself 
many  attacks  and  corrections,  which  occasioned  him  many 
bitter  hours  and  gave  him  the  appearance  of  vacillation. 

The  next  to  Gross  that  occurs  to  us  i{i  FranA  Hartmimn. 
A  simple,  ingenuous,  practical  man.  With  no  desire  to 
shine  or  put  himself  prominently  forWAtd,  he  endeCivottred 
to  promote  the  new  doctrine  of  whose  truth  he  was  oon* 
vinced  by  continuous  earnest  work.  The  proofs  of  this 
are  his  provings,  whereby  our  Maierin  MtduM  has  been 
enriched  by  a  considerable  number  of  reliable  symptoms,  as 
also  his  literary  activity  which  was  directed  to  the  publica- 
tions of  large  works,  among  which  we  may  mention  his 
Ther^grie,  to  the  writing  of  articles  in  the  ArcMv  and  AUg. 


456  HahnemanfCs  EarUe$i  JHitipleB, 

horn.  Zeitung,  to  the  editing  of  the  last-named  periodical, 
which  he  undertook  at  first  in  connection  with  Gross  and 
Bummel,  and  subsequently  carried  on  with  the  latter  to  the 
end  of  his  life.  Of  Hahnemann's  earliest  disciples  he  was  the 
only  one  who  after  the  first  enthusiasm  had  evaporated 
permitted  himself  to  assume^  to  a  certain  degree,  a  critical 
attitude,  and  did  not  shrink  from  opposing  some  of  Hahne- 
mann's views,  whereby  he  latterly  incurred  the  anger  of  the 
founder  of  homoeopathy.  His  amiability,  his  open  honest 
character,  gained  him  many  true  friends,  who  were  a  great 
consolation  to  him  under  the  many  misconceptions  and 
hateful  enmities  by  which  he  was  assailed.  I  gratefully 
recal  the  friendliness  with  which  he  received  me,  when  I 
came  to  Leipzig  in  1845,  to  study  homoeopathy,  and  with 
which  he  assisted  me  in  my  studies. 

Of  the  other  disciples  Franz  was  a  person  of  some 
importance.  According  to  Hartmann's  account  he  was  a 
man  of  rare  gifts ;  and  this  is  borne  out  by  his  drug- 
prorings,  which  are  distinguished  by  their  delicate  and 
acute  observation  as  well  as  by  their  predseness.  They 
are  an  ornament  to  our  Materia  Medica.  Being  a  good 
botanist,  it  was  he  who  collected  the  indigenous  plants 
from  which  tinctures  were  prepared.  He  acted  for  many 
years  as  Hahnemann's  amanuensis,  and  he  performed  with 
diligence  and  perseverance  the  very  tedious  and  mechanical 
work  of  arranging  the  symptoms  contributed  by  the  various 
provers  into  the  schema  invented  by  Hahnemann.  He  was 
a  great  favourite  with  Hahnemann  as  also  with  his  fellow 
workers,  whose  hearts  he  gained  by  his  thoughtful  mild 
nature.  Unfortunately  he  died  after  years  of  suffering 
while  still  in  the  prime  of  life. 

Of  Wislicenus  the  elder  all  that  we  know  is  that  he  was 
a  quiet  modest  man  of  reserved  disposition,  which  in  later 
years  increased  to  a  sort  of  anthropophobia.  Still,  as  a 
diligent  and  conscientious  prover  he  has  earned  a  title  to 
our  gratitude. 

Ernst  Friedrich  Biickert,  whom  Hartmann  in  his  narra- 
tive confounds  with  a  younger  brother,  co-operated  dili- 
gently in  proving  medicines  under  Ui^lmem^pu's  direction. 


.  by  Dr.  Lwbacher*  457 

He  pnbliBhed  some  original  worka  on  homooopathy,  and 
along  with  Lux  mar  be  considered  the  founder  of  homoeo- 
pathic veterinary  medicine.  All  that  we  know  of  his 
person  and  character  is  that  he  was  affected  with  eyer« 
lasting  restlessness,  which  caused  him  to  change  his  place 
of  residence  as  a  doctor  four  times^  and  even  led  him  to 
abandon  his  practice  altogether  for  three  years  in  order  to 
act  as  tutor  in  Livonia. 

The  least  important  among  the  members  of  this  early 
circle  of  Hahnemann's  disciples  was  undoubtedly  Lang- 
hammer,  a  man  deformed  in  body  and  mind^  without 
energy,  who  spent  his  time  in  unprofitable  brooding,  and 
who  never  could  acquire  any  enthusiasm  for  the  cause. 
Unfavorable  outward  circumstances,  for  the  successful 
combating  of  which  an  energetic  nature  was  neces- 
sary, may  have  contributed  materially  to  his  depressed 
disposition.  On  these  accounts  the  value  of  his  contribu- 
tions to  the  Materia  Medica  is,  to  say  the  least,  doubtful. 

Such  were  the  first  disciples  of  Hahnemann.  Young, 
unknown,  though  generally  highly  gifted  men,  who  were 
commencing  their  medical  career,  mostly  sprung  from  the 
lower  or  middle  classes  of  society,  who  had  to  fight  with 
unfavorable  external  circumstances,  they  were,  one  would 
think,  but  ill  calculated  to  be  the  apostles  of  a  new  doc- 
trine. And  yet  it  was  just  the  qualities  and  circumstances 
here  named  which  rendered  them  particularly  fit  for  the 
reception  of  the  new  truth.  Still  capable  of  fresh,  pure 
enthusiasm,  such  as  is  incident  to  youth  alone,  not  yet 
affected  with  exhaustion  of  the  thinking  faculty,  not  yet 
enchained  by  the  fetters  of  medical  orthodoxy,  excluded 
from  the  levelling  sociability  of  the  upper  classes,  pre- 
vented by  their  narrow  means  from  participating  in 
students'  pleasures  which  so  often  put  a  stop  to  study, 
they  were  of  all  men  the  fittest  for  doing  the  first  hard 
work  required  for  the  foundation  of  a  new  doctrine.  If  we 
add  to  this  the  personal  influence  of  the  master,  which  in 
some  way  or  another  succeeded  in  inspiring  others  with  the 
enthusiasm  for  the  cause  that  animated  himself,  and  in 
ponvincing  them  qf  its  truth^  wo  cap  then  understand  how 


458  Hahnemann's  Earliest  Disciples. 

these  earliest  disciples^  undeterred  by  the  ridicule  of  their 
fellow-students^  by  privations  and  mortifications  which  they 
had  to  endure,  went  forward  on  their  course  with  zeal  and 
steadfastness.  Thrown  upon  their  own  resources  they 
formed  a  close  alliance  with  the  master  and  with  one 
another.  His  house  was  their  place  of  assembly,  where 
they  always  got  renewed  incitement,  courage,  and  instruc- 
tion. And  BO  from  their  conjoint  labours  came  the  work 
that  constitutes  the  foundation  stone  of  homoeopathy,  the 
Materia  Medica,  which  it  is  not  difficult  for  succeeding 
generations  to  build  up.  They  themselves  grew  up  to  be 
excellent  practitioners  of  medicine,  in  which  they  perceived 
ever  more  and  more  the  truth  aud  great  importance  of  the 
new  doctrine  which  they  had  at  first  adopted  on  Hahnemann's 
sole  authority,  and  armed  with  which  they  could  defy  their 
opponents.  It  is  the  results  they  obtained  which  induced 
older  and  more  accredited  doctors  to  make  themselvea  con- 
versant with  homoeopathy.  Among  such  converts  I  will 
only  mention  the  two  men,  whose  especial  merit  it  is  to 
have  drawn  homoeopathy  from  its  then  obscure  position,  to 
have  procured  for  it  a  kind  of  recognition  on  the  part  of  the 
state,  and  greater  consideration  from  the  educated  public. 
I  allude  to  Moritz  Miiller  and  Bummel.  Both  were 
equally  distinguished  for  acute  penetrating  intellect  and 
many-sided  knowledge,  which  made  them  exactly  fitted  for 
champions  of  homoeopathy.  I  must  refrain  from  'dwelling 
at  greater  length  on  the  importance  to  homoeopathy  of  the 
accession  of  these  two  men  in  order  not  to  occupy  too  much 
of  your  time.  My  only  idea  was  to  refresh  your  memory 
to*day  with  respect  to  Hahnemann's  earliest  disdples,  and 
to  recall  their  services  to  your  mind.  I  do  not  think  I 
have  done  anything  superfluous  by  so  doing,  at  a  period 
when  among  the  younger  race  of  physicians  there  prevails  a 
certain  amount  of  scientific  conceitedness  that  leads  them 
to  undervalue  the  labours  and  merits  of  their  predecessors, 
on  whose  shoulders  they  stand. 

Let  us  dismiss  all  disagreeable  recollections,  and  let  tis 
refresh  our  minds  with  the  contemplation  of  this  first  small 
band  of  Hahnemann's  disciples,  who  stood  in  intimate  cordial 


(Enanthe  crocata.  459 

relation  to  their  master,  who  gave  themselves  up  to  his  direc- 
tions with  all  faith^  and  who  counted  the  hours  they  passed 
in  his  house  among  the  happiest  of  their  lives.  May  their 
example  teach  us  not  to  falter  at  a  time  when  our  good 
cause  seems  to  be  declining,  when  the  constantly  diminishing 
numbers  of  homoeopathic  practitioners  in  Germany  make  iis 
fear  for  its  future.  Let  us  undauntedly  labour  and  fight. 
History  teaches  us  that  no  truth  that  has  once  appeared  in 
human  knowledge^  though  it  may  be  temporarily  repressed 
and  obscured,  has  ever  been  lost. 


(ENANTHE  CROCATA.* 

We  have  found,  in  the  Montpellier  Medical,  an  excellent^ 
well-developed,  very  complete  study  of  (Enanthe  crocata,  by 
Dr.  Bloc.  The  author  insists  in  a  special  manner  upon  the 
botanical  characters  of  the  plant  and  the  poisoning  symp- 
toms caused  by  it;  he  has  studied  microscopically  the 
intimate  tissues  of  its  whole  texture^  its  chemical  composi- 
tion, &c. 

In  this  study  we  are  chiefly  interested  in  forty-nine 
observations  of  human  poisonings,  which,  whatever  was  the 
age  or  sex  of  the  victims,  presented  symptoms  nearly 
identical,  and  all  showed  the  phenomena  characteristic  of 
epilepsy.  Moreover,  we  find  in  it  cases  of  poisoning  almost 
all  fatal,  where  cattle  had  eaten  the  roots  of  this  plant ; 
here  also  the  sjrmptoms  produced  were  similar.  Some 
experiments  were  also  tried  or  reported  by  Dr.  B.  with  a 
resinous  extract  of  the  root  upon  rabbits  and  dogs ;  these 
also  produced  analogous  symptoms.  The  resemblance  of 
these  symptoms  to  those  produced  by  epilepsy  and  some  of 
its  sequelae  is  so  great  that  it  has  struck  all  the  authors  who 
have  spoken  of  it  as  well  as  the  one  whose  excellent  memoir 
we  are  analysing.     In  order  to  demonstrate  it,  we  are  about 

*  Montpellier  Medical,  Nos.  for  Oct.,  Nov.,  Dec.,  1872,  April,  May,  1878 ; 
Art  Medical,  Mar«h,  1874. 


460  (Enanthe  crocata. 

to  reproduce^  wholly  or  in  part^  some  of  the  observation! 
which  he  has  collected,  either  personally  or  from  yarions 
authors.  Bat  let  us  first  commence  with  making  the  plant 
known  by  giving  its  principal  botanical  characters.  **  The 
cenanthes  are  smooth  aquatic  plants^  with  compound  umbek, 
variable  involucres  (often  wanting),  polyphyllian  involucelles^ 
white  flowers  on  long  pedicels  inserted  on  the  ray  of  the 
umbellule,  hermaphrodite  and  sterile  by  abortion.  They 
grow  abundantly  in  the  northern  countries  of  the  Old  Worlds 
and  some  have  been  observed  in  America.  The  genus 
contains  yery  numerous  species;  and,  as  it  has  been 
limited'  by  botanists  up  to  the  present  day,  we  reckon  a 
score  which  have  been  divided  into  two  grand  sections* 

A.  Oenus  (Enanthe  (Linn.),  perennial  species,  with  fasci- 
culated tubes,  such  as  (£.  crocata^  which  is  the  one  now 
before  us. 

Synonyms. — (Enante  Bafranie.  (Enanthe  a  9uc  jaune. 
Breton,  Kiffuis,  Pembis,  Pempes  (the  root  having  five  fingers) 
pum  bys,  Welsh.  At  Nantes,  Pensagre.  Navet  du  diable. 
The  flowers  are  white,  sometimes  light  rose,  with  a  fascicle 
of  tubers;  in  one  variety  the  root  is  white,  in  another 
reddish-purple.  Without  enlarging  on  the  chemical  ana- 
lysis let  us  merely  state  that  the  plant  contains  amongst 
other  matters  a  fixed  oil,  a  volatile  oil,  a  resin,  a  yellow 
colouring  matter ;  that  one  may  ascribe  to  the  first  three 
the  venomous  action  of  the  plant;  they  exist  in  such 
abundance  that  in  order  to  see  them  you  have  only  to  cut 
the  root  across,  when  the  oils  exude  to  the  surface  and  soon 
lose  by  evaporation  their  aqueous  parts  and  the  highly 
scented  volatile  oil,  whilst  the  yellow  resinous  juice  encrusts 
the  surface  of  the  section. 

Obs.  l.-i — An  inhabitant  of  Amsterdam,  April  20th,  1677^ 
went  into  his  garden  with  a  friend  about  7  a«m.  He 
pulled  up  some  roots  to  eat  on  his  return,  taking  them  for 
Macedonian  parsley,  Bubon  macedonicum*  In  order  to  ascer- 
tain at  once  the  nature  of  the  plant  he  and  his  friend  tasted 
it.  Soon  after  they  felt  a  burning  heat  in  the  throat  and 
stomach ;  and,  with  that,  disturbance  of  intellect,  vertigo, 
pardialgia,  and  nausea,  followed  by  alvio^  evacuations.     The 


(Enanihe  crocata.  461 

first  had  bleeding  at  the  nose,  the  second  violent  con- 
vulsions^ and  the  one  who  had  eaten  most  died  in  about 
two  hours^  the  other  in  three.  The  plant  proved  to  be 
(Enanihe  crocata. 

Obs.  8. — A  woman  of  a  certain  age^  after  having  eaten 
one  of  the  roots  along  with  parsneps^  became  almost  mad 
and  furious^  as  if  drunk.  She  came  to  herself  after  having 
taken  breath  and  drank  a  little  vinegar. 

Obs.  7. — Amatus  Lusitanus  tells  us  that  a  child  of 
eleven  who  had  set  out  from  the  town  of  Pisa  after  having 
eaten^  when  fastings  some  tops  of  this  plants  was  seized  with 
convulsions  followed  by  profound  sleep ;  on  awaking  she 
neither  saw  nor  heard  anything,  and  on  being  carried  home 
died  immediately. 

Obs.  9. — In  1748  eight  Irish  boys,  having  taken  this 
plant  for  water  parsnep,  ate  several  of  the  roots ;  four  or 
five  hours  after  the  eldest  fell  suddenly  on  his  back  and 
died  in  convulsions;  four  others  died  that  day  without 
having  been  able  to  utter  one  word  from  the  instant 
the  poison  seemed  to  attack  the  nervous  system.  Of 
the  three  others  one  went  mad,  but  came  to  himself 
next  morning ;  another  lost  his  nails  and  hair ;  the  third 
was  the  only  one  who  escaped,  because  he  had  run  two 
miles  and  drunk  hot  milk,  which  produced  copious  perspira- 
tion. 

In  the  preceding  cases  we  see  that  the  roots,  eaten  raw, 
produced  vertigo,  nausea,  madness,  convulsions,  and  most 
frequently  speedy  death.  In  the  following  instance  the 
root  was  eaten  boiled  as  an  ingredient  in  soup.  Of  all 
those  who  partook  of  this,  some  were  merely  very  ill  after 
it ;  one  died. 

Obs.  12. — March  30th,  1758,  seventeen  soldiers  of  the 
citadel  of  Ajaccio  poisoned  themselves.  One  of  them 
having  a  mind  to  treat  his  comrades  with  good  soup  had 
gathered  a  plant  of  which  he  had  cut  the  leaves  and  roots. 
They  ate  it  with  avidity,  but  in  one  hour  some  fell  into 
syncope  and  convulsions.  One  died  before  the  doctor 
arrived,  two  hours  after  supper ;  a  second  was  expiring ;  a 
third  showed  no  sign  of  life,  but  trembling  and  convulsions. 


462  (Bnanthe  crocata. 

The  activity  of  the  poison  was  so  sadden  that  I  saw  two  fidl 
into  a  swoon,  whilst,  at  perfect  ease  about  themselyes,  they 
were  busily  lavishing  attention  upon  their  sick  comrades. 

Guillaume  Trelacheau^  a  man  of  strong  and  robust 
constitution^  who  was  the  author  of  this  deadly  feast^ 
seemed  the  most  hopeless.  The  upturning  of  his  eyes^  the 
contraction  of  his  lower  jaw,  the  feebleness  of  pulse^  the 
inability  to  move^  feel^  or  know  anything,  with  an  universal 
chill  spread  over  his  whole  body,  seemed  to  be  so  many 
signs  of  death.  After  vain  attempts  to  give  an  emetic  I 
had  him  rolled  and  well  shaken  in  a  blanket  by  eight  men 
for  two  hours.  He  recovered  warmth,  and  then  insensibly 
movement  and  life.  The  first  signs  were  efforts  to  vomit, 
which,  aided  by  the  emetic,  were  effectual.  The  vomitings 
went  on  for  days,  take  what  he  would.  He  fell  asleep  for 
fifteen  hours. 

On  April  1st  his  tongue  was  extremely  sore  and  swollen 
from  biting  during  the  convulsions ;  I  left  off  giving  any 
medicine.  The  2nd,  3rd,  4th,  and  5th  of  April  his  nose 
bled  twice,  and  I  bled  him  three  times  from  the  arm.  The 
following  days  his  sufferings  abated.  On  the  11th,  as  no 
appetite  appeared,  I  gave  him  some  doses  of  Juniper,  which 
soon  enabled  him  to  eat  all  his  rations.  He  went  away 
perfectly  cured,  April  1^1  st,  the  twenty-third  day  after  the 
accident,  remembering  nothing  that  had  befallen  him  from 
the  first  to  the  third  day  of  his  illness,  nor  of  the  circum- 
stances that  had  accompanied,  nor  those  which  had  caused 
it»  We  do  not  report  the  other  cases,  which  were  similar 
but  less  violent.  Let  us  only  remark  the  sudden  convul- 
sions,  trismus  with  biting  of  the  tongue,  followed  by  slumber 
and  oblivion  of  the  circumstances. 

Obs.  15. — This  is  a  case  of  a  whole  family  having  eaten 
soup  made  of  the  roots  mistaken  for  turnips,  l^hey  suffered 
from  puffs  of  pungent  heat  on  the  head,  rose-coloured  spots 
on  the  face,  breast,  and  arms.  There  were  no  convulsions, 
and  these  symptoms  disappeared  after  the  administration  of 
mucilage,  oil,  and  milk.  An  infant  of  three  or  four  months 
at  the  breast  of  one  woman  showed  the  same  symptoms 
several  hours  later. 


(Snanthe  crocatd.  463 

Obs.  17. — ^A  man  aboat  forty^  when  fasting,  tasted  this 
root ;  he  very  soon  complained  of  great  heat  in  the  throat ; 
half  an  honr  after  he  was  speechless^  fell  down  unconscious, 
and  then  was  seized  with  terrible  convulsions  for  three 
quarters  of  an  hour,  and  died  without  the  possibility  of 
giving  medicine,  his  teeth  being  closed  by  trismus^  which 
lasted  the  whole  time. 

Obs.  19.  External  use.-^—A  family  of  five,  father,  mother, 
fieurm  servant,  two  children,  the  one  eight  years,  the  other 
four  months,  being  attacked  with  the  itch,  were  rubbed 
with  a  decoction  of  (Enanthe.  They  soon  experienced  all 
the  symptoms  of  violent  poisoning.  The  boy  and  the 
children  sank  under  the  most  cruel  pain ;  the  others  were 
saved. 

Obs,  20. — February  4th,  1843,  twenty-one  condemned 
criminals  in  the  Royal  Arsenal,  Woolwich,  ate  oenanthe  by 
mistake  for  celery ;  nine  were  seized  with  violent  convul- 
sions and  loss  of  consciousness  three  quarters  of  an  hour 
after.  One  named  Williamson,  with  his  face  swollen  and 
livid,  and  bloody  froth  issuing  from  his  mouth  and  nostrils, 
stertorous  and  convulsive  respiration,  insensibility,  and 
prostration,  died  in  half  an  hour.  Another,  Knight,  a  prey 
to  the  most  violent  convulsions,  was  in  a  kind  of  apoplectic 
state ;  insensible,  speechless,  with  pupils  dilated,  face  puffed 
and  livid,  respiration  laborious,  limbs  contracted,  and 
trismus.  On  his  recovering  consciousness  the  convulsions 
were  renewed,  he  fell  into  a  coma,  and  died  in  an  hour  in 
a  fresh  fit  of  convulsions.  In  two  individuals  (Salt  and 
Williams)  the  convulsions  gave  place  to  maniacal  delirium 
with  tossing.  One  named  Jones  died  In  convulsions  an 
hour  after  the  ^commencement;  malgre  tracheotomy  per<* 
formed  at  the  last.  Others  felt  numbness  and  feebleness  of 
the  limbs*  Salt  and  Burgess  having  left  the  hospital  on  the 
fifth  day,  believing  they  were  cured,  returned,  having  been 
seized  anew  with  syncope.  Purgatives  made  them  pass  the 
dibris  of  the  poisonous  root  after  the  sixth  and  seventh 
days.  The  former  succumbed  on  the  ninth,  the  second  on 
the  eleventh  day,  after  the  poisoning. 

Thus^  out  of  six  deaths  four  took  place  within  one  hour ; 


464  (Enanihe  crecatd. 

two  at  tbe  end  of  several  days  and  always  by  the  effect  of 
the  primary  symptoms — ^the  disposition  to  syncope  and  the 
prostration.  It  is  probable  that  these  symptoms  depended 
on  the  continuation  of  the  influence  of  the  peccant  matter 
during  its  progress  through  the  alimentary  canal. 

We  will  now  give  in  toto  the  result  of  all  the  post- 
mortems which  took  place. 

Exterior  aspect. — ^Very  marked  rigidity  of  the  corpse; 
the  hand  strongly  bent  with  the  thumb  applied  forcibly  to 
the  palm  of  the  hand;  the  nails  bluish;  livid  patches  of 
small  extent  on  the  front  of  the  trunks  all  the  back  part 
presented  a  tinge  of  deep  purple  except  at  the  edge  of  the 
troughs^  where  the  discoloration  was  redder,  and  the  edges 
of  parts  submitted  to  pressure  where  there  was  no  dis- 
coloration. The  scrotum  and  penis  equally  livid ;  the  face 
too  was  injected  and  pufly,  eyelids  slightly  apart,  conjunc- 
tiva rather  congested,  pupils  widely  dilated;  lips,  gums, 
and  ears  tinged  purple ;  tongue  showing  through  the  teeth 
and  bitten  at  the  tip ;  froth  issued  from  the  nostrils. 

Nervous  system. — ^An  incision  of  the  integuments  of  the 
cranium  let  out  a  great  quantity  of  black  and  liquid  blood. 
The  veins  of  the  pia  mater  greatly  distended  form  nuiperoua 
arborescent  patterns  on  the  surface  of  the  convolutions  and  in 
their  intervals.  The  cerebral  substance  is  strongly  injected, 
especially  the  white  matter.  It  is  the  same  with  the 
cerebral  protuberance  and  the  medulla  oblongata.  Serous 
effusion  pretty  abundant  in  the  cellular  tissue  under  the 
arachnoid  and  the  ventricles  and  principally  the  base  of  the 
cranium.  The  sinuses  of  the  dura  mater  distended  with  a 
great  quantity  of  fluid  blood.  As  to  the  spinal  cord,  its 
membranous  sheath  is  strongly  injected,  the  vertebral 
tissues  are  full  of  black  fluid  blood  and  the  medullary 
substance  is  redder  and  more  congested  than  usual.  In 
one  case  (Jones,  who  died  in  an  hour)  we  found  beneath 
the  pia  mater  an  escape  of  blood  which  covered  both  hemi- 
spheres. 

Respiratory  system. — ^The  epiglottis  is  the  seat  of  a  very 
deep  discoloration  with  considerable  injection  of  the  network 
of  veins  covering   it.      The  glottis,  the  ventricles  of  the 


CEnanthe  crocata,  465 

larynx^  the  larynx  itself,  the  trachea  and  brdnchi^  even  to 
their  ultimate  ramifications^  present  a  deep  red  and  are 
coated  with  a  thick  layer  of  reddish  frothy  mucus.  The 
lungs  are  dull  and  blackish.  A  great  many  small 
extravasations  (pulmonary  apoplexy)  were  noticed. 

Circulating  system, — Heart :  bulk  normal,  but  contained 
much  black  fluid  blood. 

Digestive  apparatus, — The  papillae  at  the  base  of  the 
tongue  turgid  and  vascular.  The  velum  palati,  tonsils^ 
and  pharynx  coated  with  glairy  mucus  and  deeply  livid. 
(Esophagus  the  same.  Stomach  and  intestines  scarlet 
inside.  Interior  surface  coated  with  viscous  mucus,  under 
which  the  mucous  membrane  is  strongly  injected  and  looks 
mammillated^  owing  to  the  numerous  follicles  which  are 
prominent  and  swollen.  There  are  also  points  of  extravasa- 
tion and  black  lines  along  the  venous  trunks  of  these 
organs. 

The  report  of  these  six  post-mortems  contains  the  sub- 
stance of  many  others^  which^  being  made  much  less  care- 
fully, we  omit  as  useless. 

We  will  give  a  few  more  observations,  noticing  only  the 
principal  symptoms  and  circumstances. 

Obs.  22. — Of  three  boys,  the  eldest,  about  13,  died  after 
eating  a  root  as  big  as  one's  little  finger,  which  they  pulled 
up  in  a  field.  They  first  felt  the  effects  on  coming 
home,  one  (Evans)  stumbled  and  fell ;  as  the  two  were 
trying  to  help  him  they  fell  also;  the  first  had  a  severe 
bruise  on  the  forehead.  Emetics  and  other  remedies 
failed  because  of  obstinate  trismus.  They  lived  but  a  few 
hours. 

Obs,  24. — Two  children,  of  the  same  age,  ate  the  same 
roots.  The  first  took  vertigo  and  fell,  the  other  tried  to 
carry  him  on  his  back  and  fell  also.  Suitable  hospital 
treatment  cured  them  shortly. 

Obs.  30. — Two  children  who  ate  the  root  boiled  were 
seized  with  convulsions,  &c.  Cured  by  forcing  a  large  dose 
of  dissolved  butter  down  their  throats. 

Obs.  45. — Seventeen  prisoners  escaped  from  the  Port  of 
Lorient,  and  sufiering  from  hunger  ate  these  roots  by  mistake 

VOL.   XXXII,   NO.  CXXIX. JULY,   1874.  GG 


466  (Enanthe  crocata, 

for  radishes.  They  soon  experienced  numbness^  nausea,  horrid 
convulsions,  and  at  last  tetanic  stiffness,  coma^  and  death. 
Almost  all  died.     Hospital  treatment  saved  the  rest. 

Let  us  pass  on  to  observations  on  animals.  Cattle 
can  eat  the  stalks  with  impunity^  and  find  them  wholesome 
and  succulent^  but  the  roots  are  to  them,  also^  deadly 
poison. 

Obs.  49  and  50  are  instances.  In  the  first,  three  cows 
died ;  in  the  next,  five.  The  farmers  about  Brest  too 
often  lose  cattle  thus.  It  is  after  clearing  the  ditches  and 
streams  that  this  occurs ;  for  they  throw  the  roots  thus  dug 
up  on  the  bank,  and  the  cows  eat  them.  They  drop  as  if 
thunderstruck,  and  emit  an  extremely  offensive  reddish  fluid 
from  the  nostrils,  like  the  juice  of  the  roots  themselves. 
Their  flesh  putrefies  rapidly. 


1.  The  analogy  of  Us  effects  with  epilepsy* 

We  are  informed  that  this  toxicological  study  by  Dr. 
Bloc  was  carried  on  by  the  advice  and  under  the  direction 
of  our  coUaboratenr,  Dr.  Imbert-Oourbeyre.  The  author 
commenced  his  studies  at  the  Clermont  School  of  Medicine 
and  finished  them  recently  at  the  Faculty  of  Montpellier. 
His  memoir  got  the  prize  from  the  Society  of  Medicine 
and  Practical  Surgery  in  that  town.  If  the  young  laureate 
thought  fit  to  conceal  the  name  of  his  master,  it  is  because 
he  thought  it  probable  that  the  revelation  of  a  homoeopathic 
origin  would  not  conciliate  to  his  work  the  arch-leeches  of 
Montpellier  I  "  Audacesfortunajuvat. 


» 


Experiments  on  Animals. 

1.  Five  decigrammes  of  the  resin  of  (Enanthe  crocata 
were  given,  suspended  in  a  mucilage  of  gum  arabic,  to  an 
adult,  well-conditioned  rabbit.  At  first  it  suffered  depres- 
sion and  sadness,  refusing  its  food  ;    soon  after,  some  con- 

•  AH  MSdieal,  April,  1874. 


(Enanthe  crocata.  467 

vuldions  in  the  fore  legs  and  the  muscles  of  head  and  face, 
the  posterior  extremities  refused  their  support.  This 
state  continued  twenty  hours,  after  which  it  gradually  re- 
covered. 

2.  Six  decigrammes  of  the  resin  were  diffused  through  a 
yolk  of  egg  and  slightly  diluted  with  a  little  hot  water ;  a 
full-grown  small  dog  was  made  to  swallow  it.  He  at  first 
exhibited  the  same  depression  aod  sadness  as  the  rabbit, 
whilst  the  weakness  of  the  extremities  was  still  greater. 
Respiration  short,  the  tongue  hanging  out  and  extremely 
dry  ;  anxiety  insupportable.  The  oesophagus  was  not  tied 
lest  it  should  occasion  death.  There  was  no  possibility  of 
stopping  TomitingSy  which  were  glairy,  reddish,  and  slightly 
bloody,  which  no  doubt  carried  the  poison  out.  These 
were  accompanied  by  fetid  liquid  stools  and  an  abundant 
discharge  of  urine.  After  these  evacuations,  and  even 
during  them,  the  animal  suffered  convulsions  and  extremely 
violent  spasms  in  the  anterior  extremities,  tail  and  face. 
Gradually  these  sufferings  abated.  He  took  no  food  for 
forty-five  hours  and  then  slowly  recovered. 

8.  An  adult  strong  rabbit,  who  swallowed  three  ounces 
of  distilled  water  in  which  a  quantity  of  the  root  was 
steeped,  with  the  addition  of  a  good  deal  of  the  essential 
oil  of  (Enanthe,  did  not  experience  the  least  inconvenience. 
All  the  experiments  seem  to  prove  that  the  resin  alone  is 
poisonous  and  the  other  parts  of  the  plant  very  little  so. 

4.  Sixty  centigrammes  of  resin  were  mixed  up  with 
some  minced  meat,  of  which  three  boluses  were  made. 
'  One  was  administered  to  an  adult  dog  of  middle  size  by 
force,  as  the  smell  of  the  resin  made  him  shrink  back.  In 
twenty  minutes  he  began  to  be  restless,  and  he  kept 
turning  round  upon  himself,  seeking  for  a  comfortable 
position ;  two  or  three  minutes  after  he  had  nausea  without 
vomiting.  Then  they  gave  him  a  second  and  then  a  third ; 
the  phenomena  then  became  characteristic.  At  first, 
growling,  with  increasing  anxiety  ;  by  degrees  the  posterior 
extremities  do  not  move  in  accord  with  the  anterior. 
At  last  he  could  not  support  himself.  In  five  or  six 
minutes   he   had   bloody   stools,  at    first  containing   other 


468  (Enanthe  crocaia. 

matters^  then  blood  only.  Nausea  retarned  more  severe, 
as  well  as  a  violent  hiccough.  Four  times  he  yomited 
white  matters  tinged  with  yellow  and  coated  with  bloody 
slime.  The  muscles  of  the  face  are  contracted,  with  inces- 
sant anxiety.  Trismus  prevents  the  exhibition  of  an 
emetic;  the  vomiting  aud  stools  become  more  frequent. 
He  tries  to  walk,  knocks  himself  about  everywhere  and 
seems  not  to  know  where  he  is  going.  He  falls  back,  is 
seized  with  violent  contractions,  and  dies  in  thirty-five 
minutes  after  the  poison.     No  post-mortem. 

6.  Forty  centigrammes  of  the  alcoholic  extract  diluted 
with  a  little  water  were  given  to  a  pretty  strong  rabbit. 
He  suffered  from  depression  and  refused  food ;  convulsions 
ensued,  the  hind  legs  became  visibly  weaker;  the  muscles 
of  the  head  and  face  contracted  ;  this  state  continued  from 
nine  to  twelve  hours  and  then  he  recovered. 

6.  July  12th9  6  a.m.  I  introduced  into  the  mouth  of 
an  adult  dog,  in  good  health  and  fasting  since  the  previous 
evening,  a  teaspoonful  of  fresh  Juice  of  (Enanthe  crocata. 
At  once  he  made  efforts  to  vomit  aud  uttered  hoarse  cries. 
He  is  much  agitated,  runs,  and  attempts  to  vomit,  but  in 
vain  ;  foams  at  the  mouth  and  threatens  to  bite  ;  often 
goes  to  drink  and  seems  relieved  pro  tern.  About  9  a.m., 
after  incredible  efforts,  he  vomited  all  the  liquid  he  had 
swallowed,  refused  broth  and  slept  calmly.  On  awaking, 
ate  a  little  and  drank  eagerly  and  often.  The  gums, 
mouth,  tongue,  and  pharynx  are  red  and  injected,  with  red 
patches  at  the  edge  of  the  velum  pendulum  and  the  columns. 

Urine  scanty,  no  stool,  abdomen  slightly  distended  ;  was 
left  to  rest  all  day  and  fell  asleep ;  plaintive  barking  at 
short  intervals ;  trismus  but  little  marked.  At  8  p.m. 
he  awoke,  whined,  and  tried  to  vomit;  changed  his  place 
continually,  and  rejected,  with  violent  hiccoughs,  food 
mixed  with  bile,  smelling  remarkably  acid.  Next  day  one 
diarrhoeic  stool.  At  night  he  seemed  better.  T  mixed  a 
tablespoonful  of  fresh  juice  with  200  grammes  of  broth, 
which  he  took  without  repugnance.  But  he  was  almost 
immediately  seized  with  retching  and  rejected  the  ingesta ; 
went    to    drink    as    yesterday  and    lay    down.      At    noon 


(Enanthe  crocata,  469 

yawning,  and  three  diarrhoeic  very  fetid  stools.  Next 
day  at  8.30  a.m.  I  was  much  surprised  to  find  the  animal, 
who  seemed  doing  well  over  night,  with  a  death-rattle  after 
▼ery  fetid  green  stools  ;  his  eyes  were  stiff  and  glassy  ;  jaws 
set  fast ;  heart  beating  tumultuously  aud  irregularly  ;  skin 
dry,  with  an  eruption  or  rather  venous  red  spots  on  the 
back  and  left  flank.  He  is  nearly  motionless,  so  I  dis- 
patched him  by  cutting  the  jugular,  and  proceeded  imme- 
diately to  the  post-mortem. 

Abdominal  cavity. — Acute  peritonitis,  arborescent  injec- 
tion on  the  intestines,  which  are  tympanitic  and  empty, 
especially  the  large  intestine ;  the  ascending  and  transverse 
portions  much  injected  with  large  reddish-brown  'spots  on 
their  surface,  indicating  incipient  gangrene.  The  mucous 
membrane  of  the  csecum  partly  detached ;  the  ileum  much 
injected,  jejunum  less  so  ;  duodenum  only  inflamed  at 
the  pylorus ;  the  surface  of  the  stomach  little  in- 
jected. Stomach. — ^At  the  opening  bright  red,  with  in- 
jection over  the  whole  of  the  large  cul-de-sac ;  the  mucous 
membrane  bloated ;  the  lesser  cul-de-sac  less  injected. 
The  pyloric  orifice  is  choked  by  an  (edematous  puff  of  a 
bright  red.  The  cardiac  is  equally  inflamed,  aud  the  con- 
gestion extends  to  the  extremity  of  the  oesophagus ;  the 
interior  of  the  buccal  cavity  red,  with  spots  such  as  above 
named.  Spleen  a  little  congested.  Kidneys  congested ; 
no  uria«  in  the  renal  pelves.  Liver  nothing  peculiar ;  vena 
portse  contains  some  clots.  Gall  bladder  very  little  bile. 
Respiratory  organs. — Lungs  injected,  crepitating ;  float 
well.  Trachea  normal,  some  ganglions  congested.  Larynx. 
— Mucous  membrane  slightly  oedematous.  Circulating 
system. — Heart  very  bulky,  right  ventricle  contained  a 
very  large  blood  clot,  fibrinous  at  the  upper  part,  and 
entangled  in  the  tricuspid  valve;  the  auricle  contains  a 
small  blackish  clot;  numerous  clots  in  the  pulmonary 
artery.  Left  side  normal,  except  a  marked  violet  tint  on 
the  columns  carnese ;  slight  endopericarditis.  Brain. — 
Considerable  effusion  of  bloody  serosity  between  the  brain 
and  dura  mater ;  injection  up  to  the  edge  of  the  interior 
lobes.     Vieussieux^s  centrum  ovale  pointed.      Ventricles. — 


470  (Enanthe  crocaia. 

Serous  effusion  abundant ;  cerebellum  normal,  exeept  the 
peduncles,  which  are  injected.  Spinal  cord, — Marked 
injection  all  the  way  to  the  cauda  equina ;  at  the  edge  of 
the  oliv4B  there  was  some  serosity  indicating  inflammation. 

7th.-^A  dog  above  ten  months  old  was  poisoned  with 
thirty  drops  of  the  alcoholic  tincture  in  100  grammes  of 
distilled  water.  The  first  day  anxiety,  agitation,  nausea, 
burning  thirst.  The  second  day  forty  grammes  of  tincture 
mixed  with  broth ;  same  symptoms  with  tottering  gait 
besides ;  can  no  longer  run,  but  drags  along ;  after  this  he 
reels  and  falls  if  forced  to  walk  ;  trismus.  The  third  day 
the  animal  is  better  and  we  let  him  rest.  The  fourth  day 
at  7  a.m.  twenty  drops  of  the  fresh  juice  mixed  with  his 
broth.  Almost  immediately  violent  shaking  of  the  bead 
and  limbs;  the  same  nausea  and  vomiting;  extreme  pro- 
stration;  fetid  and  frequent  stools.  At  11.80  he  died.  A 
post-mortem  took  place,  and  nearly  the  same  alterations 
were  found  as  in  the  preceding  case.  In  these  experiments 
the  poison  was  given  in  small  doses  in  order  to  study  the 
effects  better.  All  the  symptoms  stated  by  authors  were 
confirmed  :  trismus,  convulsions,  retching,  vomiting,  evacua- 
tions of  all  sorts ;  eruptions  more  or  less  circumscribed. 


Morbid  anatomy. 

We,  report  verbatim  this  chapter  as  a  risunU  of  the 
alterations  observed  in  several  post-mortema,  of  which  we 
have  given  but  one,  which  was  more  extensive  than  the 
rest,  and  because  it  comprehends  the  post-mortems  made  on 
animals. 

External  appearance. — Strongly  pronounced  rigidity  of 
the  body;  hands  strongly  clenched,  the  thumb  forcibly 
applied  to  the  palm.  Face  livid,  sometimes  injected,  but 
rarely,  pupils  widely  dilated ;  reddish  tinge  of  the  body, 
especially  marked  on  the  parts  lying  undermost.  Scrotum 
and  penis  livid.     Abdomen  tympanitic. 

Digestive  system, — Trismus  very  difiScult  to  get  over  (a 
constant  symptom).     Labial   mucous   membrane  red,  with 


GEnanihe  crocata.  471 

ecchymotic  spots  varying  from  bright  rose  to  gangrenous 
black ;  bloody  foam  at  the  uose  and  mouth ;  velum 
pendulum  palati^  the  two  columns  and  back  of  the  fauces^ 
red,  injected,  and  also  exhibiting  brown  spots;  glairy  ropy 
mucus  almost  always  present.  Tongue  bitten  at  the  tip 
(constant  symptom).  Papillae  on  the  base  of  the  tongue 
turgid  and  vascular.  Gums  purplish-red.  CEsophagus 
nothing  exterior,  vinous-red  tinge  on  the  interior;  ropy 
mucus,  red  and  brown  spots.  Stomach. — When  death 
supervened  rapidly  nothing  at  all  was  found  in  the 
stomach.  This  is  the  exception.  Most  frequently  it 
presents  a  more  or  less  deep  tint  of  red ;  its  mucous 
membrane  is  mammillated^  and  its  follicles  prominent  and 
tumid.  The  pyloric  and  cardiac  orifices  very  bright  red ; 
their  mucous  coat  raised,  oedematous,  and  can  be  raised 
with  the  handle  of  the  scalpel.  If  the  subject  has  been 
long  ill  there  is  softening  of  the  parietes  of  the  stomach, 
and  wide  ecchymotic  spots  capable  of  proceeding  to  perfo- 
ration. The  stomach  is  generally  empty ;  sometimes  con- 
tains defyris  of  the  root,  or  a  milky-yellow  juice  or  else 
dirty  grey ;  in  which,  with  a  lens,  one  can  find  little  drops 
of  the  gum -resinous  juice  or  the  fecular  grains  of  the  poison. 
It  is  sometimes  tympanitic^  and  the  contained  gas  has  the 
scent  of  fried  celery,  which  characterises  the  (Enanthe.  In 
the  large  intestines  the  vessels  are  injected  with  broad 
ecchymotic  spots,  distended  and  mostly  empty.  The  small 
intestines  almost  always  contain  the  dSbris  of  the  poison 
under  the  appearance  of  a  yellowish  matter  in  the  jejunum, 
browner  in  the  ileunr.  Liver  normal,  the  gall  bladder 
flabby  and  mostly  empty.  Spleen  and  pancreas, — Nothing 
special.  Kidneys, — Marked  injection  of  the  cortical  coat ; 
very  little  urine  in  the  renal  pelvis. 

Nervous  system, — Effusion  of  bloody  serum  and  some- 
times of  blood  at  the  occipital  foramen.  On  cutting  the 
meninges^  the  veins  of  the  pia  mater  distended  and 
highly  arborescent  at  the  edges  of  the  convolutions ;  apo- 
plectic foci  in  the  cerebral  mass,  which  is  strongly  injected 
and  speckled  (piquete).  The  annular  protuberance, 
medulla   oblongata^   and  peduncles  of   the    cerebrum  and 


472  (Enanihe  crocaia^ 

cerebellum  inflamed^  and  present  (especially  the  latter)  a 
certain  degree  of  softening.  Serous  effusion  in  the  cellular 
tissue  beneath  the  arachnoid^  the  ventricles,  and  at  the  base 
of  the  brain.  The  sinuses  of  the  dura  mater  are  distended 
with  blood.  Spinal  cord, — The  integuments  strongly 
injected  ;  the  vertebral  sinuses  filled  with  bloody  soft  and 
fluid.     Medullary  substance  red  and  congested. 

Circulating  system. — Heart, — Bulk  normal^  sometimes 
serous  effusion^  due  to  pericarditis.  Heart  always  gorged 
with  black  bloody  containing  fibrinous  clots ;  left  side 
generally  bloodless,  there  exist  also  brown  spots  on  the 
parietes  of  both  sides  of  the  heart ;  the  large  vessels  con- 
tain black  blood,  quite  fluid.  Respiratory  system. — 
Larynx,  epiglottis. — More  or  less  deep  colouring  of  the 
mucous  linings  with  more  or  less  injection  of  the  venous 
network  which  covers  it.  It  contains  a  frothy,  whitish 
fluid.  Trachea.  —  Injection  ;  bronchial  glands  gorged. 
Lungs. — Bulk  normal,  generally  crepitant,  presenting  some 
petechia  and  nuclei  of  pulmonary  apoplexy ;  bronchi  some- 
times gorged  with  thick  mucosities.  The  vessels  are  filled 
with  black  blood,  liquid  and  ropy ;  some  obstruction  was  also 
ascertained  at  the  back ;  but  this,  we  think,  was  the  result 
of  incipient  decomposition. 

In  short,  the  symptoms  produced  by  poisoning  with 
(Enanthe  crocata  are  as  follows,  according  to  authors  in 
general  and  Dr.  Bloc  in  particular.  The  attack  presents 
two  forms  :  first,  sudden  ;  second,  consecutive. 

1.  Some  minutes  after  swallowing  it  the  subject  utters 
a  cry  and  falls  a  prey  to  convulsions.  2.  These  symptoms 
do  not  appear  again  for  about  an  hour.  Local  symptoms. — 
Some  time  after  ingestion,  spots  appear  on  the  hands,  face, 
and  limbs,  at  first  rose-coloured,  then  becoming  deep  red 
like  the  stings  of  Urtica  urens.  This  eruption  may  extend 
over  the  whole  body ;  it  is  preceded  and  accompanied  by  a 
sharp  itching.  In  about  two  days  the  redness  abates,  the 
eruption  decreases,  leaving  a  scurfy  desquamation.  But 
the  progress  of  this  eruption  is  not  always  so  gentle.  The 
dermis  is  inflamed,  the  glands  are  gorged,  and  there 
appear  shortly  signs  of  a  phlegmon  which  runs  its  usual 


(Enanthe  crocata.  478 

course,  ending  either  by  resolution  or  suppuration. 
Observe  that  this  eruption  sometimes  shows  itself  in  sub- 
jects who  are  poisoned,  but  especially  from  the  application 
of  the  juice  on  the  hands. 

General  symptoms. — 1.  Regarding  the  nervous  system : 
shivering  at  the  outset  and  horripilation  ;  loss  of  conscious- 
ness and  of  memory;  agitation  brisk,  shaking^  and  inter- 
mittent—or rather  with  remission ;  acute  cries ;  delirium 
more  or  less  prolonged  ;  stupor,  vertigo  ;  convulsive  move- 
ments of  the  muscles  of  the  face,  jaws,  and  limbs  ;  sometimes 
opisthotonos.  Well-marked  trismus  proceeding  from  mere 
cramp  to  impossibility  of  opening  the  jaws,  or  having  them 
opened  by  force.  Dilated  pupils,  contraction  of  the  muscles 
of  the  eyelids,  spasms  of  the  muscles  of  inspiration,  fainting 
fits,  sometimes  horrible  convulsions  followed  by  general  in- 
sensibility and  death.     We  rarely  observe  hallucinations. 

2.  As  to  the  alimentary  canal,  an  acrid  sensation, 
biting  and  burning  on  the  tongue,  mouth,  and  fauces ;  sen- 
sation of  constriction  of  the  pharynx.  Appearance  of  red 
and  brown  spots  on  the  parts  directly  in  contact  with  the 
poison.  Bloody  froth  at  the  nose  and  mouth.  Tongue 
projecting  and  almost  always  bitten.  Acute  burning  pain 
of  the  oesophagus,  stomach,  and  intestines ;  pressive  pain  in 
the  epigastric  and  abdominal  region.  Nausea,  efforts  to 
vomit  with  or  without  effect.  Virulent  smell  of  fried 
celery.  Loss  of  appetite.  Obstinate  constipation,  or  fre- 
quent stools. 

3.  As  to  the  circulatory  and  respiratory  symptoms: 
irrregular  beating  of  the  heart;  small  pulse,  and  thread 
like ;  respiration  short,  with  long  intervals,  and  sometimes 
appearing  to  cease  entirely.  Brisk  expirations  are  made 
from  time  to  time  to  expel  masses  of  bloody  mucus. 

4.  As  to  secretions ;  at  first,  cold  clammy  sweats ;  then 
dryness  of  skin.  Excretion  of  urine :  In  general,  there  is 
retention,  and  very  little  is  passed  each  time. 

Of  all  maladies,  epilepsy  has  most  resemblance  to  this 
poisoning ;  but  epileptic  attacks  last  on  the  average  ten  to 
twenty  minutes,  whereas  the  sufferings  produced  by  the  poison 
are  of  long  duration,  extending  beyond  eight  hours  and  even 


474  (Enanthe  crocata. 

for  days  and  weeks.  In  epilepsy  the  trismus  never  lasts 
longer  than  the  fit,  and  is  not  always  present.  In 
poisoning  cases  it  not  only  appears  during  the  general 
attack  but  lasts  very  long»  even  so  as  to  prevent  emetic 
treatment  from  impossibility  of  introducing  liquid  into  the 
mouth,  and  they  have  to  inject  it  by  the  nostrils  with  the 
(Bsophagean  catheter.  Out  of  124  poisoning  cases  whose 
phenomena  have  been  recorded  in  this  work  there  were 
fifty-five  deaths. 

As  a  result  of  all  that  we  have  related  (almost  verbatim) 
it  is  the  opinion  of  other  authors^  and  of  Dr.  Bloc  himself, 
that  (Enanthe  crocata,  and  especially  the  root,  gives  rise  in 
man  to  all  the  symptoms  of  epilepsy.  According  to  ex- 
periments on  animals  with  the  fresh  juice^  or  aqaeous 
or  alcoholic  extract^  or  even  with  the  tincture  in  small 
doses,  it  provokes  in  them  also  symptoms  analogous  to 
those  of  epilepsy.  The  lesions  of  the  dead  body  ascertained 
by  post-mortem  examination  present  in  each  case  precisely 
the  same  alterations.  From  this  similitude  of  symptoms 
ascertained  during  life,  and  of  the  organic  lesions  found 
after  death,  may  we  not  hope  that  this  plant  can  be  ad- 
ministered beneficially  to  epileptic  subjects  ?  This  is  what 
we  wished  to  try  in  the  case  of  one  of  our  dispensary 
patients.  This  young  man,  about  22,  presented  frequent 
epileptic  vertigo,  and  sometimes  biting  of  the  tongue  and 
involuntary  urine  during  the  fit,  with  total  oblivion  of  all 
that  had  happened  during  the  crisis.  We  prescribed,  for 
four  months,  (Enanthe  from  the  6th  dilution  to  the 
''mother  tincture '^  in  drops.  Sometimes  we  observed 
retardation  of  the  attacks,  which^  from  fortnightly,  became 
monthly,  and  retardation  and  diminution  of  the  vertigo. 
But  at  other  times  the  vertigo  and  fits  reappeared  as  often 
and  as  intense  as  ever,  though  we  could  not  positively 
pi*ove  that  the  strong  doses  produced  aggravation.  This 
patient  left  ofi*  coming.  I  ought  to  add  that,  having  taken 
his  medicine  from  a  druggist's  shop,  where  I  was  not  quite 
sure  that  they  had  the  Mother  Tincture  of  (Enanthe  crocata, 
and  not  from  Messrs.  Catalan,  where  I  had  verified  its 
presence^  I  cannot  feel  certain  as  to  this  experiment. 


475 


NOTE  TO  "EXAMINATION  OP  HAHNEMANN'S 
PATHOGENESIS  OP  BELLADONNA/ 

By  Dr.  Bicha&d  Hughes. 

In  the  account  I  have  given  (?ol.  xzxi,  p.  669)  of  the 
sjrmptoms  cited  from  Greding,  I  have  said  that  SS.  262^ 
507,  648,  703,  704,  968,  1255,  1283  of  Hahnemaiiii'» 
pathogenesis  are  referred  to  a  paper,  of  this  author's  on 
Sirafnanium,  and  have  nothing  to  do  with  Belladonna.  I 
made  this  statement  upon  the  following  data.  The  first 
symptom  cited  from  Greding  (S.  12)  is  authenticated  thus.: 
^'  Greding,  in  Ludwig's  Adversaria  medica  Practica,  vol.  i, 
page  670.''  Subsequent  symptoms  are  cited  as  from 
''  Greding,  a.  a.  O.  '^  (t.  e.  loc.  cit.)  with  the  page  of  eacb» 
When  we  come  to  S.  262,  we  find  '^  Greding,  a.  a.  O.,  p* 
324.^'  This  should  mean  p.  324  of  the  same  book ;  and 
my  supposition  was  strengthened  when  I  found  that 
Greding  was  there  also  the  contributor.  S.  507  was 
similarly  characterised,  only  as  at  p.  321 ;  and  I  came  ta 
the  ccmdusion  that  Hahnemann  had  through  negligence  in- 
corporated into  the  pathogenesis  of  Belladonna  symptoms 
he  had  e»;erpted  for  that  of  Stramonium.  Under  this  (I 
think  justifiable)  impression,  I  classed  the  remaining 
symptoms  of  Greding's  whose  pagination  seemed  to  refer 
them  to  his  article  on  Stramonium  with  these  two,  and 
expunged  them  all. 

But,  some  time  after,  I  noticed  in  S.  648  an  addition 
which  had  escaped  my  eye.  It  is  credited  to  '*  Greding, 
a.  a.  O.,  vol.  ii,  part  2,  p.  323."  On  referring,  accordingly, 
to  the  second  volume  of  Ludwig^s  Adversaria^  I  found  a 
paper  of  Greding's  on  the  treatment  of  jaundice  by  Bella-^ 
donna,  in  which  all  the  eight  symptoms  occur.  I  have, 
therefore,  to  shift  to  my  own  shoulders  part  of  the  burden  of 
negligence,  but  must  submit  that  I  was  led  into  the  error 
by  the  incorrect  reference  given  in  SS,  262  and  507.  (I  may 
add  that  SS.  703,  704,  968  have  also  no  distinguishing 
mark;  but  SS.  1255  and  1283  have  IL  2  inserted.) 


476  Hahnemann^M  Pathogeneiii  of  Belladonna, 

These  symptoms  have  accordingly  to  be  examined  on 
their  own  merits. 

They  occurred  in  three  patients  suffering  from  jaundice 
— not  very  favourable  subjects,  one  would  suppose,  for  a  pure 
proving.  The  first,  a  woman  of  32,  presented  SS.  704  and 
1256.  Of  these,  S.  704  (''green  stool^  with  diuresis,  and 
thereafter  sweat ")  is  quite  inadmissible ;  for  the  green 
stools  (which  continued  several  days^  with  continuous 
decrease  of  the  icteric  tint  of  the  surface)  were  simply  the 
evidence  of  the  reappearance  of  bile  in  the  evacuations. 
S.  1265,  however,  seems  a  genuine  effect  of  the  drug ;  but 
it  should  have  read  "  pulsations  of  the  arteries,  especiaUy  in 
the  temporal  region/' 

The  second  patient,  a  girl  of  17,  was  the  subject  of 
SS.  507,  703,  968,  and  1283.  Of  these,  S.  703  must  be 
rejected  on  the  same  grounds  as  S.  704.  S.  968,  moreover, 
is  merely  an  aggravation  of  a  symptom  she  had  before 
beginning  the  Belladonna,  and  cannot  be  reckoned  a  certain 
drug-effect.  The  other  two  symptoms  have  nothing  to 
forbid  their  retention,  and  S.  507  is  of  some  importance. 

To  the  third  patient,  a  youth  of  17,  belong  SS.  262  and 
648.  The  first  is,  of  course,  a  Belladonna  symptom ;  but 
the  second  is  very  doubtful.  On  October  29th  he  com- 
plained of  pain  in  the  hypochondrium,  back  and  loins ;  and 
then  began  the  remedy,  gr.  j  of  the  powdered  leaves  being 
taken  twice  a  day.  On  the  3l8t  *'  he  felt  a  sense  of  con- 
siderable weight  pressing  in  the  lower  belly,  in  place  of  the 
pains  which  had  occupied  the  hypochondrium,  back  and 
loins.''  On  November  1st  this  sensation  was  much  less 
troublesome. 

My  conclusion  is  that  SS.  648,  703,  704,  and  968  are  to 
be  rejected ;  but  the  rest  retained.  As  I  was  unable  to 
make  this  investigation  in  time  to  incorporate  its  results  in 
my  arrangement  of  Belladonna  for  the  Hahnemann  Materia 
Medicay  I  will  ask  those  of  my  readers  who  possess  it  to 
write  in  the  following  : — 

750  a.  Inflammation  of  the  tonsils,  which  after  four  days 
suppurate ;  during  the  time  she  cannot  swallow  a  drop 
{Greding,  in  Hahn.). 


by  Dr.  Richard  Hughes.  477 

1190  a.  Remarkable  heat  of  the  body,  more  violent  and 
frequent  pulsations  of  the  arteries,  especially  in  the  tem- 
poral region,  with  dnlness  of  the  head,  and  subsequently 
profuse  sweat  {Ibid.). 

1197  a.  Great  heat  (immediately),  followed  by  profuse 
sweat  {Ibid.). 

S.  262  is  not  required,  as  it  is  merely  another  instance  of 
the  action  of  Belladonna  on  the  eyes,  of  which  I  have  cited 
so  many  in  my  collection. 

While  I  am  referring  to  my  Belladonna  in  the  Hahn. 
Mat.  Medica,  I  will  ask  those  who  possess  it  to  make 
another  emendation.  Erom  the  list  of  the  authors  cited  by 
Hahnemann  the  name  of  Wagner  has  accidentally  dropped 
out.  It  should  be  inserted  on  p.  5,  first  column,  between 
Vicat  and  WeinnUinnf  thus: — "Wagneb. — {Misc.  Nat. 
Ckir.,  Dec.  II,  Ann.  10,  Obs.  108.)  A  poisoning  of  two 
old  women  and  four  children  by  the  berries  (p.  206).'' 

Again,  I  have  been  directed  by  a  recent  remark  of  Dr. 
Hering's  to  a  collection  of  materials  for  the  pathogenesis  of 
Belladonna  by  Dr.  Karl  Hencke,  in  the  16th  vol.  of 
the  Vierteljahrschrift.  Had  I  known  of  this  a  year  ago 
it  would  have  spared  me  many  a  weary  search,  as  it  contains 
(in  brief)  most  of  Hahnemann's  originals.  It  has  given  me 
three  of  those  I  had  to  leave  as  inaccessible,  and  has 
guided  me  to  one  more.  The  following  are  the  facts 
elicited  : — 

69.*  Dumoulin's  original  communication  has  turned  up 
in  Yandermonde's  Journal  de  Midecine^  vol.  xi,  part  2, 
p.  119  (1759).  It  is  an  account  of  the  poisoning  of  two 
little  girls  by  the  berries.  The  symptoms  are  correctly 
extracted,  with  these  qualifications.  1st.  The  ^'staring 
look"  of  S.  297  should  rather  be  ''bold"  {audacieuw). 
2nd.  The  term  ''  paralysis "  applied  in  SS.  729,  763,  and 
971  to  the  state  of  the  lower  limbs  and  the  sphincters 
hardly  conveys  the  true  idea.  The  sphincters  were 
'' relachees,"  and  the  legs  ''engourdies  par  une  atonic 
paraly tique ;"  but  all  passed  off  within  half  an    hour  of 

*  The  namben  are  those  prefixed  to  each  author  in  my  examination  of 
Hahnemann's  pathogenesis. 


478  Hahnemann  8  Pathogenesis  of  Belladonna, 

vomiting  the  berries.  8rd.  S.  1404  is  simply  "  elles  be- 
gayoicDt  des  paroles  hardies/' 

60.  De  S.  Martin's  case  is  that  of  a  boy  of  four  poisoned 
by  the  berries.     The  symptoms  are  correct. 

67.  Mailer's  two  symptoms  seem  to  be  taken  from  a  case 
in  which  a  man  of  50  took  Belladonna  for  angina  fauciam. 
They  are  correct. 

69.  Wasserberg's  one  symptom  (S.  221)  is  deriyed  from 
a  proving  on  himself.  After  ^^  eyes ''  might  have  been 
added,  **  with  burning  in  these  and  in  the  lids." 

The  following  letter  from  Dr.  Berridge  relates  to  this 
subject ;  aud  seems  to  me  of  sufficient  interest  to  warrant 
its  publicatioQ  here^  with  my  answer  to  its  arguments. 

4y  HiOHBtJBY  New  Park,  N.  ; 

Jfoy  23rJ,  1874. 

My  deab  Sib, 

You  asked  me  some  time  ago  to  embody  the  ideas  I 
expressed  to  you  about  our  Materia  Medica^  in  a  letter  which 
you  said  might  be  published  in  the  British  Journal  of  ffomoBO- 
pathf^y  when  your  paper  on  Belladonna  was  finished,  with  some 
reply  thereto.  I  have  hitherto  been  prevented  doing  so,  but 
having  now  a  little  more  leisure,  begin  my  say  as  follows. 

The  plan  which  finds  favour  with  yourself,  and  the  majority  of 
the  members  of  the  Hahnemann  Publishing  Society,  apparently 
is  to  exclude  from  the  schema  of  the  Materia  Medica  all 
symptoms  which  are  (1)  obtained  from  the  sick,  and  (2)  all 
symptoms  which  are  only  clinical  and  not  pathogenetic ;  and  in 
your  article  on  Belladonna  you  entirely  reject  a  large  number  of 
the  symptoms  which  Hahnemann  extracted  from  other  writers, 
and  correct  many  others.  Now,  I  fiilly  admit  that  by  printer's 
or  clerical  errors  mistakes  have  crept  into  our  Materia  Medica, 
and  any  one  who  points  them  out  deserves  the  thanks  of  the  pro- 
fession; we  also  find  that  only  some  symptoms  have  been 
extracted  from  certain  cases  of  poisoning — a  fault  of  omission,  as 
the  other  is  a  fault  of  commission.  All  these  must  be  corrected, 
and  it  only  shows  the  importance  of  always  referring  to  the 
original  sources.  While  saying  this^  however,  I  do  not  wish  for 
a  moment  to  accuse   Hahnemann  himself  of  this  carelessness. 


by  Dr,  Richard  Hughes.  479 

My  own  opmion  is  that  he  either  employed  an  amanuiBnsis  who 
was  careless  (x^d  of  this  I  have  some  strong  proof),  or  that  he 
had  not  when  he  compiled  his  Materia  Medica  access  to  the 
original  sources  of  some  symptoms,  bat  only  to  copies  thereof,  or 
perhaps  to  brief  and  imperfect  notes,  which  he  may  have  taken 
years  before  when  an  allopath.  As  a  proof  of  the  former,  we 
find  that,  in  the  later  editions  of  his  Materia  Medica,  certain 
symptoms  (given  correctly  and  fully  in  the  earlier  editions)  are  not 
merely  condensed,  but  absolutely  mutilated  and  perverted  in  a 
manner  which  neither  Hahnemann  himself  nor  any  other  man 
who  loved  scientific  accuracy  could  ever  have  been  guilty  of. 
Several  instances  of  this  were  pointed  out  by  Dr.  David  Wilson, 
in  the  Monthly  Homoeopathio  Beview,  vol.  vii,  pp.  664 — 688.  In 
Hering^s  Materia  Medica^  under  Sponyia,  we  read,  ''  By  com- 
paring Hahnemann's  second  edition  with  the  first,  sia  correc- 
tions were  made,  and  three  omitted  symptoms  could  be  added.*' 
(See  also  Symptom  521  in  Hering's  Materia  Medica.) 

With  regard  to  my  theory  that  Hahnemann  had  not  always 
access  to  the  originals^  I  may  quote  the  following  case : — 

In  Medical  and  FhUosophical  Commentaries,  1776,  vol.  iv,  p.  73, 
we  find  a  case  of  poisoning  by  the  application  of  Sulphate  of 
Copper  to  a  wound  on  the  back  of  the  hand,  reported  by  Dr. 
Simmons.  Swelling  of  hand  followed,  a  lymphatic  vessel  was  felt 
painful,  and  inflamed  a  great  way  up  the  arm,  and  there  was  pain 
in  axilla.  In  our  Materia  Medica  we  read,  however  (not  to 
mention  another  slighter  inaccuracy),  **  heaviness  of  axillary 
glands,"  this  symptom  being  unwarrantably  separated  from  the 
remainder  of  the  group.  The  mistake  is  plain.  Schmerz  was 
altered  into  Schwere,  and  this  error  has  been  copied  not  only 
into  Hempel's  Jahr,  but  also  into  two  of  the  German  repertories. 
BiU  it  is  not  Hahnemann's  mistake.  Cuprum  is  not  mentioned 
in  ^e first  edition  of  the  Chronic  Biseases^hxit  is  given  m^Stapfs 
Arehiv,  where  I  am  told  by  a  colleague  who  referred  to  the 
work  the  symptom  is  erroneously  given  as  stated.  GlearJy, 
therefore,  Hahnemann,  not  having  access  to  the  original,  copied 
from  the  only  source  available. 

I  have  written  this  to  clear  the  memory  of  the  master  from  the 
charge  of  carelessness  or  inaccuracy;  and  as  for  printer's  or 
clerical  errors,  none  know  so  well  as  authors  how  easily  they 
occur  in  spite  of  all  pains. 


480         Hahnemann's  Pathogenesis  of  Belladonna, 

Thus  much  for  erroneoualj  quoted  Bjmptoms.  I  will  now  say  a 
few  words  about  those  which  a  ou  omit,  on  the  ground  that  the 
prorers  were  not  healthy.  In  the  first  place,  to  treat  this  subject 
generally,  no  one  is  absolutely  healthy,  and  where  are  we  to  draw 
the  line  ?  and  when  we  find  even  in  that  "  purest  of  the  pure  '* 
repertory,  the  Cypher  one, "  toothache  occurring  in  decayed  teeth,'' 
that  is  to  say,  symptoms  occurring  not  only  in  the  sick,  but  in  a 
diseased  organ,  I  cannot  but  think  that  the  ''  purifiers  "  of  our 
Materia  Mediea  have  no  certain  line  of  conduct  by  which  to 
guide  their  actions. 

But  to  keep  to  Hahnemann.  In  the  first  two  editions  he  kept 
separate,  not  only  the  observations  from  allopathic  authors,  hut 
even  those  of  his  own  eo-worhers,  including  his  own  son.  This 
shows  how  cautious  he  was.  Now,  since  in  the  third  edition  he 
united  these  with  his  own,  we  may  accept  these  ujith  Hahne- 
mann's endorsement,  doubtless  as  having  been  confirmed  by  his 
clinical  experience.  I  am  aware  that  clinical  experience  is  often 
said  to  be  fihUacious;  we  are  told  that  we  know  too  little  of 
pathology  to  judge  of  the  precise  effect  of  a  medicine  in  curing 
disease ;  that  many  diseases  disappear  spontaneously ;  that  change 
of  regimen  plays  an  important  part  in  the  cure,  &c.  But  are 
these  objections  advanced  seriously  ?  If  so,  then  we  are  all  a  set 
of  ignoramuses,  and  the  fewer  clinical  cases  we  publish  the  better 
for  ourselves  and  for  homoeopathy.  But  after  eliminating  all 
doubtful  ctires,  a  vast  body  of  material  remains  behind  for  use. 
Besides,  the  objection  proves  too  much.  If  we  ignore  clinical  con- 
firmations, how  do  we  know  that  similia  similihus  curantur  ?  No 
number  of  provings  without  clinical  experience  can  prove  this. 

Now  with  regard  to  the  admission  of  clinical  symptoms  into 
our  Materia  Mediea,  In  the  Hahnemann  Materia  Mediea  they 
are  rigorously  excluded  from  the  schema,  not  even  being 
admitted  with  a  mark  of  distinction  (or  extinction)  attached, 
though  in  the  Cypher  Repertory,  published  by  the  same  society, 
several  are  admitted  *  without  any  mark  of  distinction.  I  can  only 
regret  that  such  is  the  case,  and  I  can  assure  the  compilers  of 
that  Materia  Mediea  that  it  will  never  be  favorably  received  by 
all  the  homoeopathic  profession  until  they  rescind  this  rule. 
Consider  the  value  of  an  arrangement  like  Bering's  where 
they  are  admitted.     We  see  at  a  glance  how  often  a  symptom  has 

•  If  BO,  it  is  bj  mistake. — [Eds.] 


by  Dr.  Richard  Hughes.  481 

been  produced,  on  what  prover,  and  bow  often  confirmed 
clinically;  so  that  if  a  symptom  rests  on  the  evidence  of  one 
prover  only  the  fact  is  evident,  and  we  need  not  rely  on  it  unless 
we  choose.  But  the  matter  lies  in  a  nutshell .  The  simple 
question  is,  ''  Are  climcal  iymptams  ttseful  or  necessary ^  or  are 
they  not  f  *  If  they  are  not,  away  with  them ;  if  they  are,  admit 
them,  of  course  marking  them  as  such.  I  can  only  say  from  my 
own  experience  that  they  are  both  useful  and  necessary  to  supply 
the  gaps  in  our  Materia  Medica ;  and  I  have  cured  cases  hy 
remedies  selected  according  to  reliable  clinical  symptoms  which  I 
should  not  tothenoise  have  been  able  to  treat  on  account  of  the 
deficiency  of  our  Materia  Medica.  Others  have  found  the  same, 
but  I  will  only  mention  one  case  recorded  in  the  May  number  of 
the  Hahnemannian  Monthly  for  this  year.  Many  years  ago  Hale 
published  a  clinical  but  characteristic  symptom  of  Ooffea^  viz., 
toothache  relieved  hy  cold  water.  This  symptom  was  afterwards 
repeatedly  confirmed  clinically,  but  no  proving  contained  it. 
jKow  Hale  publishes  a  case  of  poisoning  by  Coffea,  consisting 
of  this  very  symptom,  and  proving  the  accuracy  of  the  previous 
clinical  experience.  Now,  inasmuch  as  no  remedy  will  com- 
pletely fill  the  place  of  another,  how  many  patients  would  have 
remained  more  or  less  unrelieved  from  that  terrible  complaint 
had  this  clinical  experience  been  withheld  or  neglected  ?  When 
our  provings  are  more  perfect,  there  will  be  less  need  of  clinical 
symptoms,  as  they  will  be  replaced  by  pathogenetic  ones ;  there  is 
only  at  present  one  true  and  satisfactory  course  to  pursue ;  give 
every  bond  fide  symptom,  clinical  as  well  as  pathogenetic,  giving 
the  clinical  symptoms  always  in  groups  as  they  occurred,  and 
not  separated  from  each  other ;  tattoo  them  as  you  will,  only  let 
us  have  them  to  judge  for  ourselves  ;  give  us  the  food  we  ask  for, 
but  do  not  fall  into  the  nurse's  habit  of  chewing  it  first; 
multiply  provings  with  all  doses,  and  publish  all  good  clinical 
cases ;  then  in  fifty  years'  time  we  may  be  able  to  say  what 
symptoms  have  stood  the  test  and  what  have  not,  but  not 
before  ;  at  present  the  attempt  to  *'  purify  "  the  Materia  Medica 
is  like  trying  to  run  before  learning  to  walk,  and  meets  with  the 

usual  consequences. 

Tours  truly, 

"W.  Bebsidqb,  M.B.  Lond. 
Dr.  Berridge  has  a  right  to  be  heard  on  this  subject^  to 

VOL.  XXXII^  NO.  CXXIX. JULY,  1874,  H  H 


4'82  Hahnemann's  Pathoytnesis  of  Belladonna, 

which  he  has  devoted  much  thought  and  attention.  But  I 
regret  that  I  am  utterly  unable  to  assent  to  the  two  leading 
theses  he  propounds. 

I.  Dr.  Berridge's  first  point  is,  that  we  do  wrong  to 
reject  any  symptom  furnished  bond  fide  as  an  observed 
effect  of  a  drug ;  and  that  our  emendations  of  Hahnemann's 
pathogeneses  should  be  limited  to  the  correction  of  clerical 
and  printer's  errors. 

So  far  as  the  reports  of  provers  are  concerned,  I  for  one 
have  no  objection  to  the  position  Dr.  Berridge  takes  up. 
I  admit  the  uncertainty  of  tracing  effects  to  cause,  and 
would  not  reject  any  of  the  former  which  occurred  while 
the  latter  was  operating,  if  the  observer  warranted  them. 
Should  any  special  element  of  uncertainty  exist,  I  would 
(with  Hahnemann)  bracket,  but  not  expunge.  But  since 
Dr.  Berridge's  remarks  are  elicited  by  my  examination  of 
Belladonna-^jmyiom^  which  Hahnemann  has  cited  from 
authors,  I  must  understand  him  as  referring  to  contribu- 
tions from  this  source.  Here  I  cannot  admit  that  b(ma 
fides  is  any  sufficient  guarantee  of  correctness.  The  quali- 
ties we  should  require,  were  we  unable  to  verify  the  quota- 
tions, would  be  (1st)  industry,  care,  and  discrimination  on 
the  part  of  the  citer ;  and  (2nd)  that  he  should  have  access 
to  the  originals  he  uses,  and  should  excerpt  for  himself  and 
not  through  another.  But  where  we  ourselves  could  examine 
the  originals,  we  should  not  be  left  to  infer  from  such 
considerations  the  value  of  the  symptoms  cited :  we  should 
have  to  determine  their  future  estimation  from  the  facts  we 
elicited. 

Now  what  Dr.  Berridge  advocates  amounts  to  this,  that 
we  should  ignore  the  latter  mode  of  proceeding  altogether ; 
and  act  as  though  the  sources  of  Hahnemann's  citations 
were  as  hidden  from  us  as  the  day-books  of  his  provers. 
Such  a  shutting  of  the  eyes  to  facts  seems  self-condemned, 
and  needs  weightier  arguments  than  Dr.  Berridge  has 
adduced  if  it  is  even  to  receive  consideration.  But,  indeed, 
one  of  the  strongest  arguments  against  it  is  furnished  by 
Dr.  Berridge  himself  in  this  very  letter.  He  tells  us  that  he 
has    ^'strong    proof"    that     Hahnemann     '^employed    an 


by  Dr.  Richard  Hughes.  483 

amanuensis  who  was  careless  /^  and  thinks  it  most  probable 
"  that  he  had  not  when  he  compiled  his  Materia  Medica 
access  to  the  original  sources  of  some  symptoms^  but  only 
to  copies  thereof^  or  perhaps  to  brief  and  imperfect  notes 
which  he  may  have  taken  years  before  when  an  allopath/' 
Dr.  Berridge  advances  this  to  exonerate  Hahnemann  from 
carelessness ;  but  surely  the  burden  must  be  shifted  to  our 
own  shoulders  if^  believing  thus,  we  make  no  attempt  at 
verifying  citations  so  made  when  the  opportunity  is 
afforded. 

Dr.  Berridge,  however,  himself  counsels  reference  to  the 
originals,  but  only  for  the  purpose  of  correcting  printer's 
or  clerical  errors.  Let  us  see  what  would  be  the  result  of 
such  limitation,  in  the  instance  which  he  himself  brings 
forward.  The  symptom  of  Cuprum,  *^  heaviness  of  axillary 
glands/'  is  a  clerical  error.  '*  Schwere  "  has  been  written 
in  mistake  for  ''Schmerz/'  the  real  axillary  trouble  was 
'^  pain."  But  Dr.  Berridge  goes  on  to  tell  us  that  this 
symptom  is  taken  from  '^  a  case  of  poisoning  by  the  applica- 
tion of  Sulphate  of  Copper  to  a  wound  on  the  back  of  the 
hand.  Swelling  of  the  hand  followed ;  a  lymphatic  vessel  was 
felt  painful  and  inflamed  a  great  way  up  the  arm,  and  there 
was  pain  in  the  axilla."  He  admits  that  this  last  symptom 
is  "unwarrantably  separated  from  the  remainder  of  the 
group;"  but,  it  having  been  furnished  bond  fide,  would 
correct  the  clerical  error,  and  retain  it.  What  is  the 
result?  The  impression  made  on  every  mind  by  seeing 
^'pain  in  the  axillary  glands"  in  the  pathogenesis  of 
Cuprum  must  be,  that  this  symptom  resulted  from  the 
internal  administration  of  the  drug ;  and  it  would  be  used 
therapeutically  in  accordance  therewith.  Now,  a  statement 
calculated  to  produce  an  erroneous  impression  is  a  false- 
hood ;  and  if  that  impression  is  to  lead  to  action,  it  is  an 
injurious  falsehood.  Had  Hahnemann  wilfully  made  such 
a  statement,  the  deception  and  wrong  would  have  been  his. 
I  maintain  that  they  become  ours. if,  knowing  the  statement 
to  be  misleading,  we  allow  and  retain  it. 

But    Dr.    Berridge    tells    us    that    symptoms,    however 
doubtful   their    origin,    may    be    "  confirmed    by    clinical 


484  Hahnemann  8  Pathogenesis  of  Belladonna, 

experience/'  I  cannot  admit  that  such  symptoms  as  the 
above,  which  are  radically  false^  can  be  confirmed  by  any 
evidence  whatever.  But  I  take  exception  to  the  kind  of 
confirmation  suggested,  even  in  the  case  of  symptoms  which 
in  themselves  are  merely  doubtful.  The  argument  implied 
is,  that  since  simUia  similibus  curantur,  the  fact  of  a  morbid 
condition  having  disappeared  under  the  use  of  a  drug  makes 
it  certain  that  the  drug  might  cause  such  condition  on  the 
healthy  subject.  But  this  argument  only  appeals  to  those 
who  believe  in  similia  similibus;  it  has  no  force  with  others. 
And,  since-  we  all  begin  by  being  of  these  "  others/'  it  is 
most  unwise  to  put  forth  pathogeneses  having  no  better 
support  than  such  a  (to  them  unwarrantable)  assumption. 
With  ourselves,  moreover,  it  does  no  more  than  establish  a 
presumption.  Even  if  we  may  so  assume  the  universality 
of  similia  similibns,  we  get  no  proof  that  in  the  case  in 
question  the  symptom  was  actually  produced  by  the  drug, — 
which  is  the  statement  we  make.  Pathogenesy — pharma- 
cology— ^is  a  science  by  itself,  and  should  stand  upon  its 
own  ground.  Its  relation  to  therapeutics  is  a  separate 
question,  and  one  which  requires  pure  facts  for  its  decision. 

I  think  that  Dr.  Berridge  is  mistaken  in  supposing  that 
Hahnemann  relied  upon  this  kind  of  ^'  confirmation/'  He 
regards  the  incorporation  of  the  ''Observations  of  Others'' 
with  his  own  in  the  third  edition  of  the  Mat.  Med,  Pura  as  his 
endorsement  of  them,  '*  doubtless  as  having  been  confirmed 
by  his  clinical  experience.''  But  Dr.  Hering  has  lately  told 
us  that  Hahnemann  efi^ected  this  incorporation  at  the  in- 
stance of  his  disciples,  and  against  his  own  better  judg- 
ment. 

II.  And  now  as  to  the  question  of  the  admission  of 
"  clinical  symptoms  "  as  such ;  i.e.  of  symptoms  which  have 
disappeared  in  sick  persons  under  the  administration  of  a 
drug.  The  answer  will  be  somewhat  difierent  according  to 
the  nature  of  the  list  into  which  the  admission  is  claimed. 
If  it  is  a  Materia  M^dica  like  Hahnemann's,  a  pure 
collection  of  pathogeneses,  then  I  think  we  must  follow  his 
example  in  excluding  them  utterly.  This,  of  course,  applies 
to  such  a  work  as  that  forthcoming  under  the  management 


by  Dr.  Richard  Hughes.  485 

of  Dr.  Allen.  But  in  monographs  upon  medicines,  like 
those  of  Dr.  Hering  and  of  the  Hahnemann  Materia 
Medica,  clinical  experience  must  be  inserted ;  and  it  is  only 
a  question  of  expediency  how  it  should  be  done.  Dr. 
Hering  prefers  to  include  symptoms  cured  by  the  drugs 
with  those  caused  by  them  in  one  list ;  those  who  have 
contributed  to  the  Hahnemann  Materia  Medica  have  judged 
it  better  to  keep  the  pathogenetic  effects  pure  for  use 
according  to  the  homoeopathic  method,  and  to  insert  their 
therapeutic  applications  hitherto  in  notes  or  commentary  or 
appendix.  What  Dr.  Berridge  says  about  the  usefulness  of 
"clinical  symptoms^'  is  merely  what  we  all  recognise  as 
the  value  of  the  tmut  in  morbis,  and  does  not  touch  the 
question  of  the  arrangement  of  our  material. 

Dr.  Berridge  has  some  remarks  upon  a  third  point, — my 
omission  of  some  of  Hahnemann's  symptoms  on  the  ground 
that  the  provers  were  not  healthy.  I  have  no  difference 
with  him  in  what  he  savs  on  this  point.  I  have  excluded, 
in  my  treatment  of  Hahnemann's  pathogenesis  ot  Belladonna, 
no  symptoms  on  this  ground  merely ;  e.  g.,  I  have  admitted 
symptoms  observed  upon  Greding's  epileptics,  Lambergen^s 
and  OUenroth's  cases  of  mammary  cancer^  and  Wiedemann's 
children  with  whooping-cough.  I  have  only  rejected  such  as 
were  too  closely  connected  with  the  existing  disease,  as  the 
rage  of  maniacs  and  the  convulsions  of  epileptics,  or  those 
occurring  (as  in  Banter's  cases  of  hydrophobia)  in  the  very 
paroxysm  of  the  disorder,  in  which  it  is  impossible  to  separate 
idiopathic  phenomena  from  the  effects  of  a  drug  adminis- 
tered.  I  must  maintain  that  in  this,  and  in  the  rest  of  my 
dealings  with  Hahnemann's  citations^  I  could  not  have  done 
otherwise  than  I  have.  Dr.  Berridge  applauds  reference  to 
the  originals.  What  could  I  do,  when  I  had  them  before 
me,  but  correct,  expunge^  or  mark  as  doubtful,  whenever 
the  facts  so  directed  ?  And  for  those  symptoms  to  whose 
sources  I  had  no  access — what  remained  but  that,  seeing 
the  frequent  laches  which  had  been  detected  in  their  fellows 
(to  say  nothing  of  the  "  careless  amanuensis/'  the  "  brief 
and  imperfect  notes/'  &c.),  I  should  mark  them  as  not  to 
be  much  depended  upon  until,  verified.      Such  is  the  extent 


486  On  HamoptysiSy 

of  "  purification  of  the  Materia  Medica  "  which  I  advocalQ 
and  practise ;  and  I  am  at  a  loss  to  understand  the  hostility 
with  which  it  is  greeted  by  those  who  should  prise  a  reliable 
pathogenetic  collection  above  all  medical  treasures. 


ON  SOME  CASES  OF  HAEMOPTYSIS. 
By  Dr.  Herbert  Nankivell. 

(Bead  before  the  Britiah  Honueopathic  Society.) 

Mr.  President  and  Gentlemen, — I  do  not  intend  to- 
nightj  as  you  will  already  have  gathered  from  the  title  of 
my  paper,  to  deal  with  the  medical  and  therapeutical 
aspects  of  hsemoptysis,  including  under  that  term  all 
possible  varieties  of  the  disease,  but  rather  from  a  practical 
point  of  view  to  give  a  classified  rSsumS  of  certain  cases 
thereof  which  have  come  under  my  notice  during  the  last 
few  years,  and  of  the  treatment  which  has  been  adopted  in 
these  cases. 

I.  In  the  first  class  I  would  place  all  those  cases  in 
which  the  haemoptysis  occurs  without  cough,  excluding,  of 
course,  all  cases  of  oesophageal,  gastric,  or  nasal  haemor- 
rhage from  this  category.  The  hsemorrhage  in  these  cases 
occurs  from  the  mucous  membrane  of  the  gums  or  mouth, 
or  the  pharynx,  or  of  the  pharyngeal  district  of  the  larynx, 
superior  or  exterior  to  the  vocal  cords.  This  hsemorrhage 
is  usually  chronic ;  it  is  periodical,  occurring  either  during 
the  night  or  in  the  early  morning  before  rising.  So  far 
as  my  experience  goes,  it  has  been  confined  to  the  female 
sex,  and  is  influenced  considerably  for  the  worse  on  the 
arrival  or  departure  of  the  menses.  Pure  blood  is  seldom 
expectorated ;  generally  speaking,  the  sanguineous  discharge 
is  a  dirty  blackish  fluid  like  sloe  or  black  currant  juice 
mixed  with  saliva,  or  mucus  from  the  pharynx.  There  is, 
as  I  have  said,  no  cough,  and  the  extrusion  of  the  blood 


by  Dr,  Herbert  Nankivell,  487 

from  the  fauces  is  caused  by  a  reversed  action  of  the 
pharyngeal  constrictors^  the  mylo-hyloid  and  platysma  also 
being  thrown  into  movement. 

The  general  health  in  these  cas6s  varies  according  to  the 
length  and  severity  of  the  malady ;  the  pulse  is  weaker 
and  quicker  than  usual,  but  there  is  not  generally  any 
hectic.  There  is  emaciation  to  a  variable  amount ;  the 
respiratory  power  is  often  markedly  less,  both  m  the  ability 
for  exertion  and  in  the  actual  breath-sounds^  than  in  health. 

Case  1 , — A  married  lady,  aet.  30,  the  mother  of  three  or 
four  children^  came  to  Bournemouth  in  January  last.  Has 
had  morning  haemoptysis  for  several  months — dirty  bloody 
saliva,  in  fact.  Decided  gastric  derangements;  has  given 
up  fresh  vegetables  and  milk  for  a  long  time.  Pulse  72, 
weak ;  respiration  natural  in  rapidity,  but  slightly  deficient 
in  the  apices.  Gums  spongy ;  tongue  furred ;  pharynx 
streaked  with  dilated  vessels.  Laryngoscope  disclosed  no 
ulceration. 

The  diet  was  altered;  fresh  vegetables  and  a  lemon 
daily ;  two  pints  of  milk,  and  meat  twice  daily.  Nitric 
acid  2*,  Hydrochloric  acid  2^,  and  Arsen.  8"  were  pre- 
scribed in  succession  with  very  good  effect.  The  gums 
resumed  their  normal  appearance,  the  pharynx  im- 
proved, and  the  haemoptysis  was  first  reduced  to  a  mini- 
mam,  and  at  present  very  seldom  reappears. 

Case  2. — ^An  unmarried  lady,  aet.  25,  consulted 
me  first  in  1873,  had  then  suffered  from  haemoptysis 
for  three  years,  either  a  thick  mucous  or  sanious  discharge 
occurring  from  the  fauces  every  night  about  2  to  4  a.m. 
Had  been  treated  allopathically.  The  diagnoses  had 
differed^  one  alleging  a  cavity  in  the  right  lung,  the  other 
merely  a  throat  irritation.  Weight  had  been  steadily  lost 
from  the  commencement  of  the  illness.  The  chest  was 
fairly  healthy,  except  weakened  respiration  at  the  right 
apex ;  pulse  80  and  weak ;  digestion  slow  and  accompanied 
with  flatulence.  The  laryngoscope  disclosed  some 
reddening  and  thickening  of  tHe  arytenoid  cartilages;  the 


488  On  Hiemoptysis, 

vocal  cords  were  perfectly  healthy,  but  in  the  fossffi  on  each 
side  of  the  pharyngeal  surfaces  of  the  cricoid  were  superficial 
ulcerations. 

The  treatment  at  first  was  directed  to  the  digestion, 
which  had  long  been  at  fault.  Bry.^  Puls,^  and  Ign,  were 
the  medicines  chiefly  indicated ;  the  power  of  assimilation 
was  increased,  and  after  a  time  the  gradual  loss  of  weight 
ceased.  A  spray  of  carbolic  acid,  occasional  painting  with 
Glycerine  and  lod.  (gr.  zx  to  5J)>  ^^^  ^^^  internal  use  of 
Brom,  Ars.  3%  have  been  the  chief  remedies  directed  to 
the  haemoptysis  and  its  cause.  During  this  winter  the 
haemoptysis^  though  not  cured,  has  been  of  rare  occurrence ; 
the  ulcers,  which  are  still  visible,  discharging  a  thick  mucus 
every  night,  the  quantity  of  which  is  slowly  decreasing. 


II.  In  the  second  division  I  should  place  those  cases  in 
which  the  haemorrhage  is  tracheal  in  its  origin.  It  is 
usually  here,  as  in  the  first  division,  of  a  passive  character, 
and  is  confined,  except  when  severe  exacerbation  is  present, 
to  the  morning  hours,  generally  speaking,  within  the  limits 
of  5  to  10  a.m.  The  subjects  are  usually  of  the  erethistic 
strumous  type ;  stout,  florid,  and  incapable  of  sustained 
bodily  exertion,  but  of  considerable  mental  vivacity.  In 
women,  to  whom  my  observations  of  this  disease  have  been 
confined,  the  menstrual  flow  is  often  rather  excessive  than 
otherwise,  and  the  haemorrhage  either  lessens  or  is  aggra- 
vated when  the  menses  are  at  hand.  Cough  is  a  marked 
symptom  of  this  class ;  it  is  usually  laryngeal  in  character, 
and  the  mucous  membrane  of  the  larynx  is  generally  highly 
injected,  and  there  may  be  also  superficial  ulcerations  or 
abrasions  of  the  epithelium.  The  cough  bears  no  pro- 
portion to  the  amount  of  haemorrhage,  and  is  often  more 
severe  in  the  later  part  of  the  day,  when  the  bleeding  has 
quite  ceased.  The  lungs  are,  in  the  earlier  stages  at  least, 
pretty  free  from  implication,  though  occasional  crepitations 
are  detected  if  examinations  are  frequently  made,  the 
exciting  cause  of  these  being  probably  inspired  blood. 
The  treatment  of  this  disease,  whether  local  or  general,  is 


by  Dr.  Herbert  Nankivell.  489 

full  of  disappointment — at  least,  this  has  been  my  general 
experience. 

Case  8. — A  lady,  set.  40,  married,  but  without  family, 
came  under  my  care  in  November,  1872.  She  was  stout, 
easily  flushed  ;  pulse  small  and  80 ;  slight  crepitation  in  right 
apex ;  pretty  frequent  cough ;  expectoration  of  bright  bloody 
sputa  every  morning  to  the  amount  of  about  an  egg-cupful ; 
occasionally  this  was  dark  and  semi^-putrid*  After  about  a 
month's  treatment  the  right  apex  recovered  its  respiratory 
power ;  the  cough  and  expectoration  got  much  less,  but  did 
not  disappear ;  the  cough  became  in  the  spring  mostly  laryn- 
geal in  character,  and  the  larynx  on  examination  showed  a 
congested  mucous  membrane  with  enlarged  but  not  ulcerated 
follicles ;  the  veins  at  the  root  of  the  tongue  and  in  the 
trachea  were  dilated.  The  sputa  were  sometimes  only 
three  or  four  small  pink  lumps,  at  other  times  ten  or  % 
dozen ;  and  again,  the  colour  might  be  quite  dark  and  the 
smell  putrid.  The  lungs  kept  generally  free  from  compli- 
cation, but  occasional  crepitations,  probably  caused  by 
inspired  blood,  would  be  heard  either  in  one  or  other  apex. 
The  termination  of  this  case  was  as  follows :  the  lady  took 
cold  in  her  journey  home  from  Bournemouth,  and  efl'usion 
took  place  into  the  left  pleura ;  on  two  occasions  paracen- 
tesis thoracis  was  performed,  but  two  weeks  after  the  second 
operation  death  occurred. 

In  this  case  I  tried  every  remedy  in  the  pharmacopoeia 
for  the  haemorrhage.  I  gave  the  usual  allopathic  styptics 
as  well,  and  used  local  styptic  sprays;  but  nothing  seemed 
to  have  any  sustained  influence  on  the  bleeding,  which, 
however,  was  much  less  when  she  left  Bournemouth  than  it 
had  been  on  her  arrival  there. 

Case  4. — A  lady,  set.  23,  stout,  florid,  but  strumous 
looking,  had  sufiered  intensely  from  chilblains  in  the  winter 
of  1872-73,  and  came  under  my  care  in  the  summer  of 
1872  for  the  efi'ects  of  them,  and  also  for  hysterical 
aphonia.  The  aphonia  soon  disappeared  under  Ign.y  and 
the  swollen  and   stifiened  legs  and   feet  greatly  improved 


490  On  Hamoplysis, 

under  sea-bathing.  In  Augnst,  1873^  she  again  visited 
Bournemouth,  and  consulted  me  for  her  voice^  which  had 
again  disappeared.  Iffn.,  Strychnine,  lod.,  all  failed,  as  did 
the  local  application  of  electricity  and  the  continued  use  of 
Pulvermacher^s  chains.  Causticum  followed  hj  Iffn,  was 
then  given,  and  in  October  the  whisper  had  given  place 
to  a  faint  squeak.  Just  as  this  rudimentary  voice  was 
developing,  she  was  exposed  early  in  November  to  the 
intense  cold  of  two  or  three  nights;  sleeping  at  the  time  in 
an  attic  without  fires.  A  severe  and  incessant  laryngeal 
cough  came  on  accompanied  with  haemoptysis  to  the  extent 
of  one  or  two  ounces  every  morning,  about  daylight,  of  dark 
liquid  blood.  It  was  curious  that  the  cough,  intensely 
violent  as  it  was  throughout  the  day  and  evening,  was  never 
at  those  times  accompanied  with  haemoptysis.  The  larynx 
was  much  irritated  and  congested,  especially  the  epiglottis 
and  arytenoids,  which  were  superficially  ulcerated.  The 
haemorrhage  was  evidently  partly  vicarious,  as  it  suc- 
ceeded to  a  checked  menstrual  discharge,  and  continued 
with  slowly  diminishing  severity  to  the  next,  when  it  rather 
more  rapidly  disappeared.  Hamam,,  Ferr,  acei.,  GaUiccicid, 
and  Secale  were  given  in  this  case,  the  latter  alone  with 
anything  like  decided  effect ;  the  laryngeal  condition  was 
treated  with  Calc,  tod.  and  a  paint  of  Glyc.  and  lod, ;  the 
cough  was  intensely  stubborn^  and  yielded  only  to  the 
gradual  amelioration  of  the  other  symptoms.  She  after- 
wards went  to  the  Throat  Hospital,  and  was  for  eight  weeks 
under  the  care  of  Dr.  Mackenzie ;  the  voice  was  restored 
by  the  application  of  electricity  to  the  vocal  cords,  and  the 
bleeding  and  cough  ceased,  though  the  throat  remained  very 
sensitive  and  the  general  powers  low. 

III.  In  the  third  class  of  cases  of  haemoptysis  I  would 
place  those  which  occur  either  from  the  mucous  membrane 
of  the  bronchial  tubes,  from  the  pyogenic  lining  of  old 
cavities^  or  from  the  vessels  ramifying  through  the  air-cells 
themselves — no  active  destructive  change  going  on  at  the 
time  in  the  lung  tissue. 

As  a  rule  we  may  lay  it  down  that  when  haemorrhages 


by  Dr.  Herbert  NankivelL  491 

are  not  extremely  profuse,  Tvith  the  exception  of  that 
passive  bronchial  haemorrhage  that  sometimes  accompanies 
disease  of  the  mitral  valve^  they  generally  occur  in  the 
night  and  early  mornings  and  seldom  follow  immediately  on 
exertion  ;  their  occurrence  or  recurrence  can  scarcely  ever 
be  foretold^  though  they  hardly  ever  happen  ouce  only  in 
the  course  of  disease. 

The  inter-diagnosis  is  not  as  a  rule  satisfactory^  and  can- 
not be  made  directly.  The  stethoscopic  signs  admit  of  a 
pretty  wide  interpretation  ;  inasmuch  as  either  there  may 
be  no  crepitation  at  all^  or  if  there  is  crepitation,  it  may 
depend  quite  as  much  on  inspired  blood  as  on  effused  blood ; 
the  entire  absence  of  crepitation  might  compel  us  to  believe 
the  origin  to  be  bronchial  or  cavernous,  but  it  is  impossible 
of  course  to  satisfy  oneself  as  to  the  entire  absence  of  crepi- 
tation in  the  central  portions  of  the  lung. 

We  may  consider  it  as  a  rule  in  the  prognosis  of  these 
cases  that  hemorrhage  from  a  bronchus,  or  from  the  lining 
membrane  of  a  cavity,  is  of  far  less  serious  import  than  that 
from  the  air-cells  themselves ;  and  that  in  cases  of  haemor- 
rhage from  the  air-cells  the  danger  varies  directly  with  the 
frequency  and  persistency  of  recurrence,  and  very  often  if 
not  always  inversely  with  the  magnitude  of  single  haemor- 
rhages. I  can  call  to  mind  several  instances  of  this;  two 
patients  in  middle  life,  fair  strength  and  nutrition,  and 
scanty  expectoration,  the  lungs  showing  but  extremely 
slight  implication,  and  the  amount  of  fever  being  either  nil 
or  only  occasional  and  slight ;  both  of  them  had  for  years  at 
intervals  of  about  six  weeks  or  two  months  either  very 
slight  haemorrhage  or  else  merely  blood-stained  sputa. 
Both  of  these  cases^  however^  the  one  in  London  and  the 
other  in  Bournemouth,  succumbed  to  a  rapid  development 
of  tubercle  in  the  lung  after  comparatively  short  illnesses. 

As  to  the  treatment  of  this  class  of  cases,  there  is  of 
course  the  general  treatment  of  rest,  ice,  cool  atmosphere, 
and  light  fluid  nutritious  diet.  The  therapeutic  treatment 
points  chiefly  to  Ferr.  acet.,  to  Ipec,  and  to  Hamamelis ;  the 
former  I  have  seen  decidedly  useful  when  the  haemorrhage 
proceeded   from    the    pyogenic    membrane    lining   an    old 


492  On  Hamoptysis, 

cavity.  Ipecacuanha  is  useful  when  the  hsemorrhage  is  of 
moderate  quantity^  and  when  its  locale  is  recognised  by 
comparative  dulness  and  moist  r&les.  Hamamelis  I  believe 
to  be  specially  suited  to  haemorrhages  from  the  mucous 
membrane  of  the  bronchi^  and  I  believe  that  it  is  from  its 
value  in  these  cases  that  this  remedy  takes  its  high  stand 
amongst  us. . 

There  are  two  points,  however,  which  it  is  very  necessary 
to   remember  in  the  treatment  of  haemoptysis ;  first,  that  ' 

relapses  after  the  first  apparent  check  of  the  bleeding  are 
very  common,  and  very  alarming  to  the  patient  and  atten- 
dants ;  second,  that  the  efi'usion  of  even  a  small  quantity  of 
blood  into  the  bronchial  tubes  and  air-cells  may  set  up  pul- 
monary irritation  which  may  end  in  destructive  tissue 
change.  I  believe,  therefore,  that  it  is  good  practice,  and 
our  duty  to  our  patient  and  ourselves,  after  that  we  have 
selected  and  exhibited  the  remedy  best  indicated,  to  leare  a 
reserve  in  the  way  of  a  thoroughgoing  styptic  to  be  used 
should  occasion  demand  it.  And  this  is  all  the  more 
necessary  and  desirable,  seeing  that  precise  means  of  ready 
differential  diagnosis  are  generally  wanting. 

lY.  In  the  fourth  section  I  would  place  those  cases  of 
hsemorrhage  which  arise  from  what  is  called  ''  breaking  a 
blood»vessel.''  They  may  be  caused  by  the  slow  process  of 
ulceration  through  the  walls  of  an  artery  during  the  forma- 
tion or  increase  of  a  cavity ;  or  the  blood  may  be  poured 
out  from  several  small  vessels  which  have  been  ruptured  by 
the  movements  of  some  calcareous  fragment,  or  a  weakened 
and  exposed  artery  may  be  ruptured  by  some  sudden  exer- 
tion or  emotion.  In  all  such  cases  we  get  a  profuse 
hsemorrhage,  rapidly  occurring  often  to  the  extent  of  half  a 
pint  or  a  pint  in  a  few  minutes,  followed  by  a  cessation 
thereof  as  soon  as  a  clot  forms  round  the  vessel;  often, 
however,  to  be  renewed  so  soon  as  a  fit  of  coughing 
removes  the  clot  from  its  position.  Generally  speaking 
there  will  have  been  a  previous  knowledge  of  such  a 
patient's  condition,  and  therefore  the  diagnosis  can  be 
readily  effected. 


by  Dr.  Herbert  Nankivell.  493 

• 

I   do  not  cousider   the  treatment  of  these  cases  to  fall 

within  the  homoeopathic    law ;    we    have  to    all    intents  a 

wounded    yessel    pouring  out    blood    into   the  lang.     We 

cannot  cut  down  upon  it  or  tie  it,  we  can  only  influence  it 

indirectly.     This   can    be   done  either  by   a  medicine  like 

Secale,  which   contracts  in  full  doses    the  calibre  of   the 

vessel  through  the  vaso-motor  system ;  or  by  Gallic  acidy 

which  in  full  doses  has  a  similar  effect  by  acting  directly 

on    it  through   the   blood    itself.     It  is    very  difficult    to 

estimate   the  precise  value  of  these  two  remedies ;  in  the 

slighter  cases  they  do  appear  to  act  successfully  and  well^ 

while  in  the   severer  cases  they   either   or   both   may  fail 

decidedly^  and  the  haemorrhage  at  last  cease   without  any 

special  cause  whatever.     In  one  most  anxious  case  that  I 

attended  .four  years  ago  the  attacks  were  most  alarming, 

occurring  once  or  twice  in  the  twenty-four  hours^  scarcely 

ever  to  a  less  amount  than  half  a  pint^  and  they  continued 

for  ten  days>  and  then  when  all  hope  was  apparently  gone 

they  ceased  entirely  and  the  patient  rallied. 

I  believe  the  Secale,  to  be  fairly  tested,  should  be  given  in 
20  or  40  drops  of  the  mother  tincture^  and  the  Gallic  acid 
in  10. or  20  grain  doses,  stirred  up  in  water. 

There  are  several  remedies  mentioned  in  our  repertories 
and  manuals  as  valuable  in  haemoptysis  which  I  have  not 
yet  touched  upon.  Arnica  would  be  useful  in  the  third 
class,  when  the  exciting  cause  was  muscular  exertion. 
Bryonia  is  reputed  to  be  valuable  in  vicarious  haemoptysis, 
but  I  should  rather  suggest  its  sphere  of  action  to  be  that 
of  a  valuable  controller  of  the  circulation,  at  the  same  time 
that  it  prevents  lung  irritation  from  the  inspired  blood. 
Millefolium  1  cannot  say  that  I  have  derived  any  marked 
value  from,  though  T  notice  it  is  spoken  very  highly  of  by 
our  colleague  Dr.  Richard  Hughes.  Aconite  and  Ant. 
tart,  are  medicines  that  I  prefer  not  giving  in  haemoptysis, 
even  when  the  case  is  slight  and  other  symptoms  may  seem 
to  call  for  them ;  I  have  seen  them  apparently  in  several 
instances  occasioo  a  recurrence  of  the  bleeding. 

Styptic  sprays  I  have  at  times  used,  but  I  have  for 
some  time  given  up  their  use ;  they  doubtless  do  restrain 


40 i  On  HdPmoptf/sis, 

haemorrhage^  but  they  do  it  by  coagalating  a  considerable 
amount  of  effused  blood  in  the  lung,  aud  the  consequences 
of  this  proceeding  are  decidedly  mischievous.  A  kind  of 
catarrhal  pneumonia  is  set  up ;  the  alveoli  and  bronchioles 
are  blocked  with  a  cheesy  effusion,  and  destruction  of  lang 
tissue  may  ensue  with  considerable  rapidity. 

Discussion  an  Dr.  Herbert  NanktvelPs  paper. 

Dr.  Bansfobd  feels  obliged  to  differ  irom  Dr.  Herbert  Nanki- 
veil  that  large  hsemorrhages  do  not  come  under  the  homodopathic 
law,  because  the  so-called  rupture  of  a  blood-vessel  is  generally 
caused  by  pulmonary  disease,  which  must  therefore  be  treated  bj 
the  appropriate    remedies.     He   is    sure  that   greater   succefls 
can  be  obtained  by  these  means  than   by  styptics  only.      He 
speaks  not  from  personal  experience  alone,  but  also  remembers 
toe  treatment  pursued  by  some  of  the  most  eminent  practitioners 
with  whom  he  was  associated  in  early  life,  such  as  the  late  Drs. 
Abercrombie,  Begbie,  and  Davidson,  of  Edinburgh.     He  and  they 
were  then  allopaths,  and  he  contrasted  their  results  with  his  own 
and  other  homcBopaths.     About  three  years  ago  he  attended  a 
young  unmarried  lady,  who  with  her  sister  had  a  highly  respect- 
able ladies*  school,  in  which  his  patient  taught  singing.     She  had 
thrown  up  just  before  his  first  visit  about  a  breakfast-cupful  of 
bright  red  blood.     Having  for  some  weeks  before  suffered  from 
cough  attended  with  loss  of  flesh  he  prescribed  Arnica  1,  Ipe^- 
cacuanha  and  Phosphorus  3.     She  had  no  return  until  eighteen 
months  afterwards,  when  a  second  attack  occurred.     He  then 
gave  Hcmamelis  mrginica^  Phosphorus  3,  and  also  applied  cold 
compresses  to  the  chest.     He  forbade  any  vocal  exertion,  en- 
joined absolute  rest  and  nourishing  diet.     He  gave  also  Cod-liver 
oil.    The  patient  has  continued  free  from  attacks  since.    A  small 
cavity  existed  under  the  left  clavicle.     He  has  found  Tinet.  Ferri 
acetatis  useful,  and  this  is  the  only  so-called  styptic  that  he  has 
used.     He  feels  great  confidence  m  the  homoeopathic  treatment 
of  these  cases.    A  friend  used  Terehinthina  with  advantage  in  one 
severe  case  of  htemoptysis,  but  he  also  applied  a  blister  to  the 
chest.     The  ultimate  result  of  this  case  he  has  never  been  able  to 
ascertain.     He  would  do  anything  to  save  a  patient,  but  has  never 
yet  felt  obliged  to  have  recourse  to  Gallic  acid.     He  thinks  that 
by  attending  closely  to  the  jjuvantia  and  avoiding  the  ladentia 
these  hsBmorrhages  will  often  spontaneously  cease. 

Dr.  CooPEB. — There  are  two  most  important  particulars  in 
reference  to  hemoptysis  I  would  like  to  see  worked  out.  One  is, 
the  connection  between  it  and  enlargement  of  the  heart  due  to 
overexertion,  and  the  other  is  the  relationship  that  exists  between 
it  and  cessation  of  the  menstrual  flow.     My  own  observations 


hy  Dr.  Herbert  NankivelL  495 

lead  to  the  conclusion  that  enlargement  of  the  heart  is  a  lesion  of 
very  common  occurrence,  especially  in  housemaids  and  "  general 
servants ;"  it  has  often  surprised  me  how  frequently  one  meets 
with  pymptoms  due  to   cardiac  hypertrophy  in   this  class   of 
patients.     Their  muscular  systems  are  generally  feehle  and  ill- 
adapted  to  the  amount  of  strain  their  duties  require,  and  hence 
the  heart  becomes  hypertrophied  from  the  undue  tension  brought 
to  bear  upon  it.     Such  cases  I  have  frequently  prescribed  for 
upon  the  supposition  that  the  hsBmoptysis  was  due  to  obstruction 
caused  by  the  enlarged  heart,  and  have  given  lodium  in  the  3rd 
or  6th  decimal  dilution   with  singular   benefit.     In   one  case 
particularly,  where  a  young  girl  doing  hou-^emaid's  work  was 
seized  with  most  copious  htemoptysis  after  overexerting  herself, 
the   patient   made  a    good   recovery  atter   lodium   was   given. 
Arnica  is  certainly  most  useful  in  some  of  these  cases,  but  it  has 
not  answered  my  expectations  like  lodium.     As  to  the  connection 
between  it  and  menstrual  cessation  my  impression  has  always 
been  that  in  suppressing  the  menses  nature  was  adopting  her  own 
means  of  husbanding  the  resources  of  the  economy  in  order  to 
cope  with  the  diseased  process  going  on  in  the  lungs.     However, 
in  reading  Scanzoni^s  liiseases  of  Women  the  other  day  my  atten- 
tion was  struck  with  a  case  given  by  Professor  Gardner,  the 
translator,  that  goes  far  to  upset  any  such  supposition  \  the  case 
was  one  in  which  hffimoptysis  and  general  phthisical  condition 
ceased  after  re-establishment  of  the  menstrual  flow.     (*'  In  one 
case  of  scanty  menstruation  and  pulmonary  hs&morrhage  supposed 
from  tuberculosiB,  the  attempt  to  dilate  a  stricture  of  the  cervix, 
and  its  final  complete  division  with  the  knife,  resulted  in  re- 
establishing the  accustomed  quantity  of  the  menses,  the  entire 
arrest  of  the  pulmonary  heemorrhage,  the  subclavicular  tender- 
ness and  dulness  on  percussion,  and  the  general  health  of  the 
patient,  with  no  trace  of  phthisis  remaining. — Scanzonif  Diseases 
of  Women,  p.  337,  translator's  note).     As  regards  the  general 
question  of  the  treatment  of  hssmoptysis,  I  am  quite  sure  that 
tne  simpler  our  treatment  of  this  and  other  diseases  the  better. 
I  do  not  see  why  we  should  not  begin  the  treatment  of  an  ordinary 
case  of  sudden  and  profuse  hsemoptysis  bv  administering  a  solution 
of  common  salt  in  water ;  it  has  long  been  a  household  remedy, 
and  has  especially  been  referred  to  by  Graves.   Surely  it  has  never 
proved  interior  to  Gallic  acid,  Muriated  tincture  of  Iron,  Secale 
comutum,  and  the  many  other  styptics  now  so  frequently  in  vogue. 
Again,  I  would  be  inclined  to  try,  before  resorting  to  the  admi- 
nistration of  more  violent  remedies,  the  inhalation  of  powdered 
Oum  Arabic.     The  styptic  properties  of  pulverized  Oum  Arabic 
are  most  marked.     I  remember  one  case  of  violent  epistaxis  in  a 
syphilitic  patient  where,  after  failure  of  the  local  application  of 
the  Muriated  tincture  of  Iron  and  a  plugging  of  the  anterior  and 
posterior  nares,   the    simple    introduction  into  the   nostril  of 
powdered  Oum  Arabic  upon  cotton  wool  completely  arrested  the 


496  On  Hamopiysis^ 

flow,  and,  I  have  every  reason  to  believe,  was  the  means  of  savings 
the  patient's  life. 

Dr.  DuDOEOir  said  the  subject  of  hsBmoptysis  was  too  exten- 
sive to  be  discussed  completely  at  one  meeting.  He  would  limit 
himself  to  speaking  of  dangerous  hsDmorrhage  from  the  lungs, 
and  how  it  could  be  stopped.  Dr.  Nankivell  had  enumerated 
many  remedies,  but  had  omitted  to  mention  an  important  means 
of  stopping  hadmorrhage  from  the  lungs,  viz.  a  ligature  tied 
round  the  arms  so  as  to  stop  the  venous  incubation.  Tempera- 
ture too  was  important.  The  application  of  a  heated  spinal  bag 
between  the  shoulders,  according  to  Chapman's  plan,  hud  been 
frequently  found  of  use.  Secale  was  a  remedy  which  he  had 
employed  with  success  in  some  cases  of  hsmoptysis,  one  or  two 
drops  of  the  tincture  for  a  dose.  A  very  severe  case  came  under 
his  notice  lately,  which  was  treated  by  Gull  and  others  by  the 
hypodermic  injection  of  Ergotin, 

Dr.  Bates  wished  to  say  a  few  words  on  the  first,  second,  and 
fourth  classes  of  Dr.  Nankivell's  interesting  cases.  With  regard 
to  the  first  class,  where  there  is  expectoration  of  dark  changed 
blood  occurring  in  women  early  in  the  morning,  with  deficient 
menstrual  flow  at  the  periods,  he  had  generally  found  this  accom- 
panied with  functional  irregularities  of  the  Kidneys,  either  with 
a  large  flow  of  pale  watery  urine  or  with  a  deficient  excretion 
altogether,  and  in  either  case  there  is  a  want  of  free  excretion  of 
urates  from  the  system.  In  such  cases  Cantharis,  3rd,  6th,  or  3x, 
will  very  rapidly  cure.  He  (Dr.  Bayes)  had  met  with  many 
such  cases,  and  he  would  say  they  are  readily  and  invariably  (or 
nearly  so)  cured  by  this  medicine.  '*  Bloody  expectoration  after 
short  cough  *'  is  one  of  the  larynx  symptoms  of  Cantharis.  In 
the  treatment  of  the  second  class,  in  which  there  is  an  excess  of 
menstrual  flow,  his  (Dr.  Bayes')  experience  did  not  coincide  with 
Dr.  Nankivell'Sy  for  in  his  hands  Aconite  had  proved  very  service- 
able in  such  cases,  but  it  must  be  given  in  from  the  3rd  to  the  I2th 
or  even  higher  dilutions.  In  the  treatment  of  that  active  haemo- 
ptysis called  *'  rupture  of  a  blood-vessel,"  he  (Dr.  Bayes)  had  had 
no  experience  of  large  doses  of  Secale,  but  in  his  former  allopathic 
practice  he  had  much  experience  in  the  use  of  Gallic  acid  in  such 
cases,  although  he  never  used  quite  such  large  doses  as  those 
named  by  Dr.  Nankivell.  His  own  method  had  been  to  make  a 
saturated  solution  of  the  Oallie  acid  in  boiling  water ;  when  this 
cools  down  the  solution  contains  about  100  grains  to  the  ounce. 
Of  this  solution  he  used  to  give  a  dessert-spoonful  every  quarter 
or  half  hour  till  the  hsBmoptysis  ceased  or  until  the  blood  became 
dark  or  blackish ;  when  this  occurs  the  hemorrhage  usually 
eeases.  He  never  saw  any  evil  results  from  this  treatment,  but 
an  overdose  of  Gallic  acid  gives  a  sense  of  great  tightness  in  the 
head  and  ringing  in  the  ears. 

Dr.  Dbuby  said,  that,  while  giving  the  author  due  credit  for  the 
care  bestowed  on  his  paper  and  for  the  interesting  matter  con- 
tained in  it,  he  thought  that  for  the  purposes  of  treatment  some 


Therapeutics  of  Apomorphia  and  Chloral.  497. 

such  division  as  into  copious,  congestive,  and  passive  hsBinorrhages 
ixrould  be  sufficient.      Under  the   first  head   bleeding   from  a 
ruptured  vessel,  as  well  as  vicarious  hsBmorrhage,  would  be  in- 
cluded.    Under  the  second  all  these  cases  of  turgid  or  streaked 
sputa  or  even  of  small  quantities  of  pure  blood  would  be  included 
provided  the  source  was  pulmonary  and  that  it  arose  from  a 
congested  state  of  lung.     If  this  was  of  a  phthisical  character  the 
case  would  assume  a  much  graver  action  than  if  it  simply  arose 
from  an  inflammatory  state  of  lung  that  might  pass  away  and 
'  leave  no  evil  behind.     In  passive  haemorrhage  there  would  be  but 
small  trace  of  active  congestion,  but  the  prognosis  would  depend 
on  whether  tubercular  disease  were  present  or  not.     In  copious 
hsamorrhage  Ledum  and  Ipecaciuinha  would  be  found  most  valu- 
able remedies.     Ledum,  especially  in  rapidly  repeated  doses,  he 
believed  to  be  one  of  our  best  remedies.     Ohina  would  be  given 
as  the  hemorrhage  abated.     Other  remedies  would  be  called  for, 
especially  if  it  was  vicarious.     In  congestive  hsdmorrhage  such 
remedies  as  Aconite,  Bryonia,  Phosphorus,  Sepia,  Arnica,  Pulsa- 
tilla, Hamamelis,  and  China,  but   there  was  a  medicine  not 
generally  used  that  he  derived  much  benefit  from,  that  was  Nux 
moschata.     Where  a  feeling  of  weight  or  oppression  was  com- 
plained of,  with  or  without  hsBmorrhage,  he  generally  selected 
this   medicine.     It  would  be  found  suitable  also  for  passive 
haBmorrhage,  but  in  these  cases  he  considered  Arnica,  Pulsatilla, 
and  Samamelis,  especially  the  last,  as  the  chief  remedies.     There 
was,  however,  much  more  than  haemorrhage  to  be  considered  ;  its 
character,  the  character  of  the  sputa  generally,  and  the  time  and 
character  of  the  cough  and  other  symptoms,  should  be  considered 
in  each  case    separately.      The  importance  of   studying   the 
character  of  the  sputa  was  shown  if  we  noticed  the  plum-coloured 
'  sputa  of  congestion  from  aneurism  and  compare  it  with  other 
forms.     A  correct  diagnosis  thus  became  of  the  greatest  use  in 
each  case. 


ON  SOME  POINTS  IN  THE  THERAPEUTICS 
OF  APOMORPHIA  AND    CHLORAL. 

By  D.  Dyce  Brown,  M.A.,  M.D. 

(Read  before  the  British  Homceopathic  Society.) 

The  truth  of  any  scientific  law  or  system  is  generally 
demonstrated  by  an  experimentum  cruets,  and  when  this  is 
possible,  it  cannot  fail  greatly  to  strengthen  the  convictions 
of  those  who  believe  in  the  law  or  system,  and  to  impress 
those   who  are  inclined  to  be  sceptical.      In  such  a  science 

VOL.  XXXII,  NO.  CXXIX. ^JULY,  1874.  I  I 


498  Therapeutics  of  Apomorphia  and  Chloral^ 

as  therapeutics^  where  absolute  proof  is  so  difficult  to  be 
brought  home  to  the  minds  of  the  sceptics  of  the  old  schoolj 
it  adds  immensely  to  our  strength  in  ai^ument  when  we 
can  bring  forward  an  experimentum  cruets.  Such  has  always 
seemed  to  me  to  be  our  power  in  accordance  with  the 
homoeopathic  law  of  predicating  exactly  the  therapeutic 
sphere  of  a  medicine  before  it  is  even  tried  in  a  single  case. 
We  have  but  to  discover  by  experiment  or  by  accidental 
cases  of  poisoning  what  are  the  physiological  effects  pro- 
duced by  any  given  substance,  and  we  can  at  once  say, 
and  say  with  confidence  in  the  result,  iu  what  cases  of 
disease  we  shall  find  it  useful.  The  subjects  of  my  paper 
afford,  I  think,  an  excellent  illustration  of  this  point. 
They  have  nothing  in  common  therapeutically,  but  I  have 
grouped  Apomorphia  and  Chloral  together,  as  they  are  both 
recently  discovered  drugs,  and  I  think  that  I  am  the  first 
who  has  made  use  of  these  drugs  homoeopathicaily. 

To  begin  with  Apomorphia.  When  I  first  read  the 
account  of  Apomorphia  a  long  time  ago  it  was  simply  stated 
that  it  was  found  to  produce  sickness  and  vomiting  in 
exceedingly  small  doses,  and  that  it  was  proposed  to  use  it 
as  an  emetic  in  cases  where  such  was  required.  It  then 
struck  me  that,  if  such  was  the  case,  it  ought  to  be  a 
valuable  medicine  in  sickness  and  vomiting.  This  was  all 
the  information  I  had.  But  we  have  now,  thanks  to  the 
careful  experiments  of  Dr.  Galley  Blackley,  a  much  more 
full  account  of  its  physiological  action.  Dr.  Blackley's 
interesting  paper  is  published  in  the  British  Journal  of 
Homceopathy  for  July,  1873.  I  shall  take  the  liberty  of 
giving  a  sketch  of  its  action  as  given  by  Dr.  Blackley,  and 
perhaps  the  best  way  is  to  quote  Dr.  Blackley^s  experiment 
on  himself.  He  says,  ''On  May  25th,  1869,  at  9  p.m., 
my  general  health  being  good  and  the  pulse  and  tempera- 
ture normal,  in  the  presence  of  my  friend  Dr.  Wright  I 
injected  ten  minims  of  a  10  per  cent,  solution  o(  Apomorphine 
under  the  skin  of  the  left  arm,  the  pulse  and  temperature 
at  the  moment  of  injection  being  72°  and  98^  respectively. 
During  the  first  two  minutes  no  effects  were  produced. 
After  about  ten   minutes  the  pulse  began  to  rise  slightly 


by  Ih\  D.  Dyce  Brown,  499 

and  the  respirations  became  slightly  accelerated.  At  the 
end  of  four  minutes  I  felt  a  sudden  qualmishness,  which 
was  almost  immediately  followed  by  nausea  and  profuse 
▼omiting.  This  continued  for  several  minutes,  and  was 
followed^  as  soon  as  the  contents  of  the  stomach  had  been 
evacuated^  by  severe  retching.  On  taking  a  draught  of 
water  with  a  little  brandy  in  it  this  was  immediately 
rejected^  and  on  drinking  cold  water  this  too  returned  at 
once.  No  bile^  however,  came  up  in  the  vomited  matters^ 
At  the  end  of  seven  or  eight  minutes  from  the  commence- 
ment  of  the  experiment  I  began  to  feel  very  faint  and  was 
compelled  to  lie  down,  and  almost  immediately  on  doing  so 
I  fainted  entirely,  and  remained  in  a  state  of  syncope  for 
about  five  minutes.  On  awaking  from  this  T  felt  giddy 
and  chilly,  and  was  obliged  to  take  a  little  brandy  and 
water.  This  was  retained,  and  as  I  began  to  feel  slightly 
drowsy  I  remained  lying  down  for  the  space  of  about  an 
hour,  during  which  time  I  perspired  profusely.  On  rising 
I  still  felt  slight  giddiness,  but  no  inclination  to  vomit.  I 
went  to  bed  and  slept  soundly  all  night,  awaking  about 
8  a.m.  in  my  usual  health,  slightly  pale,  but  very  hungry.^' 
Its  action  upon  animals  seems  to  be  somewhat  different 
from  that  in  man,  as  in  them  a  larger  dose  was  required 
to  produce  the  physiological  effects.  In  summing  up  the 
effects  produced  by  a  physiological  dose.  Dr.  Blackley  gives 
those  of  digestion  as  follows : — *'  Qualmishness,  nausea, 
vomiting,  retching,  convulsive  movements  6f  the  stomach, 
precordial  pain,  salivation,  and  diarrhoea  (in  cats).^'  I 
refrain  from  quoting  the  other  symptoms  produced,  as,  in 
man,  the  stomach  symptoms  are  the  prominent  ones,  and 
they  are  the  only  ones  to  which  I  wish  to  draw  attention 
to-night.  From  the  experiment  above  quoted,  in  which  Dr. 
Blackley  next  morning,  after  a  good  night^s  sleep,  awoke 
in  his  usual  health  and  feeling  hungry,  and  also  from  an 
experiment  he  made  on  a  young  carman,  where  after  a 
dose  sufficient  to  cause  vomiting  given  at  8  p.m.,  the  man 
walked  home  about  9,  and  ate  a  hearty  supper  on  reaching 
his  house,  I  infer  that  Apomarphia,  though  causing  severe 
vomiting,  does  not  cause,  as  other  emetics  do,  any  profound 


500  Therapeutics  of  Apomorphia  and  Chloral, 

or  marked  interference  with  digestion,  or  even  pain  in  the 
stomach.  This  coincides  with  what  I  find  to  be  the  sphere 
of  its  action  on  the  stomach.  The  cases  where  I  have  used 
it  with  success  are  chiefly  those  where  sickness  or  vomiting 
constitute  the  disease  under  which  the  patient  is  labouring. 
We  frequently  come  across  such  cases.  The  tongue  is 
clean^  the  bowels  are  regular^  there  are  no  headaches^  the 
patient  has  a  desire  more  or  less  for  food,  and  has  no  pain 
after  eating,  but  a  feeling  of  nausea  comes  on  at  intervals, 
especially  after  taking  food,  which  may  or  may  not  be 
vomited.  In  other  cases,  where  there  is  marked  dyspepsia, 
and  where  Niax  or  Pulsatilla  is  indicated,  I  find  Apo^ 
morphia  very  valuable  given  at  the  time  of  the  onset  of  the 
sick  feeling,  and  repeated  every  ten  minutes  or  quarter  of 
an  hour  till  it  is  relieved.  This  is  over  and  above  the 
administration  of  the  other  medicine  suited  to  the  dyspepsia 
which  is  given  at  regular  intervals  through  the  day.  In 
other  cases  still,  when  the  vomiting  is  sympathetic,  as  in 
the  case  of  a  neuralgic  headache,  or  a  gall-stone,  or  a 
cerebral  affection,  or  a  uterine  complaint,  Apomorphia  is 
equally  useful.  I  observe  that,  in  the  discussion  on  Dr. 
Blackley^s  paper.  Dr.  Cooper  is  reported  to  have  stated  that 
he  had  seen  immediate  cessation  of  vomiting  in  a  distressing 
case  where  a  tumour  pressed  on  the  brain.  The  action  of 
Apomorphia  in  sickness  and  vomiting  seems  to  me  very 
much  to  resemble  that  of  Ipecacuanha^  and  it  is  indicated 
in  similar  cases.  A  very  important  point  to  be  observed 
is  that  Apomorphia  is  a  specific  emetic  and  does  not  cause 
vomiting  by  any  local  irritant  action.  This  is  clearly  shown 
by  its  producing  emesis  when  injected  hypodermically.  As  to 
the  dose  required  to  produce  vomiting,  when  I  first  read 
the  accounts  of  its  effects  as  quoted  from  a  German  perio- 
dical, it  was  stated  that  a  very  much  more  minute  quantity 
was  sufficient  than  that  stated  by  Drs.  Blackley  and  Oee. 
Dr.  Blackley  in  the  experiment  quoted  injected  sub- 
cutaneously  ten  minims  of  a  ten  per  cent,  solution,  or  in  other 
words  a  whole  grain,  and  in  the  case  of  the  carman  one 
twentieth  of  a  grain  was  injected,  while  Dr.  Blackley  states 
that  Dr.  Gee  found  it  necessary  to  give  one  and  a  half 


by  D)\  D,  Dyce  Brown.  501 

grains  by  the  mouth  to  cause  vomiting  in  a  .mau.  I  have 
unfortunately  lost  the  reference  to  the  periodical  in  which  I 
read  the  account  of  the  experiments^  but  there  it  was  stated 
that  one  five  hundredth  of  a  grain  was  sufficient  to  produce 
emesis.  In  corroboration  of  this  point  I  observe  in  tlie 
British  Medical  Journal  of  February  21st,  1871,  a  report  of 
a  paper  by  Dr.  Walter  G.  Smith,  read  before  the  Medical 
Society  of  the  College  of  Physicians  of  Ireland,  on  ^'  Recent 
Therapeutical  Remedies,^'  in  which  he  states  that  the  dose 
hypodermically  as  an  emetic  is  from  *046  to  '196  of  a 
grain. 

My  first  information  regulated  my  choice  of  the  thera- 
peutic dose,  which  was  the  3rd  centesimal  dilution.  I  have 
never  used  any  other  dilution,  and  the  results  I  have 
obtained  have  been  so  gratifying  that  I  do  not  see  the 
necessity  of  using  a  lower  potency.  I  got  some  of  the  pure 
drug  from  Macfarlan  of  Edinburgh,  and  had  the  3rd  cent, 
dilution  prepared  in  Aberdeen  in  the  form  of  tincture. 

Dr.  Blackley  advises  the  trituration  to  be  used,  as  he  says 
the  tincture  does  not  keep.  This  is  certainly  a  mistake,  at 
least  when  diluted  to  the  3rd  cent.  ;  as  it  has  always  in  my 
hands  answered  admirably,  which  could  not  have  been  the 
case  if  the  diluted  tincture  decomposed. 

I  now  proceed  to  give  some  cases  where  Apomorphia  has 
been  used  with  success  in  the  various  forms  of  disease  I 
have  named.  The  cases  are  chiefly  from  my  dispensary 
note-book  as  kept  by  the  students. 

Case  1. — Mrs.  E — ,  »t.  60,  May  17th,  1872.  Com- 
plains of  sickness  which  she  has  had  for  last  two  days. 
Has  a  constant  feeling  of  nausea,  and  disinclination  to  eat. 
No  headache.  Bowels  regular.  Tongue  slightly  whitish. 
K  Apomorphia.  This  patient  afterwards  returned  with 
another  complaint,  having  been  quite  cured  of  the  sickness. 

Case  2. — J.  M.  J — ,  aet.  fifteen  months,  June  14th, 
1872.  Has  been  vomiting  for  last  three  days.  Tongue 
whitish ;  bowels  slightly  loose ;  stools  whitish ;  R  Apo- 
morphia  3^,  drop  dose. 

17th. — Vomiting    much     better,    only     vomited     once 


502  Therapeutics  of  Apomorphia  and  Chloral, 

yesterday^  and  not  at  all  to-day.  Bowels  open  three  times 
a  day^  and  natural  in  appearance. 

Case  3.— Helen  M — ,  aet.  60,  November  17th,  1873. 
Has  been  ill  for  past  twelve  months,  but  worse  last 
three  months.      Vomits  her  food    about     an    hour    after 

« 

taking  it,  and  has  a  constant  feeling  of  nausea.  No  head- 
ache ;  bowels  open  every  second  day,  costive ;  tongue 
clean  ;  little  or  no  pain  in  stomach.     R  Apomorphia  3. 

December  1st. — Feels  much  better;  vomiting  entirely 
gone ;  bowels  less  costive,  and  open  once  each  day.  Has 
no  appetite.     Ordered  Quinine, 

Casb  4. — Mrs.  O — ,  June  4th,  1872.  Came  complain- 
ing of  frequent  vomiting  and  almost  constant  nausea; 
tongue  clean ;  catamenia  regular ;  has  leucorrhoea.  R 
Apomorphia  8  and  cold  sitz  bath. 

6th. — Sickness  quite  gone. 

Case  5. — Margaret  P — ,  eet.  50,  May  18th,  1872.  Has 
emphysema.  When  seen  complained  of  pain  and  tender- 
ness over  the  region  of  the  liver,  which  was  enlarged. 
Pulse  rather  quick ;  tongue  whitish  ;  bowels  regular.  Can- 
not retain  anything  on  the  stomach,  and  has  constant 
feeling  of  nausea ;  severe  headache.  To  have  Bryonia  2' 
every  three  hours,  and  Apomorphia  to  be  repeated  at 
intervals  of  an  hour,  till  sickness  subsides. 

17th. — Pain  over  liver  much  better.  Sickness  quite 
removed  atter  two  doses  of  Apomorphia,  To-day  felt 
twice  a  slight  feeling  of  nausea,  but  it  passed  off  in  a  few 
minutes. 

In  this  case  the  vomiting  was  evidently  sympathetic 
with  the  liver  affection.  The  following  two  cases  were 
kindly  given  me  by  my  friend  and  former  pupil  Di . 
James  Walker.  They  are  excellent  examples  of  the 
power  of  Apomorphia  to  check  sympathetic  vomiting,  in 
the  one  case  arising  from  uterine  and  in  the  other  from 
ovarian  disease. 

Case  6. — B.  L — ,  a  young  lady  about  twenty-three, 
who  about  some  eighteen  months  previous  to  coming  under 


by  Dr.  D,  Dyce  Brown.  503 

homcBopathic  treatment^  had  sustained  displacement  of  the 
uterus  from  a  severe  fall,  and  had  ever  since  been 
afflicted  with  distressing  sickness.  Since  the  occurrence 
of  the  accident  she  had  been  growing  gradually  worse  in 
spite  of  the  allopathic  treatment  which  had  been  resorted 
to,  viz,  the  local  application  of  pessaries,  astringents,  and 
caustics^  and  the  internal  administration  of  the  drugs 
usually  exhibited  in  such  cases^  and,  being  rather  dis^ 
heartened  by  such  a  result^  had  resolved  to  give  homoeopathy 
a  trial. 

The  most  prominent  symptom  at  this  time  was  an 
almost  constant  feeling  of  sickness,  with  frequent  attacks 
of  violent  retchings  which  were  followed  by  intense  pros- 
tration. Every  remedy  that  could  be  thought  of  as 
having  any  relation  to  the  sickness  was  tried,  but  in  vain ; 
the  only  one  which  in  the  least  mitigated  it  was  Kreosote 
3,  but  even  that  soon  lost  what  little  effect  it  ever  had. 
Finally,  Apomorphia  3  was  exhibited^  and  at  the  same 
time  a  cold  sitz  bath  (the  only  local  treatment  she  would 
hear  of)  was  employed  every  morning.  From  this  time 
the  sickness  began  to  abate,  and  the  retching  fits  soon 
wholly  disappeared,  and  if  at  any  time  she  felt  a  threaten- 
ing of  their  return^  a  few  drops  of  the  Apomorphia  tincture 
completely  checked  the  attack. 

Case  7. — A  lady  set.  42,  in  whom  there  was  per- 
sistent vomiting  depending  on  the  presence  of  a  large 
ovarian  tumour.  Apomorphia  was  successful  after  all  other 
remedies  had  failed.  She  was  subject  to  attacks  of  sickness 
whenever  her  general  health  was  from  any  cause  below  par, 
but  was  usually  speedily  relieved  by  Nux  vom.  and 
Petroleum.  In  the  present  instance^  however,  those 
remedies  were  quite  unavailing,  as  well  as  many  others 
that  were  tried,  and  the  sickness  continued  unabated 
for  several  days.  Apomorphia  3  was  then  made  trial 
of,  and  on  calling  next  morning  she  stated  that  after 
the  second  dose  of  the  new  medicine  the  sickness  had  quite 
left  her,  and  that  she  had  not  required  to  have  further 
recourse  to  it. 


504  Therapeutics  of  Jpomcrphia  and  Chloral, 

Case  8. — M — ,  sailor,  aet.  28,  June  7th,  1872.  For 
three  days  has  had  sickDess  and  incessant  vomiting ;  can 
keep  no  food  on  his  stomach ;  inclines  to  be  costive ; 
tongue  whitish;  pain  on  pressure  over  liver,  no  enlarge- 
ment.     Had  ague  five  years  ago.     Apomorphia  every  hour. 

10th. — After  three  doses  the  sickness  stopped  and  has 
not  returned. 

Cask  9. — Wm.  D — ,  at.  5,  December  11th,  1873. 
For  last  eight  days  has  been  vomiting  his  food  just  after 
taking  it.  No  .  pain  in  stomach ;  no  appetite ;  bowels 
regular;  tongue  clean;  is  slightly  feverish  at  night. 
Ordered  Ipec. 

7th. — Vomiting  not  much  better,  but  he  keeps  his  food 
sometimes  for  two  hours.  Complains  of  pains  all  over  his 
body,  and  headache.  Has  been  taking  entirely  milk  food. 
To  have  animal  diet.      Apomorphia, 

22nd. — Vomiting  much  better,  but  not  entirely  gone. 
Continue  Apomorphia.  Did  not  return.  From  being  so 
much  improved,  the  probability  is  that,  having  got  quite 
well,  his  mother  did  not  think  it  necessary  to  bring  him 
back. 

Cask  10. — W.  D — ,  at.  2,  has  vomited  everything  for 
the  last  five  days.  The  vomiting  sometimes  comes  on 
immediately  after  food,  at  other  times  a  little  after.  Food 
comes  up  undigested.  Apomorphia.  This  child  was  not 
brought  back. 

I  class  this  case  as  well  as  the  two  following  as 
successful,  although  the  patients  were  not  brought  back. 
Dispensary  patients  invariably  return  at  least  once  if  not 
improved.  I  always  request  patients  to  return  in  a  few 
days  if  not  better,  and  I  frequently  verify  by  after  inquiry 
the  fact  that  such  patients'  were  cured  by  the  first  prescrip- 
tion. 

Case  11. — Mrs.  A — ,  at.  32,  complains  of  sickness  in 
the  morning,  accompanied  by  headache  and  flushing  of  the 
face.     This  feeling  comes  on  immediately  after  rising  in 


by  Br,  D,  Dyce  Brown,  505 

the  morning,  and  generally  wears  off  after  breakfast. 
Tongue  clean;  bowels  regular;  sickness  not  made  worse 
by  eating ;  no  pain  in  the  stomach,  but  sometimes  a  feel- 
ing of  fulness  after  food ;  is  nursing  a  child  nine  months 
old.     Apomorphia  3  ter  die.     Did  not  return. 

Case  12. — John  M — y  aged  fourteen  months^  has  been 
vomiting  very  frequently  for  fourteen  days.  Not  only 
vomits  after  eating  and  drinking,  but  retches  even  with  an 
empty  stomach.  Is  not  weaned^  but  will  not  take  the 
breast  often,  and  will  take  no  food.  Had  formerly 
diarrhoea  which  is  now  stopped.  Tongue  clean  at  tip, 
whitish  at  the  back ;  has  five  teeth.  Apomorphia  3  every 
three  hours. 

Has  not  been  brought  back. 

Case  13. — Jessie  W — ,  at.  23,  April  29th,  1872.  Com- 
plains of  pain  in  the  back,  headache  and  sickness,  which  is 
worse  in  the  morning.  Vomits  after  taking  food.  There 
has  been  no  appearance  of  the  catamenia  for  two  months. 
Pregnancy  doubtful.     Nux  vom. 

May  8th. — Sickness  no  better.     Apomorphia, 

11th. — Sickness  gone  till  to-day,  when  there  is  slight 
return. 

16th. — Feels  much  better,  sickness  only  occasionally 
recurs.     Continue  medicine.      She  did  not  return  again. 

I  have  found  the  Apomorphia  also  successful  in  removing 
the  nausea^  which  frequently  persisted  between  attacks  of 
vomiting,  produced  by  the  passage  of  a  series  of  gall-stones, 
and  in  a  case  of  long-standing  periodic  supra-orbital 
neuralgia,  in  connection  with  the  liver,  in  a  lady  who  had 
lived  a  number  of  years  in  India,  Apomorphia  relieves 
the  frequent  nausea  much  more  uniformly  than  Ipec, 
does. 

In  the  case  of  a  young  man  whom  I  have  at  present 
under  treatment  for  chronic  dyspepsia,  with  frequent  nausea 
and  vomiting,  Ntix  is  indicated  as  the  chief  medicine,  and 
under   this  there  has  been    marked    improvement,    but  I 


506  Therapeutics  of  Apomorphia  and  Chloral, 

prescribed  Apomorphia  3,  to  be  taken  when  the  sickness 
conies  on,  and  to  be  repeated  every  quarter  of  an  hour  till 
it  goes  off.  He  tells  roe  that  he  has  found  one  drop  taken 
in  this  way  entirely  remove  the  nausea  for  the  time. 

I  think  the  cases  I  have  related  give  a  clear  proof  of  the 
value  of  Apomorphia  in  sickness  whether  dyspeptic  or 
reflex,  and  I  feel  sure  that  the  more  it  is  used  the  more 
will  it  be  found  a  most  reliable  and  valuable  medicine  in 
such  cases. 


To  turn  now  to  Chloral. 

The  only  points  in  the  therapeutics  of  Chloral  to  which  I 
wish  to  allude  to-night  are  its  ose  in  urticaria  and  eye^diS" 
eases,  chiefly  cotyunctivitis.  It  is  necessary  to  remind  you 
in  the  first  place  of  the  physiological  effects  of  Chloral  as 
producing  these  affections.  I  collected  in  the  Monthly 
Horn.  Review  for  June,  1871,  a  series  of  cases  in  which 
these  points  are  well  demonstrated.  As  they  may  have 
fallen  out  of  your  recollection,  perhaps  I  may  be  permitted 
to  go  over  the  chief  points  in  the  pathogenesis. 

In  one  case  "  an  eruption  appeared  upon  the  arms,  legs, 
and  face,  and  subsequently  over  the  whole  body,  in  large 
blotches  of  different  shapes,  raised  above  the  surface,  and  of 
a  deep  red  colour.  The  conjunctivae  were  injected,  and 
the  face  had  a  puffed,  swelled  appearance,  especially  below 
the  eyes.  Gradually  these  blotches  coalesced  till  the  whole 
skin  was  in  this  red  blotchy  state,  more  nearly  resembling 
measles  than  anything  else.  There  was  high  fever,  thirst, 
coated  tongue,  and  loss  of  appetite,  with  intense  irritation 
and  itching  of  the  skin,  preventing  sleep  at  night.'' 

In  another  case  **  an  eruption  appeared  on  the  arms 
and  legs,  exactly  like  nettle-rash,  in  large  raised  wheals, 
with  intense  irritative  itching/' 

In  a  third  case  the  patient  was  noticed  to  "  be  much 
flushed,  and  to  present  over  her  whole  body  a  diffuse 
inflammatory  redness  so  closely  resembling  the  smooth 
eruption  of  scarlatina  that  it  was  thought  prudent  to 
isolate  her  in  the  hospital  for   contagious  diseases.     Here 


by  Dr,  D.  Dyce  Brown.  507 

more  characteristic  symptoms  were  developed.  A  number 
of  loDg  pale  eleyatioDs^  or  wheals^  showed  themselves  on 
the  legs^  shoulders,  and  waist^  while  similar  ones  could  be 
produced  on  other  parts  of  the  skin  by  scratching.  At 
the  same  time  burning  stinging  sensations,  and  a  feeling  of 
tightness  and  hardness  over,  the  whole  surface,  were  com- 
plained of,  along  with  wheezing  respiration,  sharp  pains  in 
the  eye-balls,  headache,  and  lassitude/' 

In  another  case  *^  an  evanescent  rash,  of  the  character 
of  urticaria,  appeared  on  several  occasions  in  the  morning 
when  the  draught  had  been  taken  on  the  night  before,  and 
there  was  also  some  flushing  and  burning  of  the  head  and 
face.'' 

In  another  Dr.  Crichton  Browne  says,  ''  Soon  after  ex- 
periments with  Chloral  were  commenced  in  this  asylum,  in 
February,  1870,  I  noticed  a  singular  tendency  to  flushing 
of  the  head  and  face  in  many  of  those  patients  who  were 
subjected  to  its  influence.  It  was  no  uncommon  thing  to 
find  a  palcj  anaemic  patient,  to  whom  Chloral  had  been 
given,  presenting  at  certain  hours  of  the  day  a  floridness  of 
countenance  which  would  have  done  credit  to  the  rudest 
health  Of  forty  cases  in  which  Chloral  was  tried  up  to 
the  month  of  June,  and  of  which  I  possess  notes,  this  blush- 
ing was  remarked  in  nineteen,  in  greater  or  less  degree  ;  in 
a  few  suffusing  only  the  cheeks,  but  in  a  much  larger  number 
involving  the  brow,  neck,  and  ears,  and  assuming  a  depth  of 
colour  altogether  unusual  in  the  natural  process.  In  one 
case,  which  is  characteristic  of  many,  I  find  it  reported  that 
half  an  hour  after  fifteen  grains  of  Chloral  had  been  taken 
the  face,  up  to  the  roots  of  the  hair  and  down  to  the  ramus 
of  the  lower  jaw,  was  of  a  dull  scarlet  colour,  very  persistent 
under  pressure^  most  intense  over  the  malar  pi'ominences  and 
bridge  of  the  nose,  and  thence  shading  off  *iu  every  direc- 
tion. The  ears  partook  of  the  same  colour,  which  was  also 
scattered  in  blotches  over  the  neck  and  chest,  the  lowest 
blotch  being  over  the  middle  of  the  sternum^  and  the 
largest  about  the  size  of  a  florin.  This  singular  flushed 
condition,  which  was  associated  with  slight  contraction  of 
the  pupils,  injection  of  the  conjunctiva,  and  excitement  of 


508  Therapeutics  of  Apomorphia  and  Chloral, 

the  circulation,  continued  for  about  an  hour^  and  then  dis- 
appeared during  a  paroxysm  of  sneezing  and  emotional  per- 
turbation, to  recur  after  the  next  dose  of  Chloral" 

In  some  of  these  cases  you  will  observe  it  stated  that 
the  conjunctivae  were  injected,  with  varying  amount  of 
discomfort  in  the  eyes. 

The  following  case,  reported  by  Dr.  Fraser^  shows  the 
conjunctivitis  well.  Mrs.  A —  was  subject  to  periodical 
headaches,  and  latterly  to  sleeplessness  at  night.  When  she 
consulted  me  in  January,  1871,  I  ordered  her  for  the  sleep- 
lessness Chloral  in  doses  of  thirty  grains  at  bedtime.  On 
seeing  her  a  few  days  after  she  told  me  that  the  medicine 
had  not  given  her  sleep,  but  had  caused  excitement  and 
greater  restlessness,  followed  in  the  morning  by  redness  and 
watering  of  the  eyes,  lasting  for  two  days.  She  had  again 
tried  the  Chloral  before  my  seeing  her  the  second  time,  and 
had  found  the  same  effect  follow.  I  urged  her  to  try  it  once 
more,  which  she  did,  and  again  the  same  result  followed, 
viz.,  redness  of  the  conjunctiva  and  watering  of  the  eyes. 
She  now  discontinued  the  medicine,  when  the  symptoms 
gradually  disappeared.  This  patient  afterwards  found  doses 
of  gr.  viiss  produce  the  desired  effect  (sleep)  without  any 
of  the  above-mentioned  symptoms.^' 

Again,  M.  Demarquay  states  that,  '^  on  the  attentive  ex- 
amination of  animals  so  soporised  (by  Chloral),  the  ocular 
and  palpebral  mucous  membranes  are  found  injected/'  Dr. 
D.  Gordon  also  observed  '^  a  peculiar  papular  eruption  and 
a  form  of  conjunctivitis  as  the  result  of  Chloral"  The 
exact  references  to  all  these  cases  are  to  be  found  in  my 
papers  in  the  Monthly  Homaopathic  Review  for  June  and 
September,  1871. 

Having  thus  reminded  you  of  the  pathogenetic  action  of 
Chloral  upon  the  skin  and  eye,  I  proceed  to  append  cases 
where  I  have  used  Chloral  in  small  doses  in  the  treatment 
of  urticaria  and  several  forms  of  ophthalmia.  The  dose  I  have 
always  used  has  been  a  grain  of  the  pure  salt,  dissolved  in 
water  three  times  a  day,  for  adults,  and  fractions  of  a  grain  for 
children.     I  shall  first  take  the  eye-diseases. 


by  Dr.  D.  Dyce  Brown.  509 

Case  1. — Martha  W — ,  May  11th,  1872.  Pain  came  on 
in  left  eye  two  days  ago.  To-day  both  ocular  and  palpe- 
bral conjunctiva  much  injected.  There  is  a  small  nicer  on 
the  cornea^  and  a  good  deal  of  pain.  Chloral  gr.  j  ter  die. 
Eye  to  be  bandaged  up. 

May  14th. — Redness  completely  gone^  also  the  pain. 
Says  she  was  quite  well  yesterday.  The  ulcer  on  the  cornea 
is  still  visible^  but  only  about  the  size  of  a  pin-point. 

Case  2. — John  S — ,  May  18th,  1872.  For  two  days 
has  had  conjunctivitis  of  right  eye.  To-day  it  is  very  much 
injected,  with  a  good  deal  of  pain.  Left  eye  is  also  slightly 
injected.  Chloral  gr.  j  every  four  hours.  Bandage  to  the 
eye. 

May  2(>th. — Left  eye  quite  well.  Right  eye  almost 
well.  Continue  medicine.  When  next  seen  in  three  days 
was  quite  cured. 

Case  8. — ^A  baby,  aet.  2  years.  Has  strumous  con- 
junctivitis. General  health  not  good.  Sleeps  badly  and 
cries  much,  appetite  bad,  bowels  regular.  Sulphur  3  and 
<p  both  failed  to  make  any  improvement,  as  also  did  Bell. 
Chloral  gr.  ^  ter  die  was  then  given,  with  Calcarea  6  at 
bedtime.  The  child  was  brought  back  a  week  after,  when 
there  was  very  marked  improvement.  It  could  open  its 
eyes  much  better  to  the  light,  showing  a  considerable 
diminution  of  the  photophobia.  Takes  his  food  better,  and 
sleeps  well.     Continue.     Was  not  brought  back  again. 

Case  4. — Mrs.  S — ,  aet.  38,  October  5th,  1872.  Has 
been  suffering  from  catarrhal  ophthalmia  for  the  last  three 
or  four  days.  There  are  one  or  two  phlyctena  on  the  right 
eye,  at  the  edge  of  the  cornea.  Severe  circumorbital  pain 
and  photophobia.     Chloral  gr.  j  ter  die. 

Oct.  10th. — Eye  almost  quite  well ;  only  slight  injection 
remains.  Phlycterue  quite  gone,  and  the  circumorbital 
pain  has  quite  disappeared.  No  photophobia.  Continue 
medicine. 

Did  not  return,  as  the  eye  got  quite  well.     This  I  ascer- 


510  Therapeutics  of  Apomorpkia  and  Chloral^ 

tained  when  she   after  a  time  retarned  with  another  com- 
plaint. 

Case  5. — Robert  J — ,  set.  9,  October  25th,  1872.  Has 
for  a  week  had  conjunctivitis  of  right  eye  ;  not  much  pain ; 
is  of  a  strumous  family.  Chloral  gr.  \  ter  die,  and  bandage 
over  eye. 

Oct.  30th. — Less  redness  of  eye  and  ulcer  on  cornea. 
Left  eye  also  similarly  affected.     Continue. 

Nov.  4th. — Redness  of  both  eyes  gone.  The  corneal 
ulcers  just  visible  and  no  more.     Continue. 

Dec.  2nd. — (A  month  later.)  This  boy  returned  to-day. 
The  eyes  had  got  quite  well  after  last  visit.  He  then  took 
measles  a  week  ago.  To-day  right  eye  is  very  red,  and  in 
the  centre  of  the  cornea  is  a  rather  deep  cut  ulcer,  with  a 
good  deal  of  pain.  Chloral  gr.  \,  as  before.  He  did  not 
return,  which  he  certainly  would  have  done,  as  before,  if 
the  eye  had  not  got  quite  well. 

Case  6. — Jane  B — ^  »t.  25,  January  4th,  1873.  Has 
had  conjunctivitis  for  three  weeks  in  both  eyes.  Pain  and 
smarting  in  eyes,  especially  in  the  evening  and  at  night. 
Eyelids  adhere  together  in  the  morning.  Chloral  gr.  j  ter 
die,  and  simple  ointment  at  night  applied  to  the  edges  of  the 
lids. 

January  15th. — Eyes  much  better,  but  a  slight  redness 
is  still  visible,  especially  on  the  palpebral  conjunctiva. 
Continue  Chloral,  and  to  have  a  coUyrinm  of  Sulphate  of 
Zinc. 

Case  7. — Has  been  ill  five  months.  There  is  conjunc- 
tivitis and  comeitis  on  left  eye.  Cornea  is  dim.  In 
right  eye  there  is  a  cicatrix  of  an  old  ulcer  on  the  cornea, 
and  at  one  point  considerable  redness  of  the  palpebral  and 
ocular  conjunctiva.  A  good  deal  of  photophobia.  .  Chloral 
gr.  j  ter  die.     Eyes  to  be  bandaged. 

This  patient  was  particularly  requested  to  return  in  a  few 
days.  She  did  not  do  so,  and  on  inquiry  I  learned  that 
she  had  got  quickly  well. 


by  Dr,  D.  Dyce  Brown,  511 

Case  8. — Alexander  J — ,  set.  16.  For  a  month  has  had 
conjunctivitis  of  both  eyes,  worse  during  past  week.  A 
small  ulcer  on  left  cornea.  Feeling  of  sand  in  the  eyes, 
but  almost  no  photophobia.  Is  a  very  strumous  patient. 
Chloral  gr.  j  ter  die. 

This  patient  did  not  return  till  some  time  after,  with 
another  complaint.     The  eyes  had  got  quite  well. 

The  following  cases  did  not  return  at  all,  but,  as  I  before 
stated,  I  count  them  as  successful,  as  they  were  all  told  to 
return  in  a  few  days  if  not  better. 

Case  9. — E.  S — ,  aet.  12.  Conjunctiva  of  one  eye  very 
red ;  an  ulcer  on  the  cornea,  and  a  pink  circle  round  it. 
Pain  round  orbit.  Has  been  ill  five  days.  Chloral  gr.  j 
ter  die  and  a  bandage  to  the  eye. 

Did  not  return. 

Case  10. — ^Jane  McI — ,  set.  13.  Inflammation  of  con- 
junctiva of  both  eyes,  with  a  spot  of  injection  in  left  eye, 
almost  amounting  to  ecchymosis.  A  small  quantity  of 
muco-pus  comes  from  the  eyes.     Chloral  gr.  j  ter  die. 

Did  not  return. 

Case  11. — Helen  S — ,  set.  12,  October  30th,  1872. 
Phlyctenular  ophthalmia  came  on  the  day  before.  Palpe- 
bral and  ocular  conjunctiva  of  left  eye  very  red.  A 
phlycten  at  upper  edge  of  cornea.  A»good  deal  of  pain  in 
the  eye,  but  none  round  orbit.  Right  eye  red  and  in- 
flamed, but  has  no  phlycten.  Chloral  gr.  ^  and  Aconite, 
every  alternate  two  hours. 

November  3rd. — Much  better.  Redness  very  much  gone. 
Continue. 

Did  not  return  again.  (By  mistake  this  case  is  classed 
among  those  that  did  not  return  at  all.) 

Case  12. — John  T — ,  set.  23.  Five  days  ago  right 
eye,  and  three  days  ago  left  eye,  became  inflamed.  In 
right  eye  there  is  much  redness,  with  chemosis,  and  a 
phlycten  at  edge  of  cornea.     In  left  eye  a  good  deal  of 


512  Therapeutics  of  Apomorphia  and  Chloral, 

rednesB,  but  do  phlycten.     Not  much  pain  or  photophobia. 
Chloral  gr.  j  ter  die  and  bandage  to  the  eye. 
Did  not  return. 

The  following  are  cases  illustrating  the  action  of  Chloral 
in  urticaria  and  pruritus  : 

Case  1. — Jane  W — ,  aet.  13,  September  11th,  1871. 
On  the  7th  was  taken  ill  with  headache,  sickness,  and 
vomiting,  which  continued  until  the  10th,  when  an  eruption 
appeared  on  the  skin,  which  is  very  itchy,  and  rises  in 
'^  white  blisters  "  on  being  scratched  \  affects  chiefly  the 
forearms  and  legs.  No  discoverable  cause.  Chloral  gr.  ^ 
ter  die. 

September  14th. — Much  better,  only  a  few  slight  patches 
of  the  eruption  being  found. 

16th. — To-day  is  quite  well,  not  the  least  appearance 
of  anything  on  the  skin,  and  no  itching. 

Cases  2  and  8. — Mrs.  S — ,  aet.  38,  and  her  son  George, 
set.  8,  February  5th,  1872.  Complains  of  a  rash  coming  out 
every  night,  and  almost  disappearing  during  the  day,  "  like 
the  sting  of  a  nettle.^'  Has  lasted  for  a  week.  It  is  very 
itchy,  and  after  washing  with  soap  and  water  becomes 
painful.  Keeps  them  from  sleep  at  night.  General  health 
good.  No  stomach  disorder.  The  mother  has  her  cata- 
menia  every  two  months,  lasting  ten  days,  and  leaving  her 
with  a  feeling  of  giddiness  in  the  head.  Chloral  1  gr.  ter 
die,  and  gr.  \  for  her  son. 

February  10th. — On  the  first  night  after  the  above  report 
had  the  rash  as  before,  since  which  she  has  been  quite  free 
of  it.     The  little  boy  is  also  quite  well. 

Case  4.  —  Mrs.  McG — ,  aet.  30,  February  6th, 
1872.  Is  eight  months  pregnant.  Had  erysipelas  ten 
days  ago.  To-day  complains  of  nettle-rash,  which  has 
come  on  since  the  erysipelas  disappeared.  Has  had  it 
before  several  times.  The  rash  comes  out  when  she  is 
warm  and  in  bed,  and  itches  very  much.  Headache  on 
left  side,  especially  at  the  inside  of  the  left  eye.  Tongue 
clean,  bowels  regular      Chloral  gr.  1  ter  die. 


by  Dr.  D,  Dyce  Brown.  513 

February  13th. — Is  much  better.  The  urticaria  has  not, 
however,  entirely  left  her.     Continue  med. 

Since  this  report  up  to  the  present  time  (March,  1874) 
she  has  had  frequent  attacks  of  it,  and  always  asks  for  "  the 
medicine  for  the  nettle-rash,^'  saying  she  never  had  any- 
thing that  relieved  her  so  much. 

Case  6. — Miss  K — ,  set.  50.  For  some  days  has  had 
itchiness  of  the  chin  and  front  and  back  of  the  neck, 
coming  on  towards  morning — sensation  like  minute  insects 
or  hairs.  Otherwise  quite  well.  Chloral  gr.  1  ter  die. 
This  quickly  cured  the  affection. 

Case  6. — A  child,  set.  3.  Had  well-marked  nettle-rash 
for  a  month.  Chloral  gr.  1  ter  die.  As  I  afterwards 
learned,  this  child  got  well,  and  the  mother  did  not  think  it 
necessary  to  bring  it  back  again. 

Case  7. — A,  B — ,  set.  25,  November  9th,  1872.  Com- 
plained of  sic&ness  and  vomiting  for  two  days  with  headache 
and  sore  throat.  When  seen  had  urticarious  blotches  over 
body,  which  are  very  itchy.  Pulse  90;  temp,  normal. 
Chloral  gr.  1  ter  die  (no  discoverable  cause). 

November  llth.-^Bash  quite  gone. 

Case  8. — Peter  B — ,  set.  six  months,  November  9th, 
1872.  Had  been  ailing  for  several  days.  When  seen  had 
blotches  of  redness  over  legs  and  body  in  distinct  wheals, 
not  much  fever.  Bowels  regular.  Is  weaned.  Takes  his 
food  well.      Chloral  gr.  \  ter  die. 

11th. — Bash  much  faded. 

12th. — Is  quite  well. 

Case  9. — ^Alexander  G — ,  set.  2^.  Had  for  some  time 
been  much  troubled  with  an  urticarious  eruption,  which 
disappeared  by  day  and  came  out  at  night,  with  such 
itching  as  to  keep  him  from  sleep.  No  discoverable  cause. 
Chloral  gr.  \  ter  die  in  two  or  three  days  so  removed  it  as 
to  give  him  quiet  sleep,  free  from  itchiness.  The  same  has 
since  recurred  two  or  three  times,  and  has  always  been 
removed  by  the  Chloral. 

VOL.  XXXII,  NO.  CXXIX. JULY,  1874.  K  K 


614  Therapeutics  of  Apotnorphia  and  Chloral^ 

Case  10. — Agnes  O — ,  set  28,  September  26th,  1872. 
Has  had  hsemorrhoids  for  the  last  elevea  years^  which  were 
at  first  external,  but  are  now  chiefly  internal;  bowels 
scarcely  ever  open  without  purgatiTe  medicine.  Complains 
also  of  pruritus  of  the  vulva,  and  down-bearing  pains  in  the 
hypogastric  region.  Is  at  present  six  months  advanced  in 
pregnancy,     Nux  vom.  and  Sulph,  at  bedtime. 

October  3rd. — Much  better.  Says  she  is  no  longer 
troubled  with  the  haemorrhoids,  and  that  the  bowels  open 
naturally  every  day ;  the  bearing-down  pains  in  the  hypo- 
gastric region  are  also  quite  gone.  Says  she  feels  quite 
well,  except  that  the  pruritus  vulvae  is  very  troublesome. 
Stdph.  ^  bis  die. 

14tb. — No  better  of  the  pruritus.     CoUinsonia. 

Slst. — No  better.     Chloral  gr.  1  ter  die. 

31st. — Pruritus  almost  quite  gone. 

Sleeps  comfortably  at  night  now.  The  piles  are  again 
troubling  her,  for  which  she  is  again  put  on  treatment  for 
them.     She  did  not  return. 

The  following  oases  did  not  return  at  all,  but  being 
always  requested  to  do  so  if  not  improved  I  class  them  as 
successful. 

Case  11. — ^Miss  S-—,  set.  16,  October  12th,  1872. 
Cannot  sleep  at  night  for  itchiness  of  skin  of  whole  body. 
Has  had  it  for  three  weeks.  Skin  of  body  gets  quite  red. 
Redness  and  itching  gone  by  the  morning.  Is  quite  well 
otherwise.  Nothing  at  present  to  be  seen  except 
remains  of  scratching.  Chloral  gr.  1  ter  die.  Bid  not 
return. 

Case  12. — Mrs.  J — ,  set.  21.  Has  had  nettle-rash  for  a 
month,  comes  out  chiefly  in  afternoon,  and  goes  in  again  at 
bedtime.  Sleeps  well  enough.  The  eruption  is  on  the  arms 
and  face  only.  Tongue  clean.  No  dyspepsia.  Bowels 
rather  costive.  Catamenia  regular  till  last  time,  when  she 
is  now  a  fortnight  past  time.  Head  aches.  CUoral  gr.  1 
ter  die.     Did  not  return. 


Case  18. — Oeorge  C — ,  set.  16  months.     For  the  last 


•  by  Dr,  D.  Dyce  Brown.  515 

two  days  has  had  a  well-marked  urticarious  eruption^  which 
makes  its  appearance  on  every  part  of  the  body^  and  is 
mnch  worse  at  night.  Chloral  gr.  \  ter  die.  Did  not 
return. 

Case  14. — ^Ellen  S — ,  set.  28^  a  servant.  Since  coming 
to  town  ten  weeks  before  has  had  an  eruption,  red,  and  in 
spots  the  size  of  a  sixpence  or  shilling  all  over  the  body.  It 
does  not  come  out  through  the  day,  but  at  night  keeps  her 
awake  from  the  itching,  making  her  afraid  to  go  to  bed. 
Head  aches  every  day  across  the  forehead,  coming  on  in  the 
morning  and  going  off  in  the  evening.  Tongue  clean. 
Appetite  not  so  good  as  in  the  country.  No  dyspepsia. 
Bowels  and  catamenia  regular.  Chloral  gr.  1  ter  die. 
This  patient  was  particularly  requested  to  return  if  not 
better,  but  did  not  do  so. 

Case  15. — Joseph  A — ,  set.  2,  September  21st,  1871. 
On  getting  warm  a  cutaneous  eruption  makes  its  appear- 
ance, chiefly  on  the  breast  and  limbs  j  before  coming  out 
he  gets  sick  and  has  headache ;  the  eruption  is  of  a  diffuse 
mottled  character,  and  of  a  bright  red  colour ;  is  not  itchy, 
and  disappears  on  the  surface  of  the  body  being  cooled; 
pulse  quiet,  tongue  clean,  bowels  quite  regular.  There  has 
been  no  coryza  nor  cough.  Chloral  gr.  I  ter  die.  Did 
not  return. 

Case  16. — Mary  J.  D — ,  »t.  6.  Has  had  nettle-rash 
all  over  body  for  four  days ;  very  itchy,  worse  at  night,  and 
when  warm.  Tongue  clean.  Bowels  regular.  Appetite 
good.  No  cause  discoverable.  Chloral  gr.  \  ter  die. 
Did  not  return. 

I  have  only  stated  in  some  of  the  cases  that  no  cause 
was  discoverable,  but  I  should  have  stated  in  aU.  This  is, 
of  course,  a  point  of  some  importance,  as  certain  articles  of 
diet  are  known  to  produce  urticaria  in  many  people.  Of 
course,  in  such  cases,  the  urticaria  passes  off  without 
medicine,  and  would  be  worth  nothing  to  prove  the  efficacy 
of  any  drug. 

I  have  only  now  to  apologise  for  the  length  of  this  paper 


516  Therapeutics  of  Apowwrphia  and  Chloral. 

and  the  namber  of  caaes  appended,  but  in  giving  proof  of 
the  value  of  two  new  medicines  I  thought  it  of  importance 
to  preTcnt,  if  possible,  any  doubts  as  to  their  efficacy,  which 
the  enumeration  of  only  two  or  three  cases  might  hare 
provoked. 


on  Dr.  D.  Dyce  Brown's  paper. 

Dr.  Wyld  congratulated  homoBopathists  on  the  addition  of 
two  excellent  remedies  to  their  repertory.  His  only  experience 
of  Chloral  was  as  an  anodyne  and  hjpnotic.  With  this  view  he  had 
frequently  administered  twenty  drops  of  the  syrup,  but  had  never 
met  with  any  pathogenetic  effects.  He  hoped  extended  experi- 
ence would  confirm  that  of  Dr.  Brown  with  reference  to  JtpO' 
morphia  in  vomiting,  slthough  it  often  happened  in  medicine  that 
time  did  not  fully  confirm  the  anticipationfl  or  even  the  experience 
of  those  who  introduced  new  rememes. 

Dr.  DuDOKOK  considered  that  Dr.  Dyce  Brown  had  done  good 
service  to  homodopathy  by  the  addition  of  two  remedies  to  our 
treasury.  He  had  done  his  work  in  the  true  Hahnemannic  style ; 
first  ascertained  the  pathogenetic  effects  of  the  medicines,  and 
then  used  the  knowledge  so  acquired  as  the  guide  to  their 
administration  in  disease.  The  cases  were  treated  strictly 
homoDopathically,  and  the  results  as  fiir  as  these  were  ascertained 
were  quite  satisfactory.  The  only  blemish  in  the  paper  was  the 
introduction  of  cases  the  end  of  which  was  not  traced.  It  would 
have  been  far  better  to  have  left  out  these  cases  completely. 
The  cases  where  the  results  were  ascertained  were  quite  sufficient 
to  prove  Dr.  Brown's  points  without  the  introduction  of  cases  of 
such  doubtful  value.  It  would  never  do  to  assume  that  our 
dispensary  cases  were  cured  because  they  did  not  return.  He 
was  glad  to  find  that  in  Apomorphia  we  seemed  to  have  an 
excellent  remedv  for  a  very  common  form  of  sickness  that  did  not 
depend  on  the  derangement  of  the  stomach,  but  proceeded  from 
sympathy  with  some  other  organ.  Chloral  would  no  doubt  prove 
a  very  use^l  remedy  in  nettle-rash.  The  power  of  producing  an 
eruption  like  measles  had  been  long  known,  and  if  we  required 
other  remedies  for  measles  than  those  we  already  possess  we 
might. have  recourse  to  Chloral. 


517 


ADDRESS   AT   CLOSE    OP   SESSION    1873-4. 
By  Dr.  Bates^  Vice-President. 

(Read  before  the  British  HomoBopathic  Sooiely.) 

To-NiOHT,  in  concluding  the  session  of  1873-4^  we 
celebrate  the  termination  of  the  thirtieth  year  of  the  exist- 
ence of  the  British  HomcBopathic  Society. 

During  these  thirty  years  how  many  changes  may  be 
marked^  not  only  in  the  fortunes  of  our  Society  but  in  the 
world  of  medicine !  It  is  worthy  of  remark  that  in  the 
year  of  its  foundation  (1844)  four  members'  names  only 
were  enrolled ;  of  these  original  members  two  alone  remain 
among  us — Dr.  Quin^  our  venerated  founder  and  our  Presi- 
dent, and  Mr.  Came&on^  who  has  more  than  once  filled 
the  office  (which  I  vacate  to-night)  of  Yicb-Pbesident  ; 
but  in  our  present  list  of  members  we  see  that,  from  the 
small  beginning  in  1844^  our  Society  has  increased  until 
our  fellows,  members  and  inceptive  members  reach  a  total 
of  considerably  over  1 00. 

In  point  of  numbers,  then,  there  is  great  cause  for  con- 
gratulation on  the  part  of  those  who  take  interest  in  the 
progress  of  our  method  of  therapeutics,  and  especially  must 
it  be  a  moment  of  proud  satisfaction  to  our  accomplished 
president  and  founder,  and  to  our  ever  courteous  and  much 
respected  friend  Mr.  Cameron,  to  see  the  fruition  of  the 
small  seed  which  they  planted  in  the  year  1844  now  grown 
into  a  strong  and  vigorous  tree  under  whose  shadows  those 
who  have  been  ostracised  by  the  older  and  narrower 
medical  societies  can  meet  and  discuss  all  the  recent 
developments  of  clinical  and  therapeutical  advancements, 
untrammelled  by  the  fear  of  offending  jealous  rivalries  and 
uncontrolled  by  narrow  prejudices. 

Gentlemen,  it  may  seem  a  bold  thing  to  state,  but  it  is 
none  the  less  true,  that  this  and  its  kindred  homoeopathic 
societies  in  the  provinces  are  the  only  medical  societies  in 


618  Address  at  close  of  Session  1873-4^ 

Great  Britain  in  which  physicians  and  surgeons  can  openljr 
meet  and  discuss  medical  and  surgical  science  and  art,  on 
all  their  sides,  in  all  their  relations  to  therapeutics,  and  in 
all  their  bearings  to  adjunctive  means  and  to  clinical 
experience. 

We  are  not^  as  our  opponents  would  fain  represent  us, 
sectarians ;  we  do  not  claim  that  there  is  but  one  single 
truth  in  medicine,  and  that  homoeopathy  is  that  sole  truth ; 
but  we  claim  that  homoeopathy  is  a  great  truth,  that  it 
enables  us  to  cure  a  vast  amount  of  human  suffering,  and  to 
alleviate  a  vast  amount  of  human  misery  which  could  never 
be  cured  or  alleviated  were  it  not  for  Hahnemann's  great 
discovery ;  and  we  claim,  therefore,  that  homoeopathy  shall 
hold  its  place  in  the  realm  of  medicine,  and  that  it  shall 
not  be  banished  and  outcast  from  the  profession  by  mere 
clamour  and  prejudice. 

For  the  purpose  of  defending  and  spreading  the  know- 
ledge  of  an  unfairly  proscribed  medical  and  scientific  truth 
this  Society  was  formed,  and  nobly  has  it  fulfilled  its 
purpose.  Strong  as  has  been  and  as  still  is  the  combina- 
tion against  our  system  (and  degrading  to  the  scientific 
status  of  the  medical  profession  as  have  been  the  arts  used 
against  those  noble  inquirers  who,  after  careful  examina- 
tion, have  dared  to  assert  their  freedom  and  liberty  of 
action  to  follow  out  their  honest  convictions,  by  adopting 
the  homoeopathic  method  into  their  practice),  this  counter- 
combination  has  effectually  withstood  all  the  machinations 
of  the  members  of  the  older  medical  societies,  and  has  given 
us  a  place  and  a  means  of  demonstrating  to  our  fellow 
practitioners  of  liberal  views,  that  we  are  not  to  be  put 
down  nor  intimidated  by  threats  nor  by  penalties. 

That  much  good  serviceable  work  has  been  done  by  our 
Society  is  shown  by  the  record  contained  in  our  AntuUs 
and  Transactions,  in  which  have  been  published  many 
valuable  monographs  and  essays,  as  well  as  clinical  reports 
and  discussions.  These  Annals  and  Transactions  have 
already  completed  their  sixth  volume,  and  let  those  who 
accuse  us  of  medical  sectarianism  read  in  their  pages  a 
clear  refutation  of  this  slander,  and  let  them  judge  whether 


by  Dr.  Baye$.  519 

or  no  we  are  not  striving  to  our  uttermost  to  give  practical 
meaning  to  the  noble  words  of  our  master  in  the  first  pro- 
position of  the  Organon-^^*  The  physician's  high  and  only 
mission  is  to  restore  the  sick  to  health,  to  cure,  as  it  i^ 
termed/^ 

Gentlemen,  I  feel  sure  that  all  around  us  to-night  re- 
echo and  cordially  endorse  these  noble  words.  It  is  pot 
our  position  nor  our  wish  to  support  this  system  or  that 
system  of  medicine ;  we  do  not  seek  to  glorify  one  system 
nor  to  vilify  or  underestimate  another;  but  we  desire  to 
'*  restore  the  sick  to  health/'  apd  in  order  that  we  may  do 
so  faithfully,  and  in  as  perfect  a  manner  as  it  is  possible  to 
do,  it  is  our  duty  to  uphold  and  to  defend  our  right 
to  investigate  any  and  every  new  means  or  old  means 
which  enables  us  to  improve  our  power  of  healing.  We 
assert  our  right  to  practise  and  to  discuss  the  horaesopathie 
treatment  of  disease,  just  as  we  also  preserve  to  ourselves 
the  right  to  use  every  other  means  which^  in  any  individual 
case,  appears  to  us  to  be  best  adapted  for  its  cure.  And 
this  Society  enables  us  to  meet  and  compare  our  experi- 
ences with  those  of  other  labourers  in  the  greAt  field  of 
cure- work.  Let  us  ever  remember,  with  honest  pride>  that 
this  British  Homoeopathic  Society  is  the  only  medical 
society  in  London  where  all  modes  of  medical  and  surgical 
treatment  can  be  practically  discussed  without  let  and 
hindrance.  This  consideration,  gentlemen,  should  attach 
us  all  firmly  to  our  Society  and  should  warm  our  afiection 
for  and  increase  our  loyalty  to  it.  Our  members  should 
rally  •round  its  standard,  there  to  fight  against  allopathic 
blindness  and  prejudice  and  hardness  of  heart,  not  in 
bitterness  but  in  the  pure  light  of  love  for  science  and  in 
furtherance  of  our  '^  high  and  only  mission,'^  so  that  we 
may  not  only  '^  heal  the  sick  '^  ourselves,  but  may  become 
active  missionaries  in  spreading  among  those,  who  at 
present  oppose  us,  a  knowledge  of  the  improved  htaling 
means  with  which  Hahnemann's  method  has  supplied  U9. 

A  brief  review  of  the  labours  of  the  session  just  passed 
will  show  that  it  has  been  by  no  means  unfruitful  in  this 
direction.     Cases  illustrative  of  the  homoeopathic  action  of 


620  Address  at  close  of  Session  1873-4^ 

medicinal  drugs  have  been  laid  before  us  in  papers  read  by 
several  of  our  coUeagues ;  nor  have  pathology^  surgery^ 
prophylaxis,  or  pure  therapeutics  been  neglected  in  the 
past  series  of  papers  read  within  these  walls. 

The  following  is  a  list  of  the  papers  read  and  discussed 
daring  the  past  session : 

1.  "Cases  from  my  Note  Book/'  by  Dr.  Holland. 
Two  cases  of  diseases  of  the   bladder :   one  of  colic 

(with    opisthotonos),     simulating    lead    poisoning, 
cured  with  Plumb,  acet. 
Two  cases  of  chronic  dyspepsia  illustrating  the  curative 
power  of  Nitrate  of  Silver. 

2.  "  Notes  on  Re-vaccination/'  by  C«  H.  Blackley,  Esq. 

8.  "On  Certain  Pathological   Points    of  Interest/'  by 
E.  T.  Blake,  M.D. 

I.  Sublingual  ulceration  in  hooping-cough. 
II.  Frequency  of  follicular  pharyngitis. 
III.  Etiology  of  sun-stroke  and  hay.fever. 

4.  "  Some  Diseases  of  the  Genito-Urinary  Organs,  with 
Cases,''  by  Henrt  Harris,  Esq. 

Cases. — Tubercular  disease  of  prostate.  Haemor- 
rhage from  urethra  and  expulsion  of  fibrinoua 
cast.  Warts  on  penis,  treatment  by  differing 
dilutions  of  Thuja  and  Nitric  add. 

6.  "  Specific    Medication    in    relation  to  Surgery,"  by 
Dr.  W.  SiHPSON  Craio. 

"  On  the   extremely  satisfactory    results  of  Syrgery 

supplemented  by  Homoeopathic  Treatment." 
Diseases  of  the  rectum,  with  cases. 
Scirrhus  of  the  breast,  with  cases. 
Ovi^rian  cyst,  with  cases. 

6*.  ''  On  some  points  in  the  Therapeutics  of  ApomorpMa 
and  Chloral"  by  Dr.  Dyce  Brown. 

7.  "  On  some  varieties  of  Haemoptysis/'  by  Dr.  Herbert 
Nankivell. 

8.  1st,    ''On    a    Form    for    taking    Cases,"    by    Dr. 


by  Dr.  Bayea.  521 

Mackechnie.      2nd^    ''On    Lupus    and    its   Treatment/' 
illustrated  by  photographs^  by  Dr.  Edward  Blake. 

These  essays  either  have  appeared  or  will  appear  in  the 
British  Journal  of  HonuBopathy,  and  afterwards  have  been 
or  will  be  published  in  a  separate  form  in  the  volume  of 
Annals  and  Transactions,  and  our  Society  thus  places  it 
within  the  power  of  any  inquiring  medical  practitioner  or 
student  to  examine  into  the  testimony  yearly  accumulating 
as  to  the  exact  value  of  the  homoeopathic  system  of  medi- 
cine. It  is  by  these  legitimate  means  that  we  slowly  but 
surely  are  advancing  the  cause  of  true  liberty  and  liberalism 
in  medicine,  and  sooner  or  later  by  this  policy  of  honest 
work  and  its  careful  recording  we  shall  revolutionise  medi- 
cine and  place  the  healing  art  on  a  secure  foundation  and 
on  a  truly  scientific  basis. 

It  is  only  by  association  and  by  the  checking  of  the 
possible  errors  of  our  own  individual  experience  by  that  of 
our  fellow  practitioners  that  we  can  hope  to  progress 
ourselves,  and  to  convince  others  of  our  medical  right 
doing. 

There  still  remains  much  to  be  done  before  we  can 
perfect  our  art  or  can  establish  the  claim  of  our  system  to 
rank  among  the  true  sciences.  A  wide  field  lies  open  to 
our  practitioners  for  the  more  exi^ct  and  practical  classifica- 
tion of  diseased  states,  such  as  shall  indicate  the  group  of 
symptoms  to  be  treated. 

In  the  early  days  of  homoeopathy  the  homoeopath  was  a 
medical  Iconoclast,  often  properly  and  righteously  so,  since 
he  cast  down  and  destroyed  many  false  images  of  a  fanciful 
pathology^  but  in  actual  practice  images  of  diseased  states 
must  be  set  up  and  classifications ,  must  be  used,  otherwise 
the  labour  of  active  practice  would  be  so  immense  that  few 
minds  could  stand  the  wear  and  tear  it  would  involve. 

In  his  more  advanced  career  Hahnemann  himself  felt 
this  necessity,  as  is  shown  by  his  recognition  of  psora, 
syphilis,  and  sycosis  as  constitutional  diseases,  and  of 
scarlatina^  measles^  hooping-cough,  &c.,  as  specific  dis«k 
eases. 


522  Address  at  close  of  Session  1873-4, 

We  must  therefore  admit  images  as  a  necessary  part  of 
the  furniture  of  our  iBsculapian  temple,  but  we  must 
exercise  due  discretion  in  admitting  those  only  which  are 
practical  embodiments  indicating  diseased  states,  such  as 
require  an  exact  treatment,  and  we  must  reject  all  those 
which  are  mere  idle  representations  of  pathological  theories. 
Such  a  reconstmction  of  therapeutic  indications  is  a 
worthy  object  of  our  researches,  and  will  I  trust  com- 
mend itself  to  the  notice  of  our  members. 

At  present,  from  our  knowledge  that  tke  thing  named 
is  seldom  the  thing  to  be  treated,  we  are  compelled,  in  a 
large  majority  of  cases,  to  fall  back  on  the  symptom- treat- 
ment of  disease,  as  insisted  upon  by  Hahnemann.  And, 
indeed,  to  some  extent  symptom-treatment  is  the  practice 
of  both  schools.  For  example,  whether  the  pathological 
state  be  scarlet  fever,  rheumatic  fever,  pleurisy,  pneumonia, 
&c.,  if  the  inflammatory  symptoms  be  severe,  it  is  these 
and  not  the  specific  form  of  fever  which  guide  us  in  the 
choice  of  a  remedy ;  or,  where  during  the  course  of  a  dis- 
ease severe  functional  disturbances  ensue,  it  is  to  the  rectifi- 
cation of  functional  balance  and  not  to  the  specifically 
meeting  the  disease  that  our  chief  efforts  are  directed. 
And,  lastly,  structural  alterations,  occcurring  during  a 
disease  (such  as  swellings,  ulcerations,  abscesses),  may 
afford  the  chief  indications  for  treatment. 

The  elaborate  nomenclature  of  the  College  of  Physicians 
enables  us  to  clothe  our  diagnosis  in  fitting  and  scientific 
words,  but  it  does  not  increase  our  power  of  '^  restoring  the 
sick  to  health."  Indeed,  the  physician  who  should  seek  to 
treat  a  disease  in  accordance  with  its  name,  prescribing  a 
specific  medicinal  drug  for  each  disease,  would  be  looked 
down  upon  as  a  charlatan,  unfit  to  herd  with  the  men  of 
science  who  constructed  the  nomenclature,  founded  (we  are 
told)  on  an  exact  appreciation  of  pathological  conditions. 
The  modern  physician  not  only  does  not  seek  a  single 
remedy  for  each  disease,  but  employs  the  same  medicine  in 
the  cure  of  many  different  diseases,  according  to  the  state 
•f  the  patient. 


by  Dr.  Bayes,  523 

Would  it  not  then  tend  very  materially  to  a  scientific 
simplicity  in  medicine  if  the  '^  diseased  states  '^  demanding 
medicinal  treatment  were  prominently  recognised  and 
clearly  defined  ? 

In  following  out  this  inquiry,  the  worker  who  has 
acquainted  himself  with  the  pathogenesy  of  drugs  as  recorded 
in  Hahnemann's  Materia  Medica  Pura,  and  our  .more 
recent  symptomatologies,  has  already  prepared  a  foundation 
on  which  to  reconstruct  a  practical  nomenclature  of  *'  dis* 
eased  states/'  Hahnemann  has  given  us  a  new  and  im- 
mensely enriched  Materia  Medica,  but  it  remains  to  a  later 
age  to  produce  a  pathologist  who  shall  construct  us  a 
aymptom-code  of  diseases. 

Again,  it  is  not  sufficient  for  us  to  rest  content  with 
the  therapeutic  rule  of  ''  similia  similibus  curantur/' 
It  does  not  satisfy  the  scientific  physician  to  say  to  him 
dogmatically,  '^  no  matter  what  is  the  disease,  if  certain 
symptoms  are  present,  give  certain  remedies  selected  on  the 
principle  of  '  similia  similibus  curantur/  and  give  the  reme« 
dies  in  doses  far  smaller  than  those  which  would  suffice  to 
induce  these  symptoms  in  the  healthy/'  We  must  cease  to 
dogmatise,  and  must  be  able  to  give  a  rational  explanation 
for  our  rule  of  practice,  or  we  shall  fail  to  gain  the  ear  of 
scientific  physicians.  Now,  if  we  can  show  that  the  dis- 
eased states,  demanding  drug  treatment,  are  really  the 
result  of  the  paralysis  of  certain  definite  sets  of  nerves 
aflPecting  definite  parts,  tracts,  or  organs  of  the  body,  we 
shall  go  a  long  way  towards  a  rational  explanation  of  the 
apparent  paradox  included  in  the  application  of  our  rule  of 
"similia,''  &c.  For  if  '^ diseased  states"  arise  from 
partial  paralysis  of  branches  of  the  sympathetic  or  of  the 
cerebrospinal  nerves  respectively,  our  rational  treatment  of 
such  diseased  states  will  be  to  restore  the  balance  of  power 
by  stimulating  the  nerves  up  to  the  standard  of  healthy 
function. 

I  have  already  attempted  in  my  work  on  Applied  Hommo- 
pathy  to  show  that  the  probable  action  of  infinitesimal  doses 
of  medicinal  drugs  is  that  of  restorative  stimulation.  On 
page  4  of  the  above-named  essay  I   illustrate    this  pro- 


524  Address  at  close  of  Session  1878-4, 


position  by  a  quotation  from  Dr.  Ansties  essay  on  the 
Action  of  Alcohol,  and  I  have  hazarded  the  opinion  that 
probably  the  same  rule  which  applies  to  the  action  of 
alcohol  will  be  found  to  apply  to  all  poisons.  In  fact,  that 
each  drug,  when  given  in  poisonously  large  doses,  paralyses 
''a  certain  part,  tract,  or  organ/'  and  thus  induces  an 
artificial  disease ;  while,  on  the  other  hand,  the  small  dose 
of  a  drug,  when  given  to  a  patient  (having  a  corresponding 
diseased  state),  stimulates  the  same  *'  part,  tract,  or  organ*' 
which  its  large  dose  would  paralyse.  For  the  words 
stimulant  and  paralyser  do  not  point  to  two  opposite  sets  of 
drugs,  but  are  really  the  two  extremes  of  the  action  of  one 
drug,  and  represent  only  the  effects  of  different  doses.  All 
stimulants  given  in  excess  paralyse.  All  paralysers  given  in 
moderation  stimulate. 

The  solution  of  the  much  vexed  question  of  the  dose  is 
included  in  the  proper  appreciation  of  this  great  law.  It 
is  a  part  of  the  art  of  therapeutics  so  accurately  to  adjust 
tlie  dose  that  the  depressed  and  partially  paralysed  nerves 
shall  be  stimulated  exactly  up  to  the  health  point ;  any 
dose  which  goes  beyond  this  retards  cure  by  leaving  a  cor- 
responding depression. 

The  working  out  of  this  inquiry,  again,  affords  a  most 
interesting  field  for  careful  experiment  on  the  part  of  our 
members,  and  it  can  only  be  satisfactorily  carried  out  by  the 
conjoint  efforts  of  many  men  and  by  the  free  comparison  of 
many  individual  experiences. 

It  would  tend  greatly  to  the  advance  of  the  legitimate 
influence  of  homoeopathy  within  the  profession  were  we  in 
a  position  to  define  its  exact  value  in  the  realm  of  medi- 
cine. The  experience  of  many  active  workers  can  alone 
enable  us  to  prove  the  full  extent  of  its  healing  powers,  and 
the  limitations  by  which  bomceopathy  is  bounded  in  the 
treatment  of  disease. 

It  may  not,  however,  be  premature  to  indicate  that 
experience  appears  to  point  to  the  two  following  pro- 
positions : 

Firstly.  That  homoeopathy  enables  us  to  restore  the 
balance  of  functional  action  both  to  the  organs,  to  the  cir- 


by  Dr.  Bayes.  525 

culation^  to  the  nerve  force,  to  cell-growth,  and  to  meta- 
morphosis of  tissue.  Hence  the  homoeopathic  method  is 
applicable  in  all  diseases  where  loss  of  balance  between 
functional  actions  constitutes  the  disease,  or  is  the  prdminent 
cause  of  suffering. 

Secondly.  By  restoring  functional  balance  the  homoe- 
pathic  method  enables  us  to  arrest  and  to  destroy  many 
morbid  growths  and  many  parasitic  diseases  in  an  indirect 
manner.  For,  if  we  are  able  to  restore  perfect  health  to 
the  containing  or  surrounding  tissues,  we  may,  so  to  speak, 
starve  the  morbid  growth  or  parasite. 

The  illustration  of  these  two  propositions  affords  much 
scope  for  experiment.  It  will  probably  be  found  that 
surgical  interference  or  the  adoption  of  the  antiseptic 
method,  in  the  treatment  of  morbid  and  parasitical  growths, 
in  toxsemic  conditions,  pyaemia,  &c.,  will  enable  us  to 
'^  restore  the  sick  to  health  ''  with  a  still  greater  facility  and 
in  a  direct  manner,  but,  nevertheless^  a  combination  of  the 
homoeopathic  method  with  those  others  will  even  here 
enable  us  still  further  to  expedite  the  cure. 

The  interesting  paper  read  before  the  Society  by  Dr.  W. 
S.  Craig  contributes  much  to  our  information  on  this 
head.  It  must  I  think  be  conceded  that  the  ''  restoration 
to  health  '^  in  a  large  number  of  acute  and  chronic  diseases 
is  most  vapidly  accomplished  by  a  combination  of  certain 
adjunctive  means,  or  supplementary  means,  with  the  careful 
application  of  the  homoeopathic  method.  The  value  of 
palliatives,  of  heat  and  cold,  mineral  waters,  of  hydropathy, 
of  Turkish  baths,  of  electricity,  of  movements  and  gym- 
nastics, of  rubbing  and  of  certain  external  applications,  in 
some  cases,  cannot  be  denied  by  any  physician  of  experi- 
ence. I  allude  to  these  subjects  very  briefly,  and  with  the 
double  intention  of  showing  that  the  members  of  our  body 
are  fully  alive  to  the  importance  of  all  these  aids  in  their 
active  combat  with  disease,  and  to  show  also  that  our 
Society  does  not  impose  any  fetters  or  restrictions  on  the 
practice  of  its  members,  desiring  at  the  same  time  that 
they  should  fully  acquaint  themselves  with  the  practice  of 
homoeopathic    therapeutics,    and   that    they    should    have 


526  Address  at  close  of  Session  1873-4, 

perfect  liberty  to  follow  the  teaching  contained  in  the  first 
proposition  in  the  Organon,  that  ''  the  physician's  high  and 
only  mission  is  to  restore  the  sick  to  healthy  to  cnre^  as  it  is 
termerf." 

Gentlemen,  it  is  our  duty  to  increase^  in  every  Intimate 
way,  the  usefulness  of  our  system  and  the  knowledge  of 
that  mode  of  healing  which  has  been  placed  in  our  hands 
in  trust  for  the  good  of  the  public,  and  one  of  the  largest  of 
the  means  of  so  doing  is  by  our  giving  a  cordial  and  loyal 
support  to  this  Society,  which  ought  to  embrace  not  only 
112  practitioners  of  homoeopathy,  but  every  legitimate  and 
worthy  practitioner  of  homoeopathy  in  this  kingdom.  We 
ought  to  strive  to  enlarge  our  membership  and  our  fellow- 
ship. This  Society  is  not  only  the  citadel  of  homoeopathy, 
but  it  is  the  palladium  of  medical  liberty,  and  as  such  we 
ought  to  strive  to  our  uttermost  to  support  and  to  enlarge 
its  foundation  and  its  superstructure. 

When  the  time  arrives  that  we  may  safely  and  consis- 
tently ask  for  a  State  recognition  of  homoeopathy,  as  an 
integral  part  of  medical  education,  it  will  be  one  of  the 
duties  of  the  Society  to  provide  the  necessary  teachers  and 
examiners.  Speaking  personally,  I  believe  that  we  should  do 
wisely  to  inaugurate  such  a  movement  by  appointing  a  board 
of  examiners  and  clinical  professors,  in  order  that  our  younger 
brethren  might  obtain  such  teaching,  and  that  they  might 
receive  certificates  of  proficiency  before  embarking  in  the  prac- 
tice of  the  profession.  Timid  counsels  and  a  severe  reticence 
are  not  becoming  to  the  promoters  and  movers  in  a  great 
reformation.  We  must  push  forward  more  vigorously,  bind 
ourselves  together  more  firmly,  and  i^Bsnme  a  more  corporate 
existence,  and  place  ourselves  in  a  position  to  speak  with 
more  authority,  or  harm  will  come  upon  us.  Already  I  see, 
with  some  apprehension,  practices  creeping  in  among  some  of 
those  practitioners  calling  themselves  homoeopaths,  which  I 
cannot  think  they  would  fall  into  were  they  more  frequently 
to  meet  their  fellow  practitioners  in  professional  and  free 
discussion. 

Those  who  have  been  successful  in  the  tournament  of 
private     practice,    who    have,    so    to   speak,   **  won   their 


by  Br.  Bayes,  527 

spurs/'  could  by  their  frequent  association  with  their 
younger  or  less  fortunate  brethren^  feel  all  the  more 
closely  bound  to  them^  and  incline  to  give  them  paternal 
help^  and  the  younger  and  less  fortunate^  by  frequently 
meeting  with  the  successful^  might  learn  from  them  the 
secret  of  success. 

While  upon  this  subject  I  would  venture  to  urge  very 
strongly  on  the  younger  of  our  brethren  the  necessity  for  a 
very  strict  adherence  to  a  high  standard  of  medical  morality. 
Opportunities  are  certain  to  offer  themselves  to  the  patient 
waiters  upon  practice,  and  if  a  man  prove  himself  to  be 
respectable  in  his  social  relations^  and  successful  in  healing 
the  cases  of  disease  which  come  to  him^  his  success,  in  a 
pecuniary  sense^  is  certain  to  follow.  The  old  proverb  that 
''  good  wine  needs  no  bush ''  is  as  true  as  it  ever  was,  and 
no  really  good  practitioner  will  ever  find  it  needful  to  stoop 
to  lower  and  unprofessional  arts.  It  is  with  much  regret 
that  I  have  recently  seen  in  one  of  the  allopathic  journals 
a  just  animadversion  on  the  questionable  practice  of  sending 
out  a  printed  circular,  which  had  been  adopted  by  a  homoeo- 
pathic practitioner.  Such  means  of  seeking  practice  are  not 
legitimate,  and  as  a  Society  we  have  ever  discouraged 
them,  and  have  a  penalty  which  has  been  exercised,  and 
will|  if  need  be,  be  exercised  again  against  those  who  adopt 
such  methods  of  advertisement. 

Therefore  we  should  all  endeavour  to  increase  the 
powers  and  the  usefulness  of  our  British  Homceopathic 
Society,  Ist^  by  increasing  its  membership,  for  that  pur- 
pose urging  all  good  men  and  true  among  British  homoeo- 
pathic practitioners  to  join  it ;  2nd,  by  a  more  thorough 
support  of  its  meetings,  not  allowing  any  light  cause  to 
come  between  us  and  our  monthly  attendances ;  8rdly,  by 
contributing  good  papers  illustrative  of  the  action  of 
homoeopathic  remedies  in  disease.  The  cultivation  of 
public  spirit  by  no  means  compasses  any  loss  of  private 
advantages ;  but  even  were  it  so,  it  is  our  duty  to  make 
some  sacrifices  in  so  noble  a  cause  as  that  which  this 
Society  supports.  All  credit  is  due  to  that  little  phalanx  of 
writers  and   thinkers  whose  deeds  are  chronicled  in   our 


528  Address  at  close  of  Session  1873-4. 

Annals,  as  haviag  read  and  discussed  papers;  and  it  is 
earnestly  to  be  hoped  that  many  whose  names  are  unforta- 
nately  conspicaons  by  their  absence  during  the  past  session 
will  join  us  cordially  and  constantly  in  that  which  is  to 
come. 

Before  concluding  these  remarks  I  trust  I  may  not  be 
considered  as  overstepping,  in  any  way»  my  present  position 
of  Vice-President  of  the  British  Homoeopathic  Society  if  I 
▼enture  to  express  from  this  chair  a  hope  that  the  members 
of  our  Society,  while  using  the  liberty  which  I  have  claimed 
as  one  of  our  most  coveted  possessions,  will  yet  very 
jealously  guard  themselves  against  the  too  easy  admission 
of  new  and  specious  methods  of  treatment.  It  is  with  no 
little  regret  that  we  have  seen  some  practitioners,  professing 
to  be  homoeopaths,  abandoning  the  first  and  foremost  rule 
of  our  therapeutics  (that  the  curative  value  of  a  drug  in 
disease  can  only  be  ascertained  by  a  knowledge  of  its 
symptom-inducing  power  on  the  healthy),  and  embracing 
with  fervour  the  empirical  practice  of  an  Italian  count  who 
professes  to  cure  all  the  ills  mankind  is  heir  to  with  seven 
secret  remedies  and  four  bottled  liquid  electricities. 

Gentlemen,  I  am  not  here  arguing  against  the  empirical 
use  of  medicines  whose  names  are  unknown  in  such  cases 
as  have  refused  to  yield  to  known  scientific  means ;  nor  do 
I  condemn  the  practice  of  employing  empirical  means  or 
secret  remedies  when  they  have  been  proved  by  clinical 
experiment  to  be  truly  the  quickest  means  of  restoring  the 
sick  to  health ;  but  I  see  no  reason  to  believe  that  these 
seven  secret  remedies  are  in  any  sense  superior,  intrinsi- 
cally, to  seven  of  our  own  well-known  remedies,  and  their 
'curative  power  can  never  exceed  that  of  seven  such 
remedies.  Now,  is  there  any  one  member  of  our  body  who 
would  be  content  to  accept  from  one  of  our  members  seven 
bottles  of  globules,  without  name  or  dilution  stated,  and  to 
receive  them  in  firm  faith  as  containing  everything  that  is 
needful  for  the  cure  of  all  the  diseases  under  the  sun? 
I  feel  sure  that  there  is  no  one  of  us  who  would  so  far 
defer  to  the  dictum  of  the  best,  the  most  experienced,  and  the 
most  learned  physician  among  us,  yet  we  see  the  spectacle 


by  Dr.  Bayes,  529 

of  certain  educated  phyfiidaos  ahowing  an  amount  of  defer- 
ence to   an  Italian  nobleman    (deficient   in  that  medical 
knowledge  which  would  alone  make  his  testimony  of  value) 
whidi  they  would  refuse  to  give  to  any  educated  physician. 
It  is  time»  also^  that  we  should  protest  againat  the  preten- 
sion that  this  gentleman  has  put  forward  to  the  title  of 
I^anthropiat.     Were  be  truly  a  philanthropist,  and  were 
he  in  the  possession  of  seven  remedies  which  would  cure 
the  world  of  disease,  he  would  not  only  publish  the  names 
oi  the  remedies  and  their  mode   of  preparation,  but  he 
would  spread  the  knowledge  of  the  names  of  these  drugs 
and  of  their  virtues  far  and  wide  in  every  journal  of  every 
country  in  the  civilised  world.       I  am  tired  of  the  preten- 
sions of  this  pseudo-philanthropist.     How  unlike  is  his  pro- 
cedure to  that  of  our  own  noble  master,  who  spread  the 
knowledge  of  his  method  and  system  in  every  direction  and 
who  gladly   taught   his   system   to  all  inquirers;    whereas 
this  Count  charges  a  very  substantial  price  for  his  precious 
wares.       One    of   our  chemists    who    imported  the  seven 
remedies  and  the  four  bottled  electricities,  told  me  he  paid 
£200  for  his  first  parcel.     But,  say  some  of  his  supporters, 
he  gives  his  advice  to  the  poor — a  very  old  trick,  and  one 
that  has  paid  well  over   and  over  again.     Who   does  not 
remember  the  advertisements  years  ago  of  a  Reverend  Dr. 
Moseley,  who  would  gratuitously  inform   all  inquirers  of  a 
certain  cure   for   nervous  afiections.       The    patients    who 
wrote   received  a  prescription  which  could  only  be  made  up 
by    one    special   chemist,  and   the  Reverend   Dr.  Moseley 
made  his   fortune.     This   kind  of  philanthropy   has  been 
before  us    over    and  over  again,   and    whoever  reads  the 
advertisements  in  our  daily  papers  will  see  that  it  still  lives 
in  the  hearts  of  clergymen,  oflBcers,  and  others,  who  have 
infallible  cures  which  they  are  anxious  to  make  known  out 
of  pure  thankfulness  for  cures  effected  in  their  own  families. 
It  is  not  surprising  that  certain  classes  among  the  public 
should  be  imposed  upon  by  such  devices,  but  it  is  grievous 
to  see  intellectual  and  high-minded  physicians  fall  into  such 
snares. 

There  are  some  minds  so  constituted  that  every  new 

VOL.  XXXII,  NO.  CXXIX. JULY,   1874.  L  L 


530  Address  at  close  of  Session  1873-4. 

thing  appears  to  have  a  fascination  for  them^  and  this 
yearning  for  novelty  is,  probably,  the  explanation  of  the 
aberrations  above  referred  to;  but' the  greatest  seeker  after 
that  which  is  new  will  find  abundant  legitimate  food  in  a 
critical  study  of  the  remedial  drugs  already  proved,  whose 
properties  are  recorded  in  our  Materia  Medico,  in  Hale's 
New  Remedies,  and  in  other  parts  of  our  literature,  to  the 
number  of  about  or  above  400. 

Grentlemen,  with  these  remarks  we  close  the  80tfa 
Session  of  our  Society;  let  us  express  a  hope  that  each 
succeeding  session  may  show  an  increment  of  usefulness  and 
of  progress. 


531 


REVIEWS. 


BonninghausefC 8  Homeopathic  Therapeia  of  Intermittent  and 
other  Fevers,  Translated^  with  the  addition  of  new 
Remedies^  by  A.  Korndcerfer,  M.D.  New  York: 
Boericke  and  Tafel.     London  :  H.  Turner  and  Co. 

The  first  edition  of  this  work  of  Bonninghausen's  was 
published  in  1838 ;  and  had  the  honour  of  being  favour^ 
ably  noticed  by  Hahnemann  himself  in  his  Organon  (5th 
Ed.,  note  to  §  ccxxxvi).  After  an  interval  of  thirty  years, 
the  writer,  then  verging  upon  four  score,  revised  and  re- 
modelled  it.  The  preface  to  his  second  edition  (1863)  is 
given  in  the  volume  before  us.  It  explains  that,  while  the 
first  edition  treated  of  intermittent  fevers  alone,  this  limita- 
tion is  now  withdrawn;  and  the  subject  of  the  work  is 
*'  Fever  "  itself.  Under  this  term  is  to  be  included  ''  the 
various  diseased  states  of  circulation,  chill  (including  cold- 
ness and  shivering),  heat,  and  sweat/'  The  treatment  of 
the  subject  is  as  follows.  A  first  part  contains  under  the 
heading  of  each  drug,  **  a  short  extract  of  its  characteristic 
symptoms  relative  to  ieyeit/*  arranged  in  the  four  categories 
mentioned  above.  A  second  part  consists  of  ^^  a  repertory 
which  has  been  made  as  complete  as  possible,  as  regards 
the  four  stages;"  and  which  also  includes  ameliorations, 
aggravations,  and  concomitants.  **  The  third  part  gives  a 
view  of  the  compound  fevers,''  that  is,  of  the  successions 
and  combinations  of  these  fever-symptoms.  The  fourth 
and  last  part  is  a  list  of  the  pathological  (nosological)  names 
of  the  various  forms  of  fever,  with  the  remedies  best 
accredited  in  the  treatment  of  the  same.  This  section  is, 
of  course,  discredited  by  both  author  and  translator. 


532  Reviews. 

The  symptoms  whose  arrangement  is  thus  described  are 
(in  the  first  three  parts)  taken  from  the  Materia  Medica. 
The  choice  of  symptoms,  however,  in  the  first  part,  and  the 
relative  size  of  type  in  which  the  names  of  the  medicines  are 
given  in  the  second  and  third,  are  determined  by  clinical  ex- 
perience. For  this  the  author  can  draw  upon  "  the 
important  accumulation  of  115  quarto  volumes  of  moet 
carefully  kept  case-books,''  ranging  over  a  space  of  thirty- 
five  years.     The  fourth  part  is,  of  course,  clinical  only. 

Bonninghausen's  first  edition  was  given  us  in  English 
many  years  ago  by  Dr.  Hempel.  The  second  is  translated 
by  Dr.  Eorndcerfer,  who  is  a  well-known  and  laborious 
member  of  the  Hahnemannian  school  of  American  homoeo- 
pathy. He  has  added  twenty-six  remedies  to  Bonning- 
hausen's list,  and  incorporated  their  symptoms  in  the  reper- 
tory. We  regret  to  find,  however,  that  in  so  doing  he  has 
departed  alike  from  Bonninghausen  and  from  Hahnemann 
himself  in  following  the  vicious  practice  of  his  party  of 
mingling  ''  clinical  symptoms ''  with  pathogenetic,  without 
note  of  distinction.  We  want  to  know  what  febrile  symptoms 
each  drug  has  caused  on  the  healthy  body ;  and  then,  quite 
separately,  what  febrile  conditions  have  disappeared  under 
its  medicinal  use,  and  how  quickly.  It  is  simply  oonfusiiig 
and  misleading  to  blend  the  two  in  one  h(»nogeneoiis  list 
as  ''  characteristics/' 

The  volume  is  got  up  with  that  excelleoce  of  type  and 
paper  (with  leaves  already  cut)  whidi  now  distinguishes  our 
American  publications.  They  only  want  more  careful  read- 
ing of  the  press  to  make  them  models  of  typography. 

So  far  we  have  limited  ourselves  to  giving  an  aooount 
of  the  work  before  us.  And  if  it  had  been  published,  and 
this  review  written,  thirty  years  ago,  there  would  have  been 
nothing  to  add  but  an  expression  of  appreciation.  But 
when  we  oome  to  consider  it  in  the  light  of  present  know- 
ledge and  possibilities,  it  is  impossible  to  close  without  ooa* 
siderations  of  a  less  favourable  tenor. 

The  idea  is  a  good  one.  To  abstract  *'  (ejer/*  pure  and 
simple,    from   the  various   concrete    forms   in  which  it  is 


Barminghausen^s  Homceopathic  Therapeia  of  Fevers.     533 

manifested ;  to  inquire  what  medicines  produce  it,  in  what 
manner  and  with  what  concomitants ;  to  collate  the  results 
of  experience  as  to  the  power  of  such  medicines  over  it^  in 
its  generic,  specific,  and  individual  varieties  \  and  to  convey 
all  this  information  in  a  compendious  and  available  form, 
would  be  a  work  of  obvious  and  great  value.  But  it  has 
already  appeared  bow  imperfect  is  our  author^s  conception 
of  what  '*  fever  '*  is.  It  consists,  to  him,  in  disordered 
circulation,  chill  (including  coldness  and  shivering),  heat, 
and  sweat.  "  One  or  more  of  these  conditions,"  he  writes, 
'^  can,  in  general,  indicate  or  characterise  a  fever/'  Cor- 
respondingly, the  "  General  Fever  Symptoms  '*  of  bis  first 
part  include  every  disturbance  of  the  heart's  action,  every 
lowering  of  bodily  temperature,  every  sudorific  effect  pro- 
duced by  the  drugs  named — ^the  slow  pulse  of  Digitalis^  the 
chilly  depression  of  Pulsatilla,  the  sweating  of  Sambucus, 

Now  all  this  may  be  excusable  to  Bonninghausen  in  his 
study ;  but  how  can  Dr.  Korndoerfer  be  content  to  reproduce 
it  in  the  light  of  modem  science  ?  He  must  know  that  there 
are  a  hundred  derangements  of  the  circulation  which  have 
no  connexion  with  pyrexia ;  that  there  is  no  true  febrile  chill 
in  which  the  internal  temperature  has  not  already  risen ; 
and  that  mere  perspiration,  without  relation  to  heat,  may  be 
a  phenomenon  quite  foreign  to  the  present  matter.  Judged 
by  this  standard,  four  fifths  of  the  medicines  given,  and  one 
half  of  their  symptoms,  might  be  expunged  with  advantage. 
In  fact,  true  pyrexia  is  (as  Dr.  Gibbs  Blake  showed  at  the 
late  Leamington  Congress)  a  rare  pathogenetic  effect ;  and 
we  certainly  have  very  few  medicines  which  exert  a  real 
control  over  it.  The  great  majority  of  Bouninghausen's 
180  may  occasionally  come  in  to  help  in  the  treatment  of 
a  fever ;  but  unlucky  would  be  the  patient  who  had  to 
depend  on  them  (on  Agnus,  Ambra,  Asarum,  Cyclamen,  and 
such  like)  to  mitigate  its  severity  or  shorten  its  duration. 
He  would  probably  do  much  better  under  the  care  of  the 
despised  treater  of  pathological  names,  who  would  at  least 
keep  him  on  medicines  which  are  truly  anti-pjrrexial. 

These  considerations  bear  mainly  upon  the  first  part  of 
the  work.     The  second  and  the  third — the  Repertory — will 


584  Reviews. 

be  valoable  in  proportion  to  the  amount  of  clinical  ex- 
perience they  contain ;  and  practice  only  can  test  them. 
As  far  as  they  merely  refer  to  the  first  part,  they  are 
vitiated  by  its  essential  fanltiness.  The  fourth  part,  the 
'' Pathological  Names  of  the  Various  Ferers^*'  with  tlieir 
remedies  attached,  had  better  have  been  supplied  by  one 
who  had  some  sympathy  with  pathology,  which  author  aind 
translator  alike  disclaim.  The  list  is  of  the  crudest  and 
most  antiquated  kind.  Here  are  its  earliest  constituents: 
— '^  Bilious  Fever,  Catarrhal  Fever,  Cinchona  Fever, 
Congestive  (chills)  Fever,  from  overheating,  from  taking 
cold,  from  bathing,  from  getting  wet  through/'  It  is  not 
surprising  to  find  **  Nervous  Fever  "and  *'Slow  Fever" 
mentioned  as  separate  entities ;  while  typhoid  is  bracketed 
as  identical  with  typhus. 

We  are  thus  regretfully  compelled  to  pronounce  that, 
whatever  be  the  value  of  this  book,  it  belongs  to  the  Dark 
Ages  of  homceopathy,  and  .that  the  '*  Homoeopathic 
Therapeia  of  Fever  "  is  a  treatise  still  unwritten. 


Annual  Record  of  HomcBopathic  l^iterature.  1873.  Edited 
by  C.  G.  Raue,  M.D.,  assisted  by  fifteen  others.  New 
York :  Boericke  and  Tafel.    London :  H.  Turner  and  Co. 

Since  we  noticed,  in  our  number  for  April,  1871,  the 
first  volume  of  this  Record,  it  has  been  appearing  annually, 
and  the  present  volume  is  the  fourth  of  the  series.  It  con- 
tinues to  be  an  excellent  compendium  of  all  that  has 
appeared  worthy  of  note  in  German,  British,  and  American 
journals  during  the  preceding  twelve  months.  We  ought 
to  be  able  to  add  ''  French ;"  but  we  find  that  these,  with 
their  fellows  in  the  Spanish  tongue,  are  used  only  *^  as  far 
as  translated  in  other  journals.^'  Surely,  even  if  Spanish  is 
unattainable,  Dr.  Baue  could  find  some  fellow-labourer  in  the 
States  who  understands  French. 

The  three  indices  of  Diseases,  Remedies,  and  Authors 


The  Science  and  Art  of  Surgery.  535 

continue  to  be  a  most  useful  feature  of  the  work,  and  with 
their  aid  we  can  find  out  what  has  been  written  on  any 
subjecty  and  where,  during  any  of  the  years  (1869 — 1872) 
OTer  which  the  Record  extends.  This  will  be  invaluable  to 
authors,  and  only  less  so  to  practitioners.  We  advise  tdl 
our  readers  to  take  in  regularly  this  excellent  year-book. 


The  Science  and  Art  of  Surgery.  Compiled  from  Standard 
Allopathic  Authorities,  and  adapted  to  Homoeopathic 
Therapeutics.  By  E.  C.  Franklin,  M.D.,  Professor  of 
Surgery  in  the  Homoeopathic  Medical  College  at 
Missouri,  and  SiTrgeon  to  the  Good  Samaritan  Hospital 
of  St.  Louis.     Vol  II.     St.  Louis,  1873. 

The  first  volume  of  this  work  appeared  (in  two  parts) 
in  1867-8,  and  was  reviewed  in  vol.  xxvii  of  this  Journal, 
p.  821.  Its  present  continuation  has  all  the  merits  we 
found  in  the  earlier  part  of  the  work.  It  is  excellently 
adapted  for  the  students  of  the  American,  Homoeopathic 
Colleges,  for  whom  it  is  written ;  and  may  be  useful  to  any 
practitioner. 

We  have  noted  the  following  practical  observations  as 
worth  extracting : 

Page  29. — In  the  treatment  of  sprains  Dr.  Franklin 
advises  that  the  lotions,  medicated  with  the  appropriate 
remedy,  should  always  be  applied  warm.  He  prefers  Ruta 
lotion  to  any  other  application  where  the  deeper-seated 
joints  are  injured. 

Page  49. — He  speaks  highly  of  Sulphuric  acid  as  a 
remedy,  after  Aconite^  for  acute  rheumatism. 

Page  168. —  He  contributes  another  case  of  the  cure  of 
paralytic  after-effects  of  spinal  concussion  by  Hypericum. 

Page  364. — He  is  enthusiastic  in  his  praise  of  the  power 
of  Symphytum  to  promote  the  union  of  fractured  bones. 

These  are  medicinal  points.  In  the  surgery  proper  of 
his  book  Dr.  Franklin  seems  to  have  compiled  and  repro- 


536  Reviews* 

daced  well ;  and  occasionally  gives  some  usefal  experience 
of  his  own,  as,  for  instance,  a  case  of  oTariao  tunnoiir  cnred 
by  galvanism  (p.  731).  The  only  fanlt  we  have  to  find  is 
that  inveterate  one  of  our  trans-atlantic  cor^ires,  careless- 
ness in  typography,  pnnctnation,  citation,  and  arrangement. 
Thus,  the  virtues  of /od»n€  in  scrofulous  swellings  and  indu- 
rations are  mentioned  under  the  head  of  "  Ganglion ;"  and 
Dr.  Hornby's  experience  in  the  treatment  of  whitlow  as  a 
note  to  ''  Toe-nail  Ulcer ;"  lupus  and  rodent  ulcer  under 
the  head  of  Diseases  of  the  Lymphatic  System,  and  so 
forth.  The  following  is  a  specimen  of  faulty  citation 
(p.  63) : — ''  Viola  odorata.-^Three  cases  are  given  of  the 
curative  effects  of  this  drug  in  rheumatic  synovitis,  all  of 
which  were  severe  and  occurring  on  the  right  side  of  the 
body;  improvement  began  within  two  days;  complete 
recovery  followed  rapidly.  The  12th  potency  was  naieA" 
The  reference  is  to  vol.  xxiv  of  this  Journal,  p.  315.  But 
we  find  there  six  cases;  in  three  the  12tfa  dilution  was 
given,  in  one  the  1st,  in  one  several,  in  one  the  dilutions 
are  not  mentioned ;  and  the  special  point  of  the  paper  is 
to  show  that  the  action  of  the  Viola  is  pretty  well  limited 
to  the  right  carpal  and  metacarpal  joints.  There  was^ 
moreover,  much  more  variety  than  is  stated  as  regards  the 
time  at  which  improvement  began  and  cure  resulted. 

If  errors  of  this  kind  were  avoided,  and  the  press  more 
carefully  read,  our  satisfaction  with  the  American  contribu- 
tions  to  our  literature  would  be  more  unalloyed  than  at 
present  they  are. 


C.  Hering's  Materia  Medica ;  with  a  Batholoffieal  Index, 
Vol.  I.  New  York :  Boericke  and  Tafel.  London  : 
H.  Turner  and  Co. 

This  volume  is  a  collection  of  monographs  on  medicines^ 
such  as  the  author  has  given  us  before  in  his  AnterikanUche 
Arzneiprufungen.     Its  706  pages  contain  the  sixteen  reme*- 


C.  Hering's  Materia  Medico,  537 

dies  which  have  been  published  in  the  American  Journal  of 
MomcBopathic  Materia  Medica  and  the  HeJmemanadan 
M&nthhf,  Tiz.  Aluniy  Carburetum  sulphuric.  Coca,  Cuprum, 
JEupatorium  perfoliatum  and  purpureum,  Formica,  Mercurius 
iodatus  ruber,  Natrum  sulphuricum,  Nux  maschaia.  Osmium, 
Phytolaccay  SarsapariMa,  Spongia,  Stramonium,  and  T%eri^ 
dion.  They  are  here  collected  in  alphabetical  order^  and  a 
nosological  index  appended. 

Our  remarks  upon  these  moni^raphs  will  have  reference 
to  two  points — ^the  firsts  their  materials ;  the  second,  their 
arrangement. 

1.  The  materials  which  Dr.  Hering  brings  together 
consist  of  everything  \^hich  has  been  said  about  the  drug  in 
question  from  the  earliest  times  to  our  own.  He  admits 
that  in  so  doing  he  collects  tares  tx^ether  with  the  wheat ; 
but  he  thinks  that  here  (as  in  the  Parable)  the  attempt  to 
root  out  the  tares  is  premature^  and  imperils  the  wheat. 
The  '' harvest ''  to  which  he  would  have  ''both  grow 
together  '^  is  practice ;  as  the  records  of  this  accumulate, 
the  wheat  will  become  apparent,  and  the  tares  can  be 
gathered  in  bundles  to  be  burned. 

There  is  something  to  be  said  for  this ;  and  there  would 
be  more  still  were  any  reasonable  discrimination  exercised 
by  the  compiler.  All  that  was  simply  doubtful  might  be 
given,  marked  by  some  sign  to  distinguish  it  (like  Hahne- 
mann's brackets) ;  but  pathogenetic  symptoms  that  are 
simply  misleading,  and  clinical  ones  that  have  no  founda- 
tion, should  surely  be  excluded.  One  of  the  former  has 
already  been  commented  at  p.  483  of  the  present  number  of 
our  Journal ;  the  Coprum-^ymptom  in  question  stands  in 
all  its  falsehood  as  S.  814  of  Dr.  Hering's  series.  S. 
1670  of  Stramonium  is  a  specimen  of  the  latter.  From  this 
it  would  appear  that  the  medicine  had  cured  ''  progressive 
locomotor  ataxia  ''  in  the  hands  of  Dr.  H.  N.  Martin.  We 
happen  to  have  been  in  at  the  birth  of  this  ''  cure/'  We 
noticed  a  comment  of  Dr.  Martin's  on  a  symptom  observed 
in  poisoning  by  Stramonium^  that  the  patient  could  not 
walk  steadily  in  the  dark.  He  suggested  thereupon  that 
the  drug  might  be  indicated  in  locomotor  ataxy,  in  which 


538 


Reviews. 


disease  it  is  almost  impossible  to  maintain  the  eqnilibriam 
with  the  ejes  shot.  Two  or  three  months  afteiwards  we 
found  in  the  monthlj  instalment  of 
gressire  locomotor  ataxia. — H.  N. 

Eren  when  these  ''  clinical  symptoms  ''  are  true  ones,  it 
is  confusing  and  misleading  to  mix  them  up  with  those  that 
are  purelj  pathogenetic,  as  we  have  often  argued.  Dr. 
Hering  has  added  to  the  mischief  here,  bj  altering  the 
traditional  sign  for  denoting  them.  In  Jahr's  Sj^n^tcmen 
Codex,  *  prefixed  to  a  symptom  meant  that  it  had  been 
obsenred  pathogeneticallj  and  Terified  clinically,  while  ^  signi- 
fied observations  ex  usu  in  morbis  only.  Dr.  Hering  has 
omitted  the  latter  sign ;  but  uses  *  for  his  mere  ''  clinical 
symptoms." 

We  cannot  resist,  while  upon  the  subject  of  material, 
citing  Dr.  Dake's  comparative  view  of  the  plan  adopted  by 
Dr.  Hering  and  his  followers  and  the  ideal  which  pro- 
gressive homoeopathy  must  have  before  it  and  must  follow. 


I.     OBTAnriiro  07  Dbvo  Sthptoiib. 


Diteriminate, 

1.  Prom  reliable  reports  of 
cases  of  poisoning,  where  no 
diseases  were  pre-existing  and 
no  antidotes  employed. 

2.  From  experiments  on  the 
lower  animals,  carefully  coil- 
ducted  under  the  application  of 
proper  tests. 

8.  From  the  day-books  of  a 
good  number  of  provers,  of 
both  sexes,  in  good  health,  col- 
lected together  in  one  place, 
under  the  guidance  of  a  compe- 
tent director,  supplied  with  all 
the  tests  or  diagnostic  means 
necessary  in  the  examination 
of  patients;    each  prover  hay- 


Indiseriminaie. 

1.  From  the  reports  of  all 
cases  of  poisoning,  with  no 
proper  allowance  for  any  pre- 
existing diseases  or  antidotal 
means  employed. 

2.  From  experiments  on  the 
lower  animals,  conducted  by 
any  one,  in  any  manner,  and 
without  any  sort  of  tests. 

8.  From  the  reports  of  one, 
two,  or  a  dozen  provers,  scat- 
tered everywhere,  some  healthy 
and  some  not  so  healthy ;  some 
engaged  in  the  harassing  and 
fatiguing  labours  of  medical 
practice;  some  having  taken 
doses  of  the  mother-tincture, 
some  the   3rd.,  some  the   6th, 


C.  Herinff's  Materia  Medico, 


539 


Discriminate, 
ing  taken  the  same  kind  and 
size  of  dose ;  and  all  being  sub- 
ject to  the  same  rules  and  regu- 
lations as  to  manner  of  living, 
and  as  to  modes  of  observing 
and  noting  drug  effects. 


4.  From  no  other  sources  a 
single  symptom^  as  a  proper  drug 
effect. 


Indiscriminate. 
some  the  30th,  and  some  the 
200th  potency ;  some  observing 
their  symptoms  closely  and 
noting  them  carefally,  and  some 
doing  the  same  carelessly; 
some  following  one  mode  of 
life  and  some  another ;  some 
locating  and  describing  their 
sensations  after  one  plan  and 
some  another. 

4.  From  the  sick,  as  symp- 
toms removed  by  the  drug 
administered;  again  from  the 
sick,  as  symptoms  aggravated 
by  the  drug;  and  still  again 
from  the  sick,  as  symptoms 
not  properly  belonging  to  the 
disease,  but  supposed  to  be  the 
effects  of  the  drug  adminis- 
tered. 


II.   YXBISYTSQ  07   DbUO   SYMPTOMS. 


1.  By  a  critical  examination 
of  the  sources  of  all  symptoms, 
to  determine  their  character  as 
to  genuineness,  excluding  all 
the  spurious  irom  the  materia 
medica. 


2.  By  a  critical  examination 
and  comparison  of  the  day- 
books of  all  the  provers,  to 
learn  by  how  many  of  them 
the  same  symptoms  were  expe- 
rienced, and  so  to  determine 
the  comparative  value  of  the 
various  symptoms,  which  must 


1.  By  an  acceptance  of  all 
symptoms  as  furnished  in  good 
faith,  not  daring  to  "  gather 
up  the  tares*'  lest  we  "root 
up  also  the  wheat  with  them," 
and  so  letting  the  genuine  and 
the  spurious  together  go  into 
the  materia  medica. 

2.  By  taking  all  the  symp- 
toms at  par,  whether  reported 
by  one  prover  only,  or  a  dozen 
provers,  allowing  none  but 
clinical  brokers  to  determine 
their  real  value  and  to  attach 
a  premium  to  some  and  to 
lower  others   by  a  proper  dis- 


540 


Reviews* 


Discriminate. 
be    regarded    as    characteristic 
and   which  as    common,  which 
as     constant    and     which     as 
casual. 

3.  Bj  such  a  careful  practi- 
cal trial  of  each  drug,  pointed 
out  by  a  similarity  of  symp- 
toms, as  will  leave  no  doubt  as 
to  ''cause  and  effect'*  in  each 
case;  obtaining  thus  some  eri- 
dence  in  favour  or  against  the 
original  pathogenesis. 


4.  By  the  gathered  clinical 
experiences  of  physicians  who 
follow  the  homcBopathic  law 
closely  in  the  selection  of  reme- 
dies, recording  their  cases  care- 
fully and  at  the  moment,  and, 
in  all  things,  being  not  over 
confident  in  their  own  powers 
of  discernment,  nor  over  credu- 
lous as  to  the  statements  of 
others;  nor  yet  itching  to 
figure  as  great  clinical  dis- 
coverers and  authors  of  9uch 
key-notes  and  characteristics  as 
are  bom  of  clinical  experience. 


IndiMcrimimaie, 
count,  from  time  to  time. 


3.  By  an  impartial  relimce 
upon  all  the  symptoms  of  m 
drug  found  in  the  materia 
medica,  and  pointed  out  by 
repertories  and  comparative 
arrangements,  each  symptom 
being  marked  as  verified  as  soon 
as  its  morbid  likeness  in  a 
patient  is  reported  by  any  one 
as  having  been  removed  by  ^e 
drug  in  question. 

4.  By  the  gathered  clinical 
experiences  reported  in  the 
journals  from  month  to  month 
by  practitioners  of  all  grades 
of  intelligence  and  reliability; 
by  practitioners  using  crude 
doses  or  the  drd,  30th  or  exclu- 
sively the  200th  potency  of 
^i^gB ;  by  practiticnera  who 
''are,  as  it  were,  only  begin- 
ning to  pluck  the  eara  of  coro, 
rubbing  them  in  their  hands*' 
and  looking  forward  hopefully 
to  the  "  harvest  "  that 
coming." 


IS 


III.    CoLLATiNe  oi  DBue  Symptoms. 


1.  In  an  arrangement  baaed 
upon  the  several  tissues  of  the 
body  and  their  physiological 
functions,  showing  the  general 
pathogenetic  range  of  each  drug. 

2.  In  an  arrangement  based 


1.  In  an  arrangement  based 
chiefiy  upon  the  supposed  re- 
sults of  clinical  experience, 
showing  the  general  range  of 
each  drug. 

2.  In  an  arrangement  based 


C  Hering^s  Materia  Mudica. 


541 


Biscriminaie. 
upon  the  number  of  provera, 
— the  symptoms  occurring  in 
the  greatest  number  being 
marked  as  characteristic,  and 
those  occurring  in  but  one 
prover  being  set  aside  as  casual 
or  common — and  all  having 
proper  exponents  of  value  at- 
tached, showing  in  the  records 
of  how  many  provers  each  one 
had  appeared. 

3.  In  a  complete  display, 
giving  the  day-books  of  all  the 
provers,  as  submitted  to  the 
director  of  provings  from  day 
to  day,  with  his  marginal  notes 
thereupon,  the  whole  preceded 
by  a  proper  description  of  the 
respective  drugs  and  followed 
by  their  medical  and  toxico- 
logical  history  as  gathered  from 
reliable  sources. 


Inducriminate. 
partly  upon  the  regions  and 
tissues  of  the  body,  partly 
upon  their  functions  and  partly 
upon  pathological  distinctions, 
with  no  marks  to  show  whether 
a  symptom  had  appeared  in 
the  reports  of  one  prover  or  a 
dozen  provers,  or  simply  in 
some  clinical  or  toxicological 
report,  found  in  a  recent  jour- 
nal, or  in  a  musty  volume  of 
an  age  \oag  past. 

8.  In  an  arrangement,  with 
the  names  of  the  seveoral  drugs, 
their  clinical  uses  and  then 
their  symptoms,  a&  gathered 
from  all  <quarter8,  variously 
grouped  and  described,  with 
little  if  any  indication  of  source 
or  value,  except  in  occasional 
accompanying  clinical  notes  or 
subjoined  pathological  observa- 
tions. 


We  may  thiak  Dr.  Dake  a  little  too  exclusive;  bat 
there  can  be  no  doabt  of  the  supeciority  of  the  diacrimina- 
tion  he  advocates  over  the  hodge-podge  with  which  Dr. 
Hering  insists  on  furnishing  us. 

2.  When  we  come  to  the  arrangement  of  these  mono- 
graphs^ we  are  glad  to  be  able  to  speak  much  more  favour- 
ably. Each  commences  with  a  (chronological)  list  of  the 
authorities  from  whom  the  compilation  is  made^  giving 
more  or  less  full  details  as  to  the  nature  of  their  work,  the 
subjects  of  poisonings  and  provings,  &;c.  Reference  being 
made  to  this  list  nnder  every  symptom^  we  are  generally 
able  to  gauge  its  worth  for  ourBdTe8%  The  order  of  the 
schema  is  Hahnemann's^  but  subdivision  has  been  fully  and 
usefully  carried  out.  Care  has  been  taken  to  preserve  the 
Batural  groups  of  symptoms^  wherever  known^  by  references 


542  Reviews. 

between  their  component  elements ;  some  interesting 
remarks  on  Hahnemann's  teaching  and  practice  with  r^ard 
to  this  are  contained  in  'the  preface. 

With  the  reservations,  therefore,  already  made  as  to 
material,  we  commend  this  volume  of  Materia  Medica  from 
the  hand  of  our  veteran  worker  to  the  best  consideration  of 
our  readers.  It  can  hardly  fail  to  enhance  their  power  of 
applying  the  remedies  it  treats  of  to  the  relief  and  cure  of 
disease. 


ne  Hahnemann  Materia  Medica^  Part  III,  containing 
Belladonna,  by  Dr.  R.  Hughes.  Published  for  the 
Hahnemann  Publishing  Society,  by  H.  Turner  and  Co. 

We  are  obviously  precluded  from  doing  more  than 
announcing  the  publication  of  this  third  portion  and  fifth 
medicine  of  the  Hahnemann  Materia  Medica. 


L'Homceopathie   prouvie  par   ses   adversaires.      Par   Dr. 
Flasschoen.     Bailliere. 

This  excellent  brochure,  by  one  of  our  Belgian  cor^ires, 
well  shows  how  numerous  are  the  testimonies,  conscious  or 
unconscious,  to  the  truth  of  our  principle  and  the  worth  of 
our  method  occurring  in  the  writings  of  those  who  oppose 
us. 


On  the  Universality  of  the  Hommopathic  Law  of  Cure.  By 
Charles  Neidhabd,  M.D.,  &c.  2nd  Edit.  Boericke 
and  Tafel,  New  York.     1874. 

This  essay  was  delivered  as  a  preliminary  discourse  to 
the  students  of  the  Homoeopathic  College  of  Pennsylvania 
in  1872. 

It  is  all  very  well  to  attempt  to  show  the  universality  of 
the    homosopathic  law  of  cure   in  the  proper   domain    of 


Journals  of  the  Quarter.  513 

medicine,  and  a  great  deal  may  be  said  in  favour  of  the  idea 
that  every  curative  method,  whether  specific,  revulsive, 
counter-irritant,  alterative^  or  by  whatever  name  it  may  be 
called,  is  really  an  example  of  application,  more  or  less 
exacts  of  the  principle  ''  similia  simlibus  curantur/'  Of 
course  it  is  a  task  beyond  human  ingenuity  to  prove  that 
all  the  depleting  practices  of  the  old  school  come  under  the 
homoeopathic  law,  but  then  these  disastrous  methods  of  a 
*'  dying  faith ''  are  in  almost  all  cases  the  exact  reverse  of 
'*  curative/' 

We  think,  however,  it  is  rather  an  example  of  perverted 
ingenuity  to  attempt  to  trace  the  working  of  the  homoeo- 
pathic law  in  the  departments  of  morals,  politics,  education, 
agriculture,  chemistry,  and  physics.  Of  course,  far-fetched 
analogies  may  be  found  everywhere  and  even  among 
the  most  unlike  things,  but  the  discovery  of  such 
analogies  belongs  more  to  the  art  of  the  poet  than  to  that 
of  the  physician,  and  we  do  not  believe  that  any  one  was  ever 
really  converted  to  doctrines  in  one  department  of  philoso- 
phy, science,  art,  or  religion,  by  the  most  ingenious 
analogies  drawn  from  other  departments.  So  that,  with  all 
respect  for  Dr.  Neidhard,  we  fancy  his  ingenuity  in  this 
essay  is  rather  misplaced,  and  we  must  express  our  decided 
preference  for  his  contributions  to  practical  medicine,  of 
which  he  has  furnished  us  with  many  brilliant  specimens. 


Journals  of  the  (garter. 

It  is  our  intention  for  the  future  to  give,  in  every  num- 
ber, a  brief  account  of  the  contents  of  the  homoeopathic 
journals  for  the  previous  quarter.  We  receive  these  from 
France,  Belgium,  Germany,  Spain,  Italy,  and  America. 
Few  British  homoeopaths  see  more  than  one  or  two^  if  any, 
of  them.  Yet  it  cannot  be  but  that  they  contain  many  an 
item  of  interest,  many  an  article  of  importance  to  us  also 
in  this  country.  Our  risumi  will  keep  our  readers 
au  courant  with  all  that  is  going  on  abroad,   and  will  pro- 


541  Reviews. 

bably  in  many  cases  whet  their  appetite  for   some  of  the 
material  whose  presence  is  indicated. 

As  the  various  joarnals  are  sent  to  ns  rather  irregolarlj, 
we  can  observe  no  fixed  order^  but  mast  note  them  as  thej 
come. 

AMERICA. 

New  England  Medical  Gazette. — This  monthly  journal, 
published  at  Boston^  is  uuder  the  editorship  of  Dr.  C.  F. 
Nicholls^  assisted  bj  the  Faculty  of  the  Boston  University 
School  of  Medicine.*  The  number  for  March,  1874^  k  the 
third  of  its  ninth  (annual)  volume.  It  has  nothing  calling 
for  special  notice.  But  in  the  April  number  there  is  an 
account  of  the  opening  of  a  very  important  inatitation^  vis. 
''The  State  Homoeopathic  Asylum  for  the  Insane/'  at 
Middletown^  New  York.  ''This  institution/'  it  is  stated^ 
"  was  originated  in  1869,  through  the  exertions  of  George  F. 
Foote,  M.D.^  and  certain  public-spirited  citizens,  both  in 
Orange  County  and  in  other  sections  of  the  State,  who  were 
desirous  of  applying  the  principles  of  the  Hahnemannian 
school  of  medicine  to  the  cure  and  relief  of  the  insane.  In 
April,  1870,  it  became  a  duty  incorporated  State  insti- 
tution, and  a  site  was  chosen  for  it  upon  a  farm  of  250 
acres,  located  about  a  mile  to  the  westward  of  the  village  of 
Middletown,  Orange  County,  New  York,  a  spot  which 
commends  its  selection  by  the  beauty  of  the  views  which  it 
commands,  its  excellent  and  healthful  surroundings,  its 
admirable  facilities  for  drainage,  supply  of  water,  and  ease 
of  access.''  In  the  Orange  County  Press  of  April  24th  we 
have  a  picture  of  this  asylum,  which  is  an  imposing  edifice, 
consisting  of  a  main  building  containing  the  domestic  and 
administrative  offices,  and  four  wings  or  pavilions,  which 
are  reserved  exclusively  for  patients.  The  main  building, 
in  which  seventy-five  or  eighty  patients  can  be  received, 
was  to  be  opened  on  May  7th,  and  the  first  of  the 
pavilions,  to  hold  800  male  patients,  is  expected  to  be  ready 
by  the  winter.     The  medical  superintendent  is  a  Dr.  StUes, 

*  Thii  is  a  new  College,  institnted  bat  a  year  ago. 


Journals  of  the  Quarter.  545 

and  his  assistant  a  Dr.  Bailer^  both  of  whom  are  well 
spoken  of. 

This  is  a  very  important  enterprise^  and  we  shall  look 
with  great  interest  to  the  reports  of  the  medical  of&cers  to 
learn  what  homoeopathy  can  do  on  a  large  scale  for  the 
insane^  and  how  she  does  it. 

The  May  nnmber  commences^  with  Millefolium,  a  series 
of  translations  of  those  monographs  on  medicines  contained 
in  Hering's  Amerikanische  Arzueiprufungen,  which  have 
not  yet  been  rendered  into  English.  To  these  Dr.  Hering 
supplies  corrections  and  additions,  bringing  down  our  know- 
ledge  of  them  to  the  present  time.  These  articles  alone 
render  the  journal  worth  possessing. 

Ha/inemannian  Monthly. — This  journal  also  is  in  its 
ninth  year^  and  the  number  for  March  is  the  eighth  of  the 
current  volume.  It  is  published  at  Philadelphia^  under  the 
editorship  of  Dr.  McClatchey.  Each  number  of  late  has 
had  a  sheet  of  appendix^  consisting  of  a  treatise  on  Diseases 
of  the  Skin,  by  Dr.  Lilienthal.  It  is  only  a  compilation, 
but  is  very  completely  done^  and  may  often  repay  consul- 
tation. 

The  March  and  April  numbers  contain  nothing  of 
special  moment.  The  May  number  begins  with  a  transla- 
tion of  the  article  on  Argentum  nitricum  in  Dadec^a  Com* 
pendio  di  Materia  Medica  Pura  et  Terapettiica,  now  pub- 
lishing. It  is  executed  by  Dr.  Carroll  Dunham,  who  in 
the  December  and  January  numbers  had  given  an  account 
of  this  important  work.  Dr.  Dadea  seems  to  be  doing  his 
work  in  the  most  thorough  manner,  consulting  every  source 
of  information  on  each  drug,  and  indicating  these  in  the 
proper  place  as  '^  references  for  more  accurate  study.''  His 
symptom-list  however,  is  a  selection  like  Jahr's,  not  a 
complete  collection.  His  work  therefore,  if  translated  into 
English,  will  in  no  way  vie  with  Dr.  Allen's  undertaking. 
It  may  well  be  so  rendered  for  our  advantage ;  and  in  the 
mean  time  cannot  but  be  of  the  utmost  benefit  to  the 
disciples  of  Hahnemann  in  Italy. 

There  is  an  interesting  paper  in  this  number  by  Dr.  E. 

VOL.  XXXII,  NO.  CXXIX. JULY,  1874.  M  M 


546  Reviews, 

m 

M.  Hale,  entitled  "  Poisoning  by  Coffee/'  which  is  worth 

extracting. 

''It  will  perhaps  be  remembered  that  several  years  ago  I 
published  some  accounts  of  a  peculiar  characteristic  symptom 
of  Oofea,  which  had  not  been  recorded  as  pathogenetic,  namely : 
'  Terrible  toothaehe  relieved  only  hy  cold  tfxUer  held  in  the  mouik 
— aggravated  by  everything  else.' 

''  I  have  frequentlj  verified  this  symptom  in  practice,  and  so 
have  many  of  my  colleagues.  I  now  have  the  pleasure  of  re- 
cording a  casie  of  poisoning  by  Ooffea^  where  this  symptom  was 
the  most  severe  and  persistent  of  all  its  effects. 

^  Mr.  W — ,  a  young  lawyer,  wishing  to  perform  an  important 
mental  labour  in  writing,  drank  one  cup  of  intensely  strong 
coffee  without  milk  or  sugar,  about  8  p.m.  After  writing  several 
hours,  he  was  seized  with  such  an  intense  pain  in  the  teeth  of 
the  right  lower  jaw  (not  decayed)  that  it  drove  him  nearly  crazy. 
He  came  to  my  office  after  midnight  to  get  some  relief.  He 
had  already  observed  that  no  application  relieved  the  pain  but 
cold  water.  So  soon  as  the  water  became  warmed  in  the  moudi 
the  pain  returned. 

'*Not  knowing  that  he  had  taken  a  poisonous  quantity  of 
coffee,  I  gave  him  Ooffea  3 ;  but  to  my  surprise  he  came  back 
in  the  morning,  reporting  no  relief.  I  then  gave  X)qffea  80,  but 
no  relief  came  in  six  hours.  Then  he  told  me  about  his  coffee 
poisoning.  Electricity  was  tried  and  gave  relief  for  several 
hotirs  after  the  first  application;  but  subsequent  applications 
were  of  no  benefit.  He  then  tried  a  variety  of  nostrums  for 
several  days,  but  none  gave  more  than  temporary  alleviation. 
I  gave  him  Nux  vom.  and  Cham,  to  antidote  the  coffee,  and 
Pulsat.  for  *  relieved  by  cold  drinks  *  (see  Hull's  Jahr)^  but  no 
benefit  accrued.  The  odontalgia  gradually  wore  away  in  a  week, 
leaving  him  so  nervous  and  shattered  that  he  was  fully  convinced 
that  coffee  was  reaUy  a  potent  poison. 

'^  We  have  now  the  necessary  evidence  corroborative  of  the 
power  of  coffee  to  cause  and  cure  this  kind  of  odontalgia. 

From  a  '^ special  notice'*  as  to  the  twenty-seventh 
session  of  the  American  Institute  of  Homoeopathy,  to  be 
held  at  Niagara  Falls^  on  June  9th,  we  gather  that  many 
important  subjects  are  to  be  discussed.     In  the  Materia 


Journals  of  the  Quarter.  547 

Medica  section. we  are  to  have  proviogs  of  Calabar  bean, 
Ycrifications  of  Lilium  tigrinum,  and  opinions  as  to  the 
significance  of  primary  and  secondary  symptoms.  Among 
the  subjects  for  other  sections  are  cerebro-spinal  meningitis^ 
puerperal  fever^  uterine  haemorrhage^  cholera  infantum^ 
cataract,  catarrh  of  middle  ear,  and  psychological  diseases 
in  relation  to  homoeopathy.  If  half  these  matters  receive 
anything  like  an  adequate  treatment,  this  year's  Transac- 
tions  of  the  Institute  will  be  a  valuable  volume.    > 

''  The  ^'  Editorial  Notes ''  in  this  number  give  two  grati- 
fying pieces  of  information  as  to  the  public  progress  of 
homceopathy  in  the  United  States.  In  Hudson  Countyi 
New  Jersey,  a  "  County  Board  of  Health  has  been  appointed, 
consisting,  as  the  law  creating  it  stipulates,  of  the  county 
physician  and  two  other  members,  one  a  homoeopathic  and 
the  other  an  allopathic  practitioner/'  Again^  '^a  charter 
for  a  large  general  homceopathic  hospital,  including  a 
department  for  the  insane,  has  just  been  granted  by  the 
Courts  of  Philadelphia,  under  the  title  of  The  Homceopathic 
Hospital  of  Pennsylvania  at  Philadelphia/' 

American  Observer. — ^This  journal,  issued  at  Detroit, 
Michigan,  bears  the  name  of  Dr.  Lodge  upon  its  title-page 
as  general  editor  and  publisher.  Its  March  number  is 
the  third  of  the  first  volume  of  a  new  series, — ^the  old  series 
having  aparently  ended  with  its  tenth  annual  volume.  The 
only  noticeable  thing  in  it  is  a  case  of  enteralgia  of  some 
standing  in  a  broken-down  constitution,  of  which  Baptisia  3 
efiected  a  rapid  cure.  The  April  number  contains  an 
important  communication  from  Dr.  £•  M.  Hale  on  the 
VUmmum  opulus  as  a  remedy  for  dysmenorrhoea.  It  is,  at 
present,  known  only  ab  usu  in  morbis,  but  has  a  wide  and 
high  domestic  reputation;  and  as  it  is  in  the  1st  decimal 
dilution  that  Dr.  Hale  has  found  it  so  successful,  it  can  hardly 
be  from  any  other  than  a  specific  property.  He  speaks  of 
it  as  having  as  yet  never  failed  him  in  neuralgic  and 
spasmodic  dysmenorrhoea ;  so  much  so  that  he  has  looked  up 
old  cases  dismissed  as  incurable,  and  has  tried  it  with  them, 
so   far   with   success   in    every  case.      He   does   not   say 


648  Reviewi. 

whether  he  used  the  wild  plant  or  the  cnltivated  variety 
known  as  the  Qaeldres  rose.  As  the  latter  is  much 
altered  botanically,  it  may  not  have  the  properties  of  its 
progenitor.  The  same  number  also  contains  some  interest- 
ing remarks  on  JSsctdus  hippocastanum,  by  Dr.  Hart,  of 
Wyoming.  He  finds  it  very  valuable  in  abdominal  and 
pelvic  congestions,  especially  when  characterised  by  a  sense 
of  throbbing.  He  uses  the  6th  dilution.  Dr.  E.  Rogers 
speaks  of  the  value  of  Macrotin  in  helping  forward  tedious 
labour ;  and  Dr.  Allen  contributes  some  cases  of  herpes  in 
children  brought  on  by  the  use  of  Sarsaparilla,  Altogether 
this  is  a  very  profitable  number. 

The  Observer  for  May  contains  two  cases  illustrating  the 
use  of  Atrojria,  which,  as  we  have  much  to  learn  about  the 
distinctive  sphere  of  this  alkaloid,  are  worth  extracting. 
They  are  by  Dr.  W.  H.  Blakeley. 

**  Gasb  1. — Miss  Jennie  E — ,  let.  24  years,  unmarried,  of  a 
slender  build,  healthy  parents,  had  always  enjoyed  good  health 
until  about  five  years  ago,  when  immediately  before  her  regular 
menstrual  return  she  was  attacked  with  a  very  severe  headache, 
beginning  in  the  occiput,  and  passing  over  the  right  side  and 
seating  over  the  eyes  and  in  the  balls,  increasing  to  such  a  degree 
that  an  attack  \>f  epilepsy  would  set  in  which  would  deprive  her 
of  consciousness  for  eight  to  ten  hours,  awaking  only  to  a 
renewal  of  same. 

**  The  attacks  came  on  mostly  two  or  three  days  prerious  to 
menstruation,  but  sometimes  the  flow  would  be  all  right  for 
a  day  or  two,  and  suddenly  stop  without  any  cause,  and  then 
the  head  and  nervous  symptoms  would  develope.  She  had  been 
subject  to  these  seizures  so  long  that  the  eyes  had  that  peculiar 
glassy  hue  characteristic  of  an  epileptic.  Very  sad  and  morose, 
preferring  solitude  and  a  dark  room  to  the  society  of  friends ; 
throat  of  a  dark  red  hue,  teeth  white,  dry  and  shining ;  also 
during  the  menstrual  flow  she  would  have  a  severe  pain  in 
the  region  of  the  left  ovary,  which  would  increase  in  size,  and  be 
very  tender  to  touch.  Menstrual  blood  light  coloured  and 
rather  scant. 

"  After  she  would  pass  over  one  of  these  attacks  she  would  be 


Journals  of  the  (Quarter.  549 

▼erj  nervous  and  restless,  wanted  to  keep  moving  about  all  the 
time,  very  irritable,  not  answering  with  civility. 

'*  After  a  careful  study  of  the  pathogenesis  of  Belladonna  I 
concluded  to  give  Airopia,  3-10  pellets,  3  of  No.  30  every  six 
hours,  beginning  three  or  four  days  before  the  expected  return  of 
menstruation.  She  j^assed  through  the  first  time  with  only  it 
headache ;  since  then  she  has  been  exempt  entirely. 

^  Now  that  six  months  have  elapsed,  her  eyes  have  brightened 
up  and  she  enjoys  society. 

"  Case  2. — Mrs.  L — ,  ©t.  40  years.  Mother  of  seven  children. 
"With  each  of  her  other  children,  beginning  about  the  third 
month,  she  would  suffer  with  the  most  excruciating  pains  in 
the  region  of  the  left  ovary  of  a  cutting  or  drawing  nature — 
extorting  screams  from  her,  and  causing  her  to  bend  over  to 
that  side;  the  pains  were  so  severe  that  she  expressed  them 
as  unbearable.  After  continuing  in  side  for  a  while  the  head 
was  attacked,  which  would  develope  spasms  of  a  genuine  epileptic 
nature.  She  had  been  treated  during  her  other  pregnancies 
by  the  so-called  orthodox  school  with  Ohhroform  and  Kali 
hrom.^  but  without  avail ;  they  would  get  more  severe  until 
a  day  or  two  before  confinement,  when  they  were  almost 
continuous;  she  could  tell  for  several  hours  before  they  came 
on. 

''  I  began  the  treatment  with  Suh  Atropia  4-10  globules  as 
before,  three  times  every  four  hours,  until  the  symptoms  abated. 
She  passed  through  confinement  all  right,  and  without  a  single 
attack  and  eight  hours'  labour ;  heretofore  it  had  been  eighteen 
to  twenty. 

*'  In  ovarian  neuralgia,  supra-orbital  and  orbital  neuralgia,  I 
use  it  in  preference  to  any  other  remedy.  I  have  found  it 
necessary  on  one  or  two  occasions  to  flush  the  fiice  a  little  before 
I  could  get  a  permanent  effect,  after  which  it  would  be  lasting." 

The  same  writer  gives  us  a  case  of  endometritis  cured  by 
Arsenicum^  and  of  Stramonium  poisoning  in  which  the 
symptoms  rapidly  yielded  to  Morphia.  Dr.  Hoyne  con- 
tributes a  lecture  on  Natrum  muriaticum  (of  whose  action, 
by  the  way,  there  is  a  good  case  in  the  April  number). 

North  American  Journal  of  Homoeopathy. — This  journal^ 


550  Reviews. 

quarterly  like  our  own,  comes  near  to  us  in  point  of  age^ 
being  in  its  twenty-second  year.  It  is  now  under  the  sole 
editorship  of  Dr.  Lilienthal ;  and  is  published  at  Kew 
York.  The  May  number  now  before  us  contains  eleven 
articles.  The  first  is  of  deep  interest^  being  an  account  of 
an  epidemic  of  yellow  fever  at  Memphis  by  Dr.  L.  Morse. 
It  seems  to  have  been  of  a  most  pernicious  character,  and 
to  have  tried  the  energies  of  the  physician  to  the  utmost. 
The  homoeopathic  treatment  has  consisted  of  the  usual 
remedies,  with  the  addition  of  Gelseminum  and  Veratrwn 
viride ;  and  has  a  mortality  of  12  per  cent,  only  to  regret 
in  contrast  with  40  per  cent,  under  the  old  system.  A 
translation  of  ^'  Cases  recorded  by  the  Physicians  of  Western 
Prussia  at  their  Meeting,  July,  1873,''  supplies  many 
useful  practical  hints.  The  translation  of  Dr.  GouUon 
Jr.'s  prize  essay  on  Graphites  is  continued  ;  we  hope  that  it 
will  one  day  be  published  in  a  complete  form,  as  it  seems  a 
most  exhaustive  treatise  on  the  drug.  There  is  a  *'  General 
Record  of  Medical  Scieoce''  containing  many  notes  of 
interest  and  value ;  and  in  an  appendix  is  continued  a 
repertory  for  the  disorders  of  menstruation. 

Medical  Itwestigator, — This  monthly  is  published  at 
Chicago;  its  present  editor  is,  we  believe.  Dr.  T.  G. 
Duncan.  Its  March  number  is  the  third  of  the  eleventh 
annual  volume.  It  contains  plenty  of  practical  matter, 
mostly  in  the  shape  of  reports  of  discussions  at  meetings  of 
societies  and  short  clinical  cases.  Among  the  latter  is  one 
of  (well-diagnosed)  glaucoma,  in  which  great  improvement 
resulted  from  Aurum  in  high  dilutions.  The  practitioner 
was  led  to  this  remedy  partly  from  the  fact  that  his  patient 
had  twice  been  salivated,  but  chiefly  because  he  had  the 
^*  horizontal  hemiopia,''  the  upper  half  of  all  bodies  being 
dark,  which  is  so  marked  in  the  pathogenesis  of  this 
medicine. 

A  like  remark  may  be  made  upon  the  April  number, 
which  is  the  last  that  has  reached  us.  Among  other  items 
in  it  we  notice  that  Dr.  J.  S.  Douglas,  of  Milwaukee,  claims 


Journals  of  the  Quarter,  551 

to  have  anticipated  Dr.  Sharp  in  his  views  about  the  opposite 
action  of  large  and  small  doses  by  twenty-five  years. 

Altc^ther^  as  a  collection  of  hints  from  experience^  and 
as  a  periscope  of  all  of  medical  note  daring  the  month,  we 
must  place  the  Chicago  Investiffator  first  among  American 
monthlies. 

United  States  Medical  and  Surgical  Journal. — With  no 
less  indubitable  favour  do  we  regard  this  periodical  among 
American  quarterlies.  It  is  healthy,  vigorous,  and  polished. 
Its  reviews  especially  (often  given  among  the  original 
articles)  are,  and  always  have  been^  excellent.  It  also  is 
published  at  Chicago;  and  edited  by  Drs.  Small,  Ludlam, 
Adams^  and  Foster,  all  of  the  Hahnemannian  Medical 
College  and  Hospital  of  that  city. 

We  have  nothing  later  before  us  than  its  January 
number^  which  is  the  second  of  its  ninth  volume.  It  con- 
tains a  well-written  article — "  Why  are  not  all  Physicians 
Homoeopathists  V  by  Dr.  Holcombe,  which  we  are  glad  to 
see  has  been  printed  separately  in  a  cheap  form  for  distribu- 
tion. The  following  extract  will  give  an  idea  of  its  style, 
and  of  the  jubilant  condition  of  homoeopathy  at  present 
across  the  Atlantic. 

''Let  our  young  friend  step  out  from  the  little  professional 
ring  or  close  corporation  known  as  the  allopathic  school,  and 
look  at  homoeopathy  from  the  stand-point  of  the  great  reading, 
thinking,  and  progressive  public  of  the  United  States,  and  he 
will  be  amazed  at  the  di£ference  in  the  result.  Homoeopathy  has. 
now  stood  upon  its  merits  for  nearly  three  quarters  of  a  century. 
It  has  passed  the  severest  ordeals  of  criticism,  survived  all  its 
persecution,  and  marches  onward  from  victory  to  victoiy. 
Despised  and  rejected  as  a  therapeutic  reform  within  the  bounds 
of  the  old  school,  which  was  all  it  ever  pretended  or  wished  to 
be,  it  has  been  obliged  to  erect  itself  into  an  independent  system. 
The  great  reading,  thinking,  and  progressive  public  does  not 
share  the  opinions,  the  prejudices,  the  infatuations  of  allopathic 
physicians  with  respect  to  homoeopathy.  It  sees  no  humbug,  or 
quackery,  or  imposture  in  it,  and,  when  appealed  to,  is  always 


552  Reviews. 

determined  to  give  us  fkir  play,  a  iiin  hearing,  and  equal  rights 
before  the  law. 

"  Witness  the  vast  strides  which  homcBopathj  has  made  in  the 
teeth  of  ail  opposition ;  its  five  thousand  practitioners,  moat  of 
them  graduates  of  the  old  school,  its  growing  literature,  its 
schools,  hospitals,  dispensaries,  and  asylums,  and  its  lay-adherenta 
numbered  by  the  million. 

"  Witness  the  conceded  fact,  that  it  is  not  the  practice  of  the 
ignorant  and  incapable,  or  of  the  fantastic  and  hypochondriacal ; 
but  that  it  absorbs  and  holds  the  lion's  share,  in  proportion  to 
numbers,  of  the  strong-minded,  inteUigent,  travelled  and  culti- 
vated portion  of  society,  which  recognises  and  treats  homcBO- 
pathic  physicians  as  honorable  and  enlightened  men,  and 
benefactors  to  society. 

"  Witness  the  effort  made  by  scores  of  the  most  distinguished 
and  aristocratic  men  in  England  to  have  homoeopathy  introduced 
into  the  amfy  and  navy  of  their  country. 

**  Witness  the  recent  law  in  the  State  of  New  York,  that 
applicants  for  licenses  to  practice  in  that  state  shall  be  examined 
upon  homoeopathy  as  well  .as  upon  allopathy,  by  the  State 
Commissioners. 

"  Witness  the  splendid  banquet  given  by  the  Common  Council 
of  Bosten  te  the  members  of  the  American  Institute  of  Homoeo- 
pathy— a  national  organization  containing  more  members  than 
the  American  Medical  Association  ;  a  banquet  given  on  the  spot 
where,  twelve  years  before,  Oliver  Wendell  Holmes  fiacetiously 
predicted  the  speedy  and  utter  extinction  of  our  school. 

"  Witness  the  great  Fair  in  Boston,  given  while  the  Massa- 
chusetts Medical  Association  was  expelling  the  homoeopathic 
members  from  its  body ;  a  fair  which  it  took  three  of  the  largest 
halls  in  the  city  to  hold,  which  was  visited  and  patronised  by  the 
Slite  of  the  old  Bay  State,  and  which  realised  one  hundred 
thousand  dollars  for  a  homoeopathic  hospital. 

"  Witness  how  the  New  York  Ophthalmic  Hospital — ^the 
largest  and  best  endowed  eye  and  ear  hospital  in  America — 
passed  entirely  from  allopathic  into  homoeopathic  hands. 

"Witness  the  Legislature  of  New  York  appropriating  one 
hundred  and  fifty  thousand  doUars  to  the  establishment  of  a 
homoeopathic  insane  asylum. 

"Witness  the  people  of  Michigan  insisting,  through  their 


Journals  of  the  Quarter.  553 

Tepresentatiyes  in  the  Legislature,  that  homoBopathy  should  be 
taught  iu  their  State  TTniversitj. 

**  Witness  how  the  Common  Council  of  St.  Louis  compelled  the 
allopathic  professors  to  admit  homoaopathic  students  to  the 
hospital  clinics  on  an  equal  footing  with  their  own. 

**  Witness  how  the  State  Hospital  of  Pennsylvania,  at  Harris- 
burg,  was  recently  given  over  to  homoBopathic  physicians  and 
Burgeons  because  the  whole  allopathic  staff  resigned,  indignant 
that  homcBopathic  practice  was  permitted  in  a  certain  ward  of 
the  institution. 

''Witness  the  indignant  remonstrances  of  the  people  at  the 
removal  of  a  homoeopathic  Commissioner  of  Pensions  from  office 
by  his  allopathic  superior,  on  the  sole  ground  that  he  was  a 
homoBopathist ;  remonstrances  so  wide-spread  and  influential 
that  they  induced  the  government  of  the  United  States  to 
reverse  the  action  of  its  subordinates,  and  to  declare  that  no 
distinctions  should  be  made  on  account  of  differences  of  medical 
opinion. 

''  Witness  a  decision  of  the  New  York  judiciary,  fining  an  allo- 
pathic doctor  for  rnll^  a  homoBopathist  a  quack  ;  declaring 
quackery  to  consist  in  conduct,  and  not  in  creed,  and  assuring 
the  protection  of  the  law  to  honest  and  intelligent  men  when 
assailed  by  rude  and  malignant  partizans  of  another  school. 
The  quacks  on  both  sides  are  exactly  alike;  and  so  are  the 
gentlemen. 

"  These  facts  are  sufficient  to  prove  that  the  efforts  of  the 
homoeopathic  school  to  enlighten  and  educate  the  public  mind  as 
to  its  character,  rights,  and  privileges,  have  been  attended  by 
brilliant  results.  In  the  eyes  of  the  law  and  of  public  opinion 
homoeopathy  and  homoeopathic  physicians  are  just  as  much  to  be 
respected  as  allopathy  and  allopathic  physicians.  The  public 
cares  nothing  for  our  theories  or  our  squabbles.  It  regards  our 
contentions  as  quite  as  absurd  as  the  war  between  the  big- 
endians  and  little-endians,  the  two  gi«at  parties  in  Dean  Swift's 
story,  which  convulsed  the  nation  with  the  question  whether  an 
egg  should  be  broken  at  its  big  end  or  its  little  end !  The  public 
estimates  men  by  their  attainments  and  their  conduct,  and 
medical  practice  by  its  failure  or  its  success.  It  instinctively 
and  sensibly  denounces  as  bigotry  and  persecution  any  act  of 
intolerance  of  one  school  towards  another. 


654  Reviews. 

"  Wben  the  New  Orletna  Medical  Aasociatioii  pasved  a  law  to 
expel  any  member  who  conBultedy  either  in  surgery  or  obstetrics, 
with  a  homoDopathisty  however  well  educated  he  might  be,  and 
paraded  the  resolution  in  the  city  papers,  I  asked  one  of  our 
greatest  lawyers  what  he  thought  of  it.    'O,'  said  he,  'it  is 

another  iron  hoop  to  keep  the  old  allopathic  tub  firom  falling  to 

*        f  ft 
pieces. 

There  is  then  a  thoughtful  paper  by  Dr.  Gorton^  of 
Brooklyn,  on  "  The  Genesis  of  Disease/'  examining  *'  the 
pathogeny  of  air/'  and  that  of  water,''  which  •  is  to  be  con- 
tinued. Then  we  have  the  commencement  of  one  of  those 
special  repertories  which  are  springing  up  so  abundantly 
in  America  just  now,  and  which  may  be  made  so  useful, 
this  one  being  for  the  Heart,  by  Dr.  E.  M.  Hale.  Next 
comes  a  full,  searching,  and  impartial  criticism  by  Dr.  T. 
8.  Hoyne  of  the  second  edition  of  Dr.  Burt's  Characierutic 
Materia  Medica  ;  of  which,  and  of  his  new  classification  of 
remedies,  the  writer  cannot  speak  more  favourably  than  we 
ourselves  have  had  to  do.^  Another  very  valuable  article 
is  on  ''  Intermittent  Fever,"  by  Dr.  Fahnestock,  of 
Indiana.  It  is  partly  a  review  of  Komdoerfer's  Bonning- 
hauseu,  noticed  in  our  present  number ;  and  partly  a  com- 
munication of  personal  experience.  As  regards  the  latter 
he  tells  us  that  during  the  last  year  he  has  treated  nearly 
800  cases  of  the  disease ;  that  the  symptomatic  treatment, 
though  thoroughly  carried  out  for  six  months,  failed,  only 
two  cases  being  cured  quickly  and  permanently  by  single 
remedies,  PtUsatiUa  and  Arnica  respectively ;  that  under  the 
indiscriminate  use  of  Quinine,  next  tried,  his  patients  fared 
no  better,  and  that  he  finally  fell  back  upon  Dr.  Lord's 
plan,  which  we  have  sketched  in  our  review  of  his  book  on 
the  Bubject,t  and  got  better  success. 

We  cannot  go  further  through  this  journal,  but  enough 
has  been  said  to  indicate  its  value  and  interest. 

American  Journal  of  Homceopathic  Materia  Medica.—^ 
The  name  of  this  monthly  has  ceased  to  be  appropriate 
since  it  has  no  longer  been  the  vehicle  of  publication  for 

•  Vol.  xxviii,  p.  187;  xxxii,  p.  161.  f  Vol.  xxx,  p.  861. 


Journals  of  the  Quarier.  555 

Dr.  Hering's  monographs ;  but  it  is  a  useful  periodical  iu 
itself.  The  March  number  is  the  seventh  of  its  seventh 
volume.  It  is  published  at  Philadelphia^  under  the  editor- 
ship of  Dr.  A.  B.  Thomas. 

The  March  number  contains  the  continuation  of  two 
serial  works^  one  on  the  Therapeutics  of  Uterine  Discharges, 
by  Dr.  Minton,  the  other  a  Comparative  Materia  Medica. 
But  the  best  thing  in  it  (to  perpetrate  a  bull)  is  something 
which  does  not  belong  to  it^  viz.,  a  valedictory  address 
delivered  to  the  new  graduates  of  the  Hahnemann  Medi- 
cal College  of  Philadelphia  by  its  Professor  of  Surgery, 
Dr.  J.  C.  Morgan.  Such  papers  rarely  have  more  than 
ephemeral  interest ;  but  the  present  is  an  exception.  Its 
sketch  of  the  progress  of  homoeopathy  in  the  United  States 
is  full  of  interest : — 

''  In  our  own  free  and  noble  land  these  statements  find  abundant 
illustration.  The  track  of  our  best  national  and  local  progress  is 
the  track  as  well  of  homceopathic  progress.  Those  sections  and 
those  states  and  cities  which  deservedly  hold  the  first  rank  in  the 
former  particulars  are  foremost  also  in  the  latter.  Take,  for 
instance,  the  leading  cities  of  the  North  Atlantic  seaboard. 

"  Seven  years  ago,  we  stated  that  the  number  of  homcBopathic 
physicians  in  Philadelphia,  as  recently  counted,  was  95 ;  at  the 
beginning  of  this  year,  the  JHbmceopathic  Directory  contains  the 
names  of  170  physicians  in  this  city,  an  increase,  in  that  short 
time,  of  almost  eighty  per  cent. !  Then  we  published  in  this  city 
one  journal ;  now  there  are  two.  Then  a  bare  show  of  hospital 
work  was  made ;  now  the  hospital  fund  of  this  College,  the  nucleus 
of  which  so  many  of  our  citizens  aided  in  securing,  added  to  the 
College  dispensary  fund  before  existing,  and  the  whole  faithfully  and 
securely  invested,  amounts  to  a  very  respectable  sum,  which  wiU, 
some  day,  under  the  same  fostering  care,  be  developed  to  greater 
things ;  and  another,  still  grander  hospital  movement,  independent 
of  the  College,  but  endorsed  by  it,  has  just  been  incorporated, 
through  the  action  of  a  score  or  more  of  our  wealthiest  citizens, 
and  will  ere  long  place  our  system  in  its  true  position  amongst  the 
charities  of  this  community,  and  greatly  extend  its  blessings. 

"  Again,  New  York  City  has  gone  on  from  89  homoeopathic 
physicians  in  1848  to  65  in  1853 ;  increased  the  number  in  five 


556  Reviewi. 

yean  more  to  99 ;  in  six  yean  more  to  143  ;  and  at  this  time, 
ten  yean  later,  numben  210.  Besides,  there  are  there  published 
several  homoeopathic  journals,  and  in  conjunction  with  Phila- 
delphhia,  many  new  books  hare  issued  from  her  homceopathic 
press.  The  Ophthalmic  Hospital  has  been  transferred  from  allo- 
pathic to  homcaopathic  hands,  and  a  surgical  hospital  has  been 
established  in  connection  with  her  reorganised  and  successful 
College.    The  dlite  of  the  city  are  patrons  of  our  system. 

"  Boston  has  within  that  time  given  to  the  American  Institute  of 
Homoeopathy  the  most  superb  municipal  and  social  reception, 
perhaps,  ever  given  anywhere  to  a  medical  society ;  has  raised  a 
handsome  hospital  fund ;  and  the  great  Boston  Univenity,  en- 
dowed by  the  munificent  bequest  of  Isaac  Rich  with  some 
$10,000,000,  has  adopted  the  homoeopathic  system  in  its  medical 
department,  which  is  just  successfully  closing  its  fint  session. 
She  has  also  established  a  most  able  and  successfiil  journal,  and 
in  various  other  ways  is  doing  grand  service. 

<<  Ghoing  westward,  Pittsburgh  has  in  that  time  not  only  greatly 
reinforced  our  numerical  strength,  but  has  established  a  fine 
hospital;  Cincinnati  an  endowed  coUege.  So,  likewise,  has 
Cleveland  well  done  her  part ;  besides  many  other  points  of  minor 
importance. 

"  Chicago,  ten  yean  ago,  with  a  population  of  one  hundred 
thousand,  had  fifteen  homoeopathic  physicians.  The  population 
is  now  four  times  as  great,  and  the  number  of  our  physicians  reaches 
ninety-five — more  than  six  times  that  of  1864.  Then  Ae  had 
one  pharmacy,  now  four ;  then  one  society,  now  four ;  then  a 
college  and  dispensary,  now  an  additional  dispensary,  and  con- 
nected with  the  college  a  hospital  besides ;  then  one  journal, 
now  two ;  and  nearly  all  the  wealthy  class  are  homoeopathists. 

"  In  the  whole  State  of  Illinois  there  are  over  four  hundred 
physicians  of  our  school,  more  than  twice  as  many  as  there  were 
ten  yean  ago. 

'*  In  the  State  of  Wisconsin  the  number  has  doubled  within  five 
yean,  and  a  very  great  increase  is  noted  in  Iowa. 

"  In  Michigan,  the  legislature  and  the  people  are  overwhelmingly 
in  our  favour,  although  the  Begents  of  the  University,  with  un- 
exampled temerity,  continue  their  resistance  to  the  law  requiring 
the  appointment  of  homoeopathic  professon  in  its  medical  depart- 
ment. 


Journals  of  the  Quarter.  557 

''Even  Kansas  and  Nebraska,  those  advanced  picket-posts  of  our 
American  civilisation,  show  a  most  encouraging  total  result  for 
our  school. 

**  Take  another  class  of  statistics,  viz. :  tables  of  mortality  in  the 
practice  of  private  physicians  in  the  three  Atlantic  cities,  as 
ascertained  firom  official  records ;  in  Boston,  for  the  years  1870  to 
1872 ;  in  New  York,  for  1870-71 ;  in  Philadelphia,  for  1872  alone. 
Tabulated  together,  the  total  number  of  allopathic  physicians  is 
stated  at  8267 ;  homceopathic  physicians,  605.  These  gave  certi- 
ficates of  death  daring  the  periods  named,  as  follows ;  against 
which  nothing  is  allpwed  to  our  side,  on  the  score  of  larger 
average  practice,  nor  because,  often,  the  homoeopath  was  sent  for 
only  when  the  patient  was  about  to  die. 

«  The  allopathic  death-certificates  amount  to  54,679,  or  16*73 
for  each  physician ;  the  homoeopathic  certificates  were  5903 ;  to 
each  physician,  9*75 ;  or,  on  an  average,  in  round  numbers,  each 
allopathic  practitioner  buried  seventeen  patients,  whilst  each 
homoBopathist  lost  but  ten. 

"For  Philadelphia,  particularly,  the  details  are  minute.  Of 
these  a  few  may  be  mentioned.  The  allopathic  directory  ignbres 
all  who  are  not  in  perfectly  good  standing  in  that  school ;  hence 
comprises  the  acknowledged  skill  and  talent  of  their  own  side. 
To  prevent  the  confounding  of  hospital  and  private  practice,  we 
will  pass  by  hospital  physicians  of  both  schools  without  notice. 

^  No  other  homoeopathic  physician,  whatever  his  skill  or  stand- 
ing, is  omitted  from  these  tables.  The  relative  number  is  thus 
slightly  less  than  four  allopaths  to  one  homoeopath — ^we  will  say, 
four  to  one.  Please  remember  that  this  is  a  record,  not  of  cures, 
about  which  controversy  might  arise,  but  of  fiital  results,  whereof 
there  can  be  no  dispute.  Here  are  the  figures,  for  a  few  diseases. 
Total  deaths  from  apoplexy  under  homoeopathy,  28 ;  allopathy, 
162 ;  that  is,  28  died  under  homoeopathy,  whereas  allopathy  lost 
over  40,  under  the  care  of  the  same  number  of  physicians.  The 
comparison  may  be  verified  at  the  Health  Office,  by  any  one  who 
cares  to  do  so ;  or  refuted  if  incorrect. 

"  Again,  the  deaths  from  cholera  infantum  were,  under  homoeo- 
pathy, 214 ;  under  allopathy,  1149 ;  or,  for  an  equal  number  of 
physicians,  214  against  287  and  a  fraction.  Prom  croup,  27  to 
218 ;  say»  for  equal  numbers  of  physicians,  27  to  54i  ;  or,  on  the 
allopathic  side,  more  than  double  mortality.    From  diphtheria. 


558  Reviews. 

19  to  111 ;  eqafdised  as  to  number  of  phjsiciaiiB,  19  to  27i.  From 
hooping-cough,  13  to  121 ;  equalised  as  to  number  of  phyncians, 
13  to  30i ;  a  more  than  double  mortality,  to  be  charged  to  allo- 
pathy. Prom  pneumonia,  68  to  663  ;  equalised,  68  against  165}. 
From  bronohitis  and  infantile  catarrh,  31  to  257 ;  or  for  like 
numbers  of  physicians,  31  to  64^.  From  peritonitis,  8  to  96 , 
equalised,  8  against  24 ;  a  triple  mortality !  Marrellous  it  may  be, 
but  the  proof  is  undeniable.  The  deaths  from  inflammation  of 
the  stomach  and  bowels  were,  under  homcBopathy,  37 ;  under  allo- 
pathy, 195  ;  for  a  like  number  of  physicians,  37  to  48i.  Finally, 
from  smallpox,  the  deaths  were,  in  private  practice,  under 
honuBopathy,  256 ;  under  allopathy,  1502 ;  equalised,  256  to  375i, 
or  nearly  fifty  per  cent.  more.  This,  you  viill  mark,  was  in  1872, 
and  in  Philadelphia. 

''A  fit  conclusion  to  this  contrast,  and  a  financial  proof  of  its 
reliability,  may  be  found  in  the  experience  of  the  Homoaopatbic 
Mutual  Life  Insurance  Company  of  New  York;  or  of  the 
Atlantic  Mutual.  The  medical  director  of  the  former  has  iasaed 
the  following  comparison ;  Whole  number  of  policies  of  insurance 
under  the  homoaopathic  system  of  treatment,  4470 ;  deaths,  exclu- 
sive of  accidents,  32  ;  under  the  allopathic  system  of  treatment, 
insured  1437 ;  deaths  37.  From  these  figures  it  will  be  seen  that 
the  homoeopathic  people  insured  were  three  times  more  numerous 
than  the  allopathic,  yet  lost  by  death  a  smaller  number,  by  five. 
Think  of  3000  more  rieke  under  homoBopathy,  against  fewer 
deaths  by  five ! 

<<  To  be  as  unfortunate  as  allopathy,  we  should  have  lost  112  of 
our  insured  lives,  instead  of  82  ;  and  on  the  other  hand,  to  be  as 
fortunate  as  we,  the  smaUer  number  of  allopaths  insured  in  the 
company  should  render  scarcely  11  deaths  instead  of  37.  As  it 
was,  of  all  the  deaths  among  the  persons  insured,  allopaldiy  lost 
three  and  a  half  times  as  many  as  homobopathy  ;  to  vrit»  homoeo- 
pathy lost  0*71,  or  one  per  cent.,  whilst  allopathy  lost  2*57  per  cent, 
of  all  the  insured  who  entrusted  their  bves  to  it.  Or,  to  put  the 
same  facts  in  yet  another  form :  of  every  39  persons  (in  round 
numbers)  insured  under  allopathy,  one  died ;  whereas  only  one  out 
of  every  140  died  under  homoeopathy.  Or,  in  still  another  form,  we 
may  say,  that  out  of  every  seven  persons  who  died  under  the  care 
of  allopathy,  five  would  have  been  saved  alive  by  the  homoBopatiiic 
system  of  medication. 


Journals  of  the  Quarier,  559 

'  There  is  something  positiyelj  astounding  in  this  exhibit ;  but 
there  can  be  no  doubt  of  its  perfect  accuracy  and  fidelity  to 
truth.  Let  every  man  who  loves  life,  every  one  who  cares  for  the 
welfare  of  the  dear  ones  at  home,  every  hospital  manager  whose 
duty  it  is  to  consider  the  poor,  ponder  well  these  facts,  form  his 
conclusions  fiurly,  then  act  them  out  boldly." 

Nor  is  the  following  less  interesting.  It  may  be  read 
with  advantage  together  with  Dr.  Hale's  paper  at  the  late 
congress. 

*^In  strictly  scientific  language  homoeopathy  daiois  a  certain 
field  of  investigation  in  which  she  demands  to  stand  alone,  and 
hold  undisputed  sway.  Her  ambition  is  not  to  compete  with 
physiology,  pathology,  diagnostics,  or  even  pharmacology ;  but, 
availing  herself  of  dl  the  work  done  in  these  adjoining  fields,  she 
yet  claims  the  science  of  therapeutics,  the  science  which  embraces 
and  accounts  for  the  action  of  all  real  curative  agents ;  needing 
to  reject  none  to  suit  her  ends,  but  including  all  under  the  one 
great  law '  likes  are  cured  by  likes.'  This  field,  I  say,  she  claims 
as  all  her  own, 

**  She  has  not  only  gathered  her  material  and  deduced  her  law, 
but  applied  it  successfully  to  practice.  Only  the  incomplete 
scientist,  only  he  whose  mind  science  has  not  yet  set  free  from 
professional  bondage,  can  deny  her  demonstrations.  But  she  has 
much  yet  to  do.  And  physics  is  doing  much  to  pioneer  her  way. 
Micro^chemistry,  the  doctrines  of  force,  of  the  interference  and 
mutual  abolition  of  similar  force-waves,  the  spectrum  analysis — 
all  are  piling  up  invincible  demonstrations,  from  the  positions  of 
pure  science,  of  her  law  of  similars ;  of  the  wave-motion  of  drug- 
forces,  as  silencing  the  waves  of  morbid  forces,  and  of  the 
dynamic  efficiency  of  her  molecular  dose,  commonly  called  infini- 
tesimal. 

^  Let  us  consider  these  revelations  of  the  few  years  just  past, 
for  such  they  are,  firom  the  homoaopathic  stand-point,  where  all 
these  discoveries  are  to  find  their  use  in  promoting  human 
wel&re,  improving  health,  and  prolonging  life  and  usefulness  to 
mankind. 

^  First,  the  present  doctrine  of  forces.  Many  here  have 
enjoyed  the  lectures  of  Professor  Tyndall  and  others,  who  have 


560  Reviews. 

shown  the  beauty  of  uniTersal  force-action  by  so  many  brilliant 
experiments,  accompanied  by  such  lacid  explanations. 

'*  BecaU,  if  you  please,  the  theory  of  Young,  to  whom  we  are  in- 
debted, according  to  Tyndall,  for  the  doctrine  that  all  force  is  but 
undulatory  vibration  of  the  universal  ether,  which  is  believed  to 
pervade  all  space — recollect  that  slowness  and  rapidity  of  this 
undulatory  vibration  furnish  the  reason  of  all  the  forms  of  force, 
which  we  call  heat,  light,  colour,  chemical  action,  &c,y  all  residing 
in  a  single  ray  of  sun-light ;  remember  that  rapid  vibration  of 
this  universal  ether  measures  small — yes,  infinitely  small  waves — 
and  that  slow  vibration  measures  larger,  although  still  minute 
undulations.  Comparing  these  with  musical  sounds,  the  colour - 
waves  write  themselves  upon  the  staff;  whilst  the  more  rapid 
chemical  waves  move  above,  are  of  higher  pitch,  the  slower  heat- 
waves low.  Note,  then,  that  the  most  efficient  chemical  waves 
are  the  most  infinitely  small,  so  that  they  are  incapable  of  affect- 
ing vision  at  all,  and  that  the  coarser  waves  have  but  little 
chemicid  potency;  that  a  single  infinitesimal  chemical  wave,  with 
its  exact  and  specific  power,  can  do  more  to  print  a  photograph, 
or  to  explode  a  mixture  of  gases,  than  all  the  rest  of  the  sun's 
rays — and  thus  we  shall  see  that  infinitesimal  doses  of  an  exact 
specific  medicine  are  scientifically  justified. 

**  Again,  similar  waves  have  a  double  power — to  increase  and 
to  neutralize  each  other,  according  to  certain  conditions.  Throw 
two  similar  stones  with  similar  force  into  a  lake,  a  little  distance 
apart.  See  where  the  similar  waves  meet  and  interfere ;  mutu- 
ally their  motion  annuls  motion,  and  the  water  is  at  rest. 
Professor  Tyndall,  in  his  lectures  in  the  adjoining  hall,  demon- 
strated this,  partly  by  diagrams  belonging  to  the  University  of 
Pennsylvania,  which  may  witness  for  us  as  well  to-day ;  and  also 
by  means  of  acoustic  instruments,  as  the  clamp-plate,  and  the 
tuning-fork ;  and  by  the  spectrum  analysis.  You  may  recall  the 
fact  by  a  glance  at  the  surface  of  this  brass  plate,  on  which  black 
writing  sand  has  been  placed.  A  violin-bow  being  drawn  across 
its  edge,  vibrates  the  plate,  and  disturbs  the  sand.  Directly  it 
arranges  itself  in  regular  lines,  which  mark  an  arrested  vibra- 
tion ;  the  metallic  spaces  between  these  are  lines  of  vibration — of 
agitation — and,  of  course,  the  lines  of  the  settling  of  the  sand 
must  be,  and  are,  lines  of  rest. 

''Now,  then,  a  surfiice  vibrating    under  a  violin-bow  shows 


.    .  Journals  of  the  Quarter.  561 

lineB  of  vibration,  with  intervening  lines  of  rest.  What  is  the 
reason  of  this  P  Wait  a  moment ;  strike  this  tuning-fork ;  now 
hold  it  near  the  ear ;  rotate  it  in  its  long  axis,  slowly ;  at  the 
angles,  where  the  surfaces  meet,  there  is  comparative  silence,  and 
whjp  It  is  because  the  waves  of  vibration  on  the  surfEM^s, 
being  exactly  similar  in  size  and  rapidity  of  motion,  meeting  at 
eadi  angle,  interfere  and  exactly  neutralise  each  other— moving 
as  they  do  from  distinct  centres.  And  being  neutralised,  silence 
is  produced  by  two  similar  vibrations  of  sound,  as  you  perceive. 
And  the  lines  upon  the  brass  surface  did  not  agitate  the  sand 
which  lay  upon  it,  for  the  same  reason.  The  vibrations  advancing 
from  the  edges,  and  recoiling  at  the  damp,  are  similar  to  those 
which  they  meet,  coming  fresh  from  the  bow ;  hence  they  inter- 
fere, causing  lines  of  silence,  or  lines  of  rest ;  and  here  the  sand 
is  seen  to  settle. 

*' These  facts  are  a  scientific  illustration  of  homoeopathy. 
Morbid  forces  vibrate  in  a  certain  organ  or  tissue  of  the  body ; 
an  atomized  drug  whose  forces  are  similar,  and  whose  similarity 
has  been  abeady  proved  on  healthy  persons,  begets  a  series  of 
similar  waves  in  the  part  diseased.  Of  independent  origin,  they 
continually  interfere  with  the  waves  of  disease-force  in  the  cells 
of  the  tissue,  in  the  nerves  of  the  organ,  and  in  the  whole  sym- 
pathising body.  Where  disease  was  active,  now  come  the  lines 
of  rest — ^there  is  comfort^  where  a  little  whUe  ago  was  excru- 
ciating pain ;  there  is  quiet  sleep,  in  lieu  of  wakefulness  and 
tossing  ;  there  is  a  sane  brain,  instead  of  delirium ;  a  soft  pulse, 
in  place  of  the  fevered  circulation ;  the  diseased  action  has  been 
cured,  neutralised  b^  the  similar,  the  homoeopathic  action  of  the 
specific  counterpart  of  that  diseased  action,  embodied  in  the 
drug ;  and  we  have  furnished  a  new  demonstration  of  the  well* 
proved  law  of  cure — *  likes  are  cured  by  likes.' 

<<  The  solar  spectrum  afibrds  another  illustration  of  the  power 
of  similars  to  exactly  overcome  each  other.  By  it  we  know,  for 
instance,  the  sun's  atmosphere  contains  the  metal  sodium ;  and 
how?  Look  through  a  proper  instrument,  and  observe  the 
yellow  band.  A  dark  line,  which  is  a  line  of  rest  in  the  colour* 
waves,  traverses  the  yellow ;  this  is  caused  by  the  yellow  sodium 
vapour  of  the  sun's  atmospliere  ;  the  white  light  vibrating  from 
the  sun's  burning  disk  contains  the  yellow  ray ;  this  yellow  ray 
must  undulate  through  the  sun's  atmosphere,  containing  the 

VOL,  XXJai,  NO.  CXXIX,*-WULYj  1874.  N  N 


562  Reinews. 

yellow  vapour  of  sodium ;  the  two  similars  in  colour,  the  yellow 
of  the  sun's  rays,  and  the  yellow  of  the  sun's  vapour,  through 
which  it  must  pass,  neutralise  each  other,  causing  darkness. 
And  so  of  many  other  metals,  Sec,  Hence,  the  very  phrase, 
'  spectrum  analysis,'  for  thus,  by  the  homoeopathic  principle,  we 
analyse  even  the  constitution  of  the  sun  itself! 

"  Indeed,  so  absolute  is  the  demonstration  of  this  principle  in 
all  departments  of  dynamics,  so  well  understood  is  it  by  all 
scientists,  that  to  deny  it  in  medicine,  to  decry,  ignore,  or  neglect 
a  system  of  cure,  a  science  of  therapeutics  based  upon  it ;  or, 
worse  than  this,  to  persecute  or  denounce  such  a  system,  seems 
like  sheer  in&tuation.  That  some  time  it  must  triumph,  is  just 
as  evident  as  the  march  of  the  physical  sciences,  to  which  it  thus 
appeals  for  illustration  and  demonstration.  Even  the  doses  of 
homoeopathy  are  detectable  more  and  more  by  the  delicate  instru- 
ments which  science  furnishes  to  supplement  and  assist  our  dull 
senses ;  but  what  can  these  avail  to  correct  the  dulness  of  the 
mind  which  refuses  evidence  against  a  darling  prejudice,  which 
ever  maintains  the  wheel  and  the  rack,  and  feeds  the  fires  of  the 
Medical  Inquisition,  crushing,  tearing,  and  burning  the  indepen- 
dent man  who,  forswearing  authority  in  favour  of  science,  and 
accepting  the  law  of  similars  in  medical  practice,  happens  to  be 
found  in  its  merciless  clutches;  and  which,  in  regular  routine, 
inflicts  on  new  generations  of  men  the  old,  old  empiricism,  or  the 
far-fetched  and  complicated  new  philosophy  of  allopathic  thera- 
peutics. 

''  Meeting  such  men,  however,  you  may  compel  respect,  by 
your  thorough  familiarity  with  infinitesimalism  and  similarity  of 
force-waves,  as  efiective  in  physical  phenomena  generally ;  with 
the  universality  of  molecular  power,  versus  the  powers  of  any 
mass  of  matter  in  Nature ;  and  more  than  all,  by  such  familiarity 
with  the  forces  of  your  remedies  which  can  neutralise  simili^ 
forces  in  disease,  that  the  maladies  which  they  fail  to  cure  shall, 
at  your  bidding,  depart." 

The  April  number,  the  last  which  has  come  to  hand,  con- 
tains nothing  calling  for  special  notice. 

We  have  now,  as  it  were,  reintroduced  to  our  readers  the 
American  journals,    and  shall  for  the    future    treat  them 


Journals  of  the  Quarter.  568 

every    quarter  as  old    acquaintances^  noting  whatever   of 
new  and  true  they  bring  to  our  hand. 


BELGIUM. 

Revue  Homceopathique  Beige. — Webavereceivedthe  second 
number  (May,  1874)  of  this  new  journal^  and  are  glad  to  wel* 
come  it.  It  is  published  at  Brussels  under  the  editorship  of 
Dr.  Martiny^  of  that  city«  The  number  before  us  contains 
several  articles  of  interest  to  homoeopathic  readers.  Among 
them  is  a  report  of  a  meeting  of  the  ''  Societe  de  Medecine 
de  Gaud/'  from  which  we  gather  that  physicians  practising 
homoeopathically  are  not  forbidden  to  enjoy  the  membership 
and  share  the  discussions  of  medical  societies  in  Belgium. 
May  it  soon  be  so  here. 


464  CUmeal  Record. 


CLINICAL    RECORD. 


Feratrum  Viride  in  JUenHrual  Oolie. 

Mm.  W—  iB  a  picture  of  health  and  beautyy  only  thirty-eight 
years  of  age,  quite  corpulent,  nervo-aanguineoua  temperament, 
black  hair,  black  sparkling  eyes.  She  ui  a  widow  for  now  three 
years ;  never  had  children,  nor  was  she  ever  pregnant ;  was 
reared  and  lived  all  her  life  in  luxury  and  wealth ;  was  never  an 
hour  sick  until  she  married.  Her  husband  was  a  healthy, 
powerful  man,  addicted  to  high  living  and  drinking.  Her 
trouble  is  this.  Her  menses,  which  are  regular  with  regard  to 
time,  quantity,  and  character,  are  preceded  for  three  days  by  the 
most  terrible  menstrual  colic,  which  to  describe  she  has  no  words 
for ;  the  pain  extends  all  over  the  body ;  head  and  face  look 
bloodshot  to  bursting ;  the  pain  runs  into  the  head  from  the 
neck ;  pulsation  in  head,  neck,  and  carotids ;  sight  disappears  at 
times,  and  at  times,  again,  everything  is  moving  in  confusion 
before  her  eyes ;  tongue  feels  heavy,  but  is  clean  and  looks 
natural ;  great  thirst ;  pulse  full  and  bounding. 

This  case  has  puzzled  for  the  last  five  years  the  master-minds 
of  our  school,  as  well  in  America  as  in  Europe ;  perhaps  there 
are  some  of  my  readers  who  may  remember  the  case.  Nothing 
will  give  relief  except  leeches  on  the  cervix  and  electricity,  and 
this  was  only  temporarily,  and,  having  been  used  so  frequently, 
tbey  are  fast  losing  their  beneficial  influence.  Physicians  of 
such  undoubted  ability  and  skUl  had  prescribed  for  her  that  I 
thought  it  almost  laughable  to  try  my  hand  on  it,  and  still  the 
urgent  demand  was  there  to  do  something.  That  remedies  like 
^on.,  BelL^  &c.,  had  been  faithfully,  though  in  vain,  used^  she 


Veratrum  viride  in  Menatrual  Colic.  S65 

told  me  frankly.  But  when  she  insisted  on  knowing  the  remedy 
I  would  prescribe,  I  positiyely  declined  to  do  so,  knowing  that  it 
is  better  to  keep  it  to  myself.  I  gave  her,  almost  empirically^ 
Verairtsm  viride,  1st  dec,  five  or  six  drops  to  be  taken  once 
every  half  hour  during  six  hours.  At  the  end  of  this  time  I  saw 
her  again,  and  found  that  the  remedy  had  undoubtedly  exerted 
Bome  beneficial  influence ;  she  was  calmer,  and  the  pains  became 
somewhat  less  until  the  flow  commenced,  when  she  felt  quite  well 
again.  After  its  cessation  I  made  an  examination  per  speculum, 
which  revealed  but  little ;  the  vaginal  waUs,  as  well  as  the  cervix, 
were  somewhat  congested  and  puffy,  no  indurations ;  otherwise 
everything  had  a  natural  appearance.  I  now  gave  her  for  two 
weeks,  every  other  night,  a  dose  of  Veratr.  viride  200,  anxiously 
awaiting  the  next  term ;  and  on  it  came,  and  as  bad  as  ever,  too. 
I  at  once  fell  back  upon  Veratr,  vir,  1,  with  the  same  apparently 
good  result  as  formerly.  After  cessation  I  ordered  her  to  take 
the  same  remedy  in  the  same  form  during  the  whole  time  inter* 
vening,  five  to  six  drops  every  morning  and  night.  At  the 
following  term  the  good  efildots  of  this  remedy  became  so  appa- 
rent that  I  conduded  to  try  it  for  another  month,  but  here 
it  seemed  improvement  ceased.  I  still  persevered  with  the 
remedy,  but  six  days  ahead  of  the  next  term  I  ordered,  twice  a 
day,  a  warm  bath,  to  which  I  added  two  ounces  of  Verair.  vir. 
During  the  bath  I  made  her  insert  a  speculum,  so  that  the  water 
might  freely  enter  into  the  vagina.  The  result  proved  to  be 
beyond  expectation,  and  the  continuance  of  this  treatment 
during  the  next  four  months  restored  my  patient  to  perfect  and 
normal  health.  I  may  mention  here  that  warm  baths,  as  she  had 
used  them  formerly,  never  exerted  any  infiuence  whatever. 
(Dr.  E^gert,  in  North  Ameriean  Journal  of  Hotncsopaihjf^ 
November,  1878.) 


566  Misceltaneous. 


MISCELLANEOUS. 


BrUish  HomMpathie  Oongresi. 

The  Congress  this  year  was  held  in  London  on  the  4th  of  June. 
The  large  Board  Boom  of  the  London  Homoeopathic  Hospital  was 
placed  at  the  service  of  tiie  Congress  by  the  Council  of  the  Hos- 
pital. The  proceedings  commenced  at  11  o'clock  with  an  address 
by  the  President,  Dr.  Dudgeon,  '*  On  the  Influence  of  Homoeo- 
pathy in  General  Medicine  since  the  Death  of  Hahnemaon,"  after 
which  Dr.  Dyce  Brown  read  a  paper  "  On  the  Action  ot  Nitric  acid 
in  certain  forms  of  Cough,"  on  which  there  was  a  lively  discussion. 
After  this  the  Congress  adjourned  for  an  hour  for  luncheon, 
which  was  served  in  the  Physician's  Boom  of  the  Hospital.  On 
reassembling,  the  report  of  the  Hahnemann  Publishing  Society 
was  ready  and  then  Dr.  B.  D.  Hale  read  a  paper  "  On  the  Action, 
Selection,  and  Administration  of  Drugs,"  which  excited  a  long 
and  animated  discussion.  He  was  followed  by  Dr.  Edward 
Blake  with  a  paper  "  On  Malignant  G-rowths.*'  The  discussion 
of  this  paper  occupied  the  Congress  until  half-past  five  o'clock, 
and  no  jdme  remained  for  the  reading  of  three  other  papers  that 
had  been  sent  in,  viz.  a  paper  "  On  Aloes,"  by  Dr.  W.  B.  Soott ; 
one  *^  On  the  State  of  Homoeopathy  in  Brazil,"  by  Dr.  Camara,  of 
Bio  de  Janeiro ;  and  x)ne  *^  On  the  Treatment  of  the  Fever  of 
Bengal,"  by  Dr.  M.  L&l  Sircar,  of  Calcutta.  These  papers  accor- 
dingly were  taken  as  read  and  ordered  to  be  published  in  the 
Transactions  of  the  Congress,  which  will  appear  in  the  Manthfy 
Homoeopathic  Review, 

At  half-past  six  o'clock  the  members  of  the  Congress  and  their 
friends,  to  the  number  of  upwards  of  one  hundred,  sat  down  to  an 
excellent  dinner  at  the  Pall  Mall  Bestaurant  in  Begent  Street, 
Dr.  Dudgeon  in  the  chair.  Numerous  toasts  were  proposed,  and 
a  number  of  concerted  pieces,  glees,  <S^.,  sung  by  a  chorus  com- 


London  Homoeopathic  Hospital — Bazaar.  567 

posed  of  Drs.  Mackechnie,  Blackley,  B.  Hughes  and  Theobald, 
and  Mr.  H.  Turner. 

On  the  whole,  the  Congress  of  this  year  may  be  pronounced  a 
decided  succees.  Following  as  it  did  immediately  upon  the  two 
days  devoted  to  the  Annual  Meeting  of  the  British  Homoeo- 
pathic Society,  it  might|be  supposed  that  the  members  of  the 
Congress,  most  of  whom  had  assisted  at  the  meetings  of  the 
Society,  would  have  been  satiated  with  papers  and  discussions, 
but  it  must  be  acknowledged  that  no  traces  of  weariness  were 
observed,  and  that  the  long  address  of  the  President,  which 
occupied  nearly  an  hour  and  a  half  in  delivery,  and  the  elaborate 
papers  of  the  members,  were  listened  to  with  great  attention 
and  the  discussions  were  carried  on  with  great  spirit. 

The  Congress  for  next  year  is  appointed  for  the  fourth 
Thursday  in  September,  the  place  of  meeting  Manchester,  and 
the  President  of  the  Congress  Dr.  W.  Bayes,  of  London. 


Bazaar  in  aid  of  the  Funds  of  the  London  Homoeopathic  Hospital. 

The  Ghrand  Fancy  Bazaar,  in  aid  of  the  funds  of  this  institu- 
tion, which  had  been  in  preparation  for  many  months  previously, 
was  held  in  the  Eiding  School  of  the  Cavalry  Barracks,  Hyde 
Park,  on  the  11th,  12th,  and  13th  of  June.  The  most  unremit- 
ting and  praiseworthy  efforts  were  made  by  all  parties  concerned 
in  organizing  the  undertaking,  to  render  it  attractive,  and  worthy 
of  the  support  of  the  patrons  of  the  Hospital,  and  the  friends  of 
homoeopathy  generally ;  and  in  this  they  thoroughly  succeeded. 
A  prettier  sight  of  the  kind  than  that  presented  by  the  interior 
of  the  building  on  this  occasion,  it  would  be  difficult  to  conceive. 
The  bare  walls  were  hid  by  red  and  white  drapery,  which  had  a 
bright  and  cheerful  effect,  and  the  same  service  was  performed 
for  the  roof,  by  almost  innumerable  banners,  of  different  colours 
and  devices,  suspended  therefrom.  The  stalls,  which  stretched 
round  the  four  sides  of  the  spacious  building,  were  tastefully 
designed  and  erected,  as  were  all  the  other  decorations,  by  the 
Messrs,  Simmonds,  of  Newton  Street,  Holbom.  The  following 
ladies  kindly  cpnsented  to  preside   at   the   stalls,  viz.    Maria 


568  MueeUaneoui. 

Marchionesa  of  Aylesbuiy,  the  Countess  of  Sefboiiy  the  Counteis 
Cowlej,  the  Countess  Sydney,  the  Lady  Ebuiy,  the  Lady  Emily 
Dyke,  the  Lady  Alfred  Paget»  the  Hon.  Mrs.  Oenld  Wellealey, 
1^.  Bayes,  Mrs.  Cameron,  Mrs.  Leadam.  Mrs.  W.  Vanghfai 
Morgan,  Mrs.  Neville  Wood,  Mrs.  Yeldham.  The  western  end  of 
the  room  was  occupied  by  the  refreshment  and  flower  stall,  under 
the  presidency  of  the  Lady  Adelaide  Cadogan,  and  at  the  opposite 
end  a  tall  screen  was  erected,  for  the  display  of  the  prise  pictures 
and  drawings  of  the  fine  art  distribution,  and  behind  this  was  Mr. 
Chambre's  telegraphic  and  electric  room,  whilst  immediately  in 
front  of  the  screen  was  pkced  the  fine  art  stall,  under  the  control 
of  Lady  Hillary  and  Mrs.  Trueman,  for  the  sale  of  various  works  of 
art,  consisting  of  pictures,  vases,  statuettes,  choice  china,  and  the 
like.  Conspicuous  amongst  these  was  a  superb  vase  in  solid  silver, 
weighing  three  hundred  and  five  ounces,  the  gift  of  two  ladies. 
Anyattempt  to  specify  even  the  chief  of  the  numerous  and  beautiful 
articles  with  which  the  other  stalls  were  laden,  would  be  a  fruitless 
and  endless  task.  Suffice  it  to  say,  that  they  were  sufficiently  varied 
in  character  and  price,  to  suit  the  taste  and  pockets  of  all  comers. 
We  must  not  omit  to  state  that  the  Bazaar  was  entered  from  the 
park  through  a  spacious  tent,  for  the  decoration  of  which  the 
Messrs.  Yeitch,  of  Chelsea,  kindly  sent  a  magnificent  collection 
of  their  exotic  and  other  plants  and  flowers.  Here,  also,  was 
stationed  the  band  of  the  Scots  Fusilier  Guards. 

The  weather  was  fine,  and  the  attendance  numerous  and  dis- 
tinguished. The  Bazaar  was  honoured  on  the  first  day,  by  a 
lengthened  visit  fi^m  their  Boyal  Highnesses  the  Princess  of 
Wales,  and  the  Duke  and  Duchess  of  Edinburgh.  The  Boyal 
party  made  the  tour  of  the  building,  inspecting  the  stalls, 
making  sundry  purchases,  witnessing  the  working  of  the  tele- 
graph,  and  partaking  of  refr^hments  before  their  departure.  The 
Bazaar  officials,  as  well  as  the  visitors  who  were  fortunate  enough 
to  be  present  at  the  time,  were  delighted  vrith  this  mark  of 
sjrmpathy  on  the  part  of  their  Boyal  Highnesses  with  the  object 
61  the  Bazaar,  and  ahK>  with  the  opportunity  thus  afforded 
of  seeing,  in  a  quiet  way,  these  young  and  highly  popular  members 
of  the  Boyal  Family. 

Of  the  pecuniary  success  of  the  undertaking  nothing  is  yet 
definitoly  known.  There  is,  however,  every  reason  to  anticipate 
that  the    receipts,    above    e3cpenditure,    will,   ultimately,    fall 


London  HomcBopathic  Hospital — Bazaar.  569 

but  lifcUe,  if  at  al^  short  of  two  thousand  poundB.  The 
fine  art  distribution,  which  holds  out  great  attractions  to  the 
lovers  of  art,  is  to  be  kept  open  for  some  time  longer,  to  afford 
those  who  ha?e  not  yet  subscribed*  an  opportunity  of  doing  so. 
The  pictures  and  drawings  are  again  on  view  in  the  board  room 
of  the  Hospital,  where  they  will  remain  until  the  drawing  takes 
place,  of  which  due  notice  will  be  given. 

Allusion  has  already  been  made  to  an  electric  and  telegraph 
room.  Mr.  Chambre,  a  member  of  the  Bazaar  Committee,  and 
head  of  one  of  the  Telegraph  Departments,  under  whose  superin* 
tendenee  this  room  was  erected  and  managed,  has  kindly  supplied 
us  with  the  following  (somewhat  abridged)  description  of  this 
interesting  exhibition. 

"  With  a  view  to  introducing  a  novelty — ^so  far  as  we  are  aware 
never  before  attempted  at  a  bazaar — by  the  kind  co-operation  of 
the  Engineer^in-Ohief  of  the  Postal  Telegraphs,  a  room  was  fitted 
up  at  the  back  of  the  fine  arts  stall,  with  specimens  of  various 
classes  of  instruments  in  use  in  the  Postal  Telegraph  Service. 
The  instruments  were  in  working  order,  and  were  explained  to  all 
visitors  to  the  room  in  question,  by  a  special  stafiT  of  assistants 
who  attended  for  the  purpose.  Of  these  instruments,  some  of 
which  are  still  largely  employed,  whilst  others  have  fallen  into 
disuse,  by  &r  the  most  interesting  was  one,  the  invention  of 
Sir  Charles  Wheatstone,  and  known  as  a  type  recorder,  to  be 
worked  in  connection  with  Wheat8tone*s  ABC  instrument. 
This  beautiful  instrument,  in  a  case  only  some  twelve  inches  by 
eight,  was  connected  by  wire  with  an  A  B  C  in  the  separate 
telegraph  office  situated  opposite  to  the  entrance  to  the  Bazaar, 
and  during  the  three  days,  messages  were  constantly  transmitted 
from  this  office,  successively,  through  the  A  B  C  placed  there,  a 
large  dial — ^two  feet  in  diameter — hung  at  the  back  of  the  office, 
a  second  A  B  0  in  the  telegraph  room,  and  finally  recorded  in 
Roman  type  on  a  strip  of  paper  half  an  inch  wide.  When  the 
Princess  of  Wales,  and  the  Duke  and  Duchess  of  Edinburgh 
visited  the  room,  the  duke  directed  a  message  to  be  sent  to  the 
Countess  Cowley,  at  her  stall,  by  means  of  this  type  recorder,  and 
the  &cility  of  reading  the  message,  word  by  word,  as  fast  as  it 
was  sent,  appeared  to  afford  the  Boyal  visitors  much  amusement. 
Connected  with  the  telegraph  and  electrical  roomi  was  an  inner 
dark  room  for  the  exhibition  of  vacuum  tubes,  but  owing  to 


570  Miscellaneoua. 

local  and  other  difficulties,  it  was  not  found  possible  to  make  this 
portion  of  the  display  so  effective  and  complete  as  was  intended. 
The  Soyal  yiutors,  however,  expressed  themselves  pleased  with 
what  they  saw.  Electric  sparks  and  shocks  were  provided 
for  lady  visitors,  who  cared  to  venture  on  the  experiment. 

''  In  the  telegraph  office  alluded  to  above,  in  addition  to  the 
ABC,  and  large  dial  already  mentioned,  there  were  cases  con- 
taining specimens  of  a  large  number  of  the  cables  which  bind 
England,  with  a  girdle  of  fire,  to  other  lands ;  both  the  deep-sea 
and  the  shore  ends  of  such  cables  being  shown. 

"  Messages  sent  from  the  telegraph  office  to  the  electrical  room 
were,  if  desired  by  the  sender,  delivered  to  friends  at  one  or 
other  of  the  stalls  in  the  Bazaar,  or  even  to  any  one  walking 
about ;  in  the  latter  case  much  to  the  amusement  and  astonish- 
ment of  the  recipients." 

Another  novel  feature  of  the  Bazaar,  was  the  exhibition  of 
'^Tisley's  Compound  Pendulum,"  kindly  lent  for  the  occasion 
by  the  inventor,  Mr.  Tisley,  optician,  of  Brompton  Bead.  We 
regret  that,  without  the  aid  of  diagrams,  it  is  almost  impossible 
to  give  anything  like  a  dear  or  adequate  idea  of  the  curious  and 
beautiful  figures  produced  on  paper,  by  this  simple  and 
ingenious  instrument. 


Oases  of  Bingworm  treated  hy  Oleate  afMerewy,    By  Leos^abd 

CAins,  M.B.  &  B.S.  Lond. 

Is  introducing  the  use  of  Oleate  of  Mercury^  in  a  clinical 
lecture  published  in  the  Lancet  on  May  25th,  1872,  Mr.  Marshall 
mentions  its  applicability  to  certain  skin  diseases,  and  the  record 
of  the  following  cases  of  ordinary  ringworm  (tinea  circinata) 
treated  by  Oleate  of  Mercury  may  be  serviceable. 

Cass  1. — ^Here  there  was  a  well-defined,  slightly  raised 
circular  patch  of  tinea  circinata  on  the  side  of  the  neck,  about 
the  size  of  a  two-shilling  piece.  The  spot  was  rapidly  extending 
itself,  and  its  edge  was  marked  by  a  circle  of  small  vesicles, 
situated  on  a  slightly  inflamed  base.  The  centre  presented  a 
"  branny "  appearance,  owing  to  its  being  covered  with  fine 
browpish  scales,    ^hese  pcales  when  treated  with  Liquor  pctms^ 


Bingwcrm  treated  by  Oleate  of  Mercury.  571 

were  found  under  the  microscope  to  contain  numerous  spores  and 
threads  of  fungus. 

On  June  3rd  a  few  drops  (about  twenty)  of  the  Oleats  ofMer^ 
eury  (10  per  cent,  strength)  were  yenUy  rubbed  over  the  spot 
with  a  piece  of  lint.  The  Oleate  was  applied  beyond  the  diseased 
patch. 

On  the  third  day  the  patient  was  again  seen.  The  site  of  the 
patch  was  marked  by  a  flat,  circular,  reddened  spot  of  the  same 
dimensions  as  the  original.  There  were  no  vesicles,  and  no 
traces  of  any  fungi  could  be  found.  The  spot  appeared  to  be 
completely  cured,  but  as  a  matter  of  precaution  it  was  deemed 
advisable  to  reapply  the  remedy.  It  was  therefore  dabbed  over 
the  surface,  about  five  drops  being  used. 

Since  then  there  has  been  no  reappearance  of  the  disease.  In 
this  case  the  Olea^  caused  no  inconvenience  whatever.  There 
was  no  staining  of  the  skin,  no  pain  after  application,  and  the 
cure  was  rapid. 

Casb  2. — ^This  was  a  much  more  severe  case.  The  disease  had 
been  treated  by  various  remedies — namely,  by  glacial  and  ordi- 
nary Acetic  acid,  by  Iodine,  &c., — ^and  although  these  had 
stopped  its  progress  for  a  time,  it  had  invariably  broken  out 
afresh.  When  first  seen  the  disease  was  extending  almost  round 
the  whole  of  the  back  of  the  neck,  from  the  angle  of  the  jaw  on 
one  side  to  that  on  the  other.  It  was  also  spreading  very  &ast  up 
into  the  hair,  and  for  a  distance  of  more  than  an  inch  the  hair  on 
the  back  of  the  head  was  invaded  by  the  disease.  There  were 
also  isolated  patches  on  the  chin,  below  the  angle  of  the  mouth, 
and  on  the  upper  lip.  There  were  several  scars  where  glacial 
Acetic  acid,  and,  I  believe,  also  strong  NiMe  acid,  had  been 
applied,  and  in  one  place  there  was  a  troublesome  sore  produced 
by  the  strong  add,  which  was  kept  up  by  the  rubbing  of  the 
collar.  The  disease  had  existed  for  several  months,  and  a  second 
case  had  occurred  in  a  house  where  the  patient  had  been  staying 
whilst  the  patches  were  on  his  neck.  The  newer  spots  were  well 
marked  and  highly  characteristic,  and  afforded  abiindance  of 
sporules,  Ac.  The  site  of  the  older  ones  was  reddened  by  in- 
flammation, and  discoloured  by  the  application  of  the  various 
remedies  mentioned. 

On  June  16th,  after  cutting  off  as  closely  as  possible  all  the 
short  hairs,  so  as  to  remove  as  much  of  tl^e^ungus  as  it  yras 


572  MUeelUmeoui. 


poMnble,  I  applied  the  OleaU  of  Ibreuiy  (10  per  oent.)  oret  tike 
whole  of  the  affected  Bkin,  gently  rubbing  it  in  with  a  piece  of 
lint.  About  half  a  draehm  was  used  altogether.  The  isolated 
patches  on  the  face  were  similarly  treated.  Care  was  also  taken 
to  rub  the  hair  above  the  diseased  part  with  the  Oteil^.  lie 
patient  was  then  ordered  to  wear  a  loose  collar  and  not  to  wash 
his  neck  during  the  day.  Some  slight  irritation  followed  the 
application,  but  this  was  trivial,  and  not  for  a  moment  to  be 
compared  with  the  pain  produced  by  strong  adds,  Ac.  There 
was  no  staining  of  the  skin,  and,  as  the  spots  were  in  a  prominent 
position  on  the  face,  this  was  no  slight  advantage. 

On  the  18th  patient  was  again  seen.  There  had  been  no  firesh 
appearance  of  the  disease,  and  the  old  spots  had  not  extended 
themselves.  There  was  still  considerable  redness  over  the  old 
scars,  and  a  few  minute  pustules  produced  by  rtMinff  in  the 
OUate^  but  there  were  none  of  the  smaU  vesicles  which  had  been 
so  evident  on  the  former  occasion.  The  OleaU  was  reapplied 
over  the  places  to  ensure  success. 

On  the  tenth  day  after  the  first  application  the  disease 
appeared  to  be  completely  cured.  There  were  several  pale  red 
patches  showing  where  it  had  been,  whilst  the  spoti  on  the  ftce 
and  chin  had  quite  disappeared.  The  hair  had  begun  to  grow 
again*  and  showed  no  trace  of  the  spores.  The  sore  produced  by 
tiie  AoeHe  aeid  before  he  came  under  my  notice  had  scabbed 
over,  and  was  now  nearly  weU.  A  third  application  was  made  as 
a  precaution  where  the  hair  had  been  affected. 

When  seen  a  short  time  afterwards,  the  skin  appeared 
perfectly  well,  and  there  has  since  been  no  reappearance  of  the 
disease. 

The  advantages  which  Oleaie  qf  Merewy  seems  to  possess  over 
other  remedies  are : 

1.  It  is  a  0#fto»ii  rMfitfdK^  if  carefiilly  applied. 

2.  It  proditeei  no  Haining  or  injury  of  the  skin.  In  cases 
where  the  disease  appears  on  the  face,  it  is  of  great  importance 
to  avoid  any  disfigurement  or  staining. 

8.  It  is  painleti  in  its  application.  This  is  not  tiie  case  with 
the  ordinary  strong  parasiticides,  most  of  which  produce  veeiea- 
tion,  Ac. 

4.  It  readily  pene§rate9  into  the  sebaceous  glands,  hair-folIicleB, 


Ciue  of  Diabetes  MeUUw.  578 

and  eren  into  the  bain  themaelTeBy  the  Mtreury  being  in  a  state 
of  solution  in  an  oily  medinmi  and  it  is  therefore  much  more 
likely  to  destroy  the  fiingoa  than  the  spiritaoos  or  aqueous 
solutions  of  Mnremff  Ac.  This  penetrating  power  of  the  Oleaie 
may  be  increased  by  adding  a  small  quantity  of  ether  (one  part 
to  eight)  to  it« 

In  Teiy  sensitive  skins  the  irritation  sometimes  produced  by 
it  may  be  avoided  by  using  a  weaker  solution  (6  per  cent.), 
and  by  applying  it  with  a  camel's-hair  brush.  In  slight  cases 
this  method  is  all  that  is  necessary,  but  where  the  fungus 
has  invaded  the  hair  it  is  advisable  to  rub  in  the  Oleate  gently. — 
Zaneet. 


(km  ofJDuMee  MUUhu.    Under  the  care  of  Mr.  KivnnT. 

Fob  the  following  notes  we  are  indebted  to  Mr.  B.  J.  Carey, 
house-surgeon* 

Mary  G^ — ^  of  Fhuket|  aged  seventeeuy  who  has  never  men- 
struated, came  to  the  dispensary  on  Jan.  l^ith,  1874.  Though 
previously  healthy,  for  the  last  six  weeks  she  had  gradually  be- 
come weak  and  inert.  Her  skin  was  harsh  and  dry,  and  her 
appetite  voracious.  There  was  great  constipation,  thirst  and 
polyuria.  She  is  a  nervous  subject^  but  there  was  no  history  of  a 
fright  or  change  of  diet.  The  urine  (sent  that  day  week)  showed 
much  sugar  by  Trommer's  test.  She  was  given  fifteen  drops  of 
tincture  of  perchloride  of  iron  three  times  a  day,  and  skim-milk 
ordered* 

For  the  next  fortnight  she  steadily  got  worse»  and  then  the 
treatment  was  changed  to  ten  drops  of  tincture  of  opium,  and  a 
week  later  fifteen  drops,  three  times  a  day,  with  croton-oil  pills. 
By  this  time  she  was  so  weak  that  she  could  not  come  to  the  dis- 
pensary herself.  On  Feb.  18th  a  sixth  of  a  grain  of  JBTUraie  qf 
Urtmium,  in  water,  was  given  three  times  a  day,  and  gradually 
raised  to  the  third  of  a  grain.  A  weeklater  she  was  much  better. 
The  week  following,  the  bowels  were  regular,  and  the  appetite 
and  tbe  quantity  of  urine  no  longer  excessive;  while  on  Maidi 
4th,  and  for  a  fortnight  after,  she  had  gone  back  to  her  usual 


574 


Obituary — Dr.  George  N.  Epps. 


diet,  and  felt  nothing  wrong  with  herself  saye  some  mnscolar 
weakness. 

From  March  2lBt  to  April  8th  she  was  not  seen,  but  then  she 
returned  with  a  bad  cold  and  out  of  sorts  again.  HoweTer, 
though  she  was  weak  and  needed  change  of  air,  the  bowels  were 
regular,  the  appetite  defective,  polyuria  not  noticeable,  and  the 
urine  showed  no  sugar  bj  Trommer's  test  or  by  the  fermentation 
and  specific  gravity  test. 

The  following  table  shows  the  condition  of  the  urine  from 
March  nth: 


March  11th 
„      21st 

April  8th 
15th 
25th 


9» 


»> 


sp.  gr.  1038 
1021 
1025 
1024 
1025 


much  sugar 
sugar— a  trace 
no  sugar 
no  sugar 
no  sugar 


Many  may  doubt  if  the  Nitrate  of  Uranium  had  anything  to 
do  with  the  patient's  recovery,  but  as  some  cases  of  rapid  cure 
and  many  of  permanent  palliation  of  this  disease  by  the  use  of 
this  drug  have  been  recorded,*  it  is  to  be  hoped  that  practi* 
tioners  of  large  experience  will  properly  test  its  value  in  cases  of 
diabetes  mellitus.-^Zonctf^. 


OBITUARY. 


Db.  aEOEGE  N.  EPPS. 

Db.  Geobob  N.  Epps  was  bom  in  1815,  but  it  was  not  until 
1848  that  he  commenced  the  study  of  medicine.  He  took  his 
diploma  at  the  College  of  Surgeons  in  1845,  and-ever  since  then 
he  has  been  entirely  engaged  in  practice  according  to  the 
homoBopathic  system.  Before  he  took  his  surgical  qualification 
he  had  assisted  his  brother,  the  late  Dr.  John  Epps,  in  the 
lectures  given  by  the  latter  on  Chemistry,  Botany,  and  Materia 
Medica.  He  was  appointed  Surgeon  to  the  Homoeopathic 
Hospital  in  Hanover  Square  in  1845. 

*  [Where,  except  in  homoBopatliic  literature  P — Eds.] 


Correspondence — Letier  from  Dr.  Scott.  575 

In  1847  he  was  made  Surgeon  to  Harrison's  Spinal  Institution. 
He  showed  a  remarkable  aptitude  for  the  successful  treatment  of 
spinal  curvatures  and  deformities,  and  was  an  ingenious  mecha« 
nician.  He  inyented  a  mechanical  extender  for  the  reduction  of 
dislocations,  which  is  said  to  be  of  great  power  and  delicacy.  He 
published  several  volumes  on  surgical,  chiefly  orthopsadic, 
subjects.  In  1849  one  on  '  Spinal  Curvature/  in  1852  one 
'  On  the  Treatment  of  Accidents,'  and  in  1859  one '  On  Club 
Foot.'  He  enjoyed  a  large  practice,  to  which  he  was  extremely 
devoted,  seldom  or  never  taking  a  holiday ;  indeed,  it  used  to  be 
his  boast  that  he  had  never  slept  out  of  his  house  for  upwards  of 
twenty  years.  He  has  left'  a  widow  with  a  large  family,  all 
grown  up,  and  numerous  friends,  by  whom  he  will  be  much 
regretted. 


CORRESPONDENCE. 


To  the  Editors  of  the  '  British  Journal  of  Somosopathif.* 

Oentlembit, — In  my  article  on  Madeira  in  the  last  number  of 
the  British  Journal  of  HomoeoptUhy,  p.  222  (note),  I  stated,  with 
reference  to  the  celebrated  "Brompton  experiment,"  that  27 
cases  were  sent  out,  of  which  2  returned  much  improved,  7 
slightly  improved,  12  neither  better  nor  worse,  5  made  worse, 
and  1  died.  So  it  certainly  appeared  from  the  passage  whence  I 
extracted  the  statistics ;  but  having  been  led  to  feel  some  doubts 
on  the  subject,  I  wrote  to  the  House-Physician  of  the  Brompton 
Hospital^  who  kindly  sent  me  the  following  corrected  statistics 
by  return  of  post : 


Much  improved 

.      2 

Slightly 

.      7 

Stationary        • 

.      6 

Worse  .... 

4 

Died     .... 

.       1 

Tour  obedient  servant, 

W.  B.  A.  SooTT. 


Tunbridge  Wells ;  30th  April,  1874. 


676 


BOOKS    RECEIVED. 


A  a^9Um  of  Surgenf.  B7  Wm.  Tod  Hiucvth,  M.D.  Carle 
and  GbeneD,  New  York.    1878.    (Will  be  reviewed  in  our  next.) 

OueqfSione  in  the  Bladder  and  Osalwria  mtred  by  LUhoMy 
and  Hydrochloric  Acid,  Bj  Biohasd  Epfs,  M.B.0.8.  E^ps, 
London. 

Brituh  NarcoHm.  Fifth  Annual  Beport  of  the  Britiah  Anti- 
Tobacco  Society. 

On  the  Univcrtality  of  the  Homooopathic  Law  of  Cure.  Bj  Dr. 
Neidhabd.    Boericke  and  Tafel,  New  York.     1874. 

The  Science  of  Homeopathy,  Bj  Chablbs  J.  Hbmfbl,  M.D. 
Boericke  and  .Tafel,  New  York.    1874. 

The  Dublin  Journal  of  Medical  Science. 

The  Monthly  Homooopaihie  Beview, 

The  Hahnemannian  Monthly. 

The  American  HomoBopathia  Oiterper. 

The  Chicago  Medical  Inveetiyator. 

The  JUTorih  American  Journal  of  Hom4BCpaihy, 

United  Statee  Medical  and  Surgical  Journal. 

The  Hew  EngUmd  Medical  Gaaette. 

The  American  Journal  of  HomoBopathie  Materia  Medico. 

El  Criteria  Medico. 

Bibliath^gue  HomcBopathique. 

The  Calcutta  Journal  of  Medicine. 

The  Chemist  and  Druggist. 

Compendia  di  Materia  Medica  Fura.    Far  Dr.  B.  Dadba. 


tflE 


BRITISH   JOURNAL 


OP 


HOMCEGPATHY. 


HINDOO  MEDICINE. 

By  W.  B.  A.  Scott,  M.D. 

Like  philosophy  and  astronomy,  medicine  appears  to 
have  had  its  origin  in  the  East,  and  to  have  been  trans- 
mitted to  Europe  from  those  members  of  the  Aryan  race 
who  remained  in  or  near  the  birthplace  of  that  great  family 
of  nations.  Confirmatory  of  this,  we  find,  in  the  most 
ancient  Hindoo  medical  books,  health  described  as  consist- 
ing in  the  harmony  of  the  elements  of  which  the  body  is 
composed — a  doctrine  imported  into  Magna  Grsecia  by 
Pythagoras ;  and  disease  stated  to  arise  from  the  dispro<» 
pbrtionate  increase  or  diminution  of  one  or  more  of  the 
"  humours '' — ^a  theory  manifestly  similar  to,  if  not  iden- 
tical with,  the  '*  humoral  '^  pathology,  or  rather  nosology, 
of  Hippocrates.  In  philosophy,  so  intimately  dissociated 
with  medicine  in  the  earliest  times,  Empedocles  borrowed 
his  doctrine  of  the  four  elements,  fire,  air,  earth,  and  water, 
from  the  Hindoos,  who,  however,  reckoned  a  fifth  (ether), 
from  which  they  supposed  the  former  to  be  derived.  In 
strictness,  indeed,  it  would  appear  that  the  Hindoos  ad- 
mitted but  one  element,  ether,  the  medium  (according  to 
them)  or  rather  the  source  of  sound,  and  from  this  they 
derived  air ;  from  air,    fire ;  from    fire,  water ;  and  from 

VOL.  ZXXII,  NO.  CXZX.<-M>CTOBE]l,  1874.  0  0 


578  Hindoo  Medicine, 

water,  earth  ;  of  which  simplification  of  the  prima  materies 
we  have  a  good  instance  (doubtless  a  derivation)  in  the 
philosophy  of  Heraclitus^  who  ascribed  the  origin  of  all 
things  to  fire.  It  seems  probable^  too,  that  the  Hebrews 
were  not  unacquainted  with  the  Hindoo  cosmogony,  since 
the  account  given  in  the  most  ancient  Vedas  of  the  dwapar 
yug,  or  second  age  of  the  world  (for,  like  Hesiod,  the  Hin- 
doos spoke  of  four  ages  in  the  history  of  man,  precisely 
corresponding  to  the  golden,  silver,  bronze,  and  iron  ages  of 
the  Greek  and  Italian  poets),  bears  no  small  resemblance 
to  that  given  by  Moses  in  the  first  and  second  chapters  of 
Genesis.  The  common  ancestor  of  the  human  race  is  by 
the  Hindoos  described  as  having  been  divided  into  a  male 
and  a  female,  which  can  hardly  fail  to  recall  to  our  memories 
the  Mosaic  account  of  the  origin  of  Eve ;  the  name,  too,  of 
the  Hindoo  Adam  is  Adimo  or  Adom ;  but  as  Sanskrit  and 
Hebrew  belong  to  two  totally  distinct  linguistic  families^  this 
vocal  similarity  is  possibly  accidental.  Some  may,  perhaps, 
think,  from  the  intercourse  which  took  place,  through  Tyre, 
between  Palestine  and  India  in  the  reign  of  Solomon  (Max 
Miiller  adduces  various  philological  arguments  which  seem 
to  prove  that  Ophir  was  in  India),  that  in  this  last  case  the 
obligation  was  the  other  way,  and  that  the  Hindoos  were 
indebted  to  the  Israelites,  rather  than  the  Israelites  to  the 
Hindoos. 

But  while  the  cradle  of  medicine  is  to  be  sought  among 
those  of  the  Aryans  who  refused  to  take  part  in  the  general 
westward  migration,  the  eminently  conservative  disposition 
of  the  Hindoos  prevented  them  from  making  any  great 
advances  upon  the  theories  and  practice  of  the  earlier  dis- 
coverers y  and  as  non  progredi  est  regredi  is  especially 
true  in  science^  we  need  not  be  surprised  to  find  that  com- 
mentators of  later  times  have  deteriorated  rather  than  im- 
proved the  ancient  works  on  which  they  bestowed  so  much 
labour.  Some  rays,  indeed,  of  the  pristine  glory  which  had 
become  obscured  among  the  Europeans,  if  they  ever  really 
penetrated  so  far,  still  illumined  those  on  whom  the  light 
had  first  dawned,  even  to  historic  times.  Thus,  Arrian  tells 
us  of  Indian  physicians  who  cured  the  soldiers  of  Alexander 


hy  Dr.  W.  S.  A.  Scott.  679 

the  Great  of  the  effects  of  snake-bites  which  the  Greek  phy- 
sicians were  unable  to  heal^  and  the  Hindoos  appear  to  have 
been  always  familiar  with  what  is  at  the  present  day  ab- 
surdly called  mesmerism.  But  medicine  was  destined  to 
pass  through  many  hands  and  many  countries  before  it 
reached  its  present  development^  imperfect  as  that  is.  Pass- 
ing from  Hindostan  to  Asia  Minor  and  Greece^  thence  to 
Alexandria  and  Bome^  thence  to  the  banks  of  the  Tigris, 
thence  to  Spain,  and  thence  to  Italy,  France,  England^ 
Holland^  and  Germany,  from  Pagans  to  Christians^  f^om 
Christians  to  Mahometans,  and  from  Mahometans  back 
again  to  Christians,  each  successive  generation,  like  the 
torch-bearers  in  the  race,^  did  something  to  carry  forward 
the  lamp  of  medical  science— however  little  to  improve  the 
practice  of  the  medical  art — while,  (to  change  the  metaphor), 
in  its  native  home^  medicine  "  settled  on  its  lees,  neither  was 
it  poured  from  vessel  to  vessel ;  therefore  its  scent  remained 
in  it,  and  its  taste  was  not  changed.^' 

In  classical  Hindoo  medicine,  therefore,  we  have,  with 
comparatively  few  alterations  or  additions,  the  form  in 
which  the  healing  art  was  first  practised  among  mankind* 
Certain  ceremonial  rites  and  additional  therapeutical  and 
surgical  appliances  have,  doubtless,  been  appended  in  the 
various  shashtras,  but  the  essence  remains  the  same.  It 
cannot  be  other  than  an  interesting  task  to  endeavour  to 
arrive  at  some  distinct  conception  of  this,  the  earliest  system 
of  medicine;  and,  fortunately,  the  means  of  doing  so,  thanks 
to  the  indefatigable  labours  of  modern  Orientalists,  are  less 
inadequate  than  might  have  been  feared  after  the  lapse  of 
so  many  ages. 

The  most  ancient  and  sacred  Hindoo  medical  authority  is 
the  Ayar-veda,  one  of  the  Upavedas,  or  supplementary 
Vedas,  said  by  some  to  have  been  given  to  the  world  by 
Brahma  himself,  while  others  ascribe  its  authorship  to  Siva. 
Of  this  only  fragments  have  been  preserved  in  the  shash- 
tras or  commentaries,  but  from  these  latter  we  learn  that  it 
was  distributed  into  eight  divisions,  the  first  two  of  which 
treated  of  surgery ;  the  third,  of  general  or  constitutional 

*  £t,  quui  conoreut  vitae  lampada  tradont.    Lucret. :  De  Ser,  Natn  u»  78- 


580  Hindoo  ifedieine, 

diseases,  amongst  which  the  author,  with  gfeater  perspica* 
city  than  Hahnemann,  reckoned  gonorrhoea ;  the  fourth,  of 
mental  diseases,  or  diabolical  possessions  as  they  were  deemed  j 
the  fifth,  of  the  treatment  of  infants  in  health  and  disease  ; 
the  sixth,  of  antidotes  to  poisons  (toxicology),  snake-bites, 
ftc. ;  the  seventh,  the  restoratives  of  youth  and  vigour — 
somewhat  resembling  a  treatise  on  the  philosopher's  stone,  or 
elknr  vita ;  the  eighth,  of  the  means  whereby  the  procrea* 
tive  powers  may  be  preserved  and  increased.  Next  in  point 
of  time  and  dignity  comes  the  Charaka,  a  series  of  dialogues 
composed  by  the  Munis  or  Sages,  with  the  assistance  of  the 
thousand-eyed  Indra,  and  based  on  the  Ayur-veda ;  this  is 
esteemed  the  great  authority  on  Medicine.  There  is  also 
another  similar  treatise,  called  the  Harita  Sangita.  Besides 
these  we  have  still  extant  an  abridgment  and  rearrangement 
of  the  Ayur-veda  by  Susruta,  in  six  parts :  (1)  Surgery,  (2) 
Nosology,  (8)  Anatomy,  (4)  Therapeutics,  (5)  Toxicology,  (6) 
Local  Diseases.  This  is  regarded  as  the  standard  of  ultimate 
appeal  in  Surgery.  About  three  hundred  years  ago  a  com- 
pilation was  made  from  the  whole  of  the  extant  vedas  and 
shashtras,  and  entitled  Buboprukana;  but,  from  the  stag- 
nation of  scientific  inquiry,  no  less  than  from  the  fact  that 
the  ancients  dissected,*  while  later  writers  were  withheld 
from  this  practice  by  religious  scruples,  it  has  come  to  pass 
that  the  modem  commentaries  are  of  far  less  value  than  the 
treatises  they  were  designed  to  illustrate. 

The  members  of  the  Vaidya  or  medical  caste  are  supposed 
to  be  descended  from  the  virgin-bom  son  of  Amba,  a 
favourite  servant  of  the  sage  Galaba,  but  possibly  the  favour 
she  had  gained  in  her  master's  eyes  may  lead  the  scep- 
tical to  question  whether  this  was  a  real  case  of  partheno- 
genesis.    Although  the  Yaidyas  constitute  the  tme  medical 

*  The  method  of  studying  the  internal  strncture  of  the  hody  recommended 
hy  the  Rishis  or  Sages  scarcely  deserves  the  name  of  anatomy  or  dissection, 
though  it  served  the  same  purpose  to  some  extent.  The  directions  are  that 
the  "  snhject "  is  to  be  steeped  in  water  during  seven  days,  at  the  expiiy  of 
which  time  it  will  have  become  putrid ;  the  skin,  muscles,  &c.,  are  then  to  be 
removed  in  successive  layers  by  means  of  friction  with  a  brush  of  bristles  or 
bamboo  bark.  The  proper  name  for  this  mode  of  procedure  would  seem  to  be 
•*  anatripsy." 


by  Dr.  W.  B.  A.  Scott.  681 

caste^  the  Brahmans  and  Khetreyas  also  include  medicine 
among  their  studies^  and  are  permitted  to  give  advice  and 
assistance  to  the  sick^  but  they  are  not  allowed  to  receive 
any  money  for  their  services.  Nor  are  other  castes  ex- 
cluded from  the  study  of  the  medical  vedas  and  shashtras ; 
even  persons  belonging  to  the  humble  caste  of  Sudras 
are  admitted  to  the  privilege^  if  they  evince  signs  of  learning 
and  virtue.*  The  greatest  reverence  is  paid  to  the  teacher, 
who  sometimes  maintains  his  pupils  at  his  own  expense. 
Precautions  are  taken  in  order  to  insure  that  none  shall  be 
received  as  pupils  except  such  as  are  likely  to  make  a  good 
use  of  their  advantages,  and  in  the  rules  under  this  head  it 
is  interesting  to  find  a  proof  of  the  early  attention  paid  by  the 
Hindoos  to  physiognomy — or  physiognomony,  as  it  ought  to 
be  called.  The  moral  and  intellectual  desiderata  being 
that  the  pupil  should  be  inquisitive,  observant,  philanthro- 
pical,  generous,  amiable,  cheerful,  and  not  covetous,  envious, 
or  indolent,  these  inward  mental  graces  are  to  be  typified 
by  the  outward  and  visible  signs  of  an  **  agreeable  voice, 
small  tongue  and  eyes,  straight  nose,  thin  lips,  short  teeth, 
and  thick  hair.''  Various  religious  ceremonies  are  per- 
formed on  the  day  of  the  pupil's  matriculation,  and  the 
latter  solemnly  renounces  anger,  covetousness,  falsehood, 
licentiousness,  cruelty — ^in  fact,  ''  all  the  works  of  the 
world,  the  flesh,  and  the  devil/^  In  this  we  may  discern 
the  original  of  the  famous  oath  of  Hippocrates,t  though,  in 
the  case  of  the  Hindoos,  it  was  taken  at  the  beginning 

*  We  find  traces  of  caste  in  early  Greek  history ;  thus,  the  most  ancient 
dasnfication  of  the  Athenians  was  into  TcXeovrcc  or  TtXsovrtg  (coltiyators  of 
the  SOU),  o^Xfircc  (warriors),  AlyiKophe  (goatherds),  and  ApydBiic  (artisans), 
which  seems  to  have  been  based  on  the  occupations  followed  by  the  members 
of  each  tribe.  Also,  we  know  that  the  profession  of  medicine  was  for  a  long 
time  nearly,  if  not  entirely,  confined  to  the  family  of  the  Asdepiadse,  or 
supposed  descendants  of  ^sculapius ;  and  the  art  of  carving  in  wood  was 
restricted  to  certain  families — ^in  Attica  to  that  of  the  mythical  Dsodalus,  and 
in  ^g^a  to  that  of  the  no  less  mythical  Smilis. 

t  In  his  intorconrse  with  his  patients  a  physician  is  required  to  esteem  the 
following  as  privileged  communications,  made,  as  it  were,  under  the  seal  of 
confession :  (1)  the  patient's  age,  (2)  his  wealth,  (3)  family  and  domestic 
occurrences,  (4)  his  sins  or  acts  tending  to  reflect  shame  upon  him,  (5)  bi^ 
c)iapties,  (6^  his  deyptioiu. 


"-^2  Hindoo  Medicine, 

instead  of  the  end  of  the  course  of  study.  In  addition  to 
this^  the  pupil  vows  implicit  obedience  to  his  teacher,  the 
practice  of  a  voluntary  and  even  ostentatious  humility,  and 
also  that  neither  his  beard  nor  his  nails  shall  be  cut  during 
the  period  of  his  studies.  When  the  noviciate's  studies 
have  been  successfully  completed,  he  receives  the  Rajah's 
authority  to  practise.  The  physician  must  be  healthy, 
attired  in  clean  and  becoming  raiment,  kind  and  considerate 
to  the  sick,  &c. — just  the  very  requirements  made  by  Hippo- 
crates. 

But  the  omens  which  the  physician  is  directed  to 
observe  afford  melancholy  instances  of  an  amount  of 
superstition  to  which  the  ''  divine  old  man ''  of  Cos  was  a 
stranger,  or,  rather,  which  he  had  the  strength  of  mind  to 
shake  off  for  the  most  part.  For  example,  it  is  held  to  be 
a  bad  omen  if  any  person  sneezes  ;  if  lizards  are  seen  by  the 
physician  on  leaving  the  house ;  or  if  corpses,  jackals,  or 
vessels  of  water  are  seen  on  the  left.  If  the  physician  on 
quitting  his  patient  should  meet  any  one  carrying  a  vessel  of 
water,  fruit,  or  butter,  the  sick  person  will  die.  On  the 
other  hand,  it  is  esteemed  an  auspicious  sign  when  the 
physician  '^  comes  in  with  the  milk,''  t.  e.,  arrives  along 
with  the  milk-carrier.  Much  attention  is  also  paid  to 
dreams,  as  well  those  of  the  physician  as  those  of  the 
patient — in  the  latter  case  not  without  propriety.  Favor- 
able and  unfavorable  indications  are  also  drawn  from 
incidents  relating  to  the  messenger  sent  for  the  physi- 
cian, his  character,  acts,  appearance,  dress,  the  hour  at 
which  he  arrives,  &c.  Certain  days  are  esteemed  lucky 
and  others  unlucky  for  administering,  preparing,  and  col- 
lecting drugs,  commencing  medical  studies,  &c.^  Distinct 
traces  of  this  last  superstition  may  be  found  in  some  of 
the  doctrines  of  Hippocrates — however  free  he  may  in 
general  have  been  from  similar  weaknesses — as,  for  example, 
in  the  lengths  he  went  in  the  enumeration  of  critical  days 
(of  which   he   reckons  no   less  than  eleven),  months,  and 

*  The  extent  to  which  the  belief  in  lucky  and  nnlncky  days  was  carried 
among  the  earlier  Greeks  is  well  shown  in  the  ooncluding  portion  of  Hesiod's 
Work*  and  Days, 


by  Dr.  W,  B.  A,  Scott.  588 

years ;  his  teaching  {Aph,,  Ixi,  §  4)  that  a  fever  which 
departs  on  an  even  day  will  probably  return^  and  {Epidemics) 
that  deaths  from  disease  necessarily  occur  on  an  uneven  day^ 
month,  or  year.  It  is  well  known  that  Pythagoras  pushed 
such  considerations  even  farther. 

The  physician  is  carefully  to  observe  the  person  of  his 
patient,  in  order  to  discover  whether  he  has  the  signs  of 
longevity,  which  are  supposed  to  consist  mainly  in  the  exist- 
ence of  a  certain  proportion  between  the  limbs,  chest, 
neck,  &c.,  but  other  indications  are  not  overlooked.  The 
most  favorable  signs  are  long  arms  and  fingers,  long  ears, 
large  eyes,  forehead,  teeth,  mouth,  trunk,  hands,  feet,  and 
shoulders,  short  and  fleshy  legs,  short  neck,  a  large  space 
between  the  mammillse,  deep  navel,  well-formed  joints, 
good  voice,  long  respirations,  and  vigorous  intelligence. 

The  directions  given  to  the  physician  regarding  the 
examination  of  his  patient  are  such  as  would  not  discredit 
a  treatise  on  diagnosis  at  the  present  day,  and  seem  to 
have  suggested  the  minute  scrutiny  practised  by  Hippo- 
crates. The  physician  is  carefully  to  note  the  general 
appearance  of  the  patient,  his  or  her  age,  sex,  temperament, 
mental  state,  habits  as  to  food,  &c.,  occupation,  tongue, 
faeces,  urine,  general  sensations,  appetite,  breathing,  sleep, 
and,  in  the  case  of  women,  the  state  of  the  menses,  &c. — 
a  comprehensive  though  heterogeneous  list  of  indications. 
Particular  attention  is  to  be  paid  to  existing  mental  condi- 
tions, as  fear,  depression,  &c.,  as  well  as  to  the  habitual 
disposition  and  temper.  Next,  by  the  touch  the  physician 
is  to  discern  the  feverish  heat  or  coldness,  dryness  or 
moisture,  softness  or  hardness  of  the  surface,  as  also  the 
nature  of  the  pulse,*  whence  may  be  inferred  the  condition 

*  In  Charaka  and  Sasmta  the  pulse  is  but  briefly  considered  in  connection 
with  different  diseases ;  but  in  the  works  of  more  recent  writers  very  special 
attention  is  paid  to  the  pulse,  as  regards  its  volume,  force,  frequency,  &c.  It 
is  said  to  be  slow  in  the  morning  and  at  night,  and  rapid  during  the  middle 
of  the  day  and  evening — a  statement  which  ia,  perhaps,  pretty  near  tbe  truth, 
for  although  writers  of  the  present  day  Imve  8ometimes  overlooked  the 
morning  retardation  (and  this  may  not  be  so  great  as  that  which  occurs 
towards  midnight),  it  seems  to  be  indisputable  that  the  pulse  reaches  its 
maximum  about  noon,  and  very  slowly  declines  during  the  afternoon  and 


584  Hindoo  Medicine, 

of  the  vessels  as  to  tension^  relaxation^  &c«  Aascultation 
is  next  to  be  practised ;  the  natural  evacuations  and  any 
morbid  purulent  or  other  discharges  are  to  be  examined  as 
to  amount,  colour,  smell,  and  various  other  properties. 
After  these  preliminaries  have  been  duly  considered  the 
physician  is  to  prescribe  the  drugs  and  regimen  which  he 
deems  most  suitable. 

The  rewards  to  which  the  physician  is  entitled  are  said 
to  be  "  money  in  the  case  of  the  rich ;  friendship,  reputa- 
tion, increase  of  virtue,  prayers  and  gratitude,  in  that  of 
the  poor  "  (Wise,  Hindu  System  of  Medicine,  p.  29).  He 
is  to  accept  no  fee  from  a  Brahman,  a  relative,  or  one  who 
has  no  relations,  and  he  is  not  to  administer  any  remedies 
whatever  to  hunters  and  great  sinners.  The  generosity 
apparent  in  these  injunctions  descended  in  ample  measure 
to  the  earlier  Greek  physicians,  however  lamentably  it  may 
have  declined  among  their  unworthy  successors,  but  the 
implied  condemnation  of  the  chase  could  hardly  be  expected 
to  find  any  response  from  a  nation  which  venerated  Diana 
as  a  goddess  and  Meleager  as  a  hero. 

Having  thus  seen  what  were  the  notions  of  the  Hindoos 
as  to  the  origin  and  early  history  of  medicine,  and  the 
nature  of  the  studies,  requirements,  duties,  social  status, 
and  remuneration  of  their  physicians,  it  is  now  time  to 
investigate  their  system  of  medicine  itself,  together  with 
the  state  of  their  knowledge  on  cognate  subjects,  in  all 
which,  amidst  much  diflfereuce  on  points  of  detail,  we  shall 
discover   a   sufficiently    striking   general    resemblance    to 

evening ;  bo  iha^  compared  with  the  midday  acceleration,  the  morning  pnlse 
may  fairly  he  deacrihed  aa  slow.  The  importance  attached  hy  the  Hindoos  to 
attending  carefully  to  the  circumstances  under  which  the  pulse  is  examined 
may  he  seen  from  the  following  extract  from  one  of  their  sacred  writings : — 
"  When  it  is  to  he  consulted  the  patient  ought  to  ahstain  from  food,  from 
occupation,  from  the  hath  and  the  use  of  oil,  to  ayoid  cold  and  heat,  and  to 
remain  at  ease  and  awake  for  some  time  hefore  the  physician  arriTes." 
Eight  pulses  are  spoken  of ;  the  two  radials  at  the  wrist,  the  posterior  tibials 
at  the  ankles,  the  branches  distributed  to  the  alie  nasi,  the  subclayians  above 
the  clavicle,  and  the  carotids  in  the  neck.  The  pulses  of  a  woman  are  to  be 
felt  on  the  left  side,  snd  those  ol  a  man  on  the  right,— Wise's  SXndm 
Medicine,  p.  208. 


by  Dr.  W.  B.  A.  Scott.  585 

warrant  us  in  asserting  its  ancestral  claims  in  reference  to 
Greek  medicine,  and^  by  consequence,  to  the  medical 
science  of  the  present  day.  Following  the  method  of  Dr. 
Wise,  to  whose  admirable  work  on  the  Hindu  System  of 
Medicine  I  am  so  largely  indebted,  I  shall  consider  this 
under  four  heads: — (1)  anatomy  and  physiology,  (2)  thera- 
peutics, (3)  practice  of  medicine,  and  (4)  midwifery  and 
diseases  of  women  and  children. 

(1.)  Anatomy  and  physiology. — We  have  seen  that  the 
Hindoos  apknowledged  five  elementary  principles ;  to  each 
one  of  these  they  attributed  a  particular  primary  quality : 
to  earth,  smell ;  to  water,  taste ;  to  air,  touch ;  to  fire, 
colour;  and  to  ether,  sound.  But  while  such  were  the 
attributes  they  deemed  specially  appropriate  to  each 
element,  they  held  that  sound  and  touch  were  common 
to  the  first  four ;  visibility  and  taste,  common  to  earth, 
fire,  and  water ;  and,  furthermore,  asserted  that  each 
element  contributes  its  peculiar  share  to  the  physiological 
and  mental,  no  less  than  the  anatomical,  structure*  of  man. 
Thus,  fire  was  supposed  to  furnish  the  sense  of  taste,  and 
to  be  the  active  principle  in  the  process  of  digestion 
^  4  (whence  the  ''  coction  ^'  of  Aristotle  and  some  other  Greek 

writers) ;  ether  they  acknowledge  to  be  a  spiritual  element 
unrecognisable  by  our  senses,  and  to  it  they  ascribed  the 
faculty  of  hearing.  Certain  moral  and  intellectual  qualities, 
aa  revenge,  stupidity,  valour,  shame,  &c.,  were  supposed  to 
be  imparted  by  the  different  elements,  especially  by  ether 
and  fire ;  while  the  Hindoos  seem  to  have  regarded  air  as 
the  spring  of  all  movement.  During  life  they  believed  the 
human  body  to  be  animated  by  a  soul,  held  by  them  to  be 
an  emanation  from  the  Deity,  which  ultimately  returns  to 
its  Source.  Regarding  man  as  the  highest  earthly  creature, 
they  supposed  that  every  part  and  every  function  of  his 
small  microcosm  had  its  analogue  in  the  structure  and 
processes  of  the  vast  macrocosm  of  the  world — an  idea 
which,  I  think,  springs  naturally  enough  from  a  Pantheistic 
theology  such  as  theirs.  Something  analogous  to  it  may 
be  traced  in  the  parallel  drawn  by  Hippocrates  between 
the  four  humours,  the  four  seasons^  the  four  ages  of  man, 


586  Hindoo  Medicine, 

and  the  four  climates ;  while  more  than  2000  years  later  we 
find  Paracelsus  describing  the  brain  as  the  microcosmic  moon^ 
epilepsy  as  the  microcosmic  earthquake^  and  apoplexy  as 
the  microcosmic  thunderbolt  —  in  fact,  pushing  such 
analogies  quite  as  far  as  the  Hindoos  did,  if  not  even 
farther.  To  the  soul  the  Hindoos  ascribed  the  faculty  of 
dreaming,  and,  probably,  also  that  of  thought ;  but  it  is 
almost  impossible  to  discriminate  between  the  mental  and 
spiritual  endowments  attributed  to  air,  ether,  and  the  soul. 
It  is  especially  difficult  to  distinguish  between  ether  and 
the  soul,  and  traces  of  -this  ambiguity  may,  perhaps,  be 
found  in  the  strange  theory  of  Erasistratus,  that  the  soul  is 
double  (jTvtvfiatfijTiKov  and  iri^cvfta^v^cicov).*  Like  the 
Hindoo  '^  soul "  the  Greek  wevjuia  was  supposed  to  be  in  some 
way  essential  to  life;  and  in  the  writings  of  the  earlier 
Greek  philosophers  there  is  a  difficulty  in  discriminating 
between  Trvcvfta  and  xpvyn  ^ery  much  like  that  which  we 
encounter  when  we  endeavour  to  discriminate  between  the 
functions  of  the  '*  soul ''  and  those  of  "  ether." 

The  body  was  held  to  consist  of  humours  (dossoh)  and 
essential  parts  (dhatu).  Among  the  former  were  reckoned 
air,  bile,  and  phlegm  or  pituita,  blood  being  relegated  to 
the  class  of  dhatu.  We  are  at  once  reminded  of  the  four 
humours  of  Hippocrates,  and  struck  with  the  discrepancy 
both  in  nature  and  number — air  being  excluded  and  blood 
admitted  in  the  Hippocratic  classification,  while  bile  was 
subdivided  into  yellow  and  black.  But,  so  far  as  regards 
subdivision,  this  process  was  really  carried  veiy  much 
farther  by  the  Hindoos  than  by  Hippocrates,  for  the  former 
spoke  of  no  fewer  than  five  kinds  of  bile,  and  the  same 
number  of  varieties  of  air  and  phlegm.  And  we  must 
remember  that  the  classification  of  Hippocrates  was,  to  a 
great  extent,  influenced  by  his  humoral  pathology,  being 
constructed,  in  fact,  on  pathological  or  nosological  prin- 
ciples ;  while,  notwithstanding  the  humoral  pathology  of 
the  Hindoos,  their  classification  of  the  humours  is  con- 
structed strictly  on  physiological  principles,  true  or  false. 
This  being  the  case,  it  would  have  been  absurd  in  the 

•  Pr.  J.  B.  Baseell :  Sistofy  and  Eero^t  oj  the  Sri  of  Mtdicime,  p.  34. 


by  Dr.  W.  B.  A.  Scott.  587 

extreme  for  them  to  have  separated  the  blood  from  the 
dhatu    or    essential    parts^   in    order  to    place   it   among 
the  humours^  which  they  seem  to  have  regarded  as  of  a  less 
important  character.      In  the  next  place^  the  language  of 
Hippocrates  on  this  subject  is  confused  and  contradictory 
in  the  highest  degree.     As  a  rule,  it  is  true,  he  speaks  of 
humoral  dyscrasise  as  the  original  causes  of  disease,  but  in 
the  treatise  irepl  (^vauiv,^  we  find  the  air,  or  "  spirits/'  de- 
scribed as  the  fons  et  origo  malt — the  humours  being  the 
seat  rather  than  the  source  of  the  malady.     Furthermore, 
in  the  de  affectifmibus  and  de  morbis  we  find  Hippocrates 
ascribing  diseases  to  two  only  of  his  four  humours,  viz., 
bile  and  pituita.     There  is  little  doubt  that  Hippocrates,  no 
less  than  the  Hindoos,  regarded  air,  or  the  '^  spirits/'  as  the 
primum  mobile  alike  in  disease  and  health,  so  it  might  with 
perfect  propriety  have  been  added  to  bile  and  pituita  in 
the  list  of  morbific  agents ;  and  as  the  Hindoos  admitted 
that  the  blood  might  become  the  direct  subject  of  disease 
(only  after  the  humours  had  been  previously  attacked,  it  is 
true,   but    still    directly^    and    not    mediately  through    the 
agency  of  the  peccant  humours),  there  can  be  no  question 
that,  in  a  classification  arranged  upon  pathological  and  not 
physiological    principles    the    blood   would    have    found    a 
place  among  the  humours.     Curiously  enough,  the  Hindoos 
were,  in  reality,  more  entitled   to  make  this  classification 
than  Hippocrates  was,  for  the  latter  asserts  {de  affectionibus 
and  de  morbis)  that  the  cause  of  disease  in  the  blood  is  the 
admixture  with  it  of  diseased  bile  or  pituita ;  that  is  to  say, 
that  the  blood  can  only  mediately   become  the  subject  of 
disease.     The  above  considerations  seem  to  show  clearly 
whence   Hippocrates  derived  his  doctrine  of  the  humours, 
and  even  his  classification  of  them ;  it  appears  to  me  really 
wonderful  how  little  modification  the  doctrines  had  under- 
gone in  their  passage  from  India  to  Cos,  and  by  the  lapse 
of  probably  500  or  600  years. 

The  Hindoos,  as  we  have   seen,  reckoned   five  distinct 
species  of  bile ;  the  first,  they  taught,  aids  digestion ;  the 

*  It  is  fair  to  remind  the  reader  that  hy  some  this  treatise  is  ascribed  to 
Polybiiis,  son-ip-l^w  of  Hippocrates, 


588  Hindoo  Medicine^ 

second  imparts  its  red  colour  to  the  blood;  the  thirds 
which  they  located  in  the  heart,  produces  sense,  memory, 
pride,  obstinacy,  and  anger  ;^  the  fourth  confers  the 
faculty  of  vision ;  and  the  fifth  retains  the  skin  in  a 
healthy  condition.  It  was  held  to  exercise  these  functions 
in  virtue  of  the  fire  which  the  Hindoos  believed  to  be  the 
predominant  element  in  bile,  but  it  seems  not  improbable 
that  the  idea  may  have  been  suggested  by  the  observed  fact 
that  in  jaundice — a  diseased  state  of  the  bile — the  eyes 
and  skin  are  the  organs  most  visibly  afiTected,  while  the 
digestion  also  is  deranged,  and  the  moral  and  mental 
faculties  impaired. 

Among  the  five  kinds  of  phlegm  or  pituita  they  in- 
cluded the  secretion  properly  called  by  that  name  as  well  as 
synovia^  the  cerebro-spinal  fluid,  the  saliva,  and  the  aqueous 
humour  of  the  eye. 

The  Hindoos  recognised  seven  temperaments  in*  all; 
three  diiiinct  temperaments  caused  by  an  excess  of  air,  bile, 
and  phlegm  respectively,  nearly  corresponding  to  those  now 
known  as  nervo-sanguine,  atrabilious,  and  phlegmatic. 
When  any  two  of  the  humours  were  in  excess  they  supposed 
this  to  produce  a  mixed  temperament,  partaking  of  the 
characteristics  of  each  of  the  superabundant  humours.  It 
seems  somewhat  inconsistent  with  the  theories  they  held  as 
to  the  respective  properties  of  the  different  humours  that 
they  should  speak  of  phlegm  as  predominating  up  to  the 
16th  year,  bile  thenceforward  to  the  age  of  50,  and  air 
from  that  period  until  death  ;  yet  such  were  their  doctrines. 
Brahma  was  held  to  be  the  analogue  of  air ;  Vishnu,  of 
bile  ;  and  Siva,  of  phlegm. 

*  Pride  and  anger  were  long  supposed  to  be  in  some  way  connected  with 
the  biliary  secretion,  and  many  phrases  implying  this  connection  passed  into 
current  speech;  thus,  Plautos  has  the  phrase  hilem  coneire,  to  provoke  to 
anger;  Horace  has  repeatedly  such  expressions  as  meum  Jeewr  writ  bilist  I 
bum  with  indignation ;  and  Seneca  has  the  phrase^  bUem  habere,  to  be  moved 
to  anger.  The  phrases  spUndida  biUs  and  vitrea  bilie,  which  occur  in  Horace 
and  Persius,  seem  to  superadd  the  idea  of  some  degree  of  pride  to  that  of 
mere  anger,  though  some  consider  the  former  of  these  epithets  as  synonymous 
with  flava,  as  it  was  from  the  yellow  in  contradistinction  to  the  black  bile 
that  passion  was  supposed  to  arise. 


by  Dr.  W.  S.  A.  Scott.  589 

The  dbatu  or  essential  parts  of  the  body  are  seven  in 
number :  chyle^  blood,  flesh,  fat,  bone,  marrow,  and  semen. 
The  Hindoos  rightly  enough  defined  chyle  as  the  essence  of 
the  food ;  they  recognised  the  existence  of  lymphatics,  or 
distinct  vessels  for  its  conyeyance  ;^  and  although  some 
thought  that  the  chyle  nourishes  the  body  directly,  others 
were  aware  that  it  mixes  itself  with  the  blood,  and  believed 
it  to  be  coloured  and  otherwise  modified  in  the  spleen  and 
liver.  They  supposed  that  the  various  tissues  were 
nourished,  not  pari  passu,  but  in  succession,  beginning  with 
the  flesh  and  ending  with  the  semen.  They  appear  to  have 
held  no  peculiar  opinions  concerning  blood,  flesh,  and  fat, 
except  that  they  regarded  perspiration  as  the  special  excre* 
tion  of  the  last ;  perhaps  from  having  observed  diaphoresis 
to  be  an  almost  constant  accompaniment  of  obesity. 
They  reckoned  800  (some  even  306)  bones  in  the  human 
body,  swelling  the  list  by  including  under  this  head  the 
ensiform,  stemo-clavicular^  costal,  thyroid,  cricoid,  and 
arytsenoid  cartilages,  the  rings  of  the  trachea,  and  the 
teeth.  As  in  the  case  of  the  humours,  so  they  spoke  of 
five  varieties  of  bones:  flat,  round,  long,  cartilages,  and 
teeth. 

The  Hindoos  supposed  the  brain  and  spinal  cord  to 
subserve  merely  the  same  purposes  as  the  marrow  in  the 
long  bones — a  doctrine  almost  identical  with  that  of 
Praxagoras,  and  not  very  dissimilar  to  that  of  Aristotle ; 
though  Pythagoras  and  Hippocrates  held  more  correct 
opinions  on  this  subject.  They  believed  the  semen  to  be 
produced  by  the  admixture  of  the  essential  parts  of  the 
brain  and  spinal  cord  with  the  blood.  All  the  dhatu  were 
supposed  to  be  pervaded  by  an  essential  principle  called 
ozah,  which  is  the  source  ^of  their  vigour,  but  it  is  difficult 
to  see  in  what  respect  this  difiered  from  "  ether .^' 

They  enumerated  eight  kinds  of  articulation,  six  of  which 

*  The  discoyery  of  the  lymphatics  wu  probably  made  subaeqnently  to  the 
migpration  of  the  Pelasgi,  for  among  Greek  writers  Erasistratus  is  the  first  to 
mention  these  stmctures,  which  he  observed  in  the  dissection  of  goat^ 
Although  he  described  them  and  their  contents  with  sufficient  accuracy,  he 
supposed  they  were  of  the  nature  of  arteries. 


590  Hindoo  Medicine, 

may  be  reduced  to  the  modern  (^assifieation^  but  two  are 
peculiar  to  themselves — Kara^  or  ginglymus ;  Udukhata  and 
Biosatunda,  or  enarthrbsis ;  the  difference  being  that  the  latter 
term  was  confined  to  those  balUand-socket  joints  one  of  the 
boDCs  entering  into  which  possesses  a  coronoid  process,  as  the 
lower  jaw ;  while  the  former  was  most  arbitarilj  and 
absurdly  extended  so  as  to  include  gomphosis ;  Samudga 
and  Protara,  or  amphiarthrosis ;  the  former  where  little  if  any 
motion  is  permitted,  as  in  the  sacro-iliac  and  pubic  sym- 
physis ;  the  latter  where  there  is  more  movability,  as  in 
the  articulations  between  the  bodies  of  the  vertebrsB; 
Tunnasebanu,  or  sutures.  The  two  forms  of  so-called 
articulations  which  are  peculiar  to  the  Hindoo  classification 
are  the  Mundala,  a  term  descriptive  of  the  manner  in  which 
the  eyes  are  set  in  the  orbits,  the  trachea  in  the  neck,  and 
the  heart  in  the  thorax ;  and  the  Sunkha  burda,  or  mode 
of  attachment  of  the  ears.  Like  Hippocrates  and  Hero- 
philus,  they  confounded  together  nerves,  tendons,  and  liga- 
ments. 

With  their  usual  fondness  for  classification  they  divided 
the  muscles  (of  which  they  enumerated  500)  into  ten  sets, 
as  broad,  round,  short,  rough,  &c. 

The  description  of  the  vascular  system — in  which  the 
Hindoos  included  veins,  arteries,  lymphatics,  intestines, 
ureters,  Fallopian  tubes,  urethra,  &c. — ^is  so  very  fanciful 
and  erroneous  that  it  would  be  quite  inconsistent  with  the 
limits  and  object  of  this  article  to  give  it  in  detail.  Suffice 
it  to  say,  that  (misled  perhaps  by  the  observed  phenomena 
of  foetal  circulation)  they  regarded  the  umbilicus  as  the 
common  origin  of  all  the  vessels ;  that  they  divided  these  into 
three  classes ;  (1)  sera,  or  those  conveying  blood,  air,  bile 
and  phlegm ;  {2)  damanee,  some  of  which  were  supposed  to 
carry  the  same  contents,  and  others  to  perform  the  offices 
of  the  nerves  of  special  sense  ;*  and  (3)  srota,  or  canals, 
among  which  seem  to  have  been  included  the  right  and 
left  lymphatic  ducts,  the  portal  and  splenic  veins,  the 
ureters,  &c, 

*  Aristotle  laboured  under  a  similar  propensity  to  confound  yessels  with 
nerves ;  thus,  he  thought  that  the  ultimate  branches  of  the  aorta  assumed  a 
nervous  character* 


by  Dr.  W.  B.  A.  Scott.  5&1 

They  rightly  enough  described  the  cellular  tissue  (kala) 
as  that  which  connects  and  surrounds  the  diflferent  struc- 
tures of  the  body^  very  unnecessarily  adding  that  it  seperates 
the  seven  dhatu,  or  essential  parts.  It  is  treated  of  under 
seven  heads^  nearly  corresponding  to^  (1)  cellular  sheath  of 
muscles^  (2)  spongy  or  erectile  tissue^  (3)  the  omentum^ 
(4)  synovial  sacs^  and  (5)  the  mesentery.  The  sixth  and 
seventh  varieties  are  two  imaginary  structures. 

The  skin  is  said  to  consist  of  seven  layers^*  of  which^  (1) 
corresponds  to  the  superficial  part  of  the  epidermis  ;  (2),  (3)^ 
and  (4)  to  the  deeper  cells  of  the  same  in  which  the  pigment 
is  lodged^  the  so-called  rete  mucosnm ;  (5)  and  (6)  to  the 
corium,  or  true  skin ;  and  (7)  to  the  subcutaneous  cellular 
tissue  and  fascise. 

Susruta  has  enumerated  107  ^'  vital  parts/'  or  regions  of 
the  body  where  wounds  are  especially  painful,  dangerous,  or 
even  fatal.  Of  these  there  are  five  varieties  or  classes  :  (1) 
containing  nineteen,  or  those  in  which  awound  is  speedily  fol- 
lowed by  death  ;  (2)  containing  thirty-three,  in  which  the 
fatal  result  is  delayed  for  a  few  days ;  (3)  containing  three,  in 
which  death  occurs  on  withdrawing  the  foreign  body  which 
inflicted  the  wound;  (4)  containing  forty-four,  in  which  a 
wound  is  followed  by  lameness  and  paralysis ;  and  (5)  con- 
taining eight,  a  wound  in  which  causes  only  pain. 
Amongst  these  ''  vital  parts ''  or  marma,  are  mentioned 
the  seats  of  the  carotid  arteries,  of  the  lateral  sinus,  of 
the  femoral  artery  just  before  it  enters  Hunter's  canal^  and 
higher  up  in  Scarpa's  triangle,  the  heart,  and  the  bladder. 
Curiously  enough,  they  consider  that,  notwithstanding  the 
fatal  nature  of  accidental  wounds  of  the  last-named  viscus, 
it  might  often  be  intentionally  opened  with  impunity  for 
the  removal  of  a  calculus.  Susruta  also  dwells  on  the 
likelihood  of  tetanus  occurring  in  consequence  of  wounds 
near  the  great  toe ;  directs  that  instruments  similar  to  the 
trephine  and  elevator  be  used  in  cases  of  fracture  of  bones 
of  the  skull,  and  gives  a  sufficiently  accurate  description  of 
the  effects  of  wounds  of  the  testicle  and  groin. 

*  This  idea  prevails  to  this  day  among  the  ignorant  in  some  Continental 
countries,  as,  for  instance,  in  Portagal. 


592  Hindoo  Medicine, 

It  seems  not  improbable  that  at  the  date  of  the  composi- 
tion of  the  Vedas  human  life  was  somewhat  more  prolonged 
than  at  the  present  day.     Thus,  death  occurring  before  about 
the  hundredth  year  was  ascribed  to  avoidable  causes^  as 
want^  accident,  or  excess.     The  term  of  life  was  divided  into 
four  periods ;  the  first  fifteen  years  were  assigned  to  child- 
hood^ from  the  sixteenth  to  the  seventieth  years  to  man- 
hood^ and  from  the  seventieth  until  the  person's  decease  to 
decrepitude^  the  season  when  "  the  grasshopper  shall  be  a 
burden,  and  desire  fail/'  or,  as  Menu  expresses  it,  when  the 
body  shall  become  "  a  mansion    infested  by  age   and  by 
sorrows,  the  seat  of  maladies,  harassed  with  pains,  haunted 
with  the  qualities  of  darkness,  and  incapable'of  standing 
long."     Menu  aboimds  with  moral  and  religious  exhortations 
in  reference  to  this  subject  of  death  which  would  do  no 
discredit  to  a  Christian  moralist.     I  subjoin  two  sentences 
of  his   on    account   of  their    striking   similarity   to    the 
ideas    expressed   by    two    Christian    writers,    neither    of 
whom  had  ever  heard  of  his  name.     "  The  wise  man  medi- 
tates on  the  acquisition  of  knowledge  and  riches  as  if  not 
subject  to  sickness  or  death ;  and  cultivates  virtue  as   if 
death  had  already  seized   him  by  the  hair/'     And  again : 
''  Let  him  not  wish  for  death,  let  him  not  wish  for  life ; 
let   him    expect   his    appointed   time,  as  a    hired  servant 
expects  his  wages."    In  the  writings  of  Dr.  Cheyne  we  find  an 
almost  exact  reproduction  of  the  first  of  these  quotations : 
"  I  make  it  a  rule  to  neglect  nothing  to  secure  my  eternal 
peace  more  than  if  I  had  been  certified  I  should  die  within 
the  day  ;  nor  to  mind  anything  that  my  secular  duties  and 
obligations  demanded  of  me  less  than  if  I  had  been  insured 
to  live  fifty  years  more."     The  second  extract  can  hardly 
fail  to  recall  to  the  reader's  mind  the  Archangel's  exhorta- 
tion to  Adam  when  our  first  parents  were  expelled  from 
Paradise : 

"  Nor  love  thy  life,  nor  hate ;  bat  what  thou  liv'st 
"  Live  well ;  how  long  or  short,  permit  to  Heaven." 

Pabadisb  Lost,  xi,  65^^5. 

(2.)  Therapeutics. — Among  the  Hindoos,  religious  rites  of 
various  kinds  form  an  important  element  in  the  treatment 


by  Dr.  tT.  6.  A,  Scott.  598 

of  diseases,  a  circumstance  which  arises  from  their  belief  in 
the  doctrine  of  metempsychosis^  which  was  imported  into 
Europe  by  Pythagoras;  for  they  recognise  three  classes 
of  diseases :  (1)  those  of  a  retributive  character,  the  direct 
infliction  of  Heaven  on  account  of  sins  committed  by  the 
individual  in  the  present  or  previous  stage  of  existence  ; 
(2)  dyscrasise  or  natural  diseases^  caused  by  a  morbid  con- 
dition of  the  humours ;  and  (3)  diseases  of  a  mixed  nature^ 
arising  from  a  combination  of  the  two  above-mentioned 
causes.  To  these  may  perhaps  be  added  demoniacal 
possessions^*  but  I  am  not  sure  whether  such  are  not 
included  in  the  first  class.  Diseases  of  the  first  class  are 
to  be  met  by  appropriate  lustrations,  prayers^  sacrifices,  &c. ; 
those  of  the  second  class,  by  drugs  and  the  other  ordinary 
therapeutical  appliances ;  those  of  the  third  class,  by  a  com- 
bination of  both  kinds  of  treatment.  But  our  present 
concern  is  with  the  therapeutics,  not  with  the  religion,  of 
the  Hindoos,  and  that  subject  may  be  considered  under  the 
heads  of  Hygeiology,  Materia  Medica,  and  Surgical  Appli- 
ances. 

(a)  Hygeiology. — Prom  a  very  early  period  the  Hindoo 
legislators  displayed  an  exemplary  diligence  in  inciQcating 
sanitary  precepts  upon  their  subjects,  even  calling  in  the 
powerful  aid  of  religion  to  enforce  their  enactments.  But, 
unhappily,  their  injunctions  were  so  minute,  so  numerous, 
and  so  hard  to  obey  that  despair  of  being  able  completely 
'^  to  fulfil  the  law's  demands  '^  led  the  mass  of  the  people 
ere  long;  to  disregard  its  requirements  altogether.  But 
however  such  hygienic  rules  may  have  been  practically  set 
at  nought,  many  of  the  Hindoo  ideas  upon  this  subject  are 
well  worth  recording,  both  on  account  of  their  intrinsic 
merit,  and  also  as  clearly  indicating  the  source  whence  the 
corresponding    doctrines   of   Hippocrates   and   the    Greek 

*  PythBg^ras  in  like  manner  taught  that  some  diseaaea  were  the  reanlt  of 
demoniacal  poasession,  and  were  only  amenable  to  the  influence  of  religions 
services;  and  even  Hippocrates,  although  (treating  of  epilepsy,  formerly 
called  the  "  sacred  disease '')  he  stoutly  combats  the  notion  of  any  one  disease 
being  more  of  a  supernatural  character  than  any  other,  speaks  in  the 
JPrognatHet  of  a  Oiiov  n  as  one  of  the  causes  of  disease. 

VOL.  XXXII,  NO.  CXXX. OCTOBISR,  1874.  PP 


594  Hindoo  Medicime. 

physicians  were  derived.  Like  these^  the  Hindoos  de- 
scribed hot  climates  as  specially  productive  of  bilious 
derangement,  and  damp  atmospheres  as  liable  to  cause 
diseases  of  the  *'  phlegm/'  They  divide  climates  into  three 
classes :  the  moist,  the  hot,  and  the  temperate ;  and  point 
out  the  good  or  evil  results  which  may  attend  a  change 
from  any  one  of  these  to  any  other,  while  they  at  the  same 
time  acknowledge  that  with  proper  care  a  person  may  live 
in  any  climate  with  impunity — a  truth  which  has  been  too 
much  lost  sight  of  in  modern  days  when  the  facilities  of 
locomotion  have  rendered  so  many  invalid  depdts  accessible 
to  every  wealthy  and  whimsical  hypochondriac.  With 
great  propriety  they  insist  that  when  a  person  goes  to 
reside  in  a  different  climate  he  ought  to  follow  the  local 
customs  as  regards  food,  clothing,  personal  habits,  and  the 
like  of  his  new  abode,  a  practice  from  which  the  late  Dr. 
Combe  described  himself  as  having  derived  great  benefit. 
During  the  cold  months  the  diet  ought  to  contain  a  fair 
proportion  of  oleaginous  and  saccharine  principles,  together 
with  soups,  fish,  and  other  nutritious  articles.*  Wine  is 
to  be  drunk  mixed  with  water — stronger  in  winter,  weaker 
in  summer.  It  will  be  remembered  that  the  importance  of 
this  is  insisted  on  by  Hippocrates.  Fatty  substances  are 
to  be  avoided  while  the  air  is  moist,  at  which  times,  also, 
it  was  supposed  that  infection  spreads  with  greater  cer- 
tainty. The  characters  of  the  various  winds  are  minutely 
described,  together  with  their  salutary  or  injurious  effects 
on  the  constitution.     Thus  an  easterly  wind  is  said  to  be 

*  It  mast  be  borne  in  mind  that  at  the  time  when  the  earlier  shashtns  were 
composed  animal  food  was  largely  ased,  and  even  recommended.  PR>bably 
at  that  period  the  ancestors  of  the  present  Hindoos  lived  in  the  cooler 
and  healthier  northern  districts,  and  were  of  more  active  habits  than 
their  descendants.  As  they  advanced  towards  the  south,  and  graduaUy  fell 
into  the  lethargic  indolence,  both  mental  and  physical,  characteristic  of  the 
denizens  of  hot  climates,  animal  food  wonld  become  less  necessary — ^in  large 
quantities  even  pernicious — and  this  fact,  together  with  the  doctrine  .of 
metempsychosis,  probably  led  to  a  gradaal  abandonment  of  its  nae.  As 
regards  drinking  wine  there  is  a  difference  of  opinion.  In  the  Veda  Shashtras 
the  practice  is  forbidden;  but  it  is  sanctioned  by  some  of  the  Rishis,  and 
accordingly  practised  by  the  worshippers  of  Shiva. — Wise's  Sindu  Medidmef 
pp.  106—111. 


by  Dr.  IV.  B.  A.  Scott.  695 

cold^  '*  hesivj/^  and  invigorating ;  and  we  have  a  beautiful 
illustration  of  homoeopathy  in  the  further  assertion^  that^ 
while  it  is  apt  to  engender  diseases  of  the  phlegm,  it  is 
beneficial  in  cases  of  phthisis  arising  from  disordered  phlegm, 
i.  e.,  in  the  catarrhal  or  most  common  form  of  phthisis. 
Northerly  winds  are  cooling,  and  beneficial  in  cases  of 
cough  accompanied  with  haemoptysis.  We  thus  see  that 
the  Hindoos  were  nearly  three  thousand  years  before  the 
Europeans  in  discovering  that  a  warm  and  debilitating 
climate  is  not  the  true  cure  for  phthisis. 

Very  minute  directions  are  given  for  the  regulation  of 
personal  habits  in  health.  Thus  the  Hindoo  is  enjoined  to 
rise  before  the  sun,  and  to  perform  the  ofSces  of  nature 
with  his  face  towards  the  north.*  The  teeth,  mouth, 
tongue,  eyes,  and  face  are  then  to  be  cleaned  with  special 
care,  except  in  some  cases  of  disease,  and  in  children  under 
the  age  of  ten,  when  the  teeth  are  to  be  let  alone.  The 
body,  and  especially  the  head,  ears,  and  feet  must  be 
anointed,  except  at  the  commencement  of  fevers  and  after 
attacks  of  vomiting  and  purging.  Walking  and  other 
kinds  of  exercise  should  be  taken  daily,  especially  by  such 
persons  as  live  on  rich  food.  Shampooing  and  the  use  of 
the  flesh-brush  are  specially  recommended.  The  nails, 
hair,  beard,  &c.,  are  to  be  cut  every  fifth  day.  Cold 
bathing  is  strictly  enjoined,  except  at  the  beginning  of 
fevers,  diarrhoea,  and  a  few  other  diseases;  it  is  further 
recommended  during  the  course  of  some  inflammatory 
fevers ;  so  we  see  the  Hindoos  had  long  anticipated  the 
practice  of  Dr.  Currie,  of  Liverpool.  Warm  baths,  either 
local  or  general,  are  employed  to  relieve  pain  and  spasm, 
and  in  certain  fevers.  Vapour  baths  are  also  used,  both 
locally  and  generally,  chiefly  for  the  purpose  of  relieving 
pain ;  warm  water  and  vapour  baths  are  often  medicated. 

After  bathing,  antimony  is  to  be  applied  to  the  eyelids 
with    the    view    of   '' improving    the    sight,    clearing   the 

^  The  early  Greeks  had  precepts  of  a  similar  character.     Thus,  Hesiod 
{Worift  and  BmfMy  727—8)  bids  Penes 

*'  /fti|^  avT  lycXioio  rtrpaiifikvoQ  6p06s  6fux%w, 
aitrdp  iwti  m  ivy,  fii/iyq/icyoci  ^C  ^  dvt6vTa^ 


596  Hindoo  Medicine, 

itchiness  or  any  unhealthy  humours  of  the  eyes,  and  pre- 
venting the  bad  effects  of  the  glare  of  the  sun  and  diseases 
of  the  eye  in  general/'  It  is  really  very  instructive  to 
compare  this  with  the  ophthalmic  pathogenesis  of  antimony 
in  homoeopathic  treaties  on  materia  medica ;  as,  for  example, 
in  Jahr's  Manual^  where  we  find,  under  ^*  Byes/'  blindness, 
itching,  increase  of  mucus  and  of  the  secretion  of  the 
meibomian  glands,  agglutination  of  the  eyelids,  photophobia, 
and  inflammation  of  the  eyes. 

Directions  are  given  as  to  clothing,  which  is  to  be  red  in 
winter,  light  in  summer,  &c. ;  the  use  of  umbrellas,  and  so 
forth ;  but  it  would  be  foreign  to  my  present  design  to 
enter  into  more  detail  on  this  subject. 

As  regards  food,  while  it  is  acknowledged  that  the  young 
and  healthy,  especially  if  active  and  living  in  a  pure  air, 
may  partake  with  impunity  of  many  things  which  might 
prove  injurious  to  others,  and  that  habitual  use  will  often 
render  substances  harmless  which  would  be  unwholesome 
for  a  novice,  very  careful  rules  are  laid  down  as  to  the 
mixtures  which  are  injurious  or  beneficial.  Thus,  sweet  and 
sour,  sweet  and  salt,  sweet  and  pungent,  and  salt  and  bitter 
form  deleterious  mixtures.  Fish  must  not  be  eaten  with 
butter-milk,  sweet  milk,  or  sugar.  Some  substances  are 
good  only  for  persons  of  a  particular  age ;  others,  as  water, 
milk,  rice,  and  ghee,  are  beneficial  at  all  periods  of  life  from 
the  cradle  to  the  grave.  Sweet  articles  of  food  were  rightly 
held  to  increase  the  adipose  tissue  and  the  secretion  of 
milk.  Acid  substances  have  the  primary  action  of  '*  cooling, 
increasing  the  appetite,  and  promoting  digestion ;''  and  the 
secondary  action  of  producing  '^  fever,  weakness,  and  emacia* 
tionJ^  Pungent  articles  are  said  to  have  the  truly 
homoeopathic  action  of  diminishing  thirst. 

From  the  diversity  of  temperature  which  prevails  in 
different  parts  of  India  owing  to  the  more  or  less  elevated 
situations  of  various  districts,  that  favoured  country  possesses 
the  fruits  and  vegetables  of  nearly  every  climate,  from  the 
temperate  to  the  torrid  zone.  The  hygienic  and  thera- 
peutic properties  of  most  of  these  are  given  in  the  various 
Hindoo   medical  works,   but  they  are,  of  course^  far  too 


by  Dr.  W.  B.  A.  Scott.  597 

numerous  to  be  described  here.  The  use  of  the  flesh  of 
animals  is  much  more  limited^  but  different  kinds  of  milk 
are  largely  drunk.  Cow's  milk  is  preferred  upon  the  whole^ 
and  seems  generally  to  be  taken  either  boiled  or  curdled ; 
but  goat's  milk  is  used^  as  with  us,  for  some  forms  of 
haemorrhage ;  the  milk  of  mares,  buffaloes,  and  sheep  is  also 
drunk.  Fresh  butter  is  recommended  for  consumption — 
an  early  instance  of  analeptic  treatment,  which  would 
meet  with  the  approbation  of  Professor  Hughes  Bennett 
himself.  Vegetable  oils  are  largely  used,  but  chiefly  for 
inunction,  or  strictly  medical  purposes.  As  nearly  all  vege- 
table oils  are  purgatives,  it  is  interesting  to  find  that  the 
Hindoos  were  so  well  qualified  to  read  a  lesson  to  the 
allopaths  of  a  few  years  ago,  as  to  have  been  aware  that  the 
prolonged  use  of  such  oils  produces  habitual  constipation. 
Very  great  care  is  enjoined  in  the  selection  of  drinking 
water,  as  to  neglect  of  this  precaution  the  origin  of  many 
diseases  was  assigned. 

{b)  Materia  Medica. — Some  not  inappropriate  directions 
are  given  as  to  the  nature  of  the  soil  from  which  vegetable 
simples  ought  to  be  gathered,  but  they  are  unfortunately 
mingled  with  many  superstitious  injunctions  as  to  the  state 
of  the  heavens,  the  age  of  the  moon,  the  day  of  the  week, 
and  so  forth.  Simples  are  taken  from  the  animal,  mineral, 
and  vegetable  kingdoms.  Among  the  first  we  have  the 
skin,  nails,  and  hair  of  different  animals,  used  for  fumiga- 
tions in  intermittent  fevers;  the  blood,  to  be  exhibited 
internally  after  profuse  haemorrhage ;  the  flesh,  the  bones, 
to  be  given  in  nervous  disease,  and  in  diseases  of  children,  in 
both  of  which  the  Phos.  calc.  may  very  likely  have  often 
proved  extremely  useful ;  the  fat,  marrow,  and  bile ;  the 
milk ;  and  the  urine  and  fseces  (preferably  of  the  cow). 
From  the  mineral  kingdom  we  find  salt  recommended  for 
piles,  dysentery,  and  stone — to  the  two  former  of  which  it 
is  in  some  degree  homoeopathic  (Knorre  expressly  recom- 
mends it  for  dysentery),  though  it  is  certainly  not  the  drug 
which  would  in  most  cases  be  selected  by  homosopathists 
for  either  of  these  disorders.  The  metals  chiefly  employed 
internally  by  the  earlier   Hindoo  physicians  are  iron  and 


598  Hindoo  Medicine^ 

tin ;  the  former  was  given  (with  great  propriety)^  in  phthisis^ 
diabetes,  and  some  cases  of  gonorrhoea;  bat  it  must  be 
acknowledged  that  in  also  recommending  it  for  amenorrhosa 
we  have  what  at  first  sight  looks  very  much  like  a  relapse  into 
allopathy  or  rather  antipathy.  This  is  not  the  case,  however, 
for  amenorrhoea  is  a  frequent  accompaniment  of  chlorosis,  and 
we  have  long  known  that'' iron  is  hommopathic  to  all  forms 
of  chlorosis,  accompanied  or  not  accompanied  by  amenor^ 
rhwa"  (Jahr's  Symptomen-Codex,  translated  by  Dr. 
Hempel,  vol.  I,  p.  710.)  Tin  is  recommended  for  catar- 
rhal diseases  (to  which  it  is  certainly  homoeopathic),  gonor- 
rhoea, and  jaundice ;  the  pain  and  burning  along  the  course 
of  the  urethra,  which  have  been  recorded  by  some  provers, 
together  with  the  soreness  of  the  urethral  orifice,  which  has 
been  also  observed,  might  lead  us  to  suspect  that  the  metal 
is  in  some  degree  homoeopathic  to  gonorrhoea,  while  some 
symptoms  which  appear  sufficiently  well  authenticated  indi- 
cate a  distinct  action  on  the  liver.  It  was  also  used  as  an 
anthelmintic  and  to  diminish  obesity.  Most  other  metals 
were  probably  introduced  from  Europe,  and  in  Hindoo 
medicine  can  lay  claim  to  no  greater  antiquity  than  200  or 
300  years,  but  mercury  appears  to  have  been  used  from 
very  early  times,  and  is  even  spoken  of  as  a  panacea. 
There  are  various  preparations  of  this  drug ;  and  that  its 
homoeopathic  action  was  tolerably  well  understood,  we  learn 
from  finding  its  various  salts  recommended  for  dysentery, 
general  debility,  dyspepsia,  rheumatism,  dropsy,  fistula  in 
ano,  and  hepatic  disorders.  As  syphilis  was  probably  un- 
known in  the  classical  period  of  Hindoo  medicine,  we  need 
feel  no  surprise  at  the  omission  of  all  reference  to  the 
antisyphilitic  properties  of  mercury.  Gold  was  prescribed 
to  improve  the  memory  (cf.  Noack  and  Trinks),  to  restore 
vigour,  to  improve  vision,  in  phthisis,  in  gonorrhoea,  and  in 
hepatic  disorders.  We  all  know  that  general  weakness, 
incipient  amaurosis,  pulmonary  hepatization,  pricking,  and 
lancinating  pains  in  the  glans,  and  various  afiections  of  the 
liver,  are  among  the  pathogenetic  efiects  of  aurum.  Silver 
is  given  to  improve  appetite,  strength,  and  digestion.  Arsenic 
is  employed  as  a  tonic,  in  catarrhal  diseases,  asthma,  inter- 


by  Dr.  W.  B.  A.  Scott.  599 

mittent  fevers^  and  glandular  and  leproas  affections.  Anti- 
mony^ chiefly  as  a  coUyrium^  as  described  above.  Lead  is 
antipathically  given  in  cases  of  diarrhoea;  but^  on  the  other 
hand^  we  find  copper  administered  homoeopathically  for 
colic,  diarrhcea,  some  skin  diseases,  piles,  and  indigestion. 

Mica,  some  earths^  and  many  of  the  precious  stones,  are 
used  in  medicine,  as  also  are  sulphur  and  ammonia  ;  bnt  the 
two  latter  are  only  prescribed  in  combination  with  other 
drugs. 

Polypharmacy  unfortunately  prevailed  to  a  great  extent 
in  the  practice  of  the  Hindoos,  and,  as  chemistry  is  a  science 
of  yesterday,  we  need  not  be  surprised  to  find  incompatibles 
frequently  administered  together  in  their  heterogeneous 
prescriptions.  Little  care  was  taken  to  indicate  the  propor- 
tions of  the  various  ingredients,  or  even  the  amount  of  the 
dose.  They  also  dealt  largely  in  panaceas.  On  the  other 
hand,  their  assertion  that  an  overdose  of  medicine  actually 
increases  the  original  disease  would  serve  to  show  (if  other 
proof  were  wanting)  that  drugs  were  often  administered  on 
homoeopathic  principles.  There  is  also  a  prudent  injunc- 
tion that  drugs  prepared  from  the  vegetable  kingdom  are  to 
be  thrown  away  at  the  end  of  a  year.  When  administered 
internally,  they  are  exhibited,  as  in  Europe,  in  the  forms  of 
powder,  succus,  decoction,  infusion,  extract,  tincture,  pill, 
electuary,  and  so  forth.  Simple  medicines  are  always  given 
in  the  form  of  decoctions,  and  they  are  arranged  by 
Charaka  in  forty-five  classes,  which,  however,  may  be  easily 
reduced  to  three,  viz.,  (1)  those  which  exert  a  general 
action,  as  stimulants,  tonics,  sedatives,  &c. ;  (2)  those 
which  were  supposed  to  cure  individual  diseases,  such  as 
piles,  leprosy,  and  so  forth ;  and  (3)  those  which  increase 
or  diminish  some  particular  secretion  or  the  activity  of 
some  one  normal  function,  as  purgatives,  diuretics,  galacta- 
gogues,  eiThines,  &c.  Elsewhere  it  is  correctly  stated  that 
no  medicine  whatever  possesses  only  one  action — a  state- 
ment verv  inconsistent  with  this  classification  of  Charaka. 
Some  judicious  directions  are  given  as  to  the  mode  of 
administering  medicines,  as,  for  example,  that  some  are  to 
to    be   taken    when    the    patient   is  fasting,  others  when 


600  Hindoo  Medicine, 

replete ;  that  the  dose  must  be  varied  according  to  his  or  her 
age,  strengthi  and  general  condition ;  and  that  a  second 
medicine  is  not  to  be  given  until  the  action  of  the  first  is 
exhausted.  This  latter  point  is  especially  dwelt  upon  in  the 
case  of  purgatives.  There  is  also  an  amusing  injunction 
that  the  patient  must  not  make  faces  when  taking  his 
medicinei  as  so  doing  is  considered  an  impious  imitation  of 
Brahma  and  Vishnu  I  The  body  is  to  be  anointed,  and 
oleaginous  drinks  are  to  be  taken  before  the  administration 
of  any  kind  of  medicine. 

Besides  the  classification  of  Charaka  mentioned  above, 
two  other  arrangements  of  drugs  are  recognised :  (1) 
founded  on  the  humoral  pathology,  according  as  the  medi- 
cines were  supposed  to  act  on  the  air,  bile,  or  phlegm,  &c. ; 
and  (2)  according  to  the  organs  they  affected,  or  their  mode 
of  action.  There  are  five  principal  divisions  of  this  second 
classification  :  diaphoretics  (including  the  application  of  heat, 
vapour,  poultices,  and  fomentations),  emetics,  purgatives 
(including  enemata),  errhines,*  and  stimulants.  Mention 
is,  however,  made  of  emmenagogues,  diuretics,  sialagogues, 
carminatives,  and  alteratives,  which,  though  all  ranked  by 
the  Hindoos  among  stimulants,  it  would  not  be  easy  to 
bring  under  any  of  the  heads  referred  to.f  Alteratives  are 
also  spoken  of,  and  said  to  be  of  four  kinds  :  (1)  those 
which  give  pleasure,  (2)  those  which  cure  diseases,  (3)  those 
which  increase  memory  and  longevity,  and  (4)  those  which 
retard  the  process  of  natural  decay.  This  classification 
is  certainly  most  unworthy  of  the  logical  acuteness  of  the 
Hindoos,  as  it  is  manifest  that  (1)  are  not,  strictly  speak- 
ing, medicines  at  all;|    (2)  comprise  all  the  medicines  that 

*  These  (errhinea)  are  said  to  *'  clear  the  head  of  hnmoors  " — ahnoet  the 
very  words  of  Hippocrates. 

t  It  is  tme  that  emmenagogoes,  sialagogues,  and  diaretics  may  in  a  certain 
sense  be  called  local  stimulants,  as  they  increase  the  secretion  of  the  organs  on 
which  they  act ;  but  at  this  rate  errhines  and  diaphoretics  would  fall  under 
the  same  head.  The  term  ''stimulant"  is  very  improperly  used  in  this 
acceptation,  as  there  can  be  no  question  that  a  large  increase  in  the  amouni 
of  any  secretion  (accompanied  by  a  retrograde  metamorphosis  of  its  nature) 
may  be  produced  by  many  drugs  which  ought  to  be  called  "  relaxants  "  or 
"  depressants." 

t  It  is  true  that  those  substances  which  are  taken  for  the  sake  of  producing 


by  Dr.  W.  B.  A.  Seott.  601 

ever  were  or  ever  will  be  discovered  ;  and  (3)  and  (4)  are 
identical. 

(c)  Surgical  appliances. — As  in  Europe  so  among  the 
Hindoos,  surgery  seems  to  have  been  of  prior  date  to  medi- 
cine.  In  very  ancient  times  lithotomy,  paracentesis^  and 
the  extraction  of  the  dead  fodtus  were  practised  in  India  to 
a  much  greater  extent  than  is  usual  with  native  practitioners 
at  the  present  day,  for  national  prejudice  and  religious 
scruples  have  combined  to  bring  many  surgical  operations 
into  disrepute.  Certain  diseases  and  morbid  states  were 
considered  only  curable  by  surgical  means,  such,  for 
example,  as  inflammation,*  abscesses,  and  ulcers.  The 
treatment  of  these  consists  in  the  application  of  poultices, 
the  use  of  purgatives,  local  bleeding,  opening  the  abscess  at 
maturity,  and  the  administration  of  emetics,  with  spare 
diet.  Very  minute  directions  are  given  as  to  the  manner 
in  which  the  abscess  is  to  be  opened.  The  incision,  we  are 
told,  must  in  some  places  be  circular;  elsewhere  oblique; 
elsewhere,  again,  cruciform.  Sometimes  they  may  be 
opened  by  means  of  potassa  fusa.  The  directions  for  the 
treatment  of  fistula  are  very  similar  to  those  now  in  vogue. 

agreeable  sensationB,  as  wine,  opium,  cannabis  indica,  &c.,  all  exert  a  specific 
tberapentic  action ;  bnt  when  nsed  for  self-indulgent  purposes  they  lose  the  rank 
of  medicines,  because,  so  far  from  the  administration  of  them  being  part  of  the 
office  of  the  physician,  often  one  of  his  most  important  duties  is  to  see  that, 
in  this  respect,  the  patient  does  not  "  minister  unto  himself." 

*  The  Hindoos  seem  to  have  been  as  much  in  the  dark  as  to  the  nature  of 
inflammation,  and  eren  as  to  its  necessary  characteristics,  as  their  European 
descendants.  They  affirmed  pus  to  be  the  diagnostic  mark  of  inflammation, 
forgetting  that  it  is  only  at  a  certain  stage  of  the  inflammatory  process  that 
pus  is  present.  They  recognised  five  forms  of  idiopathic  inflammation  arising 
from  morbid  conditions  of  the  blood  and  our  old  friends  the  "humours,'* 
alone  or  in  combination,  which  it  would  be  exceedingly  difficult  to  bring 
under  any  modem  classification.  The  first  form  seems  to  include  such  diseases 
as  pemphigus,  pompholyx,  eczema,  &c.,  or  vesicular  and  bullar  diseases  geneially ; 
the  second,  pustular  diseases,  as  impetigo ;  the  third  would  include  smallpox, 
and  the  fourth  carbuncle ;  but  the  distinction  between  the  fifth  and  the  second 
seems  very  arbitrary,  and  it  may  very  well  admit  of  question  whether  the  first 
and  second  forms  are  not  rather  different  stages  than  different  varieties  of 
infiammation.  Many  excellent  pathologists,  as  is  well  known  (among  others 
Professor  Sanders,  of  Edinburgh),  consider  impetigo  to  be  merely  an  advanced 
stage  of  eczema. 


802  Hindoo  Medicine, 

For  performing  these  and  other  operations  the  Hindoos 
appear  to  have  possessed  a  tolerably  complete  armamenta- 
rium of  instruments,  and  so  much  attention  was  paid  to  all 
the  details  of  surgical  practice  that  no  fewer  than  fourteen 
distinct  kinds  of  bandages  are  enumerated.  They  seem  to 
have  understood  the  necessity  for  producing  "  extension  "  in 
dislocations  and  some  fractures,  and  in  order  to  insure 
practical  skill  in  the  various  surgical  manipulations  recourse 
was  had  to  the  use  of  "  dummies  '^  and  the  bodies  of  dead 
animals,  on  which  students  were  required  to  perform  the 
different  operations. 

The  practice  of  bloodletting  was  had  recourse  to  among 
the  Hindoos  from  a  very  remote  period,  but  in  early  times 
it  was  hedged  about  with  so  many  restrictions  that  (in  those 
days)  it  can  hardly  have  been  productive  of  very  much 
harm — at  least,  when  compared  with  the  wholesale  sangui- 
nary measures  of  the  Sangrados  who  derided  Hahnemann, 
and  who  are  now,  in  their  turn,  the  objects  of  such  just 
scorn  and  derision  to  the  whole  civilised  world,  not  except- 
ing their  own  disingenuous  successors.  Thus  we  are  told 
there  are  twenty  ways  of  improperly  performing  venesection 
—-it  seems  a  pity  that  they  did  not  add  that  there  is  no  proper 
way  of  performing  it.  Again,  "  bleeding  should  not  be 
performed  when  the  person  is  below  16  and  above  70 
years  of  age,  when  the  female  is  pregnant  or  soon  after 
delivery,  when  in  a  state  of  drunkenness,  when  there  are 
sores  on  the  body,  when  the  *  humours '  are  diminished, 
when  there  is  copious  perspiration,  or  when  diseases  of 
'  air '  are  present.  Patients  should  not  be  bled  in  very 
cold,  hot,  stormy^  cloudy  days,  when  the  person  is  weak, 
after  watching,  when  digestion  has  not  taken  place,  when 
afflicted  with  general  dropsy,  piles,  jaundice,  madness,  after 
vomiting  or  purging,  in  severe  fevers,  in  tetanus,  in  palsy, 
&c/'*     Unhappily,  in  after  times,  the   pernicious  practice 

*  Wise's  Sindu  Medicine^  p.  184.  With  charming  nalrete,  bleeding  is 
also  prohibited  ** when  no  disecue  u  present/**  Bat  even  this  precau- 
tionary prohibition  was  by  no  means  nnnecessary,  as  in  later  days,  in  EuropCj 
■ome  people  used  to  be  bled  '  regularly  every  spring,  sick  or  well,  very 
mnoh  as  at  the  present  time  some  old  women  of  both  sexes  are  still  f  oond 


by  Dr.  W.  B.  A.  Scott.  608 

was  retained^  and  the  wise  restrictions  in  a  great  measure 
overlooked ;  nor,  indeed,  is  it  surprising  that  an  operation 
of  such  easy  performance,  in  most  cases  attended  with  such 
immediate  (though  temporary)  relief  of  pain  and  many 
other  distressing  symptoms,  as  dyspnoea,  kc.,  admitting,  too^ 
of  a  plausible  defence  on  the  then  fashionable  ''  humoral " 
pathology,  and  last,  though  not  least,  gratifying  the 
ignorant  cravings  of  the  patient  by  the  fact  of  its  being 
attended  with  such  distinct  **  outward  and  visible  signs/' 
should  have  found  increasing  favour  once  any  one  had  the 
audacity  to  propose  it,  and  the  misfortune  to  find  some  one 
else  with  the  hardihood  to  undergo  it.  Venesection  was 
practised  among  the  Hindoos  in  just  the  same  way  as  in 
Europe,  including  the  use  of  the  bandage,  &c. ;  and  blood 
was  also  taken  by  means  of  scarification,  cupping,  and 
leeches.  Haemorrhages  were  arrested  in  four  ways  :  by  the 
use  of  ice,  astringents,  caustics,  or  the  actual  cautery.* 
Plastic  operations  were  performed  to  restore  the  nose  or 

who  take  purgatives  periodically,  and,  what  is  even  worse,  force  their  inno- 
cent children  to  do  the  same.  Those  poor,  infatuated  creatures  are,  of  course^ 
beyond  the  reach  of  argument.  But  does  not  the  subject  seem  worthy  of  the 
attention  of  the  Society  for  the  Protection  of  Women  and  Children  ? 

*  The  haemorrhage  consequent  upon  the  amputation  of  a  limb  was  fre- 
quently checked  by  means  of  bathing  the  stump  in  boiling  oil — not  an  un- 
common practice  in  Europe  previously  to  the  reintrodnction  of  the  ligature  by 
Ambrose  Par^  in  the  16th  century.  It  is  a  striking  proof  of  the  reluctance 
of  the  "orthodox"  or  sectarian  school  of  medicine  to  adopt  any  improvement, 
however  valuable,  or  however  well  attested,  that  although  the  great  French 
surgeon  amply  demonstrated  the  value  of  the  ligature — although,  too,  it  had 
antiquity  in  support  of  its  claims,  as  it  had  been  employed  by  the  later  Roman 
surgeons,  but  had  fallen  into  disuse  on  the  decline  of  surgery— Dr.  Freind, 
writing  in  1723,  tells  us  it  was  then  in  little  esteem  among  the  Germans,  and 
entirely  rejected  by  the  Dutch,  and  even  doubts  whether  it  would  have  met 
with  much  favour  anywhere  had  not  the  discovery  of  the  circulation  of  the 
blood  (which  was  not  made  till  nearly  a  century  after  the  reintrodn(ftion  of 
the  ligature)  demonstrated  its  theoretical  reasonableness.  Just  so  we  hear 
prattlers  nowadays  refusing  to  admit  the  reality  of  homcBopathic  cures  which 
occur  under  their  very  eyes,  because,  forsooth,  they  "  cannot  understand  how 
an  infinitesimal  amount  of  medicine,  which  one  can  neither  see  nor  taste,  can 
have  any  effect  j"  as  if  the  wide  possibilities  of  Nature  were  to  be  gauged  by 
the  narrowness  of  what,  on  the  luous  a  turn  lucendo  principle,  they  call  their 
own  intellects. 


604  Hindoo  Medicine, 

ears.  We  are  probably  indebted  to  the  tyranny  of 
Oriental  despots  for  the  introduction  of  these  valuable 
improvements  in  surgery^  as  cutting  off  the  nose  was  a 
favourite  mode  of  punishment  in  the  East  in  the  good  old 
times,  and  the  hapless  sufferers  naturally  set  to  work  to 
devise  some  means  of  restoring  their  original  appearance 
and  concealing  their  disgrace. 

(3.)  Practice  of  medicine. — We  have  seen  that  all  diseases 
not  of  supernatural  origin,  or  the  mere  result  of  poison  or 
external  injury,  were  by  the  Hindoos,  as  by  the  majority 
of  physicians  in  all  nations,  ascribed  to  "  derangements  of  the 
humours/'  and  disease  itself  was  described  as  the  effort  of 
nature  to  expel  the  peccant  constituents,  in  which  effort  it 
was  supposed  often  to  require  the  co-operation  of  medicinal 
drugs.  It  may  at  first  sight  appear  difficult  to  reconcile 
all  this  with  their  belief  in  specifics,  and  even  panaceas, 
but  this  difficulty  vanishes  when  we  remember  that  these 
invaluable  remedies  were  often  prescribed  in  such  massive 
doses  as  to  produce  an  amount  of  constitutional  disturbance 
in  the  form  of  purging,  diaphoresis,  diuresis,  emesis, 
ptyalism,  &c.,  sufficiently  painful  and  dangerous  to  warrant 
the  supposition  that  the  morbific  products  were  really  being 
expelled  by  means  of  the  natural  emunctories  without  any 
specific,  organopathic,  or  homoeopathic  medication  of  the 
seat  of  the  disease.  Diseases  are  variously  classified,  as 
those  which  are  easily  curable,  those  with  difficulty  curable, 
and  the  incurable;  hereditary  and  acquired,  or,  as  in 
Charaka,  those  arising  from  external  causes,  as  accidents 
and  poisons;  those  caused  by  improper  food;  those 
springing  from  mental  excitement,  grief,  fear,  &c. ;  and  the 
morbid  increase  or  diminution  of  normal  functions,  as 
thirst,  hunger,  &c.  It  will  be  seen  that  this  classification 
labours  under  the  serious  objection  that  the  first  three 
classes  are  arranged  according  to  their  causes,  and  the 
fourth  is  distinguished  by  its  symptoms.  As  a  rule^  too 
much  attention  was  paid  to  some  one  prominent  symptom 
in  the  classification  of  diseases— even  such  a  very  general 
symptom  as  pain — which  led  to  very  dissimilar  diseases 
being  classed  together.      But  the  usual  classification  is  into 


by  l>r.  fP'.  B.  A.  Scott.  606 

hereditary^  embryonic^  or  foetal ;  those  resulting  from  in- 
temperance ;  the  consequence  of  accidents  ;  those  caused  by 
the  vicissitudes  of  the  seasons;  judicial,  or  those  directly 
inflicted  by  Heaven  as  the  punishment  for  immorality  or 
irreligion ;  and  those  resulting  from  natural  decay.  It  is 
obvious  this  is  an  etiological  rather  than  a  nosological  or 
pathological  classification ;  but^  what  is  really  very  striking, 
in  their  doctrine  of  hereditary  disease  or  taint,  the  old 
Hindoos  nearly  hit  upon  the  Hahnemannic  doctrine  of 
psora.  We  are  told,  in  the  first  place,  that  care  and  atten- 
tion may  prevent  these  taints  ever  actually  producing  their 
distinctive  diseases,  and  in  the  next  place  that  the  most 
characteristic  of  these  hereditary  (psoric)  diseases  are  piles, 
phthisis,  dyspepsia,  epilepsy,  leprosy,  and  elephantiasis.  1 
say  advisedly  the  Hahnemannic  psoric  doctrine,  because,  as 
all  the  dishonest  detractors  of  Hahnemann  (with  the  excep- 
tion of  Sir  James  Simpson)  knew  perfectly  well,  a  doctrine 
of  psora  had  been  all  along  held  by  the  allopathists,  or 
whatever  they  like  to  call  themselves,  differing,  however^ 
from  that  of  Hahnemann  in  having  been  grossly  erroneous 
in  many  particulars.  Thus  the  exploded  school  taught  that 
the  serious  morbific  results  of  psora  were  only  produced 
when  a  distinct  cutaneous  eruption  was  repelled  internally. 
Like  Hahnemann,  the  Hindoos  were  aware  that  this 
constitutional  taint  may  not  produce  any  cutaneous 
symptoms  whatever,  and  yet  cause  serious  constitutional 
disease.* 

In  the  general  treatment  of  disease  the  chief  and  often 
the  sole  reliance  was  placed  on  the  regulation  of  the  diet, 
but  when  this  proved  insufiicieut  recourse  was  had  to 
evacuants,  which  were  directed  to  be  given  on  **  critical " 
days.     The  7th,  10th,  and   12th,  or,  according  to  others, 

•  «  One  important  point  in  which  Hahnemann's  views  of  psora  differed 
from  those  of  his  predecessors  was  this:  that  while  they  regarded  internal 
diseases  as  producible  only  when  the  psoric  matter  was  driven  in  from  the 
surface  of  the  body,  he  thought  that  the  constitution  might  be  elsewhere 
seriously  affected,  disordered  by  the  '  miasm/  while  the  skin  was  also  affected ; 
and  that  it  toot  not  neceuary  that  the  akin  should  ever  he  affected,  though  it 
generally  or  often  was." — Henderson's  Homaopathy  fairly  Sepreeented, 
p.  148. 


606  Hindoo  Medicine^ 

the  7th,  9th,  11th,  14th,  18th,  and  22nd  were  esteemed  to 
be  such  in  a  large  class  of  diseases.      Some  Hindoo  physi- 
cians,  on  the    other   hand,  anticipating   Brown,   class  all 
diseases   into    the    sthenic    and   the     asthenic    varieties, 
treating  the  latter  with  stimulants  (among  which,  for  some 
reason  best  known  to  themselves,  they  reckon  purgatives), 
and  the  former  with  cooling  remedies.     It  would  be  im- 
possible here  to  describe,  even  in  the  most  cursory  manner, 
the  mode  of  treatment  adopted  in  the  various  classes  and 
subclasses  of  disease  enumerated  by  Hindoo  nosologists,  of 
the  number  of  which  the  reader  may  form  some  conception 
when  he  is  informed  that  Dr.  Wise  gives  us  11  principal 
classes,  of  which  the  second  has  15   orders  and  160  sub- 
orders and  varieties,  and  that  there  are  no  fewer  than  76 
diseases  of  the  eye,  81  diseases  of  the  nose,  28  diseases  of 
the  ear,  and  65  diseases  of  the  mouth.     Class  1  includes 
all  '*  diseases  of  the  humours,'^  strictly  so  called,  by  which 
seem  to  be  meant  chronic  nervous  (air),  pyrexic  (bile),  and 
catarrhal   (phlegm)   diseases.      Class  II  includes  all  acute 
diseases  affecting  the  general  system,  among  which  obesity 
and  emaciation  are  most  absurdly  placed.     Classes  III  to  X 
include  local   diseases,   among  which  are  reckoned  mental 
affections,  as  insanity,  &c. ;  and  Class  XI  comprises  trivial 
diseases,  such  as  warts  and  baldness.     It  is  obvious  that 
all  the  purposes  of   this   clumsy   classification    would    be 
served  by  a  simple  arrangement  into  chronic  (=  Class  I) 
and  acute  (=  Classes  II   to  X) ;  the  latter  being   again 
subdivided  into  general  (=  Class  II)  and  local  {=.  Classes 
III    to    X).       Class    XI    would    have  to    be    distributed 
in  part  to  the   chronic  and  the   remainder  to   the    acute 
sections.*       Then,    to  complete    the    Hindoo    nosological 
scheme,  all  that  would  be  necessary  would  be  further  to 
subdivide  each  member  of  every  class  into  three  sections, 
according  as  the  air,  phlegm,  or  bile  was  supposed  to  be 
the  peccant  element. 

The  Hindoos  advocated  fasting  during  the  first  few  days 
of  a  fever — a  practice  afterwards  followed  by  Asclepiades  at 

*  Ciais  I  would,  uf  course,  alao  require  to  be  subdivided  into  general  and 
locaL 


by  Dr.  W.  B.  A.  Scott.  607 

Rome.  They  were  beforehand  with  Sydenham  in  pre- 
scribing the  "  cool "  regimen  in  cases  of  smallpox^  a  disease 
with  which  they  as  well  as  the  Chinese  were  familiar 
many  centuries  before  it  was  first  brought  before  the  notice 
of  European  physicians  by  Bhazes.  A  nutritious  diet 
abounding  in  oleaginous  principles  is  prescribed  for  phthisis^ 
in  the  treatment  of  which  disease  we  find  no  mention  made 
of  bloodlettings  scions^  blisters,  and  the  like  allopathic 
abominations.  Cholera  is  to  be  treated  with  emetics  and 
purgatives ;  in  acute  dysentery  the  physician  is  forbidden  to 
stop  the  stools  by  astringents,  as  this  will  prodtAce  dyspepsia, 
piles,  and  tympanitis,  and  one  of  the  drugs  recommended  is 
a  salt  of  antimony,  which  is  also  recommended  as  an 
external  application  in  ophthalmia.  Emetics  are  to  be 
given  for  diseases  of  the  chesty  sickness^  and  ptyalism. 
Most  of  the  medicines,  which  are  chiefly  valuable  in  the 
treatment  of  these  disorders  (as  Ipecacuanha  and  Tartarated 
antimony)  are  of  this  character,  as  shown  by  homoeopathic 
provings.  Purgatives  are  to  be  avoided  when  there  are 
sores  on  the  body,  in  lung  diseases,  in  infancy  and  old  age, 
but  are  useful  in  piles^  colic,  and,  as  we  have  seen  above,  in 
cholera.  For  further  illustrations  of  homoeopathy  in 
Hindoo  practice  I  must  refer  the  reader  back  to  the  section 
on  Materia  Medica,  at  p.  597. 

Gynecology,  embryology,  and  infantile  diseases. — Accord- 
ing to  the  Hindoo  theory  of  generation,  the  menses  of  the 
female  receive  the  semen  of  the  male,  and  thereby  germin- 
ate, producing  the  embryo.  It  was  supposed  that  concep- 
tion could  only  take  place  during  seventeen  days  in  each 
mouthy  i.e.,  during  the  three  days  of  menstruation  and 
the  week  immediately  preceding  and  following  it.  The  nor- 
mal period  for  the  change  of  life  is  fixed  at  the  fiftieth  year^ 
and  the  duration  of  pregnancy  is  stated  at  from  nine  to 
twelve  months.  If  conception  occurs  on  an  even  day  of  the 
menses  the  offspring  will  be  a  male.  The  signs  of  preg- 
nancy are  described  with  great  accuracy,  and  much  regard 
was  paid  to  the  gratification  of  the  '^  longings  ^^  so  common 
during  that  period.  It  was  also  believed  that  the  character 
of  the  child  is  materially  influenced  by  the  nature  of  the 


60d  Hindoo  Medicine, 

objects  beheld  by  the  mother  at  the  moment  of  conception 
and  during  gestation.  The  foetus  was  supposed  to  be 
endowed  with  understandings  and  to  have  all  the  bodily 
members  perfectly  formed  by  the  end  of  the  sixth  months 
but  it  was  held  that  a  child  born  at  the  eighth  month  must 
necessarily  die — a  doctrine  also  taught  by  Hippocrates. 
While  in  the  uterus^  it  was  thought  that  the  child  retained 
the  recollection  of  previous  states  of  existence^  and  the 
infant's  birth-cry  was  accounted  for  on  the  supposition  that 
it  arose  from  regret  at  the  loss  of  so  many  happy  memories 
which  passed  away  suddenly  at  the  moment  of  birth.  Par- 
turition was  supposed  to  be  effected  by  means  of  pressure  of 
air  contained  in  the  uterus.  The  nails,  bones,  hairs,  teeth^ 
vessels,  ligaments,  &c.,  of  the  foetus  were  supposed  to  be 
produced  from  the  semen^  and  the  flesh,  fat,  intestines, 
blood,  liver,  spleen,  &c.,  from  the  maternal  blood.^ 

During  labour  the  woman  is  to  be  attended  by  four  per- 
sons of  her  own  sex,  and  to  lie  on  her  back  with  the  thighs 
separated  and  legs  bent,  on  a  ^  soft  bed,  in  a  room  with  a 
white,  red,  yellow,  or  black  floor  according  to  the  purity  of 
her  caste.  She  is  to  be  surrounded  with  male  children,  to 
hold  flowers  in  her  hand,  to  be  anointed,  and  take  a  warm 
bath,  and  to  drink  large  quantities  of  sour  gruel  which  was 
supposed  to  aid  the  expulsion  of  the  child  in  virtue  of  its  own 
weight.  Malpresentations  are  to  be  rectified  by  manual 
interference.  If  the  child  be  dead  and  cannot  be  otherwise 
removed,  craniotomy  may  be  performed,  or  the  body  may 
even  be  removed  piecemeal.  Recourse  is  occasionally  had 
to  the  Csesarian  section,  but  I  cannot  discover  the  antiquity 
of  this  operation  among  the  Hindoos.  If  the  afterbirth 
does  not  come  away  within  a  reasonable  time,  the  mother 
is  to  take  an  emetic,  or  loathsome  substances  are  to  be  ad- 
ministered, so  as  to  create  a  feeling  of  disgust. 

Immediately   after  the  birth  of  the  child  a  little  ghee 
(melted   butter)   and  salt  are  to  be  put  into  its  mouth,  a 

*  This  distinction  between  parts  supposed  to  be  formed  from  the  semen  and 
those  supposed  to  be  formed  from  the  maternal  blood  is  strongly  instated  upon 
by  Galen,  who  tanght  that  the  latter  are  regenerable  and  the  former  nnre- 
generable. 


by  Dr.  W.  B.  A.  ScoiL  609 

practice  not  very  unlike  that  which  prevails  among  the 
lower  classes  in  England  at  this  day.  The  cord  is  to  be 
tied  at  a  distance  of  eight  finger-breadths  from  the  navel, 
and  the  infant  is  then  to  be  bathed  and  anointed.  The 
mother  is  not  to  nurse  her  child  till  the  fourth  day,  and 
most  judicious  directions  are  given  as  to  the  selection  of  a 
wet  nurse,  due  regard  being  paid  to  her  moral  no  less  than 
to  her  physical  qualifications. 

Most  infantile  diseases  are  attributed  to  constipation,  and 
accordingly  the  child  is  to  take  an  aperient  mixture  once  a 
month  to  keep  the  bowels  clear  and  to  prevent  attacks  of 
diarrhcea;  but  few,  if  any,  other  medicines  seem  to  be 
allowed  before  the  fifth  year.  The  chief  other  ills  to  which 
infant  flesh  is  heir  are  supposed  to  be  marasmus,  erysipelas, 
and  possession  by  nine  kinds  of  devils. 

The  above  r69um6  of  the  leading  doctrines  of  Hindoo 
medicine,  imperfect  as  it  is,  has  extended  to  a  much  greater 
length  than  I  had  anticipated,  and  it  now  becomes  neces- 
sary to  draw  it  to  a  close.  I  shall  be  very  glad  if  it  may 
induce  any  one  who  has  not  yet  read  Dr.  Wise's  work  on 
this  subject  (which  has  formed  the  basis  of  my  remarks)  to 
set  about  the  perusal  of  it,  feeliug  confident  that  he  will 
be  well  rewarded  for  his  pains.  As  the  accomplished 
author  was  unfortunately  unable  himself  to  superintend  the 
correction  of  the  press,  numerous  clerical  errors  occur  on 
nearly  every  page,  and  he  himself  tells  us  that  in  some 
cases  modern  doctrines  have  been  referred  to  as  forming 
part  of  the  classical  Hindoo  science  and  art  of  medicine. 
Perhaps,  also,  exception  may  be  taken  to  one  or  two  more 
general  statements  of  a  chronological  nature,  and  the  literary 
style  is  deficient  in  point  of  that  ease  and  fluency  which  the 
author's  final  revision  and  corrections  would  doubtless  have 
imparted,  had  he  not  been  prevented  submitting  his  work 
to  such  scrutiny.  But,  notwithstanding  these  blemishes,, 
the  book  is  highly  useful  and  instructive,  and  must  have 
cost  the  writer  much  labour  and  inquiry.  And  relating  as 
it  does  to  the  very  earliest  form  in  which  the  science  of 
medicine  was  presented  to  mankind,  and  that  from  which 
all  European  schools  of  physic  are  descended,  the  subject 

VOL.  XXXII,  NO.  CZZX.— OCTOBSa,  1874.  QQ 


610  Cases  of  Zinc  Poisoning, 

cannot  fail  to  interest  those  who  have  been  taught  to  regard 
this  kind  of  antiquarian  research  not  as  the  mere  pastime 
of  learned  leisure^  but  as  throwing  light  upon  much  that 
concerns  us  all  in  the  practical  work  of  our  daily  lives,  and 
conferring  unity  upon  much  that  at  first  sight  appears 
dissonant  and  heterogeneous;  not  as  mere  d^;ing  in  a 
barren  waste  for  the  perishing  records  of  the  past,  but 
rather  as  cultivating  a  fertile  field  richly  charged  with  the 
sown  seed  of  the  future. 


CASES  OF  ZINC  POISONING. 

By    J.    W.    VON    TUNZELMANN^  M.D. 

A  Sequel  io  Cases  of  Lead  Poisoning  from  Well-water,  which 
were  reported  in  the  January  number  of  this  Journal, 

Having  recently  given  an  account  of  some  cases  of  lead 
poisoning  which  occurred  at  Wimbledon  last  summer,  and 
which  were  traced  to  contamination  of  well-water  with  lead, 
from  the  action  of  the  water  on  the  leaden  pipe  by  which 
it  was  drawn  from  the  well  (owing  to  the  peculiar  condition 
of  the  water,  which  consisted,  briefly,  in  the  absence  of  car- 
bonate of  lime  and  the  presence  of  traces  of  nitrous  and 
nitric  acid  and  ammonia),  I  have  now  to  relate  the  inju- 
rious consequences  which  arose  in  one  family  (that  in  which 
Cases  1  and  3,  there  related,  occurred)  from  drinking  the 
water  of  the  well  after  a  pipe  of  galvanized  iron  (i.e.  zinked 
iron)  had  been  put  into  it  in  the  place  of  the  leaden  one. 

1. — ^The  young  lady  who  had  suffered  from  diplopia  (Case 
1,  above  related)  remained  quite  free  from  her  trouble,  after 
returning  from  a  stay  of  two  months  at  the  Lakes,  for  about 
three  months,  when  suddenly,  in  February  this  year,  after 
having  for  two  days  sufi*ered  from  a  feeling  of  languor  with 
aching  in  the  lumbar  region,  the  diplopia  returned.  On 
being  sent  for  I   tested  the  water  which  the  family  were 


by  Dr,  J.  fV,  van  Tunzelmann,  611 

drinking^  but  could  not  detect  lead  in  it.  A  specimen  was 
then  sent  to  Dr.  Frankland^  and  he  reported  that  it  was 
virtually  free  from  lead^  the  quantity  being  so  small  that  it 
could  not  be  weighed.  Subsequently  it  was  found  to  con- 
tain '58  grains  of  zinc  per  gallon^  the  presence  of  zinc 
having  been  suspected^  and  attention  drawn  to  it  further 
by  a  discovery  made  by  the  young  lady^s  mother,  on'inspect- 
ing  the  filter  one  day,  of  a  scum  on  the  water  in  the  upper 
chamber  of  the  filter ;  this  she  removed  and  brought  to  me ; 
it  had  a  metallic  lustre,  and  as  it  promised  to  explain  the 
state  of  things  I  requested  that  it  should  be  sent  to  Dr. 
Frankland  to  be  examined.  He  reported  that  it  was  car* 
bonate  of  zinc^  and  that  the  water  was,  in  consequence, 
extremely  dangerous.  The  use  of  the  water  was,  of  course, 
immediately  stopped.  An  oculist  was  consulted,  who  gave 
his  opinion  that  the  diplopia  was  owing  to  paralysis  of  the 
sixth  pair  of  nerves,  the  left  being  more  affected  than  the 
right. 

The  diplopia  increased  and  decided  strabismus  became 
developed,  which  was  not  the  case  when  the  patient  suffered 
from  the  effects  of  lead,  to  which  the  previous  occurrence  of 
diplopia  was  due.  The  left  eye  was  more  affected  than  the 
right,  in  consequence  of  which  a  pair  of  spectacles  was  re- 
commended having  a  dark  plate  opposite  the  left  eye.  This 
was  grateful  to  the  patient,  as  it  prevented  double  vision. 

This  patient  complained  also  of  pain  in  the  back  (lumbar 
region),  and  the  urine  was  dark  and  turbid,  which  was  un- 
usual with  her,  though  she  had  suffered  in  the.  same  way 
when  under  the  influence  of  lead  last  summer. 

Change  of  air,  first  to  the  country  and  then  to  Brighton, 
caused  a  steady  but  very  gradual  improvement,  and  by  the  be- 
ginning of  June  the  strabismus  had  so  much  diminished  as  to 
be  scarcely  perceptible.  After  that  the  young  lady  went  to 
Scotland  on  a  yachting  expedition  of  about  a  month,  and 
returned  without  wearing  her  spectacles,  the  diplopia  having 
quite  left  her,  and  a  slight  amount  of  stiffness  in  the  move- 
ments of  the  eyes  only  remained.  Other  members  of  the 
family  havci  suffered  also; 

2*-*A  younger  sister,  who  two  years  ago  had  suffered 


612  Cmbs  of  Zinc  Paiaaning, 

seyerely  from  rachialgia  running  into  what  appeared  to  be 
incipient  paraplegia,  which  improved  (thongh  only  alowly), 
on  removal  to  Brighton,  under  Homoeopathic  treatment  (it 
took  about  a  year  to  subaide),  and  was,  I  have  no  doubt, 
owing  to  the  continual  influence  of  lead  in  the  water,  and 
arsenic  in  the  paper  of  the  dining  room  (a  dark  green  flock 
paper,  which  on  analysis  was  found  to  contain  arsenic  in 
considerable  quantity),  began  to  suffer  at  the  end  of  Decem- 
ber last  year  {i.e.  about  six  weeks  after  the  return  of  the 
family  from  the  Lakes)  from  a  return  of  rachialgia  in  an 
aggravated  form,  so  that  she  was  confined  to  her  bed  for 
about  a  month  on  account  of  the  exhaustion  produced  by 
want  of  sleep  and  almost  total  anorexia ;  there  was  also  a 
good  deal  of  photophobia  (without  pyrexia).  She  improved 
gradually  under  Cimicifuga  1  and  8,  chiefly,  so  as  to  be 
able  to  take  carriage  exercise  (the  water  being  taken  all  the 
time,  not  having  then  been  suspected).  She  subsequently 
went  away  for  a  change ;  first  to  St.  John's  Wood  and  then 
to  Brighton ;  returning  in  the  beginning  of  June  quite  well, 
sleeping  well,  eating  well,  and  able  to  be  about  all  day. 
This  improvement  has  continued. 

8. — The  mother  of  these  two  young  ladies  has  been  suSer- 
ing  almost  the  whole  time  since  their  return  from  the  North 
from  pain  in  the  lumbar  region  of  the  spine,  as  well  as  in 
the  region  of  both  kidneys,  and  latterly  also  from  giddiness 
and  anorexia,  with  nausea  and  vomiting  occasionally,  also  a 
good  deal  of  griping  pain  at  times  in  the  abdomen,  with 
tendency  to  diarrhoea.  The  urine,  which  was  dark  and 
somewhat  turbid,  deposited  a  large  sediment,  composed  of 
urate  of  ammonia,  with  a  few  crystals  of  oxalate  of  lime  and 
a  few  cells  of  renal  epithelium ;  at  times  a  pellicle  formed  on 
its  surface  after  standing  {Carbonate  of  Zinc  ?).  A  specimen 
was  examined  on  April  25th ;  colour  rather  dark  amber, 
somewhat  turbid,  but  comes  clear  on  boiling;  odour  after 
standing  from  the  previous  evening  (in  a  corked  bottle) 
sickening  and  whey-like,  causing  a  suspicion  of  the  presence 
of  sugar ;  reaction  acid,  sp.  gr.  1028,  no  albumen ;  sugar 
distinctly  present,  though  in  small  quantity,  by  Moore's  and 
Trommer's  tests  ;  deposit,  on  standing  two  hours^  about  one 


by  Dr,  J.  IV.  von  Tunzelmann,  618 

fifth ;  composition  on  microscopic    examination,   as    above 
stated. 

This  lady  improved  steadily  under  Lachesis  6  and  Nux 
vom.  8,  which  relieved  the  giddiness ;  and  subsequently 
Phoaph,  add  \,  five  drops  four  times  a  day^  which  removed 
the  anorexia,  and  greatly  diminished  the  renal  distress  in 
about  three  weeks.  She  has  continued  to  improve  since  then, 
and  is  only  reminded  of  her  former  trouble  by  a  tendency 
to  pain  in  the  back. 

Remarks. — The  distinct  development  of  strabismus^  in 
Case  1,  is  of  interest  in  connexion  with  the  benefit  derived 
from  Zinc  in  infantile  convulsions,  according  to  Drs.  Teste 
and  Madden  (see  Hughes'  Pharmacodynamics^  second 
edition) ;  and  as  the  strabismus  of  delicate  children,  often 
the  only  distinct  ailment,  is  one  of  the  bugbears  of  medical 
practice,  even  under  Homoeopathic  treatment,  it  may  be 
found  of  value  in  this  afiection. 

The  severe  and  constant  rachialgia  of  Case  2,  so  severe 
as  to  cause  almost  total  sleeplessness  at  night,  followed  by 
heaviness  in  the  morning,  and  photophobia  (without  fever) 
during  the  day^  and  also  almost  complete  anorexia,  allies 
itself  to  the  severe  cephalagia,  which  is  a  well-known  patho- 
genetic effect  of  ZinCy  and  which  has  been  frequently  re- 
lieved by  it.  Aching  in  the  spine  with  sleeplessness  is  so 
often  a  prominent  cause  of  distress  in  hysterical  ailments, 
that  Zinc  promises  to  be  of  use  in  this  condition. 

The  presence  of  sugar  in  the  urine,  in  Case  8,  is  of  interest, 
and  though  at  present  (at  least  to  my  knowledge)  a  solitary 
instance  of  its  production  by  Zinc  in  small  but  continued 
doses,  it  may  add  another  remedy  to  our  list  for  treating 
diabetes. 

Dr.  Frankland  has  informed  me  that  the  water  of  Loch 
Katrine  has  just  been  found  to  act  on  galvanized  iron  in 
the  same  manner  as  the  water  of  the  well  in  question. 


614  Hdlmemafin*8  Pathogenesis  of  Ferrum. 


HAHNEMANN'S  PATHOGENESIS  OF  FERRUM. 

[Dr.  Cooper's  paper  in  our  last  number  has  again  drawn 
attention  to  the  dynamic  actions  of  Iron,  as  distinct  from 
those  uses  of  it  which  are  classed  as  '*  chalybeate/'  For 
the  foundation  of  the  former  we  should  naturally  look  to 
Hahnemann's  proving;  but  for  English  readers  this  is 
practically  non-existent,  having  been  omitted  (we  suppose 
from  accident)  by  Dr.  Hem  pel  in  his  translation.  It  has 
therefore  been  thought  well  to  present  the  following 
renderings  which  is  made  from  the  second  volume  of  the 
third  edition  of  the  Reine  Arzneimittellehre. 

Hahnemann  has  been  unusually  communicative  in  this 
instance  as  to  the  authors  he  has  cited.  To  Ritier,  to 
Schmidtmuller,  to  Zacchiroli,  and  to  Scherer,  he  has 
appended  notes,  on  the  first  appearance  of  their  names, 
specifying  the  dose  and  preparation  of  Iron  with  which  the 
symptoms  were  obtained.  The  first  and  last  of  these  we 
have  been  able  to  consult,  and  have  annotated  their  obser- 
vations when  necessary,  embodying  the  imformation  afforded 
by  the  originals.  Of  the  other  authors  cited,  we  have  not 
been  able  to  obtain  the  work  of  Nebel  and  Wepfer ;  Harcke^s 
contributions  to  vol.  xxv  of  HvfelantPs  Journal  have  no 
mention  of  Iron,  and  we  cannot  find  LentMs  two  symptoms, 
at  p.  75  of  his  Beitrdge,  though  he  is  there  speaking  of  the 
use  of  chalybeate  baths  in  various  diseases.] 


Iron,  Ferrum. 

We  take  soft  iron  filings,  reduce  them  to  a  powder  by 
triturating  them  sufficiently  in  a  cast-iron  mortar,  sift 
through  linen,  and  of  the  dust-like  powder  so  obtained 
(called  in  the  Pharmacopoeias  Ferrum  pulveratum)  we  take 
one  grain,  which,  as  directed  in  the  case  of  Arsenic,  we 
bring  by  means  of  trituration  for  three  hours  with  milk- 
sugar  to  the  millionth  or  third  potency,  and  then  by  means 
of  27  dilution  bottles  to  the  thirtieth  potency. 


Hahnemann's  Pathogenesis  of  Ferrum.  615 

Although  most  of  the  following  medicinal  symptoms  were 
observed  from  the  employment  of  a  solution  of  acetate  of 
iron,  there  is  no  doubt  that  they  will  as  surely  correspond 
essentially  with  those  of  metallic  iron  as  do  the  symptoms 
of  dry  carbonate  of  lime  with  those  of  acetate  of  lime. 

By  ordinary  physicians  this  metal  is  held  to  be  an 
intrinsically  strengthening  drug  and  not  only  innocuous^  but 
completely  and  absolutely  wholesome. 

How  far  from  true  is  this  allegation,  made  originally 
without  consideration  and  without  experimental  proof,  and 
repeated  by  teachers  to  their  disciples  likewise  without  con- 
sideration and  proof,  is  shown  by  the  observation  that,  if 
Iron  possesses  medicinal  power,  it  must  effect  an  alteration 
in  the  health  of  man,  consequently  also  of  the  healthy  man 
and  make  him  ill ;  and  the  more  ill,  the  more  curative  it  is 
found  to  be  in  diseases. 

Nil  prodest,  quod  non  laedere  possit  idem. 

The  very  condition  of  health  in  persons  living  beside 
ferruginous  waters  might  have  taught  them  what  powerful 
disease-producing  properties  this  metal  possesses.  The 
residents  in  the  neighbourhood  of  ferruginous  baths,*  where 
all  the  waters  of  the  vicinity  usually  contain  some  of  this 
metal,  display  palpable  signs  of  its  morbific  influence  on 
themselves. 

In  such  places  there  are  few  persons  who  from  their 
peculiar  nature  can  resist  the  injurious  effects  of  the 
continued  use  of  such  water  and  remain  in  health.  We  find 
there  more  than  almost  anywhere  else  chronic  diseases  of 
great  importance  and  peculiar  description,  even  among  those 
whose  mode  of  life  is  otherwise  unexceptionable.  Debility 
of  the  whole  body  and  of  particular  parts  amounting  almost 

*  It  is  pare  charlatanry  to  call  iron  solntions  Heel  drops,  and  ferruginons 
mineral  waters  Ueel  waters  and  steel  haths.  These  waters  are  said  to  exercise 
indnhitably  an  absolute  high  degree  of  strengthening  power;  for  to  tteel  is  a 
metaphorical  expression  for  to  strengthen.  Bat  iron  is  only  converted  into 
steel  when  its  peculiar  elasticity  and  hardness  arc  developed.  When  dissolved 
in  acids  the  steel  disappears ;  the  solution  then  contains  merely  a  substratum 
of  iron,  and  the  oxide  (iron  ochre)  when  melted  produces  nothing  but  ordinary 
iron. 


616  Hahnemann  8  Pathogenesis  of  Femtm. 

to  paralysis^  certain  kinds  of  violent  articular  pains,  abdo- 
minal ailments  of  various  sorts,  vomiting  of  food  by  day 
and  by  night,  phthisical  pulmonary  affections  often  with 
hsemoptysisj  defective  vital  heat,  suppressed  catamenia, 
premature  births,  impotence  of  both  sexes,  sterility,  jaun- 
dices, and  many  other  rare  cachexias  are  common  occur- 
rences in  such  situations. 

Where  then  is  the  pretended  complete  innocuousness  or 
even  the  absolute  wholesomeness  of  this  metal  ?  Most  of 
those  who  drink  constantly  the  ferruginous  springs,  called 
health  springs,  and  other  iron-impregnated  waters  of  the 
neighbourhood  are  unhealthy  ! 

What  prejudice,  what  inattention,  has  hitherto  prevented 
our  medical  practitioners  noticing  these  striking  facts  and 
referring  them  to  their  cause,  the  morbific  properties  of 
Iron  ? 

Without  knowing  the  effects  of  Iron  and  its  solutions, 
how  can  they  determine  in  what  cases  ferruginous  baths 
can  be  of  use  ?  Which  among  their  patients  will  they 
send  to  be  treated  there  ?  Which  advise  not  to  go  ?  When 
they  know  nothing  accurately  of  the  peculiar  effects  of  this 
metal  on  the  human  body,  what  have  they  to  guide  them  in 
prescribing  iron  waters  for  their  patients  7  Blind  caprice  ? 
Guessing  f  Fashion  T  Do  not  many  of  their  patients  return 
from  the  baths  in  a  much  worse  state  of  health,*  proving 
that  for  them  Iron  was  the  wrong  medicine  ?  God  pre- 
serve all  patients  from  a  doctor  who  knows  not  why  he 
prescribes  this  or  that  medicine,  who  has  not  convincing 
reasons  for  his  prescription,  who  does  not  know  h^ore- 
hand  what  medicine  will  do  good,  what  will  do  harm  to  the 
patient  I 

*  To  attempt  to  atrei^hen  simply,  an  is  done  in  ordinaiy  practice,  is  a  great 
mistake.  Why  is  tbe  patient  so  weak  ?  Evidently  because  he  is  iU !  The 
weakness  is  a  simple  consequence  and  a  mere  symptom  of  his  illness.  What 
sensible  person  would  think  of  strengthening  a  patient  without  having  first 
removed  his  disease  ?  But  if  his  disease  be  removed  he  has  aUoe^s,  even 
during  the  disappearance  of  the  disease,  been  recovering  his  strength  of  him- 
self  by  means  of  the  energy  of  the  organism  when  free  from  its  malady.  There 
is  not  and  there  cannot  be  a  strengthening  remedy  while  the  disease  lasts.  The 
Homosopathic  physician^only  knows  how  to  cure,  and  while  being  cored  the 
convalescent  regains  his  strength. 


Hahnemann's  Pathogenesis  of  Ferrum.  617 

It  is  only  by  having  regard  to  the  peculiar  primary  effects 
of  drugs^  and  observing  whether  these  have  a  great  resem- 
blance to  the  symptoms  of  the  disease  to  be  cured  (as 
Homoeopathy  teaches),  that  those  disastrous  mistakes  can 
be  avoided. 

The  following  list  of  morbid  symptoms  which  Iron  is 
capable  of  producing  is  by  no  means  so  complete  as  it 
might  be;  still  it  may  tend  not  a  little  to  prevent  such 
mistakes  by  those  who  will  cease  to  administer  drugs 
blindly  to  patients^  unscrupulously  watching  whether  they 
draw  a  life  or  death  ticket  in  the  lottery. 

Large  doses  of  Iron  frequently  repeated,  as  also  a  number 
of  baths  in  a  ferruginous  water,  have  a  very  long  duration 
of  action  for  months.  Even  doses  of  the  30th  potency  ('^'), 
such  as  the  Homoeopathic  practitioner  now  gives  in  the  most 
ordinary  cases^  act  for  not  a  few  days. 

Chronic  alterations  of  the  health  caused  by  Iron  are 
relieved  in  great  measure  by  Hepar  sulphuris  (i^th,  T?^th 
of  a  grain  in  one  or  two  doses),  and  most  of  the  remaining 
ailments  by  Pulsatilla,  unless  the  symptoms  (as  some- 
times happen)  are  of  such  a  kind  and  connexion  as  to 
lead  to  the  selection  of  another  medicine,  according  to  the 
principles  of  similarity. 

The  abbreviations  of  the  names  of  my  co-operators  in 
the  proving  are  as  follows :  Rosazewsky  (Bszsky.),  Gross 
(Gss.),  Pr.  Hahnemann  (Fr.  H — n.). 


Iron. 


Confusion  and  stupefaction  of  the  head  (Ritter,*  in 
Huf eland* s  Jour,  xxvi,  1). 

On  lying  down,  vertigo  as  if  he  were  shoved  forwards, 
or  were  driving  in  a  coach  (especially  on  shutting  the  eyes). 

Vertigo  on  descending,  as  if  she  would  fall  forwards. 

Whilst  walking  so  giddy  and  as  if  drunk,  as  though  she 
would  tumble  down. 

*  ObseryatiooB  referring  to  the  waters  of  Pyrmont  and  Scbwalbach,  where 
the  carboniu  acid  mnst  also  have  had  some  effect. 


618  Hahnemann*$  Pathoifenesis  of  Ferrum. 

5.  Whilst  walking  so  whirly  and  sick ;  it  is  as  though 
the  head  would  always  hang  to  the  right  side. 

On  seeing  running  water  she  became  dizzy  and  giddy  in 
the  head^  as  if  all  went  round  with  her. 

Great  congestion  towards  the  head. 

Intoxication  (Ritter^  1.  c.*). 

Undulating  headache  like  waves^  for  an  hour  (aft.  half 
an  hour),  (Emil  Rszsky.). 

10.  Drawing  headache  (Rszsky.). 

A  rush  of  blood  to  the  head ;  the  blood-vessels  on  the 
head  were  swollen  for  two  hours,  with  somewhat  Qjing 
heat  in  the  face. 

A  momentary  giddy  blow  in  the  brain  (immediately). 

The  cool  open  air  gives  her  a  peculiar  pressure  on  the 
top  of  the  head,  which  went  off  gradually  in  the  room. 

Indisposition  to  think  and  confusion  of  head. 

15.  Every  evening  headache,  dulness  over  the  root  of  the 
nose. 

In  the  morning  very  dull  in  the  head. 

Headache  as  if  the  brain  were  torn  (also  in  the  morning 
during  slumber  before  awaking). 

Emptiness  of  head. 

The  head  is  dull  and  stupid. 

20.  Head  empty  and  stupid. 

Heaviness  of  head. 

(Aching  headache  in  forehead  as  if  it  would  burst.) 

A  cutting  shooting  in  forehead. 

Violent  shooting  headache  in  left  side,  in  the  afternoon, 
for  five  hours. 

25.  (Every  two  or  three  weeks,  headache  for  two,  three, 
or  four  days,  hammering  and  beating  so  that  she  must  some- 
times lie  down  in  bed  ;  then  disgust  to  eating  and 
drinking.) 

Falling  out  of  the  hair,  whereby  the  scalp  is  painful  with 
formication. 

A  drawing  from  the  nape  upwards  into  the  head,  in 
which  there  is  then  shooting,  roaring,  and  humming. 

In  the  evening  it  was  dark  before  his  eyes;  he  got  an 

*  [Not  foand.— ^VomZ.] 


Hahnemann's  PathogenesU  c/  Ferrum.  619 

aching  pain  over  the  orbits^  and  some  blood  dropped  out  of 
his  nose. 

Pain  externally  in  the  head^  as  if  blood  were  extravasated ; 
the  hairs  are  painful  when  touched. 

80.  Cadaverous,  also  blpe  spotted  countenance. 

Cadayerous  jaundiced  complexion. 

Paleness  of  face  and  lips  (Ritter,  1.  c.*). 

In  the  evening  itching  in  eyes^  and  aching  as  from  a  grain 
of  sand  in  them. 

For  five  days,  red  eyes  with  burning  pains  (aft.  three 
hours). 

35.  Burning  in  eyes. 

Eyes  are  painful^  as  if  he  were  very  sleepy  and  they 
would  shut  up ;  also  burning  in  them. 

An  aching  in  right  eye ;  eyelids  stick  together  in  the 
night. 

If  he  writes  for  only  a  couple  of  hours,  he  cannot  open 
his  eyes  wide ;  they  become  so  watery  as  if  he  had  not 
slept  enough. 

Redness  and  swelling  of  upper  and  lower  lids ;  on  upper 
a  kind  of  stye  filled  with  pus ;  the  lower  lids  are  full  of 
muco-purulent  matter. 

40.   (Shooting  in  left  eye.) 

Pupils  capable  of  only  slight  dilatation. 

In  the  morning  on  stooping  some  bleeding  from  nose. 

Bleeding  from  left  nostril  (four  times  in  ten  hours). 

Soreness  of  left  external  ear,  as  if  there  were  an  ulcer  on 
it  (aft.  twelve  hours). 

45.  Shoots  in  right  ear,  in  the  morning  (aft.  twelve 
hours). 

Humming  in  ears,  which,  as  well  as  the  disagreeable 
feeling  in  the  brain,  is  relieved  by  laying  the  head  on  the 
table. 

Chirping  before  the  ears,  like  crickets. 

Pale  lips. 

At  the  back  and  in  the  centre  of  the  tongue  a  constant 
soreness,  like  fine  uninterrupted  stitches,  aggravated  by  the 

*  [Effect  of  uterine  hiemorrhage  indaced  by  Iron,  not  of  the  metal  itself. 
CJom.  8.  289.— 2Va«#/.] 


630  Hahnemann's  Pathogenesis  of  Ferrum, 

contact  of  food  and  drink.  When  not  eating  and  drinking 
the  part  feels  as  if  it  bad  been  burnt  and  were  numb. 

50.   (Swelling  of  gums  and  cheeks.) 

(Raw  and  sore  throaty  with  hoarseness.) 

(On  coughing  an  aching  with  sore  sensation  in  the 
gullet,  as  when  a  skin  blister  is  burst  and  the  place  thus 
made  sore.) 

(Sometime^  a  sensation  like  a  plug  in  the  throat ;  not 
when  swallowing,  but  when  not  swallowing.) 

On  swallowing,  aching  pain  in  throat  with  heat  in  fauces ; 
the  cervical  muscles  are  as  if  stiff  and  painful  on  movement. 

55.  Feeling  of  constriction  in  throat. 

Chronic  glandular  swelling  on  the  neck. 

Great  nausea  in  the  throat,  as  if  vomiting  must  ensue ; 
it  ends  with  eructation  (Gss.). 

As  soon  as  she  eats  anything  it  is  thrown  up  again. 

Vomiting  of  food  only  immediately  after  eating  (for  eight 
days). 

60.  When  she  eats  anything  she  has  heaving  like  the 
nausea  of  disgust. 

The  vomiting  is  worst  before  midnight  when  she  is 
lying,  and  especially  when  she  lies  on  the  side. 

Vomiting  of  food,  immediately  after  midnight,  followed 
by  dislike  to  food  and  repugnance  to  open  air  (aft.  six 
hours). 

She  vomits  every  morning  and  after  eating,  only  mucus 
and  water  (no  food) ;  a  sort  of  waterbrash ;  the  water  runs 
out  of  her  mouthy  and  her  throat  feels  drawn  together. 

She  has  always  disgust  and  nausea. 

65.  Inclination  to  vomit  for  three  hours. 

Everything  she  vomits  is  sour  and  acrid. 

On  taking  acids  and  beer  she  vomits  much. 

After  sourish  beer  (in  the  evening)  heartburn. 

Beer  gets  into  her  head. 

70.  After  beer-soup,  heat  and  anxiety. 

Anorexia,  without  bad  taste  or  thirst. 

(She  became  pale,  had  rumbling  in  the  bowels,  the  chest 
was  contracted,  congestion  to  the  head;  she  was  affected 
with  spasmodic  violent  eructation ;  then  heat  in  face,  partit- 


Hahnemann's  PathogeneM  of  Perrutn.  621 

cularly  the  right  cheeky  and  pain  in  head  on  the  crown,  like 
shooting.) 

Constant  eructation^  as  soon  as  she  has  eaten  anything. 

Little  appetite,  especially  for  meat ;  she  felt  so  fuU. 

75.  He  eats  with  proper  appetite  and  taste  at  noon,  but 
after  eating  there  comes  in  jerks  eructation  and  regurgi- 
tation of  food,  without  nausea  or  inclination  to  vomit. 

After  walking  he  felt  so  full  as  if  he  would  eructate : 
this  goes  off  after  eating. 

Whenever  she  eats  she  has  pressure. 

Pressive,  very  acute  pain  in  stomach  (Schmidtmiiller,* 
in  Horn's  Archiv,  ix,  2). 

Violent  stomach-ache  and  extraordinary  tension  (Zarchi- 
roli,t  in  Kvhn*s  Magazin  fur  ArzneimitteHehre^  1  St., 
Chemnitz,  1794). 

80.  Distension  of  gastric  region  (Schmidtmiiller,  1.  c). 

Spasm  in  stomach  (Nebel  and  Wepfer,  Diss,  de 
Medicamentis  Ckalybeatis,  Heidelb.  1711). 

A  pressure  in  abdomen,  just  below  the  stomach,  as  soon 
as  she  has  eaten  or  drunk  anything. 

After  eating  and  drinking,  violent  stomach-ache. 

Cramp'like  stomach-ache, 

85.   Stomach-ache  from  eating  meat. 

He  can  only  eat  bread  and  butter;  meat  disagrees  with 
him. 

All  solid  foods  taste  so  dry,  as  if  they  contained  neither 
juice  nor  strength ;  they  have,  to  be  sure,  their  natural 
taste,  but  nothing  agreeable :  he  likes  liquid  warm  food 
better. 

He  has  no  appetite,  for  he  always  feels  full ;  but  drinks 
taste  good  to  him,  and  are  taken  with  relish. 

Even  when  she  has  appetite,  she  can  eat  but  little ;  she 
is  immediately  full,  and  the  food  oppresses  her. 

90.  After  dinner  he  has  thirst;  he  knows  not  for 
what. 

Complete  adypsia. 

He  feels  so  full. 

*  From  tbe  finest  pulverized  iron, 
t  From  ft  few  grains  of  iron  filings. 


622  tiahnemann^s  Pathogenesis  of  Fertum. 

(In  the  mornings  sourish  taste  in  the  mouth.) 

Every  thing  she  eats  tastes  bitten 

95.  Sweetish  taste  in  mouthy  as  from  blood  (Bitter^ 
1.  c  *J. 

Sometimes  an  earthy  taste  in  mouth. 

In  the  afternoon  a  putrid  taste  rises  into  his  mouth  that 
takes  away  all  his  appetite. 

When  he  has  slept  for  an  hour  before  midnight,  a  heat 
comes  up  as  if  from  his  abdomen  ;  the  mouth  becomes  dry, 
and  a  bad  vapour  and  putrid  taste  rise  up  into  his  mouth. 

(Burning  in  stomach.) 

100.  Pain  in  scrobiculus  cordis  on  touching  it. 

Some  stitches  in  abdomen. 

Fine  shooting  bellyache. 

A  violent  stitch  in  the  side  under  the  ribs  (aft.  24  hours). 

Still  distended  abdomen,  without  flatulent  sufferings. 

105.  Great  ruinbling  in  abdomen,  day  and  night. 

Hard  distended  abdomen. 

Distension  of  abdomen  (Schmidtmiiller,  1.  c). 

A  quantity  of  flatus  is  discharged  (Lentin,  Beitr.,  p.  75). 

Violent  contractive  pains  in  abdomen  and  back   (Bitter, 

1.  c). 

110.  Colicky  pains  (immediately)  (Bitter,  1.  c). 

(On  feeling  the  abdomen  and  on  coughing  the  bowels  are 
painful  as  if  beaten,  or  as  if  they  had  been  acted  on  by  pur- 
gatives), (aft.  26  hours). 

Especially  when  walking,  painful  weight  of  the  bowels,  as 
if  they  would  fall  down. 

Contractive  spasm  in  rectum,  for  some  minutes. 

Itching  and  erosion  in  rectum,  and  ascarides  are  passed 
in  the  slimy  stool. 

115.  TTie  ascarides  seem  to  increase  by  its  use.  He  can- 
not sleep  at  night  on  account  of  itching  in  the  rectum.  The 
worms  creep  at  night  out  of  his  anus.f 

Obstinate  constipation  (Bitter,  1.  c). 

Constipation  and  haemorrhoids,  which  cause  a  painful 
pressure  when  he  goes  to  stool. 

«  [With  88. 167  and  181.— SVomL] 
t  From  drinking  Pyrmont  Wftter. 


Hahnemann's  Pathogenesis  of  Ferrum.  62d 

Tearing  in  rectum. 

At  every  stool  mucus  and  sometimes  blood  is  passed. 

120.  Protrusion  of  large  haemorrhoids  from  the  anus. 

Violent  hsemorrhoidal  flux  (Bitter,  1.  c). 

Frequent  urging  to  stool,  with  burning  in  anus^  and  pain 
in  back  on  moving. 

Frequent  diarrhoea. 

Diarrhoeic  stool  (Fr.  H — n.). 

125.  Diarrhoea,  with  nervous  spasmodic  pain  in  abdomen, 
back^  and  anus  (Bitter,  1.  c). 

Violent  diarrhoea  (Lentin,  1.  c). 

Frequent  diarrhoeic  stools  (Bitter,  1.  c). 

Strong  purging  (Bitter,  1.  c). 

Involuntary  urination,  especially  by  day. 

180.  Erections  of  penis. 

Erections  of  penis  by  day,  almost  without  cause. 

Nocturnal  emissions. 

(When  urinating,  burning  pain  in  urethra,  as  if  the  urine 
ran  out  hot.) 

(Clap),  mucous  discharge  from  the  urethra  after  a 
chill. 

135.  Leucorrhoea  like  whey,  which  (at  first)  smarted,  and 
made  the  parts  raw. 

A  previously  painless  white  discharge  becomes  painful  as 
if  the  parts  were  raw. 

Before  the  occurrence  of  the  catamenia,  discharge  of  long 
stringy  bits  of  mucus  from  the  uterus  ;  during  which  she 
had  the  sensations  in  the  abdomen  usually  attending  the 
catamenia. 

Pain  in  vagina  during  coition. 

Before  catamenia,  shooting  headache  and  singing  in 
ears. 

140.  In  the  morning  labour-like  pains  in  abdomen,  as  if 
the  catamenia  would  come  on  (aft.  12  hours). 

The  catamenia,  which  were  about  due,  came  immedi- 
ately after  the  iron  bath,  and  twice  as  copious  as 
ordinary.* 

*  This  ifl  the  primary  action  of  Iron  ;  the  f  oUowing  symptonu  are  Becondary 


624  Hahnemann's  Pathogenesis  of  Ferrwii. 

The  catamenia  leave  off  for  two  or  three  days,  and  then 
reappear. 

Metrorrhagia  (Ritter,  1.  c). 

Catamenia  come  on  one  day  later;  the  discharge  is 
scantier ;  consists  of  watery  blood,  and  is  accompanied  by 
violent  cutting  in  abdomen. 

145.  Menses  some  days  retarded. 

Menses  cease  for  eight  weeks. 

Menses  cease  for  three  years.  ^ 

Prolapsus  of  vagina  only  during  pregnancy,  not  at  other 
times. 

Abortion. 

150.  Sterility  without  abortion. 

A  hot  vapour  rises  out  of  his  windpipe  (Ritter,  1.  c.t). 

Sensation  of  dryness  and  mucus  on  the  chest ;  the  dryness 
is  relieved  by  drinking  only  for  a  short  time. 

Fulness  and  contraction  of  the  chest. 

Oppression  in  the  chest,  as  if  it  were  constricted  (Ritter, 
1.  c). 

155.  Contraction  of  chest  (Ritter,  1.  c). 

Contraction  of  chest ;  difficult  slow  respiration,  relieved 
by  walking  and  talking,  or  by  constant  employment  in 
reading  or  writing.  It  is  worst  when  he  sits  still  and  idle, 
and  still  worse  when  lying,  especially  in  the  evening  j  he 
must  take  several  breaths  before  he  can  fill  the  lungs  with 
air  (Rszsky.). 

Congestion  of  blood  in  the  chest  (Ritter,  1.  c.). 

Contraction  of  chest  and  cramps  of  the  limbs,  generally 
worst  in  the  forenoon ;  often  both  when  he  has  walked  a 
little;  only  sometimes  it  becomes  intolerably  bad  when 
walking  in  the  open  air. 

He  cannot  get  any  air ;  even  when  seated  his  breathing 
is  difficult. 
;  160.  (The  child  is  oppressed  iu  the  chest,  wheezing.) 

action ;  therefore  it  is  only  in  those  cases  of  suppression  of  the  menaes  where 
I  the  other  symptoms  correspond  homcoopathically  to  Iron  that  this  metal  can 

i  be  carative. 

*  From  external  nse  of  fermginous  water. 

t  [With  B8. 167  and  181.— 2V(hw^] 


Hahnemann's  Pathogenesis  of  Ferram.  625 

In  the  evening  in  bed  her  glottis  contracts^  the  blood 
rushes  to  the  head  ;  she  feels  a  burning  externally  in  the 
throat  and  betwixt  the  shoulder-blades^  and  on  the  upper 
part  of  the  body  generally^  whilst  the  feet  are  cold  ;  in  the 
morning  perspiration. 

In  the  morning  (about  six  o'clock)  painful  contraction 
in  the  scrobiculis  cordis^  followed  by  a  kind  of  spasmodic 
cough  with  sanious  expectoration. 

Contraction  of  the  chest  as  if  it  was  constricted^  difficult 
anxious  respiration,  aggravated  by  walking. 

Contractive  cramp  in  the  chest. 

165.  Difficult  breathing  and  oppression  of  the  chesty  as  if 
some  one  pressed  with  the  hand  upon  it. 

A  pressure  superiorly  under  the  sternum,  with  catarrh 
and  cough. 

Sometimes  he  must  sit  up  in  bed  after  midnight,  on 
account  of  the  contraction  of  the  chest. 

A  kind  of  asthma;  anxiety  in  the  scrobiculus  cordis, 
preventing  respiration. 

During  corporeal  exertion  heat  from  the  scrobiculus 
cordis  upwards,  like  anxiety  ;  she  must  lie  down. 

170.  At  night  in  bed,  stitches  in  the  sternum. 

During  bodily  exercise  stitches  in  the  side. 

Pain  in  the  chest  and  stitches  and  tension  between 
scapulae ;  he  could  not  move. 

Pain  in  the  chest  as  if  bruised. 

Contractive  cramp  in  the  chest  and  cough  only  when 
moving  and  walking. 

175.   (Increased  dry  cough.)     (Ritter,  1.  c.) 

Dull  cough  without  expectoration,  and  when  he  coughs 
as  if  he  could  not  get  air. 

Cough  in  the  evening  after  lying  down  dry  ;  but  on 
walking  with  expectoration. 

Cough  worse  when  moving  than  when  at  rest. 

Burning  at  the  upper  part  of  the  sternum  after 
coughing. 

180.  Nocturnal  coughing  of  blood,  followed  by  increased 
contraction  of  chest. 

VOL.  XXXIl,  NO.  CXXX. OCTOBER,   1874.  R  R 


626  Hahnemann's  Pathogenesis  of  Perrutn. 

Haemoptysis  (Bitter^  1.  c.)> 

Scanty,  thioi  frothy  expectoration  with  streaks  of  blood 
(Ritter,  1.  c). 

Coughing  of  blood  in  the  morning  on  rising  from  bed. 
By    tussiculation    he    expectorates    bloody  mucus   (aft. 

6d.). 

185.  Whilst  suckling  the  child,  cough  with  expectoration 
of  blood. 

A  large  quantity  of  white  purulent  expectoration  after 
slight  coughing^  increased  by  smoking  tobacco  and  drinking 
brandy. 

In  the  morning  he  expectorates  much  pus  (with  putrid 
taste). 

On  waking  in  the  morning  much  greenish  purulent 
expectoration  with  sickly  taste. 

Cough  all  day  and  also  after  lying  down  in  the  evening. 

190.  A  kind  of  tearing  in  the  back,  even  when  sitting 
and  lying. 

When  she  works  with  her  arms  she  has  stitches  in  the 
scapulae. 

Between  the  scapulae  a  kind  of  tearing,  even  when 
sitting,  which  is  aggravated  by  walking. 

Whilst  walking  stitch-like  jerks  in  the  sacrum,  which 
extend  more  towards  the  hips  than  upwards ;  more  painful 
after  sitting  or  standing,  almost  as  if  he  had  strained 
himself. 

Pains  in  sacrum  on  rising  from  a  seat. 

195.  Bruised  pain  in  sacrum. 

Pain  in  left  clavicle  as  if  it  had  gone  asleep. 

Creaking  in  the  shoulder-joint,  which  feels  bruised  on 
being  touched. 

Pain,  shooting  and  tearing,  from  the  shoulder-joint  into 
the  upper  arm  and  farther  downwards,  which  makes  it  im- 
possible to  lift  anything. 

Shooting  and  tearing  in  the  upper  arm  from  the 
shoulder-joint,  so  that  he  cannot  raise  his  arm. 

200.  A  kind  of  paralysis ;  inability  to  raise  the  arms  ou 

•  [With  8S.  167,  151,  and  164.— 2Vaiw^] 


I 

Hahnemann's  Pathogenesis  of  Ferrum.  ^27 

account  of  painful  tension  betwixt  the  scapulae  and  in  the 
sternum. 

Drawing  in  the  arm^  whereby  it  feels  heavy  and  as  if 
paralysed. 

.  He  has  no  rest  in  his  arms^  and  must  flex  and  extend 
them  alternately. 

He  cannot  raise  the  right  arm ;  has  shooting  and  tearing 
in  the  shoulder-joint^  which  pains  as  if  bruised  when 
touched — down  through  the  upper  arm,  and  his  shoulder- 
joint  creaks. 

Swelling  of  hands  ;  afterwards  the  skin  scales  off. 

205.   Swelling  of  hands  and  legs  up  to  the  knees. 

Coldness  of  hands  and  feet  (Bitter,  1.  c). 

Cramp  in  fingers,  which  are  numb  and  insensible. 

In  the  morning,  on  trying  to  work^  she  has  trembling  in 
the  hands. 

A  kind  of  paralysis ;  a  tearing  with  violent  stitches  from 
the  hip-joint  down  to  the  shin-bone  and  sole  of  the  foot 
(the  ball  is  always  painful  when  touched,  as  if  bruised) ;  by 
day  he  cannot  step  on  account  of  pains^  which,  however, 
diminish  when  he  walks.  In  the  evening  after  lying  down 
they  are  worst ;  he  must  get  up  and  walk  about  in  order  to 
relieve  the  pains  until  midnight. 

210.  Shooting  and  tearing  in  the  hip-joint,  which 
pains  as  if  bruised  when  touched — down  to  the  shin-bone ; 
in  the  evening  in  bed  worst ;  he  must  get  up  and  walk 
about. 

Paralytic  pains  in  thigh,  also  when  sitting ;  when  she 
has  sat  for  some  time  in  a  crouching  position,  she  must,  to 
relieve  herself,  stretch  out  the  leg;  when  she  rises  from 
her  seat  the  paralytic  pain  is  worst ;  it  goes  off,  however^ 
on  walking. 

Numbness  in  thigh. 

After  rising  from  a  seat,  relaxation  and  weariness  in 
the  hocks,  especially  when  walking*  after  having  stood 
stUl. 

Weakness  of  knees^  so  that  he  sinks  down  (imme- 
diately)* 

*  On  oommendiig  to  walk. 


628  Hahnemann's  Pathogenesis  of  Ferfuni, 

215.  Swelling  of  knees  and  ankles  and  pain  therein, 
especially  on  extending  the  knee  in  bed. 

A  contractive  pain  in  knee-  and  ankle-joints. 

On  account  of  the  pains  in  the  knees,  as  if  they  were 
over- fatigued,  he  must  at  one  time  flex^  at  another  extend 
them ;  he  has  no  rest  in  them. 

Ou  rising  from  bed  in  the  morning,  painful  cramp  in 
the  calf  (aft.  sixteen  hours). 

Tonic  cramp  of  thigh  and  leg*  (Scherer,  in  Httfeland's 
Jour,,  iii). 

220,  When  walking  in  the  evening,t  contractive  pain 
like  cramp  in  shin-bone  and  calves. 

When  standing,  cramp  in  the  calves,  that  goes  off  when 
walking  (aft.  twenty-eight  hours). 

A  painful  drawing  in  legs. 

Bruised  pain  in  legs  in  the  morning  in  bed,  that  goes  off 
soon  after  getting  up. 

The  legs  tremble,  and  on  walking  they  pain  as  if  bruised. 

225.  Legs  as  if  gone  to  sleep. 

On  resting  after  walking,  stiffness  in  the  feet,  when  she 
attempts  to  move  them  again. 

Varicose  veins  in  the  feet. 

Feet  swollen  to  the  ankles. 

Painful  cramp  in  soles. 

230.  Frequent  cramp  in  toes  and  soles. 

The  fingers  and  toes  are  drawn  crooked  with  cramp,  with 
great  pain. 

Very  cold  feet,  which  she  can  scarcely  use  on  account  of 
fatigue. 

After  eating  weariness  in  feet. 

Her  feet  will  not  bear  her. 

235.  Parts  of  the  skio  (e.  ff.  on  the  dorsum  of  thumb,  of 
toes,  &c.),  which  are  the  seat  of.  burning  pains  when 
not  touched,  smart  intensely  on  the  slightest  touch. 

Dark  hepatic  spots  (e,  g.  on  the  dorsum  of  the  hand) 
inflame  and  suppurate. 

Easily  fatigued  by  walking. 

*  From  iron  applied  to  sole  of  foot.     [In  a  case  of  chorea. — TVcnw/.] 
t  When  beginning  to  walk. 


Hahnemann  8  Pathogenesis  of  Ferrum,  629 

He  is  very  weak  and  thin. 

Very  weak  and  sleepy  (aft.  two  hours). 

240.  Very  great  weakness,  like  weariness  (immediately). 

Heaviness  of  limbs  for  forty- eight  hours. 

Heaviness,  weariness,  and  relaxation  of  limbs. 

General  weakness,  caused  merely  by  speaking. 

Great  weakness  (Harcke,  in  Hvfeland^s  Jour,^  xxv). 

245.  Great  trembling  throughout  the  body,  lasting  several 
weeks  (Harcke,  1.  c). 

Attacks  of  syncope  (Ritter,  1.  c). 

Attacks  of  syncope,  which  leave  behind  them  weakness, 
lasting  all  day  (Ritter,  1.  c). 

Weakness  of  fatigue,  alternating  with  anxious  trembling. 

Frequent  attacks  of  trembling  throughout  the  body. 

250.  The  symptoms  are  aggravated  by  sitting,  and 
ameliorated  by  gentle  movement. 

Walking  in  the  open  air  affects  her. 

When  walking,  faint  feeling ;  darkness  before  eyes,  felt  as 
if  she  should  have  an  attack  of  apoplexy,  at  every  step 
roaring  in  ears  and  head. 

Inclination  to  lie  down. 

Irresistible  inclination  to  lie  down  (aft.  one  hour). 

255,  Constant  weariness  and    sleepiness   by  day  (sleep 
'  affords  but  slight  relief). 

After  dinner  (noon)  sleepiness  and  dizziness,  alsa  some 
headache  over  the  root  of  the  nose ;  he  could  not  under- 
take any  mental  employment. 

Apt  to  fall  asleep  when  seated  at  any  time  of  the  day. 

Light,  not  sound,  slumber-like  sleep. 

She  lies  long  before  going  to  sleep. 

260.  He  lies  for  half  and  whole  hours  before  falling 
asleep. 

She  must  lie  for  two  or  three  hours  before  she  falls 
asleep. 

He  wakes  every  hour  during  the  night,  and  only  falls 
into  a  slumber  again. 

She  falls  asleep  tired,  and  sleeps  though  restlessly,  and 
lies  awake  for  a  long  time  before  again  going  off  to  sleep, 
and  yet  is  not  tired  when  she  gets  !ip  in  the  morning. 


630  Hdhnetnann^s  Pathogenesii  of  Ferrum. 

At  night  she  can  only  lie  on  her  back  ;  sha.  cannot  sleep 
on  her  sides, 

266.  Windy  colic  at  night ;  much  flatulence  is  gene- 
rated in  his  abdomen,  which  causes  pain,  akhoagh  much 
flatus  escapes. 

At  night  restless  sleep. 

At  night  vivid  dreams. 

At  night  disturbed  by  dreams ;  on  rising  in  the  morning 
much  weariness. 

Restless,  dreamful  sleep,  with  seminal  emissions. 

270.  Dreams  he  is  in  battle ;  that  he  has  fallen  into  the 
water. 

Anxious  tossing  about  in  bed  after  midnight. 

Anxiety  at  night  as  if  something  had  happened  to  her  ; 
she  could  not  sleep  ;   tossed  about  in  bed. 

Heavy  morning  sleep  till  9  o'clock,  from  which  he  can 
scarcely  rouse  himself. 

He  sleeps  with  half-opened  eyes. 

275.  In  the  evening  in  bed  he  became  cold  all  over^  in 
place  of  getting  warmer. 

Afternoon,  siesta,  heat. 

Much  perspiration  when  walking  and  sitting  during  the 
day. 

Perspiration  by  day  when  walking. 

About  midnight  frequent  perspiration  during  slumber. 

280.  Perspiration  in  the  morning  for  a  long  period. 

In  the  evening  before  going  to  sleep,  rigor  without  ex- 
ternal heat ;  in  bed  he  was  chilly  all  night. 

Nocturnal  sweat,  with  weariness. 

In  the  morning  at  daybreak  perspiration  till  towards  noon 
on  alternate  mornings,  and  each  time  preceded  by  head- 
ache. 

In  the  morning  attack  of  stretching  and  yawning,  during 
which  the  eyes  are  full  of  water  (aft.  eight  hours). 

285.   (In  the  morning  heat  of  face.) 

(Rigor,  and  dnring  the  chill  his  face  got  glowing  hot.) 

By  day  ebullition  in  blood  and  heat  in  the  evening,  espe- 
cially of  hands. 


The  Pathogenesies  of  the  ^*  Chronic  DiseMes"       681 

Heat  in  the  body  with  red  cheeks^  but  the  head  is  free 
(aft.  twenty-four  hours). 

Scarcely  perceptible  pulse  (Ritter,  1.  c.).* 

290.  (Depression  of  spirits  as  from  too  loose  bowels.) 

Violence^  quarrelsomeness ;  insists  that  he  is  right  (aft. 
four  hours). 

Alternately  too  gay  one  evening,  sad  and  melancholy  the 
next. 

Anxiety  (Nebel  and  Wepfer,  1.  c.  ;  Ritter,  1.  c). 

From  slight  cause,  anxiety  with  throbbing  in  scrobi- 
culus  cordis. 

295.  Anxiety  as  if  something  had  happened  to  her. 


THE  PATHOGENESIES  OF  THE  "CHRONIC 

DISEASES.'' 

By  Dr.  Richaad  Hughes. 

I  HATE  reason  to  believe  that  in  the  minds  of  most 
English-reading  homoeopathists^  and  therefore  of  the  great 
majority  of  British  and  American  practitioners  of  our 
school,  a  very  vague  idea  exists  as  to  the  provings  referred 
to  the  Chronic  Diseases,  Even  if  they  go  beyond  Jahr^ 
and  use  HempePs  translation  of  the  Master's  work  itself, 
the  absence  of  all  references  forbids  them  any  insight  into 
the  constitution  of  the  several  pathogenesies.  It  seems 
frequently  assumed  that  the  symptoms  recorded  are  the 
genuine  effects  of  material  doses  of  the  drugs  upon  the 
healthy  body,  and  may  be  cited  and  used  accordingly. 

I  have  been  led,  in  the  course  of  some  recent  literary 
work,  to  examine  closely  the  nature  and  materials  of  these 
pathogenesies ;  and  I  think  it  may  be  of  service  to  ray 
colleagues  if  I  put  on  record  in  this  place  the  results  of  my 
analysis. 

•  [See  note  to  s.  32.— ^VaiwZ.] 


632       The  Pathogenesies  of  the  "  Chronic  Diseases,^* 

The  first  edition  of  tbe  Chronic  Diseases  appeared  in  1828- 
1880.  After  the  exposition  of  his  doctrine  on  the  subject, 
Hahnemann  gives  a  list  of  symptoms  as  produced  by 
eighteen  new  medicines  {i.e.  which  had  not  appeared  in 
the  Materia  Medica  Pura)  and  four  old  ones^  which  he  ranks 
as  "  antipsorics/'  The  eighteen  new  medicines  are  Ammo- 
nium  carbonicutn,  Baryta  carbonica,  CtUcarea  carbonica,"^ 
Catuticum,  Graphites,  lodium^  Kali  carbonicum,  Lycopodium, 
Magnesiacarbonica,  Magnesia  muriatica,  Natrum  carbonicum, 
Natrwn  muriaticum,  Nitric  acid,  Petroleum,  Phosphorus, 
Sepia,  Silicea,  and  Zincum.  The  four  old  medicines  (their 
symptpm^list  more  or  less  enlarged)  are  Carbo  animaUs, 
Carbo  vegetabilis,  Conium,  and  Sulphur.  He  gives  no 
information  as  to  how  he  has  obtained  the  pathogenetic 
effects  here  recorded  ;  he  mentions  no  fellow-observers,  and 
cites  no  observations  from  authors  (save  once  in  a  note). 

The  second  edition  was  published  in  successive  parts^ 
between  1835  and  1839.  Besides  the  twenty-two  medi- 
cines of  the  first  e'dition  it  contains  twenty-five  others,  of 
which  thirteen  are  new^  and  twelve  had  already  appeared 
on  a  smaller  scale  iu  the  Materia  Medica  Pura.  The  new 
ones  are  Agaricus,  Alumina,  Ammonium  muriaticum,  Anacar- 
dium,  Antimonium  crudum,  Borax,  Clematis,  Cuprum, 
Euphorbium,  Mezereum,  Nitrum,  Platina,  and  Sulphuric 
acid:  the  old  ones  are  Arsenicum,  Aurum,  Colocynth,  Digi-^ 
talis,  Dulcamara,  Guaiacum,  Hepar  sulphuris,  Manganum, 
Muriatic  add,  Phosphoric  acid,  SarsapariUa,  and  Stannufn. 
In  this  edition  the  pathogenesies  appear  as  in  the  third 
edition  of  the  Materia  Medica  Pura.  Those  which  had 
already  seen  the  light  have  (generally)  large  additions ;  for 
all  he  acknowledges  contributions  from  fellow-observers, 
and  for  many  cites  symptoms  from  the  extant  literature  of 
his  day. 

The  following  table  will  exhibit  these  facts,  and  by  its 
alphabetical  order  will  enable  them  to  be  readily  ascer- 
tained in  the  case  of  each  individual  medicine. 

*  Into  this  patbogenesy  he  incorporatefl  the  270  symptoms  of  Calcarea 
aceiic€tf  which  had  already  appeared  in  the  Mai-  Med,  Pitra, 


by  Dr.  Richard  Hughes. 


638 


Name. 

Materia  Medica 

Chrouie  Diseaaei. 

Chronic  Diaeases. 

Piura. 

• 

£d.L 

Ed.  11. 

Aguicns 

•  •  • 

•  ■  • 

715 

Alumina  .... 

•  •  • 

•  •  • 

1161 

Ammoniam  carbonicum    . 

■  ■  « 

159 

789 

Ammomum  mariaticum   . 

•  •  • 

•  •  • 

397 

Anacardium     . 

•  •  • 

t  •  ■ 

622 

Antimoniam  crudnm 

•  ■  ■ 

•  ■  • 

471 

Anenicam 

1079 

•  ■  • 

1231 

Auram 

376 

•  •  • 

461 

Baryta  carbonica 

•  •  ■ 

286 

794 

Borax 

•  • » 

•  •  • 

460 

Calcarea  . 

269 

1090 

1631 

Carbo  vegetabilis 

720 

930 

1189 

Carbo  animalia 

191 

191 

728 

Cansticam 

•  ■  ■ 

1014 

1505 

Clematis  . 

•  «  • 

•  •  ■ 

150 

Colocyntb 

250 

■  •  • 

283 

Coninm    . 

375 

700 

912 

Capmm  . 

•  •  • 

■  •  • 

397 

Digitalis  . 

428 

• « • 

702 

Dalcamara 

401 

•  ■  • 

409 

Enphorbium 

•  •  • 

•  ■  • 

281 

Graphites 

■  •  ■ 

590 

1144 

Ghiaiacam 

145 

•  •  • 

160 

Hepar  solpburis 

307 

•  ■  ■ 

661 

lodiam 

•  •  • 

133 

624 

Kali  carbonicum 

•  •  • 

938 

1650 

Lycopodium     . 

•  •  • 

891 

1608 

Magnesia  carbonica 

•  •  • 

128 

890 

Magnesia  muriatica . 

■  ■  • 

69 

749 

Manganum 

331 

•  •• 

469 

Mezereum 

•  •  • 

•  •  ■ 

610 

Muriatic  add  . 

279 

«  ■  ft 

574 

Natrum  carbonicum 

•  •  ■ 

806 

1082 

Natrum  muriaticum 

•  •  • 

897 

1349 

Nitric  acid 

•  •  • 

803 

1424 

Nitmm    . 

•  ■  • 

• «  • 

710 

Petroleum 

•  •  • 

623 

776 

Phosphorus 

•  •  • 

1025 

1915 

Phosphoric  add 

679 

•  •  ■ 

818 

Platina    . 

•  •  ■ 

•  ■  • 

527 

Sarsaparilla 

145 

•  •  ■ 

561 

Sepia 

•  •  ■ 

1242 

1655 

Silicea 

•  •  • 

567 

1193 

Stannum . 

660 

•  •  V 

648 

Sulphur  . 

815 

1041 

1969 

Sulphuric  add . 

•  •• 

•  •  • 

521 

Zincum    .        .        .        .        • 

•  ■  • 

743 

1375 

The  pathogenesies  of  the  forty-seven  medicines  thus 
enumerated  we  possess  (in  English)  only  as  they  stand  in 
the   second    edition   of  the   Chronic    Diseases.      But  it  is 


634       The  Pathogenesies  of  the  ''  Chronic  Diseases,'* 

obvious  that  many  of  them  are  made  up  from  two  or  more 
distinct  sources;  and  it  is  necessary  to  inquire  whether 
these  latter  present  any  diversity^  and  what  is  the  character 
of  each. 

Few  and  imperfect  as  are  the  data  we  possess^  we  can 
nevertheless  state  that  in  the  main  the^provings  of  the 
Materia  Medica  Pur  a  were  made  on  healthy  subjects,  and 
with  appreciable  doses  of  the  drugs.  The  directions  for 
proving  given  in  the  early  editions  of  the  Organon  show  the 
latter  generally;  aud  there  are  a  few  statements  extant 
about  individual  medicines  which  substantiate  the  inference. 
Dr.  Dudgeon  {Lectures,  p.  189)  shows  this  as  regards  China, 
Helleborus,  Camphor^  Argentum,  and  Calcarea  acetica ;  and 
argues  further  in  the  same  direction  from  the  lower  attenua- 
tions being  frequently  recommended  for  curative  purposes. 
As  regards  the  subjects  of  the  symptoms,  Hahnemann  was 
at  this  time  (1810-1821)  surrounded  by  a  band  of  enthusi- 
astic disciples^  who  readily  aided  him  by  proving  medicines 
on  themselves  and  their  friends  ;  and  he  himself  {Medicine 
of  Experience)  speaks  of  the  observation  of  medicinal  symp- 
toms on  the  aiek  as  a  rare  and  difficult  task,  to  be  reserved 
to  masters  in  the  art.  He  also  discourages  (Dudgeon, 
loc,  cit.,  p.  184)  the  putting  down  as  the  pathogenetic  action 
of  the  drug  those  symptoms  of  the  patient  which  were 
aggravated  after  its  administration. 

It  is  otherwise  when  we  come  to  the  Chronic  Diseases. 
The  first  edition  of  this  work  was  published  in  1828-1830, 
after  Hahnemann  had  spent  seven  years  and  more  in  soli- 
tude at  Coethen.  We  are  told  (Dudgeon,  he.  cit,,  p.  xxx) 
that  "  in  1827  he  summoned  to  CcBthen  his  two  oldest  aud 
most  esteemed  disciples,  Drs.  Stapf  and  Gross,  and  commu- 
nicated to  them  his  theory  of  the  origin  of  chronic  diseases, 
and  his  discovery  of  a  completely  new  series  of  medicaments 
for  their  cure.**  These  are  the  eighteen  medicines  of  which 
mention  has  already  been  made.  That  he  should  now  first 
reveal  these  new  remedies,  and  in  the  three  following  years 
should  publish  copious  lists  of  their  pathogenetic  effects, 
confirms  the  inference  to  be  drawn  from  his  position  and 
from  his  silence  as  to  fellow-observers.     That  inference  is^ 


by  Dr.  Richard  Hughes.  635 

that  he  drew  these  symptoms  mainly — if  not  entirely—* 
from  the  sufferers  from  chronic  disease  who  flocked  to 
CoBthen  to  avail  themselves  of  his  treatment. 

The  prefatory  notices  to  the  several  medicines  still 
further  substantiate  this  view,  and  throw  some  light  on 
the  doses  with  which  the  symptoms  were  obtained.  He 
recommends  all  the  medicines  (save  Natr.  carb.  in  the 
12th)  to  be  given  in  the  dUutions  from  the  18th  to  the 
80th ;  and  repeatedly  makes  some  such  remark  as  this : — 
^'  For  a  long  time  past  I  have  given  the  6th,  9th,  and  12th 
potencies,  but  found  their  effects  too  violent/'  Occa- 
sionally, too,  he  must  have  used  the  3rd  triturations ;  as  he 
speaks  of  having  begun  by  giving  ''a  small  portion  of  a 
grain  "  of  these,  but,  as  this  was  an  indefinite  quantity, 
having  subsequently  dissolved  and  attenuated  them.  He 
gives  cases,  moreover,  in  which  he  treated  itch  with  Garbo 
vegetabilis  and  Sepia  of  this  strength. 

It  is  these  ''  violent  effects,^'  then,  of  the  dilutions  from 
the  8rd  to  the  12th  upon  sufferers  from  chronic  disease 
which  make  up  the  bulk  of  the  symptoms  of  the  1st  edition 
of  the  Chronic  Diseases.  The  2nd  edition  (1885 — 1889), 
issued  during  his  residence  in  Paris,  goes  still  further  in  the 
same  direction ;  but  has  a  character  of  its  own.  In  the 
first  place,  all  the  fresh  symptoms  must  have  been  produced 
by  globules  of  the  80th  dilution  ;  for  in  1838  Hahne- 
mann declares  this  to  be  the  best  plan  of  proving  medi- 
cines, and  recommends  all  experiments  to  be  so  made.  It 
is  probable,  moreover,  that  the  pathogenetic  effects  re- 
corded appeared  in  many  instances  in  healthy  individuals, 
as  names  of  fellow-observers  once  more  appear  in  the 
prefaces  to  the  medicines,  and  it  is  hardly  likely  that  their 
observations  should  have  been  made  on  their  patients  only, 
to  the  neglect  of  provings  on  their  own  persons.  Never- 
theless, a  large  number  of  the  symptoms  must  have 
appeared  on  sick  persons  ;  for  Hahnemann  himself  fur- 
nishes them  in  the  greatest  proportion,  and,  as  he  was  at  this 
time  an  octogenarian,  it  is  far  more  likely  that  he  used 
his  patients  as  materials  for  his  observations  than  that  he 
proved  medicines  on  himself. 


636       The  Pathogenesies  of  the  *'  Chronic  Diseases/* 

We  seem  justified,  therefore^  in  drawing  the  folIowiDg 
conclusions  regarding  the  pathogenesies  of  the  Chronic 
Diseases  : 

1.  Those  of  the  thirteen  medicines  appearing  for  the 
first  time  in  the  2nd  edition,  and  the  additions  to  those 
already  published,  were  obtained  from  both  healthy  and  sick 
persons  by  means  of  globules  of  the  80th  dilution. 

2.  Those  of  the  eighteen  medicines  appearing  for  the 
first  time  in  the  1st  edition,  and  the  additions  to  the  four  old 
ones  therein  contained,  wei^  mainly  obtained  from  sick  per- 
sons by  means  of  the  dilutions  from  the  8rd  to  the  12th. 

8.  Those  of  the  seyenteen  medicines  which  are  transplanted 
from  the  Materia  Medica  Pura  were,  as  a  rule,  observed 
in  healthy  persons  taking  appreciable  doses  of  the  drugs. 

The  table  will  show  the  existence  and  proportion  of 
these  elements  in  each  medicine.  But  there  is  one 
other  constituent  of  the  pathogenesies  which  must  not  be 
neglected. 

In  his  Materia  Medica  Pura  Hahnemann  availed  him- 
self as  largely  as  possible  of  the  observations  of  poisoning 
and  over-dosing  recorded  in  general  medical  literature. 
Where  medicines  have  been  transplanted  from  this  collec- 
tion into  that  of  the  Chronic  Diseases,  their  cited  symptoms 
have  necessarily  gone  with  them.  The  new  medicines  of 
the  latter  work  are,  as  a  rule,  unknown  to  medical 
literature ;  but  the  rule  has  its  exceptions,  as  Cuprum, 
lodium,  Nitrum,  &c.,  and,  with  these,  quotations  form  a 
considerable  part  of  the  pathogenesy.  The  following  list 
will  exhibit  the  twenty-five  medicines  of  the  2nd  edition  of 
the  Chronic  Diseases  which  have  cited  symptoms,  and 
the  proportion  in  which  these  exist  in  the  whole  catalogue : 


Name, 

Tbtol  ijmptomi. 

Cited  qrmptami. 

• 

715 

21 

Anacardinm 

• 

622 

3 

Antimonium  erudmn 

471 

79 

Anenicam 

•                1 

1281 

882 

Aamm 

• 

461 

6 

Baryta    . 

• 

799 

4 

Clematis 

•                1 

150 

5 

by  Vt.  Richard  Hughes. 


63? 


Name. 

Total  symptonu. 

Cited  symptoms 

Colocynth 

283 

29 

Conium  .        .        .        , 

912 

155 

Cnpram  .        .        .        . 

897 

154 

Digitalis. 

702 

181 

Dulcamara 

409 

88 

Euphorbium    . 

281 

22 

Gaaiacnm 

160 

8 

Hepar  sulphuris 

661 

11 

lodinm    .         .        .        . 

624 

348 

Mezereum 

610 

21 

Muriatic  acid  . 

574 

16 

Nitric  acid 

1424 

29 

Nitrum   . 

710 

122 

PhoBpborus 

1915 

67 

Sarsaparilla 

561 

4 

Silicea    .        .        .        . 

1198 

9 

Stannnm 

648 

5 

Sulphur 

1969 

10 

Sulphuric  acid 

521 

7 

This  coDBtituent,  existing  in  such  proportion^  has  fea* 
tures  peculiar  to  itself.  The  symptoms  it  comprises  are  the 
effect^  not  merely  of  appreciable,  but  of  large,  of  poisonous 
doses.  So  far  they  would  be,  in  the  estimation  of  many^ 
of  greater  value  than  most  of  their  surroundings.  But 
comparison  of  Hahnemann's  citations  with  the  originals 
has  disclosed  such  laxity  as  regards  both  the  materials 
used,  and  the  manner  in  which  they  have  been  transferred 
to  his  pages,  that,  until  yerified,  all  symptoms  so  obtained 
are  under  a  cloud.  I  have  good  reason  to  know  that  such 
verification,  with  the  necessary  accompanying  correction^ 
will  be  ere  long  completed  for  all  Hahnemann's  medicines. 
In  the  mean  time  they  must  remain  in  their  own  specinl 
dubiousness. 

The  facts  about  the  pathogenesies  of  the  Chronic  Diseases 
are  now  before  us.  I  ofier  no  opinion  here  upon  the 
bearing  they  have  on  the  value  of  the  collection :  I  only 
desire  that  they  shall  be  known  as  they  are.  One  practical 
conclusion,  however,  seems  to  be  plain.  Whatever  value 
may  be  ascribed  to  provings  with  infinitesimal  quantities, 
at  least  they  are  facts  of  a  different  order  from  those 
elicited  when  appreciable  doses  are  given  ;  and  we  ought  to 


638  Dr,  Russell  tUynolds  brfare  the 

be  able  to  distiuguish  between  them.  In  Dr.  Hempel's 
translatiou  of  the  Chronic  Diseases,  which  is  the  nearest 
approach  the  English  reader  can  make  to  the  original, 
there  are  no  means  of  making  such  distinction :  the  whole 
list  of  symptoms  stands  unnumbered  and  unmarked.  It 
would  be  an  inestimable  boon  if  some  one,  knowing 
German  and  having  leisure,  would  go  through  the  symp- 
toms for  us,  and  publish  lists  of  (1)  those  which  come 
from  the  Mat.  Med.  Pura,  and  (2)  those  which  are  in  the  Ist 
edition  of  the  Chronic  Diseases.  We  should  know  that  the 
residue  were  in  the  2nd  edition  only ;  and,  from  Dr.  Allen's 
forthcoming  Encyclopcedia,  where  the  sources  are  given, 
should  see  which  of  these  were  Hahnemann's  (and  there* 
fore  observed  in  patients)  and  which  those  of  his  fellow- 
observers  (possibly  provings).  As  the  same  collection  is  to 
give  us  the  cited  symptoms  verified  and  corrected,  we 
should  then  for  the  first  time  be  in  a  position  to  gauge  the 
worth  of  any  symptom  of  the  Chronic  Diseases  to  which  a 
repertory  might  direct  us.  At  present  these  pathogenesiea 
are  in  such  a  mist  that  they  are  little  used.  ,Re-proving8 — 
such  as  we  have  had  of  Sulphur  and  Natrum  murioHcum, 
and  as  the  American  Institute  promises  us  of  Stpia — are 
most  welcome.  But  for  these  we  must  wait ;  and  in  the 
mean  time  we  want  to  know  what  it  is  we  have  in  our 
hands. 


DR.  RUSSELL  REYNOLDS  BEFORE  THE  BRITISH 

MEDICAL  ASSOCIATION. 

The  perusal  of  the  thoughtful  and  eloquent  '^  Address  in 
Medicine '^  delivered  by  Dr.  Russell  Reynolds  at  this 
year's  Annual  Meeting  of  the  British  Medical  Association 
has  aroused  certaiu  considerations  in  our  minds^  which 
we  submit  in  this  place  to  him  and  to  all  whom  they  may 
concern. 


British  Medical  Association,  6i9 

The  definition  of  bomoeopathy  is  that  it   is  a  therapeutic 
method,  choosing  its  remedies  by  the  rule  ^'  let  likes  be 
treated  by  likes ;''  and  the  only  necessary  corollaries  from 
this  rule  are  the  proved  medicine,  the  single  remedy,  and  the 
small  (not  necessarily  infinitesimal)  dose.    But  man  was  not 
made  to  dwell  in  the  empirical  region;  and  the  conclusions  of 
experience  inevitably  bring  suggestions  and  modify  thoughts 
as  to  that  which  is  beyond  experience,  as  to  theory.     We 
have  found  that  the  relation  of  similarity  between  drug-effects 
and  disease  is  available  for  therapeutic  purposes  only  when 
these  drug-effects  are  dynamic,  t .  e,  neither  mechanical  nor 
chemical.     Then  the  existence  of  a  purely  dynamic  sphere 
of  action  in  medicines  inevitably  suggests  to  us,  and  makes 
us    adherents    of,  vitalism     in  physiology    and    pathology. 
Again,  our  endeavour  after   perfect  similarity  between  the 
two  series    of  phenomena  with  which    we    are   concerned 
has  led  to  several  important  points  of  doctrine  among   us. 
Pushing  our  provings  into  minutest  detail,  we  have  found 
subjective  symptoms  vastly  more  abundant  than  objective, 
and  not  less  significant  and  characteristic ;  and,  our  atten- 
tion being  thus  directed,  have  found   the  like  to  occur  in 
disease.     We  have,  moreover,  observed  that  each  individual 
reacts  in  his  own  peculiar  way  to  drug-influence ;  and  have 
hence  been  led  to  insist  on  individualisation  in  therapeutics, 
on  treating  the  patient  and  not  merely  the  disease.     The 
same  observation  has  taught  us  to  think  much  of  the  differ- 
ence between   man  and  the  lower  animals,  to  attach  but 
qualified   importance   to   experiments   with    drugs  on  the 
latter,  to  urge  human   provings  as  the  only   foundation  for 
human    therapeutics.      Lastly,    as    our    rule    of   selection 
leads  us  to  use  medicines  which  act  only  on  the  diseased 
parts,    the  light  has  shown  us    the  contrasting  darkness ; 
and    we   have   learnt   to   abhor    and    to    protest   against 
the     disturbing    and    exhausting    medication    of    healthy 
parts,  which   constitutes  so  large   a  part   of  the  ordinary 
practice. 

These  have  been  common-places  in  homoeopathic  litera- 
ture for  the  last  forty  years  and  more.  They  have  gone 
dead  against  the  stream  of  current  medical  thought ;  but  we 


640  /)r.  Russell  Reynolds  lefore  the 

have  not  greatly  cared  for  that.  It  is  impossible^  however, 
to  be  indiflferent  when  we  hear  them  proclaimed  by  such  a 
man  as  Dr.  Russell  Reynolds,  and  before  such  a  body  as 
the  British  Medical  Association.  That  they  form  the  sub- 
stance of  his  Address  in  Medicine  is  evident  from  his  own 
risumi  of  it. 

*'In  recapitulation,  let  me  remind  you — 1.  That  by  losing 
sight  of,  or  underrating  the  primary  fact  of  life,  we  deprive 
ourselves  (a)  of  the  information  to  be  gained  from  a  study  of  sub- 
jective symptoms;*    (h)    we    often  misdirect  our  therapeutic 

*  "  With  regard  to  the  former — *  objective  symptoms ' — is  it  not  coming 
to  this,  that  bat  little  attention  is  often  paid  to  the  aoooants  which  patients 
give  us  of  themselves,  their  ideas,  emotions,  feelings,  and  physical  sensations  ? 
These  are  things  which  we  cannot  weigh  in  onr  most  guarded  baUuoes; 
measure  by  onr  finest  scales;  split  up  in  onr  cmciblea;  or  describe  in  any 
terms  save  those  which  are  peculiar  to  themselves,  and  which  we  cannot 
decompose.    These  symptoms  are  often  disregarded  and  set  aside ;  and  the 
patient,  whose  story  of  disease  is  made  up  of  them,  is  thought  firndful, 
hypochondriacal,  hysterical,  nervous,  or  unreal ;  because,  forsooth,  we  have 
physically  examined  thorax,  abdomen,  limbs,  and  excretions,  and  have  found 
in  them  nothing  wrong ;  because  we  have  looked  at  the  retinsB,  examined  the 
limbs  electrically,  traced  on  paper  the  beatiogs  of  the  pulse^  weighed  the 
patient,  and  have  not  found  him  wanting.     StiU  he  is  miserable,  in  spite  of 
placebo  and  assurance  that  there  is  '  nothing  organically  wrong.'    There  may 
be  in  him  the  consciousness  of  a  deep  unrest ;   or  of  a  failing  power,  which  he 
feels,  but  which  we  cannot  see ;  or  of  a  something  worse  than  pain,  a  sense  of 
*  impending  evil,'  that  he  is  conscious  of,  in  brain  or  heart;  a  want  of  the 
feeling  of  intellectual  grasp,  which  he  may  call  '  failure  of  memory,'  but 
which  memory,  when  we  test  it,  seems  free  from  fault;  a  want  of  the  sense 
of  '  capacity  for  physical  exertion,'  which  seems,  when  we  see  him  walk  or 
run,  to  be  a  mere  delusive  notion,  for  he  can  do  either  well  and  easily  to  our 
eyes  and  those  of  others ;  and  so  he  is  called  '  nervous,'  and  is  told  to  do  this  or 
that,  and  disregard  these  warnings  that  come  to  him  from  the  veiy  centra  of  his 
life.    And  let  me  ask  whether  or  no  it  has  not  again  and  again  happened  in  the 
course  of  such  a  histoiy  as  that  which  I  have  only  faintly  sketched,  that  some 
terrible  catastrophe  has  occurred  P    Do  we  not  see  minds  gradually  breaking 
down  while  we  say  there  is  no  evidence  of  organic  change  in  the  brain  ?  hearts 
suddenly  ceasing  to  do  their  work,  when  after  careful  auscultation  we  have 
said  there  was  nought  to  fear  P     Suicide  or  sudden  death  sometimes  disturbs 
tlie  calm  surface  of  our  scientific  prognosis  of  no  evil ;  we  may  be  startled, 
and  may  then  see  all  that  we  ought  to  have  seen  before,    fiut  when  the 
ripples  that  such  unforeseen  events  have  occasioned  on  that  smooth  sur&oe 
have  subsided,  we  go  on  as  we  have  already  done,  and  still  pay  but  little 
attention  to  what  the  patient  feels,  and  delight  ourselves  in  the  precision  of 


British  Medical  Association.  641 

efforts,  by  eliciting  vital  action,  rather  than  conserving  vital 
force  \  and  (e)  lose  sight  of  many  of  the*  most  important  causes 
of  disease.  2.  That  by  failing  to  see  the  speciality  of  the  nature 
of  man,  we  underrate  or  ignore  (a)  much  of  the  etiology  of 
human  suffering ;  (h)  are  often  misled  by  the  results  of  obser- 
vations upon  animals ;  and  (0)  are  in  danger  of  misinterpreting 
the  facts  of  the  most  serious  maladies  that  may  afflict  our 
fellow-creatures.  3.  That  by  disregarding  the  individuality  of 
man  we  are  in  danger  (0)  of  again  and  in  another  way  losing 
a  due  appreciation  of  the  causation  of  disease ;  and  {b)  of 
overrating  the  value  of  statistics,  and  of  being  led  astray  by 
their  apparent  precision,  which  exists  only  with  regard  to 
masses ;  and,  4.  That  by  an  unsound  application  of  the  idea  of 
the  specificity  of  disease,  we  may  on  the  one  hand  (a)  sweep 
away  distinctions  which  are  facts  of  pathology,  and,  on  the 
other,  (h)  raise  up  or  lay  down  lines  of  demarcation  which  are 
unreal." 

There  are  some  points  raised  here  which  do  not  concern  us 
at  present.  But  that  vitality  is  a  property  per  se  ;  that  sub- 
jective symptoms  are  to  be  earnestly  regarded  ;  that  we 
misdirect  our  therapeutic  efforts  if  we  '*  elicit  vital  action,^^ 
i.  e.y  stimulate   healthy  parts  ;  that  we  ^*  are  often  misled  by 

our  knowledge  with  regard  to  physical  conditions  of  which  he  may  know 
nothing  and  may  care  still  less.  No  one  can  appreciate  more  highly  than  I 
do  the  value  of  precise  ohservation,  hut  I  do  not  helieve  that  minute,  delicate, 
and  precise  ohservation  is  limited  to  a  class  of  facts  which  can  be  counted, 
measured,  or  weighed.  No  one  can  see  more  distinctly  than  I  do  the  wrong 
conclusions  at  which  a  physician  may  arrive  by  accepting  as  true  the  inter- 
pretations which  fanciful  patients  may  offer  of  their  symptoms;  but  I  am 
sure  that,  if  we  pay  no  heed  to  these  mistaken  notions  of  a  suffering  man,  wo 
lose  our  clue  to  the  comprehension  of  the  real  nature  of  his  malady. 
Morbid  sensations  and  wrong  notions  are  integral  parts  of  the  disease  we 
have  to  study  as  a  whole,  and  we  are  bound  to  interpret  their  value  for  our- 
selves ;  but  we  can  ill  afford  to  set  them  aside,  when  we  are  as  yet  but  in  the 
dawn  of  scientific  pathology,  and  are  endeavouring  to  clear  away  the  obstacles 
that  hide  the  truths  we  hope  hereafter  to  see  more  clearly  about  the  mystery 
of  disordered  life.  The  value  of  such  symptoms  may  be  slight  in  some  kinds 
of  disease,  when  compared  with  that  of  those  phenomena  which  may  be 
directly  observed ;  but  we  are  bound  to  remember  that  there  are  many  affec- 
tions of  which  they  furnish  the  earliest  indication,  and  there  are  not  a  few  of 
which  they  are  throughout  the  only  signs." 

VOL.  XXXII^  NO.  CXXX.— OCTOBBR^  1874.  S  S 


642  Dr.  Reynolds  before  the  British  Medical  AssociaiiofL 

the  results  of  observations  upon  animals;''  and  that  we 
should  treat  patients  as  individuals,  and  not  as  units  of 
masses, — these  are  the  very  ideas  of  which  we  have  spoken 
as  brought  to  us  by  the  working  of  our  therapeutic  law. 
How  Dr.  Reynolds  was  led  to  them,  in  spite  of  the  counter- 
acting iufluences  around  him ;  whether  homoeopathic  doc- 
trine has  leaked  into  his  mind  as  homoeopathic  practice  has 
into  Dr.  Ringer's,  it  is  not  for  us  to  determine.  But  it 
is  a  serious  question  for  him,  and  for  those  who  may  read 
his  essay  with  acquiescence,  how  it  is  that  we  have  been 
holding  and  preaching  these  doctrines  for  the  last  half 
century  ?  And  it  is  a  still  more  serious  matter  for  him 
to  consider  that  we  who  have  thus  preceded  him  in  these 
convictions  should  be  under  the  ban  of  the  very  Associ- 
ation he  has  had  to  address,  and  silenced  and  excluded  by 
the  profession  he  desires  to  recall  to  right  thinking.  We 
have  no  complaint  against  Dr.  Reynolds  as  an  individual. 
But  he  is  a  member  of  a  profession,  and  has  now  identified 
himself  with  an  association,*  which  have  deliberately  re- 
fused a  hearing  to  principles  at  least  tenable  in  themselves, 
and  which  have  led  their  holders  to  conclusions  whose 
soundness  he  maintains  and  whose  neglect  he  laments. 
Can  he  rest  content,  now  at  least  that  the  subject  is  brought 
definitely  before  him,  without  examining  for  himself  these 
practical  principles,  and  claiming  for  them  from  his  brethren 
an  allowed  place  and  a  fair  consideration  7 

*  Our  readers  remember  the  famous  Brighton  resolations  of  this  Association, 
which  still  remain  in  force,  and  which  declare  as  unworthy  to  be  members  of 
the  association  all  who  practise  homcBopathy  avowedly ;  and  not  only  these, 
but  all  who  use  homoeopathic  methods  In  conjunction  with  other  methods  i 
and  not  only  these,  but  all  who  hold  professional  intercourse  with  those  who 
practise  homoeopathy.  For  the  resolutions  in  full  we  refer  to  this  Journal, 
Yol.  iz,  p.  649. 


64^ 


LUPUS  AND  ITS  TREATMENT. 
By  Edward  T.  Blake,  M.D.^  of  Reigate. 

(Bead  before  the  British  Homodopatbic  Society.) 

Mr.  Prbsident  and  Gentlemen. — In  the  authoritative 
Nomenclature  of  Diseases  issued  by  the  College  of  Phy- 
sicians in  1869  lupus  is  defined  as  '^  a  spreading,  tuber- 
culous inflammation  of  the  skin,  usually  of  the  facCi 
tending  to  destructive  ulceration/' 

It  is  resolved  into  two  varieties : 

a.  Chronic  lupus ; 

B.  Lupus  exedens;  and  rodent  ulcer  is  placed  in  a 
category  by  itself^ 

Lupus  depends  essentially  upon  a  neoplasm,  a  develop- 
ment of  new  growth  in  the  tissue  of  the  dermis,  classed  by 
Virchow  among  granulation  growths.  The  new  growth  slowly 
contracts,  strangling  the  intervening  tissues,  which  slowly 
ulcerate  away.  These  growths  are  said  to  bear  the  same 
relation  to  scrofula  as  gummata  do  to  syphilis  As  far  as 
my  own  experience  extends,  I  must  concur  with  Volkmann^ 
who  says  that  the  affinity  between  lupus  and  scrofula  is 
extremely  doubtful. 

The  cases  which  I  shall  have  the  honour  of  bringing 
before  your  notice  this  night  will  be  of  the  non-exedens 
variety,  L.  exedens  being  fortunately  a  rare  disorder ;  I  can^ 
I  am  happy  to  say^  recall  but  one  instance  of  that  truly 
horrible  disease.  Though  some  years  have  elapsed  I  even 
now  see  vividly  before  me  the  poor  little  girl  who  was 
brought  to  me,  the  subject  of  a  rapidly  spreading  sore, 
with  foetid^  black,  and  sloughing  margins,  which  had 
actually  perforated  the  cheek,  so  that  at  the  base  of  a  large 
cavity  the  teeth  and  buccal  mucous  membrane  were 
plainly  visible ;  whilst  a  noisome  odour  everywhere  accom- 
panied the  wretched  little  sufferer.  Arsenicum,  in  con- 
junction   with    highly    nutritious    diet,   entirely   failed   to 


6^4  Lupus  and  Us  Treatmeni, 

modify  the  fatal  malady,  which  spread  with  soch  terrible 
rapidity  that  in  a  few  short  days  death  had  mercifully 
come  to  the  relief  of  this  poor  little  patient. 

Happily  Lupus  non^exedens  is  far  more  amenable  to 
treatment^  and  as  it  displays  so  little  tendency  in  itself  to 
heal,  we  may  safely  attribute  improvement  to  the  remedial 
action  of  our  drugs. 

Allopathic  literature  has  placed  on  record  many  cases  of 
this  disease  cured  by  massive  doses  of  Arsenic.  The 
measure  of  success  which  has  attended  the  use  of  this 
remedy  is  perhaps  to  be  attributed  to  two  causes :  Ist. 
The  remarkable  influence  possessed  by  that  drug  over  pro- 
found perversions  of  nutrition.  2ndly,  to  a  certain 
amount  of  pathogenetic  relation  to  the  pathological  condi- 
tion obtaining  in  cases  of  lupus.  If  you  read  carefully 
Hahnemann's  prbving  of  Arsenicum  you  at  once  recognise 
the  ''  irritable  ulcer "  of  the  surgeons,  in  the  conditions 
enumerated  by  him  as  characteristic  of  the  '^  arsenic  ulcer.'' 
A  typical  example  is  seen  on  the  hands  and  scrotum  of  the 
makers  of  arsenical  papers,*  where  arsenite  of  copper  is 
used  mixed  with  hot  size,  and  in  copper  miner8,t  where 
that  metal  occurs  in  combination  with  arsenic.  The 
appearance  of  the  ulcer  reminds  you  of  those  obstinate, 
punched-out  sores  which  remain  after  the  breaking  down  of 
secondary  syphilitic  gummatous  masses ;  and  where  Nitric 
acid  has  failed  in  cases  of  that  kind,  I  would  suggest  the 
use  of  the  Cupri  Arsenias,  both  internally  and  locally. 

The  '*  arsenic  ulcer "  burns,  so  does  the  '^  kali  bich. 
sore;''  but  the  characteristic  of  the  latter  is,  as  I  have 
pointed  out  elsewhere,  ''  burning  itching,"  and  it  is  of 
''  burning  itching "  that  the  lupus  patient  so  frequently 
complains.  But  I  judge  that  the  chief  reason  why  Arsenic 
is  not  specific  to  lupus  is  that,  unlike  Kali  bich,,  it  does  not 
induce  a  truly  serpiginous  sore. 

Now  let  .us  turn  to  the  most  classic  and  complete 
proving  in  our  literature,  the  Kali  bichromicum  of  Drysdale ; 

*  Vide  third  edition  of  Ouy*s  Forennc  Medicine,  p.  454. 
f  See  the  elaborate  collection  of  evidence  by  Imbert-Gonrbeyre  in  Srit, 
Jaum,  of  Som^  vol.  xxiii.  p.  77. 


by  Dr.  Edward  T,  Blake.  645 

there  we  find  that  the  typical  action  of  Kali  Inch,  expresses 
itself  thus : — ''  first  a  burning-itching  pustule  ;  this  breaks 
down,  leaving  a  dry^  oval^  puuched-out  ulcer  with  over- 
hanging margins ;  this  remains  for  months  unchanged,  and 
if  finally  it  heal,  it  leaves  behind  it  a  dense  white  cicatrix/' 
Here  we  are  presented  with  the  nmilimum  of  lupus. 
Now,  I  have  observed  a  fact  not  very  easy  of  solution. 
Whilst  such  remarkable  benefit  accrues  from  the  use  of  the 
Bichromate  of  Potash  in  long-standing  cases  of  lupus,  I 
have  seen  it  fail  completely  in  the  recent  case. 

Case  2. — Last  October,  S.  B — ,  a  stout  healthy  looking 
girl  of  19,  consulted  me  for  lupus  in  the  incipient  stage. 
In  the  centre  of  the  right  cheek  was  a  tubercle,  of  crusty 
appearance  and  pale  yellow  colour.  It  had  existed  for 
eight  years,  and  measured  when  she  came  to  me  six  milli- 
metres  in  diameter.     I  gave  a  thorough  trial  to  Kali  bich^^ 

but  without  result.     With   the  actual   cauterv  I   then  re- 

» 

moved  it,  and  with  it  a  good  area  of  healthy  tissue.  I  had 
an  opportunity  of  examining  this  patient  a  few  days  ago ; 
there  is  as  yet  no  reappearance,  though  she  occasionally 
feels  pain  in  the  scar  (due  probably  to  the  contraction  of 
the  cicatricial  tissue),  and  sometimes  the  right  eye  hurts 
her. 

The  succeeding  instances  illustrate  the  curative  power  of 
Kali  bich.  over  advanced  and  intractable  cases.  In  the 
last  edition  of  his  work  on  The  Science  and  Practice  of 
Medicine^  Aitken  says,  relative  to  lupus,  '^  the  most  de- 
structive form  begins  at  the  tip  of  the  nose  and  at  the  ala 
nasi ;''  therefore  I  have  especially  selected  nasal  cases  to 
illustrate  the  influence  exerted  by  this  drug. 


Case  8. — Mrs  M.  D — ,  set.  60,  consulted  me  on  the 
2nd  April,  1868.  Has  bad  fairly  good  health,  with  the  ex- 
ception of  dyspepsia  and  "  sick  headache,''  to  which  as  a 
girl  she  was  prone.  She  sometimes  feels  pains  in  her 
back^  and  used  to  have  a  white  discharge. 

Twenty  years  ago  a  small  tuberde  appeared  on  the  right 
side  of  the  nose ;  this  gradually  melted  away  and  formed 
an  ulcer,  which  has  ever  since  slowly  travelled  in  furrows, 


646  Lupus  and  its  TreatmefU, 

healing  behind.  Now  there  is  an  irregular  snlcus  one  inch 
and  a  half  long ;  besides  this  there  are  scabs  on  the  nose, 
and  scars  indicating  the  sites  of  former  sores.  'Hie  itching 
is  very  troublesome.  Nit  a^cid  S'  mnque.  28  daya.  Lotio 
Acid.  ni^.  1  ad  82. 

April  80th. — No  improvement.  Kali  bich,  8'  mnque. 
28  days.     Lotio  lAq,  Carb.  dil.  1  ad  8. 

May  28th — Much  the  same,  feels  depressed,  pains  in 
back,  cough.  Bep.  med.  28  days.  L/oHo  Kali  Bich.  gr. 
xxz  ad  ^lY. 

July  2nd. — Face  better ;  back  easier ;  giddy  ;  dry  throat 
in  morning.  The  lotion  seemed  to  burn  her  so  much  that 
she  went  back  to  that  previously  prescribed,  viz.  Liq,  Carb. 
Rep.  med.  28  days.    Rep.  Kali  bich.  lotion  diluted  10  times. 

30th. — The  nose  itches  still,  but  there  is  no  breach  of 
surface ;  this  ulcer,  which  for  twenty  years  had  never  been 
closed,  has  quite  healed.      Rep.  med.  28  days. 

December  10th. — ^There  is  no  return  of  the  disease. 

Case  4. — Mrs.  E.  M — ,  set.  48,  is  a  laundress ;  has  had 
eight  children,  and  one  miscarriage.  She  was  ruptured  at 
her  last  labour.  Four  of  her  children  were  stillborn,  and 
one  was  discoloured.  Her  living  children  enjoy  good 
health.  Her  father  suffered  from  asthma.  Had  measles 
and  hooping-cough  as  a  child.  At  ten  passed  several 
round  worms.  At  seventeen  a  tumour  began  to  form  on 
the  lower  jaw  (epulis) ;  it  grew  eighteen  years.  It  was 
removed  by  a  Reigate  physician,  and  has  not  returned. 

In  the  spring  of  1866  she  first  observed  a  scab  on  the 
angle  of  the  right  nostril.  Her  husband  was  maniacal  at 
the  time  and  often  struck  her.  She  thinks  this  might  have 
originated  in  a  blow.  After  his  death  in  th^  ensuing 
summer  she  had  erysipelas  badly  for  three  wtieks.  Some 
months  afterwards  the  scab  was  "  burned  out  with  caustics/' 
It  did  not  heal,  and  another  spot  made  its  appearance  nearer 
the  point  of  the  nose.  Twelve  months  ago  the  disease  com- 
menced also  on  the  left  apex  of  the  nose,  and  since  that 
time  has  steadilv  increased. 

She  has  beeu  under  three  doctors  in  Reigate^  but  baa 


by  Dr.  Edward^  T.  Blake.  647 

received  no  benefit.  She  has  had  medicine  that  has 
''  terrified  her  eyes  and  caused  a  burning  in  the  pit  of  her 
stomach ;''  need  we  say  what  that  medicine  consisted  of? 

On  27th  March^  1873,  she  presented  herself  with  charac- 
teristic nasal  lupus  in  the  state  figured  in  my  coloured 
sketch.  There  was  no  copper  tint^  no  circumferential 
induration;  the  nostrils  were  obstructed^  occasionally  they 
discharged  yellow  crusts  and  blood.  Her  neighbours 
amiably  hint  that  the  disease  is  one  she  '^  ought  not  to 
have ;"  but  with  the  exception  of  the  discoloured  child 
there  is  no  evidence  of  specific  infection. 

The  body  is  thin  but  not  emaciated ;  she  sleeps  badly. 
She  dreams,  starts  and  talks ;  vertigo ;  eyes  swell  (especially 
the  right*)  in  the  morning ;  mouth  furred  on  waking ; 
gums  bleed  ;  throat  dry  at  night ;  nausea  before  breakfast ; 
flushes  after  food ;  epigastric  throbbing ;  borborygmus, 
threadworms,  has  been  subject  to  prolapsus  ani  (a  family 
failing)  all  her  life ;  palpitation ;  dyspnoea  on  exertion ; 
catamenia  not  painful ;  they  last  three  days  ;  they  recur 
with  regularity,  but  are  scanty  after  the  first  day ;  towards 
the  close  of  the  flow  there  is  vesical  tenesmus. 

Chiefly  by  way  of  securing  the  confidence  of  the  patient, 
and  thus  the  opportunity  of  watching  the  case  over  an 
extended  period  of  time,  I  prescribed  what  I  knew  would 
bring  present  and  sensible  relief  to  the  subjective  symp- 
toms, viz.,  Nuof  12,  gtt.  i,  hor.  I  ante  cib. 

As  I  anticipated  she  returned  in  a  week  reporting  im- 
provement *'  in  herself  /'  the  mouth  was  not  so  dry,  less 
throbbing;  she  had  felt  nausea  during  the  day,  with 
diarrhoea  (?  agg.)  ;  not  so  much  flatulence ;  less  palpitation ; 
anus  better,  less  prolapsed  ;  nose  not  so  red.  Kali  bich,  3^ 
manque. 

April  9th. — Nose  is  less  turgid  ;  there  is  less  palpitation. 
She  has  taken  cold,  and  her  throat  is  sore.     Rep. 

16th. — There  is  less  discharge  from  the  nose  ;  vertigo  and 
constant  tickling  cough.  Rep.  Kali  bich.,  but  change 
potency  to  5*. 

•  It  will  be  reracrobered  that  Case  Z  iuifered  from  eve  •ymptomi  oq  tb^ 
ftfteoted  tide. 


648  Lupus  and  its  Treatment^ 

23rd. — Nose  is  paler  and  a  healing  process  is  distinctly 
visible  at  posterior  margin.  Less  vertigo;  the  cough  is 
looser ;  pain  in  the  left  thigh.     Bep.      Ung.  Aloe  to  anus. 

30th.— Feels  better ;  the  disease  seems  to  be  culminating 
towards  the  point  of  the  nose,  i  The  anus  is  much  less  pro- 
lapsed ;    there  is  still  a  troublesome  cough.     Bep. 

Maj  7th. — ^The  apicial  crust  fell  off  on  the  1st  of  May ; 
new  skin  is  forming  round  the  site  of  the  scab ;  the  nose 
itches^  it  feels  distinctly  hot  to  my  hand.  She  sleeps  well ; 
there  is  no  vertigo,  less  nausea,  aacarides  tease  her;  the 
cough  is  nearly  gone.     Rep. 

14th. — Much  better;  copious  discharge  from  nose,  feeling 
''  as  if  cold  water  under  nostrils ;"  slight  nausea,  cough 
better.     Kali  bich.  8\ 

June  11th. — Not  so  well ;  nose  very  painful,  it  dis- 
charges freely ;  to  abandon  entirely  the  use  of  stimulants. 
Sack,  lac, 

18th. — Not  so  well ;  nose  worse,  very  little  discharge,  but 
it  is  hot  and  painful.     Kali  bich.,  return  to  5^. 

25th. — Better  certainly ;  less  heat,  occasional  nausea. 
Rep. 

July  9th. — Still  marked  improvement ;  the  centre  of  the 
nose  has  quite  healed  ;  has  for  the  past  fourteen  days  felt 
extremely  sleepy.  Rep.  One  dessert-spoonful  of  port  wine 
at  11  daily. 

16th. — Better.     Rep.      Ung.  lAq,  carb,  deterg, 

20th. — Insomnia ;  the  result^  doubtless,  of  the  worry  of  a 
lawsuit.     Rep. 

September  3rd. — The  nose  has  continued  to  improve ; 
the  deep  sulci  left  by  the  dropping  off  of  the  crusts  have  been 
filled  by  healthy  tissue ;  now  there  remain  only  three  small 
diseased  points  less  than  peas.  Head  is  weak,  scalp  numb, 
vertical  pressure,  pain  in  nape,  miod  is  much  depressed, 
tinnitus  aurium  ;  there  is  nausea  and  occasionally  wind ;  she 
cannot  make  up  her  mind  to  eat  anything,  and  in  the  very 
act  of  raising  food  to  her  mouth  she  falls  asleep  ;  menses 
regular ;  they  only  last  one  day  now.  Pulse  88.  Opium  3'. 
To  poultice  off  scabs  and  then  paint  exposed  surface  with 
Hydrated  Carbolic  acid  3J,  with  water  ^j* 


by  Dr.  Edward  T.  Blake.  649 

1 7th. — Head  symptoms  gone  ;  nose  looks  healthier. 
Pulse  76.     Kali  bich,  5*. 

October  17th. — Nose  has  been  still  improving  ;  it  is  now 
restored  to  its  normal  form ;  even  the  fosssB  left  by  the 
removal  of  the  crusts  are  filled  with  sound  tissue^  and^  with 
the  exception  of  the  red  tint  of  the  cicatrices,  she  now  presents 
her  ordinary  appearance.  Pulse  104.  Rep.  Kali  bich.  5* 
and  Fer.  mur.  8  gtt. ;  post  prand.  meridianum. 

I  saw  her  on  the  18th  December,  and  there  was  neither 
tubercle  nor  depression  on  the  nose  ;  the  interior  of  the  nose 
felt  comfortable  and  the  bowel  did  not  descend.  The  cure 
could  now  be  pronounced  complete. 

There  is  one  curious  point  about  this  case.  You  will 
perceive  that  on  her  second  visit  she  received  the  3rd 
dec.  of  Kali  bich.^  which  was  continued  for  fourteen 
days  with  very  little  benefit^  but  on  taking  Kali  bich.  5'  an 
immediate  good  effect  is  visible;  this  you  will  justly  say 
proves  nothings  but^  as  14th  May,  she  again  takes  the 
Srd  dec.  for  one  month  and  manifestly  loses  ground  ?  then 
after  a  week  of  Sacch,  lac.  and  no  result,  she  again  advances 
steadily  towards  health  under  the  5th  dec.  dilution.  The 
fact  is  the  Bichromate  of  Potash  is  a  very  powerful  drug^ 
and  will  bear  free  dilution.  It  is  never  safe  to  promise  a 
patient  that  lupus  will  not  recur. 

Our  literature  is  not  rich  in  instances  of  the  cure  of  lupus. 
In  the  Hygea,  vol.  iv,  p.  8,  1886;  in  the  Gazette  Hommo^ 
pathique,  vol.  x,  p.  46, 1886;  in  the  Archives  Homceopathiques, 
vol.  viii^  cap.  I,  p.  73,  1829,  there  are  three  examples  of 
the  cure  of  lupus  by  Calcarea  30 ;  in  the  Gazette  HomceO' 
pathique^  vol.  vii,  p.  74,  1835,  there  is  a  case  cured  by 
Baryta  carbonica  30 ;  and  another  by  Silica  30,  in  vol  x, 
of  the  same  gazette,  p.  46,  1836.*  Biickert  gives  two 
cases  cured  by  Aurum  10 ;  and  Y.  Meyer  speaks  of  a  case 
being  cured  by  Apis  4. 

There  are  in  the  British  Journal  of  Homceopathy  cases 
recording  the  disappearance  of  lupus  under  the  use  o{  Arsenic, 
Kali  chlor.y  Aurum,  Hydrastis,  and  Hydrocotyle. 

*  It  is  necessary  to  add  that  these  cases  answer  much  more  from  their 
description  to  our  ideas  of  6tn;moa»  glands  than  tme  lupus. 


650  Lupm  and  its  Treatment ^ 

And  now,  Mr.  President  and  Oentlemen,  I  take  my  aeat^ 
trusting  that  my  poor  paper  may  provoke  a  rich  discussion. 
If  by  it  I  shall  succeed  in  educing  some  of  the  valuable 
stores  of  your  practical  experience^  I  shall  not  have  laboured 
in  vain. 


Dincassion  on  Dr.  Edward  T,  Slake' i  paper. 

Dr.  Baitbfobd  wished  to  thank  Dr.  Blake  for  his  interest- 
ing paper,  and  to  confirm  his  remarks  upon  the  efficacy  of  £ali 
hichrom.  His  patient  has  been  a  gentleman,  SBt.  82.  The  cape 
is  fiilly  reported  in  the  British  Journal  of  ffomosopatky,  No.  96, 
April,  1866.  He  was  perfectly  free  from  strumous  taint ;  he  had 
resided  upwards  of  thirty  years  in  India,  where  he  had  held  high 
offices  in  the  Civil  Service.  In  the  autumn  of  1864,  after 
recovery  from  an  attack  of  diarrhoea,  the  evacuations  being  of  a 
dark  greenish  colour  of  the  couBistence  of  pitch,  and  subse- 
quently from  bronchitis  accompanied  by  intermittent  pulse,  a 
vascular  spongy  tum6ur  appeared  in  the  riffht  nostril,  distending 
it  and  apparently  growing  upwards ;  afterwards  it  travelled 
slowly  downwards  and  protruded  externally ;  the  left  nostril 
became  affected  in  the  same  way  ;  the  soft  parts  of  the  al»  nasi 
were  involved,  but  the  bony  structure  was  unaffected  ;  there  was 
but  very  slight  and  occasional  muco-purulent  discharge ;  there 
were  often  severe  paroxysms  of  lancinating  pain  in  the  affected 

Sarts  sufficie^itly  acute  to  make  the  poor  man  cry  out  loudly ; 
esirous  of  further  advice,  I  met  his  former  attendant.  Dr.  Sander- 
son, of  the  Bengal  Army,  in  consultation,  and  subsequently  Sir 
James  Paget  saw  him  likewise.   Both  of  these  gentlemen  thought 
the  case  malignant  and  hopeless,  only  suggesting  cleanliness  and 
generous  diet,  both  of  which  suggestions  had  been  anticipated.   I 
had  given  Arsenicum  in  various  dilutions  without  any  apparent 
check  to  the  ulcerative  process.    JRali  hickrom,  oocurr^  to  me.   I 
prescribed   it  in  the  8rd  dilution,  applying  it  also  locally  and 
externally  by  means  of  a  glass  syringe ;  most  unexpectedly  the 
progress  of  the  disease  was  gradually  but  visibly  checked  ;  healthy 
granulation  took  the  place  of  phagedsBnic  ulceration,  which  never 
recurred.     Sir  James  Paget  saw  the  patient  after  his  cure  and 
admitted  the  fact ;  he  lived  many  montns  after  the  healing  process 
was  accomplished,  dying  at  last  of  mere  exhaustion  of  the  vital 
powers  without  any  apparent  suffering.     He  was  one  of  a  very 
healthy  family  in  whom  no  hereditary  disease  existed.     He  had 
been  accustomed  to  take  large  quantities  of  Masulipatam  snuff; 
this  contains  ingredients  of  a  peculiar  and  acrid  nature.     Dr. 
Sanderson  was  inclined  to  think  that  this  snuff  might  have  been 
the  cause  of  the  malady.    I  cannot  give  an  opinion  of  the  true 
character  of  the  disease,  but  that  the  Kali  bichrom^  cured  the 


by  Dr.  Edward  T.  Blake.  651 

malignant  and  corroding  ulcerations  I  have  no  doubt  whatever. 
To  my  Burpriae  Dr.  Bichard  Hughes,  in  his  2nd  edition  of  his 
interesting  and  valuable  work  on  Pharfnaeodynamies,  2nd  edition, 
page  861,  sets  this  case  down  as  one  of  polypus,  to  which  it  was 
very  dissimilar.  Dr.  Hughes  had  never  seen  the  patient,  but  Dr. 
Sanderson,  Sir  James  Paget,  also  Dr.  Henriques,  our  colleague 
(on  one  occasion),  had  examined  the  nose,  and  agreed  as  to  its 
malignant  nature. 

Dr.  Dbtsbalb. — Looking  back  on  his  experience,  he  can  re- 
member few  cases  of  that  disease  which  remained  long  enough  to 
attain  complete  results,  as  such  persons  in  private  practice  are 
apt  to  go  to  specialists  ver^  soon  if  they  do  not  see  immediate 
good  results.  So  he  had  little  to  add  to  the  case  of  cure  formerly 
published.  He  was  glad  to  see  that  Dr.  Blake  had  made  sucb 
good  use  of  his  experience,  and  persevered  in  the  one  medicine 
long  enough  to  produce  effective  results.  He  felt  naturally  much 
interested  in  hearing  successiul  curative  applications  of  a  medicine 
of  which  he  had  given  the  first  proving ;  which  Dr.  Blake  had 
spoken  of  in  too  flattering  a  manner,  as  he  could  now  see  many 
defects  in  it. 

Dr.  HoLLAKD,  after  thanking  Dr.  Blake  for  his  excellent  and 
instructive  paper,  said  he  had  very  little  homoBopathic  experience 
of  this  disease ;  but,  when  dresser  to  the  late  Mr.  Aston  Key, 
he  had  seen  two  cases  cured  by  Chloride  of  Zinc  locally  applied. 
He  had,  however,  met  with  one  case  where  Kreasote  and  Thuja 
were  productive  of  great  benefit ;  in  one  of  the  cases  Kreasote 
given  in  drop  doses  three  times  a  day,  and  applied  locally  in  the 
proportion  of  5j  of  Kreasote  to  Aq.  ^ij,  and  a  little  gum  or  starch 
to  keep  it  in  suspension,  a  curative  process  went  on  for  a  con- 
siderable time,  but  the  patient  (a  man)  emigrated  to  America  and 
he  never  afterwards  heard  anything  further  of  him. 

Dr.  Haywabd  thanked  Dr.  Blake  for  his  valuable  and  interesting 
paper.  He  had  not  had  occasion  to  treat  many  cases  of  lupus 
since  adopting  homoBopathy :  in  the  one  now  present  to  his  mind 
he  had  suspected  syphilis,  and  had  prescribed  successfully  Iodide 
GfFotasHum  (gr.  j,  four  times  a  day).  He  was  pleased  to  hear 
Dr.  Blake's  facts  as  to  the  power  of  different  dilutions  of  drugs, 
for  he  was  convinced  that  good  was  to  be  obtained  by  using 
different  dilutions — that  though  one  dilution  did  not  cure,  another 
might ;  there  was  something  in  the  dose^  it  was  not  all  in  the 
drug.  He  also  approved  of  the  local  application  of  the  remedy 
in  such  cases  at  the  same  time  that  it  was  being  exhibited  in- 
ternally. 

Dr.  Bates  (Vice-President)  said  that  the  paper  was  a  very 
valuable  contribution  to  our  treatment  of  a  very  obstinate  dis- 
ease.   The  illustrations*  add  greatly  to  the  value  of  the  paper, 

*  Dr.  Blake  exhibited  photog^rapbs  of  the  patient  (Case  4)  fcnV-on  nt  difTeroiit 
timet}  when  tb«  dUeftw  wm  at  iti  height  fwd  w)^t)|i  it  w»h  perlectl^  cured, 


652  Lupu$  and  its  Treatment. 

since  photographs  cannot  lie,  and  give  the  exact  representation 
of  the  improvement  effected.  Dr.  Blake's  comparison  between 
the  pathogenesy  of  ArMeniewn  and  Kali  hiehromicum  is  clear  and 
verj  definite.  The  good  results  of  the  Kali  hiehromicum  were 
most  evident,  and  it  is  a  point  of  great  interest  to  me,  that  not 
only  is  the  choice  of  the  right  medicine  very  important,  but  that 
it  is  of  almost  equal  importance  to  choose  the  right  dilution,  the 
5th  decimal  dilution  acting  promptly  where  the  drd  decimal  dilu- 
tion had  ceased  to  act  curativelj.  Dr.  Blake's  steady  confidence 
in  the  medicine  founded  on  the  exactitude  of  its  homoaopathicity 
was  worthy  of  all  praise.  He  (Dr.  Bayes)  would  be  glad  to  hear 
from  Dr.  Blake  what  part  he  considered  the  Carbolic  add  lotion 
to  have  played  in  the  cure  of  the  case.  Skin  diseases,  with  their 
marked  objective  symptoms,  were  a  good  class  of  cases  in  which 
to  demonstrate  the  positive  action  of  remedies. 

Dr.  EnwABD  Blasjs,  in  reply,  b^ged  to  acknowledge  the 
courteous  reception  of  his  paper.  T\iq  worthy  Chairman  had 
raised  the  question  as  to  how  far  the  use  of  Carbolic  add  had 
contributed  to  the  cure.  It  was  to  be  observed  that  the  acid  was 
only  applied  during  fourteen  days;  on  referring  to  the  daily 
report,  he  saw  this  entry  made, ''  The  noee  looks  healthier  " ;  but 
marked  amelioration  ot  the  symptoms  had  set  in  before  the  use 
of  the  acid,  and  the  fortnight  of  its  employment  did  not  exhibit 
the  most  striking  progress. 


65^ 


REVIEWS. 


Uebcr  die  Incompetenz  der  Beweise  fur  und  under  die 
Homoopathie  gegeniiber  der  conditio  sine  qud.  non  um 
die  game  Homoopathische  Streitfrage  zu  losen.  Von 
Vespasian  V.  Gruzewski  :  Riga,  1874. 

On  the  Incompetence  of  the  Proofs  for  and  against  Homceo- 
pathy,  compared  with  the  conditio  sine  qu&  non  for 
settling  the  whole  Homoeopathic  Controversy,  By  Ves- 
pasian V.  Gruzewski  :  Biga«  1874. 

In  this  brochure  of  103  pages  Mr.  Gruzewski  (we  beg 
his  pardon  if  he  is  Dr.^  but  it  is  not  so  stated  in  his  work, 
which,  indeed,  betrays  the  amateur)  endeavours  to  point 
out  the  unsuitableness  of  the  methods  hitherto  adopted  to 
prove  or  disprove  the  truth  of  homoeopathy,  and  proposes  a 
method  of  his  own,  which,  he  thinks,  will  infallibly  settle 
the  whole  questicfti  and  result  in  the  general  acknowledg- 
ment of  the  truth  of  Hahnemann's  doctrines  and  the  curative 
power  of  infinitesimal  doses. 

He  says,  truly  enough,  that  the  course  hitherto  pursued 
by  both  adherents  and  adversaries  of  homoeopathy  has  not 
resulted  in  convincing  either  that  they  are  in  the  wrong. 
The  records  of  cases  which  recovered  under  homoeopathic 
treatment  are  regarded  by  our  opponents  as  instances  of 
spontaneous  recoveries,  and  those  are  said  to  be  the  victims 
of  a  delusion  who  imagine  that  cures  which  are  actually  due 
to  the  vis  medicatrix  natuns  are  examples  of  the  curative 
power  of  doses  of  medicine  so  small  as  to  be  powerless  for 
good  or  evil. 

So  records  of  cases  cured,  and  comparative  statistics  of 
homoeopathic  success  produce  no  effect  on  our  opponents, 


664  Heviewi. 

unless  to  inspire  them  with  a  high  estimation  of  the  recu- 
perative powers  of  nature,  and  to  shake  their  belief  in  the 
necessity  of  active  treatment.  Their  foregone  conclusion 
that  infinitesimal  doses  are  powerless  effectually  prevents 
them  seeing  any  proof  of  the  truth  of  homoeopathy  in  the 
facts  we  offer  them,  even  when  they  are  so  polite  as  to 
accept  our  statements  as  trustworthy,  which  is  by  no  means 
always  the  case. 

Seeing  the  fruitlessness  of  the  plans  hitherto  adopted 
for  convincing  our  opponents,  Mr.  Oruzewski  thinks  that 
there  is  a  mode,  hitherto  almost  untried,  by  which  the 
truth  or  falsity  of  the  homoeopathic  method  might  be 
demonstrated.  His  plan  is  to  take  a  case  of  disease,  to 
give  the  appropriate  medicine  which  produces  amelioration, 
then  to  refrain  giving  any  further  dose  until  the  action  of 
the  remedy  has  expired,  when  it  will  be  seen  that  the 
powers  of  nature  are  not  sufficient  to  complete  the  cure, 
the  disease  regains  the  mastery,  and  the  amelioration  again 
commences  when  a  second  dose  is  given,  and  thus  we  shall 
be  able  to  prove  to  demonstration  that  it  is  the  medicine 
and  not  the  healing  process  of  nature  that  causes  recovery. 

Mr.  Qruzewski,  says  that  as  far  as  he  knows,  Dr.  Horner 
is  the  only  one  who  has  carried  out  a  similar  demonstration 
of  the  truth  of  homoeopathy.  What  Homer  says  we  may 
quote  from  his  pamphlet  {Rea»an»for  Adopting  the  Rational 
System  of  Medicine,  p.  16)  :  "  I  then  selected  some  forms 
of  disease  where  the  symptoms  were  well  marked  and 
persistent,  and  gave  homoeopathic  medicines,  and  noted 
their  favorable  effects.  Then,  unknown  to  the  patient^  I 
administered  a  precisely  similar-looking  powder,  but  one 
that  was  unmedicated ;  when  the  patients^  or,  in  cases  of 
children,  their  parents^  voluntarily  observed  that  '  this  last 
medicine  had  lost  its  effect  and  done  no  good/  Medicated 
doses  were  given,  and  again  improvement  began,  and  relief 
was  expressed.^' 

Mr.  Oruzewski  presents  us  with  two  cases  in  which  his 
**  conditio  sine  qu&  non,''  as  he  quaintly  terms  this  mode 
of  showing  the  efficacy  of  homoeopathic  treatment,  was 
carried  out. 


Incompetence  of  Proofs  for  and  against  ttommopathy.  oSS 

The  first  case  was  originally  published  in  the  Journal  de 
la  Soc.  Gallicane  (2e  s^rie,  t.  iii,  p.  629).  It  also  appeared 
in  vols.  lix  and  Ix  of  the  Allff,  Horn.  Zeilff.,  and  was  intro- 
duced into  a  pamphlet  published  in  Paris,  in  the  French 
language,  and  illustrated  with  engravings  representing 
the  disease  while  under  the  action  of  the  remedy  and  whilst 
the  use  of  the  remedy  was  suspended. 

The  case  was  one,  as  far  as  we  can  make  out,  of  disease 
of  one  or  more  of  the  bones  of  the  middle  finger.  Silica 
30  was  the  main  remedy. 

''When  the  cicatrization  had  advanced  to  such  a  degree  of 
obviousness  and  regularity  that  ever  less  and  less  was  to  be  seen 
of  the  exposed  portions  of  the  bones,  I  wished  to  find  out  what 
the  efforts  of  nature  would  be  if  unaided  by  any  kind  of  remedy. 
With  this  view  I  gave  the  patient  a  daily  unmedicated  dose,  pre- 
cisely resembling  the  doses  he  had  been  taking,  which  consisted 
of  a  dose  of  Silica  30,  every  seventy-two  hours,  and  unmedicated 
powders  on  the  intervening  days. 

"  During  the  four  first  days  after  the  use  of  Silica  there  was 
observed  a  constant  growth  of  the  small  fleshy  granulations,  which 
formed  anew  each  day  on  the  edges  of  the  wound  and  covered  up 
the  naked  bone  ever  more  aud  more.  The  first  day  this  increased 
growth  was  considerable,  on  the  fourth  day  it  was  less ;  on  the 
morning  of  the  fifth  day  it  was  at  a  stand-still,  and  in  the  evening 
the  inner  edges  of  the  small  granulations  round  the  whole  extent 
of  the  wound  began  to  soften  and  secrete  a  watery  fluid.  On  the 
sixth  day  this  new  suppuration  had  made  such  progress  that  by 
the  afternoon  the  granulations  which  had  been  formed  under  the 
last  administration  of  Silica,  and  more  besides  had  changed  into  a 
dirty  watery  fetid  matter.  After  giving  a  fresh  dose  of  Silica  in 
the  evening  I  found  the  condition  of  the  finger  the  next  morning 
considerably  improved ;  the  fetid  purulent  secretion  disappeared, 
and  on  the  third  day  the  cicatrization  was  making  rapid  progress. 

''  In  order  to  convince  myself  still  more  thoroughly,  I  made  a 
second  similar  experiment  on  the  same  patient  at  once ;  after  the 
administration  of  the  medicine  purposely  waiting  a  while,  the 
results  were  the  same. 

''On  now  continuing  to  give  the  Silica  eveiy  five  days  the 
cicatrisation  progressed  in  the  manner  described,  and  by  means  of 


6*56  keviewi. 

the  homcBopatbic  treatment  the  patient  escaped  the  amputation 
that  had  been  proposed,  though  an  ankylosis  was  ineyitable.** 

The  second  case  is  thus  related  in  the  author's  words : 

"  Vesicular  erysipelas  of  lids  of  right  eye,  sphacelus  of  their 
surface,  inflammation  of  ear,  prodromata  of  meningitis,  ascites, 
&c.  Hecovery  took  place  by  the  administration  and  withholding 
of  the  remedy  in  the  200th  potency  procured  from  the  pharmacy 
of  Lappe.     This  observation  was  made  in  1860. 

*'  After  the  use  of  the  remedies  that  showed  themselves  most 
useful,  such  as  Aconite^  Bryonia,  Pulsatilla^  Arsenic^  Seeale,  and 
Sulphur f  the  general  state  of  the  disease  was  ameliorated.  The 
eyelids  of  the  aflbcted  eye  were  free  from  the  scabs  that  had 
formed  on  the  surface  destroyed  by  the  sphacelus.  Aft«r  the 
administration  of  Silica  30,  and  subsequently  200,  repeated  every 
forty-eight  hours,  the  raw  surfaces  that  remained  cicatrised 
almost  completely,  and  the  dropsy  got  better  everywhere,  only 
the  lids  of  the  affected  right  eye  were  still  swelled  and  fast  shut. 

"  After  a  treatment  of  twenty-eight  days  the  patient  no  longer 
complained  of  anything,  the  general  state  was  perfect,  and  the 
pulse  72 ;  but  beneath  this  apparently  satisfactory  character  of 
the  patient's  state  there  was  doubtless  a  latent  morbid  evil. 
This  seemed  to  be  a  fitting  opportunity  for  leaving  the  patient 
without  risk  for  a  certain  time  to  the  sole  efforts  of  nature ;  so 
after  the  administration  of  Silica  I  gave  him  from  the  15th  of 
November  only  an  unmedicated  powder  each  day. 

"  Nov.  17th. — The  remainder  of  the  ulcers  cicatrised. 

^'  18th. — On  rising  in  the  morning  weakness,  which  soon  went 
off.  In  the  evening  the  swelling  of  the  affected  eye  increased 
afresh.  In  the  night  great  heat  of  the  whole  eye ;  the  OBdema 
spread  rapidly  again  over  the  forehead.  I  should  say  that  during 
the  previous  progress  of  the  disease  the  forehead,  scalp,  and 
thorax  were  involved  in  the  dropsical  effusion.  Aconite  -/g,  one 
dode.  The  heat  alluded  to  diminished ;  the  o&dema  continued  to 
progress,  but  less  quickly  ;  sleeplessness. 

'*  19th. — The  whole  of  the  right  side  of  the  forehead  was  again 
involved  in  the  oedema,  which  extends  to  down  between  the  eye- 
brows. On  the  surface  of  the  upper  lid  renewed  ulceration,  with 
exudation.  On  raising  the  lid  the  sclerotic  appeared  much 
reddened,  which  was  not  the  case   before  tliis  experiment  in 


Incompetence  of  Proofs /or  and  against  itomceDpathy.  657 

expectation.  Pulse  88,  throbbing  of  carotids,  inclination  to 
sleep,  pains  in  the  bones,  the  limbs,  and  the  whole  body,  as  if 
broken  on  the  wheel.  In  bed  yawning  and  stretching ;  pain  of 
the  affected  eye,  whose  lids  were  swelled,  red,  and  turned  up. 
All  these  symptoms  were  present  at  the  commencement  of  the 
disease,  to  which  Silica  shows  the  greatest  similarity ;  so,  after 
marking  the  limit  of  the  spreading  cBdema,  Silica  ^^  was  repeated 
at  8.35  a.m.  From  the  moment  the  medicine  was  given  the 
(Bdema  ceased  to  extend,  and  the  throbbing  in  the  carotids  soon 
left  off;  the  spirits  improved;  there  was  general  amelioration. 
Towards  evening  coldness  in  the  body,  followed  by  perspiration. 
At  night  increase  of  the  temperature  of  the  body.  After  mid- 
night sleep,  and  the  following  morning  the  patient  woke  feeling 
well ;  the  swelling  of  the  forehead  diminished  visibly,  that  is  to 
say,  it  fell  back  to  the  distance  of  a  centimeter  from  the  line 
drawn  on  the  forehead. 

"  Since  that  time  the  medicine  was  continued  uninterruptedly ; 
the  amelioration  went  on  rapidly,  and  in  five  or  six  weeks  the 
cure  was  complete.  A  year  afterwards  the  cured  patient  was 
shown  by  me  to  Drs.  Brutzer  and  Brauser,  homoBopathic  practi- 
tioners in  Biga.  In  their  presence  he  attempted  to  read  large 
print  in  a  book  with  the  cured  eye,  because  an  ulceration  of  the 
cornea  which  had  remained  prevented  him  seeing  clearly  and 
reading  small  print.*' 

Mr.  Gruzewski  displays  a  remarkable  amount  of  natvet^ 
in  imagining  that  the  homoeopathic  controversy  which  has 
hitherto  kept  alive^  notwithstanding  the  bushels  of  cases 
and  the  acres  of  statistics  that  have  been  employed  in  it, 
will  be  finally  settled  by  these  two  cases^  or  by  a  whole 
cartload  of  such  cases.  We  have  translated  Mr.  Gruzewski's 
cases  as  faithfully  and  as  literally  as  possible  in  order  that  we 
may  not  incur  the  charge  of  distorting  them  in  any  way  ;  but 
we  are  perfectly  sure  that  no  scientific  practitioner  of  what- 
ever school  could  attach  the  slightest  value  to  these  cases 
as  proving  the  utility  or  futility  of  the  medicines  em- 
ployed. It  is  impossible  from  the  descriptions  to  realise 
what  was  the  precise  character  of  the  diseases  treated.  In 
the  first  case  was  the  bone  or  were  the  bones  denuded  of 
their  periosteum   or  not?     What  was  the   cause   of  the 

VOL.  XXXII;  NO.  CXXZ.—- OCTOBIBi  1874.  T  T 


668  Reviews. 

denudation  of  the  bone?  All  that  we  hear  is  that  the 
bones  were  denuded,  and  that  some  one  had  recommended 
amputation.  All  that  we  learn  of  the  cure  is  that  cicatri- 
sation took  place-^whether  with  or  without  exfoliation  of 
necrosed  bone  the  author  does  not  state;  but  with  anky- 
losis, so  that  perhaps  the  patient  would  have  done  better  to 
follow  the  advice  given  him  to  have  the  finger  amputated ; 
for  surely  no  finger  at  all  is  better  than  one  that  is  always 
sticking  out  when  the  other  fingers  are  closed,  or  which 
remains  firmly  flexed  when  the  other  fingers  are  extended. 
**  Better  a  finger  aff  as  aye  waggin'/^  ^  the  Scotch 
proverb  has  it.  If  our  opponents  persist  in  saying  that  a 
recovery  after  the  administration  of  our  doses  is  a  mere 
coincidence,  what  is  to  hinder  them  from  saying  that  a 
relapse  after  leaving  off  our  medicines  is  also  a  mere 
coincidence  f 

The  second  case  is  even  worse  than  the  first  for  any 
lesson  it  can  teach.  What  was  the  disease  7  Blaterrose 
the  author  calls  it,  which  ought  to  be  translated  *'  vesicular 
erysipelas  */'  but  who  ever  heard  of  vesicular  erysipelas 
lasting  from  nine  to  ten  weeks  f  Then  what  became  of  the 
inflammation  of  the  ear,  the  prodromata  of  meningitis,  and 
the  ascites,  that  are  mentioned  at  first  but  never  afterwards 
alluded  to  ?  In  truth,  we  can  make  nothing  of  the  case, 
and  as  for  its  proving  anything  respecting  the  virtues  of 
Silica  200,  that  we  are  quite  unable  to  perceive.  If  we 
were  asked  to  say  what  it  proved,  we  should  reply  that  it 
proves  how  enormously  long  the  case  was  protracted  under 
Mr.  Oruzewski^s  treatment.  Not  a  fragment  of  a  hint  is 
given  in  either  of  the  two  cases  as  to  what  other 
remedial  means  are  employed,  whether  local,  general, 
dietetic,  or  hygienic ;  and  yet  we  will  not  suppose  that  the 
author  neglected  these  points,  and  of  course  they  must  have 
had  their  influence  on  the  disease. 

Then  there  is  in  the  second  case  that  mysterious  ulcera- 
tion of  the  cornea  which  prevented  the  patient  seeing  dis- 
tinctly— ^^when  did  that  arise,  and  how  could  the  patient's  eye 
be  said  to  be  completely  cured  when  there  was  still  ulcera- 
tion of  the  cornea  ?     The  case  is  stated  to  have  been  shovrn 


Incompetence  of  Proofs  for  and  against  Hommqpathy,  66d 

to  Drs.  Brutzer  and  Brauser^  but  we  are  not  informed  what 
impression  this  wonderful  cure  produced  on  these  gentlemen 
when  they  found  that  the  cured  patient  could  not  see 
distinctly  on  account  of  ulceration  of  the  cornea.  In  short, 
both  cases  are  so  unscientifically  reported  that  no  one  can 
make  either  head  or  tail  of  them.  If  Mr.  Gruzewski 
expects  that  any  amount  of  cases  reported  in  this  slipshod 
manner  will  have  the  slightest  efiiect  in  "settling  the 
homoeopathic  controversy  "  he  is  wofully  mistaken. 

We  may  be  perfectly  satisfied  in  our  own  minds  of  the 
curative  action  of  a  drug  in  a  particular  case,  but  it  is 
almost  impossible  so  to  relate  that  case  that  it  shall  con- 
vince others  that  the  medicine  given  was  the  efficient  cause 
of  the  cure.  Hahnemann  was  right  in  setting  a  low 
estimate  on  the  record  of  cures  as  a  means  for  convincing 
practitioners  of  the  truth  of  his  doctrines.  '*  Machfs 
nach  !'*  was  his  constant  advice.  "  Repeat  the  experiment 
for  yourselves,  but  repeat  it  carefully  and  exactly,  and 
I  have  no  fear  but  that  you  will  come  to  share  my 
convictions  V*  And  after  all  has  been  said  that  can  be  said 
for  and  against  statistics  and  figures  and  records  of  cases, 
there  is  nought  so  convincing  as  careful  trials  made 
by  ourselves  with  the  single  desire  to  come  at  the 
truth.  This  is  the  way  we  have  all  become  convinced  of 
the  truth  of  homoeopathy,  and  this  is  how  our  present 
opponents  must  be  convinced.  It  is  quite  right  to  record 
the  cures  that  brought  conviction  to  our  own  minds,  but  we 
shall  err  grievously  if  we  think  they  will  be  equally 
convincing  to  others.  The  result  we  can  hope  from  them 
is  that  they  will  lead  others  to  make  trials  for  themselves, 
and  if  they  do  .this  *'  genau  und  sorgfaltig  " — "  exactly  and 
carefully  '^ — we  need  have  no  fear  of  the  result.  Careful 
trial  is  the  real  *^  conditio  sine  quft  non  **  for  settling  the 
homoeopathic  controversy,  as  far  as  the  individual  prac- 
titioner is  concerned,  and  there  is  no  other  method  con- 
ceivable by  which  the  homoeopathic  controversy  can  be 
settled  except  by  the  conversion  of  individual  practitioners. 

We  are  glad  to  notice  that  careful  trials  of  single 
homoeopathic  remedies  are  daily  being  made  by  the  most 


660  aevietbs. 

intelligent  of  the  old-school  practitioners,  and  we  notice 
with  pleasure  that  our  remedies  are  coustantly  being 
adopted  into  their  treatment,  and  the  whole  practice  of  the 
old  school  is  undergoing  a  change  in  the  homoeopathic 
direction. 


A  Sj/8tem  of  Surgery.      By    Wm.    Too  Helmuth,  M.D. 
New  York :  Caste  and  Grener,  1 873. 

Dr.  Helmuth,  Professor  of  Surgery  in  the  New  York 
Homoeopathic  Medical  College,  has  brought  out  a  new 
edition  of  a  work  on  surgery  published  by  him  in  1855. 

The  present  work  is  far  more  complete,  and  the  aim  of 
the  author  has  apparently  been  to  make  this  edition  rank 
as  a  first  class  text-book  on  surgery,  and  to  show  the  un- 
prejudiced practitioner  the  great  advantage  surgery  pos- 
sesses when  combined  with  treatment  based  on  homoeo- 
pathic principles. 

In  the  preface  he  mentions  that  he  will  not  discuss 
the  subjects  of  ophthalmology,  otology,  or  odontology,  as 
these  have  now  become  specialities,  and  it  would  only  be 
adding  bulk  to  the  volume  without  increasing  its  intrinsic 
value. 

Dr.  Helmuth  is  to  be  congratulated  on  his  resolution, 
because  in  putting  forth  a  work  on  surgery  there  is  a 
great  temptation  to  make  it  appear  as  complete  as  possible, 
and  to  show  a  familiarity  with  every  department  of  the 
surgical  art. 

To  compensate  for  the  omission  of  these  subjects,  he 
introduces  a  chapter  on  the  microscope,  new  in  surgical 
works,  and  chapters  on  electricity,  disinfectants,  and 
anaesthesia. 

He  commences  in  Chapter  II  an  enumeration  of  the 
instruments  required  for  surgical  practice,  such  as  probes, 
directors,   knives,    exploring    trocar,    &c.,    mentioning   the 


A  System  of  Surgery^  by  Dr.  Tod  Helmuth.         661 

articles  required  for  dressings  also  recommending  Marine 
lint  as  a  good  antiseptic  dressing,  and  giving  several  excel- 
lent rules  laid  down  by  Dr.  Smith  to  be  observed  by  the 
young  practitioner  in  order  to  dress  parts  with  elegance  and 
dexterity. 

He  refers  also  to  paper  as  a  surgical  dressings  giving  Dr. 
Hewson's  experience^  and  mentioning  that  his  own  results 
with  waxed  paper  had  been  most  satisfactory 

Whether  paper  will  ever  attain  high  repute  as  a  dressing 
is  in  the  highest  degree  doubtful. 

A  practical  hint  is  given  as  to  the  use  of  the  hypo- 
dermic injection^  viz.,  that  at  least  half  the  stomachic  dose 
should  be  employed,  and  it  is  preferable,  if  the  substances 
are  soluble  in  water,  to  use  that  as  a  vehicle,  as  it  is  less 
irritating  to  the  skin. 

He  next  mentions  two  different  kinds  of  thermometers, 
Seguin's  and  Casella's,  which  are  excellent  instruments, 
and  also  refers  to  several  diseases  in  which  noting  the 
varieties  of  temperature  would  be  of  great  advantage  to  the 
surgeon. 

This  chapter  is  meagre,  but  the  next  on  electricity  is 
more  complete  and  of  deep  interest  in  a  practical  point  of 
view.  He  tells  us  that  it  is  indispensable  that  batteries 
furnishing  the  continuous  galvanic  current  should  generate 
a  large  quantity  of  electricity,  and  that  in  administering 
this  form  of  electricity  we  should  be  careful  not  to  overdose 
the  patient.  No  doubt  the  reason  we  often  hear  that 
electricity  is  useless  as  a  remedial  agent  is  that  enthusiasts 
carry  it  beyond  reasonable  limits,  and  having  themselves 
failed,  are  blinded  to  its  merits  and  embrace  every  oppor- 
tunity of  bringing  it  into  ridicule,  and  stamping  it  as  a 
foolish  piece  of  quackery.  What  would  they  say  to 
employing  it  at  one  time  not  longer  than  ten  minutes, 
which  Dr.  Helmuth  thinks  sufficient  for  one  application  ? 

A  most  excellent  battery  is  that  manufactured  by  the 
Galvano-Faradic  Company  of  New  York,  and  we  trust 
that  every  practitioner  who  is  in  favour  of  electricity  will 
give  it  a  fair  trial,  and  if  he  then  fails,  he  may  be  sure 
that  in  bis  hjinds  at  least  eleptricity  will   pever  si^cceed. 


662  Reviews. 

It  will  be  found  very  usefdl  in  paralysis^  neuralgia^  dis- 
eases of  the  brain,  spinal  cord,  and  also  in  the  treatment 
of  indolent  ulcers,  and  the  sores  of  bed-ridden  patients. 

Faradisation  will  be  found  useful  in  rheumatism,  cur- 
vature of  the  spine,  prolapsus  ani,  aphonia,  and  a  host  of 
other  diseases. 

To  throw  aside  such  an  agent  after  a  temporary  failure 
would  show  that  the  operator's  mind  was  on  a  par  with  the 
dead  material  of  which  the  instrument  is  made,  and  that  no 
new  light  would  ever  penetrate  the  dark'  vista  of  his  under- 
standing. 

The  galvanic  cautery  battery  promises  to  become  very 
useful  in  the  treatment  of  tumours,  and  also  of  that  malig- 
nant disease  lupus,  which  up  to  the  present  time  has  resisted 
most  remedies. 

It  appears  also  to  have  been  successful  in  the  cure  of 
cancer,  nsevi,  arterial  tumours,  so  that  if  this  be  confirmed 
by  experience  a  new  era  has  dawned  in  surgical  treatment, 
and  the  knife  will  gradually  be  banished  from  those  realms 
over  which  it  has  hitherto  held  undisputed  sway. 

In  Chapter  V  we  find  disinfectants  fully  discussed,  and 
mention  is  made  of  various  substances  which  have  proved 
useful,  such  as  Bromine,  Ozone,  Iodine,  Permanganate  of 
Potash,  Carbolic  add,  i^c.  He  tells  us  that  he  has  found 
a  shallow  vessel  half  full  of  cofiPee  to  be  extremely  useful 
in  the  dissecting  room,  rendering  the  atmosphere  pure ;  at 
least  so  far  as  olfaction  goes. 

We  trust  coflee  may  come  into  extensive  use  for  the 
benefit  of  the  medical  student's  olfactory  nerves,  which 
are  usually  totally  disregarded  by  the  enthusiastic  anatomical 
teacher. 

In  mentioning  Iodine  he  says  that,  during  the  severe 
cholera  season  of  1866  in  St.  Louis,  he  employed  this  sub- 
stance continually,  and  also  ordered  all  the  vessels  used  by 
the  patients  to  be  immediately  emptied  and  rinsed  with  a 
solution  o(  Iodine, 

He  nexts  deals  with  anaesthesia,  mentioning  that  to 
America  belongs  the  honour  of  first  employing  Ether  as  an 
ansestbetic  agent,  and  to  Great  Britain  Chlorqform, 


A  System  of  Surgery,' by  Dr.  Tod  Helmuth.         663 

Lente's^  SquibVs,  and  Goodwillie's  iDhalers  are  described, 
and  appear  all  to  be  excellent  and  useful  instruments  for 
the  administration  of  Ether. 

Dr.  Helmuth  would  use  Ether  as  an  anaesthetic  in  pre- 
ference to  Chloroform,  because,  as  he  truly  remarks,  it  is 
less  dangerous^  and  -  the  surgeon  is  free  from  all  anxiety 
while  operating.  Ether  is  longer  in  producing  its  effects^ 
but  as  there  is  always' a  certain  amount  of  danger  in 
administering  Chloroform,  are  we  justified  in  abandoning  it 
in  favour  of  E^her  ? 

Surgeons  may  yet  do  so,  although  some  operators  would 
have  to  forego  that  dash  and  student^s  applause  upon  which 
their  exalted  minds  are  wont  to  feed.  Local  anaesthesia  is 
next  referred  to^  and  Dr.  Helmuth  says  that  in  whitlow, 
operation  for  paraphimosis^  and  some  other  small  operations 
he  has  found  it  extremely  useful.  In  the  sickness 
attendant  on  anaesthesia  stimulants  are  to  be  avoided,  but 
under  the  use  of  Ipec,  Veratrum,  Camphor,  ifc,  we  can 
easily  overcome  this  troublesome  symptom. 

One  of  Garrett's  electric  disks  placed  upon  the  epigas- 
trium soon  allays  the  vomiting. 

Chapter  YII  treats  of  surgical  fever,  and  the  predis- 
posing causes  are  referred  to,  such  as  a  vitiated  atmosphere, 
and  the  absorption  into  the  blood  of  vibrionic  germs.  These 
septic  germs,  together  with  pus,  poison  the  circulation,  and 
the  first  symptom  is  the  patient  being  seized  with  rigors. 
Diet,  rest,  ventilation,  and  disinfection  are  the  points  to  be 
attended  to  in  the  general  treatment,  but  with  Aeon,  as  an 
auxiliary,  we  may  in  the  majority  of  cases  successfully 
contend  with  this  formidable  complication.  Many  other 
medicines,  such  as  Bry,,  Phos,,  BelL,  tjfc.,  are  at  the  com- 
mand of  the  homoeopath,  who  can  thus  enter  with  greater 
confidence  than  his  allopathic  brother  into  the  treatment, 
being  armed  at  almost  every  point. 

In  Chapter  YIII  inflammation  is  discussed,  and  is 
treated  rather  cavalierly,  such  men  as  Paget,  Rokitansky, 
and  Williams  being  ignored  as  authorities^  so  that  the 
latest  views  on  this  important  subject  are  not  even  taken 
into  consideration.     In  treating  of  adhe^^ive  iuHantmation 


664  Reviews, 

we  should  naturally  have  expected  this.  When  the  author 
speaks  of  the  medicines  useful  in  controlling  inflammatory 
action  in  parts  there  is  a  tendency  to  huddle  remedies 
together  after  the  manner  of  Bryant  and  others. 

Suppuration,  according  to  Virchow,  is  a  pure  process  of 
luxuriaiion,  and  Dr.  Helmuth  adopts  this  view.  He 
mentions  that  Sulphate  of  Iron  has  been  used  with  great 
success  in  suppuration,  and  details  a  very  interesting  case 
treated  at  the  Children's  Hospital  at  Lausanne  with  wonder- 
ful success. 

Dr.  Helmuth  is  entitled  to  great  praise  for  his  advocacy 
of  Calendula  as  a  topical  application  in  suppurations  and 
lacerations.  In  anthrax  after  incisions  to  assist  the 
separation  of  the  slough  it  is  invaluable,  and  mentions  that, 
having  experimented  side  by  side  with  Carbolic  acid,  he  is 
most  decidedly  in  favour  of  Calendula. 

This  is  most  important,  and  will  we  trust  be  tried 
and  corroborated  by  the  homoeopathic  surgeons  in  this 
country. 

Abscess  is  next  discussed,  and  the  great  necessity  of 
diagnosing  aneurism  from  abscess  is  pointed  out. 

Some  unfortunate  mistakes  have  occurred  in  diagnosis 
to  the  most  eminent  surgeons,  and  the  young  practitioner 
cannot  be  too  careful  in  using  the  knife  where  there  is  the 
slightest  doubt  as  to  the  nature  of  a  fluctuating  tumour. 
Dr.  Helmuth  mentions  an  excellent  method  of  applying 
pressure  in  large  abscesses,  especially  where  there  are  many 
sinuses,  viz.,  by  means  of  compressed  sponge,  which  is  to  be 
placed  dry  over  the  abscess  and  held  in  position  by  means 
of  adhesive  straps  applied  at  right  angles. 

We  know  this  to  be  most  successful  treatment,  and 
would  commend  it  in  all  cases  where  pressure  is  required. 
It  is  quite  refreshing  to  observe  that,  in  the  treatment  of 
septicaemia,  we  have  a  medicine  which  in  its  pathogenesis 
corresponds  to  many  of  the  symptoms  of  this  formidable 
disease,  viz.  Rhus  radicans.  Gels,,  Bromide  of  Potash, 
Muriatic  add  and  Carbolic  add  will  also  play  an  impor- 
tant part  in  combating  the  difierent  sequelse  of  this  unto* 
ward  disease. 


A  System  of  Surgery ^  by  Dr,  Tod  Helmuth.         665 

Chapter  X  deals  with  ulceration^  which  is  handled  in  a 
very  useful  and  practical  style. 

It  is  to  be  regretted  that  here  again  we  have  a  diffuse 
arrangement  of  remedies  useful  for  the  different  varieties  of 
ulcers^  although  the  surgeon  will  find  many  valuable  hints 
to  guide  him  in  his  too  often  unsuccessful  struggle  with 
chronic  ulcers.  Dr.  Helmuth  records  a  very  interesting 
and  successful  case  of  skin-grafting,  occurring  in  his  own 
experience^  where  an  ulceration  of  five  years'  standing  was 
completely  healed  up  in  little  more  than  a  month — ^a  suc- 
cessful result  for  which  any  surgeon  might  well  claim  our 
highest  praise  and  admiration. 

Chapter  XI  treats  of  gangrene  in  an  excellent  manner, 
and  a  very  instructive  case  of  traumatic  gangrene  occurring 
in  a  sailor,  after  amputation  of  the  leg^  was  treated  by 
opening  the  flap,  and  washing  it  every  three  hours^  and 
then  carefully  injecting  it  with  carbolated  Glycerine.  A 
compress  wet  with  the  solution  was  to  be  applied,  and  Ars, 
S,  given  every  half  hour,  which  treatment  proved  highly 
successful. 

Chapter  XII  deals  with  tumours,  and  the  subject  is 
handled  by  Dr.  Helmuth  in  a  most  masterly  style,  leaving 
nothing  to  be  desired  either  practically  or  theoretically. 

The  differential  diagnosis  which  he  gives  between  inno- 
cent and  malignant  tumours  throws  quite  a  new  light 
upon  this  branch  of  surgery,  which  will  free  the  surgeon's 
mind  of  any  doubt  that  may  exist  as  to  his  diagnosis. 

We  would  especially  call  attention  to  a  most  remarkable 
and  successful  case  of  cystic  tumour  situated  on  the  right 
side  of  the  neck^  and  extending  both  in  front  and  behind 
the  clavicle.  The  tumour  after  two  hours'  dissection  was 
entirely  removed,  the  third  portion  of  the  subclavian  artery, 
pneumogastric  nerve,  and  brachial  plexus  having  been 
brought  into  view  during  the  necessary  steps  of  the  opera- 
tion, eight  vessels  also  requiring  ligature.  The  wound  had 
almost  entirely  healed  in  two  weeks.  Fibro-cellular 
tumours  may  be  cured  medicinally  by  homceopathic  reme- 
dies, so  that  we  may  here  claim  another  triumph  for  our 
principles,  and  also  afford  coipfopt  to  tho^e  patientai  wbp 


666  Reviews. 

have  an  insaperable  horror  of  the  knife.  Dr.  Helmuth 
relates  an  extraordinary  case  of  cysto-sarcomai  where  under 
the  use  of  Bromide  of  Potassium  the  larger  cysts  raptured, 
a  great  amount  of  discharge  occurring,  and  some  of  the 
smaller  cysts  altogether  disappeared.  We  trust  Professor 
Erichsen,  of  London,  may  be  yet  induced  to  change  his 
opinion  that  all  curative  constitutional  treatment  is  utterly 
useless  in  cancer,  because  there  are  many  authentic  cases 
of  cure  by  homoeopathic  medicines;  and  as  fkcta  are 
difficult  to  get  over,  the  day  may  yet  come  when  the 
learned  professor  will  acknowledge  his  error  in  this  dog- 
matic statement. 

Dr.  Helmuth  devotes  a  chapter  to  the  microscope,  which 
will  be  found  extremely  interesting  and  instructive. 

Chapter  XIV  treats  of  scrofula  in  rather  a  superficial 
manner,  but  we  are  glad  the  views  of  such  men  as  our 
English  Paget  are  endorsed  by  Dr.  Helmuth.  When  re- 
ferring to  constitutional  treatment  he  confirms  BosDning- 
hausen  as  to  the  value  of  Asafoetida  in  diseases  of  the 
bones,  but  we  should  like  to  find  further  corroboration  as 
to  the  use  of  Mercurius  as  a  remedy  in  scrofulous  diseases 
of  the  bones  uncomplicated  by  syphilitic  taint 

In  Chapters  XV  to  XVII  gonorrhoea  and  syphilis  are 
the  subjects  next  handled ;  and  we  notice  in  passing  a 
curious  history  of  the  origin  of  syphilis,  viz.  from  eating 
human  flesh ;  but  of  the  disease  we  see  nothing  particularly 
fresh  but  what  we  should  expect  to  be  found  in  any  good 
text-book  of  surgery.  As  to  his  views  of  treatment  we 
wish  to  make  a  few  remarks. 

We  think  that  recommending  the  Nitrate  of  Silver 
injection  in  the  strength  of  ten  grains  to  the  one  ounce  of 
water  as  a  safe  abortive  treatment  in  gonorrhosa  is  not 
based  on  good  scientific  principles,  nor  aare  any  cases  given 
as  a  clinical  foundation  for  such  a  procedure,  especially  as 
even  before  the  inflammatory  stage  sets  in  there  is  the 
greatest  danger  of  prostatitis,  cystitis,  and  orchitis,  which 
might  bring  the  practitioner  into  disrepute  for  his  adoption 
of  this  heroic  treatment.  Dr.  Helmuth  quotes  the  testi- 
mony of  several  eminent  medical  men   as  authorities  "in 


A  System  of  Surgery,  by  Dr.  Tod  HelmuUh.        667 

finding  the  higher  dilutions  of  medicines  more  efficacious 
than  the  lower^  especially  where  these  have  utterly  failed 
in  the  treatment  of  gonorrhoea.  Cannabis  in  the  thirtieth 
potency  appears  to  Bave  been  the  medicine  employed  with 
marvellous  effect^  and  we  shall  be  glad  to  have  this  con- 
firmed  by  the  practitioners  of  this  country^  as  confessedly 
syphilis  and  dome  cases  of  gonorrhoea  in  their  later 
stages  are  amotig  the  most  difficult  class  of  cases  occurring 
in  homoeopathic  surgical  practice. 

With  regard  to  the  treatment  of  syphilis  he  gives  us  a 
most  excellent  table  containing  the  differential  diagnosis 
between  the  simple  non-infecting  chancre  and  the  indu- 
rated infecting  chancre,  impressing  the  fact  that  local 
treatment  is  specific  for  the  one  variety^  but  constitutional 
remedies  must  be  relied  upon  for  the  cure  of  the  other 
form. 

He  is  decidedly  in  favour  of  the  mercury  group  of  medi- 
cines  in  the  treatment  of  chancre^  and  finds  from  experi- 
ence that  they  must  be  given  ,in  the  lower  dilutions^  in 
order  to  effect  a  radical  cure,  in  which  opinion  he  will  be 
supported  by  the  majority  of  homoeopathic  surgeons. 

The  treatment  of  tertiary  and  of  infantile  syphilis  is 
described  in  a  very  lucid  and  practical  manner^  so  that  the 
busy  practitioner  can  at  once  refresh  his  memory  about  any 
medicine  regarding  whose  curative  sphere  he  may  be  at  all 
doubtful. 

Chapter  XYIII  treats  of  wounds^  and  is  of  the  most 
complete  and  satisfactory  nature,  showing  that  Dr. 
Helmuth  has  paid  marked  attention  to  this  most  important 
subject,  and  we  are  sure  he  will  earn  the  gratitude  of  his 
medical  brethren  for  the  many  valuable  suggestions  con- 
tained in  this  most  excellent  chapter.  We  would  espe- 
cially call  attention  to  Sections  V  and  VI,  treating  of 
poisoned  and  gunshot  wounds.  Under  poisoned  wounds 
the  different  modes  of  treatment  are  fully  described,  and 
many  interesting  cases  narrated,  Olive  oil,  Whisky,  the 
injection  of  Liguor  AmmonuB  foriior,  and  Ars.,  having  all 
proved  successful  in  the  treatment  of  snakebite.  In  the 
treatment   of  hydrophobia   we   have   a  great  number  of 


668  Reviews, 

medicines,  such  as  BelL,  Hyoscy.,  Lach.^  Stram.^vaA  Canth., 
which  all  promise  good  results  in  dealing  with  this  dis- 
astrous disease,  and  contrast  most  l^orably  with  the 
hopeless  state  of  allopathic  darkness  and  quack  nostrums. 

It  will  be  deeply  comforting  to  the  homoeopathic  surgeon 
to  think  upon  the  manj  remedies  he  las  ^  his  command 
in  his  treatment  of  gunshot  wounds,  bat  to  any  one  who 
wishes  to  have  a  clear  conception  how  to  do  so  successful  ly, 
we  would  recommend  a  careful  perusal  df  Dr.  Helmuth's 
interesting  and  instructive  section  on  this  important  surgical 
department. 

Chapter  XIX  treats  of  haemorrhage,  and  is  written  in  a 
most  clear  and  distinct  style^  mentioning  the  latest  means 
and  instruments  for  successfully  arresting  haemorrhage^  and 
affording  the  surgeon  an  amount  of  information  that  will 
stand  him  good  in  the  hour  of  need.  Some  interesting 
information  is  given  as  to  internal  medicines  which  have 
proved  successful  in  controlling  hsemorrhage,  such  as  Verat. 
virid.  for  secondary  haemorrhage  after  amputation,  Erigeron 
for  haemorrhage  from  the  bladder,  Hamamelis  for  hsempr- 
rhage  from  the  mouth  and  gums. 

In  Sections  II,  III,  and  lY,  referring  to  styptics,  the  usr'v. 
of  flexion,  and  compression,  there  is  nothing  particularly 
worthy  of  note,  except  the  very  excellent  list  of  agents  and 
formulae  given  as  useful  for  local  haemorrhage,  and  mention  of 
various  tourniquets,  one  constructed  by  Messrs.  Tiemann 
appearing  to  be  remarkably  reliable,  easily  adjusted,  and 
giving  a  great  amount  of  direct  pressure,  not  interfering 
with  the  circulation  of  the  venous  blood. 

Dr.  Helmuth  has  used  torsion  with  success  in  the  smaller 
vessels,  and  appears  also  to  be  in  favour  of  acupressure, 
which  opinion,  we  think,  he  will  yet  see  cause  for  abandon- 
ing, except  in  hospital  practice. 

Acupressure  is  very  good  and  reliable  where  there  is  a 
house-surgeon  always  at  hand  to  stem  the  secondary 
haemorrhage,  but  as  the  surgeon  cannot  oonvieniently  leave 
an  assistant  at  every  house  where  he  may  operate,  relying 
upon  this  method  exposes  the  patient  to  needless  risk. 

7he  only  other  point  in  this  ghapter  iq  which  it  will  he 


A  System  of  Suryery^  by  tir.  Tod  Helmuth.         66ii 

necessary  to  call  attention  is  Speir's  artery  constrictor,  a 
most  useful  and  ingenious  method  of  arresting  hsemorrhage ; 
and  we  would  refer  to  Section  VIII^  where  it  is  fully 
described,  only  adding  that  it  was  applied  at  two  points  to 
the  carotid  of  a  horse,  in  the  continuity  of  the  vessel ;  the 
artery  was  then  divided  between  the  points  d'appui;  no 
hsemorrhage  followed. 

We  are  sure  that  it  will  yet  hold  a  very  high  position  in 
the  estimation  of  the  surgical  world,  after  it  has  obtained  a 
fair  and  impartial  trial  at  the  hands  of  competent  surgeons. 

In  Chapter  XX  amputations  are  described  in  a  clear  and 
intelligible  manner,  and  the  only  point  to  which  it  will  be 
necessary  to  call  attention  is  to  the  successful  employment 
of  Allium  eepa^  in  a  case  of  neuralgia  of  the  stump 
occurring  after  amputation  of  the  thigh,  which  desired 
result  ensued  after  two  days'  administration  of  the  drug. 
It  is  asserted  that  Hahnemann  completely  cured  that  re- 
nowned soldier,  the  Marquis  of  Anglesey,  of  neuralgia 
occurring  in  the  stump  after  amputation  of  the  leg,  when 
all  the  first  allopathic  physicians  of  Paris  had  in  vain  tried 
their  skill,  and  exhausted  their  infallible  pharmacopceia. 
But  this  must  be  a  mistake,  for  Lord  Anglesey,  as  is  well 
known,  remained  a  martyr  to  neuralgia  to  the  latest  period 
of  his  life. 

Chapter  XXI  treats  of  the  surgery  of  special  regions  and 
tissues^  such  as  erysipelas,  anthrax,  burns,  &c,,  and  is 
teeming  with  practical  information,  but  in  other  respects  is 
far  less  complete  than  we  should  naturally  expect  from  such 
a  man  as  Dr.  Helmuth.  In  dealing  with  erysipelas  we  look 
for  a  thorough  and  distinct  enumeration  of  the  different 
varieties,  as  (1)  the  cutaneous  erysipelas,  (2)  cellulo-cuta- 
neous  or  phlegmonous  erysipelas,  (3)  the  cellular  erysi- 
pelas ;  whereas  what  do  we  find  is  **  erysipelas  described  as 
an  inflammatory  affection,  generally  confined  to  the  epidermis, 
which  becomes  hot,  red,  and  swollen,  and  sometimes  covered 
with  blisters  (erysipelas  bullosum),  but  in  very  violent  cases 
the  deeper  seated  tissues  are  involved,  and  the  disease  is 
termed  phlegmonous  erysipelas.*^ 

If  such   an  important    disease  as  erysipelas  was  iutro- 


d70  keviews. 

duced,  it  ought  to  have  been  dealt  with  exhaustively,  and 
not  put  forward  in  such  an  incomplete  form  ;  although  there 
are  sufficient  internal  remedies  mentioned  to  help  the 
practitioner  in  his  treatment  of  this  too  often  very  dangerous 
malady,  we  yet  feel  that  the  subject  is  dealt  with  in  a  crude 
and  unsatisfactory  manner. 

We  are  glad  to  observe  that  Dr.  Helmuth  agrees  with 
Paget  in  abandoning  the  use  of  free  incisions  in  anthrax, 
unless  there  is  a  large  slough  to  be  removed,  but  dresses  the 
sore  with  a  hot  solution  of  Calendula  several  times  daily, 
relying  upon  internal  medication  as  the  best  and  most 
successful  treatment,  in  which  opinion  he  will  be  supported 
by  all  advanced  homoeopathic  surgeons  in  this  country.  In 
Section  V  burns  and  scalds  are  treated  in  a  very  practical 
manner,  and  everything  necessary  for  external  and  internal 
use  in  the  treatment  is  given  ;  but  we  are  rather  surprised  to 
find  Dr.  Helmuth  in  favour  of  free  division  of  cicatrices 
occurring  after  bums ;  for  this  reason,  that  whenever  an 
incision  is  made  a  new  cicatrix  must  be  formed,  and  this 
new  cicatrix  will  undergo  precisely  the  same  contraction  as 
the  one  which  it  was  intended  to  alleviate.  There  is  no 
doubt  that  gentle  yet  constant  traction  exerted  on  a  con- 
tracted cicatrix  by  means  of  apparatus  is  the  only  truly 
scientific  and  hopeful  mode  of  treatment.  The  only  other 
point  to  which  we  shall  refer  in  this  chapter  is  to  the  treat- 
ment of  lupus,  a  disease  which  every  surgeon  dreads ;  but 
which  under  homoeopathic  remedies  promises  to  become 
curable,  and  if  so  proved  will  confer  fresh  lustre  on  Hahne- 
mannic  principles.  Dr.  Boileau,  resident  in  the  Mauritius, 
treated  fifty-seven  persons  suffering  from  lupus  with  the 
Hydrocotyle  Asiatica,  an  Indian  plant,  in  all  of  which 
cases  without  exception  the  disease  was  arrested  in  a  very 
short  time,  and  a  case  of  Arabian  elephantiasis  of  three  years^ 
duration  was  successfully  treated  with  the  same  remedy. 

Injuries  and  diseases  of  the  muscles,  tendons,  and  bursse, 
are  described  in  Chapter  XXII,  and  we  would  call  attention 
to  an  excellent  apparatus  invented  by  Dr.  Lewis  A.  Sayre 
for  sprains  about  the  ankle-joint,  fully  described  in  Section 
III,  which  will  aflford  every  satisfaction  to  the  surgeon,  and 


^4  System  of  Surgery,  by  Dr.  Tod  tielmuih.         67l 

enable  him  to  treat  these  troublesome  complications  with 
every  prospect  of  speedy  and  certain  success. 

In  Chapter  XXIII  we  have  arteritis,  atheroma,  and 
aneurism  discussed,  but  are  at  a  loss  to  know  why  arteritis 
is  treated  so  superficially  and  meagrely,  because  the  surgeon 
and  student  cannot  have  their  ideas  too  clearly  arranged 
about  this  very  important  disease.  A  few  sentences  are 
not  enough  to  dispose  of  such  a  vital  disease  as  arteritis^ 
and  the  pathology  advanced  of  this  affection,  together  with 
atheroma  and  embolism,  is  not  of  such  a  kind  as  would  be 
expected  to  be  found  in  a^  work  professing  to  be  conversant 
with  the  latest  views  of  the  most  eminent  pathologists — a 
fault  which  we  have  no  doubt  will  be  corrected  in  the  next 
edition.  Section  IV,  on  aneurism^  is  written  in  a  concise 
and  practical  style,  and  will  be  found  to  give  every  infor- 
mation requisite  in  the  treatment,  especially  mentioning 
Verat,  viride  as  having  proved  most  useful  in  materially 
lessening  the  hearths  action,  and  also  mentioning  that  the 
galvano-puncture  treatment  had  proved  successful  in  forty- 
eight  out  of  ninety  cases,  which  curative  means  is  at 
present  gaining  much  favour  amongst  the  surgical  world. 
The  after-effects  of  the  ligature  are  far  too  briefly  described, 
and  do  not  give  a  right  estimate  of  the  many  dangers 
following  ligation,  nor  do  we  find  the  directions  for 
meeting  these  given  in  such  a  full  and  complete  form  as  we 
should  naturally  expect. 

The  diagnosis  of  the  different  aneurisms  such  as  those  of 
the  aorta,  arteria  innominata,  &c.,  are  fairly  stated,  and  the 
directions  for  ligation  of  the  various  arteries  contained  in 
Chapter  XXIV  are  as  good  and  distinct  as  will  be  found 
in  any  text-book  of  surgery,  the  plates  and  diagrams  for 
incisions  in  the  principal  operations  assisting  to  make  clear 
every  doubtful  point. 

Chapter  XXV  treats  of  injuries  and  diseases  of  the 
veins,  and  it  is  comforting  to  reflect  upon  the  many  medi- 
cines which  may  be  used  by  the  homoeopath  with  every 
chance  of  success,  as  in  thrombosis  Acon.^  Hep.  «.,  and 
especially  Lack,  will  often  act  with  magical  rapidity. 

Phlebitis    is   described    in    Section    II    with  wonderful 


67Ji  lievieios. 

brevity,  and  we  do  not  think  the  pathology  contained  therein 
will  overburden  the  reader's  mind^  although  if  he  wishes 
condensed  symptoms  he  will  here  obtain  them  to  his  heart's 
desire.  Dr.  Helmuth  has  found  a  paste  composed  of  equal 
parts  of  caustic  potash  and  quicklime  to  be  very  useful  in  the 
treatment  of  varicose  veins^  and  has  obtained  good  results 
from  the  employment  of  Ham.  virg,  both  as  an  external 
application  and  an  internal  medicine^  and  finishes  this 
chapter  by  a  reference  to  the  entrance  of  air^  wounds  and 
phlebolithes  in  veins^  which  does  not  throw  any  fresh  light 
on  this  deeply  interesting  subject. 

Shock|  tetanus,  and  wounds  of  the  nerves  are  the  subjects  of 
discussion  in  Chapter  XXVII,  and  Dr.  Helmuth  deserves 
every  credit  for  the  very  able  and  clear  manner  in  which  he  has 
brought  forward  the  latest  and  most  scientific  information 
about  the  treatment  of  these  truly  formidable  diseases.  He 
details  the  case  of  a  young  lady  who  had  been  unwell  for  a  few 
days,  and  on  retiring  for  the  night  took  a  dose  of  the  200th 
potency  of  Rhui,  and  in  the  morning  was  discovered  dead  in 
her  bed.  A  most  thorough  poit'tnortem  examination  was 
made,  every  organ  in  the  body  carefully  and  minutely  in- 
spected, the  stomach  and  bladder  examined  by  professional 
chemists,  yet  no  cause  whatever  could  be  discovered  for  the 
death.  The  author  seems  to  put  this  forward  as  an  instance 
of  death  from  shock,  but  we  remain  incredulous  as  to  the 
possibility  of  a  fatal  shock  from  Rhus  200 !  Camphor  is  a 
most  excellent  medicine  for  shock,  but  if  it  fails  recourse 
must  be  had  to  Veratrum,  which  acts  with  great  power  when 
in  connection  with  other  symptoms  there  is  nausea  and 
vomiting;  and  Dr.  Helmuth  is  inclined  to  believe  that  if 
reliance  is  placed  on  the  medicines,  we  need  not  recur  to  the 
common  practice  of  pouring  down  brandy  ad  libitum. 

In  the  treatment  of  tetanus  Dr.  Helmuth  records  a  case 
occurring  in  his  own  experience,  where  the  Hydrate  of 
Chloral  and  Opium  V  effected  a  cure,  and  in  another  case 
the  Calabar  bean  used  hypodermically,  ameliorated  the 
symptoms,  especially  the  spasm  of  the  muscles  of  degluti- 
tion. He  also  relates  the  case  of  a  soldier  cured  by  placing 
a  piece  of  tobacco,  softened  and  flattened  out,  over  the  epigas- 
trium, the  result  of  which  was  that  in  five  minutes  deadly 


A  System  of  Surgery ^  by  Dr.  Tod  Helmuth.        678 

pallor  ensued  with  twitchings^  and  the  jaws  completely 
relaxed. 

Chapter  XXYIII  treats  of  the  different  injuries  and 
diseases  of  the  bones,  and  is  of  the  most  perfect  and  exhaus- 
tive character,  exhibiting  a  thorough  acquaintance  with  the 
subject,  and  showing  an  amount  of  reading  and  thought 
the  fruits  of  which  he  has  scattered  with  a  most  lavish  hand 
through  this  very  important  chapter. 

He  tells  us  that,  in  the  treatment  of  diseases  of  the  bone, 
the  dilution  of  the  medicine  and  the  repetition  of  the  dose 
are  of  paramount  importance,  finding  that  the  30th  and 
upward  is  far  more  efficacious  than  the  lower  potencies — an 
experience  which  will^  doubtless,  surprise  those  surgeons 
who  have  in  vain  tried  the  1^  and  8',  and  to  their  own 
surprise  signally  failed. 

In  treating  periostitis  we  have  a  host  of  internal  medi- 
cines with  which  to  alleviate,  if  not  cure  this  most  painful 
affection,  such  as  Aur.y  Kali  carb.^  Lycopod.,  Merc,  &c.,  but 
on  the  formation  of  pus  recourse  must  be  at  once  had  to 
the  knife,  unless  the  practitioner  wishes  to  bring  himself 
into  disrepute ;  and  it  would  be  well  for  the  homoeopath  to 
bear  this  in  mind,  as  so  many  are  anxious  to  carp  at  any 
mistake  on  his  part.  Again,  in  osteitis  we  should  clearly 
make  out  if  there  is  any  history  of  syphilis,  mercurial 
poisoning,  or  of  exposure  to  cold,  because  we  may  very  soon 
dissipate  this  affection  by  the  administration  of  BeU.,  Mer. 
sol.,  Staphysagria,  &c.,  and  by  so  doing  convert  the  most 
prejudiced  to  a  belief  in  the  scientific  practice  of  homoeo- 
pathy, and  show  that  we  do  not  grope  in  the  dark  as  our 
allopathic  brethren  are,  as  a  rule,  wont  to  do.  We  would 
call  attention  to  the  successful  use  of  Asafcetida,  12th  dilu- 
tion,  in  scrofulous  caries  of  the  bones,  and  trust  that  the 
practitioners  in  this  country  will  give  the  higher  dilutions 
an  impartial  trial,  because  at  least  in  bone,  though  not 
perhaps  in  other  diseases,  the  curative  sphere  appears  to  lie 
in  the  higher  dilutions. 

In  Section  Y  Dr.  Helmuth  gives  the  notes  of  a  most 
successful  and  interesting  case  of  caries  of  the  lower  jaw  and 
sternum,  treated  by  incisions,  Silic.  30  and  200  internally, 

VOL.  XXXII,  NO.  CXXX.— OCTOBER,  1874.  U  U 


674  tteoiewi. 

Sulphuric  acid  and  carbolated  Calendula  extemally,  as  a 
dressing,  following  it  up  bj  prescribing  the  Acid  Phosphate 
of  Lime  and  Kal.  Hyd.,  which  line  of  treatment  effected  a 
perfect  cure  in  about  four  months,  a  result  which  reflects  the 
highest  credit  on  Dr«  Helmuth  in  a  surgical  and  medical 
point  of  view.  Asafcetida  in  alternation  with  Phosph.  acid 
has  cured  necrosis,  CaL  c,  Nitric  acid,  and  Silic.  have  all 
acted  wellj  and  in  exostosis  Hecla  lava  in  the  6th  potency 
gave  good  results;  likewise  Merc.  2.,  Phosph,,  Su:.,  have 
afforded  good  results,  although,  of  course,  a  great  deal  of  medi- 
cinal treatment  must  depend  on  the  surgeon's  discernment, 
and  his  knowledge  of  the  Materia  Medica  and  repertory,  with- 
out which  he  will  find  his  utmost  efforts  fruitless  and  discou- 
raging. In  the  treatment  of  cystic  osteoma,  osteo-sarcoma, 
moUities  ossium,  and  fragilitas  ossium,  the  surgeon  will 
find  a  number  of  medicines  given  by  Dr.  Helmuth  which 
he  may  use  with  a  fair  prospect  of  improving,  if  not  curing, 
those  diseases  which  are  confessedly  beyond  allopathic  skill, 
even  though  exercised  by  the  noble  baronets  who  head 
that  fallible  branch  of  medical  science. 

Any  one  wishing  to  rub  up  his  knowledge  of  fractures 
would  do  well  to  read  Dr.  Helmuth's  chapter  on  this  sub- 
ject, where  he  will  find  an  amount  of  information  and 
sicientific  practice  placed  before  him  in  as  clear  a  manner 
as  he  could  desire,  and  will  be  enabled  to  arrange  his  ideas 
so  that  he  may  confidently  treat  the  most  difiicult  case 
that  may  come  under  his  observation. 

A  very  useful  caution  is  given  to  the  young  surgeon 
when  called  to  examine  a  patient  in  whom  a  fracture  is 
apprehended,  viz.  to  place  him  thoroughly  under  ansesthetic 
influence  and  not  to  be  discouraged  if  the  diagnosis  is  not 
clear  upon  the  first  or  even  the  second  or  third  visit,  which 
advice  will  be  difficult  for  the  young  practitioner  always  to 
follow. 

In  Section  II  we  find  a  number  of  splints  mentioned 
for  treating  fractures  of  the  upper  extremities  which  appear 
to  be  most  excellent,  such  as  those  made  of  thin  poplar 
boards,  which  are  glued  upon  sheepskin^  and  then  cut 
lengthwise,  James'sj  of  Philadelphia,  splints  for  fractures  of 


A  System  of  Surgery,  by  Dr.  Tod  Helmuth. .       675 

the  forearm,  AhPs  adaptable  porous  felt  splints^  8cc. ;  and  as 
a  good  splint  is  half  the  cure^  we  should  advise  surgeons  to 
give  those  recommended  by  Dr.  Helmuth  a  fair  trials  and 
are  sure  that  they  will  give  satisfaction. 

Dr.  Smith's,  of  Philadelphia,  method  of  uniting  false 
joints  is  deserving  of  attention,  viz.  to  fix  the  limb  in  an 
iron  framework,  constructed  with  joints  to  allow  movement 
of  the  limbs;  by  straps  and  pads  to  steady  the  extremities 
of  the  broken  bones  in  a  proper  position^  and,  fixed  in  this 
apparatus,  allow  the  patient  to  use  the  injured  limb,  admin- 
istering at  the  same  time  the  indicated  homoeopathic  medi- 
cines. He  maintains  that  union  is  effected  with  much  less 
constitutional  and  local  disturbance  than  by  means  of 
Dieffenbach's  or  any  of  the  old  plans  so  much  in  vogue  a 
few  years  back. 

Dr.  Clark,  of  St.  Louis,  is  entitled  to  great  praise  for  his 
ingenious  apparatus  for  treating  fracture  of  the  lower  jaw 
by  means  of  a  splint  of  gutta  percha,  which  is  held  together 
with  springs,  together  with  the  use  of  a  sling  bandage  passed 
beneath  the  jaw  and  over  the  top  of  the  head ;  it  appears 
to  fulfil  a  want  which  has  long  been  felt  by  the  surgeon  in 
treating  these  troublesome  fractures.  Under  fractures  of 
the  scapula  Dr.  Helmuth  gives  some  cases  which  admirably 
illustrate  the  difiiculty  the  surgeon  always  experiences  in 
diagnosing  these  cases,  and  shows  that  we  must  not  trust, 
as  we  are  too  often  accustomed  to  do^  to  crepitus,  which 
may  be  completely  absent,  either  from  the  wide  separation 
of  the  fragments,  or  from  their  closely  riding  one  upon 
the  other. 

The  description  of  the  fractures  of  the  lower  extremities 
are  the  best  of  any  surgical  work  with  which  we  are 
acquainted,  and  we  should  advise  every  surgeon  to  get  Dr. 
Helmuth's  work,  if  only  to  read  and  thoroughly  master  all 
the  information  contained  in  this  part  of  the  work. 

We  consider  this  part  above  criticism,  and  shall  therefore 
pass  to  Chapter  XXX,  containing  a  description  of  injuries 
and  diseases  of  the  joints,  which  is  deficient  in  pathology, 
but  in  other  respects  will  be  found  extremely  useful  and 
easy  for  reference  by  the  busy  practitioner.     In  Section  II 


676  ttevieiv^. 

will  be  foand  a  description  of  Sayre's  apparatus  for  chronic 
sf  novitiSj  which  by  means  of  an  ingeniously  constructed 
steel  apparatus,  adhesive  plaster,  and  bandaging,  appears  to 
be  the  most  feasible  means  by  which  we  can  hope  to  effect 
any  good  result  in  this  troublesome  affection. 

We  would  recommend  every  surgeon  to  study  Dr.  Hel- 
muth's  apparatus  for  the  cure  of  anchylosis  described  in 
Section  IV  of  this  chapter,  and  carefully  to  read  the  cases 
of  cures  effected  by  him,  which  are  so  successful  as  to  en- 
courage a  more  general  use  of  the  method  of  forcible  flexion. 

Dr.  Sayre,  who  appears  to  be  fertile  in  the  invention  of 
all  kinds  of  apparatus,  has  constructed  a  most  useful  and 
scientific  instrument  for  the  cure  of  hip-joint  disease,  and 
we  would  refer  the  reader  to  page  749,  where  a  full  descrip- 
tion is  given,  although  the  surgeon  must  bear  in  mind  that 
homoeopathy  will  afford  him  immense  resources  in  correcting 
the  constitutional  taint  on  which  this  disease  depends. 

In  Section  VII,  treating  of  loose  cartilage  in  the  joint. 
Dr.  Cleveland,  of  Saginau,  City  Mich.,  says  that  he  cured 
a  case  of  this  nature  by  the  internal  administration  of 
Rhus  tox.  200y  but  until  we  can  get  further  corrobora- 
tion on  this  point  we  must  refer  Dr.  Cleveland's  case  to 
the  uniqtie  group  of  cures,  and  let  it  stand  or  fall  by  its  own 
merits. 

The  surgeon  will  find  Chapter  XXXI,  treating  of  disloca- 
tions, remarkably  complete,  and  every  information  regard- 
ing the  treatment  given  with  a  clearness  and  vigour  which 
is  quite  refreshing,  especially  when  we  consider  that  in 
trying  to  display  their  knowledge  in  this  branch  of  surgery 
authors  often  fall  into  the  wildest  confusion,  and  leave 
their  readers  lost  in  amazement  at  their  wonderful  classi- 
fication and  imaginary  displacements. 

Dr.  Helmuth  appears,  like  a  skilful  general,  to  have 
reserved  his  strength  till  the  last  moment,  and  we  must  say 
that  the  later  portion  of  his  work  is  by  far  the  best,  and 
fully  compensates  for  the  shortcomings  which  have  been 
noticed  in  the  earlier  part  of  his  ably  written  text-book ; 
therefore  a  brief  notice  of  the  remainder  will  suffice. 

Chapter  XXXII  deals  with  excisions  of  bones  and  joints, 


A  System  of  Surgery,  by  Dr.  Tod  Helmuth.         677 

and  we  would  call  the  reader's  attention  to  Dr.  Helmuth's 
cases  of  excision  of  the  elbow  and  knee-joints^  and  also  of 
the  bones  of  the  leg^  which  were  so  successful  that  com- 
parison with  Fergusson,  Erichsen^  or  any  of  our  great 
English  surgeons  might  be  made^  with  no  loss  to  Dr. 
Helmuth's  reputation. 

In  the  chapter  on  fractures  of  the  skull  we  are  glad  to 
see  that  Dr.  Helmuth  insists  on  the  immediate  application 
of  the  trephine  where  there  is  much  depression,  as  indi- 
cated by  the  patient  lying  comatose^  with  dilated  pupils 
and  stertorous  breathing,  and  also  in  punctured  fracture, 
that  is,  where  a  nail,  spike,  or  other  sharp  instrument  has 
been  driven  into  the  skull. 

In  scalp  wounds  with  extravasation  he  recommends 
finding  if  possible  the  course  of  the  artery^  and  making 
pressure  along  it,  not  attempting  ligature — advice  which  is 
sound,  although  some  surgeons  are  haunted  with  the  idea 
that  there  is  no  safety  to  the  patient  unless  every  bleeding 
vessel  be  securely  ligatured. 

In  speaking  of  affections  of  the  nose,  under  the  head  of 
epistaxis  arising  from  constitutional  causes,  we  are  sorry  to 
note  the  omission  of  Crotalus  which  the  valuable  researches 
of  Dr.  Hayward  of  this  country  bring  into  the  fore- 
most rank  for  haemorrhages  generally,  including  nasal. 
Under  remedies  for  polypus  nasi,  Sanguinaria  internally 
is  omitted,  which  from  personal  experience  we  can  assure 
our  author  is  invaluable  in  ordinary  nasal  polypus. 

In  ulceration  of  the  nose  we  are  glad  to  see  Kali  bich. 
in  the  first  rank,  thus  further  endorsing  the  valuable 
provings  of  that  drug,  and  Dr.  Helmuth  says  that  the 
secret  of  its  success  is  its  prolonged  use — an  experience 
which  the  practitioner  would  do  well  to  bear  in  mind,  as 
rushing  from  one  remedy  to  another  only  brings  homoeo- 
pathy into  ridicule.  There  is  a  carefully  detailed  account 
of  the  operation  for  naso-pharyngeal  polypus,  and  under 
the  head  of  rhinoplasty  the  three  varieties  of  operation, 
namely,  by  sliding  the  flaps  from  the  cheeks,  jumping  them 
by  a  twist  or  taking  them  from  remote  parts  (Tagliacotian) 
are  minutely   distinguished,      Jn  speaking   pf  h£^i'eli|)   tliq 


678  Retfiewi. 

author  is  of  opinion  that  the  operation  should  be  delayed 
nntil  the  sixth  month,  and  if  performed  at  a  very  early 
period,  that  Chloroform  is  unnecessary,  the  child  being  easily 
held. 

With  regard  to  the  latter  we  cannot  see  the  force  of  the 
argument,  as  whatever  may  be  the  diffe)rences  of  opinion  as 
to  the  existence  of  sensory  nerves  in  the  lower  orders  of 
creation,  we  presume  it  is  agreed  by  all  that  the  youngest 
infant  would  be  saved  much  suflfering,  and  consequent 
shook  to  the  system,  by  the  administration  of  an  anaesthetic 
(if  not  Chloroform,  why  not  etherisation  locally  ?),  and  we 
are  confident  that  there  is  neither  danger  in  this  nor  in 
the  operation  being  performed  during  the  first  few  weeks  of 
infant  life. 

We  have  occupied  so  much  time  in  the  earlier  part  of 
this  review  that  it  will  now  suffice  to  remark,  that  the 
chapters  on  injuries  and  diseases  of  the  abdomen,  hernia, 
and  that  on  injuries  and  diseases  of  the  female  genital 
organs,  are  written  in  a  remarkably  clear  and  vigorous 
style ;  and  are  so  admirably  arranged  by  means  of  tables 
for  assisting  the  surgeon  in  his  diagnosis,  that  a  mistake 
regarding  any  doubtful  point  connected  with  these  diseases 
is  almost  impossible.  We  are  certain  that  no  one  will  say 
that  he  has  lost  time  if  he  takes  the  trouble  of  reading 
Dr.  Helmuth's  work,  which  will  rank  as  one  of  our  best 
text-books  on  surgery,  and  is  a  most  welcome  and  valuable 
addition  to  homceopathic  literature. 


The  Sieppinff'Stane  to  Hommopathy  and  Health.     679 


The  Stepping-stone  to  Hommopathy  and  Health.  Bj  E.  H. 
Ruddock^  M.D.  London:  Homoeopathic  Publishing 
Company^  1874. 

On  the  title-page  of  this  little  book  we  find  the  state- 
ment '^  Ninth  edition.  Hundredth  thousand.'^  This  is  surely 
a  very  surprising  fact  when  contrasted  with  the  other  fact 
that  all  the  strictly  medical  journals,  except  our  own  and 
one  other,  and  all  the  medical  booksellers,  have  entered  into 
a  trades-nnion  conspiracy  to  ignore  the  existence  of  homoeo- 
pathy and  pretend  to  believe  it  is  dead,  while  at  the  same 
time  they  persecute  all  who  speak  or  act  regarding  it  with 
common  fairness  and  justice.  Consider  what  the  large 
issue  of  this  little  book  means.  It  is  only  one  of  a  great 
number  of  similar  books  also  possessing  a  large  circulation, 
and  each  of  these  probably  represents  a  family  in  which 
homoeopathic  treatment  is  more  or  less  carried  on.  The 
number  of  these  must  greatly  exceed  what  can  be  attended 
by  the  qualified  medical  men  at  present  openly  professing 
adherence  to  the  homoeopathic  law.  A  large  number  of 
families  must  therefore  be  habitually  practising  a  method  in 
minor  cases  of  illness  which  the  medical  man  they  trust  in 
life  and  death  diseases  either  afiects  to,  or  really  does,  scout 
as  folly  and  imposture.  It  cannot  but  be  that  the  said 
medical  man  should  often  be  referred  to  as  to  his  opinion 
on  homoeopathy,  and  one  he  must  give  whether  he  is  quali- 
fied to  do  so  or  not.  How  many  are  so  qualified  ?  Scarcely 
one  in  a  thousand,  if  no  better  informed  than  from  reading 
the  gross  misrepresentations  of  it  given  by  the  sectarian 
allopathic  press.  Consequently,  if  they  pronounce  against 
it  they  must  deliberately  bear  witness  against  their  brethren 
as  impostors  and  quacks  without  having  taken  the  means  of 
ascertaining  by  their  own  knowledge  whether  such  testi- 
mony is  true.  On  a  moderate  calculation  this  must  happen 
at  least  once  daily  to  all  the  medical  men  in  the  kingdom. 
It  will  happen  very  seldom,  we  fear,  that  the  answer  will 
be,  I  know  nothing  of  it  from  personal  experience,  and 
therefore  T  decline  to  give  any  opinion.     The  effect  of  thus 


680  Reviews. 

pronouncing  a  yerdict  condemnatory  of  the  moral  character 
of  professional  brethren  without  satisfactory  reason  must 
be  to  lower  the  moral  character  of  the  accusers  themselves, 
and  considering  this  must  be  daily  done  by  the  whole  pro- 
fession, it  gives  as  a  deplorable  idea  of  the  present  state  of 
the  body.  Verily  if  the  members  of  it  have  not  tried 
homoeopathy  it  has  assuredly  tried  them,  and  found  them 
wanting. 

With  respect  to  the  book  now  in  question,  we  think  it 
is  good  of  its  kind,  like  the  other  works  of  this  author. 
We  cannot  say  that  we  are  convinced  that  popular  or 
domestic  books  on  medicine  are  desirable  things  in  them- 
selves, and  the  author  seems  to  have  some  misgivings  this 
time,  as  he  seems  to  think  it  necessary  to  defend  them, 
which  he  does  at  page  4,  by  saying  that  as  it  is  a  matter  of 
fact  that  domestic  practice  does  now  and  always  will  exist 
we  may  as  well  reform  it  and  make  it  homoeopathic.  No 
doubt  this  is  the  fact,  and  if  books  on  domestic  medicines 
are  an  evil  they  are  at  least  a  necessary  evil  and  have  a  certain 
amount  of  good  to  counterbalance  that.  Dr.  Ruddock  has 
the  happy  art  of  adapting  his  teaching  to  his  audience,  and 
gives  in  a  small  compass  and  a  simple  form  just  the 
amount  of  information  likely  to  be  intelligible  and  useful. 
As  it  is  given  to  very  few  to  write  books  whose  sale  can  be 
counted  by  the  hundred  thousand,  we  naturally  feel  diffi- 
dent in  criticising,  yet  it  strikes  us  that  the  title  of  this 
book  is  in  questionable  taste;  and  we  are  sure  that  the 
continual  thrusting  forward  the  business  element  must  be 
offensive  to  all  persons  of  good  taste  and  professional  feel- 
ing.  What  we  mean  is  the  continual  reference  to  the 
other  works  of  the  author,  in  notes  whieh  are  evidently 
not  a  mere  acknowledgment  of  the  sources  of  informa- 
tion in  the  text,  or  to  guide  the  reader  to  more  complete 
information,  but  are  mainly  intended  to  direct  attention, 
and,  if  possible,  sell  the  works  quoted,  which  are  almost 
only  those  of  the  author^s.  With  the  exception  of  a  few 
blemishes  like  these,  the  author  shows  himself  a  master  in 
the  art  of  popular  book-writing,  and  he  does  for  popular 
practice^  what  Pr,  Sh^p  has  done  for  popular  (at  least  semi* 


The  Stepping-stone  to  Hommopathy  and  Health,      681 

popular)  writing  on  the  theory  of  homoeopath j,  and  it  is 
difficult  to  say  which  of  these  two  writers  has  done  most 
for  the  spread  of  homoeopathy  among  the  laity^  that  is  to 
say,  directly.  But  we  have  again  our  own  opinions  even  on 
the  spread  of  homoeopathy^  which  is  supposed  to  be  so 
much  favoured  by  popular  writings.  The  opinion  may  be 
defended  that  homoeopathy  would  have  been  far  more  spread 
now  if  not  a  single  popular  book  had  ever  been  written,  and  if 
all  our  efforts  had  been  given  to  perfecting  the  Materia  Medica 
and  producing  purely  scientific  works  directed  to  the  profes- 
sion alone.  Only  think  that  to  make  a  lay  convert  counts 
for  one,  and  that  often  a  transitory  and  capricious  adherent, 
but  to  convert  one  medical  man  counts  for  a  thousand  non- 
medical adherents,  for  that  is  the  average  of  laity  to  each 
medical  man.  Probablv  Dr.  Ruddock's  books  make  more 
lay  converts  than  Dr.  Sharp's,  but  the  latter  have  converted 
several  medical  men.  In  this  respect,  t^owever,  they  fall 
much  below  the  purely  medical  writings  of  Dr.  Henderson 
and  some  others.  On  the  other  hand,  it  must  be  acknow- 
ledged that  the  spread  of  homoeopathy  by  popular  works 
has  encouraged  and  supported  the  medical  converts  under 
the  pressure  of  persecution  and  obloquy.  Weliope,  however, 
that  these  two  authors  will  not  rest  satisfied  with  having 
merely  contributed  to  the  more  ephemeral  kinds  of  literary 
work,  but  will  contribute  to  the  purely  scientific  and  lasting 
department  of  our  method,  viz.  the  Materia  Medica,  by 
adding  each  an  elaborate  proving  to  the  Hahnemann  Materia 
Medica.  We  may  remind  Dr.  Sharp  that  many  years  ago 
his  name  was  put  down  for  Ipecacuanha^  but  the  promise  is 
not  yet  redeemed,  although  the  admirable  monograph  of 
Dr.  Imbert-Gourbeyre,  if  translated  and  analysed,  would  go 
far  to  complete  that  medicine. 


682  Beviewi. 


JoumaU  of  the  Quarter. 

GERMANY. 

Allgemeine  homoapathische  Zeitung. — This^  the  oldest 
extant  homoeopathic  joarnal  in  the  German  language^  is 
now  in  its  88th  volume^  which,  at  the  rate  of  two  volumes 
annuaUy,  shows  an  existence  of  forty-four  years;  it  has 
been  successively  edited  by  Drs.  Gross^  Rummel,  Hartmann, 
and  Meyer,  and  has  now  passed  into  the  able  hands  of  Dr. 
Kafka,  of  Prague.  During  all  these  years  it  has  appeared 
regularly  once  a  week,  and  has  during  that  long  period 
enshrined  a  multitude  of  valuable  practical  and  theoretical 
papers  which  have  greatly  assisted  the  scientific  develop- 
ment of  Hahnemann's  doctrines.  We  have  often  had 
occasion  to  present  our  readers  with  admirable  papers 
translated  from  its  pages,  and  it  continues  to  be  the  chief 
organ  of  communication  among  the  homcBopathists  of 
Germany. 

The  number  for  May  11th,  with  which  we  commence 
our  review,  contains,  firsts  a  controversial  article  entitled 
''  Similia  Similibus,''  in  reply  to  an  onslaught  on  homoeo- 
pathy in  the  Wiener  Medicinieche  fFochensckrift,  dpropos 
of  a  motion  introduced  into  the  Vienna  House  of  Deputies 
for  the  establishment  of  a  governmental  school  of  homoeo- 
pathy in  connection  with  the  Vienna  University.  The 
next  paper  is  the  continuation  of  the  translation  of  a 
proving  of  Lactic  acid,  by  Dr.  T.  P.  Allen,  of  New  York. 
The  third  krticle  is  entitled  *'  Curative  Results  from  Daily 
Practice,''  by  Dr.  H.  Goullon,  junior,  of  Weimar.  The 
subject  is  the  action  of  Kreogoie  in  menstrual  derange- 
ments. The  case  was  one  of  monorrhagia,  the  discharge 
lasting  sometimes  for  weeks  at  a  time,  and  accompanied  by 
great  ansemia.  Kali  carb.  and  Ferr.  mttr.  had  been 
fruitlessly  employed,  and  Kreosote  seemed  to  be  indicated 
by  the  circumstance  of  the  discharge  ceasing  when  the 
patient  stood  or  walked,  but  coming  on  profusely  when  she 


Journals  of  the  Quarter.  688 

lay  down.  The  medicine  was  given  in  drop  doses  of  the 
ordinary  Aqua  kreosoti,  and  its  use  was  followed  by  a 
violent  attack  of  convulsions  throughout  the  whole  body  ; 
these  were  followed  by  a  profuse  discharge^  after  which  the 
flow  gradually  ceased^  and  the  ansemia  was  much  dimi- 
nished. A  review  of  the  first  number  of  the  Rev.  tiom. 
Beige  and  some  extracts  from  American  homoeopathic 
journals  come  next.  These  are  followed  by  the  conclusion 
of  a  proving  of  Cuprum  hydrogenio-reducium. 

The  number  for  May  18th  contains  an  interesting 
paper  by  Dr.  Welsch,  of  Kissingen^  on  "  Homoeopathy 
and  Mineral  Waters/'  in  which  he  endeavours  to  show  the 
homoeopathicity  of  mineral  waters  to  the  diseases  for  which 
they  have  been  useful.  Allen's  Lactic  acid  proving  is 
continued.  Next  a  case  of  arsenical  poisoning  from  the 
Med.  Times  and  Gazette  that  has  already  appeared  in  the 
Monthly  Horn.  Rev.  This  is  followed  by  the  review  of 
a  pamphlet^  by  Dr.  Nedswitzky,  containing  the  result 
of  his  microscopic  investigations  in  cholera^  in  which  he 
discovered  bacteria  in  the  choleraic  evacuations.  Extracts 
from  American  journals  follow  this.  The  death  of  Dr. 
Earl  Julius  ^gidi^  at  the  advanced  age  of  eighty,  is 
announced.  The  deceased  was  one  of  the  earliest  disciples 
of  Hahnemann  in  Germany,  and  his  name  is  familiar  to 
students  of  homoeopathy  as  an  industrious  practitioner  and 
author. 

In  the  number  for  May  25th  we  have  the  conclusion  of 
Dr.  Welsch's  article  on  "  Mineral  Waters  '*  and  of  the 
"  Proving  of  Lactic  acid.^^  Another  reply  to  the  article 
in  the  Vienna  Med.  Wochenschrift,  irom  the  pen  of  Dr. 
V.  Yezekenyi,  Director  of  the  General  Hospital  at  Gyongyos. 
A  criticism  not  altogether  favorable  of  Dr.  Berridge's 
Complete  Repertory,  by  Dr.  GouUon,  comes  next.  A 
curious  paper  on  the  ''Cure  of  Hydrophobia/'  by  Dr. 
Ivanfy,  of  Kecskemit  (wherever  that  may  be).  He  treated 
a  great  number  of  persons  who  had  been  bitten  by  dogs 
said  to  be  mad,  and  none  of  them  got  hydrophobia,  so  he 
thinks  he  is  justified  in  recommending  his  treatment  as 
curative  of  this  disease.     His  remedies  are  mother  tincture 


684  Reviews, 

of  Cantharides  externally,  and  Cupr,  ac.  3  and  BeUad.  3 
internally. 

The  number  for  Ist  Jane  opens  with  a  report  of  the 
Linz  Homoeopathic  Hospital  for  1873.  There  remained 
in  the  hospital  from  1872,  41  adults  and  10  children. 
There  were  admitted  during  the  year  836  adults,  viz.  484 
men  and  352  women ;  and  106  children,  56  boys  and  50 
girls.  The  total  number  of  patients  treated  during  the 
year  was  993.  The  average  stay  in  hospital  was  for  adults 
18^  days,  for  children  33  days.  The  long  stay  of  the 
children  is  accounted  for  from  the  patients  being  mostly 
cases  of  advanced  scrofulous  disease  who  were  a  burden  to 
their  parents. 

With  regard  to  the  issue  of  the  cases — 

743  adults  and  86  children  were  dismissed  cured  or 
relieved. 

3  adults  dismissed  uncured. 

85  adults  and  21  children  died. 

46  adults  and  9  children  remained  at  the  end  of  the  year. 

This  was  certainly  not  a  small  mortality,  but  the  list  of 
diseases  treated  account  for  its  greatness.  Thus  there 
were  114  cases  of  tuberculosis,  with  39  deaths;  11  cases  of 
organic  heart  disease,  with  5  deaths ;  11  cases  of  ascites, 
with  7  deaths;  102  cases  of  variola,  with  20  deaths; 
28  cases  of  typhus,  with  9  deaths. 

The  patients  were  from  the  lowest  and  most  poverty- 
stricken  classes  of  the  town — a  very  different  class  of 
patients  from  those  seen  in  our  charitable  hospitals. 

Dr.  Goullon,  sen.,  questions  whether  some  of  our  reme- 
dies even  in  infinitesimal  doses  do  not  act  more  chemically 
than  homoeopathically. 

Then  comes  a  translation  of  Hamamelis  virffinica  from 
Hughes's  Pharmacodynamics, 

Next  a  translation  from  the  American  Joum,  of  Mat. 
Med.  of  Dr.  Moore's  chief  remedies  for  diarrhoea,  which 
extends  through  three  numbers. 

Dr.  Blumberg,  lately  practising  among  us,  announces  his 
settlement  at  Kreuznach,  and  his  wish  to  take  three  or  four 
children  ffom  six  tp  thirteen  years  old  to  board, 


Journals  of  the  Quarter,  686 

In  the  number  for  June  8th  Dr.  Kafka  details  a  case 
of  paralysis  of  the  glottis  which  is  not  without  interest. 
The  patient  was  a  little  girl  of  eleven.  Having  gone  to 
school  one  day  when  the  north  wind  blew  bitterly  cold,  she 
was  sent  home  by  the  teacher  on  account  of  a  cough  that 
had  come  on.  The  cough  was  of  a  very  hollow  unresonant 
character,  and  occurred  every  ten  to  fifteen  seconds.  The 
voice  was  extinct,  or  nearly  so.  There  was  no  paiu,  but 
the  fauces  appeared  dark  red.  She  got  Spongia,  but  next 
morning  was  no  better,  and  had  paralysis  of  the  right  side 
of  the  jaw.  Dr.  Kafka  now  gave  Aconite,  but  with  little 
or  no  benefit.  He  next  tried  Hepar^  RhtAS,  Graph.,  and 
Maff.  mur.y  each  for  two  or  three  days  at  a  time,  but  all  to 
no  purpose.  A  clinical  celebrity  being  called  in  in  con- 
sultation, diagnosed  paralysis  of  the  glottis  and  recommended 
Bromide  of  Potasium,  which,  however,  Kafka  did  not  give, 
but  gave  Caust.  6^  instead,  and  with  remarkably  good  effect, 
for  after  taking  it  for  a  few  days  the  little  patient  recovered 
perfectly. 

Dr.  GouUon,  jun.,  relates  a  very  severe  case  of  dysentery 
in  a  boy  of  nine  years  old,  brought  on  apparently  by  a 
draught  of  foul  cold  water,  when  he  was  much  heated. 
The  straining  was  almost  continuous,  the  pain  in  bowels  very 
considerable,  no  sleep,  an  evacuation  of  mucus  and  blood 
every  quarter  of  an  hour,  extreme  prostration,  with  clean 
tongue  and  some  appetite.  He  first  prescribed  Ars.  6,  and 
Mer.  sol.  6  alternately  every  hour  and  a  half.  The  next 
day,  the  patient  being  no  better,  besides  these  two  remedies 
he  ordered  clysters  containing  a  grain  of  Quinine.  The 
following  day  no  improvement,  he  now  gave  a  trituration  of 
one  part  of  Merc.  corr.  to  400  parts  of  milk-sugar.  This 
was  followed  by  marked  amendment,  and  in  a  few  days  the 
patient  was  well  except  that  a  feeling  of  constipation  and 
stoppage  in  the  bowels  remained,  which  yielded  to  NuXy  and 
the  stools  became  formed  under  the  use  of  Sulph. 

Follows  a  review  of  a  work  by  Dr.  V.  Gutceit  called  Thirty 
Years  of  Practice^  which  by  the  reviewer's  account  seems  to 
be   a  very  original  work,   the   author  being   familiar   with 


686  Retfiewi. 

homoeopathy  and  with  Bademacher's  system,  both  of  which 
he  used  commonly  in  his  practice. 

The  death  of  our  good  friend  Dr.  Eri^er,  of  Bern,  is 
announced  and  a  long  biographical  notice  given  of  him. 
Dr.  Krieger  was  born  in  Wasserelfingen  in  Wurtemburg 
in  1817.  In  1888  he  was  placed  at  the  gymnasium  of 
Stuttgart,  where  he  remained  two  years.  In  1885  he 
entered  as  a  pupil  the  evangelical  theological  seminary,  and 
devoted  himself  with  seal  to  theological  studies.  He  soon 
became  convinced  that  theology  was  not  a  suitable  career 
for  him,  so  he  resolved  to  study  medicine.  In  order  to 
obtain  the  necessary  funds  for  this  he  undertook  the  instruc- 
tion of  two  of  the  children  of  a  gentleman.  He  afterwards 
performed  the  same  office  to  the  children  of  a  gentleman  in 
Bern.  Then  he  was  appointed  to  the  chair  of  geography 
and  naturkl  history  in  the  Realschule  of  Bern.  He  also 
became  teacher  of  Latin  at  the  Progymnasium.  Amid  all 
these  occupations  he  found  time  to  study  medicine,  and 
took  his  degree  in  1854.  He  now  devoted  himself  entirely 
to  medical  practice.  He  was  converted  to  homoeopathy  by 
Dr.  Severin.  He  had  married  in  1845,  and  was  blessed 
with  a  daughter  in  1846,  who  was  the  joy  of  her  father's 
life,  but  who  died  in  1863,  to  his  great  sorrow.  In  1856 
he  founded  along  with  Dr.  Bruckner  of  Basel,  and  Zopfy  of 
Schwarden,  the  Swiss  Homoeopathic  Society.  Dr.  Krieger 
enjoyed  a  very  large  practice,  but  notwithstanding  his  pro- 
fessional labours  he  found  time  to  devote  much  attention  to 
natural  history  and  even  to  give  gratuitous  lectures  on  his 
favourite  study.  Though  a  busy  practitioner,  an  accom- 
plished scholar,  and  a  learned  naturalist.  Dr.  Krieger  has 
contributed  but  little  to  homoeopathic  literature. 

In  the  number  for  June  15th  is  an  article  by  Dr.  v. 
Grauvogl,  which  had  already  appeared  in  HirschePs  2kiU 
Bchrift  on  Lap%$  alius.  It  seems  that  Dr.  v.  Grauvogl  had 
introduced  under  this  name  a  new  medicine,  nature  nm- 
known,  which  had  proved  of  singular  efficacy  in  many  severe 
affections.  He  here  tells  us  what  it  is,  and  how  he  got  to 
know  it.  It  seems  that  on  one  occasion  when  on  a  visit 
to  Oastein  he  observed  that  the  inhabitants  of  the  valley  of 


JoumaU  of  the  Quarter.  687 

the  Ache^  who  drank  the  water  of  that  torrent  that  rushes 
through  its  bed  of  gneiss,  are  much  affected  with  goitre. 
He  drank  the  water  himself  for  two  weeks,  and  his  thyroid 
gland  swelled.     The  circumstance  that  the  thermal  waters 
which  rise  from  the  depths  of  the  gneiss  hill  act  unfavorably 
in  cancerous  swellings  and  ulcers  led  him  to  prove  the  gneiss. 
He  made  five  triturations  and  then  dilutions  according  to 
the  decimal  scale.     He  tested  the  6th  dilution  in  men  and 
women.     The   symptoms    most   frequently  observed    were 
burnings  and  shooting  pains  in  the  cardia  and  pylorus^  in 
the  mammae  and  uterus.     He  called  the  medicine  Lapus 
allms,  as  it  has  a  white  appearance  when  triturated,  and  he 
knew  of  no  Latin  name  for  gneiss.     This  rock^  as  is  well 
known^  contains  a  large  quantity  of  mica.     The  cure  of  a 
cancerous  ulcer  in  the  cheek  of  a  woman  aged  60,  which 
had  made  an  opening  in  the  cheek  as  big  as  half-a-crown, 
and  rendered  chewing  and  swallowing  difficulty  made  such  a 
sensation  in   Niirnberg   that  several  homoeopathic  practi- 
tioners  began  to  employ  the   Lapis  albus  which  he  had 
given  to  the  local  apothecary  to  dispense.     He  noticed  that 
under   its    use   the    woman's    complexion   improved    in    a 
remarkable    degree,  showing  that  the    blood    had  become 
quite  normal.     He  consequently  employed  it  in  chlorosis^ 
but  without  success.     But  it  proved  extremely  beneficial  in 
all  so-called  scrofulous  affections  and  ulcers,  in  all  diseases 
of  the  glands  and  lymphatics,  also  in  gland-like  tumours, 
where  physiologically  no  glands  are  usually  to  be  founds 
It  was  of  use  likewise  in  unulcerated  cancers,  in  leucorrhoea, 
and   even  in  tuberculosis.     But  it  did  harm  in  all  such 
cases  as  occurred  in  persons  who  had  suffered  from  ague  or 
other  malarious  diseases.     In  them  it  causes  relapses  of 
the  aguish  disease.     Last  year,  when  in  St.  Petersburg,  he 
tried  it  in  five  cases  of  uterine  cancer,  pronounced  to  be 
such  by  three  allopathic  attendants,  and  given  over  as  incur- 
able.    All  these  five  cases  were  completely  and  permanently 
cured  by  the  Lapii  albus.     He  has  not  yet  seen  one  open 
cancer  that  was  benefited  by  its  use.     He  is  disposed  to 
think  that  the  mica  in  the  gneiss  is  the  active  medicinal 
ingredient. 


^8  Heviews. 

la  the  number  for  June  22Qd  Dr.  Schelling,  of  Bernek, 
giyes  two  cases  cured  witb  Kali  carb.  The  first  was  a 
mower  aged  45^  who  being  heated  at  his  work  drank  some 
cold  water  from  the  Rhine.  Soon  after  doing  so  he  was 
affected  with  difficult  respiration,  formication,  pressure  in 
the  stomach,  and  nausea  with  vertigo.  Since  then  he  has 
never  felt  well.  Oastric  derangement,  vertigo,  headache, 
noise  in  ears,  rumbling  in  bowels^  bellyache,  eructations, 
empty  feeling  in  stomach,  debility,  bad  taste,  white  tongue ; 
feeling  as  if  the  stomach  were  full  of  water,  wabbling  when 
moving  or  stooping ;  staggering  and  sensation  of  unsteadi- 
ness of  the  heart  when  walking  or  driving,  nausea,  yawning, 
deep  inspirations^  fulness  in  scrobiculus  cordis  and  beating 
there.  Bowels  regular,  rather  relaxed.  Frequent  call  to 
make  water,  which  is  light  yellow  and  turbid.  Sleep  good, 
sleepy  by  day.  Eyes  red,  constant  chilliness^  cannot  get 
warm  even  at  his  work,  difficulty  of  perspiring,  very  weak. 
Calc.  carb.  80  did  little  good.  KcUi  carb,  soon  set  him  to 
rights. 

The  next  case  was  a  boy,  set.  11,  who  in  the  summer  of 
1870  became  affected  with  vertigo,  nausea,  vomiting,  and 
other  ailments,  for  which  the  domestic  remedies  prescribed 
did  no  good.  In  summer  for  many  weeks  he  could  eat 
nothing  without  immediately  vomiting.  This  continued, 
though  in  a  less  degree,  in  winter.  After  every  meal  he 
has  vertigo,  pain  in  forehead,  with  heat  of  head,  redness  of 
face,  dimness  of  vision.  The  cheeks,  ears,  and  forehead 
became  red,  the  eyes  surrounded  by  rings  and  sunk  in  ;  one 
cheek  is  often  hot,  the  other  cold.  If  he  does  not  at  once 
lie  down  he  gets  such  severe  vertigo  that  everything  seems 
to  be  whirling  round,  and  even  if  he  catches  hold  of  some- 
thing he  falls  to  the  ground,  where  he  lies  with  staring 
eyes,  and  objects  seem  distorted.  Before  he  falls  he  has 
shooting  pain  in  the  forehead,  root  of  nose  and  eyes. 
In  summer  and  autumn  the  vertigo  attacked  him  chiefly 
when  walking,  when  stooping  while  at  work,  and  on  any 
exertion ;  also  sometimes  at  night.  He  had  frequently  to 
be  carried  home  from  his  work  in  the  fields.  At  first  these 
attacks  came  once  a  fortnight^  but  latterly  more  frequently ; 


Journals  of  the  Quarter.  689 

in  printer  every  day,  and  by  day  and  night,  or  when  at 
school,  with  burning  in  eyes.  After  the  attack,  stupe- 
faction, loss  of  consciousness,  sopor  sometimes  with  delirium 
and  followed  by  exhaustion.  The  patient  has  a  pale, 
greyish-yellow  complexion,  with  dim,  dull  eyes,  and  grey 
furred  tongue ;  appetite  not  deficient,  but  nothing  tastes 
good.  After  the  least  morsel  he  feels  too  full,  and  he  can 
eat  no  more ;  has  pressive  pains  in  stomach  and  scro- 
biculus.  Rumbling  in  bowels,  much  thirst,  frequent 
yawning,  urine  scalds  and  is  foetid.  Scrobiculus  cordis 
distended,  painful  when  pressed.  At  night  has  frequently 
desire  to  pass  urine,  and  diarrhoea.  Chilliness  in  the 
evening,  often  cough  with  much  muco-purulent  expec- 
toration; difficult,  anxious  breathing,  especially  when 
walking ;  sleep  disturbed,  full  of  dreams.  In  the  morning 
exhausted,  fetid  smell  from  the  mouth,  also  noticed  by  day. 
On  the  29th  January  he  got  a  dose  of  Kali  carb.  12th. 
81st. — He  had  yesterday  a  slight  attack  of  vertigo  without 
falling  down.  He  did  not  lose  consciousness,  but  was 
sleepy  for  an  hour;  afterwards  he  felt  lighter  than  ever 
before.  Has  more  appetite  and  slept  well.  Kali  c.  12. 
4th  February. — Every  evening  chilliness,  with  pale  face ; 
slept  well.  Two  loose  motions  in  the  forenoon ;  appetite 
good ;  no  pain  in  stomach  ;  otherwise  quite  weU. 

HirschePs  Zeitschriftfur  Homoopathische  Klinik. — Shortly 
before  his  lamented  decease  Hirschel,  the  founder  and 
editor  of  this  fortnightly  magazine,  was  almost  giving  it  up 
in  disgust,  not  being  able  to  get  a  sufficient  number  of 
contributors  to  keep  it  filled.  His  announcement  of  the 
probable  abandonment  of  the  undertaking  seems  to  have 
roused  his  colleagues  to  supply  the  needful  '*  copy  '*  for 
this  periodical,  which,  since  HirschePs  death,  is  edited  by 
his  nephew.  Dr.  Edmund  Lewi,  of  Dresden.  It  is  now  in 
its  twenty-third  year,  and  has  been  a  useful  organ,  chiefly 
of  the  free-thinking  portion  of  the  homoeopathic  profession, 
as  distinguished  from  the  stricter  Hahnemannists,  who  have 
always  preferred  the  Allg,  horn.  Zeitung  as  the  organ  for  the 
publication  of  their  views. 

VOL.   XXXII,  NO.  OXXX. OCTOBEE,  1874.  X  X 


690  Reviews. 

The  number  for  May  15tb  commenoes  with  a  paper  of 
Dr.  Magdeburg,  of  Wiesbaden,  ''  On  Cares  Effected  by  the 
Wiesbaden  Waters/'  which  are  worth  reading  by  those  who 
wish  to  make  themselves  conversant  with  the  cases  for  which 
these  waters  are  especially  useful.  The  second  paper  is  the 
conclusion  of  a  compilation  by  the  editor  of  experiences  of 
various  practitioners  of  the  old  school  respecting  the  thera- 
peutic action  of  Eucalyptus  globulus.  His  summary  of  its 
pathogenetic  and  therapeutic  action,  as  fhr  as  they  are  as 
yet  known,  is  as  follows : 

I.  As  regards  its  specific  action  and  relation  to  the 
various  organs  and  systems  of  the  body,  it  has  a  decided 
action  on  the  intestinal  tract  (vomiting,  colic,  and  diarrhcsa), 
and  on  the  spleen  (alteration  of  its  size  and  consistency) ; 
it  may  also  be  credited  with  a  marked  action  on  the  heart 
and  lungs,  through  the  vagus  and  certain  nervous  tracts  of 
the  spinal  cord.  Through  the  same  channel  it  exercises  a 
fever-producing  influence. 

II.  The  chief  indications  for  the  remedy  fVom  the 
cases  related  seem  to  be : 

1.  Intermittent  fever,  and  that  chiefly  of  a  simple 
uncomplicated  character ;  as  regards  the  type,  tertians  and 
quartans.  It  seems  to  be  peculiarly  successful  when  the 
intermittent  is  a  relapse,  and  where  Quinine  has  already 
been  given  without  effect.  The  fits  seem  to  occur  chiefly 
in  the  evening  and  to  last  through  the  night,  as  often 
happens  with  intermittent  neuralgias  and  masked  agues. 
Gastro-intestinal  derangements  apparently  are  no  contra- 
indication for  its  use — a  symptom  which  may  be  regarded 
as  characteristic  is  sleeplessness  and  restlessness, 

2.  Asthmatic-neuralgic  states  from  organic  and  mecha* 
mial  causes,  with  orthopnoea  and  nocturnal  paroxysms. 

3.  The  hectic  fever  of  certain  pulmonary  disorders. 

4.  Wounds  and  ulcers  of  a  putrid  septic  character  with 
foul  secretions. 

A  marked  feature  in  this  periodical  is  the  Feuilleton, 
which  ^ives  bits  of  homoeopathic  intelligence  corresponding 
to  the  Miscellaneous  of  our  Journal.  This  number  con- 
tains, among  other  things,  a  clinical  lecture  by  Dr.  Bakody, 


Journals  of  the  Quarter.  6^1 

of  Pesth,  upon  a  case  of  trichinosis  that  occarred  under  his 
care  in  the  Rochus  Hosiptal. 

The  number  for  June  1st  contiiins  the  article  by  Dr. 
Granvogl  on  Lapis  albus  of  which  an  account  has  already 
been  given  in  our  review  of  the  Allg.  horn,  Zeitung.  This 
is  followed  by  the  fragmentary  proving  of  Eucalyptus  by  Dr. 
Faweett  from  the  Monthly  Horn.  Review,  Then  comes  a 
continuation  of  Dr.  Magdeburg's  paper  on  the  Wiesbaden 
waters.  This  is  followed  by  extracts  from  English  and 
American  periodicals. 

The  number  for  June  15th  contains  the  commencement 
of  a  thoughtful  article  by  the  editor  on  the  present  direction 
of  therapeutics^  and  a  forecast  of  its  future  outcome^ 
which  is  continued  through  several  subsequent  numbers, 
but  is  too  long  to  give  even  an  abstract  of  in  this  review. 
A  case  of  scrofulous  ophthalmia  with  intense  phptophobia 
is  related  by  Dr.  Goullon^  junr.,  which  was  rapidly  and 
promptly  cured  by  Hepar  sulph,  3  for  six  days,  followed  by 
Aurum  3,  after  a  long  allopathic  treatment  had  been  fruit- 
lessly employed. 

A  controversy  respecting  the  action  of  the  Oastein 
waters  fills  the  next  six  columns  of  this  number^  but  is 
not  of  much  interest  to  the  homoeopathic  student. 

Cases  of  poisoning  by  Agaricus  muscarius  are  given  from 
the  Wien,  Med.  Presse,  The  first  two  cases  were  those  of 
a  man,  aged  60,  and  his  wife,  aged  40,  who  had  eaten  of  a 
dish  in  which  the  fungus  had  been  introduced.  Half  an 
hour  after  partaking  of  the  dish  the  woman  had  trembling 
of  the  stomach,  weakness  of  the  limbs,  nausea,  and  violent 
vomiting.  She  trembled  all  over  and  could  scarcely  hold 
anything  in  her  hands.  She  grew  worse,  got  violent 
convulsions  in  thq  arms,  almost  like  electric  shocks.  She 
felt  as  if  her  limbs  did  not  belong  to  her,  her  legs  bent 
under  her ;  at  the  same  time  she  felt  light  as  if  she  could 
run  with  great  quickness.  She  had  dazzling  before  the 
eyes,  was  much  excited,  the  eyeballs  rolled  about,  vision 
impaired,  but  hearing  very  acute.  Towards  the  evening 
the  convulsions  ceased,  she  had  inclination  to  bend  the 
body  backward  and  forwards  and  to  stretch  ;  sleep  restless. 


692  hbviews. 

The  man  was  much  more  ill.  He  had  trembling,  convul- 
sions^ drawing  of  neck  backwards  and  stretching  of  the 
body,  excitement  and  inclination  to  vomit;  his  mind 
became  clouded,  he  fell  down  and  appeared  to  be  dying. 
Pains  in  limbs^  impaired  vision,  flatulence,  colic,  and  great 
thirst  affected  both  patients  for  four  days. 

The  other  cases  were  two  carpenters^  70  and  50  years 
old,  who,  after  partaking  of  a  similar  dish  of  fungi,  were 
affected  with  the  most  violent  brain  symptoms ;  they  cried 
and  roared  like  roadmen ;  the  elder  was  the  noisier  and 
broke  his  bedstead  to  pieces  with  superhuman  power.  It 
was  with  difficulty  that  four  strong  men  could  throw  the 
furious  patients  to  the  ground  and  bind  them  fast.  lu 
spite  of  an  emetic  the  most  violent  clonic  and  tonic  con- 
vulsions lasted  all  day.  It  was  not  until  the  following 
morning  that  they  became  quiet,  and  soon  afterwards  they 
recovered. 

The  number  for  July  1st  contains  Burt's  proving  of 
Veratrum  viri^ie,  and  an  account  by  Dr.  Mossa  of 
Noggerath's  latent  gonorrhoea  in  women  from  Virchow's 
Jahresbericht,  The  Feuilleton  contains  a  portion  of  Dr. 
Dudgeon's  address  at  the  Congress,  translated  by  Dr. 
Roth,  of  London. 

The  number  for  July  15th  contains  a  case  of  goitre 
produced  by  drinking  the  water  from  the  waterfall  at 
Grastein,  which  contains  microscopic  particles  of  mica, 
which  Dr.  ProU  relates  as  corroboratiye  of  GrauvogPs 
observations  with  Lapis  albus.  It  was  cured  by  drinking 
the  cooled  thermal  water  of  Gastein. 

Three  cases  of  arsenical  poisoning  from  the  application  of 
a  mixture  of  soap  and  arsenic  in  order  to  cure  the  itch,  in 
three  farm  labourers  of  the  respective  ages  of  23,  20,  and 
17,  are  extracted  from  the  Deutsche  Klinik.  The  author 
found  them  all  in  bed  in  a  very  prostrated  condition,  com- 
plaining of  intolerable  burning  pains  in  the  parts  to  which 
the  ointment  had  been  applied.  These  parts,  chiefly  the 
abdomen,  hands,  genitals,  and  thighs,  were  either  denuded 
of  epidermis  or  covered  with  small  serous  blisters,  with 
erythema  where  the   epidermis  remained.     The   salve   had 


Journals  of  the  Quarter,  603 

been  rubbed  in  on  thr^e  successive  nights.  Two  days 
later  all  three  were  in  a  state  almost  of  collapse.  They 
had  great  difficulty  in  moving,  there  was  great  suppuration 
and  swelling  of  the  ulcerated  parts  where  the  epidermis  had 
been  removed,  especially  on  the  abdomen,  genitals,  and 
inside  of  the  thighs.  The  vomiting,  which  had  been 
moderate,  had  ceased,  but  the  appetite  was  completely  gone  ; 
there  was  violent  fever  and  thirst,  no  sleep,  and  general 
suffering.  In  the  oldest  of  the  three  this  state  continued 
for  six  days  and  gradnally  subsided  ;  in  the  second  it 
lasted  ten  or  twelve  days,  he  had  symptoms  of  ischuria^  and 
in  both  muscular  weakness  continued  for  a  considerable 
time.  In  the  youngest  the  symptoms  were  most  serious ; 
he  fell  into  a  typhoid  febrile  state,  with  extreme  restless- 
ness^ alternating  with  stupor,  profound  mortification  of  the 
corium  in  various  parts,  almost  complete  loss  of  power  of 
moving,  and  great  emaciation.  After  four  or  five  weeks 
these  symptoms  were  much  relieved  and  he  could  sit  up ; 
he  then  exhibited  almost  complete  ataxy,  especially  of  the 
muscles  of  the  extremities ;  he  walked  as  if  he  had  severe 
chorea,  and  he  could  scarcely  raise  his  hands.  Appetite 
very  small.  He  was  subjected  to  treatment  in  a  water-cure 
establishment,  and  inductive  electricity  was  applied  for 
two  months,  which  gradually  restored  him,  but  it  was  four 
or  five  months  before  he  was  quite  well. 

The  number  for  August  1st  contains  a  review  of 
Gruzewski^s  Incompetenz,  which  the  reviewer  judges  much 
more  favorablv  than  we  have  done.  The  Feuilleton  con- 
tains  a  continuation  of  the  translation  of  Dudgeon's  address. 

Internationale  Homoopathiscke  Presse, — This  excellent 
periodical  was  started  in  1871  by  Dr.  Clotar  Miiller, 
of  Leipzig,  who  is  so  well  known  to  homoeopathic  lite- 
rature by  the  Virteljahrschrift  of  which  he  was  so  long 
editor.  The  Internationale  maintains  the  prestige  acquired 
by  its  predecessor,  and  our  pages  have  been  more  than 
once  enriched  by  translations  from  it.  It  is  now  in  the  ninth 
number  of  the  fourth  volume.  It  appears  monthly.  At 
first  it  was  only  published  every  second  month. 


694  Reviews. 

From  the  first  number  of  this  volume  we  have  already 
published  Frohlich  and  Kausmann's  ''  call  to  prove  medi- 
cines/' and  Dr^  MiiUer's  '*  treatment  of  some  skin  diseases/' 
This  number  also  contains  a  study  of  Zine  by  Dr.  Gerstel, 
the  veteran  homoeopath  of  Vienna,  which  is  continued 
through  several  previous  and  subsequent  numbers. 

A  paper  by  Dr.  Fischer^  of  Weingarten^  on  medical 
reform  reveals  and  protests  sgainst  the  same  illiberal  treat* 
ment  of  homoeopaths  by  the  allopathic  majority  backed  by 
the  government  and  the  official  world  that  we  have  so 
often  complained  of  here. 

An  interesting  report  by  Dr.  Held,  of  Rome,,  of  discus- 
sions in  the  Italian  Parliament  on  homoeopathy.  Dr. 
Frisda,  who  is  apparently  a  homoeopathic  physician  and  also 
a  member  of  parliament,  proposed  that  chairs  of  homoeo- 
pathy should  be  established  in  the  Italian  universities.  The 
Minister  of  Public  Instruction  repUed  that  the  practice  of 
medicine  was  firee  in  Italy,  and  that  if  any  of  the  professors 
of  medicine  should  deem  it  expedient  to  teach  homoeopathy  in 
the  universities  there  was  nothing  to  prevent  him  doing  so. 
To  this  Dr.  Friscia  replied,  that  as  the  number  of  citizens 
who  preferred  homoeopathy  was  considerable^  and  as  they  paid 
the  taxes  for  the  support  of  the  schools  of  medicine,  part  of 
these  taxes  ought  to  be  applied  to  the  endowment  of  special 
chairs  of  homoeopathy  in  these  schools.  On  another 
occasion  Senator  Murio,  who  is  an  adherent  of  homoeopathy, 
proposed  that  special  homoeopathic  pharmacies  should  be 
established  in  the  chief  towns,  which  should  be  placed  under 
the  inspection  of  homoeopathic  physicians.  His  proposition 
was  favorably  received  and  the  matter  referred  to  a 
eommittee.  The  speech  of  Senator  Murio  is  given  in 
fuU^  and  is  distinguished  by  its  statesmanlike  and  moderate 
tone.  Whether  the  committee  will  carry  it  out  will  be 
seen  hereafter. 

This  is  followed  by  a  long  defence  by  Dr.  Schwabe  of  his 
pharmacopoeia  against  certain  criticisms  by  Dr.  Hartlaub 
of  Blankenburg. 

Dr.  Payr,  of  Passau,  gives  some  interesting  remarks  on 
paralysis   of  the  accommodation    following  diphtheria   as 


Journals  qf  the  Quarter.  696 

observed  by  various  authors.  Tonic  treatment  with  instil- 
lation of  Calabar  seemed  to  be  the  most  successful  mode  of 
treating  this  affection. 

There  is  a  notice  of  an  operation  by  Dr.  James 
McCraith  of  Smyrna  for  ectropium  by  excising  from  within 
a  longitudinal  strip  of  the  cartilage  of  the  lid. 

An  account  of  the  last  cholera  epidemic  in  Hungary  by 
Dr.  T.  von  Balogh,  of  Pesth,  contains  some  interesting 
statistics  of  the  mortality  of  the  disease^  which  seems  to 
have  been  of  a  very  severe  character.  During  the  whole 
duration  of  the  epidemic,  i.e.  from  the  18th  October,  1872, 
to  the  end  of  October,  1873,  the  mortality  was  as  follows : 
In  6250  districts,  which  belong  to  136  jurisdictions,  repre- 
senting a  population  of  6,435,632,  there  were  attacked  by 
cholera  431,406;  of  these  were  cured  245,655,  and  died 
181,672,  remained  under  treatment  4079 » 

Prof.  Ba&el  Molin,  of  Vienna^  gives  an  instructive  article 
which  he  calls  a  "  Contribution  to  the  Doctrine  of  Epidemic 
Remedies.^'  He  says  that  on  the  occurrence  of  any  epidemic 
it  is  of  great  importance  to  discover  the  remedy  suited  for 
the  epidemic  constitution,  which  will  be  found  curative  for  all 
cases,  however  much  they  may  differ  in  external  manifes- 
tation. It  will  be  found  that  they  have  all  some  features 
in  common,  and  these  common  features  are  the  clue  to  the 
discovery  of  th^  epidemic  remedy.  He  relates  how  in  the 
latter  half  of  October,  1873,  when  the  cholera  was  rapidly 
declining,  a  severe  form  of  intestinal  catarrh  became  very 
prevalent,  which  he  regarded  as  a  kind  of  modification  of 
the  choleraic  influence  that  was  not  quite  extinguished. 
The  motions  were  from  twenty  to  thirty  in  twelve  hours ; 
vomiting  was  frequent ;  there  was  cyanosis  of  hands  and 
face ,-  corpselike  coldness  of  forearms  and  cheeks ;  the 
bowels  emitted  a  spashing  noise  when  pressed,  showing  an 
admixture  of  fluid  and  aerial  contents  ;  at  first  there  was  com- 
plete asphyxia,  total  prostration  of  strength,  and  complete 
apathy  of  mind.  These  symptoms  might  almost  have  led 
an  inexperienced  person  to  mistake  the  disease  for  cholera ; 
but  what  distinguished  it  from  that  malady  was  the  absence 
of  suppression  of  urine,  of  cramps,  and  of  aphonia.     It  could 


696  Reviews. 

not  be  considered  either  as  an  acute  intestinal  catarrh^  for 
there  was  no  fever  at  the  beginning.  It  was  only  on  the 
third  day  that  slight  febrile  symptoms  manifested  themselves 
(pulse  not  above  80  even  in  young  persons)^  and  the  peculiar 
symptoms  of  the  tongue.  We  may  give  Dr.  Molin's  first 
case  to  show  what  led  him  to  the  selection  of  the  ''  epidemic 
remedy''  which  he  found  so  successful  in  subsequent 
cases. 

''Miss  Mary  Z — ,  »t.  19,  regular  in  catamenia  for  years,  a 
quiet,  calm,  strongly  built,  blonde,  rosy  cheeked  girl,  was  on  the 
12th  October  seized  with  sudden  bowel  complaint,  which  her 
mother  attributed  to  derangement  of  the  stomach,  though  tbe  girl 
had  eaten  nothing  that  could  have  disagreed  with  her.  That 
night  she  slept  quietly,  was  only  twice  disturbed  by  the  bowels. 

'*  On  tbe  13th  the  stools  increased  in  frequency,  accompanied 
by  tenesmus  and  slight  pains  in  the  abdomen.  She  kept  her  bed, 
had  no  appetite,  but  did  not  feel  ill.  Her  mother  gave  her  several 
Dover's  powders  (1  gr.  per  dose)  in  the  course  of  the  day,  and 
warm  cloths  to  abdomen.  She  took  only  beef  tea.  That  night 
she  again  slept  quietly ;  stools  much  less  frequent  than  by  day. 

"  On  the  14th  the  bowels  began  to  act  frequently  immediately 
after  waking.  She  suddenly  became  sad,  anxious  about  her  state, 
oppressed  in  the  chest,  and  very  weak. 

"  At  8  a.m.  I  found  temperature  and  respiration  normal ;  pulse 
72,  open,  regular,  strong,  not  hard ;  chest  free ;  abdomen  some- 
what distended  but  soft,  not  painful  to  pressure,  but  emitting  a 
splashing  noise  on  account  of  the  fluid  in  the  bowels ;  contracted 
portions  of  the  bowels  could  be  felt  here  and  there  under  the 
abdominal  integuments ;  tongue  slightly  furred  at  the  back.  She 
said  she  had  been  purged  about  every  five  minutes,  but  little  at  a 
time.  Colour  of  motions  imknown,  as  they  had  been  thrown 
away.  I  learnt  that  they  were  odourless,  and  discharged  as  if 
from  a  squirt.  I  gave  Opium  1,  a  drop  to  be  taken  every  hour. 
Cool  strong  beef  tea  for  food. 

"  At  1  p.m.  the  state  was  much  the  same,  only  the  bowels  were 
not  contracted ;  the  extensor  aspect  of  the  forearms  and  the  cheeks 
were  cool  to  the  touch ;  there  was  thirst ;  motions  quite  liquid,  of 
pale  green  colour,  mixed  with  shreds  of  epithelium  ;  urine  passed 
with  each  motion.   I  prescribed  the  same  remedy  every  half  hour, 


Journals  of  the  (Quarter,  ('97 

and  a  clyster  containing  three  drops  of  Opium  1  after  the  next 
stool,  to  be  repeated  in  three  hours  if  ineffectual.  I  let  her  have 
sips  of  soda  water  for  the  thirst. 

^  At  7  p.m.  state  unaltered.  The  clysters  coulA  not  be  retained 
a  quarter  of  an  hour.  The  last  motions  were  nearly  white.  I  now 
gave  Verat,  1,  a  drop  in  a  teaspoonful  of  water  every  quarter  of 
an  hour. 

"  In  the  course  of  the  evening  the  motions  became  less  fre- 
quent, darker  coloured,  and  stronger  smelling. 

"  After  10  p.m.  the  patient  fell  asleep,  and  slept  all  night  until 
7  a.m.  next  morning  without  being  purged.  But  as  soon  as  she 
awoke  purging  recommenced,  and  a  quarter  of  an  hour  afterwards 
vomiting.  The  stools  were  liquid,  mixed  with  some  firmer  lumps, 
strong  smelling.  What  was  vomited  was  a  whitish  fluid  with  a 
shade  of  green,  with  a  sickly  smell,  and  mixed  with  mucus. 

"  At  8  a.m.  I  found  her  nearly  the  same  as  the  previous  even- 
ing. She  was  more  depressed,  complained  of  headache,  sickly 
taste,  and  incessant  thirst ;  she  often  sighed,  felt  colder  on  fore- 
head, cheeks,  and  arms  than  the  day  before.  The  splashing  noise 
in  the  bowels  on  pressure  continued,  as  also  the  tenesmus.  Feet 
and  body  warm,  and  freely  perspiring.  I  prescribed  Ipee.  1,  a 
drop  every  hour. 

''At  12  noon  I  found  that  the  vomiting  had  recommenced, 
that  the  stools,  of  the  appearance  described  above,  were  very  fre- 
quent, the  headache  persistent,  the  forehead,  cheeks,  and  forearms 
were  cold  as  marble,  and  the  bowels  were  distended  with  wind. 
I  found  the  pulse  febrile,  80,  and  very  full.  This  symptom,  in 
connection  with  the  others,  led  me  to  give  Rhus  3.  I  mixed  ten 
drops  in  half  a  pint  of  water,  and  made  the  patient  take  it  every 
Ave  minutes  in  my  presence.  The  medicine  acted  like  a  charm. 
After  four  doses  the  pulse  fell  to  72,  the  temperature  was  normal, 
the  sickly  taste  gone,  thirst  removed,  headache  diminished,  spirits 
raiseds  no  inclination  to  vomit,  no  call  to  stool.  The  medicine 
was  now  given  at  longer  intervals,  and  by  the  evening  the  patient 
had  good  appetite,  the  tongue  was  clean,  the  pulse  60,  the  skin 
moist,  the  abdomen  no  longer  distended,  hands  warm  and  moist, 
no  nausea,  no  tenesmus.  She  recovered  rapidly  without  a  draw- 
back.'» 

Twelve  other  cases,  more  or  less  severe,  were  treated  by 
the  author  with  Rhus  and  recovered  rapidly. 


608  RmewB, 

Neit  oomes  a  reTiew^by  Dr*  H.  OouIIoHi  jnn.^  of  ft  plimphlet 
by  Dr.  George  Sohmid^  of  Yienna^  advocntiiig  the  nedeMity 
of  establishing  chairs  of  homcBopathy  in  the  schools  of 
medicine.  Dr.  Sehmid's  pamphlet  is  t&ot  eonfiaed  to  this 
subj^t,  but  he  has  a  good  deAl  to  say  ou  the  stkbject  of  the 
dos^i  on  the  relations  of  homteopathy  to  allopathy,  and  on 
the  causes  of  the  persistence  of  the  quarrel  between  allo- 
paths and  homoeopaths. 

A  study  of  Lyeopodiiim  (source  dot  stated)  by  Dr  J.  fi. 
Oilman^  of  Chicago,  and  Dr.  Mann's  account  of  the  use  of 
hot  water  in  metrorrhagia^  which  appeared  in  one  of  the 
American  periodicals. 

Dr.  Payr  continues  his  ophthalmological  observations 
from  the  writings  of  distinguished  ophthalmologists,  l^his 
time  his  subjects  are  '^  Intermittent  Blepharo-spasmus/'  and 
''  Morphoetid  Affections  of  the  £ye.*^ 

A  notice  is  given  of  Professor  Nagel's  essays  on  the 
treatment  of  strangulated  hernia  with  Coffee,  a  remedy 
formerly  in  great  repute  for  that  affeetion,  but  whioh  had 
latterly  fallen  into  disuse  and  forgetfulness* 

An  obituary  of  Dr.  Hirschel  and  an  account  of  the 
'^  gc^den  wedding  **  of  Dr.  J.  E<  Veith^  of  Vienna,  closes 
this  number* 

No.  8  commences  with  a  portion  of  a  lectufe  deliter^d  in 
the  Uniyersity  of  Pesth  by  Dr.  Hausmantt,  the  newly 
appointed  Professor  of  HomoBOpathic  Materia  Medica  and 
Therapeutics.  Portions  of  subsequignt  lectures  are  givetl  in 
the  succeeding  numbers.  These  fragments  give  us  a  very 
high  opinion  of  the  fitness  of  Dr.  Hausmann  for  the  post  to 
whieh  he  has  beett  appbinted.  They  are  distinguished  by 
their  high  scientific  tone,  and  will  compare  favorably  idth  any 
lectures  we  have  read  by  the  most  distinguished  professors 
of  the  old  school.  We  congratulate  the  homoeopadiic 
school  of  Pesth  on  the  appointment  of  Dr.  Hausmann. 
He  is  evidently  the  right  man  in  the  right  place^  and  we 
cannot  help  feeling  envious  of  the  privilege  accorded  to  the 
University  of  Pesth  in  having  two  such  distinguished  and 
competent  men  as  Hausmahn  and  Von  Bakody  added  to 
the  staff  of  its  professors.     We,  in  England^  can  soaroaly 


Journals  qf  the  Quarter.  699 

expect  that  GoTemment  will  interfere  to  establish  chairs  of 
homoeopathy  in  our  medical  schools,  but  we  think  that 
private  enterprise  might  do  much  to  establish  a  school  of 
homoeopathy  in  connection  with  our  hospital  in  London. 
There  are  men  amongst  us  able  and  willing  to  deliver 
courses  of  lectures  that  would  redound  to  the  credit  of  the 
hospital  and  be  of  great  value  to  inquiring  students* 

This  number  contains  a  paper  by  Dr.  Lorbacher  "  On 
Some  Diseases  of  the  Osseous  System  in  Childreni''  illus- 
trated by  eases  from  the  Leipzig  Poliklinik.  The  subject  of 
the  present  dissertation  is  Rhachitis,  The  author  says 
that  numerous  cases  of  this  disease  were  treated  in  the 
Poliklinik.  The  ages  of  the  children  ranged  from  one  to 
four  years.  The  commencement  of  the  disease  dated  from 
the  appearance  of  the  first  tooth,  or  from  weaning,  tn  few 
cases  was  there  any  sign  of  a  scrofulous  diathesis.  Di*. 
Lorbacher  agrees  with  Niemeyer,  Vogel,  and  others,  in 
considering  rhachitis  as  in  no  way  connected  with  serofulosis. 
In  most  cases  the  disease  seemed  to  have  been  the  effect  of 
injudicious  diet  and  want  of  fresh  air.  In  one  ease  only 
was  there  any  suspicion  of  syphilis  in  the  mother.  Dr. 
Lorbacher  did  not  find  in  his  patients  any  confirmation  of 
Niemeyer's  statement  as  to  the  invariable  connectiOA  of 
rhachitis  with  an  antecedent  fermentative  diarrhoea.  Atrophy 
was  not  always  an  accompaniment  of  the  disease.  Some  of 
the  children  were  quite  well  nourished.  In  those  who  were 
atrophic  the  appetite  was  variable ;  there  was  often 
anorexia>  and  especially  distaste  for  meat  and  soup.  The 
deficiency  of  calcareous  salts  in  the  affected  osseous  parts 
shows  a  derangement  of  the  nutritive  functions.  The 
children  treated  in  the  Poliklinik  showed  the  disease  prin- 
cipally in  the  legs  and  forearms — sometimes  in  the  epiphyses, 
sometimes  in  the  shafts  of  the  bones,  the  vertebrae  of  the 
trunk,  and,  in  some  cases,  in  the  ribs  when  they  are  attached 
to  the  cartilages.  In  one  case  there  was  some  chronic 
bronchial  catarrh.  The  disease  was  not  attended  with 
danger  to  life,  but  was  apt  to  produce  deformities.  The 
fatal  cases  were  generally  among  children  who  had  long 
suffered  from  exhausting  diarrhoea.     They  generally  died  a 


700  Reviewt. 

few  days  after  admission.  In  most  cases  the  disease  was 
soon  arrested  and  a  cure  gradually  effected.  It  was  seldom 
possible  to  effect  any  considerable  alteration  in  the  regimen 
of  the  patients.  The  remedies  found  of  most  service  were 
Calcarea  earb,,  acet,,  and  p^iosph, 

Calc.  carb,  was  the  most  generally  useful.  It  was  given 
in  the  SOth  dilution.  Cole.  acet.  was  chiefly  employed  when 
there  was  present  the  above  alluded  to  profuse  ferment-like 
diarrhoea,  of  a  watery  slimy  character^  containing  curdled 
milk^  sour  smelling,  painless.  It  was  given  in  the  2nd  and 
8rd  dilutions.  Calc.  phos.  was  usually  given  in  the  3rd  trit. 
The  treatment  usually  lasted  about  five  months  before  the  chil- 
dren were  quite  cured.  In  some  cases  where  there  was  great 
atrophy  and  profuse,  fetid  discoloured  diarrhoea  with  great 
thirst  and  vomitings  Arsen.  was  necessary.  Nux  vom.  and 
Alufnin.SO  were  used  with  advantage  when  there  was  constipa- 
tion.  Cod'liver  oil  as  a  dietetic  agent  was  very  advantageous. 

Extracts  from  American  journals  come  nezt^  and  then 
an  original  article  by  Dr.  H.  OouUon^  junr. — a  comparison  of 
Causticum  with  Graphites. 

This  is  followed  by  reviews  of  books.  The  most  interest- 
ing of  these  is  a  review  by  Dr.  Gt)ullon  of  Weber's  Nature 
and  Curability  of  the  Commonest  form  of  Progressive  Deaf- 
ness,  with  an  account  of  hia  celebrated  operation  of  teno- 
tomy of  the  tensor  tyropani  for  certain  forms  of  deafness ; 
an  operation  which  is  highly  spoken  of  and  much  practised 
by  modern  aurists. 

We  notice  a  method  of  stopping  bleeding  from  the  nose 
devised  by  Surgeon-Major  B.  Strauss,  of  Munich,  by  means 
of  a  cone  of  punk  (feuerschwamm)^  which  was  imme- 
diately successful  after  the  usual  methods  by  charpie 
tampons  saturated  with  alum,  tannin,  and  liquor  ferri, 
had  been  tried  in  vain. 

Then  comes  an  address  to  Professor  Rokitansky  on  his 
seventieth  birthday  by  the  Hungarian  Society  of  Homoeo- 
pathic Physicians. 

The  number  concludes  with  an  announcement  of  the 
courses  of  lectures  on  homoeopathy  in  the  Pesth  University 
lor   the  summer  session.      1,   Professor  Dr.   Hausroann — 


Journals  of  the  Quarter.  701 

every  Monday  and  Tuesday,  *'  The  Artificial  Diseases  Caused 
by  Phosphorus  and  its  compounds ;"  every  Wednesday, 
Thursday,  and  Friday — "  Homoeopathy  (Pathology  of  the 
Artificial  Diseases)."  2.  Professor  Dr.  Bakody — every 
Monday,  Tuesday,  Wednesday,  Thursday,  and  Friday — 
"  Special  Pathology  and  Homoeopathic  Therapeutics ;" 
clinical  lectures  in  the  homoeopathic  department  of  the  muni- 
cipal hospital  of  St.  Kochus  in  Buda,  Pesth.  Both  pro- 
fessors give  private  instruction  in  Hungarian  or  German. 
Professor  Bakody  gives  a  six  weeks'  course  of  instruction 
in  diseases  of  the  lungs,  heart,  and  vascular  system. 

The  fourth  number  contains  a  paper  by  Dr.  Sum,  chiefly 
devoted  to  the  pathogenetic  effects  of  Kalmia  latifolia,  com- 
paring it  with  other  medicines  nearly  allied  to  it  botanically 
or  pathologically.  This  paper  shows  a  good  deal  of  thought- 
fulness,  but  is  of  rather  a  desultory  character.  Among 
other  things  the  author  mentions  that  a  homoeopathic 
practitioner,  Magister  Alb,  who  had  a  good  deal  of  practice 
among  artisans  engaged  in  iron  manufactories  who  frequently 
got  fragments  of  iron  in  their  eyes,  did  not  attempt  to 
remove  the  foreign  bodies,  but  only  gave  the  sufferers  Aconite, 
and  in  the  course  of  a  day  or  two  all  the  redness,  swelling, 
and  sensitiveness  of  the  eyes  disappeared,  and  the  fragment 
of  iron  either  fell  out  or  became  encapsuled  in  the  eye 
without  giving  further  trouble.  We  should  not  recommend 
this  practice  for  imitation,  as  we  believe  the  better  plan  is 
to  remove  the  foreign  body,  which  is  easily  done,  for  it 
would  not  be  desirable  to  have  a  bit  of  iron  sticking  in  the 
cornea,  even  though  it  might  cease  to  irritate  the  eye,  for 
its  presence  might  interfere  with  vision. 

Dr.  Proll  contributes  some  cases  in  which  the  waters  of 
Gastein  proved  of  use.  The  first  was  a  gentleman  who 
suffered  from  a  curious  affection  of  the  nerves  of  touch.  If 
he  touched  with  his  naked  finger  metals  and  many  other 
minerals,  a  pain  immediately  extended  from  the  finger  up 
the  arm  to  the  chest  and  back  almost  like  an  electric 
shock.  The  result  of  the  treatment  by  the  Gastein  waters 
is  not  given.  The  second  case  was  a  poor  sempstress, 
whose  nervous  system  had  been  much  upset  first  by  onanism. 


^02  Reviews. 

then  hj  bitving  had  a  child.      She  showed  a  remarkable 
seDsitiveneM  (o  crystals  of  qparts  or  rock-crystal.       She 
could  not  bear  their  smell,  and  when  she  touched  them  or 
came  uear    them  they   caused  intense  pain  through   her 
whole  body  and  threw  her  into  conyulsious  ^d  syncope. 
She  saw  the  crystals  in  the  dark  surrounded  by  a   blue 
light.     She  was    also    sometimes  thrown   into  a  state  of 
hypnotism   when  they   were  brought  close  to   her.      She 
experienced  also  various  curious  symptoms  when  she  stood 
with  her  back  towards  any  part  of  the  compass  except  the 
north.     She   was  worst  when  she  stood  or  sat  with   her 
back  to  the  south.     Crystals  of  Carbonate  of  Lime  pro- 
duced  no  effect  on  her.      After  a  course  of  Oastein  baths 
all  these  idiosyncrasies  went  off  gradually.     The  third  case 
was   a  young  woman,  who,  when   a  girl  of  17,  had  fallen 
with  the  back  of  her  head  upon  a  rock.      After  this  for  six 
years  she  was  subject  to  the  most  violent  OQQVuIsions,  for 
which  she  was  treated  by  the  most  violent  remedies  without 
benefit.     At  length  a  quiet  life  in  the  country  restored  her 
to  comparative  health.     Twelve  years  after  the  fall   she 
came  to  Gastrin,  and  Dr.   ProU  found  that  a  crystal  of 
quartz  caused  intense  pain  when  she  touched  it  with  her 
bare  b^nd ;  if  she  had  on  a  glove  she  could  handle  rock 
crystal   without  any  dispomfort;  on   the   contrary,   it    was 
rather  agreeable   than  otherwise.     She   used   a  crystal  of 
quartz  as  a  night  light,  as  a  blue  flame  issued  from  its  end. 
If  she  leapt  over  the  crystal  she  experienced  a  stupefying 
smell.      This  patient  was  cured  and  she  lost  all  the  above 
idiosyncrasies.      But  whenever  she  was  at  all  ill  she  could 
again  see  the  blue  flickering   flame  proceeding  ftx)m  the 
crystiU. 

The  n^xt  is  a  very  extraordinary  case  of  a  boy  who, 
after  suffering  from  convulsions  like  hysteria,  fell  every 
day  into  a  sort  of  somnambulic  sleep  from  which  he  could 
with  difficulty  be  roused.  A  piece  of  white  quartz  had 
a  remi^rkable  effect  on  him.  He  complained  of  its 
horrible  smell,  and  said  that  it  gave  him  pain  in  the 
occiput  as  if  he  was  beaten  there  with  a  heavy  spiked 
iustrumeut.       Many   things   were   tried   for  "him   without 


Journals  of  the  Quarter.  76d 

effect.  He  was  eventually  cured  by  ridijig  oa  horseback^ 
which  he  had  prescribed  for  himself  when  in  a  clairvoyant 
state. 

Dr.  PrSU  relates  several  other  cases  that  were  affected 
similarly  to  some  of  the  above  by  the  contact  of  quartz 
crystals. 

Dr.  Payr  continues  his  ophthalmologieal  gleanings.  In 
this  number  he  notices  the  new  idea  that  acquired  myopia 
is  a  spasm  of  the  accommodation  muscle  of  the  eye^  and 
that  it  may  be  cured  in  most  cases  by  atropinising  i\xe 
eye.  Th^  duration  of  the  treatment  is  about  four  weeks, 
and  during  the  whole  time  dark-coloured  glasses  should  be 
worn. 

There  is  next  an  account  by  Professor  Moliu^  of  Vienna^ 
of  Dr.  Thomas  Lederer,  who  died  at  Vienna  in  January 
last  at  the  age  of  88.  He  seems  to  have  been  an  amiable 
as  well  as  an  energetic  man^  and  was  much  beloved  by  his 
patients  and  friends. 

Extracts  from  American  journals^  and  Dr.  H.  NankivelPs 
essay  on  phthisis  and  its  arsenical  treatment^  with  which 
our  readers  are  familiar. 

We  learn  flrom  this  number  that  the  post  of  physician  to 
the  Gumpendorf  Homoeopathic  Hospitai^  so  long  filled  by 
Dr.  Rothansel  after  Fleischmann's  death,  is  now  occupied  by 
Dr.  Rossiwal;  Dr.  Waldmann  is  the  assistant-physician. 
Dr.  Ernest  Arthur  Lutze,  having  taken  his  degree  at 
Leipzig,  has  undertaken  the  management  of  the  homoeopathic 
institution  at  Coethen,  founded  by  his  late  father. 

The  fifth  number  contains  an  elaborate  paper  by  Dr. 
Davidson  of  Florence  on  the  "  Asiatic  Cholera^''  which  is 
continued  in  the  next  number.  The  next  paper  is  by  Dr. 
Clotar  Miiller  on  "  Scrofulous  Affections  and  in  particular 
Scrofulous  Ophthalmia/'  from  his  experience  in  the  Leipzic 
Poliklipik.  We  hope  at  some  future  period  to  present  our 
readers  with  a  translation  of  this  yaluable  contribution  to 
our  knowledge  of  this  important  class  of  diseases. 

This  is  followed  by  a  paper,  by  Dr.  H.  Kisch,  on  the 
Marienbad  waters  in  connection  with  the  diseases  of 
women.     These  waters  are  much  used  in  cases  of  scanty 


704  Reviews, 

menstruation  in  fat  wotneD.  Among  many  cases  success- 
fully treated  the  following  is  gi^en  as  an  example : 

Mrs.  X — ,  25  years  old,  six  years  married^  without 
children,  had  from  the  age  of  girlhood  continued  to 
increase  in  obesity.  She  now  weighs  186  pounds.  The 
catamenia,  always  scanty  and  pale,  had  entirely  ceased  for 
four  years,  and  the  lady  was  very  unhappy  in  consequence. 
She  is  melancholy  and  apathetic.  She  came  to  Marienbad 
in  order  to  be  cured  of  her  obesity.  I  prescribed  the 
Glauber  salts  water  internally,  and  chalybeate  bog  baths, 
[Eisenmoorbdder)  with  suitable  diet,  and  afterwards  resi- 
dence for  several  weeks  among  the  hills.  After  four 
months  the  catamenia  reappeared,  at  first  scanty,  then  at 
intervals  of  from  two  to  six  weeks,  and  finally  they  became 
regular  every  four  weeks  and  normal  as  regards  quantity 
and  quality. 

Profuse  menstruation  is  also  benefited  by  Marienbad,  and 
the  menopausic  period  derives  more  advantage  than  from 
almost  any  other  treatment.  The  following  case  is  given 
as  an  example : 

Mrs,  X — ,  42  years  old,  had  her  last  child  (the  seventh) 
eight  years  ago.  For  the  last  two  years,  whilst  the  men- 
struation continued  regular,  she  had  frequent  attacks  of 
profuse  haemorrhage  with  pains  in  csecum  and  loins.  The 
last  seven  months  these  haemorrhages  have  become  so 
frequent  that  the  lady  declares  she  is  scarcely  well  three  or 
four  days  in  the  month,  and  is  forced  to  give  up  walking 
altogether.  She  used  previously  to  be  stout,  now  she  is 
quite  the  reverse  and  very  anaemic.  Appetite  pretty  good, 
bowels  very  costive.  All  sorts  of  remedies  internal  and  ex- 
ternal had  been  used  to  check  the  haemorrhage,  but  without 
benefit.  I  prescribed  small  doses  of  the  Ferdinands- 
brunnen  in  conjunction  with  Ambrosiusbrunnen,  and  along 
with  this  steel  baths,  at  first  at  a  temperature  of  22° 
R.  and  afterwards  18°  R.  for  ten  minutes.  After  a 
walk  the  patient  was  delighted  to  find  that  no  haemorrhage 
ensued,  and  she  was  able  to  take  short  walks.  After  four- 
teen days  haemorrhage  came  on  again  and  lasted  four  days. 
After  three  more  weeks,  during  which  no  bleeding  occurred. 


Journals  of  the  Quarter.  706 

tbe  patient  left  Marienbad.  During  the  winter  she  had 
only  two  attacks  of  haemorrhage^  which  were  profuse  and 
lasted  several  days.  Copious  menstruatiou  every  three  or 
four  weeks.  The  following  summer  the  lady  drank  Ferdi* 
nandsbrunnen  at  home  for  six  weeksj  and  the  menstrual 
discharge  came  every  four  or  five  weeks,  lasting  for  two  to 
three  days^  not  profuse.  Her  strength  recovered^  sbe 
looks  well,  and  gained  flesh. 

Painful  menstruation  is  also  under  the  good  influence  of 
Marienbad.     The  following  is  one  of  many  cases : 

Mrs.  X — y  25  years  old,  a  widow  for  three  years^  no 
children,  of  blooming  appearance,  well  nourished  and  strong, 
has  suffered  for  more  than  two  years  from  painful  menstru- 
ation. When  the  period  is  due  she  complains  of  the  most 
violent  pains  in  the  hypogastrium,  pains  in  the  sacrum, 
nervous  sufferings,  migraine,  photophobia,  vomiting.  She 
must  keep  her  bed,  and  suffers  great  torture,  which  makes 
her,  though  usually  cheerful,  profoundly  melancholy. 
Examination  showed  no  organic  disease.  She  underwent  a 
six  weeks'  treatment  with  Kreuz-  and  Ferdinandsbrunnen,  at 
the  same  time  bay  baths  alternately  with  Ferdinand's 
baths.  During  the  treatment  the  menstruation  was  less 
painful,  and  she  was  soon  completely  cured,  the  catamenia 
occurring  regularly  and  without  pain. 

Chronic  metritis  is  another  of  the  affections  for  which 
Marienbad  baths  are  much  resorted  to,  and  in  which  they 
are  signally  efiScacious.  Sometimes  the  patients  are  not  at 
all  aware  that  they  have  any  affection  of  the  womb,  and 
ascribe  their  symptoms  to  quite  other  causes.  The  fol- 
lowing is  put  forward  as  a  specimen  of  the  treatment  of 
this  disease : 

Mrs.  X — ,  a  delicate  weakly  lady,  in  the  "  critical  age,'' 
has  for  a  long  time  suffered  from  that  complex  of  symptoms 
known  as  hysteria.  The  chief  and  most  troublesome  symp- 
toms, for  which  she  had  employed  all  sorts  of  remedies  and 
resorted  to  many  watering  places,  are  diminished  appetite, 
dull  pain  in  gastric  region,  frequent  eructations  of  wind,  some- 
times vomiting  of  watery  fluid  and  obstinate  constipation. 
I    insisted  on  an    examination,  and  found   that   she  had 

VOL.  XXXII,  NO.  CXXX. OCTOBER^  1874.  Y  Y 


706  Reviews. 

chronic  metritis.  As  the  patient  was  ?erj  anaemic  the 
treatment  had  to  be  very  mild.  I  ordered  two  half 
glasses  of  Kreuzbmnnen  and  two  glasses  of  Ambrosius- 
bmnnen,  afterwards  substituting  the  stronger  Ferdinands- 
brnnnen  for  the  Kreuzbrunnen.  She  had  also  steel  baths, 
with  local  douches  alternately  with  peat  baths.  After  a 
seven  weeks'  treatment,  during  which  the  symptoms  rapidly 
subsided,  she  got  quite  well.  Her  appetite  was  better  than 
it  had  ever  been.  The  vomiting  ceased  during  the  last 
three  weeks,  and  the  bowels  became  regular.  She  got 
through  the  winter  comfortably,  and  for  several  summers 
she  underwent  the  Marienbad  treatment "  out  of  gratitude.'^ 

Chronic  catarrh  of  the  genital  mucous  membranes, 
generally  attended  with  ulceration  of  the  mouth  of  the 
womb,  is  also  benefited  by  these  waters.  The  ulceration  of 
the  womb  requires  local  treatment  by  douches  and  touching 
with  Nitrate  of  Silver. 

The  Marienbad  waters  are  also  useful  in  displacements 
and  flexions  of  the  womb,  in  tendency  to  abortion,  in 
sterility,  and  hysteria,  some  cases  of  which  are  detailed  by 
the  author. 

Dr.  Gonllon,  sen.,  contributes  a  second  paper  (he  had 
formerly  given  one  in  the  third  volume)  on  the  '^  Dose 
Question.'^  Like  most  of  the  articles  on  this  vexed 
subject,  this  contributes  very  little  to  the  settlement  of  the 
question  of  the  appropriate  dose,  and  how  that  is  to  be 
determined.  It  seems  to  us  that  most  of  the  papers 
hitherto  published  on  this  subject  are  mere  apologies  for  the 
routine  of  practice  into  which  their  authors  have  drifted. 
Extensive  experiments  with  different  doses  can  alone 
determine  the  best  dose  for  each  individual  disease  or  for 
the  various  classes  of  disease,  and  these  have  still  to  be 
made. 

The  next  paper  is  on  '*  The  Laws  and  Regulations 
respecting  Homoeopathy  in  the  Kingdom  of  Prussia,'^ 
which  offers  no  particular  interest  for  the  English  practi- 
tioner. 

A  criticism  of  Dr.  G.  Schmid's  pamphlet,  "On  the 
Surest  and  Best  Rules  of  the  State  for  Terminating  the 


Journals  of  the  Quarter.  ^07 

Controyersy  of  the  Allopaths  with  the  Homoeopaths^''  by  Dr. 
y.  ViUers^  of  ^eimar^  occupies  thirteen  pages  of  this  number. 
The  number  concludes  with  an  obituary  notice  of  the  late 
Dr.  Julius  Mgidi,  He  was  one  of  Hahnemann's  earliest 
disciples,  and  died  after  a  long  and  painful  illness^  caused 
by  stone  in  the  bladder,  at  the  ripe  age  of  seyenty-nine. 

In  the  seyenth  number  Professor  Hoppe  giyes  the  first  of 
a  series  of  articles  on  **  Inductiye  Reasoning/'  which  pro- 
mise to  be  an  exhaustiye  philosophical  consideration  of  the 
subject.  It  would  take  up  too  much  space  to  enter  here  on 
a  detailed  examination  of  this  subject. 

Dr.  Hermann  Welsch,  of  Eissingen,  follows  with  a 
practical  article  on  '^  Laryngoscopy  in  Homoeopathy."  He 
shows  the  adyantage  of  a  laryngoscopic  inyestigation  in 
cases  of  cough,  aphonia,  dyspnoea,  and  other  maladies  of 
the  respiratory  organs,  eyen  where  the  homoeopathist  would 
not  think  of  applying  local  remedies. 

The  next  paper  is  by  Professor  Raphael  Molin,  of  Vienna, 
on  the  '^  Homoeopathic  Treatment  of  Diplopia,"  of  which 
we  subjoin  a  translation. 

Dr.  Payr,  in  his  excellent  *  Ophthalmiatrik,'  published  in 
the  1st  and  2nd  yol.  of  this  serial,  teaches  us  how  to  discriminate 
the  several  kinds  of  diplopia  (whether  differing  anatomically  or 
SBtiologically  from  each  other)  with  such  nicety  and  precision  that 
the  most  exact  ophthalmologist  must  be  pleased  with  the  beauty 
of  his  discrimination.  But  not  so  easily  is  the  homoeopath  satis- 
fied with  the  treatment  proposed  by  our  colleague.  For,  on 
perusing  pages  26 — 29  of  vol.  iii,  one  cannot  rid  oneself  of  the 
impression  that,  in  this  department  of  homoeopathy,  indications 
of  poverty  were  exposed.  On  myself,  at  least,  the  study  of  his 
treatment  has  produced  the  same  efiect  as  if  our  worthy  colleague, 
in  the  treatment  of  rheumatic  diplopia,  went  to  work,  not  on 
homoeopathic,  but  on  allopathic  grounds.  I  do  not,  however, 
wish  to  say  that  the  treatment  prescribed  by  him  is  entirely  to 
be  rejected ;  for  the  experience  of  so  weighty  an  ophthalmologist 
as  Dr.  Payr  speaks  too  loudly  on  its  behalf.  I  will  merely  say 
that  our  pharmacy  places  in  our  hands  very  difierent  remedies, 
which  lead  far  sooner,  and  with  more  certainty,  to  the  desired 
result.     For,   however  industriously  I  may  ransack  the  patho- 


tod  kevietdSi 

gdnesy  of  our  pIiAniiacopcBia,  I  cannot  find,  in  any  one  ot  ih^ 
medidneB  proposed  by  Dp.  Payp,  whether  JconUe^  Tbrtanu^ 
Bhuif  Camphora,  or  Fhoiphonu,  the  symptom  of  ^  doable  vision  " 
indicated,  whilst  one  finds  this  very  symptom  first  given  under 
the  remedies  which  Dr.  Payr  recommends  us  to  try  anhf  in  those 
cases  of  paralysis  of  the  muscles  of  the  eye  which  arise  in  con* 
sequence  of  fright,  anxiety,  or  terror ;  or,  as  an  accompaniment 
of  chronic  nervous  sufferings,  as  epilepsy,  St.  Vitus'  dance,  &. 
These  remedies  are  Belladonna,  Hyo9eifam$iMt  and  Siramumium. 
I  am  quite  aware  that  it  may  be  objected  to  these  remarks  that 
AeoniiCj  Bhui,  &c.,  are  anti-r^tfma^;  BeU.,  Syos.y  and  Strom., 
are  ^nti-nervaui  ;  and  that,  consequently,  whenever  the  paralysis 
is  a  rheumatic  one,  the  former  medicines,  and  not  the  latter,  ought 
to  succeed.  But  to  this  I  must  reply,  that  this  very  conclusion 
is  opposed  to  the  fundamental  principles  of  homosopathy;  for, 
although  these  remedies  correspond  with  the  *^  indicatio  easen- 
tialis,*'  yet  homoBopathy  acknowledges  neither  anti-rheumatic, 
antiphlogistic,  nor  narcotic,  but  solely  homoeopathic  medicines ; 
i,e.,  such  as  produce  definite  symptoms  in  the  healthy  organism. 
The  indicatio  euentialis  will  also  be  specially  regarded  by  the 
homceopath,  but  only  in  the  cases  where,  with  a  choice  of  several 
remedies,  airof  which  cover  the  morbid  symptoms,  he  is  led  to 
have  recourse  to  one  which  at  the  same  time  corresponds  to 
the  indicatio  essentialia;  or,  in  the  case  where  the  Materia 
Medica  cannot  present  any  medicine  which  corresponds  to  that 
indication ;  or,  when  the  purely  homcsopathic  remedy  fails  in  its 
application,  which  sometimes  occurs  too.  Besides,  it  is  often 
impossible  to  decide  (as  in  the  case  which  I  shall  shortly  describe) 
whether,  in  the  treatment  of  diplopia,  one  has  to  do  with  a  rheu- 
matic or  nervous  case,  or  with  one  depending  on  atrophy ;  and  just 
in  such  cases  does  homoeopathy  prove  Jier  superiority.  For  even 
when  it  is  a  rheumatic  case  she  must  cure  with  a  right  choice  of 
medicine,  although  in  her  decision  she  has  no  other  leading  star 
than  the  principle  "  similia  similibus.*'  Let  it  not  be  objected 
that  such  dubious  cases  betray  a  want  of  diagnostic  accuracy  on 
the  part  of  the  physician.  The  most  practised  diagnost  often 
finds  himself  in  the  presence  of  such  enigmas. 

These  theoretic  remarks  I  thought  it  right  to  premise,  to  show 
that  I  could  have  no  thoughts  of  rejecting  Dr.  Payr's  treatment^ 
still  less  of  trampling  on  it  in  a  hostile  fiishion.    I  merely  wish 


Journals  of  the  Quarter.  709 

to  justify  the  therapeutic  method  I  proposed  to  myself  in  the 
following 

Gabb. — Countess  P — ,  a  lady  »t.  60,  in  good  condition,  very 
robust,  but,  as  she  herself  confessed,  extremely  nervous,  paid  me 
her  first  visit,  p.m.,  March  17tb,  1874,  during  my  consulting 
hour.  She  complained  of  seeing  all  objects  double,  whether  far 
or  near,  and  that,  even  on  attempting  to  read,  the  letters  all 
seemed  double,  which  made  her  dizzy  and  dreadfully  depressed 
her  spirits,  because  she  looked  upon  it  as  a  precursor  of  apoplexy 
or  a  commencement  of  blindness.  As  many  patients  waited  on 
me  that  day  I  could  not  bestow  much  attention  on  her  lady- 
ship. In  the  short  consultation,  however,  I  learnt  that  she  had, 
besides,  a  sensation  of  a  large  foreign  body  under  the  left  upper 
eyelid,  that  she  did  not  remember  having  lately  taken  cold, 
though,  before  the  attack  of  diplopia,  she  had  suffered  from  a 
alight  catarrh,  but  no  pain  nor  other  rheumatic  affection  ;  that  her 
general  health,  appetite,  and  sleep  were  good,  and  all  bodily  func- 
tions normal ;  that  she  now  and  then  suffered  from  rush  of  blood  to 
the  head ;  but  that,  in  the  evening,  with  artificial  light,  the  diplopia 
almost  entirely  disappeared.  On  a  superficial  examination  of 
both  eyes  I  found  nothing  abnormal,  except  the  traces  of  a  slight 
chronic  catarrh.  This  condition  had  continued  already  more  than 
a  week,  and  was  daily  growing  more  intolerable. 

I  consoled  her  by  explaining  that  she  need  not  think  of 
blindness,  as  no  indication  of  a  cataract  nor  of  a  chronic 
glaucoma  was  present;  nor  yet  of  apoplexy,  since  no  traces 
of  ossified  blood-vessels  or  of  a  defective  heart  could  be  found. 
Besides,  I  told  her  that  the  diplopia  depended  upon  paralysis 
of  one  of  the  muscles  of  the  eye,  which  she  .probably  had 
brought  on  herself  by  the  imprudent  journey  to  Vienna  in  her 
open  carriage,  and  that  I  hoped  shortly  to  rid  her  of  the 
inconyenience.  I  gave  her  Bell.  8,  one  globule  to  be  taken  four 
times  a  day,  and  promised  to  visit  her  on  the  19th  about  noon. 

Bell,  at  once  occurred  to  me,  because  I  know  by  heart  that 
this  medicine  has,  as  pathognomonic  symptoms,  "  vertigo,  deter- 
mination of  blood  to  the  head,  a  sensation  of  foreign  bodies  in 
the  eye,  diplopia,  distorted  vision,  impossibility  of  reading,  from 
disturbance  of  the  sight." 

When  I  visited  the  lady  at  her  house,  March  19th,  I  found  her 
in  the  same  condition,  only  more  depressed  in  spirits,  and  with  a 


710  Reviews. 

feeling  as  if  the  foreign  body  was  smaller.  I  was  able  to  satisfy 
myself,  by  an  optical  experiment  familiar  to  every  ophthal- 
mologist, that  I  actually  had  to  do  with  a  paralysis  of  the  left 
rectus  eztemus.  Not  so  easily  could  I  be  dear  as  to  the  etio- 
logical import  of  the  paralysis.  The  sensation  of  a  foreign 
body  under  the  upper  eyelid  of  the  same  eye  plainly  indicated 
(as  being  caused  by  a  swelling  and  consequent  blood  stasis  of  a 
Teasel  of  the  conjunctiya)  the  rheumatic  nature  of  the  paralysis. 
Yet  the  fact  that  I  had  to  deal  with  an  excessively  nervous 
person,  who  confessed  to  me  that  she  very  often  (and  especially 
of  late)  suffered  much  from  sleeplessness,  and  also  my  want  of 
anamnestic  aid,  made  me  uncertain  in  my  diagnosis.  As  the 
diplopia  had  made  its  appearance  suddenly,  I  might  well  infer 
an  atrophy  of  the  paralysed  muscle.  But  I  was  not  able  to 
get  rid  of  a  question  whether  a  defective  innervation  were  not 
the  cause  of  the  paralysis. 

As  the  sensation  of  a  foreign  body  had  diminished  under 
two  days'  treatment  with  Bell,  (whence  I  could  conclude  that 
the  swelling  of  the  congested  vessel  was  lessened)  I  resolved  to 
continue  the  prescription  of  Bell,  in  the  above-named  dose.  I 
told  her  to  go  on  with  it  for  three  days  more,  to  amuse  herself, 
and  to  go  out  in  fine  weather,  and  I  promised  to  visit  her  again 
on  the  22nd. 

As  I  came,  according  to  promise,  on  the  22nd,  I  found  the 
patient  in  the  same  condition ;  perhaps  even  more  depressed 
than  before.  At  our  first  greeting  she  told  me  she  must  confess 
something  she  had  done,  which  would  probably  be  unacceptable 
to  me,  but  which,  under  the  pressure  of  those  around  and  from 
her  own  indecision,  she  could  not  refrain  from.  This  was  that 
she  had,  on  the  19th,  consulted  an  eminent  oculist,  who  had  fully 
confirmed  my  diagnosis,  but  pronounced  a  more  unfiivorable  pro- 
gnosis, speaking  very  doubtfully  of  her  cure.  He  had  prescribed 
a  blister,  and,  in  case  this  failed,  to  try  electricity.  She  had 
followed  his  advice  so  far  as  to  abstain  from  my  medicine  and  apply 
the  blister,  but  found  herself  worse  rather  than  better,  as  she 
saw  the  double  images  even  by  artificial  light,  and  the  "  foreign 
body  "  had  become  larger  again.  In  conclusion,  she  begged  I 
would  not  be  so  cruel  as  to  desert  her,  but  tell  her  what  she 
should  do.  I  replied  that  I  did  not  see  the  case  in  so  un&vor- 
able  a  light  as  the  oculist ;   though,  had  I  been  present  at  the 


Jaumah  of  the  Quarter.  711 

consultation,  I  should  have  opposed  the  blistering,  but  not  the 
electricity ;  only  that  as,  in  a  long  practice,  I  had  never  seen 
undoubted  results  from  that  remedy,  she  might  employ  it  only  if 
I  could  find  no  resource  in  homoeopathy  for  her  disorder. 
Meanwhile  I  would  try  another  medicine,  from  which  I  expected 
a  good  result. 

As  I  could  not  lose  sight  of  the  fact  that  I  was  dealing  with  a 
highly  nervous  individual  I  resolved,  in  case  I  found  no  remark- 
able amendment,  to  employ  Stramonium.  On  the  28rd  I  was 
obliged  to  go  to  a  consultation  at  Genoa,  and  as  Bell,  had  in  two 
days  produced  no  improvement,  I  gave  her  Strom.  6*  in  globules, 
to  be  taken  twice  a  day  for  six  days ;  then,  if  a  cure  should  not 
ensue,  to  pause  for  four  days ;  and  as  I  should  return  by  the 
eleventh  day,  I  would  visit  her ;  but,  should  she  get  well  stiU 
sooner,  she  must  at  once  leave  off  the  medicine.  And,  in  fact, 
when  I  came,  April  3rd,  the  lady  met  me  with  the  glad  tidings 
that  she  had  already  been  free  from  her  complaint  for  a  week. 
She  related  to  me  how,  on  the  second  day  of  the  Strtmonium 
(i.  e.,  after  two  doses),  the  double  images  seemed  to  get  close 
together,  and  she  lost  the  feeling  of  a  foreign  body  on  the  fourth 
day  (i.  e.,  after  eight  doses),  thus  recovering  her  natural  sight,  and, 
according  to  my  orders,  she  took  no  more  medicine. 

Tbis  is  now  the  19th  of  May,  and  since,  as  family-physician, 
1  have  the  opportunity  of  seeing  the  Countess  almost  every  day, 
I  can  testify  that  the  malady  has  not  returned. 

In  the  golden  pharmacopoBia  of  Noack  and  Trinks  the  following 
sjrmptoms  of  Stramonium  are  introduced :  *'  Voluntary  muscular 
motion  ceases,  various  parts  become  paralytic ;  a  low  ebb  of 
sensibility  and  irritability  in  general;  sleeplessness;  sadness; 
diplopia  ;  dislocated  double  sight,  t.  «.,  he  sees  no  objects  in  their 
proper  place,  but  at  the  same  time  a  second  image  of  each  is 
observed  higher  up  and  sideways." 

In  the  same  book  we  find  that  physicians  of  the  old  school  had 
already  employed  this  medicine  in  chronic  rheumatisms  and  those 
of  the  head  with  success ;  also  in  nervous  disorders  with  the 
character  of  paralysis  and  torpor.  According  to  the  homoeo- 
pathic principle  we  find  there,  too,  that  this  same  medicine  is 
prescribed  for  acute  and  chronic  rheumatism,  for  paralysis, 
unilateral,  or  of  individual  limbs,  arising  from  the  spinal  cord,  for 


712 

melancholy^  for  panljeis  of  the  upper  ejelida,  diplopia^  illasioiu 
of  the  sight,  uid  the  like  optical  ailments. 

Lastly,  the  same  work  informs  as  that  Strom,  is  used  homoeo- 
pathically  in  acute  and  chronic  rheumatism,  in  incipient  para- 
lysis, with  the  best  results.    To  this  I  will  add  no  comment. 

Afl  far  as  I  have  access  to  homoDopathic  literature  I  find  three 
cases  of  diplopia  quoted  which  were  cured  with  Oyelamen ;  one 
by  Wurmb,  one  by  Alb,  and  the  third  by  Payr.  I  freely  couiess 
that,  when  I  was  treating  the  above  case  of  diplopia,  these  three 
good  homoBopathic  cures  were  unknown  to  me.  I  cannot,  how- 
ever, but  remark  that  these  are  actually  homoBopaihic  cures.  For 
Ojfelamen  has,  as  pathogenetic  symptoms, ''  directly  after  taking  it 
I  saw  objects,  such  as  the  knitting-needle,  doubled ;  temporary 
double  sight,  which  kept  her  from  knitting ;  all  day  double  images 
of  the  surrounding  objects."  Payr's  case  is  so  much  the  more 
important  as  the  diplopia  had  eusued  from  cerebral  apoplexy. 
Unfortunately  neither  Wurmb  nor  Alb  gave  more  particular 
information  respecting  the  stiological  exciting  cause  of  the  cases 
cured  by  them.  Gullavardin,  in  three  cases  of  strabismus,  cured 
one  which  he  regarded  as  an  antagonistic  consequence  of  paralysis 
of  a  muscle  of  the  eye  with  Byos,  And  this  medicine,  too,  has 
the  following  pathognonomic  symptoms :  **  unilateral  paralysis ; 
diplopia;  all  obj ects  at  first  seem  doubled.*'  JSyoi,  is  also  prescribed 
by  homoeopaths  in  paralytic  sensations  and  rheumatic  pains  in 
nervous  persons,  and  was  employed  by  Schubert  for  strabismus  and 
diplopia.  GUlavardin  recommends  it  also  as  useful  in  paralysis 
of  the  eye-muscles ;  B^.  and  Alumina  for  scrofula ;  JBelL,  Strain.^ 
and  Syos,  for  cerebral  affections,  eclampsia,  chorea ;  and  Stram.y 
but  especially  BeU.  and  Hyos,^  for  terror,  anxiety,  and  fear. 

Finally,  I  must  mention  the  cases  of  paralysis  of  the  eye- 
muscles  which  Tavignot  has  cured  with  PAo«.,  whence  Gallavardin 
is  inclined  to  infer  an  antiparalytic  action  of  this  medicine,  even 
in  the  case  of  the  eye-muscles. 

From  all  this  accordingly  we  learn — 

1.  That  homcBopathy  possesses  actually  proved  homoeopathic 
medicines  for  diplopia,  which  have  also  succeeded  clinically. 

2.  That,  hitherto,  there  are  but  three,  Cycl,^  Hyas.,  and 
Strom. 

3.  That  Bell.f  though  firom  the  pathogenetic  symptoms  one 


Joumala  of  the  Quarter.  713 

might  expect  it  to  be  the  chief  remedy  for  diplopia,  has  hitherto 
succeeded  least  in  this  complaint. 

4.  That  a  precise  diagnosis  for  the  respective  application  of 
these  three  remedies  cannot  be  established,  because  a  sufficiently 
detailed  picture  of  the  individual  cases  has  not  been  always 
drawn. 

5.  Lastly,  that  it  were  desirable  that  henceforward  more 
attention  to  diplopia  were  given  by  homceopathic  physicians  than 
heretofore. 

Dr.  von  Yillers  endeavours  to  show  how  homoeopathy 
should  be  taught  clinically.  His  paper  may  be  worth  the 
attention  of  any  who  are  about  to  deliver  clinical  lectures. 

To  this  succeeds  a  report  of  Dr.  Ad.  Maylander's 
Homoeopathic  and  Surgical  Hospital  in  Berlin.  This 
institution  was  opened  under  the  patronage  of  H.K.H.  the 
Princess  Karl  of  Prussia,  on  the  15th  May^  1873.  It  at 
present  contains  eighteen  beds  for  private  patients,  who 
pay  a  board  and  six  beds  for  poor  gratuitous  patients. 
Since  the  opening  of  the  hospital  a  comparatively  large 
number  of  cases,  principally  surgical,  have  been  treated, 
and  numerous  operations  performed,  several  cases  of 
ovarian  tumour  having  been,  some  successfully,  some 
unsuccessfully,  operated  on. 

A  case  of  the  passage  of  very  large  gall-stones  during 
the  use  of  Carlsbad  waters  is  related  by  Dr.  Billing,  but 
offers  no  points  of  practical  importance. 

Dr.  Paz  Alvarez  gives  an  account  of  homoeopathy  in 
Spain.  Homoeopathy  was  introduced  into  Spain  and  first 
practised  in  1830,  but  it  made  greatest  progress  from  the 
year  1845  chiefly  by  the  personal  influence  of  Dr.  Nunez, 
who  for  his  services  was  created  Marquis.  He  gathered  a 
number  of  proselytes  around  him  in  Madrid,  and  founded 
the  Hahnemann  Society,  which  has  published  a  periodical 
monthly  organ,  at  first  under  the  name  of  Boletin  de  la 
Soc,  Hahn.  Mafritense,  and  then  under  the  title  of  Anales 
de  la  S.  H.  M.^  and,  lastly,  under  the  name  of  El  Criterio 
Medico.  It  is  now  in  the  25th  vol.  of  the  whole 
collection.     In  this  Journal  Nunez  published  his  patho* 


714  Reviews. 

genesies  of  Tarantula  and  Madar.  The  efforts  of  the 
Society  to  establish  chairs  of  homoeopathy  in  the  uni- 
versity were  unsuccessful.  But  it  founded  a  dispensary 
which  treats  from  6000  to  7000  patients  annually.  On  the 
anniversary  of  Hahnemann's  birthday  in  1872  the  first 
steps  for  establishing  a  homoeopathic  hospital  were  taken, 
and  on  the  26th  May,  1873,  the  hospital,  for  which  a  large 
sum  had  been  collected,  was  begun.  It  will  cover  a  space 
of  40,000  square  feet,  and  is  designed  to  hold  500  beds. 
It  is  not  yet  completed,  but  it  is  hoped  it  may  soon  be 
ready  for  the  reception  of  patients.  The  Society  holds  its 
meetings  twice  a  month,  and  there  is  a  festival  on  every 
recurring  birthday  of  Hahnemann,  when  prizes  for  essays 
are  awarded  and  a  grand  banquet  is  held.  The  following 
are  the  prizes  offered  for  1875  : 

I.  Can  the  cellular  doctrine  which  now  prevails  in  allo- 
pathic medicine  be  utilised  by  homoeopathy,  bearing  in  mind 
its  impregnable  bases  of  pure  experimentation,  the  law  of 
similars,  and  vital  dynamism  ?  Prize  2000  reals  :=  526  francs, 
the  diploma  of  corresponding  member  of  the  society,  and 
the  publication  of  the  essay  in  the  Criierio. 

II.  How  do  spontaneous  cures  occur  in  the  human 
organism,  and  what  are  the  relations  between  the  power  that 
effects  spontaneous  cures  and  the  dynamism  of  medicines  ? 
Prize  1000  reals,  the  diploma  of  corresponding  member  of  the 
society^  and  the  publication  of  the  essay  in  the  Criterio, 

III.  The  endemic  diseases  of  Cuba,  their  pathogeneses 
and  homoeopathic  treatment.  Prize  1500  reals =894  francs, 
the  diploma  and  publication  as  above. 

The  essays  may  be  written  in  Spanish,  Portuguese,  French, 
or  German.  The  essays  to  be  sent  to  the  general  secretary 
of  the  Hahnemann  Society  by  the  Ist  January,  1875,  the 
author's  name,  in  a  sealed  envelope,  bearing  the  same  motto 
as  the  essay. 

The  number  of  homoeopathic  practitioners  in  Spain  is 
now  about  500. 

Another  society,  called  the  Homoeopathic  Academy,  was 
founded  by  Dr.  Hysem,  but  it  has  ceased  to  bold  meet« 


Journals  of  the  Quarter.  715 

ings  for  two  years  and  its  organ.  Medical  Rrform,  has  also 
ceased  to  appear. 

This  number  concludes  with  a  paper  on  cerebro-spinal 
meningitis  from  Raue^s  Record,  and  a  short  notice  of  the  use 
of  Koumiss. 

The  double  number  8  and  9  contains  a  further  account 
of  the  discussion  upon  homoeopathic  pharmacies  in  the 
Italian  Parliament.  The  parliament  in  the  end  assented 
to  the  petition  of  the  homoeopathists  for  a  supervision  of 
these  pharmacies  by  homoeopathic  practitioners. 

This  is  followed  by  a  review  of  Gruzewski's  Incompetenz, 
which  is  very  severely  handled  by  the  reviewer. 

Affcer  several  other  short  reviews  we  have  an  account  of 
the  Forty-second  General  Assembly  of  the  Homoeopathic 
Central  Society  of  Germany,  held  at  Leipzig  on  the 
9th  and  10th  August,  under  the  presidency  of  Dr.  Clotar 
Miiller. 

At  the  meeting  of  the  9th  various  matters  connected 
with  the  business  of  the  Society  were  disposed  of,  and  the 
meeting  for  1875  was  appointed  to  take  place  at  Berlin, 
with  Dr.  Fischer  for  president. 

The  following  day  the  proceedings  commenced  with  an 
address  by  Dr.  Clotar  Miiller,  in  which  he  gave  a  rSsumS 
of  some  portions  of  Dr.  Dudgeon^s  address  at  the  British 
Homoeopathic  Congress. 

Dr.  Bakody  read  a  paper  *'  On  the  Homoeopathic  Treat- 
ment at  the  St.  Rochus^  Hospital  of  Pesth.^' 

Dr.  Maylander  gave  an  account  of  his  treatment  of 
several  cases  of  osteomyelitis  and  caries  of  the  head  of  the 
thigh-bone.  He  also  mentioned  his  method  of  procedure 
in  cases  of  ovariotomy,  and  drew  particular  attention  to  the 
good  effects  of  Calabar  bean  after  the  operation.  He  gives 
it  in  a  tincture  of  first  decimal  strength,  from  two  to  four 
drops  every  two  hours,  until  the  pupils  contract.  The 
Assembly  closed  its  proceedings  as  usual  with  a  dinner  that 
began  at  1.30  and  was  finished  at  5  p.m. 

Dr.  Helberger,  of  Trieste,  contributes  a  paper  ''  On  the 
Diagnosis  and  Treatment  of  Meaingitis  Cerebro- Spinalis 
Epidemica/'      This  disease  is  of  very  firequent  occurrence 


716  Reviews. 

in  Trieste  and  the  neigbboaring  coast.  It  is  a  specific 
inflammation  of  the  cervical  portion  of  the  spinal  cord, 
with  rapid  formation  of  serous  exudation,  which  as  speedily 
turns  into  purulent  exudation.  The  brain  symptoms  are 
secondary  in  their  character,  caused  by  reflex  action  and  by 
extension  of  the  inflammation  from  its  original  focus.  The 
intensity  of  the  disease  is  always  limited  to  the  affected 
portion  of  the  spinal  cord;  the  mind  is  often  unaffected 
at  the  height  of  the  disease,  therein  differing  from 
meningitis.  It  is,  he  contends,  a  mistake  to  denominate 
the  disease  morbus  recurrens,  for  the  disease  that  merits  this 
appellation  belongs  to  the  category  of  infective  and  malarious 
diseases — it  is  the  so-called  febris  pemiciosa  of  the  coast, 
and  has  its  chief  remedy  in  strong  doses  of  Arsenic. 

The  author  thinks  that  the  disease  is  chiefly  produced 
by  electric  tension  of  the  atmosphere  (whatever  that  may 
be).  It  seems  also  to  be  produced  by  all  those  causes  that 
give  rise  to  hypersemic  and  congestive  states,  such  as 
exposure  to  the  sun,  long  fatiguing  marches,  mental  excite- 
ment, &c. 

The  disease  almost  always  commences  with  prodromata^ 
only  these  are  seldom  noticed.  To  these  belong  a  painful 
feeling  of  compression  and  stretching  in  the  back  and 
extremities,  compelling  the  patient  often  to  stretch  and 
bend  backwards.  The  spirits  are  very  depressed,  otherwise 
the  functions  are  normal.  These  preliminary  symptoms 
last  from  eight  to  ten  days,  then  a  roseola  rash  makes  its 
appearance  to  which  no  importance  is  ascribed  until  the 
occurrence  of  convulsions  shows  the  serious  character  of 
the  disease.  The  head  is  drawn  backwards  so  as  often  to 
form  a  right  angle  with  the  spine.  The  sensitiveness  of 
the  nape  muscles  is  increased  to  the  highest  degree;  the 
slightest  touch  causes  violent  pains  and  convulsions.  The 
extremities  are  extended,  drawn  backwards,  and  remain  in 
this  tetanic  condition.  The  muscles  are  like  ropes.  The 
body  assumes  the  shape  of  half  a  hoop,  the  convexity  being 
anteriorly.  The  countenance  wears  an  expression  of 
anxiety,  the  pupils  are  contracted.  Consciousness  not 
lost.     The  patient  complains  of  violent  pressive  headache 


Journals  of  the  Quartef.  917 

on  the  top  of  the  head^  but  of  having  pinching  pains  in 
the  back  and  nape.  The  hearing  power  is  diminished 
or  there  is  complete  deafness.  Pulse  from  80  to  90; 
temperature  normal. 

This  is  the  picture  of  an  acute  case;  but  the  disease 
often  assumes  a  slow  stealthy  character.  The  tetanic 
convulsions  decline,  but  recovery  does  not  take  place. 
Neuralgic  pains  in  the  neck  come  on^  extending  to  the 
upper  extremities.  Then  follow  febrile  phenomena^  sleep- 
lessness, and  death  from  marasmus. 

Children  are  the  most  frequent  subjects  of  the  disease^ 
but  adults  are  also  liable  to  it.  Old  people  do  not  seem  to 
take  it.  The  prognosis  is  always  doubtful  on  account  of 
the  tendency  to  rapid  exudation. 

The  best  remedies  for  the  disease  are  Apis,  Beliadorma, 
and  Lachesis.  The  author  gives  the  three  remedies  in 
rapid  alternation,  every  ten  minutes,  in  bad  cases.  When 
the  tetanic  symptoms  are  subdued  the  immediate  danger  is 
over,  but  there  generally  remains  for  a  long  time  extreme 
sensitiveness  and  tendency  to  relapse.  Perfect  rest  must 
be  enjoined  and  care  taken  to  avoid  all  excitement.  If 
great  tenderness  in  the  spine  with  drawing  pains  remain, 
Anfftutura  and  Sepia  are  of  great  use.  The  former 
remedy  corresponds  to  the  convulsive  phenomena,  the  latter 
to  the  congestion  of  the  capillary  system.  The  following 
case  is  given  : 

Mrs.  W — ,  40  years  old,  still  menstruating  regularly,  of 
robust  frame,  but  very  nervous,  suffers  often  from  migraine ; 
in  other  respects  healthy ;  has  felt  unwell  ever  since  a  walk 
she  took  a  week  ago,  when  her  back  was  much  exposed  to 
the  sun.  She  is  periodically  attacked,  every  half  hour, 
with  convulsive  constrictive  drawing  in  the  back  and 
extremities,  very  depressed,  irritable,  sleep  restless,  other 
functions  normal.  About  1  a.m.  I  was  suddenly  sum- 
moned to  see  her.  I  found  her  with  her  head  bent  strongly 
backwards  at  almost  a  right  angle  with  the  spine,  the 
extremities  drawn  back  tetanically.  The  muscles  of  the 
nape  sensitive  to  the  slightest  touch.  Face  red,  pupils 
contracted.     Pulse   92,  temperature   normal.     Conscious* 


718  kemewi. 

ness  unaffected.  Speech  indistinct.  She  complains  of 
violent  pressive  pain  in  head  and  nape.  Very  anxious, 
thinks  she  is  dying.  No  doubt  could  be  entertained  that  she 
was  labouring  under  a  violent  attack  of  cerebro-spinal 
meningitis.  I  gave  .^tpis,  Bell.,  and  Letch,  alternately 
every  quarter  of  an  hour.  In  three  hours  the  dangerous 
symptoms  seemed  to  be  removed.  The  convulsions  were 
gone,  the  headache  much  relieved.  Only  a  sort  of  para- 
lytic weakness  remained.  The  following  night  she  had  a 
slight  relapse^  only  lasting  half  an  hour.  Improvement 
went  on^  and  in  eight  days  she  was  able  to  leave  her  bed. 

Dr.  Welsch,  of  Kissingen,  follows  with  a  paper  on  "  The 
Mineral  Water  Treatment  of  the  Present  Day.'' 

Next  comes  a  short  article  by  Dr.  Hirsch,  of  Prague,  on 
"  Acne  Pustulosa.^'  The  best  remedy  he  finds  to  be 
Calcarea  carbanica,  3rd  trit.,  night  and  morning.  A  cure  is 
effected  in  from  four  to  six  weeks. 

The  number  concludes  with  an  obituary  notice  of  the  late 
Mr.  William  Leaf,  of  London. 

We  should  mention  that  a  considerable  portion  of  the 
Internationale  is  occupied  with  a  translation  of  the  patho- 
genesies  from  Hale's  New  Remedies,  which  are  given  in  an 
appendix  to  each  number. 

FRANCE. 

From  this  country  we  receive  two  periodicals,  the  BibliO' 
thique  HonuBopathiqtie  and  the  Bulletin  de  la  Soci6t6  Medi* 
cale  Homaopathique  de  Prance.  There  is  another  French 
homoeopathic  journal,  L'Art  Midical ;  but  it  is  not  sent 
to  us. 

Bibliolhique  Hommopathique. — ^The  April  number  of  this 
journal  is  the  fourth  of  its  sixth  year.  It  is  published 
monthly,  in  thirty-two  pages  of  large  octavo ;  to  which  is 
appended  a  sheet  of  Materia  Medica  paged  separately,  and 
entitled  ^'  Pathogen&ies  Nouvelles.^'  Phytolacca  and  CarboUc 
acid  are  treated  of  in  the  numbers  before  us  (April — July), 
the  latter  commencing  a  fourth  volume  of  the  collection* 


Journals  qf  the  Quartet.  7id 

The  Journal  is  stated  to  be  published  by  the  8oci6t6 
Hahnemannienne  Fidirative,  of  which  the  Editiorial  and 
Publishing  Committee  consists  at  present  of  Drs.  Chauvet 
(pere  et  fils)^  Despinay^  Dulac,  Gallavardin^  Gaudy,  Heer- 
mann,  Leboucher^  Magnan,  A.  Magnan,  De  Moor,  Ozanam^ 
Pancin,  Peladan,  Pitet,  Prost-Lacnzon,  Boussel,  Turrell, 
van  Campenhout,  Willers,  and  van  den  Neucker.  Dr.  Pitet, 
of  Paris,  is  the  working  editor.  From  the  cases  contributed 
and  quoted,  the  Bibliothique  would  seem  to  represent  the 
high  dilutionists  of  France.  An  amusing  evidence  of  this 
appears  in  a  review  of  Dr.  Guerin-Meneville's  translation  of 
Hughes'  Pharmacodynamics,  The  writer  thinks  he  has  dis- 
covered the  reason  for  the  preference  which  the  English  practi- 
tioners give  to  the  low  dilutions  and  triturations  in  place  of  the 
globule.  It  lies  in  the  difference  of  the  surroundings  of  our 
respective  patients.  In  the  '*  brumeuse  Angleterre  "  strong 
doses  may  be  required ;  but  when  these  very  patients  come 
to  the  warmer  and  drier  regions  of  la  belle  France,  they 
cannot  continue  their  "  doses  nationales ''  without  aggrava- 
tions, and  find  on  the  other  hand  more  complete  and  lasting 
relief  from  the  globules  of  medium  or  high  potency  which 
they  are  wont  to  receive. 

There  is  very  little  original  matter  in  this  journal^  the 
bulk  of  it  consisting  of  translations  from  English  and 
American  contemporaries. 

Bulletin  de  la  SocUti  M6d%cale  Homaopathique  de 
France. — This  periodical  also,  as  its  name  imports,  issues 
from  a  society.  It  appears  monthly,  with  sixty-four  pages ; 
and  entered  its  sixteenth  year  last  May.  Its  chief  editor 
appears  to  be  Dr.  L.  Molin.  It  is  mainly  composed  of 
reports  of  the  meetings  of  the  Society,  and  of  the  eliniques 
of  the  Hdpital  Saint-Jacques  established  and  served  by  it. 
From  a  statement  concerning  this  hospital  contained  in  the 
August  number  we  learn  that  it  has  been  in  existence  for 
three  years.  It  is  about^  moreover^  to  become  the  seat  in 
Paris  of  a  school  of  homoeopathy.  Clinical  lectures  are  to 
be  given  weekly,  from  October  to  March,  by  the  physician 
on  duty ;  and  courses  of  lectures  on  Materia  Medica  and 


720 

Therapeutics,  and  on  the  History  and  Doctrines  of 
Homoeopathy,  are  to  accompany  them  as  soon  as  professors 
can  be  found.  This  proceeding  may  be  commended  to  the 
consideration  and  imitation  of  our  own  British  Homoeo- 
pathic Society  and  its  Hospital. 

The  June  number  contains  a  very  interesting  communi- 
cation concerning  the  internal  administration  of  yaccine 
lymph  (4th  centes.  dil.).  It  confirms  previous  observations 
as  to  the  efficacy  of  this  method  both  for  the  prophylaxis 
and  for  the  successful  treatment  of  variola.  It  appears  to 
effect  a  veritable  vaccination.  "  The  physician  adds  to  a 
litre  of  pure  water  ten  drops  of  the  4th  dil.  of  Vaccimum^ 
and  makes  each  patient  take  a  soup-spoonful  of  this  solu- 
tion every  morning  for  eight  days  on  an  empty  stomach. 
Towards  the  end  of  the  seventh  day  there  will  generally 
appear  on  the  face,  neck,  and  arms  an  eruption  of  vaccinia 
discreta,  most  plentiful  on  the  neck  and  other  parts  subject 
to  rubbing  by  the  clothes.  At  the  same  time  there  occurs 
in  all,  though  in  diverse  degrees,  a  general  malaise, 
anorexia,  slight  nausea,  shivering,  with  fever  and  moderate 
sweat,  trembling  of  the  limbs^  &c.'' 


BELGIUM. 

Revue  Homcsqpaihigue  Beige, — This  monthly  journal, 
whose  first  appearance  we  noted  in  our  July  number, 
continues  its  useful  course.  Its  June  number  contains  an 
article  by  Dr.  Mouremans  upon  Sarracema  purpurea,  in 
the  3rd  dil.  and  upwards,  as  a  prophylactic  and  curative 
medicine  in  variola.  His  experience  speaks  strongly  in  its 
favour.  In  the  August  number  is  an  important  case  in 
which  a  goitre  of  large  size  and  long  standing  rapidly 
disappeared  under  the  action  of  lodium  6.  The  patient 
was  a  man  of  58.  The  enlargement  of  the  thyroid  had 
been  going  on  slowly  for  fifteen  years,  but  more  rapidly  of 
late,  so  that  it  had  now  reached  the  size  of  a  child's  head 
Ht  twelve  years  old.  It  was  reddish,  soft,  and  heavy,  and 
was  interfering  with  voice  and  respiration.      On  July  12th, 


Journals  of  the  Quarter,  721 

1873,  Spongia  80  was  prescribed  ;  but  on  A^ugust  8rd,  no 
improvement  being  manifest,  it  vr as  exchanged  for  lodium  6, 
of  which  one  dose  was  then  given  and  another  three  days 
afterwards.  After  the  second  dose  the  patient  experienced 
less  tension  in  the  tumour,  and  his  breathing  was  freer. 
On  the  24th  he  took  another  dose ;  improvement  then 
progressed  steadily  up  to  September  8th,  after  which  it 
seemed  arrested.  On  the  18th  another  dose  was  given, 
and  (as  indicated  by  the  above  experience)  repeated  every 
fifteen  days  up  to  December  25th.     On  the  1st' January, 

1874,  the  tumour  had  completely  disappeared. 

The  September  number  appears  with  a  black  border  in 
honour  of  Dr.  Mouremans,  the  first  propagator  of  homoeo- 
pathy in  Belgium,  who  died  on  August  19th,  aged  71.  An 
account  of  his  life  and  labours  is  given.  Dr.  Flasschoen 
proposes  the  vomiting  of  pregnancy  as  a  fair  testing  ground 
of  the  virtues  of  infinitesimals,  and  gives  clearly  the  indica- 
tions for  its  remedies  (among  which,  however,  he  omits 
Kreasote),  recommending  the  6th  dil.  for  all. 

INDIA. 

From  this  distant  land  we  receive  the 

Calcutta  Journal  of  Medicine. — The  periodical  so  named, 
edited  by  Dr.  Mahendra  La^l  Sirca^r  (whose  excellent 
paper  on  Intermittents  adorns  the  Transactions  of  our 
Congress  for  the  present  year),  enters  with  1874  the 
seventh  year  of  its  history.  An  article  in  the  January 
number  entitled  "  Ourselves  "  displays  the  character  it  aims 
at,  and  indicates  its  past  career.  It  acknowledges  "the 
Hahnemannian  law  as  the  most  advanced  point  yet  reached 
in  therapeutics,  but  recognises  at  the  same  time  the 
necessity  of,  and  aims  and  works  at,  co-ordinating  and 
harmonising  all  the  facts  of  medicine.^^  Established  on 
this  broad  basis,  it  hoped  for  the  co-operation  of  practi- 
tioners of  all  the  systems,  ''from  the  crudest  and  the 
oldest  to  the  most  refined  and  most  recent,^'  which  contend 
fur  the  mastery  in  India,  and  which  are  fully  characterised 

VOL.  XXXII,  NO.  CXXX.-*-0CT0BE]|y  1874.  I  8 


>2i  ttevuwi. 

in  the  paper  to  which  we  have  referred.*  In  this  the  editor 
has  been  disappointed.  Expelled,  as  we  have  already  related 
in  this  Journal^t  from  the  Bengal  Medical  Association 
for  the  avowal  of  his  faith,  he  has  been  left  to  fill  his 
journal  almost  entirely  by  his  own  individual  efforts.  It 
is  to  his  very  great  credit,  therefore,  that  he  should  have 
carried  it  on  (with  few  intermissions,  and  even  these  subse- 
quently supplied)  for  six  years,  and  should  now  be  able  to 
present  us  with  such  excellent  material  as  the  numbers 
(January — May)  before  us  display. 

Each  number  has  an  instalment  of  Materia  Medica — 
Cinnabar y  Clematis,  2ii\A  Coccidus  being  the  medicines  on  which 
the  author  is  now  engaged.  As  they  are  numbered  33,  S^, 
and  85  respectively  it  may  be  inferred  at  what  rate  he  is 
proceeding,  and  what  is  the  extent  of  his  range.  Hahne- 
mann's provings  seem  retranslated  from  the  original  for 
this  series.  They  would  be  of  greater  value,  however^  if 
Dr.  Sirca'r  had  not  unfortunately  followed  Hempel's  bad 
example  in  omitting  to  append  to  each  symptom  the  name 
of  its  observer,  as  Hahnemann  has  done.  If  he  will  adopt 
this  improvement,  and  confine  hinself  to  Hahnemann's 
medicines  (leaving  the  rest  to  Dr.  Allen's  Encyclopcsdia), 
giving  these  as  they  stand  in  the  Materia  Medica  Pura  and 
Chronic  Diseases,  he  might  reprint  his  translations  in  this 
country  with  certainty  of  acceptance. 

The  remaining  space  of  the  journal  (which  has  forty 
pages  a  month)  is  made  up  with  discussions  and  reports  on 
the  diseases  prevalent  in  India— -especially  fever  and 
cholera,  with  reviews,  translations,  and  gleanings  from 
contemporary  literature.  The  January  number  also  con- 
tains a  report  of  "The  Editor's  Outdoor  Homoeopathic 
Dispensary,"  which  appears  to  be  a  flourishing  institution. 
The  number  of  new  patients  admitted  annually  has  in- 
creased from  800  odd  in  1869  to  8000  odd  in  1873.  We 
are  glad  to  see  it  stated  that  there  are  homoeopathic 
hospitals  and  dispensaries  at  Agra,  Benares,  and  Allahabad, 
though  unfortunately  (from  the  lack  of  professional  homoeo- 
paths) these  are  conducted  by  amateurs. 

•  M<miM^  £om.  Smnew,  Aug.,  1874.  f  Vol  zxv,  p.  861. 


Journals  of  the  Quarter.  723 

Dr.  Sirca^r  has  had  to  appeal  for  additional  subscriber's 
to  bis  journal.  We  hope  that  this  account  of  it  may 
secure  him  some  from  our  British  and  American  readers. 


AMERICA. 

Hahnemarmian  Monthly. — Dr.  LilienthaPs  ''  Treatise  on 
Diseases  of  the  Skin  '^  is  continued  through  this  journal 
from  May  to  August.  In  the  June  number  the  most 
noteworthy  article  is  a  paper  read  before  the  Philadelphia 
Homoeopathic  Medical  Society  on  *'  Intermittent  Fever/' 
with  the  discussion  following.  The  author  is  Dr.  Jeanes, 
one  of  the  veterans  of  homceopathy  in  the  United  States^ 
and  of  the  purest  Hahnemannian  school.  Nevertheless^ 
he  regards  the  following  conclusions  as  substantiated  with 
regard  to  Bark  and  Quinine  : 

"1.  That  in  a  majority  of  the  cases  of  intermittent 
fever  this  disorder  may  be  subdued  for  a  time  by  the  use  of 
massive  doses  of  Cinchona  or  of  its  active  principle, 
2.  That  in  a  considerable  number  of  the  cases  in  which  the 
intermittent  fever  is  thus  subdued^  there  may  be  no  return 
of  the  disorder  through  life.'' 

He  further  states  that  ''  the  attenuations  of  Cinchona 
have  less  scope  of  operation  in  intermittent  fever  than  the 
substantial  doses  *  *  *  An  attenuation  will  only 
cure  the  cases  in  which  Cinchona  is  the  absolutely  proper 
medicine."  And  again,  ''  From  an  Indian  woman  the 
world  has  obtained  its  knowledge  of  Cinchona  as  a  remedy 
for  intermittent  fever.  This  was  a  great  boon  to  humanity, 
and  can  be  well  appreciated  by  one  who  has  witnessed  the 
regularly  returning  paroxysms  of  this  4isorder,  with  their 
accompanying  sufifering  and  danger,  and  who  knows  that 
the  time  through  which  they  may  continue  to  return  is 
indefinite.  After  massive  doses  of  Cinchona  or  Quinine^  the 
disorder  ceases  after  one  or  two  paroxysms,  perhaps  never 
to  return ;  or  it  may  return  after  one,  two,  or  three  weeks. 
But  even  when  the  disorder  returns  a  second  or  third  time^ 
it  may  be  again  and  again  subdued  for  a  time,  or  for  ever. 


7^  Reviews. 

*  *  IB  Those  persons  who  have  been  cored  of  inter- 
mittent fever  by  the  use  of  Cinchona  or  Qutnine  in  massive 
doses  generally  appear  to  enjoy  as  good  health  as  could 
have  been  expected  if  they  never  had  this  disease.  In 
many  cases  also  the  health  is  improved/^  In  the  discus- 
sioUy  a  speaker  regarded  the  enlarged  spleen  as  the  resalt 
of  Quinine  rather  than  of  the  ague.  But  Dr.  Jeanes 
replied,  *'  Enlarged  spleen  was  one  of  the  marked  features 
of  bad  cases  of  ague  before  the  virtue  of  Cinchona  was 
known,  and  I  am  under  an  impression,  founded  on  obser- 
vation and  reading,  that  there  is  much  less  of  enlarged 
spleen  since  the  introduction  of  Cinchona  and  Quinine  than 
before," 

The  July  and  August  numbers  consist  mainly  of  reports 
of  meetings  of  societies,  and  contain  nothing  specially  note- 
worthy. 

American  Observer, — The  June  number  contains  cases 
illustrating  the  virtues  of  Sanguinaria,  Ist  dec.,  in  acute 
osdematous  laryngitis  and  of  Carb.  veg.  3  and  4  in  epistaxis. 
Dr.  S.  A.  Jones,  the  editor  of  the  Materia  Medica  Section, 
contributes  a  collection  of  testimonies  from  early  English 
literature  (a.d.  1000 — 1719)  to  the  virtues  of  Planiago 
major ;  also  a  chat  upon  '^  signatures "  containing  similar 
material.  Dr.  E.  M.  Hale  gives  some  fresh  pathogenetic 
symptoms  of  Baptisia,  among  others  a  complete  though 
transitory  left  hemiplegia. 

The  July  number  contains  the  following  important  paper 
on  an  old  but  neglected  remedy — Solanum  nigrum ; 

'*  Solanum  nigrum  {Deadly  Nightshade), 
"By  P.  B.  HoTT,  M.D.,  Indianapolis,  Ind.« 

*'  In  presenting  before  you  this  paper,  I  have  endeavoured  to 
collect  all  that  is  of  importance  so  far  as  clinical  experience 
and  proving  may  go;  believing  it  to  be  a  remedy  of  great 
merit,  occupying  a  place  that  cannot  be  substituted  by  any 
other. 

^  Solanum  nigrum  belongs  to  the   natural   order  Solanaces 

*  Bead  before  the  Indian  Inatitnte  of  HomcBopathy. 


Journals  of  the  Quarter,  725 

(Nightshade  family).  It  has  a  low  stem,  much  branched, 
spreading,  angular,  nearly  smooth,  with  ovate,  wavy-toothed  or 
sinuate  leaves,  and  perforated,  the  edges  erase,  as  if  gnawed  by 
inseets.  Flowers  white,  small,  with  yellow  anthers,  in  lateral 
umbels,  drooping,  five  parted,  on  bractless  pedicles. — ^The  berries 
are  black  when  mature,  globose,  and  of  a  sweetish  taste.  The 
flowers  begin  to  appear  in  June,  and  in  September  and  October 
we  find  ripe  berries,  green  berries,  and  flowers  all  appearing  on 
the  same  plant.  The  whole  plant  has  a  disagreeable  narcotic 
odour,  resembling  in  some  degree  the  tomato ;  the  root  is  white 
and  has  little  taste. 

''  It  seems  to  prefer  a  shady  locality,  though  I  have  seen  speci- 
mens growing  in  the  sun,  but  always  of  a  dwarfy,  unhealthy 
appearance. 

^  Solanum  nigrum  has  long  been  known  to  the  medical  pro- 
fession, though  it  has  been  but  little  used.  Dioscorides  in  a.1). 
54  speaks  of  its  value  ;  in  A.n.  200  Oalen  mentions  it ;  in  1552 
F.  Binard  mentions  its  use  in  cancer;  and  so  on  along  down 
to  the  present  time  it  has  been  used  for  various  difficulties ;  and 
when  we  consider  that  it  is  placed  among  some  of  our  most  valu- 
able remedies  belonging  to  the  same  family  Solanace»,  viz. 
Belladonna,  Syoscyamns,  Stramonium y  Tahacum,  and  Capncum, 
all  of  which  are  most  valuable  cerebral  remedies,  we  are  forced 
to  the  conclusion  that  Solarium  nigrum  will  prove  a  remedy  of  no 
mean  proportions. 

''  The  homoeopathic  profession  have  used  it  but  little.  We  find  a 
short;  proving  published  by  Noack  and  Triuks  in  1843.  Hahne- 
mann speaks  thus  of  it  in  his  Lesser  Writings : — 

'''The  berries  of  the  black  Nightshade  (Solanum  nigrum) 
have  caused  extraordinary  convulsions  of  the  limbs,  and  also 
delirious  raving.  It  is,  therefore,  probable  that  this  plant  will 
do  good  in  what  are  called  '  possessed '  persons  (madness,  with 
extraordinary,  emphatic,  often  unintelligible  talking,  formerly 
comsidered  prophesying  and  the  giEt  of  unknown  tongue,  accom- 
panied by  convulsions  of  the  limbs),  especially  when  there  are  at 
the  same  time  pains  in  the  region  of  the  stomach,  which  these 
berries  also  produce  in  large  doses.' 

"  '  As  this  plant  causes  erysipelas  of  the  face,  it  will  be  useful  in 
that  disease  as  has  already  been  ascertained  from  its  internal  em- 
ployment ;  as  it  causes  in  a  still  greater  degree  than  Bitter-sweet 


726  Reviews. 

by  being  used  intemallj,  external  swellings,  i.e.  transient  obstrac- 
tion  in  the  absorbent  system.  Its  great  diuretic  power  is  odIv 
an  indirect  secondary  result ;  and  hence  its  great  virtue  in  dropsy, 
from  similarity  of  action,  is  plainly  perceptible;  a  medicinal 
quality  of  so  much  the  greater  value,  as  most  of  the  remedies 
we  possess  for  this  disease  are  merely  antagonistically  acting 
(exciting  the  lymphatic  system  in  a  merely  transient  manner), 
and  consequently  palliative  remedies  incapable  of  effecting  a 
permanent  cure. 

" '  Moreover,  in  large  doses  it  causes  not  only  swelling,  but 
general  inflammatory  swelliogs,  with  itching  and  intolerable  bum- 
iog  pains,  stiffness  of  the  limbs,  pustular  eruptions,  desquamation 
of  the  skin,  ulcers  and  sphacelus.  Where  is  the  wonder  that  its 
external  application  has  caused  divers  pains  and  inflammations  ? 
Taking  all  the  morbid  symptoms  together  that  the  black  Night- 
shade  produces,  we  cannot  mistake  their  striking  resemblance  to 
raphania  (eclampsia  typhoides),  for  which  it  will  most  probably  be 
found  a  specific  remedy.* 

"  Yet  with  all  of  this  astonishing  array  of  symptoms  it  ap- 
pears that  but  few  of  the  contemporaries  of  Hahnemann  used 
Solatium  nigrum,  and  those  who  did  use  it,  used  it  only  to  a 
limited  extent.  Gross  records  a  few  cases,  and  others,  but  nothing 
of  extent. 

"In  Sibley's  edition  of  Culpepper's  Herbal  is  an  interest- 
ing and  curious  account  of  the  properties  of  the  Nightshade, 
viz. — 

" '  It  is  a  cold  saturnine  plant.  The  common  Nightshade  is 
used  wholly  to  cool  hot  inflammations,  inwardly  or  outwardly ; 
being  always  dangerous  as  the  other  Nightshades  are,  it  must  be 
used  moderately.  The  distilled  water  of  the  whole  herb  is  fittest 
and  safest  to  be  taken  inwardly.  The  juice,  being  clarified  and 
mixed  with  a  little  vinegar,  is  very  good  to  wash  the  mouth  and 
throat  when  inflamed.  Outwardly  the  juice  of  the  herb  or 
berries  with  a  Uttle  vinegar  pounded  together  in  a  leaden  mortar 
IS  very  good  to  anoint  all  hot  inflammations  in  the  eyes.  It  is 
good  also  for  the  shingles,  ringworms,  and  aU  running,  frettincr, 
and  corroding  ulcers,  and  in  most  fistulas,  if  the  juice  is  mixe'd 
with  hen-dung  and  applied  thereto.  A  cloth  wet  in  this  juice 
and  applied  to  the  testicles  when  swollen  giveth  great  ease,  as 
also  to  the  gout,  which  ariseth  from  hot  and  sharp  humours.    The 


Journals  of  the  Quarter. 


727 


juice  dropped  into  the  ears  easeth  pain  thereof  arising  from  heat 
or  inflammation.  Pliny  saith  it  is  good  for  hot  swellings  under 
the  throat.' 

^  So  far  back,  then,  in  the  history  of  medicine  we  find  Solanum 
nigrum  curing  the  very  complaints  for  which  its  pathogenesis 
shows  it  applicable ;  not  by  its  antipathic  or  cooling  qualities,  but 
because  it  is  capable  of  causing  inflammatory  action  in  many 
organs  and  tissues ;  and,  though  unwittingly,  Culpepper  used  it 
in  accordance  with  the  law  of '  similars.* 

**  Solanum  nigrum  has  often  been  mistaken  for  Belladonna. 
A  physician  in  Ohio  confidently  said  to  me  that  Belladonna 
grew  plentifully  in  every  part  of  his  county,  and  upon  my  ques- 
tioning the  accuracy  of  his  statement,  he  produced  a  very  fine 
specimen  of  Solanum  nigrum — saying,  'If  that  is  not  Bella- 
dowruiy  what  is  it  ?'  Of  course,  I  explained  the  difference ;  but 
he  still  insisted  that  it  acted  just  like  Belladonna,  and  rehearsed 
several  cases  of  frontal  headache  and  inflammatory  swellings  he 
had  cured  with  it.  And  here  it  may  be  well  to  state  the  botanical 
differences,  that  you  may  not  be  mistaken  in  the  plant : — 


BELLADONNA. 

Stems  strong,  branched,  pur- 
ple coloured,  from  three  to  five 
feet  high — ^hairy. 

Leaves  of  an  equal  size,  oval, 
pointed,  in  pairs,  on  short  foot- 
stalkB. 

Elowers  dark  or  brownish- 
purple  colour,  large,  pendent, 
bell-shaped,  furrowed,  cut  in 
five  segments. 

Berries  ripe  in  September,  of 
a  shining  black. 


I 


80LANUH  NieBUM. 

Stem    low,  much  branched, 
spreading,  rough  on  the  angles. 


Leaves  ovate,  many-toothed, 
almost  always  perforated  by  in- 
sects. 

Flowers  white,  very  small,  is 
small  and  umbel,  like  lateral 
clusters,  drooping,  five  parted. 


Berries  small,  globular,  black, 
ripe  in  September;  ripe  berries, 
green  berries  and  flowers  found 
on  the  same  plant  at  the  same 
time. 


''  These  differencee  are  00  marked  that  you  peed  pot  be  mi9* 


728  Reviews. 

taken  in  them.  I  learn  by  Dr.  R  M.  Hale  that  an  Indiana 
physician  used  Solatium  nigrum  for  two  or  three  years  instead 
of  Belladonna^  and  found  it  equal  if  not  superior  to  it.  There  is 
certainly  a  marked  resemblance  in  the  toxical  effects  of  BeQA' 
donna  and  Solanum  nigrum, 

''The  following  symptoms  have  been  collected  from  Tarious 
sources,  and  are  known  to  have  been  caused  by  Solanwn  m- 
grum: — 

*'  Complete  cessation  of  the  mental  fhnctions ;  torpor  of  the 
whole  system ;  vertigo,  with  headache,  sickness,  colic,  and 
tenesmus;  horrible  headache.  Dr.  Gatchell  cured  a  headache 
which  had  resisted  all  other  apparently  indicated  remedies, 
guided  by  the  last- mentioned  symptom.  The  face  is  congested 
with  blood  ;  red,  bloated  face ;  confused  and  anxious  expression 
of  countenance ;  open,  humid  and  glistening  eyes ;  extreme  dila- 
tation of  the  pupils ;  alternate  contraction  and  dilatation  of  the 
pupils ;  mistiness  before  the  eyes ;  loathing,  vomiting  of  ingesta ; 
copious  vomiting  of  a  greenish  coloured  matter,  tDtth  thirst, 
dilated  pupils ;  stertorous  breathing,  convulsions  and  tetanic 
stiffness  of  the  limbs ;  frequent  vomiting,  first  of  mucus,  after- 
wards of  a  bluish  or  grey -blackish  fluid  ;  purging  the  next  day 
after  the  dose  (3  grains  of  the  leaves) ;  tenesmus  of  the  anus ; 
difficulty  of  breathing;  hot  skin,  though  covered  with  sweat; 
copious  perspiration  ;  frequent  sweats  .over  the  whole  body  ;  ex- 
cessive thirst,  with  vomiting  of  a  greenish  coloured  matter; 
small  frequent  pulse,  or  quick  irregular  pulse ;  red,  scarlet  spots 
on  the  whole  skin ;  great  sensitiveness  of  the  cutaneous  surface ; 
convulsions  and  spasms ;  they  stretch  their  hands  during  the 
spasms,  as  they  would  graap  something,  after  this  the  hands  are 
carried  to  the  mouth,  and  the  boys  (of  two  or  three  years)  chew 
and  swallow,  the  spasms  are  excited  by  touching  the  skin ; 
tetanic  rigidity  of  the  whole  body  ;  trismus ;  deep  sleep  ;  coma, 
alternating  with  convulsions  and  moaning;  great  restlessness; 
violent  convulsive  restlessness ;  tremor ;  violent  subsultus  ten- 
dinum  ;  moaning  as  in  hydrocephalus. 

"  With  this  array  of  symptoms  before  y(ui,  you  cannot  but  see 
that  Solanum  nigrum  should  occupy  a  prominent  place  in  our 
Materia  Medica ;  but  this  will  be  more  manifest  as  we  proceed. 

"  FoBsart  says :  '  Solanum  nigrum  has  removed  the  following 
symptoms  when  caused  by  poisonous  doses  of  spurred  rje;-^ 


Journals  of  the  Qwtrter.  729 

tingling  in  the  extremities;  convulsions;  contractions  of  the 
flexor  tendons,  as  though  he  would  hop  about ;  spasmodic  contor- 
tion of  the  extremities  ;  tonic  spasms  ;  epileptic  attacks  ;  rage ; 
imbecility ;  risus  sardonicus ;  contraction  of  the  hands ;  drawing 
in  the  fingers ;  cramps  in  the  calves ;  inversion  of  the  feet,* 
These  are  well  worth  a  careful  remembrance. 

"  We  will  now  present  you  with  the  Symptomatology  of  the 
drug  so  fSEur  as  provings  and  observations  have  developed  them. 

"  Stmptomatoloot. 

"  Sensorium, — Vertigo  with  headache,  nausea^  colic  and 
tenesmus ;  moaning  as  in  hydrocephalus ;  fulness  in  the  head 
accompanied  with  vertigo  ;  vertigo  on  rising  or  moving  about, 
with  dimness  of  sight ;  vertigo  after  retiring ;  sensation  as  if  the 
bed  was  turning  in  a  circle ;  vertigo  on  stooping ;  everything 
seems  moving  in  a  circle;  great  weariness  and  vertigo  from 
bodily  exertion ;  when  standing  a  feeling  as  if  the  body  would 
fall  backwards ;  while  sitting  the  body  seems  to  rock  in  different 
directions. 

*^  Mind. — GonAised  and  anxious  expression  of  the  counte- 
nance ;  complete  cessation  of  the  mental  faculties ;  drowsy  aU 
day,  with  indisposition  to  study  ;  rage ;  imbecility ;  delirious 
raving ;  sadness  and  anguish ;  absence  of  mind ;  restlessness ; 
inducing  one  to  roam  about  without  sense  or  object. 

*'  Head. — Horrible  headache  ;  headache  with  red,  bloated  face ; 
severe  pain  in  the  stspra-orhital  region^  in  the  morning  on  waking^ 
aggravated  hy  the  slightest  motion;  severe  pain  over  the  eyes, 
aggravated  by  motion  or  stooping ;  a  misstep  sends  violent  pains 
through  the  temples  ;  sensation  in  the  forehead  after  headache, 
as  if  it  had  been  bruised  ;  sensation  in  the  forehead  as  if  from  a 
blow ;  severe  pains  through  the  temples,  as  if  the  head  would 
split ;  on  moving  the  head,  the  brain  feels  as  if  moving  about ; 
pain  in  a  small  circumscribed  spot  on  the  top  of  the  head ;  head- 
ache with  throbbing  of  the  carotid  arteries,  and  swimming  sensa- 
tion in  the  brain ;  sensation  of  heat  in  the  head ;  feeling  of 
lightness  in  the  head ;  sharp  gnawing  pains  in  the  right  temple, 
causing  him  to  grasp  his  head  and  shut  his  eyes ;  stitches  in  the 
temples,  and  then  in  the  ear ;  headache  with  throbbing  of  the 
temporal  and  carotid  arteries ;  increased  heat  and  redness  of  the 
face ;  countenance  looks  as  though  he  had  been  intoxicated ; 


780  Reviewi. 

violenti  throbbing  pain  in  the  left  temple,  aggravated  bj  the  least 
misstep  or  on  stooping ;  violent  throbbing  pain  in  the  fore  part 
of  the  head  ;  on  the  least  motion  after  sitting  quietly,  a  feeling 
as  if  the  brain  would  burst  from  the  forehead ;  the  scalp  feels 
sore  on  moving  the  hands  through  the  hair ;  very  severe  headache 
of  years*  standing ;  pressure  in  the  centre  of  the  forehead ;  press- 
ing pains  in  the  forehead  ;  tension  during  pain  in  the  region  of 
the  temples ;  dulness  and  heaviness  of  the  head ;  forehead  heavy ; 
pressure  in  the  forehead  and  dulness;  staggering  gait,  heavy 
and  uncertain ;  the  head  feels  very  heavy  (after  three  hours  and 
a  quarter);  pressure  in  the  vertex  and  forehead ;  dulness  when 
walking ;  body  inclined  to  left  side ;  head  feels  as  if  expanded, 
heavy  and  hot ;  pressure  through  the  temples,  drawing  toward 
the  forehead  through  the  depth  of  the  brain  (noticed  many 
times)  ;  pressing  aching  pain  in  the  depression  behind  right 
ear ;  head  dull ;  pulse  slower ; — weakness  of  the  thighs  and  con- 
tractions  of  the  pupils. 

"  By  carefully  noting  the  effects  of  Solanum  ni^nim  on  the 
cerebral  functions,  you  wiU  observe  that  they  are  fully  as  impor- 
tant as  Belladonna^  and  cover  a  range  of  symptoms  that  I  am 
fully  persuaded  can  be  reached  by  no  other  remedy. 

"  Eyei, — Dilatation  of  the  pupils ;  pupils  easily  dilated ;  dila- 
tation of  the  pupils  alternating  with  contraction ;  pupils  dilated 
more  than  usual,  and  general  heaviness  in  the  body  very  soon 
after  taking  it,  and  disappearing  after  one  hour ;  very  marked 
dilatation  of  the  pupils,  preceded  by  dulness  of  the  head ;  pulse 
slow  and  small ;  trembling  of  the  legs,  especially  of  the  muscles 
of  the  thigh,  like  short  jerks,  following  in  quick  succession; 
extreme  dilatation  of  the  pupils;  alternate  dilatation  and  con- 
traction of  the  pupils ;  black  rings  before  the  eyes  with  dilated 
pupils ;  pupils  somewhat  v^dened  next  day,  with  uncertainty  in 
walking ;  pupils  very  much  contracted,  many  black  spota  and 
strips  floating  before  the  eyes,  alternating  with  very  wide  pupils, 
which  finally  remain  dilated ;  pupils  more  contracted  than  usual ; 
everything  appears  too  bright  \  contracted  pupils ;  head  feels  dull 
and  weakness  in  the  thighs  ;  darkness  before  the  eyes  with  white 
spots  and  stripes ;  also  black  rings  around  the  eyes ;  pupils  very 
large  after  three  fourths  of  an  hour ;  mistiness  before  the  eyes ; 
dimness  of  the  sight  with  vertigo  ;  sparks  before  the  right  eye ; 
nausea;  everything  becomes  darker;  black  spots  and  network 


Journals  of  the  Quarter.  781 

(gauze)  before  the  eyes ;  the  amaurotic  symptoms  attended  by 
dulnesR  and  heaviness  of  the  head;  ordinary  light  seems  too 
light ;  pressure  above  and  in  the  depths  of  the  eyes,  especially 
when  looking  at  an  object  by  daylight;  things  at  a  distance 
looked  blurred; — pressure  in  the  forehead;  photophobia,  with 
pressure  above  the  eyelids ;  when  reading,  black  spots  and  stripes 
before  the  eyes ;  after  a  quarter  of  an  hour,  the  pupils  much 
dilated ;  the  inner  rim  of  the  iris  appears  a  bright  yellow,  as  if 
illuminated ;  bright  spots  and  black  network  float  before  the  eyes, 
and  dilated  pupils ;  flickering  before  the  eyes ;  great  weakness  of 
sight,  aggravated  by  the  bright  sunlight ;  watery  eyes ;  erethic 
amaurosis  ;  eyes  very  sensitive  to  the  light ;  eyes  very  sensitive 
while  reading  (all  day) ;  sensation  as  if  too  much  light  was 
shining  in  the  eyes ;  biting  sensation  in  the  borders  of  the  eye- 
lids ;  pressure  above  the  eyes  and  in  the  depths  of  the  eye, 
especially  when  looking  at  an  object  by  daylight;  things  at  a 
distance  look  blurred,  pressure  in  the  forehead  lasting  half  an 
hour  ;  staring,  humid  and  glistening  eyes ;  pain  over  the  left  eye, 
with  pain  in  the  bowels ;  shooting  pains  over  the  right  eye ;  pains 
in  the  inner  canthus  of  the  left  eye ;  severe  pain  over  the  eyes, 
almost  unbearable  when  looking  at  a  bright  object ;  eyes  feel  dull 
and  heavy ;  burning  in  the  eyes  and  nose,  also  redness  of  the 
eyes ;  sensation  as  if  there  was  sand  in  the  eyes ;  biting  sensation 
in  the  edges  of  the  eyelids ;  stinging  in  the  inner  angle  of  the 
right  eye,  lasting  an  hour;  pupils  sometimes  very  small  and  again 
very  large ;  muscsD  volitantes ;  fulness  and  extension  of  the 
eyes ;  burning  sensation  in  the  eyelids  ;  redness  of  the  eyes. 

"The  importance  of  these  symptoms  is  clear  and  manifest. 
Its  action  upon  the  eye  is  peculiar,  and  well  worthy  of  atten- 
tion. As  a  rule,  dilatation  of  the  pupils  seems  to  predominate, 
while  contraction  has  often  occurred,  and  these  often  happen  in 
alternation.  It  resembles  Belladonna,  and  clearly  points  to 
amaurotic  symptoms  by  its  power  of  dilatation,  to  photophobia 
in  its  power  of  contraction.  It  points  to  cerebral  congestions, 
and  reminds  us  that  it  may  be  very  useful  in  apoplexy.  The 
several  symptoms  clearly  indicate  its  use  in  several  affections 
of  the  eyes ;  they  are  so  clear  that  I  need  not  here  enumerate. 

"  iTMC.— Discharge  during  the  day  of  thin,  watery  fluid,  mth 
considerable  sneezing  ;  copious  watery  discharge  from  the  right 
nostril,  and  obstruction  of  the  left. 


782 

**JBiaee. — ^Bed,  bloated  face ;  feveriah  floahee  across  the  face ; — 
shooting  pains  from  the  lower  jaw  up  into  the  left  ear,  coming 
suddenly  and  going  as  suddenly ;  erysipelas  of  the  face ;  face  hot, 
with  heat  in  the  hands  and  along  the  back ;  face  congested  with 
blood  ;  red,  fatigued  face. 

"  £ars, — Stitches  in  the  ears ;  buzzing  before  the  ears ;  every 
sound  he  hear.^  seems  as  if  coming  from  a  great  distance. 

*'  Mouth  and  teeth. — Insipid  taste  in  the  mouth ;  mouth  very 
dry,  lips  dry  and  blistered ;  tongue  sore,  as  if  burned ;  the  whole 
buccal  cavity  is  very  dry ;  dryness  of  the  back  part  of  tongae 
and  roof  of  the  mouth ;  constant  stinging  in  the  fauces  when 
swallowing. 

'*  Throat, — The  left  tonsil  feels  swollen,  with  soreness  on 
swallowing ;  stitches  in  the  right  side  of  the  throat ;  sensation 
as  if  of  a  splinter  in  the  right  tonsil ;  raw  sensation  in  the 
throat,  painful  on  swallowing;  dryness  of  the  throat; — stitches 
from  the  fauces  to  the  internal  right  ear ;  fiiuces  dry  after  half 
an  hour. 

*'  Pha/rynx  and  CBSopha^us. — Burning  in  the  right  side  of  ike 
(Bsophagus,  arising  from  the  stomach ;  cramp-like  sensation  in  the 
(esophagus. 

'*  Oastrie  sjfmptoms, — Loathing,  vomiting  of  the  ingesta ;  copious 
vomiting  of  a  greenish  coloured  matter,  accompanied  by  thirst ; 
dilated  pupils ;  stertorous  respiration ;  convulsions  and  tetanic 
stiffness  of  the  limbs;  frequent  vomiting,  first  of  mucus, 
afterwards  of  a  bluish  or  grey-blackish  fluid ; — empty  eructa- 
tions, with  burning  in  the  stomach,  violent  heartburn,  after 
eating,  for  one  hour ;  heartburn  after  retiring ;  nausea  vnth 
sparks  before  the  eyes. 

"  Stomach. — Severe  burning  in  the  stomach,  with  vomiting ; — 
sharp  cutting  pains  in  and  across  the  stomach,  better  on  pressure 
or  on  bending  over ;  burning  in  the  stomach  with  yellow  watery 
diarrhoBa ;  severe  pain  in  the  region  of  the  stomach,  extending 
to  the  region  of  the  heart  and  left  shoulder ;  severe  cramps  in 
the  pit  of  the  stomach,  aggravated  by  walking,  relieved  by  eat- 
ing ;  pains  in  the  region  of  the  stomach  accompanied  by  madness, 
delirium  aud  convulsions  of  the  limbs;  great  pressure  on  the 
stomach  by  spells  ;  continued  pain  in  the  scrobiculus ;  inflamma- 
tion of  the  stomach  and  bowels. 

'*  Abdomen, — Sharp  pains  in  the  intestines  as  if  cut  with 


Journals  of  the  Quarter.  J'Sft 

knives,  relieyed  by  eiatmg ;  yiolent  cutting  pains  in  the  umbilical 
region. 

**  Stool  and  anus, — ^Diarrhoea  next  day  after  the  dose;  stools 
loose,  semi-solid;  loose  evacuations  of  a  yellow  colour,  some- 
what watery,  followed  by  a  burning  pain  in  the  stomach,  ac- 
companied with  nausea;  constipation,  dry,  hard  stools,  small 
in  quantity  (this  is  a  secondary  effect) ;  frequent  ineffectual 
urging  to  stool ;  at  last  nothing  but  flatus  escapes ;  tenesmus  of 
the  anus. 

'^  Urinary  organs. — Hahnemann  says  that  as  a  secondary  action 
'  it  has  great  diuretic  power  ;'  the  quantity  of  urine  increased ; 
sudden  urging  to  urinate  every  ten  minutes ;  dropsy  from  sup- 
pression of  intermittent  fever;  ardor  urinsB; — dropsy,  with  pre- 
vious obstruction  of  the  absorbent  system. 

"  Bespiratory  organs, — ^Difficulty  in  breathing ;  tickling  sensa- 
tion in  the  throat,  causing  to  cough  frequently ;  yellow  thick 
expectoration ;  beating  pain  in  the  left  chest,  in  which  there  is 
a  pain  as  if  sore  when  touched ;  pressure  on  the  sternum  and 
tenth  vertebra ;  constriction  of  the  chest ;  anxious  feeling  in  the 
region  of  the  heart. 

"  Back  and  extremities* — Dull,  heavy  pain  in  the  right  arm, 
extending  to  the  fingers;  pain  in  tbe  right  knee,  extending 
up  toward  the  hip ;  lancinating  pain  extending  down  the  left 
arm;  bruised  feeling  in  the  back  and  limbs;  the  neck  feels 
stiff  and  sore,  as  if  it  had  been  bruised ;  wandering  pain,  first 
in  the  shoulder,  then  down  the  arm,  then  in  the  lower  ex- 
tremities ;  cutting  pain  in  the  left  side ;  legs  feel  sore,  as  if 
bruised  from  walking;  stiffness  of  the  limbs;  extraordinary 
convulsions  of  the  limbs ;  great  weakness  in  both  knees, 
which  scarcely  allows  walking ;  tearing  on  the  dorsum  of  the 
left  foot,  with  creeping  sensation  in  the  calf  of  the  left  leg; 
pain  in  the  left  shoulder  and  right  wrist-joint;  arms  feel 
heavy  as  if  beaten,  especially  the  left ;  crampy  convulsions  in 
the  calf  of  the  left  leg ;  painful  drawing  in  the  arms  and  feet ; 
painful  and  itching  sensation  in  the  ulcers  on  the  feet. 

"  iS^Arm.— Obstinate  herpetic  eruptions ;  copious  perspirations ; 
red  scarlet  spots  on  the  skin  of  irregular  form  nearly  over  the 
whole  body;  great  sensitiveness  of  the  cutaneous  surface; 
spasms  excited  by  touching  the  skin ;  eruption  of  small  red  pim- 
ples on  the  forehead,  sore  to  the  touch  and  very  hard ;  a  few 


734  Revieti>s. 

small  pimples  on  the  back  of  the  hand,  itching  violently ; 
pustular  eruptions  ;  desquamation  of  the  skin ; — ulcers ;  foul 
and  painful  chronic  ulcers;  scorbutic  eruptions  and  ulcers  of 
a  cutaneous  nature;  syphilitic  eruptions  and  nocturnal  pains; 
erysipelas. 

**  Sleep. — Deep  sleep  ;  coma,  alternating  with  convulsions  and 
moaning ;  sleep  disturbed  by  dreams  of  falling  from  a  great 
height ;  dreams  of  snakes ;  frequently  awakening  in  fright ;  a 
feeling  in  the  morning  when  awaking  of  great  loss  of  sleep; 
night  terrors  in  children ;  deep  apoplectic  stnpor ;  coma  and 
torpor  attended  with  fever ;  lassitude  of  the  whole  body  without 
inclination  to  sleep ;  sleeplessness. 

^*  Febrile  eymptonu. — ^Dry,  burning  heat,  with  small,  frequent 
pulse ;  heat  in  the  face,  hands,  aad  down  the  back ;  hot  skin 
covered  with  sweat ;  frequent  sweats  over  the  whole  body ;  ex- 
cessive thirst ;  slightly  feverish,  flushes  of  heat  in  the  face ;  high 
fever  on  retiring,  lasting  for  half  an  honr,  followed  by  very  pro- 
fuse perspiration  of  short  duration ;  great  thirst,  causing  him  to 
drink  often,  and  in  large  quantities,  accompanied  with  feverish 
heat  and  redness  of  the  face ;  dry,  burning  heat ;  high  fever,  with 
pain  in  the  back  of  the  neck,  shoulders,  and  lower  extremities ; 
flushes  of  heat  running  up  and  down  the  back ;  fever  all  the 
afternoon,  with  violent  beating  of  the  carotid  arteries,  headache, 
pulse  95. 

"  Oirculatory  sffHem. — Small,  frequent  pulse  ;  quick,  irregular 
pulse ;  pulse  90  to  95 ;  circulation  generally  excited,  with  violent 
throbbing  in  the  head;  pulse  full  and  irregular; — ^pulse  small 
and  slow  ;  anxious  feeling  in  the  region  of  the  heart ;  increased 
distension  and  prominence  of  the  varicose  veins;  pulse  small, 
slow  and  soft. 

"  Sptumodic  eymptome, — Convulsions  and  spasms,  they  stretch 
their  hands  during  the  spasms  as  if  they  would  grasp  something  ; 
after  this  the  hands  are  carried  to  the  mouth,  and  the  boys  (two 
and  three  years  old),  chew  and  swallow  ;  tetanic  rigidity  of  the 
whole  body ;  great  restlessness ;  violent  convulsive  restlessness ; 
tremor,  trismus,  violent  subsultus  tendinum  (raphania)  charac- 
terised by  painful  creeping  in  the  limbs,  with  distortion  of  the 
bands,  convulsions,  tonic  spasms,  occasional  attacks  of  tetanus, 
epilepsy,  imbecility,  rage ;  convulsions  with  moaning  and  coma ; 
tingling  in  the  extremities ;  contraction  of  the  flexor  tendons. 


Journals  of  the  Quarter,  f^A 

as  though  we  would  hop  about ;  spasmodic  contortion  of  the  ex- 
tremities ;  tetanic  spasms ;  epileptic  attacks ;  rage ;  imbecility  ; 
risus  sardonicus ;  contraction  of  the  hands,  drawing  in  the  fingers  ; 
cramps  in  the  calces  ;  inyersiou  of  the  feet. 

"  Generalities. — Violent  pain  in  every  muscle  and  joint  of  the 
body,  on  walking  in  the  morning ;  severe  pains,  apparently  in 
the  muscles  of  the  neck  and  between  the  shoulders  ; — shooting 
pains  in  the  left  arm  and  wrist ;  general  muscular  soreness ;  the 
whole  surface  of  the  body  is  tender  to  the  touch ;  general 
torpor  of  the  whole  system ;  general  inflammatory  swelling ;  ex- 
ternal swelling  from  external  application ;  heat  diffused  in  a  fe.w 
hours  over  the  whole  body,  a  profuse  sweat  succeeding  this  heat, 
and  purging  next  day  (from  three  grains  of  the  leaves) ;  if  a 
sweat  does  not  follow  the  heat,  profuse  urination  occurs,  followed 
by  purging  ; — tremors  with  general  debility ;  complete  in- 
sensibility, with  relaxed  muscles,  flushed  face,  free  irregular 
pulse ;  general,  violent,  convulsive  restlessness :  great  sensitive- 
ness to  cold  air;  increased  distension  and  prominence  of  the 
varicose  veins;  excessive  fatigue  from  bodily  exertion,  accom- 
panied with  vertigo ;  pains  in  various  parts  of  the  body. 

'*  This  array  of  symptoms  clearly  sets  forth  the  importance  of 
Solatium  nigrum,  and  fixes  it  as  an  analogue  of  Belladonna, 
SLyoecyamus^  Stramonium,  Glonoine,  JEthusa  cynapium,  Agaricus 
muscariuSy  Cvmicifuga  racemosa,  Cuprum,  Sanyuinaria  canadensie, 
Trie  versicolor,  QeUeminum  sempervirens,  and  more  remotely  to 
several  other  remedies. 

"  By  reference  to  the  head  symptoms  it  appears  to  equal 
Belladonna,  and  in  many  cases  it  is  no  doubt  to  be  preferred. 
It  will  no  doubt  prove  itself  of  great  value  in  cerebral  affec- 
tions,  eruptive  fevers,  indolent  ulcers,  cerebral  typhus,  brain 
affections  of  children — in  some  cases  of  intermittent  fever, 
catarrh,  &c. 

'*  Toxical  efieets. — Concerning  its  toxical  effects  we  have  some 
marked  cases  recorded,  which  have  developed  the  importance  of 
its  pathogenetic  symptoms : — 

"  1st.  A  boy  eight  years  old  ate  some  of  the  black  berries  of 
this  plant,  which  caused  a  state  of  stupor  and  coma,  attended 
with  fever.  He  complained  of  great  pain  in  the  stomach,  and 
was  harassed  with  nausea  and  retchings. 

*'  2nd.  A  little  girl  ate  some  of  the  berries— she  was  found 


78d  tteviewk. 

entirely  insensible,  lying  in  a  deep,  apoplectic  stupor — all  the 
mnscles  relaxed,  the  face  flushed,  and  the  pulse  full  and  irre- 
gular; she  continued  in  this  state  for  about  six  hours,  then 
gradually  recovered. 

''3rd.  Two  boys,  aged  two  and  three,  having  eaten  of  the 
berries,  had  convulsions  and  spasms ;  they  stretched  their 
hands  during  the  spasms,  as  if  they  would  grasp  something, 
carrying  their  hands  to  their  mouths,  chewing  and  swallowing. 

''Two  cases  of  poisoning  by  eating  the  berries  have  come  under 
my  own  observation,  in  which  the  same  general  symptoms  were 
present,  but  lasting  much  longer — one  of  the  boys  was  ill  for 
two  weeks. 

"  My  treatment  was  Oqffea  cfruda,  Belladonna,  and  Rhus  toxi- 
codendron, 

"  Thus,  my  friends,  I  leave  Solanum  ni^um  in  your  hand^, 
hoping  that  this  lengthy  paper  will  incite  you  to  a  careful  study 
of  this  meritorious  remedy. 

"  Editorial  remarks, — The  above  excellent  paper  by  Dr.  Hoyt 
is  an  admirable  rSsumS  of  Solanum  symptoms.  The  plant  has  been 
too  much  neglected — it  is  worthy  of  an  extensive  use.  I  have 
observed  for  the  last  five  years  that  when  Belladonna  was  indi- 
cated and  does  not  seem  to  act  the  Solanum  will  promptly 
remove  the  symptoms.  This  is  especially  the  case  in  severe 
headache,  which  I  very  often  cure  with  Solanum  when  BdUh 
donna  has  been  ineffectually  tried.  I  believe  its  preparations 
are  less  liable  to  deterioration  than  Belladonna ;  but  the  tincture 
ought  to  be  made  from  tbe  ripe  berries  and  leaves  in  equal  pro- 
portions with  strong  alcohol. 

"  I  was  the  first  to  publish  a  complete  '  History  and  Patho- 
genesis of  Solanum'  in  the  Transactions  of  New  York  Stals 
Medical  Society,  1870.  It  was  made  up  of  provings  and  clinical 
cases  given  me  by  Dr.  Hering — also  some  provings  made  by  the 
students  of  Hahnemann  Medical  College  of  Chicago.  None  of 
the  MSS.  had  ever  been  published  befpre.  The  paper  occupied 
twenty-four  pages  octavo,  and  was  accompanied  by  a  coloured 
plate  of  the  plant.  Dr.  Hoyt  has  carefully  copied  the  symp- 
toms from  that  article,  and  I  am  gratified  that  he  has  presented 
them  again  to  the  profession. — E.  M.  Halb,  M.D." 

Dr«  Delamater^    the    pharmaceutical    editor,    has   some 


Journals  of  the  (Quarter.  iZ7 

remarks  on  the  preparations  of  Dioscorea,  showing  that 
alcohol  does  not  exhaust  its  virtues^  so  that  it  should  be 
used  either  in  strong  decoction  preserved  by  spirit,  or  in 
triturations  of  Dioscorein.  Dr«  Oehme  speaks  very  warmly 
of  table  salt,  in  solution,  against  haemorrhages. 

The  August  number  communicates  some  new  experience 
with  a  plant  belonging  to  the  genus  Myosolis,  and  called 
provisionally  M,  symphUifolia,  It  seems  very  useful  in 
some  chronic  chest  complaints^  especially  where  there  is 
very  profuse  expectoration.  Its  place  has  yet  to  be  deter- 
mined. Dr.  Jones  gives  another  of  his  useful  arrangements 
of  medicines^  in  this  instance  of  Cedron,  which  is  stated  to 
be  the  seed  of  the  fruity  not  the  fruit  itself^  as  stated  by 
Dr.  Casanova. 

American  Journal  of  HomoBopatkic  Materia  Medica, — 
This  journal  continues  the  serial  papers  on  *'  The  Thera- 
peutics of  Uterine  Discharges  ^^  and  on  Comparative 
Materia  Medica.  The  May  number  contains  nothing  else 
noticeable.  In  the  June  number  is  a  review  of  a  new 
treatise  on  Therapeutics,  from  the  pen  of  the  younger 
Dr.  Wood,  of  Philadelphia,  which  seems  a  transatlantic 
parallel  to  our  own  Ringer.  With  July  comes  a  paper  by 
Dr.  Cowperthwait  on  the  minute  study  of  symptomatology, 
which  want  of  space  prevents  us  inserting  in  this  number. 

Medical  Investigator. — The  May  number  of  this  Journal 
begins  with  some  scattered  cases,  of  which  we  note 
one  in  which  a  peculiar  symptom — *'  itching  as  if  in  the 
bones  " — in  a  pregnant  woman  was  found  to  yield  to  RhiM, 
Veratrum  viride  V  is  highly  praised  as  counteracting  rheu- 
matic determination  to  the  heart.  The  June  number  is 
occupied  mainly  with  a  report  of  the  Annual  Meeting  (the 
twentieth)  of  the  Illinois  Homoeopathic  Medical  Association 
at  Chicago,  which  seems  to  have  been  a  great  success. 
The  report  contains  plenty  of  matter  of  practical  interest. 
A  very  original  feature  of  this  and  the  following  number  is 
an  "  Illustrated  Repertory ,''  that  is,  a  figure  of  the  human 
trunk,  on  which  are  pictured  by  means  of  arrows  and  other 

VOL.  XXXII^  NO.   CXXX. OCTOBER^  1874.  AAA 


78d  Reviews. 

symbols  the  seat  aad  direction  of  the  pains  caused  there  by 
the  yarions  drugs  of  the  Materia  Medica.  For  practising 
by  minute  symptomatology  this  is  invaluable^  and  we  hope 
that  the  author  will  carry  it  on  for  other  pains  and  other 
regions,  the  present  including  only  the  acute  pains  of  the 
anterior  aspect  of  the  chest  and  abdomen. 

The  July  number  contains  the  fullest  report  we  have 
seen  of  the  meeting  of  the  American  Institute  of  HomcBO- 
pathy — this  year  at  Niagara  Falls.  Nearly  two  hundred 
members  were  present;  and  the  session  lasted  over  four 
days.  Judging  from  the  account  given  of  what  was  donCj 
the  Transactions  will  be  a  valuable  volume.  Several  new 
provings  were  presented,  inclnding  a  full  one  of  the 
Calabar  bean.  Dr.  Oake's  scheme  for  a  College  of 
Proven  was  discussed,  but  hardly  met  with  general  accept* 
ance.  Numerous  papers  on  Clinical  Medicine  and  Surgery, 
Obstetrics,  and  Psediatry,  were  presented,  and  the  dis- 
cussions seem  to  have  been  active.  The  proceedings  ended 
on  the  fourth  day  with  a  banquet  at  4  p.m.,  to  which  the 
''  two  hundred  doctors  and  their  lady  companions  entered.^' 
After  a  number  of  toasts  (couched  in  the  high-flown 
language  which  has  its  last  refuge  in  America,  and  which 
entitles  them  to  their  old  name  of  '  sentiments '),  '^  the 
evening  was  devoted  to  a  social  hop/*  The  next  meeting 
is  to  be  held  at  Put-in-Bay,  Ohio,  under  the  presidency  of 
Dr.  Holcombe,  of  New  Orleans ;  and  we  are  promised  for 
it  a  thorough  re-proving  of  Sepia. 

The  August  number  contains  statements  of  the  value  of 
Sanffuinaria  in  poisoning  by  Rhus  and  of  ''  Lunar  Influence 
upon  Psychological  Patients''  (which  is  strongly  affirmed 
from  observation).  There  are  a  number  of  short  papers  on 
very  practical  points,  and  a  rather  critical  account  of  our 
recent  Congress,  which  is  styled  *^  weak-kneed  '*  in  reference 
to  the  proposition  about  getting  a  representative  of  homoeo- 
pathy on  the  Medical  Council. 

United  States  Medical  and  Surgical  Journal. — The 
number  of  this  quarterly  for  April  is  now  before  us,  and 
well  sustains  its  high  character.  Among  the  contributors 
we  find  our  own  Dr.  Robert  Cooper,  with  a  very  practical 


Journals  of  the  Quarter,  i'Sd 

paper  on  ''  Muriatic  Acid  in  Diseases  of  the  Tongue.  Dr. 
Comstock  supplies  another^  of  the  same  character^  on 
^'Difficult  Obstetrical  Cases/^  Dr.  Grorton  continues  his 
"  Genesis  of  Disease/'  supplying  numerous  facts  as  to  the 
"  Pathogeny  of  Food/'  and  Dr.  Hale  his  '*  Heart  Reper- 
tory.'' Dr.  Holcombe  giyes  a  wise  and  stirring  paper  on 
"  The  Elements  of  Professional  Success." 

The  veteran  Dr.  Small  supplies  some  ''Clinical  Notes 
and  Suggestions/'  and  Dr.  Nute  an  interesting  account  of 
the  (Enothera  biennis^  which  seems  to  be  a  powerful  neurotic 
excitant,  and  has  a  large  body  of  traditional  evidence  in 
favour  of  its  virtues.     It  must  be  noted  for  proving. 

From  the  "  Eye  and  Ear  Clinique  of  the  Hahnemann 
Medical  College  and  Hospital/'  by  Dr.  Woodyatt^  we  select 
the  following  excellent  case  : — 

"  ArgerUum  nitricum  in  paralysis  of  the  accommodation, — Mrs, 
N.,  8Bt.  43,  two  years  ago,  after  passing  through  a  great  deal 
of  trial  and  anxiety,  noticed  that  her  sight  had  failed  for  near 
objects.  At  a  distance  she  could  see  as  weU  as  ever,  but  close  at 
hand  everything  appeared  blurred  and  indistinct.  Any  attempt 
to  use  them  for  a  length  of  time,  even  on  coarse  work,  produced 
pain  in  the  eyes  and  head.  She  can  assign  no  other  possible 
cause.  By  using  a  pair  of  '  old '  glasses  she  found  she  could  see 
much  better,  and  has  been  wearing  a  convex  glass  ever  since. 
But  even  now  she  can  only  bring  objects  to  a  certain  point.  If 
they  come  closer  than  12  or  14  they  are  indistinct.  She  wants 
to  know  if  anything  can  be  done.  The  case  is  clearly  one  of  a 
paralysed  ciliary  muscle.  It  is  occasionally  seen  after  a  severe 
illness ;  frequently  follows  after  diphtheria,  and  not  unfrequently 
is  found  in  connection  with  spermatorrhoea.  Exactly  how  these 
causes  operate  is  unknown,  and  it  is  quite  probable  that  the 
general  debility  suffered  by  this  patient  at  the  time  named  was 
cause  sufficient.  She  is  only  able  to  read  No.  14  Snellen,  and 
that  at  24.  With  her  convex  glasses  she  reads  No.  1  quite 
readily,  but  the  range  of  accommodation  is  almost  nil.  We  will 
give  her  Argent,  nit.  6x,  four  times  daily.  This  remedy,  I  believOi 
has  a  special  action  on  the  ciliary  muscle.  In  its  proving  we  find 
'  has  to  push  the  book  away  to  see  it,'  '  dilated  pupil,'  '  intoler- 
ance of  light,'  and  the  three  may  really  be  due  to  one  cause. 
The  ciliary  muscle  is  supplied  by  the  third  nerve,  as  is  also  thci 


ri'T  Revfeiiis. 

coimtrictor  pupill».  FaralysiB  of  these  branches  would  produce 
the  first  two  and  the  last  would  follow  naturally,  the  retina  being 
exposed  through  a  large  pupil.  It  is  quite  possible  that  glasses 
maj  be  dispensed  with  entirely,  or  at  any  rate  considerably 
weakened,  only  perhaps  to  meet  the  condition  of  the  presbyopia 
found  at  this  age.  In  some  hypermetropes  who  had  been  con- 
stantly engaged  in  near  work  and  obliged  to  increase  the  power 
of  their  glasses  from  time  to  time,  to  overcome  symptoms  of 
asthenopia,  I  have  seen  the  most  pleasing  results  from  the  use  of 
this  remedy.  Instead  of  strengthening  their  glasses,  they  have 
been  able  to  diminish  them  and  work  with  much  greater  comfort. 
To  have  such  appliances  of  art  as  the  spectacles  to  be  used  in 
such  emergencies  is  decidedly  good,  but  to  apply  remedies  that 
will  enable  nature  to  do  her  own  work  is  infinitely  better. 

"  [The  remedy  was  used  for  five  weeks.  During  the  first  ten 
days  no  change  was  observed,  but  in  the  next  twenty-five  days  the 
power  of  the  muscle  so  completely  returned  that,  without  glasses, 
No.  2  Snellen  could  be  read  at  20",  and  with  convex  2  Js  the  range 
of  accommodation  extended  between  8''  to  25".  Coincidence 
seems  entirely  out  of  the  question,  and  so  far  as  one  case  can 
demonstrate  anything  the  proof  seems  positive."] 

In  the  '^  Women  and  Children's  Clinic  **  there  are  some 
good  cases  of  successful  ovariotomy  by  Dr.  Ludlam. 

In  the  Reviews,  Dr.  Woody^itt  gives  the  judgment  of  a 
practical  oculist  on  Dr.  Berridge^s  Eye  Repertory,  which, 
as  may  be  expected,  is  not  favourable. 

New  England  Medical  Gazette. — The  June  number 
completes  the  translation  of  Dr.  Hcring's  Millefolium^  and 
begins  that  of  his  Glonoin,  which  is  continued  in  the 
number  for  August.  His  preface  to  the  provings  is  very 
interesting.  In  the  section  of  Chemistry  and  Pharmacology 
there  is  an  article  on  Cauaticum  by  Dr.  Colby,  questioning 
its  nature.  He  does  not  seem  to  be  acquainted  with  Dr. 
Black's  investigation  into  the  subject,  as  xecorded  in  vol. 
xxiv  of  this  Journal  (p.  470).  The  result  of  his  own 
following  of  Hahnemann's  instructions  in  the  second 
edition  of  the  Chronic  Diseases  produced  a  liquid  which  had 
all  the  characters  of  Ammonia,     The  same  writer  calk  for 


Relations  of  the  Profession  towards  Homceopathy.    741 

chemical  iuvestigation  of  the  urine,  &c.,  in  drug  proviDgs ; 
we  cordially  approve,  and  hope  he  will  begin  the  work. 

In  the  July  number  Dr.  Henry  Clarke  communicates  a 
useful  plan  of  exciting  respiration  in  asphyxia,  viz.  by  putting 
the  finger  down  the  throat,  and  so  irritating  the  upper  part 
of  the  larynx.  He  gives  some  cases  illustrative  of  its 
value.  Dr.  Berridge  contributes  from  this  country  some 
cases  treated  with  Fincke's  high  potencies,  which  we  know 
to  be  as  dubious  as  Jenichen's.  Homoeopathists  who  do 
not  agree  with  him  are  dubbed  ''notorious  mongrels/' 
and  the  Contagious  Diseases  Act  is  stigmatised  as  ''  that 
most  infernal  Act.''  Some  provings  of  Fluoride  of  Calcium, 
mainly  with  the  15th  dil.,  are  supplied  by  Dr.  James  Bell, 
and  an  involuntary  proving  of  Carbolic  acid,  by  inhalation 
of  a  strong  solution,  by  Dr.  C.  A  Norton. 

The  August  number  is  made  up  chiefly  of  reports  of 
Society  meetings. 


MISCELLANEOUS. 


77ie  Relations  of  the  Profession  towards  Homoeopaths. 

On  the  19th  of  August  last  a  leading  article  with  the  above 
title  appeared  in  the  Medical  Press  and  Circular,  It  ran  as 
follows : 

"  From  a  Presidential  Address  to  some  Homoeopathic  Congress,  which 
occupies  the  leading  position  in  a  recent  homoeopathic  periodical,  we  cuy  the 
following  statement,  which  we  suppose  represents  the  story  upon  the  faith 
of  which  homoeopaths  maintain  their  character  as  martyrs.  The  lecturer 
asks : — 

" '  What  does  this  exclusion  and  professional  excommunication  of  homoeo- 
pathists  mean  ?  It  means  that  a  majority  of  the  profession  allege  that  some 
of  their  colleagues  who  possess  the  same  qualifications  as  themselves,  who  have 
been  educated  ut  the  same  schools  and  walked  the  same  hospitals,  are  unworthy 
to  be  regarded  as  members  of  an  honourable  profession — are,  in  short,  immoral 
individuals,  with  whom  it  would  be  ignominy  to  associate.  And  why  ? 
Because  this  excommunicated  minority,  taught  by  careful  experiment,  are 


74&  Miscellaneaus. 

• 

oonyiaoed  thit  many  diseaies  ajre  best  treated  by  medicines  which  direct 
experiment  shows  are  capable  of  acting  on  the  same  parts  as  are  affected  by 
the  disease  a  rale  of  practice  which  the  majority  only  acknowledge  in  the 
ease  of  a  few  diseases,  as  they  haye  no  experience  either  for  or  against  the 
Talidity  of  the  rale  beyond  these  few  diseases.  The  most  exalted  virtoe  conld 
Bcaroely  contend  that  there  was  anght  of  immorality  in  the  belief  that  a  great 
many— instead  of  only  a  few — diseases  a^  best  treated  by  medicines  that 
act  similarly  to  the  morbific  cause  ;  and  yet  it  Lb  for  so  believing  that  we  are 
treated  by  onr  oolleagnes  in  a  so-called  liberal  profession  as  thoagh  we  were 
guilty  of  some  unpardonable  moral  delinquency.' 

**  We  are  obliged  to  characterise  this  statement  as  a  gross  misrepresentation. 
Indefensible  in  any  speaker  who  was  presumed  to  be  acquainted  with  the 
ntterances  of  professional  journals  on  the  subject.  The  medical  profesnon 
doee  noi  refnse  to  associate  with  homoeopaths  for  any  such  reason,  but,  on  the 
contrary,  regards  with  the  most  perfect  toleration  the  theory  and  practice  of 
tiwdUa  amiliiui.  They  regard  it  as  unscientific  and  illusory,  but  they  do  not 
take  upon  themselves  to  say  that  its  practice  is  the  result  of  anything  else 
than  a  delusion.  But  they  cannot  say  as  much  for  the  practice  of  infinitesi- 
malism,  which,  the  occasion  obliges  us  to  state  plainly,  they  regard  as  a  false 
pretence,  the  employment  of  which  disentitles  any  person  to  associate  with 
them. 

**  Medical  men  can  imagine  that  homodopaths  may  honestly  believe  in  the 
HmiUa  HmUibut  theory,  but  they  cannot  be  expected  to  conceive  that  the 
minority  of  the  fraternity  honestly  believe  in  billionths,  and  they  are  there- 
fore  obliged  to  conclude  either  that  homoeopaths  treat  disease  by  effectual 
therapeutics  under  the  pretence  of  giving  infinitesimals,  or  that  they  pretend 
to  treat  disease  by  infinitesimals,  well  knowing  that  they  are  not  treating  it  at 
alL  This  is  the  reason  for  the  exclusion  of  homoeopaths  by  the  profession. 
It  is  for  the  public  to  say  whether  an  injustice  is  thereby  done  to  them." 

Dr.  Dudgeon,  whose  Addrees  before  the  last  British  Homooo- 
pathic  Congress  was  here  attacked,  sent  the  following  letter,  which 
was  published  in  the  Medical  Preu  and  Oircular  of  September 
9th: 

^  7y>  the  Editor  of  the  <  Medical  Prese  and  Cirtmlar: 

**  Sir, — Having  but  lately  returned  to  town,  your  comments  on  my  address 
before  the  British  Homoeopathic  Congress  were  not  seen  by  me  until  to-day, 
and  I  would  ask  your  kind  permission  to  say  a  few  words  in  my  own  defence. 

"  Ton  characterise  as  a  *  gross  misrepresentation  *  my  statement  that  a 
majority  of  the  profession  treat  as  '  unworthy  to  be  regarded  as  members  of 
an  honourable  profession,  as  immoral  individuals  with  whom  it  would  be 
ignominy  to  associate,'  some  of  their  colleagues  for  acting  on  their  conviction 
that  most  diseases  are  best  treated  by  medicines  that  act  similarly  to  the 
morbific  cause— in  other  words,  homoeopathically.  You  say  :  '  The  medical 
profession  does  not  refuse  to  associate  with  homoeopaths  for  any  such  reason ; 
buti  on  the  contrary,  regards  with  the  most  perfect  toleration  the  theory  and 


Relatians  of  the  Profession  towards  Honueopathy,    743 

practice  of  HndUa  Hmilihut'  Tou  farther  state  that  it  is  the  infinitesimal 
dose  that  is  '  the  reason  for  the  ezclnsion  of  homoDopaths  hy  the  profession.' 

"  Now  it  Lb  a  very  serions  thing  to  be  accused  of  a  'gross  misrepresentation/ 
and  I  do  not  suppose  I  shall  appeal  in  vain  to  your  sense  of  justice  to  allow  me 
to  lay  before  your  readers  some  of  the  evidence  on  which  I  founded  the  state- 
ment you  thus  characterise.  I  could,  I  am  sure,  adduce  a  large  amount  of 
testimony  from  the  medical  periodicals  in  proof  of  my  allegation ;  but,  with 
all  deference  to  you,  I  believe  the  resolutions  of  public  bodies  like  colleges 
and  societies  express  the  sentiments  of  the  medical  profession  better  than 
'  utterances  of  professional  journals,'  for  I  have  not  been  editor  of  a  professional 
journal  for  thirty  years  without  knowing  that  the  editorial  plural '  we '  often 
masks  the  singular  '  I.' 

"  On  the  9th  of  May,  1851,  the  Royal  College  of  Physicians  of  Edinburgh 
passed  resolutions  against  homoeopathy  in  which,  after  referring  approvingly 
to  its  having,  in  1842,  '  peremptorily  declined  to  admit  into  its  body  a  candi- 
date for  its  Fellowship  because  he  practised  homoeopathically,'  it  goes  on  to 
say  that '  those  of  its  Fellows  who  have  become  homoeopathists,  or  any  other 
medical  practitioners  who  follow  homoeopathy,  must  necessarily  be  alien  to  the 
other  Fellows  and  to  the  profession  at  larg^,  inasmuch  as  no  Fellow  of  the 
College,  nor  any  other  physician  can,  by  any  possibility,  without  derogating 
from  his  own  honour  and  irom  the  honour  of  the  profession,  meet  practitioners 
of  homoeopathy  in  consultation,  or  co-operate  with  them  in  the  other  common 
duties  of  professional  life.' 

<*0n  the  14th  of  August,  1861,  the  Provincial  Medical  and  Surgical 
Association  (now  the  British  Medical  Association)  passed  resolutions  against 
homoeopathy  in  which  we  find  the  following  phrases :  '  That  it  is  derogatory  to 
the  honour  of  members  of  this  Association  to  hold  any  kind  of  intercourse  with 
homoeopathic  practitioners.'  '  That  there  are  three  classes  of  practitioners 
who  ought  not  to  be  members  of  this  Association,  namely  :  1st.  Beal  homoeo- 
pathic  practitioners;  2nd.  Those  who  practise  homoeopathy  in  combination 
with  other  systems  of  treatment ;  8rd.  Those  who,  under  various  pretences, 
meet  in  consultation  or  hold  professional  intercourse  with  those  who  practise 
homoeopathy.'  '  That  the  thanks  of  the  Association  are  eminently  due,  and 
are  hereby  given,  to  the  Presidents  and  Fellows  of  the  Royal  Colleges  of 
Physicians  and  Surgeons  of  Edinburgh  for  their  determined  stand  against 
homOBopathic  delusions  and  impostures.'  '  That  the  thanks  of  the  Association 
are  also  due,  and  are  hereby  given,  to  the  Universities  of  Edinburgh  and  St. 
Andrew's  for  their  resolution  to  reftise  diplomas  to  practitioners  of  homoeo- 
pathy.' 

"  In  1851,  Dr.  R.  D.  Hale  passed  his  examination,  and  obtained  his  degree 
at  St.  Andrew's.  The  Faculty  of  that  University,  learning  that  Dr.  Hale 
was  a  homoeopathic  practitioner,  demanded  back  his  diploma. 

*'  In  1851,  Dr.  J.  S.  Clarke  took  his  degree  at  King's  College,  Aberdeen. 
Soon  afterwards  some  one  wrote  to  the  Lancet  that  Dr.  Clarke  was  a  homoeo- 
pathic practitioner.  Dr.  Fyfe,  the  Professor  of  Medicine  of  the  College,  wrote 
to  the  Lancet : 

'*  *  I  beg  to  inform  you  thaty  at  the  time  of  his  examination,  not  the  slightest 


744  Miseellaneoui, 

suspicion  was  entertained  of  his  being  a  homceopathic  practitioner,  other- 
wise the  degree  would  not  have  been  conferred  on  him/ 

"In  1858,  Mr.  Haryey  desired  to  obtain  the  degree  of  M.D.  at  Marischal 
College,  Aberdeen.  He  passed  the  two  first  examinations  satisfactorily  ;  but 
a  report  of  his  homoeopathic  proclivities  having  reached  the  examiners.  Dr. 
Macrobin,  in  the  name  of  the  Faculty,  questioned  him  as  to  his  having  prac- 
tised homoeopathically.  Mr.  Harvey  objected  to  reply  to  such  an  inquisi- 
torial question,  and  Dr.  Macrobin  refused  to  admit  him  to  the  final  trial 
uiftil  he  should  be  satisfied  that  the  candidate  had  never  practised  homoeo- 
pathically. In  a  correspondence  that  ensued  Dr.  Macrobin  required  from  Mr. 
Harvey  '  a  distinct  declaration  that,  as  a  man  of  honour,  you  have  not  prac- 
tised and  do  not  entertain  any  intention  of  practising  the  profession  on  other 
principles  than  those  taught  and  sanctioned  in  this  and  other  legally  recog- 
nised schools  of  medicine ;  that  homcDopathy  or  any  other  species  of  irregular 
unauthorised  practice  is  what  you  entirely  repudiate." 

"  On  the  28th  of  January,  1859,  the  Liverpool  Medical  Institution,  by  a 
lai^e  majority,  altered  one  of  their  rules  to  this  effect :  '  But  no  one 
practising  homoeopathy  shall  be  eligible  as  a  member  of  the  Institution  or 
as  a  subscriber  to  the  library,  and  any  member  or  subscriber  who  may 
become  a  practitioner  of  homoDopathy  shall  cease  to  belong  to  this  Insti- 
tution.' 

"On  the  10th  of  August,  1861,  the  Royal  College  of  Surgeons  of  Ireland 
adopted  the  following  ordinance :  '  N^o  Fellow  or  Licentiate  of  this  College 
shall  profess  or  pretend  to  cure  disease;*  by  the  deception  called  homcBopathy.' 
'  It  is  also  hereby  ordained  that  no  Fellow  or  Licentiate  of  this  College  shall 
consult  with,  meet,  advise,  direct,  or  assist  any  person  engaged  in  such  decep- 
tion or  practices,  or  in  any  system  of  practice  considered  derogatory  by  the 
physicians  or  surgeons.' 

*'  I  need  scarcely  say  that  all  these  resolutions,  as  they  appeared  in  turn, 
were  vehemently  applauded  by  every  organ  of  orthodox  medical  opinion,  and 
that  not  one  feeble  protest  appeared  in  the  professional  journals  against  even 
the  most  extravagant  of  them. 

"I  might  give  a  long  list  of  societies,  medical,  medico-ethical,  and  registra- 
tion, which  have  passed  laws  excluding  homceopathists  from  membership,  and 
even  imposing  the  penalty  of  expulsion  on  those  of  their  own  members  who 
should  meet  homoeopathic  practitioners  professionally ;  but  the  above  wlH  suffice. 

"  The  same  system  has  been  carried  on  by  the  orthodox  majority  of  the  pro- 
fession on  the  Continent  and  in  America.  So  late  as  1871  the  Massachusetts 
Medical  Society  attempted  to  expel  its  homoeopathic  members  by  resolving 
that  any  one  who  '  adopts  as  his  principle  in  the  treatment  of  disease  any 
exclusive  theory  or  dogma  shall  be  deemed  to  have  violated  the  by-laws  of  the 
Society  by  conduct  unbecoming  and  unworthy  an  honourable  physician  and 
member  of  this  society.'  * 

*  On  the  strength  of  this  by-law  eight  members  of  the  Massachusetts  Medical 
Society,  whose  connection  with  the  Society  dated  from  forty -eight  to  sixteen 
years,  and  who  had  been  openly  practising  homoeopathy,  some  of  thi-m  for  periods 
of  thirty  years  and  upwards,  were  brought  to  trial  before  a  committee  of  the 


Relations  of  the  Profession  towards  Homceopathy.    745 

"  I  may  conclude  this  list  of  my  proofs  with  one  from  the  other  side  of  the 
Channel.  On  the  4th  of  January,  1856,  under  the  presidency  of  Professor 
Cruveilliier,  the  Anatomical  Society  of  Paris  expelled  by  an  unanimous  vote 
'  Drs.  J.  P.  Tessier,  Gabalda,  Fredault,  and  Jousset,  as  authors  of  homoeopathic 

publications,  and  M.  W ,  on  account  of  an  infamous  and  felonious  act 

already  punished  by  the  law/ 

'*  If,  sir,  I  have  been  guilty  'cf  '  gross  misrepresentation '  in  alleging  that 
the  majority  of  the  profession  have  treated  us  as  unworthy  to  be  regarded  as 
members  of  an  honourable  profession,  as  immoral  individuals  with  whom  it 
would  be  igfuominy  to  associate,  on  account  of  our  endeavour  to  act  up  to  our 
conviction  that  diseases  are  best  treated  homoeopathically,  you  will  surely  allow 
that  I  had  some  g^unds  for  the  statement ;  and  if  it  be  the  case,  as  you 
assert,  that '  the  medical  profession  regards  with  the  most  perfect  toleration 
the  theory  and  practice  of  similia  nmiUbut,*  then  you  will  admit  that  the 
language  of  the  resolutions,  &c.,  I  have  quoted  above  must  have  been  used  d 
la  TalUyrand,  to  conceal  thought,  for  to  an  ordinary  understanding,  and 
in  its  literal  sense,  it  seems  to  have  quite  an  opposite  meaning.  However,  we 
are  glad  to  have  your  high  authority  that  the  medical  profession  regards  the 
theory  and  practice  of  homoeopathy  with  the  most  perfect  toleration,  only  we 
cannot  help  feeling-  as  puzzled  by  those  demonstrations  of  toleration  as  was 
the  poor  fellow  in  the  poem  who  exclaimed — ! 

" '  Perhaps  you  were  right  to  dissemble  your  love  ; 
But  why  did  you  kick  me  down  stairs  ? ' 
"  Your  obedient  servant, 

"R.  E.DrDOEoy,  M.D., 
"  President  of  the  British  Homoeopathic  Congress  of  1874. 
"  53,  Montagu  Square,  London, 
«  29  th  August.  1874." 


Society,  and  after  various  adjournments  were  finally,  on  the  19th  of  May,  1873, 
found  guilty  of  **  conduct  unbecoming  and  unworthy  of  an  honourable  physician 
and  member  of  this  Society"  for  practising  homoeopathy.  We  need  hardly 
add  that  not  the  slightest  shade  of  an  imputation  was  brought  against  what  is 
commonly  understood  as  the  moral  character  of  these  eight  gentlemen,  who 
were  thus  cast  out  of  the  Society  they  had  so  long  been  members  of  and 
branded  as  infamous  and  dishonourable  for  having  had  the  audacity  to  inquire 
into,  and  on  conviction  of  its  excellence  to  adopt,  a  system  of  medical  practice 
that  their  judges  had  not  inquired  into  nor  adopted.  It  should  be  noted,  too, 
by  the  Editor  of  the  Medical  Press,  that  they  are  expelled  for  practising 
according  to  the  homoeopathic  theory,  and  not  for  using  infinitesimal  doses. 
The  natural  consequences  of  such  an  odious  and  impotent  persecntion  showed 
themselves  even  while  the  persecution  was  going  on.  A  bazaar  for  a  homoeo- 
pathic hospital  in  Boston  realised  the  enormous  sum  of  £20,000,  and  the  newly 
founded  Boston  University  selected  for  the  professors  of  its  medical  school 
only  physicians  who  were  conversant  with  the  homoeopathic  method,  among 
whom  were  two  of  these  very  men  whom  the  Massachusetts  Medical  Society 
have  just  expelled  and  sought  to  cover  with  infamy  and  disgrace. 


746  MiBcellanecui. 

To  this  the  following  editorial  remarks  were  appended: 

"  [Our  oolTespoDdent  very  condasiTely  proTes  that  which  reqaired  no  proof, 
•^.  that  the  medical  profetsion  adopts  a  relation  towards  homoBOpatfae  which 
implies  that  they  are  an  worthy  to  be  regarded  as  members  of  an  bononrshle 
profession.  We  have  been  perfectly  well  aware  of  the  existence  of  the  pro- 
nmneiamentot  which  he  qaotes,  and  yet  we  reiterate  oar  statement  that '  the 
medical  profes^^ion  reffsrds  with  the  roost  pexfect  toleration  the  theory  and 
practice  of  *imilia  aimilUma,*  but  that  ic  is  nevertheless  a  gross  misrepresenta- 
tion to  state  tbat  homojopathists  are  ostracised  for  holding  this  dopna  or 
practising  upon  its  principle.  The  medical  profession  recognises  the  perfect 
right  of  any  practitioner  to  hold  any  view,  however  ridicaloas  and  onscientifie, 
and  to  apply  snch  theory  in  his  practice  so  long  as  he  does  so  with  honest 
confidence  in  its  efficiency.  The  medical  profession,  therefore,  does  jnot  pat 
hydropHths  in  the  same  category  as  homoBopaths,  although  the  great  majority 
of  its  members  believe  the  universal  practice  of  water-doctoring  to  be  a  dela- 
sion  and  a  snare.  Homoaopaths  are  not  admitted  to  association  with  the 
profession,  and  have  been  made  the  sabject  of  the  denunciatory  resolutions 
quoted  by  our  corrcsjiondent  because  it  is  impossible  for  intelligent  minds  to 
place  any  charitable  construction  upon  the  practice  of  infinitesimalism,  or,  in 
fact,  to  believe  that  it  is  anything  but  a  fraud.  Homoeopaths  may,  if  they 
like,  be  visionaries ;  but  they  must  establish  their  claim  to  be  considered  to  act 
with  honest  intention  before  they  can  be  met  as  fellows  by  scientific  medical 
men.  It  is  a  matter  of  some  importance  to  the  profession  that  its  members 
should  not*  without  contradiction,  be  accused  of  persecuting  any  person 
because  he  does  not  agree  with  them  in  their  own  views ;  and  it  is  necessary, 
in  justice  to  medical  men,  to  assure  the  public  that  homoeopaths  are  not 
entitled  to  any  sympathy  as  martyrs  at  the  shrine  of  sdenoe,  but  are  excluded 
fi^m  the  pale  uf  the  profession  because  they  are  guilty  of  what  medical  men 
consider  to  be  a  public  fraud.— Ed.  M.  P.  &  C.]" 

Dr.  Dudgeon  replied  to  these  editorial  remarks  in  the  follow- 
ing letter : 

«  To  the  Editor  of  the  '  Medical  Prees  and  Circular.' 

»<  Sir, — As  you  have  bad  the  courtesy  to  insert  my  lett^  with  my  proofs,  I 
am  content  to  let  your  readers  judge  between  you  and  me  whether  I  have  been 
guilty  of  '  gross  misrepresentation  '  in  saying  that  the  majority  of  the  pro- 
fession treat  us  as  dishonest  and  immoral,  because  we  prescribe  medicines  on 
the  homcBopathic  therapeutic  principle,  and  whether  you  are  justified  in 
asserting  that  *  the  medical  profession  regard  with  the  most  perfect  toleration 
the  theory  and  practice  of  eimilia  eimiUbus,* 

**  But  if  you  will  kindly  continue  your  courtesy — or  perhaps  I  should  say  your 
toleration — I  would  like  to  make  a  few  remarks  on  a  passage  in  your  comments 
on  my  letter.  Ton  say, '  Homoeopaths  are  not  admitted  to  association  with 
the  profession,  &c,  because  it  is  impossible  for  intelligent  minds  to  place  any 
charitable  construction  on  the  practice  of  infinitesimalism,  or,  in  fact,  to 
believe  that  it  is  anything  but  a  fraud.  Homoeopaths  may,  if  they  like,  be 
visionaries,  but  they  must  establish  their  claim  to  be  considered  to  act  with 


Relations  of  the  Profession  towards  Homceopathy.    747 

•  * 

honest  intention  before  they  can  be  met  as  fellows  by  scientific  medical 


men/ 


"  I  have  no  desire  to  dispute  your  claim  to  a  monopoly  by  yonr  side  of 
'  intelligent  minds,'  bnt  I  wonld  submit  that  whether  so-called  infinitesimal 
doses  of  medicine  act  or  'do  not  act,  under  certain  circumstances,  is  a  matter 
to  be  determined  by  experiment  and  not  by  '  charitable  construction.'  Scien- 
tific belief  is  conviction  obtained  by  evidence,  and  a  belief  based  on  any  other 
foundation  may  be  held  tenaciously  enough,  but  has  no  claim  to  be  considered 
scientific;  so  if  your  side  assert  that  they  believe  infinitesimalism  to  be  a 
fraud,  we  ask.  Where  is  your  evidence  to  constitute  your  belief  scientific  ? 
What  if  it  should  turn  out  that  you  know  no  evidence  one  way  ot  another  in 
connection  with  infinitesimal  doses  of  medicine  ?  What  in  that  case  is  the  value 
of  your  belief  ?  Belief  without  evidence  is  merely  prejudice.  Tour  side 
object,  perhaps,  that  you  have  had  immense  experience  of  the  action  of 
medicines.  Granted;  bnt  not  of  infinitesimal  doses.  Your  two  hundred 
years'  experience  of  the  emetic  effect  of  a  scruple  of  Ipecacuanha  will  not 
enable  you  to  tell  how  an  infinitesimal  dose  of  that  drug  will  act  in  a  case  of 
vomiting. 

"  Again,  why  are  we  to  *  establish  our  claim  to  be  considered  to  act  with 
honest  intention  ?'  In  other  departments  of  science  is  it  considered  necessary 
that  their  cultivators  should  g^ve  proofs  of  honest  intention  ?  and  if  not,  why 
in  therapeutics  ?  Can  an  alleged  fact  in  therapeutics  not  be  considered  on  its 
own  merits  without  proof  of  honest  intention  on  the  part  of  its  propounder  P 
Some  time  ago  you  did  me  the  honour  to  notice  favourably  a  pamphlet  I 
published  on  the  mechanism  of  visual  accommodation.  Yon  considered  my 
statements  and  experiments  on  their  merits,  and  did  not  ask  me  for  proof  of 
*  honest  intention/  Why,  then,  should  I  be  asked  for  such  proof  in  reference 
to  the  action  of  infinitesimals  in  disease  ?  Do  therapeutic  facts  belong  to  the 
domain  of  morals  that  they  cannot  be  accepted  nor  even  inquired  into  without 
an  assurance  of  'honest  intention'  on  the  part  of  those  who  pat  them 
forward  ?  and  will  a  therapeutic  fact  be  accepted  aa  true  if  the  '  honest 
intention '  of  its  propagator  is  proved  ?  If  so,  by  all  means  let  us  ftimish 
proof  of  the  honesty  of  our  intentions..  But  how  is  that  to  be  done  P  Must 
we  get  a  certificate  signed  by  the  clergyman  of  onr  parish,  or  a  magistrate  of 
our  borough,  to  the  effect  that  we  are  honestly  intentioned  people,  or  will  a 
testimonial  of  two  reputable  householders  do  P  And  are  '  scientific  medical 
men '  to  ask  for  certificates  of  honesty  all  round  before  they  will  enter  into 
fellowship  with  one  another  ?  You  know  that  to  ask  for  proof  of  honest 
intention  in  regard  to  other  matters  for  scientific  experiment  would  be  looked 
upon  as  an  intended  insult,  and  we  cannot  help  feeling  that  your  side  intend  it 
as  an  insult  to  us.  Do  you  suppose  that  the  public  believe  you  when  you  denounce 
us  as  dishonest,  fraudulent,  and  unworthy  to  be  regarded  as  members  of  an 
honourable  prof ession  P  Of  course,  you  know  well  they  do  not;  bnt  there  is 
little  doubt  that  the  loss  of  consideration  of  the  medical  profession  generally  in 
the  eyes  of  the  public  is,  in  a  great  measure,  caused  by  the  habit  your  side  has 
so  long  indulged  in  of  denouncing  as  dishonest  and  disreputable  some  of  your  col- 
leagues for  no  other  obvious  reason  than  that  they  differ  from  you  on  some  points 


748  Miscellaneous, 

of  therapeotic  doctrine  and  pi«ctiee.  J*hi8  habit  of  bearing  fiU^  witness 
against  yoor  brethren  (for  yon  know  it  is  false  to  Hssert  that  our  average 
morality  and  honesty  are  inferior  to  your  own)  cannot  be  indulged  in  without 
lowering  the  moral  tone  of  those  who  practise  it ;  and  the  whole  professioa 
suffers  from  this  plan  of  making  a  question  of  therapeutics  one  of  ethics,  and 
assoming  that  a  given  method  of  practice  is  frauduleiit,  in  place  of  experi- 
mentally testing  its  value. 

"  Your  obedient  servant, 

*'  53,  Montagu  Square,  "  B.  £.  Dudoeox,  M.D. 

"  10th  September,  1874." 


The  evidence  brought  forward  bj  Dr.  Dudgeon  in  his  first 
letter  shows  conclusively  that  the  homoeopathy  condemned 
bj  the  colleges  and  societies  was  the  theory  and  practice  of 
homopopathy  and  not  the  dose  alone ;  indeed  in  none  of  these 
fulminations  is  the  dose  ever  alluded  to.  If  the  dose  was 
meant  we  cannot  be  expected  to  discover  the  hidden  meaning 
of  the  authors.  We  knew  that  we  as  individuals  were  con- 
demned and  shut  out  from  professional  intercourse,  and  we  were 
justified  in  concluding  that  we  were  thus  treated  because  we 
contended  for  the  truth  of  the  homodopathic  therapeutic  principle, 
and  because  we  regulated  our  practice  bj  it.  For  we  have  ever 
held  that  the  principle  simUia  simUibus  is  the  cardinal  point  and 
not  the  infinitesimal  dose,  and  we  follow  it  as  the  mode  of  die- 
covering  and  applying  remedies  for  disease.  Moreover  we  have 
never  advocated  sectarian  ezclusiveness,  and  we  admit  the 
utility  of  all  other  therapeutic  methods  experience  has  shown  to 
be  good,  and  hold  ourselves  free  to  make  use  of  them  when  we 
think  they  will  be  advantageous  for  our  pafients,  and  when  thej 
are  not  superseded  by  the  superior  excellence  of  the  horocBo- 
pathic  specific  method ;  just  as  the  ligature  superseded  the  pre- 
vious methods  of  stopping  haamorrhage ;  and  if  experience  shall 
show  that  acupressure  is  better  than  ligature  we  would  adopt  it 
in  practice.  If  any  one  will  show  us  a  better  method  of  treating 
disease  than  the  homoBopathic,  we  will  give  up  homceopathy. 

We  do  not  follow  in  a  slavish  manner  the  mode  of  applying 
the  homoeopathic  law  used  by  Hahnemann,  but  we  criticise  him  as 
freely  as  any  other  man. 

As  to  the  do9o  ;  before  we  ever  heard  of  homoeopathy  some  of 
the  practitioners  of  that  scIjooI  were  in  the  habit  of  giving  doses 
only  moderately  below  the  strengtli  required  to  elicit  the  physio- 
logical action  of  the  drug ;  others  pushed  the  dilution  to  what  the 


Relations  of  the  Profession  towards  Homceopathy.    749 

first  party  deemed  an  extravagant  length,  and  even  held  that  the 
very  extreme  of  dilution  was  the  corner  stone  of  homoeopathy, 
and  that  to  give  medicines  in  the  lower  dilutions  was  allopathising. 
As  a  matter  of  fact  we  side  with  the  former  party,  but  we  pro- 
fess ourselves  unable  to  draw  the  line  where  moderate  dilution 
ends  and  extravagant  infinitesimalism  begins.  Assuredly  wo 
hold  it  to  be  dishonorable,  unscientific,  and  unprofessional  to 
speak  of  those  who  carry  the  dilution  of  medicines  to  what  is  in 
our  eyes  an  impracticable  point  as  liars,  cheats,  and  impostors 
unfit  to  associate  with. 

No  doubt  the  Medical  Press  thinks  it  has  a  right  to  look  upon 
us  in  the  same  light  as  we  do  the  extravagant  dilutionists* 
But  how  does  it  draw  the  line  between  infinitesimalism  and  suffi- 
cient dilution  to  avoid  the  physiological  action  which  is  essential 
to  all  homoeopathic  treatment,  and  which  must  be  also  deemed 
essential  by  the  Medical  Press  ndw  that  it  assures  us  that 
similia  similibus  is  already  admitted  as  a  principle  (among  others) 
in  medicine.  Even  if  it  can,  on  what  ground  does  it  call  liars, 
cheats,  and  quacks,  all  who  do  not  possess  that  power,  the  secret 
of  which  has  not  been  divulged  by  the  Medical  Press  ? 

The  position  of  the  Medical  Press  is  in  truth  somewhat 
amusing.  It  says  virtually,  nobody  objects  to  us  for  foUovnng 
any  theory  of  medicine,  such  as  the  homoeopathic.  For  itself,  it 
thinks  the  theory  visionary  and  absurd,  and  the  people  who 
follow  it  fools.  But  that  is  no  objection  to  them ;  far  from  it. 
Are  there  not  fools  and  visionaries  enough  in  medicine,  even  in 
high  places  P  Indeed  it  seems  to  parody  the  scriptural  phrase, 
"  Ye  suffer  fools  gladly,  seeing  ye  yourselves  are  wise."  But  then 
its  wisdom  consists  in  knowing  exactly  the  boundary  between  in- 
finitesimalism and  propier  dosage  ;  and,  puffed  up  with  this  know- 
ledge, it  declares  everybody  a  liar  who  humbly  says  he  does  not 
possess  this  knowledge  and  believes  that  it  cannot  be  attained 
without  scientific  experiment. 

If  a  man  of  position,  such  as  the  late  Professor  Henderson, 
comes  forward  and  declares  that  he  does  not  know  a  priori 
whether  the  millionth  part  of  a  grain  of  Arsenic  will  be  sufficient 
to  cure  a  case  of  gastro-enteritis,  which  it  is  granted  it  will  cure 
in  some  dose,  but  that  the  point  must  be  ascertained  by  careful 
experiment  openly  performed  according  to  the  strict  rules  of 
science,  then  the  world  knows  how  to  appreciate  such  a  declara* 


756  ifisceltanecuB, 

tion  and  will  perceiye  that  it  is  the  declaration  of  a  man  of 
science  and  of  honour,  and  of  one  who  has  the  proper  high  idea 
of  the  professional  duty  of  a  member  of  a  profession  who  accepts 
the  care  of  the  health  and  life  of  his  fellow  creatures  as  a  sacred 
trust.  But  when  an  anonymous  writer  in  an  allopathic  medical 
journal  declares  that  for  making  that  statement  Dr.  Henderson 
is  a  dishonest  man  and  a  cheat,  and  must  be  thrust  out  of 
communion  with  the  profession  in  company  with  all  who  are  so 
banished  for  in&mous  and  felonious  acts,  then  the  public  will 
assuredly  hold  the  latter  declaration  to  come  firom  a  foul- 
mouthed  slaiiderer,  and  one  who  has  no  true  professional  feeling, 
nor  is  a  man  of  science,  nor  a  gentleman.  And  when  such  a 
declaration  is  endorsed  by  the  whole  of  the  allopathic  medical 
profession  by  means  of  their  periodical  literature,  the  edicts  of 
their  colleges  and  the  laws  of  their  societies,  the  same  verdict 
wiU  be  pronounced  by  the  public  on  the  orthodox  majority  of  the 
profession. 

It  is  an  indubitable  fact,  and  the  enlightened  portion  of  the 
public  are  beginning  to  perceive  it,  that  we  are  following  out  the 
only  method  of  gaining  for  medicine  the  fruits  of  the  homoeopathic 
principle,  namely,  by  experiment  as  men  of  science  and  honour. 
The  whole  profession  must  perforce  foUow  our  way,  for  there  is 
no  other;  and  the  only  question  is,  whether  they  will  do  so 
sooner  or  later,  whether  honestly  or  dishonestly.  As  yet  the 
majority  are  lagging  behind,  but  they  are  slowly  following  us, 
and,  unfortunately,  not  honorably  by  giving  Hahnemann  the 
credit  due  to  him  for  his  discovery  of  the  principle  and  for  his 
hard-working  pioneering  in  the  arduous  labour  of  proving 
medicines.  The  new  phase  of  the  question  is  most  embarrassing 
to  our  old  school  colleagues.  While  the  truth  of  the  homo90- 
pathic  principle  is  forcing  itself  on  the  profession,  the  di£5.culty 
they  now  have  is  to  reconcile  their  conduct  with  their  former 
unworthy  treatment  of  ourselves,  and  their  false  pride  leads 
them  to  endless  paltry  subterfuges.  This  device  of  the  Medical 
Press  is  one  of  these.  In  spite  of  the  general  and  repeated 
denunciations  of  homoeopathy,  which  included  the  principle,  the 
tactics  now  pursued  are  to  pretend  that  the  principle  was  not 
objected  to,  but  only  the  infinitesimal  dose,  and  to  prove  their 
consistency  this  is  now  made  the  excuse  for  the  reiteration  of  all 
the  accustomed,  coarse,  and  unworthy  vilification  of  coUeagnes  the 


Relations  of  the  Profession  towards  Homcsopathy,   75 1 

fruits  of  whose  honest  labour  they  are  meanly  appropriating 
without  acknowledgment. 

The  truth  is  something  must  be  said  to  show  their  zeal,  for 
thej  are  all  in  mortal  fear  of  one  another.  The  journals  fear  for 
their  circulation  unless  they  revile  homcBopathy.  The  publishers 
fear  for  their  pockets.  The  private  practitioners  fear  being 
denounced  by  the  trades'-union  clubs,  miscalled  ethical  societies. 
The  students  fear  lest  they  should  be  plucked.  The  young 
aspirants  to  hospital  appointments  fear  lest  they  should  be 
excluded  from  the  object  of  their  honourable  ambition.  The 
so-called  '*  eminent  men "  fear  loss  of  consultation  fees  and 
operations.  The  apothecaries  fear  loss  of  custom.  In  short,  the 
whole  profession,  from  top  to  bottom,  is  writhing  under  a  veritable 
Bei^n  of  Terror,  The  very  leaders  of  the  medical  profession,  the 
eminent  men  in  high  positions,  are  themselves  under  the 
influence  of  the  terror,  and  either  give  no  guidance  on  the  subject 
of  homcBopathy  or  pander  to  the  prejudices  of  those  on  whom 
they  depend  for  consultations  by  joining  in  the  senseless  hue  and 
cry  of  the  medical  mob,  and  lend  the  authority  of  their  high 
status  to  aggravate  and  intensify  the  persecution.  There  are 
some  conspicuous  exceptions  who  will  not  demean  and  dishonour 
themselves  by  persecuting  their  colleagues  for  their  medical 
opinions,  and  who  will  not  deny  professional  intercourse  to  their 
differently  thinking  colleagues ;  but  none  even  of  these  will 
make  an  effdtt  to  stem  the  tide  of  persecution  by  publicly 
claiming  for  all  a  perfect  right  to  freedom  of  opinion  and  action 
in  medical  matters.  Few  really  eminent  men  exist  in  any 
profession  in  each  generation,  and  the  posts  of  honour  and 
eminence  are  in  most  cases  filled  by  the  Dr.  Plausibles,  who  are 
eminent  only  in  the  eyes  of  the  flunkey-tribe,  and  who,  under 
the  present  Beign  of  Terror,  could  only  attain  to  their  high 
positions  by  conforming  to  the  vulgar  practice  of  treating  homoso- 
pathy  as  a  fraud  and  its  practitioners  as  scoundrels. 

This  Beign  of  Terror  is  founded  on  falsehood,  and  would  be 
dissipated  in  a  moment  if  a  few  even  of  the  ''  eminent  men,"  such 
as  they  are,  would  boldly  strike  for  freedom  and  insist  on  being 
allowed  free  discussion  on  this  as  on  every  other  subject.  At 
once  the  whole  fabric  of  terror  and  falsehood  would  collapse. 
The  sectarian  position  at  present  £EJsely  thrust  upon  us  would 
disappear.  The  name  of  homoeopathy  would  even  disappear  in  a 
short  time.    For  ourselves^  we  have  each  individually  repeatedly 


y5'2  Miscellaneous. 

offered,  and  we  now  again  collectively  offer,  to  give  up  this 
Journal,  of  which  we  are  the  editors,  as  soon  as  complete  freedom 
of  medical  writing  is  guaranteed  for  all,  for  homoeopathic  theory 
and  practice  as  well  as  for  others.  There  never  should  have  been 
any  separate  homoeopathic  literature.  Its  very  existence  is  a 
standing  disgrace  to  the  medical  profession.  It  is  unworthy  of  a 
body  professing  to  be  men  of  science  and  gentlemen  to  say  that 
no  one  can  propose  a  new  theory  and  practice  in  the  ordinary 
channels  of  the  press  or  in  medical  societies  without  being 
hooted  out  of  discussion  with  vulgar  impertinence,  the  pages  of 
medical  journals  closed  against  him,  and  the  medical  publishers 
placing  him  under  a  ban  in  consequence  of  the  "picketing" 
manoeuvres  resorted  to  by  their  customers. 

The  all-pervading  power  of  medical  obstructiveness  or  the  utter 
indifference  to  medical  matters  of  the  leaders  of  public  opinion  is 
shown  in  this,  that  though  this  persecution  for  opinion  has  been 
going  on  in  England  for  a  whole  generation,  scarcely  one  feeble 
voice  has  been  raised  in  the  non-medical  press  to  censure  a  line 
of  conduct  that  in  other  professions  would  be  visited  by  the 
severest  condemnation.  While  in  general  terms  persecution  for 
opinion  is  a  stock  subject  of  animadversion,  such  a  persecution 
has  been  going  on  under  the  eyes  of  all  without  eliciting  any- 
thing more  than  a  time-honoured  joke  about  doctors'  differences. 
But  what  we  complain  of,  and  what  we  have  endured  all  these 
years,  is  no  mere  doctors'  differences,  but  a  steady,  bitter,  and 
cruel  oppression  of  a  weak  minority  by  a  powerful  majority,  and 
that  for  merely  proposing  and  practising  what  experiment  care- 
fully and  scientifically  conducted  has  taught  us  to  be  the  right 
method.  And  though,  in  order  to  furnish  some  sort  of  justifica- 
tion of  this  persecution,  we  are  denounced  as  ignorant  charlatans 
and  mere  pretenders  to  medical  knowledge,  this  accusation  is,  as 
those  who  make  it  know,  as  unfounded  as  their  charges  of 
dishonesty  and  falsehood ;  for  many  of  those  who  have  enrolled 
themselves  in  our  ranks  have  earned  the  highest  distinction  as 
students,  and  have  borne  off  the  gold  medals  and  other  rewards  of 
conspicuous  merit  and  acquirements  at  the  colleges  and  schools  of 
medicine.  Some,  too,  like  Henderson,  have  earned  a  first-class 
reputation  ns  original  discoverers  in  pathological  science,  aud  as  a 
body  the  practitioners  of  homoeopathy  have  cultivated  with  more 
than  average  success  and  distinction  other  branches  of  science 


Relations  of  the  Profession  towards  HomtBopaths,    753 

bearing  more  or  less  on  medicine.  We  need  hardlj  say  that  the 
legal  qualifications  of  the  persecuted  minority  are  identical  with 
those  of  the  persecuting  majority.  It  is  these  men  who,  for  a 
matter  of  opinion,  are  branded  by  their  differently  thinking 
colleagues  as  unworthy  of  fellowship,  as  destitute  of  truth  and 
honour,  and  the  practical  outcome  of  these  calumnies  is,  that  we 
are  expelled  and  excluded  from  medical  societies,  denounced  by 
colleges,  insulted  by  having  our  hardly-earned  diplomas  refused 
or  demanded  back,  our  articles  excluded  from  the  medical 
journals^  our  works  rejected  by  medical  publishers.  And  the 
chief  organs  of  public  opinion  see  all  these  enormities  going  on 
under  their  very  noses  and  say  nothing. 

What  an  outcry  would  be  raised  were  a  majority  in  the 
Church  to  attempt  to  persecute  a  differently  thinking  minority 
by  reviling  them  as  hypocrites  and  liars,  and  by  depriving  them 
of  all  posts  of  honour  and  emolument.  How  the  thunders  of  the 
press  would  be  directed  against  an  association  of  engineers  who 
should  exclude  from  their  society  and  declare  unworthy  of  pro- 
fessional intercourse  any  of  their  members  who  should  propose  to 
supersede  the  traditional  methods  of  producing  mechanical 
power  by  some  safe,  cheap,  and  more  effectual  process.  And  yet 
these  things,  and  worse,  are  perpetrated  daily  by  the  dominant 
majority  of  the  profession  on  a  minority  of  their  colleagues  who 
have  had  the  honesty  to  recommend  what  they  believe  and  know, 
by  carefully  conducted  scientific  experiment,  to  be  a  better 
method  of  treatment  than  the  traditional  one,  and  even  while 
they  persecute  they  plagiarise  the  very  method  they  denounce 
and  affect  to  despise.  The  following  excellent  leading  article 
from  Figaro  of  9th  September  gives  us  hope  that  the  apathy  of 
the  newspapers  is  about  to  give  place  to  a  livelier  interest  in  a 
matter  which  concerns  the  general  public  at  least  as  much  as 
theology  or  mechanical  science. 

*'MxDiOAL  iNTOLnuirox. — ^The  progreas  of  the  art  of  healing  has  heen 
exceedingly  slow.  There  are  very  many  diseaiMW  and  very  few  ipecifica.  The 
<^iiigyi<wri«  of  one  doctor  will  he  flatly  contradicted  hy  another  doctor;  and  a 
oindid  physician  will  admit  that  when  he  first  prescribes  for  a  patient  his  pre- 
scripUon  is  merely  tentative.  Far  be  it  from  us  to  charge  the  profession  with 
incompetence  or  negligence.  We  know  that  men  endowed  with  the  finest 
intellectB  and  of  unflagging  seal  have  devoted  their  lives  to  the  study  and 
practice  of  m^^'c^****  Disease  is  very  subtle,  and  generally  the  phyuoian  has 
to  work  in  the  dark.   But  we  do  complain  of  medical  intolerance,  because  it  is 

VOL.  XXXII^  NO.  CXXX.— OCTOBBR,  1874.  BBS 


754  MiscellaneouB. 

not  only  uignuaoiis  in  itself,  but  hinders  the  deyelopment  of  the  healing 
art 

"  If  a  doctor  discovers  something  new  about  the  character  of  a  disease,  or  an 
eifective  treatment,  he  is  forthwith  denounced  as  a  qnack.  Most  likely  he 
will  be  professionally  mined ;  or,  if  he  is  fortunate  enough  to  have  a  practice* 
in  spite  of  his  daring  to  be  more  clear-sighted  than  the  rank  and  file^  he  is 
insnlted,  calnmniated,  and  oold-shouldered  by  the  profession.  After  a  time 
his  remedy  may  be  adopted,  but  his  merit  is  never  acknowledged.  When  it 
was  no  longer  possible  to  deny  the  circulation  of  the  blood,  Harvey  was  sneered 
at  as  an  impostor,  and  a  spiteful  doctor  said, '  Oh,  Harvey  has  only  circnlated 
the  eirculation/  So,  If  any  one  discovered  the  nature  of  gout,  and  a  remedy 
for  that  disease,  he  would  be  hooted  by  the  prafesrion,  and  when  his  remedy 
was  adopted,  the  profession  would  say, '  So-and-so  only  pretended  to  an  exdn- 
sive  knowledge  of  what  we  all  knew.' 

*  Thinking  only  of  the  pecuniary  weltare  of  a  man  entering  the  medical  pro- 
fesslon,  we  should  earnestly  advise  him  to  avoid  originality,  and  if  he  made  a 
discovery,  to  keep  it  secret.  Better  for  him  to  kill,  getmmdum  artem^  than  to 
cure  by  a  novel  remedy. 

"  Our  attention  has  been  directed  to  the  ungenerous  treatment  of  homoBopatba 
by  allopaths.  We  offer  no  opinion  upon  the  merits  or  the  demerits  of 
homoeopathy.  Such  a  discussion  would  be  unsuitable  for  our  columns.  The 
SommopatMo  Mtniew  remarks  that  the  allopaths  refuse  to  meet  homoeopaths 
in  consultation  at  the  bedside,  or  to  admit  them  to  medical  societies,  or  to 
allow  them  to  fill  public  professional  appointments.  Now,  we  say  that  a 
candid  allopath  must  admit  that  there  is  no  justification  whatever  for  such 
conduct. 

"  The  homoeopathic  physician  is  as  well  educated  as  the  allopathic  physician, 
and  he  has  to  deal,  and  does  deal,  with  the  same  symptoms  and  the  same  dis- 
eases. The  main  differences  between  the  two  systems  are,  that  the  homoeopath 
thinks  that,  in  the  doctrine  of  nmiUa  timilUnu  eurantur,  he  has  the  key  to 
certainty,  or  an  approximation  to  certainty,  in  his  treatment.  The  other 
difference  is,  that  the  homoeopath  does  not  administer  drugs  in  their  crude 
forms,  and  holds  that  small  doses  are  more  efficacious  than  large  doses. 

"  The  Medical  Fress  and  Circular  of  the  19th  August  says  that  the  medical 
profession  (that ^ is,  the  allopathic  branch)  'regards  witii  the  most  perfect 
toleration  the  theory  and  practice  of  Hmilia  simiUbiu.*  Well,  that  was  not 
always  the  case,  and  the  timiUa  similibus  doctrine  was  derided  by  the  allopaths. 
To  be  sure,  there  is  nothing  in  the  theory  to  offend  the  allopaths.  For  the 
homoeopaths  act  strictly  on  experiment.  They  do  not  prescribe  a  certain 
medicine  because  to  do  so  would  accord  with  a  theory,  but  they  prescribe  a 
medicine  because  they  know  its  effects  by  observation.  The  allopaths  will  not 
deny  that  the  theory  of  similia  nmilibiu  is  very  often  true,  and  a  homoeopath 
would  not  hesitate  to  prescribe  a  medicine  because  it  did  not  square  with  the 
aforesaid  theory. 

"  As  to  the  infinitesimal  dose  theory,  the  homoeopaths  hold  to  it  without  blind 
bigotry.  They  say  they  try  it  and  find  it  efficacious.  They  say  that  they 
think  it  more  effioacions  than  the  allopathic  plan  of  administering  large  doses 


Relations  of  the  Profession  towards  Homoeopaths.    765 

of  drugs  in  what  they  call  a  crade  form ;  but  they  do  not  say  that  the  allo- 
pathic doses  are  always  inefficadoas.  They  do  not  say  that  the  disease  cannot 
be  cured  by  allopathic  doses ;  all  their  contention  is,  that  the  homoeopathic 
system  is  the  best. 

*'  If  allopaths  do  not  admit  the  soundness  of  the  timilia  timilUnu  theory, 
they  accept  the  results  of  it ;  and  whether  the  theory  is  true  or  false,  whether 
it  is  or  is  not  the  key  to  the  solution  of  the  problem  of  greater  certainty  in  th^ 
treatment  of  disease,  there  is  nothing  in  it  to  prevent  the  homcBopath  being 
met  in  consultation  by  the  allopath.  As  to  the  doses,  there  is  a  difference ; 
but  it  is  not  the  difference  between  art  and  quackery.  The  homoBopath  does 
not  prescribe  nostrums.  The  homceopathic  physician,  like  the  allopathic  phy- 
sician, prescribes  according  to  his  judgment  of  the  symptoms  and  constitution 
of  the  patient. 

"Is  it  not,  then,  most  intolerant  for  the  allopaths  to  refuse  to  meet  the 
homoeopaths  in  consultation  P  Beyond  question,  allopathic  doctors  differ  from 
each  other  as  widely  as  it  is  possible  for  allopath  and  homoeopathic  to  differ. 
The  whole  community,  as  well  as  the  profession,  suffer  from  the  unjustifiable 
intolerance.  In  this  matter,  at  all  events,  we  are  free  from  bigotry,  and  we 
are  confident  that,  if  allopaths  did  not  hold  aloof  from  the  homoeopaths,  both 
one  and  the  other  would  be  benefited,  the  noble  art  of  healing  would  be  more 
rapidly  improved,  and  suffering  humanity  would  have  cause  to  rejoice  at  the 
reunion  of  the  medical  profession." 

The  members  of  the  medical  profession,  who  have  tested  and 
after  trial  have  adopted  the  homceopathic  system,  have  loDg 
borne — 

•*  The  oppressors'  wrong,  the  proud  man's  contumely. 
The  insolence  of  office,  and  the  spurns 
That  patient  merit  of  the  unworthy  takes ;" 

and  they  can  bear  these  evils  still  longer  if  necessary,  only  it  is 
hard  to  convince  them  that  they  are  necessary  evils.  True  they 
are  the  pioneers  of  a  great  reform  in  medicine,  and  as  such  they 
cannot  escape  persecution, 

**  For  sufferance  is  the  badge  of  all  our  tribe. '* 
But  persecution  is  surely  continued  beyond  its  legitimate 
bounds — if  it  have  any  legitimate  bounds,  perhaps  we  should 
rather  say  its  conventional  bounds — ^when  our  persecutors  are 
speaking  the  very  language  and  employing  the  very  remedies  for 
speaking  and  employing  which  they  have  been  persecuting  us  for 
more  than  a  generation. 

En  attendant  the  good  time  coming,  when  persecution  shall 
cease  and  co-operation  commence,  we  go  on  slowly  but  con- 
tinually improving  our  Materia  Medica.  When  our  self- 
constituted  opponents  shall  abandon  their  present  system  of 


756         Correspondence — Letter  from  C.  Neidhurd. 

adding  to  their  Materia  Medica  by  unscientific  empirical  trials  of 
new  drugs  on  the  sick  or  by  pilfering  from  our  stores,  and  shall 
join  with  us  in  the  endeavour  to  perfect  rational  pharmacody- 
namics, the  work  which  we  are  at  present  left  to  perform  alone 
will  go  on  with  tenfold  rapidity,  and  the  patient-world  will  reap 
the  benefit  of  our  united  labours. 


A  School  of  HomcBopathff  in  Paris. 

The  Societe  M^dicale  Homoopathique  de  France  lately  ap- 
pointed a  committee  to  report  on  the  teaching  of  homceopathy. 
The  committee,  consisting  of  Drs.  Cretin,  Fredault,  GK>unard, 
and  Joufiset,  reported  favourably  of  the  scheme,  and  advised  that 
courses  of  lectures  should  be  commenced  about  the  middle  of 
November : — 1st.  On  Clinical  Medicine.  2nd.  On  Materia 
Medica  and  Therapeutics.  3rd.  On  the  History  and  Doctrines  of 
HomcBopathy.  The  lecturer  on  the  first  of  these  subjects  should 
be  the  physician  in  charge  of  the  Society's  Hospital  (Maison  St. 
Jacques)  for  the  time  being.  For  the  other  two  courses  of 
lectures,  volunteers  should  be  invited  to  give  their  services. 


CORRESPONDENCE. 

JFrom  Dr.  Nsidhabd,  of  Philadelphia, 

The  intelligent  critic  of  my  essay  *'  On  the  Universality  of  the 
Homoeopathic  Law  "  seems  to  have  laboured  under  a  misapprehen- 
sion with  regard  to  my  views  on  the  subject.  I  never  protended 
to  prove  that  the  revulsive,  counter-irritant,  or  alterative  methods 
could  be  co-ordinated  under  the  homoaopathic  law.*  These 
remedial  agents,  like  hydropathy  or  allopathy,  are  merely 
imperfect  rules  devised  by  man,  and  will  cure  diseases  of  man  as 
well  as  animals  in  a  very  imperfect  way.  It  is  only  the  uncon- 
scious allopathy,  a  certain  kind  of  empirical  method  of  employing 
remedial  agents  which  I  classed  under  our  Uw  of  cure.  On  the 
other  hand,  the  more  closely  we  investigate  this  wonder^  law  of 
cure  and  trace  its  operations  through  the  departments  of  morals, 
education,  science,  art,  &c.,  the  more  shall  we  be  impressed 
with  its  universality  and  consonance  with  the  whole  range  of 
human  existence. 

*  [We  did  not  assert  fehafc  he  had.-^£DB.] 


Correspondence — Letter  from  Dr.  W,  Epps.         757 

The  examples  adduced  appeared  to  me  striking  and  self-evident. 
They  seemed  to  me  to  point  to  some  general  law  which  it  was  well 
worth  while  to  investigate  a  little  further,  although  they  are 
not  of  any  immediate  practical  application. — C.  Nsidhabd. 


From  Dr.  Washikoton  Efps. 
Jh  the  Editors  of  the  *  British  Journal  of  HomoBopathy.^ 

Gentlemen, — In  your  article  on  Diabetes  mellitus,  copied 
from  the  Lancet,  in  the  last  number  of  your  Journal,  you  put  the 
footnote  "  [where,  except  in  homoeopathic  literature  ? — Ens.]  *' 
against  the  word  **  recorded  "  in  the  last  paragraph. 

As  Mr.  £.  J.  Carey  (the  reporter  of  this  letter)  was  a  fellow- 
student  of  mine,  I  wroto  to  ask  him  whether  the  sentence  had 
not  been  much  altered  \  he  replied  that — ''  the  sense  of  the  first 
part  of  my  letter  to  the  Lancet  was  given  correctly  enough  ;  but 
as  to  the  conclusion  of  it,  the  Editor  used  the  scissors  rather  too 
freely.  This  is  the  rough  copy  of  it,  from  which  I  believe  the 
transcription  sent  in  did  not  vary  more  than  a  word  or  so. 

"  '  I  am  not  aware  that  any  other  allopathic  practitioner  has 
used  this  drug  in  the  treatment* of  this  very  unsatisfactory 
disease ;  but  as  many  cases  of  rapid  cure,  and  many  more  of  per- 
manent palliation  of  this  disease  by  the  use  of  this  drug  have 
been  recorded  by  the  homcBopaths,  I  think  fit  to  publish  this 
solitary  case,  in  the  hope  that  practitioners  with  a  wider  field  for 
experience  than  my  own  may  try  if  this  drug  is  to  be  added  to 
OTTB  Pharmacopoeia.' " 

Mr.  Carey  also  added — "  The  alteration  of  my  words  has  put 
me  to  the  trouble  of  writing  to  one  or  two  medical  men,  who  had 
asked  me  for  references,  that  the  authority  on  which  I  based  my 
statement  was  the  article  *  Uranium'  in  Dr.  Hughes'  Pharma- 
eodynamicSj  and  cases  quoted  there." 

He  further  said — "I  hope  when  they  in  time  publish  their 
cases,  that  they  will  give  the  honour  of  priority  of  discovery 
where  it  is  due." 

In  justice  to  Mr.  Oarey,  I  think  the  above  explanation  should 
appear  in  the  British  Journal  of  Homoeopathy, 

I  remain,  Grentlemen, 

Yours  faithfully, 

Washington  Epps. 

20,  Devonshire  Street;  Aoguat  10th,  1874. 


BOOKS    RECEIVED, 

Duieetion  of  Br.  Gtuanavd'i  Fareep*.    By  EDHinn>  A.  Mubpht, 
M.D.,  of  New  OrleaDB. 
«  On  Puerperal  OonvuUions,      By  T.  MooBS  Masdxk,  M.D. 
Falconer,  Dublin,  1874. 

The  Stepping-stone  to  Homosopathf  and  Health,  Ninth 
edition.     By  Dr.  Eudpock.     1874. 

The  Practical  Test  of  nomoeopathy.     1874. 

Sulphur  in  Iceland.  By  C.  Cabteb  Bulke,  Doct.  Sci.  SpoD, 
London,  1874. 

The  Contagioui  Dieeaeee  Act ;  or^  A  Few  Suggestione  for  Con- 
trolling Men  as  well  ae  Women.     London,  Henderson. 

Ophthalmology  and  the  Modem  Seieneee,  By  S.  P.  Wilsok, 
M.D.     Cincinnati,  1874. 

Homoeopathy  in  Venereal  Diseasee.  By  Stephsk  Ysldhajc, 
L.K.C.P.  Ed.,  &c.     Third  edition.     London,  Turner,  1874. 

Ovariotomy  by  Enucleation,    By  B.  Ludlam,  M.D. 

Surgical  Diseases  Curable  without  Cutting.  Fart  I.  By 
BiCHABn  Epps,  M.D.    London,  Epps. 

Flxperimental  Besearches  on  the  Physiologieal  and  Therapeutic 
Action  of  Phosphate  of  Lime,  ,  By  L.  DusAifT.    2nd  Ed.     Paris. 

Sketches  of  Hahnemann  and  Madame  Hahnemann,  Boston: 
Clapp. 

Text-Book  of  Modem  Medicine  and  Surgery  on  HomcBopathic 
Principles.  By  E.  H.  Euddoce,  M.D.  London:  HomcBopathic 
Publiehin^  Company.     1874. 

Trial  ofDrs.  Bushnell,  Gregg,  Russell,  Thayer,  Fuller,  Hoffen- 
ddhl,  Talbot^  and  West,for  Practising  Homoeopathy,  Boston.  1873. 

The  Diseases  of  Women  Homaeopathically  Treated.  By  T.  B. 
Leadam,  L.B.C.P.  Ed.     2Dd  Ed.     London :    Gould.     1874. 

Boston  University  School  of  Medicine.  Second  Annual  An- 
nouncement.    August,  1874. 

Boston  University  Year-Book.     1874. 

Fl  Anfiteatro  Anatomico  Fspanol, 

Transactions  of  the  British  Homoeopathic  Congress.     1874. 

Revue  Homceopathique  Beige. 

The  Dublin  Journal  of  Medical  Science. 

The  Monthly  Homoeopathic  Review. 

The  Hahnemannian  Monthly, 

The  American  Homoeopathic  Observer. 

The  Chicago  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy, 

United  States  Medical  and  Surgical  Journal. 

The  New  Fngland  Medical  Gazette. 

The  American  Journal  of  Homoeopathic  Materia  Medico. 

Fl  Criterio  Medico. 

Bibliothhque  Homceopathique. 

The  Calcutta  Journal  of  Medicine. 

The  Chemist  and  Druggist, 

Compendio  di  Materia  Medica  Pura,     Par  Dr.  B.  Dadea. 


INDEX  TO  VOL.  XXXII. 


Aberdeen,    King's    College,    and    Dr. 

CiiASKE,  744 ;  Marischal  College  and 

Mr.  Habyby,  744 
Accommodation,  paialyuB  of,  ar^enium 

mUrieum  in,  789 
Acne,  treatment  of,  241 
Aconite,  Mr.   J.    H.   Naitkiybll  on, 

70 
AcwoBTH,  Dr.,  death  of,  883 
AgaricuM  musearius,  physiological  ef- 
fects of,  848 ;  — ,  poisoning  by,  691 
Affarieus  phdUoideSy  physiological  ef- 
fects of,  350 
AiiLBir's  JEncyolopadia  of  HomtBopathic 

Materia  Medico,  339 
Allgemeine    Momdopathische   Zeitun^f 

682 
American  Institute  of  Homceopathy, 

meeting  of,  738 
America*   Journal    of  SomoBopathie 

Materia  Medico,  654, 737 
American  Observer,  647 
American    remedies,  the  new,  by  Dr. 

R.  T.  MA88T,  159 
AnwKU  Record  of  SomMopatkio  Liter  a- 

ture,  Raub'b,  634 
AnBTiB  on  bromide  qfpotateium,  272 
Antozone   and  ozone,  Dr.  W.  Scott 

on,  385 
Apis  after  tapping  in  ovarian  disease, 

309 
Apomorpkia  and  ehioral.   Dr.    Dtob 

Bbown  on  some  points  in  the  thera- 
peutics of,  497 
Argentwm,  headaehes  of,  88 
Argeninm   nUrieum    in    paralysis    of 

accommodation,  739 
Arsenic  poisoning,  cases  of,  692 
Asphyxia,  mode  A  exciting  reflplration 

in,  741 
Asylum  for  the  insane  at  Middletown, 

homosopathic,  644 


Atom,  ultimate  size  of  the,  179 
Airopia,  cases  illastrating  the  uses  of, 
by  Dr.  Blakblby,  648 

JSaptisia,    transient    left    hemiplegia 

cured  by,  724 
Baths  and  wells  of  Europe,  by  Mac- 

PHBBSON,  156 

Baybs,  Dr.,  address  at  close  of  session 
1873-4  by,  617 

Bazaar  for  the  London  Homoaopathic 
Hospital,  667 

Bee-sting,  paralysis  caused  by,  32 

Belladonna,  Hahnbhann's  patho- 
genesis of,  note  to  examination  of, 
by  Dr.  R.  Hitohbs,  475;  — ,  Dr. 
Bbbbidgb  on,  478;  — ,  by  Dr.  R. 
HuoHSS,  in  the  Moknemann  Materia 
Medico,  64iSi 

Bbbbidgb,  Dr.,  letter  about  Hahkb- 
MANN'S  Materia  Medica  by,  478 ; 
— ,  Dr.  HuGHBs'  reply  to,  481 

BibUoth^que  ffomaopcUhique,  718 

BiKZ  on  bromide  of  potassium,  272 

Blaokley,  Mr.  C.  H.,  notes  on  re-vac- 
cination by,  90 

Bladder,  irritation  of  neck  of,  iron  in, 
415 

Blaxb,  Dr.  £.»  on  certain  pathological 
points  of  interest,  281 ;  — ,  on  lupus 
and  its  treatment,  643 

Bloo  on  OManthe  crocata,  459 

BOBNXKaHArsBK's  therapeia  of  inter- 
mittent and  other  fevers,  531 

BOBBIOEE  and  Tabbl's  QuarterUf 
Bulletin  of  Medical  Literature,  338 

Boletus  satanus,  physiological  effects 
of,  361 

Bostout  bazaar  for  homoBopathic  hos- 
pital at,  746 

Boston  Homoeopathic  Hospital,  713 

British    Homceopathic    Society,  pro- 


760 


Index, 


grets    of,    617;     — i    papers    read 

during  session  1878-^  520 
British  Medical  Association,  resolntiona 

against  homoeopathy  of,  744 
Bromide    of    polasiimm,    Bnis     and 

Akbtib  on,  272 ;  — ,  failare  of,  in 

epilepsy,    278;    — ,    action   of,    in 

sexnal  excitement^  273 
Bronchitis  a  cause  of  phthisis,  41 ;  — , 

chronic,  cases  of,  hy  Dr.  8maij«  874 
Bronchitis  and  chronic  metritis,  case 

of,  hy  Dr.  MAOKSOHim,  881 
Bbotchu  on  the  treatment  of  nlcera« 

tion,  meningitis,  and  conjnncuvitii^ 

165 
Bbowk,  Dr.  Dyob,  on  some  points  in 

the  therapeutics  of  apomorpkia  and 

chloral,  4ff7 
BuUHin  d0  la  aoeUUUMieaUhomtBO- 

patkique  tU  Framoe,  719 
BuBirsss  and  Matob  on  the  specific 

action  of  drugs,  884 
BuBT,  Dr.,   the  physiological  patho- 
logical hasis  of  the  Materia  MedicM, 

161 


Calabar  after  orariotomy,  715 
CaUmiia  Jowmal  of  Medieime,  721 
Cancer,  lapit  aliu$  in,  687 
Cancer  of  rectum,  case  of,  880 
Carbo  veg,  in  epistaxis,  724 
Carbwretwm    n^hmris,    physiological 

effects  of,  App,  86 
CauttiewH,  Colbz  on  the  nature  of, 

741;    — ,  in  paralysis    of    glottis, 

685 
Osdron  seeds  used  in  medicine,  787 
Cerehral  exhaustion  from  orer-study,  hy 

Dr.  Dbtbdaxa,  178 
CerebrOMipinal  meningitis,  Hilbbbgsb 

on,  715;  — ^,prodromataQf,716;  — , 

symptoms  of,  717 ;  ^,  remedies  for, 

717 ;  — ,  case  of,  717 
Chloral  and   apomorphia.    Dr.  Dtob 

Bbown  on  some  points  in  the  thera- 
peutics of,  497 
Chlorosis,  case  of,  by  Dr.  MAOxxomriB, 

827 
Cholera  in  Hungary,  statistics  of,  696 
Choleraic  diarrbcBa,  rhut  in,  696 
Chrome  diteates,  pathogenesis  of,  by 

Dr.  HnGHBS,  681 
Coffee,  poisoning  by,  by   Dr.   Haia, 

546 ;  — ,  in  strangulated  hernia,  698 
Cold,  taking,  by  Dr.  Haywabd,  160 
Colic  simulating  painter's  colic,  by  Dr. 

Holland,  79 


Congress,  British  Homoeopathic,  383, 

566 
CoigunetiTitis,  Dr.  Bbotohib  on,  171 ; 

— ,  chloral  in,  609 
Consumption,  curability  of,   BBionrrr 

on,  215;  — ,  case  of,  cured,  217;  — , 

treatment  of,  220 ;    — ,  climate  of 

Madeira  in,  228 
CooPBB,  Dr.  R.,  on  the  action  of  him, 

409 
Cbaig,  Dr.,  on  spedfic  medication  in 

relation  to  surgery,  804 
Cmprwm    and    its    salta,   pathogenetic 

effects  of,  App.  99 ;  — ,  propMal  for 

the  proving  of,  257 
Caprum  aeetwam,  physiological  action  of, 

260;  — ,  cases  of  poisoning  by,  261 ; 

— ,  experiments    on    animals   with, 

268 
Cypher  repertory,  by    Dr.    Hvghss, 

224;  —,  history  ot  the,  246;  — ^,Dr. 

Dbtsdalb's  remarks  on  the,  249 
Cystitis,  chronic,  by  Dr.  Hollakd,  84 

Dadba's  CofHpemdio  di  Materia  Medica 

iWa,545 
Daxb's  discriminate  and  indiscriminate 

obtaining  of  drug  symptoms,  538 
Deafness,  tenotomy  of  tensor  tympani 

in,  700 
Diabetes  melUtus  followed  by  phthiris, 

49 ;  — ,  fiUraie  of  uramimm  in,  578, 

757 ;  — ,  caused  by  zinc  poisoning,  612 
Diplopia  caused  by  lead  poisoning,  18  ; 

— ,  caused  by  zinc  poasoning,  610; 

— ,  Professor  MoLUr  on,  707;  — t 

case  of,  cured  by  stramonimm,  709  ; 

— ,  homoeopathic  remedies  for,  712 
Disinfectants,  682 
Dose,  Dr.  Goullok  on  the,  706 
Dbtbdalb,  Dr.,  on  cerebral  exhaustion 

from  over-study,  178 
DuDGBON,  Dr.,  letters  to  MeOeal  Preee 

and  Circular,  742,  746 
Dubs'  Ufe  of  Sir  J.  Y.  Sikfbok,  114 
Dysentery,    meremriut   oorroeimu    in, 

685 
Dyspepsia,  chronic,  by  Dr.  Hollabb, 

85 ;  — ,  nocturnal,  iron  in,  417 

Eczema,  treatment  of,  286 

Edinburgh  College  of  Physicians,  reso- 
lutions against  homoeopathy  o^  743 

Electricity  in  sargery,  661 

Sneyclopmdia  ofHonuBopaUue  Materia 
Mediea,  Allbb's,  889 

Enuresis,  case  of,  by  Dr.  Hoclabb,  82 

Epidemic  remedies.  Dr.  MoLor  on,  695 


Index. 


761 


Epilepfly  produced  by  aananthe  crocata, 

459 
Epistazis,  plngging  with  pnnk  in,  700; 

— ,  earho.  veg,  in,  724 
Efps,  Dr.  G.  N.,  death  of,  574 
Epps,  Dr.  W.,  letter  from,  757 
Erythema    nodosum,  case  o^  by  Dr. 

MAonCHim,  823 
Srythroxylon  coca,  pathogenetic  effects 

of,  ^PP'  96 
Sucahfpiftt  glohuUut  action  of,  690 
Expulsion  of  Tbssieb,  Gabalda,  Fbe- 

DAULT    and    JonsBBT,     from    the 

Anatomical  Society  of  Paris,  191 

Femtm,  Hahvsmanv's  pathogenesis 
of,  614;  — ,  symptoms  of,  617 

Fever,  intermittent,  Dr.  Jbakbs  on, 
quinine  in,  723 

Figaro,  article  on  medical  intolerance 
in,  754 

Fissure  in  anus  cured  by  forcible  dila- 
tation, 307 

Fistula  in  ano,  healing  of,  a  cause  of 
phthisis,  52 

Flasbohobk,  Jyr^L'SomoBopathieprou- 
vSe  par  teg  adversairet,  542 

Flbtchbb'b  physiological  views,  156 

Follicular  pharyngitis,  Blakb  on,  285 

Formioa,  physiological  effects,  of  App. 
82 

Fbakiexiv'b  Science  and  Art  of  Sur- 
gery, 585 

Fbaitz,  account  of,  456 

Fungus  poisoning,  treatment  of,  852 

German  homceopathy,  naYvet^  inherent 

in,  by  Dr.  Eafea,  275 
Glaucoma  cured  hy  phosphorus,  7f  9; 

— ,  HAHNBMAim  on,  11 
Glottis,  paralysis  of,  eausticum  in,  615 
Goitre,  iodine  in,  720 
Gonorrhoea,  nitrate  of  silver  injections 

in,  666 
Gbauyogl's  lapis  alhus,  686 
Gbobb,  account  of,  455 
Gbvzbwbki  on  the  incompetence  of  the 

proofs  for  and  against  homcBOpathy, 

658 
Quaco  and  its  uses,  188 

Hsmoptysis,  some  cases  of,  by  Dr.  H. 

Nakkitbll,  486 
Hahnemanman  Monthlg,  546,  723 
Hahnemann  Materia  Medica,  Part  III, 

Belladonna,  by  Dr.  R.  Huohbb,  542 
Hahkbmakk'b  pathogenesis  offerrum, 

614 ;  — ,  Venereal  Diseaees,  review  of, 


by  Dr.  W.  B.  A.  Scott,  55;  — 
earliest  disciples^  by  Dr.  Lobbachbb, 
451 

HaiiB,  Dr.,  and  the  fiiculty  of  St. 
Andrew's,  744 

Hasbib,  Mr.,  on  some  diseases  of  the 
urinary  organs,  295 

HABTHAirir,  account  of,  455 

Haubmakh'b  lectures  at  the  Pesth 
University,  698 

Hay-fever  and  insolatio,  Blakb  on,  288 

Haywabd,  Dr.,  taking  cold,  by,  160 

Hblmuth'b  System  of  Surgery,  660 

Separ  sulphuris  in  the  purulent  pro- 
cess, by  Dr.  Ringbb,  368;  — , 
THOBOWGOODon,859;  — ,  BuBirBSB 
on,  860 

Hbbiko's  Materia  Medica,  536 

Hernia,  strangulated,  coffee  in,  698 

Herpes,  treatment  of,  239 

Hi&GiKS  on  the  ophidians,  168 

HiLBBBGBB  on  cerebro-spinal  menin- 
gitis, 715 

Hindoo  medicine,  by  Dr.  W.  Scn)TT, 
577 

HiBSCH  on  the  connection  of  scrof  niosis 
and  phthisis,  86;  — ,  on  secret-case 
practitioners,  364 

HiBBOHBl*,  Dr.,  death  of,  383;  — , 
Zeitsohrift  fur  homdopathische  Kit- 
nik,6SQ 

Holland,  Dr.,  colic  simulating  pain- 
ter's colic,  by,  79 

Hommopathii  prouvSe  par  ses  adver- 
saires,  by  Dr.  Flabbchoen,  542 

Homoeopathy  and  scientific  medicine, 
Htjmphbbt  on,  189 

Hooping-cough,  sublingual  ulceration 
in,  Blakb  on,  281 

Hobnbxtso,  account  of,  454 

Hospital,  homoeopathic,  at  Berlin,  713 
— ,  homoeopathic,  of  Pennsylvania, 
547 

HoYBY  on  rabies  mephitica,  442 

HUGHBB,  Dr.  B.,  Belladonna,  by,  542 ; 
— ,  Cgpher  Mepertory,hy,24Ai  — , 
pathogenesiesof  the  Chronic  Diseases, 
681 ;  — ,  Pharmacodynamics,  French 
translation  of,  164;  — ,  note  to 
examination  of  Hahnkmank's  pa- 
thogenesis of  belladonna,  4f76 

HuBLPHBXT  on  homoeopathy  and  scien- 
tiflc  medicine,  189 

Hungary,  epidemic  of  cholera  in,  696 ; 
^,  professorships  of  homoeopathy  in, 
269 

Icterus  satuminus,  case  of,  20 


762 


Index. 


Impetigo^  treatment  of,  241 
Incompetence  of  the    proofs  for  and 

against  homoeopathy,    by  V.    Gbu- 

zswBKi,  653 
Infinitesimal  doses,  letter  on,  175 
Insolatio   and   hay-fever,    Blakb  on, 

288 
Intermittent  and  other  fevers,  Bojr- 

KiKGHAUBBU's  therapeia  of,  531 
Internationale  Homoopathitche  Pretse, 

693 
Intolerance,  medical,  Figaro  on,  754 
Iodine  in  goitre,  720 
Ireland,  Royal    College   of    Snrgeona 

of,  anti-homoQopathic  resolutions  of, 

746 
Iron,  Dr.  Coopbb  on  the    action  of, 

409 
Italian  Parliament,  discnssion  on   ho- 

mcBopathy  in  the,  694 

Jbnichbn'b  introduction  of  high  dilu- 
tions, 181 
Journals  of  the  quarter,  548,  682 
JoussBTT  on  the  hypodermic  ii\jection 
of  filtered    water   to    relieve  pain, 
188 

Kafka,  on  the  naivete  inherent  in 
German  homoeopathy,  275 

Kali  hichromicum  in  lupas,  646 

Kali  carbonumm,  cases  cured  by,  688 

KisCH  on  Marienbad  in  female  dis- 
eases, 703 

Koeszlbb'b  remarks  on  the  deficiency 
of  young  homoeopathic  physicians, 
258 

Kobndobbvbb's  translation  of  Boy- 
ninghaubbk's  Therapeia  of  Inter- 
mittent  and  other  FeverSt  631 

Kreasote  in  menorrhagia,  682 

Kbibobb,  Dr.,  death  of,  686 

lAincet^  suppression  of  acknowledg- 
ments to  homoeopathy  by,  757 

Lanqhammbb,  account  of,  457 

Lapit  allnu  in  cancer,  687 

Laryngitis,  oadematous,  eai^uinaria  in, 
724 

Lead-poisoning  from  well    water.   Dr. 

VON  TUHZELMAVN  OU,  17 

Lbdbbbb,  Dr.,  death  of,  703 
LiEBBBHBiSTEB  OU  cold  baths  in  typhoid 

fever,  251 
Linz  Homoeopathic  Hospital,  report  of, 

684 
Liverpool    Medical     Institation,     law 

against  homoeopaths  adopted  by,  744 


London  Homoeopathic  Hospital, 
from,  by  Dr.  MACEBCHiriB,  320 

LosBACHBB  on  HAHNBKAirir's  earliest 
disciples,  451 ;  —  on  rhachitis,  699 

Lupus,  treatment  of,  241 ;  — ,  by  Dr. 
E.  BiAKBi,  643 ;  discussion  on,  650 

Mackschis^ib,  Dr.,  cases  from  the  London 

Homoeopathic  Hospital  by,  320 
Macphbbsok'b   Baths  and    Well*  of 

Surope,  156 
Madeira,  climate  of.  Dr.  Scott  on,  193 
Madrid  Homoeopathic  Society,  prixfes 

offered  by,  714 
Marienbad  in  female  diseases,  by  Dr. 

KisCH,  703 
Massachusetts    Medical     Society,  ex- 
pulsion of  homoeopathic  members  by, 
745 
Mabbbt,  Dr.,  on  the  new  Anoerican  re- 
medies, 159 
Materia  Medico,  C.   HEBOro's,   536; 

— ,  Hindoo,  597 
Materia  Medica,  physiologico-patboloo 
gical  basis  of  the,  by  Dr.  Bubt,  161 
Matob  and  Bubitbss  on  the  specific 

action  of  drugs,  334 
Medical  intolerance,  Figaro  on,  754 
Medical  Iwoettigator,  550,  737 
Medical  Prete  and  Cirenlar,  on  the  re- 
lations of  the  profession  to  homoeo- 
paths, 741 ;  — ,  Dr.  Dui>aBO]C'B  let- 
ters to,  742,  746 
Meningitis,   Dr.   Bbotchib   on,    168; 
— ,  cerebro-spinal,  Hi£BJS&aKB  on, 
715 
Menorrhagia,  kreatote  in,  682 
Menstrual  colic,  veralrum  viride  in,  564 
Mephitic  rabies,  Hoyby  on*  442 
Mereurius  corrosivns  in  dysentery,  685 
Merettrins  solubili*  JSahnemamni,  58 
Mercury,  early  use  of,  as  a  specific  for 
syphilis,  65 ;  — ^  oleale  of,  in  ring- 
worm, 570 
Metritis,  chronic,  and  bronchitis,  case 
of,   by  Dr.   Mackbcbkib,  331;  — i 
Marienbad  waters  in,  705 
Metrorrhagia,  Uguor  soda  clUorata  in, 
RoELANDTB  OU,    363;    — ,    thlaspi 
bursa  pastoris  in,  370 
MoBaAK's  sketch  of  progress  of  ho- 
moeopathy in  America,  555 
MouBJUCANS,  Dr.,  death  of,  721 
MuLLBB,  Dr.  CL,  on  the  treatment  ot 

some  skin  diseases,  225 
Myopia,   a  spasm    of    accommodation 

muscle,  703 
Mjfosotis  symphUtfoUa,  737 


Index. 


763 


NAJnuYBix,  I>r.    H.,  some   casei   of 

limnoptysiii  by,  486 
Nakkiyell,  Mr.  J.  H.,  on  aeonite,  70 
Nbidhabd,  Dr.,  on  the  nniversality  of 

the  homoeopathic  law,  542;  — ,  letter 

from,  756 
Neuralgia,  phosphoru»  in,  1 
New  England  Medical  Oatette,  544, 

741 
North  Amerieam  Jammal  of  HomcdO' 

patk^,  549 
Nua  moeehata,  physiological  effects  of, 


(Skanihe  crocattty  Dr.  Bloo  on,  459 
(Bnothera  biemtit,  739 
Ophidians,  by  S.  B.  HieGiXfl,  158 
Ophthalmia,  scrofulous,  cured  by  kep€Hr 

and  awrwn,  691 
Opisthotonos  with  colic,  Dr.  Holland 

on,  79 
Ovarian  irritation,  iron  in,  412 
Ozone   and  antosone,  Dr.  W.  SooTT 

on,  385 


Painter's    colic,    colic   simulating,  by 

Dr.  HoLLAKD,  79 
Paralysis  caused  by  bee  sting,  82 
Paris,  Anatomical  Society  of.  expulsion 

of  homoeopathic  members  by,  745; 

— ,  School  of  Homoeopathy  in,  756 
Pathogenesis  of  the  Chronie  XHaeoioSf 

by  Dr.  HuOHZS,  631 
PathogemUo  CyeloptBdiai  The,  246 
Pathological  points  of  interest,  Dr.  £. 

Blasv  on,  281 
Pesth  University,  homceopaihic  profes- 
sors In,  700 
Pharmacodjfna/mie$^  Huohbb'b,  French 

translation  of,  164 
Pharyngitis,  follicular,  Blakb  on,  285 
Phoep^rw  in  neuralgia,  1 
Prizes  offered  by  Madrid  Hahnemann 

Society,  714 
Prosopalgia  cured  by  phoephorue^  11-16 
Prostate,  tubercular    disease    of    the, 

Mr.  Habbib  on,  295 
Proving  of    medicines,  call  upon  all 

homoeopathic  physicians  for  the,  265 
Prurigo,  treatment  of,  229 
Pruritus,  chloral  in,  512 
Psoriasis,  treatment  of,  238 
Pulmonary     consumption,     Waldbn- 

bttbo'b  experiments  applied  to,  32 
Purpura  hsBmorrhagica,    case    of,  by 

Dr.  Mackbchiob,  822 


QMHerUf  Bulletin  of  Medical  Litera- 
ture, BoBBiCEB  and  Tapbl'b,  338 

Quartz,  crystals  of,  singular  sensitive- 
ness to,  Pboll'b  cases  of,  701 

Quinine  in  ague.  Dr.  Jbahbb  on,  723 

Rabies  mephitica,  by  H.  Hoyby,  442 ; 

— ,  differs  from  rabies  canina,  443 ; 

— ,  symptoms  of,  448 
Rachitis,  Lobbaohbb  on,  699 
Rayinbbqub  on  thlaspi  bursa  pastorie 

in  metrorrhagia,  370 
Raub's  Annmal  Becordof  HomcBopathio 

Literature,  534 
Rectum,  cancer  of,  case  of,  380 
Relations  of  the  profession  to  homoeo- 
paths. Medical  Preee  on,  741 
Repertory,  the  cypher,  by  Dr.  HuaHBS , 

241 ;  — ,  an  iUustrated,  738 
Re- vaccination,  by  Mr.  C.H.  Blagklbt, 

90 
Revue  Homoopathique  Beige,  563, 720 
Rbtnoldb,  Dr.  R.,  before  the  British 

Medical  Association,  638 
Mhus  radicane  in  septicamia,  664 
Bhus  tox,  in  choleraic  diarrhoea,  696 
BiCHASDSON,  Dr.  B.,  on  the  simplicity 

of  life,  155 
Rm&BB    on   eulphidee    of  potasHum, 

todiwn,  and  calcium,  853 
Ringworm,  oUate  of  mercury  in,  570 
RucKBBT,  £.  F.,  account  of,  456 
Ritddook'b  Stepping 'ttone  to  Horn  cbO' 

pathg  and  Health,  679 
Bueeula,  physiological  effects  of,  352 

St.   Andbbw'b,   faculty  of,    and    Dr. 

Halb,  744 
Sanguinaria  in   oedematous  laryngitis, 

724;  — ,  in  scirrbus  of  breast,  308; 

— ,  in  mammary  tumour,  308 
Sareaparilla,  paUiogenetic  effects  of, 

App.  99 
Scabies,  treatment  of,  229 
Scientific  medicine  and  homoeopathy, 

HincFHBBX  on,  189 
Scirrbus    of    breast,    eanguinaria    io, 

308 
Scorbutus,  case  of,  by  Dr.  Mackbchkib, 

320 
Scott,  Dr.  W.  B.  A.,  on  the  climate  of 

Madeira,  193 ;  — ,  on  Hahnbmavn'b 

venereal  diseases,  55 ;  — ,  on  Hindoo 

medicine,  577;    — ,  on  ozone   and 

antozone,  385 
Secret-case  practitioners,  HiBScn  on  ,364 
Septicaamia,  rhue  radicane  in,  664 
Sickness,  apomorphia  in,  501 


764 


Index. 


Slw»r,  mUrmU  of,  iigMiioiii  of,  ia  goo- 


ffimplieity  of  Iif«,  by  Dr.  R.  BicmiSD- 

lov,  166 
SniTMW,  Sir  J.  T.,  Dun*  life  of,  114 
Skin  dinuei»  MGiia  on  the  trcst- 

nentof  MUM^  226 
Skunk,  rMm  euMd  by  the,  442 
Small's  cum  of  cbtonie  bfonehitie, 

274 
Snake  Tenom  entidoted  by  nnke  bitfl^ 

158 
8odm  eklormia  m  meteorrbagia,  Bos- 

LASiynon,802 
Solammm  miffrmm.  Dr.  Host  on,  724; 

— ,  bebitat oi,  726;  — ,  HAmmun 

on,   726;  — ,  comiMared  with  hM^ 

727 ;  — ,  fymptonntokigy  o^  729 
Spain,  booKBopatby  in,  71S 
Specific  action  of  dmgi,  BuxvsM  and 

Matob  on  tbe,  824 
Specific  medication  in  relation  to  tnr- 

gery,  by  Dr.  Ceaio,  804 
Stafv,  account  of,  464 
SUppimg-gUme    to   MomaopaUgf   amd 

Health,  by  Dr.  Buddock,  079 
Strabinnni  earned  by  wime  poiioning, 

611 
Stnunonimn,  pathogenetic   effecte  of, 

Jpp,  68 
S^lphids  offoiattmm,  RiireiE  on,  868 
Snigery,  FainuJv'B  tcienoe  and  art 

of,  686;  — ,  Hxlxuth's  •ystem  of, 

660;  ~,  Hindoo,  601 
Syphilif,  HAHimcAirH's  and  HnvTXE'B 

agreement  ■•  to  the  natore  of,  68 

Tenotomy  of  tensor  tympeni  in  deaf - 

new,  700 
Thlatpi  burta  pattoria  in  metrorrhagia, 

lUviBBSQrB  on,  870 
Thnnder  itorm,  rappoied  emell  of  sal- 

phnr  doring  a,  986 
Tubercle,  natore  of,  211 
Tuberculotif,  acute,  nature  of,  218 ;  — , 

Waldivbvbg's  experiments  applied 

to,  82 


TmnKJun,  Dr.  tov,  ob 
ing  from  well  water,  17;  — 
time  poisoning;  by,  610 

Typhoid  fefer,  cold  batlM  in,  280 


Ulceration,   sftbGngnal, 

eongh,  BLAKKon,  281 
UkerOion,  tnatment  oC  by  T.  B.  Bj 

CHix,  166 
Umtod  8tatm   Mtdicml 

Jomrmal,  661 
UntTcnality  of  the  homoBopathie  law,  by 

Dr.  NBTPHiMi,  642 
ITrem'aw,  ailrafo  of,  in  Aabetes  melfi- 

tos,  673;  — ,  Mr.  CammTe  letter  on. 

767 
Urinaiy  orgnna,  Mr.  BAxmiBondiseasoa 

of  the,  296 
Urticaria,  ddoral  in,  612;   — ,  tveai- 

mentofl;240 

Vaccination,  best  means  of  ptesutilng 
the  lym|di,  91;  — ,  quantity  of 
lymph  required  to  eflfect,  91 

Venereal  disiiases,  HAmmcAini's  TiewB 
of,  66 

VeraUmm  viride  in  menstnial  coiie, 
664 

VUmnmm  opmlms,  a  remedy  for  dya- 
menorrfacBa,  647 

Vomiting,  apowuprpUa  in,  601 

WALDmuBO'B  experimenii  applied 
to  human  tubereuloos  and  phthisis, 
82 

Water,  hypodermic  injection  o^  to 
relieve  pun,  188 

Wbbme'b  case  of  glanconia  cured  by 
pko§pkoru9f  9 ;  —  operation  of  teno- 
tomy of  tensor  tympani  in  deafness, 
700 

WiBLicnnrB,  notice  o^  466 

Womb,  irritability  of,  iros  in,  410 

ZitNO  pkotpAide  in  neuralgia,  2 
Zimc  poisoning,  cases  o^  by  Dr.  TOS 
TirirzBL]CAm,610 


TaOTED  BT  J.  1.  ADLABD,  BABTHOLOKBW  OLO0B. 


a 

1  3r 


-3 


EST 

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