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T H E
. U N I T E D S T A T E S
MEDICAL AND SURGICAL
(7/?? 7
JOURNAL.
A Quarterly Magazine of
THE HomoeoPATHIC PRACTICE OF MEDICINE AND MEDICAL
ScIENCE IN GENERAL.
§ 3.
EDITED BY
GEORGE E. SHIPMAN, M.D.
ASSISTED IN VARIOUS DEPARTMENTS AS Follows:
P. P. WELLS, M.D., Brooklyn, N. Y. . . . Theory and Practice.
CARROLL DUNHAM, M.D., New York City . Materia Medica.
C. WESSELHCEFT, M.D., Boston, Mass. . . Physiology.
E. C. FRANKLIN, M.D., St. Louis, Mo. . . Surgery.
R. LUDLAM, M.D., Chicago, Ill. . . . . Obstetrics, etc.
F. A. LORD, Chicago, Ill. . . . . . Chemistry and Botany.
T. F. ALLEN, M.D., New York City . . . Department of Microscopy.
H. P. GATCHELL, M.D., Kenosha, Wis. . . Climatology and Hygiene,
VOLUME IV.- 1868–9.
C H I C A G O :
C. S. H. A. L S E Y, 147 C L A R K S T R E E T.
BUFFALO : 270 MAIN STREET.
1869.
17NTERED, according to Act of Congress, in the year 1869,
BY C. S. H. A. L S E Y,
In the Clerk's Office of the District Court for the Northern District of Illinois

SPECIAL INDEX.
A.
Abortion, delivery of placenta in, 72,
Acalepha indica in tuberc. haemop-
tysis, 233.
Aconite lotion in sprains, 265; Reith
on, 369.
Action of remedies: Harveian que-
ries, 255.
Acupuncture in diagnosis of uterine
polypi, 104.
AEther phosph. in cholera, 483.
Agaric. in chorea, 233.
“ in delirium tremens, 233.
Aggravations from arsenic., 234.
Ague, Harkness on cause of, 386.
Ailanthus in scarlatina, Dunham On,
330.
{{ Wells' case, 330.
{{ Chalmers’, 334.
Amoeboid motion, Dönitz on, 464.
Allopathic Statistics, Dunham on,391.
{ % treatment of cholera, 482.
Ammon. carb. in sprains, 264, 268.
Amputation in utero, spontaneous,
Lord's case of 245.
Anapnograph, 253.
Anaesthetics, various, 1.
Aneurism cured by compression, 239.
Animal starch, 110.
Antidotes, chemical of Phos., 110.
Antim. crud. in aphonia, 233.
Antiseptics, 133.
Apis in cholera, 416.
“ compared with Bell, and Lach.,
0
10.
“ in diphtheria, Tietze on, 156,
412
“ in erysipelas, 418.
“ in headache in women, 417.
“ in rheumatic gout, 419.
“ in sprains, 267.
Aphonia, Ant, crud. in, 233.
Arnica in sprains, 267.
Arsenic.in gastritisin pregnancy,234.
“ poisoning by, 390.
Atomic notation, 515.
Atoms, Gatchell on, 167.
Attenuation, Searle on, 405.
& 4 Grauvogl on, 444.
B
Barium under spectroscope, 407.
Basedow’s Disease, 256.
Bell., Ap., and Lach., compared, 10.
66 44 {{ in diphtheria,
in inversion of
uterus, 218.
Benzoic acid in ganglia, 223.
Bi-Sulphate of lime preserves animal
broths, etc., 109.
Blood and Pus, Wesselhoeft on, 455.
Borax in great excitement from noise,
British correspondent, letters from,
225.
Bromide of potas, in nervous affec-
tions of pregnancy, 103.
Bromide of potas., Reynolds on, 230.
Bromine, how eliminated, 236.
Bry. in typhoid fever, 428.
Buffalo Med. and Surg. Jour. on sim-
plicity in prescription, 292.
Butter and Brains, 108.
6& £& {{
C
Cadmium, Dunham on, 390.
Camphor in cholera, 483.
{ { in sprains, 266.
Cancer of stomach cured by Phos.,
Canth. in diphtheria, 288.
Capsicum in diphtheria, 244.
Carbolic acid in burns, 137.
44 in diphtheria, 244.
{{ in dressing wounds, 135,
238,
66 Lord on, 129.
$6 poisoning by, 140.
iv. Andex.
Carbolic acid preserves broths, etc.,
{{ tests for, 131.
Carb. veg. in cholera, 483.
Caries, 271.
Catarrhal colitis, 46.
Catheter in female bladder, 107.
Cause of ague, 386.
Causticum in post-diphtheritic pa-
ralysis, 383.
{{ in diseases of eye, 233.
Cervical glands swollen, in diphthe.
• ria, 415.
Chelidonium in Cholera, 483.
Chemistry and Physical Science, 385.
Chloride of Uranium produces sugar
in urine, 12.
Chloroform as anaesthetic, 1.
{{ causes of death from, 107.
4 & death from at Winona, 8.
46 injections of in labor,103.
{{ Sedillot on, 3, 4.
4 & Youmans on, 6.
Chlorosis, Apis in, 416.
Cholera, Schweikert's reviewed, 477.
{{ Hallier on, 477.
“ Schmidt, 479.
44 Horn's experiments, 480.
6& infantum in, 237.
46 “ with hooping-cough,
184.
Chorea, Agaricus in, 233.
Cinnamon in metrorrhagia, 233.
Climate of various places, 249.
Coffee in delirium tremens, 117; intes-
timal strangulation, 115.
“ in hernia, 116.
Cold water in puerp. peritonitis, 102.
Colytics, 133.
Compresses for aneurism, 239.
Conium mac., Harley on, 445.
Consumption and climate, 524.
Contact potencies, Wells on, 24.
convulsº puerperal, Gelsem. in,
2.
Cupr. Sulph. in cholera, 483.
Curare, notes on, 67.
Cyanuretum merc. in diphtheria, 415.
ID
Dangers of Chloroform, 1, 107.
Death of Prof. McDowell, 523.
Delirium tremens, coffee in, 117.
* {{ { % Agaricus in, 233.
Delivery of placenta in abortion, 200.
Deoxidizers, 132.
Diphtheria, Tietze on, 156,412.
46 discussion on, 243.
Disease, Basedow's, 256.
Diseases, two may coincide, 192.
{{ Wells' definition of 195.
Disinfectants classed, 131.
Dislocation of the humerus of four
months’ standing, 239.
DOSe, the, Jones on, 31.
Doubters unfruitful, 469.
Drosera in hooping-cough, 234; 12th
succeeds where 3rd fails, 234,
Drug action, 149.
“ defined, 196. *
“ proving, Lord (I.S.P.), on, 140.
Dynamic Power, Gatchell on, 90.
Dynamism erroneous and danger-
Ous, 15.
Dysentery with hooping-cough, 187.
E
Education, medical, 501.
Elbow-joint, dislocation of, von Tagen
on, 290.
Electricity in cholera, 480.
Electro-capillarity, 504.
Enteric affections incident to pertus-
sis, Ludlam on, 183.
Enuresis, Murex in, 235.
Erectile tumors treated by caustic
ligature, 238.
Ergot, objections to use, 203.
Erysipelas, Apis in, 418.
{ { Sequelae of, Graphites in,
419
Exanthema like Scarlatina with diph-
theria, cured by Apis, 413.
Experiments, Andral's, 486.
44 Horn's in cholera, 480.
F
Ferrocyanogen, how eliminated, 237.
Fungus haematodes cured by Phos.,
517.
Ferr, sulph. best antidote for cyan.
pot., 109.
Foetus retained three years, 105.
Force, Gatchell on, 165, 336,432.
French politeness, 257.
G.
Ganglia, Benz, ac, in, 233.
Gastric juice, Schiff on, 97.
Gastro enteritis, Phosph. in, 234.
Gelseminum in parturition, etc., 440.
{{ in puerp. Convulsions,
442
Glands, cervical, swollen in diphthe-
ria, 415.
Graphites in Sequelae of erysipelas,
419. \
Index.
V.
EI
Haemorrhage after abortion, 85.
Hair and skin, muscles of 113.
Head, delivery of in pelvis presenta-
tion, 502.
Headache, Apis in, 418.
4 ( Dunham on, 240.
Heart, needle in, 237.
Hep. sulph. in diphtheria, 244.
Hernia, Howard's new apparatus for
treating, 237.
HO or H2O, 515.
Homoeopathic and Allopathic treat-
ment of cholera, 482.
Homoeopathy and Allopathy com-
pared, by Peters, 489.
Homoeopathy in cholera, Macloughlin
}
{{ in Russia, 254.
{{ in Switzerland, 125.
{{ in University of Paris,
373.
{{ in University of Pesth,
1.
{{ and Life Insurance, 119.
Hooping-cough, enteric affections in,
183.
Hospital report (Munich), 393.
Hydrastis in diphtheria, 244.
IIumerus, dislocation of 289.
Hypericum in sprains, 265.
Hypoleº injections, Anstie on,
31.
I
Indication of longevity, 523.
Injections, intra-uterine, in abortion,
Injuries and Diseases of Joints, Frank-
lin on, 261.
Inversion of Uterus, 216.
Iodine in sprains, 266.
“ how eliminated, 286.
Intestine, strangulation of — coffee
in, 115.
Ipecac in cholera, 483.
Isopathic remedies, Searle on, 54, 197.
K
Rali bichrom. in diphtheria, 160,243.
L
Lachesis compared with Bell, and
Apis, 10.
44 in diphtheria, 161.
44 Dunham on, 65, 69.
Lachesis, Searle on, 404.
Letter from British Correspondent,
225.
Letter from French Correspondent,
Life physiologically considered, 340.
“ not a unit, 343.
“ defined, 344, 349, 433.
“ physical basis of— Huxley on,
509.
Ligature, caustic, 238.
Lime in diphtheria, 244.
Liver, sugar formed in, 99.
Lycopod. in sprains, 268.
Lymphatics, origin of in Serous mem-
brane, 111.
M
Marasmus with hooping-cough, 191.
Materia Medica items, Dunham on,
115, 240, 389, 505.
Medicinal substances, how elimina-
ted, 234.
Medicine, are we to have scientific
basis for ? Lord on, 246.
Meningitis, verminous and tubercu-
lar, diagnosis between, 519.
Menyanthes in headache, Dunham
on, 240.
Metrorrhagia, cinnamon in, 233.
Merc. iod. in diphtheria, 244.
Michigan University, 118.
Microscope in diagnosis of sterility,
302
Microscopical items, Allen on, 111.
Millefolium, Hale on, 315.
Miscarriage, fatal, 503.
Morphine, poisoning with, 505.
Motion, amoeboid, Dönitz on, 464.
Munich, hospital report, 68, 397.
Murex in enuresis, 233.
Muriatic acid in diphtheria, 244.
Muscles in hair and skin, 113.
N
Navel, Sanders' dressing, 105.
Needle in heart thirteen months, 237.
Nitric acid in diphtheria, 244.
Nux wom. in cholera, 483.
{{ in typhoid ſever, 428.
O
OBITUARIES :
John Barker, M.D., 258.
Gen. C. G. Halpine, 127.
A. Cooke Hull, M.D., 127.
Obstetrical items, 102, 242, 383.
vi. Andew.
Ocimum ºum in nephritic colic,
234.
QEdema after sprains, 271.
One at a time, 292.
Organization and life, 339.
Origin of lymphatics in serous mem-
brane, 111.
OS uteri, rigid, Gelsem, in, 441.
Oxidation in organic life not destruc-
tive, 475.
Oxidizers, 132.
Oxygen, action of 349.
P
Paralysis, diphtheritic, 103.
Paris quad. in headache, 240.
Pemphigus, Sepia in, 233.
Peritonitis, cold water in, 102.
Pertussis in enteric affections, 183.
Petroleum in sprains, 268.
Pelvis presentation, delivery of head
in, 502. -
Phosphorus, case of poisoning with,
506
{{ chemical antidotes of,
{{ turpentine as antidote
of, 509.
44 in gastro-enteritis, 234.
46 in cholera, 483.
& 4 in typhoid, 423.
Phytolacca in diphtheria, 244.
Placenta, delivery of in abortion, 72,
200.
{{ adherent after abortion, 85.
{{ praevia, Trillin in, 384.
Poisoning by Morphine, 505.
{{ by Phosphorus, 506.
Poisonous articles in common use,
248
Polypus uteri, acupuncture in diag-
nosis of 204
Poultice injurious in sprains, 270.
Pregnan § affections of tobacco in,
381.
Prurigo of pregnancy, 381.
Psorine, Searle on, 56, 401.
{ { Dunham on, 68.
Pterygium crassum cured by Zinc,
Puerperal convulsions, Gels. in, 442.
Pulsatilla in typhoid fever, 428.
Q
Quackery, suppression of 396.
Quinine, does it produce symptoms
of ague 493.
F.
Re-discovery of screw, 361.
Remedies, Isopathic, 397.
Iłetention of foetus three years, 105.
REVIEWS:
Banning's Trunkal Muscles,
352.
Bell's Therapeutics of Diar-
rhoea, etc., 498.
Braithwaite, 355.
Breyfogle's Epitome, 358.
Calcutta Journal, 854,
Conférences sur L’Homoeo-
pathie, par M. Leon Si-
mon, 492.
Die Cholera — eine Epide-
mische Lähmung der
Capillaren der Darm-
Schleimhaut und der
Nerven, von Dr. Joh.
Schweikert, 000,
Douglas' Homoeopathy for
the People, 356.
Eldridge on Self-Enervation,
496
Half-Yearly Abstract, Janu-
ary and July, 1868, 96.
Hartshornc's Essentials, etc.,
853.
FIempel's Let. to Palmer, 499
Homoeopathic Quar., 356.
Homoeopathic Sun, 222.
Hughes' Therapeutics, 494.
Illustrated Catalogue, Vick's,
359.
Illustrated Travels, 497.
Lessons in Element'ry Chem-
istry, Roscoe's, 222.
Little Corporal, 355.
Materia Medica in its Sci-
entific Relations, 220.
On the Dynamics, Princi-
ples and Philosophy of
Organic Life, by Z. C.
McElroy, M.D., 474.
Palmer's Lectures on Homoe-
opathy, 484, 499.
Proceedings of Third An-
nual Session of Hom.
Med. Soc. of Pennsyl-
vania, 1868, 000.
Provings of Carbolic Acid,
499.
Seventeenth Annual Report
New York Ophthalmic
Hospital, 1868, 497.
Transactions of the Fifth and
Sixth Annual Meetings
of Western Institute of
Homoeopathy, 498.
Index. vii.
REVIEWS:
Transactions of Twenty-first
Session of American In-
stitute of Homoeopathy,
495.
Rheumatic Gout, Apis in, 419.
Rhodanum, how eliminated, 237.
Rhus in sprains, 264, 267.
Rupture of a muscle, 267.
Ruta in sprains, 264, 568.
S
Saliva, Chase on, 278.
* Scarlatina, Ailanthus in, 330.
Sepia in pemphigus, 233.
Silicea in headache, Dunham on, 240.
Spectroscope, Searle's experiments
with, 407.
Spongia in diphtheria, 244.
Spontaneous amputation in utero,
245
Sprains, franklin on, 261.
Statistics, Allopathic, 391.
44 Homoeopathic, Peters on,
Sterility, Sims on, 302,
Strontium under spectroscope,407.
Stumps of vessels left in abdominal
cavity, 244.
Surgical items, 520.
T
Tar-water, Berkley's, 409.
Thallium, Marmé on, 389.
Therapeutics founded by Hahne-
mann, 493.
Thermoºr, its value in diagnosis,
The physical basis of life, 509.
Tobacco and baldness, 122.
Tobacco in prurigo and vomiting of
pregnancy, 381
Tracheotomy in young infants, 104.
Tubercular hamoptysis, Acaleph. ind,
in, 233
Tumors, ºile caustic ligature for,
238.
Turpentine in sprains, 266.
{{ antidote to Phosph., 509.
Typhus and typhoid fever, Jahr on,
420
Typhus and typhoid fever, compli-
cations of 424
Typhus and typhoid fever, treatment
of 427
Typhus and typhoid fever, use of
thermometer in, 425.
Typhus cerebralis, 428.
|U
Urine, its importance, 14
|Urocystis cholera, 478.
Universe defined, 432.
V
Waginal Caesarean section, 520.
Variolin, Searle on, 400.
Venom, serpent, Searle on, 403.
Veratrin, Dunham on, 239.
Vichy water and Dr. Daumas, 377.
W
Wolffia, Allen on, 114. ~3.
Wounds dressed with Carbol. ac.,238,
Z
Zincum, 200th, cures pterygium CTBS-
sum, 408.
NOMINAL INDEX ;
OR,
List of Contributors and Authorities.
A.
Allen's Ophthalmoscope, 124; micro-
scopical items, 111.
Andral's experiments, 483.
Anstie on hypodermic injections, 231.
B
Barker, Dr. Herbert, on disinfectants,
131
Bacmeister, Prof., testimonial to, 393.
Bernard, Claude, testimony regard
ing medicine, 493.
C
Cooke's test for Carbolic acid, 131.
Conheim's Inflam. Phenomena re-
viewed by Dönitz, 464.
Chase, Dr. Henry S., on saliva, 272.
D
Dunham, Carroll, M.D., reply to
Searle, 61, 411; on Reith, 360;
On Ailanthus, 330; on Harley's
Con. mac., 445; Andral's experi-
ments, 486; Mat. Mcd.items, 115,
240, 389.
Daumas, Dr., and Vichy Water,377.
E
Eulenberg on sugar in liver, 99.
Eggert's case of retention of foetus,
105.
F
Franklin on Injuries and Diseases,
of Joints, 261 ; Surgical Items,
237.
G
Gatchell, H. P., M.D., on “Dynamic
Power,” 90; cause and cure of
disease, 293; on Force and its
relations to life, etc., 165, 336,442;
on climate of various places, 249;
# Pettenkoffer's experiments,
251.
Grauvogl on dynamism, 15, et seq. ;
on disease, 467; review by Wells,
174; on attenuations, 444.
Guéniot on delivery of placenta in
abortion, 72, 200.
Gulº on elimination of medicines,
234.
Hale, E. M., M.D., on contact poten-
cies, 24; on catarrhal colitis, 46;
on the dose, 283; on Millefolium,
315.
Hallier on cholera, 477.
Harkness on cause of ague, 386.
Harley on Con. Imac., 445.
Hedges, S. P., M.D., on Chloroform, 1.
Higbee on inversion of uterus, 216.
Hofrichter on Basedow’s Disease, 256.
Horn's experiments in cholera, 477.
Huxley, Prof., on physical basis of
life, 509.
J
Jones, S.A., M.D., on Hale's Dose, 31.
Jahr on typhus and typhoid fevers;
420,
L
Lister on Carbolic acid, 136.
Lilienthal on Jahr's typhoid fever,
etc., 420.
Lord, F. A., M.D., on Carbolic acid,
X.
AVomżna! /ndex.
139; case of spontaneous ampu-
tation im, utero, 245; Chemical
antidotes of Phos., 110 ; Chemis-
try and Physical Science, 107,246,
385, 509; Death from Chloro-
form, 107; on IIarkness' Cause
of Ague, 386; Progress of Chem-
istry, 385; Scientific Basis for
Medicine, 246 ; on “Physical
Basis of Life,” 509; review of
Hoyne's Classification of a few
of the New Romedies, 357 ;
Hughes' Therapeutics, 494; Ma-
teria Medica in its Scientific Rela-
tions, 220; Practical IIomoeopa-
thy for the People, 357; Pro-
ceedings of the Third Annual
Session of the IIom. Med. SOC. Of
Penn., 223; Proceedings of the
Fifth and Sixth Annual Sessions
of Western Institute of Homoe-
opathy, 498; Proceedings of the
Twenty-first Annual Session of
American Institute of Homoeop-
athy, 495; Roscoe's Chemistry,
222 ; Self Enervation, 496.
Lord, I. S. P., M.P., on drug-prov-
Ing, 14U.
Ludlam, R., M.D., enteric affections
incidental to pertussis, 183;
translation of Guéniot's delivery
of placenta, 72, 200; obstetrical
items, 102, 242, 383, 502.
M
Macloughlin, Dr., on cholera, 488.
Marmé on Thallium and Cadmium,
Minº; "sun, on the inconceivable,
Miº experiments reviewed, 65,
et 86%. º
Molin's, Dr., Letter from Paris, 373.
N
Neftel on thermometer, 425.
P
Page, M. F., M.D., on Gelsem, in
parturition, 440.
Palmer's, A. B., M.D., Four Lec-
tures, 484.
Pearce on vaccination, 228.
Pettenkoffer's experiments, Gatchell
On, 251.
Peters on Quinine, 486; Homoeopa-
thic statistics, 489.
R
Reith on Aconite, 369; rejected for
Aberdeen Infirmary, 372.
Reynolds, Dr. Russell, on Bromide
of potas., 230.
S
Salisbury's theory of ague, 387.
Sanders' dressing for navel, 105.
Sayre's apparatus for sprains, 268.
Schiff on sugar in liver, 99.
Schmidt on cholera, 479.
Schweikert, on cholera, 482.
Searle on Isopathic remedies, 379.
Stilling's new operation on lachry-
mal canal, 122.
T
Tietze, E., M.D., word to other side,
10; review of Guernsey, 303; on
Apis mell., 156, 412 ; review of
Schweikert on cholera, 477; ex-
perience with a few remedies,
412.
Theobald's, Robert Masters, Esq.,
Letter from London, 225.
V
Virchow on blood and pus, 456; on
life and disease, reviewed by
Grauvogl, 467.
Von Tagen on dislocations of elbow
joint, 270.
W
Wells, P. P., M.D., review of Tietze,
178; on Wright's resolutions,
194.
Wesselhoeft, C., M.D., notes on physi-
ology, 97, 234; on blood and pus,
455.
U N I T E D STATES
Medical and Surgical Journal.
Vol. IV.-OCTOBER, 1868.- Wo. 13.
CHLOROFORM AS AN ANAESTHETIC : ITS DAN-
GERS, AND WHENCE THEY ARISE.
Report read before the Illinois State Homaeopathic Medical Society, May
20th, 1868, by S. P. HEDGEs, M.D., Committee on Chemistry.
TITE appointment upon so broad a subject as Chemistry,
made it necessary for your committee to select some subject
or department, within that science, upon which to report.
As we supposed the largest latitude would be accorded, in
this liberty of choice, we hope none will be disappointed at
our subject; while, at the same time, we hope too much
will not be expected.
The subject of our report, which we shall mainly consider
from its chemical aspect, is as follows: viz., Chloroform as an
Anaesthetic; its Dangers, and whence they arise.
In the course of the last ten years, so many deaths from
Chloroform have occurred, that the scientific world has been
laboriously searching after some other, and safer, anaesthetic.
The chemists of Europe and of this continent have brought
forward, at different times, various agents, which were
claimed to be equal or superior to Chloroform, with few or
Vol. IV. — No. 13. I *}
2 Chloroform as an Anaesthetic. [October,
none of its fatal qualities. The different methylic com
pounds, with their varying equivalents of Carbon, Hydrogen,
and Chlorine, have all been examined or experimentally used,
with a like unfavorable result. In these researches, it has
been found that the nearer the substance resembles Chloro-
form, the more nearly perfect is it as an anaesthetic. The
latest anaesthetics which have been, or are now being, urged
upon the medical profession, are the Tetrachloride of Carbon,
whose formula is C Cl4 ; and the Bichloride of Methylene,
whose formula is CII* Cl”. It will be remembered here that
the formula of Chloroform is C*HCl3. The Tetrachloride of
Carbon was introduced to the profession by Dr. A. E. Sanson
and Dr. John IIarley, in the year 1864. The Bichloride of
Methylene was first used and recommended by Dr. Richard-
son, in 1867. The latter substance is more nearly allied to
Chloroform, both chemically and physically; and hence is
better than the former, which has in it no atom of Hydrogen.
Neither of these substances has come into general use; and
in case either should, it would be found, we venture to say,
as fatal as Chloroſorm, if not more so, - and from the same
reasons which are given in this report.
JElher, as an anaesthetic, has been considered, by many,
safer than Chloroform. Yet statistics from European sources
do not prove this to be the fact; as see “British Medical
Journal,” July 20th, 1867, page 48.
It is not necessary to mention, in comparison with Chloro-
form, those minor agents which have had only an ephemeral
existence as anaesthetics, because lacking in many funda-
mental qualities demanded in such an agent. Neither shall
we speak of the different anaesthetic gases, at the head of
which rightly stands the Protocide of Nitrogen, or Nitrous
Oxide ; since even this, so much superior to all the others,
lacks the necessary quality of persistence in its effects, so
imperatively required in severe surgical operations.
After an extended examination of the opinions, upon this
subject, of men of the highest science and of the largest
experience, it will be the object of this paper to advance the
following propositions:
1868.] Chloroform as an Anaesthetic. 3
1st. That there is no anaesthetic equal to Chloroform in
the rapidity, persistence, and ease, in which its effects are
attained; and also none that add more to the power of Sur-
gery, without diminishing its security.
All authority is united in considering Chloroform, in all
these qualities of an anaesthetic, as having no equal; and
only on account of the danger arising from its use, has it
ever been expedient to discover some more harmless agent.
The remarks already made, preceding this proposition, we
would use as proof of its verity.
Our second proposition is best stated in the language of a
celebrated French physician. M. Sedillot, speaking of Chlo-
roform, says: “Chloroform, when pure, and properly used,
never destroys life.”
There are two things here which are necessary, that there
may be no danger to life. In the first place, the Chloroform
must be pure. It must contain only the three elements that
make it what it is. It must have one part of Hydrogen, two
parts of Carbon, and three of Chlorine ; no more, no less, –
not even a little aqueous vapor; and these must be in just
the proper relations to each other. In the second place, the
Chloroform must be properly used. This includes the proper
manner of actual administration; which should be accord-
ing to the rules laid down by the most competent authority.
Of this, we do not propose to treat in this paper. We claim,
however, that there is a proper mode of administering pure
Chloroform, so as to place the life of the patient in no danger.
We understand that patients with flabby or dilated hearts,
or with fatty degeneration of the heart, or with large aneur-
isms near the heart, are not proper persons to whom Chlo-
roform may be administered. Neither should Chloroform be
given to drunkards. With the exception, then, of these classes
of persons, Chloroform may properly be given to any one, what-
ever the age or temperament; and, if the article used is pure,
death can not result from its proper administration.
In regard to the manner of giving Chloroform, it has been
proved from the statistics of death from Chloroform, that the
great majority of the cases occurred to those little expe-
4. Chloroform as an Anaesthetic. [October,
rienced in its use; while those using it often, have few or
no fatal results in their practice. Upon this point, we wish
to quote the same authority before given. M. Sedillot says:
“If Chloroform, when pure, and properly used, can produce
death, and strike down patients in spite of every precaution,
it must be that this terrible accident should occur in the
practice of the most avowed advocates of chloroformization;
and while their experience shows their practice to be free
from mortality, while that of practitioners less versed in its
use furnishes the most frequent casualties, we can not but
see, in this result, something more than mere chance.” +
These words convey impressions of truth, most difficult
to set aside. But, allowing that very many deaths from
Chloroform occur from its improper administration, there
are still instances which can not be thus explained.
And here we will state our third proposition: to wit.,
that all the deaths occurring from Chloroform properly
administered, are due to impurities, or extraneous matters
in the Chloroform ; and further, that these foreign matters
are poisons, and cause death in their own peculiar and spe-
cific manner.
It is a fact that death from Chloroform occurs, generally,
Soon after its first inhalation, before any complete and pro-
found anaesthesia could be produced. Dr. C. N. Andrews,
in a report read before the St. Louis Medical Society, upon
Chloroform as an Anaesthetic, says: “The history of the
mortality from Chloroform, shows that the danger is almost
entirely from its primary effects, and not often from any
secondary or too profound anaesthetic effect.” This would
be the result in every instance in which a poison was inhaled;
it would cause at once its peculiar and fatal symptoms. IIow
often it happens, in case of death from Chloroform, that the
patient, after a few respirations from the napkin, charged
with the anaesthetic, goes at once, apparently, under its full
influence; and the word being given to the operator, he has
no sooner introduced the knife, than trouble is announced.
The respirations have ceased; the pulse can no longer be
* See this Journal, Vol. II, p. 334.
1868.] Chloroform as an Anaesthetic. 5
felt; and no skill and promptness can restore them. In
most of these instances, the fatal symptoms manifest them-
selves suddenly. The respirations do not become gradually
slower and slower, but stop at once ; an effect which has
never been produced by pure Chloroform, but only by cer-
tain poisons, which are perfectly irrespirable.
We now propose to show, as far as we may, what these
poisons are, how they are introduced into Chloroform (even
a properly manufactured article), and how they may be
detected; as also a few directions regarding the safe-keeping
of Chloroform after manufacture.
Chloroform is made according to two or three different
processes; but the usual one is, to mix 3 gallons water and
30 fluid ounces of rectified spirits, in a large retort, and
bring them to 100° Fahrenheit; then to add 10 pounds of
Chloride of Lime, and 5 pounds of slaked Lime; a heat suf-
ficient to cause distillation is then applied, and as soon as
distillation is fairly begun, the heat is removed. This dis-
tillate consists of water, aqueous vapor, free chlorine gas,
aqua chlorinii, HCl gas, and liquid HCl. This is washed in
Several waters, where it loses, by absorption, all these impuri-
ties, except the water and aqueous vapor. The Chloroform
is then shaken with its bulk of SO3, which removes all the
water. If all of these processes have been rightly performed,
we have a pure article; but if not, we have, at the start,
Chloroform, containing free Chlorine, ‘IOH and water.
With these present, there is, owing to the strong affinities
of H, and Cl, a constant decomposition going on, increasing
the amount of HCl gas, which is absorbed by the water as
fast as formed. Now, what might be expected if some of
this liquid is poured upon a napkin and inhaled ž The
Chloroform, being in excess, would begin to produce its own
anaesthetic effect; but the moment a little HCl is inhaled
(who shall say how much 7) we have sudden closure of the
glottis, and death from asphyxia. The verdict which should
be rendered is — Death from poisoning by HCl But in
such poorly manufactured Chloroform, there is also free Cl
gas, which, on account of the absence of sufficient water to
6 Chloroform as an Anaesthetic. [October,
absorb it, is in its gaseous form. This gas is very heavy,
and would be retained in the folds of the napkin or hand-
kerchief, and thus inhaled. Such, no doubt, has been the
case in those sudden deaths after only one or two inhala-
tions. These fatal effects, instead of being caused by the
paralyzing or anaesthetic effects of Chloroform, were the
natural and specific effects of respired chlorine gas. The
same effect, though not so rapid, would be produced by
inhaling a saturated solution of Cl.
We have so far considered Chloroform as primarily impure,
that is, as coming from the manufacturer impure. But if
Chloroform, when purchased by the physician or druggist,
thoroughly tested, and found perfectly pure, stands any
length of time before using, is it possible for it to become
poisonous? In other words, is Chloroform subject to spon-
taneous decomposition ? If it is, what are the agents caus-
ing the change 2 The authorities agree that it is subject to
decomposition. They also agree that light, heat, and moist-
ure, are the most potent agents in causing such changes. In
I3rande and Taylor’s Chemistry, p. 591, concerning the spon-
taneous decomposition of Chloroform, is the following: “It
appears that a free exposure to light, favors this decomposi-
tion. It also takes place more readily when a little moisture
is present, than when it is quite free from water.”
This fact has been demonstrated by W. J. Youmans, M.D.,
of Winona, Wisconsin. He exposed a bottle of Chloroform,
known to be pure, to the light of the sun, for a few hours
each day, in his office; and after the twenty-fifth day, noticed
a greenish colored fluid upon the surface of the Chloroform,
which, on testing, was found to be IICl. IIere, light and
heat were the agents of decomposition.
Let us examine the stages by which this was reached. In
the Chemistry above quoted, p. 85, we find this also: “Light,
like the electric fluid and heat, has, in Some instances, a
combining power over gases;” as illustrated by the union
of the gases, H and Cl, to form HCl. Chloroform is com-
posed of two atoms carbon, one atom hydrogen, and three
of Cl. There is 89 per cent. of Cl, in Chloroform. Under
1868.7 Chloroform as an Anaesthetic. 7
circumstances not as yet understood by chemists, the affini-
ties, or powers, which hold these three elements in their
certain proportions, in a union as represented by Chloroform,
become weakened. The union, although still existing, only
requires some disturbing cause to hasten its partial or entire
disintegration. Now, we are informed that light, heat and
moisture, may and do become, in the instance of Chloroform,
such disturbing agents. Cl, an element with as wide and
strong affinities as oxygen, is the most fickle member of the
three. H, and Cl, have the greatest affinities for each other;
hence they separate, under these conditions, leaving a union
where Carbon is present, to enter into another where it is
not. This union of H, and Cl, in equal volumes, to form
HCl, of course liberates carbon; which, when oxygen is
present, forms CO2. There is, in this decomposition, from
the excess of Cl, over H, free Cl gas left; and as water is
usually present, also a greenish yellow fluid, called liquor
(aqua) chlorinii. These are the results, under certain circum-
stances, by the aid of light, when the Chloroform is pure.
But the presence of a little water and heat, makes the decom-
position still more rapid. Water has the power of absorbing
480 or 500 times its bulk of HCl; and it being quite as
impossible to keep Chloroform absolutely free from water,
as it is to preserve SO* absolutely anhydrous, we see that
there is, almost necessarily, water always present in Chloro-
form, sufficient to absorb HCl in poisonous quantities. HCl
is perfectly irrespirable, and causes the same effect, though
with less laryngeal irritation, as Cl gas: viz., sudden, fatal
closure of the glottis.
To sum up, then, there is present, as a result of sponta-
neous decomposition of Chloroform, Cl, both as a gas and in
solution in water, and HCl. These are poisons, rapidly
fatal when inhaled; so that we feel confident that we are
justified in taking the positions we have, and believe that,
if more attention were paid to this subject by the profession,
it would richly repay for all the labor expended.
It is surprising that, in the large number of deaths from
Chloroform, so little attention has been given to immediate
8 Chloroform as an Anaesthetic. [October,
and careful analysis of the fatal liquid, to determine the
real cause of the casualty; so that, if an impure article has
been given, the blame might be laid where it belongs, to the
practitioner, rather than that so necessary, merciful and really
harmless an agent as is Chloroform in relieving the surgical
diseases of humanity, should be condemned. There is much
danger that the medical profession will be debarred the use
of so valuable and powerful an adjunct in the treatment of
disease, as Chloroform, from this very reason; and therefore
investigations should be made, and proofs accumulated, to
establish what your committee believes to be a truth, that
pure Chloroform is a harmless agent, when properly used;
and if improperly or carelessly used, even by the most
skilled and scientific physician, let him suffer, and so pre-
vent the resources of medicine from receiving any diminu-
tion. The time is coming, yea, is even now here, when the
ignorant or careless administration of a poisonous article of
Chloroform will bring down ruin and disgrace upon the indi-
vidual using it.
A fatal result lately followed the administration of Chloro-
form, at Winona, Wis., in which the dentist was arrested
and lodged in prison. This arrest followed an investigation
at the coroner’s inquest, in which the specimen of Chloroform
used by the dentist was found to contain sufficient IIC1, mot
only to give the acid reaction strongly, but even to be per-
ceived by its color. Now, in this instance, there may have
been ignorance, carelessness, and improper administration,
as well as a poisonous article, all combined ; yet none will
say that any thing caused death, but the poison. It was,
properly, a poisoning from IIC], - as much as Strychnine or
Arsenic would be, given in a cup of coffee. This case at
Winona is set down as a result of death from Chloroform.
IIow long shall we permit such reports to go forth, to the
injury of one of the most powerful adjuncts in the practice of
medicine and surgery : Let us stamp the truth upon such
reports; and this we can do only by immediate and rigid
examination of all the circumstances of such occurrences:
Regarding the tests for pure Chloroform, and also for the
1868.] Chloroform as an Anaesthetic. 9
above-mentioned poisons which are contained in it, we add,
in conclusion, the following:
Chloroform, when pure, is a colorless, heavy, transparent,
neutral liquid, of a sweetish, pungent taste. Its specific
gravity, when pure, is 1.5. A few drops of Chloroform,
placed upon the hand, speedily evaporate, and produce a
great degree of cold. If pure, there is no residue, and no
unpleasant odor. If an article of Chloroform gives an acid
reaction, there is certainly II, Cl, present. When Chloroform
is poorly manufactured, H,Cl, is easily detected by mere
inspection; except when the bottle in which it is kept is of
a greenish or greenish-yellow color. If the bottle is of this
color, or if it has a slight bluish tint, the presence of II, Cl,
is not observed; because H,Cl, is either transparent, or else
it is so near the color of the bottle as to escape notice.
IHence, a very poor article of Chloroform, if put into a per-
fectly colorless, transparent bottle, as should be done before
using, will be at once detected by its peculiar color. If to
a specimen of Chloroform containing II, Cl, a solution of Ni-
trate of Silver be added, it will throw down a white clotted
precipitate; for when Nitrate of Silver is added to pure Chlo-
roform, it only gives a white cloudy appearance, as when
Chloroform is dropped into water.
The tests for Chlorine or Aqua Chlorinii are: Its odor,
greenish color, and bleaching properties. If Chloroform
possesses any of these characteristics, you may be sure there
is Chlorine in poisonous quantities.
After a pure article of Chloroform has been obtained, it
should be kept in a cool, dark place, in a well-stopped
bottle. But, in all cases, Chloroform should be carefully
tested, as we have mentioned, immediately before using it. If
thus rigidly tested, immediately before use, and proved per-
fectly pure, it will prove, when properly administered, the
best, as well as the safest, anaesthetic.
A WORD TO THE “ OTHER SIDE.”
III.
BY EMIL TIETzE, M.D., PHILADELPHIA, PA.
ON page 535, Vol. III. of the “Hahnemannian Monthly,”
we are told that “objective symptoms obtained by involun-
tary provings (poisonings or Allopathic treatment), have
little, if any, value for practical purposes,” and that “the
attempt to prove medicines till pathologically changed con-
ditions of the organs and tissues are obtained, will prove a
failure forever;” and that “even if the possibility existed
that such changes could be produced, it would still be an
almost impossible task to obtain them.”
The above remarks surprise us, especially as they origi-
nated with a teacher of Materia Medica; and we can not but
fear that party spirit has blurred, if not seriously impaired,
the Doctor's vision. At any rate, we deem it exceedingly
doubtful whether Homoeopathic physicians would ever have
thought of Belladonna as a remedy for various diseases, had
not the objective (toxicological) phenomena of the drug on
the skin, fauces, tonsils, pharynx, eyes, etc., been their trust-
worthy and unerring guides. Its effect upon the blood,
which we have mentioned in our previous article, is very
significant, and sufficiently explains, we think, the small
number of deaths which have occurred from poisonings,
with it. But even if such proved fatal, they have still given
us ununistakable and valuable hints, positive and negative,
in post-mortem appearances. We refer here, for example,
to the absence of serous exudations in the meninges.
Belladonna, Apis, and Lachesis, form an interesting patho-
genetic group, the diagnostic differences of which have puz-
zled, probably, many of us, at one time or another, for the
reason that we overlooked some of their objective symp-
toms, which greatly facilitate the study of those drugs, in
1868.] A Word to the Ożher Side. II
so far as they serve as correct starting-points. For instanee,
with the aid of those symptoms, we observe that this group,
notwithstanding its many symptomatic resemblances, has,
so to say, a positive and a negative pole, Belladonna repre-
senting the former, Lachesis the latter; while Apis stands
nearly midway between them, and may be marked as posito-
negative — the negative character, however, predominating.
This distinction seems to us well warranted; and, on a little
reflection, offers us the most essential general diagnostic
differences of those drugs.
Further, we beg leave to point to the objective symptoms
obtained from provings of, or poisonings by, Rhus, (erysip-
elas, scarlat. mil., eczema;) of Tart. Stib., (variola;) Croton
tigl., (eczema;) Urtica urens, (urticaria;) to the cutaneous
and renal symptoms of Cantharis and Terebinthina, (burns,
nephritis, haematuresis.) It is well known what induced
Hahnemann to prove Sepia and Thuja, and we scarcely need
more than mention Mercurius. Besides these, we will briefly
remind the Doctor of Arsenicum, (gastritis;) Iodium, (laryn-
gitis;) Aconite, Bryonia, Kali hydrojod., (pneumonia;) of
Phosphorus, (pneumonia, myocarditis, endocarditis;) Secale,
(gangraena, uterine haemorrhages;) and we beg his pardon,
for we had almost forgotten to mention Cubebae.
We might increase this list of remedies considerably: but
those above-named suffice, we think, to prove our point.
Moreover, we wish to direct the Doctor's attention to the
contradictio in adjecto contained in the quoted passages. He
speaks of objective symptoms obtained by involuntary prov-
ings, etc. Well, if those objective symptoms were obtained,
they must have been obtainable — must have constituted visi-
ble and palpable facts. And yet, he remarks that “the
attempt to prove medicines, till pathologically changed con-
ditions of the organs and tissues are obtained, will prove a
failure forever;” and that, “even if a possibility existed
that such changes would be produced, it would be an almost
âmpossible task to obtain them.”
Finally, we are very sorry, indeed, that our Doctor has
profited so little, apparently, by the well-known tragico-
I 2 A Word to the Offſher Søde. [October,
comical fate of the late Prof. Joerg, of Leipzig; however,
we live in hopes that, some day or other, the Doctor will
meet with a second Gutmann, who will quickly unbutton,
and show the Doctor the bottom — of his mistake. For,
really, there is nothing more convincing to an obstinate
mind, than such an “ocular inspection.”
On p. 536, the author has given us another of his peculiar
treats. He says: “Again, pathological anatomy can not
give us any satisfactory solution of the effects of medicine.”
Now, we can not remember ever to have heard any Homoeo-
pathic physician assert that it does ; for we all know but too
well, that, if ever, it will be a good while before we can
boast of having satisfactorily Solved so difficult and perplex-
ing a problem. And, “it is proposed,” the Doctor continues,
“to ascertain, by means of a chemical analysis, the process
of the changed organic life, and with it, its changed condi-
tion, which the medicine has produced.” Here, again, the
Doctor does us injustice; for, to the best of our knowledge,
no one has ever proposed such a thing. We only mean to
find, in this way, the abnormal vito-chemical products which
accompany the action of drugs, as part of their pathogenetic
results, as part of their objective symptoms.
Again, we hear that “to give and prove medicines accord-
ing to such theories, is more than risky, as the chemical
action constitutes the opposite of organic life.” Some IIom-
ceopaths, it is true, deem it high time that our school should
have a home-made physiology; but, if the above is to give
us a taste of what threatens us in this direction, we beg
permission to inform our well-meaning friends that we
would rather do with what we have received from another
side; and, in view of the above sample, we sincerely hope
they will not think us trespassing, in humbly expressing our
doubts as to the probability of their winning laurels in that
direction.
Baehr, Vol. I. p. 638 of his Therapia, mentions that he
read, in a medical journal, of a French physician having
observed that Chloride of Uranium, given in daily doses of
1.5 centigrammes, produces sugar in the urine. He remarks
1868.] A Wordſ to the Off/her Side. I3
that he immediately saw the importance of this observation,
and that he would have proved Uranium if he possibly could
have done so. Soon afterwards, however, he was consulted
by two patients, the one a boy of thirteen, the other a peasant
of forty years of age, both suffering with diabetes mellitus.
IIe concluded to test the value of the remedy. Without
making any change in their diet, the specific gravity of the
urine of the boy fell from 1042 to 1030; that of the man,
from 1039 to 1031. Thirst, hunger, and quantity of urine,
decreased considerably at the same time; though he con-
fesses that, on account of the impatience of his patients,
(both were in his care for two months only,) he could make
but few and incomplete observations. He finally adds that
the same observation was made by his colleague, Weber, on
two patients, who both suddenly died under typhous—prob-
ably uraemic — symptoms; and that Uranium alone, given
in the second trituration, had invariably reduced the specific
gravity of the urine.
Now, will our author be kind enough to tell us what pos-
sible risk there can be in proving and prescribing medicines
with the view of obtaining results similar to those stated
above. If he sees risks in such a proceeding, he must like-
wise see risks in Hahnemann’s provings, and in those of
other Homoeopathic physicians. For the fact that after Ura-
nium has been taken by healthy persons, in large quantities,
their urine becomes loaded with sugar, does not prove to us
that this phenomena rests simply upon a direct chemical
action, but, on the contrary, we consider the vito-chemical
change but the result produced by the pathogenetic action
of this drug upon the respective diosmotic membranes.
IIence, the sugar in the urine is, to us, merely a symptom;
not more, and not loss; though we may deem it—and with
good reason, too—a very important one.
The Doctor adds: “I will further show how it is practi-
cally impossible to carry out this mode of investigation.
Suppose we possess the chemical analyses of all the secre-
tions caused by a remedy, and wish ourselves to apply them
under the Homoeopathic law of the similars, we must,
I4. A Word to the O//her Side. [October,
accordingly, analyze with great accuracy, and very fre-
quently, all and every secretion of the patient. The analysis
must be very accurate, for a few atoms of oxygen, hydrogen,
carbon, nitrogen, or chlorine, may change the most innox-
ious substance in the most noxious. If such a course were
to be pursued, consistently and conscientiously, one physician
could not well attend more than one patient a day.”
As regards the different secretions of the human body,
the urine is, to practical physicians, of more importance
than any other. Valentin calls it “das Spillwasser des Blutes,”
(the wash-water of the blood,) a designation which is well
chosen, and briefly expresses the physiological importance
of that fluid. Abnormal quality and quantity of the urine
are of great pathological interest to us in a number of dis-
eases, either constitutional, or confined to the urinary organs.
In the latter cases, these anomalies frequently constitute
their most important pathological features.
It was practical need that called for chemical analyses of
this secretion, and it is but due to add that they have thrown
much light upon some diseases heretofore buried in utter
pathological darkness. Yet we do not wish to deny the
probable importance of chemical changes in other secretions
of the body, for practical purposes, although the practical
demand in this direction has been far less urgent and imper-
ative; and for the reason, perhaps, that thus far, anomalies
In those secretions do not present to us objective data of
such pathological importance as to consider them the prin-
ciple momenta of well-defined morbid processes. IIence,
practical wants and pathologico-chemical discoveries will
mark off the ground for chemical analyses, as well as the
limits to which they ought to be extended for practical ends.
Now, we readily admit that future chemical discoveries may
possibly increase the labors of the practical physician, in this
respect; yet, in view of the trifling sacrifices of time, and
difficulties of manipulation, which, now-a-days, are associa-
ted, for example, with the different analyses of the urine
for practical purposes, we hope that, even under increasing
demands, we shall not be compelled to abandon a strictly
1868.] A Word to the Other Side. I5
scientific diagnosis and rational treatment of disease, for
want of time. At any rate, the Doctor will probably admit
that the reason given by him, in this instance, is not a sci-
entific reason; hence, out of place in a scientific essay.
But, whence arise all these, and many other, errors and
objections of our orthodox friends? In our opinion, mainly
from the unconditional acceptance of the doctrine of dynam-
ism as an absolute truth, a pillar upon which rest the Safety
and success of our school. Moreover, it is this doctrine, and
nothing else, that divides our ranks — that causes collisions
and strife among us; and we deem all attempts for recon-
ciliation, all endeavors for peace, vain and hopeless, as long
as this theory has not either been generally accepted or gen-
erally rejected.
However, men imbued with high ideas of truth and
honor — such as, we are sure, constitute the Homoeopathic
school — do not contend annong themselves for personal and
small ends. Hence, if we are at war among ourselves, we
are at war for the sake of truth; and whatever be its result,
it will be but for the best of Homoeopathy. We would wish
that this conviction of ours would also compose and support
those among us, who, apparently alarmed at the hostile tur-
moil, make haste to rid themselves, in good season, of all
future responsibilities, by loudly proclaiming that “Katy-
didn’t.”
Now, for our part, we hold the doctrine of dynamism to
be as erroneous in theory as it is dangerous to the welfare
and growth of Homoeopathy. It is for this reason that we
combat it. In No. 10 of this journal, Prof. P. P. Wells,
of Brooklyn, has published an elaborate article in its
defense. Yet, with all due deference to the venerable Doc-
tor, we believe him to labor under serious mistakes. For
this reason, we will, as an offset to his teachings, lay before
the reader a translation of some passages from Grauvogl’s
“Lehrbuch der Homoeopathie,” which touch upon this sub-
ject, and deserve, as we think, a careful perusal. He says:
“Powers are properties of bodies which we can distinguish
as changeable and unchangeable. Only properties of bodies
I6 A Word to the Ożher Side. [October,
which can be comprehended merely by virtue of their exist-
ence, which isolate them completely from others, as regards
quality, which are necessary and immutable, hence remain
specific of bodies, under all circumstances; only such, we
ought to call powers — as, for instance, the power of each
single element, which conditions the never-varying equiva-
lents of its combination with hydrogen or oxygen; the spe-
cific gravity of each body; also, the specific qualities of
organic forms, etc. Yet, if we observe a change in bodies,
brought about by an external cause, it is evident that this
can take place only by means of their changeable powers;
i. e., by means of their different properties — their volume,
density, color, their different manner of chemical combina-
tion, etc. Hence, if, according to Liebig, we mean to speak,
for instance, of a peculiar chemical or physical power, our
knowledge would not be enlarged in the least; for these
ideas constitute but vague generalizations, without any defi-
nite limit, and are but inventions of our reflective capaci-
ties.” (I. Th., S. 15.)
“The idea of the vital power has not yet died out. Dife,
however, means the self-acting form of a totality of recip-
rocal action; under power, we understand the property of a
body, in its relation of cause and effect to another. Now,
One side holds on to the idea of power, and develops its argu-
ments against the vital power, from the law of constancy of
matter and power, — and very logically, indeed; the other,
also correctly, draws its arguments from the law of recipro-
cal action, in as far as it starts from the idea of life.
“The opponents of the vital power lean upon the fact that
there is no beginning and no end of matter, because it is
eternal, and changes its status only; i. e., the one manner
of existing is the cause of the other, and an immaterial
cause is something inconceivable, for all life is the expres-
sion of matter. Those adhering to the vital power, point
to the coéxistence of the manifold, the change of formation
and metamorphosis under the aegis of a higher agency, which
transplants itself from parents to children. This can easily
be comprehended from the analysis of the term vital power,
*
1868.] A Word to the Other Side. 17
which contains two ideas of relationship, contradictory to
each other; for there exists only a possibility to live, accord-
ing to the reciprocal action of matter brought in contact,
and the powers resulting therefrom.
“The aid of a vital power is entirely superfluous for the
study of therapeutics. This idea can not rise even to the
dignity of a physiological explanatory argument, but, on
the contrary, remains a problem itself; since it is impossible
to fix an object by ideas. The contest turns upon two oppo-
site pivots; the one side, as regards a subject, moves upon
the standpoint of observation, — the other, in the region of
flexion, which can not be presented in the shape of definite
knowledge, and remains an ever incomplete thought, like
any other transcendental idea.” (Ibid., S. 17.)
“From the laws of physiology, thus far presented, we can
not infer a vital power. The idea of a life-power is but a
predicative abstraction, yet no subject or object. It is an
idea, but no object of the senses, – a subjective perception,
like that of the arch of the heavens. Should that high
authority of our day, Liebig, say, “The scale is the life-
power of chemistry,” justice would have been done, at
least, to the form of a conclusion. But when I say, “life-
power is what conditions, forms, and supports life,” then the
question arises, first, what is it to constitute that “what ?”
and then we have no other answer than “life-power.”
IIence, this “what ” signifies nothing but a vacant space.
Life-power is a teleological phantom, notwithstanding Liebig
and Virchow.
“Nothing is more convenient, yet nothing is also more dan-
gerous for science, than to use abstract ideas as explanatory
arguments. We rock ourselves on the surface, and keep
our hands idle; for the depth is unfathomable, at any rate,
and why should we, therefore, search for the bottom ? It
is true, the fundamental law of reason is that of necessary
wnity — yet of unity in a two-fold manner: at one time, as
harmony of our material knowledge with the laws of nature; at
another, under the form of ideas, as direct perceptions of rea-
Son. Thus, we observe a deviation of two opposite law-
Vol. IV. — No. 13. 2
I8 A Wordſ fo the Ożher Szałe [October,
giving powers, of the law-giving power for the idea, and the
law-giving power of nature. IIence, the superstition with
regard to the vital power, like the multitude of errors of
equal importance, of men learned and unlearned, arises
from an involuntary mixing up of the law-giving power of
the spiritual world, with that of the material world.” (Ibid.,
S. 31, etc.)
“As regards the phenomena of material exchanges, the
cells represent the laboratories for the substances introduced
into the organism; and the teactus cellulosus, as a general
rule, forms the frame for the organs, nerves, vessels, etc., in
which we observe minute gaps and small canals. The latter
allow import and export between the organs and the blood
of the capillaries. The sanguineous and also the lymphatic
capillaries are found every where without a wall of their
own, capable of isolation ; they are canals, dug into the tis-
sue of the organs, which stand in direct communication with
the cells of the latter.
“New, having previously paid attention to the oxydizing
and reducing processes of material exchanges, we have yet
to speak of the mechanical factors, which at one time assist
in such processes, at another impede and modify them.
“Capillary attraction supplies, in the capillaries, the pres-
sive force of the regulators of circulation, for the purpose
of moistening and saturating the adjacent organic parts,
which arc all porous. Notwithstanding, now, that a direct
contact takes place in the capillaries, between blood and
lymph, on the one hand, and the organic parts, on the other,
yet blood and lymph experience manifold resistances, pro-
hibiting their direct combination with the fluids of the cells.
These resistances are given in the porous membranes of the
cells. But, although different fluids are separated by the
porous walls, they nevertheless do not retain their chemical
differences for any length of time, but endeavor to equalize
their opposite contents; and, if a chemical combination is
impossible, a change of locality in the minutest fluid parti-
cles will follow, at any rate. The blood corpuscules, for
example, are likewise cells, which float in an abundant inter-
1868.] A Word fo the Off/her Side. I9
cellular substance — the liquor sanguinis. This substance
belongs to the cells, in the smallest portion; and has been
added to them, also, from without. This holds good of
nearly all the intercellular fluids. The intercellular sub-
stance, however, surrounds the cell,— at one time in a fluid
state, at another, in a solid form. Contents and surround-
ings of cells may originate in a two-fold manner: they are
either products of the cells, or flow around them, and are
absorbed by them. Yet, to accomplish this, the direct
afflux of blood is not always necessary; for also the imbibi-
tion fluid of the organs suffices — as with cartilages, and the
capsule of the lens, which, in a healthy state, are free from
vessels. Even the nervous influence is not always necessary,
as we observe, for instance, on the cornea, which is not pro-
vided with any nerve. However, under all these circum-
stances, we always find separating walls between these
motions, which allow in port and export — i. e., diosmosis ;
and, as we shall see, according to the following laws. Dios-
mosis reduces the law of gravity to the individual cell. In
this, it is true, the diosmotic equivalent — i. e., the definite
quantity of water, which is a different one for the diosmotic
process in different fluids — depends upon the chemical
peculiarities which those fluids, brought in mutual contact,
have among themselves; yet principally upon the differences
and affinities which exist between the fluids, cell-membranes,
and textures, – and, at the same time, upon the degree of
their concentration, temperature, and velocity. Hence,
diosmosis takes place the more rapidly, the more dissimilar,
as regards chemical composition, the fluids are, which move
on both sides of the membranes; yet it is the membrane, the
specific anatomical construction, material peculiarity and
molecular motion of which, conditions other different modi-
fications. Solutions of sugar, for example, injected into the
veins, do not pass into the milk, but into the bile. If we
take Iodide of Potassium, it appears much sooner in the pan-
creatic juice, and in the tears, than in the bile and urine.
Strychnine affects the ganglionic cells of the spinal marrow,
but not the peripheric nerves; while Opium affects both.
2O A Word to the Off/her Side. [October,
This proves that different cells, as long as they are alive,
have, according to their construction, a specific affinity for
different substances. IIence, the resistances of life-endowed
membranes, limit the dead chemismus; and “all physiologists
and physicians (Berger, die cellul. Pathol.) acknowledge, as
indubitable facts, that several substances can be expelled
from the blood by certain definite channels only, which are
represented in the different secretory organs, and that the
one prefer this, the other that route; they acknowledge,
also, that certain curative substances affect these or other
parts, in preference, and that their effect manifests itself in
certain parts of the body, in a definite manner, and without
exceptions.” (Ibid., S. 30, 31.)
“The specifico-chemical properties within the organism
are and remain the same as they are outside of it; yet, these
bodies suffer the most manifold separations and combina-
tions, under those local conditions and specific motions of
each single organic part. According to the laws of nature,
no difference can be discovered in these motions, except
the one necessarily arising from the specific nature of sub-
stances, and that of organic textures, together with the
resistances of movable membranes. (2 Th., S. 92.)
“We must always remember that, in diseases, we have
nothing before us but either primary chemical changes,
which are followed only by physical changes, or vice versa,
or both simultaneously; and that we have to deal either
with a local, or, as in all cases accompanied by fever, or in
chronic diseases, with a general chemismus, which is not
the chemismus of the specific form of the organism taking
place in the resistances of its movable membranes; but, as
has partially been proven in the previous $$, a changed che-
mismus — changed on account of combinations with sub-
stances and influences of morbific causes; that, however,
we have but to neutralize, by means of new combinations
induced, this changed chemismus, according to the laws of
function and nutrition, mentioned before, and to prevent,
if possible, the disturbances, probably only local, in the
resisting membranes. (Ibid., S. 86.)
1868.] A Word žo the Offſhar Szale. 2 I
“Out of thoughtless opposition to Allopathy, and for want
of a clear perception of its own nature, Orthodox IIomoeo-
pathy attempts to defend itself with hypotheses. Thus, it
presupposes, as first cause of diseases, a purely dynamic
disturbance of the vital power ; and for its cure, a curative power
of drugs. Such a hypothesis is not only illusory and arbi-
trary, but also superfluous. What is to be understood by
vital power, we find in §§ 18, 23, and 27; it is identical with
what physicians have attempted to unite under the idea of
curative power in general. The curative power is already
present with life, and nothing separate from it.
“Mechanics, the science treating of the laws of equilibrium
and motion, in their application to the material world, is
divided into statics and dynamics, in so far as bodies are in
a state of equilibrium or motion. Yet, in the organism, we
find neither a statical nor dynamical state alone. Neither
is our attention to be directed solely to the powers of the cura-
tive agencies, but also to the substances of the organism, and,
at the same time, to the morbific agencies of the external
world; since certain specific properties, or qualities, inhere
in them, the reciprocal action of which we have to study.
The effects of magnetism and electricity also depend upon
their material causes, and are perceptibly material, even to
Some one of our senses.
“Finally, what is to be understood by dynamic disturbance,
is not appreciable either by the art of experiment or that
of observation. Dynamic disturbance, vital power, curative
power, are all obscure ideas of existing relations. (Ibid.,
S. 87.)
In accepting the difference between the chemico-physical
and the so-called dynamic action of remedies, and in adopt-
ing the hypothesis of a dynamic power, we lose ourselves
in the region of theology and the spiritual world. Thus,
we are told, for instance, in a pronunciamento from Brook-
lyn: “An action, an effect, must have a cause, which, on its
part, can not again be the effect of another cause; and, in
this way, if we do not wish to move around in an eternal
circle, we finally return to the Supreme and last dynamis,
•
:
22 A Word to the Other Side. [October,
God, whose connection with the perceptible material world,
through the Swedenborgian spiritual world, we call vilal
power.” This is to be, as has frequently been remarked,
the dynamismus of IIomoeopathy, in which a medicinal Spirit
is to correspond to those products of nature called medicinal
substances. Now, where is the proof that it was, for instance,
the spirit of Arsenic, in the thirtieth dilution, which gave me,
for one or two days, a continuous and unquenchable thirst,
when I experimented with this dilution, upon myself Ż
This is easily proven, it will undoubtedly be remarked, by
analogy; according to which, for instance, an increased
peristaltic motion follows, even after fright, etc. This
would be the same modus argumentamdi as if, according to
Mitscherlich, we would place Sulphur and Alcohol in the
same class, for the reason that both substances belong to
the excitantia. But do not the gentlemen feel that, thus
far, they have entered into analogy only, and that they are
still very far from a proof? IIowever, since we know of
morbific causes which can not be perceived by our senses—
as, for instance, the causes of Scarlatina and measles — we
might also argue the logical necessity of administering a
Belladonna and Aconite spirit. To this we might answer,
“Go, and let the simple-minded come to you; for of such
is the kingdom of heaven!”
However, these ideas, which are defended with passion,
even by physicians, – for, in this instance, there can be no
claim laid to knowledge, – and which, it is true, return as
often as they are believed to be annihilated, have a deep
foundation in the nature of the human soul, and spread
themselves as long as we find men whose education does
not permit them to see through this nature. Hence, from
a scientific stand-point, such ideas have to be annihilated
patiently, as long as they are regurgitated from a subordi-
nate stand-point. This subordinate stand-point marks itselſ,
also, in this: that it fancies itself to have said something, in
remarking that the chemical understanding of the vital pro-
cess was, even in the eyes of the immortal founder of IIom-
ocopathy, an abomination and a nonsense. This may have
1868.] A Word fo the Off/her Side. 23
had its valid claims, at that time; but to-day, we would, in
adhering to it, barricade all progress in science, and raise
the standard of lawlessness.
“Nothing ought to be asserted without that foundation of facts
which is generally acknowledged. According to $28, KCl
is contained, de facto, in the blood-cells, in portious much
smaller, than quadrillionth parts of a cubic millinn eter, and,
in this state of dilution, can not be perceived by our senses;
hence, according to the hypothesis of the dynamists, is to be
found as spirit in the blood-cells. We see that the founda-
tion of facts, with regard to dilutions, drives the dynamists
from their field; yet, for all that, they raise their ghostlike
head again and again — not, however, in proof of truth,
but as proof that the reign of transcendental ideas, according
to the model of the old school of speculative philosophy, is
still possible ; which, however, was as little a philosophy as
the theosophic views of Swedenborg.
“If the dynamists should wish to hold the ground, they
have to prove, at first, that their hypothesis is the only one
possible ; that all phenomena in the material world, if not
resting upon deceit, are based upon hallucination and decep-
tion of our senses; a view which is not only unfounded, but
proven decidedly erroneous, –for we see, at every sick bed,
that our remedies, no matter whether they are given in low
dilutions or in high potencies, have the same specific effects,
hence, must have originated from the same material causes,
although, as it is well known, some side-effects, which are
caused by the lower dilutions, may not appear from high
potencies.
“Have I not, myself, repeatedly pointed out that, if we
wish to ascend from the effects to the causes, we must neces-
sarily arrive at something that has not been caused — that
a series of changes presupposes something unchangeable 7
But, in this, the laws of nature are neither denied nor
detracted from. The sphere of the physician is not the
absolute totality of the idea of things existing, but nature, —
the idea of things as far as they are throughout connected,
with regard to causality, reciprocal action, etc. The whole
24 Contacá Požencies. [October,
3.
theory of the dynamists is the negation of the material; yet
this independence of what constitutes a necessity according
to the laws of nature, exists in the idea only, not in reality.
Every dynamic system comes in hostile contact with the
incontrovertible rights of mathematical views.
“If the mental predilection of the dynamists throws itself
upon the eternal and unchangeable, the materialists can
oppose them with something entirely the same. In the
world of matter, there is no beginning, and no end ; but all
is change of formation, metamorphosis, and variation. Mat-
ter itself is indestructible, imperishable, ever and etermally
the same, without the slightest loss. There is also no change
in quality; a substance can not be changed into another.
Upon this, experiment and induction, for the explanation of
the phenomena of nature, rest more securely than the ideas
upon the absolute. However, from ideas we can not develop
positive knowledge — and, therefore, can explain nothing.
IIence, theoretical knowledge, and that obtained from ideas,
diverge from each other, and have nothing in common ; for
the former belongs to knowledge, the latter to faith. We
would wish that the dynamists might comprehend this truth
at last, and might not contend any longer for things entirely
mythical. (Th., I, S. 157, 158.)
CONTACT POTENCIES. — RORSAIKOFF AND DIR.
HALE.
By P. P. WELLs, M.D., BRookLYN, N.Y.
IT is sometimes pleasant, to a certain class of minds, to feel
that they are passing, and have passed, with their fellows,
for more than they are worth. The detection of the deceit
is another thing, and not always so pleasant. To another
class, the discovery that a neighbor is not quite so well
posted up in certain matters, as they had supposed, is pecu-
liarly sweet. It seems to help self-complacency, in raising
1868.T Contacá Potencies. 25
the discoverer to a position of superiority, in his own esti-
mation. This he likes; and he likes it so much, that it is
often a pity to disturb the enjoyment, by any such presenta-
tion of facts as will show that, after all, he has been mis-
taken. In the case of the “Contact Potencies '' and
Rorsakoff, Dr. Iſale makes his first mistake in supposing
the writer uninformed as to the experiments of this learned
and laborious Russian. His second was, going to Dudgeon
for his information, instead of to “Stapf’s Archiv.,” Band.
viii. 2, S. 161, and xi. 2, S. 87, et seq., and 3, S. 104, et seq.,
and xii. 1, S. 74, et seq. He would have found here what
Rorsakoff did, and how he did it; and on S. 162, Band.
viii. 2, and S. 97, B. xi. 2, and S. 83, B. xii. 1, he would
have found letters from IIahnemann, commenting approv-
ingly and admiringly on these experiments and labors. I
fail to find, in either of these letters, any trace of evidence
that he “discarded ” them as “useless, in a practical point
of view.” Here appears only approbation, even where the
statement of Korsakoff appears that he had found the 1500th
of Sulphur promptly and radically curative, in cases of
chronic disease, where the use of the 30th of the same drug
had been followed by no good result. IIahnemann unques-
tionably had sufficient good sense to see that, “in a practi.
tical point of view,” this was not altogether “useless.”
Dr. H. is roused by the casual remark, on page 251–2, Vol.
III., of this journal, that, so far as the writer knew, Dr. Chan-
ning, of New York, was the first to observe the fact of
“potentization by contact.” This is all he wants, to convict
of ignorance; and he does not withhold his verdict, “Knows
less than I thought.” As this is the result of the utterance,
we might regret it ; for it would be pleasant to stand well
with Dr. II. But, at the risk of exciting still further his
disgust, we repeat, in the face of this rebuke, so far as we
know, Dr. C. was the first to observe this fact. We do not
say he was the first; we have not said so ; — but only so far
as we know. If we knew more, we could, no doubt, be
more certain ; and if we knew enough, we might be almost
as certain as Dr. H. Seenus to be that he was not.
26 Cozzłacá Požezczes. [October,
%
3.
The facts in the case, so far as the writer is informed by
a personal acquaintance with Channing and the contents of
the “Archiv.” as above noted, are about these : Dr. II. B.
Gram came to New York in 1824. IIe almost innediately
made the acquaintance of Channing, and Channing almost
as immediately became Gram’s convert to the doctrines of
Homoeopathy. Dr. C. was a man of great powers of mind,
not one to be altogether led, even by so great a man as
Gram. IIe did his own thinking, and generally thought
remarkably well. IIe was quite equal to thinking out this
matter of “potentization by contact.” As he was early
practicing with its results, it is quite likely he did this. I
do not know certainly that he did this independently — I
know he was able to do it, and that to do it, would have
been exceedingly like him. Korsakoff’s first announcement
of his experiments in the matter, were published in Leipzig,
in 1832,--at least six years after Channing might have been
in possession of the same idea. I do not know that he was;
but only that, in 1841, when he first told me his experience
with Aconile, as already related, he had been using this drug,
So potentized, “many years,” — how many, I do not know.
If Dr. II. does, he can probably tell us exactly; and if there
be any importance attaching to the fact, it is well that there
is to be no more uncertainty about it. I do not know that
Channing had then seen the 11th volume of the “Archiv.”
If Dr. II. knows, and knows when and where, and that it
was from this that he got his notion of “potentization by
contact,” he can tell all about it. It may be remembered
that, in 1832, there were not many copies of this excellent
quarterly received in this country. I do not know that
Channing had ever a copy; though often in his library, I
never saw one there. There may be some great importance
attaching to this grave fact, which is not apparent, at first
glance, to ordinary minds. If so, then perhaps Dr. II. will
give us all we need to know about it.
If there be a mistake in this conclusion, it may be found
to be accounted for in the slight confusion of ideas which
appears in the Doctor's statement of the facts with which,
1868.] Cozzfacá Požezzczes. 27
otherwise, he seems to be so familiar. To be sure, he says
the whole subject “is nothing more than a revivification of
an old and obsolete method,” while, in the same paragraph,
he speaks of the “accidental discovery '' of it by Channing,
as I have described. Now, as I have described nothing of
the kind, and have no reason for believing the “discovery”
to have been “accidental" on Channing’s part, it is just
barely possible that Dr. H. is mistaken, also, in his state-
ment of Channing's practice being only a “revivification ”
of IKorsakoff’s “obsolete method.” I do not know how
much Channing was indebted to Korsakoff, or if he were
so at all. The probability is, in view of the facts, that the
practice of Channing preceded Korsakoff’s publication of
the account of his experiments. It may have been other-
wise — and it may be that Dr. II. can tell exactly how it is.
If he knows that Korsakoff’s discovery preceded Channing’s,
let him tell us the exact date of each; and after that, there
will be time enough to cast all useful accusations of ignor-
ance. If he can not do this, he may be suspected of more
haste than wisdom, in his echo of Dudgeon’s aversion to the
true philosophy of morbid and drug force, as presented in
the doctrines of Hahnemann, and, to a great extent, con-
firmed by the experiments of Korsakoff.
This is not the only instance of unwise haste contained
in the brief paragraphs of Dr. H. It is evident that he, with
Dudgeon, does not like the idea of “potentization by con-
tact.” If it be a truth, then Dr. D. and Dr. H. may be called
on to change some opinions; and this a middle-aged Scotch-
man does not like to do. So it is well to discredit the whole
matter, by mixing it up with the prejudiced notions of the
day; and here he has “high potencies” and Dr. Fincke
ready to his hand, and, with an audacity altogether remark-
able, he declares there is not a doubt that Dr. F.’s method
is the same as that of Count K. I suppose he is equally
well informed on this subject, as on the chronology of the
practice of Channing. The information he imparts in this
declaration, will greatly relieve the anxieties of some of our
friends in Philadelphia, who have shown no little earnest
28 Cozzfacá Potezzczes. [October,
Solicitude to compass a knowledge of the ſact, just how
Fincke did prepare his “high potencies.” They have been
almost ready to quarrel on the subject. They must be
greatly relieved. It may be quietly hinted to Dr. II., pri-
vately, that there is doubt on this subject; that those who
know Fincke best here, believe he has kept the secret of his
method very much to himself. They do not believe he has
in parted a knowledge of it to Dr. II. ; and that, as to Dr.
II.'s guessing, he is quite as likely to be wrong as right.
And then, both Korsakoff and Hahnemann seem to have
regarded the newly-medicated globules as identities in med-
icinal power with that of the medicated globule introduced
to them, from which they had derived all their own power.
They did not regard the new as one or more degrees higher
in the scale of potentization, than the old. I think IIahne-
mann speaks on this point distinctly. Does Dr. Fincke dif-
fer from these philosophers? Will Dr. H. tell us?
But there is another reason for doubting the accuracy of
this statement of Dr. II. Dr. Fincke is one of the most
exact of living experimeuters. He says his “high poten-
cies '' are exactly what they purport to be — a scale in the
centesimal ratio, up to the highest number he has announced.
We know Dr. F. to be a truthful man. We have known
him for years, and bear willing and earnest testimony to
this fact. IIe is intelligent, and he would know, as quick
as any man, the utter impossibility of measuring the com-
municated power, so as to be able to say of it, that, as found
in the newly-medicated globules, in his scale, it is in the
exact rising centesimal ratio. And yet, this he avers of his
scale of high potencies. The Philadelphia gentlemen know
this; and it may be necessary for Dr. II. to guess again,
before they are entirely relieved.
The declaration that IIahnemann considered Korsakoff’s
“high potencies” “useless,” and that he “discarded ”
them, needs confirmation. It does not receive this from
either of his three letters, which follow the papers of Kor-
sakoff, above referred to. Even if the statement were true,
it is not very clear that it has any thing to do with the chro-
1868.] Contact Potencies. 29
<
mology of Channing's practice, or the prior observation, by
himself or Korsakoff, of the fact of potentization by con-
tact. It is evident, after all, that even Dr. H. does not
regard this prior question as of any great moment. He
has more concern about the “high potencies;” and hence,
second-hand from Dudgeon, he attempts to discredit them,
by an asserted disapproval of IIahnemann. The paragraph
which has probably given rise to this asserted disapproval,
is the closing one with which he follows Korsakoff’s second
communication. IIere it is :
“In the mean time, it is to be borne in mind that this
preparation (1500th of Sulphur), aids (diente) the investiga-
tion of how high the potentized medicinal dilution can be
carried, without its effects on the human susceptibility
(menschliche Beſinden) becoming a nullity, upon which every
experiment is invaluable. Still, for the Homoeopathic treat-
ment of the sick, it is appropriate (Zweckmässig) in the prepa-
ration of medicines of all kinds, to adhere to the decillionth
dilution and potentization, that Homoeopathic physicians may
have uniform results in their cures /* *
This is all; the italics are our own. We see no “discard-
ing” in it, as “useless, in a practical point of view.” If
there be any other paragraph in the writings of Hahnemann,
where he makes this repudiation of Korsakoff’s preparations
or experiments, I am yet to be informed of it. It may be
well to remember that when this paragraph was penned, the
whole subject of the “high potencies” was of the newest.
Rorsakoff had just startled and astonished the world of
IIomoeopathists, IIahnemann included, with the fact that at
least one drug had been carried, phial by phial, to the 1500th
potency, and that this was still capable of affecting the living
organism. The bare fact had been announced — no rhore.
As to its practical value or “uselessness” at that time,
neither Hahnemann nor Korsakoff were informed ; and
IIahnemann was certainly less likely to go off “half-cocked,”
on such a subject, than some who have affected to be his
* This is not the first time this assertion of Dudgeon has been made to do
the office of a false witness, nor is it the first time it has been corrected.
3O Cozzłacá Požencies. [October,
followers — and, perhaps, to some extent, his admirers.
Subsequent experiments abundantly proved the practical
value of these preparations, to both these philosophers; and
both had the sense to profit by the knowledge. But Sup-
pose it had been otherwise, and Hahnemann had died with-
out the knowledge of the facts which now show the practical
value of high potencies so abundantly, what would it mat-
ter? Would it be any sufficient reason for either Dr. H. or
myself stultifying ourselves by burying ourselves in the
same ignorance, and insisting on shutting our eyes to all
evidence which he had not received, and excluding all con-
victions from experiences to which he was a stranger, or
which may even have been only subsequent to his death, as
most of those in relation to this subject have been 7 We
commend to the attention of Dr. II., the paragraph which
immediately precedes that which we have translated. It
contains IIahnemann’s views of those who hold “high
potencies” in light esteem.
The parenthetical inquiry of Dr. II., as to the identity of
the Gross who “gave his adhesion to the doctrine” of high
potencies, with that other of the name who has so greatly
excited his disgust by a book on “Comparative Materia
Medica,” affords an opportunity to express surprise at the
T}r.’s want of intelligence as to these great names in IIom-
Oeopathic literature. We shall not avail ourselves of it, for
the simple reason, we are not surprised at all. But he may
as well know, hereafter, that the “adhering” Gross is the
one who, at the time, was joint editor with Stapf, of the
“Archiv,” than whom, there are few among those who
have contributed to the literature of our school, more
worthy of his acquaintance and honorable regard. It is
safe to believe, if the Dr. had been better acquainted with
the writings of this master, his own innate modesty would
have prevented his characterizing the work of the younger
brother in terms quite so contemptuous as those he employs.
He might, in this instance, have been better instructed as to
the subject-matter of the work he spurns, than he seems to
be now. There are those who think that, even if there are
1868.] 7%e Dose. 3 I
some things in this work, which, to the partially instructed,
may appear absurd, it is far from being the “most absurd
and useless of all rubbish.” And more than this, even :
that there are other quite voluminous works, which, if
divested of all their “useless * contents, would be mate-
rially reduced in size. In plain words, Dr. H. ought to
have known that it is not likely to be accepted by others as
either becoming or wise, in one of his present standing, to
employ such language in characterizing the works of one
so worthy of respect for his great learning and industry.
He occupies no such position in the world of letters or sci-
ences, as warrants his speaking with contempt of the labors
of the younger Gross. He can not do this, without especial
damage to himself. IIe has the right of adverse judgment
in the matter, but not to cast contempt.
“THE DOSE : A LAW SUGGESTED FOR THE
SELECTION OF THE PROPER QUANTITY. By
E. M. HALE, M.D., of Jon ESVILLE, MICH.” +
BY S. A. Jones, M.D., ENGLEwood, N. J.
THE writer is one who was fascinated with this Law of Dose,
and he would here express his obligations to its author for
having furnished such a thought-evoking topic.
This question of the dose is one which has elicited the
earnest consideration of many of the ablest of our school.
Dudgeon’s pages show what a diversity of opinion has been
entertained; and the practice of to-day reveals the undenia-
ble fact that, as a school, we are not yet posologically a
unit.
Hahnemann’s desire to establish the “regulation 30th *
as the uniform potency for our employment, seems to have
been regarded as the prompting of policy, rather than a
* N. A. Jour, of Hom., Vol. IX., p. 261, et seq.
32 7%e Dose. [October,
conviction that it was the dose. IIe, indeed, advances in its
favor the assertion that, by adopting it, the “other side ’’
could not accuse us of having no fixed posological basis.
There is a somewhat general dissatisfaction with the IIahne-
mannian standard; and this dissatisfaction is justified by
the contents of that pocket-case which IIahnemann “used
shortly before his death.” +
Surely, neither the hardiest disciple of “low” materiality
nor of “high '' spirituality will call this a freak of semility.
It is, rather, a lesson to both factions. He who is our mas-
ter, pinned his faith to neither extreme of the posological
scale; he startled the “low” dilutionists by employing the
highest “spiritualities” of his day; he horrified the “high "
priests of Homoeopathy, by countenancing the “low” pub-
licans of the faith.
We may here remark, that IIahnemann is one of the very
few whose deeds are better than their words; for it can not
have escaped the careful student, that the “characteristic ’’
of his writings is self-contradiction. But our every cavil is
Satisfied, when we go from his theories to his practice: in
the former, he is often contradictory; in the latter, straight
as the plumb-line of Truth.
There is, then, curative potentiality in the extremes of the
posological scale; and these seekings for a law of dose are
the results of a legitimate yearning for a fixed formula, to
show wherein we should employ the one or the other dose.
The writer owes it to Dr. IIale to confess that he once
imagined physiological experiment had already furnished
facts enough to demonstrate the truth of his law. If he now
doubts this sanguine belief, it is because a trifle more know-
ledge, slowly and painfully gathered, has shown him how
very much there is to be proven, in order to substantiate the
law. Only the wholesome fear of a “premature delivery,”—
a fear which will surely be allowed in a medical writer —
* “The dilutions contained in this case were not all alike ; still less wero
they all the regulation 30th. On the contrary, they ranged from 3 up to
30; showing that, up to the latest period of his life, IIahnemann employed
a variety of dilutions.” (Dudgeon's Lectures on Homoeopathy, p. 407.)
1868.] 7%e /Dose. 33
restrained him from “rushing into print,” with the crude
results of his study of the law. IIe may be allowed to say
that, while reading, research, and reflection, have revealed
much truth in Hale's Law of Dose, they have also suggested
doubts, and shown that there are many missing links in the
chain of its logical completeness; let us add, we believe
these missing links will be found before the full dawn of the
next century.
IIaving thus defined our position in regard to Hale's Law
of Dose, we can not be considered as being actuated by any
feeling inimical to him. If we do not now write from a
higher altitude than is reached by the dung-flies of criticism,
verily, the “court does not know herself.” We present our
queries with honest earnestness, and ask an answer with all
the sincerity of one who seeks the truth — come that truth
whence, or from whom, it may.
In this Journal for October, 1867, p. 31, “On the Action
of Digitalis,” we find Dr. IIale reisserting his Law of Dose.
In the “North American Journal of Homoeopathy ’’ for
February, 1868, p. 365, “Analysis of Remedies,” we find
him saying: “One thing must be observed by every physi-
cian who reads our literature. It is this: that these men
who have made the analysis and comparative diagnosis of
medicines a special life-study, are those who make cures
with the high and highest potencies. In my own practice, I
have found, even with new remedies, that the more closely
I analyze the remedy, or remedies, selected to be prescribed,
the better success I have had with the high attenuations.
The ºth will often cure, if prescribed empirically; the 30th,
if its symptoms nearly correspond with the disease; and, if
the remedy is the exact similimum, the 200th or 2000th cures
more promptly still.”
In as far as we accept any writer as a teacher, in so far
have we the right to demand that he shall explain his utter-
ances. Because, then, we have given precious time to the
consideration of IIale's Law of Dose, we demand of him an
explanation of this strange passage.
It may be well to say that we have ever been a “low”
Vol. IV. — No. 13. 3
34 7%e Dose. [October,
dilutionist; that, led by the results obtained by men whom
we believe and trust, we are seeking light in regard to the
“high attenuations;” that, so far as we know our own
heart, we are looking toward the higher potencies with an
earnest desire to know the truth. Therefore, because this
dictum is so pregnant with significance, we demand an
explanation of this extraordinary assertion. Be it, however,
distinctly understood that we do not, for a moment, deny
the curative potentiality of the 2000th ; and that we use the
words “extraordinary assertion,” not from skepticism, but,
simply because, tried by his Law of Dose, his assertion is
indeed eactraordinary.
See what is required of a believer in the Law of Dose, in
order that he may accept this “extraordinary assertion.”
This Taw teaches that when the 200th or 2000th is pre-
scribed, it is for the unmistakable “primary symptoms”
of the “remedy or remedies selected to be prescribed.”
From this it should follow that the more “closely ’’ we
analyze a remedy, the more certainly are its “primary
symptoms” revealed to us. This, we are not prepared to
believe; but, granting that it be true, we are constrained to
ask: If the “better success '' is thus obtainable, why resort
to “secondary symptoms” and large doses at all ? Is it not
possible to meet a diseased state wherein the “secondary
symptoms” of one remedy, and the “primary '' of another,
are coéxistent: and, if so, does not Dr. Tſale’s “better suc-
cess” demand that we should prescribe ſrom the latter, and
employ a high attenuation ? If this be so, we must confess
that the Law of I)ose assumes the unseemly aspect of an
“easy method” for those who will not or can not make the
very desirable close analysis. And iſ there be any one truth
in science and in art, it is, that there are only two ways: the
right and the wrong. True, if not capable of the right way,
it remains for us to do to the best of our ability. But, if
genuine Homoeopathy requires the very closest analysis, it
follows, inevitably, that the farther we are from the closest
analysis, the farther we are from genuine Homoeopathy. In
1868.] 7%e Dose. 35
this light, we see the Law of Dose only as a seducing flesh-
pot of Egypt.
In this “extraordinary assertion,” Dr. Hale has virtually
reiterated what IIahnemann has already asserted; namely,
that we should base treatment upon only primary pathogene-
tic symptoms. This admission, coming from the author of
the Law of Dose, assumes the full solemnity of unconscious
testimony to a truth not seen (or clearly recognized) by him
who testifies. And it is this which gives it an unspeakable
value to us, individually; for it is such testimony, derived
from old school writers, that has reassured us in those hours
of darkness and trembling faith, known to every young
physician. We look up, at this very instant, to some three
hundred volumes, bearing many a name unfriendly to our
cause; yet have they, in very truth, been friends to us, for
their unconscious testimony hath made us what we are
to-day, from the “low ground and bottom * of our heart,
“only a IIomoeopath.”
We now desire to speak even plainer, and with the earnest
hope that our sincerity will save us from giving offence. Dr.
Hale says: “The ºth will often cure, if prescribed empir-
ically; the 30th, if its symptoms nearly correspond with the
disease; and, if the remedy is the exact similimum, the 200th
or 2000th cures more promptly still.” Does Homo"opathy
recognize such a sliding-scale of therapeutic possibility ?
Dr. Hale will answer, for he has said: “All cures are Hom-
ocopathie cures, whether made with the 200th, or with grain
doses of the crude drug.” +
Now, we are free to confess that we trace our partiality
to the Law of Dose, to a very natural desire of being enabled
by it to explain such cures. But, while we accept the cure
as a thing accomplished, yet are we forced to ask, is there
mothing which is Sui generis Homoeopathic in the method of
obtaining a cure ? and does the law of Similia apply to quan-
tity as well as to quality ?
Before considering the latter clause of this query, we will
* “New Remedics,” 2nd Edition, Preface, p. ix.
36 The Dose. [October,
Say that such a methodus medemdi as Dr. Iſale outlines in the
use of the ºth and 30th, is a slovenly, slipshod “practice.”
Truth compels the writer to confess that it is his practice, to
such an extent as shows his shameful ignorance. IIe has
ever sought to shrive himself with the poor plea of self-
acknowledged ignorance; and he has ever done it with the
innermost conviction that it is not IIomoeopathy.
What does Dr. Hale mean by the empirical employment
of the ºth 2 There is but one empiricism in Homoeopathy,
and that is a rational empiricism; an empiricism which can
give the reason of its empiricism. We are even pre-empiric
in that very “experience ’’ which is the basis of empiricism,
because our experience is pathogenetic before it is therapeu-
tic. Therefore, we can truly say, no physician is a pure
Homoeopath when he stands at the bedside with a remedy
which is an “unknown quantity,” — the undetermined ac or
y—in his hands.
Then must we not insist that the “empirical” use of the
Hºth, of which Dr. IIale speaks, is not Homoeopathy, because
Homoeopathy does not consist in claiming every “cure,”
however made 2 If we could, indeed, lay this flattering
unction to our soul, we should to-day be a more exultant
IIomoeopath than we are.
In regard to cures and the method of their attainment,
we respectfully say that we think Hippocrates better testi-
mony than IIale; and the “divine old man of Cos” obtained
more cures under the C. C. C., than the S. S. C. (Contraria
Contrariis Curantur, may not be denied ; and, as a school, do
we not waste that strength in denying Contraria, which
might be employed in “proving ” Similia 2)
Is not Dr. IIale’s use of the 30th, when “its symptoms
nearly correspond with the disease,” very much of a Chat-
ham street transaction ? You know the unsophisticated
countryman steps into a Jew’s shop, and puts on a coat.
The wily Israelite buttons it, and, taking up with his hand
a goodly fold of the superfluity between the shoulders,
gleams admiration from his oily face, and exclaims, “Ah, it
is fit you shplendid!”
1868.] The Dose. 37
5
Pity it is; but we often “cover'
shop of therapeutic old-clothes.
We are fain to say that when Dr. Hale's 30th has cured,
mayhap the vis medicatric natura, might rightfully charge
him with breaking the eighth commandment, if he claimed
the cure.
Homoeopathy demands not merely symptoms which
“nearly correspond,” but those most nearly corresponding.
When these are obtained, and the ºth and 30th prove not
equal in results to the 200th or 2000th, then doth it behoove
us to look into this matter; but until Dr. Iſale has tried the
#5th and 30th, each under its “exact similimum,” we must
beg him not to attenpt the role of a law-giver in the IIom-
oeopathic Israel.
We have entered these objections to what Dr. Iſale says
of the Hºrth and 30th, because, as we undergtand him, it indi-
cates a laxity of precision (?) very much out of place in a
Professor of Materia Medica; for we must add that the
climax of Goldsmith's picture of the Village Pastor is
especially applicable to the priests of our Therapeia:
Our cases, in the Jew-
“— as a bird each fond endearment tries,
To tempt its new-fledged offspring to the skies,
He tried each art, reproved each dull delay,
Allured to brighter worlds—and led the way.”
We urge not one sin, but many, against Dr. Hale. We
deprecate many of the criticisms evoked by the “New Rem-
edies. We fancied them aimed at “the power behind the
throne,” rather than at the throne as a seat of judgment,
(this may be needful, for the lash is wholesome, and the
argentum nitricum of truth is good for “proud-flesh,”) and
they only angered us, and blinded us to the very truth they
had to tell. On the other hand, we were grieved that Dr.
Dunham could find that which justified his critique. But
by the light of this last article of IIale’s, we see the “New
Remedies” as we never saw them before. There is good
in them. But Dr. Hale's last utterance leads us to consider
them as a boomerang: thrown by a skillful hand, the instru-
38 7%e Dose. [October,
ment returns harmlessly to the hand that threw it; unskill-
fully employed, it rebounds, only to brain the unfortunate
who used it, — and the very facility of the adept, tempts the
novice to his destruction. The looseness which character-
izes that indefinite use of the ºth and 30th, yet boldly
frames a dictum on it, pervades the work; its pages are
sprinkled with references to the Law of Dose; yet the last
words of the very author himself, give the lie to both.
While our ignorance is as Egyptian darkness compared
to the sunlight of knowledge which others, perhaps, enjoy,
yet have even little we learned to see and to fear that gener-
alizing spirit which gives a pseudo-philosophic aspect to the
“New Remedies;” and, though neither a prophet nor the
son of a prophet, we feel that generalization is the only
grave which IIomoeopathy need fear.
Resuming a thread lately dropped, we ask, Does the Law
of Similia apply to quantity as well as to quality ? Is our
dead master’s pocket-case a sufficient answer? Experience,
post-empirical experience, the experience that groweth out
of a rational empiricism, placed the 3rd and the 30th side
by side in it; but Hale's dietum demands their room for the
“200th or 2000th.” Surely, this is making the law of Similia
appertain to quantity as well as to quality. But we mean,
in the light of the Law of Dose: it has demanded of us to
recognize conditions wherein, with the “exact similimum,”
we should employ the large dose of the ºth, or the mother
tincture. We wish to see if I)r. Hale has entered the shrine
of his earlier worship, and turned iconoclast, because his
idol was a false god. If it be this, he shall cry “unclean,”
not louder than we.
Turn we, then, to the thoughtful seekers of the other
school. If they do sin against the clear light of our thera-
peutic law, it is only a “ day-blindness,” — for they, verily,
see in many dark places better than we. To them, then,
we look for experimental corroboration; for when physio-
logical research shall give us the law of stimulation, we,
who now “see through a glass, darkly,” will know when
to use the 3rd, and when the 30th. Perhaps we are nearer
1868.] Zhe Dose. 39
this glad consummation than many of us imagine; but, just
now, how dark is it, — for a very little earnest study of the
theory of primary and secondary symptoms will take us, seven
times out of ten, to precisely where Hahnemann left off with
it. Very probable is it that he dropped the terms “primary ''
and “secondary,” for the same reason that some of us have
doubted their validity: namely, because experiment Sug-
gests them to be scholastic subtleties, rather than fixed phe-
nonena. To instance: a minimum dose of Digitalis can
produce, as primary, symptoms which we also observe as
Secondary to a maximum; while those evoked by a medium
dose, differ entirely. Therefore, in what we now call pri-
mary and Secondary symptoms, the producing quantity of the
drug must be taken into consideration, in determining the
sequences of drug action.*
Adopt what view we may in regard to the dynamization
theory, a drug is a stimulus, not in a therapeutic sense, but
* The fact that we can obtain from differently sized doses of Digitalis, the
following Scries of primary and secondary symptoms, teaches that quantity
is a member of the pathogenetic equation :
1 Primal y : Increased frequency of cardiac pulsation.
• U Secondary : Decreased { { § { { { { {
Primal y : { { { { { { { { § {
' ' Secondary : Increased { { { { { { & &
Those friends whom we have thought hyper-Homoeopathic, need not scent
treason in the camp from this. Even if we accept a dynamic spiritualiza-
tion, and acknowledge in our remedy only a force liberated from materiality,
then, either that force is a quantity, or there is no need of a series of atten-
uations. º
As this note is more than half apologetic, permit us to say that we Hom-
ocopaths are too fearful of our theories; we accept them in faith, and are too
apt to deem him an infidel who would question or closely scrutinize them.
In more momentous matters than physic, we are bidden to “prove all
things;” and when, with reverent fear, we do this in physic, Homoeopathy
need never tremble. Stripped of her every error to-day, she would only run
the race with flecter and frcer step. That she has ran so long and so well
with all her theories, is proof not of their truth, but of her vitality.
A true friend of Iſomoeopathy has said of the Homoeopath : “His science
is too gasiform. He must fix it in the solid bones, the firm flesh, and the
liquid blood, of living systems. As a speculator, he is in danger of becoming
attenuated and mystical. But for the best thing about him — viz., the fact
that he is a successful and eminently practical physician — his theory might
have evaporated long ere now. As it is, there is no man of science, of the
present day, who stands so much in need of being implored to study other
4O 7%e /Jose. [October,
physiologically. And beyond this is the fact that there
is a ratio between the stimulus and the responsive condition
of the organism. We see this exemplified in drug and in
food idiosyncracies. Are there degrees of what we will call
responsivity in disease? We may answer, Yes, in so far as
the “action ” of any one drug is concerned. Take the term
ërritability, as Fletcher employs it, and physiological experi-
ment has demonstrated the truth of what we now affirm.
Take it as meaning the degree of the capability of respond-
ing to a physiological stimulus, and then consider the effects
of a galvanic current on the heart: a weak one will increase
the frequency of its pulsations; but soon they begin to
decrease in frequency. Then a stronger current again
increases them; but, after a time, they again decrease.
Thus, a continually greater stimulus is necessary to produce
a given effect; and it will do it, until the sum of the irrita-
bility is exhausted. Our friends of the old school perform
a similar experiment, when they “establish a toleration of
the remedy.”
So far as we know, this is the only experimental basis on
which the Law of Dose can rest — oh, the missing links —
but from this experiment, we deduce the following physio-
logical law : (?)
When the irritability is plus, a weak stimulus.
When it is minus, a powerful.
In therapeutics, we assume the following formula:
When the organic susceptibility is plus, a “high" attenuation.
When it is minus, even the awful (). *
departments profoundly. The apostle of Homoeopathy should be a very
learned man, in order to harmonize the new doctrine, at first sound, so dis-
Cordant, with the old culture and the swelling sciences. His Solemn duty is
to promulgate his truth, not like a sectarian, but as becomes a catholic mom-
ber of the universal school of scientific investigation.” (Dr. Samuel Brown
“On the Theory of Small Doses.”)
* Evidently, one member of the equation is left out. We supply it, hypo-
thetically :
Irritability in health =5.
{{ “ disease=54-5, or 5–5.
If this is hypothesis, we have the poor satisfaction of knowing that one
1868.] 7%e Dose. 4 I
Hale has illustrated this formula in his first paper on the
Law of Dose, and especially where he speaks of giving
“minute doses of Aconite or Veratrum, in the chilly stages
of all fevers.” It may insure from the reader a more can-
did consideration of the theory which attempts to explain
this, if we say that Hahnemann himself looked upon this
very theory, in its infancy, with longing, and not condemn.
ing eyes. It is the despised strictum and lazum of old-time
pathology. Scattered through Hahnemann’s writings, we
find mention of “rigid fibre,” “rigidity of fibre,” etc. It
is the strictum and lazum, moulding the opinions of him who
wrote a contempt of pathology, even while he could not
fling pathology wholly aside. Latter-day research is taking
the dry bones of strictum and lacum, and is clothing them
with the muscle and nerve of demonstrated details, and
soon we hope to see the theory a living fact.
Neuro-pathology lives, despite the sneers of cellular-
pathological-Virchow, and the vaso-motor theory is fast
merging into the realm of tangible demonstration. To-day
it says a plus of irritability obtains in the “chilly stages of
fevers;” therefore, a “minute dose of Aconite or Veratrum.”
When the irritability of the vaso-notors is exhausted,
and becomes minus, it points to a dilatation of the sanguin-
eous vessels, and an unusual afflux of blood, - the hot stage
of fevers, wherein Dr. Hale's law directs “large doses of Aco-
quite or Veratrum,” which accords with the formula — irri-
tability minus, dose large. With this, be it remembered
that the Tincture of Aconite applied to the frog’s web, has
produced a primary contraction and a secondary dilatation of
the vessels, as shown by the microscope.
We will now attempt to consider how far the Law of Dose,
as interpreted by a vaso-motor theory, countenances Dr.
IIale’s “better success with the high and highest poten-
cies.”
of our school's hypotheses must perish with our own. The 5–5 will be
understood as referring to the hypothetical action of one drug-Say Digi-
talis, as Dr. Wilks used it.
42 The Dose. [October,
1. The law requires Dr. H. to have prescribed for primary
symptoms, because of the sized dose employed.
2. The theory demands that the primary Symptoms equal
a plus of irritability, for the same reason. *
It may be well here to define what we mean by a plus of
irritability, in this connection. It is the supposed function
of the vaso-motor system, to give that “tone * to the blood-
vessels which preserves their normal calibre. Suppose we
represent that degree of irritability which preserves the nor-
mal calibre, by 5: if vaso-motor action reduces that calibre
one-half, we would say the irritability is then plus 5, which
would make the actual condition 5 +5=10; evidently a plus
of the “tone,” “action,” “force,” or what you will, that
regulates the calibre. Is it in view of this plus of irritability,
that Dr. IIale says, in his first paper on the Law of Dose :
“I consider it manifestly irrational and unsafe (Hempel not-
withstanding) to give massive doses of Aconite in the collapse
of cholera or congestive fever; and I consider it equally
unsafe to give the highest potencies of that drug in acute
fever and congestion ?”
Does this view of a plus of irritability occasion a single
nom Sequitur in any disease-rationale which we may attempt to
explain by it? One glance at the very dissimilar “actions”
of Nua, vom. and Gelseminum, would lead us to expect a mom
Sequitur at once; but festina lente is a fine motto in every
thing.
In view of the action of Veratrum viride, f we ask if the
* Although this is a petitio principii we take the liberty of presenting it,
because the various phenomena of vaso-motor action are, as yet, capable of
being diversely interpreted. The writer is aware that one assertion made
by Cl, Bernard, bears directly against the hypothesis we are now framing.
The reader will, therefore, remember that the view we are now presenting
rests upon a purely scholastic basis.
f Because the action of Veratrum presents the phenomenon of periph-
cral anaemia, with central hyperacmia, Dr. IIale's remarks under “Mucous
Membranes" provoke a query. “Its action on these membranes is probably
extensive. Like Tartar emotic, it will cause hyperacmia, and even inflamma-
tion, if applied locally, or even by its internal administration. In the latter
instance, however, its action is secondary.” (“New Remedics,” 2nd Ed., page
1868.] Z%e Dose. 43
vaso-motor system has its polarities, so that, while a con-
striction of the vessels obtains in one portion of its sphere,
a dilatation coéxists in another ? We ask the question,
because some of its phenomena resemble that chill-stage of
some fevers, wherein there is pallor of the cutaneous Sur-
face, and a minus of blood in the cutaneous vessels; while a
fearful congestion of a viscus, or of viscera, at the same
time exists. In such an instance, the condition of the liver,
spleen, or stomach, might excite a serious hæmatenesis;
and should we attribute that to the hyperaemied viscus, or go
farther back, and trace it to the anaemied skin 7 This, then,
would seem to negative an active polarity, and refer us to
pure physics for an explanation. It is emphatically hypo-
thetical; for who can tell us that the irritability of a viscus
is not exhausted sooner than that of the skin, so that the
congestion which we deem primary, may really be the secon-
dary of a brief primary condition ? While we may incline
to a physical view, on the ground that the displaced blood
must go somewhere, we must still ask, why should it “deter-
mine ‘’ to the brain at one time, the liver at another, the
spleen at another ? In “biliousness,” (a word which is a
synonym of ignorance,) why should hepatic anaemia (?) give
us cerebral hyperaemia (?) and vertigo 2 Is the menstrual
cycle dependent upon physics only 7 Is there not, rather, a
pathological law of organic election ? And if we assume
two conditions in disease-states —
1. Active : A plus of irritability.
2. Passive : A minus “ {{
must we not confess that our 2nd is a postulate 2
But can we show that primary symptoms depend upon our
assumed first condition, while secondary symptoms are equally
dependent upon our second Again we refer to the mon
scquitur which seems to spring up, on the first glance at the
1050.) Remembering the sympathy existing between the skin and intestinal
mucous membrane, we ask if the antennia of the skin also obtains in the intes-
timal mucous membrane, during the primary action of Veratrum ; and when
we see cutaneous anaemia occurring pathologically, how far may we assume
the coèxistence of anaemia in the intestimal mucous membrane *
44 7%e Dose. [October,
primary symptoms of Nur vom. and of Gelseminum ? Nua.
vom. : primary — spasm; secondary — paralysis. Gelsemi-
num: vice versa. If primary symptoms depend upon a plus
of irritability, and if a plus of irritability equals a constric-
tion of the vessels, can we call the primary Symptoms of these
two drugs alike :
We do not yet know, beyond all doubt, but that the first
effect of every drug is to produce a constriction of the vessels,
and that this may escape observation, owing to the fact that
the stage of constriction may be an exceedingly brief one.*
If constriction of the vessels is an active condition, a bona
fide plus, while dilatation of them is an equally passive
condition, a boma fide minus, analogy would lead us to believe
that the plus condition obtains first in disease. We are led
to accept this, because our organism seems as if it offered a
certain resistance to the attack of disease. For instance,
Digitalis is really a cardiac debilitant; yet it will, at first,
increase the action of the heart.
But, it may be the “action ” of a drug to add a plus, or
to add a minus to the organism. Gelseminum may, at first,
add a plus, but be instantly followed by a minus condition ;
or, it may add a minus from the first instant of its action.
The view that it adds a minus, may explain one assertion of
Dr. Hale's, which has seemed unpathological to some of his
readers: “It causes hyperäemia of that organ (the brain),
which stops just short of inflammation. But its paralyzing
influence on the great reactive forces of life, prevents that
termination, by destroying the reactive power of the sys-
* Those who have studied the phenomena of medicinal action, with the
microscope, are not yet positive that a constriction of the vessels does not
obtain, although the period of its duration is sometimes So brief that it may
be called just an oscillation. Cold constricts them, heat dilates; but Lister
found that “tepid water, applicd to the frog's foot, first induced constriction,
then dilatation of the arterics.” A marked degree of heat, Suddenly applied,
will produce as sudden a dilation. Is it because the irritability is ovel-
whelmed by the stimulus? If not, what will explain the diverse action of
small and of large doscs of Digitalis? Lister's inhibitory thcory counte-
nances this view.
1868.] 7%e Dose. 45
tem.” It may be the action of Gelseminum to add such a
minus at once, as “loosens the golden cord.”
Our inquiry assumes the phase that primary Symptoms
may be antipodal. Then, seeking the “better success,”
shall we give the “highest attenuation ” of Aconite for the
“primary " Aconite anaemia, and the “highest attenuation *
of Gelseminum for the “secondary" Aconile hyperaemia 7
The Law of Dose says, emphatically, No |
“If the primary Symptoms of a disease are present, and we are
combatting them with a remedy whose primary symptoms are sim-
ălar, WE MUST MAKE THE DOSE THE SMALLEST COMPATIBLE WITII
REASON; and, if we are treating the secondary symptoms of
a malady, with a remedy whose secondary symptoms corres-
pond, we must use as large a dose as we can with safety.”
This is the utterance of 1861, with the italics and “small
caps” included. The same voice of one crying in the wil-
derness of symptoms, in 1868, says: “The better success I
have had with the high attenuations,” having “the exact
similimum, the 200th or 2000th cures more promptly still.”
Dear Doctor, you are like the pathogenesis of Aconite, for
you “blow ’’ both hot and cold. But, fellow-laborer, let us
ask thee if the “secondary '' symptoms of a febrile chill-
stage present the “exact similimum ” of Aconite “secondary
symptoms,” how dost thou manage now to obtain thy “bet-
ter success 2'' And tell us what was thine other “success;”
was it 100. or .001 7
If our feeble effort has not cast the shadow of a single
truth upon the Law of Dose; if we have not presented the
faintest show of a reason why the Law of Dose should not
be rejected, we are even then content to point to the mas-
ter’s pocket-case, and ask that its testimony be not cast
aside by the assertion that, with “the exact similimum, the
200th or 2000th cures more promptly.”
Could even Dr. IIale stand before that statue at Leipsic,
and accuse HIM of having, in the maturity of his experience,
used the 3rd and the 30th without THE Similimum ?
IBecause Dr. IIale has both differed with the master and
enunciated the Law of Dose, we ask of him an explanation
46 A Case of Catarrha/ Co/i/?s. [October,
of this last “extraordinary assertion.” As one who has
wrestled with death after the manner of his teachings, we
demand of him a recantation of either the impotent Law
of Dose, or of this last utterance — the pseudo axiom which
is not a “self-evident truth,” when judged by that Law of
Dose.
A CASE OF CATARRIIAL COLITIS, RESULTING
IN ULCERATION, CURED BY OLEUM TEREBIN-
THINAE.
BY E. M. HALE, M.D., CHICAGo, ILL.
THE following case presents so many peculiar symptoms,
and is so interesting in every way, that I have had no hesi-
tation in reporting it at some length. It presents three pecu-
liarities which will attract the attention of the physician:
I. The absence of painful symptoms.
II. The unusual duration of the disease.
III. The facility with which it yielded to the specific
remedy, after many apparently indicated remedies failed to
CU] I’O.
On the 3rd of September, 1867, I was called upon to pre-
scribe for Mr. K., a thin, light-haired, blue-eyed person, of
nervo-sanguine temperament, aged 38 years. His symploms
were simply slight pain in the region of the ascending and
transverse colon, with frequent loose, mucous stools, without
tenesmus. The history of the case was, in brief, as follows:
After exposure to cool, damp air, in the evening, he was
seized with a chill, not very severe, but attended with a
sensation of “great weakness in the centre of the bowels,
with a feeling as if the intestines were hung upon, or drawn
to, a central point, and radiated from thence, like the spokes
of a wheel.” The abdomen seemed to him “drawn up,”
although such was not the case. After the chill passed off,
no perceptible febrile reaction occurred; no actual pain in
1868.] A Case of Catarrhal Colițis. 47
the bowels, but a peculiar sensitiveness, as if he could not
press upon them, or walk as well as usual. The next morn-
ing, he commenced to have loose mucous stools, mixed with
small portions of foecal matter. It was not until the third
day after this occurrence, that he came to ine, presenting
the first-mentioned symptoms. His brother had just recov-
ered ſrom an attack of dysentery, which lasted about ten
days; and I supposed I had to deal with the beginning of a
similar case.
Prescription. — Merc. Sol., 2nd trit., every 3 hours.
Two days afterwards, the patient could not report any
improvement. The stools continued about the same, and
were very slightly streaked with blood. Tongue slightly
coated white; some appetite; pulse 80, a little too full. He
had, up to this time, pursued his usual routine of business;
I advised quiet and confinement to his room, and the recum-
bent position.
Prescription. — Pulsatilla, 3rd, every 3 hours.
This medicine was continued for several days, or until I
was satisfied no good would result from its further adminis-
tration.
During the next week, there was no apparent change in
the symptoms. The stools continued to be frequent, about
every three hours, and were composed of transparent gela-
tinous mucus, with scarcely a trace of blood, and occasional
scy bala. In this week, he got Colehicum, Podophyllum, Merc.
corr., and Dulcamara; but without effecting any decided
change for the better.
Two weeks had now elapsed since my first prescription,
and the result of the treatment was very unsatisfactory.
With a view to a better understanding of the real character
of the disease, and to discern, if possible, the presence of
some latent miasm which might retard the curative action
of medicines, I instituted inquiries, which evolved the fol-
lowing:
Mr. K. had, for ten years, stood at the head of a mer-
antile house engaged in an immense trade, and had
devoted his whole energies in that direction. During
48 A Case of Catarrhal Colitis. [October,
these years, he had been in the habit of going to his place
of business at 8 A.M., and remaining, closely confined,
until 10 or 11 P.M., without any mid-day meal — except,
Occasionally, a hasty lunch, eaten in his office, without suſ-
ficient mastication, and washed down with cold water.
After arriving at his house, late in the evening, a hearty
supper of meat, etc., was eaten, sometimes only a few
moments before retiring. As might be supposed, he suf-
fered from indigestion, had frequent “bilious attacks,” for
the relief of which he resorted to “Congress water ’’ and
“compound cathartic pills.” He rarely allowed himself any
real recreation. Several times a year, he went East, taking
Saratoga on his way, at which place he drank large quanti-
ties of the water, as is the absurd custom. Such travel was
equally bad as his life in Chicago; for in the cities of New
York and Boston, his time was engrossed with the toil of
making heavy purchases. On inquiry, I found that his
father was decidedly “scrofulous;” had been troubled with
obstinate eruptions, ulcerations of the legs, etc.
After carefully reviewing the symptoms of the case, as
well as the patient’s history, and with the full belief that
inherited psora, or a scrofulous diathesis, prevented the
proper action of the remedies used, I made the following
Prescription. — Graphiles, 30th, every six hours.
In several cases, I had found this medicine of great value
in intestinal disease, caused by the retrocession of some erup-
tion. Mr. K. could not remember of having had any skin
disease, except a roughness of the hands and fingers, which
he said had been called by physicians “Salt rheum.” I could
not discover any appearance of such an eruption on his
hands, or any portion of the body. Graphites not only cor-
responded to similar eruptions, but to all the Symptoms of the
patient; and I felt confident that benefit would accrue from
its administration. I was disappointed. At the end of a
week, my patient’s condition was worse. His appetite,
until this time moderate, began to fail; his strength also
gave way; he became despondent; he had slight febrile
action in the afternoon, with pulse at 90, hot hands, and
1868.] A Case of Catarrhal Co/itis. 49
dryness of the mouth; heavy, dull feeling in the head;
tongue coated yellowish-brown; a feeling of heaviness, full-
ness and oppression, after eating the simplest food; tender-
ness along the track of the ascending and transverse colon;
urine scanty, and high colored; stools four or five times a
day — generally in the morning, from 6 to 10 o’clock, with
an occasional one in the evening. These stools were very
peculiar, consisting of large masses of thick heavy mucus,
sometimes resembling the white of egg, at other times hav-
ing the appearance of a layer of oysters in the bottom of the
vessel (rounded opaque masses); no tenesmus, and no tor-
mina, only an uneasy feeling, with Sudden desire for stool, and
difficulty of retaining it. Every second or third day, the stools
would consist in part of small dark-colored Seybala, coated
with mucus. When these passed, quite severe griping
would occur; or “as if the hard balls scraped a sore, raw
surface, as they passed along the colon.”
Prescription. — Aloes, 2nd centesimal trituration.
This remedy was selected because of the symptoms in
italics, and from reading Dr. Dunham’s cure of several cases
of diarrhoea having those symptoms. The remedy was
used several days, but effected no improvement — probably
because the pathological state did not indicate it.
A study of the pathogenesis of Asarum europeum, showed
many points of resemblance between the symptoms of that
medicine and those of my patient; the “shaggy masses of
mucus,” as well as the “strings of mucus,” were, however,
not present in his case. The use of Asarum, 1st and 3rd,
for four days, failed to elicit any improvement.
Sulphur, 30th, a single dose in the morning, and Phosphor-
w8, 3rd, every three hours, were prescribed.
After three days, no improvement occurring, this was
changed to Phosphoric and Nitric acid, 2nd, which was con-
tinued for five days. dº e
Up to this time, although I had carefully inspected the
stools every day, I had not observed any thing having the
appearance of pus. In order to be sure, however, a few
drops of the discharge were placed under the microscope,
Vol. IV. — No. 13. 4.
5O A Case of Catarrhal Co/iſis. [October,
and also subjected to chemical tests, with the result of elic-
iting only the presence of broken-down blood corpuscles,
epithelium (some of them ciliated), mucus, and barely a
trace of pus. I had all along feared the accession of ulcera-
tion of the colon, and was not surprised at the appearance
of pus. I deemed it my duty to acquaint my patient with
its appearance, and explain to him its important bearing on
the prognosis.
The Nitric acid was suspended, after a few days, and Sili-
cea given in its place. The stools, however, became more
offensive, and decidedly purulent.
At this juncture, Dr. Ludlam was called in consultation.
After a careful examination, and a full acquaintance with
the patient’s history, he fully agreed with my diagnosis; i.e.,
that ulceration, probably scroſulous, had supervened on a
sub-acute inflammation of the ascending colon. Dr. P. II.
Hale, who also saw the patient, coincided with these views,
and discovered, also, the presence of indurations (of the
mesenteric glands? or irregular thickening of the walls of
the colon 7) directly over the seat of the disease. A few days
before this consultation, Mr. K. complained of a stiffness of
the knee; but no swelling was apparent, until the night
before Dr. Ludlam's visit. The consultation resulted in a
return to the use of Nitric acid, in alternation with Bryonia;
the latter for the swollen knee, which rapidly assumed all
the characteristics of a sub-acute synovitis.
(I will here digress, to mention a peculiarity which I have
forgotten to record, namely: the coating on the tongue — a
yellowish brown — was not persistent, but would clear off
about every four or five days, only to return again, as badly
as ever.)
The diet was modified, by the exclusion of all fatty mat-
ters, and a restriction to albuminous substances, such as
white of egg, beef-tea made from lean muscle, and a few
other articles. No external applications were advised, except
a weak Bryonia lotion to the knee, and an Arnica plaster
over the diseased intestine.
It may be useful, in this place, to inquire as to the proba-
1868.] A Case of Catarrhal Colitis. 5 I
ble results of such cases as this one, if the treatment adopted
fails of arresting the disease. We may also inquire into the
resources of Allopathy, and the usual results of that method
of treatment. One of the best authorities of the opposite
school of medicine, makes the following observations on
this disease: *
In describing the pathology of the disease, Iſabershon
observes that after the first and second stage has passed, the
third, or that of ulceration, occurs with the following charac-
ters: “Ulceration, sometimes merely as minute circular
ulcers, or, more frequently, the ulceration is much more
extensive, often oval in form, and placed in the transverse
axis of the intestine, the edges raised and much injected, the
margins irregular and undermined, and the floor formed by
the cellular and muscular coats. These ulcerations gradu-
ally extend, so as to coalesce, till at last nearly the whole of
the mucous surface is destroyed, except here and there prom-
inent isolated portions, which become intensely congested,
and resemble polypoid growths. In severe cases, the whole
colon, from the caecum to the rectum, is in this condition,
or greater spaces intervene, or ulcers are only found in the
rectum, sigmoid flexure, or caecum. It sometimes happens
that the ulceration extends through the muscular and peri-
toneal coats, leading to fatal peritonitis from perforation; or
the coats of the intestine become sinuous abscesses, so that
on dividing a prominent portion of mucous membrane,
between the ulcers, several drachms of pus escape.” When
the ulcerative action has been checked, “the cieatrix has an
irregular puckered appearance. The contraction of the
cicatrix sometimes produces considerable constriction of the
intestine, and occasionally tends to fatal obstruction. Very
frequently, above the cicatrix, all the coats become hyper-
trophied, showing that there has been much impediment.”
Dr. Baley, a prominent English physician, who has writ-
ten quite extensively on colitis, describes the process as one
of sloughing, rather than ulceration. Whilst describing this
* Habershon.
52 A Case of Ca/arrhal Colițis. [October,
“ epithelial degeneration,” as he terms it, he states that, in
most cases, the destruction of mucous membrane consists
in a process of mortification and sloughing, and not by sim-
ple ulceration; and that the disease commences in the soli-
tary glands of the intestines.
In the case under consideration, the destruction of mucous
membrane was probably limited to the ascending colon; for
in this location alone could we discover any tenderness, and
the pain was felt only in that region. When the patient,
every second or third day, had an evacuation of sybala,
painful sensations were felt only when they passed along
that portion of the intestine.
It would be interesting to discuss the relation of the sub-
acute synovitis, to the disease of the colon. Was it a purely
sympathetic inflammation ? or was it the result of pyaemia
from absorption of pus? Or was it merely a rheumatic
affection ? It is doubtful if such a condition of the knee-
joints can arise from sympathetic irritation alone. He had
never had rheumatism. The synovitis did not result in Sup-
puration. What, then, was the cause of the inflammation
of the knee-joint 7
IIabershon describes a variety of ulceration, or sloughing,
of the colon, under the head of “Strumous diseases of the
alimentary canal.” The case just narrated, may have been
of that class. The history of the patient, and the heredi-
tary scrofulous taint in the family, strongly tended to such
a disease. If such was the case, the recovery was certainly
not to be expccted; as such cases are usually as fatal as pul-
monary phthisis, with which they are generally associated.
The treatment, it will be observed, was in accordance with
Such a possible complication; and its success seemed to be
proof that it met the indications satisfactorily.
Another study of the symptoms and pathological condi-
tion of the patient, resulted in my selection of the Oil of
Turpentine as the remedy most likely to result in permanent
benefit.
We have not a pathogenesis of Turpentine as complete as
its merits demand. It is entitled to a proving as exhaustive
1868.] A Case of Catarrhal Colitis. 53
as the Vienna physicians bestowed upon Thuja, and if such
provings had been made of Turpentine, the Homoeopathic
medical profession would have been presented with results
of far greater value.
The use of Turpentine in intestinal ulceration, is not of
recent origin. According to Kinglake, Vogt, and Paris, all
old authorities, it “is an incomparable remedy in chronic
diarrhoea, with such discharges as denote the mucous coat of
the intestines to be chiefly affected.” Dr. Chapman recom-
mends it highly in dysentery, “when gangrene is menaced.”
Dr. Wood, of Philadelphia, after the most thorough trial of
Turpentine, in the Pennsylvania IIospital, declares that it is
superior to any other remedy, even Nitric acid, in ulceration
of the bowels occurring in typhoid fever, dysentery, and
similar diseases.
In our school, its virtues in nearly all diseases are gener-
ally ignored. This neglect is very properly denounced by
Dr. Hempel, in his Materia Medica. In 1859, I called the
attention of our school to the value of Turpentine in typhoid
fever, especially in the stage of ulceration.* Since that
time, I have habitually used it for the symptoms and condi-
tions pointed out in that paper — symptoms which are well
defined in its pathogenesis, meagre as it is. I do not find,
however, that the latest writers on Materia Medica, in our
school, place Turpentine in its proper place. Dr. Lippe gives
no characteristic symptoms of the intestinal discharges,
except “evacuations of mucus and water.” No mention is
made of its value in discharges of pus and blood from the
bowels, although, in such cases, it is superior to any other
remedy, in very many cases.
The Oil of Turpentine was prescribed for Mr. K., in the
first decimal dilution, ten drops every four hours. No other
remedy was given, except Bryonia occasionally, for the
recurring swelling of the knee-joint.
The first week, little or no change was perceptible in the
nature or frequency of the discharges. The second week,
* “ North American Journal of Homoeopathy,” Vol. VII., p. 421.
54 Isopathic Remedies. [October,
the urine became more profuse, and deposited less of the
thick flocculent sediment; and the amount of pus in the
stools was slightly diminished. It was not until the end of
the third week, that the purulent evacuations were much
diminished. At that time, soft, natural faecal stools occurred
every third morning, and the discharges of pus occurred
but once or twice a day, generally in the morning and even-
ing. The general condition of the patient, by this time,
had decidedly improved, and his diet was accordingly
increased in variety and quantity.
At the end of the fourth week, the purulent evacuations
ceased Suddenly — so sudden, in fact, that I feared metastasis
would occur; or, to speak more properly, a change of the
ulcerative process to some other organ or tissue. No such
result took place, however; and from that date, his conval-
escence was rapid.
ISOPATHIC REMEDIES.
CARROLL DUNIIAM, M.D. — Dear Doctor : —You once
kindly prescribed a remedy for me, with whose action I was
entirely unacquainted; and, whether owing to its dynamic
effect upon my brain, or from mere coincidence, I was led
to reason a little about the matter, with very little satisfac-
tion. That remedy was Psorine, or Psoricum, or Psorinum,
as it is variously called. I am frequently met, too, in our
works on Practice, and in the journals, by the recommenda-
tion of several other medicines, which may be termed the
cognates of this. Such are Vaccinine, Variolin, Glanderine,
IFarcine, Calc. urinaria, Cholesterine, etc. These substances
have been gradually creeping into our Materia Medica, till,
to the man of weak stomach, it seems to deserve the title
of Materia Medica Impura, rather than Pura.
Of these substances, I am not aware that more than one
(Psorine) has been proved; at least, no provings of them
appear in our text-books. They seem to be, and to have
1868.] Isopathic Remedies. 55
been, used on the warrant (?) of our law, as remedies for the
diseased conditions which produce them. Whether those
who have introduced them have deduced, from the similarity
of the proving of Psorine to suppressed itch, the conclusion
that all similar substances must act in the same way, and
that, therefore, provings of them are unnecessary, or whether
they deem the material products of disease to be & priori
IIomoeopathic to the abnormal conditions which produced
them, is not evident. In either case, is it not carrying
probability or hypothesis too far 7
These circumstances have induced me to address you
publicly, and to request you to lend the high sanction of
your approval to an enunciation of the principles governing
the use of such remedies, as well as some rational explana-
tion — if, indeed, they have any remedial virtue.
While it is not my desire to prejudge this subject, it may
be allowable to express some of the thoughts suggested by
it. The first and main question is this: Is the use of these
substances, while unproven, a legitimate application of our
law of cure? This query must receive a negative answer.
True, we do use some remedies which have not been regu-
larly proven, but never without a knowledge of their toxi-
cological effects, which shows at least the coarser outlines
of their pathogenetic action. But how can it be claimed
that the symptoms manifested in diseased states are patho-
genetic of the products of abnormal conditions? The theory
of Hahnemann claims that the causes of abnormal action
are IIomoeopathic to sinnilar (not identical) diseased condi-
tions; which is a far different thing. Such a theory as
seems to be countenanced by the use of these substances,
seems almost too absurd to reason upon. Were it true, we
should not have far to seek for our remedies. We should
have only to take diseased excretions, and prepare them by
trituration and dilution. Cancer would yield to a dilution
of cancerous cells, and dynamized feces would cure diar-
rhoea, etc. But this line of illustration is too disgusting to
pursue. And yet is it not a legitimate development of the
ideas which are suggested by those gentlemen who have
56 Isopath Žc Aremedzes. [October,
introduced these substances into our works on Materia
Medica and Practice Raue, in his late volume on Pathol-
ogy, Diagnostics and Therapeutics, advises us to administer
triturated urinary calculi, for that condition of the kidneys
which leads to their formation 1 and gall-stones are proposed
for cholesteraemia ( ! Can this be IIomoeopathy 7 Do they
thus read IIahnemann, in the school which bears his hon-
ored name * Perhaps we shall be referred to the proving
of Psorinc, which really simulates scabies very closely.
Before, however, yielding implicit credence to even this
proving, several questions of importance should be answered.
Was this proving actually made 7 or were the symptoms of
scabies written down as the pathogenesis of Psorine 3 Was
the prover in good health 7 Had he and his ancestors never
had the itch, or other similar disease ? Did he know what
he was proving : The power of imagination is such that it
can never be safe to allow a prover to know what substance
he is taking — at least, if the name affords any clue to its
known or suspected effects. Surely, any one at all versed
in the influence of the mind over the body, will not deny
that this is a most important, and, indeed, necessary condi-
tion of eliciting perfectly reliable and truthful provings.
The proneness of men to self-deception, in such and other
matters, is too well known and acknowledged to require
illustration and argument. It is as foolish to be too skep-
tical, as too credulous; but in a case like this, which logi-
cally leads us to look for remedies in the products of disease,
we can not be too careful of our premises and our reasoning.
Error in our Materia Medica, is error in our practice; and
error in our practice is death to our patients. Once acknow-
ledge that dynamized Psorine will generate scabies, or its
close analogue, in the healthy organism, and, consequently,
is IIomoeopathic to scabies and its analogous diseases, and
there is no objection to the conclusion — may, we must con-
clude — that other products of disease may, and probably
do, act in the same way. The door is open for Variolin,
Calc. urin., and the whole filthy herd of similar proposed
remedies. And however complacently our medical philoso-
1868.] Isopathic Remedies. 57
phers may regard the practical workings of such a theory,
it seems hardly probable that an intelligent community will
swallow either the dose or the doctrine.
Two other considerations here present themselves. An
old adage says, “The proof of the pudding is in the eating.”
Now, if these remedies are truly Homoeopathic, as they have
been prescribed — if this is a legitimate outgrowth of the
great law of Similio — how is it that brilliant cures are not
reported, which would tend to confirm the theory 2 If it is
a logical deduction from our law, that the products of dis-
eases are the truly Homoeopathic remedies for the diseases
which produce them, surely we can not find a closer simi-
larity any where; and, from their use, we should expect
most brilliant and triumphant and unfailing cures. Do the
records of such cures exist? True, Surgeon Schnappauf,
and Dr. Trinks, of Dresden, laud the virtues of Variolin very
highly ; but it seems good ground for supposing that these
gentlemen mistook the “post” for the “propter,” that their
experience does not seem to have been confirmed by others.
Indeed, a careful reading of the American and British jour-
mals, for several years, does not, so far as I remember, furnish
a single case of small-pox in which this remedy of remedies
has been used. Tartar emet. is in our hands a hundred times
where Variolin is prescribed once. Where is the case of
scabies cured by Psorine 2 Is not the old standard, Sulphur,
far better? Has Prof. Raue ever cured calculous nephritis
by Cale. urin., or cholesteraemia by prepared gall-stones?
If these wonders have occurred, they have failed to reach
my eyes; and if they have not, the ground upon which the
use of these substances rests, is too small to warrant the
places they have obtained in our philosophy.
Again, why should we turn from the myriad substances
which nature offers us, and which are yet untried, to the
filty excrements of the human or animal body ? We have
hardly entered the outskirts of the great field which our
law opens to us, in the various departments of nature.
Surely, here is material enough, and of a most promising
kind.
58 Isopathic Aremedies. [October,
IIere, our subject trenches upon another and kindred thera-
peutic theory, which is held in our school. We have claimed
that abnormal excretions or secretions from the human
body, are not and can not be IIomoeopathic to the conditions
which produce them. But what shall we say of the poison-
Ous secretions of animals, which, when introduced beneath
the skin, produce such rapid and fatal results 2 Are these
proper and legitimate remedies for the Homoeopathic phy-
sician : This question is quite a different one from that
which we have been discussing, but still has points in com-
mon with it. Assuredly, they are legitimate, and should be
powerful remedies; and would be proper, if they were capa-
ble of being proved, and had been proven. But are they
thus capable, and have they thus been proven 7 As the first
part of this query involves the last, to a great degree, let us
see if it can be satisfactorily answered.
It has long been held that serpent venom could be swal-
lowed with impunity — at least, in mass. And this is doubt-
less true; though it has occasionally been denied. Mead,
Mangili, Redi, Russell, all testify to the fact; while Dr. S. W.
Mitchell, whose studies of the rattlesnake venom, in the vol-
ume of the Smithsonian Institute for 1860, and in the “New
York Medical Journal” for January, 1868, are most thorough
and exhaustive, comes to the same conclusion. An assistant
of Mangili swallowed the poison of four large vipers, with-
out perceptible effect; and Mitchell shows that a mixture of
the venom with gastric juice, outside the body, destroys its
poisonous properties. It may, then, be regarded as fully
established, that the serpent poisons may be ingested — in
mass, at least — without pathogenetic effect. Still, it is
claimed that these substances, when diluted or triturated
after Hahnemann’s method, and ingested, do possess patho-
genetic power; and that it closely resenbles, or is identical
with their influence, when placed in contact with the blood.
We find, too, numerous clinical records confirming this view,
which seem worthy of confidence. IIow shall we explain
this anomaly 7 IIitherto, it has not been attempted. Our
authorities have been content to accept their pathogenetic
1868.] Isopathic Remedies. 59
action as a fact, especially established by their usefulness as
remedies. But the subject seems well worthy of investiga-
tion for its own sake, as well as for the consequences which
an adoption of this view imposes upon us. For, if venom
has the same effect, whether ingested or inserted beneath
the cuticle, the necessity of proving many substances is
avoidable; and our toxicological records will furnish us
with a symptomatology far more complete than could be
otherwise attained. &
A friend once suggested to me, that venom was probably
cellular in structure, and incapable of absorption, until
broken down by trituration and dilution. But Dr. Mead
found no such forms under the microscope; only a homo-
geneous mass, containing minute acicular crystals; and Dr.
Mitchell states, positively, that the venom of the rattlesnake
contains no vesicles, and is readily soluble in the fluids of
the primae viae. He states, too, that these fluids destroy its
poisonous properties, both within and without the body.
Now, how shall a small portion escape, where a large one
does not It can not be because the small quantity does
not excite a secretion of the intestinal fluids, which antidote
the poison; as any one may see by reading Dr. M.'s papers.
Can you offer any rational explanation, or must we acquiesce
with unhesitating faith ?
IIughes, page 87, “Pharmacodynamics,” claims that it is
a “question of fact,” and that the facts of the proving are
equally reliable with all opposing facts; and he believes
both. But I submit that, where opposing facts are so strong,
we should be very careful in our provings, and mindful of
the deceptions to which we are liable.
One other theory, in connection with therapeutics, I would
be glad to have you discuss; viz.: the transferability of the
peculiar dynamic virtues of a drug, with which the Creator
has invested it, to a non-medicinal substance — for instance,
sugar of milk, or alcohol. This theory is the refuge of all
high dilutionists, when confronted with the absence of a
drug in the preparations which they deem medicinal.
Should the spectroscope show the entire absence of metallic
6o Isopathic Remedies. [October,
gold in the 12th dilution, this fact would have no terrors;
for it is at once claimed that its dynamic properties have
been transferred to the menstruum. This is a very conven-
ient dogma; for, if untrue, there seems to be no way of
disproving it. We can reason upon it, only from analogy.
And it is claimed that a similar transference takes place in
the forces of nature. IIeat, magnetism, electricity, are
called in as witnesses. We can make and destroy a magnet
at pleasure. Very true; but these are forces which are uni-
versal, and exist in all substances, to a greater or less degree.
We can cause an accumulation or a loss of them, in any
substance; but when we make a magnet, we simply bring
about a chaige of quantity — we do not impart an entirely
new quality. So it is with heat and other forces: we may
accumulate them, or correlate them ; but it is not a change
which is comparable to imparting the virtues of gold to
Sugar of milk.
Again, it is held that the dilution of a drug develops new
dynamic virtues, which were not possessed by the crude
drug. If this be so, we shall need an entirely new symp-
tomatology, containing provings of the high dilutions, or we
can not logically use them in accordance with our law of cure.
Certainly there is a limit (and it can not be a very distant
one) to the subdivision of metallic substances, and long before
our higher dilutions have been reached, the particles of the
metal in solution must have disappeared. Still, there are
the clinical records, by as truthful and careful men as can
be found; and some of them are very knotty facts for those
who disbelieve in high dilutions.
I have been betrayed into a longer and more discursive
letter than I had intended. I trust, however, that I have
not wearied your patience, nor asked too much. It is high
time that these subjects were freely, fully, and dispassion-
ately discussed. I desired to urge upon you the importance
of laying down clearly the doctrines of the Homoeopathic
school, and supporting them by such facts and arguments as
are at your command. Inquiringly yours,
W. S. SEARLE, M.D.
TRoy, N. Y., May, 1868.
1868.] Isopathic Remedies. 61
\
DR. DUNHAM'S REPLY.
Far be it from me to presume “to lay down clearly the
doctrines of the Homoeopathic school;” if for no other rea-
son than that, except the law “Similia Similibus Curantur,”
no doctrine has yet been universally accepted by that School.
I can only express the conclusions to which reasoning and
observation have led me, individually. And I take pleasure
in stating that, on many questions of doctrine, I have reached
no conclusion, but await experience and testimony; for I
have no ambition to appear as one who has exhausted the
Springs of knowledge, and whose mind is made up on all
subjects.
If it is claimed that the symptoms manifested in diseased
states are pathogenetic of the products of abnormal condi-
tions, and if it is thence inferred that such products would
be IIomoeopathically indicated in “abnormal conditions °
which manifest similar “symptoms,” let Dr. Searle demand
a reason of him who makes this claim and draws this infer-
ence. I have never heard of them, and do not endorse
them.
It is a fact that I once prescribed Psorimum for Dr. Searle.
Psorinum was proved, and the proving published in the
“Archiv.,” Vols. XIII. and XV., over the names of several
of our most distinguished colleagues. In the proving, are
ſound a number of symptoms which closely resembled those
detailed to me by Dr. Searle. On the strength of this sim-
ilarity, I prescribed Psorinum — with as good justification,
it appears to me, as I should have had in prescribing Mercu-
rius for a case of dysentery in which the symptoms were
similar to those produced on the healthy by Mercurius.
This is the whole of my offending.
Whether Vaccinin, Variolin, Glanderine, Farcine, Cale. M.,
Cholesterime, etc., have ever been proved upon the healthy
subject, I do not know. If not, then it would be impossi-
ble to use them, in strict accordance with the Homoeopathic
law; and no Homoeopathist, as such, could prescribe them.
62 Isopathic ſeemedies. [October,
Dut our Materia Medica, large as it is, is far from adequate
to the exigencies of our therapeutics. We sometimes meet
a patient to whose symptoms it affords no similar. The
patient’s necessities admit of no delay. Now, if, in such a
case, our intellect should furnish a deduction, or our imagi-
nation suggest an analogy, by which we could anticipate a
proving of any substance, and perceive, in its assumed path-
ogenesis, a similarity to the symptoms of our patient, would
not a successful result, justify our temerity ? Such cases
must be very rare, but they sometimes happen. This would
not be regular Homoeopathy, but it would be legitimate prac-
tice of medicine. It is somewhat like the process by which
a physician, guided by the similarity of one or two symp-
toms of a remedy to symptoms of his patient, infers the
power in that remedy to produce, if completely proved,
symptoms similar to the rest of those which his patient
presents.
If Prof. Raue has successfully used the substances named
by Dr. Searle, whether proved or not, inquiries addressed
to him would, no doubt, receive a satisfactory response. IIe
is a gentleman not apt to erect a pyramid upon its apex.
Touching the disgusting nature of these substances, Dr.
IIering has made some interesting remarks, apropos of Pso-
rinum, (“North American Journal of IIomoeopathy,” Vol.
II., p. 361). Mankind are notoriously inconsistent in their
disgusts. Things to which we are not wonted, disgust us,
if they spring from a repulsive source; while those of equally
odious origin may become even welcome, through habit.
Our friend is nauseated by the mere idea of triturated oxal-
ate or phosphate from the bladder, or cholesterine from the
gall-bladder, or lymph from the itch vesicle, or pus from the
glandered horse, or faeces from the diseased intestine, (for
none of which, be it observed, do I stand god-father.) Yet
he will regale himself with the mushrooms, wherewith the
dew of this morning has crowned the cow-dropping of yes-
terday; will consume, with a gusto, raw oysters — intestine,
faeces, cholesterine, and all; will insert into the life-blood
of himself and of all who are dearest to him, lymph from
1868.] Isopathic Remedies. 63
the vaccine vesicle of Who-Knows-Who’s infants; will sat-
urate his handkerchief, and titillate his olfactories, with
Lubin’s perfumes — prepared, notoriously, by the aid of the
vilest secretions of man and beast; and will place in his
mouth, and “roll, as a choice morsel, under his tongue,”
Ilynchburg tobacco, which has been, for months, worked
over and fermented in the factory, and has received its final
and most delicate aroma from the decomposed urine of an
“inferior” (i.e., a non-Caucasian) race! Such are our incon-
sistencies. So true is it, “De gustibus mon est disputandum !”
It is probable that whatever substance, from whichever of
the kingdoms of nature, has the power to modify or alter,
in any way, any of the functions and tissues of the healthy
body, is capable of being used as a remedy for diseased con-
ditions. When we know how it alters and modifies the
functions and tissues of the healthy body (a proving shows us
how it does so), then the law Similia Similibus Curamtur teaches
us in what cases to apply it as a remedy.
Of all the substances named by Dr. Searle, Psorimum alone
has, to my knowledge, been thus proved. Under my obser-
vation, it has been used, according to the similarity of the
symptoms, in the treatment of cutaneous eruptions, of diar-
rhoea, and of a complication of typhoid fever. Although it
might be supposed that its use in cutaneous affections was
suggested by a theory based on the origin of the Psorinum,
yet, as a matter of fact, such a theory had nothing to do
with its selection in the cases that came under my notice.
It was chosen just as Staphysagria might be, from what
appeared to be a similarity of the symptoms. I should,
perhaps, add that I have not often used Psorinum. The
particular history of the proving is not known to me; neither
is that of Pulsatilla. I accept both, through my confidence
in the eminent men to whom we owe them – Hering and
Hahnemann, respectively. It is indeed true, that even such
men may err, and may receive, as genuine pathogeneses,
symptoms which have no value as such. How may such
errors be detected?
64 Isopathic /Pemedies. [October,
We depend on clinical experience to confirm our prov-
ings. It has established the polychrests of our Materia
Medica, as such. Here we meet Dr. Searle's question,
“IIow is it that brilliant cures are not reported ?” etc., etc.
This is a legitimate criticism upon such provings as we speak
of, and is open to only one fallacy: If the great body of our
physicians become so prejudiced against a proposed remedy,
because of its disgusting origin, or through distrust of the
prover, that they will not administer the remedy in cases in
which it appears IIomoeopathically indicated, then there can
be no accumulation of clinical experiences. If, as Dr. Searle
says, “a careful reading of the American and British jour-
mals, for several years, does not furnish a single case of
small-pox in which this remedy of remedies has been used,”
why, then, these journals give us no information at all about
this remedy; — certainly they bear no testimony against it.
If, as Dr. S. continues, “Tart. emet. is in our hands a hun-
dred times, where Variolin is prescribed once,” then Dr.
Searle's experience with Variolin, and his qualification to
judge it as a remedy, must be very slight, considering that
small-pox is not very frequently met in private practice, and
a hundred cases would be a large number to meet in a pri-
vate practice of fifteen years. If, then, the reports of Dr.
Trinks be nearly all that we find in our journals concerning
Variolin, and they are favorable, we must concede that the
balance of testimony is in favor of the remedy. The non-
use of a remedy is no evidence against its value, especially
if the non-users be prejudiced (have foréjudged) against it.
Were this otherwise, how would all of our IIonoeopathic
remedies, and our system itself, stand, considering the great
majority of medical men (the Allopaths) who will not employ
them or it 2
Even so is it with Lachesis (and Crotalus and Naja.) Many
IIomoeopathists refuse to prescribe it — some, because a Ger-
man proved it, and they distrust the Germans, forgetting
that IIahnemann was of that nationality; some, because
they can not, themselves, easily procure the pure venom,
and triturate it, or give massive doses; some, because the
1868.] Isopathic Remedies. 65
proving was made with tritirations or dilutions taken inter-
nally — and Redi and S. W. Mitchell have shown that ser-
pent-venom may be swallowed with impunity, even in large
quantities; nay, the latter has shown that gastric juice,
added to venom, destroys its poisonous properties. On the
strength of such testimony and demonstration as this, they
reject the symptoms recorded by such men as Hering, Neid-
hard, Bute, Reichhelm, Matlack, Russell, Stokes, Drysdale,
and Dudgeon, as having been produced in themselves by the
venom of Lachesis, Crolalus and Naja, triturated and diluted
according to the Homoeopathic formulae. But why thus
reject such testimony of men who represent all varieties of
Homoeopathic faith, practice and nationality,+ not all “high
dilutionists,” nor drearning enthusiasts, nor Germans? Sim-
ply because an anatomist says that he introduced the crude
venom into the stomachs of dogs, rabbits, and cats, (and
Redi saw a man swallow it,) and that it produced no effects!
What effects did he look for 7 Death, actual or imminent,
such as results from introducing venom into a wound 7
Could the rabbits, dogs, or fowls, on which he experimented,
report the throat or head or heart or uterine symptoms of
Lachesis, even had they experienced them :
But why should the negative testimony of Dr. Mitchell,
in this case, weigh so heavily with our friend? Have not
Allopaths, long ago, proved our processes of trituration and
dilution of drugs to be physically impossible — not alcohol
nor water enough in the world to make the 30th dilution ?
and yet do we not make it daily 7 And may there not,
likewise, be a fallacy in the demonstrations of the impossi-
bility of venom acting when taken internally Suppose,
for a moment, that Mitchell’s experiments are conclusive;
there are the opposing facts, vouched for by our provers,
who are certainly as competent observers, and much better
trained than Mitchell. What is to be done when we meet
opposing series of facts? Must we absolutely reject the one
series, and accept the other ? Do we, of necessity, at once,
choose between them, or is it sometimes wiser to await farther
light? The operations of our provers are so simple, and
66 Isopathic /Pemedies. [October,
their observations so direct — and, moreover, so repeatedly
confirmed by independent and distant provers — that we
can not refuse them credit. Finally, they have received
that a posteriori confirmation which comes from a manifold
clinical experience, and which, to those who believe the
IHomoeopathic law, must be irresistible.
On the other hand, it should not be forgotten that Dr.
Mitchell experimented with the crude venom; whereas our
provers used it in trituration and dilution. Precisely what
effect these processes may have upon such a substance, we
know not; but analogy justifies us in assuming that they
may so affect it as to make it capable of being absorbed, and
acting upon the system, when, in the crude state, it might
not be so.
Metallic Mercury, in its crude state, may be ingested with- .
out pathogenetic effect. Not so when it has been triturated.
Lycopodium is inert, unless triturated. Carbo veg., although,
in the crude state, it relieves flatulence, probably does so by
virtue of its great power of absorbing gases. I have never
heard that it produces that profound alterative effect, or
those peculiar chest symptoms which characterize the path-
ogenesis of the 3rd trituration, (see Hahnemann’s “Chronic
Diseases,” Carbo veg.,) and which make it so valuable a rem-
edy. The same may be said of the precious metals, and of
Sileſc, and other of our remedies.
It is not necessary to be able to say how trituration oper-
ates; whether it makes the substance capable of absorption,
or protects it from the annihilating action of the gastric
juice, or “develops in it new dynamic virtues, which were
not possessed by the crude drug,” — a theory of which I
never heard, until it was stated above by Dr. Searle, although
I have heard it surmised that trituration develops in the
drug a power to act on the human organism, which was not
displayed by the crude drug, but lay latent in it. It is
enough that experience shows that triturations of some
drugs are active, when the crude substance is less, or not at
all so. Since, then, Dr. Mitchell has not experimented
with triturations, and with a view to observe and note all
1868.] Isopathic Remedies. 67
e
deviations from the normal of the subject of his experiments,
as possibly the effects of the venom, his results can not be
received against those of our provers.
I further remark, that physiological experiments, like
Mitchell’s, are difficult, and open to numerous fallacies, as
the history of many physiological theories has shown. Dr.
Mitchell has shown, as others had already done, that venom
may be swallowed with impunity. The same thing has
been demonstrated of Curare, the physiological action of
which, Bernard so beautifully demonstrates, (“Leçons sur
les Effets des Subst, tox. et Med., 1857.) Bernard, in this
work, shows that the effect of a poison depends on the quan-
tity of it, present at one time, in the blood; that if even
IHydrocyamic acid be introduced gradually, in very small
quantities at a time, it may not prove fatal — may even pro-
duce but slight effects; because, the elimination being as
rapid as the introduction, it does not accumulate in the
blood. He further shows that if the deleterious action of a
poison be exercised upon only one organ or apparatus of the
body, the poison may be introduced into the blood without
any toxic effect whatever resulting — provided, in the course
of the circulation, the poison meet with the organ which
eliminates it, before it comes to the organ for which it has a
specific toxic affinity. Establishing these and other general
principles, Bernard shows that Curare closely resembles ser-
pent venom, in that it causes speedy death when introduced
into the blood through a wound; whereas, it may be swal-
lowed with impunity.
In 1867, Dr. L. Hermann published, in Reichert and Du
Bois Reymond’s “Archiv.,” p. 64, some notes upon Curare
and serpent venom. Referring to Bernard’s demonstrations
of the fact, that, if a poison be introduced so slowly into the
blood, that it may be eliminated as fast as introduced, no
serious effects will follow, - and also to Bernard’s experi-
ments, in 1863, on Salts of Potassa, which are shown to be
deadly poisonous when injected into the veins, while, as we
all know, they may be swallowed in considerable quantity,
with comparative impunity, -he asks, “Why is this?” The
68 Asopathic Zºemedies. [October,
reason is, that these salts, when taken into the intestines,
are slowly absorbed ; whereas, they are always rapidly elim-
inated from the blood, by the kidney. IIence, the quantity
at any one time, in the blood, must be exceedingly small.
Now, he asks, may not the case be the same with Curare
(and with serpent venom)? May it not be a substance
slowly absorbed and rapidly eliminated, and hence compara-
tively innocuous when taken internally
IIermann considers that Potassa, Curare, Hydrophobin, and
probably snake venom, form a class of substances of which
absorption and excretion are executed with equal rapidity,
and hence they have but slight poisoning power when taken
into the stomach. Investigating and experimenting in the
line of these ideas, IIermann found that animals which
Secrete slowly from the kidneys, are poisoned by Curare, —
as, for example, frogs and birds; and, in this connection, it
is noteworthy that Fontana gives a case in which a bird was
poisoned by Snake venom, introduced into the stomach.
(See Mitchell’s articles.) In like manner, Hermann found
that men with diseased kidneys, which secrete slowly, can
not tolerate (are poisoned by) Nitrate of Potassa. Further,
he gave Curare to rabbits, which were not affected thereby.
IIe then tied the renal artery of a rabbit, to prevent excre-
tion by the kidney; whereupon, the rabbit was poisoned by
as small a dose of Curare as would have caused death if
introduced into the blood. IIe concludes, then, that Curare,
when ingested, is absorbed, but is immediately excreted by
the kidneys—and is, therefore, innocuous; and he infers
that the same is true of snake venom.
These investigations suggest a possible fallacy in Dr.
Mitchell's conclusions, and open a new line of research,
upon which we are quite content to leave these physiolo-
gists, Mitchell and Hermann, to “fight it out,” (not doubt-
ing it will “take all summer,”) while we and our patients
shall profit by the pathogeneses procured by the labors and
sufferings of our provers. If our friend, Dr. Searle, awed
by Dr. S. W. Mitchell’s + dicta, refuse to believe our prov-
* To show how far Dr. S. W. Mitchell fell Short of the candid, earnest
1868.] Isopathic Remedies. 69
ers—just as the Allopaths refuse to accept even so much
of our Materia Medica as Dr. Searle receives — then, so
much the worse for his patients, as for theirs. And if, in
either case, such refusal be against the demands of right
reason, on the heads of the skeptics will rest the conse-
quences.
It seems to me to be, in the main, true, that the symptoms
reported by our provers are, in character, analogous to those
resulting from the introduction of venom into the blood;
but I see no reason to believe that toxicological records
would ever obviate the necessity for proving by taking the
venom internally. The effects of the former process are too
violent and stormy, too little under control, to give us those
finer shades of pathogenetic action which correspond to the
beginnings of disease, and furnish us indications for the
inception and curable stages of maladies.
It is true that even Dr. Mitchell perceives the Homoeo-
pathicity of snake-venom to the effects of purulent infec-
tion ; and gives unconscious testimony to the law under
which Homoeopathists have so often treated pyaemia, etc.,
with Lachesis, when he says: “The one form of poison
which most resembles venom, is that of putrefactive sub-
stances; and I am inclined to think that from putrefying
material may yet be separated a substance which, concen-
trated, will prove active toxically, and will, perhaps, enable
the observer to repeat the facts I have witnessed here.”
(“New York Medical Journal,” January, 1868, page 311.)
But the symptoms of the throat and the rectum, which have
led to so many successful applications of Lachesis in prac-
spirit in which he professed to make his investigations, I quote from the
Bibliography of his Essay on Rattlesnake Venom, his description of Dr.
Hering's masterly Essay on the Effects of Snake-poison: “A collection of
wild absurdities in regard to the analysis of venom, and to its use in hydro-
phobia, etc.” He speaks of this essay as “translated into English,” and pub-
lished in the “British Quarterly Journal of Homoeopathy,” 1844. In that
journal, only the introductory essay on “The Study of Materia Medica,”
and a few cases cured by Lachesis, are published. Not a word about analy-
sis, or about hydrophobia. Dr. Mitchell never saw Hering's work—or
else ?
7O Isopathic Remedies. [October,
tice, have been produced only by the internal use of the
triturated or diluted venom. I may instance : Symptoms,
1764, “Larynx painful to touch;” 1765, “Larynx and throat
painful when touched, and on bending the head backwards;”
1767, “When any thing touches the larynx, the latter is not
only very sensitive, but it is as though it would suffocate
him ; it also increased the throat-ache behind;” 1769, “Dur-
ing the heat, as if from ebullition of the blood, he is com-
pelled to loosen his neck-covering; it seems to impede the
circulation of the blood, with a feeling of suffocation;”
1780, “Pressure upon the larynx causes to cough;” 1803,
“On touching the throat, there comes a dry, hacking cough;
also in the morning, after sleep, at night, and from tobacco-
smoke, etc.” Let these suffice for examples. They will
recall to every reader who has often used Lachesis, scores of
cases presenting similar symptoms, and which were promptly
cured by that remedy. IIad the provers of Lachesis been
Satisfied with the statements of Redi and Fontana, that
venom taken internally would have no effect, we had never
had these symptoms, which clinical experience has verified
beyond the possibility of a reasonable doubt. It is a matter
of course, that those whom the authorities above named
(together with Mitchell) have deterred from ever using ser-
pent-venom in practice, can have no experience to appeal
to, whether for or against these provings. They can have
no premises from which to argue. They can only cavil.
Touching the question of the nature of a “high potency,”
— that such potencies act powerfully, when the drug is
IIomoeopathically indicated, I can not doubt, having so
often witnessed the effect. Iłut whether matter be so
infinitely divisible that particles of the drug are present in
the 200th centesimal potency, or whether the “spirit” or
“force’ of the drug has been transferred to the vehicle or
medium, I can not pretend to say. Difficult as the subject
is, in every aspect, I find ſewer difficulties in conceiving the
former than the latter idea. Every new discovery in physics
enables us to recognize a finer subdivision of matter than
we had previously known of, and brings us nearer to the
1868.] Isopathic Remedies. 71
“infinitely little.” On the other hand, I do not now recall
any instance that proves a transfer of specific properties
from the substance which they identify, to a substance to
which they are foreign.
It is an error to say that all “high potency men’’ are
believers in this migration of forces. I believe that the
arch-potentiator himself, our respected and learned colleague
Dr. Fincke, holds to the material presence of the drug in
his highest potencies. If my friend, Dr. Searle, will discern
the times in which he lives, he will perceive that “high
dilutionists” are no longer (if they ever were) wont to “take
refuge ’’ in any theory; nor are they apt to be “confronted”
with any “facts * so hard to deal with as are the clinical
“facts” with which they “confront” the skeptics. Least
of all, would they dread being “confronted * with an
“absence” of any kind. Will Dr. S., with “spectroscope,”
or any other weapon, undertake to “demonstrate ’’ any
“entire absence ’’ — even that of gold in the 12th dilution ?
The expert IIomoeopathist will straightway, by clinical dem-
onstration, show him, through the “pathological test,” which
is far more delicate than any physical test, that gold is there;
its presence being proved by its action in disease. In a
physical exploration, we can not demonstrate an “absence,”
we can only show our own inability to See, with the implements
at hand, what (we must admit) a stronger or more power-
fully aided vision might enable us to see. And what our
eyes may always fail to see, it may not be difficult for our
minds, by the aid of right reason, to discern, if we approach
the subject with a candid, inquiring temper; and not in a
doubting, caviling spirit. C. D.
|UNIVERSITY OF PESTII.— It seems, from our European exchanges, that
the Michigan University question is agitated abroad. The Hungarian
nation, being now governed by a ministry of its own, one of its first acts
was to propose to the University of Pesth an inquiry as to the best method
of giving Homoeopathy a place among the studies of the University, and
requesting an answer at the earliest moment practicable. We shall keep
an eye on this matter.
THE DELIVERY OF THE PLACENTA IN ABOR-
TION. y
BY DR. GUí NIOT, Surgeon of the Hospitals.
(Translated from the Bulletin Général de Thérapeutique Médicale et
Chirurgicale for 1867. By R. LUDLAM, M.D.)
SECTION II.
TIIOROUGIILY to appreciate the nature and importance of the
indications presented in abortive labor, it is necessary to
know the true source and nature of the symptoms presented.
Defore inquiring into the best treatment of this variety of
delivery, it is indispensable to glance at the peculiarities
proper to it.
In premature labor, if we except cases of mal-location of
the placenta, the expulsion of the foetus and that of the pla-
centa includes two series of phenomena, which are not only
more or less distinct, but successive, also.” In abortion, on
the contrary, when the uterine contractions commence, and
before the cervix is shortened or obliterated, the partial
detachment of the placenta takes place, giving rise to a san-
guineous flow, which is more or less abundant. The deliv-
ery of the placenta begins with the first pains, and continues
through all the acts which are necessary for the subsequent
expulsion of the embryo.
In abortion, the two series of symptoms are not separated.
|Unlike what happens in labor at term, they are performed
simultaneously. They are confounded, and sometimes the
* The first series includes: 1. The complete obliteration of the utering
neck; 2. The dilatation of the os; 3. The rupture of the sac, and the escape
of the amniotic liquor; and, 4. The expulsion of the foetus. Although
belonging CSSentially to labor, I purposely omit the pains, uterine contrac-
tions, etc. The Second Series cmbraces: 1. The detachment of the placenta;
2. The expulsion of the placenta, cord and membrancs.
1868.] 7%e Delivery of the Placenta, etc. 73
sac is expelled entire, without previous rupture. It is of the
first consequence to know that, during the whole period of
labor in abortion, the haemorrhage is closely related to the
uterine contractions.
In spite of the ready detachment of the sac, as the pla-
centa is relatively very adherent during the early months,
although the uterine contractility is but slight, it often hap-
pens that the complete separation of the placenta, and
especially of the decidua, is effected with great difficulty.
IIence the extreme delay incident to the first act of deliv-
ery; and hence, also, the danger from haemorrhage and
exhaustion.
The first period of this labor is attended with difficulties
and dangers peculiar to abortion. The second period, how-
ever — id est, that of the expulsion of the placenta — is not
less liable to various contingencies with which we should be
familiar.
The length and firmness of the uterine cervix, render its
obliteration so difficult, that, in abortion before the fourth
month, this obliteration is extremely tardy. The cervix is
shortened slowly, and dilates with difficulty and extreme
slowness. At this period of gestation, the firmness of its
tissues is such that the contractility of the womb remains
weak, and incapable of forcing the dilatation of the neck
and os. Without being peculiar to primiparae, this condition
is often observed in them. The neck is not, as in labor at
term, a ring with a thin border, torn and pliable, which, in
escaping from the womb, the placenta must overcome, but
a real canal, with firm and muscular walls, and capable of
contracting under the influence of any excitant. In other
words: in abortion, the struggle that takes place at the
moment of delivery, between the contractions of the body
of the uterus and the resistance offered by the neck of this
organ, is not ended, as in labor at term, by a complete vic-
tory of the former over the latter. The cervix yields only
in part; it is shortened and dilated, instead of being really
obliterated, and forced open to the extent of tearing its
fibres.
74. 7%e Delivery of the [October,
Moreover, in abortion, during the early months of preg-
nancy, the volume of the placenta is relatively large, and,
in its exit, forces an opening two or four times as large as
that necessary for the discharge of the foetus. When the
Sac is prematurely ruptured, and its waters escape, the pla-
centa, which alone remains within the womb, must dilate
the neck with a Spongy body, almost without consistence,
and one that is quite unfit to serve as a point upon which the
contractile fibres of the uterus can act. And yet the dilata-
tion of the orifice is indispensable for the passage of the
entire placenta — a fact which explains the delay at this
period. It is true that the aſter-birth and membranes may
be delivered in fragments, through a canal which appears
too narrow ; but whether it be spontaneous and natural, or
if it be artificial, at the hands of the playsician, – in both
cases, it ceases to be normal, and is, consequently, more or
less dangerous.
It will thus be remarked that, in abortion, although the
expulsive forces may be notably weaker than in labor proper,
the resistance and the obstacles opposed to the delivery of
the placenta, are much greater. Hence, in accomplishing
the last stage of abortive delivery, the woman is liable to
frequent returns of haemorrhage, to a progressive loss of
strength, putrid infection, metritis, metro-peritonitis, etc.,
as in the first stage.
Jºn résumé: On the one side, premature and partial Sep-
aration of the sac, extreme slowness in its entire detach-
ment, and considerable difficulty in the delivery of the
placenta; on the other, feeble contractility of the Womb,
the length and firmness of the uterine cervix, and, finally,
the relative size of the placenta; — such are the chief causes
of the accidents already enumerated.
The existence of so many contingencies of delivery, in
case of abortion, is explained by the fact that abortion is
really an accident of gestation, which it brings to a prema-
ture close. For this reason, the organic sympathies that
are designed to protect the pregnant state, become so many
obstacles to the expulsion of the embryo. We can only
Q
1868.] Placenta ºn Aóortion. 75
wonder that such complications do not occur more fre-
quently; for we should remember that spontaneous delivery
is the rule, whilst dangerous and accidental labors form the
exceptions.
SECTION III.
>k >k >k The haemorrhage, being the essential
part of abortion, really constitutes an accident only when it
threatens the health and life of the woman, by being either
too abundant or too prolonged.
Again, for the anatomical reasons already specified, labor
in abortions takes place in a slow manner. The delivery
should be classed as irregular, or relarded, only when it is
not completed after a lapse of time, varying with the case,
but always longer than is recognized as normal in labor at
term. This important practical remark needs elaboration.
I shall refer to it again.
Besides, when it is prolonged, the increased duration of
labor may depend on a variety of circumstances. Some-
times it results from a premature rupture of the membranes,
and the sudden escape of their contents. Sometimes it is
due to a too intimate adhesion of the placenta to the uterus.
Again, it depends upon the feebleness of the uterine con-
tractions, which, although they are sufficiently regular and
frequent, yet remain powerless to overcome the resistance
of the cervix. Finally (and this fact merits especial notice)
despite the force of the uterine contractions, and the more
or less complete separation of the placenta, it sometimes
happens that the expulsion of the latter becomes tardy,
difficult, and vexatious, because the process of delivery is
arrested for several long hours during each day.
This intermittent type, which is not rarely observed in
case of abortion, varies in the intervals which claracterize
it. A regular labor is not thus interrupted. The paroxysm
and the repose have, undoubtedly, a common cause in the
fatigue of the uterus; but, although this influence appears
76 The Delivery of the [ October,
to play only a secondary part in the former, it seems quite
sufficient to produce the latter.
Although, in other respects, it is not especially interesting,
I report the following, as a very characteristic oxample of
this species of intermittent labor:
Case 1. — December 1, 1862, my friend, Dr. X., desired
my advice in his wife’s case. She was then about two
months advanced in pregnancy, and had been in labor for
two days. The horizontal posture, and injections containing
Laudanum, failed to arrest the pains and the passive flow
which had continued from the first. By the touch, I found
the womb resting almost horizontally on the right side; the
neck, which was still unopened, was, by reason of its dis-
placement, almost inaccessible; blood flowed in small quan-
tities from the vagina, and the rectum was filled with hard
and irregular masses. Although of a decided nervous tem-
perament, Mad. X. was calm and composed.
Abortion not being inevitable, we sought to avert it. We
first administered a laxative enema; then, after an abundant
evacuation, several small injections, strongly impregnated
with Laudanum. The horizontal posture was scrupulously
enjoined, etc., etc. But, despite all, the labor progressed.
The next day, December 2nd, the uterus had approached
to its normal position; the neck became more accessible,
had returned to the axis of the vagina, and had begun to
dilate; the passive flow, which was no especial source of
uneasiness, persisted, as before.
But we were more especially struck with the fact that,
from this day forth (the fourth since the beginning of the
mishap), the labor was characterized by the remarkable
peculiarity of daily intermittence. Every evening, about
2.30 P.M., the uterine contractions recurred very forcibly,
with violent rending pains in the ribs, the lower abdomen,
the groins, and the thighs. At about 5 P.M., after two or
three hours, during which time the womb had contracted
every ten or fifteen minutes, all signs of labor ceased; the
pains, the agitation, the flow, were suspended, not to reap-
pear until 2 P.M. of the next day. During the long interval,
the patient resumed her usual cheerfulness; she conversed,
ate, and slept, almost as well as when in her usual health.
Sinilar paroxysms returned each day, as long and as
decidedly, until December 6th, when, at about 4 P.M., in a
Series of violent pains, the product of conception was
1868.] Place0, £a in Aóortion. 77
expelled entire. For three days, the sac had been recog-
nized by the finger, in the canal of the cervix; but the same
evening, I had vainly attempted its extraction by the abor-
tion forceps.
The enclosed mass was a spurious sac, enveloped in fibrin-
ous clots, and deprived of every vestige of an embryo. It
included a placenta and membranes, which contained a clear
liquid. The whole mass was shaped exactly like the cork
from a champagne bottle.* I did not observe, among the
débris any fragments of the parietal bones. Yet, from this
monent, all the eontingents of abortion were removed; and
but for the occurrence, ten or twelve days later, of a horri-
ble and persistent neuralgia, the convalescence would have
been quite natural.
A fortnight after the beginning of her pregnancy, Mad.
X. had already experienced several accidents (slight haemor-
rhage, lumbar pains, etc.,) which had not been repeated
until with renewed violence, six weeks later. It is to this
first attack, undoubtedly, that we should refer the death of
the embryo, and its subsequent dissolution in the amniotic
liquor.
In this case, we remark that, the embryo being dead at
the beginning of pregnancy, there was no need for a contin-
uance of gestation. Abortion was, therefore, inevitable; and
this, I believe, explains the intolerance of the womb for
this aborted product — an intolerance that resisted the most
appropriate means for arresting a premature labor. Con-
cerning its daily intermittence, to which I desire particularly
to direct attention, it seems to have been produced by the
triple influence of the nervous temperament of the patient,
the operation of the anti-abortive remedies she had taken,
and the fatigue of the uterus after each crisis of the labor.
Another phenomenon which is frequent in difficult deliv-
eries, and which, since it has not been mentioned by them,
* This is the characteristic and peculiar form which, when the abortive
labor has been protracted and painful, is not rare among the products of
delivery. It results from a species of moulding of its contents, by the con-
tracting womb. The swollen portion, resembling the head, corresponds to
the cavity of the womb, the cylindrical part to the canal of the cervix, and
the narrow portion to the unyielding ring at the internal os. In such cases,
the substance of the placenta, and even of the clots that surround it, is
discolored, pale, like veal, and almost entirely deprived of moisture; facts
which are explained by the pressure to which it has been subjected.
78 The Delivery of the [October,
appears to have been lightly regarded by authors, consists
in variations of the direction and situation of the uterus.
Despite the energy of the uterine contractions, and the per-
sistence of labor, the expulsion of the entire sac, or only of
the placenta, which are evidence of delay, we often see the
womb which had inclined forwards, or backwards, or upon
either side, return gradually to its normal position — or, at
least, to a position quite different from that first recognized
by the touch. But, in such cases, there is a decided descent
of the entire organ, as shown by the approach of the cervix
to the vulva, it becoming thereby more accessible to the
finger. Without enlarging upon this peculiarity of labor in
abortus, I will say that it undoubtedly depends upon the ill-
timed and immoderate efforts of the woman herself. Pos-
sibly, also, certain of these deviations are favored by the
proper uterine contractions, and by the variable state of
repletion of the rectum and bladder. Whatever the cause,
in order to prevent it from becoming permanent, we should,
especially after delivery, direct the patient to maintain a
proper posture.
Numerous other accidents or morbid symptoms may man-
ifest themselves in abortive delivery. Omitting putrid infec-
tion, metritis, exhaustion, etc., already mentioned, it must
suffice to enumerate chills, fever, vomiting, dysuria, and
various forms of neuralgia, as being by no means uncom-
mon. Finally, uterine phlebitis and purulent inſection, with
metastatic abscesses, may also complicate abortion — an
unfortunate example of which I had in “La Maternité,” in
1861.
SECTION IV.
To determine, in different cases of abortion, what is the
best method to favor the complete expulsion of the placenta
and the membranes, as well as successfully to combat the
ill results that may spring from their retention, is the grand
therapeutical problem to be solved. For the clear under-
standing of this intricate question, it is necessary to classify
1868.7 A/acenta in Abortion. 79
the facts. Now, a classification that we find indicated by
I3audelocque, and which, as well as that of Cazeau, deserves
to be remembered, consists, in so far as the delivery is con-
cerned, in studying abortions of the two first months, those
of the third and fourth months, and, finally, those of the
fifth and sixth months, separately. I shall adopt this
arrangement. To this distinction belongs the question of
the extreme limit of time which we should allow to normal
or unaided labor, at these different periods of gestation. It
is a singular fact that authors who have so carefully elab-
orated the conduct of labor at term, far from having studied
and discussed whatever concerns abortive delivery, have not
even classified it.
During the two first months of gestation — or, rather,
during the second month (for abortion, during the first
weeks, passes by, most frequently, without recognition,
under the form of the menses,)—the sac is usually expelled
entire; in which case, the whole delivery is accomplished
in a single morbid act. When the sac has not been ruptured
by interference, this mode of delivery constitutes a rule,
with few exceptions. In these gases, the labor may be more
or less prolonged and painful; it may drag along for one or
two days, or more, without being complicated or dangerous.
This is its habit—a circumstance which inclines us to extend
the normal limit of its duration to two days.
At the third or fourth month, it is different. On the one
side, we have more emergetic uterine contractions; on the
other, diminished resistance of the membranes, usually
resulting in a rupture thereof, and the emptying of the sac
at a period when labor is not advanced, or before the pla-
centa is completely separated, and the cervix sufficiently
dilated for its free passage. Hence the necessity for an extra
labor — one especially for the placenta; and it is this labor
which is not only painful, but the source of serious dangers.
In this group of cases, what is the natural limit for the
completion of unaided delivery : It certainly is not two
days, as in the former variety; but if we specify twenty-four
8O The Delivery of the [October,
hours from the emptying of the sac, I apprehend we shall
conform to the facts observed.
Concerning abortions after the fourth month, a much
shorter duration than the preceding is allowed. Indeed,
although very analogous, in their symptoms, to abortions of
the former group, in whatever concerns the placenta, those
of five or six months bear a strong resemblance to labor
proper. The marked disproportion between the size of the
foetus and that of the placenta, is less than it was previously;
the womb being better developed, more muscular, and con-
sequently more contractile, is no longer so slow to detach
and expel the placenta. Besides, the cervix is more soft-
ened, and more readily obliterated and dilated. Finally,
when intervention is urgent, the more spacious uterine cav-
ity readily permits the introduction of the hand. The same
reasons which lead us to regard delivery at term, when it is
delayed more than two hours, as tardy or abnormally slow,
induce us to limit the maximum duration of abortive labor
at the fifth and sixth months. I apprehend that a delay of
twelve hours after the expulsion of a foetus at five months,
and one of six hours only, in a foetus of six months, repre-
sents the general limit most in accordance with the facts
observed. I shall, consequently, adopt them in this case.
JEn résumé: two days for labor in abortion, during the first
two months; twenty-four hours for that of the third or fourth
month; twelve hours, if at the fifth month ; and six hours for
labor at the sixth month ; — such are the extreme limits
within which labor is usually normal, but beyond which the
delivery is abnormal.
It will, doubtless, be objected that these divisions are use-
ful only when the exact duration of pregnancy is certainly
known; and nothing being, in general, more difficult to
determine, especially during the first half of pregnancy, this
objection would be valid, if it were founded in fact. At best,
the classification is only approximate, but is certainly a very
useful one.
I. As a rule, in every abortion, it is insisted upon that, in
whatever concerns the placenta, we should carefully inspect
1868.] A lacenza ºn Aéorèzon. 8I
all the matters expelled from the vagina. It is unnecessary
to urge this precaution. Beside an interrogation concerning
the symptoms, and an examination of the female organs,
there is no other means than to examine directly the expelled
products, in order to obtain an exact knowledge of the state
of affairs. And, so long as the delivery is incomplete, we
should always arrange for the preservation of whatever may
escape the vagina, in order to its thorough examination. To
attain this end, a knowledge of the anatomy of the placenta,
at different periods of pregnancy, is indispensable. In addi-
tion to these precautions, we should practice pouring a
stream of water, from a height, upon these substances; or,
better still, the matters themselves may be plunged into a
basin of water, and spread out by means of a stylet, forceps,
or any blunt instrument whatever. The resemblance which
clots sometimes bear to the placenta, and of fibrinous layers
to the membranes, renders this proceeding absolutely neces-
Sary.
II. Considered as a whole, and with respect to the history
of the delivery in different cases, there are many varieties
of abortion. In studying their special therapeutics, it is
possible to refer all these varieties to the five following
types:
1. The abortion is complete; the delivery of the placenta
is incomplete, and there is no accident.
2. The abortion is complete; the placental delivery is not
so, and there are accidental complications.
3. The abortion is effected, but it is doubtful if the pla-
centa has been expelled.
4. The abortion is over; the placenta has been delivered,
but, in consequence of the labor, there are accidents which
require the aid of the physician.
5. Finally, the abortion is not yet consummated; but it is
more or less advanced and recognized to be inevitable, what-
ever may have been done to prevent it.
Let us inquire as to the indications presented, and the
best means of filling them.
Vol. IV. — No. 13. 6
82 The Delivery of the [October,
1. The abortion is complete; the delivery of the placenta is
incomplete, and there is no accident.
(a) When time alone has effected the delivery, and has not
exceeded what we have considered the rule in normal cases,
all active interference is manifestly contra-indicated. In
case the labor is more tedious and prolonged, what are the
conditions that justify such intervention ? Family duties,
impatience, and the entreaties of the woman, however
urgent, could not alone justify the employment of those
artificial means which are always more or less dangerous.
No indication — no action, is a principle from which we
should not depart. In a supposed case, we should limit
ourselves to a simple expectancy, the prescription of Ergot,
general or special excitants, the employment of Dugé's
crotchet, the abortion forceps, intra-uterine injections, etc.
>k >k >k >k >k
(b.) Agreeably to the maxim that I have formulated, i.e.,
to abstain from all premature interference, the great major-
ity of abortions are self-limited. In exceptional cases, how-
ever, the expulsion of the placenta is more or less delayed,
the labor is powerless, long-suspended, and tedious. None
of the ordinary accidents have yet arrived; but if this state
is protracted, we fear their almost certain advent. Under
these circumstances, what must be done 7 Must we act? or
should we persevere in our expectancy, and await the com-
ing danger? Such is the problem to be solved. In spite
of its importance, this subject has not been clearly defined
by authors; and we seek in vain, in special works and mon-
ographs, for some explicit directions in this regard. But,
if cases of tedious delivery, without threatening contingen-
cies, are rare, they are almost almost always a source of
anxiety to the physician. I will cite an example of this
kind, published in this journal (“Bull. Gén. de Thérap.,”
t. lxiv., p. 550,) by Dr. Laborde: º
Case 2. — Retention of the placenta after an abortion at the fifth
month. No particular accident during the first cleven days, then
qrave and repealed hamorrhage, followed at last by the expulsion
of the placenla. Cured. — A woman, aet. 30, having already
1868.] Placemfa ºn Abortion. 83
had nine pregnancies, of which three only extended to term,
and six had terminated in abortion, found herself again
pregnant, at a little more than four months. In consequence
of over-exertion, she was taken in the seventh miscarriage.
The expulsion of the foetus, which was dead, offered nothing
especially notable. But the placenta remained adherent;
and slight traction upon the cord ended in a separation
thereof, at the point of its insertion. As there were no
urgent symptoms, the physician prudently waited — or,
rather, prescribed a small dose of Ergot, which accomplished
nothing. But, a few clots having been expelled, and the
patient improving somewhat, they claimed to have recog-
nized the débris of the placenta; and on the tenth day,
thinking herself well, the woman left her bed for three-
fourths of an hour.
She was too weak to rise, the next day; and that night,
was seized with a dangerous haemorrhage — for the relief of
which, Dr. Laborde was called in.
After a careful examination, the Doctor concluded that
the placenta was still retained in utero; but, there being no
decided symptom thereof, he could not say positively.
Under these circumstances, as grave as embarrassing, Dr. L.
desired my counsel.
By the touch, we found the cervix quite closed; the finger
could, with difficulty, be passed through it to the internal
os. However, in pressing on the hypogastrium, so as to
force the womb downwards, I could partly explore the cavity
of this organ, which I found lined throughout with a smooth
polished membrane, resembling the amnios. I thought that
my finger penetrated the interior of the still adherent sac.
At one point, I felt that the membranes were detached and
elevated, like a sort of intra-uterine blister. Although una-
ble to reach or to recognize the placenta, I had little doubt
of its retention. -
The closure of the internal os, and the retracted state of
the uterus, prevented a successful attempt to remove the
placenta. It was, therefore, necessary to postpone, if not
to reject as dangerous, the use of manual or instrumental
means of delivery. The patient, moreover, lost nothing,
the lochia had no putrefactive odor, and her general condi-
tion remained very satisfactory. But her situation was,
nevertheless, perilous; and we were obliged to confer
together. Dr. L. and myself decided to prescribe Ergot
($ to 2 grammes in 24 hours), with a view to produce the
detachment of the foetal sac. In truth, the delivery could
84 The Delivery of the [October,
not otherwise be accomplished. But, to avoid the inevitable
haemorrhage, it was agreed that the patient should be scru-
pulously watched.
Our prophecy and our fears were soon realized. The
patient became decidedly worse. The placenta, which was
partly expelled through the cervix, was extracted without
difficulty, by MM. Laborde and Dumoulin. It was still
fresh. The haemorrhage ceased immediately; and the
woman, after having had symptoms of anaemia and of
metritis, recovered entirely.
I shall not pause, but will allude to this case again. Suf-
fice it to say that, although the placenta was retained in the
womb during eleven days, no notable accident followed.
The sac had remained adherent throughout almost its entire
extent — a fact which explains the absence of haemorrhage
and of putridity of the lochia. It is really to the persistent
adherence and continued nutrition of the placenta, that we
owe the temporary harmlessness of such cases of retained
placenta after abortion.
In similar examples, in which the limit of normal delivery
is passed without accident, we should anticipate the almost
certain occurrence of dangerous symptoms. Moreover, if
they are demanded, the longer we delay the use of proper
means, the more difficult their application, and the more
doubtful their results. These are the reasons in favor
of an interference which is designed to anticipate and
avert such contingencies. Add to them, the unrest of the
woman, who knows that delivery has not been completed,
and the inconveniences to her from being compelled to
remain for a long time in the horizontal posture; for what-
ever time may have elapsed since the abortion proper, and
despite the absence of incidental symptoms, it is absolutely
necessary, in these cases, that she should remain in bed.
On the other hand, the means of intervention often pre-
sent, in themselves, such difficulties and dangers, that,
unless we are compelled to resort to them immediately, we
may judge it best to defer their employment. Hence, it is
plainly seen that the indications and contra-indications are
1868.] A/acenta in Abortion. 85
to be derived from the study and comparison of future acci-
dents, if we abstain, and present dangers if we act.
In order to render this comparison fruitful and suggestive,
we should not forget this cardinal fact: that, despite the
retention of the placenta in the womb, for three, five, eight,
or more days, a complete absence of serious symptoms is
observed only in those cases in which the placenta has remained
almost completely adherent. In the opposite class of cases,
haemorrhage, putridity of the lochia, chills, fever, etc., are
accidents which are more or less inevitable, and which con-
stitute a very different state of things from that under con-
sideration. It is imperative, besides, that we should bear in
mind the division or classification of abortions into the
several groups already specified — more especially, as this
arrangement is based on reasons which are both anatomical
and physiological.
(a.) In abortions of the first two months, the uterine sinuses,
which are but slightly developed, yield, at the time of the
separation of the sac, only a moderate quantity of blood.
Besides, however serious the haemorrhage, at this season of
pregnancy, it is always possible to control it by means of the
vaginal tampon, which, if but slightly compressed, may yet
be efficacious. The patient bears the tarnpon for a sufficient
period, and suffers repeated applications thereof without its
becoming, of itself, a source of mischief. The haemorrhage,
in this class of abortions, is, therefore, not very formidable.
Again, if the separated placenta chances to be retained
in the womb, and to putrify therein, it is not compact
enough, but is too friable and too small to escape disintegra-
tion and final expulsion, by piecemeal, with the lochia.
Rigors, fever, a peculiar paleness of the face, diarrhoea,
dryness of the tongue—in a word, the various signs that
announce the advent of pupulent infection — may, doubt-
less, be manifested; but employment of constitutional tonics,
a rigid cleanliness without, and the repeated use of vaginal
injections, will probably triumph over these symptoms. It
is very rare that patients have succumbed to these mishaps,
under these circumstances, unless other causes, and the
86 7%e De/ivery of the [October,
absence of proper care, have been superadded. In abor-
tions of the first two months, the dangers occasioned by a
retention of the placenta have not, therefore, the extreme
gravity incident to those of a more advanced period of ges-
tation; and, under proper treatment, they are successfully
managed.
Now, with regard to this prognosis: if we place the
numerous difficulties induced by mechanical means—as the
finger, the crotchet, the forceps, the curette, and intra-uterine
injections; if we include the uncertain termination of metri-
tis, peritonitis, of uterine perforation, of haemorrhage, etc.,
to which the patient is exposed; if, finally, we consider that,
without being more efficacious, such remedies as Ergot, cer-
tain emnenagogues, stimulating drinks, and irritating injec-
tions, are sometimes not less dangerous than the mechanical
means, we shall, of necessity, reach this practical conclusion,
viz.: that, whilst it is unſtllended by any accident or complication,
the retention of the placemla, however prolonged, in an abortion of
the first two monlhs, requires no active interference. Such a case
only demands constant watching and especial care. To
guard against Sudden haemorrhage, we should be supplied
with a tampon and its accessories. We should insist upon
the patient remaining in bed, should calm her fears and
anxiety, see to it that her food is nourishing but not stimu-
lating, and, in every respect, afford her an intelligent assist-
3,1] CC.
(b.) In abortions at the third and fourth months, the haemorrhage
induced by the separation of the placenta, although generally
more abundant than where it occurs at an earlier period,
may also be successfully controlled by means of the vaginal
tampon. Being more difficult to subdue, however, it is
necessary to use a more compact tampon, which is, conse-
quently, less easily borne by the patient.
But it is not enough that the placenta shall be separated
(as in the class already detailed); it is also requisite that the
womb should be rid of it. When, after the expulsion of
the footus, the delivery is not completed within twenty-four
hours, the uterime cervix closes upon itself promptly; its
1868.T Placemia in Aóortion. 87
orifices contract, and, finally, oppose a great obstacle to the
delivery of the placenta, whether by natural or artificial
means. Once detached, the latter is decomposed, and Sonne-
times induces poisonous consequences, which prove rapidly
fatal. If the haemorrhage may be controlled, the putrid
infection, having a persistent cause at work, may resist all
our efforts. IIence, the definite indication — by a timely
delivery, to prevent So formidable an accident.
To avert the dangers of metritis, peritomitis, of phlebitis,
and of intra-pelvic inflammation, which are usually in ratio
with the length of time during which the placenta is retained,
constitutes the principal indication. Dut is the resort to
artificial delivery so free from danger, as to warrant it in
the absence of all accident? This is the question now
before us.
The placenta not being entirely detached, the first thing
necessary is to effect its complete separation. This can be
accomplished artificially, only in two ways: either by the
use of mechanical means, which act directly upon the pla-
centa; or else by stinlulating the uterine contractions, to
effect this separation.
Among the first, that which suggests itself as most availa-
ble, is the umbilical cord, considered as a means of traction.
Dut if this promises to be the easiest, we must add that it
is the most deceptive. Being very slender and frail, at this
period of pregnancy, it is certain to be torn when used as a
means of dragging the placenta out of the womb. It is,
therefore, the rule not to make traction upon the cord for
this purpose, but, on the contrary, to be careful to preserve
it intact. By this means, the cord serves to attest the pres-
ence of the placenta in the uterus, and to prevent a possible
error in diagnosis. It also affords a useful guide to the
physician, when artificial delivery becomes necessary. Con-
sidered, therefore, as a means of traction, suited to remove
the placenta, the cord is a resource which is not to be
depended upon ; and it would be wrong to employ it thus.
We may sometimes make use of the index finger, passed
high up into the uterine cavity. After having gently intro-
88 The Delivery of the [October,
duced the hand into the vagina, all the fingers, except the
first, being closed, this finger should be passed through the
cervix, and, having reached the placenta, we should attempt
its separation, by gliding the finger, curved like a crotchet,
between it and the uterine wall. To facilitate this manoeu-
vre, the bladder and the rectum should have been previously
emptied, and an assistant instructed to press with the hand
upon the hypogastrium, in order to fix the womb, and to
render its cavity more accessible. With these precautions,
this operation is quite possible, in many cases. But to this
end, it is necessary: (1) that the uterine neck be sufficiently
dilated to allow the free passage of the finger; (2) that the
size of the vagina will permit the entire hand to penetrate
to the region of the cervix; and (3) that it is possible to
separate the whole placenta.
Now, the first condition — which is rarely found when
some hours have elapsed since the abortion proper — is
almost never met with, at the end of a few days. The Sec-
ond can not be effected, at this period of gestation, without
causing extreme pain, and great risk of contusion and lacer-
ation of the soft parts. Besides, when the hand is cramped
in a too rigid vagina, the finger can not be used without
great difficulty. Hence, it follows that this apparently sim-
ple expedient is sometimes impracticable, and almost always
dangerous. Although I had long ago elaborated it, and
concluded to employ it, under the name of the uterine touch,
and afterwards found that the operation had been mentioned
and extolled by Levret, I do not at present hesitate to declare
it to be a resource which is very uncertain, and frequently
of doubtful efficacy.
Are the forceps, curette, and crotchet, more convenient
and useful, and less dangerous? They are, perhaps, more
convenient, because, in their application, it is necessary to
insert but two fingers into the vagina. But it is easily seen
that their employment is, on the contrary, much more dam-
gerous and uncertain than that of the well-directed finger.
To manipulate with these instruments, in a narrow cavity,
like that of the uterus, at the third or fourth month, and
1868.] Alacenta in Abortion. 89
attempt the entire separation of the placenta, by this means
only, would be to expose one’s self, unnecessarily, to acci-
dents as serious as those we wish to avoid.
Concerning intra-uterine injections, first used and extolled
by Recolin, with the object of bringing away the débris of a
decayed placenta, they are really useful. Independently of
the mechanical action they exert upon the placenta, they
also cause the uterus to contract, and thus exert a favorable
influence. But, since there is danger lest they penetrate
into the peritoneal sac, through the Fallopian tubes, we
should lessen the risk of this accident by employing a sound
(canula 2) with a double current, which expedient lessens
the effect desired to be produced. As these injections offer
no protection from the haemorrhage consequent upon the
partial detachment of the placenta, I apprehend they do not
most successfully meet the indications presented; and hence
they should be classed as an exceptionable resource.
As we have seen, the mechanical means that act directly
upon the placenta, are all more or less inefficient, difficult
of application, and dangerous. Let us inquire if those
which are designed to excite uterine contraction, are really
preferable.
So far as concerns the majority of the latter — as, for
example, cold, electricity, irritation of the uterine cervic, the prep-
arations of wormwood, rue, and Sabina, Stimulating injections of
all kinds, etc., -it is easy to decide upon their merits. In
general, they are mild and inefficient. Unless, as seldom
happens, there is a decided proneness in the womb to con-
tract, these means will certainly be powerless, the organ
will remain passive, and tolerate the placenta for a long
time. Their employment is sometimes inconvenient. For
this double reason, I think they should be rejected.
But if such is my opinion concerning agencies which are
usually more promising than useful, I esteem the vaginal
tampon and the prepared sponge, and especially the uterine
dilator and pulverized Ergot, more highly.
(To be continued.)
“T)YNAMIC POWER.”
BY H. P. GATCHELL, M.D., KENos.HA, WIs.
IF Prof. Temple desired to confirm the impression made by
his reply to Dr. Jones, he has fully succeeded. After maun-
dering over several pages of the Journal, he leaves his
meaning quite as undefined as before. But he displays, at
least, one kind of talent — that of forging views for an oppo-
nent, and then assaulting him, by flinging them at his head;
and if this article is but little relevant to the original ques-
tion, it is because Prof. Temple's reply is chiefly devoted to
a display of this undesirable talent. His blundering allu-
sions to Aristotle and Spinoza, need no comment; and very
few lines will suffice for so much of his reply as he seems to
have supposed to be in the nature of an attempt at definition.
According, then, to Prof. Temple:
1. The living body is moved by dynamic force, and that
force is life :
2. The therapeutical action of a remedy is due to dynamic
power, and that power is its vital principle.
3. An epistle may affect the recipient, by means of its
dynamic power.
Bating the useless phrases “dynamic force” and “dynamic
power,” the superficial expression, “vital principle,” and the
utter breaking down of all scientific distinctions in attribu-
ting a vital principle to medicine, I have no special objec-
tion to these otherwise sufficiently commonplace statements.
But where does the definition come in 7 To assert that
dynamic power is a vital principle, is one thing; to define
dynamic power, is quite another thing. Has the epistle a
vital principle, also : This confounding of living and life-
less, only leaves the matter in a greater muddle than before.
Dynamic power is the vital principle, and the vital principle
is dynamic power; and lifeless bodies, as well as living
bodies, have a vital principle.
1868.] Dynamic Power. 9I
But it would be a waste of time and paper, to expose all
the inconsistencies involved in this palpable absurdity. Is
it possible that Prof. Temple is ignorant of the fact that the
difference between statics and dynamics is merely this: that
while the former relate to bodies at rest, the latter relate to
bodies in motion — inorganic, as well as organic 2 His
assertion that dynamic agency affects only organic beings,
has not the slightest foundation in nature or scientific works.
If he is as ignorant as he seems, he would do well to consult
some respectable dictionary — or some intelligent school-
boy. And what does he mean by bringing forward again
the fact that isomeric bodies differ in their properties? Has
he not learned yet, that they differ in structure and, there-
fore, in properties 7
As to his assertion of inconsistency on my part, it will be
time enough to notice it farther, when he produces the
mutually conflicting propositions.
To his representing of me as believing “that what is
‘termed the primary cell, is a positive, natural entity,’”
(whatever that may be,) I can only reply, that he would be
much better employed in trying to lend some definiteness
of idea to his own views, than in manufacturing a creed for
me. The former task is quite enough for his capacity.
As to confusion of ideas, let the reader decide between
us, on which sides lies the confusion. When I betray such
utter disqualification for philosophic discussion, as to treat
of the existence of matter as a property of matter, I will
incontinently withdraw from the field, and quietly resign
myself to manifest imbecility. In Prof. Temple, this method
may be consistent with the profoundest ability.
And here I would take leave of him — conscious that I
have already devoted too much space to his reply — had he
confined himself to my article, instead of exercising his
inventive genius in manufacturing views for me. To con-
sider, then, his erroneous statements and false accusations
in detail :
1. I did not, as he alleges, object to the existence of some
92 Dynamic Power. [October,
term. As to the term “dynamic,” I expressly recognized
its existence, as to necessity.
2. I did not, as he alleges, object to the use of some term.
As to the term “dynamic,” I expressly recognized its use,
only objecting to his mis-use.
3. I did not, as he alleges, ask for the meaning of the
meaningless phrase, “dynamic power;” but only intimated
a desire to know what he means (provided he means any
thing) when he uses it.
4. I did not, as he alleges, teach that “force is the ema-
nation of matter.” Nor can I well appreciate the haziness
of intellect, out of which came such a phrase — idea, there
is none apparent.
5. I did not, as he alleges, ignore the fact that the primary
cell had a beginning. I made not the remotest allusion to
the primary cell, or to any other cell. The whole statement
is a rank forgery; such as, perpetrated in the relations of
business, and according to the forms of business, might con-
sign the offender to the penitentiary.
6. I did not, as he alleges, state, or in any manner imply,
that I believe in the existence of no power, unless it be
mechanical, chemical, or catalytic. I was discussing phys-
ics, not metaphysics; and I expressly recognized a “mental
sphere,” as distinct from the material, and a psychological,
as distinct from the physiological, - thus answering, in
advance, his insinuation of regarding thought as a secre-
tion from the brain. But if all thought were like some that
could be specified, one might be tempted to hold the doc-
trine of secretion.
7. I did not, as he alleges, enunciate any thing in the
slightest degree involving materialism — if by materialism
he means that doctrine which holds the universe to consist
only of matter and its relations. I hold that the material
universe thus consists; and so does every one, in his senses,
except idealists — if, indeed, they can be said to be in their
senses. But, while I have been the strenuous opponent of
the former materialism, I have never been guilty of the
meanness of attempting to cast odium upon its advocates
1868.] Dynamic Power. 93
on account of their views. I hold too sacred the right of
all men to their own conclusions, uninfluenced by any
inquisitorial agency, and undeterred by any attempt to heap
ecclésiastical odium upon them.
I am not an atheist, as he substantially alleges, in terming
me a materialist—intensifying the allegation by a quotation
as to the “atheistic tendencies '' of the doctrine which he
so impertinently attributes to me. Nor, if I were, and if I
should fail to sustain myself in the discussion of a question
in physics, would I resort to the artifice of attempting to
divert attention from my failure by falsely — or truly, for
that matter — attributing unpopular views to an opponent.
I could not resort to such means to supply a lack of argu-
ment. Whether this recklessness of statement on the part
of Prof. Temple, is compatible with hig assumption of spir-
itual excellence, let the reader judge.
And who is this man, Temple, that he thus flings charges
of profanity, materialism, and atheism, at his opponents?
What is he, that he should seek to scandalize by indirection,
and to slaughter by a quotation, representing those who
presume to doubt his intelligence in physical science, as
moving in the “narrow sphere of a mere bread-earning
craft.” If such doubt is his test of demerit, he will find
(notwithstanding his affectation of spiritual superiority) the
circle of Saints of which he is the centre, to be an exceed-
ingly small circle of exceedingly small saints.
NoTE. — Since writing the preceding article, I have seen,
in the “Investigator,” another reply by Prof. Temple, to
Dr. Jones, in which occur the following sentences:
“Suppose it can not be seen by such men as Dr. Jones;
does that militate against the fact that matter is endowed
with force — a vital, active force, which is not material 2
That remedies act by virtue of their dynamic power, in
curing diseases, is now acknowledged by most Allopathic
writers, of any standing.” This he attempts to fortify by a
94 Dynamic Power. [October,
quotation from Pereira; the whole forming a jumble which
I will try to dissect:
1. Prof. Temple appears to be unconscious of the fact
that the passage from Pereira, so far as it is authority,
refutes one of his own hasty notions, viz.: that dynamic
action is exerted on organic bodies solely; Pereira expressly
recognizing it as pertaining especially to inorganic bodies.
2. Pereira states that this influence, of which we have
evidences in the inorganic kingdom, is regarded by “sev-
eral pharmacologists” as including, in part, that of medi-
cines on the organism. IIe does not say that most Allo-
pathic writers, of any standing, teach thus; and, in view of
the character of Prof. Temple’s assertions, his testimony is
hardly sufficient. I think the truth to be, that most writers
of the Old School are silent on the subject.
If Prof. Temple could prove that most Allopathic writers,
of any standing, do thus use the term “dynamic,” it would
have no bearing on the question. Nobody objects to the
propriety of thus using the term “dynamic.” The objec-
tion is to the phrase “dynamic power,” as mere confusion.
4. In the second sentence, quoted above, he uses the lan-
guage, “this dynamic power.” Now, what does the term
“this?’ refer to ? It can refer to nothing but the “force,”
in the preceding sentence; which “force ’’ is there defined
as “vital” force. Now, if Prof. Temple means to intimate,
as the structure of the passage indicates, that most Allo-
pathic writers, of any standing, recognize the existence of
a vital force in medicine, he means to assert what readers
know to be utterly untrue. It may not be his intention to
assert what he does assert. It may be only a specimen of
his usual jumble.
He does, however, with his accustomed good breeding
and logical force, introduce one cogent argument in favor
of “dynamic power.” He charges Dr. Jones with infidelity.
If that does not settle the question in regard to “dynamic
power,” what can 7
Really, it is humiliating to find one’s self engaged in a
discussion with a man who appears to be utterly incapable
1868.] Reviews of Books. 95
of confining himself to the intellectual relations of a ques.
tion, and who incontinently resorts to personal attacks. If,
in repelling his grossly unwarrantable assaults I have char-
acterized them by appropriate terms, the fault, if any, is
with the assailant, and not with the defendant. If he is
capable of a logical discussion, and of confining himself to
it, I should be pleased to hold such discussion of some views
implied or expressed by him. But, if he lacks this capacity,
and if he can only eke out his incapacity by flings at his
opponent, about matters wholly foreign to questions under
discussion, then I prefer not to descend to the arena where
he stands.
AºA VVE WS OF PO OA. S.
THE HALF-YEARLY ABSTRACT OF THE MEDICAL SCIENCES :
being a Digest of British and Continental Medicine, and
of the Progress of Medicine and the Collateral Sciences.
Vol. XLVII. January and July, 1868. Philadelphia:
Iſenry C. Lea.
As usual, Ranking's IIalf-Yearly Abstract is just the thing
for every medical man; containing the pith and marrow of
more than a score of journals, utterly inaccessible to all but
a very few. The price, $2.50 per annum, puts it within the
reach of all. No physician can afford to be without it.
Those who attempt so to do, impoverish themselves, and
rob their patients.
N. B.—We wish particularly to call the notice of our readers to the necessity
for their contributions being received at least NINETY days before the date of
publication. Attention to this rule will save them from many disappointments,
and the editor much trouble. This refers to lengthy papers ; items of nºw8
will be received any time.
BOOKS TECEIVED.
On “Nervousness.” Its True Nature and Treatment. By Henry R.
Madden, M.D.
Buffalo Medical and Surgical Journal.
Journal du Dispensaire Hahnemann de Bruxelles.
The Dental Register.
The Dental Cosmos.
New York Medical Journal.
The American Journal of Materia Medica,
Seventh Announcement Hahnemann Medical College of Missouri.
The Detroit Review of Medicine and Pharmacy.
Allgemeine Homoeopathische Zeitung.
The Western Homoeopathic Observer.
The New York Citizen.
The Chicago Medical Journal
The New Orleans Journal of Medicine.
El Criterio Medico.
Rivista Omiopatica.
Revista Médico Quirurgica y Dentistica, Habana.
The Ohio Medical and Surgical Reporter.
Bulletin de la Societé Médicale Homoeopathique de France.
American Eclectic Medical Review.
Pacific Medical and Surgical Journal.
The Journal of Materia Medica (Bates and Tilden’s.)
Nashville Journal of Medica and Surgery.
The Medical Record.
Ranking's Half-Yearly Abstract.
Dental Materia Medica; Compiled by Jas, W. White. Philadelphia:
S. S. White. 1868. A condensed view of the Medicals and Chemicals in use in
the practice of Dentistry, presented in elegant form. An appendia, containing
the Homagopathic remedies, approved by long experience, in the treatment of the
teeth, would add much to the value of the work.
The Monthly IIomoeopathic Review.
Nineteenth Annual Commencement and Catalogue of the Cleveland Hom-
opopathic College. This announcement contains a list of the graduates of the
college, from its foundation ; but we do not know how to account for the omis-
8ion from this list, of the name of E. M. Hale, M.D., who is 8aid to be a gradu-
ate of the college, nor for that of the Editor-in-chief of this journal, who received
am Honorary degree from this institution.
The Truth concerning Homoeopathy: What it is, and what it is not. By
S. A. Robinson, M.D., Laporte, Ind.
A DITO/P/A Z.
AVO ZTAES OAV ZAZ / S/O / O G 7.
By C. WESSELHOEFT, M.D., BosTON, MASS.
TIEW INVESTIGATIONS CONCERNING THE SECRETION OF
GASTRIC JUICE, AND THE FUNCTION OF THE PANCREAS
AND SPLEEN. BY DR. M. SCEIIFF.
(Translated from “Momatsblatt der Allgemeine IIomoeopathische Zeitung,” Vol. 75. Semester
XVI. November, 1867. No. 5.)
ALREADY, some time ago, M. Schiff published observations on this subject,
which appear to be of great theoretical, as well as practical, significance.
Schiff had found that, through resorption of so-called peptogenous bodies,
a “charged ” state of the gastric mucous membrane, with pepsine, occurred ;
by means of which, the digestion of albuminous matter is increased, in a
great measure. In order to strengthen these facts, contested by Domenic,
by new proofs, Schiff now furnishes the result of new experiments concern-
ing the matter.
A piece of coagulated albumcn, of a certain size, envcloped in a little bag
of muslin, was inserted into the stomach of a large dog, through a gastric
fistula, existing for five weeks; and this was done repeatedly — always fifteen
or sixteen hours after a copious meal. The quantity of albumen dissolved
in the course of 5% to 6 hours, was very nearly the same in all experiments;
for the cubes of albumen, measuring 5 cubic centimetres, had been lessened
by 1.9 and 2.5 centimetres. If, under equal conditions, 20 to 40 grammes of
dextrine, enveloped in unsized paper, were placed into the stomach of the
same dog, together with a cube of albumen of 7 cubic centimetres, then the
thickness of the piece of albumen was found to have diminished by 5.2 to 6.4
centimetres. In order to show that the increased secretion of gastric juice
was not owing to mechanical irritation, Schiff made experiments in which
equal quantities of wool or cotton were introduced with the albumen — of
which, however, no more than 2.2 or 2.5 centimetres were dissolved. After
the injection of peptogenous substances into the rectum, the power of action of
the gastric juice also proved to be increased. If peptogenous substances,
like “bread extract,” digested meat, or albumen, were injected into the rec-
tum, instead of the peplogenous addition to the cube of albumen in the
stomach, the diminution of this cube amounted to from 5 to 7 centimetres;
while this diminution amounted only to 1.8 or 2.4 centimetres, after injec-
tions of mere water or sugar.
Vol. IV.-No. 1 3. 7
98 Edź/orza/. [October,
In the case of a second dog, where no solution of coagulatcd albumen,
without poptogenous addition, was observable 12 or 13 hours after a copious
mcal, 250 grammes of raw meat, with 150 grammes of water, were intro-
duced into the stomach, on one day; on the third day, an equal quantity of
mcat, previously boiled, together with 150 cubic centimetres of the broth;
and on the fifth day, 150 cubic centimetres of water, were introduced into
the stomach, with the albumen. This series was repeated several times.
After the mere addition of water, only traces of the albumen were dissolved;
but on the addition of raw meat with water, 4.8 to 6 continuetres were found
to have been dissolved. The diminution of the piece of albumen, with the
addition of the boiled meat with the broth, amounted to 6.4 and 8 centime-
trCŞ.
It has been demonstrated by Schiſſ, as well as by Corvisart, that the func-
tion of the pancreatic juice is intimately connected with digestion of the
stomach. The oesophagus and pylorus of dogs were tied, and the vagi scv-
ered, after the animals had been ſed; after five hours, the food in the stom-
ach was intact, and the extract of the pancreas was totally without effect
upon albuminous substances. If only non-azotized substances, such as rock-
candy, olive oil, or only mechanical irritants, like sand, were introduced into
the stomach, without previously arresting the digestive power of that organ
by division of the vagi, then the pancreatic secretion was also found to be
ineffectual after five hours. If, thirdly, after division of the vagi and liga-
ture of the pylorus, various substances (liquid albumen, flour paste, Solution
of sugar,) dissolved in water, were introduced, which could be, and actually
were, partially absorbed after five or six hours, the pancreatic secretion was
likewise found to be inert, after the lapse of that time. Neither the mere
repletion of the stomach, nor the recurrence of resorption from the stomach
in general, suffice to produce a “charged ” state of the pancreas; for which
purpose, the actual process of digestion must have taken place in the
Stomach.
Artificially digested meat having been introduced into the stomach of a
hungry dog, after ligature of the pylorus and division of the vagi, the pan-
creas was found highly charged five hours afterwards. The Same experi-
ment was repeated, under the use of “fibrin pepton ;” and with a similar,
but less marked result, under the use of a gelatinous solution. The action
of the pancreas, therefore, is governed by the absortion of the products of
digestion, by means of the gastric juice; but dextrine, as was shown by the
experiment, acted quite as well as the peptogenous Substances, provided that
the absorption took place from the stomach, and not from the Small intos-
tine.
As a continuation of his earlier experiments, from which Schiſſ inferred
the coöperation of the spleen in the process of charging the pancreas, he
furnishes the following results of his investigations: When a fistulous open-
ing had been made in the duodenum of a large dog, near the orifice of the
pancreatic duct, and the animal accustomed to the Same, pieces of albumen,
always of equal size, introduced into the fistula, were always absorbed more
rapidly, when digestion was going on at the same time in the stomach, and
more slowly when the stomach was emptied. According to Schiſſ, the diſ.
1868.] Adžāorial. 99
ference depends on the circumstance, that, in the first instance, intestinal
Becretions act, in conjunction with the pancreatic juice, upon the albumen,
while in the second instance, the intestinal secretion acts alone. Iſence,
after having repeatedly established the preceding observations, if the spleen
of one of those dogs was extirpated, then the difference of time ceased to be
observable in the solution of the piece of albumen placed into the duodenum,
whether the dog had been fasting or not. (Med. Centr, Zeitung, 1867, 77.)
THE QUESTION OF SUGAR FORMATION IN THE LIVER, By
DR. ALBERT EULENBERG, BERLIN.
(Translated from “Momatsblatt der Allgemeine IIomoeopathische Zeitung,” Vol. 75. Semester
XVI. Wovember, 1867. Wo. 5.)
It is well known that, several years ago, W. Pavy made the surprising
statement (first in 1858,” and more elaborately in 1862,+) that the sugar dis-
covered in the liver during Cl. Bernard's fundamental researches, should be
regarded as a post mortem phenomenon, and that sugar is never produced in
the liver before death, under normal conditions; and that, consequently, the
liver of the healthy living animal contained no sugar. These discoveries
were, in a certain degree, capable of nipping in the bud the far-reaching
expectations regarding Bernard's experiments, hitherto promising a better
understanding of the physiological functions of the liver, as well as of the
pathogenesis of diabetes. Hence, it is readily conceived why Pavy's asser-
tions were at first regarded with decided suspicion, and almost entirely
ignored for some time; although Meissner f soon defended the same, basing
his arguments upon his own experiments. Recently, however, Ritter §
repeated Pavy's experiments, principally upon rabbits; and corroborated
them throughout. The process adopted by Ritter consisted in quickly plac-
ing the fragment of liver, torn or cut out of the animal, and divided into
minute particles, into constantly-boiling water, kept close at hand. The
extract, prepared in this manner, after the addition of a small quantity
of acetic acid, was then filtered, and tested for sugar. The test was made
by adding a small quantity of solution of Sulphate of copper and carbonate
of potash to the extract, usually while it was hot; whereupon the whole was
heated to ebullition. The result of these experiments, with a single excep-
tion (see below), was that the liver of the healthy living rabbit, containing
an abundance of glycerine, does not contain the least trace of sugar, but
that the formation of sugar commences in the liver immediately after death.
(P. 72.)
In the course of several experiments which I made upon rabbits, during
* Guy's IIospital Reports, 1858, IV., p. 291.
+ Researches on the Nature and Treatment of Diabetes. London : 1865.
+ Jahresbericht, 1862. P. 810, 8s.
§ On the Amylum and the Sugar of the Liver. Zeitschr, fur Rationale Medizin (8 R.) XXIV.
|P. 65-81.
:
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*
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:
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:
IOO Adžāorial. [October,
the past summer, in the laboratory of Prof. Stacdcler, and wherein I observed
most carefully the directions of Ritter, I was repeatedly surprised to obtain
distinct saccharine reaction ; but, more frequently, this was indistinct and
vague, since the mixture, on boiling, assumed only a dirty-brownish green
color, depositing, on cooling, a flocculent muddy-brown or yellowish sedi-
ment, instead of a red scdiment of sub-oxide of copper. In rare cascs, there
was no reaction at all ; but when, in cases of the latter class, the mixture
was ultimately Saturated with a great eaccess of carbonate of potash, and kept,
if necessary, at the boiling-point for several minutes, a distinct Saccharine
reaction always took place. If, finally, Ritter's directions were deviated
from, by adding a test-fluid composed of weighed quantities of solution of
copper, pure tartaric acid, and solution of potash, then the reaction never
failed to appear.
These results necessarily raised the suspicion, that the absence of reaction
in Ritter's experiments might have been owing to the want of a certain
degree of care in the performance of the test for sugar; since no tartaric
acid, and an indefinite, and probably insufficient, quantity of solution of pot-
ash, had been used, thus preventing successful reduction. I was, therefore,
forced to assume that the extract prepared according to Ritter's directions,
always contained a trace of Sugar; this sugar, however, need not necessarily
have been pre-formed in the normal liver, for it might have originated
through the faulty method, subsequent to the separation of the fragment of
liver from the body, and during the preparation of the extract. Hence, it
appearcd possible that, on being put into boiling water, the particles of liver
did not immediately reach the boiling point at their centres, and that, conse-
quently, the development of fermentation was not at once completely arrested,
thus permitting a portion of glycogen to be transformed into sugar. Ritter
himself obtained Saccharine reaction in this manner, in one instance, because,
as lie supposed, the substance of the liver had not been sufficiently commin-
uted, on which account the pieces were not heated rapidly enough. It might
also have been supposed that the products of glutinous substances, formed
in boiling in an acidulous solution, might have suffered a further decompo-
sition, leading to the separation of Sugar.
These considerations, and the advice of Prof. Stadeler, led me to the adop-
tion of a different process in the investigations of the liver, insuring an
immediate and complete arrest of fermentation, avoiding the formation of
gluten ; and, lastly, permitting the performance of the Sugar test in a more
appropriate manner, and with a less doubtful result.
The animal being held in a stretched horizontal position, a transverse
incision was made immediately below the xiphoid process of the sternum,
laying open the abdominal cavity. From the liver, thus exposed, a piece
was torn off, and speedily and forcibly triturated in a mortar, with pulver-
ized glass and alcohol. In this way, the alcohol is permitted to act at once,
in excluding all fermentation ; and the friable viscus is reduced to a fine
pulp in a few seconds, provided the fragment was not too large. In this
manner, no time is lost, as in the former process of cutting the liver to picces
with a knife. The alcoholic extract is filtered into a glass vessel, digested,
for a short time, in moderate warmth, and then filtered; whereupon the
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1868.] * Adžforza/. I O I
alcohol is evaporated, the residue dissolved in a moderate quantity of water,
and mixed, drop by drop, with as much acetate of lead as is required for pre-
cipitation. It is then filtered. The filtrate, having been freed from the lead
by means of HS, and SPC separated again by filtration, and the excess of
HS having been removed by warming, the liquid, neutralized with a drop
of soda, is then ready for the test. Instead of the treatment with HS, a
more expeditious course may be pursued, after the precipitation with acetate
of lead, by adding, dropwise, so much soda, that the cloudiness, appearing
in the beginning, again disappears; thus leaving the possible excess of lead
to remain in Solution, which, as the result showed, did not interfere with the
test for sugar.
As it is well known that the mixed test-fluid of Fehling may give rise to
errors, through the spontaneous separation of the sulphate of copper, caused
by the more or less rapid decomposition of the tartaric acid, I made use of
Stacdcler's mixture,” in order to exclude entirely the possibility of sponta-
neous reduction. The extract to be tested for sugar, was added to the boiling
test-fluid, and the mixture allowed to boil uninterruptedly for three minutes.
If no reaction occurred after this length of time, this was considered as a
sufficient proof of the absence of sugar.
The trials executed in this manner, furnished negative results throughout,
in the cases of six healthy rabbits; their livers did not contain a trace of
sugar during life. In accordance with the process above described, pieces
of liver, as nearly as possible of equal size, were torn from five other rabbits,
and immediately, or soon, afterwards, subjected to treatment with boiling
water and acetic acid. In all these cases, the extract prepared according to
the katter method, exhibited distinct saccharine reaction, provided a sufficient
quantity of potash was added, and the fluid allowed to boil long enough.
On the other hand, not a trace of sugar was found in the liver substance,
triturated with pulverized glass and alcohol. Hence, the superiority of the
latter method, in deciding the question at issue, can not well be doubted.
In the case of one rabbit, however, slight but distinct traces of saccharine
reaction were exhibited by a piece of liver, treated with alcohol. But since
the gall-bladder was contained in this fragment of liver, this gave rise to the
supposition that perhaps the bile was the cause of the Saccharine reaction.
In two subsequent experiments, therefore, the gall-bladder was purposely
torn out, with the fragment of liver, and the extract, with its admixture of
bile, thus obtained, was tested for sugar — without, however, cliciting any
trace of sugar. The cause of the deviating result in the case of the first
rabbit, must, therefore, remain unexplained. I will only remark, that the
animal was exceedingly emaciated, and afflicted with itch ; so that, possibly,
this circumstance may not have been without influence in the exceptional
result exhibited by its liver.
Ritter lays stress upon the avoidance of anaesthesia by means of ether or
chloroform, as well as morphia, in these experiments, because — as has been
proved by Reynoso, Bence Jones, Coze, and partially by Pavy — transient
diabetes occurs under such circumstances. But this fact is by no means
* See Liebig and Kopp, Jahresbericht, 1854, p. 747.
I O2 Adžforza/. [October,
constant; and, besides, there is a total absence of proof regarding the neces-
Sary connection between the appearance of sugar in the urine, and the vital
formation of sugar in the liver. The two following experiments demonstrate
that, in the Casc of rabbits at least, etherization, if not carricq to a fatal or
deleterious degree, will not call forth formation of sugar in the liver.
Two vigorous white rabbits were made to inhale pure sulphuric ether for
1–1% minutes, consuming about 80 drops, poured into a cloth, held at a short
distance. After perfect anaesthesia was established, together with a coma-
tose condition, and myosis, the abdominal Section was made, and fragments
of liver removed and tested in the usual manner. After the lapse of a few
minutes, the animals were killed by bleeding them to death. The pieces of
liver, abstracted during life, and during continued anaesthesia, were entirely
free from sugar, in both instances, as well as the urine taken from the blad-
ders, after the death of both animals. The pieces of liver, however, taken
out after death, when subjected to the same treatment, manifested decided
saccharine reaction ; as was also the case, without exception, with animals
not under the influence of anaesthetics.
A third rabbit was subjected to the influence of freshly prepared bicarbu-
ret of chlorine (C2 Clſ) for three minutes, by means of a bladder drawn
over the animal's head, until a severe toxic effect was produced, in the form
of facial respiration, spasmodic dyspnoea, and apparent death. At this
stage, the abdominal cavity was opened, and a piece of the liver taken out ;
during which, the heart was still seen to pulsate feebly. In this case, the
substance of the liver distinctly contained 8wyðr. Even the urine, obtained
from the bladder after death, manifested decided Saccharine reaction. It
appears, therefore, that ante-mortem formation of Sugar in the liver — and,
perhaps, also diabetes — can be called forth only by intense narcotization,
approaching the point of fatal, or at least extreme, intoxication by means
of inhalation.
As regards the results obtained with liver-fragments taken out after death,
my investigations correspond exactly with the observations of earlier exper-
imenters, particularly with those of Ritter. Already, immediately after
death, a piece of liver, triturated and treated ever so carefully with alcohol,
exhibits distinctly the presence of sugar, which evidently increases very
rapidly within a short space of time. (Berlin, Klin. Wochenschr, 1867; 41.)
O AEP,S. ZTAE 7/? YC.S.
By R. LUDLAM, M.D., CIIICAGO, ILLS.
COLD WATER LOCALLY, IN PUERPERAL PERITONITIS.
Tirm “Ann. de la Soc. de Med. de Saint Étienne,” for 1867, publish a case
of this disease, treated by topical application of cold water. It occurred in
a primipara, three weeks after delivery, and was accompanied by the follow-
1868.] Adźforza/. IO3
ing symptoms: Pulse 140, Small and compressed ; face pinched and anxious;
the abdomen tympanitic; continual nausea and vomiting, with hiccough, etc.
Not having ice at command, Dr. Briant substituted it with water, which
was as cold as possible, applied by means of bladders, that were to be changed
every five minutes.
The next day, there was slight improvement; pulse 120, less prostration,
less frequent vomiting, no hiccough ; the tympanites persists, as well as the
sensitiveness to pressure. The cold applications were continued, without
other treatment, and with marked improvement, for about one week; at
which time, the patient was out of danger, and they were discontinued.
BROMIDE OF POTASSIUM IN THE NERVOUS AFFECTIONS
INCIDENT TO PREGINANCY.
DR. CERSoy communicates to the “Bull. Gén. de Thérapeutique” for 15th
May, 1868, a case of obstinate cough in a pregnant woman, cured by this
agent. The patient was aged 30, of good constitution, and pregnant for the
Second time. The cough was dry and capricious, sometimes incessant, and
permitted her little rest at night; the paroxysms being so strong as to make
her fear an abortion on account of it. No signs, on physical exploration,
and no expectoration. It was, evidently, of nervous origin.
“I employed, successively, Opium, Belladonna, Cherry-water, Aconite,
JBalsam of Tolu, and Sulphur, without benefit. I thought, finally, after two
months' treatment, of the Bromide of Potassium, which I prescribed at the
rate of two grammes per day, in four spoonsful of Syrup of Tolu. At the
end of the second day, the cough had almost disappeared. The remedy was
given in smaller doses, at longer intervals, for about two months. She was
safely delivered at term.
In a case of vomiting, incident to gestation, which recurred each day, the
trouble was promptly arrested by the same means.
*=======ºs
CHLOROFORM INJECTIONS IN LABOR.
A writer in the “Würtemberg Medicin,” etc., No. 10, 1866, cites two cases
of protracted delivery, with constriction of the os uteri, in which labor was
brought to a safe and specdy close, by injections, consisting of chloroform,
the yolk of egg, and an infusion of chamomile flowers. A simpler and
equally efficacious method is to administer the chloroform in injections with
sweetened water, as recommended some years ago, by our colleague, Dr.
Holcombe.
INHALATIONS OF OXYGEN, FOR THE CURE OF DIPHTHE-
RITIC PARALYSIS.
IN No. 152 of the “Union Médicale,” two cases of this singular and trouble-
Some malady are reported cured by inhalations of oxygen gas. In the first
IO4. Adžforzaz/. [October,
of these, the ordinary treatment had been tried, and failed. (Dr. Foucher
had already lost two adults from this disease.) The deglutition and respiration
Were very painful, the speech very difficult, vision impaired, and the paraly-
sis had attacked the extremities. The patient was a man, act. 36. Dr. F.
Caused him to inhale a small quantity of oxygen, which was of immediate
benefit. After a suspension of four hours, another inhalation was given,
and with decided improvement. At the end of some hours, and especially
the next day, the cnbarrassment of swallowing, of breathing, and of speech,
had notably diminished. This case was finally cured.
The second case was that of a woman, aged 28, who had paralysis, with
extreme debility, after an attack of diphtheria. It had continued a fortnight,
with great dyspnoea and dysphagia. The oxygen inhalation was given
Sept. 16th, 1866. On the same day, the pharyngeal paralysis, and that of the
respiratory muscles—and, indeed, all the symptoms — were considerably
relieved. The next day, the patient could rise, and the most marked improve-
ment was noted. Five days later, despite the use of tonics, she was failing,
and the paralysis attacked the extremities. The inhalations were repeated.
For six days, they were continued, with the effect to dissipate most of the
Symptoms of paralysis, and to improve the cachetic state decidedly. During
the month of October, the patient could go and come, although she was not
quite well; and, being absent, neglected the treatment. Consequently, the
weakness and numbness of the extremities returned. The oxygen was
given for four days more, with prompt effect; and she was soon cured
entirely.
TRACHEOTOMY IN A WERY YOUNG INFANT.
THE “Gazette des Hôpitaux,” No. 66, 1868, reports an interesting case, in
which this operation, of which French physicians are very fond, was suc-
cessfully performed by Dr. Isambert, in a child of only twenty-two months.
The little patient had been ill a whole week, with laryngeal diphtheria;
during which time, the most energetic measures were powerless. The
deposit was first observed in the mouth, then upon the tonsils, and finally
invaded the larynx. And yet these excellent authoritics have diagnosti-
cated and reported the case as one of croup /
ACUPUNCTURE IN THE DIAGNOSIS OF UTERINE POLYPI.
TIIE “Arch, gen. de Méd.” furnish very interesting details of an example
of fibrous polypi of the uterus, in which it was extremely diſficult, by the
usual means, to arrive at a correct diagnosis. Dr. Guéniot proposed and
practiced acupuncture through the speculum. The tumor was aſterwards
excised, and the diagnosis confirmed. Concerning the value of this means
of exploration in similar Cascs, Dr. G. reaches the following conclusions:
1. That, thanks to the gift furnished by acupuncture, which enables us to
decide upon the Sensibility or inscrisibility of intra-uterine tumors, this mode
of exploration enables us to distinguish fibrous polypi of the womb, from
1868.] Adžforzał. IO5
partial inversion of the same organ; 2. That the polypi, with altered and
softened tissue, of which the surface remains sensitive from being connected
with the uterine mucous membrane, constitute the exceptional cases, which
alone may be excluded in applying this means of diagnosis; 3. That, in the
examination of deep-seated tumors, acupuncture is properly indicated, along
with the uterine cathcterism — it being useful in the diagnosis of partial
inversion of the womb, while catheterism is not applicable or useful in cases
of complete inversion of the organs.
RETENTION OF THE FOETUS IN UTERO FOR THREE YEARS.
Reported to the Cook County (Ill.) Homoeopathic Medical Society.
BY W. EGGERT, M.D., INDIANAPOLIS, IND.
IN October, 1864, I was called to see Mrs. J. M., of this city. She had been
attended by another physician, for the last twenty-four hours. He had pro-
nounced her to be in labor — a condition which she considered impossible;
hence, he was discharged, and I was called. When her husband related the
case to me, I thought it singular that either the lady or the physician should
be so badly mistaken. Full of apprehensions, I went to see my patient. It
was evening. On entering the bed-chamber, a glance at her, together with
that moaning Sound peculiar to parturient women, convinced me that I was
in a lying-in chamber.
I procceded to make an examination. Vagina hot and dry; the os par-
tially open, lips quite rigid. Entering the uterus, the index met a hard,
callous substance, which easily might have been taken for the head of a
foetus; but I could neither discover a fontanelle, nor any resemblance to a
skull, or any other part of the human body. The surface felt roughish,
almost dry. Abdominal examination revealed nothing but the usual enlarge-
ment of pregnancy, and the presence of something in the uterus; but what
this something was, remained undecided. There was considerable pain in
the right ovarian region, but without swelling. Labor-pains, which had
been, during the twenty-four hours previous to my arrival, regular and
severe, became less frequent and milder.
Here, them, I found myself in a dilemma, out of which how to escape, I
hardly could conceive. The case had a history. The lady was 22 years of
age, well built, short, anaemic, phlegmatic, face bloated and pale; had had
no monstruation for the past three years; had never had a child, nor a mis-
carriage. When living in Ohio, three years before this, her menstruation
ceased ; and she herself, as well as her family and physician, considered her
pregnant, from the presence of the usual signs. She never experienced any
fostal movement. But when the time of her confinement arrived, no symp-
tom tending to delivery made its appearance. Her physician diagnosticated
the presence of hydatids, from which she would be delivered at a proper
time. As she remained otherwise well, nothing clse was done; in fact, she
became so accustomed to her condition, that she hardly paid any attention
to it, until the present pains made their appearance.
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1868.] Adźforza!. IO7
ting to take charge of the foetus and its shell, so as to preserve it, and when
I saw it again, six or eight hours after this, it had decomposed so rapidly
that it was impossible to preserve it—a neglect on my part, which I regret
very much.
The pain in the right ovary had, the next morning, considerably increased.
I put her on Apis ; and in ten days from the delivery, my patient was up
and well.
*ass=mºs
CATHETER IN THE FEMALE BLADDER.
DR. SüSS-IIahnemann gives an account, in “Allgemeine Homoeopathische
Zeitung,” 76, 126, of his losing a catheter in the female bladder. He was
called in great haste, early in the morning; took the first catheter which
came to hand, partially introduced it, when, by a sudden motion of the
patient, it cluded his grasp. It then occurred to him, for the first time, that
it had lost its ring. What to do, was the question. The surgeons of the
hospital (the London Homoeopathic) were called together ; the Doctor was
soundly berated, but all attempts at relieving the patient failed. At 7 P.M.
they had finally concluded to open the bladder, for the purpose of reaching
the instrument. While the surgeons were discussing which operation to
perform, the Doctor requested permission to make one more attempt. He
introduced his finger into the bladder, found the catheter lying across the
exit of the bladder, now empty, and firmly grasping the instrument It all
at once occurred to him to inject the bladder full of water. A fine silver
tube was passed up along his finger, the bladder was filled, and, on withdraw-
ing his finger, the catheter followed — to the great relicf of all concerned.
A few doses of Arnica and Cantharis removed all difficulties in a few days.
CAHAZMZS ZTA’ 2.
By F. A. LoRD, M.D., CHICAGO, ILLS.
IDEATHIS FROM CHLOROFORM.
TIE ideas of Dr. Hedges, in his article on this subject, in the present No.
of the Journal, in regard to the spontaneous formation of chlorine and
hydrochloric acid in chloroform, though not new, are important. The pos-
bility of such changes, under the influence of strong light and heat, is
undoubted, and should be generally known as one of the sources of impurity
in this agent. The assumption, however, that all the deaths from chloroform
have been caused by the poisonous effects of these substances, and that their
presence, either as original impurities or as products of spontaneous decom-
position, is a common occurrence, are, we think, more than the probabilities
or facts of the case will allow.
The most common impurities of chloroform are the chlorinated pyrogen-
IO8 Adžāorga/. * [October,
OuS oils, ether and alcohol; the presence of the last of which, is known to
be preventive of decomposition. To our certain knowledge, some specimens
of chloroform which have been carelessly kept for several years, and more
or less cxposed to ordinary light for weeks together, are perfectly free
from these contaminations; while, on the other hand, chloroform to which
hydrochloric acid has been purposely added, has failed to prove fatal to
animals. w
As regards the tests for purc chloroform, it is only that which contains
alcohol, that “gives a white, cloudy appearance,” when dropped into water.
Pure chloroform, when evaporated from the hand, leaves no offensive smell;
and dropped on white paper, leaves no stain. The best article is manufac-
tured from methylated spirit.
Independently of any impurities it may contain, chloroform may produce
death in healthy persons, in either of three ways : First, when it is inhaled
without sufficient admixture of air to support life ; or, in other words, by
deprivation of oxygen. Second, by its paralyzing effects on the nervous
centres of respiration, when its general effects are allowed to go beyond a
certain stage; or, in other words, from an overdose. (Death, in the preced-
ing Cases, takes place by asphyxia, and is the kind of death that may be
prevented by proper care and skill in the administration. It is also the kind
of doath which, when threatening, may sometimes be averted by the use of
restoratives — the cold dash, artificial respiration, etc.) Third, chloroform
may cause death by directly paralyzing the cardiac nervous centres and
ganglia, owing to some unaccountable and unknowable individual idiosyn-
crasy of the patient, which determines its action specifically to the blood
centre, producing death by syncope. This, it is believed, is the true explana-
tion of those deaths that occur suddenly, and after only a few inhalations
of the anaesthetic vapor. Respiratory movements have been observed in
some of these cases, after the hcart had ceased to beat. These are the cases
which no amount of precaution seems to avail to prevent, nor any degree
of skill and energy to restore.
BUTTER AND BRAINS.
DURING the late session of the “Scientific Congress” in this city, Prof.
Horsford, of Cambridge, Mass., presented an interesting paper concerning
“Phosphoric Acid a Constitutent of Butter.” IIe said Liebreich had found
Some years ago, in the alcoholic extract of the brain, and also of nerve fibre,
a crystalline substance, of fatty character, which readily broke up into Sev-
eral fatty bodies, including cerebrin, stearic, and perhaps other fat acids, and
a body which he called nervinc, which was combincól with glycero-phos-
phoric acid. This nitrogenous body, nervine, was observed by Wurtz to
consist of the same elements, in the same proportion, that would be required
to form an oxide of ammonium, in which one of the atoms of hydrogen is
replaced by ethyl, and the other three by atoms of methyl, Baeyer and Lic-
breich found sugar in the compound, and it was doubtless the body formerly
known as lecithin, and was called by Liebreich, protagon. Wurtz attempted
* Chicago “Tribune.”
1868.] Adžtorial. IO9
the synthetic production of nervine, and succeeded perfectly ; SO that, in all
its reactions, the body he obtained corresponded with the nervine derived
from the brain. It combines with platinum and gold Salts, and with various
acids; yielding the same crystalline forms, and the same reactions, that were
obtained with the nervine procured from the brain. Since then, Hermann
has found protagon in the blood corpuscles, and IIoppe Seigler in the serum,
and in the red and white corpuscles, in Indian corn, in wheat, in wine fer-
ment, in the yellow of the egg, and in some fat oils.
In view of these facts, it seemed to the Doctor highly probable that it
would be found in butter, which is the fat constituent of milk, from which
the blood and brain of young animals derive their nutriment. In his
first experiment in search of this body, or of the phosphoric acid it contains,
he selected a very choice sample of butter, quite free from buttermilk and
water, and rubbed it up with carbonate of magnesia and pulverized caustic
potassa. It saponified, in a short time, to a mealy mass. This mass he
threw, in successive small portions, into a platinum crucible, and burned.
The residuum he extracted with nitric acid and water, filtered off the
unburned charcoal, and tested with molybdate of ammonia. The precipi-
tate was so immediate and large, that he was led to suspect that either his
potassa or magnesia contained phosphoric acid. They proved to be entirely
free from it. It then occurred to him that a trace of caseine, or of butter-
milk, present in the butter, might be the source of the phosphoric acid. He
proceeded then to heat a mass of butter into ether, pouring off the extract,
when the residuc was reduced to a pale milk-and-water fluid. The extract,
he left to spontaneous evaporation. The milk-and-water fluid yielded scarcely
a trace of phosphoric acid to molybdate of ammonia. From the ether extract,
after slight concentration, there separated abundant crystals; and at length
the whole became, as the ether evaporated, semi-fluid crystalline magma.
This mass, he rubbed up with carbonate of magnesia and powdered hydrate
of potassa, calcined as before, and dissolved in diluted nitric acid, filtered
through sand, previously boiled with hydrochloric acid, and thoroughly
washed with water, and tested with molybdate of ammonia. The yellow
precipitate was prompt and abundant. There can, therefore, be no doubt
of the presence of phosphoric acid in the etherial solution of this sample of
butter. It is not improbable that it is present in all butter. The result, if
it be true, then, is that butter is not a luxury, but a necessary article of food.
DR. TAYLOR regards a strong solution of sulphate of iron as the best anti-
dote to cyanide of potassium. Dangerous poisoning from this substance is
not unlikely to occur, as it is extensively used by photographers. Chlorine
and aqua ammoniae are usually recommended as antidotes.
IT is said that a few drops of a solution of the bisulphite of lime will per-
fectly preserve animal broths, teas, jellics, and the like, in the sick room, or
elsewhere, during warm weather. The one-thousandth part of Calvert's
perfectly pure carbolic or phenic acid, will do the same. He has succeeded
in producing an article that is without tarry odor or flavor.
I IO Jºdžforza/. [October,
ANIMAL STARCII.
M. C. DARESTE announced to the French Academy, Doc. 31st, 1866, that he
had discovered, in the yolk of an egg, microscopic globulcs, which assumed
a blue tint under the action of iodine, and whose form and structure were
remarkably like those of grains of starch. IIe now presents new analogies
touching this question, which were developed by the following process:
Having washed the yolks in ether, to remove the yellow oil which thcy
contain — and this must be done very rapidly, to prevent the coagulation
of the albuminous matter soluble in water — he then washed them in water,
to remove every thing soluble in water, and particularly the soluble albu-
minous matters, and sugar. The residuum was treated with acetic acid —
this part of the process lasting three months, during which time, a precipi-
tate of very attenuated particles took place; these particles being composed,
to a great extent, of an amyloid substance.
The largest of these grains, subjected to the microscope, presented the
optical peculiarities noticed by Biot, when grains of starch were examined
by polarized light. gº
These grains expanded, and finally cracked, when submitted to the action
of sulphuric acid, potash, or soda. Nothing of the kind occurred when
they were exposed to acclic acid or ammonia; and these reactions, M. Payen
long ago set down as peculiar to the feculae.
Finally, the analogy was made complete, by the conversion of the starch
thus obtained, into sugar; but for the process by which this was done, we
must refer to “Comptes Rendus,” LXVI., 1125.
A SURGEON, writing in the last No. of the Journ AL, speaks of using, as an
anaesthetic, “chloric ether, a preparation of chloroform and ether, in the
proportion of one-third of the former to two-thirds of the latter.”
What is ordinarily known in medicine as “chloric clher,” is a compound
derived from the distillation of chloride of lime with an excess of alcohol.
It is really an alcoholic solution of chloroform — a very diſſerent thing from
a mixture of chloroform and ether, which should not, therefore, roceive this
designation,
*==
CFIEMICAL ANTIDOTES OF PHOSPHORUS.
THE oxydized products of phosphorus—viz., phosphorus and phosphoric
acid — have generally been considered the form in which phosphorus pro-
duces its poisonous eſfects, when introduced into the system. M.M. Eulen-
berg and Landois (“Aerztliches Literaturblatt,” No. 12, 1868,) have given
the results of a somewhat extended research into the subject of phosphorus
poisoning, and conclude that the acids are not the toxic agents, so much as
the vapor of phosphorus, produced by the heat of the body. They, there-
fore, further conclude that the basic substances, such as lime and magnesia,
which have usually becn recommended as the best chemical antidotes, on
1868.] Adžforza/. I I I
the supposition that they would neutralize the acids of phosphorus, are infe-
rior to the salts of copper, which have a very decided reducing action upon
phosphorus, even in a state of vapor. They especially recommend the car-
bonate of copper. Another substance spoken of in this connection, on
account of its powerful oxydizing properties, is the peroxide or binoxide
of hydrogen (HO2.) “It is miscible with watcr, under all conditions; and
is not, even in large quantities, injurious to the organism.”
It has been stated, by high chemical authority, that the peroxide of hydro-
gen, though one of the most powerful oxydizers known, might remain in
contact with phosphorus and phosphorous acid for some time, without
effecting their oxydation. Probably MM. E. and L. have satisfied them-
selves, by actual experiment, that this is not the case.
AZZ CA OSCO AE’?’.
By T. F. ALLEN, M.D., NEW YORK CITY.
THE ORIGIN OF THE LYMPHATICS IN SEROUS MEMBRANES.
IN the first number of the forty-fourth volume of Virchow’s “Archiv.,”
issued the 22nd of July, is an article upon this subject, by Dr. Afonassiew,
which affords an opportunity of reviewing the present state of investigation
into this interesting subject.
There are two distinct views as to the origin of the lymph vessels, each
of which is supported by most cminent observers:
The one, that they are proper capillaries, with a distinct wall, separate
from the connective tissue, but often closely adherent to it.
The other, that they arise from fissure-like spaces in the connective tissue,
and, at their origin at least, possess no proper wall.
Kölliker * supports the former view ; so does Teichman. 4 Teichman
believes they arise either from stellate cells, distinct from the cells of connect.
Čve tissue, or from blind canals, which possess a distinct wall — as in villi
and papillae.
The latter view (no walls) is advocated by His, Frey and von. Reckling-
hausen. The latter demonstrated a layer of epithelial cells, and concluded
that they arose from fissures in the connective tissue, with lacunae corres-
ponding to the connective tissue corpuscles, though he was doubtful whether
injections would communicate with the lymphatic capillaries.
NoTE. — The present view of the structure of connective tissue should be
understood. (Consult Virchow's “Cellular Pathology.”) Mere aggregation
of spindle or stellate cells will not suffice; there seems to me to be evidence
of a mass of inter-cellular substance, (analogous to formation of cartilage.)
This inter-cellular substance fibrillates — seems to split up, forming fissures;
While the cells, and their anastomosing processes, remain surrounded by
* Kölliker, “Handbuch der Geweberlehre d. Menschen,” 4th Edit., 1863.
t Teichman, “die Saugadersystem,” Leipsig, 1861.
II 2 Adźforza!. [October,
this substance; the cells, usually continuing patulous, form a wonderful
system of canaliculi, through which circulates nutrient fluid. The writer
of this paper, referred to, now wishes to demonstrate that the lymphatics
arise from this ultimate system of nutrient vessels.
Two methods of injecting these vessels, have been made use of: injecting
through a needle-point, thrust into the tissue at random; or trying to force
back the injection from the larger vessels. The first method is very uncer-
tain, making extravasations, dilating and bursting the capillaries, so giving
very imperfect results. The second method is impracticable, for these finest
vessels.
A third method promises better — that of physiological injection, causing
the lymphatics to inject themselves. It is performed in the following man-
ner : A Solution of carmine is prepared by dissolving 1 drachm of carmine
in 2 ounces of water, by the aid of 30 drops of strong ammonia. This must
be neutral (the ammonia will escape, or might be boiled away,) and filtered.
The skin of the animal may be opened, between the fifth and sixth ribs,
dissection carried down to the pleura, when a blunt tube (catheter) is thrust
into the pleural cavity, and then some fluid injected. When the animal is
killed, the pleural surface must be washed with a 5 per cent. Solution of
Common salt, to remove the carmine from the surface; and then the tissues
(lung and costal pleura) immersed in alcohol, to harden.
The examination is made by cutting thin scCtions. The epithelial cells
are examined by a novel and simple way of putting a solution of gum arabic
On a thin covering glass, and turning this upon the Serous surface, when
patches of epithelium will remain sticking to the gum, and may be examined
in aqueous humor, or iodized serum, or silver solutions, without disturbing
their relations.
In five minutes after injecting, the epithelium is deeply stained, the
nuclei being intensely red; but the color has ponctrated no deeper.
In ten minutes, the connective tissue is colored in streaks; the corpuscles
and their processes are full of carmine, but it has not yet penctrated the
lymphatic capillaries.
In twenty minutes, the lymphatics are filled, staining the walls most
markedly; but no connection can be traced between the network of connect-
ive tissue corpuscles and epithelial cells, nor do I believe any to exist.
After two hours (the time which should clapse, after injection, before the
death of the animal,) the lung and pleura may be removed and washed; the
carmine has penetrated all the lymphatic vessels and glands of the chest —
even extended into the abdomen, staining the upper portion of the perito-
neum and surface of organs, reaching the kidneys and penetrating their
parenchyma, filling the uriniferous tubules (the straight most deeply tinged),
and being found in the urine, though no particle has entered the blood.
The conclusions derived from these very interesting observations, are
Summed up as follows:
1. The method of physiological injection of a soluble coloring material
(carmine), aſſords the best method of examining the origin of the lymphatics
in Serous membranes.
2. The connective tissue corpuscles are proper cells, in the Sense of Wir-
chow.
1868.] Adžforial. II.3
3. The processes of these corpuscles form, by means of free anastomosis
on all sides, a system of nutrient canals.
4. The ultimate lymphatic capillaries are formed by a union of these
nutrient canals.
5. The lymphatic capillaries possess proper structureless walls.
6. The fissures in the connective tissue have not the slightest connection
with the lymphatic vessels.
7. The substances (carmine) absorbed through serous membrancs, first
pass into the nutrient canals, and through them are carried into the lym-
phatics.
8. The existence of openings between the epithelial cells of serous mem-
branes, is very doubtful.
9. There is no doubt as to the existence of smooth muscle fibres in the
walls of the alveoli of the lungs (air cells.)
ScFIULTz's ARCHIVE FOR MICRoscopic ANATOMY, Vol. IV., Part 2, contains
a remarkable number of articles on nerve-structure, especially their termi-
nations:
1. The Nerves in the Tail of the Frog-larva. By Dr. Hensen.
2. Cells of the Spinal Ganglion, and of the Sympathetic. By Courvoisier.
3. Structure of the Lachrymal Gland. By Franz Boll (one of Schultz's
students.)
4. Taste Organs of Mammals and Man. By Schwalbe.
5. Invaginated Cells. By Dr. Steudener.
6. Waterian Bodies in the Beak of the Snipe. By Leydig.
As a result of great research, Dr. Hensen has concluded (as histologists
now generally concede) that the peripheral nervous system — and, indeed,
all nerves except the sympathetic — are developed from the corneous layer
of the embryo, and, therefore, must end in cells of this layer; which is
shown, and beautifully illustrated.
Courvoisier writes about the straight and spiral fibres, and “pitches into"
Beale, Kölliker, Arnold, etc.
Boll's paper is exceedingly interesting. He points out the existence of a
network of multipolar nerve-cells in the gland tissue, and demonstrates the
termination of fibres in the gland cells. The structure of these glands is
very analogous to that of the salivary system, exceedingly rich in nerve
structure, and explains the great sympathy of the secretions with nervous
emotions.
Dr. Schwalbe's paper is a very complete monograph upon the taste papillaº,
and is abundantly illustrated.
All the articles are elegantly illustrated.
THE muscles of the hairs and skin have been receiving attention at the
hands of the Vienna microscopists. They are said to be more numerous
than generally supposed — each hair possessing at least two muscles, each
of Which has several fibrillae running in different directions; and that there
Vol. IV.-No. 13. 8
II.4. Adžáozza!. [October,
are numerous fasciculi of smooth muscle fibre, parallel to the surface, which
cause the wrinkles and folds of the skin, under certain circumstances. The
effect of these muscles upon the superficial capillary circulation, and hence
upon the excretions, is commented on with much interest.
THE “Quarterly Journal of Microscopic Science,” for July, contains a paper
on the Lingual Membrane of Mollusca, and its Value in Classification, by
Jabez Hogg, the author of a very useful work, “The Microscope,” which is
certainly one of the most generally useful books on the microscope, ever
published; the sixth edition, just published, contains over 750 pages, is pro-
fuscly and elegantly illustrated, and is sold here at the astoundingly low
price of $3.50, currency,
In this number, Mr. Piper describes a reversible compressorium, with a
revolving disk, which seems to be a most desirable acquisition.
A “SEcoRD Series of Microscopic Observations on the Human Hair,” by
M. Pruner-Bey, has lately appeared, with five plates of figures, showing the
forms of transverse Sections of the hair, in various races of mankind, and at
different agcs. Numerous examples of each racq establish, with considerable
certainty, the characters of the hair.
The Negro's hair is not always black; ashy tints, and even red, have been
obscrved. In the East, every race south of the Himalayas, possesses black.
The essential characters of hair are determined by transverse sections,
viz.: size and form. The form of the hair in the Semitic races (Arabs and
Jews) is more or less angular. In the Asian races (Greeks, Brahmins, etc.,)
it is a regular oval; the form of hair and outline of face remarkably coin-
ciding.
The ape's hair resembles that of the human inſant, but diſfers in the per-
fectly uniform dissemination of the black pigment, and consequent entire
absence of any trace of structure.
-*-
THE Smallest flowering plant in existence, is now in flower in my office;
and, since it attracts so much attention from my brother botanists in our
Lyceum and Botanical Club, may interest the readers of the JOURNAL.
Wolffia (its name) belongs to the Lemma family (little plants that float
upon the surface of pools, sometimes called “duck-meat,”) but differs from
the Lemma in having no roots, and being of a globular form. In fact, the .
little thing — no larger than a pin's head — only consists of a globular mass
of cellular structure, which increases by buds. It has only been known in
this country a short time, and never known to be in flower, until I discov-
ered some by the roadside, near Catskill, a fortnight since. The flower
bursts from a little round opening on the top of this ball, and consists of a
stamen, with a double head of pollen masses, and a short, Wide-mouthed pistil,
te
:868.] Adžforza!. I I5
which seems to yawn to receive the pollen grains. We can see the flower
well, by using a microscope of low.power, (50 diameters will do.)
It is wonderful that such a little thing should be a true flowering plant,
and not a cryptogam. T. F. A.
August 25th, 1868.
MA 7'EAP/A MA. DJ CA.
By C. DUNHAM, M.D., NEw York CITY.
(NotE.-This paper having been prepared by an assistant, no responsibility attaches to the
Editor of this Department.)
FALSE INTESTINAL STRANGULATION CURED BY INFUSION
OF COFFEE, IN LARGE DOSES.
MARGUERITE, 46 years of age, entered Hospital Necker, October 8, 1866.
She had been suddenly taken, eight days before, with very severe pains in
the belly. The pains made their appearance at 6 P.M.; at 10 P.M., vomit-
ing ensued, and she vomited all night, nothing but bilious matter. Three
days after the access of the disease, the vomiting and the pains in the belly
continuing all the time, the physician was called. He attempted in vain to
overcome the constipation, first by a purgative, which was thrown up, and
then by two injections, which were also unsuccessful. She was then brought
to the hospital.
On examination, a very considerable distension of the abdomen, with
meteorism, was discovered; sensitiveness to pressure very great. No tumor
nor doughiness in any part of the abdomen, Very frequent vomiting of
bilious matter; constipation persistent.
Oct 9th. Treatment. —Ice ; 30 grammes of Castor oil ; purgative enema.
10th. The vomiting persists, as well as the constipation; ejecta still bil-
ious, Castor oil, taken the evening before, was thrown up almost as soon
as taken.
11th, M. Guyot, next morning, found patient as follows: Very considera-
ble distension of the belly; the knuckles of small intestine show themselves
very visibly under the skin. The large intestine does not seem distended;
hence, it was presumed that the hindrance to the course of the contents of
the bowels, was in the small intestine.
The belly is very painful all the time; palpation difficult; the pains
extend over the whole abdomen. Just before the visit, the patient had vom-
ited matter very clearly fºcaloid. On examining the belly, the cicatrices
of old leech-bites were to be seen in the hypogastric region. The patient,
interrogated upon this point, said that, twenty-five or twenty-six years
before, she had had a very painful affection of the abdomen, probably a peri-
tonitis.
M. Desormeaux was consulted ; he advised expectation. The touch, both
rectal and vaginal, showed that there was no tumor in the vagina. The
I I6 Adžforza/. [October,
knuckles of intestine pressed strongly upon the recto-uterine cul-de-sac, and
were felt through the vagina. *
Theatment. — Ice ; Calomel, 1 gramme; injections of Senna, and the Sulphate
of 306ta.
12th. The fecaloid vomiting was repeated many times yesterday; the
patient threw up the Colomel. The purgative enema had no effect. Pulse
Small and frequent. The ice was continued ; a bath of an hour was given,
and a purgative enema; also, a pill containing half a drop of Croton oil.
13th. The next day, they showed us what they supposed had been passed
by the paticnt yesterday; but it was only the enema, colored by some bilious
matter contained in the large intestines. The belly is still distended and
painful ; the knuckles of intestine are distinctly visible under the skin; the
vomiting continued during the night. M. Guyot prescribed ice, and eight
cups of black coffee—one given every half-hour.
On the night of the 13th and 14th, after taking six cups of coffee, which
threw the patient into great agitation, there was a general break-up ; four
or five Stools followed each other, in a few hours. The matters voided were
liquid, of a bilious color. The next day (14th) we found the belly supple;
no vomiting during the night. On examining the abdomen with the great-
est care, it was impossible to find any tumor there, or any point presenting
any thing of doughiness. The discharges continued during the day — eight
or ten bilious and diarrhoeic stools.” (Bull. Gén. de Thér., 72, 36.)
The rest of the treatment presents nothing of interest, but it is curious to
inquire whether a smaller amount of coffee would not have produced the
same effect, thus saving the patient the “great agitation.” We remembered
to have cured as bad a case of cholera morbus as we ever saw, with one
teaspoonful of black coffee, tatto, cito, et jucunde. Within ten minutes after
taking it, the patient was relieved of all his fearful pains, and in a profuse
SWeat.
In this connection, the following will be of interest:
OF THE USE OF COFFEE IN THE REDUCTION OF HERNIA.
“IN the last number of the ‘Bulletin,” reference was made to the influence
exerted by the infusion of coffee, in the reduction of strangulated hernia;
an influence which has been established, at various times, by corroborative
examples. I have observed a case of this kind, where the favorable action
of coffee Scemed so evident to me, that I have thought good to give detailed
account thereof.
On the 6th of August, 1865, about noon, I was called to Aymard, a painter.
This man has had, for two or three years, a right inguinal hernia; which,
having come down only occasionally, in consequence of Some exertion, has
never attained a great size, and has always been easily reduced by himself.
He has never worn any truss. In the morning, the hernia protruded while
he was at work. It was readily reduced; but, as he continued his labors,
which required considerable exertion, it protruded a Second time, and became
irreducible. On arriving, I observed colic, nausca, and a small pulse. A
tumor, of the size of a small orange, round, very hard, giving a tympanitic
1868.] Adžforza/. I 17
sound on percussion, was found in the right groin, but not reaching into the
8Crotum. Its relations with the cord and a line drawn from the anterior
Superior spine of the ilium to the pubes, together with the previous symp-
toms, indicated that I had to do with a strangulated inguinal hernia. Taxis
was practiced, according to the usual methods, for an hour, without success.
Injections with an infusion of tobacco with sea-salt, Belladonna ointment,
Cold cataplasms. In the evening, distension of the abdomen, and some vom-
iting ; the same prolonged and fruitless attempts at reduction. The next
day, on two occasions, I tried in vain to reduce it. The vomitings, which
were more and more frequent, began to have an unpleasant taste and odor;
the constipation was still obstinate ; the distended belly was painful, as well
as the tumor, which could no longer be touched — on which account, the
two last attempts at taxis could not be pushed very far. The hernia, more-
over, presented the same hardness and the same rigidity as on the day pre-
vious. I told the patient that it would be necessary to operate on the next
day, if the remedy which I was about to give did not act. To my own
mind, the operation was inevitable; and the infusion of coffee was ordered,
only to occupy the time which should intervene before the operation, and
without any hope of success.
Take 100 grammes of burnt coffee and freshly ground, and five cups of
boiling water; make an infusion, and strain; half a cupfull every hour,
taken cold, and a swallow at a time, not to provoke vomiting; — such was
the prescription.
The next morning, I went to hear the decision of the patient regarding
the operation, when I learned from him, to my great surprise and satisfac-
tion, that this hernia, so hard and unyielding, had suddenly relaxed, after
the sixth dose, and had returned to its place, with a gurgling sound. A
truss was applied at once, and the hernia had not returned, to this day.
AUBUsson, Jun. 17th, 1867. DR. A. Bourſ LLON.
— (Bull. Gén. de Thérap., LXII.)
It would seem from the following, that we have warrant for using coffee
in other diseases than those of the bowels:
COFFEE IN DELIRIUM TREMENS.
DR, WIIITEIIEAD gives account (Med. Record, II., 340,) of his treatment of
this disease with the usual remedics, and but little success; — chloroform,
tincture of hops, ale, becſ-tea, chicken-broth, whisky, 12 gr. blue mass, 8 gr.
Calomel, to be followed by a clyster; Sulphate of Morphia, followed by a
clyster (and a blister); Bromide of potassium, 20 gr, at a dose, every two
hours, (this was the ninth day); Magendie's Solution of Morphia, 30 drops
injected three times, sub-cutaneously; then more whisky, followed by Bro-
7mide of potassium in drachm doses, of which he took two, at an interval of
two hours; then a cup of coffee; then 90 gr, more of Bromide of potassium;
then a clyster; the next day, two doses, of 90 gr. cach, of Bromide of potas-
8ſum, then coffee, and a little more whisky; finally, to the happiness of the
II 8 Adžāoria/. [October,
patient, the Doctor settled down upon coffee; this was on the thirteenth day
of the disease, and the ninth day of Dr. W.'s treatment. The Doctor says:
“At 2 P.M., about a pint of very strong coffee was prescribed, with a
little cream, enough to make it palatable for him ; and a broiled steak
ordered, a part of which he ate. At 8 P.M., I found that he had slept four
hours. He drank again a large cup of coffee, and took 15 grains of blue
maSS. (1)
“On the 27th, I found that he had slept nearly all night, but was then
restless. His bowels had been moved, and his general condition was very
much improved. Very shortly, coffee was again prescribed ; and at 12.30
P.M., I found him asleep. After this, the coffee was repeated a few times.
He continued to improve, and soon recovered.”
Frank's Magazine, II., 68, gives a case which sheds a peculiar light upon
this case of Dr. W. It is short, so we give it entire :
“A man 66 years of age, who never drank wine, but used coffee to great
excess — finally amounting to thirty cups a day — after an attack of gout,
with great prostration and weakness, was attacked with delirium tremens, in
full bloom, which was cured with Laudanum, 5 drops every two hours.”
In another case (Id., I., 41,) where thirty-two cups had been taken, by a
Servant girl, containing the essence of 4 ounces of coffee, there was a great
rush of blood to the head; and the night following, she was “very restless,
and slept mome.”
The fact that coffee will produce wakefulness, is pretty familiar to a great
many observers; that it will produce intoxication, is also well known by
some. On more than one occasion, the writer has been made so dizzy by
drinking coffee, that he was ashamed to walk in the street; on one occasion,
indeed, he could not walk any where. He has also given it in delirium
tremens, in teaspoonful doses, repeated at Short intervals, with results highly
satisfactory. In one case, where there had been no sleep for more than 48
hours, but a few spoonfuls were taken before the patient fell into a sound
sleep, which lasted more than 24 hours, and from which the patient awoke
quite well.
We have seen very marked effects follow the administration of Coff., 200th,
in soothing intense mental excitement, and producing sleep; and we should
like to be informed why it is not quite as logical to refer these effects to Coff.
as their cause, as it was in either of the foregoing cases?
MYS CAE Z ZA/VAZ O ÚS.
sºmºsºsºsºmºsº
MICHIGAN UNIVERSITY.
TIIE medical affairs of this institution, as well as the minds of many inter-
ested in them, are in a great muddle. The Supreme Court decided, July
2nd, that the action of the Regents in establishing a IIomoeopathic School at
Detroit, did not meet the requisitions of the charter, that Homoeopathy
1868.] Adžtoria/. II 9
should be taught in the University; hence, the State Auditor and State
Treasurer are justified in not paying to the Regents the desired funds, or
any part of them. We learn nothing which invalidates the assertion in our
last No., that the organic act establishing the University, requires that there
should be a Chair of Homoeopathy in the University. Mcantime, the Allo-
paths are bestirring themselves to establish a new School in Detroit; and
certain Homoeopathists, we learn, are contemplating the same, – as we know
of, at least, one chair which has been offered by parties having chairs at their
disposal.
The State Medical Society of Michigan, at its June meeting, was much
exercised upon this point. Dr. Palmer (A. B.) said: “IIe felt deeply on
the subject. The best part of his life had been spent spent in the University.
He could not think thercon without emotion. [At this period, the veteran
Professor was compelled, by emotion, to cease speaking; for which he apolo-
gized to the Society.]” This sentence in brackets is the note of our friends
of the “Detroit Review.” We have seldom read any thing more touching;
any body but a society of Allopathic Doctors would have retired at once,
till the “veteran Professor" had relieved himself! But to sit it out — that
shows what hardened creatures they were ; and then to receive an apology
During this Same Session, one Dr. Christian offered a series of resolutions
which deserve the palm for reckless disregard of truth. Homoeopathy is
called “a wild theory,” “an insane hypothesis and proved imposition,” “an
“ism” that denies all claim of rational medicine, while, at the same time, it
unblushingly steals all the merit it possesses, from the source it vilifies; and
professes, in theory, what it has never been able, nor even essays, to verify
in practice; and thus, while professing one thing, is in the constant practice
of what it emphatically condemns and vilifies.”
A patient of ours, in delirium, once said to those about his bed, pointing
to them successively, “You are a true Christian — and you; and so are you,
but — in a restricted sense.” In such a sense only, could a man be called a
Christian, who could utter such a tissue of untruths; something harsher,
We should feel warranted in calling them, did we not know how impenetra-
ble is the darkness in which these Allopaths abide, as regards any knowledge
of Homoeopathy. We trust that the Chair of Homoeopathy in the Uni-
versity of Michigan will dispel these clouds, and let a little daylight into
those benighted Allopathic minds.
HOMOEOPATHIY AND LIFE INSURANCE.
BESIDEs a Life Insurance company in London, which offers more advan-
tageous rates to Homoeopathic, than Allopathic, insurers, we have, in this
Country, three Life Insurance companies which take risks under Homoco-
pathic treatment at 10 per cent., or thereabouts, less than under Allopathic.
In the London company, the wisdom of this course was arrived at by the
consideration of facts; and the three companies in this country, which are
Organized as professedly Homoeopathic companies, must have the same solid
Substratum of facts to stand upon, or they will come to nought. Time wil.
*
I 2 O Editorial. [October,
soon settle this question. The Hahnemann Life—the pioneer Homoeopathic
Life Insurance company—seems to have no fear of this test, as it has just
declared a cash dividend of from 15 to 50 per cent. On all policics in force,
issued previous to January 1st, 1867; which is really equal to from 25 to 60
per cent, in other companies, as a discount of about 10 per cent, was allowed
on premium payments. The Hahnemann has a table of mortality of its
own ; believes in the cash system — and, as this is better in every thing clºc,
it is hard to see why it is not better in Life Insurance, than credit — and
offers the most liberal inducements to all who wish to secure a competency
for old age, or the means of support for their families.
We need only add, in conclusion, that the affairs of this company, and
their manner of doing business, have been thoroughly examined by some
of our most competent business men, with results entirely satisfactory.
By-the-by, if Allopathic treatment is really better than Homoeopathic,
why would it not be a good investment to establish an Allopathic Life
Insurance company, which should take risks at 10 or 20 per cent. lower than
the Homoeopathic? “What'll you bet?” is a favorite test of the world's
people, when any assertion is made ; the test is somewhat low, but it is very
Bearching. Men will not part with their money, as a general thing, without
a pretty good assurance of a return ; and what they believe strongly in,
they will venture their money for. But who will take this risk * Where
are the Allopathic capitalists, to invest on the credit of the Allopathic treat-
ment? Three Homoeopathic Insurance companies have becn established
within a few years, and all are doing well, so far as known ; but where, oh
where, is the Allopathic?
This insurance matter is giving great importance to a question which we
propounded some time ago; and as nobody answered it, we repeat it:
WHAT IS HOMOEOPATIIY 2
This is not a matter of theory. Mr. A. has a policy of $10,000 or $20,000
on his life, in a Homoeopathic company — the contract made on the implied
promise to use none but Homoeopathic remedies. In course of time, Mr. A.
dies, and the company finds that he has been taking such doses as the follow-
ing—and we can furnish any quantity of such prescriptions—what be.
comes of the policy 2
Quin. Sulph., gr. viij.
Ect. Cannab. ind, gr. iv.
East. Acon, rad., gr. iv.
Make 8 pills; take one every 3 or 4 hours.
Here is another :
IIydrarſ. Sub. mur., gr. iij.
Mass, II/drarg. gr. iij.
Aloes, gr. iij.
Podophyllin, gr. J%th.
Make 4 pills, all 4 to be taken at once.
And here are two more :
I} Tr. Cammab., 3 i. B Cºrbol ac., gtt. xxx.
Tr. Acon. nap., gtt. XX, Tr. Calend, ſ) 4 Ss.
Tr. LIydrast, Ż i. Hydrastis, () 3 ss.
Bals. Copan), Ži. Glycer., 3 i.
Alcohol, 3 iſ. Water, 3 ij.
M A teaspoonful 3 times a day. Use as lotion.
1868.] Adžāorial. * I 2 I
If any of our readers can demonstrate these to be Homo!opathic prescrip-
tions, our pages are open to him.
Per contra, our Allopathic friends are making a change of base, and giving
Homoeopathic medicines slyly. They can drop a few drops of Some dilution
of Aconite, high enough to be colorless, into half a glass of water, as gingerly
as the best of us; and if Fame does not tell naughty stories, other Homoeo-
pathic remedies are used by our Allopathic friends, when in the lurch.
How strange it would be if, in twenty-five years, our sturdy Regulars should
be contending for the virtues of the 30th and 200th, and the Homoeopathists
should be wallowing in the slough of Polypharmacy. We bespeak a reserved
Seat among the Regulars, before that day comes.
Since writing the above, we have received the last Volume of the “Trans-
actions of the American Institute of Homoeopathy,” and find that, June 7th,
1865, the following Resolution was adopted :
“IResolved, That the Institute can not view the advertising of remedies as
nostrums, or the combining of several medicines in one prescription, in any
other light than as irregular practice, and subversive of the best interests
of Homoeopathy; and that we will not tolerate in our membership, one
guilty of such practice.”
Who can tell how that Resolution was passed, or why the Institute toler-
ates in its membership, not only one, but many, who “combine several med-
icines in one prescription ?”
P. S. We have just heard of a new competitor for the honors and profits
of Homoeopathic Life Insurance, in “The Homoeopathic Life Insurance
Company,” of New York. This company has a Cash Capital of $150,000,
and is founded on these two prominent points of belief, viz :
1st. That it is not necessary to charge any one as high rates for Life Insur-
ance as are now generally obtained — because, if it were, no company could
honestly seek business (as many do) by promising its patrons a dividend of
fifty per cent. Of the premium, from and after the first year. Either that is
erroneous, or else the premium need not be so high.
2nd. That Homoeopathic treatment, regularly adopted and pursued in case
of sickness, lengthens life, and therefore renders less premium sufficient;
because, the longer a man is likely to pay a premium, the less that premium
needs to be.
Holding these views, the company has adopted two sets of tables, one for
non-Homoeopathic insurers, considerably lower than those of any other New
York company; and one, still lower, for those who make use of the Homoeo-
pathic practice in cases of sickness.
The office of the company is at No. 231 Broadway, New York, where all
desired information respecting the company and its plan of operations, will
be furnished in person, or transmitted by mail when requested.
The following is a list of the officers: D. D. T. Marshall, President ; Jas.
Cushing, Jr., Vice-President ; Edward A. Stansbury, Secretary; A. Halsey
Plummer, Ass’t. Secretary; Elizur Wright, Consulting Actuary, Stewart
L. Woodford, Counsel ; E. M. Kellogg, M.D., J. W. Mitchell, M.D., Medical
Ecſtminers.
The idea of this company, that insurance rates are too high, is one which
I 2.2 Adžforza/. [October,
we have always advocated; and we shall watch with interest its practical
effect. The lowest possible rate consistent with undoubted Security, is that
to which all insurance companies must come, before long ; and if Allopathic
treatment is really so much better than Homoeopathic, here is a good oppor-
tunity to underbid the lowest Homoeopathic rates. We will gratuitously
advertise the first company organized on this basis.
DOES TOBACCO PRODUCE BALDNESS AND GRAY HAIRS 2
DR. HoFFMAN proposes this question, in the “Pacific Medical and Surgical
Journal,” and was led to make the inquiry by observing the multitude of
bald and gray young men in California—an affliction not shared, to any
great extent, by the young women. He evidently leans towards an affirma-
tive decision; and the more so, as a friend of his, a great slave to tobacco —
bald and gray — was obliged to forsake the weed, and was pleased to find
that his self-denial was soon rewarded “by an unusual growth of natural
hair.” There seems to be no end of wonders in California ; — this one cer-
tainly caps the climax. If the Doctor could only prove the connection
between these two facts to be supplied by tobacco, there would be a great
fall in the price of that vegetable. The facts which have come to our notice,
Inowever, do not at all sustain Dr. Hoffman's supposition ; the most inveterate
consumers of tobacco with whom we are acquainted, being neither more
bald or more gray than their time of life would warrant. As for the Cali-
fornians, there are many things which the young men do, which are not
done by the young women, besides using tobacco. It is presumable that
they drink more whisky; that they are exposed to the sun more; that their
brains are more taxed ; and that, in fine, in one way or another, their whole
vital energies are more drawn upon, than are those of the gentler sex. We
presume that tobacco comes in for a small share in this matter; but if any
of our readers have any facts on this point, we should be glad to hear from
them.
STILLING'S NEW OPERATION FOR THE RADICAL CURE OF
STRICTURE OF THE LACHRYMAL CANAL, BY MEANS OF
INTERNAL INCISION.
A FEW months since, Dr. J. Stilling, of Cassel, Germany, issued a small
pamphlet of 24 pages, with the above title, which is worthy of wide circula-
tion. The very imperfect and transient results obtained from Bowman's
probes—the slow, and, in many cases, doubtful, action of drugs upon these
organic strictures, especially if the canal is almost or entirely closed, and
chronic blepharitis, conjunctivitis, or oven keratitis, from the retained lach-
rymal Secretion, complicate the case — induced the surgeons of our Ophthal-
mic Hospital to adopt Stilling's method at once; especially as he gave reports
of very brilliant results. And, that it may be tried by others of our school,
induces me to make this note of the operation, in advance of any detailed
reports of the Hospital practice, which will, ere long, appear.
1868.] Adžtorial. I 23
The accompanying figure represents the knife of the natu-
ral size. The triangular blade is 13 millimetres long, and, at
the broadest part, where it joins the shaft, 3 millimetres wide,
the point rounded, with a cutting edge, and at the tip, 3%
millimetres broad. The shaft, between blade and handle, is
equal in length to the cutting blade, is flattened, and double
the thickness of the largest Bowman's probe. The handle is
about 10 centimetres long. (The figure is the exact copy of
Stilling's figure, from which the Hospital knife was made.)
The length of blade and shaft represcnt, anatomically, the
average distance from the entrance of the lachrymal sac to
the nasal fossa; so that, when plunged its whole extent, the
point just enters the nose, as the junction of the shaft and
handle rests upon the upper part of the sac.
The operation is not exceedingly painful, and (as in my
last operation, on a lady,) may be endured without an anaes-
thetic; it is bloody, and sponges are needed. In operating,
stand behind the patient, for the right eye, (and also for the
left, if ambidextrous.) First, introduce a sound, to ascertain
the seat of first stricture, which may be found at the entrance
of the canaliculus into the sac. (We are in the habit of slit-
ting up the canaliculus, by a probe-pointed knife for the pur-
pose, if this has not been done, for introducing large probes.)
Then introduce Stilling's knife, “holding the broad surface
upward, and cutting-edge forward.” (If the canaliculus
is already slit up, the cutting-edge of Stilling's knife may
be directed upward, and a little forward.) It is then
showed into the sac. The position of the second stricture
may now be ascertained. Withdrawing the knife, and
introducing again a probe, the knife re-introduced into the
sac, the handle raised to a vertical position, (care should
be taken of the median [inner] wall of the sac, by slightly
withdrawing the point after it has struck it,) and the knife
firmly carried down through the strictures in the sac and
canal, plunge it in the whole length, till the handle presses
against the sac externally, and the point reaches the nose;
then slowly and carefully withdraw to the point, turn it a quarter round,
and plunge again; do this three or four times, till the knife turns freely in
the canal; and if the blood runs from the nose, all the better. The bleeding
is generally free, and some extravasation of the lid, and even cheek, may
ensue; but no after-treatment is needed. The cut strictures retract, leaving
a clear central canal; and the patient is greatly relieved, and probably
cured. T. F. A.
\
|
-
|
º
i
i
º
“IT does not afford me the least consolation, at the death of patients who
have entrusted themselves to me, to consider that death was declared
inevitable by the School. I never can rest upon the ill successes of others.”
GRAUVOGL.






I 24 Jºdžāoria/. [ October,
NEW YORK HOMOEOPATIIIC MEDICAL COLLEGE.
TIIE regular Course of Lectures will commence on Tuesday, October 13th,
1868, at 10 o'clock, A.M.
SPECIAL ANNOUNCEMENT. — An Introductory Course of Lectures will
be delivered previous to the Regular Course, commencing on Thursday,
Oct. 1st, by the following physicians: George E. Belcher, M.D., Diseases
of Infants; Henry D. Paine, M.D., Medical History; Robert McMurray,
M.D., Diagnosis; John W. Dowling, M.D., Medical Deportment; Frank
S. Bradford, M.D., Life and Health.
By arrangement of the Faculty. J. BEAKLEY, M.D., Dean.
GRAMMERCY PARK House, N. Y., Sept. 2nd, 1868.
DAILY CLINICAL LECTURES will be held at the New York Ophthalmic
Hospital, corner of Twenty-fourth Street and Fourth Avenue, after October
1st. T. F. ALLEN, M.D.
A SLIGHT modification of Liebreich's small ophthalmoscope has been devised
by me, whose only merit consists in its simplicity and cheapness — it costing
only about one-half the ordinary price. The mirror is perforated (never
buy one with merely a little spot of silvering rubbed off the back, if you
can get a hole through the glass); it carries on its back, a holder, for a small
convex or concave glass, for a far or near sighted observer or patient, which
holder is not fixed by a hinge at the side, as ordinarily, but at the base, next
the handle, by a screw, giving it a lateral motion. A large 2%-inch convex
condenser, and a small 10-inch convex and 8-inch concave, accompany the
instrument, in a neat case. They have been made by order abroad; and
Otto and Rynders can furnish them at $3.50 or $3.75, according to the price
of gold. T. F. A.
ANIMAL POISONS.
WE take pleasure, pursuant to a request from Dr. Barlow, in calling atten-
tion to the following
NOTICE.
The subscriber earnestly requests of medical men, students and laymen,
information in relation to the following points, to wit:
1. Statement of all symptoms known to have been produced by bites of
the rattlesnake. 2. Percentage of fatal terminations from the bites ? 3. A
list of all remedics known to have been used successfully or otherwise?
4. Temedics found most bencficial ; doses; modes; repetitions, etc. ? 5. In-
dian or other remedies; names of the plants, roots, leaves, barks, etc., mode
of preparation and application. 6. Is it a fact, or otherwise, that there are
two, three, or four females to one male of the Crotalus genus? 7. Is it, a
fact that persons bitten and recovered, are every year afterward, at or about
the same Season, subject to illness of a character similar to what they suf.
fered from the bite 2 8. Is it a fact that Crotali copulate in large bodies
together and not singly 9. Any facts going to prove the power of fascina-
1868.] Jºdžforza!. I 25
tion of the Crotali are requested. 10. Do they or not, possess the power of
fascination over animals and men 11. Do persons having once been
fascinated (sic), appear afterward to be biassed, or rendered physically,
montally, or morally obliquated by such fascination ? 12. Any other facts
relating to the creature's nature, habits, powers, etc. 13. What medical
uses have been known to have been made of the flesh of the rattlesnake ; of
its gall and its oil or fat, and for what diseases and with what measure of
Sll CCGSS 2
Also, information as to bites or stings of spiders; locusts; rats; scorpions;
centipedes; Scolopendrae ; bees; wasps; hornets; adders and other species
of Snakes; all symptoms; effects; acute or chronic ; symptoms arising from
the poison from wounds in post-mortem examinations, dissections, etc. From
handling of dead animal or human bodies; flaying of diseased animals;
poison arising from the use of several species of fish ; poisoning by the
matter from glandercd horses; and finally, all possible modes and kinds of
animal poisons; their symptoms very fully ; cases related ; cures, remedies
used ; cases any way germain to the whole subject, cut from newspapers,
old almanacs, etc., etc., sent to me are acceptable, and references sent to me
as to books in which histories of cases of poisoning may be found, and, in
short, every possible species of information on the whole subject will be
useful, and thankfully acknowledged, by SAMUEL B. BARLow, M.D.,
55 East 21st St., Wew York.
*
HOMOEOPATHY IN SWITZERLAND.
FROM the “Journal du Dispensaire Hahnemann” we learn of a remarkable
series of events taking place in Switzerland. Baron de Heyer was obliged
to leave Hungary during the late war between Prussia and Austria. He
settled at Aaran, the principal town of the Canton of Argovia, where he
practiced Homoeopathy gratuitously, as he had been doing in Hungary for
fifteen years. He here cured many cases which had defied Allopathic doc-
tors, through whose influence he was banished the Canton for having
illegally practised medicine. Here is a part of the indictment, which the
editor well says, one might suppose came from a comedy of Molière, or a
satire of Boileau : “The globules given by de Heyer to his patients have
been examined by two chemists. These have found nothing in them but
sugar of milk; but sugar of milk having a place in the Pharmacopoeia as a
drug, de Heyer is consequently found guilty of having illegally dispensed
drugs contained in the Codex.”
From Argovia our hero went to Soleure, where his reputation had
preceded him, and where he had a large and successful practice; but he was
banished hence and found an asylum in Morgenthal, where he obtained
permission of the police to practice Homoeopathy for two years.
The constitution of the Canton of Argovia, which has 40,000 inhabitants,
allows a petition, signed by at least 5,000, to be presented to the supreme
tribunal, for the purpose of promulgating a new law, or modifying an old
one. If the tribunal rejects the petition, the inhabitants meet in their
various communes, and vote for or against the innovation.
I 26 Adžforza/. [October,
So the good people of the Canton of Argovia presented to the tribunal a
pctition with 9,000 signatures, in which it was demanded that overy citizen
should be permitted to practice homoeopathically. This produced a great
stir, cSpecially among the medical public; but the tribunal refused to con-
sider the petition. The matter being thus brought directly before the
people, a vote was taken December 15th. Of 31,000 votes cast, 15,289 were
for the free exercise of Homoeopathy, and 15,225 against it, 486 having been
rejected on account of informality. The majority was not large enough to
cstablish the law desired, but the vote shews clearly enough how matters
are tending in Argovia. Is it probable that the law will be long in force
which banishes a man for curing his fellow-men homoeopathically 2
VOLTAIC BATTERY.
As VERY many of our professional brethren are finding great advantage in
the use of galvanism — voltaism — or what you please to call it — in some
morbid conditions of the nerves and muscles, we avail ourselves of a little
space to call attention to the most convenient, economical, durable, and, at
the same time, powerful voltaic batteries we have yet seen. It is a simple
voltaic pile, the cxciting solution being common vinegar, held betwcen the
plates by capillary attraction only.
Now vineffan” can be had any where, and there is no risk to one's clothes
in handling it; and again, the acid it contains is so weak that its action on
the plates of the pile is but slight, and they will endure a long time. The
plates being connected by a liquid only, instead of by Saturated cotton or
woolen stuſ, the action is constant and uniform. The ingenious arrange-
ment of the plates of the pile is also worthy of notice, as it brings the whole
battery into so small a space that the case containing it, with conductors and
electrodes, measures but three inches by five. A very practical book of
2nstruction for the use of galvanism in diseased conditions accompanies the
apparatus; and, what is still more pleasing and practical, the price of the
whole is but $6.50. They can be obtained of Mr. C. S. Halsey — our pub-
lisher, and, probably, of other pharmaceutists.
REV. PETROLEUM W. NASBY.—We read, Some time ago, that Some promi-
nent Democrat — there could not have been morè than one— had written
to the Post Master General, begging him to remove Mr. Nasby from office,
as he was using an official position to the injury of the party. We thought
the joke a good one, never dreaming that Uncle Samuel's domains containcá
any body capable of perpetrating such an absurdity. Our skepticism has
vanished, however, since receiving the “Buſſalo Medical and Surgical
Journal,” and the “Nashville Journal of Medicine and Surgery.” There
are two of that kind, at least, at large, since both of these journals copy a
silly and malicious slander, uttered by the “Chicago Medical Journal,”
touching the Hahnneman Medical College, in this city. Any body capable
of giving credence to such a fabrication, would be most likely to wish Mr.
Nasby removed.
O AEPA 7'OAA’ 1.
A. COOKE HULL, M.D.
THE number of those who practiced Homoeopathy in the United States,
twenty-five years ago, was very Small. In this small number, time has of
late been making Sad havoc; and we are now called upon to record the
departure of one of the few survivors. Dr. Hull was born in Utica, August
2nd, 1818; received a thorough classical education at Union College, gradu-
ated, in 1840, at the College of Physicians and Surgeons, in New York, and
removed thence to Brooklyn, where he continued in the practice of his pro-
fession, till his death, which occurred in Catskill, July 3rd, 1868.
His brother practitioners in Brooklyn, who knew him best, speak most
highly of his excellence in every walk of life, as will appear from the follow-
ing Resolutions, which were unanimously adopted, at a special meeting of
the Homoeopathic Medical Society of the County of Kings:
“Your Committee would respectfully report, as the expression of this meeting —
“That, in the death of our distinguished fellow-member and former President, A. Cooke
Hull, M D , this Society sustains the loss of a sincere friend, a public-spirited citizen, and a
Christian physician ; and that we extend to his bereaved family, the earnest assurance of our
heartfelt sympathy, in this, their hour of trial.
“That, in all our intercourse with Dr. Hull, we ever found him courteous and helpful to his
associates, mindful of the dignity and claims of his chosen profession, wise in counsel, able,
liberal-minded, and successful in practice.
“That his whole connection with the “Kings County Homoeopathic Society,” was marked by
readiness to defend its rights, to promote its interests, and, by every means within his power,
to maintain that esprit du corps so essential to its prosperity.
“That a suitable report of the proceedings of this meeting be presented to the family of the
deceased, and published, also, in the daily papers, and IIomoeopathic medical journals.”
The meeting then adjourned.
GENERAL CHAS. G. HALPINE.
OUR readers who knew General Halpine, and who mourn, as we do, the
unexpected termination to his brilliant career, will not need any apology
from us, for departing from usual custom, and noticing the death of one not
connected with the medical profession. To those who knew him not, it is
enough to say that General Halpine was the ever-ready and efficient cham-
pion of our cause, against the illiberality and bigotry of our opponents; and
for his efforts in our behalf, his name deserves a kindly place in the memory
of all Homoeopathists. He has all the more title to this place, from the fact
his advocacy of our cause did not (probably) arise from any spirit of parti-
zanship, but from an innate love of fair play and hatred of whatever savors
of tyranny or oppression. A man of noble and generous impulses, with a
heart readily touched by the sufferings of others, and overflowing with
I 28 Jºdžforza/. [October,
kindly feelings to all the race, with a hand ever open to minister to the
needy, to raise the falling, or guide the erring, with a brilliant imagination
and abounding humor, all tempered and heightened by a thorough colucation
and by much intimacy with men and their affairs, what wonder is it that
Miles O'Reilly had a power of attracting men to him, with which few are
ever favored, or that those who never knew and never saw him, mourn his
loss as that of an old and tried friend or brother? Among that number, may
We be written l
DEPARTMENT OF CLIMATOLOGY AND HYGIENE.
OUR readers, we are sure, will be pleased to notice that we have added the
above to the Departments of our Journ AL, and that the charge thereof has
been accepted by Prof. H. P. Gatchell, of Kenosha. Prof. G.'s familiarity
with this subject is very complete — as our readers will have opportunity to
See for themselves, in the next No.
We are also happy to announce that a paper from the veteran JAHR is on
the way, and will appear in the January No. ; and also,
Another letter from our British Correspondent, which, unhappily, arrived
too late for the present No., together with an article on Carbolic Acid, by
Dr. F. A. Lord, which we regret has to stand over.
ExPULSION FOR CONSULTING WITH A HOMOEOPATHIST. — At the meet-
ing of the Genesee County Medical Society, held June 9th, 1868, Dr. N. G.
Clark was expelled from said Society, for consulting with a Homoeopathist.
None of the members are to be allowed to consult with said Dr. Clark in
future. Nothing on the record goes to show that he did any thing more
than that for which the Good Samaritan was commended. Our Allopathic
friends are welcome to all the distinction they can obtain by such acts, and
we shall always take pleasure in giving them publicity.
REMOVAL. —Dr. Ciro S. Verdi, formerly of Georgetown, D. C., has
removed to Cleveland, O. His elder brother, Dr. T. S. Verdi, still remains
at Washington. :
sºmºmºmº
ERRATA – VoI. III.
On page 245, 8th line from top, for “cure” read “own.”
{{ 258, 2nd {{ {{ {{ {{ {{ as” {{ “thus.”
{{ 393, 13th “ “ {{ “ “analytic” “ “catalytic.”
{{ 426, 5th “ “ bottom, “ “preparation” “ “proportion.”
{{ 430, 10th “ {{ {{ “ “useful ?” “ “Careful.”
46 432, 16th {{ {{ {{ {{ { { this } } { { { % his.”
{{ 446, 8th “ “ “ “ “stomach” “ “ Sternum.”
64 451, 6th “ {{ {{ “ “influence ’’ “ “inference.”
UN I T E D STATES
Medical and Surgical Journal.
Vol. IV.-j.AMUAR2, 1869-Mo. 14.
CARBOLIC ACID.
BY F. A. Lord, M.D.
[Read before the Cook Co. Hom. Med. Society, Aug. 6, 1868.]
CARBOLIC ACID, called also phenic acid and phenic alco-
hol, was discovered by Runge, a German chemist, as long
ago as 1834; but remained comparatively unknown till
1841, when Laurent devised a practical way of separating
it from the other products of the distillation of coal tar.
IIis method consisted in submitting the light oils of coal
tar to a fractional distillation, and treating the products so
obtained with caustic potash; then separating the heavy
alkaline fluid from the hydro-carbons that rose to the sur-
face, and finally neutralizing the solution by an acid, thus
liberating the carbolic acid.
The article thus obtained, however, was not pure, but a
mixture of carbolic and cresylic acids with other similar
substances, and the next step in advance was a modification
of Laurent’s method, consisting in using soda instead
of potash, and in treating the whole of the light oils
instead of a part only. The product was still impure, yet
up to 1857 it was the best known to chemists or to com-
Vol. IV.-No. 14. I
I3O Carbo/7c Acid. [?anuary,
merce. At about this time the demand for a pure and
cheap article became so urgent on account of the variety
of brilliant colors derivable from the acid, that F. C.
Calvert & Co., of Manchester, England, instituted and con-
tinued a series of improvements in the purifying process
up to as late as 1864, and finally succeeded in producing a
perfectly pure article, and in the required quantity. Their
method is to treat the impure benzines or naphthas of com-
merce with weak alkaline solutions, afterwards submitting
the product to careful distillation. Quite recently they
have gone even further, and have discovered a process by
which they produce an article of carbolic acid free from
disagreeable odor or flavor. This preparation is the best
adapted to medicinal and dental purposes. It occurs in the
form of white detached crystals; but is usually sold as a
hard white fused mass. It is soluble in only 20 parts of
water, is fusible at 106° F., and boils at 359° F. The best
article manufactured by Laurent’s method is a white solid
substance, soluble in 33 parts of water, fusing at 93° F.,
and boiling at 367°F. This is sufficiently pure for ordinary
purposes and external application. A third quality is still
nearly white, and fuses as low as 81°F. It is soluble in 50
parts of water and may be used for disinfecting dwellings,
hospitals, etc. Still another grade is met with in commerce
which has a dark brown color, and extremely pungent odor,
and is a mixture of carbolic and cresylic acids. It is less
soluble than any of the others, but when diluted with 100
parts or more of water is valuable for out-of-door disinfecting
purposes, water-closets, drains, etc.
A variety of crystallized carbolic acid, manufactured by
Merck, of Darmstadt, is also found in our markets. It has
a reddish tinge, and is said to contain about 98 per cent. of
pure acid, and to be sufficiently pure for all practical pur-
poses. It is somewhat cheaper than Calvert’s pure prepar-
ation.
The demand for commercial carbolic acid has been so
great that a nearly worthless mixture of oil of tar has been
1869.] Carðolic Acid. I3 I
extensively put into market, and purchasers should be on
their guard.
Mr. William Crookes, F.R.S., has suggested two simple
and practical tests, based upon the solubility of the acid in
water, and in twice its bulk of a solution of caustic soda ;
while the oil of tar is nearly insoluble. To apply these
tests :
“1st. Put a teaspoonful of the carbolic acid in a bottle;
pour on it half a pint of warm water; shake the bottle at
intervals for half an hour, when the amount of oily residue
will show the impurity.”
“2nd. Dissolve one part of caustic soda in ten parts of
warm water, and shake it up with five parts of the carbolic
acid. As before, the residue will indicate the amount of
impurity.”
Various and valuable as have been the applications of
this remarkable substance in the departments of industry,
it is chiefly interesting to us on account of its sanitary and
medicinal properties. These all depend, so far as I am
aware, on its wonderful disinfectant and antiseptic or
colytic properties. As regards these properties it is very
generally acknowledged to be of unrivaled efficiency.
The panspermic theory of M. Pasteur, which holds that
“the processes of putrefaction and fermentation are owing
to the growth and multiplication of living organisms, the
germs of which are always present in the atmosphere,” is
now very generally received as an improvement on the
chemical or zymotic theory of Liebig, upon which the
prevalent ideas in regard to zymotic diseases are based.
While as yet, perhaps, this theory can not be said to be
actually proved, it is certainly rendered highly probable;
and in speaking of the subject of disinfection, the existence
of these germs will be assumed, as a matter of convenience
Dr. Herbert Barker, the author of the Hastings Prize
Essay, classes disinfectants under three heads:
1. Agents which chemically destroy the noxious body.
2. Agents that hold the noxious body inactive by arrest-
ing chemical change. (Antiseptics proper or colytics.)
Jº.
I32 Carbolic Acid. [3amuary,
3. Agents that physically restrain the action of the
noxious compound, in such a way that its poisonous proper-
ties are neutralized, or held in abeyance.
The great majority of the disinfectants in common use
belong to the first and last of these classes, viz.: those that
chemically destroy the noxious substance, and those that
physically restrain its action. Among the latter are char-
coal, fresh earth, ashes and lime, (the last having also a
chemical action), agents which, though much lauded by
certain interested parties, are really entitled to only a very
subordinate rank among disinfecting agents.
Of those which act chemically, nearly all are either
oxidizers or deoxidizers. The chief of those which destroy
noxious matter by oxidation are IIeat, Chlorine, Iodine,
Bromine, Ozone, Permanganate of Potass, the Peroxide of
IIydrogen, Sulphuric and Nitric acids and their metallic
salts. Of the deoxidizers sulphurous acid is the chief,
laying hold of oxygen wherever it can get it, and especially
if in the nascent condition, and being by it converted into
sulphuric acid. Other chemical substances, as the chlo-
rides of iron and zinc, enter into combination with organic
matter, and so arrest or prevent disintegration.
It would seem that these powerful chemical agents would
prove most efficient disinfectants, and so, indeed, some of
them are; and yet they all expend a very large share of
their energy in destroying the offensive gases that are the
attendants of decomposition, and which are comparatively
harmless in their effects. As long as compounds of hydro-
gen are evolved, upon which putrescent odors mainly
depend, the oxidizing agents, owing to stronger affinity,
will be occupied with them, while the real morbific matter,
the specific virus, or septic germs, will not be attacked
until all these other substances have been thoroughly
oxidized.
Thus, in order to be effectual, large quantities of these
agents must be employed, sufficient to effect the perfect
oxidation of the whole mass of the organic matter, as well
as the morbid germs it may contain. Even then the action
1869.] Carão/7c Acid. I33
of these chemical agents is only temporary in its effect; for
if the substances so acted upon are again exposed to the
atmosphere for a length of time, they again become subject
to decomposition and decay, and the disinfecting process,
in order to be permanent in its effects, must be repeated
from time to time.
On the other hand, the true antiseptics, or, as they have
been lately styled, colytics, constitute a comparatively lim-
ited class, and have been hitherto but little used for disin-
fecting purposes. Among them are corrosive sublimate,
arsenic, the essential oils, and lastly, and chief of all, Car-
bolic acid. These substances, by their peculiar properties,
attack and destroy at once the prime sources of decompo-
sition, viz.: the germs of putrefaction and fermentation
themselves, leaving unaltered the mass of other matter
present. By their action on the cause of decay, in the lan-
guage of Mr. Crookes, they “put the organic matter in such a
state that it never reacquires the tendency to putrify.” The anti-
septics deal with the causes, then, while other disinfectants
expend their energy mainly upon the effects. Their opera-
tion is therefore direct, radical and permanent, and may
be obtained from small quantities, as the organic germs
constitute but an exceedingly small portion of the mass of
matter in which they are contained. From these consider-
ations, the great superiority of this class of agents over all
other disinfectants, becomes at once apparent. They are at
once deodorizers, antiseptics, and disinfectants in the fullest
possible sense of the word ; because, in a word, they
destroy the source itself of all noxious 'gases, and of all
organic decomposition.
As compared with carbolic acid, the other substances
which have been named as belonging to the same class, are
expensive, and require to be used in large quantities.
Moreover, they lack the diffusibility of carbolic acid, and
being deadly poisons to the human system in small quan-
tities, are liable to be used for illegal purposes.
IIaving thus seen that carbolic acid belongs to the most
efficient class of disinfectants, and that it deservedly stands
I 34 Carðo/7c A cºd. [?anuary,
at the head, and far in advance, of others of its own class,
we are prepared to appreciate the very high estimate which
has been put upon it by all scientific men, as a general anti-
septic, and as a means of preventing and arresting zymotic
disease.
Examples and proof of its exceeding efficiency, when
employed for these purposes, are so numerous and striking,
that it is only difficult to select from so many equally
deserving of consideration and confidence. Sir William
Crookes and Dr. Angus Smith have devoted much time and
energy to the investigation of the properties of this agent,
and its homologue, cresylic acid, and have embodied many
of the results of their experiments in a “Report of the
Commissioners Appointed to Inquire into the Nature and
Origin of the Cattle Plague. London: 1866.” Mr. Crookes
has shown that one per cent. of carbolic acid in water will
preserve fresh meat indefinitely, and without materially
affecting its taste or flavor; also, that one per cent. will
destroy the power of yeast to induce fermentation, without
any alteration of the yeast-cells, appreciable by the highest
powers of the microscope. He infers, moreover, from the
fact that it does not prevent diastase from converting starch
into dextrine, that its action is not chemical, but rather cata-
lytic; and that “it acts by attacking vitality, in some mys-
terious way.” Dr. Angus Smith prefers to regard this action
as anti-catalytic, as the effect seems to be the arrest of vital
movement. To express this action, he has introduced the
word colytic, derived from the Greek koluo — to restrain.
It has also been shown, by actual experiment of others,
that mºnth part of carbolic acid will prevent decomposition
of urine, blood, glue, flour paste, feces, etc., for months,
and that “its vapor alone is sufficient to preserve meat, in
confined spaces, for weeks; and even a little vapor of this
useful substance will preserve meat for several days, in ordi-
nary atmosphere, and prevent its being fly-blown.”
The fact of the diffusibility of carbolic acid in the air, is
one of its most valuable characteristics, thus enabling it to
destroy the germs, or sporules, which float in the atmosphere,
1869.] Carão/7c Acid. I35
as well as those which are retained in grosser material. This
was shown in the investigation of the cattle-plague. Mr.
Crookes condensed the breath of diseased cattle on cotton-
wood, and having inoculated healthy animals with the
matter thus obtained, they were at once attacked with the
disease. Further, Mr. Beale, the distinguished microscopist,
discovered, in the blood of diseased animals, certain living
microscopic bodies, corresponding to the germs found in the
exhalations of the lungs. The natural inference is, that
these germs, existing in the blood of diseased cattle, and
exhaled by them into the air, become, in turn, by inhalation,
the cause of the same disease in others; and the operation
of the carbolic acid not only demonstrated its own exceed-
ing value in arresting disease, but likewise contributed to
confirm this theory of the propagation of this, and of other
diseases; “for,” says Mr. Crookes, “I have not yet met
with a single instance in which the plague has spread, on a
farm where the acid has been freely used.”
In regard to the value of carbolic acid in preventing the
spread of cholera, Dr. Ellis, of Bangor, England, testifies :
“I have, in many instances, allowed whole families to return
to cottages in which persons had died from cholera, after
having had the cottages well washed with carbolic acid, and
in no case were any persons, so allowed to enter such puri-
fied dwellings, attacked with the disease.” Prof. Chandelon,
of Liége, has stated that, out of 135 nurses who were em-
ployed to attend upon cholera patients, of whom 2,000 died,
only one nurse died; but that the nurses were themselves
washed, and had their clothing sprinkled, with carbolic acid.
Dr. Letheby states that, by the use of Twº ºth part of car-
bolic acid in the sewers of London, during the existence of
cholera, they were nearly deodorized. Dr. Lemaire, of Paris,
has published a work on “Phenic Acid,” in which he repre-
sents it as the most effectual means known for combating
contagious and pestilential diseases, including typhus fever,
small-pox, scarlatina, measles, etc.
As a surgical dressing, carbolic acid has been used with
such remarkable success, by some of the most distinguished
136 Carbo/ic Acid. |[j'anuary,
surgeons, as to have given rise to what is called “the anti-
septic treatment,” and to mark a new epoch in surgical his-
tory. Mr. Lister, Professor of Surgery in the University
of Glasgow, has given, in the Lancet, at different times,
such accounts of his experience with this mode of treatment
as are well calculated to excite our profound interest and
admiration. He says: “The first class of cases to which I
applied it (carbolic acid), was that of compound fractures,
in which the effects of decomposition in the injured part
were especially striking and pernicious. The results have
been such as to establish, conclusively, the great principle
that all local inflammatory mischief, and general febrile
disturbance, which follow severe injuries, are due to the
irritating and poisoning influence of decomposing blood, or
sloughs. These evils are entirely avoided by the antiseptic
treatment; so that limbs which would be otherwise unhesi-
tatingly condemned to amputation, may be retained, with
confidence of the best results. Since this treatment has
been brought into full operation, and wounds and abscesses
no longer poison the atmosphere with putrid exhalations,
my wards, though in other respects under precisely the
same circumstances as before, have completely changed
their character; so that, during the last nine months, not a
single instance of pyaemia, hospital gangrene, or erysipelas,
has occurred to them.”
Prof. Lister quite unconditionally accepts the “germ
theory” of Pasteur, in explanation of the success of the
antiseptic treatment; and, according to him, “the cases in
which this treatment is most signally beneficial, are divisible
into three great classes: incised wounds, of whatever form;
contused or lacerated wounds, including compound frac-
tures; and abscesses, acute or chronic; — a list, indeed,
which comprises the greater part of surgery.”
In regard to the treatment of abscesses, he says, in another
place: “All that is requisite is, to guard securely against
the possibility of the penetration of living germs from with-
out, at the same time that free escape is afforded for the dis-
charge from within. When this is done, we witness an
1869.] Carbo/ic Acid. I37
example of the unaided curative powers of nature, as beau-
tiful as, I believe, it is entirely new. >k >k :k >k
The irritative fever and hectic, hitherto so much dreaded in
large abscesses, are, with perfect security, entirely avoided.
In suppurations of the vertebrae, or of the joints, the results
of this treatment are such as I ventured, with trembling
hope, to anticipate. In short, the element of incurability
has been eliminated from caries.”
Much other similar testimony might be adduced. Dr.
Maisonneuve, of the Hotel Dieu, the eminent physician
James Paget, Mr. Wm. Adams, Dr. James Martin, Prof.
James Syme, of Scotland, and others, unite in their favora-
ble testimony as regards surgical treatment with carbolic
acid, and claim about equal success with Prof. Lister.
Dr. Allan Wilson, and Wm. Pirrie, Professor of Surgery
in the University of Aberdeen, have likewise reported in
the Lancet very favorably of the use of carbolic acid in
burns and scalds. Dr. Wilson used one part acid to thirty
parts of the ordinary oil and lime-water emulsion, applied
by means of saturated linen rags, covered with oiled silk.
Prof. Pirrie applied closely over the burned and scalded
surface “two folds of surgeon’s lint, dipped in a lininment
of one part carbolic acid to six parts of olive oil; a double
layer of tin-foil was placed above the lint, and the whole
secured by a bandage.” In one case of a severe burn, this
dressing had the very remarkable effect of stopping the pain
in fifteen minutes, and promoting healing without any sup-
puration whatever. In simple incised and punctured wounds,
and even such as have opened directly into the knee-joint,
or been caused by the removal of large tumors, the use of
carbolic acid lotion has resulted in healing by first intention,
without local or constitutional disturbance.
The forms in which carbolic acid has been mainly used in
surgery, and which are recommended by Prof. Lister, are
three: 1st, A simple lotion, or mixture of one part acid to
from 30 to 100 parts of water; 2nd, A mixture of the acid
and boiled linseed or olive oil, in the proportion of 1 to 6;
3rd, A mixture of the last, or carbolic oil, with whitening, in
A.
138 Carbo/ic Acid. [?anuary,
proportions to form a soft putty. Either of these may be
used, as will best fulfil the indications of the case in hand.
It may also be prepared as a glycerole, or cerate, by using 5
grains to the ounce of glycerine or simple cerate.
Carbolic acid is said to be a cure for a common disease
among sheep; viz., the “scab.” The shorn animal is dipped
into a bath, containing ºth part of the acid; and a single
immersion is said to effect a cure. The “foot-rot,” also a
common sheep-disease, is efficaciously treated with this sub-
stance. It may be applied as an ointment; or the sheep, if
numerous, may be made to pass through a trough containing
the medicated mixture, which thus becomes adherent to the
feet. Washing horses and cattle with a weak solution of
carbolic acid, is an effectual preventive of the annoyance of
flies and mosquitoes. Thus, the brute creation come in for
another share of the blessings of this really wonderful sub-
Stan Ce.
Of course, so powerful a modifier of living tissues as car-
bolic acid has proved itself to be, in various ways, has not
escaped the attention of medical men, as an internal thera-
peutic agent. The results of its internal administration thus
far, however, seem to have been comparatively meagre and
unsatisfactory. The idea that substances which are capable
of destroying noxious agents out of the body, will also cure
the diseases caused by, or associated with, these agents, is a
very captivating one—especially to our Allopathic brethren,
who know nothing better than a rude kind of tinkering of
the body. The history of the medical use of the sulphites,
is sufficiently familiar to the profession. Since first recom-
mended, in 1857, by Dr. Polli, in zymotic diseases, on account
of his having observed their antiputrescent effects in the
dead bodies of dogs, the sulphites have been very extensively
experimented with in these diseases, and have quite gener-
ally been reported favorably of. Their success in cholera,
however, has not been flattering. It is not unlikely that
carbolic acid will now pass through a similar history. In
the “Medical Press and Circular,” (January, 1868,) we find
Dr. A. E. Sansom arguing that the sulphites do not prevent
1869.] Carbo/7c Acid. I39
decomposition by virtue of oxidation, as Dr. Polli believes,
but that they possess a power, similar to that of carbolic
acid, of destroying vitality in organic germs, by their pecu-
liar catalytic properties. He further argues that cholera, as
well as other diseases that seem to depend on morbid germs,
may be successfully treated by internal administration of
antiseptics. The obstacles in the way of success in cholera,
heretofore, he thinks, have been that the sulphites, which
are readily absorbed, lack sufficient energy; and that car-
bolic acid, which possesses the requisite potential efficacy,
lacks the absorbability. The desideraturn, then, according
to him, is an agent which shall combine the qualities of the
two. This, he thinks, he has succeeded in producing, in
the shape of the double-salts, or sulpho. carbolates of potash,
soda, magnesia, and ammonia. We shall see whether he
will have any better success with his new septicidal agents.
Carbolate of quinia is another form which has been sug-
gested, and claimed to have been beneficially used in puer-
peral fever, typhus, pyaemia, etc. The IHomoeopathist must
receive these “claims,” however, with Saline qualifications.
By the douche, and by inhalation, carbolic acid has been
employed in bad cases of catarrh and ozoena, with advan-
tage. It is also extensively used by the French, and other
specialists, in throat and lung diseases — especially in diph-
theria, ulcerated throat, bronchitis, and phthisis. It is said
to produce a decided modification of the symptoms of hoop-
ing cough,” when used by inhalation, and to be efficacious in
measles and scarlatina. In tinea capitis, and other forms
of skin disease, it is also recommended. In those that
depend on fungi, it will undoubtedly prove curative. It
will certainly destroy the acarus scabiei, and is a “dead-
shot” on pediculi and vermin of every kind. As an injec-
tion, in mild solution, it is an efficacious remedy for pin-
worm. As an injection in gonorrhoea, and an application
* NoTE. — Since the above was written, a number of cases of hooping
cough have been reported to the Cook County Society, as either materially
benefited or cured by carbolic acid in the 3rd dilution, internally adminis-
tercd.
I4O Carðo/ic Acid.
to syphilitic ulcers, it promises well; and is undoubtedly the
best substance in use for correcting and destroying the
foul effluvia from malignant and other ulcerating surfaces.
Finally, it is a most useful article for the sick room and the
lying-in chamber; the disagreeable odor of which may be
effectually removed by sprinkling a weak solution on the
carpet and bed-clothing. The same, if applied directly to
the genitalia, by means of wetted cloths, will destroy the
odor of the lochial discharge. In the close stool, it also
finds an appropriate place, preventing all unpleasant odor
therefrom.
Among other uses to which this substance has been
applied, may be mentioned the preservation of wood,
embalming the dead, preparation of anatomical subjects
and specimens, the preservation of the albumen and starch
thickeners used in calico-printing, and the gelatine size used
in sizing cotton goods. The trade in bones and hides
between England, Australia, South America, and other
countries, is said to have been immensely benefited by the
use of carbolic acid, and the value of the hides doubled.
These are only a few of the uses to which this substance
has been put in medicine, surgery, agriculture, commerce,
and the arts and manufactures; while a wide field of appli-
cation yet remains to be made.
Three cases of poisoning by carbolic acid, are reported in
the “British Medical Journal,” for March, 1868. It was
used externally, in a wholesale manner, for the itch, under
the supposition that it was a sulphur lotion, by three inmates
of a workhouse. Two of the cases proved fatal. The strength
of the solution is not known. The danger of its application
to large surfaces, unless thoroughly diluted, should, there-
fore, be borne in mind.
T)RUG PROVING.
BY I. S. P. Lord, M.D., PoughkeepsIE, N. Y.
(Read before the Central W. 2. Hom. Med. Society.)
I HAVE read Dr. Lippe’s article on “Drug Proving,” and
must confess to a slight disappointment. I expected to find
something indicative of independent thought ; some search-
ing idea; something, in short, of Dr. Lippe. But after sev-
eral careful perusals I can not recall any thing that might
not have been written by any ordinary man, of common
mental capacity, without exciting the least surprise. Such
shadowy generalizations are too common, and afford no
durable satisfaction to the earnest inquirer, however well
they may sound in a public address.
The issue between the two schools is fairly made, and
what we need now is work — real work. The blowing of
“rams’ horns” might topple the walls of Jericho, but it
will require something more than a flourish of trumpets to
prostrate the wall that hides from our eyes the mysteries of
special Histology, and thus open unto us something more
than a twilight glimpse of Physiology. I say Physiology,
for Pathology is only Physiology with the “bit” between
the teeth.
If we really desire to say something profitable about
“Drug Provings,” we have first to determine what a drug
is; second, what a drug does; third, what that action is.
1st. What is a drug” A drug is any substance employed
in the cure of disease, and technically, only in diseases of
animals.
2nd. What does a drug perform 2 If it uniformly cured,
it might be said to perform cures.
We can only define it as a substance intended to act on
the living animal organism for the cure of disease. Drugs act
only on living organisms; never on inorganic, or on dead ani-
mal or vegetable matters. Physiologists have favored us with
I42 Drug Proving. [j'anuary,
only very indefinite information in regard to the elements
acted upon, or the mode of action. Some speak of the
“molecular action ” of, and in, the tissues and organs, which
means little, and perhaps nothing. Thinking, then, is mole-
cular action of the brain; secretion of bile is molecular action
of the liver.
But Gall and Spurzheim demonstrated that the brain is
not a homogeneous mass — a unit. And no modern physi-
ologist will affirm it to be. Could we take another step
back, and demonstrate the differential constitution of the
neurine cells that compose each separate phrenological dis-
trict, we should be in a position to get, at least, a transient
view of the relation of mind to matter. Our present pur-
pose, however, is merely to show the connection between
matter and drugs.
We assume, then, that drugs act only on living animal
organisms. And the question meets us: What is — not an
animal organism, but what is the animal organism on which
a drug acts?
A man is an animal organism. Surely it will not be
claimed that any drug has a molecular action on a man.
On the contrary, man is a complex organism — an aggre-
gate of organisms. One drug is said to act upon the liver,
another on the brain, another on the lungs. This may sub-
serve the purposes of antiquated therapeutics, but is far too
indefinite for “Our School.”
It may or may not be true, for instance, that a certain
drug acts on the liver, when it only increases or lessens the
Secretion of bile. The liver is itself composed, mainly, of
two kinds of organisms, and a drug can act upon one of
these without affecting the other. They are as distinct
from each other as are the pancreas and spleen. And the
bile-cells differ as much from the other cells of the liver as
does the spleen from the kidneys. If we go beyond and
below the bile and other cells, we find nothing in the liver
that has life. The cells are found every where. They con-
stitute the substance of all the organs and tissues that
“make up ’’ the man. They are, each and every one, a
1869.] Drug Proving. I43
perfect organism, and the lowest, most minute form of mat-
ter that manifests the phenomena of life. Connective tissue
cells pervade every part, organ, and tissue, and are essen-
tially alike. But the bile cells differ from the salivary cells,
these from the pepsin cells, these from the muscle cells, and
these again from the neurine cells, while these different
kinds differ among themselves. And so through all the
various differing organs and tissues. And this diversity is
not merely apparent. There is a demonstrable difference in
form, constitution and arrangement.
In speaking of the long delay in discovering the circula-
tion of the blood, Sir Gilbert Blane observes: “If a mod-
ern anatomist were to find in a new animal of uncommon
structure, just brought from New Holland, a large muscu-
lar organ, the function of which was not obvious, he would
not merely conjecture, but decide with the most confident
certainty, that it performed some important function requir-
ing powerful mechanical action. A moment’s serious reflec-
tion on the materials and structure of the heart ought, in like
manner, to have revealed the circulation to physiologists,
many ages before it was detected by Harvey.”
Upon the whole, if the subject of final causes, as an index
of the operations of nature, be duly considered, it will no
longer be deemed unphilosophical to avail ourselves of
them, as a clue for tracing some of the most secret opera-
tions of nature.
So when we see a number of kinds of cells in the liver,
each differing from the other, one kind constituting the
mass, apparently having only a general relation of contact
or aggregation, and another differing greatly in constitu-
tion and form, and having a peculiar and specifically unva-
rying arrangement, we may decide, with the most “confi-
dent certainty,” that some specific purpose was originally
designed. And when, on examination, we uniformly detect
free bile in contact with them, and no where else, we can
only conclude that they manufacture the bile. And if this
be further verified by observation of the salivary and other
glands, we may safely lay down the rule.
I44 Drug Proving. [j'anuary,
Difference in cell-form, or cell-constitution, or cell-
arrangement, indicates difference of function. And what
is function ?
Function is what a cell does. The muscle-cell contracts,
the bile-cell manufactures bile, the neurine-cell correlates
nerve force, and so of all others. When a cell acts or does
any thing, it is function ; and the telling about it is Physi-
ology, unless it be disordered, when it becomes Pathology.
But as the animal does not act as a whole, nor does any
organ constituting it as a whole, to produce any one result,
does the ultimate organism, which is also complex, to wit:
the cell, act as a whole in producing specific functional
results 2
For instance, in the general organism, the brain has one
general function, the liver another, the salivary glands
another, the lungs another, and different tissues or parts of
these several organs have different and more specific func-
tions.
Now shall we stop here, or shall we carry the rule down
to the ultimate organism — the cell ?
The animal cell, with three unimportant exceptions, is
uniform in its elemental structure, i. e., composed of the
same number of parts.
1st. The cell proper, or a membrane inclosing water and
granules.
2nd. A nucleus within this, “made up,” like the cell, of
a membrane and granular matter and water, but differing
chemically and otherwise from the contents of the cell.
3rd. A nucleolus within the nucleus, having, like the
nucleus, a membrane and granular contents, with unknown
qualities.
Now recurs the question, Do each of these parts have a
special function, or is function the collective act of all ?
The last conclusion is unwarranted by the rule. It is man-
ifestly inadmissible.
But we will examine a bile cell, and inquire into the
capacity and ability of each part to produce bile. Is the
function of a bile cell in the nucleolus 7 Now setting aside
1869. T Prug Proving. I45
its microscopical proportions and manifest incapacity, we
are met at the threshold with the objection, that inasmuch
as the portal blood, from which bile is manufactured, can
not come in contact with the nucleolus without first passing
through the cell proper and the nucleus, it is absurd to
maintain that it has any thing to do with the making of
bile. Moreover it seems to have a special function of its
own, to wit, reproduction; for cells never duplicate unless
they have a nucleolus, and all cell division or reproduction
begins with a division of this nucleolus. The same objec-
tions, though perhaps with less force, might be urged against
the nucleus. There can be little doubt that the nucleus has
a special function of its own, to wit, life. sº
A cell may lose its nucleolus and still live, though it can
not reproduce. It may lose its granular matter and water,
one or both, and recover them again, and continue to live.
But immediately it loses its nucleus it perishes; while a
free nucleus will live a long time in serum and chyle.
There is nothing left for the cell proper, then, but func-
tion in general, or the secretion of bile, saliva, and gastric
juice, and muscular contraction, and all other functional
phenomena.
Function, then, is what the cell proper does — cell action.
Cell action is cell motion, for there can be no action with-
out notion. Now what moves 7
It has been noticed that, in certain large vegetable cells,
there is a current of granules around the inside, always in
the same direction, and apparently beginning at the nucleus
and passing the same point in ever recurring revolutions.
The motion is intermittent, remittent, irregular, accelerated,
rapid, retarded, or continuous, according to circumstances;
that is, the presence of more or less light, heat, external
motion, etc.
A weak current of electricity accelerates this motion, a
strong retards, arrests it, and if too long continued, it is not
resumed, and the cell perishes. If the motion is resumed,
the current starts from the nucleus and runs in the original
direction. It needs no elaborate argument to enable us to
Vol. IV.- No. 14. 2
I46 Drug Proving. [j'anuary,
reach the conclusion that this motion is the essential of
vegetable cell function ; that is, the cell does nothing, pro-
duces nothing without it. It is the active agent in the man-
ufacture of the almost infinite variety of vegetable products,
from essentially the same material, and moved by the same
forces. And if the constructing material and the power are
essentially the same in all vegetables, it follows that the cells
must differ to produce so diversified results. The granules
in the starch-cell of a poppy must differ essentially from the
granules of the poison or opium-cell; and doubtless there
is an equivalent difference in the cell motion. Put a poppy
and a belladonna seed (which are only compound cells)
together into a pot half or three-fourths filled with earth;
furnish them with light, heat, water, and subject them to
the same conditions, and the result will be two plants, one
a poppy, the other a belladonna. The form, color, taste,
and smell of these plants have nothing in common, and the
functional, specific products differ as much as if one were
produced in the western, and the other in the eastern hem-
isphere.
Certainly this can be explained only on the assumption
of a constitutional difference in the specific, or poison, and
other cells. In the animal, as we have remarked, all the
organs and tissues are composed of cells similar to vegeta-
ble cells, and we meet the same diversity of form and func-
tion. As the poison cells of the poppy have a peculiar form
and arrangement, so in the animal kingdom we find, as in
the rattlesnake, a peculiar apparatus, and a specific cell
form, for the manufacture of the specific poison.
The analogy is sufficient, and we assume that if a certain
specific motion in a vegetable cell determines certain spe-
cific and uniform results, which we call function, function
in an animal must be the result of a certain and specific
motion in the animal cell. In a normal condition there is
always a certain motion imparted to cell contents by the
nucleus, the very lowest and inappreciable degree of cell
function. As if a man should keep up some degree of
motion in the machinery of a steam flouring mill with a lever,
1869.] Drug Proving. I47
while the steam was turned off, because there was nothing
to grind. The motion might be imperceptible; but, appre-
ciable or inappreciable, it would be the normal motion of
the machinery. When the bins are replenished with wheat,
and the hoppers filled, and the steam turned on, then the
proper function of the mill appears in the products. This
is mill function. Now the equivalent of this man power
in the mill is the nuclear power in the cell; and so long
as there is life, so long will the nucleus furnish the power.
We admit that this is only a deduction, and that it is only
when the specific excitant is furnished, that the cell pro-
duces the phenomena that we call function. For example,
when, after a full meal, an ample supply of portal blood
(the normal excitant of the bile cells) is poured into the
liver, the activity, or, technically, the granular motion of
these cells, is indefinitely increased, and the result is a nor-
mal supply of bile.
Now is any one prepared to affirm that there was no
granular or functional motion in the cells before the portal
blood arrived 2 Which of the two is most reasonable —
that it caused the motion, or that it only increased that
which existed before. We see that the impulse of the
heart, the mere mechanical vibrations, becomes a life and
functional force in the animal organism. Why then should
not the nucleus, ceaselessly vibrating from the impulses of
the various life forces, impress more or less motion upon
the granules of the cell. Indeed, it is impossible that it
should not cause a granular motion, and that the motion
should not be in the precise direction required by the origi-
nal construction of the cell.
If we take a voluntary muscle-cell for an example, and
assume that specific motion is the essential of function, and
contraction is function, then it follows that when the spe-
cific or will-force is withdrawn or ceases, there will be no
contraction ; a state, in short, equivalent to paralysis. This
conclusion is of course, inadmissible. The specific will-
force only increases or accelerates the motion that existed
before.
I48 Prug Proving. [3anuary,
The specific force of the involuntary, as well as the volun-
tary muscles, is furnished by neurine cells; but the same
difference in form, and doubtless in constitution, is found
here as elsewhere, and the same inevitable change of action
resulting in change of function, and continuous supply of
ganglionic force to the cells of the involuntary muscles. If
the heart and arteries depended on the neurine cells of the .
cerebrum for a supply of nerve force, there would directly
be neither function nor life.
And here we may remark, that all these phenomena,
reproduction, life, and function, result from the application
of forces to certain forms and conditions of matter; and
that a human organism is no more independent of the forces
we call light, heat, motion, etc., than is a vegetable. Nei-
ther has any inherent life, more than a crystal, or a grind-
stone. Function is a compelled motion — action. A cell
does nothing except what it is forced to do. What is called
the vis vitae has but little to do with function proper. The
only vis vitae is the nuclear motion, which, as we have seen,
impresses a small, but never ceasing, motion on the contents
of the normal cell, just enough to keep it, so to speak, in
working order.
I3ut the nucleus has no inherent life, more than the cell
proper. It, also, is the creature of compulsion. Its gran-
ules are moved by the same excitants as the nuclear gran-
ules of vegetable cells. In the absence of all excitants,
nuclear motion ceases, and life is suspended, or ‘becomes
extinct. So long as the nuclear contents move at all, they
move specifically, or, so to speak, in the line of life, and the
unvarying tendency of nuclear force is to restore normal
motion to disordered cell contents, as well as to preserve
the normal motion when undisturbed.
And this is the “vis medicatriæ naturae.”
Light, heat, electricity, motion, and other life, and gen-
eral functional excitants, act on cells with different degrees
of intensity, from the most trifling acceleration of normal
motion, through the degrees of increase, to the highest point
of normal activity. Or the action may be farther intensi-
1869.] Drug Proving. I49
fied so as to arrest, and even destroy, both cell and nuclear
motion at once; as when one is struck by lightning; or
in concussion of the brain, or when exposed to a great
heat. e
Now in all cases where the motion of the cell contents,
alone, has ceased, and the nuclear motion remains unim-
paired, the nuclear force is sufficient to restore the lost
motion. If the nuclear motion has merely ceased, and the
granules are not changed, and their arrangement not dis-
turbed, a slight mechanical force will restore life and func-
tion, just as one shakes his watch, that has run down, after
winding it up.
And now we are somewhat better prepared to investigate
drug action. We assume that drugs do act on the human
organism. That some act in one way, some in another;
Some on one part, and some on another; some sooner and
some later. That no two act equally on the same part, and
no two produce precisely the same results. There is also, in
these results, the same diversity that we have shown to exist
in function caused by normal excitants. Drugs, therefore,
must act on the same living organisms, and in our inquiries,
we may properly confine ourselves to the cell. The func-
tion of the specific cells of any organ requires the applica-
tion of some specific force, direct or indirect, absolute or
relative.
The portal blood, for instance, is not only the material of
which bile is made, but conveys, also, the normal, excitant
force or forces that compel the cells to make it. But this
same portal blood would be an irritant in the brain, and
act precisely like a drug on its neurine cells. The acids,
fixed salts, and urea, are the normal excitants of the secer-
ning cells of the kidneys; and even when considerably in
in excess, only increase the secretion, or function. But
they disorder, and sometimes arrest the function of the neu-
rine cells of the brain, when the least in excess, while they
have little or no effect on the neurine cells of the spine.
Opium acts directly on the neurine cells of the brain, but
there is no evidence of any direct action upon the bile cells,
I5O ſ Drug Proving. [3anuary,
or the specific spleen-cells, or those of the pancreas, kid-
neys, or ovaries, or mesenteric glands. Aloes, probably,
acts directly and exclusively on the bile-cells. It certainly
has no direct action on the neurine, or muscle-cells. So we
conclude:
1. That a normal excitant of one “set ’’ of cells, may be
an abnormal excitant or irritant to another. In other
words, that which causes functional activity in one organ,
may disorder, and even annihilate function in another.
2. That excess of normal constituents of the blood may
only increase the functional activity (cell motion) of one
organ, while it disorders, and may even destroy it, in
another. $
3. That excess of normal excitation does not differ essen-
tially from drug irritation, and both produce disorder or
death in precisely the same way.
4. That most drugs act, directly, only on one kind of
cells in an organ, and, unless greatly in excess, only on the
cell contents, and not at all on the nuclear.
5. That drugs are not necessarily cell disturbers or irritants.
This last conclusion is perhaps somewhat startling, and
if not, it is certainly novel ; but in the further consideration
of it we shall discover that it is not only the key to drug-
pathogenesis and therapeutics, but, if rightly understood,
“lays” that ghostly vagary that shrouds in its shadowy
form our Materia Medica; I mean “primary and secondary
symptoms.”
To begin at the beginning : when a pathogenetic dose of
a drug is taken into the organism, it acts upon the cells of
some particular part, as opium upon the neurine cells of
the brain, strychnine upon those of the spine, cantharides
upon the secerning cells of the kidneys, and mercury upon
the epithelial cells of the lymphatic glands.
What does the drug do?
If it requires an excess of a normal excitant to disorder or
change the normal granular motion of the cell, while a very
considerable increase merely adds to the normal activity, is
it to be credited that the feeble, incipient action of a patho-
1869.] Drug Proving. I5 I
genetic dose of a drug can change a normal cell motion.
At least, if this is not admitted, it will not, assuredly, be
denied that the dose of a drug might be so minute that it
would only increase the normal cell motion or function.
This is the physiological significance of the ALTERATIVES
of “Ancient Physic.”
And if a dose can be so small as only to accelerate the
normal motion, and thus increase normal function, is it
possible to determine the precise dose necessary, and the
exact time required to change or disorder function.
There is a great relative difference in the activity of drugs.
Some seem to act only on cell contents, somé on nuclear,
and some on both. It is quite possible, after all, that it
may be resolved into the law of quantity.
For instance, a little electricity or mechanical force may
be, and is, a life and functional excitant, but as we have
already shown, when greatly in excess, either of them may
arrest both nuclear and cell motion. Doubtless a very
minute dose of the upas tieuté, or prussic acid, would only
increase cell motion ; but in a very considerable dose, they
arrest cell and nuclear motion precisely like electricity and
mechanical force. Dose, then, is merely relative; intensity
or activity being the equivalent of quantity. A grain of
magnesia can have no perceptible effect, and an ounce only
disorders the function of the epithelial cells of the aliment-
ary tract. One twentieth of a grain of calomel will increase
the activity of the bile-cells; twenty grains may disorder
all the epithelial cells of the whole digestive apparatus.
Admit that the law is quantitative as regards the drug; it
by no means follows that it is so in regard to the cell.
Experiments prove that a dose producing symptoms in one
organism (person) may have no apparent action in another.
We have time here only to remark, that susceptibility to
drug actions depends, not upon blood vessels, or nerves, or
lymphatics, or glands, or color, or civilization, or refine-
ment, or “delicate sensibilities,” but upon the original con-
stitution of the granules of the cell and of the nucleus; on
the size of the cells; on their proximity; on their freedom
I52 Drug Proving. [3anuary,
from undue, and subjection to proper, pressure, and on the
fluidity of cell contents. If, for instance, there is too large
a proportion of water in the cell, the motion will be accel-
erated, but the functional product scanty ; if too little, the
motion will be retarded, and the products imperfect. So of
pressure, and all other conditions, varying from a perfect
normal standard. The same difference, in this respect,
exists in the cell as in the entire “microcosm,” or in the
“body politic.”
Difference of susceptibility admitted, and the susceptibil-
ity given, what quantity or dose will cause pathogenetic
symptoms ? Manifestly that dose which, soon or late, changes
the normal motion of cell contents so much as to produce a
change of function. For change of function is the only evi-
dence we can have that a drug has acted as a drug.
The simple increase of the normal motion is not the path-
ogenetic — disorder—or disease—generating action — of a
drug, because it is not a disorder or disease at all. Again,
it is not in any proper sense drug action at all, inasmuch as
it is only a simple increase of what existed before, and not
in any way characteristic of the drug, being common, not
only to all drugs, in some quantity, but to all excitants.
Drug Symptoms, then, are only those phenomena that
appear after the drug has changed the cell motion from nor-
mal to abnormal, and this abnormal motion will continue
until the drug is withdrawn, or eliminated, or has by per-
sistence, or excess of action, arrested cell motion, as in par-
alysis, or changed the constitution of the granules, and
introduced some other motion or function, as in fatty degen-
eration. In either, or any like case, however, there can be
no drug-action recognized. Paralysis is not a pathogenetic
symptom of any drug, nor is any drug directly homoeopathic
to paralysis. It is an entire loss, or absence, of cell motion
or function. It may be a consequence of the action of a
drug, but is not a primary, or secondary, or any action of a
drug, whatever.
From the first pathogenetic symptom to the last, a drug
always acts in the same line. It effects a certain change
1869.] Drug Proving. I53
peculiar to itself; an alteration in the specific normal direc-
tion of the cell granules; and so long as it can maintain this
change of motion, there will be change of function, or drug
symptoms.
Immediately the drug is withdrawn, the normal motion,
under the influence of the nuclear force, will be resumed, or
at least that will be the tendency. This is functional disor-
der. But if the drug has changed the constitution of the
granules, so that they are not of the same form, or size, or
density, or material, we have structural disease.
In passing we may remark, that some drugs seem to act
more in the same “line '’ with normal excitants, and require
a much longer time, and much larger doses, to disorder
function, than others.
Again, some drugs cause only functional disorder, though
taken regularly for long periods, while others immediately
produce structural disease.
Apply the principles we have sought to establish, to our
Materia Medica, and there would be a wild scattering of
symptoms. It is now completely lumbered, and clogged,
and swamped with “primary and secondary,” and non-spe-
cific, and “curative ’’ symptoms, not one of which has any
business there.
To prove a drug, we need first to determine precisely
what the drug is; next, the susceptibility of the prover.
Then give the least dose that will cause an alteration or
change in the normal condition of the prover. Let the
symptoms be carefully observed, and determine if possible
what part is first acted upon by the drug. It is highly im-
portant at the outset to determine whether the symptoms
result from the direct or indirect action of the drug.
For instance, the first drug symptoms are irregular or
prolonged contractions of the muscles — altered muscle-cell
function. Does the drug act directly, on the muscle-cells,
or indirectly, on the neurine-cells that furnish nerve force
to the muscles 7
Or if the drug symptoms are nausea, faint feeling at the
stomach, griping in hypogastrium, pressure in the right
I54 Drug Proving. [January,
hypochondrium, heat in the rectum, and bilious stools, does
the drug act directly on the inner surface of the intestinal
canal, or does it act on the bile-cells, causing an increased
quantity of bile, more or less changed ? If the first, then
they are all drug symptoms; if the last, the mere abdominal
symptoms are pathogenetic of some kind of bile, to be deter-
mined by analysis, and only the liver symptoms are to be
accredited to the drug. They are the only drug symptoms,
and all the consequent ones belong to the bile, and are, sim-
ply, evidences of the increased secretion and vitiation of the
bile, and not drug symptoms at all.
Similar phenomena follow the ingestion of an excessive
quantity of digestible food, causing excess of portal blood.
Excess of portal blood causes excess of bile, and excess of
bile all the other symptoms. Having determined the place
where the drug really acts, special histology will be your
guide, and physiology your teacher, in determining the
value of every symptom as it appears; and you can select
from the mass the characteristic symptoms at sight.
This is the true relation of physiology to drug proving,
and is infinitely better than poisoning puppies and stran-
gling kittens in search of secondary symptoms and struc-
tural lesions. From this point it is but a step to the region
of therapeutics, where we feel inclined to stray, but time for-
bids.
Before we close, however, we can not refrain from sug-
gesting that far too much importance seems to be attached
to the “one remedy" dogma. Polypharmacy is doubtless
erroneous in theory and disastrous in practice. In mixing
two or more drugs, and thus bringing them in direct con-
tact, there is some risk, at least, of chemical and dynamic
changes. But it is difficult to conceive that a remedy which
gets into the circulation, and is carried to the bile-cells in
five minutes, can interfere with another introduced half an
hour later, which goes directly to, and acts upon the neu-
rine cells of the spine, and indirectly on the muscle cells of
the heart and arteries, and thus only remotely, through a
disturbed circulation, acts on any other organ or tissue.
1869.] Drug Proving. I55
If urea, and uric acid, and creatine, and zanthine, and sul-
phur, and chlorine, and phosphorus, and soda, and potash,
and lime, and magnesia, and sulphuric acid, and phosphoric
acid, or their proximate elements, can be hustled through
the arteries and veins, like the various articles of commerce
which are rushed through the thoroughfares of a great city,
and each safely reach its appropriate destination, we need
have no doubt of the result, when we are sure that we have
introduced the proper remedy for the disorder of one organ,
if we are obliged, directly after, to follow it with one designed
for the disorder of another. And although, as an individual,
I would discountenance the practice, yet it would be a par-
donable credulity, if one should believe that two or more
drugs, introduced together into the organism, might safely
and without interference, finally reach their proper destina-
tion, and each act as specifically as if there were no other
drug in the pharmacy, or in the world.
Recoveries, at least, follow such prescriptions, and why
not cures 7
The carbonates, and chlorides, and alkalies, and acids, and
sulphur, and phosphorus, and lime, move harmoniously
along in close proximity for half a century or more, and
why should they elbow and quarrel with their infinitesimal
relatives, when introduced by some young, ambitious, and
enterprising prescriber. But, seriously, if it is allowable in
extreme cases to repeat the dose every few minutes, and
even alternate medicines when contradictory symptoms
appear, why not, where there is less urgency, in cases equally
perplexing and contradictory : The fact is, that disease
is neither practically nor yet theoretically a unit; and,
though it may be true in the abstract, that no two abnor-
inal actions can be carried on in the same place, at the
same time, in the same organism, it is equally true that two
pathogenetic forces may act on the very same cell contents
at the same time, producing modified results more or less
unlike those of either when acting separately on the same
cells If a man is exposed to a dozen pathogenetic agencies
at once, and two or three of them are specific irritants of
156 My Experience wgth [%anuary,
the bile-cells, it is impossible to conceive that either should
produce its own pure and unmixed symptoms. Probably all
of them would act, and each would certainly modify the
action of the others. The result would be, practically, a
mixed disease, in which the keen observer would discover
unusual, and perhaps incongruous symptoms, having their
similars in the pathogeneses of no proven drug. The spe-
cific poisons of Scarlet fever, measles, diphtheria, etc., etc.,
certainly modify each other, though they do not act equally
and alike on the self-same organs, tissues, and cells.
It is illogical to conclude that either or any of the patho-
genetic agencies stand aloof and refrain from interfering
with the action of another, except on compulsion. It is cer-
tainly not impossible that two or more different disorders
may, at the same time, occur in the several different kinds
of cells of an organ, each being measurably independent of
the other. The bile-cells, for example, might be disordered
by a specific cause, and the parenchyma of the liver by a
general one, and a drug that will act on one will not act at
all upon the other. Shall we give one remedy and cure the
parenchyma, and then another and cure the disease of the
bile-cells, or shall we alternate the medicines and cure both
together ? But we can go even further. The contents of
the cell may be disordered without immediately affecting
the nucleus.
MY EXPERIENCE WITH A FEW REMEDIES.
BY E. TIETzE, M. D., PHILADELPHIA, PA.
APIS MELLIFICA.
IN the early part of last spring, during a long spell of wet
weather, several cases of diphtheritic affections of the throat,
seven in number, came under my treatment, which were
all cured with Apis mel. In five of those cases, Apis was the
only remedy given from the beginning to the termination
1869.] A Few Zeemedies. I 57
of the trouble, while, in the remaining two, another remedy
was administered previous to prescribing the bee-poison.
With one exception the patients were all children of from
four to fourteen years of age, of lymphatic constitution and
scrofulous diathesis, and had been more or less predisposed
to angina tonsillaris. As regards sex, four of them were
males, three females. The oldest patient was a girl of
seventeen, with a very marked scrofulous taint. She had
suffered in her childhood from chronic inflammation and
suppuration of the subcutaneous glands of the throat and
neck, mementos of which affection she still carries in
several old cicatrices. Five of these cases bore such a
strong resemblance to each other that I may safely speak
of them collectively, without danger of losing sight of their
individual character, and thus falling into the error of a too
sweeping generalization. The remaining two cases were
both of a more severe type, and were complicated in a
manner that makes it necessary to speak of them separately.
All these cases came under my treatment several days after
the beginning of the affection, and the peculiar diphtheritic
exudates were already formed in each case.
The general symptoms were those usually met with in
diphtheritis; a sudden failing of strength and loss of spirits.
The smaller children complained of being tired and sick,
lay down frequently, or wished to be nursed, and, when
returning to their plays, now and then, were soon compelled
and inclined to seek rest again. There was fever, frequently
preceded by, or intermingled with chilliness, mostly remit-
ting during the morning hours, almost always exacerbating
about 4 P.M., and gradually but slowly increasing till mid-
night, with a quick, small and weak pulse, a dry, but not
very hot, skin, drowsiness and sleepiness. The patients
complained of pain in the throat, principally when swallow-
ing, of a continual collection of saliva in the mouth, an
aching in the parts affected, and of stitches occasionally
running thence into the ears. However, the discomfort,
pain and difficulty of swallowing in all these cases were less
severe and troublesome, than I had frequently observed
158 My Žxperience w?ſh [5anuary,
them in attacks of common angina. Besides this, the
patients suffered more or less from dull head-ache, confined
to the forehead or occiput, and of stiffness and pains in the
muscles of the neck. The neck was mostly swollen, and
had a puffy and bloated appearance, which, at one time,
seemed to arise merely from a bloated state of the subcuta-
neous cellular tissue, and, at another, resulted from, or was
increased by, the swelling and induration of the subcutane-
ous glands. But this latter affection prevailed mostly only
in the more aggravated form of the disease, while the
former was noticeable in almost all cases, and frequently
extended to the face.
The objective symptoms within the oral cavity differed
somewhat as regards localization, extent and intensity of
the morbid process. For, while in one case the trouble
was confined more to the one or the other tonsil, or to both
of them, it involved in another the surrounding parts,
principally the palatine arches; the latter being, as a rule,
more affected, if the diphtheritic exudation appeared only
on one tonsil. The exudates were of the usual color,
grayish white; at times, with a darker border around them,
of different sizes, and either merely dotted the tonsil on its
free upper surface, or the dots increased in circumference,
became confluent, and covered the whole organ, at times
spreading also upon the adjacent parts. The tonsils, as well
as the arcus glosso-palatini and pharyngo-palatini showed
different degrees of congestion and inflammation; the former
generally enlarged, of a hard appearance, and dark color,
were covered with a smaller or larger number of congested
vessels, of which those around the exudate sometimes bled
spontaneously or at a slight touch; while the latter looked
more puffy, were of a brighter hue, and almost always
covered with a thin layer of a transparent, albumen-like
mucus, which gave those parts a glossy appearance, so much
so as to make them look almost as if they were varnished.
The pharynx, in a slight degree, also partook of the
affection, and felt generally dry and raw. Frequent incli-
1869.] A Few Remedies. I59
nation to hawk; breath offensive, without being foetid,
speech difficult and heavy.
In all these cases, Apis acted very promptly and effica-
ciously, relieving, within a short time, at first the general
symptoms, such as prostration, fever and pain, while the
local process for the first twenty-four hours did not show
any improvement. But during, or at the expiration of the
next twenty-four hours, a change for the better was visible
also in this respect; the exudates diminishing both in
thickness and circumference, until they were entirely re-
moved, which took place, more or less rapidly, on the 3rd,
4th or 5th day; congestion and inflammation of the adjacent
parts decreasing pari passw.
This action of the remedy was so constant, certain and
reliable that, in order to allay the fears of the parents, I
always told them at the outset of the treatment, not to
expect a favorable visible change of the local symptoms
within the first twenty-four hours; a caution which, in view
of the dread persons have of this disease, and their nerv-
ousness in consequence of it, sufficiently recommends itself.
As a matter of little importance, and more for the sake
of the completeness of my report, I will add here, that
the remedy was given, in every instance, in the first
decimal dilution; ten drops of it mixed with half a tumbler-
ful of water. Of this a teaspoonful was given every two
hours. This was done in five cases, while, in the remain-
ing two, the same dilution was given on sugar of milk.
Before I shall mention those symptoms, which I consider
the characteristic indications of Apis in this disease, I will
first briefly narrate the remaining two cases, which differed
more or less from the former on account of their compli-
cations.
One of them was that of a boy from seven to eight years
old, a very scrofulous and anaemic subject. When called
to see him, the disease had lasted already five days. The
first symptom, which very forcibly impressed itself on me
on entering the sick-room, was an intolerable, foetid smell,
which penetrated the whole apartment, and became more
I6o My Experience with [9anuary,
intense and nauseating on my approaching the patient. To
avoid unnecessary repetitions I will but add that the general
symptoms, mentioned above, with the exception of the
pain, were present in this case in a much higher degree.
More alarming than these, however, were a quick breathing,
a croupy noise, accompanying inspiration, a hoarse voice,
and a short, weak cough. Besides these signs of evil omen,
the submaxillary and parotid glands were swollen considera-
bly on both sides, especially the former, and imbedded, as
it appeared, in a bloated, doughy cellular tissue. These,
and the swelling of the cervical glands, also present, ren-
dered any motion of the head very difficult and painful.
The mouth, constantly filling with saliva, could be opened
but slightly; yet sufficiently to observe, by a strong pres-
sure upon the tongue, the left tonsil and palatine arches
inflamed, and the former covered with diphtheritic exu-
dates. In how far the swelling of almost all the soft parts
within the oral cavity, by itself, may have been sufficient
cause of the impediment of respiration, etc., etc., I can not
fully determine; yet the supposition that the diphtheritic
process had probably reached the larynx, appeared certainly
not unwarranted under those circumstances.
These conditions induced me to give Kal. bichr., 2, in
solution, and six hours afterwards, on my second visit, I
could not but be surprised at the great change in the
nauseating, footid smell, which, in comparison to what it
was in the morning, seeemed now trifling; a fact which
had also been noticed by the parents of the boy. Breath-
ing, voice, etc., had also improved. After continuing with
Ral. bichr. for twenty-four hours longer, all danger of a
diphtheritic invasion of the larynx had subsided, and the
swelling within the oral cavity had somewhat decreased;
the inspection of the parts being, therefore, a much easier
task.
I found now also the right tonsil covered with exudates,
while those of the left, as well as the swelling of the dif.
ferent glands, still remained in statu quo. Now, I gave
Apis, and had the pleasure of seeing the boy make a rapid
1869.] A Few Aremedies. I6 I
recovery; a noticeable abatement of the local symptoms
clearly manifesting itself, even in this case, after the expi-
ration of from thirty to forty-eight hours.
In the second case, that of a boy of twelve years of age,
the affection, accompanied by the usual symptoms of a
general character, showed itself on the left tonsil, which
was covered with a diphtheritic patch of the size of a pea.
Around the tonsil, within a circle of about an inch in
diameter, the mucous membrane of the adjacent parts pre-
sented a livid and somewhat spotted appearance, was very
dry, and exceedingly painful in swallowing; yet, if any,
but very little swollen. Laches., 6, in water, improved this
state so rapidly, as to make me discontinue my visits within
a few days. Two days afterwards, however, I was called
again to see the same patient. This time the affection had
attacked the right tonsil, and the inflammation had spread,
to a large extent, over the surrounding tissue. The in-
flamed parts were of a bright red color, and presented, in a
high degree, that peculiar, glossy, gelatinous and varnished
appearance, spoken of; yet there was but very little pain
in swallowing.
However, the patient complained of a great stiffness of
the right side of the neck, associated with pains which
spread occasionally over the shoulder of the same side, were
increased by the slightest motion of the parts, and com-
pelled him to keep his head bent over toward the left side.
There was no swelling of the subcutaneous glands of the
throat and neck, but a good deal of bloatedness of the cel-
lular tissue on the side affected. Besides this, he suffered
very much from a darting, cutting pain, which started a
little back of the right ear, and flashed across the top of
the head to a corresponding place behind the left ear, and,
at times, branched off toward the nape of the neck, and lost
itself along the spine. It appeared periodically, and seemed
somewhat relieved or shortened by hard pressure. There
were great prostration and fever, with drowsiness, exacer-
bating in the afternoon. Pulse weak and quick, skin
somewhat hot, with frequent slight chills running over
Vol. IV. — No. 14. 3
I62 My Experience with [Sanuary,
him, especially when he made the slightest attempt at
moving about. Very little thirst, sometimes slight nausea,
no appetite.
Apis very soon relieved the intense pain in the head; the
pain, stiffness and swelling of the neck, as well as the fever
and prostration. Exudates and inflammation of the tonsil,
etc., showed a marked improvement within forty-eight
hours, and a few days afterwards the boy felt entirely well,
with the exception of a still lingering feeling of weakness.
Now, the special characteristic indications of Apis in diph-
theritis, in my opinion, are the following:
1. Grauvogl’s hydrogenoid constitution.
2. The bright red color of the inflamed parts, their puffy,
glossy, varnished appearance, in contrast to Lachesis with
its purple, livid color of the inflamed parts, and their dull,
dry appearance and little swelling.
3. The comparatively small amount of pain accompany-
ing an apparently intense and extensive inflammation, in
contrast to Lachesis, with its intense pain accompanying an
apparently small amount of inflammation.
4. The puffiness and bloatedness of the subcutaneous tis-
sue of the neck and face.
5. The pain in the neck and shoulders, in the back part
of the head, starting back of the ears, and radiating in
different directions, of a darting, cutting character, periodi-
cally returning, more external, and on the affected side.
6. The fever exacerbating about 4 P.M., with slight
chills, frequently returning when moving about.
From the above remarks it is evident that Apis corre-
sponds more to the lower and middle grades of the diph-
theritic process, and is hardly sufficient in those cases,
which are ushered in very suddenly and with great vehe-
mence, and arrive at a fearful height within a very short
time. Yet, since, as a general rule, this disease, now-a-
days, mostly appears in a milder form, and cases of that
fatal development, which we frequently heard of in the
past, seem to be much rarer, a fact which is owing, pro-
bably, to the better knowledge we have of the affection,
1869.] A Few Remedies. 163
and to a more judicious treatment—we will, perhaps, have
frequent occasion to prescribe the bee-poison, especially as
the symptoms of our late epidemics, at least so far as I have
observed them, were very often pointing to that remedy.
However, notwithstanding all this, even the most san-
guine among us will, probably, admit that our present
drug-armamentarium, is not always sufficient to keep the
disease from developing into its dangerous forms, and that,
now and then, we meet with those alarming cases to which
even our best and usually most reliable remedies prove
inadequate. Under such circumstances it is certainly very
gratifying to hear of a means which, although not homoeo-
pathic, nevertheless is well grounded and promising of the
most hopeful results. I refer to Grauvogl’s method of
treating diphtheritis with alcohol. To judge from a report
on this method, written by Dr. Zwingenberg, of Germany,
and published in the “Allgem. Hom. Zeitung, Bd. 77, No.
1,” the results of its application in practice are so cheering,
as to make it appear our duty, as physicians, to apply it
whenever we have an opportunity. To convince the reader
of its importance, I will quote a part of the paper men-
tioned :
“In the autumn of 1867, an epidemic of diphtheritis
raged in Döberitz and Premnitz, villages situated in the
low-lands of the Havel. My colleagues of the neighboring
town, Rathenors, all Allopathic physicians, treated it, lege
artis, with the most fatal results. Now, I was called into
requisition, and not another case has terminated fatally.
It is literally true, not a single case treated by me at that
time, at a later period, and still more recently in town here,
ended fatally; it being, therefore, true, without the least
shadow of a doubt, that v. Grauvogl’s method cures that
form of diphtheritis, – and we have had no other species,
and never observed one under other circumstances — which
comes under our treatment in low countries, makes its
appearance in damp houses, at wet seasons, or during long
lasting spells of rainy weather.
“I have used this method in the following manner. Im-
I64 My Experience with, etc. [?anuary,
mediately on observing diphtheritic exudates, I order most
of the patches in the throat to be touched with alcohol
(Spir. vin. rect.), by means of a small goat’s hair brush.
This is repeated every hour. Besides this, if the patient is
a sensible person, I let him gargle with a mixture, consist-
ing of a table-spoonful of tepid water and five drops of
alcohol. Internally, I give Merc. Sol. Hahnem. 3, centes. tritur.
0.05, (gr. ºn 7) dissolved in three ounces of water, a tea-
spoonful every two hours. As a preventive, I let the poor
take a small quantity of whisky (Branntwein), the richer, a
little red wine, after every meal. Children ought to gargle
repeatedly every day with a mixture of tepid water and a
few drops of whisky (Branntwein), and, if circumstances
allow it, with tepid red wine. Following these rules there
is never another simultaneous case of diphtheritis in the
same family.”
This report argues still more in favor of Grauvogl’s
method, when we consider that the remedy administered
simultaneously with it is no simile for the diphtheritic pro-
cess, consequently entirely indifferent as regards the favor-
able results obtained; an opinion on which most of my
colleagues will, probably, agree with me.
I will, finally, speak of another trouble in which Apis has
rendered me eminent service. I have reference to those
summer complaints which drag out from week to week,
sometimes slightly improving, and then relapsing again,
until anaemia and nervous exhaustion have reached such a
degree as to terminate in hydrocephaloid. The emaciation
of such children is immense; there seems literally nothing
left of them but “skin and bone.” Even the head shrinks;
the different sutures standing out prominently, on account
of the adjoining cranial bones having softened at their
edges and gradually overlapped each other. The extremi-
ties are cold, the pulse thread-like, scarcely perceptible at
the wrist, while the heart often beats violently against the
chest. There are symptoms of low fever, now and then,
with faint flushes upon one or the other cheek. Somno-
lence, turning of the eyes upward and lids half-closed,
1869.] Aſorce. 165
heat in the head, which seems the only warm part of the
body. Ghastly paleness and sickness at the stomach, and
sometimes vomiting, when the child is raised up. Diar-
rhoea not too frequent, mostly in the morning hours, vary-
ing much in character; sometimes very offensive, other
times hardly of any smell, greenish-yellow, mixed with mu-
cus, not too thin; at times again watery, and mingled, rather
than mixed, with little bits of faecal matter. The abdomen
sunk in, but no hardness of the mesenteric glands. Very
little appetite, and little thirst. Two such cases I saw
recover under Apis, 200 (Lehrmann), beef-tea and raw finely-
scraped beef. I will add that, in both cases, the improve-
ment set in before either beef-tea or raw beef could possibly
have taken effect.
In cases of a more acute form, and at a stage not so far
advanced—I will say at that period, when excitement seems
to struggle with depression, with the chances rapidly grow-
ing in favor of the latter, I have seen excellent results of
Veratr. viride, of which I will speak at another time.
FORCE:
AND SOME OF ITS RELATIONS TO LIFE, DISEASE, AND MEDICINAL
ACTION.
BY H. P. GATCHELL, M.D., KENoshA, WIs.
No. I.
IT is quite certain that no generally accepted definition of
life has, as yet, been given. Nor would it be difficult to
show that each one — at least, so far as contained in any
systematic work—is radically defective. Nor can such
definition be given, without a previous analysis of the
nature of life; and this must needs be preceded by a know-
ledge of the nature of force.
I66 Aſorce. [j'anuary,
That it is impossible fully to discuss force, without an
extensive acquaintance with the details of physical and
chemical science, I am well aware; and it would argue a
kind of presumption quite foreign to my nature, did I not,
in entering on this discussion, most painfully feel my defi-
ciency in such details. At the same time, I should not be
guilty of the impertinence of laying this article before the
readers of the Journ AL, did I not suppose, notwithstanding
that deficiency, that I have something to communicate which
will prove worth the trouble of reading—at least, to such as
are capable of thinking. My conviction, whether well or ill
founded, is that, before the publication, in this country, of
Grove’s masterly essays, and before I knew of their exist-
ence, I did — pursuing the subject of force in a different line,
with greatly inferior knowledge, and for far less numerous
results—attain to some principles which are not only impor-
tant to a clear idea of the nature of force and life, but which
suffice to give as clear and definite an idea of the latter, as
the labors of Grove have furnished of the former. And if I
add that I think these principles capable of contributing, on
one or two points, to a more just idea of force than his labors
have done, I must needs submit to the imputation of indis-
tinct views or presumptuous confidence, if I fail.
But, however deficient I may be in the details of physical
and chemical science, I can not, on that ground, justly be
charged with want of modesty, provided I confine myself
within the small circle of facts and principles with which I
may be comparatively familiar.
In order to a proper idea of force, it is necessary, first, to
consider matter itself. We know matter only by its phe-
nomena. Now, the word phenomena signifies appearances.
Wherever there are appearances, there must, of necessity,
be an entity that appears. And however little we may be
able to know of this entity, in its essence, we are compelled
to conclude that it exists, and also to classify its several
kinds, by their respective groups of phenomena. Chemists
accordingly recognize some sixty-five different kinds of
material substances. These several kinds, they have reduced,
1869.] Aſorce. 167
as to their ultimate composition, to imperishable and indi-
visible atoms.
Every one of these atoms is endowed with power. At
least Newton considered that an inevitable conclusion from
observed phenomena — a conclusion accepted by physicists.
But we do not need to resort to Newton’s grand generaliza-
tion relative to gravitation, as evidence that power is a uni-
versal attribute of matter. It is implied in that elementary
property of matter, which is termed impenetrability; since,
in virtue of this endowment, each atom is capable of exclud-
ing every other atom from the occupied space. Power,
being inherent, is absolute, and as unchangeable as the atoms
themselves, of which it is an attribute.
The unchangeableness of atoms and atomic power may
be illustrated by tracing an atom of oxygen through a series
of possible changes of relation. To-day a constituent of
the atmosphere, floating uncombined and ready in its une-
qualled avidity, to seize on almost every existing thing,
to-morrow it may, inhaled by man or animal, enter into the
constitution of a molecule of carbonic acid. This molecule
having entered into the connposition of a plant may serve to
nourish an animal cell; from which, eliminated by decay,
it may escape into the atmosphere to be absorbed by a
plant-leaf, there under the influence of the solar ray to be
decomposed, giving off its oxygen, again to return to its
former aerial home.
In the various changes of relation, the original properties
of the oxygen were in a measure obscured and concealed;
and had not science, with watchful eye, traced all its migra-
tions, no suspicion would have existed that the same inde-
structible element, with the same imperishable properties,
was concerned in all the various forms into which it had
entered, and all the various groups of phenomena to which
it had contributed. But it has resumed its place in the
atmosphere, the identical element that it was when it left.
For a moment after its escape from combination, while in
the nascent state (due, perhaps, to electrical excitation
dependent on the molecular changes, pertaining to decom-
I68 Aorce. [3anuary,
position,) it manifests a more potent affinity; but fully
restored to the atmosphere, it differs in no respect from an
atom that may have been at the surface of the aerial ocean
for countless centuries. It is through this definite and
unchangeable character of its component atoms that the
universe has a stable condition. Without this character of
constituent atoms, all bodies would be in a state of per-
petual flux; no one could reckon one moment on the
universe of the next. º
Since every atom is endowed with power as an attribute,
without which it would not be matter, it is evident that
each atom carries its power as a contribution to every form
into the composition of which it enters, and consequently
that it is an element of power in that form. All the power
pertaining to any body can only be the sum of the powers
of its constituent atoms. If, in any combination or mixture,
we substitute an atom of lime for an atom of magnesia, or
the converse, the combination or mixture is, in that degree,
modified as to its power. It is in this respect, as well as in
composition, no longer identical with what it was. Physi-
cally and chemically its properties are altered. And so of all
atomic changes in all possible combinations and mixtures.
We can not change a single atom without a corresponding
change in the power of the body; and since force is but a
manifestation of power, atom and force are indissolubly
associated. It is evident, therefore, that force is but a
result of the action of matter upon matter—in fine, that
force is but matter in action. This much we know with
regard to force; any other view is purely speculative.
Power is an attribute of matter, a part of its existence. The
effect of this power, when exercised by one body upon
another, is force.
It follows, from these premises, that while power is
inherent and absolute, force is relative and conditional.
While the power of the atom of oxygen was found neither
to have increased nor diminished by the various relations
it had sustained, its avidity was very much modified by
those relations. And the same is true of all atoms in all
1869.] Aſorce. 169
possible relations during their existence. Citric acid is
capable of neutralising magnesia. But it has no effect on
the magnesia until brought into the relation of insensible
distance. Nor, if brought into this relation, can it avail any
thing towards the neutralisation, except in the presence of
moisture, to furnish the mobility necessary to enabling its
molecules to enter into the new combination. Citric acid
and magnesia, therefore, can not be said to have absolute
combining force. It depends on proximity and mobility,
to say nothing of other conditions that might be specified.
The force does not exist unless the conditions are furnished.
It is consequently relative and not absolute.
But whatever may be the conditions necessary to any
given display of force, nothing is more evident than that
the force of each and every body is but the sum of the
forces of the various atoms that enter into its composition.
Sulphuric acid displays force solely in virtue of the sulphur
and oxygen that comprise it. Diminish, for instance, the
atoms of oxygen, and forth with you change its force. And
as much as the mild plaster of Paris differs from caustic
lime and corrosive sulphuric acid, it is only because of the
capacity that these two substances have of modifying one
another's display of force. In virtue of this mutually modi-
fying influence each ceases to destroy human flesh. The
force of the plaster is none the less derived from its con-
stituent atoms.
Atomic force may be displayed in the production of either
stasis or motion, the latter illustrated in catalytic as is the
former in chemical action. Though in the former, as in the
latter, motion is first caused, continuing in the former case
until the molecules have entered on their new arrangement;
when the same force that produced the motion maintains
the stasis; as, in the falling of a stone, the same force that
brings it to the ground continues to bind it there. Certain
displays of force in the production of motion have been
defined by the resulting motions; light, heat and electricity
being termed modes of motion. But whatever the mode
of display, and whatever the name applied, it is equally
17o Aſorce. '[3anuary,
true, in every instance, that force is but the action of one
body on another. Wherever the same elements exist under
the same conditions, there is the same display of force.
If allotropic forms and isomeric combinations betray a
difference of force, it is only because difference of arrange-
ment is difference of condition. The moment we alter the
arrangement of atoms or molecules, that moment we alter
their relations, and, of necessity, their reciprocal action and
aggregate influence. And we may sum up the whole in
the proposition that the aggregate forces of a body are
equivalent to the sum of the forces of the constituent atoms,
modified by their polar arrangement.
What is true in this respect of the inorganic is equally
true of the organic. We have seen that the atom of oxygen
returned to its inorganic source with its power unchanged.
It was, after its completed migrations, in every respect
identical with what it was before it commenced them.
Whatever force it possessed, it must needs have continued
to exercise in the various organic bodies into which it
entered as when it was an atmospheric atom, the mode of
manifestation being modified by its existing relations; as
the line of direction in which a body is impelled by any
force or forces is modified by the introduction of a new
force, operating at a different angle. We find also in the
organic, as in the inorganic, that the slightest change in
atomic composition or arrangement results in a correspond-
ing change of force. Chondrine and gelatine are both
nitrogenous substances, differing a little in their atomic
constitution, and with corresponding difference in their
physical properties and physiological relations. Albumen
and syntonine are identical in atomic composition, differing
only in atomic arrangement. And everywhere throughout
the organic world, physical and physiological changes occur
in proportion to changes in atomic constitution and ar-
rangement.
That the forces of organic bodies are peculiar, results
from the peculiarity of constitution. They are more com-
plex, and wherever vital operations proceed they are satu-
1869.] Aſorce. 171
rated with moisture, hence in a state of mobility favorable
to chemical or other atomic and molecular movements
involving constant development of calorical, electrical and
other forces acting and reacting in the most complicated .
manner. In addition, wherever vital processes are carried
on, nitrogen, that remarkable element, capable of such
marvellous display of force, and lending such instability to
the combinations into which it enters, is ever present.
Assuming the existence of an organic body, there is no .
difficulty in referring all its forces to the atoms that enter
into its composition. And it is noteworthy that every
advance in physiological science is in this direction, every
day rescuing something from the realm of mystery and
reducing it to a display of atomic force. Organic chemistry
is fast becoming coextensive with physiology. Therefore
I define the life of any body as being essentially the sum
of the powers of the various atoms that enter into the com-
position of the body; phenomenally the sum of the mani-
festation of the atomic forces of the body, modified in
their manifestation by peculiarities of composition and
arrangement; or reducing the expression to the present
favorite method of defining light, heat and electricity, it is
a mode of motion of the molecules of an organic body; and
this I repeat, is proportioned to composition and structure.
NOTES.
(1.) It is proper for me to add, lest I be suspected of that meanest of
thefts, literary pilfering (a kind of larceny which, if punished as it deserves,
would forth with compel enlargement of our jails and penitentiaries), that
the preceding article was not only written, and in the hands of a friend for
examination and opinion, but was also in type, before the appearance of
the October number of Hays' Journal, containing the notice of Henry
Bence Jones' Croonian lectures on matter and force. In fine, the entire
series which I propose, will be but a reproduction of the substance of lec-
tures which I delivered some fifteen years ago, and something may be par-
doned to the weakness of human nature, if I find some cause for gratification
in the fact that, with very meagre scientific knowledge, I then, unaided by
books or communication, epistolary or oral, with scientific men on the
subject, attained to views (compassionately spoken of by my colleagues as
I72 Jºorce. [9amuary,
some of my theories; theories, however, that are destined to afford a scien-
tific basis for the knowledge of life, disease, and medication), which are now
just beginning to be entertained by the most advanced minds of the pro-
fession, as the necessary results of recent demonstrations in physical Science.
(2.) Dr. Jones' use of the phrase latent force, and the confounding of the
terms force and power, do not add to the lucidness of his lectures. Force
is power displayed, and, where that distinction is observed, we can dispense
with all such unscientific expressions as latent force, latent heat, and the
like; calorific power being the scientific equivalent, implying capacity to
produce heat, as heat itself is the power displayed.
(3) Dr. F. A. Lord, formerly Professor of Chemistry in Hahnemann
College, a gentleman to whom I am indebted for genial and Searching
criticism, requests me to call attention to the fact, that the line between the
inorganic and the organic is an arbitrary line, and that it is fast disappearing.
Since chemistry is but the science of atoms and atomic forces, the artifi-
cial (however convenient for classification's sake) character of that line is
declared in the statement that elementary atoms are the seat of power, and
that mere atoms pass from the inorganic to the organic entirely unchanged.
The power of the material universe is but the sum of the powers of its
component atoms, and the conservation of force rests fundamentally on no
doctrine of convertibility (more properly transmissibility) of force, but on
the imperishable and unchangeable character of these constituent atoms.
Since force is but atomic action, one form can no more be converted into
another than one set of atoms can be converted into another.
When chemical action of sulphuric acid on copper and zinc causes elec-
trical action in connected wires, the motion of the molecules of the plates is
no more converted into the motion of the molecules of the wires, than the
molecules of the one are converted into the molecules of the other.
So when the motion of the molecules of the wires causes, in another body,
that motion which is termed heat; the former motion is no more con-
verted into the latter than are the molecules converted.
So when the Smith Smites the anvil; the movement of the smaller iron
mass through space is no more converted into the molecular movement
that takes place from contact with the greater mass, than is the hammer
converted into the anvil.
It is worthy of observation in these, and in all similar cases, that force
does not act on force. There is always intervention of other matter. In
no instance whatever is a force known to act on a force.
Force may be said to be in this manner transmitted; but it is more accu-
rate to say that it is produced; and it is well to remember what confusion
has existed in the world, and what endless disputation has accrued from
lack of precision in the use of language. Language is used with precision
in proportion to precision of thought.
(4.) With these preliminary statements, as to the nature of universal
force, I shall be prepared to discuss, in the Second article, the physiological
relations of force to life.
(5.) Atoms are inconvertible, power is inherent in atoms, force is a display
of power; it is the action of one body, in virtue of its power, on another
sº Tietze and his Word to the Other Side. I 73
body in virtue of its susceptibility. Now, force is no more convertible than
power, and power no more than the atoms to which power pertains.
If there were but one atom in existence, there could be no force, though
its power were infinite. When this atom finds another body to rest in,
causing in it a development of force, in virtue of which it acts on a third
body and modifies its condition, the force of the first has not been converted
into that of the second. It has merely called the power of the second into
action.
And so in all cases of alleged conversion of force, there is simply nothing
but a calling into action of the power pertaining to and inhering in the
the second body, by manifestation of the power of the first. To call into
action is not to undergo conversion, and it is most inaccurate and unphl-
losophical so to term it.
TIETZE AND HIS “ WORD TO THE OTHER SIDE.”
BY P. P. WELLs, M.D., BROOKLYN, N. Y.
IN a paper on the “Essential Nature of Disease,” pub-
lished in the number of this Journal for January, 1868, it was
our aim to place that nature before the reader, as it exists
in the ordinance of Almighty God, by presenting it in
examples, such as are often met in practice, and, therefore,
such as all might be supposed to be sufficiently familiar
with, to make their force, as illustrative of our subject,
readily appreciated. We thought these examples sufficient
for the purpose for which they were presented, and that
they little, if at all, less than demonstrated the nature of
disease to be dynamic, and nothing else. The argument
admits of much enlargement, the facts and examples pre-
sented, of additions to a very great extent; but as those
given were deemed conclusive for the purpose of the paper,
the more brief and simple course was preferred and adopted.
On a re-perusal of the paper, we see no reason to change
our conviction then entertained, that the dynamic nature
of disease, as opposed to that view which regards it as
material rather, is fully proved by the facts there given,
and by numberless others, of like character, familiar to all.
I74 Zºe/2e and his [3anuary,
If there are those who differ in their judgments of these
facts, and come to another conclusion, we concede their
right to do so most readily; but do not in this, for a mo-
ment concede, therefore, that we are in error. So far as it
is a matter of opinion, we concede, and claim, equal rights.
We claim to exercise authority over no one. We have, in
this case, spoken, as we believe, for the truth, and for the
truth we stand. If it be for our side, it is well. If against
us, there is nothing for us but to submit to its authority,
whatever opinions of ours this may require us to change.
But before apology or retreat, we demand the proof of
€r l’Or.
T)r. Tietze believes we “labor under Serious mistakes.” This
he may well do, and no one can complain of him for it.
But when he makes the charge, he should point them out,
and then, if he is not himself mistaken, we have the oppor-
tunity to “mend our instance.” Instead of this, where we
have given the facts of nature to sustain our position, he
cries out “serious mistakes,” and gives us von Grauvogl.
If it were a matter of authority in science merely, he would
have but to mention the name of this eminent man, and
there would be nothing left for us, but to remove our cap,
make our lowest bow, and retire. But it is much more
than this. It is nothing less important than truth or error.
We have brought what we regard as abundant evidence of
the truth we maintain being one of nature’s laws. In
refutation of this evidence (and there is plenty more of it),
Dr. T. brings opinions of von Grauvogl. We can not accept
the mere opinions of any man as superior in their claim on
our confidence to facts of nature. Dr. v. G. would not
expect it of us. Does Dr. T. ? Dogmatism in so important
a matter, it is submitted, with all deference, is no answer
to evidence drawn from well known living facts. Those
which we have presented, remaining as they do, unchal-
lenged, and there being no error pointed out in the conclu-
sion we have drawn from them, we should be fully justified
in leaving the matter as it is, and await the indication of
the “serious mistakes,” with which we are charged, before
1869.] Word to the Offſhe?' Side. I75
giving especial attention to this opinion of Dr. T. And
this would be our course were the matter of personal con-
sideration merely. In the present state of the case we should
be warranted in the conclusion, as no other evidence of
mistake has been adduced than the opinions of von Grau-
vogl, that Dr. T. has no other or better, and that as against
these, the facts of nature on which we rest are more than
sufficient. If these are the best that can be adduced
against the proofs of the dynamic nature of disease which
have been given, then, we submit, that nature is established,
and controversy on the subject is at an end. It may as
well be known, now as hereafter, that dogmatism is not
current coin in this matter. And here the matter would
be permitted to rest, were it not that mere opinions, when
left unchallenged, come after a time to have the practical
effect, on some minds, of established truth, and so the par-
tially instructed are made liable to be misled. For this
reason, we shall notice some of these opinions of von
Grauvogl, and see, if we may, how far they will bear exam-
ination. It is for this reason only, and in no wise because
they are in any way or sense an answer to the paper against
which they have been adduced.
The first which we shall notice is sufficiently remarkable;
of all that we have seen lately, certainly there has been no
one more so. Here it is: “ The aid of a vital power is entirely
superfluous for the study of therapeutics.” The sentence, as it
stands, is a little obscure. But we will not receive it as
meaning virtually that a dead man is the equal of a live
one in the study of this science, but rather, that the idea
of a living power has no necessary connection with the
subject. This is the only other construction the sentence
seems to admit of, though this is hardly less absurd than
the other. If it means any thing, it asserts that a system
of therapeutics may be constructed with which the living
forces of men shall have no necessary connection. And
yet the objective of this science is the healing of sick living
men. That of which they are to be healed is a modifica-
tion of the living processes within them, so that whereas
176 7% effze and his [3anuary,
they were, in their unmodified state, conservative — of
organs, functions, and even of the whole organism—now
they are destructive of these. That is, it is a modified life,
with destructive tendency, which is to be restored to its
former conservative state, and all this to be done without
regard to the one chief element in the problem, the life of
the subject of the cure. That which is sick, and which is
to be restored, is the life processes, changed as we have
seen, whatever the view we may take of these, whether
dynamic or otherwise. And it is these processes, moved
by the life forces, on which we are to act; and yet we are
told that in our study of the science by which this is to be
effected, we may, without detriment to science or practice,
disregard these forces, a consideration of them being wholly
“Superfluous.” Who does not see that it is upon these
forces alone we can act, whatever view we may entertain
of the nature of disease, or whatever agencies we may
employ for its cure ? There can be no disease out side of,
or distinct from, the life. Is there any one so absurd, as to
claim that there is, or can be, disease in the dead? And
yet, the system of therapeutics which is created or studied,
which excludes from its domain the life forces, is only a
system for the dead.
The second opinion of von Grauvogl, brought as an
answer to the “Essential Nature of Disease,” is also not a
little noteworthy. It is this: “From the laws of Physiology,
thus far presented, we can not infer a vital power.” “The idea
of a life power is but a predicative abstraction.” We reply,
that Almighty God has not left this high gift to man to be
a matter of “inference.” It is nothing less than a self-pro-
claimed, and self-demonstrated fact, in every process of life
in man, sick or in health, from the highest intellectual
movement, to the absorption and rejection of the smallest
effete molecule. Nothing has here been left to “inference;”
all is plain demonstration before our sight, and every pro-
cess in the series, from highest to lowest, proclaims the
existence of this power, by its cessation the moment this
chief power becomes extinct.
1869.] Word fo the Offſher Side. 177
He says farther: “It (the life power) is an idea, but no object
of the senses.” + “ Is it but an idea 2 Is it an idea only
that gives me the power of thought, motion, pleasure, pain;
that moves the functions of organs, and governs their decay
and reparation ? But “it is not an object of the senses.”
Neither is the power which created the universe, but is it,
therefore, only an idea—an abstraction ? If any be tempted
to say of this that it is too weak and absurd to merit
serious reply, we remind him that it is von Grauvogl who
speaks, while, at the same time, we admit that it derives its
whole importance from this fact. And then Dr. T. believes
it a good argument against the truth of the dynamic nature
of disease. We venture to believe there are few others
who will so receive it. -
And further from von Grauvogl: “Nothing is more conve-
nient, yet nothing is more dangerous for science, than to use
abstract ideas as explanatory arguments.” This is an argu-
ment against the truth of the dynamic nature of disease,
and the existence of the living forces of the human organ-
ism. Think of it! Think of these forces as a mere
“abstract idea,” and, if you can, of their being so regarded
by one who is justly held as a philosopher of no ordinary
attainments' Think of this, and from it receive new ideas
of the possible extent of the blindness, which preconceived
judgments may impose on even the learned and the wise.
The living forces are abstract ideas — no more | Where,
then, in all the results of creative wisdom and power, are
we to look for an actual fact, if this, from which all the
pleasure, and all the pain, all the movements, contrivances,
and improvements by which the one is to be enhanced, and
the other avoided, all the products of the mechanics and
the arts, all which raises the acting, thinking man above
the statue which bears his form, where are we to look for
an actual fact, in all God’s universe, if that from which all
these things have come is a mere “abstract idea & " We
claim for these forces, and with right, notwithstanding this
utterance, the very first place in the whole array of existing
facts, and for them, as facts, an importance which attaches
Vol. IV.-No. 14. 4.
178 7% effze and has [January,
to no others. The denial to these forces of the place and
consideration due to facts, is, in all that we have known of
human prejudice and perverseness, only equaled in the
case of that other philosopher, who, for consistency’s sake,
was compelled to deny his own existence, as a fact. The self-
evident existence of his person was certainly no more an
apparent fact, than the existence of those forces by which
the varied vital processes of his body and mind were ex-
ecuted. The one is no more apparent, as a fact, than the
other. We have no more right to regard the one as a mere
“abstract idea " than the other. Neither has von Grauvogl.
The beautiful statement by von Grauvogl, of the mul-
tiform arrangement of capillary and cell, of intercellular
spaces, and intercellular matter, indeed of the whole
arrangement of the details of the material machinery for the
execution of the living processes, is quite satisfactory. But
to what end is all this, if it is not to move till compelled by
an “abstract idea 2° Here has surely been a singular waste
of ingenuity and facts, if there be no other motive power
than this. These material parts are just as perfect, in gross
and detail, in the unfortunate victim of the lightning stroke,
as in the most healthful athlete. The stroke which has put
all their motions to rest, so that they shall never move
again, has made no change in these. They are just as per-
fect in all their parts now as they were but the few moments
ago, when he who is now dead was alive, and thought, felt,
and acted, under the power of that force, the extinction of
which has been the cessation of all these, and which carried
in itself all the difference there is between the living and
the dead. Is this a mere “abstract idea 3’ To what use is
all this wealth of parts for the accomplishment of so
numerous offices, if they are to be left by their inventor and
creator without a motive power, or with no other than the
alleged “abstract idea 2° The wisdom of the Supreme, in
this case, would be just paralleled by that of the man who
should provide for the production of fine fabrics on the
large scale, all the needed mechanical appliances of the
most ingenious contrivance, and of great and complex
1869.] Word to the Offſher Side. I79
detail, and there stop, omitting wholly to provide the steam.
It is not overlooked that von Grauvogl seems, when he has
laid out the mechanical arrangement of parts before his
view, to regard the resulting processes of their action as the
product of their self-impelling motions, which are wholly
independent of forces existing outside of, and distinct from,
these complicated mechanisms. This seems to be, to him,
an adequate explanation of all those processes of healthful
and diseased life, which we are constrained to refer to an
agency acting upon and through these mechanisms, and
which, for the lack of a better term, we call the living forces.
We are driven to this by the knowledge of the fact, that all
these mechanical parts are as perfect in the dead as the
living, and yet in the dead they do not move. If the
impelling power were inherent in these mechanical parts
and arrangements, then, while these continue in their
integrity, the resulting processes should never cease. If,
perchance, arrested, for the moment, by the lightning,
the inherent power, if a fact and not a fancy, should imme-
diately set them again in motion, and so maintain them
while the parts endure. As in the case of death by light-
ning, so in the analogous case of sudden arrest of life pro-
cesses by rapidly fatal scarlet fever, as we have pointed out,
the renewal of these processes by this inherent power of
the mechanism, should surely sometimes occur. And yet
it never does. Something more than a “predicative abstrac-
tion” has been extinguished, and is not to be restored by any
inherent power of the mechanism, nor by any perfection in
its adaptation to the ends for which it was ordained, and
which it has so perfectly accomplished, till this final and
fatal catastrophe.
The first profession of faith in this inherent power in the
organic mechanism to maintain the life processes by its
own independent action, “so far as we know,” is the fol-
lowing:
“‘In a fortnight or three weeks,’ added my uncle Toby, smiling, “he
might march.” “He will never march, an’t please your honor, in this
world,” said the corporal. ‘He will march,' said my uncle Toby, rising from
18O Zºetze and has [?anuary,
one side of the bed with one shoe off. “An't please your honor,” said the
corporal, “he will never march, but to his grave.’ ‘He shall march, cried
my uncle Toby. * * * * “He shall march to his regiment.’ ‘He can not
stand it,' said the corporal. ‘He shall be supported,” said my uncle Toby.
‘He'll drop at last,' said the corporal, ‘and what will become of his poor
boy ' ' He shall not drop,” said my uncle Toby, firmly. “A-well o'-day
— do what we can for him,' said Trim, * * * “the poor soul will die.”
“He shall not die, by Heaven º' cried my uncle Toby.”— Sterne.
Here it is, in its earliest expression. Whether von
Grauvogl borrowed his idea from Capt. Shandy, we are
not informed, but we feel justified in believing, that in the
amiable earnestness of his confidence in the great dogma,
the Doctor has not greatly surpassed the hearty faith of his
illustrious predecessor.
The next opinion of Dr. v. G., which it will be necessary
to notice, is in these words: “What is to be understood by
dynamic disturbance is not appreciable, either by the art of exper-
iment, or that of observation.” In this respect, this disturbance
occupies the precise ground of that numerous class of
causes of diseases known as miasms. We know nothing
of these, except as we have learned of then from their
effects. These have not left us wholly in ignorance. They
are quite proper and adequate objects of observation. So
of the “dynamic disturbances.” No man need be. ignorant
of them unless he chooses to be so. Their effects are not
obscure. They are easily recognized, and we can assure
the Doctor we have found them, after many years of obser-
vation, not a little interesting. If the Doctor means by
“inappreciable to observation,” that these disturbances are not
perceivable by the sight, hearing, or smell, neither are the
miasms, But are they not facts, therefore ? The resulting
disturbances of both are sufficiently apparent to the senses
to give a virtual practical contradiction to this bold asser-
tion. If not seen, they are sometimes felt in a manner not
altogether pleasant. But as to these disturbances, we con-
cede more than is true of many of them, when we allow
they may not be recognized by the sight. The sudden
reddening of the congested head and face, after strong
inhalation from a phial of Nitro-Glycerine, is quite apparent,
1869. Word fo the Other Side. I81
and is a complete negative of this declaration of the Doctor.
The blush of every modest maiden is no less an apparent
negation of this careless assertion. And we may hope that
the Doctor's own honest face will bear testimony in like
manner, when he has better considered the subjects of
which he has thus spoken more hastily than wisely.
“Chemismus.” The word sounds well, because it has in
it a savour of the “Scientific.” It seems to be a favorite
word with von Grauvogl. It expresses much of what he
appears to regard as the essential nature of disease. IIe
says: “We must always remember that, in diseases, we have
nothing before us but either primary chemical changes, which are
followed either by physical changes, or vice versa, or both simul.
taneously.” This is another of the remarkable statements
of Dr. von G. We submit, if we do remember this, we
remember what is not true. So far is this from true, that
there are numbers of diseases to which the idea of chemical
change can not attach. The numerous and multiform
neuralgias are examples. The megrims, also, are examples
of disease of which these changes can not be predicated.
The same is true of the family of hysterias—of the chronic
rheumatic affections, without redness or swelling — of the
whole class of nervous affections from moral causes, and
many others. Where are the chemical changes, which
“we must always remember,” in the convulsions resulting
from sudden joy or grief? It is perfectly evident these
have no place but in the imagination of exceedingly inge-
nious men. And this is the principle which Dr. v. G.
opposes to Dynamismus, or the doctrine of the vital forces
as applied to diseases, and which Dr. T. seems to think a
“serious mistake.” It is altogether inadequate to the
demands of an enlightened pathology, in this, that it leaves
so large a part of human suffering wholly unprovided for.
The bed is too short. A truly philosophical pathology
can not be stretched upon it. As a system it must soon
vanish, before even a very moderate degree of insight into
the facts which nature presents to our daily observation.
The dynamic nature of disease, and the existence of the
;I 82 7% effze and has [3amuary,
living forces, as living facts, we have no doubt will survive
this quasi pathology, and all else which limited intelligence
or prejudice has opposed to them.
And then again : “ The specifico-chemical properties within
the organism are, and remain, the same as they are outside of it;
and yet these bodies suffer the most manifold separations and
combinations, under those local conditions and specific motions of
each single organic part. * * * No difference can be discovered
in these motions, eaccept the one necessarily arising from the Spe-
cific mature of the substances, and that of the organic textures,
together with the resistance of movable membranes.” If we
understand this paragraph, it asserts the identity of chem-
ical affinities and processes within the living organism and
without it. Chemistry is eminently a science which admits
of demonstration. It teaches by this. It is much in the
way of challenging with denial that which can not be so
confirmed. It receives dogmatism from no authority
whatever, but will ever insist on the proof of the
truth of the matter asserted. If not responded to by this,
it rejects the whole. In this spirit of the science appealed
to, we challenge Dr. v. G. to the proof. Let him, without
the living body, repeat the processes which are executed
within, and from them bring forth the same results, and he
will have presented the only ground on which he can claim
for this assertion the slightest respect. Let him, from any,
or all, the various articles of human food, elaborate a single
muscular or nerve fibre, as the chemistry within is ever
doing, or even a single cell, of whatever kind, and we can
listen to him with patience. But, till he does this, this
assertion is in science no better than false pretence in trade.
We do not overlook the reserved provision of the Doctor, in
the “Specific nature of substances, and that of organic textures.”
But the provision is not equal to either a logical defence or
retreat from the absurdity into which he has brought him-
self. We concede to him all the “substances” employed in
the operations of the chemistry within, with whatever of
“Specific nature” they may possess, and there is no objection
to going farther, and adding the “organic textures,” with all
1869.] On the Enteric Affections, etc. 183
their “specific nature,” whatever this may be, except the
rejected “abstract idea,” which, of course, he will not accept,
he shall have all these “textures,” but he shall have them
dead, and now let him produce a single living fibre or cell,
such as the chemistry within elaborates continually, and we
may be constrained to accept this assertion as some thing
more than learned nonsense. Till then, we affirm, that this
“specific nature of organic textures,” of which he felt com-
pelled to avail himself, is a matter he will do well to further
and carefully consider. Indeed he may as well come out
square on the truth, and admit, that of “Specific nature,”
these “teactures,” in the living and the dead, have all in
common, and are in nothing different, except in the matter
of the “abstract idea.” That this “specific nature” is nothing
more, nothing less, than the living dynamismus, without
which a Liebig is as powerless to produce a fibre, or a cell,
as he is to create a planet. Was it not rather ignoble, after
rejecting this great power from his philosophy of life and
disease, to thus resort to it for relief from his difficulty,
under the mask of “specific nature ?” The disguise is too
thin. The features of the truth are not thus to be covered
up.
ON THE ENTERIC AFFECTIONS INCIDENT TO
PERTUSSIS.
A Synopsis of a Lecture delivered in Hahnemann Medical College, Chicago,
Session 1868–9, by R. LUDLAM, M.D., Professor of Obstetrics and the Dis-
eases of Women and Children.
GENTLEMEN: It is generally conceded, that simple idio-
pathic hooping cough is not a dangerous affection. When,
however, it is complicated with certain other diseases, this
rule is reversed. Bronchitis, pneumonia, pulmonary em-
physema, convulsions, meningitis, and hydrocephalus are
included in the usual list of the concomitants of pertussis.
184 . On the Enteric Affections [j'anuary,
I shall not speak of these especial complications and
sequelae of the disease in question, but will direct your
attention to the bowel complaints that are incident to it.
In this I shall be the more explicit, because the various
authorities have either failed to enumerate them in this
connection, or to put the proper emphasis upon their rela-
tive importance.
Hooping-cough is most apt to prevail in the spring and
autumn. This fact includes a clinical item of great signifi-
cance. For, as a rule, it may be stated, and should have
been recognized long since, that cases of this disease occur-
ring in the winter and spring, are more likely to be accom-
panied or followed by one or another of the pectoral
affections just named ; while those commencing in the late
summer and autumn months are more frequently compli-
cated with alimentary disorders. The season, therefore,
exerts a modifying influence upon the character, the pecu-
liarities, and especially upon the prognosis of hooping-
cough.
The bowel affections that most frequently complicate this
disease, are cholera infantum, dysentery, and tabes mesen-
terica. In rare cases enteritis may also be met with, but it
is of the former of these that I intend to speak more
particularly.
I. OF CHOLERA INFANTUM WITH IIoop1Ng Cough.
Convalescence from “summer complaint,” is often pro-
tracted, and the little patient is liable to frequent relapses.
Indeed it is doubtful if in any given case, the digestive dis-
order is quite repaired before winter has set in. The
intestinal mucous membrane and glandular apparatus are
so diseased, in consequence of the first attack of cholera
infantum, -occurring, perhaps, as early as June or July,
that diarrhoea, dysentery, or marasmus are apt to supervene.
Under these circumstances, more especially in the case of
children who are being brought up artificially, the system
becomes enfeebled, and the blood impoverished. Assimila-
tion is embarassed, and the little organism falls an easy
1869.] Incident to Pertussis. . . . 185
prey to repeated attacks of the original disorder, or of some
kindred and equally serious affection. * * * *
But not only does the species of cachexia, induced by
one or more attacks of cholera infantum, predispose to
relapses and to similar derangements of the bowels. It
renders the child more than usually liable to incidental, and
particularly to epidemic disorders. If the hooping cough
is prevalent, and the little fellow has never had it, his sus-
ceptibility may be increased thereby. He will, perhaps,
contract it, and both diseases may run their course together.
For it is a singular fact that, while other intercurrent dis-
orders, as for example, pneumonia, remittent fever, etc.,
either modify or supersede the hooping cough, or vice versa,
the law or rule of supersession does not apply to the enteric
affections which are incident to this disease. The hooping
cough, and one or another of the alimentary diseases we
have named, may, and do, frequently exist in the same
patient, at the same time.
In the case we have supposed, you will observe that the
hooping cough is the secondary affection, as much so as the
pneumonia that succeeds an attack of measles. It is en-
grafted upon a form of endemic cholera, and is, therefore,
a more alarming and dangerous disease than when it is
simple and uncomplicated. The symptoms are confused
and commingled. Sometimes the cough and the diarrhoea
seem to alternate. Again their course is very irregular.
But the digestive disorder does not give place to the per-
tussis proper. They run their course simultaneously, and
the danger from either is increased by their co-existence.
Not unfrequently, however, the order of their coming is
reversed, and the cholera infantum becomes secondary to
the hooping cough. The latter may continue for weeks,
gradually impairing the strength of the little sufferer. The
gastro-intestinal mucous membrane becomes implicated.
There is swallowing and subsequent vomiting of an indi-
gestible mucus. Or this ropy fluid may occasion a serious
and persistent diarrhoea. The stomach loses its tone. The
food is rejected. The appetite becomes fickle and capri-
I86 On the Enteric Affections [j'anuary,
cious, or is entirely lost. A tempting and unwholesome
aliment may have been thrust upon the nutritive system.
This is the exciting cause of serious alimentary derange-
ment. The hot season, the vilé atmosphere of towns and
cities, the lack of proper ventilation and of clothing, con-
spire to induce an attack of “summer complaint,” in addi-
tion to the disease which is already existing. And thus it
is that cholera infantum may be secondary upon, and com-
plicate the hooping cough. The danger is proportioned,
not alone to the relative or the individual severity of these
concurrent affections, but more especially to the weakened
and impaired condition of the system present when the last
of these began its course. * * * * You will readily
perceive that, whatever the order of their advent, this is a
grave complication. And there are numerous reasons why
this is so. In the first place, it is more than possible that
both these diseases originate in the brain. The hooping
cough implicates the respiratory ganglion of the medulla
oblongata, and spends its force upon the pneumogastric
nerve in its distribution. A similar train of nervous de-
rangements is incident to cholera infantum. Both affec-
tions are most liable to occur during dentition, when for
obvious reasons the cerebral functions are extremely prone
to derangement. So far as the brain is concerned, they
doubtless run a latent course in many and, perhaps, most
cases. But the intimate, and especially the closing, history
of a given example, if it proves fatal, demonstrates the
existence of lesions within the cranium.
Cerebral complications are, therefore, likely to develop
themselves at any moment during the course of either of
these affections, when they exist singly. Perhaps as large
a proportion as one-half the cases of hooping cough are
attended by convulsions, which may be slight and infre-
quent, or severe and repeated. The closing stage of a fatal
attack of cholera infantum is attended by similar symptoms.
Under these circumstances, it is not uncommon to hear
physicians speak of a sudden metastasis of the disease from
the bowels to the brain, when in fact the problem of disso-
1869.] Incident to Pertussis. & 187
lution is being solved at its original starting point. The
danger of coincident brain affections in both these diseases
is greatly increased, by the depraved and impoverished
condition of the blood that is attendant or consequent upon
them. t
Add to this, that a possible suppression of the urine, and
consequent uraemia, are incident to every case of cholera
infantum, and of pertussis, whether they be idiopathic,
secondary, or associated. By reason of its imperfect or-
ganization at so early a period of life, the brain is particu-
larly vulnerable to the poisonous effects of the urinary
elements that may be retained in the blood.
When, therefore, these diseases invade the same delicate
organism, and exist conjointly, our prognosis should be
guarded. For fatal contingencies cluster thickly about such
a case. Indeed recovery is the exception, and not the rule.
II. OF DYSENTERY WITH HOOPING Cough.
{
What we have said of the complication of cholera infan-
tum with hooping cough, applies also to dysentery as a
concomitant affection. In most instances, however, the
cough precedes this derangement of the bowels, after which
they may exist conjointly. I have never met with a case in
which pertussis was engrafted upon genuine dysentery,
but always the opposite. * * * *
Hooping cough, as recognized by Trousseau, is a com-
pound affection, with nervous and catarrhal or mucous
symptoms. The same is true of infantile dysentery. Hence
the very existence of the former sometimes constitutes a
predisposing cause of the latter. This is especially true in
scrofulous subjects. When the hooping cough prevails in
the autumn, the season also favors the development of
dysentery among infants and children. For these epi-
demics, like those of Scarlatina and diphtheria, for example,
may invade the same district, or neighborhood, and even
attack the same patient. * * * *
It is not difficult to explain the physiological similarity
I88 On the Enteric Affections. [3anuary,
and relation existing between the spasmodic cough and
vomiting of pertussis, and the more prominent symptoms
of dysentery. Dr. IIolcombe says most expressly,” that
“Tenesmus is simply the vomiting or the coughing of the
rectum.” Now, when the child that is ill with hooping
cough is seized with dysentery, the alimentary spasm and
excess, or derangement, of secretion do not supplant the
disorder of the respiratory tract, but they are superadded
thereto. We have thenceforth to deal with a double-headed
monster. The paroxysmal cough, which reaches its climax
in the whoop, and closes with expectoration, retching or
emesis, has its counterpart in the tormina, the tenesmus
and the dysenteric evacuation. Not unfrequently the
coughing fit brings on an irresistible desire to stool, and
the one follows the other in regular order. Or the worry
and suffering of the patient, on account of the bowel diffi-
culty, especially if denied the vessel, may provoke the
cough. Usually, however, the stools are the more frequent
and painful. And, since infants and children can not
always be taught to resist the inclination and to refrain
from having a passage, any more than one can teach them
how to expectorate, the number of the dejections may be
very great. This is especially true of those little patients
who, by reason of temperament, or of previous and coinci-
dent disease, are extremely nervous. Serious cerebral
complications in cases of this kind are often accompanied
by an almost constant, I might say characteristic, tenesmus
of the rectum. * * * * The only especial modification
of the cough that I have remarked in patients ill with both
dysentery and pertussis, is that it becomes less frequent at
night than during the day, which is the reverse of the rule
in uncomplicated cases of hooping cough. On the contrary,
the stools are, as is usual in dysentery, more frequent at
night. If these two sets of symptoms occur in alternation
for many successive days and nights, they wear out the
little sufferer very rapidly. The want of sleep induced
* U. S. Medical and Surgical Journal, Vol. I., p. 2.
1869.] Incident to Pertussis. 189
reacts fearfully upon the nervous system, and precipitates
the cerebral complication. The most delicate issues and
indications are presented. In order to live, the child must
sleep. To compel rest with opiates is to make certain the
impending calamity. Under these circumstances, and with-
out there being present any symptoms of immediate danger,
I have known a little child to die in a comatose state a few
hours after taking an injection of starch and laudanum.
Perhaps in the whole range of our experience there is no
more pressing and painful need of rest than in a case of
this kind. And the indication must be filled most cau-
tiously, or the little sufferer will be sacrificed to our igno-
Tall Ce.
Renal and uraemic complications are less frequent than in
cases of cholera infantum with hooping cough. The urine
is discharged in small quantities with almost every stool,
and care must be taken, therefore, lest you be led into the
belief that, because it is not passed separately and freely, it
is, therefore, scanty or entirely suppressed. For, as in
simple dysentery, the tenesmus of the rectum is apt to be
accompanied by that of the bladder also, a state of things
which results in the frequent evacuation of this organ. The
odor and fluidity, as well as the color of the discharges, and,
when passed into the vessel, their unmixed character, will
enable you to determine if the urine is present in proper
amount and quality. * * * *
In simple dysentery obstinate vomiting is one of the most
untoward symptoms. The experienced physician will some-
times give an unfavorable prognosis from this sign alone.
At the beginning of the attack it may portend as serious an
illness as when it occurs in the early stage of scarlatina. It
signifies a profound implication of the nervous centres, a
deep-seated lesion of organic life. Even before the symp-
toms proper to the disease have disclosed themselves, it
threatens the most dangerous consequences.
When dysentery supervenes on the hooping cough it begins
its course under similar unfavorable conditions. The child
may have been vomiting at short intervals for days or
I90 On the Ænteric Affections [j'anuary,
weeks, and the stomach become exceedingly irritable. Its
function is impaired or suspended, and all its sympathies
are out of joint. The lesion of the pneumogastric, with its
spasmodic cough, and the abnormal secretion of mucus
which characterizes it, perpetuate the gastric disturbance.
It may be quite impossible to arrest it. And hence the
discouraging circumstances under which the secondary
disease makes its appearance.
Sometimes the vomiting, which persisted until the dysen-
tery commenced, is suddenly arrested, and the whole force
of the perverted peristaltic action is spent upon the lower
bowel. Such cases are exceedingly troublesome and dan-
gerous. It is not, therefore, a favorable sign when the
vomiting ceases, especially if it stops abruptly, or is suc-
ceeded by increased and inveterate tenesmus.
The excess of mucus secreted in hooping cough is quite
remarkable. When this disease is complicated with dysen-
tery, the catarrhal flow is not limited to the respiratory
mucous membrane, but is also poured out by that which
lines the alimentary tract. The greater extent of surface
implicated, and the extravagant quantity of fluid sometimes
secreted, renders it a source of debility and of positive dan-
ger. For this direct drain is added to the weakening and
depressing effects which result from the functional derange-
ment of the nervous system, common to both these disor-
ders. In exceptional cases this continued loss of albuminous
matter runs the little patient into marasmus, and the dis-
ease is still further complicated. * * * *
You may not be aware of the clinical fact that persons
who are predisposed to phthisis pulmonalis, and to pectoral
affections generally, are exempt from dysentery. While
consumptive patients are extremely liable to diarrhoea, they
seldom have dysentery. By this rule it is rare for a case
of hooping cough, which is complicated with the latter
affection, to develop, as in other cases, the tendency to
tuberculosis. Such a case may indeed terminate in tabes
mesenterica, or in tubercular meningitis, but it is likely to
1869.] Incident to Pertuss?s. 191
run its course too rapidly to degenerate into a chronic
affection of any kind.
I have already more than hinted at the unfavorable prog-
nosis that we are forced to render in cases of hooping cough
complicated with dysentery. After a somewhat enlarged
and extended experience in cases of this kind, I am free to
say that I have never succeeded in curing one of them. In
this remark I, of course, refer to the genuine, bona fide,
epidemic dysentery, and not to a spurious form of the com-
plaint, which is not necessarily a serious affection. All the
cases that I have witnessed, of the complication of which I
have been speaking, have terminated fatally during the first
or the second week of the dysentery. In the majority of
them the pertussis had existed for three weeks or more
before the dysentery commenced. Only one died from
pulmonary complication and engorgement, the remainder
from cerebral congestion and effusion. While, therefore,
either of these diseases is amenable to proper treatment
when it exists singly, they become very dangerous, and are
seldom cured, when they exist together in the same patient.
III. OF MARASMUS WITH Hoop1NG Cough.
In the case of children who inherit a tuberculous diathe-
sis, the occurrence of a severe and prolonged attack of
pertussis is apt to develop phthisis in one or more of its
several varieties. The form of the disease known as maras-
mus, or more properly tabes mesenterica, is almost always
secondary upon some alimentary disorder, and hence it is
classed among the bowel affections incident to infancy and
childhood.
It is only when the hooping cough has existed for a con-
siderable time in the person of the little patient, and his
strength is exhausted by this and allied affections, that he
is seen to be wasting away with the general atrophy of the
tissues, emaciation and hectic that characterize marasmus.
The tubercular degeneration of the mesenteric glands,
I92 On the Enteric Affections [3anuary,
which is the specific lesion of this disease, is a sequel of the
cough and the alimentary disorder. The little patient may
have had the cough, and a persistent diarrhoea, or, perhaps,
the cholera infantum, for weeks together, until the nutritive
functions are become seriously and organically implicated.
The liability to this result is increased if the child is teeth-
ing, or if it has been weaned at an early age, and is being
reared artificially. In rare cases, as already said, it may
succeed an attack of dysentery conjoined with pertussis.
Sometimes, as in phthisis pulmonalis proper, it exists con-
jointly with tuberculous deposit in the lungs, both affections
being the sequelae of the hooping cough. * * * *
Whenever it occurs, either as a complication or sequel
of pertussis, this is a formidable and dangerous affection.
The chances of recovery are lessened by the lingering and
exhausting nature of the previous disease or diseases. The
strength has been sapped, and the vitality of the little
organism runs low. There is little to build upon, even if
the lesion of the mesenteric glands were not tubercular.
When the proper physiological function of these glands is
perverted or suspended, it becomes impossible to fortify the
strength with a proper nutriment. Assimilation can not
proceed, the growth and repair of the tissues is overbalanced
by their decay and waste. The atrophy is general and pro-
gressive, and it becomes a mere question of time and of
power of endurance with the little patient. The great
majority of such cases prove fatal sooner or later. -
>k >k >k >k >k >k
Before closing this lecture I wish to direct your attention
to two points of practical interest germane to my subject.
The first of these concerns the possibility of two separate
diseases occurring conjointly in the same person.
One of the lessons of actual experience, which you will
learn when you have enteréd into the practice of your pro-
fession, is that, as you find them at the bedside, diseases are
less distinct and more complicated than you had been taught
to believe, or to suppose. You will discover that certain
affections, whose nosological outline is as distinctly indi-
*
1869.] Ancident to Perfuss?s. I93
cated by our teachers and writers, as the boundaries of the
several States are laid down upon the map, have really a
species of affinity for each other, and are frequently con-
founded. Thus, for example, we may have scarlatina and
diphtheria; croup and diphtheria; typhoid and typhus
fevers; typhoid fever with bronchitis, pneumonia, or dys-
entery, and sometimes with meningitis; rheumatism and
neuralgia, or syphilis; cerebral and enteric affections; and
hooping cough complicated with cholera infantum, dysen-
tery, marasmus, and various other diseases. The nosological
lines that separate these, and many other affections, are
written in a species of sympathetic ink. The distinctions are
arbitrary, and by no means infallible.
The doctrine of supersession, which holds that one dis-
ease must succeed and supplant another that is already
existing, before it can invade the organism, is, therefore,
fallacious. The rule undoubtedly holds in a majority of
cases, but there are many exceptions thereto. And this not
alone in the diseases we encounter, and are expected to
cure, but in the effects of remedies also. If this were not
true, there would be no such thing as a mercurial cachexia
superadded to syphilis, rheumatism, or any other disease,
or a quinine cachexia complicated with intermittent fever,
etc., etc. * * * * §
The second point relates to the relative danger of simple
and complicated diseases. Most idiopathic affections are easily
managed. But, when two or more diseases are engrafted
upon the same stock, and are more or less confounded, the
greatest skill is sometimes necessary to solve the patholo-
gical problem, and to cure the patient. If we could succeed
in keeping them distinct, the practice of the medical art
would be very simple and efficacious. But the difficulties
in the way of appropriate treatment, and the dangers
opposed to recovery are proportioned to the complicated
nature of the attack, and not unfrequently to the existence
in the same person of two or more diseases.
It is for this reason that I have thought best to speak of
the enteric affections that are incident to pertussis. Your
Vol. IV.—No. 14 5
y
I94 Dr. Wright's Resolution. [jamuary,
knowledge of that disease is by no means complete until
you have familiarized yourselves with its possible compli-
cations and contingencies. The domestic prescriber may
succeed in curing it in the simple form, or it will cure
itself by limitation, but the best professional skill and talent
may be requisite, and even fail to master some of its con-
comitants and sequelae.
DR. WRIGHT’S RESOLUTION.
By P. P. WELLs, M.D.
AT the monthly meeting of the Homoeopathic Medical
Society, for the County of Kings, in the State of New York,
for March, 1868, a resolution was offered by Dr. William
Wright, a member of the Society, as follows:
“Pesolved, That while the doctrine of ‘Similia Similibus Curantur’ is
true, that of ‘curing natural diseases by creating similar artificial ones’ is
mot true, and ought, therefore, not to be received by the profession.”
The resolution was laid on the table for one month, at
the instance of the mover, and called up at the next meet-
ing, when he gave his views at some length on the negation
essential in the resolution. The following paper was read
in reply to Dr. W. :
This resolution affirms the truth of the doctrine of simi-
lars, while it denies that natural diseases are cured by
similar artificial ones. Here, then, if the negation be sus-
tained by carefully observed facts, the principle affirmed
fails in an extensive class of examples, where similars do
not cure. So that the affirmation requires modification to
this extent. It ought to say, “the doctrine ‘Similia Simili-
bus Curantur’ is true,” some TIMEs. This is what it says,
virtually, when it excludes from its healing applications all
artificially produced diseases. The doctrine affirmed in the
resolution, we admit. He is quite likely to be brought to
1869.] Dr. Wright’s Resolution. I95
shame who denies its truth, if he lives long. It is not cer-
tain that attempts to fix partial limits to its practical appli-
cation will be followed by a different result. Certainly not,
unless God has so limited it, in that which He has ordained.
What He has established, there is likely to be poor success
in attempts to either limit or remove. How is it in this
case ?
We admit the truth of the doctrine of cure by similars,
not because it is affirmed by authority, but because ten
thousand times repeated observations of facts in nature
have proved its truth. These have proved that the principle
is planted deep down in the nature of men and things, with
the other fundamental principles created and established
when He, in the beginning, made the world, and man to
dwell in it. Equal observation has proved that this princi-
ple, or law, is no more a subject of caprice or accident than
other natural laws, which, like this, are universal in their
application. This is a necessary result of its origin in the
divine ordination. This we all admit, and are only inter-
ested at present to know, whether the class of agencies,
excluded from its domain by the negation of the resolution,
is excepted in the Divine arrangement, and whether this
so reduces that to which we have been accustomed to
ascribe the dignity of a universal law, to the low estate of a
principle, only partial in its application, if, indeed, it can
have any possible practical application at all. Let us see
how this is.
The whole question can be examined only after we have
assigned to the terms, natural “diseases” and artificial dis-
cases, their true signification. We have then first to settle
what is a disease 2 second, what are matural diseases 2 third,
what are artificial diseases? and then see, if we can, whether
the negation of the resolution be true or false.
What is disease ? We answer, a disturbance of that
balanced action of the vital forces in the living organism,
which, in its integrity, preserves the integrity of all parts
of the body. Whatever of such disturbance is prejudicial to
any of these, is a disease. By natural disease, then, we may
196 Dr. Wright's Resolution. [3anuary, ,
understand any such disturbance, when it is the result of
the operation of any of the forces of nature on the organism,
without the intervention of human intent or agency. The
different forms of malaria are familiar examples of the
causes of such diseases. Intermittent and scarlet fevers,
measles and small-pox, are equally familiar examples of the
diseases themselves.
Artificial diseases are the same disturbed balance of the
vital forces, when this is the result of the application of
whatever cause, itself being a product of nature or art, when
applied by human agency and intent. The vaccine virus,
and the result of its application by art, afford an example
of cause and effect of this class. The effects of the action
of drugs on the organism are also familiar examples of this
class of diseases. Those effects of mercury, as they have
often been observed, in its developed action on the bones,
glands, mucous membranes, and skin, are but too familiar
to us, and make farther examples for the illustration of the
argument needless.
In our present examination of the negation of the reso-
lution, we shall deal chiefly with artificial diseases, as they
are produced by drugs. And the first step is to answer the
question — What is a drug 2 The reply is, any form of
matter which has the power of producing that impression
on the vital forces of the organism, which shall so disturb
the balance of their action as to modify the sensations and
functions of organs, changing them from that which is con-
servative of life and parts, to that which, in its nature, is
destructive. That is, a drug is that form of matter which
has the power to produce disease, as above defined. This,
in its relation to the living organism, is its one sole power
with which, in the present discussion, we have any thing to
do. It impresses the vital forces when in that state we call
health, and their actions are changed to that other state we
call disease. Of the action of drugs, as such, on the organ-
ism, we know no other result. It is this power to produce
diseases which constitutes any form of matter or a drug.
Whenever taken into the organism in quantity sufficient to
1869.] Dr. Wright's Resolution. I97
affect its sensations, or other vital processes, this is the kind
of result which follows. The extent of the disease, its
nature, and destructive force, are determined by the nature
of the drug, the susceptibility of the recipient to its action,
and the manner of its administration. If a drug be taken
into the system, i. e., a substance which, in other cases, has
been found to produce such change, and in this it produces
none, then no result follows — as to this case, it has the
character of a neutral. But if any result follows, this is the
kind. This change is the result of its impress. We can,
by possibility, have cognizance of no other. If these sub-
stances produce such disturbances, they are perceptible to
the subject of them, or to the administrator of the drug, or
to both. If this be true, then where drugs are received,
and this is followed by sensible action, artificial disease is the
result.
Now, to apply this to the negation of the resolution. If
we are right in our definitions, and statements of facts,
which seems to us to be self-evident, the resolution denies
that diseases are ever cured by drugs at all. It is not sup-
posed that the author of the resolution intended to make
this declaration. But to escape logically from this conclu-
sion, it will be incumbent on him to show that drugs act in
disease by virtue of a different nature, and by a different
power, and through a different channel, than they do in,
health. That is through some other channel than the vital.
forces of the organism. Is there any new kind of power
given to the drug when it is employed in the treatment of
disease, different from that which moved the vital forces
when the drug was proved, by which it produced the arti-
ficial disease, the symptoms of which are the record of its
pathogenesis? If not, then its action here must be the
same as there. If there be a new and different power, then,
as to the treatment of the sick, the records of our Materia
Medica are wholly without value. Their authoritative
claim on our confidence, while selecting curatives for the
sick, has always been founded on the thousand times
observed fact, that the action of drugs on the organism, in
198 Pr. Wright's Resolution. [j'anuary,
disease and health, is the same. Their employment in the
treatment of disease, according to the law of similars, has
been governed always by this fact, the truth of which has
been demonstrated by every added practical success which
has followed the use of drugs, selected and used in accord-
ance with the law of similars. If the action be not the
same, then the affirmation of the resolution is a mere use
of words without meaning. You may say, “like cures like,”
and repeat it till you are weary, but what is the use of this,
if you are at the same time to tell me that the record of the
Materia Medica is no standard of which we can avail our-
selves to discover the like which cures 2 This it can never
be, if the action of drugs on the organism in health, from
which its records have been derived, is at all different from
that of the same drug given in disease. So that the nega-
tion of the resolution, if accepted, practically nullifies its
affirmation of the truth with which it starts. Thus it
appears that to deny that “natural diseases are cured by
similar artificial ones,” is to deny the truth of the founda-
tions on which the whole of homoeopathy rests. Establish
the truth of the denial, and the whole of homoeopathy is
effectually wiped out. It never has cured, and it has never
pretended to cure, natural diseases, in any other way, than
by exciting similar artificial ones, as has been defined
above.
It has not been forgotten that it has been often denied
that drugs do act the same in disease and health. The
denial has come from physicians of the old school, i.e., from
those who had little or no knowledge of the specific action
of drugs in either state, and, therefore, has been of no
importance.
These objectors have been driven to the assumption of
another and different power in the drug, from that which,
makes sick, which they put forth as the power which cures.
They have sometimes come so near the truth as to permit
this assumed new power to be a correlative of the power
which makes sick, while they deny the identity of the two.
There are two objections to this view of the matter, either
1869.] Dr. Wright’s Resolution. I99
of which is no less than fatal to it. The first is, that the ex-
istence of the second, or correlative, force is sustained by
no evidence, other than the fact of cure. The case stands
thus. Drugs do cure diseases sometimes. This cannot be
successfully denied. But they do not cure by the efficient
agency of that force which makes sick. Therefore there
must be some other force by which they do it. This has
Quite the air of a logical syllogism. It lacks the force of
one, only because that which stands for its minor premise
and conclusion are simple assertions, and not proved facts.
They are only assertions, which stand on no shadow of a
demonstrated foundation — and the whole is but a pitiful
example of that weakest of all resorts in argument, called
“begging the question.”
The second objection to this assumption of a new and
different force, as the efficient agent in cures, is the fact
often visible, and hundreds of times recorded by those who
have observed it, that the force of the drug which makes
sick is present and active in the cure, in the phenomenon
in the sick-room, called, familiarly, “aggravation,” meaning
a new imparted intensity to the symptoms of the natural
disease, by the force in the drug which produces a similar
artificial one. That is, the force of the artificial has been
added to that which was natural. This has been seen so
often that it can hardly be necessary to follow the matter
farther, but only to say, that it presents us with no less
than a demonstration of the fact of the presence and activity
of the identical disease-producing force in the operation of
the cure.
That there is a difference in the action of drugs in disease
and health is certainly true. It is equally certain that the
difference is one of degree, or quantity, and not one of kind,
or quality. And, that experience has taught us, that this
difference is determined by the greater susceptibility of the
organism, in disease, to the action of those drugs, the
effects of which on the organism, in health, are similar to
the symptoms of the disease present, in the person of the
recipient, when the drug is taken. This difference is the
2OO The Delivery of the [j'anuary,
result of a different state of the organism in the two condi-
tions, and in no case of the presence of a new force in the
drug, added by virtue of the presence of the morbid state
of the organism receiving it. This quantitative difference
is the only one of which we have any knowledge, and the
only one the existence of which is sustained by any better
evidence than sheer assumption. The conclusion of the
whole argument then is, that each cure, the result of the
action of drugs, which is similar to the symptoms of the
disease cured, is a complete refutation of the negation
declared in the resolution of Dr. Wright.
THE DELIVERY OF THE PLACENTA IN ABOR-
TION.
By DR. GUí NIOT, Surgeon to the Hospitals. Translated from the Bulletén,
Général de Thérapeutique Médicale et Chirurgicale, by R. LUDLAM, M.D.
[CONCLUDED FROM PAGE 89.]
THE bag of india-rubber introduced as far as the internal
os, and distended with tepid water, after the delay of a few
hours, almost invariably causes uterine contractions. The
continuous irritation of the internal os, which is produced
by its presence, is the real cause of its efficiency, for the
internal orifice of the uterine cervix is the susceptible part
of the womb, as the region of the sphincter ani is for the
large intestine. Hence the sponge-tent, when well applied,
is also useful; but it does not equal the former in respect
either of its power, or the mildness of its action. The
dilated bag constitutes in fact a species of artificial bag of
waters, which art substitutes for the natural sack that has
been prematurely ruptured. Its action, therefore, resembles
nature. In this manner it not only excites the uterine con-
tractions, but it also assists mechanically to open the cervix.
More than this, by obstructing the orifice, it may, within a
certain limit, act as a tampon, and moderate the haemorrhage
1869.] Placenta in Abortion. 2O I
incident to the detachment of the placenta. I should
remark, however, that this latter result is equally apt to
follow from the presence of the foetus itself, when it has
been forced into the cervix by the contractions of the womb.
Here, as we all know, the haemorrhage may be dangerous,
if not from its excess, perhaps from its duration.
This is, therefore, one of the objections to the india-rubber
dilator in case of abortion. I will add, that being a peculiar
instrument, which requires a certain degree of practice in
its use, and being found only in the larger cities, it really
is an excellent resource only for the special accoucheur, and
not for the general practitioner. Now, when physicians,
far from populous centres, and who are deprived of our
resources, are called to cases of abortion, undoubtedly such
inconveniences are not fatal to their usefulness, although
their resources are crippled. They must neglect theory for
the realities of practice, and act upon the general principles
which we have formulated.
En résumé, the uterine dilator, carefully employed, con-
stitutes an excellent means of exciting labor in abortive
delivery. For efficiency and harmlessness, none of the
means we have mentioned compares with this. Neverthe-
less, its inconveniences, although not very marked, do not
permit us to accord to it our unqualified preference.
To close what I have to say upon this method of inter-
ference, I will report the following case, which was sent me
by M. Chassagny:
Case 3. Madame X. had reached the third month of her
second pregnancy. In consequence of an effort to prevent
a fall, she was seized with pains in the loins and haemorrhage.
The pains followed and soon took on the character of those
of parturition. Abortion seemed inevitable ; the sae de-
scended partially into the uterine cervix, which was slightly
dilated. The patient thought she experienced the escape
of the waters, and the sac was probably ruptured. The
neck, however, was closed, and we hoped the labor would
be arrested. But, soon the flow of a foetid liquid did not
leave any doubt of the death of the embryo.
I did not hesitate to interfere, and to meet one of the
indications for which I had brought my appliances. The
2O2 Zhe Delivery of the [3anuary,
introduction of the dilator was easily performed. I injected
the bag in such a manner as to increase its size to that of a
Chinese orange. In ten minutes the pains began again.
These increased in frequency and intensity, and five hours
later the foetal sac was engaged in the cervix, which was
largely dilated. A slight traction freed the uterine orifice.
The finger could then penetrate into the uterus with great
facility, whence I extracted, without pain, a placenta whose
attachments had doubtless been severed during the artificial
labor. It presented marked signs of commencing decom-
position. There was no trace of the embryo, which might
indeed have been expelled when the waters escaped. The
patient recovered promptly.
In lieu of the uterine dilator, I have already remarked,
that we may sometimes employ the prepared sponge
(sponge-tent?) and the vaginal tampon. The sponge,
passed as far as the internal os, and well fixed in the
uterine neck, possesses nearly all the advantages of the
before-named dilator. It has them, however, in a slighter
degree, and in its action does not so nearly resemble the
natural dilatation of these parts. Besides, it is difficult to
keep it in position, and sometimes very difficult of intro-
duction. Undoubtedly it acts as an excitant of uterine
contraction, and directly promotes dilatation; but in the
majority of cases it becomes necessary to employ the com-
pact vaginal tampon along with it, an expedient which
offers an obstacle to all exploration of the uterine cervix.
The tampon, however, offers the inestimable advantage
of protecting the woman against profuse flowing, a result
which is not so well secured by any other means. More-
over, its irritant effect upon the womb, although limited to
the os tincae, which is the least excitable portion of the
cervix, may suffice in some cases to bring on expulsive con-
tractions. These two good results are not counterbalanced
by two oljections, which consist in intra-pelvic torture,
produced by it, and a more rapid decomposition of the
utero-vaginal secretions. Therefore I am not surprised to
observe that Dr. Suckling, in a recent article in the Medical
Times and Gazette, has proposed the vaginal tampon with
the sponge, as a good means of overcoming the retention
1869.] Placenta in Abortion. 2O3
of the placenta after abortion.” But the tampon alone will
often prove powerless. It is especially as auxiliary to other
expedients, and as a certain protection against metrorrhagia,
that it deserves to rank among the most useful means of
artificial delivery.
After specifying the well-known effects of ergot, Dr. G.
objects to its employment, for the reason that it sometimes
causes a tetanic closure of the cervix, and a complete reten-
tion of the placenta. This spasmodic rigidity may even be
so obstinate as to require that other means be employed to
overcome it, and thus prevent putrid infection, from the
resorption of post-organic matters within the womb. He
is of opinion, that, in the first half of pregnancy, this unfor-
tunate effect of the ergot is less apt to follow than in the
latter portion thereof. He recommends to employ the
tampon in conjunction with the ergot, and, coucerning this
and the means already discussed, reaches the following
conclusion, that despite its manifest power, and because of
the danger which may arise from its employment, the ergot
should take the third rank, and should always be used in
conjunction with the tampon. In short, the attempts to
detach the placenta directly by means of the finger, or
intra-uterine injections, should be considered only as a last
resort, after the employment of which it would be proper
to delay further effort on our part.
IIitherto I have considered the placenta as being retained
in its totality within the womb. Now, it may happen that
only a part of it will remain adherent. In this case, as in
complete retention, we are sometimes obliged to proceed
in such a manner as to prevent two possible accidents —
putrid infection and metrorrhagia. The smaller the frag-
ment which is adherent, the less the danger from the former
of these contingencies. In order to produce serious and
dangerous consequences of this sort, at least one-fourth or
one-third of the placenta must be retained. In respect of
the haemorrhage it is very different, for a fragment thereof,
however small it may be, may occasion profuse flooding.
* Gazette Médicale de Paris, 1867, p. 588,
2O4. The Delivery of the [9anuary,
This is an important item, and one which should never be
forgotten. The following is a curious and very decided
illustration of this fact.
Case 4. Abortion at the fifth month. Incomplete delivery.
Absence of all uterine mishaps during the first seven days. Sud-
den and frightful ha'morrhage on the eighth day. Ectraction of
the placental fragments left in the womb. Cured.—About two
years ago my friend, Dr. A. Fournier, desired me to visit
a seamstress who, nine days previously, had aborted at the
end of the fourth month. She had been treated by a mid-
wife, and Dr. F. had not been called in until six days after,
in order to relieve her of a gastric difficulty. The abortion
was then supposed to have been completely over. There
was no doubt of it, as the sequelae appeared quite natural.
However, on the eighth day Dr. F. was called in great
haste, not to prescribe for the digestive derangement, but
for a frightful haemorrhage, which had commenced without
any premonition. An injection of the perchloride of iron
and the vaginal tanpon stopped the flow, but the loss had
been such that the woman was already exsanguine and
moribund. Accordingly the following day, before entering
the house, we inquired if she was not dead, and after having
learned of her almost desperate condition, we discussed the
propriety of transfusion.
The suddenness of so abundant a flow, happening without
evident cause, but after an abortion eight days previously,
left no doubt of the retention of a part, or the whole, of the
placenta in the womb. In spite of the detailed information
gathered by Dr. F., concerning the escape during the abortion
of a bloody and fleshy mass, to which a small cord was attached,
I was still convinced that the haemorrhage had been caused
by the separation of a portion of the placenta. And, in fact,
having removed the tampon (which was a long and labori-
ous operation, for the reason that the perchloride had tanned
the vagina, and hardened the clots and the charpie), we re-
cognized, at the uterine orifice, some fragments of the pla-
Centa.
The neck had remained slightly dilated, and permitted
the introduction of the finger. The patient not having a
drop of blood to lose, we thought best to attempt the ex-
traction of the foreign body, in order to prevent all future
loss. With the finger I succeeded in removing the greater
part of these fragments, which consisted of small and un-
doubted portions of the after-birth. I prudently reapplied
the tampon, but without using the perchloride.
1869.] Alacemia in Abortion. 2O5
The following day, contrary to our fears, or rather to our
prophecy, we found the patient still alive. She had not
sustained any further loss, and the few spoonfuls of wine
and broth that we had ordered had been well borne. After
the extraction of a few more fragments of the placenta, the
tampon was replaced.
Finally, the cautious and progressive employment of
tonics sufficed to restore the patient’s strength, and two
months later she had completely recovered.
Metrorrhagia may, therefore, be feared whilst any part
of the placenta is retained in the womb. But as it can
always be controlled by the vaginal tampon, it is not neces-
sary to anticipate it by any active treatment. We should,
according to the case, limit ourselves to a careful watching
thereof, and, if necessary, apply the tampon.
From the foregoing considerations, we infer that when
there is a partial retention of the placenta, without accom-
panying accidents, two sets of symptoms are possible. In
the first, the adherent portion appears too small to provoke
any serious tokens of putridity; and the patient is but
slightly liable to hamorrhage. If both these mishaps occur
they can be promptly relieved by appropriate treatment.
When such a case is encountered, it is found to bear a strong
resemblance to complete retention in miscarriage of the
first two months, and really requires the same treatment.
In the second variety, on the contrary, the placental frag-
ment that is retained in the womb is large enough to pro-
duce, by its putrefaction, a fatal poisoning. IIere is grave
danger, and the case being very similar to one of complete
retention, needs the same management.
c. In abortions at the fifth and sixth months, the accidents
caused by the retention of the placenta are as much to be
feared as those incident to retention at the full term. At
this state of pregnancy, in fact, the general development of
the uterus, and also of its blood-vessels, and the volume of
the placenta are such as to occasion haemorrhages, or a
purulent infection, which are rapidly fatal. When a proper
time has expired (twelve hours for an abortion at the fifth,
and six hours for one at the sixth month), and when careful
2O6 7%e Delivery of the [%anuary,
traction on the cord has been tried without good result, it
will be necessary to institute a more active treatment, and
to practice artificial delivery.
The uterine cavity being large enough to admit the
introduction of several fingers, or of the whole hand, we
should employ this instrument in preference to others,
which are more blind and less useful. We proceed in its
employment as in making the uterine touch. Under these
circumstances the vagina is sufficiently relaxed, and the
uterine cervix sufficiently dilated to render the operation
practicable. If, however, it is otherwise, emollients and
narcotic injections into the vagina may be employed, with
belladonna ointment locally to the neck of the womb, in
order to produce relaxation. But the use of these means
proving powerless, and the extraction of the after-birth
with the hand being impossible, we should not delay to
employ either the uterine dilator, or the conjoined use of
ergot and the tampon, or, finally, injections of tepid water
into the womb, taking the precaution to make the latter as
before directed. * * * *
I have supposed hitherto that the adherence of the
retained placenta is normal, or nearly so. Now, it may
happen, in a very rare case, between the second and the
sixth month of pregnancy, that there will be abnormal adhe-
sions, or a more or less intimate fusion, between the pla-
cental and the uterine textures. It will be recognized that
in such a case the means already advised would be useless.
The hand or the fingers only would sometimes suffice to
effect the separation of the placenta; but as we have seen,
this means is only exceptionally useful in case of abortion.
Such a complication, which happily is very rare, seems, in
the majority of cases, beyond the reach of art. In the em-
ployment of the various means of artificial delivery, we
should never exceed a certain limit of effort. After a pru-
dent trial of these expedients, it is sometimes preferable to
leave the case to Nature. It is better not to fight against
threatening danger, than to precipitate its occurrence and
consequences by a mischievous and useless interference.
2% >k >k >k >k >k
1869.] Placenta im Abortion. 2O7
If the placenta is not decomposed, and can produce no
accident until several hours after its separation, it presses
against the cervix as a tampon, and arrests the haemorrhage.
The uterus being contracted there is only a slight flow, and
if this condition of diminished loss of blood, and absence
of putridity of the lochia, is marked, it is really of short
duration. After a few hours, however, it finally terminates
in the complete expulsion of the placenta, in haemorrhage,
or in putrid infection. In such a case, unless the cervix is
softened and dilatable, and we can operate readily, it is best
to try the virtues of a vigilant expectancy.
2. The abortion is complete; the labor is incomplete, and it is
complicated with accident. Here the contingencies are the
most important. Their nature, the degree of their intensity,
their greater or lesser gravity, constitute the chief indica-
tions. Undoubtedly the difficulties and dangers of active
interference, and the period of pregnancy at which the
abortion has occurred, should also be taken into considera-
tion, but only with reference to the choice of therapeutical
means. As for the time which has elapsed since the expul-
sion of the foetus, and the size of the placental fragment
which is retained, these are matters of secondary import-
3,1] Ce. *
The contingents of this species of abortive labor may be
divided into two classes. The one, which is most common,
consists of metrorrhagia and putrid infection. The other,
which is more rare, usually springs from the first, and
includes syncope, metritis, uterine phlebitis, and purulent
infection, intra-pelvic inflammation, uterine perforation and
peritonitis. But, whatever they may be, whether happen-
ing early or late, and if simple or compound, they almost
always follow the more or less complete separation of the
placenta. Moreover, the majority of them admit of degrees,
and may appear mild or dangerous. These general divi-
sions should be carefully studied.
A. Slight complications. From the moment in which there
exist any dangers, however slight, we should promptly
ascertain by the touch the physical condition of the uterine
208 The Delivery of the [3anuary,
cervix, and the particular condition and situation of the
placenta. One of three cases may be recognized:
(a.) Sometimes the state of softening and dilatation of the
neck of the uterus, and the degree of advancement of the
placenta is such that the latter, for some cause, may be
extracted easily. We should then proceed immediately to
its removal, either with the fingers, – instruments which
are far preferable to all others, – with the abortion forceps,
or any blunt hook. At the fifth, but especially at the sixth
month, we may make traction upon the cord, which is
already sufficiently strong.
(b.) Sometimes the chief mass of the placenta, partially
engaged in the uterine cervix, and even in the vagina, is
retained by the constricted internal os (this is the form of
the champagne cork). In these apparently favorable con-
ditions, we are often tempted to try traction upon the
accessible portion of the placenta, but all such attempts
should be forbidden, unless we proceed with such extreme
caution as not to break the continuity of the placental
structure. Otherwise it will be torn by these forcible
efforts, and all that part which is above the cervix remain
incarcerated in the womb. Besides, the detached fragments
which can no longer excite the neck, or stimulate the ute-
rine contractions, can no longer be a conductor to the prin-
cipal bulk of the placenta. It will be more harmful than
useful, for the reason that it changes favorable to unfavor-
able conditions. It is proper, therefore, to resist the pro-
pensity to make traction upon the accessible portion of the
placenta. The accidents being slight, we may wait and
leave all to Nature. We should limit our interference to
controlling haemorrhage, by refrigerants or the tampon;
putridity of the lochia, by vaginal injections; and metritis,
by emollients, etc.
(c.) Sometimes the placenta is totally enclosed within the
womb, and not engaged within the cervix, which is rigid,
slightly dilated, and does not permit of the extraction of
the placenta. In such a case we should abstain from trying
to remove it. Such attempts would only break up and
1869.] Placenta ºn Abortion. 209
accelerate the putrefaction of the placenta, as well as weary
the woman, without any benefit. If the time elapsed since
the expulsion of the foetus, does not exceed that which we
have recognized as forming the extreme limit of normal
delivery, we may, as in the preceding case, confine ourselves
to overcome the complications, without interfering other-
wise with the placenta, the exit of which may be provision-
ally left to nature. But if, on the contrary, the ordinary
duration of a normal delivery has been exceeded, the con-
tingents, although slight, are to be regarded as forerunners
of great danger. We should not only combat the existing
complications, but also endeavor to excite the uterine con-
tractions, either by the uterine dilator, or the sponge and
the tampon, or by the latter only, or finally, by the simul-
taneous employment of the tampon and ergot.
B. Serious complications.—When the life and health of
the woman is seriously compromised, there is present an
evident indication to interfere. Moreover, contrary to what
we have just said concerning slight complications, the
means should not only be addressed to the complication,
but also, and especially to the cause thereof: id est, to the
retention of the placenta.
Before specifying the best course to adopt in this case, I
would make a very important clinical remark. Thoroughly
to appreciate the indications to be met, it is indispensable to
consider, not only the accident itself, but likewise the par-
ticular circumstances under which it existed. Thus, a
slight haemorrhage may have very different results in case
the woman is robust, or on the contrary, very much enfee-
bled by any cause whatever. The sanguineous loss may
have been arrested, but, as in Case IV, the patient is greatly
debilitated, and the case is really a grave one. And what
is true of haemorrhage is also true of certain other symp-
toms. In order, therefore, to judge of the slight or grave
character of the complication, it is important not to over-
look the general state of the patient’s strength.
When the placenta, by the degree of its engagement, or
by the degree of softening or dilatation of the uterine
Vol. IV.-No. 14. 6
2 IO The Delivery of the [9'anuary,
J
cervix, appears to be of easy extraction, we should proceed
without delay to deliver it. And to accomplish this, the
more direct means of traction are to be preferred. Accord-
ing to the case, we employ the fingers or the whole hand,
the abortion forceps, or the crotchet.
If the placenta is only partially engaged in the cervix,
and its principal bulk is retained within the internal os,
which is rigid, the attempts at direct removal would be
likely to tear away the accessible portion, and to leave the
Femainder securely imprisoned. Since this unfortunate
result would seriously aggravate the situation, it is prefer-
able to avoid it, and by having recourse to indirect means.
Under these circumstances, the ergot is well indicated. By
stimulating the uterine contractions, it hastens the expul-
sion, en masse, of the foreign body, while that portion which
is already engaged prevents a tetanic spasm of the cervix.
Finally, in cases in which the placenta is totally retained
in the womb, and where the too resisting and contracted
uterine neck does not allow us to seize it, and if there is
haemorrhage, it will be proper to apply the tampon, and
perhaps also at the same time to administer the ergot. If
there is putrid infection, which dates from the first or the
second day at farthest, we might prescribe ergot, but omit
the tampon, since the latter would only increase the pu-
tridity of the lochia, without compensation. Intra-uterine
injections, or rather vaginal injections, and constitutional
tonics should also be concurrently given. But, if the em-
ployment of ergot seems to be harmful, or if the putrid
infection has already existed for several days, and there are
symptoms of metritis, we should severely prohibit this
agent, which, in all probability, would only produce evil
results. The womb, like the intestine in peritonitis, is as
if paralyzed, or struck with torpor; it ceases to contract,
and its inflamed tissue mortifies. We should, therefore,
limit ourselves to employ, every three or four hours, intra-
uterine injections of tepid water, by the double-current
canula. And if, at the end of eighteen or twenty-four
hours, this means should prove powerless for the removal
A
1869.] Placemia in Aborizon. 2 I I
of the placenta, we should persevere for another half day,
but proceed after the manner of Recolin, which is to use a
simple canula, and a syringe by which the pressure of the
Tiquid can be graduated. I must add, however, that this
practice is really dangerous, and should be employed very
cautiously, and only when the extreme gravity of the case
requires it.
In this case, however, if the intra-uterine injections fail,
or if we judge them too dangerous, we may have recourse,
with advantage, to certain means of direct extraction. The
fixed or moveable curette of Récamier, or that of M. Pajot,
are the instruments commonly employed for this purpose.
The introduction of the speculum is then generally requisite,
and we should proceed to the operation with the utmost
delicacy. If the uterine cervix should be so closed as to
render the introduction of the sound, or of the curette, im-
possible, it should be previously dilated by a tent of sponge,
or laninaria. In a case of this kind, M. Depaul succeeded
in this manner to effect delivery, and the woman recovered
promptly. But all forcible and violent means of dilatation,
as for example, the three-branch dilator, the forcible intro-
duction of the finger, etc., etc., are contra-indicated.
Such are the different expedients which appear most
proper to employ in the artificial delivery, and with which
to overcome those most fearful complications — haemor-
rhage and putrid infection. As for the secondary compli-
cations (peritonitis, metritis, etc.,) they require, in whatever
concerns delivery, the same treatment as the preceding, as
well as a special treatment which is appropriate to them,
and of which I need not speak in this connection. !
3. The abortion is commenced, but we are uncertain if it has
been completed. — A doubt concerning the actual state of the
case, may occur in one of the three following circum-
Stances :
(a.) A woman miscarries; the matters expelled the vagina
are carelessly thrown away, and it is only some hours, or
perhaps several days, after, that the services of the phy-
sician are called into requisition. If the cervix, which is
2 I 2 The Delivery of the [3anuary,
already closed, prevents the exploration of the uterine
cavity, and if the particulars have not been gathered by a
competent person, we can readily perceive the uncertainty
belonging to such a case.
(b.) The physician has kept pace with the different stages
of the abortion. But in examining the placenta, he recog-
nizes that the uterine mucous membrane, the decidua, has
not been expelled. As I have shown, this membrane is not
necessarily exfoliated in abortion during the first two
months, and if it proves to be a case of this kind, the
finished or incomplete state of the delivery remains thence-
forth uncertain. }
(c.) Finally, where the placenta escapes in fragments,
however attentive we may be, it is not always easy to
recognize clearly the different portions thereof, and espe-
cially to know if the whole of it has been expelled or
extracted. When, for example, there is a fatty degenera-
tion, in which the placenta is transformed into clusters of
vesicles, only the manual exploration of the uterine cavity
will enable us to make the proper diagnosis. But this
expedient may be impracticable, or perhaps contra-indi-
cated, in which case the uncertainty is not removed.
Whatever may be the cause of the doubt in our minds,
either there are no complications, or there are more or less
serious accidents connected with every case of this kind.
(a.) If there are no complications, this is the proper place in
which to apply the maxim: “In doubt, abstain;” by which
I mean that one should abstain from all active measures
of relief, and not from all necessary exploration, with a
view to the proper diagnosis. For in these cases, it is
necessary, on the contrary, to redouble our care and atten-
tion. We should prescribe the careful preservation of all
matters that escape the vagina; and renew, several times,
the exploration of the womb; the woman should be kept
in bed, and constantly watched; a tampon should be in
readiness, in case of sudden haemorrhage, and one should
avoid all causes of uneasiness to the patient, by offering a
pretext for this unremitting care. The uncertainty could
1869.] Placenta Żm Abortion. 2 I3
not be greatly prolonged. If we find that the uterus is not
completely empty, it would be proper to proceed as recom-
mended for the retention of the placenta, without other
complication.
(b.) The accidental complications are, menorrhagia, putridity
of the lochia, chills and fever, etc. If menorrhagia happens
several days, or even one or two weeks, after an abortion,
we may be almost positive that it is due to a partial or
complete retention of the placenta. However, as a uterine
polypus might occasion it, we may not always be quite
positive. But as a small fragment of the placenta is also
sufficient to produce it, until we know the actual condition
of things, it is not well to try to extract it, neither to pro-
voke a new labor for that purpose. We should limit our-
selves to combat the haemorrhage by the tampon, or other
preferable means; and, if it persists, or returns again, the
cervix should be so dilated as to permit us to recognize the
true cause of the difficulty. To this end the sponge-tent
should be cautiously employed. The diagnosis made clear,
the treatment adapted to the morbid condition should
follow.
In case of putrid poisoning, all doubt as to the diagnosis
would be still more quickly dissipated ; for, unless in ex-
ceptional instances, as in case of gangrene, cancer, or of a
decomposing polypus, the presence of a putrefying placenta
in the womb could not remain long unrecognized. In
combatting the symptoms of infection, by means of injec-
tions frequently repeated, and by the use of internal tonics,
we should also apply ourselves, especially to the matter of
diagnosis. And the retention of the placenta being certain,
we should have recourse to the means already advised for
similar cases.
4. The abortion is over; the placemia has been delivered, but,
in consequence of the labor, there are complications which require
the aid of the physician.—When the labor has been difficult,
or complicated by various accidents; and especially when
we have been obliged to interfere, by a difficult operation,
to extract the placenta, we can easily understand that the
2I4. The Delivery of the [3anuary,
emptying of the womb, even when complete, may leave a
profound anaemia, an extreme prostration, symptoms of
putrid poisoning, of metritis, peritonitis, or a perforation
of the womb, etc. These various affections evidently re-
Quire a special treatment, which is more or less active.
T}ut, as this belongs to general therapeutics, I will only
remark, concerning the anaemia, which succeeds to an
abundant haemorrhage, that it is not always best nobly and
prodigally to waste tonics and reconstituents upon the
patient. This practice, which is usually followed, appears
to me defective. A few spoonfuls of wine, and especially
of beef-tea, will be sufficient aliment for several days. The
stomach, in fact, as susceptible as that of an infant, will not
tolerate solid food, wine in large quantities, brandy, iron,
or quinine. It is only slowly and progressively, in ratio
with the building up of the digestive forces, that we should
have recourse to this class of substances. º
5. Finally, the abortion is not yet consummated; but it is more
or less advanced and recognized as inevitable,” whatever may have
been done to prevent it. — If abortion is recognized to be inev-
itable, it is clear that, far from trying to arrest it, we should,
on the contrary, aid the labor as soon as it seems to lan-
* It is often a grave and difficult question in practice, to decide if abor-
tion is, or is not, ºnevitable. When the sac is ruptured, and the amniotic
Iiquor has already escaped, the Solution of this question is easy. When the
foetus can be felt by the finger directly, or has partly escaped from the
uterus, there is still less of uncertainty. Finally, abortion is certain in case
the foetus has been dead for a long period, or when it has disappeared, by
being dissolved in the amniotic liquor. But, in the first months of gesta-
tion, how shall we recognize that the foetus is dead, when its existence is
not yet assured by a single pathognomonic sign 2. It has been offered as a
certain criterion that labor, in abortion, can not be arrested when there is a
complete, or very advanced, obliteration of the uterine neck. I apprehend
that this circumstance does not render abortion inevitable, but only very
probable, as an abundant loss of blood, in a very short time, significs an
extcnsive separation of the sac itself.
When there is abortive labor, and especially in the first months of preg
nancy, the physician often finds it impossible to know if abortion will be
completed, whatever he may do to prevent it. Nevertheless, when in
doubt, he should act as if it could be arrested, and strive to stop the pro-
gress of labor.
1869.] Placenta in Abortion. 2 I5
guish. But, with the intention ultimately to expedite the
delivery, especial precaution is necessary, id est, to preserve,
as far as possible, the entire sac, until the cervix is suffi-
ciently dilated. Far from rupturing the membranes volun-
tarily, it will be proper to remove all causes which are
likely to rupture it prematurely. Thus, I can not endorse
the opinion of M. Jacquemier, who, even in abortion of the
first three months, advises the artificial perforation of the
sac as a means to prevent hamorrhage.” In such cases I
would very much prefer the employment of the vaginal
tampon; for it would not only be more useful in prevent-
ing the haemorrhage, but it would not compromise the sub-
sequent delivery of the placenta.
[REMARKS.—It is hoped that the liberal, not literal, trans-
lation of the foregoing paper will prove useful to the pro-
fession. The readers of the Journal, may not be aware of
our lack of detailed information upon this very important
subject. No single American or English writer on obste-
trics has carefully elaborated, or given explicit and available
instruction concerning it. As a consequence, thousands
of patients must have been sacrificed. In the whole range
of obstetrical literature, there is but one other essay deserv-
ing of the name upon this most practical topic. We allude
to a paper by Dr. Wm. O. Priestly, contained in Vol. III. of
the Transactions of the Obstetrical Society of London for
1861, p. 146, et seq.
To draw a line of separation between strictly therapeu-
tical, and what might be called surgical indications, is
sometimes as difficult a thing for the physician to do, as it
is vitally important for the welfare of the patient that it
should be done. The essay we have translated includes the
question of the relative and specific reliance to be placed
upon medical and mechanical means in the delivery of the
placenta, in case of abortion. While, in the management
of this form of labor, one class of physicians undoubtedly
places too great stress upon, and is disposed to resort to,
* Manuel des Accouch, tome 1, p. 487, Paris, 1846.
216 Inversion of the Uterus. [3anuary,
surgical expedients too freely, and without discrimination,
the other puts a premium upon the exclusive employment
of internal remedies, and through an unqualified dislike of
local adjuvants, sometimes imperils, and even sacrifices, the
life that should have been saved. º
It is not for us to adjudicate between these extremists.
We simply take occasion to insist that our individual judg-
ment in a given case, or class of cases, should be based
upon detailed information derived from both these classes
of practitioners, and not from one alone, nor from our per-
sonal experience merely, however extended and successful
it may have been. — TRANS.]
A CASE OF INVERSION OF THE UTERUS.
BY DR. C. G. HugbH.E, RED WING, MINNESOTA.
MAY 27th, 1868, I was called ten miles into the country
to see Mrs. W., a German woman, aged about thirty, who
had been delivered, in the afternoon of May 22d, 1868, of
her sixth child. The midwife and friends who were with
her, reported a natural and not very protracted labor. But
little flowing occurred, and no haemorrhage until after the
delivery of the placenta, in the manner hereafter stated.
The placenta did not come away naturally, and after wait.
ing until about midnight of the 22d, Mr. W. came to this city
and called Dr. —, a “regular,” to visit his wife. Those
present reported that the Doctor made an examination,
and began immediate traction upon the umbilical cord, not
giving any remedies, or waiting for nature to complete her
work. He continued very forcible traction—notwithstanding
Mrs. W. repeatedly told him he was “pulling her inside
out,” was “killing” her, etc., etc., and her cries were heard
several rods from the house — until he completely inverted
the uterus and vagina, pulling them into the bed, together
with the placenta still adherent. Mrs. W. Says she had no
1869.] Inversion of the Uterus. 217
labor pains during the whole time the Doctor was operating.
IIe then coolly called for a light, saying, “he had some-
thing there he did not know what it was.” He then sepa-
rated the placenta from the uterus, and merely pushed the
still inverted uterus up into the vagina, administered some
medicine and left there, telling them that if she died before
morning to let him know it. Her friends say, that from the
time the Doctor pulled the uterus and vagina out, until after
he had pushed the uterus into the vagina, Mrs. W. flowed
profusely, so much so that the blood ran through the bed
and along the floor, and that she was very much prostrated,
and could scarcely speak audibly. However, she did not
die, but in a few hours began to suffer acutely from the
pressure of something upon the urethra, so that she could
not urinate, and when she was raised up for that purpose,
the uterus came out externally again. When the Doctor
visited her, the morning of the 24th, he introduced a cathe-
ter, and left it inserted, so that the urine passed off as fast as
it was poured into the bladder. The inflammation and
swelling became so great, that the woman removed the
catheter—which caused pain—and by gently inserting the
fingers and raising the uterus, Mrs. W. could urinate. Thus
the case progressed, the inflammation and swelling increas-
ing, until the afternoon of the 27th, when I first saw her,
five days after the accident.
By examination I found the fundus of the inverted uterus
pressed down to the labia, the os and cervix firmly con-
tracted. The tenderness and swelling of the abdomen, and
all the organs of generation, were so great, that it was with
extreme difficulty I made out the diagnosis as above. Her
pulse was one hundred and forty-four, throbbing and full.
Mental excitement great, having had no sleep, or but little,
if any, since her labor began. No appetite; tongue coated;
great thirst. Could do nothing more at this visit than pre-
scribe for existing symptoms. Gave Aconite 3rd, and Bella-
donna 3rd, in alternation every hour, and inserted a sponge
to support the uterus, so that she could urinate without
trouble.
218 Inversion of the Uterus. [j'anuary,
May 28th I visited her again, taking with me, for an
assistant, my student and brother, A. E. Higbee, and such
instruments as I had, or could obtain, that I thought would
be needed. My patient had slept some the previous might,
and was not quite as nervous, but otherwise her condition
was not changed from that of the day before.
All my attempts at reduction, without the use of chloro-
form, were unavailing. The case had gone so long since
inversion, and the local and general condition of the patient
was such, that I decided upon still longer delay, to get her
in better condition to bear the shock of an operation for
the reduction of the tumor. Left Aconile 3rd, and Bella-
donna 3rd, to be given alternately, every two hours, with
orders for them to report the case to me every day.
On 29th received a favorable report, which from day to
day improved, until June 5th, when I again visited her,
and, upon examination, found the uterus in nearly the same
position as upon my second visit, but less swollen, and the
sensitiveness of the abdomen, uterus, and vagina much
diminished. Pulse ninety (90); appetite good, and bowels
move daily. Called Dr. F. E. Canney, of Lake City, in
counsel.
Dr. Canney met me at Mr. W.’s, June 6th, and, after a
careful examination of the case, fully approved of the course
I had taken. We decided to place her under chloroform,
and use all proper means for the reduction of the displaced
organ. The patient was placed upon a low lounge, the
hips near the lower end, the legs flexed upon the thighs,
and feet in chairs, placed for the purpose, the shoulders
slightly elevated, so as to give free expansion to the lungs.
Dr. C. administered the chloroform, and when she was
fully under its influence, I passed my right hand into the
vagina, holding between my first and second fingers a piece
of sponge, well saturated with mother tincture of Belladonna,
which I applied to the cervia, and 08 as well as possible,
reaching, as I had to do, around the fundus of the uterus.
After waiting ten or fifteen minutes I attempted reduction,
by grasping the uterus, and pressing steadily in the direc-
1869.] Inversion of the Uterus. 2 IQ
tion of the superior strait. Failing in this, I then resorted
to a stick, the size of a hoe handle, rounded at the end and
covered with silk. The fundus was so firm and oval, I
could not get this instrument to retain its place under pres- .
sure, so as to produce any result toward reduction. I again
introduced my hand, bringing the fingers in close contact
with each other, and after pressing firmly against the fun-
dus for about thirty minutes, could feel it begin to ascend,
and, continuing the pressure, in about fifty minutes from
the commencement of the operation, had the uterus fully
restored to its normal position. This I proved by passing
a sound into it four inches above the os. But little haem-
orrhage occurred. I then placed an air-pessary in the
vagina, and inflated it sufficiently to keep the uterus in
position, removed the sound, restored the patient to con-
sciousness, placed her in bed, the hips level with the shoul-
ders, ordered rest, quiet, light food, prescribed Sec. cor. 1st,
and Nua. 3rd, and left her feeling that she had yet some-
thing to live for, and thankful for what we had done for her.
May 7th. Pulse 100. Some tenderness and heat over
the uterus. Slept last night, and tolerable appetite this
morning. Continued Nuz, but gave Acom. 3rd, in place of
Sec.; Acom. and Nua were continued until the fever subsided,
and then Nua alone until she was fully restored to health.
We kept her in a recumbent position for three weeks.
Removed the pessary, and injected a weak solution of
calendula, about every three days at first, and then every
week, taking precaution, the first ten days, to hold the uterus
in place, by means of a sound, while the pessary was removed.
She had no trouble in urinating after the reduction of
the uterus; the bowels moved without aid as often as
necessary. The discharge from the uterus, which was
considerable, soon after reduction, subsided before final
removal of the pessary. The milk returned to her breasts,
and for the last five weeks she has done work for her
family, and nursed her child. This happy result was
obtained after the uterus had been inverted for the space of
fifteen days, or from May 22d to June 6th, 1868.
RED WING, MINNESOTA, Oct. 12th, 1868.
AºA: WIE WS OF PO O.A.S.
THE MATERIA MEDICA IN ITs SciENTIFIC RELATIONS. New
Haven, Conn.; Judd & White, 240 Chapel Street, 1868.
Pamphlet, 42 pp.
IF the suggestions contained in this little work shall ever
be faithfully carried out, it will constitute an epoch in the
history of medicine.
The author aims to indicate a strictly scientific basis and
method, for the study and development of the Materia
Medica. In order that Materia Medica may constitute a
true science, it must be gradually built up, just as other
natural sciences have been measurably perfected, viz.: by a
strict adherence to the processes of induction, from experi-
ment and observation. Reasoning from supposed princi-
ples, theorizing and speculation of every kind and degree,
must be rigidly excluded. The end to be attained, viz.:
“the determination of the special properties of medicinal
agents,” must ever be held distinctly and definitely in view,
and no secondary end, however tempting, should be allowed
to turn aside the pursuit. To explain the operation of
medicines is useful and instructive, in a certain way, but is
not the precise thing aimed at. It should constitute no
part of a scientific Materia Medica. It has always led to
false and distorted results.
Not only should the aim be single, but the method of
investigation, and the material gathered, should also be
distinctly and exclusively appropriate to the end in view,
the knowledge derived from the related sciences may be
useful, as furnishing aid and suggestions; but should never
be allowed to determine the inductions of a scientific
Materia Medica. In this science, the fact that two substances
have similar chemical or botanical relations has no appro-
1869.] Reviews of Books. 22 I
priate place. “Even the phenomena of therapeutics have
no proper place in such a Materia Medica.” The facts of
each science must stand apart by themselves; and “at
every stage of investigation, the analysis of the phenomena
must be carried to its utmost limits before the process of
synthesis is begun.”
Moreover, “during the stage of scientific inquiry, no
questions are to be raised as to the final use to be made
of the facts elicited. Such questions preoccupy the mind,
and distort our conclusions.” Experiments on animals,
and the action of medicine in disease, while useful sugges-
tively, are not to be admitted to the inductions of a Materia
Medica, which lays claim to the precision of a science.
Anatomy was kept in swaddling clothes for centuries,
because dissections were restricted to brutes. “Materia
Medica still suffers from a similar cause.”
In collecting the material for a scientific Materia Medica,
the author insists on the utmost accuracy and precision in
every thing that pertains to making and recording the ex-
periments, as well as in comparing, analyzing, and classi-
fying the facts obtained. “What is essential is that
systematic arrangements be made, which shall include the
facts of Science, and eacclude every thing else, and place the facts
in their relations to each other, and to them only.”
A Materia Medica, based and constructed on these princi-
ples, will be thoroughly systematic, comprehensive, and
immediately suggestive of therapeutic application. In deter-
mining new remedies it will “assert its place as a science,
and keep even in advance of accident, of caprice, of empiri-
cism.” It will be “a depository of knowledge, ever growing,
yet never unmanageable, because well ordered and systema-
tized. Its positions once accepted, it will stand forever.”
Who has not yearned for such a scientific Materia Medica?
Who is not willing to assist in the up-building of such a
magnificent structure for the healing of the nations?
We are at a loss to surmise the motive which prompted
the author of so valuable a contribution to medical litera-
ture to withhold his name from the public, and the pro-
fession which he has laid under obligation. F. A. T.
222 Reviews of Books. [?anuary,
LEssons IN ELEMENTARY CHEMISTRY: Inorganic and Organic.
By IIenry E. Roscoe, B.A., F.R.S., Prof. of Chemistry in
Owen’s College, Manchester. New York: Wm. Wood &
Co., Publishers, 61 Walker Street, 1868.
THIS meat little book is an American reprint of a work that
is almost universally adopted as a chemical text-book in
England, and has already been translated into the German
and Russian languages. It is just what it professes to be,
viz.: an Epitome of Modern Chemical Science, “suited to
the present requirements of elementary instruction.” In
turning over its pages one is forcibly reminded of the fact
that chemistry is a progressive science; and that the text-
books, in common use in this country, come far short of
representing the true status of this science at the present
time. The student who in these days commences his
chemical studies, with such aids as Silliman’s, Fowne's, and
Johnston’s, Turner's, will shortly have much to unlearn and
re-learn, in bringing his ideas to conform to the language
and formulae of modern chemical literature. It is especially
desirable that the medical student should receive, at the
outstart, correct ideas in all that pertains to chemistry and
physical science.
Whatever may be the unwillingness of those whose
chemical education began and ended in days gone by, to
abandon their favorite forms of instruction, this little
pioneer from across the water will prove the entering
wedge that will soon crowd them and their antiquated
science off the shelf. No truly scientific teacher will be
satisfied to stand still in these days. Onward and upward
is the word. . JF. A. L.
THE HOMOEoPATHIC SUN, is the name of a new journal
published by Radde, in New York, and edited by F. W.
Hunt, M.D., the second number of which has just reached
us. Its title is an ambitious one, but well directed ambi-
tion no one can blame. The sun shines alike upon the evil
and the just, so may the Homoeopathic Sun send its beams
1869.] Areviews of Books. 223
upon the wicked Allopath and the just Homoeopath. It
dispenses life, and light, and heat to all animal and vege-
table creation; here our simile limps, for it does all this
for nothing, while the terms of the Homoeopathie Sun are —
two dollars per annum. The rising sun bedims all other
luminaries; perhaps our friend Hunt does not mean to try
that though; however, we shall be ready to “douse our
glim,” when we find that it casts no shadow. The setting
sun — well, we will pursue the comparison no further, hop-
ing not to see the setting of this Homoeopathic Sun in many
a long day, as we feel assured that if anybody can edit a
real Homoeopathic Sun, it is the very one who has set his
hand thereto.
Any physician who will send his name and address will
receive the first three numbers gratis, and can thus see for
himself just what the Sun purports to be, quite as well as
we can tell him, so we forbear.
PROCEEDINGS OF THE THIRD ANNUAL SESSION OF THE HOMOEO-
PATHIC MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA,
\. º
held in Harrisburg, May 12th and 13th, 1868.
This forms a very respectable volume in size, and, what
is better, contains an unusual amount of valuable matter.
The session seems to have been characterized by general
harmony and scientific zeal. Dr. Williamson presided, and
Dr. Frost delivered the annual address. A marked feature
was the reading of brief reports from various County Soci-
eties in the State. A report was also read from the dele-
gates to the French International Congress. There is not
one of the regular reports, in the different departments of
medicine and surgery, but contains matter of general
interest to the profession. Dr. Lippe furnishes a collection
of provings of the arsenite of copper. The important report
of Dr. Guernsey, on Obstetrics, is the same as that presented
to the American Institute, at its last meeting. It elicited
quite a spirited discussion on the means of arresting uterine
haemorrhage, and the use of the bandage for post partum
WOI)] (211.
224 Aooks Received.
The remarks of Dr. Rockwith, a delegate from the New
Jersey State Homoeopathic Medical Society, have the ring
of good metal. He says: “Let us endeavor, before we
turn out a student as Doctor of Medicine, to make him a
student of natural philosophy, let us teach our young
physicians the collateral and fundamental sciences. We
borrow almost hourly from mineralogy, without knowing
its foundation ; we rob botany of its choicest treasures,
without understanding the language it utters. * * * Even
the laboratory of the chemist is more or less a mystery.”
The neglect of these studies, he thinks, “has begotten
bigotry, and a fear to encounter opposing theorists and
schools.” Speaking of “a high and a low school,” he says
we should take warning by the present volcanic state of
affairs among the Episcopalians. We hope to hear the
Doctor preach again from a similar text. F. A. L.
BOOKS RECEIVED.
The Hahnemannian Monthly.
Transactions of the Third Annual Session of the Homoeopathic Medical
Society of the State of Pennsylvania.
The Medical Investigator. New York Citizen.
The Detroit Review of Medicine and Pharmacy.
Fourteenth Annual Report of the Chicago Board of Education.
Allgemeine Homoeopathische Zeitung.
Journal du Dispensaire Hahnemann de Bruxelles.
The New York Medical Gazette. El Criterio Medico.
First Annual Announcement of the Cleveland Homoeopathic Medical
College and Hospital, 1868–1869.
The New England Medical Gazette.
Bulletin de la Soc. Med. Homoeopathique de France.
Dental Register. The Chicago Medical Journal.
Buffalo Medical and Surgical Journal.
Pacific Medical and Surgical Journal.
The Materia Medica in its Scientific Relations. Published by Judd &
White, New Haven, Conn.
Nashville Journal of Medicine and Surgery.
The Journal of Materia Medica (Bates & Tilden's).
American Homoeopathic Observer.
New York Medical Journal. The Homoeopathic Sun.
Revista Médico-Quirurgica y Dentistica. Por Los Sres, Wilson y Gon-
zalez, Habana y Neuva-York.
A /O/7'O/P/A/C.
LETTER FROM OUR BRITISH CORRESPONDENT,
ROBERT MASTERS THEOBALD, ESQ., 25 LEE TERRACE, BLACKHEATH, S. E.,
LONDON.
“IT is admitted, by all practical physicians, that the science of therapeutics
is in a most unsatisfactory state.” With these words, Dr. Reith, Physician
to the Royal Infirmary of Aberdeen, begins a paper which bids fair to
inaugurate a new era in the career of Old Physic. All who are convinced
of the truth of Homoeopathy, know perfectly well that the citadel of Allo-
pathy must ultimately surrender. And any one who knows any thing of
human nature, will readily surmise, that, when the magnates of the domi-
nant school adopt Homoeopathy, they will not accept it as a gift from us,
but announce it as an independent discovery of their own. Dr. Reith has
made a discovery which bears a very strong resemblance to Homoeopathy.
Indeed, he admits that the practical conclusion to which he is led is the
same, but he backs out of it theoretically, and even manages to make his
salaam to the principle Contraria Contrariis, while he admits that his
practice is, at first sight, Homoeopathy. The article in the “Edinburgh Med-
ical Journal,” for February last, is most interesting and remarkable, and is
worthy of notice in our own Annals. He begins by some familiar remarks
upon the decay of faith in drugs, and the strange divorce between Path-
ology and Therapeutics. Then he dons his mantle and begins to prophecy.
He notices two mistakes, into which observers of the action of medicines
have fallen — first, in relying too much on observation of effects upon the
lower animals; second (and here begins his own theorizing), “in regarding
the symptoms produced in the human economy, as the only and invariable
physiological phenomena characteristic of the substances ingested.” The
scope of this criticism will appear afterwards; we must make a little spec-
ulative cruise, and then we shall return upon it. All diseases, he assumes,
may be traced to one centre and origin, in the joint cerebro-spinal and
vaso-motor nervous system. Most diseases are attributable to a morbid
state of the nervous system, which may arise in the nervous system itself,
or from the presence of noxious elements in the blood. But the first step
is derangement of nervous influence. He illustrates this by tracing the
origin and course of inflammation, which starts with paralysis, for the time
being, of the vaso-motor nerves; and at the same time a profounder
derangement of the cerebro-spinal system, causing a suspension of molecular
function, acting on the minutest cells and nuclei of the parts affected. But
the chief origin of the mischief is in the vaso-motor nerves. By their para-
lysis, the blood-vessels which they supply, and keep tonically contracted,
Vol. IV. — No. 14. 7
226 Adžforza/. [j'anuary,
become dilated — hence afflux of blood, and increase of vital function in the
parts visited by this afflux. Now, Dr. Reith supposes that this vaso-motor
paralysis is not the first cffect of the presence of the morbid agents which
produce inflammation. The first effect is exactly the reverse—over-stimu-
lation ; the paralysis is a secondary reaction. Iłut this first condition of
over-stimulation is generally so transient as to be passed over. Now, as it
is with disease, so is it also with the action of medicines— the primary
action of the medicines is on the same vaso-motor system — the cflects pro-
duced are similar to inflammation. In this case, also, there is a double
action, first stimulant, then depressing. As in disease, too, the stimulating
action, which is primary, is very transient, and generally escapes observa-
tion — the bird has flown before you have time to put your salt on his tail.
And here comes in the point of the criticism with which we started— the
ordinarily observed physiological results of medicines are not the whole
effect produced ; an earlier stage has escaped observation, of a precisely
opposite character. Now for the practical conclusion. If we want to cure
any disease, we must not produce these secondary playsiological effects, by
large doses, but the primary transient effects, using doses large enough to
produce these without going any further. So you antagonize the symp-
toms. It is true, you are guided in the selection of your remedy, by the
fact that its scCondary effects resemble those which you have to treat ;
according to crude physiological impressions, you are giving a “similar.”
But the dose makes all the difference, and converts the similar into an
opposite, and so the darling principle of Antipathy — Contraria Contrariis
—is rescued, and the citadel of Allopathy is not obliged to lower its flag, or
capitulate, even though it is obliged to adopt the practical rules of its
enemy. The point of all this evidently is, that you get Homoeopathy, with
its small doses (how small is not yet determined, or pronounced), while the
credit of Allopathy is saved. Dr. Reith can not, of course, help Seeing that
he is getting into bad company, and is likely, unless he takes care, to get
confounded with the adversaries of the regnant school, and gibbetted in
their company. This is the way in which he rescues his orthodoxy :
“The question will naturally arise: Do these therapeutical views not favor
Homoeopathy 2 If by that term be understood the principles and practice
of the followers of Iſahnenmann, so far from these receiving encouragement
from what I have stated, I am persuaded that when the double action of
medicine is universally recognized and acted upon, the props and stays of
Homoeopathy will be cut away. Put if the term be taken in its literal
signification, the principles laid down most certainly give Countenance to
it. There can be no doubt that, with all its absurdities, IIomoeopathy
contains a germ of truth. That germ is its original doctrine of Similia
Similibus (ſuratºtatº. IIahnemann's double (ºrror, in which he has been
exceeded, even to cxtravagance, by his disciples, consisted in making that
dictum universally applicable to all diseases, and in pushing the small dose
to infinitesimals. IIad he stopped where he began, there would have been
an end of all controversy. Iłut when he developed his extraordinary opin-
ions, and intelligent minds had naturally revolted from a system so absurd,
they recoiled, also, from the truth out of which it sprang. IIence the
doctrine of similars came to be, as it is now almost always, associated and
confounded with infinitesimalism. The two, however, are essentially dis-
tinct. On the other hand, our error has been to push the principle of
1869.] Adžforza/. 227
Contraria Contrariis, to a corresponding extreme. The truth, I appre-
hend, lies midway between those two extremes. It is this middle position
that I am endeavoring to establish. Let the Homoeopaths abandon, as
many of them are doing, their wild theories of potentization and infinitesi-
malism, agreeing to receive the principle of Contraria Contrarils, as
having a certain range of application ; and let us abandon our Correspond-
ing exclusiveness, adopting the principle of Similia, Similibus, where it is
indicated by the pathology; let this take place, and we should have agree-
ment upon a rational system of therapeutics. It must come to this sooner
or later. For, after all, the doctrines of Hippocrates are still as true as they
were on the day of their first declaration. “Some diseases are cured by
discases which produce the opposite effects, and some diseases are cured by
medicines which produce the same effect.’”
Perhaps this is as much as we have a right to expect. We will accept
these suggestions of a compromise with a civil bow, and if we have any
objections to offer would do so with all courtesy, with a beg-pardon air,
regretting that we can not abandon our own position in favor of Dr.
Reith's, via media. We can not, however, help asking how he has managed
to find out this double action of diseases and medicines, as such an invariable
phenomenon as to fix the law of their relationship. It seens almost as if
this hypothesis was an after-thought to cover the Allopathic surrender.
Moreover, the other elements of disease are forgotten when the therapeutic
law is determined — I mean those elements which depend on cerebro-spinal
action, and cause molecular and functional change of quite a different kind
to that which vaso-motor disturbance occasions. How is the rescue of
Contraria Contrari is effected in this point of view 2 Then, as to infinitesi-
mals, it is admitted that the dose must be too small to produce the similar,
physiological effects, only large cnough to produce the first transient and,
generally, invisible stimulation. But as this first stage is transient and
invisible, may it not itself require a correspondingly transient and invisible
dose. How transient? how invisible? what measure is to be applied ?
how is the proportion to be ascertained ? why assume all at once that the
dose must neither be physiological on the one hand, nor infinitesimal on the
other 2 If the physiological gauge is abandoned, why not wait for expe-
rience to determine what gauge shall be substituted for it? Then, more-
over, we are entitled to ask, why we should abandon our own law, which
is intelligible—at once simple and profound, as all great natural laws are —
for some nondescript via media, the limits of which are not determined 2.
What do you mean by “a certain range of application for this law or the
other?” For our own czperience is that these “certain ranges” are in
practice most uncertain. How is the law of similars to be restrained by the
bit and bridle of pathology 2 Upon what principle is the partition between
the two opposite laws of contraries and similars to be affected 2 Which
disease shall we assign to each, and why? I need not push these interro-
gations any further. Dr. Reith promises to give the results of his own
testing of this therapeutic law. He has written, also, to the “Monthly
Homoeopathic Review,” acknowledging that he is convinced of the truth
of our system “in its fundamentals.” The cautious, not to say “canny,”
way in which the North British Savan guards his admissions, is very char-
acteristic of his countrymen generally.
228 Adžāorial. [9amuary,
Dr. Pearce, one of our best Metropolitan Homoeopathic physicians, has
recently published a very valiant “Essay on Vaccination,” in which he
attempts to show the dangers resulting from the practice—its failure as
usually performed to protect against small-pox—its tendency to introduce
other diseases into the system. He brings a long array of figures and
statistics to prove his thesis, but seems obliged to eke out their defective
probative value by speculation. He speaks of it as “not improbable” that
the materies morbi of small-pox, if prevented, by vaccination, from its natu-
ral development, changes its tack and appears in other form—such as
phthisis, scrofula, erysipelas, chronic skin diseases, etc. I am always apt to
be suspicious of any chain of reasoning that is suspended upon a “materies
morbi,” which is the most overburdened scape-goat that pathologists ever
frcighted with their fancies. These “not improbable” notions are sup-
ported by no facts. Both of our journals, the “British" and the “Monthly,”
have given excellent articles on this subject, which has come into great
prominence lately, owing partly to the number of cases of small-pox that
have proved fatal, and the more stringent laws that have been enacted about
vaccination. It seems to me that some explanation of the partial efficacy
of small-pox is to be proved in the unsatisfactory quality of the government
lymph, which has not been renewed by a visit to the cow since the time
of Jenner. The authorities first tried to explain the ravages of small-pox,
by attributing it to bad vaccinnation — then they made an ea post facto
theory that the protection given by vaccination is only temporary, and
requires to be renewed. This is a novel theory, and unnecessary. Let
unsophisticated lymph be more frequently used, and these defects would
probably cease. Great complaints have been made of the oppressive action
of the legislature, in enforcing vaccination under penalties. From all that
I have scen, the law is not very strictly enforced, and may be generally evaded
by those who wish to do so. And, indeed, it would be scarcely possible to
put such a law into very rigorous action. Sir James Simpson proposes to
attack Small-pox by another kind of legislation. He would “stamp" it out
— not by using the pole ax, as in the cattle plague, but by keeping all
small-pox patients, and their attendants, in a state of complete isolation,
drawing a cordon round the infected persons. Doubtless this would have a
certain amount of efficacy, but no quarantine on land could do more than
quarantine at sea has done, to prevent the spread of contagion, and it is
wcll known how uncertain that measure of precaution is — how germs of
disease may be conveyed to susceptible persons by healthy persons, them-
selves incapable of being attacked, and perhaps unconscious that they are
the carriers of any destructive influence. The fact that 50,000 persons died
in England alone of small-pox, in the ten years from 1856 to 1866, and that
in 1864 its victims amounted to 9,425, may well incite all who are interested
in public health, in seeking for some effective mode of meeting such a fearful
scourge. After all that has been said against vaccination, by the few (but
very eloquent) persons who have raised their voices against it, I believe its
value can not be fairly disputed. Though the victims from small-pox are
numerous, the scars which it leaves behind it in the community are not
nearly so deep; the blind, deaf, the hideously disfigured, are undoubtedly
1869.] Fażforza!. 229
not so often found as they were when no modifying agent, such as vaccina-
tion, was at work. Dr. Ballard, in his recent able and exhaustive work on
vaccination has expounded this side of the question in great detail, and with
reasoning that appears to be as conclusive as the nature of the case admits.
Several interesting articles and pamphlets have recently been published,
referring to the value of thermometric observations in estimating the nature
and intensity of disease, and its probable issue. In some cases the diagnosis
of an obscure case can be importantly aided by help of the thermometer.
For instance: suppose the case of a patient, who has a sudden attack simulat-
ing apoplexy—he becomes semi-conscious, or entirely unconscious—various
symptoms of paralysis of hemiplegic kind are observed—the case may be
cither haemorrhagic apoplexy, or acute cerebral softening. So far as obser-
vation goes at present, the distinction may be made by observing whether
the normal temperature of the body (about 98.4) is exceeded or not. If the
temperature is unchanged, the case is probably hamorrhage; if the temper-
ature is raised, it is a case of softening. In epileptiform convulsions, with
elevated temperature, there is reason to suspect some graver disease than
uncomplicated epilepsy—cerebral softening or tubercular deposit. In con-
tinued fever, the rise of temperature to a very high point, such as 104° in
the morning, and 105° in the evening, is often the earliest indication of
approaching danger from cerebral complications, and the fall of tempera-
ture, when the symptoms appear unchanged, may indicate that the stress
of danger is passed. Dr. Maclagan says, that he has never found the tem-
perature higher than 105.2°, in cases which terminated favorably. Other
sources of danger, such as asthenia, or failure of the heart's action, pulmonary
complications, and albuminuria, are not indicated by the thermometer, but
are easily estimated by observations of the heart and lungs. In the diag-
nosis of phthisis the thermometer may give very valuable aid. Dr. Sidney
Ringer has investigated this point very carefully, and his conclusions are as
follows: There is probably a continued elevation of temperature of the
body, in all cases where a deposition of tubercle is taking place in any of
the organs. This elevation of temperature is rather attributable to the
general condition of tuberculosis, than to the actual deposit of tubercle
(tuberculization). The secondary complications, which are apt to occur in
tuberculous cases, are not in themselves attended by a rise in temperature.
In simple bronchitis it does not occur; neither does it in albuminuria, in
ulceration of the intestines, or the chronic inflammations that accompany
phthisis. Pleurisy and pneumonia, if sufficient to cause long continued
elevation of temperature, would manifest themselves in their own charac-
teristic ways. Moreover, the severity of the disease is pretty accurately
indicated by the extent of increase of temperature, and the fluctuations of
the two (the disease and the temperature) correspond, and give clearer and
more unequivocal indications of the patient's state, than the physical signs.
Dr. Ringer gives a very interesting case, in which the diagnosis of tubercle
was made, and subsequently proved to be correct, in a case where no indi-
cations of tubercle were afforded by any other signs or symptoms, the case
being one of hemiplegia, with twitchings of the affected side, headache, and
gradual failure of the intellect. Thermometric observations will generally
23O Adžāorial. [?anuary,
decide when the diagnosis of phthisis is uncertain—when, for example, the
symptoms and signs are obscured by emphysema, or simulated by dilatation
of the bronchi, carcinoma, or aneurism. Lastly, it is to be noted that a rise
of temperature is often observable shortly before death, which continues
after (leath. A case was reported to the clinical society, of acute rheumatism
with fatal termination ; temperature 108° F. Ten minutes after death the
temperature was 107° in the axilla, 1098° in the rectum. This rise of tem-
perature is attributable to a paralysis of the cerebral functions, a general
relaxation and dilatation of the arterial system, and consequent congestion
and accumulation of blood, just as in the first stage of inflammation. The
attendant cerebral symptoms, indicative of this brain paralysis, were at first
great’ restlessness, with the passage of a large quantity of pale alkaline
urine, followed by delirium, then coma, rapid breathing, stortor, fixed pupils,
pulse over 130. Tischendorf found accelerated respiration and elevated
temperature in animals, after section of the pons varolii at its junction with
the medulla oblongata.
This investigation of the diagnostic value of temperature is one of the
most useful contributions to medical science recently made. You will
observe it belongs to the favorite province which Allopathy has almost
exclusively cultivated — diagnosis. I have before mentioned some indica-
tions of the growing tendency to cultivate the therapeutic side of medical
science more systematically. The most recent illustration of this tendency
is to be found in the establishment of a monthly periodical, called “The
Practitioner,” devoted entirely to therapeutics; edited by Dr. Anstie and Dr.
Lawson. The first paper, in the first number, is one by Dr. Russell Rey-
nolds, on the uses of bromide of potassium. He points out, with admirable
lucidity and clearness of pathological discrimination, certain classes of dis-
eases in which this drug may be serviceable. He has found it most service-
able in some cases of epilepsy, and has tried it in other spasmodic affections
—general spasmodic jerkings, hysteric convulsions, chorea, local clonic
spasms, such as wry neck — but without very much result. He sums up
the result of his observations in this class of diseases thus: “1. Its efficacy
is most marked when the disease is ‘paroxysmal.' 2. Its value is high in
proportion as the disease approximates the type of convulsion known as
‘epileptic.' 3. When spasmodic movements are ‘habitual,' be they either
tonic or clonic, local or general, its remedial influence is at best extremely
doubtful.” He finds it also very useful in vertigo, occurring paroxysmally
and in paroxysmal headache, especially with heat of head and flushing of
face. In some cerebral disorders, marked by sleeplessness, it has proved
useful in large doses (30 or 40 grains at bed-time, and 10 or 15 grains fre-
quently repeated during the day). In acute mania, with heat of head, and
redness of conjunctiva, he has repeatedly scen refreshing sleep follow the
administration of one full dose; and after a few days of this treatment,
recovery sometimes follows. It usually aggravates the wakefulness of
melancholia, but sometimes not ; and is often most beneficial in the insomnia
of acute alcoholism. There are other paroxysmal affections, which Dr. R.
Reynolds attributes to vaso-motor disturbance, in other parts than the head,
in which the bromide is useful. Such disturbances are analogous to
1869.] Aditorial. 23 I
epilepsy — but in epilepsy the disturbance is cerebral. In other parts they
show themselves as “sudden numbness, coldness, deadness, or pricking
sensations in one or more limbs; sudden distressing but indefinable feelings
in the epigastrium, abdomen, or hypogastrium ; or Sensations akin to rigor,
with much anxiety, and palpitation or fluttering of the heart. In such
cases it may be observed that the local circulation is interfered with ; that,
for example, the pulse, in one arm becomes faltering, irregular in force and
rhythm, occasionally intermitting, while that in the other arm may remain
unaltered, and the beat of the heart may maintain its normal character.
These phenomena have now been observed by myself in a large number
of cases, and I am quite sure that many of the symptoms mentioned, which
have often been referred to some changes in the nervous centres, i. e., to
either the brain or spinal cord, are in reality due to the condition I have
mentioned, viz., a derangement of the local circulation, in consequence of a
morbid state of the vaso-motor system of nerves. Nothing can far exceed
the misery which some of these symptoms occasion ; they often persist for
years, or rather occur paroxysmally for years, without finding any distinct
or permanent relief from ordinary treatment of the head, spine, and heart.
They may, however, be diminished and entirely removed, by the use of
Bromide of potassium, in such moderate doses as ten or five grains, taken
twice or three times daily.”
This is surely a very instructive study, both of disease and of the drug
in question, and the “paroxysmal” key note may turn out very valuable.
He does not, however, tell us, what any real science of therapeutics must
tell us, how the uses and properties of this salt have been discovered and
investigated. He mentions a good number of diseases in which it is not
useful, thereby suggesting the inquiry how he came to find out so many of
these barren negative facts. Was it by giving the medicine, in the cases
indicated, on the speculation that it might do good, precautions being of
course taken (what?) that it should not do any harm 2 If this was the
method of investigation adopted (and no other is suggested), we are entitled
to protest against it as most unsatisfactory and unscientific. Patients have
a perfect right to object to being made the subjects of doubtful experiments.
They may justly claim of science, that no drug should be brought to them
till its properties have been investigated, and its uses ascertained. Let Dr.
IRussell Reynolds then take this most obvious and elementary problem in
hand — how to find out all about a drug before bringing it into the sick-
room — how to anticipate the cases in which it will not be useful, so as to
avoid the certain waste of time, and possible risk involved in giving it to
such cases. Common sense, as well as humanity, demand this, and if thera-
peutic science has never fairly fronted this problem, it is self-condemned,
and the scepticism, almost amounting to contempt for drug-treatment,
entertained by so many eminent medical authorities, is abundantly justified.
This question is still more pertinent to Dr. Anstie's paper on the “ hypo-
dermic injection of remedies.” Dr. Anstie gives a list of drugs thus used,
and places an asterisk against those found useful; the rest, he says, proved
either inert or superfluous. They are as follows: Opium, morphia,”
codeia, atropine and its sulphate,” veratrine,” caffeine,” camphor,” Indian
2 3 2 Adžforza /. [9'anuary,
hemp,” strychnine,” aconitine, quinine,” podophyllin, prussic acid,” corro-
sive sublimate,” arsenic,” woorara,” nicotine,” conia,” digitalis,” and tartar
emetic.” From this list it appears that Dr. Anstie has injected beneath the
skin, without doing any good to his grateful and long-suffering patients by
it, the following drugs — opium, atropine, aconitine, and podophyllin. IIe
does not say whether he has not sometimes also injected the others without
good result—probably he has. Would he venture to narrate these negative
results to a respectable unprofessional audience 2 I do not say he deserves
to be hissed, but it is evidently very probable that he would mcct with
some such reception, if he ventured the recital under the conditions Sup-
posed. Surely a true science would blush to have to make such confessions
as these — no loyal son of science could stand by a bed-side and say, “Herc
is the corpus vile on which I performed that experiment.” I need hardly
say that I am far from wishing to say any thing disrespectful of Dr. Anstie,
who is, I am persuaded, as excellent and humane a man, as he is a patient
and accomplished investigator. The reproach falls not on any one man, but
upon the method of inquiry which the reigning medical science has adopted.
Dr. Anstie has used caffeine, by hypodermic injection, in cases of obstinate
sleeplessness, with good results. A correspondent in the August number,
asks how caffeine can act in this way, its reputation being of a precisely
opposite character; so much so that it is given as an andidote to opium, to
rouse the patient who finds the tendency to sleep irresistible. The editorial
answer to this question is not very satisfactory — how could it be, when the
only possible explanation is that which Homoeopathy supplies? He tries
to account for the difference, by contrasting the doses given in the two
cases; but it is quite likely he could give a better explanation if Mrs.
Grundy would let him.
A few days ago I received a letter from a very old friend, who is now an
Allopathic surgeon in Ceylon. He came home invalided last year, and
after trying the most approved medical authorities in his own branch of the
profession, was cured by lay Homoeopathic treatment. He is naturally a
man of very open, receptive mind and character, and is well stored with all
sorts of knowledge. I know few with better natural gifts, and riper cul-
ture. After his cure he hunted me up — we had lost sight of each other for
about fifteen years—and we then had plenty of interesting discourse on
Homoeopathy and other topics. He has not yet fully adopted our methods
in practice, but I do not think he will wait much longer before doing so.
He stumbles at present at the necessity for the minute individualization
which Homoeopathy demands. This is what he says:
“I don't know what to say about Homoeopathy. If there be truth in it,
I am sure of this, that not one man in a thousand can have the peculiar
qualifications required by a Homoeopathic practitioner. He must mascitur
non fit / The crowd of drugs you have to choose from, and the singularity
of the key symptoms, demands a genius to apply the System. On the other
hand, I am so dissatisfied with Allopathy, that I would most gladly throw
it over to-morrow, did I dare. I use Homoeopathic medicines for all my
own ailments, and those of my family, and they appear to cure the most
obstimate and , chronic disorders. They apparently cured almost every
ailment I had in a year; many of which I had suffered from for twenty
years, and never experienced any relicf from Allopathy. I have had per-
1869.] * Aditorial. 233
fect health since I adopted these remedies. I may say the same of my
family. This is curious, but it's only a post hoc, and conveys no conviction
to my mind; the inductions must be innumerable first.”
I have not yet answered this letter, but I intend to quiz my old friend,
for allowing his mind to remain so long inaccessible to valuable practical
truth, by a rigorous and excessive application of the post-hoc-ergo-propter-hoc
precaution. I know of no more effective barrier to conviction, than a too
fastidious use of this deep moated logical fastness. I well remember hearing
a warning against this fallacy before I had been a week at College, and I
very soon saw how plentifully the Allopathic mind allows itself to be
swindled out of legitimate inferences from facts, by putting this blind and
deaf old warden at the gate, and allowing him to thrust aside, with his
surly truncheon, all facts which scemed bursting with innovating conclu-
sions. I have rarely heard an Allopathic doctor argue against Homoeopathy,
or other tabooed doctrines, without dragging in the well-worn motto: Post
hoc ergo propter hoc. Allopathy looks at all nature, outside its own territory,
through these spectacles — which would be less mischievous if they were
simply opaque; but they are of such hugely refracting power, that every
thing seen through them looks blurred and distorted.
Here I think it prudent to stop, or I may bewilder your readers and
myself, by plunging into a wild phantasmagoria of mixed metaphors.
I add a few cases supplied by British practitioners to the journals:
SEPIA. — Dr. J. Murray Moore reports a case of Pemphigus in a married
woman, act. 37, otherwise healthy, cured in three weeks, by Sepia 3rd, taken
four times a day.
MUREx. — Harriet Vaughan, aet. 13, complains of constant desire to pass
water; the flow being clear, pale, limpid. S. g. 1002, neutral, no albumen,
no sugar. A pale-faced, delicate girl, with no other definite ailment.
Mure.v purpurea 3rd, gr. j., three times a day, immediately modified and
soon entirely cured this state.
ACALEPIIA INDICA, Mr. Clifton, of Northampton, has found in the 7th
dil, most useful in tubercular hapmoptysis.
AGARICUs cured two cases of delirium tremens, after other remedies
failed. Also, it cured in 3rd and 6th dil. the following symptoms in an
over-worked clerk, apt. 50. Fullness and pain in the temples, dizziness,
uncertain footing when standing, frequent diplopia, epistaxis, trembling and
coldness of hands, weak tremulous pulse, weary and drowsy by day, sleep-
lessness at night. Also, Chorea, in a thin, spare girl, aet. 18, subject to chil-
blains, cold extremities, dilated pupils, muscular weakness, etc. — CLIFTon.
ANTIMONIUM CRUDUM cured aphonia on getting heated, either from the
weather, or from a room.
BENZOIC ACID, used as a cerate, gr. iij. to 3.j., and internally in 6th dil.,
has cured ganglia of the wrist.— BAYES and CLIFTON.
Bor Ax 12th, cured a child who was almost convulsed by any sudden or
loud moise, as the slamming of a door, a note on the piano. — CLIFTON.
CAUSTICUM has been often useful in scrofulous and rheumatic diseases
of the eye, especially with constipation ; in general, dryness of skin; in
rheumatic prosopalgia, or facial paralysis of the left side; in fistula lachry-
malis; in psoriasis palmaris. – CLIFTON.
CINNAMON, 1st dec. in menorrhagia without pain, every two or three
weeks.
234. Adžāorial. [9anuary,
DROSERA in 12th dil. cured a severe spasmodic cough, when the same
medicine in 3rd dil. failed. — DR. BELCIIER.
Dr. Belcher relates similar instances of cure by Arsenicum 12th, and
Colchicum 6th, after the 3rd and 1st dilutions had failed.
ArtsBNICUM. — Dr. Chalmers, in narrating the incidents that led to his
adoption of Homoeopathy, narrates a case of gastritis in pregnancy, of very
aggravated character, cured by Fowler's Solution in drop doses, which had
to be diminished to one-half drop, on account of severe aggravations.
PIIospiromus. – IIe also relates a case of gastro-enteritis, in a young man,
aet. 24, with health shattered by an accident ; cured by a course of Phospho-
pus 2nd, followed by Mercurius Sol. 3rd. The symptoms were acute agon-
izing pain over the tense, tympanitic abdomen, which could not bear the
weight even of the bed-clothes; clammy, cold perspiration ; pinched, worn
face; eyes sunk, and unnaturally clear (dilatod pupils); hurricq, thoracic
breathing ; vomiting of all matters swallowed; hiccup; every few minutes,
bloody, sanious mucus is ciected from the stomach; scanty, high-colored
water, often voided ; intense thirst ; tongue dry, cracked ; pulse imper-
ceptible; weak, husky, Squeaky voice.
OcłMUM CANUM 30th, has proved very efficacious in relieving severe
nephritic colic, brought on by every playsical eſſort, except those of the
most trifling character; in a gentleman, act. 50, long subject to gouty
attacks in the left eye, stomach, and to gouty asthma and bronchitis, Oci-
mum 30th, and Zincumn 200th, have done more than any other medicine, in
this case. — THEORALD.
AVO ZTAES OAV ZAZ 2 SAO/CO G 2.
By C. WESSELLIGEFT, M.D., BosTon, MASS.
THE ELIMINATION OF MEDICINAL SUBSTANCES THROUGH
THE INTESTINAL MUCOUS MEMBRANE.* By DR. H. GUINCKE,
A88istant in the Medical Clinik of the University of Berlin.
WE would like to give our readers this article in full, but, being limited in
space, we give an extract of the result, which will suffice to establish certain
doubtful points of physiology, and, at the same time, furnish the practicing
physician with useful material.
It is important to know the courses pursued by certain bodies, during
their sojourn in the organism. Under certain pathological conditions, as
well as after therapeutic treatment, the intestinal Secretions are so changed
in their nature, as to eliminate, not only the ordinary material, but also
foreign substances introduced into the body; and it is of practical import-
ance to know which substances are eliminated by the intestinal mucous
membrane, and which are not thus thrown off.
The pure secretions of the intestinal mucous membrane have not been
investigated with reference to this point; but only the fºcces, or contents of
* Translated from Archiv für Anatomie, Physiologie und Wissenschaftliche Medicin. Drs.
O. B. ſeeichert and Du Boid Reymoma.
1869.] Aditorial. 235
the intestines, of starving animals were hitherto tested, without cxcluding
the other glandular secretions of the digestive tract.
We omit the details of the preparations and precautions taken by the
author, in conducting his experiments, for the purpose of obtaining the
pure intestinal secretion ; suffice it to say, that several dogs were operated
upon in the following manner : An incision having been made in the mid-
dle of the linea alba, a loop of the small intestine was drawn out and cut
oſt at both ends; the upper and lower end of the intestine having been
united by means of a suture, so as to form again a continuous canal, one end
of the isolated loop was also closed by suture, and returned into the abdom-
inal cavity, while the other end was made to form a fistulous opening in the
abdominal wall; the secretions exuded from this were collected by means
of a glass funnel, strapped to the belly of the animal, kept suspended by
girths, according to the method of Ludwig. After the conclusion of the
experiment, and the death of the animal, dissoction proved the isolated
intestinal loop to be a portion of the ileum, separated from two to nine
inclies above the ileo-coecal valve.
The intestinal secretion thus obtained is light yellow, feebly opalescent,
and generally contains but few roundish cells; it is thin and fluid, and of
strong alkaline reaction, effervescing with acids (giving off C O2). It does
not become turbid upon addition of alcohol, or by boiling. Being neutral-
ized with acetic acid, a flocculent albuminous precipitate appears. Acetic
acid, added at a low temperature, produces a precipitate which soon
vanishes, leaving only slight opalescence. Ferrocyanide of potassium and
chloride of mercury produce a precipitate, but not constantly. Dilute
hydrochloric acid at first produces a precipitate, which is dissolved upon
farther addition of the H Cl; if still more is added, a new precipitate is
formed, again dissolved by excess of H Cl; whereupon boiling produces no
change in the fluid.
Boiled with oxide of copper and potash, the intestinal juice assumes a
violet color. It does not contain rhodamide of potash. Left standing, it
does not become putrid for several days. The ash contains but little pot-
aslı, much soda, traces of lime and magnesia; much hydrochloric acid, less
sulphuric and phosphoric acid. Ferrum was scarcely to be detected.
Concerning the physiological functions of intestinal juice, Dr. Guincke
found it entirely without effect upon butter, raw and boiled meat, and
coagulated albumen, even after digestion of several days. The results
regarding fibrin and starch were variable. The fibrin was dissolved several
times, the process requiring more than twelve hours; at other times it
would merely swell up, or exhibit no change whatever. The effects upon
boiled starch were by no means uniform ; though some effect could be
observed in nearly every case.
In some cases, after standing for two or three hours, at a temperature of
40°, suboxide of copper was precipitated on applying the copper test.
Frequently the fluid exhibited an acid reaction, while the intestinal juice
alone never became acid on standing. . . .
The author finds, that the digestive properties of the scoretion, obtained
fron, the isolated portion of intestine, correspond entirely with the results
236 Aºdžāorial. [j'anuary,
obtained by Frerichs, and he comes to the conclusion, that the intestinal
Secretion has but little to do with digestion proper, or with the solution and
metamorphosis of nutriment; its chief function probably consists in neu-
tralizing the acid Secretion of the stomach, and of the free acids formed
during digestion.
[Although the author considers himself justified in concluding that he
“had to do with normal intestinal juice,” it must be remembered that it
was obtained from animals maimed by a formidable operation, and kept in
an extremely unnatural position and condition of body. The appearance,
the chemical and physiological properties of the intestinal secretion of the
healthy, unmutilated animal, may, after all, differ essentially from that of
mutilated and, perhaps, starving animals. – C. W.]
The author now passes to investigations of the excretions:
I. Iodine.
1. A dog with abdominal fistula has 0.7 gramme of iodide of potassium
administered internally. The intestinal juice is tested every half hour for
iodine. The albumen having been removed by boiling and acetic acid, a
thin solution of starch and nitric acid is added. The secretton collected
two hours after the exhibition of the medicine, contained no iodine, but
after another half hour some blueness made its appearance, but iodine
could not be traced after twenty-four hours.
2. A second dog with fistula had 0.5 gramme of iodide of Sodium
injected subcutaneously; one and a quarter hours after which, iodine
appeared in the intestinal juice; but ceased to be apparent after twenty-
four hours.
3. A small rabbit, having its oesophagus and small intestine ligated near
the coecum, had 0.2 gramme iodide of potassium injected beneath the skin.
After one and a half hours the animal was killed. Iodine was found
abundantly in the whole of Small intestine, ..besides in the Saliva, urine,
Serum of the blood, and humor aqucus, none in the stomach and large
intestine.
These, and two subsequent similar experiments, proved that iodine will
appear in the intestinal secretion in one and a quarter to one and a half
hours after subcutaneous injection, and in two and a half hours after inter-
nal administration. The result was the same in the case of iodide of potas-
sium and Sodium.
II. Bromine.
Bromide of sodium was administered with bread and water, to two fistu-
lous dogs. In order to find the bromine in the intestinal juice, the latter
was freed of albumen; the filtrate treated with chlorine water and shaken
with ether, which assumes a yellow color in the presence of bromine;
while pure intestinal juice, treated in the same manner, leaves the ether
perfectly colorless. The intestinal juice, taken in the first two hours, con-
tained no bromine, which, however, was discovered after the third to the
fifth hour.
1869.] Aditorial. 237
III. Rhodanum.
In order to discover this metal in the intestinal juice, this was deprived
of its albumen, by boiling with a little acetic acid, and the filtrate treated
with a small quantity of H Cl, in order to prevent the formation of reddish
color through acetate of iron. Upon the addition of chloride of iron (Fe2
Cl3), the fluid turns red if rhodanum is present. An excess of H Cl is to
be avoided.
Two dogs were fed with 2 grammes of rhodanide of potassium. In one
and a half to two hours rhodanum could be distinctly traced in the secretion
of the isolated intestinal fold; all traces of the metal did not cease until the
third day.
IV. Ferrocyanogen.
To see if this compound would be absorbed and eliminated, several dogs
had ferrocyanide of potassium and ferrocyanogen administered to them,
with and without meat. The secretion, having been de-albumenized, was
tested with chloride of iron, acetate of copper, and with sulphate of iron,
without obtaining the slightest traces of ferrocyanogen. It may be added
that Cl, Bernard found that iodine passes very rapidly into the pancreatic
juice and saliva, while ferrocyanogen is never to be detected in these
secretions, but it passes over into the urine much more speedily than iodine,
from which circumstance M. Bernard explains its absence in the saliva.
S UAE GAA’ 1.
By E. C. FRANKLIN, M.D., ST. LOUIs, Mo.
A NEW APPARATUs For TEACHING HERNIA. — Dr. Benj. Howard, Lec-
turer on Operative and Minor Surgery, in the Medical Department of the
Jniversity of New York, has invented a very ingenious apparatus for
teaching this important branch of surgery. It consists of a model, con-
structed of wire, muslin, and sheet tin, made to represent the actual ana-
tomical construction of the parts interested in hernia. It is impossible to
give a description of this apparatus, which must be seen and studied to be
appreciated. It is unquestionably far ahead of all other processes for teach-
ing the surgical anatomy of hernia, as well as its “reduction by taxis.”
The apparatus is simple in its construction, easily made, cheap, and enables
the student to learn, by actual manipulation, what can only be gained by
theory, in the ordinary process of teaching. We recommend it to our
schools, as an improvement far aliead of the usual mode of teaching the
surgical anatomy of inguinal hernia.
A NEEDLE, SIX AND A QUARTER INCHES LONG, REMAINING IN THE
HICART AND THORACIC CAVITY THIRTEEN MONTHS. — M. Tillaux has
recently reported, to the Imperial Society of Surgery in Paris, the case of a
238 Adźforza/. [?anuary,
man, aged fifty-five years, who, in a temporary ſit of insanity, had forced a
three-sided needle, six and a quarter inches long, and one-twelfth of an inch
in diameter, within the thorax, about one quarter of an inch below the loſt
nipple. Emphysema and ecchymosis, at the point of entrance, cmsued.
His face was pale and anxious, thighs flexcd upon the pelvis, respiration
difficult, body bent forward, so as to relax the thoracic and abdominal
muscles, and vague shooting pains in the chest, increased by pressure.
Respiration was feeble on the left side; sounds of the hcart were regular
and normal. It was observed, that, with the first sound of the hcart, the
needle was pushed directly forward and outward. The patient had several
attacks of severe pain, threatening syncope, and demanded immediate ex-
traction of the forcign body. Four days aſter, inflammatory symptoms of
the lung appeared, which continued, with considerable violence, for about
one month; at this time there was palpitation and great irregularity of the
heart's impulse, with occasional slight hapmoptysis, though the patient
gained strength, and was able to walk about till cleven months after the
injury, when there appeared a cardiac soufflet with the first sound, loudest
at the base. This increased for the next two months, with cougll and
haemoptysis, when death ensued from syncope.
AUTOPSY. — The needle was found traversing the whole length of the
posterior wall of the left ventricle, but not entering its cavity, passing
between the spinal column and ocsophagus, and through the lower lobo of
the right lung. The tissue of the hcart showed no trace of inflammation,
but in the lung the needle was surrounded by a membranc, which separated
it from the hepatized lung. —“L’Union Médicale.”
ERECTILE TUMoRs TREATED BY THE CAUSTIC LIGATURE. — M. Wallette,
of Lyons, France, strongly recommends that, in the treatment of erectile
tumors by the multiple ligature, a Seton, impregnated with chloride of zinc,
be passed through the strangulated mass. Fifteen or twenty hours aſter-
wards, he cuts down on to the subcutaneous caustic Scton, and removes it,
introducing a further quantity of caustic, if necessary. IIe Says, that this
method is much less painful than the simple ligature, and more efficacious
than it, or the treatment by caustics alone.
TIIE ANTISEPTIC PRINCIPLE IN GUN-siiOT Wounds. – A very Severe
case of compound comminuted fracture of the neck and trochanteric portion
of the femur, which resulted in perfect bony union, without a trace of suppu-
ration, has been reported by Mr. Cresswell, Chief Surgeon to the Dowlais
Iron Works, England. The treatment, besides the use of splints, and
appropriate dressings, consists in having the wounds well mopped out with
carbolic acid, Squeezing it well into the interstices. “Then,” says he, “have
a picce of lint, soaked in a mixture of carbolic acid and boiled linsced oil,
in the proportion of one part of acid to four of oil, placed over the wounds,
and over this a layer of antiseptic putty, and the whole covered in with
lead-foil, and secured by a spica bandage.”
We shall watch, with great interest, the results of this new principle of
treating wounds, and report, from time to time, our views thereon, in the
pages of this Journal.
1869.] Adžforza/. 239
PopLITEAL ANEURISM CURED BY COMPRESSION IN TWENTY-EIGHT
Hours. — Sir IIenry Thompson, of the University College Hospital, Lon-
don, reports an interesting cure of popliteal aneurism, in twenty-eight
hours, by compressing the femoral artery at one point just opposite Pou-
part's ligament, and at another point, about five inches lower down, with
two of Corte's compressors. The patient himself, an intelligent man, he
adds, “changed the compressure about every three-quarters of an hour, and
felt little discomfort from its application.” In twenty-eight hours after
the first application of the compressors, all pulsation of the tumor had
entirely ceased, and in ten days the patient left the hospital, perfectly well.
DISLoCATION OF THE HUMERUS, OF FOUR MontiIS STANDING, SUCCESS-
FULLY ſtiºd UCED. —In the September number of the “Medical and Surgical
Reporter,” a case is reported by Dr. Libby, of Fond du Lac, Wis, in which
a dislocation of the left humerus was reduced by the use of Jarvis' adjuster.
The patient was fully anaesthetized, and the adjuster applied until the bone
was thoroughly disengaged from its abnormal sockct. Then an assistant,
placing himself at the opposite shoulder of the patient, with his left fore-
arm beneath the patient's left axilla, as a fulcrum, seized the clbow with his
right hand, and brought it, with a powerful sweep, across the patient's
chest, towards the right shoulder; at the same time, the Doctor pressed the
acromion firmly up with the right hand, the fingers of his left hand press-
ing the bone downward and outward, toward the glenoid cavity. The head
of the bone returned to its cavity with a distinct snap, perceptible to the
bystanders. The manipulations occupied one hour and thirty minutes, the
operation terminating in complete success.
MA 7TA: /ø/A MAE ZOA CA.
By C. DUNHAM, M.D., NEW YORK.
AN interesting controversy has been carried on, in the columns of the
“London Medical Times and Gazette,” between Prof. Taylor, the celebrated
toxicologist, and Drs. Rodgers and Borham. Two children having died
under suspicious circumstances, Rodgers ascribes the deaths to poisoning
with Veratrim ; whereas Taylor regards them as the natural result of an
attack of cholera. Taylor questions the value of the chemical test of Vera-
trim, by the use of sulphuric acid and chloride of tin, and places reliance
on the “physiological test” alone, with which, however, he failed, in these
cases, to elicit any evidence. Rodgers and Borham vindicate the chemical
test from Taylor's aspersion ; according, at the same time, full value to the
“physiological test,” with which, they say, that, in these cases, using the
mixture, which was suspected of containing the poison, they succeeded in
producing, upon themselves and upon dogs, symptoms analogous to those
of Veratrºn.
* “ U S. Medical and Surgical Journal,” Vol. III, p. 416.
24O Editorial. [j'anuary,
Wheraver the right may lie in this dispute, it is interesting to us, Homoe-
opathists, to have the testimonies of these distinguished physicians, to the
efficacy and delicacy of the “physiological test,” which is another expres-
sion for “drug-proving upon the healthy;” and especially interesting to
bave the evidence of Prof. Taylor, that the pathogenetic symptoms of Vera-
trim, and the symptoms of cholera, are so very similar as to be undistin-
guishable, save by the absence of poison in the contents of the stomach;
consequently that Veratrim is exquisitely homoeopathic to cholera.
SILICE A, PARIs QUADRIFol.1A, MENYANTIIES TRIFoll ATA.— In the haste
and anxiety of our daily work, we are in danger of taking a one-sided view
of remedies, which have an eminent value in certain well defined conditions,
and of forgetting that they may be indicated likewise in other and very
different conditions. We are in danger, also, of entirely overlooking reme-
dies that are not very frequently required in our practice, but which, when
required, are indispensable. In either case, we shall fail to cure patients
whom we might otherwise cure.
Silicea is a drug universally recognized and esteemed, as having a won-
derful control over the suppurative process — as our most frequently indi-
cated remedy in “simple ulcer"—and, perhaps, the best in whitlow. I
believe, however, that the symptoms of the cerebro-spinal nervous centres
have not been appreciated, by practitioners. Silicea produces the following
group of symptoms:
Severe pressing or shattering headache; the pain is felt in the nape of the
neck, whence it ascends to the vertex, and thence to the Supra orbital
region. Also, from the occiput to the eye-ball, especially the right eye-ball,
sharp darting pain, and a steady ache, the eye-ball being Sore and painful
when revolved. The headache is attended by nausea. It is aggravated by
noise, motion, even the jarring of the room by a footstep, and also by light.
It is relieved by enveloping the head in woolen cloths, or in hot compresses. It
is to be specially noted, that the relief comes from the heat, and not from
the pressure. Spigelia, Thuja, and Cimicifuga, among other drugs, have
similar symptoms, but none of them has the above group, with its concom-
itants and conditions. Guided by this group of symptoms, I have used
Silicea in headache, apparently from nervous exhaustion, as well as where I
supposed that there was lesion of the upper part of the spinal cord. The
following cases illustrate its action:
1. Mrs. C., aged forty-one, mother of three children, is in good circum-
stances, a thrifty housewife. Has been subject to headache for twenty
years. Always has an attack at least once a week, lasting twenty hours.
Pain begins in the right occiput, a pressing ache. Thence it extends
through to the right eye and temple, as well as up to the vertex, and down
the nape of the neck, and the shoulder. Accompanied by nausea and faint-
ness, and by sweat of the head. Aggravated by motion, noise, and light, to
which the eye is very sensitive during the headache. The pain comes
gradually, and goes gradually. It is much relieved by hot applications to
the occiput and forehead. When very severe, the pain in occiput is throb-
bing. Any extra fatigue or anxiety will at once bring on a headache, e.g.,
sickness in the family. March 26th : Silicea 200th, three globules to be
1869.] Adžforza/. 24. I
dissolved in four ounces water, a tea-spoonful every six hours, for a week.
October 30th : She has had but one headache since March. This was
induced by extreme fatigue and anxiety, and yielded in a few hours to a
dose of Silicea 200th.
2. Miss G., aged twenty-two, in narrow circumstances; has to sew four
or five hours daily; is anxious and careworn ; depressed in mind, languid
in body. Bowels and menstruation regular. Every Sunday morning has
a headache, which grows worse as the day advances, and passes off during
the night; a splitting headache from the neck up through occiput to
vertex, and sometimes a sharp pain extending through the head, from occi-
put to right eye. Much aggravated by noise, motion, and light; relieved
by wrapping the head in a warm Shawl, but she can not bear pressure on
the head.
March 17th, 1867: Silicea 200th, to be dissolved, and taken every night
and morning, for a fortnight. While taking the medicine she escaped her
usual Sunday headache. Afterwards she took a powder of Silicea 200th, as
above, for one week of every month, until March, 1868. During this time,
and since, up to October 15th, she has had no return of headache.
3. Miss M., aged thirty-one, the youngest of a family of six, three of
whom, as well as the father, have died of myelitis, having become paralyzed
in the lower extremities. She began, three years ago, to exhibit the same
symptoms with which the disease attacked her relatives; they may be
reduced to three groups: attack of violent pain and Soreness in the heels,
with tendency to tonic spasm of the flexors of the leg; incessant dry cough,
as from a feather in the larynx, the coughs coming very rapidly, and the
disposition to cough becoming the more intense the more it is indulged;
and a headache, similar to that already described as produced by Silicea.
These groups present themselves one at a time. I have found Silicea 200th
to control the headache, Ignatia 200th the cough, and Agaricus musc. 200th
the other group, and the lady is now in better health, and much less fre-
Quently afflicted with any of these symptoms, than she was two years ago.
She bids fair, as indeed she has done thus far, to fight off the family ailment
much longer than any of her relatives did.
Another remedy, not very unlike Silicea, but neglected (as I suppose,
from hearing many colleagues say, they have never used it), is Paris
quadrifolia, the proving of which is found in Hartlaub and Trink's Materia
Medica Pura, III., 149. Paris produces the following headache :
Constricting pressure in the forehead and temples; towards evening the
forehead-pain involves the whole sinciput; it feels as though the skin of
the forehead were contracted, and the bone scraped sore; as though the
membranes of the brain, and the brain itself, were tense — with a tense feel-
ing in the region of the eye, as though the skin were thick, and could not
be drawn into wrinkles; the eyes feel as if they projected, and at the same
time, there is a sensation as if a thread were tightly drawn through the eye-
balls, and backwards into the middle of the brain; it is a very painful
sensation. The sight is weak. This headache is aggravated by motion and
excitement, and especially by using the eyes. Along with it, a sense of
Wol. IV.- No. 14. 8
242 Editorial. [jamuary,
weight and weariness in the nape of the neck, and across the shoulders.
The following case illustrates these symptoms:
Mrs. P., aged twenty-seven years; lives comfortably, but works pretty
hard ; has chronic headache for thirteen years; mostly in forehead and
temples, involving the eyes. “Things feel dark.” “Eyes feel as if they
were drawn back into the brain by a string.” Throbbing in the head
when going up stairs. Relieved by pressure on the head and temples.
Sometimes this headache lasts for months.
December 15th, 1866. Paris quad. 200th, dissolve, and take every six
hours, until relieved. Resume when headache returns.
March, 1867. Reports wonderful relief. Paris controls the headache
perfectly, and within a few hours.
July, 1868. “Paris is a priceless blessing to me.”
A third remedy, which has some points in common with these, is Meny-
anthes trifoliata, a remedy very efficient in irregular intermittent fever,
when the paroxysm consists chiefly of a cold stage, which is incompletcly
developed, the hands, or ends of the fingers, and the toes or feet, and the
end of the nose, alone becoming very cold. The headache of Menyanthes is:
Pressing headache in the forehead and temples; a pressing from above
downwards in the head, relieved by firm pressure with the hand, but recurring
when the pressure is removed; pressing headache, much worse on going
up and down stairs, when it seems as though a heavy weight lay upon the
brain, which presses outwards at the forehead. Here we have a headache
relieved by pressure, as that of Silicea is not.
Mrs. A., aged thirty-seven ; in good circumstances and condition; has
had uterine disease; never had intermittent fever. Constant pressing
headache in the vertex, producing dizziness and nausea. It is relieved by
firm pressure downwards, with the hand on the vertex. It feels like a
heavy weight upon the brain. November 2, 1860. Menyanthes 30th, ten
powders. Take one, dry, every night. The headache, which had troubled
her very much for several years, was relieved within a week, and has never
returned (Oct., 1868).
OBSTE TRICS, AND DISAEASES OF WOMEN AND
CA/ZZ ZXA' A' AV.
BY R. LUDLAM, M.D., CIIICAGO, ILL.
DIPHTHERIA.
IN opening the discussion upon this subject, at a recent meeting of the Cook
County (Ill.) Medical Society, Dr. A. E. SMALL, Sr., directed the attention
of the members especially to the serious nature of this disease, when it
occurs in scrofulous subjects. In his opinion it is this complication which
renders this so formidable an affection. He related the case of a little girl
of seven years, who had but little Soreness of the throat, no pain, a febrile
1869.] Affa'zāorza/. 243
pulse, dyspnoea, breathing interrupted and croupal, which could be heard all
over the house. Prescribed, in succession, Lachesis, Spongia, and Kali
bichrom. The breathing softened, and she expectorated a cast of the trachea
about three inches long. Said she felt well, and he left, very hopeful, at
9 A. M. At 3 P. M. the father came for him in great haste. When he
reached the house she was dead. She had remained well, to all appearance,
until 2 P. M., when she called her mother to her, and said, emphatically
and dispassionately, “I am going to die,” and, when the clock struck three,
she had passed away. Dr. S. had seen a number of similar cases, but inva-
riably there was this scrofulous taint in the family, and loyalty to truth
compelled him to say that he had had little success in treating them.
Another class of cases were more easily and successfully managed.
Aconite, in the first stage, to keep the skin moist and soft. This is followed
by Kali bichrom., which, in his hands, acts better than the Merc. bijod.
When croupal symptoms indicate a threatened closure of the air-passages,
he has successfully given Spong, and Hepar sulph. Never employed the
Crotalus. Belladonna is useful in the early congestive stage, but no single
method is to be recommended in all cases. Each case should be a subject
of special study. Dr. S. has made local use of the preparations of Lime,
Muriatic acid, and the Permanganate of Potassa. Has also derived benefit
from Phytolacca dec. where the cervical glands were swollen and tender, and
the neck was painful.
Dr. S. P. Col.B said, that he had never succeeded in saving a case of
diphtheria, after the membrane had become fully developed, and filled up a .
large portion of the pharynx, or of the air passages. He did not allude to
the isolated spots, but to extensive patches of membrane, covering a con-
siderable extent of surface. If such a membrane is removed it forms again.
In the first case that he saw, the patient complained, at mid-night, of a stiff
neck; sent him some medicine. At noon, the next day, found him in a
severe chill, with fully developed local symptoms of diphtheria. The mem-
brane cleared from the throat, and for ten days every thing passed on
quietly ; he appeared to convalesce slowly but surely. At the end of that
time, upon being moved suddenly, he died instantly. Dr. C. has given
Merc. protojod., Belladonna, and Phytolacca. He also, sometimes, employs
the mother tincture of the latter, in the form of a gargle, six drops to a
glass of water; and at other times a gargle of the Chlorate of Potassa.
DR. C. C. SMITII passed through a severe epidemic of diphtheria five:
years ago. Under Allopathic treatment, as many as three or four died in
one house. Dr. S. employed chiefly Capsicum 12th and 30th, and Nitric
acid, one-tenth, in water. He only lost one case, in which the death
occurred from relapse, due to exposure at an open window. For that par-
ticular epidemic, the foregoing remedies seemed almost absolutely specific.
Caps, is indicated for burning in the throat, as if on fire, and for chills run-
ning up the back. In one case, in which a membrane plugged the nostrils,
and another was also found in the vagina, he prescribed the Hydrastis,
locally and internally. The patient recovered. He sometimes painted the
throat with Hydrastis one-tenth, which seemed to shrink the membrane.
Cured four cases in one family. The fifth case, in the same family, which
244 Adžtorial. [3anuary,
was treated with the Witrate of Silver, and after the “regular ” method,
died. Have used the Phytolacca in only one case, and that successfully.
Have prescribed Lachesis with good success, even in the high potencies.
Rarely give Aconite or Belladonna in this disease. It is almost impossible
to cure diphtheria, when engrafted on a scrofulous constitution. Such cases
die rapidly and suddenly. In croupal diphtheria the Kali bichrom. is the
remedy in case there is a coughing up of stringy mucus, which is sometimes
found hanging out of the mouth.
DR. G. D. BEEBE expressed himself as satisfied, that in time it will be
demonstrated by the microscope, that this disease depends upon minute
septic germs, which are introduced from the atmosphere, and finally develop
their results upon the mucous membranes. Apply an antiseptic, the
deposit is detached, and the ulcer takes on a healthy character, Dr. B.
suggested the use of Carbolic acid, applied through an atomizer. If the
organic enemy has reached the blood, it will be more difficult to overtake it
before organic ruin is already worked. A treatment will perhaps be
devised, by which remedies which speedily diffuse themselves, as for
example, Carbolic acid and Ammonia, will be made available. The Kali
bichrom. is also an antiseptic. The dynamic remedics are competent either
to destroy the germs, or so to affect the tissues that they shall no longer
prove a congenial soil for their development. There is no good reason why
the high potencies may not be very efficient and useful. He has given
Rhus top. where the symptoms assume a typhoid type, and the discoloration
of the throat is very dark ; Belladonna if it is bright.
DIt N. F. CookE has employed the usual remedies, but thinks much of
Cantharis. Is of opinion that the Proto-iodide of Mercury is more readily
absorbed, and more prompt in its action, than the Bin-iodide. Has not
succeeded with Bromine, Spongia, or LIepar 8wlph. It is important to guard
against anorexia, to give an aliment which is easily assimilated, and to
abstain from violent remedies, as well as from an exclusive reliance upon
local means. He had observed a great variety of Sequelae, among which
were amaurosis; ulcers of the cornea, with loss of one eye; permanent
aphonia; otorrhoea; ozoena ; chronic ulceration of the conjunctiva; and a
spurious form of urticaria, which did not yield to treatment proper to
nettle-rash, but was followed by desoluamation.
DR. Holbrook counselled the more frequent and varied use of the Car-
bolic acid in diphtheria.
DR. BEEBE suggested the employment of this acid as a disinfectant in
dwellings in which diphtheria prevails.
INVESTIGATIONS RELATIVE To THE ACTION OF THE TISSUES Excised,
AND, ALSO, OF THOSE ENCLOSED IN LIGATURES, OR SUBJECTED TO THE
CAUTERY, AND LEFT IN THE ABDOMINAL CAVITY. A ContribuTION to
OvARIOTOMY. — Virchow's Archiv, B. 44, H. I. S. 69, contains, under this
heading, a paper by Profs. O. Spiegelberg and W. Waldeyer, which ad-
vances views not generally entertained. If subsequent experience estab-
lishes these views, a revolution will be effected in other operations, besides
1869.] Aditorial. 245
that for ovariotomy. These writers say—for we can only give the results
of their experiments:
“Our experiments show that we can leave small, foreign bodies in the
abdominal cavity without danger; they show that tissues cut off by liga-
tures, and cauterized tissues, do not mortify in this cavity, and that they
produce no injurious effects upon the parts about them, provided only that
this cavity is closed completely.”
The experiments were performed upon bitches; sections were taken from
the horns of the uterus, and from the ovaries; in some cases the stumps
were left longer, in others shorter; in some the ligatures were brought out
through the wound in the abdomen, in others they were left in the abdomi-
nal cavity. In three bitches the cornu, or the body of the uterus were
burned, by means of galvano-caustic apparatus, and the burned portions
left within the abdomen.
With one exception, all the animals bore the operation well; there was
but slight febrile action, and moderate diarrhoea; the wounds in the abdo-
men healed remarkably quick, and generally by the first intention. The
great omentum appeared in every case as the protecting organ for the
intestines; thus it was always found closely agglutinated with the wound
in the intestines, as it lay like a thin wedge between the two lips of the
wound. On making a transverse Section of the cicatrix, the omentum
could be traced in to the depth of one or two millimetres. . . . . Even in
one case, in which part of the intestine hung out of the cavity of the abdo-
men, the greater part of the wound in the peritoneal cavity had healed by
the first intention. It is especially noteworthy how rapidly and surely,
even after grave operations, healing occurs in the serous membrane.
In those cases in which the ligatures were left entirely in the cavity of
the abdomen, no injurious effects were noticed. The ligatures were either
found: 1, encysted by newly formed connective tissue, or, 2, free in the
abdominal cavity; or, 3, floating, free in a small cystic cavity of the stump.
No trace of mortification was noticed in any case.
As regards the “stump,” that is the portion left between the ligature and
the line of section; it has been, heretofore, taught that this must be left as
short as possible, since there is danger of mortification in the portion thus
secluded, but these experiments demonstrate that, at least, in bitches, no
mortification ensues in such portions of the uterus.
SPONTANEOUS AMPUTATION IN UTERO.
Reported to the Cook County Medical Society, by DR. F. A. LORD, CHICAGo, ILL.
A CASE of this kind occurred in my practice, November 5th, 1868. The
child—a girl — was born during a natural, but tedious, labor of twenty
hours. It weighed nine pounds, and was well formed in all respects, with
the exception of the right arm, which terminated, about an inch and a half
below the elbow, in a rounded, well-shaped stump, similar to what is pre-
sented after circular amputation with the knife. The elbow-joint is perfect;
246 Adžāorial. [?anuary,
the bones below the elbow sceming to be united, and the radius being
about a half inch longer than the ulna. The well-defined end of the radius,
covered with the plump, soft cushion of flesh, has exactly the feel, as well
as the look, of an artificial stump. Upon the end of the stump is a large,
deep, smooth, and funnel-shaped depression, the integument being perfect
to its lowest point. This corresponds, nearly, to the end of the radius. A
little external and posterior to this, and connected with it by a shallow
sulcus, is another depression, less deep, and less regular, having, near the
bottom, a small, hard lump, or tubercle, covered with natural skin, and
about the shape and size of a small half pea. Anterior to these, and about
mid-way between them, is a third depression, or pit, very small, and per-
fectly regular.
There is nothing in the history of either parent, or of the mother's gesta-
tion, which can be supposed specially to account for the phenomenon. The
mother, however, has been an invalid since childhood; is predisposed to
lung disease and paralysis; and is excessively nervous. She has, moreover,
been married five years; has always been regular in her catamenia; has
always desired children; has never suffered from uterine disease, so far as
known ; and was never before pregnant.
Careful but unavailing search was made among the Secundines for the
missing hand and fore-arm.
Three almost precisely similar cases are mentioned in “Simpson's Me-
moirs,” Vol. II., p. 333; and what is particularly remarkable in this con-
nection, is the fact that in all these cases the deformity occurred in the right
arm, and the subjects were all females. Simpson also refers, without par-
ticulars, to three cases seen by Chaussier, in two of which the amputation
occurred at the upper third of the fore-arm.
The question, whether these malformations are really the result of am-
putation in utero, or of arrest of development, is a very interesting one,
and worthy of more thorough investigation than it has received.
CA/A2M/STR 2 AAVZ) PA 12S/-CA/C SC/A2/VCAE.
BY F. A. LoBD, M.D., CIIICAGO, ILL.
ARE WE TO HAVE A SCIENTIFIC BASIS FOR MEDICINE 2
IT is daily becoming more apparent, to the attentive student, that the great
advances in Medical Science, to which we are ever confidently looking for-
ward, are to be realized primarily through profounder insight into univer-
sal physical and chemical laws; thus giving to Medicine a strictly scientific
basis, destined sooner or later to furnish the most valuable practical results.
The spirit of earnest physico-philosophical inquiry, so eminently character-
istic of the best mind of our times, is already beginning to bear some of its
1869.] Aditorial. 247
rich first-fruits; and gives promise of an early and final solution of some of
the most difficult and fundamental problems in Medical Philosophy.
Chemistry has of late been making rapid inroads upon the mysteries of
Organic Nature. It has already achieved most brilliant analytical triumphs
among the elaborate products of the living organism; and by skillful recom-
bination of their component molecules, has produced, artificially, not a few
of the secondary products of the animal and vegetable world. A number
of organic bodies have even been formed by direct chemical union of their
simple elementary constituents; thus proving that the mysterious “vital
forces,” of which we have heard so much, in days gone by, have no exist-
ence whatever, Save among the chimeras of the human imagination, whose
fertile creative powers have ever been so subservient to preconceived ideas.
Organic Chemistry, though yet in its infancy, is thus rapidly bringing us
to more definite and Scientific vicws of vital processes. Physiology is
becoming more and more merged into Chemistry; and it need not surprise
us to sec Pathology following in the same footsteps. Even with the present
limited knowledge on this subject, Dr. Henry Bence Jones, one of the most
accomplished and scientific men in Europe, has ventured to attempt an
explanation of many discased actions on chemical principles; and with no
little apparent success. The Reverend Professor S. Haughton, also, in a
recent brilliant address before the British Medical Association, at Oxford,
on the “Relation of food to work done by the body; and its bearing on
Medical Practice,” has given a chemico-physiological explanation of the
pathology of typhus fever, cholera, and diabetes mellitus, which has been
justly styled, “the most important and beautiful application that has been
made of modern physiology to pathology and therapeutics.”
Dr. Bence Jones has also attempted a classification of medicines, in accord-
ance with their supposed chemical actions in the body; and “The influence
of direct chemical addition upon the physiological action of medicines,” has
already engaged the attention and experiment of Some of the most eminent
European savans.
In Physics, the inseparability of matter and force—a fact of immense
bearing upon medical Theory and Practice—has at length been definitely
stated by Dr. Bence Jones, in his Croonian lectures, recently delivered at
the Royal College of Physicians. This doctrine is now being put in an
original and still clearer light, by an honored member of our own School
of Medicine, who, so far as is known, was the first to elaborate and distinctly
teach it. The present number of this Journ AL contains the first install-
ment of what is already prepared for the printer.
Again: the so-called “Law of Conservation and Correlation of Forces "
—though, as at present generally understood, probably only a half truth—
has undoubtedly sounded the death-knell of all “special entities for the
explanation of physical and physiological phenomena;” and it is now
generally believed, by the most advanced in Science, that the universal laws
of Matter, Force, and Motion, when more fully comprehended, will be all-
sufficient for such explanation. This view is entertained and advocated by
such men as Professors Grove, Liebig, Mayer, Helmholtz, Carpenter,
Letheby, Tyndall, and others, who stand confessedly among the foremost in
248 Adžāorial. [3anuary,
scientific ranks. In his later days, the illustrious von Humboldt distinctly
said: “I call no longer that a ‘vital principle,’ which probably is only the
result of the reaction of long familiar elements, and their material activities.”
In view of these indications of the tendency of Modern Science, and
others that might be cited, it is confidently believed that the time is at hand
when Physiology and Pathology will be put upon a purcly chemico-physi-
cal basis, and the effects of drugs on the living system will be known to be
dependent alone on their chemical and physical properties; using the
former term in its widest sense, and as including molecular constitution, as
well as atomic composition and relation.
We are aware of the incredulity, and impatience even, with which these
ideas will be met by many who may chance to read these pages. We are
aware of the tenacity with which time-honored theories, and long cherished
opinions cling to the most liberal-minded. We are aware, also, of the indis-
position of the mass of medical practitioners to study the subjects broached
in these remarks, and of their consequent ignorance of them. If what has
been imperfectly said, shall have the eſſect to turn the attention of some
thoughtful ones, to the profoundly interesting and important subject of the
relation of the Physical Sciences to Medicine, our object will have been
accomplished.
Nor should any be deterred from this investigation by the cowardly fear
that some present convictions may be found wanting a solid foundation.
Such discoverics have no terror for the ingenuous mind. That Homoeo-
pathy will appear to any real disadvantage in the full light of present and
future scientific attainments, we do not believe; but, rather, that Similia
Similibus, the pole-star of our faith, will, only receive increased lustre from
all the light that can be shed upon it by other scientific truths. This, how-
ever, is really a matter of secondary importance. We seek the only valua-
ble and lasting thing, viz., TIIE TRUTII, come whence it may, and with
whatever consequences attended. Whoever can not endorse this sentiment,
should abandon at once all claim to scientific aspiration, and all right and
title to the Sacred name of physician. |
Poisonous ARTICLES IN COMMON USE. — The Berlin “Allgem. Medecin.
Central-Zeitung” calls attention to several articles in common use, which
are dangerous to life and health. They are:
Stearine Candles. One kind of these is remarkable for the alabaster
whiteness; when broken they show rather a spongy than a crystalline
texture, and on burning emit a feeble garlicky Smell, and a slight white
smoke. These contain arsenic, and should be avoided.
Visiting Cards. Some of these present a brilliant white crystalline super-
ficies, which readily separates from the body of the card when it is bent.
This is produced by a thin layer of acetate of lead, and, therefore, children
should never be allowed to play with such cards.
Blotting and filtering paper. Much of this is used by confectioners, cooks,
and druggists. That cheap quality, which is of a light-grey color, is made
from paper cuttings and old carpets, and is seldom entirely free from arsenic
1869.] Adž/orial. 249
and other mineral poisons, which are used in dyeing these latter. A chem-
ical examination disclosed one grain of white arsenic, five-sixth grain oxide
of copper, one-quarter grain oxide of lead, in twenty-five grains of this
paper. It should never be applied to such purposes.
Woolen Dyes. The dyes now largely employed in woolen fabrics are
often deleterious, and even the time-honored red flannel, as it is now manu-
factured, may be positively injurious when worn next the skin, owing to
the danger of absorption.
It is better to use white than colored under garments. – “Medical and
Surgical Reporter.”
It was distinctly stated to the Cook County Homoeopathic Medical Soci-
ety, before reading the Report on Carbolic Acid, contained in this number
of the JOURNAL, that the paper was mainly a collation, from what had
previously appeared on the subject in various Medical and Scientific Jour-
nals
CZ/MA 7'O/C OG 2 A/VZO H1(G/AEAVAZ.
BY H. P. GATCHELL, M.D., KENOSIIA, WIs.
EDITOR OF Journal, : The following letter was written in reply to
inquiries, regarding several places, in view of an intended change of resi-
dence on the part of a Homoeopathic physician. After the writing, it
occurred to me, that though written for a special purpose, it might serve
the more general one of directing the attention of Homoeopathic physicians
to the growing North-West. Whether it may or may not be worth pub-
lishing in the columns of the JourtNAL, is a point which I submit to your
better judgment. H. P. G.
KENOSHA, Wis., November 15th, 1868.
DEAR -— : I take pleasure in contributing such information as I con-
veniently can, relative to the places about which you inquire.
1. There is no particular virtue in salt water. There may be just as
much “bilious” disease near to, as remote from, salt water. It depends on
other conditions, chiefly heat and moisture, so far as climatological influ-
ences are concerned.
2. The North-west, near to, or remote from, Lakes Michigan and Superior,
is more healthful than the north-east, near to, or remote from, the Atlantic.
There is less consumption, and more average health.
As to St. Louis and Washington, they are among the last places to seek,
if one wishes to have a healthy liver.
An acquaintance of mine, once a zealous abolitionist, having got an office
in Washington, and become infested with the moral (immoral?) atmosphere
that oppresses it, got an attack of snobbishness, and wrote to a northern
paper, the reports about the insalubrity of Washington were northern lies.
ſº
25O Adžāorial. [3anuary,
He did not know, probably, that Jefferson was accustomed to leave it in
Summer on account of its unhealthfulness.
As to St. Louis, the climate is equally bad, or worse. The summers,
laden with moisture from the Gulf, are very debilitating, and the winters,
abounding in frost from the Rocky Mountains, are Savagely chilling.
Wilmington is a pleasant, thriving city, about which I can not add much
to what I formerly wrote. Its mean summer temperature, 75° Fahr., is
about the same as that of Louisville, as is its mean winter, about 35° Fahr.
Nor is there any great difference in the extremes, or in the degree of mois-
ture (a quality which always exaggerates the effects of both heat and cold)
of its atmosphere, the vapor from the Gulf in the one case being about
equivalent to that from the Atlantic in the other.
The climate, in either case, is passable; August (as is the case with the
coast in general as compared with the interior) being somewhat more sultry
at Wilmington than at Louisville. Both of them are subject to the numer-
ous fluctuations, which, pertaining to the whole country, from the Rocky
Mountains to the Atlantic, are especially characteristic of the middle
latitudes.
The region which you indicate, on the sound, east of New York, has a
climate very much like that of Cleveland, about the same temperature, and
a little more moisture: about the same class of diseases, and about the same
relative mortality. It has some ague, some bilious and typhoid fever, and
about the same ratio of consumption. Of the various regions about which
you inquire, I regard this as, in the whole, the most desirable, unless
Brooklyn may be a little more so. The difference, of course, can be but
trifling between places so near and so similar in topographical features and
relations. Not one of them has as good a climate as the western shore of
Lake Michigan. I do not mean to indicate that as by any means a perfect
climate. No one can be regarded so, unless it belongs to the class which
meteorologists term mean, i. e., moderate climates. The immense region
cktending from the Rocky Mountains to the Atlantic, constituting, in view
of a fair estimate of its advantages and disadvantages, perhaps the noblest
national heritage on the globe, is in all of its latitudes, an extreme climate,
having a great annual and diurnal range; we have this side of the Pacific
coast no really delightful climate. We may have such as are relatively, but
none that are absolutely so. It is in vain to seek such.
But of this you may be assured, that, in general, the region, about 500
miles wide, lying north of 42° latitude, and stretching about 1,900 miles
from Lake Michigan to the Pacific Ocean, has fewer colds, less consumption,
and less mean mortality, and begets more good constitutions, than any
large region whatever, between Lake Michigan and the Atlantic, in cor-
responding latitudes; while the ratio of bronchitis, pleurisy and pneumonia
is much less than in more southern climates.
You see that I have strong convictions relative to the Superiority of the
great North-west. It is destined to be the home of a population, probably,
unsurpassed in vigor. The vastness of its resources, agricultural and
minerał, will redecm it from that penuriousness, into which the Gnforced
frugality of most northern regions is so apt to degenerate; its dry, tonic
1869.] Baſitorial. 25 I
atmosphere will contribute to a high degree of energy; its fertile plains and
valleys will sustain an immense population, that must needs, in a great
measure, rule North America, and hence, in Some degree, the world.
It is pre-eminently a region to be sought by the young, the energetic, the
ambitious, by those who wish to be among the founders of empire.
Hoping when you do change your location, that the change may be a
successful one, I remain, +
Very truly yours, H. P. GATCHELL.
AN INTERESTING EXPERIMENT.
“DR. PETTENKof FER, of Munich, by the aid of the King of Bavaria, has
recently been making some experiments, which serve to give the scientific
world some new facts and ideas on the question of the uses of Sleep. That
sleep is a period of rest and repair for the mental and physical systems,
experience told us as long ago as when Adam used to take his afternoon
nap ; but it is something more. It is a state or condition in which the
body busies itself in laying up a store of force, for use in the hours of wake-
fulness, when the greatest demands are made upon the mental and physical
strength. As oxygen, long suspected of being the universal stimulus, was
to be questioned, Dr. Pettenkoffer constructed a chamber capable of being
hermetically sealed, and otherwise so managed that the composition and
quantity of the air, entering it as needed, could be accurately determined.
The exit for the air was, as well as the cntrance, controlled by a valve, per-
mitting passage only in one direction ; at the exit valve the changes in the
air, consumed in the clamber, could be ascertained. In this chamber, cer-
tain workmen pursued their usual avocations, of a light character, during
the day, and had their accustomed sleep in the night. It was found, con-
trary to all expectations, and in contradiction of the theories, heretofore,
generally entertained, that during the day, when the waste of force was the
greatest, the quantity of oxygen absorbed by respiration was only half of
that absorbed in the night, when the body and mind were at rest; and that
the exhaled carbonic acid was fifty-eight per cent during the day, and
forty-two per cent. in the night, or rather during sleep. It follows then,
that not the least of the uses of sleep is this restoration of the vital forces,
by storing up oxygen in the system to meet the demands of labor during
the day; and that to the presence of oxygen in excess is due that exhilara-
tion and buoyancy, which are apt to greet the waking hours of those who
are in perfect health. The one practical lesson, which Dr. Pettenkoffer
derives from these new facts, is that old one, that can not be too often, nor
in too many ways, repeated, viz.: The absolute necessity, for mental and
physical soundness, of a full supply of air, the oxygen of which has not been
consumed by the inhalation of others, during the period devoted to sleep —
that is, that well ventilated rooms, for occupation during the night, are
more indispensable to physical vigor, than pure air during the hours of
labor, because from that air we charge the blood with the potent stimulus,
which carries us through the toil of the morrow. On extending the experi-
ments further, it may be found that the craving of the physical system, for
the artificial stimulus of alcoholic drinks, may be mainly due to the imper-
fect ventilation of our rooms; hence, that, instead of enacting prohibitory
laws, such as those by which the Cleveland reformers, the other day, pro-
posed to stop the sale of all alcoholic beverages, more good may be done by
convincing men that they may have a natural stinaulus laid up for each
day's consumption, by opening a window when they lay down to rest. In
these interesting experiments there is, it seems to us, much which illus-
trates the wants of our domestic life; and as such, as well as for the inter-
252 Jºditorial. [3anuary,
ests of science at large, we shall be glad to know that they are to be
continued.”
The preceding passage, which I cut from the “Post,” contains a state-
ment of facts, of no little interest in their relations to hygiene. But what
strikes me as singular, is that they should be of recent discovery, by Dr.
Pettenkoffer, and that I should have been teaching them eight or ten years
ago, and referring their discovery to Bernard. I can not now lay my hands
on the medium through which I originally obtained the information; I
Only know that I taught, as among Bernard's discoveries, that oxygen is
stored up during fasting, rest and sleep, and that the accumulation occurs
chiefly in the muscular system.
Nor is it, if I am right in my recollection, the only instance in which
Bernard's discoveries have subsequently been claimed (though at first
opposed) by German physiologists. But, however this may be, no one can
fail to realize the importance of thus storing up oxygen.
It seems to be well established, by recent experiments, that power is
developed by the action of oxygen on hydro-carbonaceous food; and that
this is the chief source of the energy displayed in the mental, mechanical,
and physiological action through the animal organism. If oxygen is stored
up, for this all-needful use, during fasting, rest, and sleep, we acquire new
ideas of the necessity of these several conditions.
Prof. Scharling (quoted by Carpenter) states, that in one instance, the
hourly exhalation of carbonic acid during sleep sank from 160 to 100, in
another from 194 to 122, and in another from 99 to 75—that in one instance
the exhalation increased after breakfast, from 140 to 177, and in another,
after dinner from 112 to 189.
Vierrordt (quoted by the same author) states that the exhalation of carbonic
acid is increased thirty-three per cent. by moderate exercise. If the excr-
cise be prolonged, however, so as to occasion fatigue, it is succeeded by a
diminished exhalation. Let every one remember when he begins to feel
fatigued, that it is a suggestion of the organism as to the need of a new
supply of oxygen necessary to effecting muscular contraction ; perhaps by
electrification of the muscle-cells.
The relation of oxygen to development of power, and that of sleep to its
accumulation contribute, also, to explaining the pernicious effects of in per-
fect and deficient sleep. For it is quite certain that oxygen Serves the
same purpose relative to brain as to muscle, and that the cells of the former,
equally with those of the latter, become paralyzed in its absence.
The effect of eating, in causing increased consumption of oxygen, affords
added evidence of the perniciousness of Chambers' advice, that dyspeptics
should eat frequently; than which scarcely any practice contributes more
to causing dyspepsia. My observation leads me to the conclusion that the
longer dyspeptics fast (not to rush to Some absurd extreme) the more
specdily they recover. There are very few of them that are not benefitted
by abstaining from supper, even when the dinner is eaten as early as 1 P. M.
The first effect is an increased schse of faintness at the epigastrium ; but
this gradually subsides, and is succeeded by increased and permanent relief.
I do not mean to state, that this abstincmce alone is sufficient to cure dyS-
1869.] Aºdžforza/. 253
pepsia, but only that it is one important condition. It may be that a full
stomach interferes with that storing up of oxygen, during sleep, which is
all-important to health and vigor.
It demands some firmness, on the part of the dyspeptic, to endure the
trial to which his nerves are subjected during the first few days of absti-
nence. But the system acquires vigor, and the stomach tone; and, at
length, the abstinence becomes a Source of pleasure, instead of suffering.
Instead of rising with a coated tongue, an offensive taste in his mouth, and
no appetite for breakfast, he rejoices in a relish for his morning meal, a
sweet mouth, and a clean tongue.
Let no one, therefore, be misled by Chambers' advice, into inducing his
dyspeptic patients to (what they are altogether too ready in many instances
to do) eat frequently.
M/S CAE Z ZAAVA. O.O.S.
THE ANAPNOGRAPH.
WE herewith present our readers with the draught of an instrument lately
presented to the French Academy, for registering the respiration, by MM.
L. Bergeon and Ch. Kastus. “A registering lever, furnished with a writ-
ing point presents, at its opposite extremity, an expanded portion closing a
tube, through which respiration
is made. This expanded portion,
which plays the part of a valve,
is very light; it is formed of a
leaf of aluminium, reduced to an
extreme thinness; this leaf is
connected with the tube, by a
very delicate suspension, permit-
ting motion about a horizontal
axis, and resisting all sorts of
lateral motion.
|t
The system of the valve, of the
writing lever, and of the axis, is
in a state of indifferent equilib-
rium, which completely annihi-
lates its weight; to maintain it
vertical in its position of repose,
an accessory organ hence is ne-
cessary. For this purpose we
- Wºlſº have placed, at each side, a small
==|º ſº; i spiral spring, which would draw
-
i. ***... another spring of the same force,
FIG. 1. for respira-
- the valve to itself, were it not
º ######## drawn in another direction, by
tion is attached. "Movable valve. R. R. Screws brought to the same degree of
for regulating the springs. S. Writing point; the e º
registering apparatus. tension by a regulating Screw.



254 Balzformal. [jamuary,
The valve placed thus, between two equal forces, will remain motionless
and vertical, as long as the equilibrium between the two springs is kept up.
But let some force act upon it; since the valve is maintained in a vertical
position only by the action of the springs, it will not of itself offer any
resistance; its rôle will be entirely passive; it will be but intermediary
between the force and the spring, while the spring will yield at every
moment exactly in accordance with the intensity of the force. . . . . Each
Current of air, inspiratory or expiratory, . . . . is represented by a curved
line, having, as the arterial pulsation of the sphygmograph, three very
evident directions, the ascent, the summit, the descent.
The regularity of the clock-work (sufficiently perfect)
\ which unrolls the paper, the length of the springs, so ar-
% ranged that the valve shall never open beyond a certain
| extent, and, finally, the exquisite sensibility of the apparatus,
which registers the most feeble shocks, such as the bursting of
a bubble in a bottle, enable us to appreciate the frequency of
the respiratory movements—the relative duration of each
one, their intensity, and especially their form.
The respirations are effected through the nose. Fig. 2
shows an India rubber cap, which is drawn over the nose —
\ this cap is applied to a metallic tube, which is applied to the
instrument at A, Fig. 1. Our authors say, that a tube
#7 placed between the lips is not easily closed, and is not with-
#7 out its inconvenience, when several persons have to use it;
moreover, they add, “the nose is, rather than the mouth, the
true respiratory orifice (conduit). According to Ph. Berard,
respiration by the mouth is no longer a normal respiration.
Two sizes have sufficed to register the respirations of a great
number of subjects, from eighteen months to ninety-six
years.”
“Destined,” they say, “chiefly to register the motions of
automatic respiration,” our apparatus is called an Anap-
nograph, ºvartvo) signifying respiration. — “Comptes
Rendus,” LXVII., page 554.
HOMOEOPATHY IN RUSSIA.
OUR medical exchanges, and the secular press, have been teeming with the
wonderful news, that the Emperor of Russia had prohibited the practice of
Homoeopathy in Russia, under severe penalties. It was curious to notice
how one after the other took up the cry, while any one with half an eye
might have seen how absurd and impossible the report was,
The “Courrier Médical” has the honor of giving birth to this falsehood;
the “London Lancet’’ took it up, and so it went on through the whole list.
The “Lancet” now acknowledges that there is no truth in it; the editor
says, that in his “simplicity he merely copied a statement to this effect


1869.] Adžfozzaſ. 255
from another paper.” It does one good to hear the editor acknowledge his
simplicity. He never said the prayer : “O wad some power the giftie
gic us,” etc., or, if he did, it was never answered, for other people knew long
ago, what he has just discovered. Simple Lancet! Doves and lambs will
cease to be the emblems of simplicity, and the “Lancet" will occupy that
time-honored place. Who would have thought to see the day when the
“Lancet” (!) should be the emblem of simplicity.
Talking of ukases, we learn from the “Monthly Homoeopathic Review,”
(Nov. 1st, 1868), that a “ukase has been issued by the Emperor, officially
Sanctioning the formation, by the Homoeopathic physicians of St. Peters-
burg, of a Medical Society, which was obtained, moreover, in spite of the
active opposition of the medical council of the Empire!”
A writer in the “Rivista Omiopatica,” published in Rome, in remarking
upon this rumor, says: “There are Homoeopathists practicing from Peters-
burg to Moscow, and from Moscow to Odessa, in every part of the Empire,
ignorant of the imperial ukase, and probably of that of the “Courrier.”
At St. Petersburg there is Dr. Gastfreund, Physician to the Imperial Marine;
Dr. Wedrinscki, Army Surgeon and Counsellor of State; Dr. Schering,
Counselor of State and Chief of the Hospital of the Imperial Guard; Dr.
Sullyer, editor of a Homoeopathic Journal, and Director of a large dispen-
sary; Dr. Sollier (from Marseilles), Honorary Physician to the household
of the Grand Duke Constantine, together with more than thirty others.”
The “Monthly Review " also informs us, that whilst the physicians of
the large hospitals in St. Petersburg admit a mortality of 33 per cent., Dr.
Hering, a Homoeopathic physician, who, in his capacity of medical officer
of police, was in charge of a temporary hospital, containing ten beds, con-
stantly occupied with cholera patients for eight weeeks, lost not a single
case. . . . At the conclusion of the epidemic, Dr. Hering's services were
acknowledged, and his success attested by an Imperial decoration.
[?” ALLOPATHIC EXCHANGES PLEASE COPY. &l
THE ACTION OF MEDICINES.
(From our British Correspondent.)
THE Therapeutical Committee of the Harveian Society has resolved to cir-
culate the subjoined questions, amongst the medical men of the United
Kingdom, and to ask the co-operation and assistance of the profession gene-
rally, in carrying out the objects of the committee:
1. Have you found any of the following drugs, namely, Digitalis, Cantha-
rides, Chlorate of Potash, Belladonna, Arsenic, Quinine, and the tincture of
the Muriate of Iron (as distinguished from the other forms of iron), partic-
ularly useful in any special form of disease?
2. In what form of preparation, and in what doses, are you in the habit
of administering these drugs? And what results have you observed to
follow their administration, in the disease to which you refer?"
3. Can you, from your personal knowledge, give any information respect-
ing the use and doses of any drug not commonly employed ? or respecting
256 Adžāorial. [9amuary,
any method of treating any disease, which you have found particularly
useful in your practice? or can you give information as to any fact in
therapeutics, not commonly known to the profession ?
Answers to any of these queries will be gladly received by the honorary
secretaries, I. B. Cargenven, Esq., 11 Cravenhill Gardens, W., and W.
Hickman, M. B., Dorset Square, N. W., from whom copies and any further
information may be obtained.
BASEDOW’S DISEASE. BY DR. J. HoFRICHTER.
IN a late number of the “Allgemeine Homoeopathische Zeitung,” my friend,
Dr. Teller, brings upon the carpet a case of Basedow's disease, which he
observed in Reinerz, and in which he attempts, but without success, to
ascribe the apparent improvement, which ensued, to Ferrum. At the same
time, he calls upon his colleagues, who meet with cases, to publish them
and their treatment.
Such cases might well be rare, and in my practice of thirty-eight years, I
have had the opportunity but twice to contend with this disease.
Sometime in 1848 it might have been, that I had a lawyer under treat-
ment, who had, after syphilitic iritis, an Hypopion, of which, as well as of
the eye-ball, I caused an absorption, so that a glass eye could be introduced.
Whether from this successful (!) treatment, or some other circumstance, his
sister called on me — a blonde girl, with gray eyes, Scanty menstruation,
and stared at me with a friendly smile, in a very unpleasant manner. It
was the look of a goat, with which I used to amuse myself when a child at
home. The eye-ball was enlarged and pushed forward, though the cornea
by itself was not at all advanced ; the conjunctiva was moderately injected,
probably because the cyc-lids could not close, a circumstance which annoyed
the patient very much. Corresponding to the cleft between the ever
open eye-lids, there was already upon the eye-ball, a yellow, dirty,
opaque line. But this was not the occasion of her calling to see me. She
was a good singer, but since her eyes enlarged she could no longer sing in
the church choir, for, at the same time, she was taken with a swollen neck.
Percussion gave no dull sound, as in struma ; the swelling was clastic, and
uniform, extending in front to the pit of the throat, and on both sides,
Her voice was not changed, but on singing she got out of breath, and com-
plained of dyspnoea; her speech was interrupted; producing throbbing
of her heart. Examination of the heart showed eccentric dilatation, a
bellows sound with the systole, bruit de diable in the carotids. When one
passionately devoted to singing can not sing, it is a great grief to her and
to me.
That I had no inkling, at that time, of Basedow's disease, is clear enough.
Where should I classify the disease? There Hahnemann was right, and
ever will be, let ever so many names be conceived for diseases, and their
Consequences (lomonstrated with scalpel and microscope. A blind hen will
find a kernel now and then, and so it happened with me. I did not hesitate
long ; gave her Natrum mur. 24th, to be taken every day, and in a few
1869.] Adźforza/. 257
months the young lady was relieved of her disease. In 1850, while staying
at the baths for the benefit of my corpus, Illad the pleasure of hearing her
sing a Demedictus solo most clarmingly. She was then married.
In 1861, a bewitchingly beautiful, slender woman came to me, with blue
eyes, and golden locks, just according to my taste. I called her “Miss,”
which provoked a lovely smile; she was married, a mother, ctc. She told
me that she came from Moravia cspecially to sec me, that she had suffered
long from projection of the eyes, had consulted playsicians in Brún, Vienna,
and elsewhere.
The old story ! I assumed the part of Mephistopheles. Her chemisette
was closely buttoned up to the chin. Suddenly I said to her : “You have
also had a swelling of the neck lately 2” She was surprised. “That might
be well covered, as you see,” she replied ; “but it is true, that my swollen
ncok begins to incommode mc, and does not contribute at all to my beauty.”
“And the heart? That beats and bangs? You lose your breath when
going up stairs, or up a hill 2 ” “You understand my disease, I see that
very well. Go on, now, and cure it.” Had I been young, I would have
bet — but never mind.
The neck presented a notable swelling, and the heart gave indication of
an eccentric dilatation, bellows sound with the systole, bruit dº diable in
the carotids. Watrum mur. 24th, daily. The improvement was very rapid,
and in half a year the lady had nothing to complain of I must observe,
however, that she was by no means so poor in blood as was the songstress.
— “Allg. Hom. Zeitung,” Bd. 77, S. 101.
PRAGUE, Sept. 18, 1868.
FRENCII POLITENESS. — In a late number of a French Journal, Dr. G.
Dujardin-Beaumetz, writing of the treatment of progressive locomotor ataxy,
quotes the work of M. Gallavardin — a Homoeopathist — on phosphoric
paralyses. The fact is remarkable enough, for it is seldom that Homoeo-
pathic writings are quoted at all by Allopathists, who prefer to seem to
live in a sublime ignorance of all heretical writings. But what is more
remarkable, the reference is not coupled with any expression of contempt
or disrespect; true, the conclusions of M. Gallavardin are not accepted—
our author even refutes them, as he thinks, but he goes about it as he
would if he were writing about Trousseau or Pidoux, or any other of his
own school. Can it be that they cnjoy a higher degree of civilization in
France than in this country? It would seem So, hence we look with the
greatest satisfaction on the fact that so many of our Allopathic neighbors
are going to Paris!
BUST of HAHINEMANN. — Our Sanctum is graced — thanks to the kind-
ness of Mr. Halsey — with a bust of Hahnemann, the great scholar and
physician, of whom Sir John Forbes says:
“Halinemann was undoubtedly a man of genius and a scholar; a man of
indefatigable industry, of undaunted energy. In the history of medicine
258 Adžāorial. {}anuary.
his name will appear in the same list with those of the greatest systematists
and theorists; unsurpassed by few in the originality and ingenuity of his
views, superior to most in having substantiated and carried out his doc-
trine, into actual and most extensive practice.” — Sir John Forbes, “British
and IForeign Medical Iłeview,” XLI.
Postcrity will endorse these vicws of the character of Hahnemann, and
abundantly add thcreto — meantime, to those who would cherish and honor
his memory, this bust, which is said to be very correct, can not but be
acceptable.
NEW YORK HomoCopATIIIC Col.1.BGE. — Dr. H. D. Paine has accepted
the Chair of Obstetrics, vice Prof. D. D. Smith, who has left the city for
country retirement.
DIR. C. H. VON TAGEN has removed from Philadelphia, and formed a
partnership with Dr. R. Ross Roberts, 120 S. Second Street, Harrisburg,
Pa. A paper, from his pen, on dislocation of clbow joint will appear in
next number.
WE are happy to announce to our readers, that our next number will
contain an article from the pen of Dr. Hering, and that similar contribu-
tions may be anticipated in future numbers.
Also, we shall begin, in the April number, a series of papers by Dr. Jahr,
on Diseases of the Mind, and their Homoeopathic treatment.
And, Dr. Dunham has a few words to say about a screw, which has been
re-discovercºl. Our readers will regret with us that it came too late ſor
appearance in this number, but will enjoy the pleasures of anticipation, in
looking for it in the April number.
A reply of Dr. E. M. Hale, to Dr. S. A. Jones, was unavoidably crowded
out of this number, but will appear in the next.
We have to regret, also, that no space could be found for a paper from
Dr. Searle, of Troy, N. Y., giving account of Some very interesting revela-
tion by the Spectroscope, in the domain of infinitesimals. We hope to be
able to prescnt it, enlarged and revised, in April.
As we are about to go to press, we learn that our agent in Paris has
made arrangements, by which he has secured the scrvices of Dr. L. Molin,
a French correspondent for this Journaſ. We hope to hear from him in
time for the April number.
O/3/7 UAAP 2.
JOIN BARKER, M.D., of BROOKLYN, N. Y.
Born, June 2d, 1823. Died, April 18th, 1868. Of the many playsicians of
our school, whom death has taken from our midst, during the current year,
few have been so sincercly lamented, and by so wide a circle of personal
friends and clients, as Dr. John Barker, of Brooklyn.
Occupying no position which brought him, ea;-officio, before the public,
1S69.] Aºdž/orzaz/. 259
whether personally or by his pen; busied exclusively in the exercise of his
professional dutics, he was yet so widely known, and so generally esteemed
and beloved, in the city of his residence, that he was truly Said to be, “next
to IIenry Ward Beecher, the most popular man in Brooklyn.”
Dr. Barker was born in Wallingford, Conn., June 2nd, 1823. His child-
hood, and a portion of his youth, were spent in Connecticut, but most of
the latter in Atwater, Ohio, where, at about the age of twenty-two, he
began the study of medicine, under the guidance of Dr. Friend Cooke (an
uncle by marriage).
He attended one course of lectures at Cleveland, and, subsequently, one
or more at the College of Physicians and Surgeons, New York, during
which attendance he was a pupil of Dr. Lewis A. Sayre. About this time
his health began to fail, and, without graduating, he went to Wisconsin,
where he practiced a few months, and then, with a view to the re-establish-
ment of his health, undertook and accomplished, in 1849, the overland
journey to California. An accident which befell him, at the age of eighteen,
involving a fracture of the right thigh, had resulted in necrosis of the femur,
and abscesses, by reason of which he had become much enfeebled.
During the journey to California, and a brief residence in that State, the
discharge ceased, and the sinuscs healed. It was supposed that he had
entirely recovered; but, as subsequent events proved, the mischief still
Hurked in his system, to be aroused at a later period of his life, when he was
reduced by excessive professional labors, into the storm which carried
him off.
After remaining two years in California, engaged, more or less constantly,
in the practice of medicine, Dr. Barker returned to New York, attended
another course of lectures at the College of Physicians and Surgeons, and
graduated at that Institution in 1852.
While in California his attention had been turned to the subject of Homoe-
opathy, and he had Satisfied himself, by observation and study, that it is the
true Science of therapeutics. Accordingly, on his graduation, he at once
embarked in the practice of Homoeopathy, entering, in 1853, into partner-
ship with the late Dr. A. C. Hull, of Brooklyn. This connection was
severed in 1854, from which period, until that of his death, Dr. Barker was
uninterruptedly engaged in practice, on his own account, in the city of
Brooklyn.
His success in business was uniform and quite remarkable. Commenc-
ing with no especial advantages of consanguinity, connection or introduc-
tion, he rapidly advanced to the front rank of the profession, and, for
several years before his death, he enjoyed, unquestionably, a larger and
choicer business, than any physician in Brooklyn, of whatever school.
It is not easy to say, precisely, what are the qualities of mind and body,
and how proportioned to Cach other, which shall constitute the successful
and acceptable physician. But Some we may safely assume, and such
assumption may aid us in analyzing character. As a matter of course, the
successful and acceptable physician must be well grounded in the science,
and an expert in the art of medicine. And his knowledge must lie in his
mind, ready for instant application. He must possess presence of mind to
200 Adžforza/.
Confront, with steady sclf-possession, an unanticipatcd danger; courage to
Counteract it at cvery legitimate risk, and calmness to await, the issue.
Blended with these must be that other quality, which the metaphysician
can not define, but which even the hod-carrier instantly recognizes—tact,
whereby the temper and morale of the patient, and his friends, are instantly
perceived and understood, and the physician's adapted to correspond with
them. And, tempering all, must be a genial and bencvolent hearliness of
Specch, manner, and action, which shall satisfy the patient that his interests
are held as of the highest importance in the physician's mind, and that his
Concerns are the subject of carnest consideration — a quality which can
hardly exist, Save as the outgrowth of a Christian's devotion of his life to
the dutics of his humane profession.
In all of these respects, Dr. Barker was eminently qualified for the suc-
CCSS which he achieved. There have been many who surpassed him in
familiarity with books, and with the systems and records of science. But
Very few lave so completely at command as he had, in the sick-room and
the consulting chamber, the practical knowledge they have gaincd by study,
by experience, and by intercourse with other minds. He had a clear ap-
prehension, and a retentive memory, which seized upon every fact that
came within reach, and stored it in an appropriate nook of his mind, ready
for instant application. Morcover, his professional judgment was singularly
quick and Sound, and he had intuitive facultics of a high order, cnabling
him to thread successfully the mazes of many a labyrinth of obscure discase,
to which no systematic works on Practice could have furnishcd him a clue.
That his deportment commanded the confidence, and won the love, of his
patients, the crowds that thronged his office, and solicited his attendance, as
well as the mourning hundreds, who pressed to .pay the last tribute of
respect to his remains, most abundantly testify.
Towards his professional brethren, Dr. Barker was ever courteous and
generous. Always ready, in diſficult cases, to seek aid for his patients from
the counsels of others, and never exhibited any apprehensions of incurring
any loss thereby. Devoid of guile himself, he did not suspect it in his
colleague. Though free and fearless in the expression of his opinions, in
matters of doctrine and practice, he rarely made an enemy in consequence,
SO modest were his utterances, and so free from imputations upon the Capa-
cities or motives of his opponents. In the annoying cases of the transfer
of their patronage, by patients, from a colleague to himsclf— Cascs which
often breed coolness and hard feeling between playsicians — he always acted
frankly, and made a point of speaking to his brother physician on the
Subject without delay.
In a word, his conduct, towards patients and colleagues, appears to have
been modeled upon a just and intelligent apprehension of that Golden Rule,
which is the foundation of ethics, medical as well as Social : “As ye would
men should do to you, do ye even so to them.”
And, in this earnest, conscientious, and most successful devotion to the
duties of his profession, our dear friend and brother persevered, after his
health had been undermined by excessive labor, until a fresh outbreak of
his old discase hurricq him to a premature grave. C. D.
UNITED STATES
Medical and Surgical Journal.
Vol. V.-APR/Z, 1869.-Mo. 15.
*INJURIES AND DISEASES OF THE JOINTS.
CHAPTER I. — SPRAINS.
A SPRAIN, or strain, is an injury of a joint, in which there
is more or less contusion, stretching or laceration of the
ligaments, and neighboring parts, without displacement of
the articulating surfaces, and accompanied by subsequent
inflammatory action. When occurring in subjects of a
rheumatic or scrofulous diathesis, the consequent symptoms
are often of a serious and persistent character.
The joints most likely to become affected in this manner,
include the ginglymoid, as the knee, ankle, elbow, and
wrist, which is due to the circumstance that these joints are
surrounded by short, firm, and unyielding ligaments, while
their motion, also, being limited to flexion and extension,
renders it very easy to cause a severe stretching or rupture,
by putting the parts upon violent tension. The orbicular,
or ball-and-socket-joints, on the contrary, in consequence
of their greater freedom of motion, and the elastic character
of their ligaments, are less exposed to this accident, though
* A complete chapter from Wol, II, Franklin's Science and Art of Surgery.
Vol. W.-No. 15. 1.
262 Injuries and Diseases of the joints. [AA,i,
occasionally extreme abduction of the limbs is quite suffi-
cient to produce serious injury of this nature.
The cause of sprain may be either mechanical violence,
as a blow, fall, or severe twisting of the articular surfaces
upon each other, or sudden and violent muscular action, as
leaping, lifting, or forcibly hurling a weight, which causes,
may also be sufficiently energetic to complicate the accident
with luxation or fracture. Thus, the radius or fibula, offer-
ing quite a marked resistance to the lateral movement of
their respective articulations, sometimes become fractured
in sprains of the wrist and ankle, while, also, one or more
of the carpal, or tarsal, bones may undergo displacement.
Predisposing causes of sprains are met with in rheumatic
and scrofulous patients, owing to a morbid condition of the
ligaments, produced by swelling of the joints; also, in per-
sons affected with club-foot, or other deformity, in which
the articular surfaces of the bones are not in the proper
relative position.
Symptoms. – The symptoms indicating sprain will, of
course, vary according to the severity of the injury. In the
more marked cases, however, there is an immediate occur-
rence of pain, which is often so severe as to cause faintness,
or sickness; there is partial or complete loss of motion or
control over the affected part; heat, tenderness, and swell-
ing of the structures implicated rapidly supervene, while
there is often more or less discoloration of the parts, in
consequence of the extravasation of blood into the cellular
tissue. After the lapse of a few hours, there are serous
effusions into the bursa mucosa, and in the cavity of the
articulation, followed by induration, and a sense of crepita-
tion when manipulating the joint. The pain, which is
excessive from the first, often produces a very marked
depressing influence upon the entire nervous system. In
rare cases, the bursae become so highly inflamed as to
terminate in Suppuration and sloughing.
Convalescence is generally tedious, the joint remaining
weak and tender for several months, and Sometimes for
years. Indeed, it not infrequently happens, especially in
1869.j Injuries and Diseases of the joints. 263
ill-treated cases, that the original strength and movements
of the joint are never restored, the corresponding limb
becoming atrophied, exquisitely sensitive, neuralgic, and
subject to severe exacerbation during motion, or changes in
the weather. Very severe sprains are hence often a more
serious affection than a luxation or fracture.
In the slighfer forms of sprain, the pain may be very
intense for a time, but gradually subsides in the course of
twelve or fifteen hours, the swelling and tenderness disap-
pear, and the joint regains its strength and functions in two
or three days, provided perfect rest has been observed.
Diagnosis. – A sprain may be confounded with a luxa-
tion, or a fracture, especially when occurring in the wrist
or ankle joint. Thus, a sprain of the wrist, accompanied
by an effusion into the bursa of the flexor tendous, produc-
ing a tumor on the palmar surface of this articulation, might
readily be mistaken for Barton’s fracture, and vice versa.
Likewise, serous formations in the bursae of the back of the
wrist, often bear a strong resemblance to a dislocated
carpal bone. Careful manual examination, by making
compression upon all the surfaces of the joint, by flexion and
extension, adduction and abduction, twisting internally and
externally, a comparison of the length of the two limbs,
the patient’s control of the joint, etc., are the only means
we have to ascertain what is going on in the joint. Find-
ing that by pressure, pain can be produced, even in the
slighest degree, it will not be safe to discharge the patient as
cured, or well, so long as this state of things exist. The cartilage
of the joint in a healthy condition is not sensitive; it pos-
sesses no nerves, except those of nutrition; any pain, there-
fore, is evidence of an abnormal condition of these surfaces.
The blood extravasated beneath the cartilage by the injury
received, remains there as a foreign body, producing in-
flammation, and, if not absorbed, serious disease. By the
continued pressure of the joint surfaces together, the mis-
chief slowly but persistently increases, and if the constitu-
tion is at fault, its progress is correspondingly more rapid.
Treatment. — The treatment of sprains will depend en-
264. Injuries and Diseases of the joints. [AA,i,
tirely upon their degree and severity. In the slight or
simple variety, especially when the sprain is seen immedi-
ately after injury, the first indication is, to prevent the
development of inflammatory action, and restore the joint
to its wonted functions. This is effected by immersing the
whole limb in warm water, and retaining it there for fifteen
or twenty minutes, then withdrawing it and covering the
joint involved with a warm saturated lotion of Arnica,
JHypericum, Jehus toº., or Ruta grav., as the nature of the
case demands, maintaining the limb at perfect rest during
treatment. Instead of removing the cloths as soon as they
become cool, it is better to squeeze the lotion upon it as
hot as can be borne, from a sponge, as often as occasion may
require. I generally prefer the Ruta lotion to any other
in the deeper seated joints, and Hypericum, or Rhus toac., in
the superficial, applied by means of flannel, arranged in six
or eight layers, and covered with a superficial layer of oiled
silk, to confine the heat and moisture. After twenty-four
hours, if the pain has materially abated, the heat and mois-
ture of the cloths may be gradually, and imperceptibly,
diminished, and, in twenty-four hours thereafter, gentle use
of the joint may be attempted. If the motion produces an
aggravation of pain, it should be at once discontinued, and
not attempted again until movement of the joint is painless.
In sprains of the ankle joint, Prof. Gross says, he has “fre-
quently seen the happiest effects produced by protracted
immersion of the limb in hot salt-water.” Under the treat-
ment recommended, sprains, of the less severe type, are cured
without the use of any internal treatment, and frequently
very promptly and satisfactorily. In the Severe and more
common variety of sprain, in addition to the treatment
already referred to, the injured limb should be carefully
bandaged, and placed perſectly at rest, in an easy, elevated
position, by means of carefully adjusted splints, and be
retained in this manner, so as to insure more certain
quietude. An excellent plan, is to place the limb upon a
pillow, covered with a strip of oiled silk, to prevent accumu-
lation of the secretions, and to ensure cleanliness; continue
1869.] /n/uries and Diseases of the joints. 265
ta
the fomentations as advised. When the pain and swelling is
unusually severe, and there exists more or less constitutional
irritation, with febrile reaction, Aconite lotion may be substi-
tuted for the Arnica or Rhus applications, and, at the same
time, be given internally. Arnica, Bryonia or Rhus are rem-
edies of value after the subsidence of the more active symp-
toms. In congestions of the joint following sprain, Aconite
is a much more serviceable remedy than Arnica, as it tends
both to check the traumatic fever, as well as to control the
inflammation, and scatter the congestion going on within
the joint. In sprains of a severe type, I have frequently
used Aconite internally, and Rhus or Rula as a lotion to the
affected part, with the most satisfactory results. The violent
strain which the nervous system, in the neighborhood of
the injury, undergoes, superinduces inflammatory excite-
ment to a greater or less extent, which invariably requires
the administration, internally of Aconite, and externally of
II/pericum. If obstinate constipation occurs during treat-
ment, which is very apt to ensue, the bowels must be
relieved either by an enema, a dose of Nua wom., Opium,
Platina, Podophyllin, or other larative remedy. Throughout
the conduct of the case the bandage should be applied and
watched carefully; as when properly and evenly applied,
support is afforded to the injured joint, swelling and spasm
prevented, and absorption of effused fluids promoted; but,
let it become loose, or be unevenly applied, producing
constriction of the limb at one point, and irritating the
extremities by hanging loosely at another, much more
harm than good will inure from its use. After subsidence
of the more urgent symptoms, stimulating lotions, by the
hand, in lieu of fomentations, which should be gradually
withdrawn, will be found of great service in assisting the
removal of effused fluids, and promoting the gradual resto-
ration of the functions of the joint. At first they should
be applied once or twice a day, cautiously increasing the
frequency as pain and tenderness abate, using the precau-
tion to keep the parts covered by flannel cloths saturated
with the remedy employed. A weak solution of the tincture
266 Inſuries and Diseases of the joints. [Azrit,
of iodine, in the proportion of one to three of alcohol,
I have found exceedingly beneficial in restoring impaired
functions of the joint. Camphor, Ammonia, and Turpentine
embrocations I have often found of exceedingly great
value after the subsidence of acute symptoms. Towards
the close of treatment, the daily application of the roller
must be kept up, for, beneficial as it is in the first stage, it
is even more so, during the secondary stage, for the pur-
pose of giving support and tone to the already weakened
limb.
At a later period in the treatment, or when the disease
has assumed a chronic form, producing sub-acute inflam-
mation, or thickening of the tissues of the joint, the first
attempt at movement of the limb is sometimes quite diffi-
cult, and attended with more or less pain. In this condi-
tion, along with the internal treatment, great benefit will
be derived from medicated shower-baths, or cold douches;
the parts immediately afterwards to be well rubbed with
the bare hand or a piece of coarse flannel. In those cases
where a more powerful impression is desirable, the use
of the hot and cold douche, in rapid alternation, has been
highly recommended. Prof. Gross has received “marked
benefit from the daily application of fish brine, which
seems,” he says, “to possess other properties than those
simply dependent upon the presence of saline matter,
though it is impossible to define their character.” Painting
the surface of the skin over the joint daily with tinelure of
iodine, I have frequently found a remedy of considerable
value.
As soon as the disease has reached that stage, when
passive motion does not kindle anew symptoms of acute
inflammation, the joint must be gently exercised, and the
patient compelled to move about in the open air. It must
be remembered that motion, as Prof. Gross remarks, “is
the proper stimulus of a joint, as air is of the lungs, or food
of the stomach, and when, after an injury, it is long ne-
glected, serious consequences are sure to arise.”
During this time the general health of the patient must
1869.] Injuries and Diseases of the joints. 267
be attended to; exercise in the open air insisted upon;
dietetic and hygienic regulations enforced, and either one
of the following remedies taken internally: Agnus cast.,
Arnica, Ammonia carb., Hypericum, Bryonia, Pulsatilla, Rhus,
Ruta grav., Nuſc vomica, and Sulphur. Of these remedies,
Arnica, Hypericum, Rhus toac., and Ruta are the most valua-
ble, and, under ordinary circumstances, fulfill all indications
of treatment.
Arnica. —In the case of a laborer, who sprained his right
shoulder very severely while at work, this remedy was
given, and in one week the pains in the shoulder had
ceased, improvement went on uninterruptedly, and in three
weeks the patient was discharged cured.*
Rhus toac. — In a sprain involving the middle joint of the
thunib, in a strong, athletic, and vigorous person, the parts
being exquisitely tender and painful to the touch, Rhus to c.,
30th, was administered, and the patient was cured in three
weeks. Hypericum is also a remedy of great value in con-
tusion and laceration of nerve fibres. See its action, page
618, vol. 1.
Apis M. — In the case of a young man, aged twenty, of
sanguine, bilious, lymphatic temperament; his left knee
was badly sprained from being thrown from a horse; two
doses of Apis are reported to have cured the patient in two
weeks.f
In those cases of sprain involving the periosteum, Ruta is
the best remedy, according to my experience, especially if
the pains are aggravated during rest, and relieved by motion;
Rhus tor. is better adapted to injuries done the ligaments
and fibrous tissues of the joints, when the symptoms are
increased during rest, and Arnica is more appropriate when
the muscular and soft structures become implicated in the
disease.
Fupture of a muscle, whether occurring from external
violence, or from its own contraction, occurs almost always
* British Journal of Homoeopathy, Vol. 23, p. 185.
+ New York State Transactions, Vol. 2, p. 351.
268 Injuries and Diseases of the joints. [April,
at the point of origin of the tendon, and requires relaxation
by position, so as to approximate its divided ends, and
maintain the limb for a sufficient length of time in this
position, for proper union to take place. The internal
treatment consists in the administration of Rhus, which is
particularly adapted to sprains occurring in tendinous parts,
with swelling and great pain. It may be used both locally
and internally; the external application being graduated to
meet the sensitiveness of the skin of the patient.
Bryonia may be given in sprains where the pains are
darting and aggravated by motion, and especially when
the muscular tissues are implicated.
Ammonia carb. is useful in sprains attended with fatigue
and weakness in the limbs, as if bruised; drawing and
tension in the joints; contraction of the limbs, as if the
tendons were too short.
JLycop., Petrol., or Ruta, are appropriate when the more
acute symptoms have passed away, and the disease begins
to assume a chronic character.
Sepia is recommended by Dr. Goullon, for many trouble-
Some constitutional symptoms that may supervene upon a
strain.
If the patient suffers from the constitutional effects of
any pre-existing disease, the remedies required to meet this
defect must be given inter-currently with the indicated
medicine for the sprain. I have treated several cases of
sprain occurring in syphilitic constitutions, which improved
rapidly and permanently, when constitutional remedies
were employed to overcome the syphilitic dyscrasia, at the
same time the treatment was adapted to the injured limb.
Mechanical Treatment. — An instrument well adapted to
these injuries, in those neglected, or persistent cases, when
the muscles have become involved, and by their contraction
continually press the diseased articulations together in-
creasing the disease and the deformity, has been devised by
Prof. Lewis A. Sayre, of New York. This instrument is
for the purpose of making proper extension, and consists
of a foot piece, of firm steel or hard rubber plate, made to
1869.] Injuries and Diseases of the joints. 269
fit the sole of the foot. “At the heel is a hinge-joint, and
attached to it a rod, slightly curved at the bottom, and
extending up the back of the leg to near the knee. Over
the instep is a stirrup-like arch, with a hinge-joint above,
from which another rod mounts up in front of the leg, of
equal length with the hinder one. These rods have a male
and female Screw, or ratchet and cog, for purposes of ex-
tension, which are connected above by a firm band of sheet-
iron, with a hinge on one side and lock on the other, some-
what like a dog-collar. Fig. 222.
FIG. 223.
This instrument is applied with firm adhesive strips, one
inch in width, and long enough to reach from the ankle to
the middle of the patella, and placed entirely around the
limb, as is shown in Fig. 223. The plaster is secured in its
position, to within an inch or two of its upper extremity, by
a well adjusted roller, as is seen in Fig. 224.
FIG. 224. FIG. 225.
The instrument is fixed, and the foot firmly secured by a
number of strips of adhesive plaster, as seen in Fig. 225,



27o Injuries and Diseases of the joints. [April,
carefully applying a roller over the ends of the plaster, to
prevent their slipping, taking care to turn the upper ex-
tremities over the collar, which has been previously locked
just tight enough to be comfortable, and thus secured by a
turn or two of the bandage, as is shown in Fig. 226.
In this disease the foot assumes the condition of talipes
equinus, through contraction of the gastrocnemii and soleus
muscles, and, in some cases, it may be necessary to divide
the tendo achillis, before the foot can be brought into its
proper position, especially in those persons where these
muscles are organically contracted. Usually, however, the
foot can be adjusted by the use of this instrument alone,
and the patient is able to bear his weight upon the diseased
limb, without causing pain, the instrument taking off the
pressure from the diseased joint.
If general oedema takes place, the disease increasing in
severity, and especially if the parts have been too freely
poulticed, as is most apt to occur, there will be observed a
bluish, livid appearance of the part, denoting a passive con-
gestion of the capillary circulation. There is probably no
system of treatment so pernicious in its effects upon a
diseased articulation, no matter where it be situated, as the
continued application of a poultice. In the more advanced
stages of joint disease, the circulation is feeble and slow,
and the heat and moisture inherent in poultices, entices an
increased flow of blood to the part, engorging the capillaries
to such an extent as to paralyze their power of action, and
having no power to pass the current along, Oedema, and
finally disintegration of the parts, is the result. To over-
come such a condition, and to assist the over-burdened
capillaries, pressure upon the hypertrophied cellular tissue
about the joint should be made, and the limb placed in a
horizontal position. Compression may best be made by the
use of a large, coarse sponge, the water being pressed out,
and the sponge bound tightly and firmly around the joint;
then the sponge, absorbing the medicated lotions that are
poured upon it, increases in size, and a constant and uniform
pressure is kept up, relieving the Oedematous condition and
livid apearance of the joint.
1869.j Inſuries and Diseases of the joints. 271
If the disease has still further advanced, and pus is con-
tained within the articulation, as may be known by the
concomitant symptoms, such as fever, loss of appetite, pale-
ness, emaciation, irregular chills, etc., etc., a free opening
should be made in the most dependent part of the joint, so
as to permit a thorough drainage of the contents. This
should be kept up as long as any matter forms within the
joint. If there is caries of the bone, a probe, armed with
oakum, passed through the joint from one side to the
other, and forming a seton, is the most thorough and per-
fect manner of effecting complete drainage of the articula-
tion. As the Seton is changed from time to time, small
particles of bone will frequently pass out with it, and the
opening will continue to diminish in size as the disease
abates; the thin, sanious, and watery discharge, will, under
the use of this agent, and the constitutional remedies above
described, yield to a thick, laudable, and cream colored pus.
As this takes place, the size of the seton should be grad-
ually diminished to a single thread, and finally removed
altogether. Care should be taken that the opening be not
closed, until every particle of matter is removed, as a few
drops only have been known to produce serious mischief.
At this period of the disease it is a question, still mooted
among surgeons, whether the joint should be permitted to
become anchylosed, or an attempt be made to retain
mobility, by passive and continued movement of the limb.
Dr. Sayre instances the case of a young lady, in whorn the
ankle joint had been setoned ten or twelve years ago, small
pieces of bone having been thrown out, yet “the mobility of
the joint is now perfect.” A result so desirable calls for the
most careful and assiduous attention of the surgeon, partic-
ularly so, as frequent cases of this character have occurred, in
which almost perfect motion of the joint has been preserved.
Slight sprains are more liable to lapse into this condition
of disease, than those of a more severe character, owing to
inattention of the patient to the injury in the first stage, in
consequence of its slightness, and the neglect of appropriate
treatment at the commencement of the accident.
ſº
THE SALIVA : A FEW REMARKS ON ITS PIHYSI-
OLOGICAL CHEMISTRY.
BY HENRY S. CHASE, M.D., D.D.S., ST. Louis.
THE Saliva is not a simple fluid of the mouth, but rather a
mixture of fluids and solids, from various sources within
the buccal cavity.
To obtain a fair sample of this fluid, which I will call
mixed saliva, the teeth should be thoroughly cleansed with
brush and water, and the interspaces, also, by the use of
the tooth-pick. The mouth should then be rinsed in clear
water. After a half hour, the saliva may be evacuated, as
often as the mouth fills, into a clean tumbler, or large test
tube. It is evident that if one has lately partaken of a
meal, there will be particles of food adhering to the teeth,
and between them, which, if evacuated with the saliva,
would very much modify its physical character, and very
likely, also, its chemical reactions. For these reasons, also,
the mouth should be free from tobacco, or other juices,
produced by chewing, etc.
Mixed saliva is the product of the parotid glands, also
the submaxillary and sublingual; and, besides these, we
have a small secretion of mucus from the labial and buccal
glands, the small glands of the palate, and the tonsils.
Besides this enumeration, large quantities of epithelial cells
are constantly being cast into this fluid from every portion
of the oral mucous membrane. Even the follicles of the
tongue, also, contribute a small amount to the stream.
The parotid glands furnish the greatest volume of saliva;
next, the submaxillary, followed by the sublingual. The
parotid is the clearest fluid, and has the greatest specific
gravity, being, according to Mitscherlich, 1.0061 to 1.0088.
While Jacubowitsch found the submaxillary fluid to be
1.0041.
1869.] 7%e Sa/?wa. 273
The sublingual glands are very small; yet they furnish an
abundant secretion, thicker and more tenacious than either
the parotid or submaxillary, on ordinary occasions; but
when excited by the presence of a smooth, metallic instru-
ment, or by pressure beneath the chin, they pour out an
abundant and clear fluid, often with such force as to drive
it entirely out of the mouth. Especially is this the case in
dental operations.
The secretion, from the various buccal, labial, palatal,
lingual, and other glands, is a thick, whitish, and tenacious
substance; and this, together with the epithelium, gives the
turbid color to the freshly evacuated saliva, and, also, its
principal deposit.
When saliva is first evacuated, according to the directions
before given, it is a frothy, water-colored fluid, tinged with
blue. Its slight viscidity has entangled numerous globules
of air in its substance, and it is not until some minutes have
elapsed that the air has passed away, and the fluid becomes,
in this respect, homogeneous. By the time the air has dis-
engaged itself, however, we may see a whitish deposit
slowly accumulating in the bottom of the test tube. As
the latter operation progresses, the supernatant fluid be-
comes clearer, and, at the end of twenty-four hours, we will
see a very clear fluid, with a faint bluish tinge; and at the
bottom of the glass tube, the deposit spoken of, occupying
about one-tenth of its depth, and its particles lying very
loosely together. After two or three days in a warm place,
the deposit is much more compact, and has much the
appearance of wheat flour.
When first evacuated from the mouth, the saliva has a
slight and disagreeable odor, which increases, if allowed to
stand for a few hours, as its animal matter is then under-
going chemical decomposition. In health, one’s own saliva
is tasteless, before and immediately after evacuation; but
that of another has taste and smell which is disagreeable,
unless it happens to be of precisely the same character as
one’s own saliva.
Very soon after evacuation the saliva undergoes a chem-
274 Zhe Saliva. [April,
ical change, which renders it still more objectionable to the
taste.
In disease, the saliva is, in some cases, constantly disa-
greeable to the patient; and often the first symptom one
has of approaching sickness, is the changed taste of that
fluid.
Bilious saliva may be found in any condition of the sys-
tem, when abnormal quantities of bile are circulating in
the blood; and the oral fluid has then a particularly “bil-
ious taste.”
Sweet saliva is found in many diseases, and especially in
miasmatic intermittent fevers.
In my own case, all starchy substances were instantly
changed to glucose in the mouth; and eating of food con-
taining starch in much quantity, was rendered very offen-
sive by the constant presence of sugar.
Sour saliva is more common than that having a sweetish
taste. This is common in fevers, and some other diseases.
It may be rendered so by partaking inordinately of acids,
or of sugar — the latter being changed by chemical process,
instead of being digested by physiological operations. Ar-
senious acid, in continued small doses, will also change the
saliva to a very acidulous state, as proven by litmus paper,
and the natural taste. The saliva will, in this case, cause
all starchy and saccharine substances to taste sour, so rapid
is the chemical change that it causes in these kinds of food.
The sour saliva caused by Arsenic is so intense that it
causes rapid chemical decay of the teeth, and especially
around the necks of the teeth, at the margin of the gums.
The teeth became exquisitely sensitive at these points;
and, besides that, the teeth are generally extremely sensi-
tive to cold draughts of water or air.
Alkaline Saliva. – In some diseases, the saliva has a deci-
ded alkaline taste. It also has, in health, after partaking
freely of alkaline carbonates.
The Quantity of Saliva, as furnished by the same person,
varies at different times, depending on the condition of
health, and, also, on the character of food partaken of.
1869.] 7%e Sa/z va. 275
There are, also, many artificial stimulants to the salivary
glands, such as table condiments, medicines, etc. A large
number of metallic oxides produce a great increase of the
salivary stream; among these are Mercury, Arsenic, Lead,
Antimony, etc.
The largest quantity, secreted in health, is during the
mastication of food; and this, too, varies according to the
quantity of water which the food either naturally or artifi-
cially contains. Experiment on myself, a healthy person
weighing 140 pounds, demonstrated the amount to be 850
grains in one hour—the experiment being commenced four
hours after breakfast, reading a book during the time.
Experiments at other times have not materially varied from
this.
The Dental profession knows very well that there is a
great difference in the amount of the salivary secretion
during the performance of operations in the mouth. They
find, too, that the parotid gland is not always the one which
furnishes the greatest quantity of saliva; but on the other
hand, that the submaxillary and sublingual glands are far
the most active. Other experimenters state the amount of
saliva, as observed by them, to be from 500 grains to 1500
grains per hour. Considering, then, my own experiments
to be about the average quantity, it will be seen that for
twenty-four hours the stream would increase to the aston-
ishing amount of forty-three ounces. Allowing a reduction
of thirty-three per cent. an hour, during the eight hours of
sleep, and we still have forty ounces. Dalton estimates the
quantity, for the same time, at a little less than three pounds.
That a large amount of saliva is secreted during sleep,
one may observe in the involuntary act of swallowing by
the sleeper. Some who do not swallow the saliva during
sleep, are much incommoded by the secretion running from
the mouth, and wetting the pillow and bed-clothes.
Colin states that the activity of the different glands is
produced either on one side of the mouth or the other,
according to the side upon which mastication is in progress.
In animals which do not masticate, there are only rudi-
276 7%e Sa/Zva. [April,
mentary salivary glands; and in those which masticate but
little, they are but partially developed.
The chemical composition of Saliva varies in different indi-
viduals and animals, as well as in different conditions of the
system. Therefore, the analyses of mixed saliva have not
been the same by different observers — although the differ-
ence is mainly in the relative proportions of water and solid
constituents.
The following, by Bidder & Schmidt, is one of the most
reliable:
COMPOSITION OF HUMAN SALIVA,
Water, © e ſº e © Q . 995.16
Epithelium, o e « © O 1.62
Soluble organic matter, . ſº te © . 1.34
Sulpho-Cyanide of Potassium, e o © 0.06
Phosphates of Soda, Lime, and Magnesia, * . 0.98
Chloride of Potassium, do. of Sodium, tº tº 0.84
1000.00
In speaking of the physical properties of saliva, I men-
tioned the apparently large amount of organic matter in
the saliva. Most of this will remain upon the filter; but a
small portion passes through, as do, also, the mineral con-
stituents — being soluble.
The solid portions of saliva are much increased in some
diseases, and under some physiological conditions. In
cases where the kidneys do not perform their duties, a
larger amount of salts are found in the Saliva; evidently the
effete materials of nutrition. Persons who indulge largely
in fresh meats, also, have a greater quantity, not only of
salts, but of organic matter, in the saliva. Vegetable food,
also rich in lime and salts, increases their amount in the
saliva. And in those animals whose food is of this charac-
ter, it is particularly observed, especially in the horse and
COW. gº
Of the inorganic ingredients, the Sulpho-Cyanide of Polas-
sium is the least; but, on the other hand, it is a very con-
stant one. I have not failed to detect it in any case, by
1869.] Zhe Sa/tva. 277
evaporation of a portion of the fluid; and that from my
own mouth has always yielded the result, just as it was
evacuated from the cavity. The test used was the Perchlo-
ride of Iron. Whenever eggs were freely eaten, the Sulpho-
Cyanogen seemed to be increased — the red color produced
being more intense.
Wright states, that Prussic acid, the Salts of Cyanogen, and
Sulphur, taken internally, increase the quantity of Sulpho-
Cyanogen in the saliva.
The salts of lime, soda, and potash, are also very constant
ingredients of saliva; but vary in different individuals of
the human species, and in different animals. In the horse
and cow the proportion of these salts is much greater than
in man; which may, perhaps, be accounted for by their
more natural mode of life. It is these salts which give
alkalinity to the saliva in these animals, and also to that of
the human species, when it is alkaline.
These salts, together with the organic matter, is that
which composes the “Tartar,” or dental calculi.
The CHEMICAL REACTION of fresh saliva, as it is found in
the human species, is nearly always acid or neutral. I have
tested the saliva of over two hundred persons, within the
last six weeks, and have found all acid but two, and they
were both neutral. In the commencement of my experi-
ments, I was very much surprised at the results; for I had
learned from the books, that it is invariably alkaline.
Lehmann states that it is acid in fasting, and in some dis-
eases. Flint states that it is almost invariably alkaline.
Dalton states: “The alkaline reaction varies during the
day; but it is nearly always sufficiently distinct.”
In addition to my own experiments, I have obtained the
assistance of several physicians, who have reported more
than fifty cases, all going to show the acidity instead of the
alkalinity of the mixed saliva.
Women emceinte gave a more intense red to the litmus
than others. This may be owing to the great demand for
the alkaline phosphates to build up the Osseous tissues of
the child.
Wol. W.—No. 15. 2
278 Zhe Sa/Zva. [April,
In fevers and acute inflammations, the Saliva showed also
very much greater acidity.
Some nursing infants showed the saliva neutral. All except
these infants lived on a mixed diet of meat and vegetables.
Their habits of life were various — Some approaching a
physiological standard nearer than others. Those having
the most natural habits came nearest to a neutral reaction
of the saliva.
Reasoning from physiological premises, I have always
regarded the saliva alkaline, without testing it. It would
seem that for the preservation of the teeth it should be so;
and when I found my experiments had overthrown my
preconceived ideas, I thought that it must be owing to the
artificial mode of life in mankind; and that if I studied the
subject among the lower animals, I might find quite a
difference between the chemical reactions of their saliva,
and that of human kind.
My attention was first directed to a well arranged livery-
stable, where the horses had excellent care, being fed
exclusively on good hay and oats, and pure river water.
They were clean, and had daily exercise. Ten (10) horses
were examined, which were in good health. The saliva of
all was decidedly alkaline. One horse which ate his rations,
but which had been blistered for pneumonia, had a neutral
saliva. At another stable, where the horses were equally
well cared for, the reaction was equally decidedly alkaline.
Both litmus and tumeric paper was used in these experi-
ments. Some of these animals were mares, and others
were geldings — no natural males.
My next visit was to a cow-stable, in the city, containing
one hundred and fifty cows. The building was badly ven-
tilated, and badly drained, and very hot. The food was
poor hay and “ship feed.” A large number of these cows
were examined, and the saliva in no case was found to be
alkaline. Many of them were decidedly acid, some faintly
so, and others neutral. It is my opinion, that if these cows
had been in a physiological condition, their saliva would
have been alkaline; for in a subsequent examination of
1869.] The Salzva. 279
several country fed cows, living upon grass at pasture, their
Saliva was alkaline.
A mare, with foal, at grass, had also alkaline Saliva.
Several male and female dogs had a neutral Saliva. All
the horses and cows examined were eating.
I have examined about fifty (50) persons, one minute
after they had finished a meal. Some after each of the
three meals of the day. In every case the saliva was
neutral. In half an hour after, an examination of the same
persons showed a decided acid reaction. The same persons
were also examined one minute before a meal, and the
aliva was acid.
There is strong ground then for concluding that the nor-
mal condition of the saliva should be alkaline, in man as
well as in all other animals. That a departure from a truly
physiological state, causes that fluid to be either neutral or
acid. Also, that nature makes a strong effort to place the
saliva in a physiological condition, at the time food is being
masticated, preparatory to stomach-digestion.
Acid fruits, condiments, acid drinks, do not prevent the
saliva from being alkaline during and immediately after
eating.
Drinking a sour wine had the effect, for a half hour after-
ward, to render the saliva neutral, which immediately before
was distinctly acid.
THE OFFICE OF THE SALIVA has been, and still is, in much
dispute; many contending for its merely mechanical or
physical function; and others equally strenuous, that it has
only a chemical work to do. I think that both are wrong.
It is very evident that dry food could not be swallowed
without being moistened in the mouth. The last act that
the oral cavity has to perform, is to furnish, from the ton-
sils and palatal glands, a glairy mucus, to varnish the bolus
with, that it may be easily swallowed.
We have seen that the saliva contains considerable air.
The permeation of food, by the air and water of the saliva,
renders its digestion more easy. For the law of the diffu-
sion of fluids and gases would ensure an early penetration
28O The Sa/z va. [April,
of the gastric juice, through the alimentary bolus, and thus
facilitate the digestive process.
The experiments of many observers go to prove abund-
antly that the starch contained in food is immediately acted
upon, chemically, by the saliva, and that portions of it are
soon converted into glucose. This will take place out of
the mouth, as well as in it, provided the natural warmth of
the body is maintained in the fluid.
We have seen that the quantity of saliva secreted is
between two and a half and three pounds. This is much
more than sufficient to moisten the food, and we find, too,
that the secretion continues between the periods of eating;
therefore, we may well suppose that the saliva has other
uses. One of these may be to prevent thirst, by bringing
from the blood a comparatively pure liquid, which may
moisten the mouth and throat, and continue to assist in the
digestive process, after the food has passed into the stomach.
The speech becomes difficult when the saliva ceases to flow,
as it often does from Some mental excitement, or patholo-
gical state.
A still more important function, is the preservation of
the teeth, by bathing them in an alkaline fluid, which shall
neutralize any acids formed around and between them
from the decomposition of food. This is undoubtedly the
case among the most natural livers. But we have seen that
the saliva of civilized man is neutral or acid, and this latter
condition has a very deleterious influence on the dental
Organs.
Food remaining between the teeth for half an hour, in
the mouth of a person having moderately acid saliva, will
become much more acid than the saliva itself, as the
intensity of the reaction on the litmus will show. Lean
meats in particular show this, as the acid formed from them
is nitrous or nitric.
How important, then, it is, that people should return to
a more rational system of living, both as regards diet and
other habits of life. Undoubtedly, one cause of acidulous
saliva is to be found, in the fact that so many people make
1869.] Zhe Sa/zza. 28I
extravagant use of fine flour, from which the miller has
removed the greater portion of the alkaline phosphates,
such as lime, Soda, and magnesia.
I have before said, that the stream of saliva amounts to
about forty-two ounces daily. According to the analysis
of that fluid already given, it may be seen that there are
about forty grains of alkaline substances in that amount of
saliva; which should have an important influence in cor-
recting the acidity of the mouth, from the decomposition
of food and effete epithelium of the mucous membrane. I
have found the latter substance yielding invariably a more
intense acid reaction than the saliva. Undoubtedly, the
mixed saliva is materially influenced in its acid reactions
by this cast off epithelium.
A person may brush the teeth thoroughly with clean
water, and also thoroughly cleanse the mucous membrane
of the mouth with water, and then find the saliva very
slightly acid. In half an hour from that time, the saliva will
be found with a far more intense acid reaction.
Besides the uses of the saliva already discussed, we may
consider it a fountain, deriving its supply from the streams
pouring into the mouth from the various glands, and send-
ing the conjoined streams down the O'sophagus into the
stomach; thence to be absorbed into the blood, to keep up
its volume and furnish the ultimate cells with a fluid, by
which their chemico-vital processes can be carried on with
facility — thus giving the system an opportunity for econo-
mizing, both water and the mineral elements, of which all
the tissues are composed.
In health, we must not consider the saliva an excretion ;
it becomes only in a measure so in some pathological con-
ditions. Therefore, we must not hold the mineral con-
stituents of saliva to be effete, as we are bound to do in the
case of wrime.
In concluding this subject, upon many interesting points
of which I have barely touched, and some of which I have
not mentioned, I will indulge in a few
282 7%e Sa/Zva. [April,
GENERAL CONSIDERATIONS.
There is yet much to be done in the way of chemical
analysis before an exhaustive history of the Saliva can be
written. Those analyses which have been made, do not
state what the diet of the individual was, nor his other
babits of life. It is certain that experiments made during
pathological, or doubtful physiological conditions, should
be received with considerable allowance.
|Pood, rich in alkaline phosphates and carbonates, in-
creases the percentage of these salts in the current of blood
and of the saliva; and, therefore, it is of much consequence
that the kind of food which made the blood should be
noted, and the proportionale quantity of the different articles
of diet, also.
The large amount of organic matter in the saliva, should
caution us, as dentists, against the incorporation of that
fluid in our gold plugs for the restoration of the teeth.
The mere wetting of the gold, in the process of filling,
causing non-adhesion, can be but a small part of the injury
to the operation, as we may well suppose that the organic
matter, combined with the saliva, and intermixed with gold-
foil, or gold-sponge, would soon undergo decomposition,
and, by the expansion of gases, loosen the plug and blacken
the dentine, resulting in a continued decay of the tooth.
This organic matter, which is seen at the bottom of the
test tube, is not all the organic matter contained in the
saliva; a considerable amount remains in solution; and it
is in the latter that the ptyalin is found, which is supposed
to be the true salivary principle upon which the first process
of digestion is dependent.
The organic matter deposited is seen under the microscope
to be composed of epithelial scales, mucous corpuscles, and
fat-globules. If the mouth has not been thoroughly
cleansed, of course there will be the remains of particles of
food; and if there be carious teeth, there may be vibriones
or cellular growths, washed from the cavities of decay into
1869.] Zhe Dose. 283
the saliva stream. But this deposited organic matter is, also,
able to change starch into glucose, when a proper tempera-
ture is maintained, and longer time given; and Flint states
that the serum of the blood, cystic fluid, and intestinal
juices, have similar power.
TIIE DOSE: A BRIEF ANSWER TO DR. S. A. JONES.
BY E. M. HALE, M.D., CHICAGO.
THE summing up of Dr. Jones’ paper, criticising the “Law
of Dose,” which was suggested by the writer several years
ago, amounts to this, namely: — “That while reading,
research and reflection have revealed much truth in Hale's
‘Law of Dose, there are many missing links in the chain of
its logical completeness; let us add, we believe these miss-
ing links will be found before the full dawn of the next
century.” +
Such frankness is admirable, and we take a sincere pleas-
ure in making an equally frank answer, in which we shall
attempt to supply a few of the “missing links.”
We wish to start with the proposition that we believe the
knowledge which we now possess, of the quality of drug-
action, notwithstanding the labors of many great minds, is
very meagre in comparison with what it will be at the end
of this century. In other words, the science of Materia
Medica is yet in its infancy, or where geology, botany, and
anatomy were many centuries ago.
Leaving this proposition to take care of itself, we will
consider something which has disturbed the equanimity of
Dr. Jones, namely: an assertion which we made in an
article on the “Analysis of Remedies,” to the effect that
we had found the more closely we analyzed a remedy, the
better success we had with the high dilutions.
* U. S. Medical and Surgical Journal, October, 1868, p. 35.
284 Zhe Dose. [April,
It will not take long to explain what the writer meant.
It is well known that our doctrine is, that if a cure of a
symptom, or symptoms of disease, is made with a high potency,
such symptom or symptoms belong to the primary action of the
7medicine.
This will lead us to the consideration of the still open
question of the action of medicines. It is manifest that the
pages of a Journal are too contracted to admit of the full
discussion of this subject. We propose, therefore, to lay
down certain propositions, as defining our position. If Dr.
Jones sees fit to take up each proposition serialim, and the
readers of the Journ AL will bear the infliction of a discus-
sion relative to their merits, we have no objection to such
discussion.
I. Certain medicines, nearly all the polychrests, cause a
series of symptoms and effects, which may generally be
classed as primary and secondary; the latter nearly always
antagonistic to the former.”
II. Some medicines seem to cause a series of alternate
effects, very difficult to classify, as Hahnemann observed in
Ignatia. Other medicines cause periodical paroxysms, in
which we may trace both primary and secondary symptoms
(China, Arsenic). This last class of medicines, also, causes
definite and continued primary and secondary symptoms, as
well as periodical.
III. The so-called anti-psorics have a peculiarity of action,
* It is a matter of indifference, so far as the Law of Dose is concerned,
whether we term the action of medicine primary, secondary, or “alternate,”
(as Hahnemann did in his last days), or “wave-like" (as Hering expresses
it). There is still a first and second action, upon which to base our selection
of the dose.— Hule.
+ “The primary symptoms of Ignatio, constitute a double serics, anti-
pathic, the one to the other.”— Mat. Med. Pura.
“Those who asssert that the secondary action of medicines is no action,
but only a re-action of the organism,” I would refer to Dr. Hering (Ameri-
canische Arz, ; 26), who says, that both the so called primary and Secondary
actions “must be regarded as medicinal actions, from first to last, be the
time shorter or longer, for what is called re-action of the organism has no
existence.”
1869.] Z%e Dose. 285
deep-seated, insidious, permeating, and long-lasting. It is
doubtful whether we can ever arrange the pathogeneses of
this class, into primary and secondary symptoms, if they
have any, which I doubt; while the classes named in the
first and second propositions, may be analyzed more per-
fectly.
It is our present belief, that when cures are made with a
high potency, the symptoms So cured are either primary, or
belong to an anti-psoric, or alterative medicine, which has
no primary and secondary series of symptoms. (We will here
state, that we believe the class of true anti-psorics, as we
understand them, is very small).
We can not see why our assertion was so very “extraor-
dinary.” We might have been more definite; have qualified
our assertion, but we took it for granted that our position
was well known.
Dr. Jones quotes the assertion of Hahnemann, that we
should base the selection of a remedy upon only primary
pathogenetic symptoms. We do not wonder that Hahnemann
came to that conclusion in his latter days, when he used the
high potencies (30th) almost exclusively. The exclusive high
potency practitioner, if he judged from results, could come
to no other conclusion, for, if he prescribes a high dilution
for real secondary symptoms, he will generally fail to cure,
(we use the word “generally,” because we believe there are
cases of extreme susceptibility, wherein the 30th is as large
a dose as the 3rd would be in another person of average
susceptibility.)
The speculations indulged in by Dr. Jones, relative to the
action of medicines, and his illustrations by algebraical
formula, are very interesting. We hope he will follow still
farther that train of thought, which, in his hands, may be
productive of great good to the science of Materia Medica.
We do not propose to discuss that portion of his paper.
When all that is to be known, is known, relative to the path-
ological action of medicines, the necessity of discussing a
Law of Dose will be removed.
In relation to the reason why different doses of a medi-
286 Zhe Dose. [April,
cine should produce differing series of symptoms, we con-
sider it due to us to state what we believe to be the truth.
It is well known that not all persons have the same
susceptibility to medicinal action. We have three classes
of subjects, namely: those of average susceptibility; those
of deficient susceptibility, and those of abnormally increased
susceptibility. Now, it is evident that an amount of medi-
cine which would cause primary and secondary symptoms in
their regular order, in those of average or deficient suscepti-
bility; would cause secondary symptoms alone in those of
hyper-susceptibility. We must explain this last sentence,
by stating that it is our belief, based on much research and
observation, that if a large dose or doses of medicines be given
to persons of only average or hyper-susceptibility, such doses
have the power of causing only Secondary symptoms,” or, as Dr.
Jones would say, larger doses may add a minus to the sys-
tem without first adding a plus ; or, vice versa.
To illustrate : If a massive dose, say one ounce or even
less, of Tincture Digitalis is given to a healthy man, the ton-
ing or plus effects (primary) of the drug are not felt, but the
heart is paralyzed, partially or wholly (secondary effects).
Dr. Jones gives an erroneous impression in his table of
Digitalis actions. It should read:
FIROM ORDINARY DOSES.
1 Primary. Increased force of cardiac pulsation.
Secondary. Decreased force of cardiac pulsation.
FROM EXTRAORDINARY DOSEs.
tion is not an increased force of cardiac pulsation, but an irritability
Secondary. Decreased force of cardiac pulsation. The apparent reac-
2
with loss of power.
* “The more moderate, within certain limits, the doses of medicine used
for such experiments, the more distinctly are the primary actions developed,
and these, which are most worth knowing, occur alone, without any
admixture of Secondary actions. Where excessively large doses are used,
on the other hand, there occur not only a number of Secondary actions
among the symptoms, but the primary actions also come on in such hurried
confusion, and with such impetuosity, that nothing can be accurately
observed.”— JIahnemann, Organon, c2(xxvi.
In other words, none but secondary symptoms occur.— Hale.
1869.] 7%e Dose. 287
The real primary action of Digitalis never comes after the
paralyzing effect of large doses; it is only a condition of
increased mobility with deficient vitality.
Another illustration of this proposition is to be found in
the effect of massive doses of Quinine. In such cases,
according to Wood and other eminent authorities, none of
the primary, stimulating, or tonic effects manifest themselves,
but the “sedative” or prostrating effects, or those com-
monly observed as Secondary, immediately set in. These
effects are “great prostration, loss of sight and hearing,
almost absent pulse, cold skin, cold sweats, slow respira-
tion, feeble voice, profound stupor, or, a condition simulat-
ing delirium tremens,” etc., etc.
Now, I have nowhere found that any of the genuine pri-
mary symptoms of the drug follow this secondary action.
On the contrary, the after effects are all in keeping with its
well-known secondary prostrating action.
Digitalis and Quinia are only examples of nearly all medi-
cines, except, as before stated, the few real “alterative ’’
drugs.
If this theory of drug-action be untrue, we sincerely hope
it will be proved to be false, and so soon as such proof
appears we shall be among the very first to accept the true
explanation.
We will now attempt an answer to another of Dr. Jones’
questions.
After quoting the following sentence from an article,
namely: “The tº will often cure, if prescribed empiri-
cally; the 30th, if its symptoms nearly correspond with the
disease; and, if the remedy is the exact similimum, the 200th,
or 2000th, cures more promptly still; ” he asks the question,
“Does Homoeopathy recognize such a sliding scale of ther-
apeutic possibility ?” I answer, unhesitatingly, YES, so far
as the remedy Selected closely corresponds to the primary symp-
toms of the drug (if that drug be one which causes definite
series of primary and secondary symptoms), or any of the
symptoms, if the medicine belong to the small class of anti-
psorics above mentioned.
288 7%e Dose. [April,
It is this close similarity to certain symptoms that has
given rise to the selection of remedies from their characteris-
tic symptoms. Such Masters in our Art as Hering, Shipman,
Guernsey, Hempel, Morgan, Dunham, Douglas, and Pulte,
know full well, that if the symptoms of the disease and
those of the medicine are almost identical, a prompt cure
results from its admistration. They also know that if the
close similimum can not be found, and a remedy has to be
chosen whose similarity is not closely marked, no such prompt
and decided result is attained. If Dr. Jones will examine
the writings of these men, he will find a similar opinion
expressed by every one of them.*
But there are exceptions; there occur cases (and every
physician’s experience will bear me testimony) where the
medicine selected may have symptoms almost identical with
the characteristic symptoms of the malady; we administer
the medicine, expecting to have a prompt curative result,
but to our mortification, the result is nil / We think the
preparation of the medicine unreliable, and blame the phar-
maceutist, or blindly wonder why such a failure resulted.
We believe this failure, in nearly all cases, is due to the
non-selection of the proper dose. It will be observed that
such disappointments rarely occur when we prescribe high
dilutions of the “anti-psorics.” A true anti-psoric, if closely
affiliated, cures in almost any dose of the dynamized medi-
cine. But with the other classes these failures often happen.
If the characteristic symptom happens to be one of the second-
ary series, a high-dilution-dose is not the proper dose, nor
will it effect a cure. A cure may follow, but, we sincerely
believe, it is not due to the medicinal action.f
We can assure Dr. Jones that our definition of empirical
accords with his own. Rational empiricism is IIomoeopathy.
* Dr. Koch, in his great work (Die Homöopathie, page 586) says: (1.) The
more similar the remedial power to the disease, the smaller should be the
dose, and the more certain will be the cure. (2.) The less similar the medi-
cine the larger should be the dose — but the cure is not so certain.
# We believe that a true knowledge of the natural history of disease
would scatter to the winds many of our so-called curé8.
1869.] The Dose. 289
If a medicine cures, it is because it was homoeopathic to the
disease, or, in other words, to its primary or secondary
manifestations. I would ask Dr. Jones if he really believes
that our experience should always be “pathogenetic before
it is therapeutic ** If this is so, what would become of all
our really valuable experience with Hamamelis, Collinsonia,
Caulophyllum, Trillium (whose curative effects he so much
admires), and many other medicines. Even the venerable
IIering has decreed that some of our most valuable remedies
were “born with a breech presentation,” i. e., the thera-
peutic experience came before the pathogenetic.
A medicine without a pathogenesis is not an “unknown
quantity.” If veritable cures have followed its administration
it is just as valuable, so far as those cures go, as a pathoge-
nesis could make it. Does not Dr. Jones know that a
proving or pathogenesis of a medicine always shows such
medicine to be truly homoeopathic to the cures it has made 2
Does not Hahnemann prove this by a hundred or more
citations 7 Do not the provings now made of new medi-
cines all substantiate that assertion ?
True science rests upon facts, not theories or assumptions.
Let us test the science of therapeutics by facts alone. Let
those who deny our assertions and beliefs above expressed
bring facts to disprove them. Disprove, if you can, that all
medicinal cures are not homoeopathic cures. Prove that IHip-
pocrates “obtained more cures under the C. C. C., than
the S. S. C.”
Collect all the veritable, undoubted cures you can lay
your hands on, together with the potency or dose used in
each case, and by them prove that our Law of Dose is
unreliable. Prove that primary symptoms have been
“promptly, easily, and permanently cured,” by the lowest
potencies, without medicinal aggravation. Prove that
secondary symptoms have been cured by the high potencies
(no hyper-susceptibility present). When you have done
this it will then be time for you to call upon us to recant
our Law of Dose.
We will admit that, in the present state of our knowledge
290 Case of Dislocation. [April,
of drug-action, it is very difficult to classify symptoms.
There are, however, a sufficient number of medicines,
whose pathogenetic history presents us with well-known
primary and secondary effects. With these we may insti-
tute investigations, which will go far to prove or disprove
the Law of Dose, referred to in this paper.
A RARE CASE OF DISTIOCATION OF THE EIBOW
JOINT.
By DR. C. H. von TAGEN, Lecturer on Surgical Anatomy, in the Hahne.
mann Medical College of Philadelphia, Pa.
S. B., a lad aged fourteen, some time in the early part of
May last, fell from a horse, striking upon the palm of his
left hand, dislocating the ulna backwards. A surgeon in
the neighborhood was summoned, in the absence of the
family physician, who at once reduced the dislocation, and
applied a rough rectangular splint to the inner side of arm
and forearm and bandaged it, the forearm being pronated.
Thus the limb was left, with the exception of an occasional
re-application of the splint and bandage when loose, until
the expiration of some three or four weeks, at which time
all the dressings and appliances were removed.
The regular family physician took charge of the case on
his return home, some five or six days after the accident;
the surgeon who reduced the luxation saw the case but the
once. At the expiration of nearly four weeks, as before
remarked, the dressings were removed, the joint carefully
examined and pronounced all right, with the exception, of
course, of a certain amount of stiffness about the joint, a
natural consequence after an injury of the kind; to use the
doctor's own words, “there was, with some assistance, good
mobility of the joint,” and I have no doubt his statement
was correct. The case was then dismissed, with the injunc-
tion, to be careful and not use the arm too much, merely to
1869.] Case of Dislocation. 29I
use gentle exercise daily. Some ten days or two weeks
elapsed from this time; the lad was playing with some com-
panions in the water, and while using the arm rather vio-
lently, he either fell and struck upon the inner condyle of
the humerus, or possibly by a violent effort while swim-
ming, the joint was a second time luxated. Some three
weeks were allowed to elapse, for some unexplained reason,
and the limb being still useless, the writer was summoned,
by the family physician, to attend the case. Two or three
careful examinations revealed the displacement to be that
of the radius forward, the head resting on the anterior sur-
face of the corresponding (outer) condyle of the humerus,
well up under the tendon of the biceps muscle; while the
olecranon of the ulna was thrown backwards and upwards,
(the coronoid process of the ulna fractured), and hitched up
behind the trochlea of the humerus, and resting in the
olecranon fossa, or depression. The arm was flexed, par-
tially (about one-fourth), and somewhat supinated, the limit
of motion being very slight in any direction, and only then
by using force.
The patient was placed under the influence of Chlorie
AEther (four parts of Æther Sulph, to one part Chloroform,
and a drachm or two of alcohol to produce complete com-
bination), and after repeated attempts of the usual manip-
ulations laid down in the books, and one hour's hard
work, failure rewarded the combined efforts of myself and
two strong assistants. The following plan was then
adopted: Grasping the arm firmly above the elbow with
the right hand, also the forearm, midway 'twixt elbow and
wrist joint, with the left hand, and then applying the knee
as a fulcrum, the patient lying flat on the back, the forearm
was extended, backwards as far as it would permit, and
supinated. This motion drew the head of the radius down
to the lower border of outer condyle of humerus. Sud-
denly flexing the forearm upon the arm, and by aid of an
assistant, keeping up a certain amount of extension, the
radius was slipped into position.
The ulna was replaced in same manner, by repeated
292 Case of Dislocation. [April,
efforts, care being taken to keep the forearm completely
supinated.
The limb was then dressed with roller bandage, and an
anterior angular splint, to which was attached a spring wire
guage, by which means the angle of the limb could be
altered and fixed at pleasure, thus preventing anchylosis.
As a natural consequence, after so severe manipulation the
joint became much inflamed, and the surrounding soft parts
swollen and very painful, which necessitated the loosing up
of the dressings. A single application of the compound
Tincture of Iodine, freely applied, reduced the inflammation
in less than twenty-hours, and gave the patient complete
immunity from pain.
Rxperience has taught me, during the past six or seven
years, in numbers of cases, the efficacy of this remedy in
this and similar cases; in fact, in my judgment, it is superior
to all other remedies at present known to me.
After the tumefaction and inflammation had subsided,
the linb' was again bandaged, and splint re-adjusted as
before. g
For the purpose of permitting passive motion to be made,
the dressings were removed semi-weekly and re-applied,
this being an indispensable feature to prevent anchylosis
from following.
At the termination of the fifth week the splint was laid
aside. At this present time the limb is almost, if not quite,
as useful as before the first mishap.
I was ably assisted in the reduction by Dr. Kornderſer,
of Philadelphia, and upon my leaving Philadelphia, which
I did a week later, the case passed into the hands of Dr.
Farrington, who conducted the subsequent manipulations
very creditably.
ONE AT A TIME. — The “Buffalo Medical and Surgical
Journal,” December, 1868, says: “We hope physicians
will cultivate simplicity in form of prescription — will give
one medicine at a time as far as possible, and not confuse
its operation by too many adjuncts.” An admirable piece
of advice.
DR. WELLS ON DISEASE, CAUSE, AND CURE.
By H. P. GATCHELL, M D,
DISEASE.
IT is some satisfaction to encounter an antagonist of intel-
lect and learning. There is a fair presumption, if such a
One does not sustain the cause he advocates, that it is due
to the weakness of the cause. Dr. Wells is the ablest of
those who have undertaken to defend what I can not but
regard as a very visionary hypothesis. Indeed, he is the
only one, so far as I have seen, who has brought to the dis-
cussion any special supply of brains. If he fails, we may
not unreasonably regard the hypothesis as untenable.
Dr. Wells defines a disease as a “force,” as a “state of
the living forces,” and as “a change in the state of the
vital forces.”
IIere is admirable confusion. That forces are vital, con-
tributing to sustain life, is quite credible; that they are liv-
ing, possessed of life, is quite incredible; and still more
incredible it is, that they should be both.
And this confusion is enhanced by disease being defined
as a “force,” as a “state’’ of forces, and as a “change’ in
the state of forces; and all this in the same sentence.
That these definitions are all wrong is altogether possible;
that they are all right is quite impossible. I can only con-
clude that the mistiness of that misty hypothesis about
dynamics, which not one of its advocates has ever succeeded
in defining, has infected Dr. Wells' mind.
Dr. Wells argues that disease is a state of the vital forces,
because individuals, alike in form and size, differ in their
susceptibility to the influence of the same morbific agent.
It is not the form and size that determine the vital condi-
tion, it is the state of the internal organs.
To establish his conclusions, he alludes to the condition
of a patient at the commencement of a typhoid fever, his
Wol, W.-No. 15. 3
294 Dr. Wells on Disease, [April,
dullness, peevishness, listlessness, etc., and asserts that we
recognize in these phenomena the effects of the poison on
the vital forces.
Did it never occur to him that they may be but the effects
of the poison on the organism, and of the consequent changes
in the functions of the organs? The common mind can
much better conceive that poisons act on the system than
it can that they act on the forces of the system. We know
that poisons can do the former, we do not know that they
can do the latter.
Dr. Wells attempts to clinch his doctrine by the follow-
ing statements:
1. Diseases produced by specific poisons may exhaust the
susceptibility of the system to their influence.
Is the subsequent immunity due to a change in the vital
forces or in the organism : If he replies, in the vital forces,
he merely assumes the point in question. If he insists that
no change is discoverable in the organism; neither, I reply,
is any discoverable in the vital forces. The life of the indi-
vidual is no more changed than the body.
2. Dead bodies do not become diseased.
And does Dr. Wells really hold that there is no differ-
ence between a living and a dead body — no difference in
the body itself? When we recall the fact that the micro-
scope is constantly revealing changes where formerly none
were suspected, and that with every improvement, addi-
tional discoveries are made, until now scarcely a body dies
but the changes can be told and mapped, this seems to me
a most illogical conclusion. I will make my assertion to
meet his; and that is, that he can not find one dead body
in a thousand but a skillful microscopist can point out
changes in the organism itself.
If there is a thousandth (which I doubt), is it not becom-
ing, in view of the indications derived from all advances in
the science of minute anatomy, to set down the absence of
visible change in this thousandth to our imperfect methods,
to ignorance rather than non-existence?
I have aimed to present and to meet Dr. Wells’ strongest
1869.] Cause, and Cure. 295
points. To put it all in a nut-shell, I give the following
resumé:
1. Persons similar in form and size, are not susceptible
to the influence of the same morbific agents.
2. Patients at the commencement of typhoid fever are
dull, peevish, listless, etc.
3. Diseases produced by specific poisons may exhaust the
susceptibilities of the system to their influence.
4. Dead bodies do not become diseased :
Therefore disease is a force, a state of the living forces,
a change in the state of the vital forces.
I think most readers will reply, non sequitur.
CAUSE.
Dr. Wells having established, to his own satisfaction, that
disease is immaterial, proceeds to state that the cause must
needs be immaterial also. But he excludes, for the present,
from the discussion, those affections which result from
chemical and mechanical causes, as well as those from the
violation of the laws of hygiene.” It is pretty certain that
chemical and mechanical agents are not immaterial, what-
ever the laws of hygiene may be. And if disease may be
produced by material causes in known cases, there arises
a pretty strong presumption that it may in the unknown,
Dr. Wells selects the miasms, whatever they may be, as
his representative and unquestionable immaterial causes of
disease.
There is one advantage in selecting these. Exceedingly
little is known about them. Concerning chemical, mechan-
ical and hygienic causes and conditions there exists not a
little exact knowledge. Regarding them, any error of
statement can easily be detected. Assertions in regard to
miasms are comparatively safe. I have met quite a number
of persons who professed to see ghosts present. I could
not disprove the reality of the alleged vision; I merely
knew that I did not see them. So, if any one asserts
with regard to miasms, he has this advantage, that readers
know but little about them. Does he know any more ?
296 AJr. We//s on Oisease, [April,
No one, from Hahnemann to Dr. Wells, has particularly
illuminated the subject.
Dr. Wells asserts that small-pox, ague and cholera are
caused by miasms, which are forces and not matter; and
that the emanations from sewers are of the same character.
IIe offers in evidence the following statement: A young
physician, who had been repeatedly vaccinated, attended
twenty-six Severe cases of small-pox without contracting
the disease. Immediately after the recovery of these cases
he attended a little girl, slightly affected with the same
disease, from whom he contracted it in its most violent
form.
In order to make this report of any value in the way of
evidence, Dr. Wells should have stated the length of time
that elapsed from the physician’s attendance on the first
of the twenty-six cases, till he was himself attacked; and
more especially the interval between discontinuing attend-
ance on them and the time of his attack. Even then it
Inight not avail much.
Writers lay down with commendable precision the time
within which infectious diseases should attack their subjects
after exposure. But the diseases do not always conform.
Four weeks elapsed between the appearance of measles on
one of my children and their appearance on another who
was fully exposed from the first. When scarlet fever
invaded my family, it attacked the eldest of five children
first. When he was pretty well advanced in convalescence,
the next was seized, and so on in order to the youngest, an
infant; each elder one being convalescent before the next
younger was attacked. It did not occur to me that this
singularity was due to the immateriality of the infecting
Cºll] S62.
Dr. Wells is aware also that there comes about a time
with many, if not most persons, when vaccination ceases to
be prophylactic. Would it not be quite as reasonable to
assume that this cessation occurred about the time when
the physician commenced attending the little girl, as to
resort to the violent supposition of immateriality ?
1869.] Cause, and Cure. 297
In regard to “ague malaria” Dr. Wells informs us that
Irish families living on a marsh escaped ague entirely,
while wealthy residents of neighboring side-hills (hill-
sides?) were great sufferers. Similar instances are not
uncommon, and they have generally been explained on the
supposition that the marsh-poison ascends into the atmos-
phere, and is carried by the prevailing wind to the hills.
This is certainly quite as plausible a conjecture as that of
Dr. Wells; and it has this in its favor, that in other cases
reported, the hills have been in the direction towards which
the prevailing currents of air moved. The latter conjecture
may at least be permitted to antagonize the former. Dr.
Wells intimates that the families on the hill-side suffered
because the poison was more attenuated there. According
to this doctrine, by the time it was diffused through a thou-
sand miles of atmosphere, it should have struck down whole
populations like lightning.
But the cholera-miasm is said to have moved against the
wind, crossing the Indian Peninsula, e.g., against the south-
west monsoon. It will be time enough to admit that the
cholera-poison travels through the atmosphere in opposi-
tion to its currents when such reports have been thoroughly
investigated.
In the year 1852 (I think it was) the cholera suddenly
appeared in Cleveland, while there was none in the vicinity,
as if it had dropped down out of the atmosphere. But it
appeared first in the family of a person who had recently
returned from the south part of the State, where it was
then prevailing, and from this family it radiated.
During the first cholera epidemic in America, while there
was none elsewhere in Kentucky, it suddenly appeared in
the little town of Petersburg. The clothes of a man who
died of cholera in New Orleans were boxed up and sent
home to Petersburg. His wife opened the box and took
the cholera.
Cholera was propagated on the banks of the St. Lawrence
by a mattress thrown overboard from a passing ship.
In the absence of knowledge of these facts, the unex-
298 Dr. Wells on Disease, [April,
pected appearance of cholera in these instances might have
been attributed to forces dissociated from matter. But is
it not a little singular that forces should travel associated
with matter for hundreds of miles, and then, as in the
Petersburg case, suddenly dissociate themselves and fero-
ciously attack some poor victim.
It is not sufficient to be told that cholera travels against
the wind. The question is, how it travels. It is perfectly
well known that it ordinarily travels along with human
beings, and it would be hasty in the extreme to set aside
this, its ordinary method, in behalf of a most vague and
shadowy hypothesis. When such cases as that of the
Indian Peninsula have received a searching investigation
on the part of competent persons; when it shall have been
shown that none of the hundred millions of Hindoostan
went or sent their clothes or rags along with it, we may
then begin to search after some unusual method.
A fourth class of miasmatic poisons, which, according to
Dr. Wells, demonstrate their own immaterial nature, are
the emanations from sewers and similar places. He alludes
to the notorious National Hotel case as of this kind. IIe
states that the disease was traced to its cause, the contents
of a sewer which had escaped into a cistern from which
water was drawn for the use of the house. Gases from the
sewer also entered the house. He does not inform us
whether in this case we are to regard the gases or the con-
tents of the sewer as immaterial, thus leaving this affair
rather indefinite as evidence.
He makes a strong point, however, of his own case. He
has suffered several times from similar poisons, and is there-
fore competent to pronounce as to their immateriality. In
one instance, while passing from the hotel-office to his
room, he became aware of a leak in the soil-pipe, and at the
same instant was attacked as with the suddenness of a blow.
IIe concludes, therefore, that he suffered from an imma-
terial miasm. How he became aware of the leak, he does
not inform us. But if in the ordinary way, by the olfactory
1869.] Cause, and Cure. - 299
nerves, he must have smelt a miasm, if it is immaterial;
an interesting fact in regard to immaterial things.
As to the suddenness of the attack, every physiologist
knows that a second or two would suffice after the emana-
tions entered the lungs for them to reach the vital centres;
and it is quite possible that he inhaled them before he smelt
them. Besides, people do not measure time very accurately
when great and startling impressions are made on the sys-
tem, and where seconds are concerned.
Dr. Wells aims to make this suddenness of attack on the
part of “miasms” a strong if not an essential point in favor
of his hypothesis of immateriality. But in this he seems
to me to be very inconsiderate. It is bad logic to endeavor
to establish a rule by its exceptions. And every physician
knows that persons are not usually attacked by measles,
Scarlet fever, small-pox, and other infectious diseases, till
days after exposure, and then the invasion is usually
gradual.
In those cases the immaterial force takes its time, is quite
leisurely in its hittings. The truth is, that the instances of
protracted interval are to instances of sudden seizure as
millions to one. And his argument from suddenness is
worthless.
To sum up the case, so far as facts are presented to sus-
tain it:
1. A physician, after attending twenty-six severe cases
of small-pox, was attacked while attending the twenty-
seventh, a mild case.
2. Families living on a marsh (on the border of a
marsh 7) escaped ague, while those on a neighboring hill-
side suffered.
3. Cholera is asserted to have traveled against the wind,
(because human beings traveled in that direction ?)
4. Dr. Wells was very suddenly attacked by a miasm
(that he smelt?) in a hotel; therefore, the causes of disease
(with certain specified exceptions) are immaterial.
I can not but think readers will pronounce the same judg-
ment as in regard to immateriality of disease.
3OO AXr. Wells on Disease, [April,
CURE.
Dr. Wells having established, to his own satisfaction,
that disease and cure are both immaterial, naturally con-
cludes that cure is also.
That remedies are immaterial, he argues, because very
high dilutions may cure. In order to render this fact of
any avail, he must first show that exceedingly attenuated
matter can not cure. Against his hypothesis of dissociated
force, that we know nothing about, I offer the fact of exceed-
ing divisibility of matter that we know not a little about.
He contends also that cures are effected by dissociated force,
because this may be communicated by medicated pellets to
unmedicated by shaking them together. He assumes that
this is accomplished by transmission of force without mat-
ter. I assume on the other hand, that force is trans-
mitted because matter is. About the latter we know not a
little; about the former nothing. Emanations of unimag-
inable tenuity proceed most probably from all bodies, from
solid woods and hard metals, as well as from volatile cam-
phor and musk. The absence of odor is no evidence of the
absence of emanation. The atmosphere, though in constant
contact with the nasal membrane, makes no impression on
the sense of smell.
Dr. Wells alludes to magnetism. Does he suppose that
a few taps shake the magnetic force out of a magnetic
body ? Is it not more reasonable to refer the loss of force
to a change in the molecular arrangement (which we know
can be effected by concussion), since all change of mole-
cular arrangement is attended by change of property 7 Is
it not better to reason from the known than from the
unknown 7
But he asserts that curative power is increased by attenu-
ation. Here he seems to fall into the very error that he
complains of in reference to the opponents of high dilu-
tions, that of ignoring well authenticated facts. There is
satisfactory evidence that low dilutions sometimes cure
when the high fail. IIow does this comport with his hypo-
1869.] Cause, and Cure. 3OI
thesis? Again, does Dr. Wells hold that remedies possess
two kinds of force, one pathogenetic and the other thera-
peutic; the former in the direct and the latter in the inverse
ratio of quantity ? This is the logical result of his premises
on his hypothesis, and quite inconsistent with the fact I
have stated in regard to the low dilutions. Besides, if the
pathogenetic property of drugs is associated with neither,
how does it comport with the immateriality of cause, since
pathogenesis is in proportion to quantity ? Dr. Wells holds
that the reverse of this is the law of dissociated force, the
less matter the more force. Is he prepared to admit that
drug-diseases have material causes 7
Is it not more probable that the same force acts in both
cases, only under different conditions? Dilute nitric acid
may coagulate and render opaque albumen in solution that
a more concentrated nitric acid will re-dissolve, rendering
the fluid clear again. Should we not conclude that some-
thing analogous takes place with reference to remedies and
cures, rather than resort to the extravagant hypothesis of
dissociated force :
But Dr. Wells regards the suddenness of action of reme-
dies as quite incompatible with their materiality. I did
write out an analysis of the two cases that he cites, which
analysis showed, in my judgment, that they are worth
nothing in the way of evidence. For lack of space I omit
it, and enter a general plea.
Dr. Wells insists on it, that no material movement can be
as rapid as the transmission of curative influence from the
tongue to the suffering region of the body. Let us take his
case of the injured woman and allow a distance of two feet
from the tongue to the ribs. Now sonoriferous undulations
of air move (in round numbers) 1,200 feet in a second. At
this rate the movement from the tongue to the ribs would
require ºr part of a second. Was it more rapid than
that?
It is very strange, if all cures are wrought by dissociated
forces, and if such suddenness of action is the evidence of
dissociation, that the suddenness is the exception and not
3O2 AMr. Wells on Disease, [April,
the rule. Rules, I repeat, should not be based on excep-
tions. I have made a great number and variety of experi-
ments on super-sensitive subjects, and I have always found
an appreciable interval between introducing the remedy
into the mouth and any sensible effect. The experience
of that most careful and trustworthy observer, Dr. Joslyn,
accords with my own.
It will be quite time enough to assert the immateriality
of therapeutical agents when electricity can be made to
cross an atmospheric vacuum ; though even that would not
be conclusive, so long as physicians recognize an ether
vastly more attenuated than air. To resume:— Dr. Wells
argues as follows:
1. Exceedingly attenuated remedies cure, and the more
attenuated the more potent the cure.
2. Unmedicated pellets shaken up with the medicated
become thereby medicated.
3. Remedies act with great suddenness; therefore, thera-
peutical agents are forces dissociated from matter.
It is ever my desire to give an opponent the full benefit
of his own statement and argument, if, perchance, there lurks
Some truth before unknown to me, and, recognizing it, I
may thereby become wiser. If I have failed thus to pre-
sent Dr. Wells’ position, it must be attributed to dullness
and not to intention. For the desire was heightened by
my respect for Dr. Wells.
I can only, in conclusion, express my regrets that he has
devoted his fine powers to the difficult task of attempting
to sustain what appears to me to be a very visionary hypo-
thesis. Let the reader decide.
ON THE MICRoscoPE, As AN AID IN THE DIAGNOSIS AND TREATMENT
of STERILITY, BY J. MARION SIMs, M.D., NEW YORK. — The January
(1869) number of the New York Medical Journal contains a valuable paper
on this subject. The three points to be determined by the microscope
alone are : 1. Are there spermatozoa in the Semen? 2. Do the spermato-
zoa enter the cervical canal & 3. Are the ScCretions of this canal favorable
to the vitality of the spermatozoa º
A FEW REMARKS ON PROFESSOR GUERNSEY'S
THEORY OF IMPREGNATION.
By EMIL TIETZE, M.D., PHILADELPHIA.
“A vivid imagination is able to explain every thing from its standpoint;
science, however, is but poorly served thereby.”— Grauvogl.
IN an essay on “Reproduction,” etc., read before the Homoe-
opathic Medical Society of Philadelphia, Prof. G. presents
to the profession his arguments in defence of his peculiar
view, as to the course taken by the semen in its passage to
the ovary. The theory referred to, according to the Pro-
fessor’s statement, originated with De Graaf, and centres in
the idea of the aura seminalis being transmitted through
the porous structure of the uterine walls and ovarian liga-
ments, and thus reaching the ovary and fertilizing the
ovum. The Doctor has adopted and promulgated this
theory in his work on Obstetrics, and in his recent article
attempts to support it by scientific argumentation.
Now, we are truly sorry that we can not accept this doc-
trine, for the reason that the arguments offered in its sup-
port seem to us deficient in every instance, and devoid of
all convincing evidence. However, before stating our rea-
sons for so opposite and out-spoken an opinion, we beg to
assure the learned Professor that it is not, as might be
wrongly supposed, the spirit of mere contradiction and
fault-finding that makes us array ourselves against him in
this question. For, like him, we seek the truth; yet for
this very reason feel ourselves compelled to combat his
theory.
To a certain extent, at least, we agree with Prof. G., in
his statement that “the whole question is still a matter of
opinion, rather than of actual demonstration; ” yet, not-
withstanding this concession, do not deem ourselves justi-
fied in sacrificing a theory, which carries with it strong
evidence of truth, and rests on the ground of numerous and
3O4. " Theory of Impregnation. [April,
careful experiments, to a mere belief, which, to all appear-
ance, finds but a very feeble support, in a small number of
incomplete and insufficient observations, all of which may is
be correctly explained, in such a manner as to deprive them
of any weight in its favor. And what service we should
render science by preferring a belief, built up upon dreamy
speculations, to a theory, founded upon exact researches, we
have been taught, often and painfully enough, we should
think, by medical history.
Prof. G.'s first argument, in support of his doctrine, is
the following: “In numerous cases of extra-uterine preg-
nancy, the cause of the non-transmission of the impregnated
ovule into the uterus, has been found to be an imperforate
condition of the Fallopian tubes. In these cases there could
be discovered no sign of an opening ever having existed,
through which the semen might have passed to the ovary.
The only natural channel which otherwise appears is that
through the ovarian ligament.”
We do not know whether facts, in the Doctor’s posses-
sion, fully justify him in the above statement; yet it seems
to us, as if this attempt of his to seal our lips could hardly
be considered a fair one. For, as he can not reasonably
expect us to accept his statement in blind faith, he should,
if for some reason or other he omitted to quote some of
those cases in detail, at least, have informed us where we
could find their history; so as to enable us to judge for
ourselves, whether the inference drawn by him, could be
accepted by us as correct, and as giving strength to his
theory. That an imperforate condition of the Fallopian
tubes, or, as we would say rather, an obstruction or oblite-
'ation of the Fallopian tubes, has frequently been the cause
of the non-descent of the impregnated ovulum, and conse-
quently of extra-uterine pregnancy, is a fact well-known to
all of us; yet this fact could be wielded by the Doctor as a
weapon against us only, if he were able to prove, at the
same time, that this imperforate condition had existed pre-
vious to impregnation. For, the mere assurance of the
non-discovery of any sign of an opening in that organ after
1869.] Theory of Impregnation. 3O5
death, can certainly not be deemed sufficient proof of its
never having existed during life. Moreover, if we consider
the pathological changes and disorganizations of the Fallo-
pian tube, in the course of a case of tubal pregnancy, we
will at once perceive the almost insurmountable difficulties,
if not absolute impossibility of rendering, post festum, a valid
decision as to the state of that organ previous to its path-
ological disturbance. Now, it is true, the arrest of the
ovulum, in its descent through the Fallopian tube, may be
occasioned by an obstruction more direct and primary, than
the one that follows the rapid growth of an incarcerated
ovulum, arrested in its downward journey by other differ-
ent causes, as, for instance: by a disturbed, abnormal or
absent peristaltic motion of the tube; an abnormal or
absent motion of the ciliated epithelium ; an impeded or
absent rotatory motion of the ovulum itself, etc.; yet, to
explain this obstruction, it is, in our opinion, not necessary
to adopt the highly improbable hypothesis of an imperforate
condition of that organ previous to impregnation, even if
post-mortem appearances should somewhat favor such a sup-
position. For recollecting that, soon after effective copula-
tion, the uterus covers itself with a rapidly growing mem-
brane (membrana decidua Hunteri), which lines the entire
uterine cavity, closes the uterine opening of the Fallopian
tubes, and completely obstructs the cervical canal down to the
os uteri externum; it seems not improbable at all, that, under
favorable conditions, this luxuriantly growing membrane
may also enter the Fallopian tubes, to a greater or lesser
extent, and, favored by constitutional anomalies, organize
into cellular tissue, and obliterate the oviduct so completely
as afterwards to give it the appearance of a solid cord.
However, we frankly admit that in all this we have, at
the best, given but negative proof of the weakness of the
Doctor's hypothesis, and that in order to fully demonstrate
its untenability, we must furnish more direct and positive
evidence. This, as far as it can be done probably, we will
endeavor to do in the statement that, according to Haigh-
ton’s experiments, impregnation did not take place after
306 Theory of Impregnation. [April,
coitus in animals, whose Fallopian tubes had previously
been obliterated by the application of ligatures. (I. Budge,
Memoranda der spec. Phys. der Menschen.)
The Doctor's second argument in support of his theory
is “that normal uterine pregnancies have been found, where
the os uteri was entirely wanting, and where not the slightest
trace of its ever having existed, could be detected, and that
in these instances, as well as in those of an imperforate con-
dition of the tubes, the semen certainly could not pass up
to impregnate the ovum through the Fallopian tubes.”
To this we have to say but little in reply, since our former
remarks, with their full force, apply at the same time to this
argument. On the one hand, the obliteration of the os
uteri, previous to impregnation, can not be proven, and
there is no evidence of its having existed in the cases of
Dr. Ashwell, mentioned by Churchill, at least not so far as
Dr. G.'s quotation goes; while, on the other hand, obstruc-
tions of the os and cervix, from various causes, such as a
high degree of rigidity of the cervix, obstructions of the os
and cervix by polypous growths, or bends in the latter by
anteversion or retroversion of the uterus, in numerous and
well authenticated cases, have proved themselves the only
and direct causes of sterility. For, after their removal,
impregnation soon took place after an effective coitus in
many cases; facts which we may consider as carrying with
them sufficient and positive evidence of the impossibility of
impregnation, in cases of a closed os or cervix uteri.
Prof. G.'s third reason for the adoption of his theory is
the following: “This modified doctrine of absorption is
descriptive of the most simple process that nature could
adopt for conveying the semen to the ovary; and, while it
is true that the assertion that the semen is conveyed
‘through the walls of the uterus, and out through the
ovarian ligament to the ovary,’ is not predicted upon ana-
tomical discoveries of ducts or passages, that I have made
in the human uterus, such ducts or passages have been
found in the elephant, and by Dr. Gartner, of Copenhagen,
in the cow and sow.”
1869.] Theory of Impregnation. 3O7
Sure enough, here the Professor has presented us with
an “elephant,” and we don’t know what to do with it.
For, in vain, we have tried to find in those words an argu-
ment in support of his theory. Because the information
given us, that ducts or passages leading from the uterus
through the ovarian ligaments to the ovary, have been
found in those animals, does certainly not prove his hypo-
thesis that the semen, in the human female, passes through
the walls of the uterus and ovarian ligaments, in which, as
yet, no such passages have been discovered, to the ovary.
On the contrary, if there be any argumentative force in
that statement, it is rather hostile to his doctrine, in so far
as it proves that the semen in those animals does not reach
the ovary by means of absorption within the uterine walls
and ovarian ligaments, but is conveyed thither directly
through open gang-ways. , And if he admits that the semen
may pass through those ducts to the ovary, why does it
seem improbable to him that it should be conveyed through
the Fallopian tubes to its ultimate place of destination? For
these reasons we are compelled, at present, to return the
“cow and sow ’’ with thanks, and will leave them in the
Doctor’s care, patiently waiting for the time, when, assisted
by his further elucidation on this subject, we shall also be
enabled to admire his “elephant.”
We now come to the Doctor's fourth argument. He
says: “The correspondence of the general affection of the
whole female organism to that of the male, requires that
even as the semen is given from the inmost of the male, so
it shall be received into the immost of the female, even into
the ovaries, and there perform its vitalizing function. And
here we wish to remark that, while it is admitted that the
reception of some portion of the semen into the ovule is
necessary, in order to impregnate it, still this portion need
be no more than the minutest particle, which in organized
bodies corresponds to the elementary or primary atom of
the inorganic world. And that in addition to this, the doc-
trine of the universal impregnation of the blood of the
female by means of the seminal aura of the male, seems to
308 Theory of Impregnation. [April,
be confirmed rather than refuted by the later discoveries of
modern physiological science. The entire system of the
female is influenced most powerfully, and in a direction
highly favorable to reproduction, both by the general mag-
netic sphere of the male, and by that richly endowed secre-
tion, which is given off as the representative of his energetic
vitality.”
If any one should have been surprised at Prof. G. for
adopting so singular and antiquated a theory, he will, with-
out much trouble, find the “key-note” to the Doctor's aber-
ration in the quoted passages. Prof. G. is a dynamist par
excellence, and as such deals largely in transcendental
speculations, and, like all the members of that persuasion,
has a very strong antipathy against what, with a deep sigh
from that quarter, is commonly called “materialism.” Our
school has always counted a number of such men in its
ranks, and they have more or less, and at all times, labored
to remodel medical science according to their creed, in
order to support the one by the other, and to enjoy the
Sweet pleasures of the “happy family.” They all speak with
the greatest respect of modern science; yet, for all that,
can not fully enjoy it, on account of its “low tendency.”
From this it is evident that the present theory of impregna-
tion is not to their liking, and it is quite natural that Prof.
G. should have thought of supplying his brethren with
another. IIowever, in some of these assertions we may,
apparently, be mistaken, since the Doctor asserts that later
discoveries of modern physiology had rather confirmed than
refuted the old doctrine, of the universal impregnation of
the blood of the female by means of the aura seminalis of
the male; yet, as we have looked about in vain for an
authority in support of this statement, the Doctor may yet
have occasion to regret his rashly spent affection, and we
may remain in the right.
Spallanzani and Rusconi impregnated ovula of the frog
with very minute quantities of diluted semen, but they both
testify that the aura seminalis alone was not sufficient to
impregnate such ovula. (Budge). We are not aware of any
;
:
:
e
ſº
© º
gº © tº o
o © ... O
1869.] Theory of Impregnation. 3O9
one else having impregnated such, or ovula of other animals,
with quantities of semen smaller than those applied by
Spallanzani and Rusconi. Now, Prof. G. will hardly be
ready to assert that the quantities used by those experi-
menters, though exceedingly minute, were so small as to
contain the final primary atom of the semen; since the
dilution, used by them, does not reach even our fifth cen-
tesimal potency. What portion of the semen, then, contains
the aura, which, according to their testimony, did not
impregnate the ovula of the frog’ Hardly portions larger
than those successfully applied by Spallanzani in dilution.
And if smaller, then the particle, successfully used by him,
was not the minutest particle conceivable, the final primary
atom. Hence the Doctor’s assertion, that the minutest
particle of the semen, corresponding in organized bodies to
the elementary or primary atom, would be enough for
impregnation of the ovum, is not warranted by those exper-
iments, and of any other experiments of this kind, we have
never heard. However, if the Doctor can show, by demon-
stration, that he is able to impregnate females — under
favorable conditions, to be sure — by letting them inhale
the aura seminalis of a human male, or, still better, by
letting them smell at a single globule— of the size of a
poppy seed, to be sure — saturated with the 100,000th
potency of the semen virile, then, indeed, he would have
given us the most indubitable proof of the possibility of the
universal impregnation of the blood of the female, by means
of the aura seminalis of the male, and the minutest (?) par-
ticle of the semen virile; and we shall stare at this miracle
with eyes widely opened, though without fearing that this
modus operandi of propagating the human kind would ever
be adopted as a general and favorite practice.
We now proceed to the Doctor’s fifth and last argument.
IIe says: “It is to be remembered, that the ovaries are
encompassed by, first, the serous peritoneum, and, secondly,
by the tunica albuginea, a highly organized and dense
fibrous tissue, impervious in a much greater degree than the
comparatively porous textures of the uterine walls and the
Wol. W.-No. 15. 4
3 IO Theory of Impregnation. [April,
*
ovarian ligaments. Thus, though it may be true, as is
claimed, that spermatozoa have been observed on the ovary,
it does not follow that impregnation of the contained ovule
is effected through the passage of these spermatozoa through
the Fallopian tube. Theovules are within the ovary, at one
end of an uninterrupted porous chain, and it is reasonable
to argue that the vivifying principle is conducted to the
ovule by that way.”
“Again, it is to be remembered, that the Fallopian tubes
(oviducts) being lined by ciliated epithelium, have the ciliae in
a direction to aid movements from the ovary and towards the
uterus, and to retard movement in the opposite direction.”
The nearer the female body approaches sexual maturity,
the more does the shape of an ovary change from an oblong
into an egg-shaped form. This change is occasioned by the
steady development and growth of the Graafian follicles, at
that end of the ovary which looks towards the oviduct.
Here the follicles swell up more and more, stretch the
tunica albuginea and its peritoneal coating, and gradually
rise above the level of the ovary; the ovula within them
ripening, meanwhile, into maturity, and moving from a
more central position, within the follicle, to its highest
peripherical point. Now, the anatomical position and con-
struction of every organ in the human body are such as to
fit it for, and facilitate, its physiological function. The
function of the ovary is to (form 2) harbor, and, above all,
to develop and ripen the . ovula contained therein, in rapid
succession, and to such a degree, as to prepare and qualify
them for impregnation by the semen of the male. Yet,
since the contact of the semen with the matured ovulum is
a condition sine qua non of subsequent developments within
the ovulum, it may be reasonably supposed that it had
been placed in the ovary in such a manner, as to increase
its chances for impregnation as much as possible, i. e., so as
to bring it most surely, easily, and quickly within the reach
of, and in contact with, the semen. But since the vitalizing
fluid had to reach the ovulum from without, it was neces-
sary to provide a channel through which the former could
1869.] Theory of Impregnation. 3 II
be conveyed to the latter. This channel is formed by the
genital organs of both sexes, each sex supplying one-half
of it, and begins, double, at the testes, with the vasa defer-
entia, continues, single, through the urethra, and — by
means of connecting the ostium urethrae cutaneum with the
ostium vaginale uteri — through the canalis cervicalis and
cavum uteri, and finally terminates, double, as it began, in
the tubes at their orificia abdominalia. However, we
observe that, while at its beginning this channel is directly
and firmly connected with the testes, it is, at its termination,
not directly connected with the ovaries, but — surrounded
by organs (fimbriae) which, by means of their length and
great mobility, can grasp the ovaries under exciting
causes — ends open in the abdominal cavity. This might
be considered as a sort of proof of the Fallopian tubes hav-
ing no part in the formation of the channel mentioned.
Yet, if we go back to embryonal development, we find those
tubes, the former excretory ducts of Wolff's bodies, in
direct connection with the ovaries, though their detach-
ment takes place at a very early date. This provision was
necessary in order to prevent certain accidents, and to
accomplish certain purposes in the future. We will briefly
point out a few of the former.
We have already stated, that the ripe ovula are to be found
at that part of the ovary nearest to the Fallopian tubes, and
that this arrangement was necessary in order to bring the
semen in contact with the ovulum. But those tubes, besides
serving, as we shall presently see, as a means of conveying the
semen to the ovary, were also to be the means of seizing and
transporting the impregnated ovulum. Now, if those tubes
had remained in direct connection with the ovary, they would
(since the growth of the Graafian follicles, at the tubal end of
the ovary, is very rapid, and takes place in quick succession)
have suffered such structural changes, as either would have
separated them from the ovary by tearing, or have unfitted
them for their function by destroying their power of contrac-
tion, in consequence of repeated distention or over-stretching.
Thus the impregnated ovulum would either have been lost in
3I 2 Theory of Impregnation. [April,
the abdominal cavity, or have been deprived of the vis a tergo,
that was to start its forward movement, and extra-uterine
pregnancy would have taken place. Again, the bursting
of the Graafian follicles, the formation of corpora lutea and
cicatrices, in case of a direct connection of the Fallopian
tubes with the ovary, would not only have impeded, if not
entirely excluded, future impregnation, by preventing the
semen from entering the ovuſum by diosmosis; but the
follicles, subsequently developing, unable to break through
the hardened tissue before them, would also have lost the
chance of floating their ovula into the tubes. That all this
mischief is prevented by the open termination of the Fallo-
pian tubes, and their final and repeated division into long,
movable, and elastic fimbriae, can easily be perceived on a
little reflection. And certainly there was never a name
more unjustly applied, than the one given to those fimbriae
by former anatomists, who called them the “morsus
diaboli.”
Thus we have found the channel of transportation from
the testes to the ovaries. Now, we will briefly consider the
means and powers of transporting the semen through this
channel. They again are distributed over both sexes, and
consist in the construction of a wisely arranged muscular
apparatus, which, set in motion by the intense sexual
excitement during, and principally at, the close of copula-
tion, drives the semen from one end of this channel to (or
nearly to) the other. But since the motive power of the
male is not sufficient to convey the semen through the
whole length of this channel, it was necessary that, at the
point of its exhaustion, another similar force should seize
that fluid, in order to carry it to the ultimate place of its
destination. This power is given in the rhythmical expan-
sion and contraction of the uterus from its os toward its
fundus, during sexual excitement, and in the peristaltic
motions of the Fallopian tubes, opening into the uterine
cavity at such a place and angle, as to compel the semen,
arrived within the uterus, both by the contraction of its
walls, and the counter-pressure of its fundus, to escape into
1869.] Theory of Impregnation. 313
those tubes. Here we will, also, direct the attention of the
reader to the insertion of the so-called ligamenta rotunda—
which, instead of being ligaments, in the true sense of the
word, are real prolongations of the uterine substance —
very near the Fallopian tubes, and their termination at the
pudendum, in the neighborhood of, and probably in the
tissue of, the clitoris.
It is hardly necessary more fully to demonstrate the
adaptation of this wonderful contrivance to the purposes in
view. By means of it the semen had to be conveyed through
the Fallopian tubes to the ovary most directly, surely,
easily and quickly. And, if the Creator had laid out a plan,
according to which the semen was to be conveyed to the
ovary by another route, he would, in the constructions
arranged for this purpose, have foiled his own plan, and,
accidentally have hit upon means, by which the ends aimed
at had been gained much surer and better, than by those
originally designed by him. Indeed, a very flattering com-
pliment to the Creator.
Whether the spermatozoa and the ciliated epithelium of
the Fallopian tubes, present additional motive powers of
conveying the semen to the ovulum, we can, as yet, not
fully decide upon; though we incline to the opinion of those
who do not believe the former to assist in this work, mainly
on account of the great irregularity of their movements,
frequently in a direction opposite to the one necessary to
reach the ovary, and who suppose them to be destined
merely to keep, by their constant motions, the semen in
such a degree of agitation, as is necessary to prevent its
early decomposition. The movements of the ciliated epithe-
lium, at least so far as our present knowledge goes, take
place in the opposite direction; an observation, however,
which, in consideration of the great capriciousness of these
bodies as regards the direction of their movements, would
hardly form a serious objection to the theory of their being
part of the motive force of the semen through the oviducts.
Thus we have seen that, for theoretical reasons, the semen
has to pass, in substance, through the Fallopian tubes to
314 Theory of Impregnation. [Afriº,
the ovary, and observations on animals, killed from six to
forty-eight hours after copulation, have demonstrated the
correctness of this view. For in all those cases the semen
was found in the Fallopian tubes as well as in the uterus,
and even covered the ovary. (G. Valentin, Grundriss d.
Phys. der Menschen.)
Now, as an argument in support of the theory that the
semen was to pass through the walls of the uterus and
ovarian ligaments, Prof. G. very naively asserts that such a
route would be by far the easiest, on account of the com-
paratively porous texture of those organs; while the passage
of the semen through the serous peritoneum, and the dense
and highly organized fibrous tissue of the tunica albuginea,
could not but meet with serious impediments. Indeed, it
is hardly worth while to waste words on so ingenious an
argument, since we know, on the one hand, how exceed-
ingly thin and delicate those membranes are, in consequence
of the follicular growth; while, on the other hand, the very
thick, dense, and leather-like walls of the uterus, at that
date, and the long ovarian ligaments — by the way, strong
cords, firmly knitted together of “highly organized and dense
fibrous tissue”—from their uterine to their ovarian insertion,
are thousands of times thicker than the fine and delicate
coverings of the follicle. But not enough of that, for, in
addition to it, the semen would also have to pass through
the main body of the ovary, in order to reach the ripe
ovulum. Indeed, a most singular arrangement of nature—
if an arrangement of nature it were — in order to accom-
plish one of her highest aims, in the surest and best man-
ner. And, then, just think of the poor spermatozoal Oh,
it is too dreadful to think of them and thus we will leave
off here; however, not without deeply regretting the Pro-
fessor’s sad attempt at suicide, by suspending himself by
that “uninterrupled porous chain.”
MTLLEFOLIUM: (ACHILLEA MILLEFolium, Yarrow.). A
PATHOGENETIC AND CLINICAL STUDY.
BY E. M. HALE, M.D., CHICAGO, ILL.
Medical History. — This common plant has a history run-
ning back into the early morning of the Art of Healing.
It is a little singular to note, that it is one of those plants
whose reputation has always been limited to a small sphere
of action, and has never deviated out of this sphere.
In looking through some rare old medical works which
we possess, we found some interesting information relative
to this plant.
Woodville” says: “This plant appears to be the Erpaxtoym:
yūtoºvX20ct of the Greek writers, by whom it was esteemed
as an excellent vulnerary and styptic, and was generally
employed internally as a useful astringent in all haemor-
rhagic complaints. Instances of its good effects in this way
are likewise mentioned by several of the German physicians,
particularly by Stahl and Hoffman, who also recommend it
as an efficacious remedy in various other diseases; the
former found it not only an astringent, but also a powerful
tonic, anti-spasmodic and sedative. In proof of the last
mentioned quality, we may remark, that in some parts of
Sweden it is used in making beer, in order to render it
more intoxicating; and Sparrman has observed that it is
employed for this purpose in some parts of Africa.
From a huge vellum-bound, antiquated-looking quarto, i.
written in Latin, by one John James Mangetus, M.D.,
“Chief Physician to the King of Prussia,” and published
in 1703, we extract the following mention of the Millefoil:
* Medical Botany (1790), p. 179.
# Stratioles, Matthiol, in Dios.
# “A Pharmaceutico-Medical Library,” etc.
316 Millefolium. [April,
“The powers of this plant, Shrodius thus briefly enume-
rates: Its effect is to staunch blood. It is, therefore, suit-
able for use in all haemorrhages and flowings, of the nose,
uterus, bowels, or wounds, also for bloody hawking, vomit;
retained urine, stone, bloody urine, gonorrhoea, piles,
uterine flow, fig-shaped tumors,” etc.
“Outwardly it is useful for head-ache, bleeding of the
nostrils, and wounds, tumors of piles, hernia, poisoned
stings, tumor of penis,” etc. (?)
“More recent observations (says C. Hoffman) shows our
Milleum to be so far from having the faculty of staunching
haemorrhages, that it even Stimulates them (but J. Bankinus
thinks that bleeding of the nostrils is caused by Millefoil, on
account of astriction), and that it is even a vehement diuretic, so
that by its daily use it produces bloody wrime. Hoffman,
therefore, distinguishes, and thinks that it has that power
of staunching, because it is sour; of opening and dissolving,
freeing the urine, destroying intestinal worms, etc., because
it is bitter.”
Old Culpepper, in his “English Herbal,” says it “stop-
peth the bloody flux,” and cures incontinence of urine.
The Millefoil is among those plants which have been
banished to the limbo of obsolete medicines. This fate fell
upon many worthy medicines, for the reason that the Allo-
pathic school never took pains to inquire into their physio-
logical action; but used them after a grossly empirical
manner. No medicinal substance can long maintain its
position in any school, unless it have a pathogenesis, or a
series of experiments, instituted with care and method,
whereupon to stand. The empirical use of any medicine
will not render its fame permanent.
The next mention we find of the Millefoil, is a remark
made by Hahnemann, very suggestive, and showing acute
observation. He says: *
“We should endeavor to find out if the Millefoil can not
itself produce haemorrhages in large doses, as it is so effica-
cious in moderate doses in chronic haemorrhages.”
* “On the curative powers of Drugs.” Lesser Writings, p. 269.
1869.] MŽ7/e/o/ium. 3 I 7
The only pathogeneses of Millefoil extant (so far as we
know) are those of Iſartlaub and Trinks (Ann. iv. Archiv. xv.
3, etc.), and Dr. Hering’s, and others, and is to be found in
“Amerikanische Arzneiprüfungen,” (1857), pp. 122–170.
Dr. IIempel, in the first edition of his Materia Medica,
says there is a proving by Dr. Hering, but in his second
edition that remark is omitted.
Dr. Lippe, in his text-book of Materia Medica, which he
says “contains the characteristic and most prominent special
symptoms of the best proved and most used of our medi-
cines;” gives a pathogenesis, which we shall have occasion
to mention further on.
In the Clinical Observations, found prefixed to the path-
ogenesis in the Symptomen Codex, the Millefoil is recom-
mended for “congestion of blood to the head and face,
lungs, heart, etc. For haemorrhages from various organs,
nose, ears, (?) stomach, (?) rectum and anus, bladder, uterus,(?)
lung, and skin. According to Noack and Trinks, it has been
successfully exhibited in the following effections: Excessive
bleeding from the hamorrhoidal tumors, haematuria, haem-
optoe, pulmonary phthisis after haemoptoe, epistaxis.”
A STUDY OF ITS PATHOGENESIS. *
It will be remarked, that a study of the symptoms of
Millefoil, obtained by homoeopathic provers, does not show
one instance of hamorrhage caused by it. Those provings,
however, show that the experiments were not made with
sufficient thoroughness, or with sufficiently large doses, to
cause such results.
Of the seventy-four symptoms given by Lippe, fifty-two are
not pathogenetic symptoms, but what are termed curative. The
question here arises, Where did Dr. Lippe get these symp-
toms, or curative indications : We are told in the start,
that the “characteristic and special' symptoms only, are
given in the text-book. Is it just and consistent, after this
assertion, to lug into a pathogenesis, all the empirical uses
3.18 Millefolium. [April,
of the medicine 7 What proof have we that any of the
“curative symptoms” are reliable.
Dr. Lippe stands at the front of that portion of our school
who claim that we have no right to use a medicine not pre-
viously proven; that the use of a medicine, based on the
observations of other than IIomoeopathic physicians is ille-
gitimate. If this be the true doctrine, what business has
Dr. Lippe to introduce into his book a single symptom not
genuinely pathogenetic 2
The profession will please remember, that when the
writer issued his “New “Remedies,” it was severely criti-
cised by Dr. Lippe and his friends, because the clinical
observations of physicians of other schools were given to
illustrate the curative effects of the medicines. It was
alleged that such testimony was unreliable, for two reasons;
first, because the witnesses were not IIomoeopathic physi-
cians; and, Second, because the cures were not based on
pathogenetic symptoms.
Any one who will compare the “New Remedies” with
Dr. Lippe’s “Text-Book,” will see that, in respect of using
clinical testimony, the latter work has no advantage over
the former.
If any one will compare the pretentions of Dr. Lippe,
with those made in the preface to “New Remedies,” he
will see which is the most consistent.
I can not ascertain that Dr. Lippe has done otherwise
with Millefoil, than I have done with Caulophyllum and other
remedies. IIe has collected the traditionary domestic uses,
the assertions of Allopathic physicians, the empirical uses,
and the dicta of a few Iſomoeopathic physicians, and given
this testimony as “characteristic and special" symptoms
of Millefolium. I collected the same kind of testimony, but
in using it, did not palm it off for what it was not.
We would observe here, that we do not doubt but the
Millefoil may prove curative in many of the conditions men-
tioned by Dr. Lippe, but we contend that the truth should
* A new proving has since been published, in the “Zeitschrift for Hom.
Klinik,” by Keil.
1869.] Millefolium. 3 IQ
be told in all cases. The student or physician who reads
the pathogenesis given by Dr. Lippe, will naturally suppose
he sees therein the pathogenetic symptoms of the medicine,
when he sees no such thing, for out of the seventy-four,
only twenty are really of that character; the rest are clinico-
empirical observations.
In the present condition of our Materia Medica it is an
important question, how we shall deal with such remedies
as the Millefoil.
There is evidently but one way that we can consider them,
and at the same time be consistent and truthful, namely:
(a). To designate the purely pathogenetic symptoms by
some symbol; those which have been confirmed by clinical
experience, by some other symbol; and the purely clinical
or empirical by still another symbol.
(b). To point out those symptoms in the provings which
would naturally lead to conditions, such as are recorded
among the clinical experience.
Dr. IIempel has ably conformed to the last rule. When
writing of Millefoil he says: “We have a few provings by
Hartlaub and Trinks, and other experimenters, which fur-
nish abundant testimony of the homoeopathicity of this
agent to conditions immediately preceeding harmorrhage; or to
conditions arising from the abnormal suppression of habitual
or accidental haemorrhage.” (The italics are our own.)
This, in our opinion, is the proper way to represent the
matter. Here are no subterfuges, no misrepresentations,
but a plain, scientific, and consistent course of procedure.
Take, for example, the head-symptoms — how closely
they represent those symptoms, and the pathological state
which immediately precedes epistaxis, namely: “Painful
roaring and confusion in the head; sensation as if the whole
mass of blood would rush to the head; rush of blood to the
head when stooping, relieved by raising the head.”
On the contrary, a careful study of the symptoms fails to
give us any which indicate that it has caused the “charac-
teristic and special” symptoms given by Dr. Lippe, namely:
“Suppressed itch, and from it fever, fistulous ulcers, can-
32O Millefolium. [April,
cerous ulcers, convulsions after parturition,” and many
others found in his pathogenesis.
Again, Dr. Lippe affects a great contempt for pathology,
pathological symptoms, etc., but with that remarkable con-
sistency so characteristic, he gives no less than twenty or
Inore, distinctly pathological States, and all as “characteristic and
special symptoms” of Millefoil!
If I have hitherto not given my opinion of Dr. Lippe’s
compilation, it is not because I was ignorant of its faults.
Whichever way we dissect the Text-Book, it is unpractical
and unreliable.
If we strip it of its false symptoms, by which I mean the
clinical and empirical, nothing is left but a few pathogenetic,
which we could get in better shape by consulting other
authors. If we take from it the pathogenetic, we leave a bare
enumeration of empirical uses, clinical experience, and
theoretical recommendations, gleaned from all sources, of
doubtful reliability, making a compilation in no wise supe-
rior to the “Therapeutics,” or “Dispensatories,” of the
other medical Schools.
In general terms, we earnestly protest against any man, or
set of men, taking the great responsibility of tearing in
pieces the provings of a drug; of arranging the symptoms
in an arbitrary manner; and further, of selecting, arbitra-
rily, any of these symptoms as “characteristic and special,”
without the most reliable and accurate knowledge as to
whether the selected symptoms are truly so. To use a com-
mon phrase, this “characteristic ’’ business has been “run
in the ground.” Any drug-symptom may become, under
certain circumstances, a “characteristic ’’ one. A charac-
teristic symptoms in one case may become a very insignifi-
cant one in another.
We also protest against the introduction of a single clin-
ical observation, as a “characteristic” symptom. If Dr. A.
gives Mr. B. a dose of Sulphur, 40,000th, for a few pinuples
on the face, which disappear in a few days or weeks, has
Dr. A. any business to put into the pathogenesis of Sulphur,
“ pimples on the face 7” The Allopath who observes that a
1869.] Millefo/ium. 32 I
fit of bilious vomiting ceases after twenty grains of Calomel;
or the Eclectic, who observes a paroxysm of colic subside
after ten grains of Caulophyllum, has the same right to claim
cures. Probably the “pimples’ would have disappeared
had no sulphur been given, and so might the “vomiting,”
and the “colic,” in spite of the Calomel and Caulophyllum.
In common with the best friends of Homoeopathy, we
have long since come to the conclusion, that what our sys-
tem most needs is to get rid of those who tinker with our
pathogeneses, and in their places have men who can observe
correctly, and who will tell the truth.
In order that the profession may judge whether we have
done justice to Dr. Lippe, and that they may see the method
which we claim should be adopted in arranging a patho-
genesis; we have taken Dr. Lippe's, and arranged it so as to
give each symptom its due importance, and at the same
time designate what kind of symptom it is, and the source
from which it was obtained. A pathogenesis thus arranged
will inform the physician or student of the value of each
symptom, the authority, and the kind of authority for each
symptom, or clinical recommendation.
It is only by such an arrangement that the value, and
origin, of our symptomatology can be determined.
In order that the pathogenesis may be better understood,
I shall adopt certain symbols, in explanation of the symp-
toms, similar to those used in my pathogenesis of Myrica,
namely:
Pure pathogenetic symptoms, (p.)
Verified pathogenetic symptoms, (p. v.v.)
Pathogenetic symptoms confirmed by cures, (*).
Clinical symptom, unconfirmed, (0.)
Clinical (empirical) symptom, confirmed, (o. c.)
For the authority or source of the symptom, the capitals “H” and “A.”
are used to designate the Homoeopathic and Allopathic. The remarks in
brackcts are our own.
MIND AND DISPOSITION.
(0.) Very excited, with pain in the pit of the stomach. (Hering's Symp-
dom, 177, from Normand.)
(0.) Sighing and groaning of children. (Ib.)
322 Millefolium. [April,
[It has caused “stupefaction, intoxication, and vertigo.”— Linné, Flor.
Succ., p. 299.4]
HEAD.
(p.) Wertigo when moving slowly, walking, but not when taking violent
exercise, with nausea when stooping, not when lying down. (Dr. Bérens)
(p.) Sensation as if all the blood ascended to the head. (Schrodius, Mure.)
(o.) Violent head-ache, with twitching of the eyelids and muscles of the
forehead, (Norman de Soſny, A.)+
[Why were the twelve other symptoms, given by Trinks, omitted ? Espe-
cially the following: “Painful roaring and confusion of the head;”
“IRushing of blood when stooping, relieved by raising the head.” Surely
these are important and characteristic, and explain the action of the
medicine.]
EYES,
(p.) Glistening eyes. (Mure.)
(p.) Agglutination of the eyes in the morning. (Wenning.)
(0.) Lacrymation and discharges from the eyes. (Old Books, A.)
. [Why was the symptom – “Mistiness of the eyes, only at a distance”—
discarded ?]
EARS.
[Why did Dr. Lippe omit the ear symptoms? were they worthless; if so,
how did he know? Or did he leave them out because Hempel put them in 31
FACE.
(p.) Redness of the face, without internal heat. (Wenning.)
[“The leaves of the Millefoil, broken up and put into the meatus audito-
rius, often relieve tooth and jaw-ache.”— Tabernaemontanus. This should
be sufficient authority to enable Dr. Lippe to introduce into his pathoge-
nesis “Odontalgia” and “Prosopalgia.”]
NOSE.
(c. o.) Bleeding of the nose. (Schrodius, and others, A.)
[The older English botanists called it Nose-bleed, “because the leaves
being put into the nose caused it to bleed.” Bankinus seems to imply that
he has known it to cause bleeding from the nose, so this symptom might
perhaps be put down as pathogenetic. I have not met with any report of
its confirmation in our literature.]
* Dr. Hughes (Pharmacodynamics) says it caused him to have “vivid and
unpleasant dreams.”
# This case is not correctly given—it should read: “The cephalalgia
was caused by repressed itch; the eruption was re-produced, and the head-
ache, of three weeks duration, and so intense as to force the patient to dash
his head against the wall, and posts of his bed; it was accompanied with
convulsive movements of the eyelids and frontal muscles.”
1869.] .* Millefolium. 323
MoUTH AND THROAT.
(0.) Ulcers on the gums. (Old Books.)
(0.) Stomacace. (Ib.)
(p.) Tongue swollen and coated. (Mure.)
(o.) Elongation of the palate. (Old Books.)
(o.) Ulcers in the throat. (Ib.)
[We should like to know what was the appearance of the ulcers on the
gums, and in the throat? What kind of stomacace was cured by the medi-
cine * Why was the following palate-symptom omitted ? “Fine stinging
in the palate, with sensation as if cut to pieces.” Was this symptom
changed to: (0.) “Elongation of the palate?”
STOMACH AND ABDOMEN.
(p.) Painful gnawing and digging in the stomach, as from hunger. (Nen-
7, ing.)
(p.) Burning in the stomach, extending into the chest. (Ib.)
(0.) Violent pain in the pit of the stomach. (During retrogressive small-
pox, Dr. Maumery, A.)
[This should be, “Stomach pains supervening in the course of a confluent
small-pox.” Taken from Ancien. Jour. de Med., vol. 34, p. 402, 1770.]
(p.) Vomiting when coughing. (Mure.)
(p.) Nausea with vertigo. (Berens.)
(0.) Pain in the region of the liver. (Ib.)
(o.) Congestions to the portal system. [Merely a thoretical recommen-
dation by Stahl, A.]
(o.) Colic during menstruation.
[What has this last symptom to do with the “abdomen?” If the colic
was “during menstruation,” it was most likely in the uterus, not the intes-
tines. This symptom was doubtless taken from Dr. Maumery, (A.) who
claims to have cured “hysterical colic,” with the Millefoil.
(o.) Ascites. (Chomel, History of Plants, p. 427, A.)
(o.) Incarcerated hernia. (Schrodius, A.)
(p. v.) Frequent emission of foetid flatulence. (Hering, Wenning.)
(0.) Violent colic, with bloody diarrhoea (during pregnancy). (Chomel.
(0.) Dysentery. (Maumery, Culpepper, Morrow, A.)
STOOL AND ANU.S.
(0.) Haemorrhages from the rectum, caused by too violent exertion. (A.)
[This is from Dr. Pauli, who thus reports the case: “Six ounces of the
juice, with as many of nettles, taken in two doses, an hour between, has been
effectual in my practice in arresting a haemorrhage from the intestines; this
lappened in two working-men trying to lift a very heavy weight, and who
had already passed upwards of two pints of blood; it was also given in
injection.” Why pervert the word “intestines” to “rectum ?” Does Dr.
Lippe mean to teach that this is a pure Homoeopathic cure? and that the
Millefoil alone—notwithstanding the nettlejuice — was the sole curative
agent? Would he expect to cure a similar case with Millefoil 1000th
324 Millefolium. [April,
Would it not be more proper to give both Urtica 1000th, and Millefoil
1000th 2 Should they not be mia!ed a la Dr. Leutze 2]
(0.) Mucous diarrhoea. (Stahl, et al.) [Why omit the pathogenetic Symp-
tom, “Rumbling and cutting in the abdomen, followed by two diarrhoeic
stools, succeeded by tenesmus?”]
(c. o.) Profuse bleeding from the hacmorrhoidal tumors. (Buckwald,
Ičersovitz, Chomel, A., Wodck and Trinks, II.)
[Pauli says: “But females, subject to haemorrhoidal flows, should not
continue the use of it too long, as it would cause a suppression of the men-
scs, more disastrous than the haemorrhoids;” a very suggestive observation.]
URINARY ORGANs.
(*) Haematuria. (Schrodius, Hoffman, A., Noack and Trinks, “Wiedman,
Gaz. Hom. de Leipsig, vol. 4, p. 321,” H.)
[This case is a notable one. “Clironic ha-maturia—very abundant, with
pain in the left kidney. Emission of blood very profuse, five days. The
attack came on every five or six weeks, and the emission was alwas accom-
panied with tenesmus of the bladder. One fourth drop of Ø, several times
repeated. Cured, after an exacerbation of twenty-four hours.]
(o.) Involuntary micturation. (Incontinence of urine.) (Chomel, Cul-
pepper, A.) [“Chomel's incontinence,” says Hering, “is the only observa-
tion made, there is no where a real involuntary micturation.”]
[Bankinus says it is a “vehement diuretic, and its daily use causes hloody
urine.” It also causes “constant desire to urinate.”]
SEXUAL ORGANS.
Men. (0.) Swelling of the penis or testicles. (Old Books.)
(o.) The semen is not discharged during an embrace. (Hering.)
(0.) Sycotic excrescences. (Schrodius, A.)
[This same Schrodius says it has cured “tumor of the penis,” and “fig-
shaped tumors.” Dr. Lippe probably got his two symptoms above from
that source. Certainly very misty and intangible authority for a purist to
accept.]
Women. (0.) Haemorrhage from the uterus from too violent exertions.
(C/homel, A.)
(o.) Menses too profuse. (?) [Probably a mere theoretical recommenda-
tion, drawn from old books.]
(0.) Suppressed monstruation, with epileptic attacks. (N. de Sogny, A.)
[Suppression of the menses is doubtless caused by Millºfoil. Sce Dr.
Pauli’s statement.]
(o.) Barrenness, with too profuse menstruation. [This is probably a
perversion of Maumery's cure of “Metrorrhagia Supervening on a miscar-
riage " Or from G. Lingen, A.]
(o) Suppressed lochia, with violent fever; suppressed ScCretion of milk,
or convulsions; convulsive motion of all the limbs, with violent pain. (Dr.
Maumery, Ancien. Jour. de Med., vol. 34, p. 402, 1770. A.)
(o.) Lochia too profuse. (Schorff, A.)
(0.) Sore nipples. (Dr. Reichiwau, Rust's Mag., vol. 13, ch. 1, p. 179, A.)
1869.] Millefolium. 3.25
[This is from a recommendation to “apply the juice of the fresh plant
against the fissures of the breasts of nursing women.”]
RESPIRATORY ORGANs.
(0.) Very difficult breathing, with tetanic spasms. (W. de Sogny, A.)
(0.) Oppression of the chest, with bloody expectoration. (Ruckert, H.)
(0.) Haemoptysis. (After falling from a height, in the afternoon (?) in
connection with haemorrhoidal symptoms.) Is this from Goullon, in Arch.
Homoeop. Allem., vol. 20, cap. 2, p. 145, where he makes the assertion
(without proof, as Roth says,) that “in haemorrhoidal subjects hapmoptysis
yields only to the mother tincture?” We should also like to ask the
important question, whether Millefoil will cure ha-moptysis caused by fall-
ing from a height, if the accident did not occur in the afternoon? Dr. Lippe
seems to imply that it would not /
(0.) Violent palpitation of the heart, and spitting of blood,
[The three last symptoms of the respiratory organs are made out of two
cases reported by Ruckert:
CASE I.—“A female, forty-eight years old, after the critical period. For
eight days, spitting of blood every evening, followed by cough, bringing on
a fresh expectoration of vermillion colored blood, very abundant, nearly a
pint; extreme debility; Millefolium, 1st, repeated three times in three days,
produced a cure.”— Am. Hom. Allem., vol. 1, p. 114.
CASE II.-“Millefolium afforded speedy relief in a case of copious expec-
toration of blood, continued oppression of the chest, and violent palpita-
tion.”— A. L. Z. V., p. 248.]
Gross reports a case of haemoptysis: “A young man subject to attacks
of cough, with expectoration of pure blood, was cured by a single dose.
(The particulars of this observation not given.)
EXTREMITIES.
(p.) Pricking and numbness of the left arm. (Hering.)
(p.) Heat of the hands. (Mure.)
(p.) The feet go to sleep; first the left foot, later the right; disappearing
on walking. (Newning.)
(p.) Heat of the feet. (Mure.)
[Why were the fifteen symptoms of the extremities, given by Hartlaub,
and more in Hering's provings, omitted ?]
GENERALITIES.
(0.) Rheumatic and arthritic complaints. [Crudely empirical.]
(0.) Convulsions and fainting attacks of infants. (Normand.)
[This symptom is distorted by Lippe. It should read: “A new-born
child had convulsions and fainting; after a warm bath better, but whining
and sighing, then Millefoil tea cured."]
(0.) Hysterical spasms. (Maumery, A.)
(o.) Paralysis and contraction of the limbs. (Old Books, A.)
(0.) Tetanus. (N. de Sogny, A.) [A mere assertion that he cured with
Millefoil (aided probably by many other drugs), a “Malignant fever with
Wol, W.-No. 15. 5
326 Millefolium. [April,
tetanus.” A slender basis, surely, for a purist to make a clinical case, or
“characteristic symptom,” out of Why did Dr. Lippe not put this under
his “fever" symptoms?]
(0.) Convulsions after parturition. (Maumery, A.) [A symptom re-hashed
from No. 41.]
(0.) Epileptic spasms,” from suppressed menstruation. (N. de Sogny, A.)
[Another re-hash )
(0.) Haemorrhages from various organs. [More hash.]
[Pauli says he has known women produce abortion by a decoction of the
Millefoil.]
SLEEP.
(p.) Violent yawning, without being tired. (Wenning, Hering.)
(p.) Goes to sleep late, and does not feel refreshed in the morning.
[“Goes to sleep late,” is a symptom by Schrodius. Lippe has probably
imagined the rest.]
FEVER.
(0.) Pulse accelerated and contracted. (From Normand's small-pox case.)
(p.) Chilliness, with pain in the kidneys. (Wideman. Ought to have
been, “pain in left kidney.”)
(0.) Colliquative perspirations. (Crudely empirical.)
[Dr. Lippe should have inserted “tertian ague” among these symptoms,
for Culpepper says: “There is an ancient charm for curing tertian ague,
with Yarrow. A leaf of it is to be pulled off with the left hand, pronounc-
ing at the same time the sick man's name, and this leaf is to be taken.”
The French physicians use the alkaloid Achilleine for intermittent fevers,
with alleged success. Dr. Maumery also used it in tertian ague.]
SKIN.
(0.) Suppressed itch, and from it fever.
(o.) Painless varices of pregnant women. (Pits raft.) [Ought to be “pain-
ful varices.”
(0.) Fistulous ulcers. (Culpepper, A.) [“Especially,” says this old
writer, “such as abound with moisture.”]
(o.) Ulceration of internal organs. (Chomel, A.) [“It deterges in a
wonderful manner internal ulcers, especially vomica of the lungs.”—
Chomel, History of Plants, p. 427.]
(0.) Cancerous ulcers. (Scudder, Eclectic Mat. Med.) +
(0.) Wounds, after the operation of stone of the bladder. (Ohomel, A.)
* According to Tabernaemontamus, the distilled water of this plant is
good in epilepsy.
+ Dr. Scudder, the Eclectic, says: “In cases of cancer of the breast, it is
said that half an ounce of the juice, taken twice a day, and the bruised herb
applied locally to the parts, first bathing them with the juices, has effected
a cure.” Surely, Dr. Lippe must be “drifting into Eclecticism,” to accept
such flimsy evidence as this
1869.] Millefolium. 327
[This is based on a rocommendation that “there is no better remedy for the
purulent discharge following the operation for the stone.”]
(o.) Bruises, bleeding from the wounds. [The old Greeks called this
plant Achilleſt, because it was the plant “where with Achilles cured wounds
of the soldiers.” It has retained its reputation as a vulnerary down to this
day.]
(o.) Bad effects from a fall (from a height), and sprains. [The “fall”
must occur in the afternoon, or the remedy is not indicated. (See symptom
45.) It is a tremendous stretch of imagination, to teach that the medicine
is good for “effects from a fall (from a height),” because some old Allopath
pretended to cure, with Millefoil, haemoptysis caused by such an accident.]
Dr. Lippe should have added, “caries of the bones,” for Gross says he has
“used it with considerable success in the caries of bones.” Roth evidently
don’t believe it, for he says it is an “assertion without proof;” but if all
such assertions were expurgated from our books, the contents thereof
would be very meagre.
CONDITIONS.
Especially suitable for aged persons, children, and for women.
Coffee causes congestion to the head. [This may at first sight seem
irrelevant, or as if a coffee symptom had got lost, and wandered into
Millefoil. Perhaps it means that a prover of Millefoil observed that coffee
increased the congestion to the head; if so, why is it not plainly stated.
Dr. Lippe should have added to these condition, “Effects of falling from
a height in the afternoon.”]
TABULAR ANALYSIS OF LIPPE's PATHoGENESIS.
We here present a table representing the quality and origin of the
so-called symptoms, which Dr. Lippe has collected, and which he has digni-
fied by the name of “characteristic and special symptoms,” and arranged
into a schema which he miscalls a pathogenesis.
Purely pathogenetic symptoms,...... . . . . . . * * * * * * * * c e g º e gº 18
Curative indications, etc., (Allopathic). . . . . . . . . . . . . . . . . . . . 52
Curative symptoms, (Homoeopathic). . . . . . . . . . . . . . . . . . . . . 4
Whole number of symptoms,. . . . . . . . . . . . . . . . . . . . . . . '74
To this table may be added another, showing what Dr. Lippe's schema
does not possess, namely:
Cures reported by Homoeopathic physicians,............. 5
Symptoms of Dr. Hering's collected provings,”........... 430
What does the Homoeopathic profession think of a teacher
of Materia Medica — an author of a Text-Book of Materia
Medica, which he asserts contains only “characteristic and
special” pathogenetic symptoms, and who arrogates to
* “Amerikanische Arzneiprüfungen,” pp. 144 to 170, (1853).
328 Millefolium. [April,
himself the championship of pure Hahnemannian Homoeo-
pathy—who collects fifty-two so-called symptoms, which are
not symptoms, but a jumble of Allopathic cures, crude empiri-
cal recommendations, repetitions, domestic uses, traditional
old-wives sayings, etc., and putting these with twenty path-
ogenetic symptoms, and only four Homoeopathic clinical or
curative symptoms, calls the heterogeneous mixture (a very
“witch’s broth *) a PATHogENESIs, which IIomoeopathic
physicians and students are to follow, prescribe by, and give
the high potencies | |
We have still another fault to find with this “patho-
genesis.” The fifty-two curative symptoms, should be so ar-
ranged as to make only twenty-six. The other twenty-six
are mere repetitions of portions of the real twenty-six.
Now what is the use of this cutting and slashing of clinical
cases, and this scattering of their mangled remains all over
a pathogenesis?
If any one supposes the pathogenesis of Millefolium has
been selected because it was particularly faulty and open to
criticism, he is greatly mistaken. There is not a patho-
genesis in the whole Text-Book, but is open to a certain
annount of criticism, although not all are as faulty, as unre-
liable, and as much a disgrace to our system, and a stain
upon our Materia Medica.
And this is the kind of Materia Medica which Dr. I. S. P.
Lord, and his clique, declares to be very nearly the ideal
thing, and praise in the same Journal, and almost on the
same page, whereon they denounce the “New Remedies' "
There is not a medicine mentioned in the latter book, in
which the authority is not given for each and every patho-
genetic symptom; each clinical case; and every therapeuti-
cal recommendation. No attempt at deception can be
found in its pages, and no palming off of obsolete uses and
unreliable assertions for pure “characteristic and special
symptoms.”
The only value of Lippe's Text-Book, consists in the fact
that certain portions of it are very fair extracts from Boen-
1869.] Millefolium. 329
ninghausen’s works, of certain symptoms and indications
of medicine not heretofore translated.
The student of Boenninghausen will observe, that all the
drugs not mentioned by that author, are very meagrely and
badly given by Lippe; while all the drugs written of, or
elaborated by the former, are given in better shape, especi-
ally in the symptoms relating to the head, the cough, and the
fever. The works of Boenninghausen chiefly drawn from
are: (1.) “Whooping Cough;” (2) “Domestic Physician;”
Part I., Head; (3) “Treatise on Intermittent Fever;” (4.)
“The Pocket Repertory,” etc.
Of all the pathogeneses given by Dr. Lippe, the Kali
bichromicum is probably the best. A singular criticism on
the Text-Book, is afforded by a comparison of Grauvogl’s
cures made by Argentum nitricum, with its pathogenesis as
given by Lippe. Upon a few points only is there any cor-
respondence.
It may be interesting, while we are engaged in the study
of this plant, to inquire into its analogues. Although we
can not, as a rule, take the botanical affinities of plants as a
reliable guide to their medicinal action; we occasionally
find whole families and genera, whose medicinal affinities are
quite strongly marked. Take, for example, the composite
family (Order compositae), and we find a notable similarity
in the general effects. The following, known to us as med-
icines, are members of this family:
Millefolium, Erigeron, Tussilago, Solidago, Silphium, Tana-
cetum, Artémisia, Chamomilla, Erechthites, Senecio, Arnica,
Bupatorium, and Bidens.
It will be observed that all these plants have a reputation
for curing hamorrhages from various organs, the uterus,
kidneys, lungs, nose, or bowels. They all act as irritants
to the mucous tissues, and nervous system. Although the
special pathogenetic symptoms of these plants differ, we
may consider them as medicinal as well as botanical ana-
logues.
The other medicinal analogues of Millefolium are: Asarum,
Cannabis, Capsicum, Cantharis, Cinnamon, (?) Crocus, Copaipa,
33O Az/anthus in Scarlalºma. [April,
Cubeba, Hamamelis, Hedeoma, Petroleum, Pulsatilla, Ruta,
Sabina, Trillium, Terebinthina.
These latter, like the botanical analogues, have a reputa-
tion for curing haemorrhages. Their general action on the
organism is similar to the Millefolium, while their special or
characteristic actions (or symptoms) are so marked as to
enable us to select the one from the other, with considera-
ble certainty. So, also, their primary action and Secondary
effects bear a sufficiently strong resemblance.
AILANTHUS IN SCARLATINA.
BY CARROLL DUNHAM, M.D., NEW YORK.
In the “American Homoeopathic Review,” Vol. IV., pp.
385, et seq., 1864, Dr. P. P. Wells, of Brooklyn, in the course
of a most interesting paper on Scarlet Fever, related the
following case of poisoning by the juice of the Ailanthus:
“A girl, fifteen years of age, rose in the morning, feeling
slightly ill, dressed and went immediately to the breakfast
table. She could take no food; the sight of it made her
feel so much worse, she immediately left the table, and
went to her room. She was seized suddenly with violent
vomiting; severe head-ache; intolerance of light; dizzi-
ness; hot, red face; inability to sit up; rapid small pulse;
drowsy, at the same time very restless; great anxiety; two
hours after the first attack, the drowsiness had become
insensibility, with constant muttering delirium; did not
recognize the members of her family; she was now covered,
in patches, with an eruption of miliary rash, with efflor-
escence between the points of the rash, all of a dark, almost a
livid, color; the patches between the points of the eruption
were of a dingy, dull, opaque appearance; the eruption was
more profuse on the forehead and face than elsewhere, and
especially on the forehead.
“The whole aspect of the eruption, and the whole con-
1869.] Az/anthus in Scarlatina. 33 I
º
dition of the patient, were so just like those so many times
seen in cases of this variety of scarlet fever (which Dr.
Wells had just been describing in the essay from which we
quote: S. maligna), that the case was unhesitatingly recog-
nized as an example of it, and in its most violent and hope-
less form. The pulse was now small, and so rapid as hardly
to be counted; the surface had become cold and dry; the
livid color of the skin, when pressed out by the finger,
returned very slowly; the whole was a most complete pic-
ture of torpor, and seemingly a perfect instance of that
manifestation of it which immediately precedes dissolution
in these rapidly fatal cases of scarlet fever. There was
apparently no prospect of the patient’s living more than a
few hours. Such cases, in the practice of the writer, had
always gone to a fatal termination, and this had been more
rapid in its progress than any he had seen. The patient
being his own child, he had opportunity for most carefully
watching the case. In about three hours from the first
appearance of the eruption, the livid color began to lose
something of its dark hue; the restlessness and anxiety
diminished; the pulse became more distinct and less fre-
quent; consciousness partially returned; the eruption be-
came of a brighter red; and the whole train of symptoms,
so similar to this pernicious form of the fever gradually gave
place to a train of phenomena scarcely less remarkable, but
not at all like those of any variety of scarlet fever.
“Of course, this was not a case of scarlet fever at all;
but, for a short time, it was a great puzzle. What could it
be 2 what could have produced it? were questions not to be
put aside, and, when consciousness had so far returned that
questions could be intelligently answered, the nature and
cause of the case were no longer a matter of doubt. As
the eruption began to lose its dark hue, and take on a
brighter red, there was a repetition of a series of symptoms,
then recently treated in the case of a small lad, who had
been poisoned by eating the seeds of the Ailanthus. This
resemblance was quite a surprise, and at once excited sus-
picion that this was a case of similar poisoning. And so it
332 Atlanthus in Scarlatina. [April,
proved to be. This patient, and one of her young associates,
had been amusing themselves, the evening before the attack,
by stripping the outside bark from the young and tender
shoots of the Ailanthus, and then, after writing letters on
the stalks with the point of a pin, these were moistened
with saliva, which was rubbed on them by the end of the
finger. This was many times repeated, and in this process
the juice of the stalk was conveyed to the mouth in consid-
erable quantities. Its taste was an intense bitter. Both the
experimenters were made ill, with similar symptoms, but
the symptoms were much less violent in the patient’s friend.
It is a singular fact, that this patient has been attacked by
a similar miliary rash each year since this poisoning, at the
Season of the blossoming of the Ailanthus, and is always now
more or less ill each year from this cause. * * * * This
case is also given here with the object of urging on the
profession the importance of a thorough proving of this
powerful poison. If the subsequent history of my patient
can be received, as showing in her suffering the continued
workings of this poison, and if drug agents are indeed
related to diseases as curatives, by the law which we receive
as the universal law of cure, then the relation of the Ailan-
thus to many important diseased conditions is clearly estab-
lished.” + 3 +
This publication, by Dr. Wells, comprises the first sug-
gestion ever made to use Ailanthus as a remedy in treating
Scarlatina. Since that date, no epidemic of Scarlatina has
appeared in the practice of Dr. Wells, which presented such
cases as those which he has described as similar to the poi-
soning by Ailanthus. About a year ago Dr. Tuthill Massy
published, in the “London Honoeopathic Review,” several
cases of scarlet fever, which, acting on the above quoted
suggestions of Dr. Wells, to which Dr. A. C. Pope, of Lon-
don, had called the attention of English IIomoeopathists, he
had treated with Ailanthus. An examination of these cases,
however, shows that they were not at all malignant, and
gives little reason to suppose that Ailanthus had any thing
to do with their favorable course and issue. In the
1869.] Ailanthus in Scarlatina. 333
“Monthly IIomoeopathic Review,” of December, 1868,
(London), Dr. Chalmers publishes an article on the “Use
of Ailanthus Glandulosa in Malignant Scarlet Fever,” with
details of seven cases, which justify Dr. Wells' anticipations
of good results from this remedy. Dr. Chalmers describes
the epidemic, in which he used the Ailanthus, as follows:
“The type of disease throughout has been adynamic ; its
mortality has been great. * * There was general prostra-
tion, with strongly marked head affection; in some cases
there were convulsions, the head being hot, eyes suffused
and congested, attended with incoherence and incontrollable
restlessness, breathing irregular, hurried and heavy. Pulse
small, weak (in some cases, almost imperceptible from an
early period of the disease), and often irregular; skin very
various, but generally hot, harsh and dry; eruption dark
colored in many instances, and, in some, almost of a violet
hue, being scanty, patchy, evanescent, and, often, long .
delayed, and accompanied by miliary and papular rashes;
in three cases under my care there were large maculae and
bullae filled with claret-colored serum; in all great thirst,
with dry, parched tongue, the throat being much congested,
very dark colored, in some cases ulcerated, and attended
with great glandular enlargement. Not often was there
nausea or vomiting, but many cases were complicated with
diarrhoea, too often induced or aggravated by a practice
very common here, of prefacing all treatment by a dose of
Castor Oil, or, as in this case of Scarlet fever, and other
eruptive diseases, by a large dose of Sulphur in whiskey,
which caused much distress; urine scanty and high-colored,
and, in some cases in which it was examined, contained
albumen from an early period. In all there was more
marked inflammation and ulceration of the Schneiderian
membrane, than I ever remember to have met with in other
epidemics of this fever, and, in some, the eyes were much
inflamed and gummy. Death, in a few cases, could be
attributed to the thorough malignancy of the disease; in
these it occurred at an early period. More commonly, it
took place on the eighth or ninth up to the sixteenth day,
334 Az/anthus ºn Scarlatina. [April,
from exhaustion, and, in three cases under my care, was
caused by pyaemia, resulting from the absorption of pus
from the ulcerated sore throat.”
“All treatment hitherto adopted, in such a type of fever
as this, is generally admitted to be unsatisfactory, while its
fatality is notoriously great. We have here no remedy on
which we can place reliance. Turing this epidemic, the
simple form of the disease was well met by Belladonna and
good nursing. In the malignant cases this medicine was
of no service. Rhus, Arsen., Am. carb., Apis, and, in the
only case in which I used it, Lachesis disappointed me. * * *
Alcoholic stimulants were worse than useless. They were
repugnant to the patients, frequently giving rise to nausea
and vomiting, and aggravating the head symptoms.” “ ” *
Dr. A. C. Pope, having called his attention to Dr. Wells’
notice of the similarity of the symptoms produced by Ailan-
thus juice to those of malignant scarlet fever, Dr. Chalmers
used it in all cases, which he saw after that time, presenting
adynamic symptoms. From his experience with it, he char-
acterizes Ailanthus as “a hopeful remedy in a hitherto well
high hopeless form of disease.” He adds: “I would
recommend the use of a low dilution, or the pure tincture.
The dose should be frequently repeated — every half hour,
or every hour — until signs of amendment are apparent.
It should also be given early. The signs of improvement I
like to see (and I believe the Ailanthus has, in the cases now
to be recorded, been powerful in helping to induce them)
are a bright colored general eruption, in place of the dark-
colored and partial one. Next to this, a marked diminution
in the frequency, with more regularity and increased firm-
ness, of the pulse, along with restoration to consciousness.”
Here is one of Dr. Chalmers’ cases:
“CASE 3.—A. S., act, two years and five months, August 30th, 1868. One
of two ill. Rather a delicate child, and prone to bronchial attacks. She
has been fretful and uneasy for two days; at night feverish and restless.
Eruption appeared on the face last night, and on the body and extremities
this morning. She had a very bad night, and was threatened with convul-
sions; and there are still very bad twitchings of the muscles, particularly
of the right side. Eruption is dark-colored, Scanty, and patchy. The
1869.] Ailanthus in Scarlatina. 335
mother tells me it has disappeared from places where she saw it. Skin is
hot and dry; pulse very frequent, weak, and irregular. She is quite
incoherent, and does not appear to know any one, or comprehend any
thing; breathing quick and irregular; eyes suffused and congested, and,
When she is roused, have a wild, startled look; glands of neck are swollen,
and apparently tender; Swallows with freedom, and greedily, but the
stomach rejects every thing almost immediately. It is impossible to see
the mouth or throat, she is SO restless and incontrollable. To have Ailan-
thus, gr. ix. gtt. SS., every hour. A light poultice for the throat. Milk diet.”
“Vespere.—She has had seven closes of the Ailanthus, is much calmer, and
has slept a good deal at intervals, but is still stupid and unmanageable.
Skin generally covered with eruption, which is bright and normal-looking;
muscular twitchings abated ; she swallows well, and desires drink greedily;
vomiting has not occurred for several hours; bowels have moved three
times; pulse is more marked, but still very frequent and feeble; expression
still wild. Continue Ailanthus, ix. gtt. ss., every second hour.
Thirty-first. Passed a very restless night, and refused to take any thing—
medicine, milk, or water—until early this morning; pulse not so frequent,
rather more vigorous, but still weak and shaky ; skin is moist, and erup-
tion general and well colored, but mixed with miliary points over the body;
the nose bled a little this morning, supposed to have been caused by a
knock during her extreme restlessness; she appears to be more conscious;
the eyes more natural in expression ; she is swallowing well, and took now
a dose of Atlanthus, and a little milk; twitchings of muscles quite gone ; no
vomiting ; bowels rather relaxed. Continue Ailanthus every fourth hour.
Milk as before.
September 2nd. From this date improvement was continuous; the erup-
tion gradually disappearing; the glandular swelling rapidly diminished; a
discharge of blood and pus took place from the nose to-day, and some fissures
were noticed around the angles of the mouth.
She was ordered Merc. vivus, 3rd, twice daily, and in a few days was quite
convalescent. Her recovery was rapid and complete.”
Other cases related were much more severe than the
above. Dr. Chalmers concluded by saying: “I think
there can be no doubt, that the cases above narrated were
alarming instances of the type of disease which prevailed
during this epidemic, and even doubly so to me, when
reflecting on the reports of a daily increasing rate of mor-
tality in the immediate neighborhood. * * * To my eyes
they had a most painful and alarming similarity to most
of the cases I lost earlier in the course of this epidemic, and
the result of the treatment by this drug (Ailanthus) was, and
is, to me a source of sincere gratification and thankfulness.”
Although these cases are, as Dr. Chalmers says, “too
336 Aſorce. [April,
few to establish the specific character of a drug, in so terri-
ble and rapidly fatal a disease as this,” they, nevertheless,
render it probable that this remedy, for the suggestion to”
use which we must thank the sagacity and keen insight of
Dr. Wells, will fill, to a certain extent, at least, a deficiency
in our Materia Medica, which has been sadly felt by all who
have had to deal with scarlatina maligna.
Dr. Wells has communicated to me the following addi-
tional symptoms of Ailanthus, which I give in his own
words:
“1st. Ailanthus produces an eruption which has an exact
resemblance to ordinary measles, but is attended by no
catarrhal symptoms, or other concomitants of that eruptive
fever.
“2nd. While proving Ailanthus, a sore appeared on the
prepuce of the prover, which had the exact appearance of
incipient chancre. On ceasing to take the Ailanthus, the
Sore dried up and disappeared after a few days. The rash
and sore may be remembered in connection with the similar
rash and similar sore, which characterize primary syphilis,
for which the Ailanthus may possibly be found to be a
remedy of value.”
FORCE:
AND SOME OF ITS RELATIONS TO LIFE, DISEASE, AND MEDICINAL
ACTION.
By H. P. GATCHELL, M.D., KENOSHA, WIS.
NO. II. ©
LIMITS OF DESIGN.
HAVING determined the nature of force, I now propose to
define the conditions that result in the development of the
forces termed vital, and this I propose to do with reference
only to conditions as they exist in the organism.
Force is either static, pertaining to rest, or kinesic, per-
1869.] Aſorce. 337
taining to motion. In virtue of what physicists term inertia,
all bodies tend, through equilibrium of forces, to a state of
rest. Some disturbing cause is necessary in order to
motion. To the earth, the sun is the disturbing cause.
Though at the distance of 93,000,000 of miles, it impels,
through intervening ether, in the brief space of eight min-
utes, undulations on which depends all action on the surface
of our globe. But for the Solar ray, the earth would swing
lifeless and voiceless through space. Utter stagnation, utter
death would prevail on its surface; every atom held and
fixed in the grasp of relentless cold.
But again, some antecedent cause operates to produce
motion of the constituent elements of the sun, generating
that vast heat, which is the exciting cause of all motion on
the earth, and throughout our solar system. And thus
along that chain of cause-effect, and in which each effect
becomes the cause of each succeeding link, might one
gifted with omniscient capacity, run back eternally.
Not being thus gifted, I do not propose attempting to
trace the endless chain, or even to discuss the productive
relations of the Solar ray. I propose to myself the less
ambitious task of discussing the conditions of life as they
exist in the organism; and, especially, by reaching some
fundamental principle of vital action, to reduce physiology,
which has been, for the most part, but a series of compara-
tively disconnected chapters, to that harmonious relation
which has characterized chemistry since the enunciation of
the law of definite proportions.
DIFFERENTIATION.
Were there but one kind of element, with the consequent
sameness of force, in existence, the universe would present
no variety of forms or phenomena. Absolute uniformity
would prevail through infinite space. Differentiation is a
necessary result of variety of elements. In the sun itself,
where, if any where, under the influence of intense, all-
pervading, and all-decomposing heat, perfect homogeneous-
ness should prevail, and where it inevitably would, if there
338 f Aſorce. [April,
were but one kind of matter, differentiation is known to
exist, and the various metals can be distinguished as on our
colder earth.
On the other hand, were there no common forces, so
great would be the diversity of substances, from all the
possible combinations of sixty-five elements, that the human
mind could never master them. But while the various
species of matter have specific properties, lending variety to
the universe, they have also common properties promoting
uniformity. There are four modes of force, common to all
Kinds of matter belonging to the earth. These are, light,
heat, electricity, and magnetism. No molecular movement
occurs without a greater or less disturbance of these several
forces, and mere friction is sufficient to develop them to a
degree appreciable by the human senses. On the other
hand, each species of element has its peculiar modes of
force, distinguishing it from all other kinds of matter.
That this is so, is evident, since thus only could gold or
lead, oxygen or hydrogen be known. Were they the same
in their modes of affecting matter, they would make the
same impression on the human brain, and all substances
would seem alike to us. Indeed, if their properties were
alike, the substances themselves would be alike.
The differentiation resulting from specific elements and
specific forces, is manifested in the existence of organic
and inorganic forms and structures; the latter divisible
into amorphous and crystalline, the former into vegetable
and animal, with numerous sub-divisions, and almost innu-
merable individual members. It is in virtue of different
elements and different forces that divisions exist. It is in
virtue of common elements, and common forces, that classi-
fication is possible. And these two laws obtain throughout
nature, that bodies resemble one another in proportion to
similarity of composition and structure, and that bodies
differ from one another in proportion to dissimilarity of
composition and structure.
1869.l Aſorce. 339
ORGANIZATION AND LIFE.
Composition and structure distinguish the organic from
the inorganic; the three basic elements, carbon, hydrogen,
and oxygen, constituting a combination unknown among
minerals. They are the organogens, without which organ-
ization can not exist, and their combination is absolutely
distinctive of organic nature. Of these three organogens,
the great bulk of the vegetable world is composed; they
being sufficient to completeness of organic structure and
form.
But where vital operations are carried on, there is ever
present another remarkable element along with the organ-
ogens ; and since the animal lives at every point, it is, in
the animal organism, a universal accompaniment. Most
vegetables, on the other hand, living only in parts, it is
more sparingly distributed in their organisms. This ele-
ment is nitrogen, bearing, as a constituent of organic
nature, a relation to life, similar to that of the organogens
to organization. It may, therefore, be appropriately named
the biogen.
And it is a remarkable exemplification of the economy
of nature in the use of this most precious element, that as
life leaves the heart-wood of the tree, the nitrogenous cell-
lining is carried forward to promote vital action in young
and growing parts, or to be stored up in seeds for the
propagation of the kind, or for the sustenance of animal
life. This is a singular thrift on the part of nature, in
view of the nitrogenous ocean forty miles deep around our
earth. But the vegetable can not, in general, if at all, avail
itself directly of this abundant supply; but must needs
depend, for its nitrogenous food, on so much of that ele-
ment as enters into the composition of ammonia, which
constitutes but a very minute proportion of this vast atmos-
pheric ocean.
The great importance of nitrogen is due, perhaps, to a
three-fold relation. It promotes, in an eminent degree,
instability of substances into which it enters as a constitu-
34O Force. [April,
ent, and hence it is highly favorable to that incessant move-
ment, that perpetual change, which is an indispensable con-
dition of life. But it not only promotes instability in the
compounds into which it enters; it is also a very important
catalytic agent, exciting similar motions in hydro-carbons;
as in germination in the ground, or in the act of malting,
or in fermentation. Again, no other element is endowed
with such marvelous power. Gunpowder, nitro-glycerine,
and chloride of nitrogen, the latter substance compressing
into a few grains almost the energy of a thunderbolt, are
familiar illustrations of the terrible force which it lends to
matter.
To these four elements, three organic and one vital, are
added some twelve others, to serve as conditions and causes
of differentiation, and as agents in producing the various
structures, and in effecting the various processes that dis-
tinguish one body, or one part of a body, from another.
I3ut as complex and as varied as is the human body, the
crowning work of organic creation, the minute anatomist
is not able to disclose in it, any more than in the vegetable
organism, other than three primary, structural forms. These
are granules, cells and fibres. Out of these all organs and
tissues are composed, and by means of these they may be
classified, very much to the simplification of the ordinary
lumbering tables. Though the question may fairly be
raised, whether, in strictness of definition, granules should
not be considered as the sole primary forms, apparently
necessary precedent conditions to the existence of all other
parts. As such, indeed, I have been accustomed to treat
them in teaching.
LIFE PHYSIOLOGICALLY CONSIDERED.
To give a hitherto wanting precision to the idea of life in
a body thus constituted, is the design of this paper. The
definition of life, given in the first article of this series,
related solely to those principles which are common to
organic and inorganic structures.
1869.] Aorce. 34. I
As already stated, atoms pass from the inorganic to the
organic world, carrying all their properties along with
them. But they combine there in arrangements unknown
among minerals. Now, the smallest possible combination
of atoms is a molecule, and the peculiarity of organisms is
not in their atoms, since these are common to them and
minerals, but in their molecules. Organic molecules are
unknown in the mineral world.
An atom of oxygen combines with an atom of hydrogen,
(according to the old formula,) to constitute a molecule of
water. Two atoms of oxygen combine with an atom of
carbon, to constitute a molecule of carbonic acid. Three
atoms of oxygen combine with one of carbon and one of
calcium, to constitute a molecule of carbonate of lime.
Cellulose, one of the simplest of organic combinations, out
of which woody cells and fibres are formed, is composed of
twelve atoms of carbon, ten of hydrogen, and ten of oxygen,
so that a molecule of cellulose is constituted of thirty-two
at Om S.
Two kinds of action, two kinds of motion, are possible in
the interior constitution of all composite bodies. One is
atomic and the other molecular. But the second only, in
any appreciable degree, is consistent with the continued
existence of a composite body. When chemical decompo-
sition or recomposition occurs, atomic motions attend. But
these motions pertain solely to the forming, or to the destroy-
ing, of a composite body. While the body exists, its ulti-
mate normal motions are molecular. The molecule is to the
composite body what the atom is to the simple, the unit of
force and motion. It is the true structural element, deter-
mining both the mode of organization, and the quality of
force.
In the act of decomposing water, atomic motions are
produced. But the oxygen and hydrogen at opposite poles
have ceased to co-operate. So long as they remained united
in molecules of water, they acted not as oxygen and hydro-
gen, but as water. The oxygen could not excite combus-
tion; the hydrogen could not burn. Every pair of atoms
Vol. W.—No. 15. 6
342 Aſorce. [April,
constituting a molecule, is as really water as an oceanic
mass; and while the atoms continue to be water they act
only as molecules.
On the other hand, when electricity agitates, instead of
decomposing, a composite body, there occurs no appreciable
atomic movement whatever. Motion may be propagated
from one end to the other, as through water, for instance,
but it is exclusively a motion of molecules. When the
movement is propagated to the constituent atoms, they
cease to constitute water and pass to different poles. But so
long as the body remains intact in its chemical composition,
it is a molecular vibration that occurs. All the Tyndalls
and Faradays, all the Matteuccis and Peletiers agree in this.
Indeed there is no dissenting voice among the cultivators
of Science.
The vegetable may act to produce atomic movements in
substances submitted to it, for the purpose of preparing
organic molecules to build up its tissues. But all atomic
changes in its own structure, either result from poisoning,
or attend on decay.
So also the animal may effect atomic changes, in sub-
stances which it is reducing towards the mineral state, to
be excreted into the world of inorganic matter. Beyond
this, as in the vegetable, is poisoning or decay.
Both vegetables and animals being composite bodies, all
atomic changes in their tissues are destructive changes.
And we may sum it all up in the statement, that all vital
movements are molecular movements. Of course, I do not
refer in this statement to those movements of masses, which
are merely mechanical, but only to those that are peculiar
to organisms. All vital actions must needs concern those
primary constituent forms which give character to the
organization. Any motion not affecting it thus intimately
does not reach the peculiar forces of the organism; since
these have been shown to depend on these primary combi-
nations. On the other hand, any influence extending to the
interior of the molecules, and acting directly on the indi-
vidual component atoms, is chemical and not vital, destruc-
1869.] Aſorce. 343
tive not organic. One essential difference between chemi-
cal and vital action is that the former is atomic and the
latter molecular. Any one who has not advanced thus far
in his knowledge of the science of life, has yet to learn its
alphabet.
As each atom in a volume of atmosphere, has its own indi-
vidual force, which it contributes to the mass, so in the living
body, does each individual organic molecule have its own
individual force and motion, which is its life, and which
it contributes to the smallest primary structural form.
And as the life of each granule is the sum of the lives of
its component molecules, so is the life of each cell or fibre,
the sum of the lives of the constituent granules. So, also,
is the life of each organ and tissue the surn of the lives of
its component granules, cells, and fibres. And the life of
the entire body, is the sum of the lives of its component
organs and tissues. And this life, like the life of each indi-
vidual part, can be maintained so long as composition and
structure are unimpaired, and so long as the conditions of
molecular action are unchanged. In the act of dying, dif-
ferent parts die at different intervals, fatal molecular changes
occurring in some sooner than in others.
Life, therefore, is not a unit. Life is multiple. It is
true, there are common conditions and harmonious rela-
tions, that are indispensable to its maintenance; but it is
none the less various; the life of each part differing from
that of every other in proportion as its composition and
structure differ. The life of any one part is individual and
peculiar, so far as composition and structure are so; sys-
tennic and common, so far as determined by common con-
stitution, and especially by the action of the blood. The
life of the muscles is not that of the nerves; the life of the
tendons is not that of the muscles. In each case the life is
the sum of the organic phenomena of the part.
That life, as well as nutrition, is dependent on the blood,
is evident, because the life begins to fail as soon as the
blood is withheld, and returns as soon as the blood is
restored; provided it is not withheld until the organization
344 Aſorce. [April,
has become impaired. Brown-Sequard finds it practicable
by injecting blood to restore the life, even after the so-called
rigor mortis has stiffened the body. And this he can do to
every single amputated member. But if the attempt is
delayed till relaxation ensues, life can no longer be resusci-
tated; indicating clearly that molecular changes have
occurred, which are fatal to vital organization. So that it
is not the rigor which should be named of death, but the
relaxation; and relaxatio mortis should take the place of
rigor mortis.
Life, therefore, may be defined physiologically as the
result of action and reaction between blood and tissue.
“The life thereof is the blood thereof.” Each granule,
cell, fibre, organ, or tissue, having its own individual life, so
far as vital conditions are furnished by its own constitution;
and sharing a common life, so far as those conditions are
furnished by the blood, by withholding which, life may be
arrested in any part, no matter how minute, while it may
remain unaffected in the rest. If it could be cut off from a
single molecule, that molecule alone would perish ; so of
a granule, cell, fibre, a finger, an arm. And thus the
experiment might be continued until involving some organ
in relation to which important mutual dependence exists,
before affecting the rest of the organism.
PREVIOUS DEFINITION NOT FINAL.
“* * A substance which, by its essential nature, is the unrelenting and
ever active foe of all organization, we call it oxygen gas. * * It can
demolish, but it can not build up ; it can disorganize, but it can not con-
struct; it can cause to perish, but it can not cause to grow.”— Youmans,
“When I consider the relations which oxygen gas maintains to the plic-
nomena of this globe; * * when I reflect on the office that it discharges
as the great destroying agent, that it causes the decay of animal and vege-
table beings, and is the antagonist of life, * * it is an embodiment of the
destroying angel, * * * 3: ' ). * *
To it is committed the duty to destroy all animal races, * * pervading
each instant, every part of our bodies, and bringing on interstitial death.
— Draper.
But a still more intimate and precise definition may be
1869.] Aſorce. 345
given; one beyond which, in the present state of Science, it
is not possible to advance.
While the plasma furnishes the materials of structure, it
does not furnish the conditions of life. Of course, if there
were no structure, there would be no life, since there would
be nothing to live. But this does not prove that nutrition
is the source of life, since it is well known that organs may
and do live, not only while they are receiving no nourish-
ment, but while they are constantly wasting.
Let us farther consider, that the food which we consume
is lifeless. Or if we swallow a living body, it must needs
die and become decomposed before it can be appropriated.
And though, after elaboration by hepatic and lymphatic
glands, it may become re-converted into albumen, for
instance, yet no one imagines that the albumen of the blood
has the same life as the nerve or muscle, which it may after-
wards serve to nourish. Nor does it have, until it becomes
a constituent part of nerve or muscle, and then partakes of
the peculiar molecular arrangements, conditions, and mo-
tions, that characterize the structure and life of the tissue
of which it has become a part; and these are evidently
communicated to it in the act of uniting with the molecules
of the tissue. Just so, molecules of chloride of sodium
acquire the peculiar properties that characterize a crystal in
the act of becoming part of a crystal. So we see that food
rather receives than imparts the characteristic life of the
tissue into which it enters.
It is, therefore, an obvious error of Carpenter, and other
physiologists, to refer life to nutrition as its cause; else, I
repeat, how can parts live many days (in the lower ani-
mals, months), while deprived of all nourishment and under-
going atrophy : And yet, the moment the circulation is
arrested in any part, the life is arrested in that part. There
must, therefore, be some constituent of the blood on which
life is especially conditioned. And, yet, that constituent
does not enter into the constitution of the plasma. We
must look elsewhere, then, for the efficient haematic cause
of life.
g
346 //orce. [April,
In our search after this all-important agent, we may de-
five aid from noting the first faint dawn of life in the seed
and egg. Whatever life is, in egg or embryo, that it essen-
tially continues to be, however varied and complex it may
become, in the adult.
The seed does not live any more than the unchanging
heart-wood of the tree. Place it in the ground, supply it with
moisture and warmth, conditions essential to liberation of
constituent molecules from that solid state which is incom-
patible with change (without which life can not exist); let
molecular movement commence, and the result is, in the
absence of free oxygen, decay. But let oxygen touch the
incipiently decomposing mass, and forthwith life springs up.
The constituent elements, instead of combining into and
escaping as carbonic acid and ammonia, leaving the fixed
minerals in the soil, are projected upward, a part to form
the plumule, and driven downwards, a part to form the
radicle. And that same element, which is thus seen to be
necessary to initiating life, is equally necessary to continu-
ing the begun life. But, in order to render this clearly
apparent, it is necessary to correct existing views as to the
nature of vegetable respiration.
The higher plants derive their nourishment chiefly from
water and carbonic acid. The fixed minerals, and more
especially nitrogen, constitute but a relatively small propor-
tion. But, in order to the appropriation of water and car-
bonic acid, it is necessary that they should decompose the
latter, that its carbon may be combined with the elements
of water in the production of the various oxy-hydro-carbons,
of which their structure is chiefly composed. This is accom-
plished in the leaf-cells, under the influence of the solar ray,
the superfluous oxygen escaping into the air. This, which
is evidently a part of the nutritive process, is termed by
vegetable physiologists, the respiration of plants. If it
were so, it would seem that plants have no use for ſree
oxygen, and that their only effort is to rid themselves of it.
But this is no more the respiratory process, than is the
escape of superfluous aliment or indigestible substances by
1869.] Aſorce. 347
the kidneys or bowels of animals. The water furnishes
the oxygen in just the proportion needed by the oxy-hydro-
carbons, leaving that of the carbonic acid to escape as super-
fluous.
It is only after the sun has withdrawn his aid, after decom-
position has ceased, and exhalation of oxygen is at an end,
that the leaf, which has been acting as a gland, now takes
on the function of a lung, and gives passage to carbonic
acid into the air, presenting evidence that the oxygen has
been at work in the plant as well as in the seed. And this
is conclusively shown, since, if the plant is deprived of free
oxygen, it perishes. Plant-respiration goes on most active-
ly, however, when it is preparing to propagate its kind, in
the flowering process attending the union of its sexual ele-
ments, and the consequent formation of the seed. At this
time, so rapid is the absorption of oxygen, with correspond-
ing combination of carbon, that the temperature may rise
fifty or more degrees above that of the surrounding atmos-
phere. The plant is “in heat.” At other periods, and with
the leaves in general, respiration occurs only at night. The
plant feeds by day, and breathes by night.
The egg, like the seed, has not begun to live. Like the
seed, it has life (in scholastic phrase), in posse, not in esse.
ISut, unlike the seed, the egg has a sufficient supply of
moisture within itself. It is necessary, therefore, in order
to induce molecular motion, to afford only the necessary
warmth. Supply this, and, in the absence of free oxygen,
if any molecular movement does take place it ultimates in
decay. But, with proper supply of oxygen, the pabulum of
which it consists, first granulates, then the granules com-
bine into cells. These, in their turn, divide and subdivide.
Fibres are formed, tubules are hollowed out, tissues are
constructed, and organs appear, until animal or man stands
forth, complete in physical organization. But, at every
step in the process, the presence of free oxygen is neces.
sary. Arrest the supply, and, at once, the whole curious
and complicated series of movements ceases. Life retires
and death assumes dominion. Organic molecules cease to
348 Aſorce. [April,
exist. In the absence of oxygen, other agents have been at
work, setting in operation forces that have acted directly on
the atoms. Atomic, instead of molecular, movements have
taken place. The atoms have entered into new combina-
tions, tending to the mineral condition, and organic mole-
cules have disappeared. The egg or animal ceases to exist.
If oxygen is needed to the generating of organic forms in
the simple egg, much more is it in the complex adult; if in
the feebly and intermittently breathing plant, much more
in the vigorously and constantly breathing animal. While
the animal may be deprived of food for several days (some
for months), with impunity, a very brief privation of oxygen
is sufficient to destroy life.
Vegetable and animal life is essentially the same. Each
is produced by the action of oxygen in the tissues, the life
varying as the tissues and the supply of oxygen vary. The
distinction made by Bichat, and generally adopted by physi-
ologists, into vegetable and animal life of men and animals,
has no foundation in fact. Life, in whatever part of the
system, is due to the action of oxygen in that part. The
distinction proposed is based on the difference between vol-
untary and involuntary processes. But the former are
mental, and not vital. That the mind makes use of a living
organ to serve its purposes, does, in no degree, change the
Thature of that life. Mental phenomena should no more be
confounded with vital, than should spirit with matter. That
matter and spirit are inseparably associated does not consti-
tute them one. No more does the presence of vital and
mental phenomena in the same body render them the same
in kind. Whatever may be the relations of oxygen to the
brain, rendering it the instrument of mental manifestation,
mere molecular movement is none the less utterly distinct
from thought and emotion. And I return to the original
statement, that there is no ground for the distinction of
organic and animal life. It is all organic, and oxygen is
the exciting cause.
1869.] Aſorce. 349 .
FINAL DEFINITION.
Life, therefore, we can now define, more accurately, as
the sum of the molecular movements developed by the
action of oxygen in organic tissues; exclusively those, how-
ever, of which nitrogen is a constituent. It is oxygen that,
carried to every part of the body, and reaching the minutest
points of all tissues, becomes the vitalizing agent. Life is
the complex result of oxygen and tissue. As tissues differ,
modes of molecular motion must needs differ. As tissues
resemble, modes of molecular motion must needs resemble.
There must be similar motions, because there are motions
common to all kinds of matter. There must be dissimilar
motions, because there are motions peculiar to each kind
and combination of matter. If oxygen can develop atomic
motion by action on the hard plates of a galvanic battery,
and this motion, in its turn, can produce atomic motion in
the connected wires, it is doubly sure that it does so in the
soft, nitrogenous tissues of vegetable and animal bodies,
when the same relation of sequence is found to exist in the
one as in the other. In either case, prevent access of oxy-
gen, and the characteristic action of plate or tissue ceases.
Restore the oxygen, and the action returns. Let oxidized
material accumulate on plate or in tissue, thus interfering
with oxidation, and action is proportionately feeble. Re-
move this accumulation, and, in either case, development
of incessant energy, galvanic or vital, ensues.
In the living body, porosity and accompanying circulation
enable the oxygen to reach and to develop force at every
point. It is as if the galvanized plates were porous to the
minuteness of an atom of oxygen, with direct currents to
bear it in, and reverse currents to carry out and bear away
the oxydized material. Then the plates would become gal-
vanic at every point, internal as well as external, as the
body becomes vital at every such point.
It makes no essential difference that the direct action of
the oxygen is chiefly on the hydro-carbonaceous constitu-
ents of the food, and indirectly on the tissues. The force
350 Jºozice. [April,
developed by this action affects the tissues, as the force
developed by the plates affects the wires. As the motion
produced in the plates excites motion in the wires, so does
motion produced in the pabulum excite motion in cell,
nerve and muscle. They are the wires of the animal, the
living machine. Subtle and searching, this all-compelling
element penetrates minutest pores, pervades all cells, and
insinuates itself amidst all molecules. On it every move-
ment, the most minute or the most ample, directly and
momently, depends. And the sum of these movements is
what we term life. Let us remember that there can be no
active development of force, no kinesic display, without
movement. And it is oxygen that is the immediate cause
of those molecular movements, which, in the glands, result
in excretory or elaborative processes, in the muscles in con-
traction, in the nerves in transmission of vibrations, in the
brain in rendering its cells avenues for the transmission of
sensation, intellection, and emotion.
Given the organism, in appropriate molecular state;
granted a due supply of oxygen, and, as we see in the man
restored from drowning, the organism acts; secretes sal-
ivary, gastric, pancreatic juices; elaborates fat, fibrine,
corpuscles; affords alike the indispensable conditions of
carrying away the gates of Gaza, and of amazing mankind
by the production of Hamlet. In these and all imaginable
processes, the oxygen employed is, other things being equal,
the measure of the force developed. And how beneficent
the provision by which it, too, relaxing somewhat from its
efforts, is hidden away in our hours of slumber, waiting till
returning morn shall summon us to our daily toil, that it,
too, with renewed vigor, may spring to its appropriate task.
Silent and unobtrusive, it goes with the laborer to silent
field or lonely forest. It guides the noiseless plow; it wields
the echoing axe. It carries brick and mortar in the crowded
city, to build the stately mansion, or to rear the lofty temple.
It elicits light and heat from the black masses that were
stored up in the dark mine ages ago, that it may cheer and
warm the household of to-day. It gives light to the stu-
dent’s page by night; it prepares his food by day. It hurls
1869.] Aſorce. 35 I
along the ponderous train with a speed which rivals that of
the bird. It drives the mighty steamship, as it plows the
yielding, watery plain.
Where yonder tall chimney flames out upon the night,
the fiery signal tells of the place where it melts down the
rigid iron to serve the wants of man. The agitated acid in
the laboratory betrays how it works to decompose resisting
minerals, and to compel material forms to yield up their
most cherished secrets to the inquiring chemist. Invisible,
penetrating, all-pervading, tireless, it finds no work too
minute, none too vast, for its powerful, plastic hand. It is
the active destroyer of dead, the beneficent sustainer of
living bodies. It makes earth green with vegetation, and
bright with blossoms. It lifts up the vast weight of forests
that crown the supporting soil; it lives, and breathes and
moves in the herds of animals that rest in their shade, dis-
port among their branches, or cleave the encircling air. It
is alike active and essential in minutest, microscopic proto-
zoon, or in vast unwieldly elephant, or where the whale,
mightiest of sea-monsters, floats upon the supporting brine.
And when these various organisms have ceased to live, it
lays hold of and bears away the decaying material. Where-
ever work is done under the sun, there is oxygen, the all-
compeller, nature’s most active and efficient element, man’s
most useful and willing slave.
Like its fellow-agent of vital phenomena, this tireless
worker, this all-compeller, is poured out forty miles deep
around our earth, that it may never be wanting, either to
the ruder displays of force in the inorganic world, or to those
finer and more occult phenomena throughout the lengthen-
ing chain of vegetable forms, or in the crowded ranks of
animal life.
It is present alike in the first heart-beat of the new-born
infant, and in the first faint sensation that agitates his feeble
brain, as, with the help of oxygen, he enters upon his indi-
vidual vital career. It withholds its vitalizing force, when,
that same heart ceasing to beat, and that same brain ceasing
to respond, that infant, now an old man, lies down in the
embrace of death.
REVIEWS OF Books.
A RATIONAL TREATISE ON THE TRUNKAL MUSCLES, Elucidat-
ing the mechanical cause of chronic spinal, pelvic,
abdominal, and thoracic affections; and of bronchial and
other derangements incident to the clerical, legal, and
musical professions; with the rationale of their cure by
mechanical support. By E. P. Banning, M.D. New
York: W. A. Townsend & Adams. 1868.
Some one has said, that no opinion is so incontrovertible
as that which is unintelligible. By such a rule it would be
very difficult to prove, from the text, that this is not one of
the wisest and best of medical books. For it is written in
a language which we confess we can not interpret. What-
ever the matter of the volume (if the kernel could be ex-
tracted), the manner or style adopted has covered it with so
hard a shell, as practically to prevent us from getting it.
Our limits forbid more than a few brief extracts, which are
altogether characteristic. One of the “fundamental propo-
sitions” is that
“The viscera are as much under the law of a specific orbit of being and
bearing as the bones, and any departure from this, will constitute a prac-
tical dislocation, which may involve corresponding functional derangements
by cancelling the primary relations between these organs and their vital
forces.”
Of the mechanical support, for the relief of uterine pro-
lapsus, we are told at page 147:
“I have now, in the light of mathematical law, made the following points,
viz.: that visceral weight must always be a primary or make-weight cle-
ment in the production and maintenance of uterine displacement, whatever
the concomitant pelvic relaxation may be ; that to diminish superincum-
bent visceral weight to the last degree, is the first indication in a radical cure;
that ordinarily, in proportion as the pelvis is properly horizonto-vertical,
the upper trunk poised behind the Spinal axis, and the abdominal and dorsal
1869.] Reviews of Books. 353
muscles duly tensed, the aggregate actions are, to shield the pelvic organs
from pressure, by virtue of simple position, and to elevate the viscera from
the pelvis; and, lastly, that when from habit or debility these bearings are
lost, the mechanical combination just described is mathematically compelled
to restore the proper bearings, elevate the pressing viscera, remove the
aggressive agency in the case, and fully enfranchise the pelvic forces in
elevating the uterus.”
“Ce qui se conçoit bien s' annonce clairement,
Et les mots pour le dire viennent aisement.”
These passages, which are as angular and unwieldy as
the harness they are designed to introduce and extol, will
give our readers a good idea of the drift (or drift-wood) of
the volume. It is a matter of history, that Davy Crockett
would not be induced to hear the celebrated Daniel Webster
throughout one of his famous speeches, “because he could
understand every word he said.” The medical members
of the Crockett family will be sure to appreciate this pre-
tentious publication. R. L.
ESSENTIALs 0F THE PRINCIPLES AND PRACTICE OF MEDICINE ;
a hand-book for students and practitioners. By Henry
Hartshorne, M.D., Professor of Hygiene in the University
of Pennsylvania, etc., etc. Second edition, revised and
improved. Philadelphia: H. C. Lea, 1869. Chicago:
Cobb, Pritchard & Co.
The appearance of a second edition of this work enables
us to repeat the recommendation which we made of it
when first issued. For students and young practitioners it
is invaluable, and as for the older practitioners, they must
have kept pace remarkably with the progress of medicine
who do not find something new in this volume; indeed,
one's memory must be very vigorous and retentive who
can not, at some time, find it refreshed by turning to this
work. It is weak enough in therapeutics, as are all works
of the Allopathic school — the author acknowledges that a
scientific empiricism is all that they have or can look for.
We hope he may hear of something better before he issues
many editions more.
354 Reviews of Books. [April,
THE CALCUTTA Journ AL OF MEDICINE ; a monthly record of
the medical and auxiliary Sciences. Edited by Mohendro
Loll Sircar, M.D.
At an annual meeting of the Bengal Branch of the
Dritish Medical Association, Dr. Sircar, the Vice-President,
read an address on “The Supposed Uncertainty in Medical
Science, and the Relationship between Diseases and their
Remedial Agents.” In this he cited several writers who
acknowledged “the necessity of discovering the physiologi-
cal action of medicines, before using them as therapeutic
agents.” In this connection he mentioned the name of
IIahnemann, and said that “he could not understand the
extreme attitude of hostility which the profession has shown
towards him and his system, . . . . he tried some of these
remedies, according to their indications—as he could glean
them from their pathogenesis, and to his utter, but agreea-
ble, astonishment found that they were actually efficacious.
. . . . He, therefore, felt it his duty most humbly to urge
upon the profession the necessity of recognizing the system
of administering drugs on the principle of similarity of
symptoms, as one of the systems of therapeutics.”
A discussion arose after reading this paper, which we do
not give in full, for two reasons: First, for lack of room;
secondly, because we do not wish to expose the ignorance
and bigotry of the Allopathic fraternity, the members of
which are disgracing themselves fast enough without our
help. We must be allowed a line or two, however; those
who want more will find the whole affair, in full, in the
“Monthly Homoeopathic Review,” May, 1867, from which
we quote. Dr. Sircar was defending his address, when Dr.
Waller said: “If you speak a word more, Dr. Sircar, we
will turn you out of the room. He, Dr. S., ought to be
expelled from the Association.” Dr. Ewart said he was of
the same opinion, too. Dr. Chuckerbutty said that was his
impression also, and much more of the same sort. One
would think that he was reading again the trial of Christian
and Hopeful in Vanity Fair.
1869.1 Peviews of Books. 355
The final issue of the matter was, that Dr. Sircar has
become a Homoeopathist, and issued the first number of
his Journal, in defence of his new views, January 1st, 1867.
It is a Journal of thirty-four pages. The editorial shows
the editor to be a seeker of truth, and ready to accord to
others the same liberty which he seeks for himself; then
we have a chapter on snake poisons, which gives us reason
to look for some original investigations, in that line, in
India; then an extract from “L’Art Medical,” upon IIom-
oeopathy, closing with a review of a work on the indigenous
drugs of India, and an extract from the speech of Judge
Ironsides, on the opening of the Benares Homoeopathic Hos-
pital and Dispensary. Our best wishes attend the new
Journal and its editor, and we venture to assure him of the
deep interest which all his American colleagues will take
in his enterprise.
BRAITHWAITE’s RETROSPECT OF MEDICINE AND SURGERY.
Part LVIII.
Our limits forbid our doing more than to acknowledge
the receipt of this valuable work, from the publishers,
Messrs. W. A. Townsend & Adams. It contains several
papers on various drugs of special interest to Iſomoeopath-
ists, and one on Reduction of Dislocation of the Shoulder-
Joint by Manipulation, page 125, in which we were partic-
ularly interested, since the possibility of the thing has been
denied, while we happen to know of its having been per-
formed in, or rather near, this city, some six or eight years
ago.
THE LITTLE CoRPORAL, by A. L. Sewell & Co., is still
crying “Excelsior,” and there is no telling where it may
get to if it does not stop. It has already attained an envia-
ble circulation, and if its inner excellence keep pace with
its outward prosperity, the boys and girls will have a paper
in which they may well delight.
356 APeviews of Books. [April,
THE IIoMCEOPATIIIc QUARTERLY: A Journal devoted to the
interests of Pure Homoeopathy. Rollin R. Gregg, M.D.,
editor and proprietor, Buffalo, N. Y.
The first number of a Journal bearing this pretentious
title appeared January 1st. The first half is occupied with
the proprietor's peculiar views in regard to the cause and
treatment of consumption, and the last half with an article,
by the same person, on “The Physical Evils of Alcohol.”
As this number is, of course, intended as a specimen of
what is to follow, the “the interests of pure Homoeopathy”
seem likely to be chiefly promoted on the title page. “A
synopsis of a forthcoming work upon consumption, and its
numerous kindred maladies,” etc., etc., by R. R. Gregg,
M.D., etc., etc., etc., published in 1865, is appended to the
forty-eight pages of the Journal. We do not feel disposed
to enter upon the extended criticism which the style and
contents of this emphatically one-man Journal suggest. It
will, no doubt, commend itself to a certain class of mind,
and perhaps find that it has “a sphere.” F. A. L.
PRACTICAL HomoCoPATHY FOR THE PEOPLE: * * * *
including a number of most valuable new remedies.
Eighth edition. By J. S. Douglas, A.M., M.D., etc.,
etc. Chicago: C. S. IIalsey, 147 Clark Street. 1868.
The appearance of the eighth edition of this little work
is ample evidence of its popularity and usefulness. Plain,
practical, and concise, it is admirably adapted to the purpose
for which it is intended by its able and experienced author.
The introduction constitutes one of the very best tracts on
Homoeopathy that can be circulated among the non-profes-
sional. Although no friend to domestic practice in general,
we know of no book of the kind we should be more willing
to have placed in the hands of the laity. For the price, it is
undoubtedly the best in the market. F. A. L.
1869.] Reviews of Books. 357
CLASSIFICATION OF A FEW OF THE “NEW REMEDIES,” accord-
ing to the parts of the body acted upon, after the plan
of Bönninghausen. By Temple S. Hoyne, A.M., M.D.
Reprint from “Western Hornoeopathic Observer.” St.
Louis: H. C. G. Luyties, Publisher, 306 North Fifth
Street. 1868.
With commendable zeal in a favorite department of
study, and following the example of the illustrious Bönning-
hausen, Dr. Hoyne has put the provings of some forty of
the best proved of the “new remedies” in a convenient
form for reference and comparison. To those who have
confidence in the provings, this will be of much value in
facilitating (what with the Homoeopath is always a para-
mount object) the accurate adaptation of the remedy to the
case in hand, and it will doubtless induce some to make a
trial of these remedies, who have hitherto abjured them on
account of what they have considered a lack of definite
indications. To the latter class it will serve as a ready
means of testing the reliability of the claims put forth for
these remedies. All parties, therefore, are under obliga-
tion to Dr. Hoyne for his pains-taking industry. It consti-
tutes no real objection, either to the provings or the “class-
ification,” that so few symptoms are detailed for so many
remedies, provided, all those given are reliable. This is
what we want to know, and what the “classification * will
assist in determining. Besides new remedies, some half
dozen or more are included which would hardly come under
that head. The publisher and printer have well done their
part of the work (barring a somewhat formidable list of
“errata,” to which, by the way, it would have been well to
have added “carbonate of lead,” p. 2, third line), the whole
forming a neat octavo pamphlet of seventy pages, which
should be on the table of every practitioner who desires to
be up with the times. F. A. L.
Wol. W.-No. 15. 7
358 Reviews of Books. [April,
EPITOME of HoyſgoPATHIC MEDICINEs. By Wm L. Brey-
vogle, M.D.
This little work, gotten up in a convenient shape to carry
in the pocket, we recognize as a truly valuable acquisition
for ready reference; in its own way it is unique, a little
paradise of Materia Medica. As far as we are able to
judge, the author has made most capital selections of symp-
toms. To the sources mentioned in the preface we should,
without hesitation, add “several courses of lectures by our
old veteran, C. IIering.”
The arrangement in comparative form is new, and one
of the best features of the book. We advise the profession
at large to invest. + T. B.
ARCHIVES OF OPHTHALMOLOGY AND OTOLOGY. Edited and
published simultaneously in English and German, by
Prof. H. Knapp, M.D., New York, and Prof. S. Moos,
M.D., Heidelberg.
Messrs. Wood & Co. announce the appearance of this
Journal May 1st. It is to be issued twice a year, each
number to contain 250 or 300 pages, at $7 per annum.
WE gladly give place to the following, which will interest
the many friends of the “Chemical News: ”
SPECIAL NOTICE.
The American publishers of the “Chemical News” propose to add to the
English edition a Supplement, containing Notices of the current Progress
of Chemistry and the Physical Sciences in America, Notices of New Books,
Ičeview of the Markets, Movemcnts in Trade, etc. The new feature was
inaugurated in the December issue, and will be under the cditorial charge
of Professor Charles A. Seely.
W. A. TownsLND & ADAMS,
434 Broome Street, New York.
This “American Supplement,” under the able manage-
ment of Prof. Seely, adds greatly to the interest and value
of this widely known and useful Scientific Journal.
F. A. L.
1869.] Peviews of Books. 359
IIoMCEOPATHY, ALLOPATHY, AND ExPECTANCY : A criticism of
Sir Jno. Forbes’ “Nature and Art in the Cure of Dis-
ease,” and an exposition of Homoeopathy. By Rob't M.
Theobald, M.A., M.R.C.S., Eng.
The whole matter of controversy, between old and new
therapeutics, is gone over in this pamphlet of some eighty
pages, and the subject is treated with the directness and
good taste by which the writings of “Our British Corres-
pondent” are well known. We wish a copy of the pam-
phlet might be put into the hands of all who are seeking,
or should be seeking, for the truth, and regret that our
limits do not admit of giving our readers a taste of its
quality.
Our acknowledgments are also due to “Our British Cor-
respondent” for several Tracts which have been published
by him, for the purpose of enlightening the “dear people.”
It is astonishing what a deal of enlightenment they need,
but particularly gratifying to us that any one as able as Mr.
Theobald, is as willing to shed light upon this subject, so full
of doubts and perplexities to many minds.
VICK's ILLUSTRATED CATALOGUE. — We do not purpose to
go much beyond our record to notice any person or thing;
but we are devoutly grateful that flowers (and those who
raise them, of course) are just within our domain. Botany
is a part of the comprehensive science of medicine, and so
is Vegetable Physiology, hence quite within the range of
medical notice; but more than this, what medicine for the
mind, and body too, does one find by strolling through a
flower garden | Horace told us, years ago, that care would
climb the brazen prow of a vessel, and not be left behind
by the horsemen swifter than deer, or the clouds driven by
the east wind, which all may be very true, but in a garden
bedecked with flowers, care can not enter, much less abide.
From flowers it is no great difficulty to transfer one’s
good will to those who raise and scatter them, and among
those standing high in our regard, in this respect, we may
360 Books Received, Etc. [April,
nention WICK, the well-known seedsman and florist, of
Rochester, N. Y., to whom we are indebted for a catalogue
of flower—and vegetable—seeds, which Diogenes himself
could not have read — supposing that he ever read — with-
out making his eyes water, and his mouth too. Such of our
readers as have gardens, and we trust they all have, or soon
will have, will do well to send to Mr. Wick for his Illus-
trated Catalogue, and when they have once seen that, they
will need no further advice. His seeds are sent, postage
paid, to all parts of the Union, so that all may be supplied
with very little trouble or expense.
BOOKS RECEIVED.
Dental Cosmos; Chicago Medical Journal; New York Citizen; Wick's
Illustrated Floral Guide; Chemical News and Journal of Physical Science
(W. A. Townsend & Adams, New York); Canada Journal of Dental
Science, edited by W. G. Beers, Montreal; The Hahnemannian Monthly;
Introductory Address delivered before the Class of the Medical College
of Ohio, October 6th, 1868, by Theophilus Parvin, M.D.; Detroit Iteview
of Medicine and Pharmacy; Dental Register; The Boston Medical and
Surgical Journal ; Journal of Materia Mcdica, Bates & Tilden's ; American
Journal of Obstetrics; Capt. Mayne Reid's Onward; The Little Corporal;
American Journal of Dental Sciences, Baltimore, Md. ; Homoeopathic Indo-
pendent ; The Homoeopathic Sun — does not shine every month in our sanc-
tum; The Western Homoeopathic Observer — comes out in a new dress,
promises to be good in future; Medical News; The Ohio Medical and Surgi-
Cal Reporter; New York Medical Journal ; Braithwaite's Retrospect;
Tanking's Half-Yearly Abstract; Allgemeine Homoeopathische Zeitung;
El Criterio Medico; La Homeopatia; Bulletin de la Société Médicale
Homoeopathique de France; The Nashville Journal of Medicine and
Surgery; The Pacific Medical and Surgical Journal; New York Medical
Gazette.
TO CORRESPONDENTS.
N. B.-We wish particularly to call the notice of our readers to the necessity
jor their contributions being received at least NINETY days before the date of
publication. Attention to this rule will save them from many disappointments,
and the editor much trouble. This refers to lengthy papers ; items of news
will be received any time.
DR. T. F. ALIEN will remove, May 1st, to No. 3 E. Thirty-third Street.
A.D./7'O/C/A/.
THE RE-DISCOVERY OF THE SCREW.
A CARROLL DUNHAM, M.D., NEW YORK.
IT is related of James Ferguson, the somewhat celebrated Scotch astrono-
mer, that, while a poor shepherd boy, his mind intent on mechanical sub-
jects, he devised what he supposed to be a new mechanical power, but
which, when exhibited, turned out to be the – SCREw. It seems incredible
that a Scottish lad, old enough to tend sheep, should never have seen a
Screw; but such was the fact in Ferguson's case in 1725. His invention,
therefore, had all the merit, though not the profit, of originality, and he
was, and has been, honored accordingly.
But suppose it had appeared that Ferguson, instead of having grown up
in the solitude of the sheep-walks, away from books, and ignorant of the
ways and mechanisms of civilized men, had been in constant communication
with the most learned of his time, had had access to every publication, had
even lived in the centre of a vast throng of clanging engines and whirring
machinery, and from such a position had come forth parading an alleged
discovery of a new mechanical power, which, on examination, proved to be
the Screw, well known for ages, and in constant manufacture and daily
use by thousands of his fellow citizens ! What adequate name could we
apply to such a claim, of which only the effrontery could surpass the
dishonesty.
Dr. Archibald Reith, a countryman of Ferguson (we know not that he
began his career as a shepherd boy), physician to the Royal Infirmary of
Aberdeen, in a paper on “The Therapeutical Action of Medicines in Dilated
Conditions of the Blood Wessels,” read before the Medico-Chirurgical Society
of Aberdeen, and published in Edinburgh, 1868, presents us with alleged
discoveries of his own, in which we recognize a well-known Screw.
Beginning with a confession of the confused state of therapeutics, and
deprecating, as illogical, the scepticism regarding the value of drugs which
has grown out of this confusion, Dr. Reith says, that the difficulty in
reaching a satisfactory theory of the therapeutic value of drugs, comes from
incorrect views of the fundamental nature of diseases, and of the action of
drugs upon the system, as well as from the erroneous notion that the thera-
peutical action of a drug must be the same as its physiological action.
He says that, “If our pathology be correct,” all diseases “arise from the
same centre. This centre is the joint cerebro-spinal and vaso-motor nerv-
ous systems.”
Confining his attention now to the consideration of Inflammation, which
occupies so prominent a place in the production of disease, he says:
“Inflammation is, as I understand it, pi imarily and essentially, a disorder of the nervous
362 Adžāorial. [April,
system. The stagnation of blood, the eſfusion of lymph and serum, the suppuration, etc.,
which are conjunonly identified with in ſlammation, are themselves only the result of deeper
seated morbid processes, aſſecting conjointly the cerebro-Spinal and vaso-Inotor nervous
Bystems.”
Stating the order of this affection of the nervous system to be : first,
eacitement, producing contraction of the capillaries, diminution of blood,
and decrease of vital properties; and, Second, paralysis, producing dilatation
of blood vessels, afflux of blood, and increase of vital properties, Dr. Reith
goes on to say:
“A serious oversight has been made, leading to very erroneous practice. It is commonly
supposed that the paralysis of the sympathetic, on which inſlammation in a great measure
depends, is the primary effect of the exciting cause; whereas, in truth, it is its 8econdary
effect. * * * Thus, inflammation, as observed in the body, is a reaction from a previous,
and often invisible stimulus upon the motor system.”
To illustrate :
“If ether spray be directed on the skin the effects of the intense cold will be seen by the
naked eye. * * Contraction of the blood vessels, diminution of blood, and decrease of the
vital properties, manifested by the whiteness and insensibility of the part. When the stim-
ulus is removed, reaction gradually takes place, till the parts resume their natural appear-
ance; but it does not stop there. It goes beyond health, and approximates disease. The
surface is congested ; there is dilatation of the blood vessels, more blood and more vital
energy, as increased heat and sensibility, than are found in the ordinary state.”
FIe continues:
“If a strong stimulus be directed on the nervous circle, such as cold from without, or a
poison from within (such as a fever poison), it is thrown into a state of temporary excitement,
causing those rigors and general depression which usher in a fever, and constitute its cold
stage. The reaction from this is its hot or febrile stage,” etc.
“Having thus,” says Dr. Reith, “‘given a brief outline of the part played by the vaso-motor
system in the incipient stages of inflammation, I have now to show that the action of medicine,
on the living body is precisely analogous. Whatever may be the ultimate effect of a substance,
whether it be known as a purgative, tonic, or a narcotic, its primary action is on the vaso-
motor system. * * The local effects of drugs will be found always to involve, more or less,
the vaso-motor system, and to produce in it changes similar to, if not identical with, those
which occur in inflammation. Medicines may be arranged under two heads: * * pure
astringents, acting chemically on the tissues, and those which, after their stimulant or spas-
modic action has passed off, are followed by more or less reaction to paralysis of the sympa-
thetic or dilatation of the blood vessels. To this latter class belong nearly all the contents of the
Materia Medica. They possess the double property of stimulating and paralyzing the sympa-
thetic — in other words, of contracting and dilating the blood vessels. Take the case of purga-
tives. A double action is universally ascribed to them, their purgative effects being usually
followed by more or less constipation. But, what I wish particularly to call attention to, is,
that, in accordance with the laws of inflamination, prior to their purgative action, and essential
to it — the cause of it, as it were — there is a previous spasm of the blood vessels, or excitement
of the sympathetic, and that the subsequent purgation is in proportion to the intensity and
duration of that excitement. We know well that laxative medicines act by creating irritation
and inflammation of the mucous membrane of the intestinal canal — an in ſlainmation not to be
distinguished from that which is called idiopathic. If, then, the idiopathic inflamination
originate in the manner I have already described, as it undoubtedly does, it is but a natural
inference to conclude that purgatives operate in a slmilar way, and beſ, in their action with
spasm of the blood vessels.”
Saying that tonics and narcotics act in a similar way, first inducing
spasm of the blood vessels, Dr. R., proceeds:
“Indeed, Belladonna is now recognized as having the double action which, I am endeavor-
ing to show, belongs to medicines in general. Brown-Sequard, speaking of the remedial
effects of Belladomina, says: ‘A remedy can produce, with different doses, two opposite
1869.] Aditorial. 363
eſſects. Belladonna, for example, by its influence on the blood vessels of the spinal cord, will
diminish sensibility, the reflex faculty, the tendency to convulsions, etc., but if the doge be
towic, there will be a morbidly increased sensibility, reflex faculty, and convulsions will occur.
* + A number of remedies may have quite opposite action in remedial and toxic doses.’”
Dr. Reith proceeds:
“It will not be out of place here to notice the singular analogy subsisting between the pri-
mary effects of medicines and those of fever poisons. As each medicine acts on its own portion
of the sympathetic, so each fever poison implicates a particular part of the same system. In
typhus, for instance, the cervical sympathetic suffers. * * Enteric fever involves the
abdominal sympathetic, the ganglia of which are found enlarged and 8oftened. The other
febrile diseases also have their favorite nidus. Curiously enough, too, they all commence their
action by inducing spasm of the blood vessels (cold stage), and the reaction from that indicates
the particular disease present (febrile stage).”
“I come now to the practical application of the doctrines I have been inculcating * *
If medicinal agents stimulate the vaso-motor system primarily (spasm of the blood vessels),
and paralyze it secondal ily (dilatation of the blood vessels), it may be supposed that, inflam-
mation being a paralysis of the same system, it would be aſſgravated by medicines in their
ordinary physiological doses. Experience confirms this supposition. We find in practice that
purgatives are injurious in, and aggravate, diarrhoea; tonics and emetics increase pre-existing
rritation of the stomach ; narcotics are hurtful in congested states of the brain; diuretics in
inflammation of the kidney. All this is true, 8 upposing the medicine& Given in the usual
prescribed doses of the Pharmacopoeia. But, if we concede a double action to medicines, if we
admit that, prior to their recognized effect on the economy, they have a spasmodic action on
the blood vessels, inducing their contraction, we will naturally inquire how this primary action
may be turned to practical account. What I maintain is, that medicines, given in very small
Doses, when the blood vessels are dilated (paralysis of the sympathetic), will exert their pri-
many action of contracting the blood vessels (excitement of sympathetic), and no more. Their
action will then cease; for, whatever benefit is to be expected from administering medicinal
agents in doses so small as to go no further than spasm of the blood vessels, it will then be
accomplished.” + + +
“Ilow a minute dose should thus affect a paralyzed nerve, while it uninfluences it in its
ordinary state, is a phenomenon we can not explain. But that it does so, there can be no
doubt There seems to be a peculiar susceptibility to medicine manifested by the sympathetic
in its paralyzed state. The same thing is witnessed by physiologists in animals. In Brown-
Sequard's Physiology and Pathology of the Nervous System, we find the following results
described, among many others, as due to the section of the sympathetic :
‘‘‘27. The first convulsions after poisoning by Strychnia take place there.”
“‘28. A galvanic current too weak to act on the other side may produce contractions there.”
“From which experiments we conclude that a dose of a medicine, too weak to eacert any
action on the sound nerves, will operate on them when paralyzed. If we suppose Strychnia
to be primarily a stimulant to the vaso-motor system, it would, in the same manner as a purga-
tive, agg, avate a pre-existing pan alysis of that system, shown by the increased vitality of the
parts, and greater readiness to contraction of the muscles But if a very small dose be admin-
istered, it would, by contracting the blood vessels, remove those symptoms previously existing,
All medicines act in a similar way on the nerves for which they severally have an affinity, the
ther apeutical dose being considerably smaller than the physiological, and only to be deter-
mined with accuracy by repeated eaſperiments on those morbid parts for which they are
ºn (lºcated.”
“A proposal has lately emanated from high quarters, to the effect that a systematic and
careful investigation should be made on the physiological action of medicines on the system.
The importance of this proposal can not be over-estimated. * * * But I expect much more
from the investigation than the proposers probably have dreamt of. When the physiological
effects of a medicine are fairly established, they will become a guide to its therapeutical action
in those morbid conditions which are attended with dilatation of the blood vessels (paralysis
of the sympathetic). We shall know, then, that, in such conditions, its remedial action is the
reverse of its toxic; and, moreover, that the dose required for the former action must be much
less than for the latter. And then another field of observation has to be entered upon. We
Bhall have to inquire what is the therapeutical dose of each medicine, the physiological dose
364 A.ditoriale [April,
of which we already know. As already stated, this can only be done by experiments on
diseased nerves. * * The result to therapeutics will be something like the following: each
medicine will be found to irritate, or cause a determination of blood, to that part of the system
for which it has a special affinity originally, whatever may be the subsequent effects; and,
in morbid conditions, where such determination of blood is one of the chief symptoms, the
medicine having an affinity for the affected part, will prove to be the remedial agent, in doses
much smaller than are required for its toxic effects ''
“The conclusions to which I have arrived are these :
“1. Whatever may be the ultimate and varied effects of medicines on the system, their pri-
mary action is analogous to the primary steps of the inflammatory process, namely, excitement
of the sympathetic (contraction of blood vessels), followed by paralysis (dilatation of blood
vessels).
“2 The variety in the symptoms produced by the diſferent medicines is due, partially at
least, to the local tissues or nerves for which they severally have an affinity.
“8. In diseases attended with a dilated condition of the blood vessels, the proper medicines
to administer are those which act physiologically on the aſſected part, and the dose must be
such as will do no more than excite contraction of the dilated vessels (stimulus of sympathetic).
“4. In so far as the dose proper to such conditions is unknown, it is to be determined by
experience, and by observation on the paralyzed vaso-motor system.”
Let us now take breath, and render into language more familiar to our
ears, the propositions which Dr. Reith has, awkwardly and timidly, but yet
clearly enough, laid down. He holds that (most) diseases begin with a pri-
mary action, which, however, is so brief as to be imperceptible, except in a
few, such as fevers, etc., and which speedily gives place to a secondary and
more permanent condition, viz.: paralysis of the vaso-motor system. When
we see our patients, they are almost all in the latter conditions. Now, he
holds that medicines have a similar two-fold action, of which the primary
is in most cases momentary and imperceptible, while the secondary condi-
tion (paralysis of sympathetic) is permanent, and is that which we recognize
as the physiological or toxic (or pathogenetic) effects of the drug. In his
judgment, this secondary effect of the drug, being similar to the manifesta-
tions of the disease, indicates that the drug is to be administered as the
curative agent; but, in a very small dose, so that it may produce only the
primary effect, viz.: excitement of the vaso-motor system.
With much circumlocution and obscurity, he says, in substance, a remedy
is to be selected which acts on the tissues and organs affected by the disease,
and which produces toxic effects, similar to the symptoms of the patient—
but it must be given in a much smaller dose than the physiological dose !
What is this but the law Similia Similibus Curamtur, and the doctrine
of the “small dose ?”
Lest we appear to strain our construction, hear what Dr. Reith himself
Says:
“The question will naturally arise: Do these therapeutical views not favor Homoeopathy f
If by that term be understood the principles and practice of the followers of Hahnemann, so
far from these receiving encouragement from what I have stated, I am persuaded that when
the double action of medicines is universally recognized and acted upon, the props and stays
of IIomoeopathy will be cut away. But, if the term be taken in its literal significance, the
principles laid down most certainly give countenance to it. There can be no doubt that, with
all its absurdities, IIomoeopathy contains a germ of truth. That germ is its original dictum,
Similia. Similibus Curantur. * * * IIahnemann's double error consisted in making that
doctrine universally applicable to all diseases, and in pushing the 8mall doso to infinitesimals.
* * * Hence the doctrine of similar's came to be, as it is now, almost always, associated
with inſinitesimalism. The two, however, are essentially distinct. On the other hand, our
1869.] . Adžforza!. 365
error has been to push the principle of Contraria Contrari is to a corresponding extreme.
The truth, I apprehend, lies mid-way between these two extremes. It is this middle position
that I am endeavoring to establish Let the Homoeopaths abandon, as many of them are
doing, their wild theories of potentization and infinitesimalism, agreeing to receive the princi-
ple, Contraria Contrariis, as having a certain range of application,” and let us abandon our
corresponding exclusiveness, adopting the principle of Similia Sumilibus where it is indicated
by the pathology; let this take place, and we should have agreement upon a rational system
of therapeutics. It must come to this sooner or later; for, after all, the doctrines of Hippo-
crates are still as true as they were on the day of their first declaration. “Some diseases are
cured by medicines which produce the opposite effects, and some diseases are cured by medi-
cines which produce the same effect.” + + When we examine the action of the few specifics
we possess, it will be found that they exercise their remedial influence in accordance with the
same principle. Mercury, the specific for syphilis, will, in large doses, produce symptoms
resembling that disease. Quimine, as Cullen remarks, causes intermittent fever, and cures it.
Chlorate of Potash, the remedy, par eaccellence, for ulcerative stomatitis, will, in large quan-
tities, cause soreness of the gums, and inſlammation of the mouth. Bromide of Potassium, sº
beneficial in epilepsy, will, when very freely administered, induce symptoms resembling the
effects of that disease. Antimony, so valuable in pneumonia, will induce congestion of the
lungs (and Dr Gairdner declares that the beneficial effect of Antimony in pneumonia ceases
on the development of the physiological symptoms, and that the remedial doses must, there-
fore, be much less. We find also in Grave's Clinical Medicine, a similar statement regarding
47ttimony as a tonic in dyspepsia).”
We surely do not misrepresent Dr. Reith when we say that he proclaims
the formula, Similia Similibus Curantur, to be the chief therapeutic law,
and teaches that the therapeutic doses must be very small (how small, he
says, experience alone can teach us), and that, if large enough to produce
physiological effects it ceases to be curative; which reminds one of the
Homoeopathic doctrine of “medicinal aggravation,” from too large doses.
But, Dr. Reith has further developed these ideas in a practical paper “On
the therapeutic action of Aconite in dilated conditions of the blood vessels.”
(Edinburgh Medical Journal, April, 1868, p. 894). He states that, of most
drugs, the primary action, though intense, is but momentary, and hence
hardly perceptible, while the secondary action is more permanent, and
constitutes those symptoms which are generally recognized as the physiolo-
gical effects of the drugs. Aconite, however, is an example of a small class
of drugs, of which the primary action (stimulus of the sympathetic and
contraction of blood vessels) is prolonged; SO much so, that it is sometimes
regarded as the sole physiological effect of the drug.
“It is easy to see what confusion this has introduced into therapeutics. The double action
of medicines has been disregarded ; in some, the primary, in others, such as Acom ite, the
secondary phenomena have been overlooked. Both these actions, however, must be taken
into account before we can form a correct estimate of the therapeutic value or application
of remedial agents.”
“The chief brunt of Aconite falls on the nerves of the heart. * * * There is a diminu-
tion of blood in, and a decrease of the vital properties of the organ. Its pulsations become
less frequent, and may fall so low as forty per minute. The surface of the body becomes cold;
there are rigors, shiverings, cramps, denoting defective circulation in the system. The general
condition of the patient in this state resembles the collapse of cholera. In fact, it is a true
tollapse, induced by a poison, as much as is that of cholera. The sympathetic system is in a
state of excitement, and the blood vessels in a state of contraction. If a moderate dose of the
poison be taken, the symptoms induced are those of the chilly stage of a fever, a less advanced
• The proper application of Contraria Contrari is belongs to Hygiene, and not to Thera-
peutics See an essay, “IIomoeopathy, the Science of Therapeutics,” American Homoeºpathic
Review, New York, Vol. III., 1868. C. D.
366 Aaſiforial. [April,
degree of collapse. These, then, are the recognized physiological effects of Acomºte on the
circulation. The attention of observers seems to have been arrested at this stage. Any further
phenomena, characteristic of the medicine, appear to have been totally overlooked, or, at
least, considered unworthy of especial notice. Whereas, the truth is, that the subsequent
manifestations of Aconite on the circulation are equally important with, if not more so than,
those Just mentioned. * * * The chilly stage of a fever is succeeded by the febrile stage.
In like manner, the primary symptoms of Acon ite, just detailed, are followed by a correspond-
ing reaction. In proportion to the stimulus exerted upon the cardiac nerves, more or less
paralysis ensues. The blood vessels of the heart are preternaturally dilated, more blood is
sent to its tissue, and there is a consequent increase in its vital properties. The pulsations are
increased in frequency and strength, the circulation is more active, and there is consequently
a febrile condition present. IIad our nomenclature been consistent, this Aconite fever should
have been regarded as the physiological action of the drug, and brought it under the same
category with other medicines, whose secondary symptoms have been regarded as their proper
physiological manifestation. If the duplicate phenomena, however, be admitted, the nomen-
clature is of little importance. Now, these febrile symptoms 4 * are practically ignored.
They are never inentioned as aſſording any indications of its thcrapeutical application '' + +
“The secondal y action of Aconite being attended with dilatation of the cardiac blood vessels
and quickened circulation, it follows that, in accordance with the views formerly expressed,
it should prove more or less remedial in conditions of the system where such dilutat, om ewisted
— the dose, of course, beinſ, 8m/t/l enough to induce only the primary effects. The fell rule state
is that for which Aconito is specially indicated And herein is exemplified the advantage
of recognizing the double propel ties of medicines. Aconite, viewed solely as a depressor of
the heart's action, that is to say, a stimulant of the cardiac plexus, has been strongly recom-
mended by some physicians in various kinds of febrile disorder. But, overlooking the secon-
day action of the drug, and guided only by the primary, thqy have prescribed it on the
principle of, the larger the dose the more powerful the effect. The experience of its use in this
way is very diverse. Sometimes it has succeeded; but it has as often failed, and, in many
cases, dangerous symptoms have occurred. Sir James Simpson says : * * “It is diſficult to
regulate its eſfects, and in many persons it produces an almost dangerous and depressing effect,
even in very small doses.” There can be no doubt that the conſlicting testimony, regarding
Aconite, is in a great measure due to the quantity prescribed. Forgetting the feblile reaction
which takes place, the tendency among observers has been to use gradually increasing doses.
Finding injurious effects produced, * * the medicine was, consequently, alyandoned alto-
gether. It never seems to have struck any one that, by still further diminishing the dose,
more accurate results would have been obtained. On the contrary, the idea has been taken
up, as with many other medicines, that, unless benefit were derived from the doses of the
Pharmacopoeia, it was contra-indicated. Now, I beg to call attention to the following funda-
mental axiom of therapeutics, which has never, so far as I am aware, been stated before. It
is this:
“Medicines, whose recognized physiological action is in reality their secondary manifesta-
tion, when indicated by the pathology as proper remedies for a particular disease, are
unsuitable for, and injurious in that disease, when given so as to develop the physiological
symptoms.” + +
* * “They find that, in febrile cases, even five minims of our tincture, or three of Flem-
ing's, will often cause alarming symptoms. Such a dose would have little effect on a healthy
8wliſect. But, in conformity with that morbid susceptibility which I have repeatedly insisted
upon, in the febrile condition it become excessive. Why, then, not diminish it * This is the
very point where experimenters have failed. It seems singular that, when they found five
minims to depress the heart too much, they did not try four, three, two, or even one. If they
had done so, the value of Aconite would have been, by this time, universally acknowledged.
* * I have found it not necessary to give more than one drop, nor less than a quarter of a
drop. On three occasions I have found even this latter quantity to act too powerfully. * *
It may be given in water, simply ; every half hour, hour, or two hours, according to clºcum-
8tances.”
Let us sce again, by the light of these illustrations, the points which Dr.
Reith seems to claim to have cstablished :
1. The double action of all drugs (excepting such as act chemically on the
1869.] Aditorial. 367
tissues), the first action resulting in contraction of the blood vessels, and the
Second in a corresponding dilatation. And a similar double action of mor-
bific causes. The primary action of both drugs, and morbific causes, is
almost always transient, and in most cases so brief as to be unnoticed, or
imperceptible; while the secondary is more enduring, and constitutes what
are recognized, respectively, as the physiological effects of the drug on the
one hand, and the symptoms of disease on the other.
2. The remedy for a given disease is one, which, acting upon the same
tissue or functions that are affected by the disease, produces, upon the
healthy, enduring, that is, &econdary symptoms, similar to those presented
by the disease; this will be the remedy, provided only the subjoined pre-
caution be observed, viz.:
3. This remedy must be given in so small a dose as shall be insufficient to
produce the secondary symptoms (i.e., playsiological effects) of the drug.
And such a dose must be much smaller than would be sufficient to produce
physiological symptoms on the healthy subject, because,
4. The diseased (paralyzed sympathetic) tissue or function possesses an
unnaturally increased susceptibility to the action of a drug, which would
produce, on the healthy, a similar diseased condition (paralyzed sympa-
thetic of that tissue or function).
5. JIow small the dose must be to produce just enough action, and to stop
short of a mischievous over-action, must be determined by experiment.
We only know at present that it must be far smaller than has been ima-
gined practicable by physicians.
These points cover, as all IIomoeopathists at once perceive, the law :
Similia. Similibus Curamtur, as, indeed, Dr. Reith himself admits; the doc-
trine of the morbid susceptibility of the diseased part to a drug which is
homa!opathic to the morbid state, and the consequent danger and inconveni-
ence of a “medicinal aggravation,” and the necessity of giving a much
smaller dose than would produce symptoms on the healthy; and the maxim
much dwelt upon in our Journals of late years, that the “question of the
dose is an open one,” and must be determined hereafter by an analysis of
accumulated experience.
Dr. Reith claims no originality on the score of the law, Similia Similibus
Curantur; nor did Hahnemann. Both ascribe its first enunciation to
Hippocrates. But this being premised, behold, in the above propositions,
the SCREw which he parades, with elaborate specifications, before the gaze
of his colleagues, and which he claims to be “the first" to have discovered
Not one of them but is “familiar to our ears as household words,” in the
IIomoeopathic literature of the last twenty years.
Hahnemann speaks constantly in the “Organon,” $106, et seq., of the pri-
mary and secondary effects of the drugs, regarding the latter as the reaction
of the organism, and, although the pathologists of his day knew but little
of the sympathetic and its function, as the vaso-motor, and though his
phraseology has, to our ears, a vague and antiquated sound, yet we can not
but recognize in his utterances the same idea that Dr. Reith expresses in
No. 1. Dr. John Fletcher, in his Pathology, expresses himself in the same
sense; and Dr. Clotar Müller, of Leipzig, in an essay, published in “Allge-
} }
368 Aditorial. [April,
meine Homöopatische Zeitung,” XXIX, 49, uses almost the very words of
Dr. Reith, illustrating his theory of the curative process by that of inflam-
mation. IIe shows that inflammation consists of, or depends upon, a kind
of paralysis of the nerves of the capillaries, and affirms that the medicine
cures by stimulating these paralyzed nerves; and he states that it thus
stimulates by its primary action, its 8econdary action being a paralysis of
the nerves, similar to that of inflammation. He then shows that the action
of the medicine is, in this sense, the opposite of the actual diseased condition,
and that, while the law, Similia Similibus Curamtur, is our guide in the
selection of the remedy, it does not necessarily express the action of the
remedy in curing. These views, together with similar reflections of his
own and others, were published by Dr. Dudgeon, of London, in his “Lec-
tures on the Theory and Practice of Homoeopathy,” 1854, and must have
come under Dr. Reith's notice. But for the fact that these Homoeopathists
wrote ten or twenty years before Dr. Reith, it might seem as though they
had copied his expressions.
The necessity of proving drugs upon the healthy, in order to ascertain
their curative sphere of action upon the sick, which Dr. Reith urges with
all the gushing naïveté of an ingenuous discoverer, Hahnemann repeatedly,
and for years, not only enforced by theory, but illustrated by that constant
and long-suffering labor to which we owe the provings of the Materia
Medica puro, and the chronic diseases, without which Homoeopathy would
be but a name.
Of the increased sensibility of the diseased tissue to a drug Homoeopathic
to the discascd condition, and of the consequent necessity of giving an
cxtremely Small dose of a drug, when indicated according to the law,
Stmilia Similibus Curantur, IIahnemann speaks very clearly in the
“Organon,” $ 275 to 284, although he uses the phrases of an obsolete
pathology. The views of his disciples have been collected and published by
Dudgeon, in his Lectures, and must have been seen by Dr. Reith, who
speaks So familiarly of Homoeopathists and their practice, their errors and
their changes of opinion. That the size of the dose can be settled by expe-
rience alone, was the conclusion reached by Hahnemann, who says, “Or-
ganon,” $ 278, “how far the dose of a Homoeopathic remedy, in any given
Case of disease, ought to be reduced, in order to derive from it the best
possible cure — no theoretical conjecture can furnish an answer to this
problem. * * It is by pure experiments alone, and precise observations,
that this object can be attained. It would be absurd to bring forward, as
an objection, the large doses used in ordinary medicine, which are not
applied to the suffering parts themselves, but merely to those not attacked
by the disease. This would be no argument against the minuteness of the
doses which pure experiment has proved to be necessary in Homoeopathic
treatment.”
Finally, as to the axiom which Dr. Reith claims to be the first to state:
“Medicines, whose recognized physiological action is, in reality, their secon-
dary manifestation, when indicated by the pathology as proper remedics for
a particular disease, are unsuitable for, and injurious in, that discase, when
given so as to develop the playsiological Symptoms?”— (although this, as
1869.] Aditorial. 369
from an Allopath, is a great improvement on Christison's direction to push
a remedy until its physiological effects are produced) — we recognize the
same idea in the following passage of Hahnemann's Organon, § 280:
“The doses of all Homoeopathic medicines, without exception, are to be
attenuated to such a degree, that after being introduced into the body, they
shall merely produce an almost insensible aggravation of the disease.” By
all Homoeopathists it is admitted and affirmed, that the dose should be such
as not to produce the “medicinal aggravation,” which is what Dr. Reith
calls “the development of the physiological symptoms.” Considering Dr.
Teith's small experience in the use of drugs, according to the law Similia
Similibus Curantur, and his crude ideas of what constitute the indications
of remedies under that law, his protest against “infinitesimals,” and in favor
of “very small doses,” is almost ludicrous. We refer him to the test to
which he has himself appealed : eaperience, and wish him a long and busy
professional life.
Nor do we care to dwell on the seeming littleness of mind, which could
permit a physician, instead of frankly acknowledging the truth of views
hitherto rejected by his school, to bring them forward as original and novel
— to announce, as his discovery, a power so well known as the Screw 1
Rather let us rejoice that, however ungraciously and awkwardly, a clear-
headed antagonist has acknowledged the truth in medicine, and has
reformed his practice; and let us wish his colleagues everywhere as clear
an insight, and greater manliness.
And when the revolution in the theory and practice of the Allopathic
school, which these writings of Dr. Reith surely presage, shall be in full
tide of accomplishment, and the essential points of Homoeopathic doctrine
shall be universally admitted, and shall be working to their ultimate con-
clusions, impelled by the energy of the then united medical profession —
the law, the morbid susceptibility, the single remedy, the minimum dose —
what will be the position of those “Homoeopaths” who are now so eager to
protest against “Hahnemann's errors”— who compound remedies in their
prescriptions, who would restrict the application of the law, and give doses
with which those recommended by Dr. Reith are almost infinitesimals in
comparison—and all this, to curry favor with the dominant School? Verily
“they do not discern the signs of the times.”
We can not take leave of Dr. Reith without a reference to his practical
remarks upon Aconite. He says:
“1. In the first place, the secondary action of Aconite being analogous to
the febrile state, we infer that it will prove remedial in cases of simple
uncomplicated fever.
“2. * * The dose must be correspondingly small; and, on account of
the eveeeding susceptibility of the paralyzed sympathetic to stimuli, care must
be taken to regulate the dose accordingly.”
“The first proposition excludes Aconite entirely from the domain of spe-
cific fevers (except, perhaps, rheumatic fever * *). I have used it exten-
sively in typhus and enteric [typhoid] fevers, without the least advantage.
* * It is vain to expect any good from it in such cases. * * Belladonna.
is so beneficial that I have not resorted to Aconite when treating erysipelas.
370 Editorial. [April,
J
Mr. Liston spoke highly of Aconite in the last named disease, but his cxam-
ple does not seem to have been followed. [Is not Dr. Reith mistaken 9 Mr.
Liston spoke highly of Belladonna in crysipelas, and we believe he had the
manliness to acknowledge his indebtedness to Dr. Quin, the Homoeopathist,
for the suggestion to use it..] * * Then, again, even in inflammatory
fever, for which it has been highly extolled, and with reason, no impression
will be produced on the symptoms, if there be eatensive local lesion. In such
a case, the medicine acting physiologically on the affected part is the remedy
properly indicated, whether it be Belladonna for meningitis, Antimony for
pneumonia, or Cantharides for nephritis. * * The use of Aconite must,
therefore, be limited to simple fever, without local complication. * *
The true place of Aconite is at the onset of local inflammation, or the con-
gestive stage.”
In an article, entitled “Observations upon Aconite,” published in the
“American Homoeopathic Review,” Vol. VI, 1865, we find the following
remarks: “Aconite produces, so far as we know, almost no localized diseased
conditions. * * It gives evidence of no dyscrasia. Its action bears no
resemblance to that of the poison which produces any of the miasmatic
diseases—such as the exanthemata, or typhus, or intermittent, remittent or
continued fevers. Neither does its action, from beginning to end of a fatal
case of poisoning, resemble the well defined course of any local acute inflam-
mation — as of the brain, heart, lungs, etc. For these reasons Aconite can
never come into requisition, * * for any of the miasmatic fevers, or
dyscratic diseases. * * Aconite can never be the single remedy by which
a patient may be safely carried through a complete course Óf pure, acute
inflammation of any organ or system ; because, in the action of Aconite, that
localization is lacking, which is an essential feature of these diseases. Yet
in all of these pure inflammations there is a period in which Acomºte may
be indicated, and may do a heroic work— the first stage of arterial excite-
ment, * * prior to the stage which is characterized by change of func-
tion, and of tissue, and by local deposit.” It is possible that Dr. Reith may
not have seen this article, but the same views are expressed, and this article
is quoted, by Dr. Richard Hughes, in his “Manual of Pharmacodynamics,”
London, 1867, which must have been in the hands of so well-read a physi-
Cian as Dr. Reith.
And, as we take leave of the subject for the present, let us assure Dr.
Reith that even in his expression of surprise that his colleagues, who found
the ordinary doses of Aconite too dangerous, never thought of making them
smaller, he has been anticipated by IIahnemann. Reith says: “It Secns
singular that, when they found five minims to depress the heart too much,
they did not try four, three, two, or even one. If they had done so, the
value of Aconite would have been, by this time, universally acknowledged.”
Hahnemann (Introduction to Colocynth, Mat. Med. pura, 6, 173, 1827),
after saying that, by reason of the large doscs used, Colocynth had come to
be regardcd as a dangerous remedy, and that, to obviate the danger attend-
ing its use, various corriſſentia had been devised and added to it, which,
however, did not alter the nature of the drug—says: “It is a matter
of wonder that, in the schools of medicine, men seem to have avoided
1869.] Adžāoria/. 37 I
reflection, and that in such circumstances as these the simple, child-like
thought should never have occurred to them, that if heroic drugs, in certain
doses, act too powerfully, this depends less upon the drug than upon the
excessive dose, and that the dose may be diminished as much as may be
necessary; and that such a diminution of the dose, while it leaves the drug
unchanged in its properties, only tones down its strength, making it innoc-
uous and useful, and, therefore, this must be the most natural and suitable
corrigens of all heroic drugs. If a pound of alcohol, drunk at once, can kill
a man, this depends not upon the absolute poisonous nature of alcohol, but
upon the too great dose. Two drops of alcohol would not have harmed the
man. Whereas a drop of strong Sulphuric acid immediately vesicates and
corrodes the spot of the tongue upon which it is placed ; on the other hand,
when diluted with 20,000 or 100,000 drops of water, it affords a mild,
slightly acid liquid. These facts show that the most natural, the simplest
corrigens of all heroic substances is found alone in the dilution and diminu-
tion of the dose, until it becomes useful without being hurtful.”
The above was written soon after the appearance of the papers by Dr.
Reith, on which it is based. Since it was written much “history has becn
made” in Aberdeen, and Dr. Reith's position is not at all what it at that
time appeared to be. Nevertheless, it has seemed well to leave unchanged
what has been written, that there might be on record the criticism of a
distant Homoeopathist, upon papers which Dr. Reith, an Allopathist in
good standing, had read with acceptance before a distinguished Allopathic
Society, and had procured to be published in an Allopathic Medical Journal
of unquestioned orthodoxy, the “Edinburgh Medical Journal.”
The articles which we have reviewed were prepared for, and read to, the
Medico-Chirurgical Society of Aberdeen, were applauded by them, and
unanimously recommended for publication. After publication, they drew
from many eminent physicians of the United Kingdom letters of encourage-
ment, endorsement, and gratulation to Dr. Reith.
It appears that no one detected “the cat in the meal tub,” no one recog-
nized “Homoeopathy’ in these statements of doctrine and method.
But, not long after this, Dr. Reith, in the course of his practice as physi-
cian to the Royal Infirmary of Aberdeen, made a requisition for certain
medicines not comprised in the British Pharmacopoeia — medicines, in fact,
which are popularly known as “Homoeopathic remedies.” This was whis-
pered to his colleagues, and caused an inquiry from them, in answer to
which Dr. Reith frankly stated that he had been, for two years, investigat-
ing Homoeopathy, having been led to it by physiological considerations,
that he had found it efficacious in practice, and that he had stated his views
fully in the papers already published, and to which no objection had been
made on the ground of heresy.
Innocent Dr. Reith ! He had supposed that his evident candor and
sincerity, and moderation, and his abstinence from all use of the offensive
name, would win him a tolerant hearing, and liberty of practice His
colleagues called a meeting of the managers, and demanded the dismissal of
Dr. Reith, as one guilty of medical heresy. The managers demurred, and
37.2 Adžforza/. [April,
finally declined to interpose their authority against liberty of opinion and
action in qualified physicians. The physicians of the Infirmary are elected
and hold office for one year. The subject was adjourned to the annual
meeting. Meanwhile Dr. Reith and Dr. Dyce Brown issued a pamphlet,
entitled “Homoeopathy; its nature and relative value,” etc. In the preface
Dr. Reith says: “So far from seeking a rupture with my brethren, it has
all along been my most anxious desire to keep on friendly terms with them.
Knowing their traditional horror of Homoeopathy, I refrained from using
its “bad name’’ as much as possible (except when I had to condemn its
errors), in order to remove their unfounded prejudices. I explained to them
my views, publicly and privately, met their objections, tried to remove
their difficulties, and assumed a position midway between the old and new
systems, in the hope of helping forward a reconciliation. In this hope I
was encouraged by communications from medical men in all parts of the
country. I conducted every thing in the most free and candid manner.
ALL IN VAIN. Even small doses of regularly authorized medicines are as
offensive to them as Homoeopathy. * * * I have but one charge against
the profession. * * * The one stain on its character, the one blot is its
treatment of Homoeopathy. For this, no excuse can now possibly exist.”
With this protest Dr. Reith leaves the ranks of the dominant school, and
joins the minority of the Homoeopaths; his pamphlet being a clear and
unanswerable argument in favor of Homoeopathy.
At the annual election of officers of the Infirmary, the managers, who are
laymen, proposed to re-elect Dr. Reith with the other officers, and to allow
freedom of practice to each physician. But the other physicians and
surgeons laid before them a document, in which they threatened to resign
their positions in the Infirmary and College, unless Dr. Reith were rejected.
Under pressure of this threatened “strike” the managers yielded, and Dr.
Reith was not re-elected.
A strong feeling of disapprobation, as well of this coercion on the part
of the physicians, as of the pusillanimity of the managers, has been expresseſ,
in the public prints of Great Britain, and it is not unlikely that the estab
lishment of a Homoeopathic hospital, in Aberdeen, may be the issue of thi
dissatisfaction.
It is noteworthy that Dr. Reith's conversion to Homoeopathy was an:
nounced, not by a loud confession of faith, but by a statement of principles
most carefully framed to conciliate opponents, and to spare prejudice, and
that this step was successful. Not until something was done that broughº,
in the name “Homoeopathy,” were suspicion and enmity aroused. Shaks
peare has said: “That which we call a rose, by any other name woul-
smell as sweet,” (and vice versa, of course).
Dr. Reith thought differently, the rose being Homoeopathy, and the olfac-
tories those of Allopathic doctors. The Scquel has justified Dr. Reith, and
not Shakspeare. C. D.
In addition hereto we are happy to inform our readers, that though Dr.
Reith was not re-elected to his position in the Aberdeen Infirmary, means
have been taken to procure WARDS in Said Infirmary for the reception of
1869.] Adžtoria/. 373
patients to be treated Homoeopathically. Furthermore, Dr. Dyce, who
offered a resolution to the Aberdeen Medico-Chirurgical Society for the
expulsion of Drs. Reith and Dyce Brown, withdrew said resolution, with
permission of the Society.
LETTER FROM OUR FRENCH CORRESPONDENT.
FY DR. MOLIN.
WE take pleasure in presenting our readers the following letter from our
French Correspondent, Dr. Molin, with the assurance that this is but the
first of similar favors:
To understand the progress which has been made in Homoeopathy,
it is important to feel, as it is said in common parlance, the public pulse,
and this is what it has seemed good to us to do in this, our first scientific
conference addressed to the readers of your Journal. Permit me first to go
back a little of the fact itself, which is the origin of this inquiry, that the
very special importance which attaches, in Paris, to the opening of a course
upon the doctrines of Hahnemann, at the Salle Gerson, may be better
understood.
With us, medical science is taught by the Faculty of Medicine, its
Professors, its adjuncts (agrégés), certain Professors of l'Ecole Pratique, its
Hospitals, etc., but all under the direction of the Minister, and it may be
said that free instruction does not exist for medicine as it does for the other
sciences. Of late years repeated attempts have been made to obtain, in
default of complete liberty, at least the right to teach what one thinks to be
truth. A Minister with liberal ideas, and convinced that men of science are
not disturbers of the peace, has not only felt that he could readily grant us
this permission, but has even become a patron of this free instruction, by
generously furnishing us with a shelter. Thus we have entrance to the
Salle Gerson, thus named from the street on which it is situated ; it is not
quite the same as having a footing in the Sorbonne, but it, nevertheless,
admits us to one of its precincts; let us hope that this little fish may become a
great one, if God permit it to live.
Up to this time our doctrine has been obliged, every year, to demand
permission to show itself in public; then the professor had to deliver his
course as best he could, for his own interests. Now, this favorable permis-
sion has not only been given us, but more than this, this young science is
permitted to present itself in the famous Free-Lecture Hall. Thus, while
we have hitherto been wanderers and persecuted, behold us now admitted, by
authority, to the same rights with all other sciences. We do not live, as
yet, upon the budget, it is true, but we shall make it appear that, having
faith, we can remove mountains, and that is indeed a terrible mountain,
made up of prejudices; the accumulation of ages.
This will all seem very strange to you, a free people, where every one
has the right to teach what he knows, and what he thinks to be useful; but
374 Aditoria/. [April,
what can we do but learn to be contented, and, with the little granted us,
make the truth, which the Master has bequeathed to us, triumph.
Let us render homage to those who previously endeavored to popularize
Homoeopathy by word of mouth ; to Dr. Léon Simon, Sr., who, from the
first introduction of our doctrine into France, has given courses of lectures
at the Athenaeum; suspended, and then taken up again at different times,
they exerted a certain effect upon people of the world, but made few prose-
lytes among the students; to Dr Tessier, who, at the Hospital, demonstrated
to his pupils, at present the valiant defenders of our doctrine, the value
of the law of similars; finally, to Dr. Jousset, who held conferences at
the Quartier des Écoles, upon the application of Homoeopathic remedies to
diseascs; I should recall here, also, the conferences held by Dr. Imbert-
Gourbeyre, Professor at Clermont Ferrand, in that city, then in the year
following at Nice. You see that the disciples of Hahnemann have not been
asleep; that they have done all that the law permitted, to popularize the
thoughts of the Master. They have been sustained by some friends of
truth, obstinate Seckers. It was these, and the practitioners who every day
gave battle to the enemy at the bed side of the patient, who have prepared
the way for teaching Homoeopathy under the protection of the authorities.
Thus, on the 14th of January last, at the hall of the Free Lectures, a
course upon Homoeopathy was opened. More than four hundred auditors
presented themselves, at the invitation of the Professor, and at last the new
doctrine had a public capable, by its numbers and quality, to represent it
in all its splendor.
That which seems to us of great importance, and most worthy of remark,
was the great number of persons present at the first lecture. When we
compare them with the thirty or forty auditors assembled heretofore at the
Quartier des Ecoles, we could not fail of being proud of the course pursued
in the last twenty years; no one could say that the merit of the Professor,
and his great talent besides, were the cause, or the pretext, of this con-
course. Dr. Léon Simon would not believe this if I said it, and, still more, he
would find that I do not render homage to the oratorical talents of his father,
so remarkable. It was then because the new method had increased, had
disseminated itself every where, that the period of mocking and joking had
passed; one must say that there must be some merit in a science which has
resisted persecution, and the conspiracy of silence, one of the most terrible
arms which envy could employ.
In this first lecture the Professor did all in his power for the purpose of
conciliation. He showcd that this new science was part of the Science of the
past; that it could accept all its present conquests, and had no fear of the
researches of that pleiad of young workers. I shall not analyze this lecture
for you, since it could be but a mere introduction; we found the public all
sympathy, and returning thanks by their applause to the Professor, who
had endeavored to initiate them into a part of Science, which, up to this
day, had becn for them a dead letter.
We trust that M. Léon Simon will be zealously attended, and that he will
succeed, by his teaching, in gaining some new disciples to the ideas of
Hahnemann. This didactic teaching is a great undertaking, but we are
1869.] Adžforza/. 375
convinced that he will conduct it to a favorable issue; the talent will not
fail him, he will not lack ability, since he will have, in the moment of
difficulty, the remembrance of his father to sustain him. We know that it
is an inheritance, attended with great responsibility, for it is no trifle to
equal, I would not dare to say surpass, such a brilliant orator as Léon
Simon was in his prime. But let us be truthful above all things; let us not
say, as certain enthusiasts do, that Hornoeopathy has a chair; for then they
might accuse us of presumption, and of bad faith, and that is only allowed
to constituted authorities, who wish to preserve their positions per fas et
néfas. The truth itself, because it is true, is great enough to prevent the
necessity for any such procedure. We speak frankly; Homoeopathic
medicine has indeed been furnished with the franchises necessary to enable
it to declare its principles theoretically. Of course, reason, and all that it
can produce, are powerful weapons; but who is there among us so rash as
to think that we shall obtain the triumph of our cause by didactic teaching
alone. Let us grant to theoretical teaching, written and spoken, all that it
can effect, but let us not forget that our most brilliant field is the applica-
tion of Hahnemann's admirable discoveries to suffering humanity. As the
master has said, the first duty of the physician is to cure; the unanswer-
able proof of the truth of the law of similitude should be furnished at the
bed side of the patient, and there also only the truth of the law of posology
could demonstrate itself beyond dispute. We may always avail ourselves
of analogy and the grand laws which should be applicable to all the sciences,
to demonstrate the truth of principles which one has to present; but the
field of dispute is immense, and falsehood, as well as truth, finds defenders.
Thus we should turn all our forces towards clinical demonstration ; we
should desire to be put in position to cure by the application of our principles;
we should succeed in establishing, in France, the Hospital Service under
the Homoeopathic method.
You will learn, with pleasure, that there are several Dispensaries in
Paris, and among others, one under the direction of an eminent ecclesiastic,
M. le Curé de St. Laurent; that some Hospitals of the Province are under
the direction of the disciples of Hahnemann (the Hospital of Roubaix, Dr.
Iliagre, Physician); at Lyons, the second city of the Empire, our colleagues,
Emery and Gallavardin, have been fortunate enough to obtain a very
considerable sum, destined by the donor to the foundation of a Homoeopathic
Hospital. We trust to the zeal of our devoted colleagues for assurance that
this will shall be realized as promptly as our beautiful French administra-
tion may permit.
Other attempts in the same direction have been made, by the foundation
of a Hahnemannian fund; at the close of the Congress of Paris, in 1867, and
under the initiative of the celebrated Spanish Doctor Hysern, subscriptions
were received to establish this fund, which shall be applied to obtaining
medical aid as complete as possible. Finally, the Bibliothèque Homa!opathique
has just opened, in its columns, a subscription, which has for its aim also
the foundation of a Hospital.
You see that if we speak, we act also. I will not dwell here upon this
subject, reserving the examination of the question of the French Scientific
376 Faſitorial. [April,
Homoeopathic press for another letter. Here, then, we have demonstrated,
by a prime fact, the constant progress accomplished by our doctrine. Let
us proceed to another order of ideas, which will not appear to you less
intercsting, I am sure.
One of our most distinguished practitioners, former Agrégé at L'Ecole de
Medicine, former Professor at Val-de-Grace, Dr. Marchal de Calvi, wishes,
in his Journal, to open an investigation upon the value of Homoeopathy.
In a very sensible article, and full of humor, having for a title “An appeal
to the people,” he undertakes to revise the judgments delivered against our
doctrine. He demands that each Homoeopath or Allopath shall present his
evidence for or against its condemnation; he engages Homoeopathic physi-
cians to furnish data for experiments readily made in any disease; ho
invites the Allopaths to experiment (preparing the drugs themselves to
avoid every source of error), in the cases indicated by the Homoeopaths,
and then to publish the result of their experiments.
He quotes a fact personal to himself, in which, that which first struck
him was the agreement of two Homoeopathists in the choice of a medicine,
then the rapid cure of the patient under the administration of this agent.
Dr. Jousset, always found in the front rank when battle is to be done for
our doctrine, immediately addressed him several letters, in which he briefly
opens the question; gives the preparation of the drugs; then studies certain
pathological states, specifying, as exactly as possible, the indications which
lead one to choose the remedy; then indicates the remedy, the dose and the
mode of administration. *
These various articles you may read from time to time, reproduced in
our Journal.” I content myself at present by indicating their tenor. This
is yet another fact, then, to add to previous ones, to show even the blind
that the waves rise higher and ever higher — the cry of alarm uttered by M.
Amédée Latour, in L'Union Médicale, a long time ago.
I am convinced that this act, which many persons would have thought
rash on the part of our distinguished confrére, Dr. Marchal de Calvi, will
be very fruitful, for it answers to the wants of the moment. There are but
few at present, who, strong in their ignorance, pronounce, in a Superb
manner, a funeral oration upon the IIomoeopathic doctrine; some of these
physicians, too, have made a soft pillow for their idleness from that which
the old school has taught them, and are very much vexed that any one
should come to awaken them, and show them the necessity of incessant
labor. These are the dealers who must be driven from the temple that the
light may shine. This mission belongs to the Allopathic press, and Dr.
Marchal was better fitted, by his character, than any one else to accomplish
this great work.
We read to-day (January 14th, 1869) the following statement: “During
the month of December, I received a number of the ‘Tribune Médicale,”
which, from many motives, has determined me to become a subscriber to
your Journal; at first it was a matter of fellowship (for I am a pupil of
Val-de-Grace, returned long ago to civil life), as well as the merit of your
* Bulletin de la Sociëte Médicale Homoeopathique de France.
sº Aditorial. 377
publication; another motive, which I hardly dare utter, was the doctrine
of M. Jousset, with the letters which appeared in the ‘Tribune;' and,
finally,” . . . . an observation followed, the whole signed by Dr. Peyrecane
de Leognan. Here we have a poor, honest fellow, whom mauvaise honté
prevents from mentioning Iſomoeopathy, who has to use a circumlocution
to express it, and he conceals himself as if he had been reading some bad
book. Courage, dear confrère, to you, and to all in your case; only dare l
You will not be alone; the Homoeopathists will cover the whole earth, and
you will then be in a good and numerous company.
I come now to speak of thermal, or hydro-mineral, treatment.
The importance which this has gained within a score of years, and the
large place which it occupies, in the treatment of chronic diseases, are well
known. At present, as soon as thermal institutions are opened, patients
demand to be sent there; those in good health go without leave. As regards
the first I make no complaints. Chronic diseases are so tenacious, so
rebellious against drug action, so discouraging, both for the patient and the
physician, that one must rejoice when there is found for them a new mode
of treatment and of cure.
But, if I do not find fault with the use of these mineral waters, I protest,
with all my convictions, against their abuse. Now, what has been done
and seen in their employment to the present time, is their abuse—the
result of erroneous therapeutical principles, and a blind routine. That
which the medicine of contraries, and of large doses, has collected, is unsuc-
cessful treatment, sad mistakes, disastrous reverses; and certainly Homoe-
opathic medicine was well inspired to refuse the perils of such a medication
to its patients.
The first physician who has, I will not say introduced the law of simili-
tude into the thermal therapeutics (this would be difficult), but who has
attacked, combatted, and, in fine, overthrown the method of the Contratria,
and demanded, from the physiological and clinical study of the waters, if not
the absolute law of their action upon the organism, at least the rule of their
employment, this is Dr. Casimir Daumas, consulting physician at the
waters of Vichy. I will dwell a moment upon this word, that I may make
more clear the importance of the service rendered by our confrère, and the
difficulties which he had to encounter.
Of all the thermal springs of France and of Europe, Vichy is that where
patients most do congregate. The alkaline composition of its waters on the
other hand, lends itself most readily to the ideas of the medicine of contra-
ries. One might almost say that they were created with this very thing
expressly in view, for the treatment of chronic diseases, which always, or
nearly always, give birth to morbid secretions, and products which are
acid. You see the antagonism here — acid, alkaline, neutralization what a
triumph for the Contraria Contrariix / Hence it was no longer necessary
to see in human pathology more than one disease — acidity—embracing,
without distinction, all chronic maladies.
And you see, also, how charming it is, “You are acid,” says the physi-
cian, “drink alkalies, and neutralize yourself,” and the patient drinks and
neutralizes himself. “Double the dose,” adds the physician. “Saturate
378 Adžtorial. [April,
yourself,” and the patient triples it, and Saturates himself. . . . . Ten,
twenty, thirty glasses of water a day ! . . . . The result of which is, he
leaves the waters sick of his disease as before, and more cnfeebled, and
sicker in consequence of his Saturation. . . . . I will leave you to reflect
a moment upon this Sad result.
However, Dr. Casimir Daumas, sceking, as we have Said, in the physio-
logical action of the drug, the reason of its therapeutical action, had
remarked that the gouty, who gave themselves up to excessive libations,
could indeed obtain, during a certain time, a remission of the attack, but
that afterwards they were fatally seized by a sudden retrocession of the
disease. And not by an attack of Sanguineous apoplexy, for example, but
by a serous apoplexy.
On the other hand, he had seen articular affections arise 8pontaneously
'under the influence of the Vichy waters, in case of patients who were not at
all disposed to gout, neither by their antecedents, nor by their habits;
neither by their regimen, nor hereditarily. In such cases if sufficed to
suspend the medication, to suppress the attack, which did not return again.
He had seen, moreover, that of all the diseases which came to Vichy, to
Seck help from the waters, chlorosis, anaemia was that which most readily,
and most fully, experienced their Salutary influence, and yet soda is the ,
grand chemical solvenf of the fibrine and the albumen of the blood, and the
waters of Vichy contain five grammes of bi-carbonate of soda to the litre
These are clearly questions of Pathogenesis, the solution of which Dr. C.
Daumas will find in physiological experiments, and which will lead him,
we believe, to adopt the Halinemannian law of similitude. We shall then
have a book which will be the complement of that which our confrère has
already published upon The Mineral Waters of Vichy.
In this work, which you may read, and which has had the honor of being
translated into English, Dr. Daumas makes a clear sweep of the system
admitted and practised in the administration of the waters, and clearly
establishes the question of posology in the Hahnemannian sense. To large
doses he replies by little doses; to ten and twenty glasses he replies by a
third, or a quarter, of a glass, often indeed by spoonfuls; to saturation he
opposes perturbation, danger, death, . . . . (disturbing treatment, he says,
is bad treatment).
It is all a work of destruction, as I have said, and one may readily com-
phehend the astonishment, and the resistance, with which it has been met.
But, nevertheless, the day has dawned ; sooner for the patients than for the
doctors, as need not be asserted. The idea was just and true, and truth has
triumphed.
In pursuance of his object, Dr. Daumas has obtained, and introduced as
drinking cups at Vichy, glasses and measures graduated to grammes, for the
purpose of taking the waters at the spring, and there is not a drinker in
Vichy who does not use them exclusively. The patient does not believe in
84turation ; he wishes to know what, or how much, he drinks; he measures
it, and does well, for he thereby gets well.
1869.] g Adžāorial. 379
To-day, then, the 8mall doses are introduced into practice at the mineral
waters. All the physicians, hostile to Homoeopathy, certainly have not the
Courage to order them, but no one has the courage to condemn them.
Truly, the reform introduced at Vichy, by Dr. C. Daumas, does not meet
all the desiderata of Homoeopathic science; but such as it is, it is of very
great importance, and must answer for a beginning. Our confrère has
advanced with the greatest rapidity; when the water overflows its banks
and invades the land, the first thing necessary is to shut the gates.
And we all, disciples of Hahnemann, is it not upon this very question,
moreover, that we are the most often and most rudely attacked 2 If we
chance to meet a physician of the old School at the bed-side of a patient,
we may disagree upon the choice of the remedy to be given; but where we
always differ, is the question of dose. Here is the arena of the strife.
Let us congratulate ourselves then at Seeing men of talent and conviction,
armed as we are, joining us against our adversaries. At Vichy we have
gained, in Dr. Casimir Daumas, a distinguished confrère, to whom we can
entrust our patients with all security, we who are deprived of the benefit
of the waters, by the certainty of the danger there to be encountered. At
the other Springs the example of Dr. Daumas finds imitators. The Hahme-
mannian idea penetrates, widens, becomes general; let us congratulate
ourselves. Q
While I am in the camp of the Allopathists, considering chronic diseases
especially, let us see if, in another particular, they require nothing of
Hahnemann's doctrine.
Dr. Pidoux, physician at Eaua-bonnes, admits as constitutional typical
maladies, syphilis, scrofula, and arthritis; M. Bazin, Professor at St. Louis,
and forming a School there now, admits to the same group, under the name’
of constitutional maladies, syphilis, scrofula, arthritis, and herpes. To estab-
lish this connection, he takes his stand upon the analogies which these four
diseases present in their symptomatology, their morbid products, their
course, and their terminations. Then the difference between these two
clinical teachers consists in this, that M. Pidoux refers herpes to the dis-
eases which he calls secondary, or intermediate. Another physician, Dr.
Gigot Suard, attacks the morbid unity set forth under the name of arthritis
by these two authors. He reproaches these two physicians with not
demonstrating what is this arthritic constitution, with not giving it more
precise characteristics, and confounding, under this same name, gout and
rheumatism, just at the moment when the School at Paris, and the English
school, are separating, with the evidence in hand, these two diseases, the
one from the other.” And to these words of M. Pidoux— what do the facts
say, observed in the light of the principle which have guided us in the
study of chronic diseases in general? And, first, what do they say when
we consider their hereditary nature? They say that rheumatic patients
have been known to beget the gouty, and vice versa. Thus these two diseases
(rheumatism and gout), so radically distinct in the eyes of our absolute
specificists, are reciprocally metamorphosed into each other I (Annales de
la Société d'hydrologie medicale de Paris). It replies as M. Pidoux does,
and as you all assuredly will. I attach great importance to that which is
38o Adžtorial. [April,
hereditary in the pathogenesis of chronic diseases, and for this reason I shall
address this question in my turn to my honorable colleague. Have you
never observed, in your practice, that a dartrous or herpetic patient, to use
your language, has begotten a gouty or rheumatic one? For my part, I
have often had occasion to observe facts of this kind” (Des affections cutanées,
. . . . Gigot-Suard).
Behold, then, this famous arthritis, so demonstrated by M.M. Bazin and
Pidoux, battered down by M. Gigot-Suard, quite ready to return to the
psora of Hahnemann, referring that famous mother of diseases to herpes, a
word created to replace that recommended by Hahnemann. Thus we shall
come back, then, to herpes, Syphilis, and Scrofula, as constitutional diseases;
the sycosis of Hahnemann will remain without.
From these divergencies it seems to me that these different authors are
still far from understanding each other, and that which is so perfectly
demonstrated for some, is quite obscure for others. It would then have
been well not to have ridiculed too much the origin to which our master
attributed chronic diseases, since they need to cultivate the same field. He
was in the right way; all modern labors demonstrate that names change;
that the generative principles seem to be ternary, or quaternary. I would
venture even to think, if I might be allowed a part in the discussion, that
the origin is but one, and constitutes the predisposition ; that all which
follows is a consequence of that predisposition influenced by special modifi-
cations. I desire no better proof of this, than that view of one of these
physicians, speaking of one of these entities, the most distinctly defined, and
which seems the most evident. “This character of the inoculation of
syphilis is so striking, that it has led authors to consider this disease as
>consisting, so to speak, quite entirely in the syphilitic virus, in the specific
cause. However, we must not exaggerate the importance of this latter, and
lose sight of the totality of the question. Now, certain persons are refrac-
tory to the syphilitic virus, even when they are, experimentally inoculated
with it; moreover, nothing is found to explain the different forms which
the disease may take, which is sometimes benign, and at others malignant,
In the malignant forms, as is well known, we have observed neither
lymphatism, nor a scrofulous, nor any other constitution, nor physiological
taint or cachexia, which might permit us to explain the gravity of these
accidents” (Bazin-Leçons). If it is so difficult to elucidate this grave
question, in a discase which seems to lend itself so readily for this pur-
pose, let us be modest Let us labor; let us seek the truth, but let us not
ridicule ideas advanced by a man of genius.
This last extract I quote for you from the Journal of Dr. Marchal de Calvi,
who is, in my opinion, one of the greatest thinkers in the medical world.
“On the general pruritus of pregnancy, cured by tobacco smoke. Madame
W–, essentially nervous, becoming pregnant a few months after mar-
riage, experienced, during the first weeks of her pregnancy, besides the
usual disturbances of digestion, an insupportable itching over the whole
surface of the body. The skin presented every appearance of the most
perfect health, but the itching was such as to provoke an extreme agitation,
and real nervous spasms. During several weeks they used externally the
1869.] Aditorial. 381
vapor of camphor, narcotic baths, simple baths, alkaline baths, frictions
with Laudanum, camphorated pomade, washing with a solution of Boraa: ;
internally, alkalies, Hahnemann's mercurius solubilis, the most varied anti-
spasmodics; all was in vain. At the seventh month, however, baths, with
a decoction of walnut leaves, afforded a little momentary relief. About this
time, an intense pyrosis appeared, which also resisted the most various
means. The insomnia persisted, and her strength began to ſail, when a
dental neuralgia supervened. Her husband, a great smoker, advised his
wife to try smoking, and this means, so simple, cured at once the neuralgia,
the pyrosis, and this general itching, which had lasted for five months.
She smoked a segar every evening; her sleep returned, etc. Unhappily,
she experienced a fright at eight months and a half, which brought on her
accouchement. She became pregnant again fourteen months after, and at
the fourth month was taken again with the itchings, but they were less
violent and less extensive than before ; always without the least eruption.
Having a great repugnance for tobacco, she did not wish to smoke, and
tried various remedies without success; towards the fifth month the pyrosis
re-appeared with great intensity, and Madame W. determined to resort to
the segar again, which immediately quieted the pyrosis and the pruritus.
Without appreciable cause, this time her accouchement took place at seven
months and a half. The child lived. (This observation is rigorously exact,
though necessarily concise.)
The sedative effects of the decoction of tobacco are well known in certain
cases of pruriginous affections of the skin; but never, to my knowledge,
have similar effects been observed from smoking tobacco. We may observe,
moreover, that it was for the purpose of trying to assuage a dental neu-
ralgia, and not with the intention of quieting the itching, that the husband
induced his wife to smoke; so that the cure was doubly the effect of chance.
The tobacco smoke caused the pyrosis, the neuralgia, and the pruritus, to
cease at once; observe this well; at once — immediately How much of
the principle of the tobacco could have entered into the economy, to pro-
duce, and to explain, an effect So sudden, and so complete 2 Let us not lose
sight of the fact, that the effect was as prompt, and as complete the second
time; that, consequently, it would be unfair to ascribe it to chance, which
is the great argument of the incredulous in such cases. And yet, one would
deny a priori, as impossible, or incomprehensible, the action of infinitesimal
doses Come, now, say that you do not understand it ; there are s many
things that you do not understand l but do not deny facts.
The tobacco, in the case of M. Gros, could not have acted but on the
nervous system. Does it result from this, that there was nothing else but
an action of the nervous system to produce the pyrosis and the pruritus?
(I say nothing of the neuralgia, which may be explained by diseased teeth.)
That is not my opinion. There existed probably a herpetic diathesis, led
to the point of manifesting itself by the nervous action, which, in its turn,
was excited by sympathy emanating from the gravid uterus. Suppress a
link of the chain (here the nervous action, from the effect of tobacco), and
there is no longer any chain ; the effect ceases.
But one may say, how can we understand that the perverted nervous
382 Adžtoria/. [April,
action could lead the herpetic diathesis to the point of manifesting itself?
Probably by an actual excess of acidity. Suppose a man under treatment
at Vichy for some time, and having his urinc neutral, or even alkaline; the
urine is tested in the morning; he receives bad news, which moves him
deeply, and, a few moments after, his urine is found to be acid. Evidently,
it is the nervous action which has determined this phenomenon. One may
say that it is by acting upon the secretory organs, the kidneys, as in the
entrance of the milk, the moral influence, that is, the nervous, acts upon the
breasts. Iłut, since the materials of the secretion are in the blood, why not
admit that the nervous action exerts itself upon the blood, through the
medium of the internal membrane of the vessels? Moreover, here is
another example: Our confrère, Dr. Amadée Latour, whose most noble
title is, that he has so powerfully contributed to establish the unification
and the solidarity of the medical corps in our country, was attacked, soon
after the first medical congress, with a purpura haemorrhagica, which
Seriously compromised his life. He had performed an amount of intel-
lectual labor which seemed to surpass the measure of human strength ; all
the other conditions of his life remained the same. The nervous, or more
precisely the cerebro-intellectual, action had been exerted to the very utmost,
and there was no other explanation possible of the alteration which had
taken place in the composition of the blood. I saw him at this period, a
martyr to his devotion to the interests of the corporation, and I had no
other idea. There is, then, an action of the nervous system upon the com-
position of the humors. In the case of M. Gros, the nervous action
per verted by uterine sympathy (subsequently rectified by the tobacco),
would have had the effect to have added an acid co-efficient to the pre-
existent uro-herpetic diathesis, whence the pruritus and pyrosis; the pyrosis,
a phenomenon continually acid in itself. Finally, I speak conditionally; .
in such a matter no one would be justifica to speak affirmatively.
The editor of the “Annales de Dermatologie et de Syphiligraphie’ has
made the following remark regarding this case: “Has the benefit (of the
tobacco) been without its corresponding disadvantage 2 Did not the nerv-
ous fluxion, suddenly turned back from the periphery, exercise upon the
general health Some injurious influence? Let us observe, that each time
the normal course of the pregnancy was interrupted, and the second time
without any cause capable of explaining it.” That judicious remark is
equally applicable in the supposition of a diathesis.
Be that as it may, we have henceforth an indication, to recur, in case
of certain accidents of pregnancy, for example, irrepressible vomitings, to
this remedy which has succeeded so marvelously in this case just quoted.
I know a fashionable lady, every way very distinguished, whose manners
were most elegant, and she particularly nice in her person ; very tasty, as we
commonly say ; and who, in her first pregnancy, after having seen a mason
Smoke, who was at work on a house opposite her apartment, was taken, to
the great surprise and scandal of her friends, with an irresistible desire to
smoke a pipe. It was necessary to procure her the required implement,
and permit her to smoke. She was delivered, in the midst of the greatest
dangers of a hydrocephalic child, which had been dead for several days. I
1869.] Aditorial. 383
do not establish any relation between the aberration of the mother and the
disease of the child, and, if I cite the fact, it is not on account of any relation
it has to that of M. Gros, but simply because the occasion to present it
offered itself”—Marchal (de Calvi), “Tribune Medicale,” 31 Janvier, 1869.
Do you think that any one could say more and better? I do not, and,
therefore, I have not been willing to omit a word.
I conclude here, and think that I have demonstrated the progress made
by our doctrine in France; in the official world, by the opening of the
course at the Salle Gerson; in the medical world, by the admission of atten-
uated, some even say, infinitesimal doses, from researches into typical
maladies, and the sources to which we refer them. . . . . I do not speak
of pure experimentation, nor of the law of Similia; many make use of these
two laws without avowing it.
Truth progresses, and I see the day near at hand when all physicians will
be Homoeopathists of yesterday, though they were so only in petto.
L. MoLIN, D.M.P.,
General Secretary of the Homatopathic Medical Society of France.
OBS ZTE 7 RACS, AAWD DISAE ASAES OF WOMEN AWD
CA/ZZ ZOA’AºAV.
By R. LUDLAM, M.D., CHICAGO, ILL.
POST-IDIPHTHERITIC PARALYSIS.
AT a recent meeting of the Cook County (Ill.) Medical Society, the subject
of paralysis, as a sequel to diphtheria, was discussed at some length. Prof.
Bacmeister said, that he had not failed in a single instance to procure speedy
and permanent relief by the use of Causticum 30th.
Prof. Allen had been equally successful with drop doses of the mother
tincture of Gelseminum, repeated thrice daily.
THE DELIVERY OF THE PLACENTA IN ABORTION.
THE czcellent paper upon this subject, contained in the two last issues of
this Journal, has brought us many flattering letters of approval from all
quarters. Among them is one from our friend, Mrs. E. G. Cook, M.D.,
of Buffalo, who writes: “In reading your translation on the Delivery
of the Placenta in Abortion, I felt desirous that the profession should know
a very simple means of removing a retained placenta, whether in abortion
or at full term. We have used it for many years, and have never failed in
producing the desired result. Take a pint of tepid water, add half an ounce
of Tincture of Lobelia, and a pinch of pulverized Capsicum. This mixture
is to be thrown into the rectum, and retained as long as possible. If the
placenta does not pass when the bowels are moved, wait a few hours,
perhaps twenty-four (according to circumstances), and repeat. I remember
384 Aditoria/. [April,
once only of having to use it a Second time. The Capsicum does not irri-
tate, as you may suppose, but prevents flooding, and many times ‘works
like a charm,’”
Dr. Bacmeister places great confidence upon Sabina in case of retained
placcnta.
TRILLIN IN PLACENTA PRAEWIA.
IN his thesis presented to Hahnemann Medical College, in February last,
Dr. Chas. L. Misick reports an interesting case of placenta praevia. At the
Seventh month the patient was seized, while sleeping, with profuse haemor-
rhage, without labor pains. Sixteen days later it recurred, the os being
but slightly dilated. Eighteen days after it returned once more, and very
profusely. At the end of another week (forty-one days after the first
attack) it came on again. The pains were slight but regular, and the os was
dilated to the size of a quarter of a dollar. Through it the Doctor recog-
nized the placenta, “centre for centre.” An egg-shaped bit of compressed
Sponge, Smeared with Belladonna cerate, was then introduced into
the cervix, and the latter thereby considerably dilated. The flow was
arrested, and the pains increased, but he was obliged to give ten grains of
8ecale Cornut., in order to make them more efficient. The head followed the
placenta into the inferior strait. The placenta was removed, the cord
ligated, and, with two or three more pains, the child was born. Both the
mother and child did well.
The treatment in the interval of the attacks of haemorrhage consisted in
the use of Trillin, keeping the hips raised, and the patient always in the
horizontal posture, cold cloths over the vulva during the paroxysm, and
the taking of acidulated drinks,
NEW BOOKS, JOURNALS, ETC.
AMONG recent issues in our department we find, A Treatise on the Diseases
of Infoney and Childhood, by J. Lewis Smith, M.D., Curator to the Nursery
and Child's Hospital, New York, etc., etc. Henry C. Lea, Philad'a, 1869.
Diseases of Children, ; A Clinical Treatise based on Lectures delivered at the
Blospital for Sick Children, London. By Thos. Hillier, M.D., etc., etc.
Philadelphia: Lindsay & Blakiston, 1868.
On the Signs and Diseases of Pregnancy. By Thos. Hawks Tanner, M.D.,
etc. Philadelphia: Henry C. Lea, 1868.
Vesico-Vaginal Fistula, from Parturition and other causes ; with cases of
I?ecto-Waffinal Fistula. By Thos. Addis Emmet, M.D., etc. New York:
Wm. Wood & Co., 1868.
A late number of the “Western Homoeopathy Observer,” announces
that Dr. T. G. Comstock, of St. Louis, Mo., has given birth to a new
Obstetrical Forceps — no body better able to do it—for further particulars
we refer to the journal aforesaid.
CA/A2M/STR 2 AAV/O PA 12S/CA/C SC/ZAVCA2.
BY F. A. LORD, M.D., CHICAGO, ILL.
THE PROSPECT.
DR. ODLING, the distinguished Chemist, says of the three great classes of
alimentary substances, the production of the oleaginous is now quite within
his reach; the Saccharine almost within it; and the albuminous only still
far beyond it. There is reason to hope that even this may be attained.
The efforts of chemists and physiologists quite generally seem to be bent on
exploration of vital phenomena. Does any one suppose that the advance
in Science, bearing on this subject, will be less marked for the next twenty
or forty years, than during a past similar period? Nor is it mere presump-
tion — this determined persistence in the attempt to penetrate the mystery
of organic changes. See what has already been accomplished in this,
and in other fields of investigation; reflect upon the heaven-implanted
instinct, which ever cries out for more knowledge of self and the universe;
think of the infinite ocean beyond, on whose shore as yet have been
gathered a few pebbles only; and then, if you can, dare to fix a limit to the
attainment of the human intellect in its comprehension of natural phe-
nomena
Says Sir David Brewster, “the being of a day has pierced backwards into
primaeval time, deciphering its subterranean monuments, and inditing its
chronicle of countless ages. In the rugged court and shattered pavement
of our globe, he has detected those gigantic forces by which our seas and
continents have changed places; by which our mountain ranges have
emerged from the bed of the ocean; by which the gold and silver, the coal
and the iron, and the lime, have been thrown into the hands of man as
materials of civilization, and by which mighty cycles of animal and vege-
table life have been embalmed and entombed. * * * He has ascended
the Empyrean, and, by steps of physical research, has reached the visible
boundaries of the universe, and has scanned, with eagle-eye, the mighty
creations in the bosom of space. He has marched, intellectually, over the
mosaics of the sidereal systems, and has followed the adventurous Phaeton
in a chariot which can not be overturned. * * Ideas like these, when
first presented to a mind thirsting for knowledge, are apt to disturb its
equilibrium, and unsettle its convictions. Should this be the mental con-
dition of any one of you, be not alarmed for its result; for this species of
scepticism is the infant condition of the uncurbed and generous intellect.
There can be no convictions where there have been no perplexities and
doubts; and that faith which comes in the train of early scepticism will
finally rest upon an immovable foundation.”
The following, from “Marshall's Outlines,” the latest and most complete
work on human and comparative physiology, will serve to give to those
who have not carefully watched the progress of chemistry, some idea of the
386 Adžforza/. [April,
tendency of late advances in this science, and their bearing upon physiology,
and the great problem of LIFE :
“Until comparatively recent times, a broad distinction was supposed to
exist between all organic chemical compounds, or the substances immedi-
ately derived from their decomposition, and purely inorganic chemical
substances; the former being believed to be alone producible by vital
actions. But the distinction has, in regard to many substances at least, been
completely eſſaced by the discoveries of Wöhler, and more especially by the
labors of Berthelot, and others. The former chemist first showcd that urea.
is identical with Cyanate of Ammonia, which can be artificially produced,
and hence is named artificial urea. Ammonia, formerly supposed to be
producible only from the decomposition of previously organized matter,
can now be obtained from inorganic materials, by first making carbon and
nitrogen unite artificially, under the influence of Carbonate of Potash, to
form Cyanogen (in Cyanide of Potassium), which, decomposing with water,
yields Ammonia. Again, tartaric and oxalic, and some other organic acids,
and even alcohol, have been made artificially by a series of synthetic steps,
without the intervention of any vital process, or the employment of any
organic substance, or the product of any previous vital action. Thus
Acetylene (C2 H2) is formed by electric sparks passed from carbon points
through hydrogen gas; this Acetylene is made to combine with Copper, and
then, when subjected further to the action of nascent hydrogen, produces
JEthylene (C2 II.4); the Ethylene, united with Sulphuric Acid, forms a com-
pound (C2 H4 SO4), which, when diluted with water and distilled, gives off
Alcohol (C2 H4 O). It would, therefore, secn possible that other and higher
so-called organic compounds, such as sugar, quinine, and even albumen,
may hereafter be artificially produced from inorganic materials only. These
researches already suffice to show that the synthetic actions, by which
plants build up organic substances from inorganic elements, are similar in
nature to those which have been devised by man ; and that, accordingly,
the chemical molecular attractions employed, or Operating in each, are
identical. So, also, the analytic, or decomposing processes of the chemist,
are paralleled in the laboratory of the living organic world; for sugar in
solution, at certain temperatures, under the influence of the yeast fungus,
Torula cerevisiae (supposed to be one form of the Penecillium glaucum),
produces alcohol; at lower temperatures, under the action of the vinegar
plant, mother, or Mycoderma aceti (said to be another form of Penecillium
glaucum), it yields Acetic acid; and in the presence of Oidium lactis (like-
wise referred to the same fungus), lactic acid.”
“These facts, moreover, furnish proof of the identity of the chemical
force acting in the organic world, and that which is artificially set in
operation by man.”
THE CAUSE OF AGUE.
The Boston Medical and Surgical Journal, of January 14th, contains an
interesting communication from Dr. H. W. Harkness, of Sacramento, Cal.,
on the subject of the cause of intermittent fever, in which he arrives at
conclusions quite different from those of Prof. Salisbury.
1869.] Faliforial. 387
Dr. H. has occupied his leisure hours for several years, in the investiga-
tion of vegetable histology. For six years past he has been familiar with
the phenomena presented by the Palmella, having had his attention speci-
ally called to this plant, by the motile condition of its cells, simulating
animal organisms. Since the publication of Dr. Salisbury's ague theory,
three years ago, he has very carefully noted the characteristics of this
plant, the most curious and interesting varieties of which are found in great
abundance in his immediate neighborhood.
Dr. Harkness argues, in the first place, in regard to Cryptogamic spores
in general, that there is no evidence that they rise in the damp, cool air
of the night, and remain suspended at a certain height, to fall again as soon
as the sun has risen. On the contrary, it is when desiccated by the sun,
during the day, that they rise from their bed, and, instead of remaining at
certain altitudes, regardless of atmospheric currents, are wafted away by the
winds to remotest distances, their tendency to return to the earth being
greatest when they have again imbibed moisture from the damp night air.
From the very nature of these spores, light as air, and invisible to the
unaided eye, they arc not confined to any particular localities, but may be
found, whenever sought for, in all parts of the world.
The Palmella is no exception in this respect. It has been found on the
highest summits of the Alps, among the icebergs of the Northern Ocean,
and the mariner, far out in the Indian Ocean, may find them entangled in
his sails, brought thither by the trade-winds from the distant islands of
Java and Borneo. If it were true, as Dr. Salisbury believes, that a single
spore is capable of producing myriads in the human system, in a short
time, from this universal distribution none could escape malarial infection,
whether residing upon high or low grounds, or even navigating the open
S08.
Again, Dr. Salisbury's theory is directly opposed to the fact, long known
to those living in the vicinity of Sacramento, that residence in the centre
of the great malarial marshes is healthier than near their borders. Dr. H.
accounts for this by the presence of sufficient water, at and near the central
portions of the marshes, to maintain a cool temperature of the earth, thus
preventing putrefactive fermentation, which he regards as the cause of ague.
Near the borders of the marshes the water, being more shallow, allows the
earth to become thoroughly heated during the day, furnishing just the
condition for rapid decay and fermentation of the vegetable matter. Hence
arise exhalations of volatile principles, which poison the air of the shore-
line, and, conveyed to the plains beyond, produce there likewise the most
malignant fevers, till, by admixture of pure air, they lose their power for
further mischief.
The appearance of Palmella spores in the urine, is accounted for by their
development in this fluid subsequent to its evacuation, those already in the
vessel, or furnished by the surrounding atmosphere, finding in the urine
of fever patients just the conditions requisite for their rapid growth and
multiplication. So with the saliva; during both day and night the spores
of various cryptogams are constantly collecting, and may be found in the
expectoration.
388 Aditorial. [April,
In the cases of ague, mentioned by Dr. Salisbury, which were produced
in two men, by placing boxes of malarious earth in the open windows of
their sleeping apartment, Dr. Harkness thinks the result would have been
the same, had the boxes been covered by some material capable of prevent-
ing the escape of the spores, while freely allowing that of “the noxious
emanations from the damp and fermenting soil.”
While making microscopic examinations of various samples of Soil from
ague districts, with a view of preparing this paper, the Doctor had three
distinct paroxysms of ague, and was enabled to complete his manuscripts
only by the daily use of Quinine. This might seem to favor Dr. Salisbury's
theory, were it not for the fact that this was not the only occasion on which
the investigator paid this penalty for his microscopic zeal. In his investiga-
tions of fresh-water algae, it was his habit to keep his specimens in a vessel
of water, examining them from time to time till decomposition had progressed
So far as to render a new supply necessary. “Unless using prophylactics,
he has never conducted such experiments without suffering from ague.”
One other interesting observation is cited, to show that ague is caused by
exhalations from decaying vegetable matter, and not by living organisms
taken into the system, to wit: It was at one time a fashionable employ-
ment among the ladics of Sacramento, to prepare skeleton leaves, the pro-
cess being as follows: A quantity of leaves was collected, covered with
water, and exposed upon the roof to the rays of the sun. After a few weeks
the leaves are found in a nearly decayed condition. They are then taken
out of the vessel, the leaf-cuticle easily stripped away with the fingers, and
the endochrome removed with abundant washing, leaving nothing but the
frame-work behind. The heat of the Sun, in these cases, is too great to allow
of cryptogamic growth in the shallow vessels employed; yet the Doctor did
not meet with a single (or married ?) lady who had been engaged in this
Occupation, who did not have ague.
That emanations from flowering plants sometimes produce disease is no
evidence that cryptogamic spores may do the same. There is no analogy
between the latter, which are independent organisms, and the volatile
exhalations of plants. Neither is it true that the exhalations from certain
plants are more poisonous during the flowering period than at other times;
or that, at this time, the air is loaded with pollen-grains. Were this the
case it would be impossible to preserve varieties, and the farmer who plants
one kind of corn would harvest a mixture of all.
In conclusion, Dr. H. thinks that we must still look to the chemist for the
discovery of the real cause of ague.
It would not be difficult to raise objections to some of the arguments of
Dr. Harkness; yet they are worthy of careful consideration. Much good
must eventually result from agitation of the important subject of the causes
of disease, and we are justly indebted, to every careful observer, and inde-
pendent thinker, who favors us with the results of his labors in this inter-
esting field.
“WIIAT IS LIFE 2'' Is it “but a vapor ?” It is to be hoped that no one
will fail to read, and to read carefully, Article No. 2, of Prof. Gatchell, on
1869.] Adžāorial. 389
“Force, and its relations to Life,” etc. In the first of the series the author
attempted, and we think successfully accomplished, a clear and definite
statement of the relation of the atomic forces of matter to the life of an
organism. Life was defined, physically, as “the sum of the powers of the
various atoms that centre into the composition of the body.” In the pre-
sent number, the more difficult task is attempted, of giving a precise
physiological definition of life; in other words, if we understand him, the
Professor undertakes to tell us in what life essentially consists, viewed in a
strictly physiological aspect. This is no Small undertaking, surely. No
one hitherto, as far as we are aware, has deemed it possible to give such a
definition. Certainly no one has attempted it in any scientific writing. If
the Professor shall succeed in this bold and (considering the present state
of science) mentally Herculean task, he must stand acknowledged among
the greatest scientific thinkers the world has ever produced. If he has
failed, let his errors be pointed out. We hope the man who has brains
enough to expose the fallacy, and to successfully controvert the position
taken by Prof. G., will speedily set about it If he is to be found in our
own school, so much the better for us; if not, we will believe him, speaking
the truth logically and sensibly, just as soon.
As for ourselves, we have no hesitation in declaring our belief in the
soundness of Prof. G.'s conclusions, as regards vital phenomena. We think
he has simply anticipated a doctrine, which, in all essential features, will be
universally received science, a few years hence. But whether we agree or
disagree on this point; whether we are prepared to appreciate the full force
of his argument, or not, all must agree that herein is rich food for thought.
Will the profession take it up, and digest, and profit by it now, or must it
remain neglected until a clearer mental atmosphere, and fuller scientific light
shall furnish the conditions for its thorough appreciation ?
MA 7'Aº R/A MAE ZO/CA.
By C. DUNHAM, M.D., NEw York.
Thallium.— Dr. Marmé, of Göttingen, investigating the physiological
action of Thallium and Cadmium, reports the symptoms produced by
repeated small doses (% millegramme), as follows: Nausea, vomiting, loss
of appetite, ptyalism, emaciation, pains in the intestinal canal, diarrhoea,
and even bloody stools, respiration slow and difficult, diminished frequency
of pulse; farther: anomalies of motion, trembling and un-co-ordinated chorea-
like movements, which often appear even before the appetite is involved;
very frequent conjunctivitis, with abundant production of mucus (perhaps
also disturbance of vision).
The local action is manifested as hyperamia, swelling and excessive
secretion, especially on application to the conjunctiva. In poisoning with
large doses, there are, post mortem, swelling and ecchymosis on the gastro-
intestinal mucous membrane; less in the subcutaneous connective tissue,
390 Aditorial. [April,
buccal mucous membranes, and serous membranes. Post mortem, we find,
as signs of remote action, of Small haemorrhages, and pneumonic infiltrations
of the lungs, hyperamia of the abdominal vessels, enteritis, great increase
of liquor pericardii, epicardiac haemorrhages, but never fatty degeneration
of muscle or glands.
Thallium compounds, when absorbed, are discovered in all the organs.
The elimination by the urine continues for three weeks after the poison has
ceased to be taken. With the spectroscope, Marmé easily recognized the
Tºwntºwn woºth part of a gramme of Sulphate of Thallium in 100 Cem. of
urine.
Cadmium. — Marmé states the physiological symptoms of Cadmium, as
follows: The local effect of small doses, introduced into the stomach, is
vomiting; of poisonous doses, violent evacuations, up and down, and gastro-
enteritis from the catarrhal to the ulcerative form, but no perforation.
The remote effects are: vertigo, vomiting, diarrhoea, circulation and respi-
ration retarded, failure of strength, loss of consciousness, spasms which,
however, do not precede death, in all cases. The heart's action continues
longer than respiration; and the peristaltic action still longer.
Long continued administration of small doses leads to chronic poisoning
(disturbance of digestion, increasing emaciation), and to death. Post mortem,
are found developed gastro-enteritis, not constant sub-pleural haemorrhages,
and consolidations of lung, sometimes fatty liver and heart, and diffuse
nephritis.
Arsenical Poisoning. — A man, forty years old, who had scabies, after
taking the soap-cure, applied, of his own accord, a concentrated solution of
Arsenious acid in water (prepared by boiling). He washed the most of his
body with it. After a few hours, appeared upon those parts of the body
that had been thus washed, a freely-exuding eczema, upon which subse-
quently appeared several large blisters, quite like those caused by a burn ;
then came vomiting and diarrhoea, with pains in the abdomen, violet cardi-
algia, palpitation, head-ache, xanthopsia, abundant flow of Saliva, having a
garlic taste, and inflammatory Swelling of the tongue. Pulse 110, soft.
The fifth day, he died quietly. No autopsy allowed. Neither the gastric,
nor the cerebral symptoms were So intense as to account for death — which
the reporter ascribed to the skin affection, and explained just as similar
cases, resulting from extensive burns, are explained. — Prof. Warucke
(Copenhagen).
MYS CAE ZZAME O ÚS.
eºsºmºsºmsº
ALLOPATHIC STATISTICS.
WE publish the following statistical summary, “without note or comment.”
Nothing could be said that could increase its significant bearing upon the
condition of therapeutics in the “dominant School.”
1869.] Aditorial. 391
Substance of a report by Dr. Besnier, to the Société Médicale des Hopi-
taux, Paris, January 10th, 1868, on “The Prevailing Diseases.” (L'Union
Médicale, January 14th, 1868.)
Phthisis pulmonalis occupies, as usual, the first rank. Of 903 consump-
tives in the Paris hospitals, during the months of November and December,
1867, 477 died, or 52.82 per cent. This mortality is not exceptionally large.
It corresponds to that of the last half of 1867. During the preceding year,
1866, of a total of 4,740 consumptives treated in the Paris hospitals, 2,440 died,
more than one-half (51.47 per cent.); whereas, during the cholera epidemic
of the same year, of 4,970 sick, only 1,679 died (33.78 per cent).
Far from diminishing, as year after year witnesses the most incontestable
progress in hygiene and therapeutics [!], this mortality of phthisis pulmo-
nalis seems to increase, at least if we may judge from our personal impres-
sions, and from the documents already published in the “Statistique Médicale
des Hopitaua de Paris,” by M. Husson. Thus, in 1861, of 4,791 consump-
tives, 1,786 died (36.02 per cent.) In 1862, of 5,154 consumptives, 2,079 died
(40.33 per cent.) An increasing mortality this, but far inferior to that of
1866, which reached 51.47 per cent.
The following table, prepared from the “Statistique,” enables us to see, at
a glance, the relation of the mortality by phthisis pulmonalis to the general
mortality in the Paris hospitals during 1861 and 1862:
1861. 1862.
Mortality by Phthisis pulmonalis, te º . 36.02 per ct. 40.33 per ct.
{{ diseases of apparatus of circulation, 33.27 “ 35.37 “
{{ “ of annexes of digestive tube, 27.04 “ 23.03 “
{{ {{ of Respiratory organs, . 25.97 “ 27.14 “
64 66 of Genito-urinary, . . 24.30 “ 27.84 “
46 64 of Nervous system, e 15.00 “ 14.03 “
{{ Fevers, . tº e º º . 11.18 “ 11.60 “
{{ Skin diseases, . & © e 6.68 “ 7.78 “
(£ diseases of primae viae, . . . 6.26 “ 5.48 “
{{ Poisonings, . te º tº e 5.78 “ 5.24 “
In Paris, the average mortality being 50,000 per annum, we may reckon
about 8,000 deaths from phthisis pulmonalis, or about one-sixth of the total
mortality.
Next after phthisis, in the scale of mortality, comes pneumonia, with
regard to which an illusion seems to exist in the minds of some practitioners,
as remarked by Grisolle, who does not entertain the favorable prognosis
of pneumonia which some optimists express (Traité de Méd. prat., 1864, p.
541). For the month of November, 1867, of 126 patients with pneumonia,
in the general hospitals of Paris, 44 died (34.92 per cent.); and, of 151 in
December, 60 died (39.07 per cent.) In 1866, of 2,009 pneumonia patients,
651 died (32.40 per cent.); and, in 1867, of 1,970 patients, 704 died (35.63
per cent.); whereas, in 1861 and 1862, the average mortality from pneu-
monia was 28.57 per cent. Allowing for every possible error, M. Grisolle
states the average mortality of pneumonia, in the most favorable view, as
certainly not less than 20 to 25 per cent.
392 Faſztoria/. [April,
“What, then,” says M. Besnier, “are we to think of the statistics fur-
mished by authors (notably not French) who bring, in favor of such or such
a treatment, figures like those of Dietl, for example, who, treating pneu-
monia by pure expectation, lost only 7.4 per cent.— except to wonder, with
M. Grisolle, that such propositions have been accepted in France, not only
without opposition, but even with a degree of confidence which would not
have been accorded to a physician of our own country, who should have
expressed opinions so contrary to the teachings of traditions? And what
of the report of Bennet, who, treating pneumonia only by tonic medication,
professes a mortality of only 3.10 per cent. There is here, it seems to me, a
subject worthy of most serious discussion 1"
Pneumonia is much more fatal in women than in men, and so are all
affections of the respiratory organs, which is the more remarkable, because,
in the Paris hospitals, the general mortality of women is about 3 per cent.
less than that of men, as will appear from the following statistics:
GENERAL MORTALITY FROM ALL DISEASES.
1861. Men, 15.63 per cent, ; women, 12.37 per cent.
1862. “ 15.07 “ . & 4 12.13 “
MORTALITY FROM PNEUMONIA.
1861. Men, 25.37 per cent. ; women, 40.33 per cent.
1862. “ 22.86 “ “ 27.61 “
MORTALITY FROM PHTHISIS PULMONALIS.
1861. Men, 35.28 per cent. ; women, 39.35 per cent.
1862. “ 37.72 “ “ 44.20 “
MORTALITY FROM ACUTE PLEURITIS.
1861. Men, 7.67 per cent. ; women, 15.26 per cent.
MORTALITY FROM CHRONIC PLEURITIS.
1861. Men, 9.76 per cent. ; women, 16.67 per cent.
MoRTALITY FROM PLEURITIS (NOT OTHERWISE DEFINED).
1861. Men, 5.65 per cent. ; women, 12.39 per cent.
Thus far, M. Besnier's report.
“In 1853, M. de Feulins published, in the “Revue Médicale” (Vol. II., p
475), a table of mortality of diseases in 1811 and 1851, respectively. It
appears, from his figures, that, from 1811 to 1851, the deaths, by small-pox,
have diminished by one-half, thanks to the prophylactic influence of vac-
cination; the deaths by phthisis,* ha-morrhages, apoplexies, have remained
about the same in proportion; still-births, and sudden deaths, have
increased four-ninths; deaths by inflammatory affections, of all kinds, have
increased at least fifty-four per cent. From these data, M. de Feulins infers
the decline of medicine during the last forty years (up to 1851).” (Revue
Méd. Homoeopathique d'Avignon, Vol. IV, 1856, p. 243.) C. D.
+ M. Begnier shows, that subsequently to 1851, viz.: from 1861 to 1866, the mortality from
phthisis decidedly increased.
1869.] Adžtorial. 393
WE take great pleasure in giving place to the following well deserved
TESTIMONIAL TO PROF. BACMEISTER.
CHICAGO, ILL., February 9th, 1869.
PROF. BACMEISTER:
At a meeting of the Students, held in the Lecture-room of Hahnemann
Medical College, the following resolutions were presented and unanimously
adopted, viz.:
WHEREAs, The Chair of Materia Medica and Therapeutics in our College
has been, during the past Session, occupied by you for the first time, and,
WHEREAs, This position, which we consider to be one peculiarly difficult
and embarrassing, has been filled by you in a manner So eminently success-
ful and acceptable, and,
WHEREAs, Our appreciation of this fact is of so thorough and complete
a character as to demand expression, therefore be it unanimously
Itesolved, That we, the Students of Hahnemann Medical College of Chicago,
do tender to you our most sincere and hearty thanks, for your untiring and
earnest cxertions in our behalf, while endeavoring to conduct us into a
knowledge of that most difficult, and yet most important, branch of medical
science — Homoeopathic Therapeutics.
Resolved, That we recognize in you a faithful student, and an enthusiastic
advocate of true Homoeopathy, and rejoice that our College has been so
fortunate as to secure the services of a man so well qualified, to give
instruction in this department.
[Follow the names of the class.]
REPORT OF THE HOSPITAL AT MUNICH, FOR THE YEAR 1868.
IN this Hospital, under the care of Drs. Jos. Buchner and Max Quaglio,
sixty-five patients were treated; thirty-one males, thirty-four females. Of
the diseases, forty-two were acute and twenty-three chronic. Of these,
forty-eight were perfectly cured, four died, one was transferred to small-pox
hospital, four left improved, two left no better, six remain under treatment.
Of the diseases, there were four cases of typhus, one of variola, three of
endocarditis, two of pneumonia, four of acute articular rheumatism, two
of inflammation of psoas muscles, two of melaena, four of erysipelas, two
of diphtheria, one of tonsillary croup, two of periostitis, two of pleurisy,
two of cystitis, two of Bright's disease, three of cerebral apoplexy, two of
hypertrophy of left ventricle, three of pulmonary tuberculosis, one of cancer
of the bladder. Of the four fatal cases, one died from septic blood poison-
ing, one of advanced pulmonary phthisis, two of cerebral apoplexy — Second
or third attack. The number of days of treatment were 1,258, making an
average of 19.2 days.
394 Adžforza/. [April,
EIGHTEENTH ANNUAL MEETING OF THE NEW YORK STATE
HOMOEOPATIIIC MEDICAL SOCIETY.
A report of the proceedings has just been received. In the language of the
ScCretary, “The attendance at this meeting was large, the papers and
reports read were of more than usual interest, and general concord and
good will prevail.
A semi-annual meeting of the Society is to be held in New York city in
Oct. '69, and in Rochester next year. The Annual Address was delivered by
the President, W. H. Watson, M.D., of Utica: from it we learn that Drs.
W. S. Searle and H. N. Avery are about to issue half-yearly Abstracts of all
our Journals in this country. We learn, also, that the number of Homoe-
opathic practitioners in New York State has increased 600 per cent. in
twenty-six years. There are nine hundred regular Homoeopathic physi-
Cians in the State of New York.”
Since writing the above, the Transactions have appeared — a portly
volume, but arrived too late to obtain any further notice at present.
DR. H. N. AvRBY, late of Poughkeepsie, N. Y., has formed a partnership
with Prof. D. D. Smith, of New York City — address, 10 East Twenty-
eighth Street — his business in Poughkeepsie he has left with his brother,
Dr. E. W. Avery.
OUR European exchanges bring us the Sad intelligence of the death of
two of the oldest standard bearers in our cause, Dr. Trinks, of Dresden, and
Dr. Fleischmann, of Vienna. Both stood high in the medical profession.
Dr. Trinks was a pupil of Hahnemann, and Dr. Fleischmann has been at
the head of a large Hospital for thirty years. It was his success in cholera
which induced the Emperor of Austria to remove the prohibition, previ-
ously existing against the practice of Homoeopathy.
THE COMMENCEMENT EXERCISES OF THE HOMOEOPATHIC
MEDICAL COLLEGE OF MISSOURI,
Took place last night, in the large hall of the Public School Polytechnic
building. The hall was crowded with a large and attentive audience of
ladies and gentlemen, all of whom seemed to take a lively interest in the
proceedings.
The exercises were opened with music by Spicring's Band, after which a
fervent and eloquent prayer was offered by Rev. Mr. Porteus. Music
succeeded, following which Dr. J. T. Temple, Dean of the Faculty, delivered
a brief address.
Mr. W. B. Baker, President of the Board of Trustees, then made some
appropriate remarks, and distributed the College dregrees to the following
GRADUATE8.
James R. Reed, Pittsburg, Pa.; John Keck, Cairo, Ill.; D. L. Deyoe, St.
Louis, Mo.; D. G. Allen, Cairo, Ill. ; S. C. Grant, St. Louis, Mo.; O. G.
Strong, Canton, Ill. ; J. B. Williams, Centralia, Ill. ; J. Wenz, New Orleans,
3.
1869.] Adžforza/. 395
La. ; Peter A. Aikman, Canada West; W. L. Hedges, Girard, Ill. ; J. A.
Campbell, St. Louis, Mo.; J. M. Taylor, Bloomington, Ill. ; John Schmidt,
Quincy, Ill. ; James M. Kershaw, St. Louis, Mo.; G. H. T. Johnson,
Atchison, Kansas; J. Petros, Virden, Ill., W. D. Foster, Hannibal, Mo.
HONORARY DEGREE.
Martin Mayer, Leavenworth, Kansas; J. T. Talbot, Boston, Mass.; C. J.
Hempel, Grand Rapids, Michigan; C. W. Spaulding, St. Louis, Mo.; John
TMoore, Liverpool, England; R. E. Dudgeon, London, England; H. R.
Madden, London, England; Richard Hughes, Brighton, England; W. H.
Holcombe, New Orleans, La.
Prof. Hartman delivered the Hospital diplomas to the graduating class,
accompanying them with an address.
Dr. Comstock then delivered the prize for superiority in obstetrics to
Dr. John Keck, of Illinois.
REMARKS OF PROF. COMSTOCK.
LADIES AND GENTLEMEN: I have the honor to inform you, that at the
commencement of the present Session of the College, I announced to the
class that a silver medal would be awarded to the student who should make
the best examination in obstetrics.
After the close of the final examination of all of the candidates for the
degree of Doctor of Medicine (that is, after they had passed through the
“Green-room”), some eight of them signified their wish to compete for the
prize. They were accordly invited, by me, all together in one room, pens
and paper given to them, and then they were required to answer, in writ-
ing, three difficult questions, and to the one who should make the best
answers was to be awarded the prize. The gentleman who has won the
silver medal is Dr. John Keck, of Illinois.
I feel it, my duty to, also, inform the audience, that the answers of Dr. P.
A, Aickman, of Colchester, Canada, deserve very honorable mention; and,
indced, the responses of all the other gentlemen exhibited a very remarkable
proficiency, theoretically and practically, in their studies.
Dr. Keck: It gives me great pleasure to award to you this medal ; you
have gained it honorably. Remember its motto, the pleasures of science
will be your reward, and you will be an honor to your profession.
Motto — Scientia est potestas /
The prize of a fine set of surgical instruments, donated by Prof. Franklin,
was awarded to Dr. J. S. Reed, of Pittsburg, Pa.
The valedictory was delivered by Prof. N. D. Terrell, and was a very
able and elaborate cffort. No synopsis would do it justice, and we trust it
will be published in pamphlet form.-St. Louis Daily Democrat, Feb. 26th.
“HIGH’” TRITURATIONS.–By referring to back numbers of this and
other Homoeopathic Journals, it will be found that a desire has been
expressed, for Some years past, by leading ones in the profession, that we
should be supplied, by some means, with higher triturations of the metals,
396 Adžforza/. [April,
salts, and other insoluble drugs employed by our School. It is asserted that
a continued trituration with Suffar of Milk, develops the curative proper-
ties of many of these substances more perfectly than succussion with alcohol
after the third trituration. With this view some of the fraternity have,
with much labor, carried a few preparations to the 30th by trituration, and
feel repaid by the results of their use. We are told that the demand for
these high triturations has become such that a pharmacist, in Germany, is
now supplying his patrons with a considerable number of remcdics in the
30th trituration, and we are glad to notice in Mr. Halsey's new catalogue
and prices-current (just issued), that he is now ready to furnish both the
12th and the 30th (riturations of his own manufacture. Physicians will soon
be able to decide whether or not these preparations possess any advantages •
over the alcoholic attenuations. , We hope Mr. H. will receive so many
order for the “high" triturations, that he will be induced to give us the
12th and 30th of all the remedies used in the dry form.
SUPPRESSION OF QUACKERY. — Some of our Chicago Doctors are trying
to gºt a bill through the Legislature of this State, for the suppression of
quackery. We understand all physicians in the State are to be required —
if the bill passes—to get a license from a Board, consisting of two Doctors
and — the County Clerk | But this is a great expenditure of talent — why
two Doctors? The County Clerk can tell who is a quack, without the help
of the two Doctors, and if the two Doctors themselves should be quacks—
as they mostly likely would be — what confusion would there be.
But, seriously, we hope the bill will not pass just yet. If all quacks were
forbidden to practice, we Homoeopathists should have more than we could
attend to. We are making Homoeopathic Doctors about as fast as we can,
but do not feel able to attend to the whole community at present, so if some
of them can be content with quacks a little longer, and the quacks do not
wish to retire just yet, we will get ready for the new order of things as soon
as possible.
AN explanation is due to our readers, relative to some promises made in
the January number. Owing to protracted illness, Dr. Hering was not
able to prepare the paper promised ; we are happy to state that the Doctor
has recovered his health, and we may hope to hear from him in the July
number.
Dr. Jahr's manuscripts were received, but as it was found that they con-
tained the same as he had recently published in German, it did not seem
best to give the paper a place in the Journ AL — especially as We were
informed that a translation was about to issue from the press.
Dr. Searle's paper will appear in the July number, as well as a paper
from Dr. Lilienthal, of New York, on Typhoid Fever, and the use of the
thermometer.
UNITED STATES
Medical and Surgical Journal
Vol. IV.-5 UZ2, 1860.-No. 16.
ISOPATHIC REMEDIES : A REJOINDER TO CAR-
ROLL DUNHAM, M.D.
By W. S. SEARLE, M.D., BRooklyn, N. Y.
MY DEAR DOCTOR: I regret that the ambiguous wording
of my reference to a prescription received from you has
occasioned a misunderstanding. My language certainly
implies that I condemn your prescription; while nothing
was further from my thoughts than to cast a reflection upon
the knowledge, skill, and kindness which led you to give
•me Psorine. This explanation is due both to you and the
profession.
While thanking you for your courteous reply, we can not
help remarking the solicitude with which you, apparently,
regard every thing that looks to the introduction of dis-
cordant views into our Homoeopathic “Happy Family.”
Nor can we pass unnoticed the admirable tact which so
guards your language as to protect alike truth and error.
IBut to one holding your prominent position in the Homoe-
opathic school, an evasion of the points presented in our
previous letter is simply impossible. These subjects are
agitating our school to its foundations; and must agitate it
till they are settled. It is no time for a temporizing or
Wol, IW.—No. 16. 1
398 Isopathic Remedies. [9 uły,
compromising policy. In the homely phrase of the back-
woodsman, “we must hew to the line, no matter where the
chips fly.” Isopathy and other errors have fastened upon
Homoeopathy, and hang like a mill-stone about her neck.
And they must be torn off and cast aside, if we would make
progress. We, at least, can not deprecate the spirit which
must challenge a dictum before it can receive it; and we
submit, that a school which criticises its theories rigidly has
more claim to credence than one which not only accepts
every thing unquestioned, but cherishes all with equal
regard.
Surely a theory •which has run the gauntlet of fearless
and honest criticism, is more worthy of acceptance than one
which is smuggled into the “IIoly of IIolies,” by juggling
priests. IIave we not been too careful of our excrescences;
too chary of dissecting our theories, forgetting that nothing
is of much worth, unless it can endure the most searching
criticism of both friend and foe 2 Truth is not an exotic,
but a hardy perennial, which can both stand, and be
strengthened by, the most adverse blasts.
Away, then, with the timidity, which shouts, “Great is
Diana of the Ephesians,” whenever a questioning Paul lifts
his voice. We owe it to ourselves to “prove all things”(1)
in medicine, as well as in religion. And the catholic spirit
of every school should hold itself ready to dethrone any
idol which is proven to be a false God,
Entertaining these sentiments, you will readily under-"
stand why I have again addressed you.
The chief object of our first letter is attained, through
your emphatic avowal that the use of unproven remedies is
not, and can not be, pure or recognizable Homoeopathy.
This is the protest which we desired you to place on record.
But, in sugar-coating the pill for Professor Raue, you say,
“he is not the man to erect a pyramid upon its apex.” He
certainly is that very man, unless he has provings of Calc.
Urinaria and Cholesterine. And the fact of your ignorance
of the existence of such provings is, to my mind, very
strong evidence that they have never been made; while if
1869.] Isopathic Remedies. 399
they have not, this Professor of “Pure Iſomoeopathy.”
stands convicted of an attempt to foist Isopathy upon the
Homoeopathic school.
Nor can we admit the other plea you put in for the Pro-
fessor, viz.: that we are sometimes confronted with cases
for which no similar exists in our Materia Medica. We
admit the fact, but deny the inference; for, in such a
dilemma, we have the clinical records of the Allopathic
school to fall back upon, which is certainly better than a
resort to the exploded and disgusting therapeutics of the
middle ages.
For these remedies are disgusting, in spite of Dr. Hering's
non Sequitur. We have a high respect for that gentleman
and scholar, but we really must summon him before
Whately and Locke, when he attempts to prove that cer-
tain substances are not properly disgusting, because we
daily use others that are so also. Because he eats oysters,
shall his stomach not abhor snails? (2) Heaven defend us
from such logic
It is then agreed that the line of demarcation between
Homoeopathy and Isopathy is distinct; and no Homoe-
opathist can cross the line without changing his uniform.
You, however, consider a resort to the latter justifiable in
certain circumstances, (3) while we can not, for these rea-
sons: 1st. That Isopathic remedies are disgusting, and
tend to drive both patients and practitioners from our
school. 2nd. That while the medicinal resources of Nature
are not half exhausted, there can be no need of proving or
prescribing them. 3rd. That there is no a priori evidence
in their favor. 4th. That there is little or no a posterior;
evidence to sustain their use.
A few words upon this last point.
We must repeat the question of our first letter, viz.: If
Isopathic remedies are useful, “how is it that brilliant cures
by them are not reported ?” If the principle of Isopathy
be correct, or it is a legitimate offspring of Homoeopathy,
surely no more simple and easy method of cure was ever
devised; and from none should we look for more speedy
4OO Isopathic Remedies. [ºuly,
and certain curative results. Every patient presents us
with his own remedy, more closely similar than we can
hope to find in our Materia Medica, for it is modified by
the temperament and idiosyncracies of each individual.
The proving exists in his own symptoms. Simple and
easy, truly, but is it effectual? What say the clinical
records? “Tartar. emet, is in our hands (as a school) a
hundred times where Variolin is prescribed once.” “And
a careful reading of the American and British Journals, for
several years, does not afford a single instance in which
this remedy of remedies has been used.” Similar remarks
equally apply to the rest of the filthy herd.
That some of our school have avoided these remedies,
because they are disgusting, or of German extraction, or
from some other prejudice, may be true, but is not an
explanation. For others, and probably the majority, have
had no such scruples, and have found them ineffectual.
Schnappauf and Trinks probably continued their use.
Where are their later records? Homoeopaths too, like men
of other schools, generally record their successes, not their
failures. gº
We submit, then, that the “balance of testimony” is not
in favor of Variolin, or any other of these remedies. It
would seem, also, that in defending the use of Variolin, you
advocate the very Isopathy you condemn.
In the first instance of its employment, Schnappauf took
the virus from the body of the very patient to whom he
gave it. Now, where does this legitimately end ? Surely
he has no right to be the only innovator. When next we
meet a chancre, why may we not give its dynamized pus to
the unfortunate patient, and crow over the effects of
chancrine : Why not give our next eclampsic patient her
own albuminous urine to drink? We may remark here, in
passing, that one disease-product — urea — is said by IIead-
land to be a powerful diuretic. But do we find urea in
diuretic conditions? Not if we have read correctly. On
the contrary, urea is plus where the urinary flow is minus.
Yet from its effects urea should prove remedial in plus con-
1869.] Isopathic Remedies. 4OI
ditions of the renal excretion. If a reliable proving should
establish the reverse, and thus show the Homoeopathicity
of urea to plus conditions, then it will become us to recog-
nize a twin-birth, and receive Isopathy with a “Hail,
brother l’”
But enough upon this topic. Reason and experience
combine to disprove the value, and dissuade from the use
of Isopathic remedies.
We now beg leave to consider your justification of Psorine.
It has been proven, and, with its pathogenesis in its hand as
a passport, demands a place in the Materia Medica pura. Is
there no appeal from this? We think there is. The ulti-
matum is, that a proving invests any substance with the
right of citizenship in our Materia Medica. This is evi-
dently too sweeping; for, you know, a Dr. Würzler set
about proving a certain pudding which he imagined gave
him the gripes one day at dinner. Now, suppose Dr.
W. had obtained a long pathogenesis, with its suite of
modalities and characteristics, how could we logically deny
the ergo with which this gripe-producing pudding would
demand a place in our literature and our pocket-case ?
Ah! yes. This remedy is open to objections; a priori, of
course, for we do not expect such things from Orthodox
puddings.
But are there no a priori objections to Psorine? To the
“pure Homoeopathician’” there certainly should be, for this
remedy savors of the flesh-pots of Isopathy; so strongly,
too, that we can not imagine how many provings would be
needful to disinfect it.
Waiving, however, the at least questionable character of
Psorine, we inquire whether the clinical records have veri-
fied its proving 7 As we remarked in our former letter, its
pathogenesis certainly simulates scabies, and this disease
it should cure, if any. But has it cured an unmistakable
case of itch? A friend once assured us that it had cured
one case for him; acknowledging, however, that it had
failed in all beside. And from the corresponding want of
success of others, we more than suspect that some surrep-
4O2 Isopathic Remedies. [%uly,
titious ointment deserved the credit in this instance. If it
really cured this one case, it should not fail in all others.
(Psorine even fails to come up to the standard of its fellows
of the Isopathic class, for attempts have been made to con-
vey scabies by inoculation of the fluid from the itch vesicle
[Freytag and Dudgeon], and they utterly failed.)
Dr. Freytag (see “North American Journal,” X., 193)
states that a purely internal treatment, comprising the most
carefully selected remedies, including Psorine, failed in
sixteen cases. At the date of writing, he retained for this
mode of treatment two patients who had had the disease
eight and ten months.
These facts strongly tend to invalidate all opposing ones
on record (and they are very few in number). Errors in
diagnosis, and the surreptitious use of inunctions, explain
the discrepancy. As to the success of this remedy in the
other forms of disease in which you have used it, we can
say nothing, since we have no experience in this direction;
and, so far as we know, there are no instances of success or
failure on record. We can only repeat that, judging from
its pathogenesis, it should cure scabies and similar diseases,
if any, and here the pathological test decides against it.
We now ask, what could have suggested the proving of
Psorine & Confessedly, the Isopathic idea. Is it not the
same idea which suggests its use in scabies 7 Reading its
pathogenesis, who does not find himself standing in the
very shrine of Isopathy 2 Did not this idea suggest its use
in my own case, as well as others? Whether proven or
unproven, it is the deserter — Isopathy — wearing the
IIomoeopathic livery to escape detection and exposure. We
do not doubt that its pathogenesis comes to us under cover
of orthodox respectability. But must this great school
accept every proving thrust upon it? In many a “first
family’’ there be children who only disgrace the “long,
untainted line,” and children gotten in the course of nature,
too. Are we, indeed, exempt from such infirmities : The
truth is, Psorine was proven by those who had Isopathic
visions flitting before them; and so, like Jacob’s cattle, the
1869.] Isopathic Remedies. 4O3
product of their conception is “ring-streaked and speckled”
all over with the marks of their imagination. Thus the a
priori argument is, to say the least, suspicious, while the
pathological test fails to confirm its value as a remedy.
With reference to the remarks in our former letter on
serpent venom, and Mitchel’s experiments with the same,
we have little to add in the a priori view of the case. No
cavil can disprove the fact that, outside the body at least,
gastric juice destroys the poisonous property of the sub-
stance; and its ingestion was not followed by any of those
remarkable symptoms which mark inoculation, or which
are said to have been experienced by the provers. Prob-
ably the experimenters cited by Mitchel did not expect
“ instant death,” as you suggest, or they would not have
been likely to swallow the poison. But certainly had they
felt the symptoms recorded by the provers — even those
cited by you — they could not have missed them, for they
are not so slight as to escape the notice of any one, much
less one who is familiar with the effects of snake bites, and
is looking for them.
To your suggestion that attenuation so modifies the sub-
stance in some mysterious way as to enable it to escape
the gastric juice, and manifest specific effects upon the
human body, and the examples of Mercury, Lyc., Carbo. veg.,
etc., which you introduce to support this view, we reply
that the analogy fails, since these latter substances, not
being soluble (4), are physically incapable of absorption
until reduced to a certain degree of fineness, while venom
is undoubtedly soluble, and, therefore, physically at least,
capable of absorption. Besides, no soluble substance
(except venom) fails to give, at least equal, and, with few
exceptions, more violent symptoms for the larger dose.
The idea of Hermann that, like Curare, venom is slowly
absorbed, and rapidly excreted, also fails to solve the prob-
lem, since this is as true of large as of small quantities.
Certainly, if the small doses of the provers could produce
the symptoms given, we should look for, at least, as marked
results from larger quantities, which, remaining in the
4O4. Isopathic Remedies. [3tuły,
intestinal canal, and being slowly absorbed, would keep the
system for a longer time under the influence of poison.
Another fact demands notice here. While Apis and
Cantharis may be called cognates of venom, considered as
animal secretions, they never fail to produce severer Symp-
toms for the larger dose. At first glance this fact would
seem opposed to our view of the case. But it by no means
follows, from the destructive influence of the gastric juice
over venom, that all animal poisons are destroyed by it, nor,
conversely, that it may not antidote venom, because it does
not annihilate Apis and Cantharis. However, claiming what
you do for venom, you will find it difficult to explain why,
like these substances, it does not enhance suffering in larger
doses; and still more, why large doses have no effect at all.
When we come to the pathological test, we think the
balance of testimony is against Lachesis at least. It may be
that the preparations of this remedy have deteriorated, or
the similimum may have been missed, but certain it is that
Lachesis in any attenuation has failed to cure any case for
us, or (with one or two exceptions) any of our professional
friends. The large majority of the school, too, after trials
as frequent and as careful as are given to any remedy, have
no confidence in it. Its characteristics are so marked, and
we so often meet with its similimum at the bedside, that we
can hardly have failed to use it properly, but, as before said,
with no curative results. At the date of this writing, we
are treating two cases with this remedy — one acute and
the other chronic; both present nearly the same symptoms,
viz.: Little fever, and that in flashes; larynx painful to
touch, and on bending head backward; suffocative parox-
ysms in the larynx, especially at night; sensation of a lump
in the throat; constant urging to swallow; deglutition
difficult; dryness of larynx and fauces; tickling irritation
to cough, as from a dry spot or crumb in the throat; slight
sensation of rawness, and a little occasional hoarseness.
Now, we happen to have some Lachesis in the 6th trit. and
30th dil., which we obtained a few days since from Tafel,
in Philadelphia; and which, we are told, is vouched for by
1869.] Isopathic Remedies. 405
Dr. Hering as reliable. But after a trial of four days,
neither of these preparations relieves these symptoms in
the least. What is the reason 2 Have we missed the simi-
limum again? or not gone high enough 7 We are within
bounds when we say that, in a practice of twelve years, we
have prescribed Lachesis, in dilutions from the 6th to the
200th, more than one hundred times, and never yet saw a
curative result. So you don't mean us when you say that
those who have no experience with this medicine can only
cavil.
Let us now turn our attention to the subject of attenua-
tion. We stated, as a theory held by some, that trituration
and dilution “develop in remedies new dynamic virtues
which were not possessed by the crude drug.” You object
to this mode of expression, and put the theory thus: “Tri-
turation” (and dilution ?) “develops in the drug a power to
act on the human organism which was not displayed by the
crude drug, but lay latent in it.” Truly, it would “puzzle
a Philadelphia lawyer” to discover any difference in the
ideas involved in the two formulae. However, we are will-
ing to adopt your version of the theory, and, so far as insol-
uble substances in their few first triturations are concerned,
the proposition is doubtless true. But we think we are
justified in saying that this doctrine is held by some in res-
pect to all remedies. If this is not the theory of high dilu-
tionists, how can they explain the oft-asserted fact, that a
high dilution sometimes cures where a low one of the same
remedy has failed? And if it is held by them, how are they
consistent in prescribing from a Materia Medica made up,
in part, from provings of crude drugs?
Again, if attenuation does thus develop new or latent
powers, or intensifies those present in the crude drug, how
can we escape Hahnemann’s notion, that it is dangerous to
succuss a dilution too long, or explain the notorious fact
that low dilutions, and even crude drugs, cure at times
when higher dilutions fail? You, yourself (if we are not
misinformed), have met with even sensitive women upon
whom no remedy higher than the 3rd would produce a cura-
4O6 Isopathic Remedies. [%uly,
tive effect. A multitude of instances, to the same purpose,
are on record from the days of Hahnemann down; while
the pocket-case of the Master himself, containing 3rds as well
as 30ths, speaks volumes upon this point. Still another
problem is found in the query, Why does not the high
potency manifestincreased and different pathogenetic as well
as curative power? And yet another, Why should sensitive
organizations only be susceptible to these more powerful
potencies? Again, we find high dilutionists asserting that
only a portion of our remedies will bear attenuation. Cam-
phor will not bear dilution, but Cham. is no better than cat-
nip in the tincture, while in the 12th it is a wonderful
remedy. ' And this in the face of the doctrine that attenua-
tion increases power, and develops latent power.
In spite of your disclaimer, too, the notion that the
dynamic virtue of drugs is transferred to the menstruum in
the process of attenuation, is a very common one ; and the
“contact potencies” afford one example of it. Nor, if we
could prove, what there is every a priori reason to believe,
an absence of the original particles in the 200th dilution,
do we doubt that you, too, would take this horn of the
dilemma, so great is your confidence in the pathological
test alone. We say there is every a priori reason to believe
the absence of the original particles in the 200th, because
beginning even with a soluble substance, and with one drop
of a tincture; ending with one hundred drops of the 200th,
and claiming in it the presence of a single original particle,
we must believe that in that little drop of tincture there
were aggregated particles to a number which it requires
20,000 ciphers (200 feet, counting 100 to the foot) and a figure
1 to express.” This is nothing to Fincke's 100,000th, in
which you say he believes the original particles are present.
Is there any thing he does not believe? No! the theory you
disclaim is the only tenable one, and yet you find “fewer
* It will assist very slightly in an attempt at appreciating this number,
to recall the fact that a microscope which can make visible an atom one
millionth of an inch in diameter is one of the wonders of this century; but
to express this fraction only six ciphers are necessary.
1869.] Isopathic Remedies. 4O7
difficulties” in the material doctrine. Shall we be cited to
that hackneyed grain of musk? We ask, in reply, how far
up the scale of dilution can your olfactories detect the odor
of Moschus 2 If you can perceive it in the 12th, we will
own to a poor nose.
These are a part of the inconsistencies, contradictions and
absurdities which we are invited to believe in and practice
upon ; and for not yielding implicit credence to which, the
more rampant of the “highs” are ready to read us out of
the Homoeopathic school. Whereat, with fear and trem-
bling, we exclaim, in the words of Trabb’s boy, “Hold us!
we're so frightened ' " To use an old theological distinc-
tion, these theories are not only beyond reason, but contrary
to it.
It is apropos here to refer to our experiments with the
spectroscope. This inistrument is most sensitive to Sodium,
and, perhaps, next, to Strontium. The former is said by
Bunsen (whose calculation was very coarse, however) to be
visible in the 195 millionth of a grain. Probably a more
accurate mode of subdivision would prove the vanishing
point to be beyond this. But it was found useless for us to
experiment with it, since it exists in the alcohol, cork,
Sacch. lac., and pellets which we use in dynamization, while
the dust of an ordinary room is filled with it. If, by very
careful management, we succeed in getting the spectrum
clear of it, the slightest touch of a perfectly clean platinum
wire to the palm of the hand will give enough Sodium to
make its bright yellow line distinctly visible. We, there-
fore, turned to Strontium, and tested it in dilutions from the
1st to the 200th, both in its soluble and insoluble salts; but
in none above the fourth decimal could the line of the sub-
stance be seen. The brilliance of the line, too, rapidly
diminished with each successive dilution. The same results
followed from Barium and Lithium, so that only about the
100,000th of a grain could be detected. Of course these
results are inferior to those of chemistry as showing divisi-
bility of matter. We may, however, draw several conclu-
sions from these experiments. 1st. That the dilutions of
408 Isopathic Remedies. Işuly,
Natrum are not what they purport to be. (Probably the salt
of Sodium, which is present so universally, is the muriate,
since its source in the air is supposed to be the ocean, and
muriatic acid is known to exist in the atmosphere.) 2nd.
The presence of Nat. mur. in food, air, alcohol, water, and
every tissue of the body, throws great doubt upon this
wonderful high dilution specific for intermittent fever. 3rd.
The rapid diminution of the brilliance of the lines with
each successive dilution tends to disprove the existence of
original particles in high attenuations.
Coming to the pathological test, we would first inquire
whether, if it be granted that high potencies do at times,
and in certain forms of disease, really prove curative, you
further hold that, in these identical cases, a low dilution
would not have been equally effectual? In other words, are
high potencies absolutely essential 2 If not, cui bono 2 why
use them at all ? But if you deem them necessary, we
demand some rational, a priori grounds for your confidence;
for this pathological test is a deceptive one, even in a statis-
tical form, and much more so in regard to isolated cases.
As illustrating this point, let me put a case — and one
will serve for all. One of the very best instances of cure
by a high potency is that reported by yourself, of Pteryg-
ium crassum. The probabilities almost amount to a certainty
that Zine. 200th did cure this case. But a single instance
of the same disease, presenting the same symptoms, in
which Zine. 200th should fail to cure, would throw the
“burden of proof” upon you; while a series of like failures
would put the probabilities entirely upon the other side.
One such instance of failure has come to our knowledge,
and doubtless the list would be much increased could we
come at the experience of the whole profession. We say,
doubtless, because, in default of any other known effective
remedy, this has probably been extensively used, and yet
your case still stands alone upon the record. (8)
Allopathic records are full of supposed cures, many of
them little less marvelous than yours, which, in the light of
expectant knowledge, are to-day the laughing-stock even of
1869.] Isopathic Remedies. 4O9
that school. Had we a full knowledge of all that the vis
medicatrix naturae can accomplish in all forms of disease, this
“pathological test,” upon which alone you rely so confi-
dently, would be more trustworthy. , '
Before us lies a volume published in 1746, by that great
scholar, Bishop Berkley, on the virtues of “Tar-Water.”
With many quaint speculations, it contains 462 cases of cure
by this miraculous remedy. Many of these are reported by
hospital physicians, all of whom testify from experience.
The next century may look upon some of our wonderful
cures with quite equal derision to that with which we now
regard those of Berkley. Well said the “divine old man
of Cos,” “Life is short, the art long, the occasion fleeting,
experience fallacious, and judgment difficult.” (9.)
But perhaps you will ask, do you, therefore, reject the
pathological test entirely, because it is at times fallacious?
How, then, will you substantiate any mode of cure, or prove
the superiority of Homoeopathy 7 We do not intend to be
misunderstood here. Most decidedly, we do not reject this
argument a posteriori. On the contrary, while we are aware
of the circumstances which render it fallacious, we esteem
it the very crowning point of the cumulative evidence in
favor of Homoeopathy; especially as compared with the
other systems. Here it is eminently trustworthy, for all are
equally open to the objections made against it. But, inside
our own school, we do not hold it conclusively by itself,
nor shut ourselves up in it as a stronghold which can not
be shaken, when we are driven from every other post of
defence.
But, for the sake of argument, let us agree to base con-
clusions on it alone. How then stands the case, as between
high and low dilutions? There are few men in our ranks
who have not made more or less extensive trials of high
potencies. In the range of our somewhat extended acquaint-
ance, we do not recall one; and how stands the school
to-day ? Out of over 4,000 American practitioners, a liberal
estimate will not give 500 who have enough faith in their
curative efficacy to make them the staple of their practice.
4IO Isopathic Remedies. [3'uly,
Are there twenty-five in New York city, out of your one
hundred practitioners ? Surely you will not deny candor
to the man who must daily fight the “king of terrors” for
his own family and friends. Nor will you claim that,
among your opponents, there can not be found as great
skill in diagnosis, selection of remedies, or logic, as is mani-
fested by a Wells, a Temple, a Lippe, or a Fincke. Now,
why have not the mass of the school discovered the superi-
ority of high potencies? Why was not Hahnemann so con-
vinced of it as to discard 3rd dilutions from his ordinary
pocket-case ?
The truth is that men as candid, as truthful, as able, as
anxious to save life, and far more numerous than their
opponents, have carefully, faithfully and skillfully tried high
potencies, and have no confidence in their curative vir-
tues. (10.)
You and I differ also as to the habits of high dilutionists,
as a class, in conducting an argument. Not questioning
your experience with them, we surely may give our own.
We have never yet heard a theory too wild for the majority
of them to accept; and the nearer its origin to Hahnemann,
the more eagerly did they gulp it down. Their facts are
every thing favorable to their theories; their fallacies every
thing adverse. And for “taking refuge ’’ they out-do the
ostrich itself, with quite as much wisdom as is displayed by
that bird. Their clinical facts are too often furnished by a
Schnappauf, and verified by a Trinks. Trinks, as an Iso-
pathist, is acceptable testimony, but Trinks as an author of
Materia Medica is very questionable. Too many of them
need Lycopodium, for the half-sight which only enables them
to discern their half. To them the spectroscope which
shows gold in the 30th is unimpeachable evidence, while
that which will not show it in the 12th is not reliable.
Such we have found to be the rule, while we gladly
acknowledge some noble exceptions, among whom, my dear
doctor, we count you.
And now, finally, we trust you will not find occasion in
what we have written to charge us with that “caviling
1869.] Isopathic Remedies. 4II
spirit” which you so justly deprecate in scientific inquiry
or discussion. Doubt we may, and must; nor do we regret
it, since progress is, in great measure, the child of doubt.
We have endeavored to manifest a “candid, inquiring”
temper; and if we are slow to be convinced of what we
esteem doubtful, and are defiant and pugnacious toward
error, we trust we shall prove equally tenacious of truth,
whatever it may be, or from whatever source it may come,
when it is clearly apprehended.
NOTES.
(1.) This would be more properly rendered “Test all things.” Has Dr.
Searle fairly tested all against which he brings theoretical objections, e.g.,
potentized remedies?
(2.) Snails are an important and esteemed article of diet among many
nations; the modern Italians, for example, who distinguish them as “frutti
della terra’ from fish, or “fruttà del mare.” The Spaniards also eat snails.
(3.) I justified, under certain circumstances, the use of unproved remedies.
Jnless it necessarily follows that all “unproved ” remedies must be Isopathic,
all the remarks of Dr. S. on the subject of Isopathy are outside the record.
(4.) Is Watrum muriaticum soluble 2 The Vienna provers found that the
30th dilution had a power to produce and to remove symptoms which the
crude substance and the lower dilutions did not exhibit. At least, so says
Dr. Watzke, as zealous an opponent of potentization as our school has pro-
duced, and a most learned and Sagacious man. Bidder and Schmidt suggest
modifications of crude Natr. mur. by the gastric juices, such as the dilutions
do not seem to undergo. Does this elucidate the venom question ?
(5.) Why not accept facts, instead of trying to “dispose of them 2’” The
Royal Society spent a long time in discussing the reasons of Charles II.'s
problem before it occurred to them to test and reproduce the facts / If Dr.
S. questions the proving of Lachests, why not reprove it, with as much care
as the Austrian physicians observed in reproving Hahnemann's remedies?
Instead of proving that a thing can't be thus, let us ask, “Is it thus?”
(6.) If my testimony be good in favor of a low potency, why not equally
good in favor of a high
(7.) It might be equally conclusive if physiology, pathology and semei-
ology were perfect sciences, which is not the case just yet.
(8.) Several similar cures are now on record.
(9) “Tar Water,” and “Perkins' Metallic Tractors,” had their career, it
is true; but let us remember that, so soon as their claims were once sub-
jected to Scientific scrutiny by competent physicians, they at once fell into
disrepute, and were speedily forgotten. Homoeopathy has been subjected
to Scrutiny much more rigid for a series of years, from Hecker in 1810 to
Simpson in 1850. The result has been that most of “those who came to
4 I2 My Experience with [3 uły,
laugh, remained to pray;” the ranks of our school having been made up of
converts from the old School; and the demonstrations of those who were
not convinced have had no effect in retarding the growth of Homoeopathy.
Anticipating Dr. Searle, Dr. O. W. Holmes, in 1842, recited the history of
“Tar Water,” and the “Tractors,” to illustrate his estimate of Homoeopathy,
suggesting that as those succumbed to the first serious onslaught of a
scientific mind, So in like manner should Homoeopathy, and especially
infinitesimalism; saying, “Its pretensions and assertions can not stand
before a single hour of calm investigation.” Yet they stand I Only once
have the walls of a fortress fallen at the blast of a ram's horn, and that
was miraculous! Hypothetical explanations of the effect of trituration and
potentization are of course defective, and apt to be contradictory. Objec-
tions to these explanations may be well taken, but do not necessarily touch
the facts, for we are satisfied of the reality of many facts which we can
not explain. No man criticized, reports of the action of high potencies
more keenly and ably than the late accomplished Dr. Watzke, and yet he
died substantially a believer in high potencies. (See his last work, “One
Day of my Practice.”)
(10.) The only body of physicians known to me, either personally or by
their writings, who have made such comparative experiments methodically
and with the accuracy demanded by modern science, and who have based
their conclusions on statistical tables, are the physicians of Vienna, notably
Dr. Wurmb and his comrades. Their conclusions are at variance with
Dr. Searle's estimates. Finally, my regard for truth compels me to say that,
in my judgment, the majority of those who use potentized remedies do
select remedies after a minuter study of Materia Medica, and with greater
accuracy—perhaps on a somewhat different principle — than those who
do not use potencies. After witnessing the methods of Hering, Haynal and
Wurmb on the one hand, and of Fleischmann and his party on the other,
I am constrained to say thus much. C. D.
MY EXPERIENCE WITH A FEW REMEDIES.
DY EMIL TIETZE, M.D., PHILADELPHIA, PA.
BEFORE mentioning a few other diseases in which I have
derived benefit from Apis, I beg to be allowed once more
to point to its great efficacy in diphtheritic affections.
Thus far our winter has been unusually wet. During the
months of December and January we had a large number
of rainy days, and diphtheritic troubles were very numer-
ous in consequence. Judging from the cases under my
care, the epidemic, though apparently an extensive one, did
1869.] A Few Remedies. 4. I3
not evince a malignant character; yet there seem to have
been exceptions to this rule, since I heard of several deaths
having occurred, lately from this disease. From the middle
of December, 1868, to the beginning of February, 1869, I
treated twenty-one persons afflicted with this disorder.
The youngest of these patients was an infant of ten months,
the oldest a lady of forty and some years of age. As to
sex, the majority of them were females. All these cases
did not differ materially from those I have reported in my
previous article; yet, with some of them, I observed varia-
tions and complications, such as I had not witnessed
before. In two patients, both small children, an exanthema,
very much resembling Scarlatina, principally confined to
the face, neck, breast, shoulders, and back, now and then
disappearing on one place and reappearing on another,
though, upon the whole, of but short duration, showed itself
simultaneously with the diphtheritic deposits on the tonsils.
In these cases the fever ran very high, and the older child,
a little girl nearly three years old, was slightly delirious
during the first and second night of her illness. In another
case, that of a lady of twenty-five, an eruption similar to
measles, thickly covered the left regio iliaca and lumbaris,
and occasioned a feeling of aching and Soreness in those
parts. Differing from those, I observed another cutaneous
affection in a lady of eighteen, who had contracted the
disease at Baltimore, where, according to her statement,
diphtheritis had been prevailing to a great extent, and
whence she returned home sick, after a visit of nearly a
week. It closely resembled petechiae, principally covered
the trunk, and began at the scrobiculus cordis, gradually
extended over the abdomen and back, and finally spread
over the lower extremities. In this case the eruption
appeared after the diphtheritic exudates, which were of
considerable extent, had almost entirely disappeared. The
spots were of different sizes, from that of the head of a pin
to that of a lentil, round in shape, and purple in color, and
were accompanied by a good deal of aching, principally at
Vol. IV.-No. 16. 2
4I4. My Experience with [july,
the legs, and great general prostration, a symptom the more
remarkable, for the reason that this patient had a very strong
and excellent physique. In another instance I observed simi-
lar spots, though much smaller in size, and of a darker hue,
almost of chocolate color, on the uvula and palatine arches.
The largest of these covered the uvula, while the smaller
dotted the arches; the dots very perceptibly decreasing
in size and number in the direction towards the tongue.
The parts thus affected were but slightly swollen and
inflamed, and I noticed but a very small diphtheritic exu-
date on the left tonsil, which, like the one of the other
side, was slightly congested and darker in color. The cer-
vical glands on both sides of the neck were enlarged and
indurated, caused stiffness of the neck, and were tender on,
pressure. Besides those, I saw still another variation in
the case of a middle-aged lady. She suffered from a more
severe form of diphtheritis. Thick exudates, of a dirty
appearance, dark in color, and in a state of softening around
the border, emitting a very foetid smell, covered the tonsils
on both sides, and partly spread over the palatine arches
and uvula. There were much difficulty and pain in swal-
lowing, high fever, intense headache, great prostration, etc.
However, all this changed for the better within forty-eight
hours, and the patient would have been comparatively com-
fortable had it not been for the extension of the trouble
over the pharynx in a form entirely new to me. There
were no exudates on any portion of the pharynx, but a num-
ber, probably half a dozen or so, of narrow, bright-red
stripes, which looked almost as if they had been painted on
it. Some of them were nearly an inch and a half in length,
others shorter, but all came to a point at the ends, and were
broader in the middle. They ran parallel with the longi-
tudinal axis of the pharynx, some of them upon its superior,
others upon its inferior portion, and seemed to extend down
into the oesophagus. They caused much pain in Swallow-
ing, and at all times a feeling of great Soreness, and were
produced by the inflammation of the mucosa, and the abra-
1869.] A few Remedies. 4. I5
sion of its epitelial” coating; their bright-red color arising
partly from the former, partly from minute quantities of
blood slowly oozing out upon the denuded surfaces.
In my former article I mentioned that only in the more
severe cases I had noticed any remarkable enlargement and
induration of the different glands of the neck and face;
but that a puffy, bloated appearance of those parts had been
a very prevailing symptom. Now, this rule did not hold
good in the last epidemic, since the swelling and indura-
tion, especially of the cervical glands, even in light cases,
constituted early and constant symptoms of the disorder,
while the bloatedness of those parts, though perceptible,
was less predominating and striking. However, as an
exception to this rule, I met with a case in which the
bloated state of the face reached such a degree as to
amount to regular Oedema, and simultaneously with it I
found oadema of the feet.
All these cases were successfully and exclusively treated
by Apis, and fully confirmed my previous observations as
regards its great efficacy in this disease, and the time
required for the remedy to exhibit its effect upon the various
subjective and objective symptoms. In the case of the mid-
dle-aged lady, I was strongly tempted to exchange Apis for
Cyanuretum Mercurii, a remedy highly recommended in diph-
theria by Dr. v. Villers, of Dresden, Saxony, and a drug
that apparently deserves our confidence, even in the malig-
mant form of the disease, consequently a friend in need,
which will be warmly welcomed. However, not being fond
of changing remedies, except when absolutely convinced of
the necessity of a change, I continued with Apis, and my
patient recovered, though I admit that probably from the
beginning the Cyan. Merc. would have been the better
simile. For various reasons, and as previously, the remedy
was administered in every instance in the first decimal dilu-
*In dropping the letter “h” in the word “epithelial,” as usually but
wrongly written, I act on the proposition of “G,” in No. 26, Bd. 77, of the
Allg. Hom, Zeitung. Hyrtl, in his text book of anatomy, pointed to the
mistake almost twenty years ago.
416 My Experience with [ºuly,
tion, and the dose repeated from one to three hours; a
piece of information by which I do not intend either to
please or displease any one, although I should not feel
offended, of course, at any body for suiting himself in this
matter according to his tastes and inclinations.
Another disease in which I have seen good effects of
Apis is chlorosis, and especially that form of it which,
partly for constitutional reasons, partly for want of strict
adherence to rational rules of living, or from injurious
effects of a bungling routine treatment, has grown very
chronic and obstinate. It is often exceedingly difficult to
find the right remedy for such cases, since their symptoms
are frequently so indefinite, vague and varying, as not to
point with precision to any one remedy, or so multiform,
intricate and complicated as often to confound our judg-
ment and to dim our therapeutic sight. It is true, my
experience with Apis in chlorosis is very limited, and I
can not claim to have cured with it alone, even a single
chlorotic patient, yet I have observed in several instances
of this kind so decided and beneficial effects of it, as to
make me value it very highly in a certain form of this dis-
ease. Any one who will take the pains carefully to study
the pathogenesis of Apis, as presented in C. Hering's Arznei-
prüfungen, will agree with me that its Homoeopathicity to
chlorosis is sufficiently apparent from the symptomatic
record. However, it is evident, at the same time, that it
is not the light and incipient form of this disorder, usually
developing at the time of pubescence, in consequence of
quantitative deficits in nutritive material, produced by dis-
turbances in the organs of digestion and assimilation, to
which the bee-poison is the Homoeopathic simile; but its
more grave and chronic form which, gradually grown out
of the former, and aggravated by constitutional anomalies,
mostly inherited, has wrought a very important qualitative
change in the crasis of the blood, which, in turn, again has
become a new, ever-active and potent cause of its aggrava-
tion and various complications. This abnormal change in
the sanguineous crasis seems to consist frequently in the
1869.] A Few Aremedies. 4I'7
abnormal increase of the watery portion of the blood at
the expense of its fibrin, and as subsequent results of this
change we observe diseases of various organs, complicated
according to circumstances in a manifold way, yet all bear-
ing the asthenic character, and all very apt to terminate in
dropsical affections of different grades. It is in such cases
that Apis is a very valuable remedy, corresponding not only
to the essential character of the disorder, but fulfilling at
the same time, by the similarity of its local affinities and
pathogenetic symptoms to those of the disease, all the main
conditions to render it a truly Homoeopathic remedy. How-
ever, it would prove a delusion always to expect of Apis a
complete cure in such cases, since it will frequently reduce
them only to cases of a milder form, for which it will be
necessary to select other remedies according to the prevail-
ing symptoms. The indications of Apis in such affections,
in my opinion, are: The puffy, bloated-waxy appearance
of the face, oedematous swellings of the eyelids and feet, and
a peculiarly annoying aching or pain in the ovaries, espe-
cially in the right one, usually shortly before and during
menstruation, frequently accompanied by intense headache
at the occiput, and a sort of zoo-magnetic coma, now and
then interrupted by a more or less violent outbreak of
hysterical symptoms.
Closely related to the former is another trouble in which
Apis has proved to me its curative power. The patients
afflicted with it were women approaching the climacteric
years, who in their girlhood suffered from chlorosis, but
had, as it seemed, entirely recovered from it. Being mar-
ried they gave birth to and nursed a large number of chil-
dren, and notwithstanding this exhaustive work, and though
formerly verythin, grew more and more fleshy. From their
appearance they are taken to be very strong and healthy
persons. Yet, on close examination, we find their flesh
soft and flabby, their strength little and easily exhausted, and
though enjoying a tolerably good appetite, they frequently
suffer from constipation and flatulency, and a very annoy-
ing feeling of distension at the epigastrium. But, above
418 My Experience with [3 uly,
all, they are tormented with fearful headaches, which ascend
from the neck to the occiput, where the pain is usually most
severe, and whence it soon spreads all over the head. It
is deeply seated, and described sometimes as pressive or
throbbing, but much oftener as indescribable. This head-
ache often returns every day, sometimes, however, intermits
for a day or two, and is most severe shortly before menstrua-
tion, which is insufficient in quantity and rather watery.
At those times the headache reaches such a height, now and
then, as even to cause delirium and convulsive twitchings
of the muscles of the face and upper extremities, and finally
terminates in a comatose sleep. When the pain is severe
the face appears swollen and very much flushed. IIowever,
this flush is not occasioned merely by an increased afflux
of blood, but, simultaneously with the latter, we observe a
kind of erythena, principally at the cheeks and forehead,
which will appear more distinctly, when, by temporarily
abating congestion, it marks itself off in sharper outlines
from that portion of the skin which for a time returns to its
normal color. It is accompanied by great burning, grad-
ually disappears, and is followed by slight desquama-
tiou, which gives the skin an unclean and rough appear-
ance. During the attack the radial pulse is weak, the
extremities cold, while the carotids beat strongly, and the
head feels hot; after it, the face looks bloated especially
around the eyes, and the feet frequently swell Oedema-
tously.
Again I will testify to the great efficacy of the bee-poison
in erysipelas, especially in persons of hydrogenoid constitu-
tion. In fact, the presence of this constitutional peculiarity
seems to me a necessary condition for achieving any marked
success with it in this complaint. Apis in a low dilution, and
frequently repeated in such cases — I say in a low dilution,
for I have no experience with the higher and highest in this
trouble — often surprised me by its very prompt curative
action. In a case of this kind, which I lately treated, the
erysipelas was occasioned by taking cold, the patient, a lady
of seventeen, having stood for Sometime at the open door
1869.] A Few Remedies. 4 IQ
s
in the damp night air. She felt a slight chill while stand-
ing there, which, more severe, returned once or twice dur-
ing the night, and was followed by high fever. By next
morning the affection appeared on the right side of the
nose, and within four days spread over both cheeks, eyelids,
the right ear, forehead and a part of the hairy scalp, upper
lip and a part of the chin. That the case, ab initio, was a
severe one, was manifest from the intensity of the gen-
eral (fever, headache, gastric disturbances), and local symp-
toms (very numerous bullae, quickly uniting into one large
blister on the cheeks, forehead and chin, intense conjunc-
tivitis of the right eye.) However, the remedy very soon
held decided control over the trouble, and, though it spread
over both sides of the face, the several successive eruptions
had a dead appearance at the very outset, and the disease
ran through its course within six days. I have to add that
this patient had never suffered from erysipelas before. An
inflammatory affection of the mucous skin of the right side
of the nose, accompanied by smarting and burning, and a
thin discharge, slightly corroding the skin around the right
nostril, and an external swelling, principally at the bridge
of the nose, which, as sequels followed the primary disor-
der, were removed within a few days by a few doses of
Graphites 30.
Finally, I will point to the value of Apis in attacks of
so-called rheumatic gout, especially if they affect the feet.
Here I have seen several times a very marked and benefi-
cial effect of it, though I must confess that, in this affection,
my experience with Apis, as well as with other remedies,
is very limited.
º
A CHAPTER FROM JAHR'S LATEST WORK, “EX.
PERIENCE OF FORTY YEARS’ PRACTICE.”
(TRANSLATED BY S. LILIENTIIAL, M.D., NEW YORK,
THE DIAGNOSIS OF TYPHUS AND TYPHOID FEVER.
IN former times “febris nervosa versatilis, typhosa, cere-
bralis, abdominalis, putrida, ship, and hospital fever,” were
considered as essentially different diseases; in our day they
are thrown together under the name of “typhus.” We all
know that in a well-formed case, the original type of the
disease, there appear usually at first the cerebral symptoms,
then the abdominal or pectoral ones, so that the disease really
embraces all three of these different affections, and in very
severe cases all three may be observed at the same time.
Dut as in all epidemics all patients are not attacked by the
whole complex of symptoms, but in one some part is more
affected than others; and as in cholera, for example, one
may suffer from cramps, the other from vomiting and purg-
ing, or a third one may have it from the start in its cyanotic
form, but in a neglected case all these forms may run one into
another, so we see it also in typhus. The inflammatory attack
of the brain always opens the whole series of typhoid mani-
festations. The disease may remain stationary in light
^ases at this stage, and we have then only that disease which
the French call “fièvre cérebrale,” typhus cerebralis, the old-
fashioned febris nervosa cerebralis, although in the begin-
ning and at the end of epidemics, and even in some sporadic
cases the disease may remain at this point, and be removed
in fifteen to twenty-one days, whereas the fully developed
typhus (P. abd.) lasts frequently forty-two days. Still it
would be a wrong conclusion to make a separate disease
of it, being only a typhus arrested in its development. On
the other side, when this peculiar specific inflammation
spreads with great celerity from the brain to the spinal mar-
A Chapter from Şahr’s Zatest Woré. 421
row, the cerebral stage passes quickly over into an intestinal
affection, and the disease offers the picture of an abdominal
typhus, in which the simultaneous, never-failing brain symp-
toms appear like consensual reflexes; whereas, after all, the
intestinal affection is only a symptom of the whole disease.
Should, at the height of an epidemic, symptoms of dissolu-
tion of the fluids appear cotemporaneously with such a
sudden abdominal affection, as blueish ulcers of the mouth,
ecchymoses, cadaverous-smelling stools, etc., some physi-
cians might diagnosticate a spontaneous putrid fever,
whereas it is only a typhus, quickly rising to its most dan-
erous height. If the lungs are more affected than the
abdominal organs (Peyerian glands), it is usually called
typhoid pneumonia, which must not be confounded with
the simple pneumonia, in the course of which nervous
symptoms arise, for in the former we see from the very
beginning some cerebral symptoms peculiar to typhus; more-
over, even in the mildest case of cerebral typhus, we find
the mucous membrane of the bronchi affected with catarrh,
and if this affection is severe, combined only with cerebral
symptoms, but leaving the abdominal organs intact, then
we have that form which was usually called febris pituitosa
(fièvre muqueuse), which may also run its course mildly, or
pass over into the severest abdominal typhus. Under what-
ever form finally the typhus may appear, we may always
rest assured that we have to battle with a typhoid process,
when we see in a given case these peculiar general symp-
toms; as, e.g., rapid-sinking of the forces, standing in no propor-
tion to the ailment, with the necessity to keep the bed for no
other reason than this general feeling of prostration; entire
indifference, apathy and dullness, irritable, quick pulse (but not in-
creased in strength); catarrhal irritation of the respiratory organs
(and of the intestines); gurgling and rolling in the ilio-coecal
regions, and more or less perceivable swelling of the spleen.
The swelling of the Peyerian glands, which some authori-
ties consider the essence of the disease, may be wanting at
first, and still the disease be a typhus, and if wrongly treated
by venesections, or Homoeopathically by large doses of
422 A Chapter from jahr’s Zatest Work. [Sºuty,
Aconite or Crocus, we will see them sooner than it is pleas-
ant to us.
2. No disease is more insidious in its course than typhoid
fevers, for over night they may change from an apparently
light case to a most critical one, still for the normal course
we may accept the following stages: 1. Prodromi. 2. The
stage of phlogistic irritation, with predominating cerebral
affection. 3. The stage of decreasing vitality, with begin-
ning abdominal affection. 4. Perfect abdominal typhus.
5. The crisis. In its regular course each stage lasts about
a week, and generally the progress of typhus makes itself
known in periods of seven days. The prodromal stage shows
already very characteristic symptoms. The patient feels
tired, indisposed, not in good spirits, with the presentiment of
an approaching severe disease, want of appetite, painfulness
of the pit of the stomach to strong pressure, from time to
time pains in the back or electric twitches in the extremi-
ties, sometimes vertigo, headache, with feverish pulse, at
times diarrhoea. These three last symptoms, which, added
to others, are to me a sure forerunner of a typhus, pass off
frequently (except the feverish pulse) shortly before the
eruption of the fever itself, without any medicinal aid.
The eruption commonly takes place on the eighth day of
the prodromi, and even sometimes after the patient appeared
to feel better for twenty-four to forty-eight hours, and had
relished some food; it is announced by a chill, eman-
ating from the back, followed by severe burning heat and
a degree of debility, forcing the patient to keep his bed.
Henceforth the heat increases, with great thirst, full, fre-
quent pulse (mostly 120), scanty, red-brown urine, and
evening exacerbations; painful pressure in forehead and occi-
put set in, with vertigo, and dullness of the mind, increasing
soon to stupefaction, and buzzing in the ears; cough, with
some expectoration, and more or less oppression in the
chest; sometimes, but rarely, inflammation of the tonsils,
or of the lungs. Frequently towards the fourth day of this
stage the Sudamina or white miliaria, or petechiae, so peculiar
to typhus, appear; these are most apparent on the abdomen;
1869.] A Chapter from Şahr's Zatest Woré. 423
and, after this eruption, epistaxis or swelling of the parotid or
maxillary glands sets in, the catarrhal affections decrease, and
about the sixth or seventh day of this stage the patient feels
somewhat easier. But on the night of the eighth (fifteenth
from beginning of prodromi) new fever-heat arises, the skin
feels dry and like parchment, calor mordax, shows the
beginning of a new stage, where the petechiae, if not pres-
ent before, are sure to make their appearance; a brown
mucus accumulates on the dry tongue, on the teeth, and
in the nose; the abdomen bloats, gets sensitive to pres-
sure, and frequently a cadaverous-smelling diarrhoea sets in.
The more the abdominal affection increases at this stage the
more we will see of the well-known typhomania, during
which the patient lies unconscious and stupefied on his
back, and is absolutely insusceptible to the impressions of the
outer world. These symptoms increase steadily up to the
fourteenth day (the twenty-first from the appearance of the
prodromi), although some imperfect critical endeavors may
show themselves on the tenth and eleventh, but most symp-
toms aggravate mostly after them. Toward the thirteenth
and fourteenth days of the real fever the danger of life is
at its height, as a new aggravation sets in again, wherewith,
if no decided crisis is brought out, the disease enters its
fourth stage, that of the exquisite abdominal typhus in its acme.
Should no critical decision follow at this time, death by
apoplexy may ensue at the entrance of this stage; or, if
this does not happen, all symptoms increase at any rate in a
fearful manner, the patient sinks down to the foot of
the bed, stool and urine pass involuntarily, carphology
and twitching, and death follows on the twenty-first or
twenty-eighth day of the fever (the twenty-eighth or
thirty-fifth of the prodomic included). But should the
crisis have been decisive on the fourteenth and twenty-first
days, with the breaking out of a copious, alleviating sweat,
and undulating pulse, further critical symptoms will mani-
fest themselves in this stage; pultaceous, though foul-
smelling, still alleviating stools appear, the urine increases
and makes a sediment, the plugs in the nose and the mucus
424 A Chapter from jažr’s Załest Work. [galy,
in the bronchi loosen, the tongue cleanses itself and gets
soft, consciousness returns, the fever ceases, the thirst is
gone, and all functions return by degrees to their natural
state. Thus the critical process continues with more or
less celerity up to the twenty-first or twenty-eighth day, but
on this day new fever symptoms frequently show them-
selves, which, wrongly treated or through dietary mistakes,
may arouse light deliria, disturbing the critical excretions,
so that its duration may be lengthened to the twenty-eighth
or thirty-fifth day. But even, without any mistake being
made, the twenty-first and the twenty-eighth days of the
real fever are always more or less critical days for the con-
tinuance of the excretions, taking often fourteen days for
its completion, so that the total course of a fully developed
typhus is never finished up before the expiration of the
fourth week, counted from the real eruption of the fever.
But if the crisis is the least disturbed, it will take two weeks
more to finish it. The most momentous days during its
whole course are the thirteenth and fourteenth of the real
fever; and should there no amendment have taken place,
and no crisis appeared even on the twenty-first or the
twenty-eighth, then I consider the patient past all hope,
especially if he was treated with abstraction of blood and
large doses of Quinine.
3. Complications.—As such I consider all manifestations,
which, though a natural consequence of the typhus, do not
belong necessarily to its essential complex of symptoms, but
may be present or not. Such are the vertigo, the epistaxis,
or syncope in the beginning of the disease, which some con-
sider as unfavorable symptoms, although I do not fear them
more than any others. But when, after the prodromi have
passed off, the chill is followed quickly by heat, and the
patient loses right off all consciousness, with involuntary
passing of stool and urine, then we may give a diagnosis
infaustissima. Neither am I afraid of pneumonia or hepa-
titis, appearing at the first true stage, or haemorrhage from
the anus, if only the other symptoms are not unfavorable,
and the strength does not give way too much. The sooner
1869.] A Chapter from 7ahr’s Załest Woré. 425
petechiae or sudamina appear, the more favorable I consider
my case; but red miliaria or erysipelas allow only a bad
prognosis. Parotitis, or gangrenous ulcerations are not
absolutely unfavorable. Diarrhoea, before the crisis has
set in, may be looked upon as one of the worst symptoms,
indicating always ulceration of the Peyerian glands, which
are justly so much dreaded. But at the critical time pulta-
ceous and alleviating stools are welcome signs; before that
period the most obstinate constipation is far more prefer-
able than the smallest diarrhoea. As favorable symptoms,
may be considered therefore : Appearance of sudamina
and petechiae from the fourth to the eleventh and from the
ninth to the sixteenth days, full remissions during morning
hours, a moist tongue, and when the mucus in the nostrils
remains moist. But should the eruption not make its
appearance in the first week of the true fever, or if the
petechiae are of a pale or purple color, or haemorrhages from
nose or anus set in, with bluish aphtha and ulcers in the
mouth, dry, brown tongue, Sordes on mouth and gums, dry
crusts in the nose, or, worse still, if we see suggillations
under the skin, carphology, twitchings, blueness of the nose
and ears, then it will tax our utmost skill to save our patient.
In general I am not afraid of a dry, brown tongue, with
sordes on nose and lips, if the patient has only a good consti-
tution, and no other bad symptoms are complicating the case.
In fact we can never say from one symptom, as such, that
it is good or bad; we must take the totality of symptoms
to render a decision in such a case. For, under the most
favorable circumstances, we do not know what we may find
the next morning, after leaving our patient in a perfectly
satisfactory state the evening before, and a perfectly cer-
tain prognosis is just an impossibility in such an insidious
disease.
[Jahr has forgotten to value the use of the thermometer
in typhus as a ready means for diagnosis and prognosis.
Dr. W. Neftel shows, in the “Medical Record,” that the
average temperature of a healthy man, examined in the
426 A Chapter from Şahr’s Zatest Work. [gay,
axilla, is 98.6° F., and should not exceed a few tenths of a
degree on either side. Virchow teaches, as soon as the heat
of the body is above 100.4° we must consider the patient
in a febrile condition, and fever may already be suspected
when the heat exceeds 99.5°. Dr. Neftel shows, then, that
in the period of invasion that the temperature increases in
regular zigzag, as:
1st day, morning, 98.6; evening, 100.4,
2nd “ {{ 99.5; {{ 101.48.
3rd “ {{ 100.4; {{ 102.56.
4th “ {{ 101.66; “ 104.
This curve is quite characteristic for the diagnosis of typhoid
Jever, as no other disease presents similar fluctuations of
temperature. In the second stage the heat continues to rise
during the exacerbations, until it arrives at its maximum
(104 to 106.7), and remains so for several consecutive even-
ings, falling off in the morning remissions from # to 13°.
Then, at the end of the second week, sometimes, after a
critical perturbation, begins the period of defervescence.
During it the exacerbations become lower, and the remis-
sions fall considerably deeper, until all difference between
the morning and evening temperature has disappeared, and
the return of the normal 98.6° announces convalescence.
Between the first and last stage comes the undecisive
period (Wunderlich’s amphibolous period), lasting from a
few days to several weeks, presenting a great variety of
irregularities in the fluctuations of the temperature, gener-
ally remaining as high as during the fastigium. Irregular
rising of the temperature is the early and sure sign of some
local trouble, either in consequence of new deposits in the
intestinal canal, or of some complications, or of a relapse
of the disease. When, on the other hand, the temperature
has suddenly fallen, sometimes much under the normal, it
is the earliest symptom of perforation of the bowels, or
haemorrhage.
The amphibolous stage goes over either into the defer-
vescent or into the proagonic stage, in which last case the
1869.] A Chapter from jah?’s Zatest Woré. 427
heat continues to rise enormously, without remission, to
108.5° to 109.4°.
With regard to prognosis, the thermometer is again our
best guide. A case is always severe when the morning
temperature exceeds 103.1° to 104°, and that of the evening
gets over 104.1° to 105.8°, when the exacerbations begin
early, or continue after midnight, and the remissions com-
mence late, and are of short duration.
Wunderlich considers the temperature of 106.16° of very
great danger; at 106.51° twice as many patients die as
recover; and from 106.7° upwards, recovery is an excep-
tion. If the morning temperature rises to 106.16°, death is
certain. Any, excess over 107.6°, is incompatible with
life.—Medical Record, Nov. 16, 1868.]
4. Treatment of Typhus.-Jahr is decidedly opposed to the
alternation of remedies as it is usually done. Something
quite different is the alternation of Rhus and Bryonia, as
recommended by Hahnemann and Boenninghausen, where
this alternation is not simultaneously, but in such manner,
that when Bryonia after a few days gives no improvement
we change to Rhus, and when this has done all we expect
from it, we may return to Bryonia, if it should be clearly
indicated again. Goullon recommends to give each remedy
time to develop its remedial resources, and only, if we see
after twelve hours no amendment whatever, to change to
another one. Even in the most severe cases I have hardly
ever used any other remedy but Bryonia, Rhus, (Nua, Vom.,
Bell.), Lycop., (Carb. Veg.), Phosph., Arsen., Calc., Nit. Ac.,
and Sulph. The use of cold water, for sponging, is recom-
mended in all cases; also the constant opening of windows,
in order that the patients may enjoy always a pure air, being
only careful not to have them exposed to a draught; for it is
a well-known fact, that in armies on their march, the soldiers
attacked with this fever do better during the march, being
exposed all the time to a pure, fresh, and even cold air, than
their comrades in the dingy hospitals. I recommended
once to a lady, suffering from typhus, to pass all the day,
428 A Chapter from Jahr's Zatest Work. [gº,
if possible, in her garden (it was in hot summer), and she
passed through the disease without any untoward symp-
toms. In relation to diet, I allow the patient, till the appear-
ance of critical sediment in the urine, nothing else but
slimy drinks (oatmeal gruel, ice water, etc.,) and only, after
the fever has passed off entirely, some good beef tea; then,
after a while, a quarter of a-pigeon, as first animal nourish-
ment, with some stale bread; after a few days some lean
mutton chops, and so they may return by degrees to their
usual meals; but only then when they are able to take a
walk, or begin to follow their usual avocations again.
(a). Prodromal Stage.—Taken hold of in time, the whole
disease may be checked, or so moderated that the patient
has only the usual typhoid apathy, absolute loss of appetite,
with slight gastric affections, morning remissions and even-
ing exacerbations, and by the twenty-first day the usual
critical sediment in the urine, and the decisive perspiration.
As soon as a patient complains of this, general malaise, with
headache, white tongue, loss of appetite, frequent eructa-
tions, and restless sleep, especially when constipation and
empty eructations are present, I prescribe Bryonia ; or when
to the constipation is added vertigo, or sour or bitter eruc-
tations, N. Wom. But should diarrhoea be present (for which
Bry. will sometimes help), and should Bry. have done noth-
ing, and the eructations are still empty, Rhus is indicated;
and should this fail, or the eructations be bitter-sour, we give
Puls., or Phosph. I always use only one dose of 2–30, dry,
on the tongue, and if there is no amelioration in twenty-
four hours, neither in the headache nor in the diarrhoea,
then we change to another remedy.
(b). First Stage of Cerebral Irritation (Typhus Cerebralis).-
Aconite is here never indicated. The chief remedy is, in all
cases, Bryonia, especially when we have also chest-symp-
toms, as dry cough, pleuritic stitches, etc. If the pains are
drawing, tearing, aggravated by motion, or even hammer-
ing, one dose of Bryonia sometimes suffices to remove this
irritation of the brain, with or without delirium. But when
the patients rave with open eyes, or see terrible phantas-
1869.] A Chapter from jahr's Zatest Work. 429
mata as soon as they shut them, or furious delirium, with
desire to escape from the bed, sets in, then Bell, is prefer-
able; or if this does not help, Hyose., or Stram., as, on the
contrary again, for mild deliria about business, Bryonia is
indicated. Again, when the delirium alternates with som-
molent coma and loud snoring, with open mouth and hang-
ing down of the lower jaw, Opium or Lachesis are the
remedies. Should the patient fall in apathetic stupefac-
tion, with perfect loss of sensation and consciousness, Hyosc.
ought to help, and when stool and urine pass involuntarily
during the stupefaction, give Arnica. When the vital power
sinks suddenly to a very low degree, with murmuring deliria,
apathic condition, insensibility, bluish-red color of the face,
and weak, intermitting pulse, give Veral. alb. All these
are only intermediate remedies, after the use of which, when
the symptoms threatening danger have been removed, and
the disease does not pass over into abdominal typhus, we
do well to return again to Bryonia, which frequently helps,
even when sudamina and petechiae are already present, and
in general, if there is only no diarrhoea; but if the bowels
are already loose, and the tearing pains in the extremities
are worse during rest, we prefer Rhus, for the moment,
although Bryonia is sure to come after a while again into
play. Should Bryonia do nothing for the catarrhal affection
of the respiratory organs, Phosph. ought to be tried. In this
stage I use every remedy, 8–30, in water (every two or three
hours a teaspoonful).
(e). The Stage of Depressed Vitality and of the Abdominal
Affections, (Typhus Abdominalis).-This stage, composing the
forming and the perfect abdominal typhus, requires mostly
other remedies besides Bryonia, and especially Rhus, Arsen.,
Calc., Lyc., Nit. ac., Phosph., and Carb. veg. If the patient
is still constipated, and not yet suffering from ulceration of
the intestines, the continued use of Bryonia may carry the
disease through to its critical decision, especially when the
sudamina and petechiae appeared during the inflammatory
stage. But if these exanthemata are tardy in their appear-
ance, and should the fever, on the fourteenth day of the real
Wol. IV.-No. 16. 3
430 A Chapter from jahr's Zatest Woré. [guly,
disease, exacerbate anew with irritation of the brain, twitch-
ings, deliria, frightful visions, or great anguish, then Cale,
carb. can not be recommended enough (whether there is
diarrhoea or not), or Lycopod., when we have murmuring
delirium, with carphology and meteorism. If no diarrhoea
has appeared, and the exanthemata are fully developed,
Bryonia may be given again with good success till critical
secretions have brought the disease to its close. Iłut if
diarrhoea has set in, and the stools are yellow, watery
and slimy, the tongue lightly coated and pale, the patient
very weak, with stupefaction, and ulceration of the fauces,
we give Phos. ac., even if the stools pass unconsciously; but
when the tongue has a thick, white coating, and the stools
are green and slimy, Nit. ac.; for dry tongue, and painless,
copious, blood-streaked stools, like water in which meat
has lain, Phosph.; for dry, withered tongue, and hard as
wood, with watery, yellowish-brown, cadaverously-smelling
or bloody stools, Rhus ; for brownish-black, unconsciously
passing stools, Arsen., or Carb. veg. : or Phosph., when the
stools are entirely black, like coffee-grounds. Should to
these symptoms of ulceration of the bowels be added haem-
orrhages from the anus, Nit. ac. will mostly be indicated,
and should this not suffice, Arsen., Mur. ac., or Phosph. ;
for haemorrhages of other organs, Phosph., Arsen., or Carb.
veg. Against excessive prostration, with sinking down in
bed, and threatening paralysis, we may try Rhus, or Arsen.,
or Muriat, ac., or Carb. veg.
(d). Pneumo. Typhus and Affections of the Liver.—The pneu-
monic symptoms in typhus yield mostly to the remedies
given for the totality of the symptoms, especially Bryonia
and Rhus. But should they appear with such force as to
supplant, as it were, all the other symptoms, and Rhus or
JBryonia have availed little, then we may give Phosph, with
confidence, especially if a concussing cough, either dry,
or with thick, yellow, tough expectoration, troubles our
patient. If there is much mucous rattling, with stupid
or furious delirium, Hyose. Should oadema pulmonum
threaten, Tart, emet, Carb. veg., or Phosph., may ward off
1869.] A Chapter from Jahr's Załest Work. 431
all danger. For irritation of the liver in typhus, we may
try Bryonia, Laches., Lycop., or Mercur.
(e). The Critical Stage.—It happens, sometimes, that at
this stage the disease takes again a bad turn, but the same
remedies, mentioned already, suffice, and Rhus, Arsen.,
Carb. veg., and Mur. ac., are more frequently indicated.
If after the cessation of critical excretions, a feverish state
remains, the appetite does not return, and the patient still
feels under the weather, then Cocculus will produce this
feeling of reconvalescence, and if the strength will not
return, Veratrum will help.
Dr. Neftel says, in the article already mentioned, that the
degree of intensity of typhus and the danger of life depends
on the high temperature, and there remains, therefore, but
one predominating indication, to subdue the heat. Brand’s
principal rule is never to allow the temperature to rise
above 103.1°, and as soon as it comes to it, immediately
to cool the patient according to the degree wanted. Brand
in his work, “Die Heilung der Typhus,” (Berlin, 1868),
orders the following treatment: IIe gives his patients a
tepid half-bath, with cold affusions, four or six times per
day. As the greatest heat occurs from ten to twelve A.M.,
and from four to six P.M., a bath is given just before ten
and before four o’clock, and besides, at every other time,
when the thermometer shows 103.1°. The patient is left
in the bath from five to fifteen minutes. The cold bath
diminishes the temperature of the body from 1.8° to 5.4°,
according to its intensity and duration. In order that the
evaporation of water should continue to produce cold, the
patient is not dried after the baths, between which he is
occasionally sponged over. A wet cloth is laid on the
head, and another on the chest and abdomen, so that a
continual refrigeration is kept up on one-third of the body.
Every quarter of an hour, if the patient is not asleep, he is
offered a little cold water to drink, and every three hours
nourishing food in a fluid state. The room is kept well
ventilated, and stimulants are avoided, unless a collapse should
432 Aforce. [3 uly,
take place; that, however, does not occur under this treat-
ment. By keeping the temperature below 103.1, all exacer-
bations are avoided, and the fever kept in a continuous
remission. The course of typhoid fever is thus rendered
mild and short, the convalescence very rapid, and the mor-
tality none whatever. *
Typhus fever, so dreaded by the regulars, will be another
triumph to Homoeopathy and Hydropathy, for if we are
able to reduce its mortality to a minimum, we have done a
great service to humanity. *
FORCE:
AND SOME OF ITS RELATIONS TO LIFE, HEALTH, DISEASE, AND
MIEDICATION.
By H. P. GATCHELL, M.D., KENOSHA, WIS.
No. III.
THE material universe has been defined as matter and
motion. If to this we add arrangement, the definition
may be considered as complete. Accordingly, all the phe-
nomena of the material universe may be reduced to
quality, arrangement, and motion of matter This propo-
sition includes alike chemical and physical, inorganic and
organic.
It is not improbable that all movements of bodies, vast
or minute, inorganic or organic, may be due to impulses
received from contact of other substances in motion; and
since heat is but an expression of a certain mode of motion
of the minute constituents of matter, it would seem that an
interior movement must be incessantly maintained in all
bodies*. What is true of the mode of motion termed
heat, must be true also of light and electricity. The con-
stituents of bodies must needs be influenced more or less
* Heat, regarded as a cause, is an imparting of motion; regarded as an
effect, it is a receiving of motion. º
1869.] Aſorce. 433
by photic or electric undulations inadequate to affect sen-
sation, as well as by those which are adequate.* All
motions thus produced must be either atomic or molecular;
since all bodies are either simple, constituted of one kind
of atoms, or composite, constituted of two or more kinds;
and the molecule is the smallest possible chemical combi-
nation.f The two classes of bodies may, therefore, differ
very much as to their interior motions. For if the motions
of the atoms of composite bodies extend beyond mere vibra-
tions within their respective molecules, the result is, of
necessity, decomposition, or chemical change. The interior
movements of these bodies must, therefore, be limited to
those of their molecules only. In other words, their
atomic movements are materially modified by their mole-
cular arrangement. This is a deduction, it seems to me,
too obvious to need proof, since all observable change of
arrangement involves change of property. But Tyndall
has shown that the thermal force of a molecule may exceed
by several hundred fold that of its constituent atoms, this
difference, of course, extending to the entire body consti-
tuted of the molecules.
Now, as all organized bodies are composite, as the char-
acteristic movements of these bodies are molecular, and as
molecular movements are physical, it follows that life is the
sum of the physical movements of organized bodies; the pecu-
liarities of motion being due, primarily, to peculiarities
in kind and arrangement of atomic constituents. So that,
though chemical action is incompatible with vital, as being
destructive of organic constitution, yet chemical combina-
* Perhaps the Brownian motion is but an exemplification of these
movements agitating the entirety of very minute bodies.
# Chemistry is the science of the combinations and dissolutions of dis-
similar atoms. If, therefore, the atoms of simple bodies combine in definite
molecular forms, as the phenomena of allotropism would seem to indicate,
some other term than molecule is desirable to express such combination,
since its properties differ much from those of the chemical molecule. If
the term molecule is employed to express a simple union, it should at least
be qualified by the word physical, to distinguish it from the composite which
is chemical.
434 Porce. [$ºuly,
tion underlies all organization, and chemical law is co-ex-
tensive with physiology; the slightest difference in chemical
composition involving a corresponding difference in interior
motions, and hence in vital phenomena.
While, therefore, organic chemistry is not identical with
physiology, it is not only inseparably associated with, but
is fundamental to it. Deing so, it must ultimately, when
atomic relations and influences are better understood, fur-
nish the basis of explanation of vital operations. For what-
ever may be the peculiarities of the organic molecule, those
peculiarities depend on the nature and arrangement of its
atoms.
Robin and Clemenceau betray very superficial thought
when they say, as distinguishing the inorganic from the
organic, that in discussing the chemical combinations of the
former, “we necessarily go back to the atom which alone
is immutable; ” since the organic molecule is, in general,
still more mutable than the inorganic; and in discussing
its chemical combinations we equally go back to the atom.
For, unless we would plunge into remediless confusion, we
must recognize the molecular as the elementary action of all
composite bodies, whether organic or inorganic ; and we
must limit the idea of chemical action to atomic changes,
whether in the inorganic or organic.
Accordingly, an accurate expression of the relation of the
molecule to life is essential to a definite and correct idea
of the latter, and this I will now endeavor to give.
In my first and second articles, I did, for simplicity’s
sake, and in view of the partial development then given of
the subject, express the force of the molecule as the sum of
the forces of its constituent atoms. But, at the same time,
I intimated the provisional character of this definition in
the allusion to gypsum as compared with lime and sul-
phuric acid, and still more distinctly in the illustration
derived from several forces acting at different angles on
the same body. While the force of a body composed of
similar atoms may be but the sum of the forces of its con-
stituents, the force of a body composed of dissimilar atoms,
1869.] Aorce. 435
chemically combined, is a resultant, rather, of the forces of
its various elements. Hence, the force of every composite
body is a resultant rather than a sum; and as every organic
body is composite, it follows that vital force is always a
resultant*. If any organ or tissue is composed of simi-
lar structural forms, then its force is the sum, merely, of the
forces of those primary forms. But if it is composed of
dissimilar structural forms, then its force is not so much
the sum as the resultant of the forces of those primary
forms. A striped muscle-fibre is simple tissue so far as
it is composed of discs (or at least of granular arrange-
ments), that are similar throughout its entire length; and
its force is but the sum of the forces of these discs. But,
as an organ, it is not to be considered apart from the capil-
laries that supply it with nutriment and oxygen, or the
nerves that rouse it to special action. Thus viewed, it is a
complex structure, and as such it must be regarded as dis-
playing a force that is a resultant rather than a sum. And
this is much more emphatically true of the whole body,
composed as it is of such a variety of atoms, molecules,
cells, tissues, and organs.
It is the variety and complexity of the operations of
organic bodies, resulting from variety and complexity of
composition and structure, that have contributed so much
to causing their forces to be regarded as belonging to a
different sphere from the inorganic. But when we consider
that the fundamental operations are carried on in almost
inconceivably minute pores, and when we consider farther
how greatly the efficiency of action is increased by thus
bringing substances into exceedingly intimate local rela-
tion, we shall cease to wonder so much over organic pro-
cesses. We shall find them to differ from inorganic rather
in variety and complexity than in kind or degree. Such
is the force exerted by minute pores in the absorption of
fluids, that it may, according to Draper, be equivalent to
the pressure of several atmospheres; and the develop-
* Power, not being conditional, is a sum and not a resultant.
436 Aſorce. [9 uly,
ment of science is constantly bringing to light new analo-
gies in the actions of inorganic and organic bodies.
If muscles are capable of storing away oxygen in their
interstices, so does platinum-black absorb and store away
many times its own volume of oxygen and hydrogen.
If digested and elaborated food is oxydized in the inter-
stices of organic bodies, with development of heat, so is any
easily oxydized liquid when dropped on platinum-black.
Even charcoal, at a red heat, is capable of effecting both
decomposition and recomposition of water.
Nor do I discover any thing more wonderful in the
decomposition of carbonic acid in the leaf-cell, or of nitro-
genous compounds in the liver-cell, than in the decomposi-
tions effected in platinum- or charcoal-cells. If in the latter
case heat is necessary to accomplishing some results that are
obtained in the former at a lower temperature, it only indi-
cates that the catalytic action of the former is more energetic
than that of the latter. In other words, the vibration of its
constituent parts is attended with greater display of force.
And if heat is necessary to intensify this vibration in the
carbon, it must be remembered that the mobile nitrogen-
ous compounds, constituting the leaf-cell, possess the
capacity of vibration, and hence of catalytic action, in a
very high degree.
Nor do I discover any thing more strange in the subse-
quent combination of the liberated carbon with water to
form carbo-hydrates, than in the combinations effected by
charcoal or platinum. Nor does there appear to be any
essential difference between the various compositions and
decompositions effected by organic bodies and those effected
by the galvanic battery.
We see substances, in the mode of motion termed gal-
vanic, impinging on free oxygen and hydrogen, and impel-
ling them to combine in the form of water; or on the same
elements thus united, and causing them to separate.
We also see organic substances in the mode of motion,
termed catalytic, impelling atoms to separate or combine.
If they accomplish these results without the aid of galvan-
1869.] Aſorce. 437
ism, so does platinum accomplish without, what charcoal
accomplishes with, the aid of heat.*
It does not matter, so far as the result is concerned, what
the special agency is, by which motion is produced in the
substances acted on. It may be heat, galvanism, or any
other motion of the operating atoms or molecules. And
no where can the subject of action be more favorably
placed than among the loosely combined elements of nitro-
genous substances, which are found wherever vital actions
are carried on.
But it would be assuming too much to deny that both
heat and electricity are active in the interstitial operations
of organic bodies, since they attend on molecular actions in
general. That the photic movement also attends these opera-
tions is shown by the development of light, where the vibra-
tions are sufficiently rapid. And it is to be remembered
that comparatively feeble motions, whether electric or
thermal, are capable of producing remarkable effects when
the substances to be acted on are brought into indefi-
nitely close local relation to the substances acting. This
relation is much more intimate in the interstices of organ-
isns, than is that between the wires and the water to be
decomposed by the galvanic battery.
As to the variety of operations performed by organisms,
as for instance by the liver, that depends in a great measure
on the variety of substances submitted to action. Let us
not forget what a variety of processes is accomplished, and
what a variety of results is obtained through the agency
of the comparatively simple platinum, according to the
number and character of the substances exposed to its influ-
ence, every new substance involving different atomic move-
ments and different material results.
The diversity of organic operations is in no greater ratio
than the complexity of composition and structure of organic
*Is it not probable that these black and porous substances manifest
so great energy, partly in consequence of their capacity for absorption of
light and heat; in other words, the capacity of their constituents for
motion?
438 Aforce. }uly,
bodies, and to the variety of substances acted on by them.
Accordingly we have, in the complexity of organic forms, in
the looseness of their combinations, in the freedom and variety
of motion of their elements, and in the minuteness of the
pores in which substances are subjected to their influence, suf-
ficient explanation of both variety and force of action. And
I conclude that the action of the leaf-cell, and of the organic
cell in general, belongs to the same order as the action of
platinum- or charcoal-pores; that it is physical action in the
leaf just as much as in the metal or coal; and that in all
these cases we have but the exciting of motion in the sub-
stance acted on through the motion of the substance acting.
I emphasize the operations of the plant, because its mole-
cular actions are more energetic than those of the animal.
It is capable of effecting atomic changes quite beyond those
of the latter. It alone is capable (with the possible excep-
tion of some low animal organizations with less structure
than plants themselves) of building up organic substances
out of mineral matter. It alone can form albumen, fibrin,
or casein. The animal can not even form the carbo-
hydrates or hydro-carbons (in this respect surpassed by the
chemist in his laboratory), but in the way of degradation
of the nitrogenous combinations, as a step in the process of
reducing them back to the mineral state. The animal, for
which the plant exists, can only accomplish the destruction
of those complex combinations which the plant with infinite
pains has organized; it can not restore them. The animal
expends in muscular and mental action the force which the
plant expends in those indispensable productions.
Let us consider also that the cell, which is the principal
if not the exclusive agent of elaboration, is, by its form,
peculiarly adapted to the discharge of this function.*
* All cell-function may be, at least so far as cell-contents are con-
cerned, not inaccurately stated as that of communicating motion atomic or
molecular. In the process of elaboration the communication is attended
with a new atomic arrangement and composition, an action that is charac-
teristic of gland-cells. º
Nerve-cells, on the other hand, merely cause molecular disturbance in con-
nected nerve-fibres, without atomic displacement.
Molecular movement also is implied in the act of Secreting.
1869.] Aſorce. 439
Its especially active elements are confined within a limi-
tary membrane. Into the midst of these mobile elements
the substances to be acted on are introduced, and, thus
surrounded, they readily respond to the motions of the cell-
COntents.
Tyndall has shown that the vastly inbreased thermal
energy of the molecule, as compared with that of its constit-
uent atoms, is associated with the absorption of the ther-
mal waves into, and radiation from, its interior. Not only
are the atoms combined into the molecular form, capable
of manifesting much greater energy than they are capable
of when uncombined; but apparently, also, they act more
efficiently through the influence of their individual vibra-
tions on the absorbed fluid than if that fluid were external
to, and agitated by the swing of, the entire molecule.*
Now the cell, in the process of elaboration, acts only on
those fluids that have penetrated its walls. These, absorbed
by its granules, are subjected to the action of their vibrat-
ing molecules; as, in the molecule described by Tyndall, is
the more ethereal fluid by the surrounding atoms. . As the
contractile force of a muscle is but the force of its various
fibres, so is the secretory or elaboratory force of a cell but
the force of its various molecules.
But it should not be forgotten, that in the performance
of its functions, especially of secretion, the cell-walls
play an important part, since they discriminate more or less
as to the substances they shall introduce. This is no more
evident as to the terminal cells of the radicles of plants than
it is as to salivary, gastric, pancreatic, hepatic, or ence-
phalic cells. So that the results of cell-action depend
quite as decidedly on the agency of the walls as on that of
the contents. &
* To one not learned in such matters, Virchow's doctrine of “cell-juris-
diction” seems quite absurd, notwithstanding his dogmatic method; and if
Beale is at all to be relied on, it would seem that there is no foundation
whatever for Virchow's assertion. It is ever well to remember that noth-
ing acts where it is not.
44O Ge/sem?mum ºn Parturition. [9'uly,
The secretory function of the cell-wall may be defined as
elective absorption, some substances being admitted and
others repelled; the elaboratory as well as molecular action,
resulting in atomic changes in substances submitted to that
action.
When tubules or fibres are developed by changes in cell-
walls, or from materials elaborated by cell-action, cell-struc-
ture and cell-function have ceased. Whatever may be the
character of the fibre, elastic or non-elastic, contractile or
conducting, it is a fibre and not a cell. It has its own pecu-
liar functions, quite distinct from those of a cell. It is no
longer a secreting or elaborating organ.
But it may still be living, and may contribute conditions
important to the general life, as may other parts that have
not a fibre-form. In its interstices, e.g., may be stored
up oxygen during sleep, rest, and fasting, to combine with
the interstitially circulating plasma for the development of
heat and electricity, or whatever mode of force is necessary
to systemic action.
ADIDENDUM.
It is probable that the substance of this article would
more appropriately have constituted a continuation of the
first of the series. But there were some points that I had
not sufficiently matured at that time. I am fully conscious
that they may yet need revision, but I could not well delay
longer.
GELSEMINUM IN PARTURITION.
By M. F. PAGE, M.D., OF APPLETON, WIS.*
Case 1.-GELSEMINUM IN RIGIDITY OF THE Os-UTERI.—
Mrs. , aet. thirty-eight, was in her seventh labor. The
labor had begun five days previous to my first visit. Three
physicians had been in attendance, and all of them had
given her up to die undelivered. The reason they assigned
* Communicated to the Cook County (Ill.) Hom. Medical Society.
1869.] Ge/seminum in Parturition. 441
for this verdict was that the soft parts were so highly in-
flamed and swollen that it would be impossible to use any
kind of instruments calculated to finish the labor. The
abdomen was extremely tympanitic and tender, the pulse
rapid and bounding, and she was rational, but in mortal
fear of death. She had every variety of labor-pains during
the five days already expired. Recently they had been
irregular, wandering, and severely aggravating in charac-
ter, recurring at intervals varying from five minutes to an
hour. The condition of the soft parts rendered an exam-
ination per vaginam quite impossible without a resort to
Chloroform, which she positively refused to take. I ordered
warm compresses, with a lotion of Arnica, to be topically
applied. She took Acon. 3, and Bell. 3, every five minutes
for a few doses. In forty minutes she fell into a quiet slum-
ber, which continued for half an hour. The pulse was
materially changed, and in three hours became quite nor-
mal. Meanwhile the pains had ceased. Examination now
revealed a vertex presentation, with extreme rigidity of the
os-uteri.
After twelve hours, during which interval she had taken
slight nourishment for the first time in nearly four days,
I gave her at one dose five drops of Gels. 1 dec., with a
view to relax the cervix. Ten minutes later I passed
my finger into the os and found it dilating, and more
readily dilatable. At this juncture the pains returned, but
were still irregular and aggravating. I waited a quarter
of an hour and then gave her five drops more. In less
than ten minutes after taking the second dose of the Gels.,
the os yielded, the pains became quite regular and expul-
sive. She grasped hold of surrounding objects to help her-
self, her inspirations became deeper, and in one hour from
that time she was delivered of a bouncing boy, whose
weight was exactly twelve pounds. She recovered rapidly,
and without post-partum haemorrhage, which she had always
had before.
I consider the Gels, specific for this unnatural rigidity of
the os-uteri in tardy labor, and never use any thing else.
442 Ge/sem?mum ºn Partwrition. [july,
Thus far it has never failed me in a seven years’ practice.
In some cases it may be well to give the mother tincture
instead of the 1st attenuation.
Case 2. —GELSEMINUM IN RIGIDITY OF THE Os-UTERI, WITII
PUERPERAL CONVULSIONS.—Mrs. , aet. thirty-five, primi-
para, was supposed to have reached “term.” Without any
premonitory symptoms of labor she was seized with con-
vulsions. She had had two of them when I arrived. They
were general and very severe. She was quite unconscious
after the second paroxysm, and I found her with stertorous
breathing, and in a comatose state. Bell, and Nua appeared
to mitigate the severity of the fits, and to lessen their fre-
Quency somewhat. Yet, for all this, at the end of twelve
hours from their onset she had had thirty-seven of them.
The os remained extremely rigid, and but slightly open.
The waters were intact.
I now commenced to give her of Gels. 1st four drops every
twenty minutes. After the third dose, or at the end of an
hour, the os became quite relaxed and dilatable at will with
the finger. The convulsions became much less frequent
and severe, and in three hours from the time she began to
take this remedy she was safely delivered of a living,
healthy child. She, however, remained unconscious during
the whole process, and for twelve hours afterwards. Her
recovery was unusually rapid, for, incredible as it may
seem, she dressed her own baby on the third day !
Case 3. —GELSEMINUM IN CONGENITAL CONSTRICTION OF
THE SoFT PARTs.—Mrs. aet, only sixteen years, and
undeveloped physically, was brought to labor at full term.
IIer physician, after a thorough examination, declared labor
to be “impracticable,” and that a resort to embryotomy
would be imperatively demanded. I was called in, and
found that the vagina and vulva were incredibly small, and
the os rigid and cartilaginous to the touch. The pains
were those proper to the first stage of labor, irregular and
extremely tormenting. I gave her of Gels. 1 dec. three
1869.] Ge/seminum in Parturition. 443
drops every twenty minutes for two hours consecutively.
In consequence the pains became more regular and forcible,
and the os began to soften and dilate. The Gels. was now
repeated every half hour. Olive oil was freely introduced
into the vagina, and applied to the vulva. At the end of
twelve hours she was happily delivered of an infant which
weighed eight pounds. Although the head was “moulded”
more than that of any case I ever saw, the child did well.
The mother convalesced promptly and without any mishap.
Case 4.—GELSEMINUM AS A PROPHYLACTIC of PROTRACTED
LABOR.—I was called early one morning in April, 1865, to
go fourteen miles into the country to visit a woman said to
be in labor with her eighth child. When I arrived she was
sitting at the table eating her breakfast. She afterwards
expressed herself satisfied that her labor had really begun,
but went on to say that she had never been delivered in less
than five days from its commencement, and had always
suffered extremely with wandering pains that continued at
intervals during all that period. Nothing she had ever
taken had changed their character, or shortened the dura-
tion of this species of martyrdom. She also stated that she
was accustomed to “flow herself almost to death,” and that
after delivery her convalescence was sometimes prolonged
to from two to three months. I resorted to the “touch,”
and found the os quite normal and closed. The pains had
already continued about twelve hours. I remarked that
if five days were allowed her, she might as well take it
quietly. I prescribed five drops of the mother tincture of
Gels., to be taken immediately, and followed by two drops
of the same every two hours during the day. In the even-
ing she was comfortable. The pains had ceased entirely.
Next morning about the same. Slept well, and no pains.
The third and fourth days she had a few slight fugitive
pains, which did not disturb her equanimity. The Gels.
was given in drop doses at long intervals. At nine P.M.
of the fifth day she went to bed with the impression that
she should be sick before morning. Having inclination to
444 Grauvogl on Attenuations. [Sºuly,
stool she left the bed, and without any pain whatever she
felt the child coming, and settled herself upon the floor.
In a twinkling the whole process was completed, and with-
out suffering on her part. The child was alive. She did
not flow more than women ordinarily do, and in a fortnight
was engaged in her household duties.
GRAUWOGL ON ATTENUATIONS.*
TRANSLATED FROM GRAUVOGL's LEIIRBUCH.
§.238.
Now because Homoeopathy is in every respect an incompre-
hensible subject to its opponents, these opponents shall be
set right by an English writer. John Stuart Mill expresses
himself rightly in his “System of Inductive Logic” (p. 461),
with regard to such errors arising from lack of compre-
hension, refuting them by examples, as follows:
“It is inconceivable,” said Newton in one of his letters
to Dr. Bentley, “that inanimate brute matter should, with-
out the mediation of something else, which is not material,
operate upon and affect other matter without mutual contact.'
That gravity should be inmate, inherent, and essential to
matter, so that one body may act on another at a distance,
through a vacuum, without the mediation of any thing else,
by and through which their action and force may be con-
veyed from one to another, is to me so great an absurdity,
that I believe no man, who, in philosophical matters, has
a competent faculty of thinking, can ever fall into it.”
This passage should be hung up in the cabinet of every man of
science, who is ever tempted to pronounce a fact impossible, because
it appears to him inconceivable. In our own day one would
be more inclined, though with equal injustice, to reverse
the concluding observation, and consider the seeing any
* This paragraph was intended to be the conclusion of my reply to Dr.
Searle, but reached the printer too late. It will, however, be just as forci-
ble here. C. D.
1869.] Dr. Harley on Conium Maculatum. 445
absurdity at all in a thing so simple and natural, to be
what really marks the absence of “a competent faculty of
thinking.”
“Gravitation, without an interlying medium, may be
incomprehensible in itself; but even if one assumes it to be
incomprehensible, yet this may be a limitation of our own
minds without being a limitation of nature.”
This denunciation reaches not only Allopathists, to whom
the efficacy of all attenuations appears inconceivable, but
also many Homoeopathists to whom the efficacy of high
potencies sounds like a fable. *
But the contents of this work will show, beyond a ques-
tion, that both parties are wrong; and let one consider that
to them also the well-being of man is entrusted, that hence
they should know all means which can help the patient
towards health again, so that every a priori depreciation of
the practical experience of others exposes one to the
reproach of the most revolting want of conscience. This
heathenish want of conscience is to be presumed concern-
ing every physician who has not studied and properly
appreciated the whole of Homoeopathy, for to this inex-
cusable want of conscience, thousands of human lives fall
victims every day, and the French Academy of Science,
which covers this want of conscience with the nimbus of
its authority, can not too soon and too openly recant its
gross error.
T)R. HARLEY ON CONIUM MACULATUM.
BY CARROLL DUNHAM, M.D., NEW YORK,
THE idea of a Materia Medica Pura — a collection of the
effects of drugs upon the healthy—did not originate with
Hahnemann. He, himself, quotes several of his predeces-
sors — notably, Haller, who explained and urged the neces-
sity of such a collection, as the only means of acquiring an
exact knowledge of the relations of drugs to the human
organism, and a possible key to their therapeutic use. But
Wol. IV.-No. 16. 4.
446 Dr. Harley on Conium Maculatum. [gay,
Hahnemann was the first physician who seriously devoted
a large part of his life to the labor of ascertaining these
effects, and making such a collection. Many a critic has,
to his own satisfaction, demolished IIahnemann’s work,
and shown the fallacy of his demonstration of the value of
proving on the healthy. And, until very recently, the task
of systematically developing the pure, that is the physiological,
Motéria Medica, has been left to our own school of medi-
cine. Dut the same mysterious mental and moral influ-
ences which have “drifted ” the dominant school into
admissions of the (at least partial) truth of the law similia
similibus curantur; into advocacy of the single remedy (in
theory at least); and into the concession that the therapeu-
tic power of a drug is not necessarily in the direct ratio of
the quantity, have recently overtaken prominent physicians,
especially of England; and Sir Thomas Watson has dis-
tinctly pointed to a pure Materia Medica as the possible
way to a therapeutic law, and an escape from the present
chaos of therapeutics. And Dr. John Harley, of London,
in the Gulstonian Lectures of 1868, on “The Old Vegetable
Neurotics,” has given us an installment of the “pure Ma-
teria Medica” of the future, as the Allopathists understand
and propose to construct it. His work presents the physio-
logical action and therapeutic use of Hemlock, Opium, Bella.
donna and Henbane, alone and in combination. It is worthy
of our most thoughtful study. We must not allow a par-
donable feeling of satisfaction that the opponents who
would have overwhelmed with scorn our Materia Medica
Pura, have now come to build such a structure for them-
selves after our plan; nor hug ourselves in self-sufficiency
because they disdain to use the materials we have fathered.
While we have labored in our departments of Materia
Medica and Therapeutics, the Allopaths on their side have
not been idle. The sciences of physiology, pathology, and
organic chemistry have, through their industry, made won-
derful advances, and now all the resources which these
sciences afford them are brought to assist our opponents in
their physiological provings of drugs. It behooves us, with
1869.] Dr. Harley on Con?um Maculatum. 447
minds devoid of prejudice and conceit, and with a teachable
spirit, to scrutinize their labors and canvass their achieve-
ments, that we may profit by their contributions to useful
knowledge, and avoid the errors into which, through an
erroneous application of these auxiliary sciences, they may
chance to fall.
The first drug treated by Dr. Harley is the Conium macula-
tum. We propose to give a summary of his pathogenesis,
and his views of the therapeutic uses of this drug, and then
to give a parallel summary of Hahnemann’s provings and of
our clinical experience, with reflections upon the similari-
ties and differences. A similar treatment of the other
remedies discussed by Dr. IIarley will follow.
Some remarks in the preface are worthy of quotation.
Dr. Harley says:
“My object throughout has been to ascertain, clearly and definitely, the
action of the drugs employed on the healthy body in medicinal doses, from
the smallest to the largest; to deduce simple practical conclusions from the
facts observed ; and then to apply the drug to the relief of the particular
conditions to which its action appeared suitable.”
A Homoeopathist might almost have written this, cer-
tainly the first section. But in the deduction “ of simple
practical conclusions from the facts observed,” the door is
opened to hypothesis and error; and how can one “apply
the drug to the relief,” etc., unless one possess a therapeutic
law expressing the relation between such “conditions” and
the pathogenetic “facts observed ?” Here are the weak
points of Dr. Harley’s system. Until he shall have a thera-
peutic law, other than the general rule, “causa sublata,
tollitus effectus,” he will be unable to apply the remedy
therapeutically, except through the intervention of two
hypotheses, one in pathology, to account for the symptoms
of the patient, and the other in pathogenesy, to explain the
phenomena produced in the drug-proving; and the intro-
duction of hypotheses into a scientific induction makes
way for error.
Dr. Harley devoted much time to an examination of the
relative value of the different officinal preparations of
448 Dr. Harley on Conium Maculatum, gay,
Comium, most of which he regarded as destitute of medi-
cinal power. sº
Discarding the Tinctura conii fructus, the Tinct. conii (dried
leaf), and the Ectractum conii, of the London Pharmacopoeia,
as positively or comparatively inert, he describes the mode
of making the Succus conii, which he regards as a uniform
and very active preparation. We may say, briefly, that
liis process is substantially the same as that employed by
Messrs. II. M. Smith & Brother, the well-known IIomoeo-
pathic Pharmaceutists of New York. Pereira wrote in
1858: “In the present state of uncertainty with respect
to the real physiological operations of Hemlock, it is obvi-
ously impossible to lay down indications for its use which
can be much relied on.” Dr. IIarley proved Conium first
on himself, and says: “IIaving assured myself of the effects
of Hemlock in my own person, I have thus been able to
fully appreciate its operations in others, and proceed much
more boldly than I could have done without such personal
knowledge.” It would be a satisfaction to add, “more
intelligently ’’ also.
“Physiological Action of IIemlock.-The first effect of Hemlock is a depres-
sion of the motor function; and its last is the complete obliteration of all
muscular motion derived from the cerebro-spinal motor tract.”
“1. After taking 3 iij of the Succus conii, I set out walking ; and three-
fourths of an hour after the dose, I felt a heavy, clogging sensation in my
heels. There was a distinct impairment of motor power. I felt, so to
speak, that ‘the go' was taken out of me. It was not that I felt fatigue just
then, but it seems as if a drag was suddenly put upon me, and that it would
have been impossible to walk fast if urged to do so. After walking about
a mile up hill, this sensation was very decided, and on putting a foot on the
scraper at the door the other leg was shaky, and felt almost too weak to
support me. My movements appeared clumsy to mysclf, and it seemed
necessary that I should make an effort to control them. At the same time
there was a sluggishness of the adaptation of the eye. My vision was good
for fixed objects; but when an uneven object was put in motion before the
eyes, there was a haze and dimness of vision, producing a feeling of giddi-
ness. The pulse and pupils were unaffected. These were the whole of the
effects; and, after continuing for an hour, they rapidly disappeared and left
me in the possession of my usual vigor.
“2. If a strong, active individual take five or six drachms of the Succus
on getting up in the morning, and start off for a long walk, he will be over-
taken in the course of half or three-quarters of an hour with a feeling of
1869. Dr. Harley on Conium Maculatum. 449
general tiredness and a special weakness of the knees, as if he had been
regularly tired out by walking all day to the full extent of his powers. If
he be unusually active and strong, he will not, perhaps, yield to the inclina-
tion to rest, but will proceed slowly on his way, feeling a strange lightness
and powerlessness of the legs, with a tendency to drop forward on his knees.
This will be associated with some giddiness, and a feeling of heaviness over
the eyes. At first the feeling of languor will be most oppressive, but it will
soon become more tolerable; and if he should continue the journey for an
hour, he will find that the feeling of fatigue has by this time nearly passed
off. In the course of another hour he will be as active as ever.
“3. The following were the effects produced in my own person during a
period of rest, and they contrast well with the foregoing :
“Three-quarters of an hour after taking five drachms and a half of the
Succus conii, on raising my eyes from the object on which they had been
fixed to a more distant one, the vision was confused and a feeling of giddi-
ness suddenly came over me. That these symptoms were due to impair-
ment of power in the muscular apparatus employed in the adaptation of
the eye, was obvious to me; for, so long as my eyes were fixed on a given
object, the giddiness disappeared, and the definition and capacity of vision
for the minutest objects were unimpaired. But the instant that I directed
the eyes to another object, all was haze and confusion, and I felt giddy; and
in order to recover my vision and dismiss the sense of giddiness, it was
necessary to lay hold upon some object, as it were, with my eyes, and rest
them securely upon it. It was clear to me that the adjusting muscular
apparatus of the eye was enfeebled, and its contractions so sluggishly per-
formed that they could no longer keep pace with the more active movements
of the external muscles of the eyeball.
“Within ten minutes of the appearance of this disorder of vision, a general
muscular lethargy affected me, and the eyelids felt as heavy as if they were
oppressed with the deepest drowsiness. The pupils were considerably
dilated. I sat down to note these observations, but, being afraid to main-
tain this posture lest the rapidly increasing muscular lethargy should get
the better of me, I rose up again and tried to shake it off. An hour and a
quarter after taking the dose I first felt decided weakness in my legs. The
giddiness and diminution of motor power continued to increase for the next
fifteen minutes. An hour and a half after taking the dose these effects
attained their maximum, and at this time I was cold, pale, and tottering.
The pulse, which had been emotionally excited by the sudden accession of
the foregoing symptoms, was now sixty-eight, quite regular, and of undi-
minished force and volume. The legs felt as if they would soon be too
weak to support me. There was a positive diminution of voluntary power
in every part of the muscular system, and this nearly amounted to complete
paralysis as far as the hamstring and levator palpebrae muscles were con-
Cerned. At one time the greatest exertion was required to elevate the
eyelids. The mind remained perfectly clear and calm, and the brain active
throughout; but the body seemed heavy and well nigh asleep. After con-
tinuing for about half an hour at their maximum, the symptoms began
450 Dr. Harley on Conium Maculatum. [guly,
rapidly to decline, and within three hours and a half after taking the dose
they had totally disappeared.” * * * 3&
“A delicate young woman, of inactive habits, took four drachms of the
Succus. Twenty minutes afterwards, and while attending to her usual
duties, she experienced nausca and giddiness. She dropped an inkstand
which she was holding in her hand, and was unable to walk, and she was
placed in the recumbent posture. These symptoms came on with alarming
swiftness, and the pulse went up to one hundred and twenty-six from emo-
tional excitement; (?) but, in a few minutes the heart regained its usual
quietude, and She remained perfectly comfortable and calm, but without
power to move the arms or legs. An hour after taking the medicine there
was nearly complete muscular paralysis; the eyelids were closed, the pupils
widely dilated, and the mind clear, calm, and active, and she expressed her-
self quite comfortable. She tried perseveringly to raise the eyelids when I
requested her to do so, but she was quite unable to separate their margins.
The pulse and respiration were normal ; the surface warm. At the end of
an hour these symptoms passed off, and after three hours she had com-
pletely recovered her activity and resumed her duties. The next day she
complained of slight, wearisome pain in the muscles of the legs.” & 3 +
“I proceed now,” continues Dr. Harley, “to consider in detail the action
of Conium upon the nervous system. The earliest indications of the opera-
tion of the medicine are invariably those that arise from the depression of
the motor function of the third pair of nerves. They are giddiness; the
sensation of a heavy weight, depressing the eyelids, or actual ptosis; a dull,
lazy or fixed, expressionless stare, like that of a drunken person; dilatation
of the pupils. After moderate doses, the interference of vision is only such
as results in haziness, as if a thin film of transparent vapor were floating
between the eye and the object. * * * It occurs independently of any
dilatation of the pupil, and is compatible with good definition for fixed
objects. It is due to imperfect adjustment of the refracting media of the
eye from partial paralysis of the ciliary branches of the third nerve. It
is through these minute branches that the individual first becomes conscious
of the effects of the IIemlock, and if he should be reading at the time, he will
suddenly find the occupation fatiguing, and very soon afterwards it may be
impossible, and he will be glad to close the eyes to relieve himself of the
symptom, and, as the muscular lethargy begins to be felt, content to lie per-
fectly still as if asleep.
“In full doses, the depressing influence involves the other branches of the
nerve, and the lazy movements of the cycball, or dull, fixed and occasionally
divergent stare, indicate the partially paralyzed condition of the external
muscles of the eyeball ; while more or less drooping of the upper lids oxpresses
a similar condition of the levator palpebrae.
“Double vision, from inability to maintain the convergence of the optic
axes, excepting as a very evanescent effect, is a comparatively rare result
of the action of LIemlock. I have only observed it in a few persons. In one
of these, a delicate invalid, confined by weakness and ovarian disease, chiefly
to the recumbent position, two drachms of the Succus coni produced full
1869.j Dr. Harley on Conium Maculatum. 451
effects, accompanied by double vision. This was a constant symptom; it
came on half an hour after taking the medicine, and lasted twenty minutes.
After having taken the IIemlock for six months, she told me, as often as I
happened to see her during the operation of the medicine, that she saw each
object in the room double, that my eyes were also doubled, and that she felt
as if she were Squinting.
“Dilatation of the pupil occurs usually after only very large doses, and then
it is often but slight, and only observable in a subdued light — the excite-
ment of strong light overcoming the tendency to dilate just as the exertion
of a strong will strengthens for a time an enfeebled limb.
“The absence of any preponderating action of the muscles, supplied by
the fourth and sixth pairs of nerves, shows that they are equally affected
with the third pair.
“A proportionate diminution of power is also observed in the muscles
supplied by the motor branches of the fifth and seventh pairs. The con-
tractile power of the m. orbicularis, in particular, is distinctly weakencó.
“Upon the eighth pair the action of Conium is not very apparent in a state
of health; but in the spasmodic affections, arising from irritation of this
nerve, its influence is very decided.
“As to the hypoglossal nerve, I have never observed any decided loss of
voluntary power in the tongue during the action of Conium, unless, as in
chorea, some derangement of this centre pre-existed. * * * *
“In the absence of irritation, functional or lesional, it is equally difficult
to recognize any particular influence upon the spinal cord. Hemlock affects
the motor function of this part of the nervous system last of all, and, short
of a poisonous dose, it does not interfere with its motor activity, or reflex
function as it is called, in any appreciable degree. * * * *
“When, however, there is a morbid excitability of the reflex function of
the spinal cord, the influence of Conium in subduing it is powerful and
direct.
“Conium, then, in a state of health, and in the fullest medicinal doses that
we can venture to give, exerts its power chiefly, if not exclusively, upon
the motor centres within the cranium. And of these the corpora striata, of
course, are the parts principally affected.”
“Excepting, then, the reflex action of the cord, the whole motor function of
an individual, under the full influence of Conium, is actually asleep; and this
is the simplest view that we can take of the physiological action of Hemlock.
It is to the corpora striata, to the smaller centres of motion, and to the
whole of the motor tract, precisely what Opium is to the brain of a person
readily influenced by its hypnotic action; and just as Opium tranquil-
izes and refreshes the over-excited and weary brain, so does Conium
soothe and strengthen the unduly-excited and exhausted centres of motor
activity.” # * * * *
“The influence of Comium appears to be in proportion, not to the mus-
cular strength of the individual, but to his motor activity. * * * A
dull, inactive child requires, to produce a given effect, only half the quantity
that a lively active one does.”
452 Dr. Harley on Conium Maculatum. [galy,
This observation is in conformity with the law; the more
similar the symptoms the smaller the dose.
“Upon the cerebrum, IIemlock is powerless. I have never been able to
recognize the least narcotic, nor directly hypnotic, effects.”
“Like the cerebrum, the sensory part of the nervous system is altogether
unaffected directly by the action of Conium. Its anodyne power in certain
diseases may be fairly attributed to muscular relaxation in the diseased
parts, rather than to a direct influence upon the sensory nerves. * * *
Of its anodyne influence upon the facial branches of the fifth nerve, I have
been unable hitherto to obtain other than very doubtful evidence. * * *
I think that we may trace the anodyne influence, which Hemlock undoubtedly
exercises over the sensory branches of the fifth nerve, to the power that it
possesses of calming the general irritability of the motor centres. * * *
Conium has no influence upon the circulating organs, upon the secretions,
or excretions, or directly upon nutrition. Its influence upon the sexual
functions is traceable to a direct action upon the spinal cord.”
After thus describing the physiological action of Conium,
Dr. Harley discusses its therapeutic value, giving examples
which comprise all the cases in which he has used Hemlock
alone. He gives the following general conclusion: “Hem-
lock given in doses which fall far short of producing its
proper physiological action, is useless in the treatment of
diseases for which, it is adapted.” The Homoeopathist will
perceive that Dr. Harley comes to this conclusion because
he regards and uses Hemlock as “adapted ” only to cases to
which it is emantiopathic.
“In selecting IIemlock as a remedy in the treatment of nervous diseases
* * * we must be guided by that simple view of its physiological action
which I have now so fully stated; and then the only question to be pro-
posed will be, is there irritation, direct or reflex, of the motor centres? If
there be, Conºwm is the appropriate and hopeful remedy.”
The Homoeopathist will ask: May there not be many
varieties of such irritation, varieties in kind, extent, and
complication ? And again: May not the results of irrita-
tion occurring in individuals of different idiosyncrasy, be
very various? And are all such varieties to find their
“appropriate and hopeful remedy” in Conium ? How con-
stantly, then, will Conium be prescribed in our daily prac-
1869.] Dr. Harley on Conium Maculatum. 453
tice; for how few cases fail to present “irritation, direct or
reflex, of the motor centres 7 °
Dr. Harley gives examples of the beneficial action of
Conium in cases presenting tendencies to convulsions. A
case of epilepsy was ameliorated. Muscular tremor and
chorea were cured; but the rapidity of the cure in the six
cases of chorea is not such as a Homoeopathic physician
would consider creditable. Dr. Harley does not ascribe
chorea to a perversion of the co-ordinating function. He
doubts if there be such a function, and regards chorea as
due to “an undue excitability of the motor centres, which
throw off impressions so rapidly that the will is puzzled to
control them.” If this be all that chorea is, Conium, accord-
ing to Dr. Harley, should cure every case. As a matter of
fact, we see a great variety of symptoms in different cases
of chorea, and similarly we see great varieties in the modi-
fications which different medicines produce in the motor
functions. Dr. Harley's (the physiological) method takes
no account of such varieties. It is not broad enough for
the facts of nature with which it assumes to deal.
He proposes to use Conium in tetanus, and has employed
it in spasm of the oesophagus and stomach; in the globus
hystericus; in spasmodic cough, laryngismus stridulus, and
pertussis; in paraplegia, and in concussions of the spine,
and in exhaustion and irritability of the sexual organs.
He speaks highly of Conium as a remedy in inflamma-
tory diseases of the eye, and gives six cases of “strumous
inflammation of the conjunctiva, more or less involving the
cornea and iris, successfully treated by Comium alone and un-
aided by external applications. The speedy relief from the
photophobia, lachrymation, and spasm of the orbicularis has
often surprised me.” He accounts for its action on the
ground, that “in producing complete muscular relaxation
it acts beneficially in relieving pain and tension, and thus
removing irritation.” It is difficult to believe that stru-
mous ophthalmia (keratitis) depends on “spasm of the
orbicularis and corrugator supercilii.” Conjunctivitis pal-
pebralis, at least, is well established, and, in most cases,
454 Dr. Harley on Conium Maculatum. [guly,
destructive keratitis has set in before the spasm becomes a
prominent symptom. Dr. IIarley gives an excellent case
of this disease cured in three months by two drachm doses
of Comium every second day. I shall give the record of a
severe case cured in one month by a few doses of Conium
200.
In cancer he considers Hemlock a palliative, in that it
allays muscular spasm, and thus mitigates pain. In glan-
dular enlargements, and in cerebral diseases, he has found
no benefit from Conium.
In these citations we have given a fair and full view of
Dr. IIarley’s proving of Conium, and experience in its thera-
peutic use. He admits its imperfectness, but seems to
regard this as relating to extent rather than to method or
principles.
Let us now reflect a moment on this method of regarding
and stating the physiological effects of a drug. How satis-
factory it appears to have the entire action of a drug con-
densed in one crisp generalization like this of Dr. Harley,
instead of having to read page after page of symptoms
arranged in anatomical order And how easy seems the
application of such a generalization to therapeutics, possess-
ing as we do the law. Let us not, however, be led astray
by such fascinations ! Such generalizations are not possible
in the present state of medical science. So long as there occur
in the healthy body, phenomena physical, mental or psychi-
cal, which we can not fully explain by known physiologi-
cal processes, and there are thousands; so long as the sick
present symptoms, physical, mental or psychical, which we
can not account for by well-understood pathological pro-
cesses, and their name is legion — so long will it be impos-
sible to reduce phenomena and symptoms respectively to a
general physiological or pathological formula. And, con-
versely, whoever in his therapeutic philosophy includes
only such phenomena of symptoms as he can thus explain
and account for, disregarding or overlooking all others,
binds therapeutics to the slow chariot-wheels of physiology
and pathology, and forbids that more rapid progress of this
1869.] A/ood and Pus. 455
practical department of medicine which is possible under a
therapeutic law that turns to account every phenomenon of
pathogenesy, and every symptom of the patient. This will
appear more clearly when we come to study the Homoeo-
pathic proving of Conium.
BLOOD AND PUS.
By C. WESSELHOEFT, M.D., BosTon, MASS.
THE object of the following observations is to give an
account of the present state of the discussion regarding the
nature of blood and pus, and the relation of one to the
other. Every body knows what blood is, or, at least, what
standard works and treatises have taught on the subject.
But it appears that our knowledge of blood, like that of
most other elements of the animal organism, has been
limited and imperfect, and that a step has been taken in
advance, principally under the leadership of R. Virchow,
whose views we briefly subjoin, since they seem to form the
centre of the question under discussion.
Virchow vindicates the supremacy of the cell,” and arrives
at the conclusion that “the cell is actually the ultimate
form-element of all vital phenomena, and that we dare not
place action proper beyond the cell.” Further on (Chap. I.)
it is asserted “that cytoblastema, instead of giving rise to
the formation of cells, is itself originated by and dependent
on the cell, which provides for its external substance as
well as for its own contents. The old contest of humoral
pathology and solidism should be resolved into cellular
pathology; e.g., nerves and blood should no longer be con-
sidered as simple apparatus or simple fluid, but the numer-
ous active centres (cells) should be thought of Physiological
tissues are divisible into three kinds: 1st, Simple aggrega-
tion of cells without inter-cellular substance, i. e., cellular
tissue; 2nd, Tissue composed of cells with inter-cellular
* See “Cellular Pathology.”
456 A lood and Pus. [july,
substance separating the cells (connecting tissue); 3rd,
Tissues giving character to the animal, such as nerves,
muscles, vessels, blood. We under-score this word, because
the position assigned to blood among histological elements
is one of the most significant steps of modern science;
blood is no longer “regarded as a mere fluid, or mixture of
liquor sanguinis, fibrine, red and white corpuscles, but as
something higher in the histological scale.” The following
will elucidate the meaning of our master in the art of
observing :
“The separation of fibrin from the fluid constituents of
the blood has a particular significance, inasmuch as fibrin,
like blood-corpuscles, is a peculiar phenomenon, since it is
found exclusively and alone in the blood, and the juices
most nearly related to it; that, in fact, it may be considered
as more intimately connected with the blood-corpuscles
than with the water of the blood. When we examine the
blood in its proper specific parts — those parts by virtue
of which it is blood, and by which it is distinguished
, from other fluids — it can not be denied that, on the one
hand, the corpuscles with their haematin, and on the other
hand, the fibrin of the inter-cellular fluid (liquor sanguinis,
plasma), are those parts in which the specific differences are
most prominent.” The microscopic appearance of a coagu-
luin is thus described : “Hence,” continues the author, “a
coagulum always contains, as an essential feature, a net-
work composed of fibres, in the meshes of which the blood-
corpuscles are enclosed. When we allow a drop of blood
to coagulate, we see every where how fine fibrinous fibrils
start out between the blood-corpuscles.”
Thisingenious view of the subject is truly of vast import-
ance, and shows us how the eye of the artistic observer sees
and comprehends the relationship of elements hitherto seen
only, without any idea of their connection with each other.
Since a tissue of the animal organism must be composed
of nucleated cells, with or without inter-cellular substance,
and since red corpuscles are not nucleated, the author then
proceeds to fortify his theory as follows: “As regards the
1869.] A/ood and Pus. 457
second portion of the blood, namely the blood-corpuscles, I
have already mentioned that at present nearly all histolo-
gists agree that the colored blood-corpuscles of man and
the higher mammalia, at the adult age, do not possess nuclei;
but that they represent simple spherical sacs, the cellular
nature of which might be doubted, if we did not know that
at certain periods of embryonic development, each of these
corpuscles does contain a nucleus.” Hence, it appears
that the cellular nature of red corpuscles is not without
foundation, and this being accepted, blood must henceforth
be classed and described as belonging virtually to the tissues
of the animal organism. The consideration of the white
blood-corpuscles will be spoken of in connection with pus
in the following paragraph.
Having briefly reviewed Virchow's theory of the nature
of blood, we next proceed to the consideration of pus, and
what it is supposed to be, in the light of modern science;
and since the colorless corpuscles (lymph corpuscles) of the
blood seem to play so important a part in the formation of
pus, we quote Virchow's description of the same : “They
occur in relatively small quantities, in the blood of the
healthy human body, about in the proportion of one color-
less corpuscle to three hundred red ones. As commonly
found, they represent spherical bodies, being sometimes
larger, at other times smaller, or of the same size as the red
corpuscles, differing from the latter in their entire want of
color, and in their perfectly spherical shape. In a stagnant
drop of blood, the red corpuscles are generally found in
rows resembling rolls of coin, adhering together with their
flat surfaces; in the interstices may be noticed here and
there a pale spherical body, presenting only a somewhat
nodular surface. On the addition of water, this body
swells up, and discloses a membrane with granular contents,
gradually becoming more visible as distinct nuclei. The
appearance of the latter is more rapidly brought about by the
addition of Acetic acid, which causes the nuclei to appear as
dark bodies with sharp outlines; there may be one or more,
according to circumstances. In short, we are in this man-
458 Blood and Pus. §uly,
ner enabled to see an object like that first described by
Gueterbock as the usual appearance of pus-corpuscles.”
It becomes apparent at once that Virchow regards the
white blood-corpuscles and pus-corpuscles as alike, if not
identical, although he leaves the question of their origin
unsettled, as we shall see.
“The question as to the similarity or dissimilarity of the
white blood-corpuscles to the pus-corpuscles continues to
occupy observers, and their views of the relation of color-
less corpuscles to pyaemia, will probably require a number
of years before they will be cleared up so far as to preclude
relapses of discord. It is a fact that when blood of numer-
ous persons is examined, corpuscles are found in some
having but one large nucleus, while the blood of others
contains corpuscles with several nuclei. Since these have a
great similarity with pus-corpuscles, it is not to be wondered
at that observers, having perchance previously observed
only corpuscles with one nucleus, should suppose that they
had discovered something very different, namely, pus-cor-
puscles in blood containing corpuscles with several nuclei,
and that they had before them a case of pyaemia. However,
the corpuscles with one nucleus are the exception, and one
may search a long time before he can find blood of which
the corpuscles possess only one nucleus.” And further on
(P. 143, German Ed.) he adds, “The same blood-corpuscle
may, in the course of its existence, contain one or several
corpuscles, of which the former belong to an earlier, the
latter to a later stage of life.” While speaking (P. 147) of
the appearances of coagulum of blood, he remarks, that the
crusta lymphatica of the clot, under all circumstances, resem-
bles pus, “and since, as we have seen, the individual color-
less bodies have the constitution of pus-eorpuscles, it is
easily understood why we might easily find ourselves in a
position to consider the colorless corpuscles as pus-corpus-
cles, not only in the case of a healthy person, but more
particularly in pathological conditions, where the blood
and other parts are full of these elements. The question,
as here and there propounded, is very natural: “Whether
1869.] A/ood and Pus. .* 459
pus-corpuscles are not simply extravasated colorless blood-
corpuscles, or vice versa, whether colorless corpuscles found
within the blood-vessels are not pus-corpuscles, having
found their way in from without 7. A pus-corpuscle is only
to be distinguished from a colorless blood-corpuscle by the
manner of its origin. If we do not know whence it came,
we are unable to say what it is; and we may find ourselves
greatly embarrassed in trying to decide whether an object
of that kind is a pus-corpuscle or a colorless blood-corpus-
cle.”
In order better to understand the extracts we propose to
give from other authors, we will continue to quote Vir-
chow's views regarding the formation and origin of pus;
for, even if they should not be considered true by those
who make the investigation of that matter their special
vocation, the light in which Virchow considers the organism
and organic processes, has something in it that fascinates
the mind of a practitioner of medicine, often fatigued and
annoyed by the clumsy mechanical construction and explo-
ration of vital organic processes, toward which modern
science so strongly tends, and from which Virchow so
happily deviates, at least in his doctrine of blood and pus,
if not in other matters. He begins by setting aside the
doctrine that cells and subsequent organic structures derive
their origin from blastema, which, like a small chaos, was
hitherto thought to produce every thing else, and sets up in
its place the doctrine that all neoplasms proceed from con-
necting tissue and its equivalents; this is exemplified by the
growth and development of bone. The longitudinal growth
of bone proceeds from cartilage; the lateral growth from
periosteum; while the perichondrium of the ends of bones
changes into periosteum. Bone at first solid becomes hollow,
containing the marrow (medulla), originating, for its own
part, from medullary tissue, substituted for original osseous
tissue; in short, the entire process of formation of bone
may be said to depend on substitution of tissue (P. 385), and
morbid elements are formed according to the same rule; for
instance, osseous elements are converted into cancerous
46o A/ood and Pus. [?uly,
&
elements, the existing Osseous tissue being the matriæ for
the next following cancerous tissue — the cells of the cancer
are immediate descendants of the bone-cells; cell comes from
cell, never from eacudation or blastema.
The same principles are now applied by the author to the
formation of pus, which is virtually an increase of cells from
existing (connecting) tissue, and diminution of fundamental
or original substance; pus is formed regularly from existing
elements, not by generation de novo. Bone, first formed
from cartilage, retrogressively becomes medulla, then gran-
ular tissue, and lastly pus; this is first of a mucous nature
before it is perfect pus. Creamy or matured pus is a soften-
ing of interstitial tissues. Thus development and retrogres-
sion, i. e., physiological and pathological conditions, are
based on analogous if not identical principles: permutation,
transmutation, and substitution.
It appears that Virchow leaves us to fill up a certain
vacancy or blank space for ourselves. On the one hand, he
1makes the identity of colorless blood-corpuscles and pus-
corpuscles quite plausible; on the other hand, pus is dis-
tinctly said to be derived from pre-existing tissue, i. e., con-
necting tissue. It seems that the student is left to his own
devices in harmonizing the process by means of which white
blood-corpuscles become pus-corpuscles; for connecting tis-
sue stands between blood and pus, and the question neces-
sarily arises: Is pus formed directly from the blood, or
indirectly from connecting tissue; or are both processes
possible :
It appears that this query, or some other motive, has led
others to make researches with a view to the solution of the
problem. One of these researches is that of Dr. Cohnheim,
of whose treatise a considerable portion is contained in
“Half-Yearly Compend. of Medical Science,” translated
from “Virchow's Archiv.,” XL., p. 1.
While experimenting upon the inflamed cornea of frogs,
the author was first struck with the specific difference
between the stellate cells composing the cornea, and others
which eventually proved to be pus-corpuscles. In order to
1869.] A/ood and Aºus. 461
discover and to demonstrate the origin of the pus-corpuscles,
aniline-blue was injected into the lymph sac of frogs; the
result was that in the inflammation of the cornea, subse-
quently indicated, a portion of the pus cells always con-
tained pigmentary nuclei, while the tissues of the animals
showed neither free-coloring matter nor pigmented cells.
“Put the circumstance that the result was the same whether
the aniline-blue was thrown into the lymph sac of the head,
back, abdomen, or leg, etc., made it less probable that the
pus-corpuscles reached the corneal tissue by way of the
lymphatic vessels, and forced upon him the thought of the
agency of the blood-vessels.” The blue nuclei of blood-
corpuscles appeared also after injecting the aniline-blue
directly into the blood. “From this,” continues the report,
“it may be concluded that some of the pus-corpuscles of the
ânflamed cornea were previously colorless blood-corpuscles, and
that they had passed out of the blood-vessels into the cornea.”
The author then experimented upon the mesentery of
frogs, rabbits and kittens, in which he excited an artificial
inflammation, the process of which he observed under the
microscope. We pass by the description of the inflamma-
tory process, and come at once to the great sight of the
occasion. The report continues: “Soon the eye observes,
on the outer contour of a venous wall, the appearance of
individual, small, knob-like elevations, which slowly and
very gradually become larger. After some time, it appears
as if a hemisphere lay upon the external venous wall, of
about the size of a half white blood-corpuscle; later, the
hemisphere assumes a pyriform shape, which finally begins
to radiate fine prolongations and serrations from its peri-
phery; through this, the previously more or less rounded
contour assumes very manifold forms. The principal mass
of the corpuscle, the enlarged, now serrated end, departs
steadily further from the vessel’s wall, while the narrowed
end gradually draws itself out into a fine and lengthening
pedicle. Finally, this pedicle severs its connection with
the wall of the vessel, and we have then a colorless, some-
what shining, contractile corpuscle before us, with some
853
Wol. IV.-No. 16. 5.
462 A lood and Pus. [...}uly,
short prolongations, and one very long; and this body fully
corresponds with the colorless blood-corpuscles, both from
its size and from the presence of one or more nuclei.”
* * * “During this gradual, and, with time, augment-
ing, crowding forward of colorless blood-corpuscles from the inside
of the vein through the intact wall of the vessel, the previously
developed condition of the blood-currentis sustained entirely
unchanged; afterward, as before, the inner marginal stra-
tum consists of a simple uninterrupted layer of white cor-
puscles, and the red current of the blood flows continuously
through the tube formed by it. It must also be stated that
among colorless corpuscles which have passed out of the
vessels, not even a single red one becomes visible. In
order to confirm this, Cohnheim repeated his experiments
on animals, a portion of whose white blood corpuscles had
been impregnated with pigmentary matter, as described in
foregoing experiments, and found the correctness of his
observations established in the clearest manner.”
“The first thing to be observed is a change of form in the
hitherto spherical, colorless blood-corpuscles; this may be
more or less rapid or extensive, but always shows the well-
known character of amoeboid motion. Now it does not take
long until we see a spot, where, internally, in the capillary, a
white corpuscle lies, outwardly, on the contour of the vessel,
a small hump-like elevation, or even a fine, thorn-like out-
growth, which gradually increases in size, and finally, just
as in case of the veins, becomes changed into a colorless
corpuscle, which is only yet connected with the capillary
wall by means of a long-drawn pedicle, and is further on
entirely separated from the wall.” + “ ” “But in these
capillaries it is not, as in the veins, that only colorless cor-
puscles pass out, but also red globules reach the outside through
their walls.”
In order to explain the actual process by which the blood-
corpuscles pass through the walls of the vessels, the author
assumes that the passage occurs through previously-formed
* A similar process is seen in the capillaries.
1869.] A/ood and Pus. 463
avenues, i. e., through canalicular spaces in the wall of
the vessel, through which lymph-corpuscles can pass, as
is said to be well established, leaving only the transit
through the epithelial layer of the capillaries to be
accounted for by the openings (stomata) between individual
epithelial scales. The opening being given, a force must
be sought for, which impels the corpuscles, and this is found
partially in the amoeboid motion, which takes place in the
white corpuscles as soon as they become stagnant in the
blood-vessel, and partially in the increased pressure of blood,
consequent upon dilatation and diminished resistance of the
arterial walls, transmitted to the capillaries.
Red blood-corpuscles are never seen to pass through the
walls of vessels until after the white corpuscles have passed
through.
The inference drawn from these observations is, that
“the development of pus-cells, which was formerly located
in the inflamed tissue itself, must now be regarded as having
its seat in those organs which we know from physiological
experience to produce colorless blood-corpuscles, namely,
the lymphatic glands and the spleen ; secondly, that there is no
inflammation without vessels, their dilatation, injection, and
hyperamia forming the essential first stage; thirdly, it is now
explained why suppuration always remains bound to the connective
tissue, that is, on account of its canalicular dilatable spaces.”
We observe at least one point of harmony between two
eminent observers, and that is the identity of colorless
blood-corpuscles and pus-corpuscles. The vacancy which
Virchow left, in regard to the manner in which white cor-
puscles from the blood-vessels come to pass through the
connecting tissue till they reappear as pus, has been to a
certain extent filled up by Dr. Cohnheim’s observations;
which, however, have already met with objections, which
we quote herewith".
464 A/ood and Pus. [july,
ON THE SO-CALLED AMCEIBoID MOTIONS, AND THE INFLAMMATORY
PIIENOMENA OF COLINHEIM. BY DIR. W. DöNITZ.*
The investigation of the lymph from fresh variola-pustules, furnished
results so remarkable that it might not seem unimportant to report them
here. When the microscopic object to be examined is prepared in such a
manner as to allow air bubbles to remain beneath the glass cover, then the
pus-corpuscles, contained in small number in fresh lymph, will accumulate
around the border of the air bubbles. After the lapse of about a quarter of
an hour, a very peculiar phenomenon is to be witnessed. Hyaline pro-
cesses, of pale outlines, begin to start out from the border stratum of the
fluid, and extend into the stratum of air between the glass cover and plate
holding the object. These become visibly longer and broader towards their
free extremity, which, in its turn, sends out smaller processes; these are
always withdrawn again, in proportion to the extent to which the chief
mass of the extruded substance has retired from the drop of lymph. The
thin fibres connecting the wandering bodies with the border of the drops of
lymph, break, one after the other, so that finally corpuscles of various shapes
surround the lymph-drop at some distance. These bodies are throughout of
hyaline transparency; only sometimes they appear as more or less granu-
lar, owing to unevenness of their surfaces, or accidental adhesion of
granules. No trace of a nucleus becomes visible. Their size is variable;
but they frequently exceed the pus-corpuscles considerably in size. They
all lie in one plane, since they adhere to the surface of the glass. We are
enabled to understand their origin, when we direct our observation to those
points where single pus-corpuscles lie within the border of the lymph-drop.
, There it will be seen that each fibre or thread proceeds from a pus-corpus-
cle. No matter how large the protruded mass is, in proportion to the pus-
corpuscle, this never leaves the lymph-drop.
In their optical and micro-chemical properties, these bodies have the
greatest similarity with the so-called “albumen-drops,” which, however,
suspended in fluid, assume a spherical shape, while the formations in
question assume polymorphous shapes under the influence of the adhesion
of the glass surface.
It is possible that evaporation plays a prominent part during the extru-
sion of the hyaline bodies from the capillary stratum of fluid. This seems
to be caused by the circumstance that the extrusion occurs most promi-
mently at the free edge of the lymph-drop ; but it is less prominent when
the air bubbles are small, around which the pus-corpuscles are gathered.
But a small air bubble is so rapidly satiated with moisture, that evaporation
ceases already before the described phenomenon has time to occur.
This process is, even in respect to the minutest detail, an accurate picture
of the inflammatory phenomena described by Cohnheim, as observed in the
mesentery of the frog, with this difference, that he examined white blood-
corpuscles, while we observed pus-corpuscles, and that in his case the wall
of the blood-vessel was traversed, the resistance of which was represented
* Archiv. fur Anat. Physiol. and Wissenschaftl. Med. By Reichert and Du Bois-Reymond.
1868. No. 8, p. 894.
1869.] A/ood and Pus. 465
wº
in our case by the cohesion of the border-stratum of the fluid lymph-drop.
But, in the interpretation of his observation, Cohnheim committed the error
of considering the bodies traversing the walls of the vessel as blood-cor-
puscles, while, in reality, they were only swollen portions of the contents
of blood-corpuscles, while the nuclei, together with the greater portion of
the contents, remain in the cavity of the vessel. Supposing these pro-
cesses really to lead to suppuration, then the extravasated substance may
possibly furnish some material for the formation of pus, but it will never
become a pus-corpuscle, So long as it remains unproved that cell-nuclei can
be formed by themselves in an entirely homogeneous albuminous substance.
Hence we arrive at the conclusion that the existing doctrine of inflam-
mation has not been modified by Cohnheim, and that it is erroneous to
compare the bodies in question with amoebae, and to call their change of
form, amoeboid motion, since this designation would apply only to an active
change of form; and when foreign particles adhere to them, or are forced
in to them, it is at least an abuse of language to call this “devouring.”
The described phenomenon may also be observed in the pus of wounds,
which, however, contains too many pus-corpuscles and molecular admix-
tures to permit a perfect view of the process. Many phenomena of motion
of white blood-corpuscles within the vessels, or in a drop of blood, should
be interpreted in a manner similar to that of the described apposition. It
hardly needs to be mentioned, that the purely mechanical changes of
form occurring in white (as well as red) blood-corpuscles in the circulation
are to be excepted. When a corpuscle adheres to the walls of a vessel,
the passing current may draw it out into an elongated form, and change
it into a bulbous body, whose pedicle consists of a tenaceous semi-fluid
hyaline mass, and whose head contains principally the granular mass,
together with nuclei. In a given case, therefore, it will be necessary to
observe carefully the causes giving rise to the change of form, in order to
understand it correctly.
We have now shown what the united wisdom of those
eminent observers has furnished us. One step is gained,
that is, the analogy, if not the identity, of pus-corpuscles
and white blood-corpuscles; then, it seemed as clear as day-
light that the latter quietly slipped through the walls of
blood-vessels to reappear as elements of pus; but scarcely
have we settled down to quiet contemplation of the victory
gained by mind over matter, when the whole structure is
again shaken to its very foundation, and we are very nearly
in the same place and condition as before. Yet something
has been gained, and we do not underrate it. There is
something positively true in all the observations referred
to; the main difficulty lies in the manner in which those
466 A/ood and Pus.
observers saw and described things. Nothing is more diffi-
cult than to describe things exactly as we see them, i. e.,
exactly as they present themselves to our vision, and this
applies particularly to microscopic observations; any one at
all conversant with the great difficulty of seeing through the
microscope will know this. If observers would or could
confine their descriptions exactly to what they actually saw,
we would have very different reports, without being behind-
hand in knowledge. The difficulty is, that each observer
is not satisfied with what actually occurs before his eyes,
but he strains also his mind's eye to see the explanation of a
phenomenon together with the phenomenon. The result
is, for instance, that he “saw'” white blood-corpuscles pass
bodily through apparently intact walls of vessels; he “saw”
them send out and retract “amoeboid projections;” he saw
them “devour” other molecular particles, etc. Now, if a
man says he saw all that before his eyes, must we not accept
his testimony ? Not necessarily; for when we examine the
statements, especially in the light of another good observa-
tion, we are not positively sure that he did see all this; for
he did not see the canaliculi of the vessels, nor the stomata
of the connecting tissue, for these are as yet hypothetical;
he only saw a white blood-corpuscle, inside of a vessel first,
and then saw a body, perhaps exactly like it, on the outside,
and inferred that it passed through. He saw it take up
within itself other particles, and inferred that it “devoured”
them, and so on.
We do not pretend to discredit any of these statements,
and have merely analyzed them to show the different man-
ner in which different men perceive objects and actions,
and to point out that an object or action is one thing, and
its interpretation another. At present the matter rests
here; as fast as the subject is investigated, and new facts
or plausible theories developed, we will endeavor to record
them.
DISEASE.
TRANSLATED FROM v. GRAUVogL's LEHRBUCH DER HOMOEOPATHIE.
§. 31.
Now, as we may venture to presume, it is understood how
Virchow expresses himself upon fundamental pathological
views, and it only remains to overthrow their error.
His opinion that the common cause of all the phenomena in
sickness, as well as in health, is life itself, and that the very
essential difference between them consists only in their condi-
tions, is an erroneous view at the very outset; for there are
only reasons of perception (perceptive reasons — rationes cog-
moscendi), and reasons of existence (essential reasons — rationes
essendi), of which the former have to express the logical,
the latter, the real connection of things. Only on giving
the essential reasons can we speak of conditions; for the
condition is the cause of a thing being so, and not other-
wise, in the succession of space and time. So far would
the assertion, that life was the common cause of sick as
well as of healthy phenomena, be a proper expression; for in
the space of the healthy life the diseased life develops itself
in course of time. But in the logical relation, life can not be
accepted as the common cause of diseased and healthy phe-
momena; for the law of causation assures us, with unvarying
conformity to law, that a body can not contain simultaneously
the only condition of its various forms of existence, for noth-
ing consists of itself, but must have a cause, and the equally
inevitable law of vis inertiae adds to this, that this cause can
only come from without. Hence if life, according to its physio-
logical laws, comprises the one presupposition and the one
inner side of the conditions of the possibility of a diseased
process or condition in itself, then must the exciting cause of
this (process or condition) be another, eacternal thereto, and
this must present the other side of the conditions of this pro-
468 Disease. [3 uly,
cess, whether they are hereditary or acquired. Further, since
the essence of a thing is its cause, because every thing which
exists, contains only expressions of cause which have of neces-
sity called it forth, so must there be also, as will be clear
from what follows, a causal and hence an essential, or what
here amounts to the same thing, a very essential difference
between substances and forces, by virtue of which healthy,
and those by virtue of which diseased,life exists.
Š. 32.
On what now is the very remarkable appearance of
Such unwarranted but specious assertions founded, in the
minds of all the learned ones of the physiological school?
Indeed, one of its best writers says, in his “Clinic of diseases
of the Liver,” almost with the very same words: “In our
times we are all agreed that the science of life is indivisible,
that between its various forms of phenomena in healthy and
diseased conditions, there are no essentially marked lines, but
the same laws govern in one as in the other.” For the sake
of gaining some kind of a foundation for his ideas, this writer,
like Virchow, resorts to an obsolete mode of considering
the subject, continuing, as he does, “the general points of
view have become more simple, since we have ceased to
separate the disease from the sum of the phenomena of life,
as something foreign, existing by itself, and independent.”
Already, in the previous century, and in the early part
of this, Pinel, Bichat, Corvisart, and Broussais, were the
authors and founders of these views which yet prevail in
Germany. It is true that they were the physicians who
first gave prominence to the importance of objective phe-
nomena, but sought to demonstrate, according to physio-
logical laws, from its anatomical tissues and systems, why
the organism became diseased; and the Schools which they
established are still called the physiological.
The idea of the foreign and independent in diseases, as
if some especial spiritual beings were underlying them, as,
with the Romans, nymphs were supposed to dwell in the
streams, or fauns in the woods, as it certainly existed in
1869.] Pisease. 469
pathology before the appearance of these learned men, is
consequently long ago done away with.
But on what grounds have the learned men of the physio-
logical school in Germany, for the last twenty-five years, in
almost all their works, come to accept these views of former
times? Is it, perchance, that they wish thus to excuse their
own lack of advance in therapeutics, which they themselves
acknowledge? The author of that clinic of disease of the
liver gives this very answer in these words: “Between the
scientific contents of clinical medicine, and practice — its
peculiar mission,-- is an abyss over which only a few inse-
cure ways are found.” That painful sense of the practical
impotence of this school, or, as they have begun quite lately
to re-christen it in clinical medicine, its poverty in therapeutics,
are the very reasons for which these learned men seek to
excuse themselves by making comparisons with former
times, and to delude their pupils into errors. And this
delusion has, in the course of years, proceeded so far; these
false doctrines, the most prominent of which we shall learn
in the following pages, have become so deeply rooted, that
they stand undisturbed in the very front of every new
medical work, and every one thinks it praiseworthy to copy
them bodily from others.
The answer to this question points at the same time to
the twin brothers of subjectivism, to the incomprehensible
things of skepticism, and the dogmatic fidelity to conviction,
ever the greatest enemies of all science.
The history of philosophy has already taught us, that
after subjective tendencies, after stoicism and epicurism,
skepticism has always followed as the highest development
of these tendencies of subjectivism.
Doubters are to-day, as ever, arrayed against the certainty
of knowledge. Hence the attacks of skepticism have been
especially directed against causality. But if this be over-
thrown, the very thread of being and thinking is broken.
The skeptic Hume, for instance, called the law of caus-
ality the unfounded habit of the mind, arising only from
repetition. What have we gained by that ?
47O Misease. [?uly,
Consequently, the determining of the universal and neces-
Sary must come to nothing, and every opinion of the
physician at the sick-bed must be set down as error, a
priori.
Skeptical opinions always remain unfruitful, since they
do not advance us a hair's breadth. At no time has any
creation belonged as yet to a doubter, as his own production;
hence the doubter leads the unfruitful life of a nun. IIe who
doubts judges first, and has nothing to tell him, whether
truly or falsely; hence we will never know any thing; for,
as soon as he knows any thing, he must change his pro-
gramme. But to know any thing, facts are necessary
above all things; facts which can not be doubted, and of
which we know also that they happen according to neces-
sary laws. ICnowing and doubting then, form contradictory
antitheses, from their very origin; and to doubt is a subjec-
tive condition of the human mind, just because it lacks the
objective law.
The scientifically observed fact does not doubt. Hence he
who doubts about therapeutics, has observed nothing of it;
but, neither has he brought any proof of its non-existence.
Now this indeed characterizes the doubt of the analyzer.
But the word “doubt” may create misapprehension in the
unlearned. The analyzer doubts and denies, and that is
the end of it. But the doubt of the synthesyzer is no doubt
merely, but rather a demand for proof of the subject,
Hence, the synthesyzers are never reckoned among doubt-
ers, because they seek after laws, and thus neither deny or
affirm, till they have found the law of the course of events
as yet to them unknown. They have become scarce at the
present day.
Dogmatism would like to proceed from a principle, from
the consideration of a problem, e.g., of the life-force, and
from this seek explanatory arguments. It has constructed
for itself knowledge from empty ideas, without inquiring
after the right by which it has obtained it. If its principle,
however, should contain a fundamental law of nature, or
be opposed to none, it could not make the assertion, that
1869.] ZXisease. 47 I
the common cause of all phenomena, diseased as well as
healthy, is life itself, for this assertion contradicts the
natural law of causality, and hence is false.
The dogmatism of the physiological school, it is true,
does not consist in credo ut intelligam — I believe that I may
understand — but in the I believe only just so much as
the knowledge which I have accidentally obtained. The
argumentative force of this article of faith, which is also
brought to bear against Homoeopathy, needs no further
COmment.
Š. 33.
Virchow says: “What we call disease is a mere abstrac-
tion, an idea, by which we separate certain complex phe-
nomena of life from the sum of the rest, while no such
separation exists in nature.” For representation, for speech,
he thinks such abstractions may be necessary, for the rea-
son that only thus the reciprocal relation can be under-
stood. With regard to practice, and for the comprehension
of separate cases, they must be abandoned, since they bring
with them the danger of neglecting the patient for the dis-
ease, and the reality for the idea. The patient only, he
thinks, is the object of medical activity, and the physi-
cian should never forget that his aim must be an aim of
humanity.
To form an abstraction, without any separation in nature
corresponding thereto, would be, he thinks, an impossi-
bility for a philosopher; it is, in his eyes, a self-contradic-
tion. But is what we call disease really only an abstrac-
tion? We make use of the expression only in a three-fold
Iſlan Il CI -
First.—When we abstract a law from a given case, and
recognize it as holding good for all other cases. In § 25 it is
stated, for example,that Horn made experiments upon him-
self with regard to the excretion of carbonic acid, and found
that it increased and diminished again twice in twenty-four
hours, and that at particular times of day. From this every
one can form the abstraction for himself, that the same change
472 AM?sease. [?uly,
in this function must take place with all other men. Hence,
by virtue of abstraction, the mind may infer these phe-
nomena, already perceived by the senses, as being peculiar
also to those men in whom the phenomena have as yet not
been immediately observed. At this separated possession
of consciousness, that this occurrence must be universal, the
mind arrives, as we see, only through the first form of
abstraction. This meaning, however, can not be applied
to the above given assertion of Virchow.
JFurther.—We can abstract, and conceive as separated,
marks or properties from an object, analogous to subtrac-
tion, e.g., an aggravation from bad weather, or good, etc.,
hence, the presence of many conditions accompanying the
diseases, as if they were not present, or deserved no regard,
as unhappily too often occurs in physiological medicine,
because it does not know how to connect with it a practical
judgment.
Thirdly.—A view or idea may be abstracted from all its
phenomena, e.g., the idea of a form of disease, by a com-
parison of all its symptoms with those most prominent, as
the idea of fever, according to Virchow, from the phlogosis,
in order to gain a general idea by separating all other pecu-
larities.
Of all these forms of abstraction Virchow must surely
have had the second in view, for he defines a definite suc-
cession of pathological disturbances to be the simple mega-
tion of the physiological. To this, in his opinion, also
belongs morbid conditions, for he proceeds: “The merely
negative disturbances are no phenomena, no processes, no
real diseases, but either primary changes, which may become
the points of termination of morbid phenomena, or final results
of morbid processes. In opposition to these negative con-
ditions we find the positive, active, reactive phenomena of the
disease.”
In affirmative opinions the mind comprehends the real
as positive; the negation, however, is formed arbitrarily.
Proceeding critically, I hence may set down nothing else as
negative than the direct opposite. But Virchow denies this
1869.] AP2sease. 473
over and over again, for according to him, e.g., the same
phenomena must be at once physiological and pathological.
What now is really the view held by Virchow is not easy
to puzzle out from such a confusion of ideas.
§. 34.
Tłut if a man in his expressions goes to work somewhat
logically, what he needs for expressing himself in speech,
he must also need in practice, for theory never can outstrip
practice with impunity.
Language, which serves to express the theory of practice,
and to communicate it to others, has, however, nothing
more important to do than to be clear. But the theory itself
must be such that it can be based, in conformity with the
laws of nature, upon facts given by practice, in order to be
ready for all future cases; for the connection of facts can
not be explained from a problem of the reasoning powers,
but only from the laws from which it follows. Hence, to
protect ourselves from dogmatism and skepticism, we must
always follow the path of the Critique based upon the laws
of nature.
But this Critique is not a doctrine or a particular system,
and no theory, but the demand rightly to conclude and to
judge. Hence this Critique alone is able to form correct
opinions in therapeutics, by the aid of which the physician
can, a priori, establish the connection of events prior or
subsequent to phenomena at the sick bed, i. e., by which
he can establish his anamuensis, diagnosis, or prognosis.
To be continued.
TO CORRESPONDENTS.
N. B.-We wish particularly to call the notice of our readers to the necessity
for their contributions being received at least NINETY days before the date of
publication. Attention to this rule will save them from many disappointments,
and the editor much trouble. This refers to lengthy papers ; items of news
will be received any time.
AºA WZZ WS OF APOOATS.
ºmºsºmºsº
º
ON THE DYNAMICs, PRINCIPLES, AND PHILOSOPHY OF ORGANIC
LIFE; An Effort to Obtain Definite Conceptions of IHow
do Medicines Produce their Effects? Waledictory Ad-
dress to the Muskingum County Medical Society, Zanes-
ville, Ohio, May 6, 1868. By Z. C. McELRoy, M.D.,
President.
In 1866, we think it was, Dr. H. Bence Jones delivered a
series of original lectures on “General and Local Chemi-
cal Disorders,” in which he aimed to show that most, if not
all, diseases result from either excess or diminution of the
normal oxydizing process that takes place in every part of
the body; and that inflammation is essentially a peroxydation,
He also taught that all medicines act either as direct or
indirect retarders or promoters of oxydation, or of nutri-
tion; * and proposed a classification of medicines upon this
basis.
Apparently having pondered upon this idea until it
seemed to be, in some degree, original with himself:
impressed also with a fancied resemblance between the
effects following the introduction of a solution of Morphine
under the skin, and modern electro-magnetic telegraphy,
(the relevancy of which, by the way, is not very evident),
Dr. McElroy believed he “had made a valuable generaliza-
tion,” and, as in duty bound, has attempted to demonstrate
it to the profession at large in the above pamphlet of forty
pages.
We have read the pamphlet carefully, and it amounts sim-
ply to the proposition, that medicines retard and promote
nutrition, or constructive metamorphosis, on the one hand,
* See Braithwaite, No. LIV., p. 221, and U. S. MED, AND SURG. Jour.
for April, 1868, p. 295, et seq.
Areviews of Books. 475
or oxydation, or destructive metamorphosis, on the other:
and this is regarded as a tolerably definite answer to the
question, “How do medicines produce their effects?”
In the first place, we are unable to see that the author
has added any valuable fact or idea to those of Dr. Bence
Jones, or that the case, has been put in any clearer or truer
light, by his statement or argumentation of it. On the
contrary, the proposition has lost something of its original.
force and perspicuity in its second-hand announcement.
In the next place, the definiteness of the answer to the ques-
tion, “IIow do medicines produce their effects?” may well
be questioned by the thoughtful physician. We think
the answer exceedingly general and indefinite as to medical
action, and not more likely to be final, or to lead to valu-
able practical results, than many others that, in the his-
tory of medicine, have been proposed to this important
question.
Thirdly, we believe that both Dr. Jones and Dr. McElroy
have made one grand mistake in the assumption that oxyda-
tion in living tissue is a destructive process. What evidence
is there that oxygen has any agency whatever in breaking
down living tissues? After the material has served its
purposes in the economy of life, we know that oxygen
seizes upon it as effete matter, and hurries it out of the
system, and that it attacks with violence all forms of dead
matter, in the effort to reduce its constituent elements, as
speedily as possible, to simpler forms and combinations; but
that its presence is in any way antagonistic to life there is
no reason to believe; but rather that it is every where an
essential condition of vital manifestation.
In a single expression, on page 31, the author seemingly
recognizes this fact in regard to the true function of oxygen
in the body; but is no where, apparently, conscious of the
inconsistency of this expression with the idea of regarding
oxydation and destructive metamorphosis as synonymous
terms. We can not here discuss this point, but can only
indicate the inconsistency of the idea that oxygen can act
476 APeviews of Æoožs. §uly,
as a life-giver and a life-destroyer at the same time. To
determine which of these characters represents the true
function of oxygen in living tissues, is an exceedingly
important point, and one which must necessarily precede
any such generalization or classification as is attempted in
this pamphlet.
An address before an Allopathic society would, of course,
be incomplete without a demonstration of the absurdity of
IIomoeopathy. Accordingly, on page 33, we find the follow-
ing: “If diseased action consists of too much or too little
force, the action of medicine for its relief must be exactly
the opposite, liberating more force when it is deficient, and
restraining it when it is in excess. Thus the cardinal
point of the Hahnemannic faith is shown to be an
absurdity.”—What could be plainer, more logical, more
directly to the point?
There are just four unfortunate things about this argument:
Eirst, the premises have a very large “IF’’ before them;
second, that the action of medicines can liberate or restrain
force, is an absurdity quite as evident as that of “the
Hahnemannic faith; ” third, the fact that the law of similia
is useful as a guide in selecting the remedy, does not neces-
sarily imply that it explains the mode of drug action in
effecting the cure. Homoeopaths do not pretend to know
exactly “how medicines produce their effects.” Many of
them believe that the action of the remedy is really anti-
pathic, while consistently holding that the law of similars
is the only reliable guide to its selection. [If this is beyond
the comprehension of any candid Allopathic brother, let
him read the contributions of Dr. Reith, of Aberdeen,
Scotland, to medical literature during the past year, and the
history of his conversion to Homoeopathy]. Fourth, this
argument, like most others from Allopathic sources, instead
of showing the absurdity of “the Hahnemannic faith,”
only demonstrates the chosen blindness, the willful ignor-
ance, of its author in regard to the special object of his
hatred. How much more becoming and respectable is the
course of such a man as H. Bence Jones, who, in a Scien-
1869.] Reviews of Books. 477
tific discourse, can confine himself to subjects of previous
honest investigation, upon which he is competent to give a
valuable opinion.
There are some other things in this address that are open
to criticism; but we will only say, further, that a writer
upon such a subject as is proposed, and aiming, upon his
title page, to afford “definite conceptions” to his readers,
is hardly excusable in making frequent use of such unscien-
tific and meaningless expressions as “liberation of force ’’—
“dynamic force’—“dynamics of life”—“the wild dynamics
of life”—“force is promoted or retarded,” etc., etc.
We have no doubt there is the germ of an important
truth in the lectures of Dr. Jones, on which this address is
based, and we yield the palm to no one in our sincere
desire to see it developed and rendered available in the
ars medendi.
That Dr. McElroy should have chosen this subject upon
which to address the Muskingum Society, is one among
many recent indications of a growing interest in a hitherto
neglected but most inviting field of physical research.
F. A. L.
DIE CHOLERA, eine epidemische Lähmung der Capillaren der
Darmschleimhaut und ihrer Nerven, etc. v. Dr. Joh.
Schweikert.
This pamphlet does not contain any thing especially new
as regards the Homoeopathic treatment of cholera, and was
written, apparently, more for the purpose of establishing an
aetio-pathological point. Dissenting from recent writers in
his views as to the probable cause and nature of cholera,
the author offers in the above-named essay his own ideas
with regard to that disease, presenting, at the same time,
his arguments against two of the most recent cholera hypo-
theses, those of Prof. Hallier, of Jena, and of Dr. G. Schmid,
of Vienna.
Hallier’s microscopic examinations of cholera-discharges
Wol. IV.-No. 16. 6.
478 Reviews of Books. [9 uly,
demonstrated the presence of numerous fungi (micrococcus),
some of which had reached their highest development into
cysts. By a series of experiments the Professor observed
the various transition-forms of this fungus from the micro-
coccus to the cyst. The latter reminded him of another
fungus frequently found upon wheat and rye. He remem-
bered also that Asiatic cholera had been considered at one
time as being closely connected with a disease of the rice-
plant (oryza saliva), and that for this reason Tytler, an Eng-
lish physician, had named that disorder morbus oryzeus,
rice disease (1817). This induced IIallier to plant rice and
to moisten the ground containing the seed with cholera-
dejections, and, as the result, he observed that"very soon the
cholera-fungi penetrated into the texture of the young plants.
Yet, whether this fungus is identical with the one found in
India upon the rice, is still an open question. IIallier
named his fungus Urocystis cholerae, and observed that alco-
hol, permanganate of potash, red wine, sulphate of quinine,
and sulphate of iron, were most destructive in their effects
upon it; less so was carbolic acid. IIe considers the cholera-
contagium as being identical with those fungi, provided the
former can be proved to be of vegetable origin, and is of
the opinion that they can thrive only in a high temperature
(hence the appearance of the cholera during the hot season),
and that they are principally found in sinks, privies, etc.,
where they develop into cysts, and cast their microscopic
spurs. These, some how or other, find their way into the
human body, and produce cholera by investing and destroy-
ing the intestinal epitelium. Plausible as this hypothesis
appears at first sight, Dr. S. nevertheless considers it unten-
able on more mature reflection, and as arguments against
it mentions:
1. The suddenness and intensity of the disease in many
cases. Healthy persons attacked by Asiatic cholera fre-
quently die within a few hours. The fungi, for their devel-
opment into cysts, require from nine to twelve days.
2. The appearance of cholera epidemics during the cold
season. At Breslau (the place of the residence of the
1869.] Areviews of Books. 479
author) the number of cholera cases during the winter of
1849 rapidly increased in very cold weather (–15 to 16° R.)
The fungus thrives only in a high temperature (+ 25 to
30° R.)
3. The fact that persons engaged in the cleaning of
sinks, privies, etc., are not any more attacked by cholera
than those not engaging in such work. In Moravia, G.
Schmid reports, where cholera raged fearfully at one time,
the inhabitants, having lost all confidence in old school
treatment, externally and internally applied manure-water,
and thus mostly saved themselves.
4. The prompt and efficacious action of small doses of
Homoeopathic medicines in this disease.
5. The fact that Prof. F. Cohn's (of Breslau), recent exam-
inations of cholera-dejections did not establish the presence
of any cysts, but of bacteria, which can be multiplied by arti-
ficial culture, and have nothing in common with IIallier’s
cholera-fungus, being, as they apparently are, but forms of
ferment-cells. However, Dr. S. admits the possibility of a
sudden intoxication by means of those fungi, if under favor-
able conditions for their development in the intestinal tract,
and by their great numbers they should be capable of pro-
ducing a poisonous matter, destructive to the action of the
intestinal nerves; a supposition, however, very problematic.
According to Schmid's hypothesis the cholera-poison is a
cyanogen-compound (at one time hydrocyanic acid, at another
cyanate of ammonia), the result of organic decomposition
in consequence of electro-atmospheric changes. The most
malignant type of the disease (cholera sicca) he attributes
to the effects of the hydrocyanic acid suspended in the air
and water; the milder forms to cyanate of ammonia devel-
oping within the body. As arguments against this hypo-
thesis Dr. S. mentions:
1. The efficacy of the hydrocyanic acid in cases of cholera
sicca, testified to by Schmid and other Homoeopathic physi-
cians, which can not be explained by the law of similia
similibus.
2. Our total ignorance of the effects of cyanate of ammo-
48o Reviews of Books. [S/uly,
nia upon the human body according to Schmid's own con-
fession.
As favorable, in a measure, to this hypothesis, the author
mentions the experiments of H. IIorn, of Munich. Horn
charged one or two glasses filled with water, with — E,
the other with + E. From smelling at the different kinds
of water he experienced different sensations. Smelling of
water charged with — E caused symptoms entirely similar
to those of cholera, smelling at the other removed the
symptoms produced by the former. Grauvogl, who took
the different kinds of water internally, confirms those
effects. Now, we find that a cyanogen-compound called
antozone, forms at the – P of the electric machine brought
into action, while ozone is developed at the + P. On the
strength of these experiments Dr. S. deems it justifiable to
adopt the hypothesis (if a hypothesis has to be formed at all
hazards), that the decrease of the normal amount of + E in the
absorption or a sudden change from + E into — E in the air is,
probably, the most essential condition of the origin of cholera epi-
demics. This hypothesis Dr. S. thinks plausible if one
locates the punctum saliens of cholera in the nervous
system; for — E, and even a minus of + in the atmosphere,
has a depressing, weakening, if not a paralytic effect upon
the whole organism; while + E produces the opposite
state. Why a plus of — E at one time causes cholera, at
another typhus, putrid fevers, etc., still remains a problem.
It can also not be decided whether the predominating — Ein
the air occasions a direct abnormal state of the electro-ner-
wous current, which conditions paralysis, or whether this par-
alysis is the result of blood-poisoning from the same cause.
Dr. S. adopts the former view. This brings us to the
nucleus of the pamphlet; to the author’s pathological clas-
sification of cholera as a paralytic affection of the muco-intes-
tinal capillaries in consequence of a parelic or paralytic affection
of the intestinal nerves, or, as in the most malignant forms of the
disease, of the entire nervus sympathicus.
The author considers the pathological process to be the
following: In consequence of the paralysis of the muco-
1869.] Areviews of Books. 481
intestinal capillaries and their nerves, the epitelium mor-
tifies and is cast off; the capillaries are deprived of their
covering and allow the serum to transudate in large quan-
tities. The loss of serum changes the blood, which thickens
and is decomposed; all the subsequent symptoms and fur-
ther course of the disease resulting from the sanguineous
decomposition. As arguments in favor of his view, the
Doctor mentions:
1. That mental depression predisposes to cholera, while
exaltation lessens this predisposition. The return of the
victorious Prussian army to Breslau in 1866, with its exalt-
ing influence upon the population, rapidly diminished the
the number of cholera cases during an epidemic then at its
height there. A perfectly healthy old gentleman, after an
intense fit of passion, got the cholera, which was then epi-
demic, and died within a few hours.
2. That poverty, with its many evils, works in those
afflicted with it, the greatest predisposition to this disease.
3. That a weakening medical treatment during such an
epidemic predisposes to cholera.
4. That among perfectly healthy persons the greatest
immunity from infection exists, while sickly children and
old people fall its first victims.
5. That all gastric affections appearing at the time of a
cholera epidemic exhibit the adynamic character.
6. That the inclination to profuse night sweats during
such epidemics, observed by the author, point to a paretic
state of the cutaneous capillaries.
7. That the sensation of contraction, and the cramp-like
pains in the calves, very common in cholera times, are occa-
sioned by a disturbance in the ganglionic system which
eradiates upon the spinal ganglia.
8. That the sensation of precordial distress directly de-
pends upon the plexus solaris and sympathicus in general,
and must be considered a premonitory symptom of impend-
ing nervous paralysis.
9. That the influence of — E during cholera epidemics
is very unfavorable.
482 Reviews of Books. I}uly,
As to the logical inferences to be drawn from his hypo-
thesis, the author deems them of importance with regard
to the semeiotic value of the various symptoms and thera-
peutics, in so far as, in harmony with it, we must ever con-
sider those symptoms as most essential and characteristic which
point to the paralysis, and that only remedies which are capable
of producing a parelic or a paralytic state within the domain of
the sympathetic nerve can claim and deserve the mame of cholera
Temedies.
Imbued with and in accordance to this view, he classifies
the remedies principally applied in this disorder, rating as
drugs of first rank those which were first proposed by
Iſahnemann : Camphor, Veratrum, and Cuprum, of the latter
of which he advises to use the sulphate in preference to
métallic copper. As remedies of second rank he names:
JPhosph., Arsenic., Carb. veg., Acid, hydrocyam., Secal, corm.,
Arg. nitric., and Colchicum, deeming Jatropha curcas and
Ipecac, Homoeopathic to light cases only (cholera diarrhoea),
and finally points to Nua, vom. and the Strychnine prepara-
tions as promising well in the painful, tonic cramps of the
calves. Besides these remedies he advises us to ozonise
the air in sick rooms (especially in hospitals), to let the
patient drink ozonised water, and to try the uninterrupted
galvanic current. Of the transfusion of blood he does not
expect any favorable result previous to the removal of the
nervous paralysis.
Finally Dr. S. gives us his personal experience in the
treatment of cholera during the years 1866 and 1867. In
the former year he attended to one hundred and fifty cases,
eighty of which were cases of real cholera, the remaining
seventy cases of cholera morbus. Of this number he lost
twenty-seven by death, eight passed into other hands, and
the rest recovered. In the village of Krictern, near Dreslau,
an Allopathic physician treated seventeen cholera patients,
all of whom died. The author, at the same place, treated an
equal number with only four deaths. In 1867 he attended
to thirty-eight cases of cholera morbus, none of which ran
into real cholera, and thirteen cases of real cholera, four of
1869.] Reviews of Books. 483
which proved fatal. In cholera morbus he prescribed
Veralr. 1 and Phosph. 2, three drops of each to be given
alternately from one-fourth of an hour to two hours. In
cases where he apprehended danger at the very outset, from
two to five drops of Tinct. camphorae concentrata on sugar,
three doses in succession, and at intervals of from ten to
fifteen minutes; afterwards Veratr. 1 in alternation with
Phosph. 2, in the same doses and intervals. Veratr. and
Cuprum sulph. deserve proference, in his opinion, in
case of early appearing cramps and colic pains. Veratr.
and Phosph., on the contrary, when those symptoms are
absent altogether. In the asphyctic stages he considers
Camphor of no use, even in the strongest doses. Here he
recommends Arsen. and Phosph. (the latter in Kafka’s man-
ner, mixed with a few drops of Æther phosphoratus), and
Carb. veg. Acid, hydrocyan., in the epidemic of 1849, did
good service, but failed entirely in 1866. For gastric and
bilious symptoms, very common during such epidemics,
he saw good effects of Ipecac, Nua wom., and Chelidonium.
Such is Dr. S.’s pamphlet. Aside from all the informa-
tion it contains, it recommends itself by its logical arrange-
ment as well as by its plain and clear language, and will
certainly repay perusal.
As to the propriety of alternating remedies in this dis-
ease, I will not say any thing at present, partly in remem
brance of Trinks’ and Watzke's opinion, that as yet we
have no one remedy covering all the symptoms of, and being
entirely Homoeopathic to, cholera; partly for fear of being
considered impolite in asking my opponents questions, when
probably at the very moment they are engaged in deep
meditation over an answer with regard to that subject,
which is both to surprise and annihilate Grauvogl; a hope
they may certainly indulge in, I think, with regard to the
first part of their expectation,in consideration of their many
other wonderful exploits. E. T.
484 Areviews of Books. [$taly,
Four LECTURES ON IIoMOEOPATHY: Delivered in Ann Arbor,
Michigan, December, 1868, by A. B. Palmer, M.D., Pro-
fessor of Pathology, Practice of Medicine, and Hygiene,
in the University of Michigan, Ex-Vice President of the
American Medical Association, Honorary Member of the
New York State Medical Society, etc.
These lectures pretend to give a fair account of Homoe-
opathy, and the Doctor says, “Nothing will be designedly
suppressed which is necessary to a fair and full representa-
tion of its true character.” How any thing could be Sup-
pressed without design is not very clear, but, with or without
design, he has omitted some items of interest which we hope
to see duly mentioned in his next course upon this subject,
and to which we call his attention for that purpose. Dr.
Hempel has been kind enough to call his attention to others
in his letter to the Professor, etc.
The first lecture begins with a biographical notice of
Hahnemann, from which one, who had access to no other
source of information, would judge him to have been a sort
of medical vagabond. If moving from place to place is a
reproach to a man, Dr. Palmer is not exactly the man to
urge it, and it might be well in his next course to tell the
students why he came to Chicago some years ago, and why
he did not stay here, as well as the causes of any other move
he may have made.
Dr. Palmer's hearers could hardly have obtained from
these Lectures an idea that Hahnemann was a man of learn-
ing, a master of French, English, Latin and Greek; that he
was distinguished as a chemist; that he wrote a work on
Arsenic, which is a standard to this day; that he was the
first who “advocated and practiced the moral treatment of
the insane,” or if not the first he was entitled to divide the
honor with Pinel; that, besides his numerous translations,
he wrote many articles in “Hufeland’s” and other Journals,
besides pamphlets and larger works, all of which testify to
his vast erudition in medicine and its kindred sciences, as
well as in general literature. These matters are fully set
1869.] Areviews of Books.' 485
forth in Dudgeon’s Lectures, which Dr. P. quotes, and
hence must have read. Let any one read Dr. Dudgeon’s
first Lecture, which is upon the life of Hahnemann, and then
Dr. P.’s notice of the same life, and he will see how much
fairness was exhibited. And then, to cap the climax, we
have Dr. Peters as an authority that Hahnemann was only
a half-educated physician | To those familiar with IIahme-
mann’s labors and Dr. Peters' (!) nothing can ever appear
half so ridiculous as Dr. Peters sitting in judgment upon
the education of Hahnemann. We do not hesitate to
charge Dr. Palmer with vilifying the memory of a man
whose greatness has been abundantly testified to by mem-
bers of Dr. Palmer's own school, and with doing this before
a class of hearers who had but little, if any, opportunity to
know the truth: something very like stabbing a man in
the back.
It is no part of our intention to discuss the points raised by
Dr. Palmer. He has said nothing which has not been said
as well or better twenty times before — nothing which has
not been answered time and time again. Jokes which were
old twenty-five years ago, statements which never had any
truth, and arguments which never had any reason in them,
the falsity of which has been exposed times without num-
ber, as Dr. Palmer must have known, were retailed to his
listeners and enforced upon them with all the authority of
Dr. P.’s standing ! If his hearers were not the merest dolts
that ever walked on the earth, these Lectures were a gross
insult to their understanding as well as their learning.
We shall cite but two instances to sustain this charge.
At the close of his last Lecture he refers to that silly report
which was so eagerly copied from one Allopathic Journal
into another, that the practice of Homoeopathy had been
forbidden in Russia by Imperial Ukase. We repeat that
Allopathic journals were eager to copy it, while but few of
them had the manliness to acknowledge that they had been
deceived. Dr. Palmer does not indorse it, neither does he
say, as he might and should have done, that there never
was a word of truth in it. The impression he evidently
486 Areviews of Books. [%uly,
intended to make upon his students was that it might have
been true.
And then, Andral’s experiments! No honest man, of
any medical reading, can quote these experiments against
Homoeopathy without blushing. The evidence that this
“fair trial” was no trial at all, was within Dr. Palmer’s
reach. It can not be that he never saw it, if he had read
a tithe of the Homoeopathic literature which he pretends
to have read. His dear friend, John C. Peters, M.D., was
once an editor of the “North American Journal of Homoe-
opathy,” in which this matter is fully set forth; though he
was not an editor of the Journal at the time the following
extract was published, he must have known of it. IIow
could he have allowed Dr. Palmer thus to disgrace himself?
In the “North American Homoeopathic Journal,” Vol.
II., p. 263, we find the matter of Andral’s experiments fully
discussed, by Dr. Carroll Dunham, of New York. We can
find room for the following lines only :
“At Paris, March, 1851, I asked M. Andral whether he had experimented
on IIomoeopathy at La Pitié, and where the results of his cxperiments had
been recorded. He replied that he had experimented, but not so exten-
sively and accurately as the subject deserves, for that Iſomoeopathy domands
earnest investigation at the hands of every physician. He said that no
report of his experiments had been published by himself or by his authority,
but that his chef de clinique, M. Vernois, had recorded them in the ‘Bulletin
de la Thérapeutique,” and that the record is substantially correct. IIe Said
that he himselſ did not now think those experiments conclusive. I asked
whether, in conducting his experiments, he had referred to the original
works of IIahnemann. IIe replied that he had not read the German works
on Iſomoeopathy, but had derived his information from French IIomoeo-
pathic writers.”
Further on Dr. D. says:
“In a pamphlet published a few years after the experiments were made
(IIoma!opathie, Analyse de la Matiéré Medicale, pan M. Vernois), M. Vernois
admits M. Andral's ignorance of IIahnemann's provings, and calls it ‘‘ſnor-
ance obligée,' referring to the fact that no translations of the Materia Mcdica
had appeared in France.”
Whether Dr. Palmer was ignorant of the true state of
the case in this matter, or whether he designedly suppressed
the truth, we shall not inquire. But one thing he is ignor-
ant of, as appears by the following question :
“Will Quinine produce intermittent fever, or any thing
like it?” asks Dr. Palmer, and adds: “Of medical men I
1869.] Peviews of Books. 487
need not ask the question.” We wish to call his attention
to the views of a medical man whom he has chosen to use
as authority, one Dr. John C. Peters; we can not give his
evidence at length. Dr. Palmer will find it in the “IIomoeo-
pathic Examiner,” Vol. II., p. 25, et seq. Meantime the
following brief extracts must suffice:
“It is in the cure of intermittent fever that Peruvian bark
is particularly efficacious. Yet it is well known " that Cul-
len stated long ago that Peruvian bark would excite a
species of intermittent fever. After quoting many authors
to the point, Dr. Peters concludes: “Hence we think that
there is proof sufficient offered that Peruvian bark causes
chills; ” and in the next paragraph he proceeds: “We have
already shown that Peruvian bark causes fever. * * *
It now only remains for us to prove that Peruvian bark
causes profuse sweat.” This point he fully substantiates,
and concludes: “IIence, physicians of the old school
* * * freely give a drug in order to cure fever and ague
that causes chills, fever and sweat in the healthy person.
Surely,” Dr. Peters adds, “they can not think that it is
absurd to treat diseases Homoeopathically.”
In the same Journal, p. 101, Dr. John C. Peters proceeds
“to show why Peruvian bark cures intermittent fever more
frequently than almost any other drug.” This he does at
length, and from Allopathic authorities, and concludes thus:
“To sum up, we have shown that Peruvian bark causes
fever, congestion, chills and fever, followed by sweat, en-
largements of the liver and spleen, and dropsy, in the
healthy subject, while experience has proved that it will
cure all the above conditions; ” and finally adds: “Is it
very absurd to CURE diseases Homoeopathically?”—a ques-
tion which we leave Drs. Palmer and Peters to settle be-
tween themselves.
Dr. Palmer goes into Homoeopathic statistics. We can
not spare the time to set him right in all points, nor would
it avail any more than to show a rainbow to an owl or a
* Except by Dr. Palmer.
488 Reviews of Books. [?'uly,
bat. Nevertheless, we must give an item or two which Dr.
Palmer suppressed, without design, of course:
In Wilde's “Austria, its Literary, Scientific and Medical Institutions,” ”
it is remarked : “Upon comparing the report made of the treatment of
cholera in the Homoeopathic hospital at Vienna, with that of the same cpi-
demic in other hospitals of Vienna at a similar time, it appeared that while
two-thirds of those treated by Dr. Fleischmann recovered, two-thirds of
those treated by the ordinary methods in the other hospitals died. This
very extraordinary result led Count Kolowrat (Minister of the Interior)
to repeal the law relative to the practice of Homoeopathy; the hospital in
question, it should be added was daily visited by two Allopathic inspecting
physicians appointed by the government; Dr. Roth, of Munich, also, who
was sent by the Bavarian government to observe the cholera in different
localities, and report upon the effects of its IIomoeopathic treatment, pub-
lished in 1833 an interesting pamphlet which has furnished a considerable
portion of the statistics above detailed. The statistics from Tischnowitz,
in Moravia, (where there were three hundred and twenty-seven cases and
thirty-two deaths), were furnished by the authorities of that place, accom-
panied by a letter of the most grateful acknowledgement. Dr. Veith, one
of the practitioners, whose results are quoted in the above list, had formerly
been a medical practitioner in the Allopathic school, but was, at the time
when the cholera raged at Vienna, chaplain to the Court and to St. Stephen's
Cathedral, and whilst administering the consolations of religion to those
infected with cholera, he was shocked at the awful mortality that pre-
vailed; and the idea of treating them according to the Homoeopathic sys-
tem, with which he was already familiar, occurred to him. His success
was sº, great, that of one hundred and twenty-five patients he lost but
three. *
In this connection the following facts are of interest; they may be found
in the same pamphlet, “Wilde's Austria,” p. 62:
“When the Bavarian Parliament and the Hungarian Diet, in 1843, unani-
mously agreed to recommend the merits of Homoeopathy to the favorable
consideration of their respective governments, it was shown:
1st. “That in Germany the mortality in Homoeopathic hospitals was not
quite six per cent., whereas in Allopathic hospitals it amounted to more
than twelve per cent.
2d. “That in severe inflammation, the mortality in Allopathic hospitals
was nearly fifteen per cent., and in Homoeopathic hospitals not quite five
per cent.
3d. “That in cholera the mortality in Allopathic hospitals was fifty-sia, and
$n LIomatopathic hospitals under thirty-three per cent.
4th. “That the average number of days which the patients remained in
the hospital was from twenty-eight to twenty-nine in Allopathic, and from
twenty to twenty-four in Homoeopathic hospitals. And
5th. “That in Homoeopathic hospitals the charge for each patient is nearly
half the cxpenditure for each patient in Allopathic establishments.”
Here is the second :
Says Dr. Macloughlin, one of the Medical Inspectors of the Board of
Health, London:
“You are aware that I went to your hospital prepossessed against the
Homoeopathic system ; that you had in me, in your camp, an enemy rather
than a friend ; and that therefore I must have seen some cogent reason
* This is the work of an Allopathic surgeon, the talented editor of the
“Dublin Quarterly Journal of Medicine.”
1869.] Reviews of Books. 489
there, the first day I went, to come away so favorably disposed, as to advise
a friend to send a subscription to your charitable fund; and I need not tell
you that I have taken some pains to make myself acquainted with the rise,
progress and medical treatment of cholera, and that I claim for myself some
right to be, able to recognize the disease, and to know something of what
the medical treatment ought to be; and that there may be therefore no mis-
apprehension about the cases I saw in your hospital, I will add, that all I
saw were true cases of cholera in the various stages of the disease; and that
I saw several cases which did well under your treatment, which I have no
hesitation in saying would have sunk under any other. In conclusion I
must repeat to you what I have already told you, and what I have told
every one with whom I have conversed, that although an Allopath by prin-
ciple, education and practice, yet was it the will of Providence to afflict me
with cholera, and to deprive me of the power of prescribing for myself, I
would rather be in the hands of a Homoeopathic than an Allopathic adviser.
I can not suppose that any thing I have said above can be of value to the
Homoeopathic system, but such as it is, you are at full liberty to make
what use you please of this letter.”
At the risk of being tedious, we offer for Dr. P.'s consid-
eration “the statistical tables, compiled with a great deal
of care, by Dr. Peters,” the identical Dr. Jno. C. Peters,
whom Dr. P. delights to quote. They are found in the
same volume (II.), already quoted, of the “North American
Journal of Homoeopathy,” page 229, in which Dr. Peters
(Jno. C.) shows that the average Homoeopathic mortality
in hospitals was “a very little more than five in a hundred;
the usual mortality in Allopathic hospitals being from eight
to nine per cent.” The writer of this statement, Dr. Peters,
for aught we know to the contrary, says in view of these
facts: “Our fiercest adversaries have not denied but that
our statistics show as favorable results as those of Allopathic
medicine. We thank them for an admission fatal to their
pretensions, for surely he must be a gratuitous hero who
would undergo their heroic tortures when he is convinced
that our mild means and gentle appliances will give him an
equal chance of life and health.”
We can not help giving Dr. v. Grauvogl’s translation of
this latter strain. We do not know as Dr. Palmer reads
German, but Dr. Peters does, and he can translate it for
him :
“Dr. Peters ruft bei der Berichterstattung aus; Wer mâchte
bei Solchen Daten ein so grossen Narr sein, sich dem heroischen
Verfahren der allen Schule zu unterwerfem.”
* “Iehrbuch der Homoeopathie,” Part II., p. 848.
490 Reviews of Books. [$ºuly,
Another item which Dr. Palmer undesignedly suppressed,
and this will be the last at present, is, that several years ago
a London Life Assurance Company offered insurance to
Homoeopathic patients at lower rates than to Allopathic, and
that there are THREE Homoeopathic Life Insurance Com-
panies in this country, all doing well. Will Dr. Palmer
make a note of this fact — he perhaps never heard of it
before — and state it to his students the next time he lec-
tures to them on this subject 7
There is one point in Dr. P.'s Lectures where he does
really hit us somewhat of a telling blow. It is no argument
against the law similia similibus curantur, that some who pro-
ſess to believe it, do not adhere to it, any more than it is an
argument against the Christian religion, that some who
profess it are reprobates. Nevertheless, it is damaging to
us as a body — there is no denying it — to have men in our
fellowship who do such things as Dr. P. charges. It would
be much better that they should follow Dr. Peters back into
the Allopathic ranks.
On page 75 Dr. P. says:
In the “New York Medical Gazette,” Vol. I., p. 328, it is stated: “Hahne-
mann taught that one grain of Sulphur well rubbed up with one hundred
grains of Sugar of milk, could be developed into a mcdicine of tremendous
power and energy. But Dr. Barlow, of New York, who ranks as a Homoeo-
pathic physician of excellent standing, advises that 2 grs. of very pure Sul-
phur be mixed with 126 grs. of Conium, Qwºrvine and Morphine. A favorite
prescription is: Take
“Sulphur Pura, 2 grs.
“Jºvt. Conium Mac., 90 grs.
“Sulph. Quinia, 30 grs.
“Sulph. Morphine, 3 grs.
“Podophyllin, 3 grs.
“M. ft. pil. No. xxx, Dose, one or two, several times a day.
“Each pill contains one-fifteenth of a grain of the Sulphur, three grains
of the Com?um, one grain Quinia, one-tenth grain each of the Morphine and
Podophyllin.”
If these allegations are true, and those which follow, it is
for Drs. Barlow, Freligh, etc., to justify themselves. We are
not called upon to defend them, neither is Homoeopathy; and
if every Homoeopathist did the very same thing it would
have no more bearing upon the question, “Is there such a
1869.] Feviews of Books. 491
law in Therapeutics as similia similibus curantur º’ than it
has upon the question whether the moon is inhabited.
We close this part of our notice with another quotation
(from page 76), and only add, let those who are hit defend
themselves as best they can. We know, if Dr. P. does not,
that there are members in our school who would scorn
deceit and treachery as much as he would or his friend Dr.
Jno. C. Peters — we do not know exactly how strong that
expression is — but let it pass for the present.
“A few years ago I was called to see a gentleman at Some distance, who
had been my patient previously, and who was then in an alarming condi-
tion from an acute inflammation in the chest. Arriving by the cars late in
the night, the attending physician was not present, but he had left a note
for me, stating that the patient was taking Morphine, and, I think, some
other medicine, in the ordinary doses prescribed by regular physicians. In
the morning this physician came in, and a consultation was held in the
case, during which not an allusion was made, or an expression dropped,
which excited the least suspicion of any irregularity in the views or prac-
tice of the person with whom I was consulting. He spoke freely of other
cases which had occurred in his practice, and of his treatment, among
which I distinctly remember rheumatism, which he said he had treated suc-
cessfully with large doses of alkalies; and pneumonia, in which the excite-
ment of the pulse and other symptoms had been controlled by the usual
doses of Veratrum viride. A course of treatment for the patient was agreed
upon, without there being the slightest reference to Homoeopathic princi-
ples; and not until he had left the house to procure the medicine, when I
was informed of the fact, had I the least suspicion that this man, I had thus
met, was a professed Homoeopath. When he returned, in the presence of the
family of the patient, I charged him with deception in professing a system
he practically repudiated—for giving to Homoeopathy the credit he had
met with in the use of remedies given in accordance with the practice
of the regular school; and I enjoined upon the gentleman who had sent for
mc, to convey my apology and explanation to the regular physicians of the
town for having been unconsciously in consultation with a Homoeopath ;
who, had he adhered to his professed principles, could not have agreed with
me, in any prescription I could conscientiously have made. This man was
no obscure and unknown pretender, but at the time an associate editor, as
I was informed, of a New York Homoeopathic Journal; was soon after, and
I believe now is, a professor in a Homoeopathic College, and is the author
of a work on Homoeopathic Materia Medica.”
Dr. Palmer makes quite a handle of an extract (mon-
strously garbled) from this Journal — from a letter of our
New York correspondent — calling upon the IIomoeopa-
thists to produce something. It is not a very powerful
argument to say, “You’re another,” nevertheless, it is quite
as good as any Dr. Palmer has at his command, and it must
suffice for the present to ask Dr. Palmer what he has ever
produced. If he will favor us with a list of his publications
492 APeviews of Books. [ºuly,
we will endeavor to match them from the Homoeopathic
literature, though we hope he will leave out of the list these
Four Lectures; they are without a parallel.
CoNFáRENCES SUR L’HomoCopATHIE. Par M. Léon Simon,
Docteur en Médicine de la Faculté de Paris, etc., etc.
The readers of our Journal were apprised, in the last
number, of the fact that free lectures were given in Paris,
under authority of the Minister of Public Instruction, and
were shown just how much the fact signifies. We are in
receipt of the few first Lectures. In the first Lecture, the
question, What is Homoeopathy 2 is answered. M. Simon
sets forth the cardinal doctrine of the system, showing how
it leads to and includes: 1st, Drug-proving upon the
healthy; 2nd, A knowledge of diseases by determination of
their causes, and by a knowledge of their symptoms; 3rd,
The dynamic nature of diseases; beyond this there is yet
another principle, specificity — specificity of life, specificity
of the disease, specificity of the drug. He then proceeds to
give a sketch of the medical notions prevailing at the time
when Hahnemann promulgated his peculiar views; showing
where he agreed, and where he disagreed with, and was
superior to, them ; showing the fallacy of the principle con-
traria contrariis (which was then acknowledged, though now
said to be discarded), and the vain attempts which were
made to reduce it to practice.
Having shown the inability of the Allopathic school to
meet the requirements of medicine, he takes up the saying
of Trousseau, To know is to foresee, but one foresees with prim-
ciples, not with facts, and shows that this knowledge — this
science, rested with Hahnemann, since, before he had ever
seen a case of cholera, he foretold what would cure it; and
the remedies recommended by him have been triumphant
in every epidemic from that day to this, in every part of the
world. M. Simon concludes this Lecture by a rapid sketch
of the rise of Homoeopathy in Europe and America.
1869.] Areviews of Books. 493
Lecture II. is upon the law of the Similars. M. Simon
begins with a quotation from Claude Bernard’s lecture,
given in 1847, “The scientific medicine, which I am charged to
teach you, DoES NOT EXIST.” In 1869 he holds the following
language, this same Claude Bernard: º
“1. The medicine of observation was founded by Hippocrates. This medi-
cine has for its object prognostics, diagnostics, nosology. Here, the igno-
ramus can not be confounded with the scholar, and he who has not studied
clinical medicine, pathological anatomy, Semeiology — in a word, the
medical science of observation, will be incapable of solving the problems
which relate to the history of diseases.
“2. Experimental medicine corresponds to therapeutics, to the treatment
of disease. To this day this MEDICINE DOES NOT YET ExIST I IT IS PLUNGED
IN EMPIRICISM. Here the ignorant, the charlatan, and the learned physician
become confounded with each other again, so that those who regard the treat-
7nent of diseases, have good 7'eason to 8dy THAT THEIR MEDICINE IS NOT YET
A SCIENCE.”
In discussing this law M. Simon shows: 1. That the ex-
perimental proofs, even in Allopathic authorities, are numer-
ous, that Quinine does produce symptoms of ague;* that
what holds good of Quinine and ague, is true of Mercury
and syphilis, Sulphur and the itch, Belladonna and scarlatina,
etc. He then shows that what is established by experience
is justified by reason'; that the law of the Similars expresses
specific actions; that with this law, though we can not always
cure, we can always apply that which is curative in the drug
to that which is curable in the disease. To which he adds:
“You see now the distance which separates Homoeopathy from a medica-
tion.} A medication makes use only of a certain number of therapeutical
agents, and Homoeopathy employs them all ; a medication is suitable only
for a certain number of diseases, while the doctrine of Hahnemann applies
itself, not only to all affections, but to all patients: hence it has in this a
character which you can not fail to recognize.
“You will understand now why Hahnemann assumed to have founded
therapeutics, and not merely a party in therapeutics; why we maintain
that Homoeopathy is the assured foundation of the art of healing; why it
alone is capable of conducting us to the logical and happy choice of a cura-
tive drug.”
And here we must take leave of our earnest and gifted
confrère for the present. Our hasty and imperfect sketch
we fear has done him injustice, but if it leads any of our
readers to obtain the Lectures and read for themselves, the
notice will not have been written in vain.
* Dr. Palmer, A. B., would do well to read this Lecture.
ł This word is untranslatable; the context will show just what it means
Wol. IV.-No. 16. 7.
494 Reviews of Books. [ºuly,
A MANUAL OF THERAPEUTICS. By RICHARD ITUGHES, L.R.
C.P. Ed. (Exam.), M.R.C.S., England. London: IIenry
Turner & Co., 1869.
THIS is the sequel and companion volume to the “Pharma-
codynamics,” which appeared two years ago, and to which,
in external appearance and typographical execution, it cor-
responds. The two volumes, together, give a comprehen-
sive view of IIomoeopathic practice; the one from the stand-
point of Materia Medica, the other from that of disease, and
are intended as “A Manual of Homoeopathic Practice for
Students and Beginners; ” and, as we are told in the preface
to Part I., especially for practitioners of the old school who
may desire to inform themselves in regard to our practice.
In the preface to the present volume the author says: “If
I can make the study of Homoeopathy less bristling with
difficulties, and the early attempts at its practice less tenta-
tive and hap-hazard, I think I shall have done good service.
We should have been a larger band than we are, were it
not for the many would-be students who have been repelled,
and the many beginners who have fainted and turned back,
for lack of a guide.”
We think the author has carried out his purpose in a
manner highly creditable, both to himself and the profes-
sion. The work will undoubtedly prove most valuable in
just the sphere of usefulness for which it is intended.
There can be no question but many inquiring minds in the
old school have been repelled from a full investigation of
Homoeopathy, by having their prejudices and preconceived
ideas too violently shocked in the first attempts to inform
themselves of our system. These books will help to smooth
the way for such into our ranks. The work manifests,
throughout, a respectful and conciliatory spirit towards old
school physicians, which we can not but commend, and
which we feel sure will do no harm. It is simply folly and
bigotry to deny to Allopathic medicine all virtue and all
improvement. Such an attitude of our school only re-
dounds to our injury. We shall be much more likely to
1869.] Reviews of Books. 495
obtain for Homoeopathy justice and candid investigation, at
the hands of our professional opponents, by giving them
due credit and consideration, than by the opposite course,
which a portion of our school prefer to pursue.
But students, beginners, and Allopathic inquirers, are not
the only ones likely to be benfitted by these volumes.
There are few Homoeopathic practitioners of very consid-
erable experience, who may not consult their pages with
interest and profit. As a work for convenient reference
we believe they will be valued by a large majority of our
physicians in active practice. An idea, or a hint, may be
gathered, here and there, which, even if not entirely new,
may jog the memory, and so be of service to many an one
perplexed and wearied amid pressing daily duties.
The frequent reference to standard works and mono-
graphs upon the subjects under consideration, gives addi-
tional value to the work, and will often save time, labor,
and research to the practioner; or possibly cite him to
some source of information forgotten, or previously un-
known. As examples of this, we find, in the introduction
to Part I., a nearly complete list of works, to date, on
Homoeopathic Materia Medica; and on page 233, of the
“Therapeutics,” a list of the papers and monographs that
have appeared in Iſomoeopathic literature on the subject of
Diphtheria.
These noticeable features, together with the clear, pointed,
practical and entertaining style in which these volumes are
written, render Hughes’ Manual, Parts I. and II., “Phar-
macodynamics” and “Therapeutics,” a work which richly
deserves a place in the library of every physician in the
land, of whatever name and School. F. A. L.
TIE TRANSACTIONS OF THE TWENTY-FIRST SESSION OF THE
AMERICAN INSTITUTE OF HOMOEOPATHY, held at St. Louis,
June 2nd, 3rd, 4th, and 5th, 1868, have come to hand some-
what larger in bulk, but in the same admirable dress as
those of the previous year, from the printing house of
496 Reviews of Books. [Šuly,
Alfred Mudge & Sons, Boston. In typography the volume
is a model of elegance and accuracy, and reflects great
credit on those who have had its publication in charge. In
the matter of contents, too, the volume is the most creditable
to the profession that has appeared. In all the departments
the reports are full, and most of them bear evidence of hav-
ing been prepared with much care and ability.
The arrangement of the Reports of each Bureau in sep-
arate sections, each separately paged, so as eventually to
form complete volumes from each of the Bureaus, is a great
improvement on the old method of publication, and obviates
one of the most formidable difficulties encountered in the
issues previous to that of 1867.
The Committee of Publication deserves the thanks of the
profession for the inauguration and success of the “New
Series.” F. A. L.
SELE-ENERVATION: ITS CoNSEQUENCES AND TREATMENT. By
C. S. Eldridge, M.D., Bay City, Michigan; with an
Introduction by Prof. Joseph Hooper, M.D. Chicago:
C. S. Halsey, Publisher, 147 Clark Street. 1869.
Book-publishing is an art. The little monograph before
us demonstrates the fact, if any one is inclined to doubt it;
and, furthermore, that Western enterprise and taste in
general, and Halsey’s in particular, are fully equal to the
production of the highest style of this art. Having already
acquitted himself well in this department, Mr. H. has now
seemingly undertaken to outdo himself, and, we think, has
most successfully accomplished even this bold enterprise.
In quality of material, and style of mechanical execution,
the book will compare favorably with any lately issued from
the ablest Eastern houses. All hands concerned in giving
it form and comeliness, are entitled to great credit.
Intrinsically, the work is intended by the author to sup-
ply a want,which has doubtless been often felt by physicians
and others, of reliable information in regard to the nature,
consequences, and rational treatment of an evil too much
1869.] Reviews of Books. 497
ignored in standard medical works. We have hastily
glanced over its pages, and judge the author's treatment
of the subject to be eminently judicious and practical.
The elegant little volume is offered at the low price of
$1.00, and will doubtless meet a rapid and extensive sale.
F. A. L.
SEVENTEENTH ANNUAL REPORT OF THE DIRECTORs of THE
NEW YORK OPHTHALMIC HOSPITAL, FOR THE YEAR 1868.
This will be remembered as the Institution which, two
years ago, discharged its Allopathic Board of surgeons and
appointed a Homoeopathic. The Report says:
“The Homoeopathic system, here adopted, has been found successful
beyond the expectations of the Board in treating (at the rate of twelve
- hundred per year) the most obstimate forms of ophthalmic disease in
patients from different parts of the city and State, who have sought out
this Hospital and come to it for relief.” -
The accommodations of the Institution having become
already too strait for them, the Directors are looking for-
ward to the erection of a Hospital commensurate with their
necessities. Funds for this purpose may be sent to Mr.
John M. Seaman (President), No. 10 East Twelfth street;
Mr. Thomas C. Smith (Vice-President and Chairman of
Finance Committee), No. 15 Park place; and Mr. C. C.
Corson (Treasurer), East River Bank; and we should be
happy to report in this Journal large contributions to this
end. Some of our colleagues have grown rich by their
practice, and (we trust that) they would be happy to con-
tribute to such a noble institution, if they only were made
aware of its urgent wants.
ILLUSTRATED TRAVELS : A Record of Discovery, Geo-
graphy and Adventure. Published by Cassell, Petter &
Galpin, New York.-A magazine of rare interest and value.
Worth a dozen or more of the average magazines of the day;
it is as well illustrated as the best of them, and, as a source
of information, is second to none.
498 | Peviews of Books. [3tely,
THE IIoMOEOPATHIC THERAPEUTICS OF DIARRIICEA, DYSENTERY,
CHOLERA MoRBUS, CIIOLERA INFANTUM, AND ALL OTIIER
Loos.E EvacuATIONS OF THE BOWELS. Dy Jas. R. Bell,
M.D. Philadelphia: Tafel. 1869.
This little work gives, in a condensed form and con-
veniently arranged for reference, the symptoms, regarding
the above mentioned diseases, of one hundred and eight
remedies. As far as we have had opportunity to judge and
compare, the symptoms are given with accuracy and cor-
rectness. Under each remedy we have stools, their charac-
ter, aggravation, ameliorations; symptoms before, during and
after stool, accompaniments, with a few concluding remarks
of a practical nature. In Part II. we have a Repertory,
which makes the whole work quite complete and readily
accessible.
On turning over the pages, the question occurred to us
whether some of the remedies might not have been omitted
without loss. Perhaps not. One certainly might have been
added with advantage, and that is Ledum. We take great
pleasure in recommending the work to the profession.
tºmºsºmºsº
TRANSACTIONS OF THE FIFTH AND SIXTH ANNUAL MEETINGS
OF THE WESTERN INSTITUTE OF HOMOEOPATHY, at Indiana-
polis, May 23rd and 24th, 1867, and Milwaukee, May 21st
and 22nd, 1868. Chicago: Printed for the Institute, by
F. C. S. Calhoun, 157 Randolph Street, 1868.
These form an octavo pamphlet of 150 pages, 32 of which
are taken up with the discussions and miscellaneous pro-
ceedings. Then follow a Surgical Section, containing four
reports; a section of Clinical Medicine, with four reports;
an Obstetric Section, with two reports; and a Materia
Medica Section, with two reports, twelve in all for the two
Sessions — a rather meagre display as to both quantity and
quality. The volume should have had a table of con-
tents. F. A. L.
1869.] Reviews of Books. 499
PROVINGs of CARBOLIC ACID. By T. Bacmeister, M.D., T.
S. Hoyne, M.D., T. C. Duncan, M.D., S. P. Hedges, M.D.,
C. W. Boyce, M.D. Chicago: W. B. Keen & Cooke,
Nos. 113 and 115 State Street, 1869.
These gentlemen have inaugurated an investigation of
the pathogenetic properties of this remarkable substance.
Two hundred and eighty-four symptoms have been elicited
by the five provers, and conveniently arranged for refer-
ence. The results attained should be an incentive to more
thorough and extended provings of the drug. F. A. L.
A LETTER. To PROFESSOR: A. B. PALMER, A.M., M.D., OE THE
UNIVERSITY OF MICHIGAN; being a Reply to his Four
Lectures on Homoeopathy. By Chas. J. Hempel, M.D.
In this letter Dr. Hempel dissects Dr. Palmer’s Lectures
with unsparing hand, and shows clearly that he was ignorant
of the subject on which he was lecturing, and meant to
leave his hearers in ignorance also. The façt that Dr. P.
did garble the Homoeopathic authorities which he quotes is
set forth beyond any dispute. Those of our Allopathic
readers who wish to read the other side, would do well to
procure this letter.
CoRRESPONDENTs will please address their letters of business to the pub-
lisher, C. S. Halsey, 147 Clark Street. The Editor never knows why the
subscribers do not get their Journals, nor how much they have paid; nor
does he even know who the subscribers are; hence he is unable to answer
any questions on these points.
AUTIIoRs, where their works pertain to any speciality, will do us a favor
by sending said works, if they wish to have them reviewed, to the Editor,
who has charge of that speciality. Any work on Materia Medica, for
instance, should be sent to Dr. Dunham, New York, etc.
ExcIIANGEs will please address their favors to UNITED STATES MEDICAL
AND SURGICAL Journ AL, 292 West Randolph Street, Chicago, and not to
the Editor. Our foreign exchanges are again notified that we have no con-
trol of the Postoffice Department, and but little “influence with the admin-
istration.” Heretofore neither the postoffice at Chicago nor that in New
York has known the rates of foreign postage. They think they know now,
but as they have thought so many a time before when they have known
nothing about it, we recommend to our foreign friends the grace which we
have much need to exercise ourselves in these matters— patience; if they
can cultivate a little hope at the same time, so much the better.
5OO Aooks Received.
BOOKS RECEIVED.
Dental Cosmos. Nashville Journal of Medicine and Surgery. L'IIahne-
mannisme. New York Medical Journal. The Monthly IIomoeopathic
Review. The New York Medical Gazette. The American Journal of
Homoeopathic Materia Medica. The Detroit Review of Medicine and Phar-
macy. Public Parks: Their Effects upon the Moral, Physical and Sani-
tary Condition of the Inhabitants of Large Cities, with Especial Reference
to the City of Chicago; by John II. Rauch, M.D., Member of the Board of
Health, Sanitary Superintendent of the Vital Statistics of Chicago. Jour-
nal du Dispensaire Hahnemann de Bruxelles. IIalf-Yearly Compendium
of Medical Science: S. W. Butler, M.D., Philadelphia. Little Corporal.
Waledictory Address, delivered by IIenry Noah Martin, M.D., March 3rd,
1869, at Hahnemann Medical College of Philadelphia: On the Dynamics,
Principles and Philosophy of Organic Life, an Effort to Obtain Definite
Conceptions of How do Medicines Produce their Eſſects; Waledictory
Address, delivered to the Muskingum County Mcdical Society, Zanesville,
Ohio, May 6th, 1868, by Z. C. McElroy, M.D., President. The British IIomoe-
opathic Directory for 1869. Hughes' Manual of Pharmacodynamics;
Hughes' Manual of Therapeutics; from the publishers, Henry Turner &
Co., London. Provings of Carbolic Acid, by Drs. Bacmeister, Hoyne, Dun-
can, Hedges, and Boyce. Buffalo Medical and Surgical Journal, Journal of
Materia Medica (Bates & Tilden's). The Western Homoeopathic Observer.
The Boston Medical and Surgical Journal. Waledictory Address of Homoe-
opathic Medical College of Missouri, February 25, 1869, by M. D. Terrill,
M.D., Professor of Chemistry and Toxicology. A Brief History of the
Materia Medica, by Samuel Bancroft Barlow, M.D., Professor of Materia
Medica and Therapeutics in the New York Homoeopathic Medical College.
The American Journal of Dental Sciences. The Pacific Mcdical and Sur-
gical Journal. The Probe. Conférences sur L’Homoeopathie, par M. Léon
Simon. The Homoeopathic Sun. Transactions of the Fifth and Sixth
Annual Meeting of the Western Institute of IIomoeopathy. Missouri Den-
tal Journal, Bulletin de la Soc. Méd. Hom. de France. Bibliothèque
Homoeopathique. Illustrated Travels: A Record of Discovery, Geography
and Adventure: Cassell, Petter & Galpin, 596 Broadway, N. Y. The
Homoeopathic Quarterly. El Criterio Medico. Dioscorea Willosa and Dios-
corein, by A. M. Cushing, M.D., Lynn, Mass. The Manufacturer and
Builder (Western & Co., 37% Park Row, N.Y.) A Letter to Prof. A. B.
Palmer, by Charles J. IIempel, M.D. American Homoeopathic Observer.
Proceedings of the State Medical Society of Michigan. Monthly Homoeo-
pathic Independent. Seventeenth Annual Report of the Directors of the
New York Ophthalmic Hospital, for 1868. The New England Medical
Gazette. Monthly Report of the Department of Agriculture, for March
and April, 1869, for which we are indebted to R. F. McLain, Esq., Washing-
ton. The Hahnemannian Monthly. Transactions of the Illinois State
Homoeopathic Medical Association, at its Fourteenth Annual Meeting. Bell
on Diarrhoea and Dysentery; Philadelphia, Tafel, 1869. The Ohio Medical
and Surgical Reporter, Steiger's Literarischer Monatsbericht.
A.D./Z'OAP/A/.
REGULAR MEDICAL SCHOOLS.
WE understand what they are now—the American Medical Association,
at its recent session at New Orleans, settled it — Schools that do not charge
less than $120 for a course of lectures. How simple ! And then, as a con-
sequence, Regular practitioners are graduates from these schools. Nothing
could be plainer, and thus a problem has been solved which has vexed us
for a quarter of a century or more, since we have seen men calling them-
selves regular, whose conformity to rule we never could discern.
And then Congress is to be petitioned to establish a grand collegel
What a sublime conception that was And then, we presume, a law will
be passed preventing the dear, naughty people from employing any one
but the graduates of this college.
But it is too sad a matter to joke about. The Allopathists, with all their
parade, have made no great advance in medical education ; neither have
we. Where is the academical college in the land which admits students
and passes them from one grade to another without examination ? On the
other hand, where is the medical school which does make any such pre-
liminary or intermediate examinations?
It might be advantageous to run this parallel a little further. An Acad-
emic College teaches, among other things, Latin, Greek, and Mathematics.
But does it take students utterly ignorant of these things 2 Not at all.
They must not only have mastered the rudiments, but made some consid-
erable progress in these branches of learning, besides having some knowl-
edge of their own mother tongue. Now, why should not the same practice
obtain as regards Medical Colleges? Let the candidate for admission give
evidence, upon examination, of familiarity with the English language, and
the common branches as taught in our best High Schools, and THEN be
required to pass an examination in Anatomy, Physiology, and Chemistry.
Not such an examination as one would expect to pass who was competing
for the Chair of Anatomy, Physiology, or Chemistry, but such as would
manifest a knowledge of these subjects which might be obtained by attend-
ing one course of lectures. If the question arises where should they obtain
this knowledge, the reply would be, let them get it where they best can;
the having it, is the main thing. Now let the students who are in the col-
lege proper have three grades, and no passing from one to another without
a thorough and impartial examination upon the studies already pursued.
These grades need not be limited by time. If one student could learn in
one year what another could not in less than two, he should have the
benefit of it, and be allowed to pass over one grade, even, if his examina-
tion would bear him out.
5O2 Aditorial. [%uly,
But the cry is, the expense I the expense who will meet the expense?
Why, the students, of course. The best college in the United States will
have the most students, and if half or one-third of our colleges could attain
to such a high stand as many desire, the remaining half or two-thirds would
die of inanition, and the sooner the better. Students do not flock to the
poorer and cheaper colleges, but the best— to those having reputation for
themselves, and some reputation to lend their graduates; and the college
which rises first to the position which a Medical College should have, and
maintain itself there, will have always the greatest number of students, let
the cost be what it may.
We hope those having control of our colleges will give heed to these
things, and make at once salutary and radical changes. If each waits for
the other, lest a student or two may be lost, the thing will never be done;
rather let each set out for itself, irrespective of any others, and see what a
height of excellence it can attain. Or, if this is not to be hoped for, have
we not one college, at least, that will make some decided advance in this
direction ?
O/3S ZETRICS, AAWD THE DISAE ASAES OF WOMAEAV
A/V/D CA/V/L/D/?A2/V.
By R. LUDLAM, M.D.
THE SAFE DELIVERY OF THE IIEAD IN PELVIS PRESEN-
TATIONS.
THE “Boston Medical and Surgical Journal,” for April 22, 1869, contains
an excellent paper upon this subject, including the delivery of the child's
head in case of version by the feet, as well as in original breech presenta-
tions. After detailing the rules for rupturing the membrane, awaiting and
facilitating the dilatation of the os, we read:
We will now suppose the head to be in the pelvis, the face inclining back-
ward into the hollow of the Sacrum, the shoulders and arms liberated, the
funis compressed, but the child still alive, the pains inefficient, the woman
discouraged ; there is great anxiety about the life of the child, and we have
not our forceps at hand. What shall we do?
Under these circumstances the body of the child should be carried directly
forward between the thighs of the mother, until it forms a right angle with
the long axis of the pelvis, or even until its back is nearly in contact with
the abdomen of the mother, and be supported in this position with the right
hand, or, if the labor be not immediately finished, by an assistant. In the
meantime, one or two fingers of the left hand should be passed so as to
reach the chin, or a higher portion of the face, which should be gently
depressed and brought down, and at the same time, if necessary, the occiput
may be pushed upward by the fingers of the right hand in such a manner
as to give the head a quarter turn on its own axis, and bring the mouth and
nose directly to the vulva. This manoeuvre can usually be accomplished
with great facility, especially if favored by a pain, or a little voluntary aid
of the mother in forcing down the uterus. In order to be successful, how-
1869.] Faitorial. 5O3.
ever, this evolution must be performed with dexterity and not with force,
and should not be attempted until the head has descended, or is descending,
into the hollow of the sacrum; as to separate the chin too early from the
breast deranges the natural process of labor, and while the head is high up
the body should be kept in a line with the axis of the pelvis, and should be
gently swayed from side to side, or backward and forward, to excite the
womb to action, and the chin, when it can be reached, be depressed upon
the breast. . The uterus should, in the meantime be gently compressed and
kneaded, with the view of exciting action. When the head has been brought
into the position described, the mouth and nose presenting at the vulva, the
child, if not asphyxiated, or too much exhausted, can breathe freely, and
will sometimes attempt to cry many minutes before the head is expelled,
and with a little attention to keeping the labia separated and the perineum
pressed backward, its chances of life arc, for a sufficient length of time, nearly
as great as after complete delivery. The most favorable position of the
woman is on the left side, a little inclining towards the back. The thighs
should be widely Separated, and the right one supported by an assistint.
* * * * * * • * * 3: 3%
When the face is forward — a somewhat rare occurrence — the body of
the child should, of course, be carried backward, when the same object will
be attained. With the view of expediting the delivery of the head, the
vectis or forceps can be used with great advantage, and the position into
which the head is brought by this manoeuvre is the most favorable position
possible for the operation.
A SIMPLE DRESSING FOR THE NAVEL IN NEW-BORN BABES.
IN a communication to the Homoeopathic Medical Society of Ohio, Prof.
Sanders extols the cotton batting as a dressing for the navel of infants.
He says:
Its manner of use is the simplest possible. Take a pledget of batting of
the thickness of the hand, and of a length and width once and a half the
length of the cord, and place it across the abdomen above, and upon this
vertically lay down the cord, draw down on either side sufficient batting to
thoroughly imbed the umbilical circle; over the cord thus placed apply
another of nearly equal size, and then use the bandage for its support as in
the old dressing.—Ohio Medical and Surgical Reporter.
I).EATH FOLLOWING MISCARRIAGE.
THE following case, reported to the Chicago Academy of Medicine, by Dr.
S. P. Hedges, of this city, affords another illustration of the importance of
the subject to which we have frequently called attention, id est, the delivery
of the placenta in abortion:
March 22d, 1869–I was called to see Mrs. S-. I found a lady of about
twenty-eight years, dark hair, eyes and complexion, above the medium
height, slight figure, and nervous bilious temperament. I received from
her and the nurse the following details:
Seven days before, being about six months pregnant, she slipped on the
stairs and sprained her ankle very badly. The pain was so excruciating as
to cause her to faint. The ankle swelled and turned purple, and continued
to pain her until the second day, March 17, when she commenced to flow,
and in the evening labor-pains came on and she aborted. The footus was
dead. The nurse, being ignorant, told the lady that all had passed. She did
not know that there should be an afterbirth. No physician was called, and
5O4. Faſitorial. [3'uly,
in this way five days were allowed to pass, when the lady not seeming to
gain as was expected, I was sent for. I found a high fever, with extreme
prostration, pulse 120, tense and hard, respiration rapid, skin dry and
parched, eyes glassy, great nervousness, occasional chills, heavily brownish-
coated tongue, severe headache, backachc, and sleeplessness. On examin-
ation I found the uterus high up in the pelvis, firmly contracted, the os
tightly closed, rigid and hot, hardly any discharge. The abdomen was dis-
tended and hot. The index finger could only be introduced about half an
incli within the os uteri, yet the rough surface of the afterbirth could be
felt. I at once decided that all these symptoms were caused by a retained
placenta.
I ordered hot fomentations over the abdomen and vulva, and warm water
injections into the vagina. I gave Arnica 3x, and China 3x, in water,
every hour in alternation.
March 23rd.—There was an increased discharge from vagina; pulse 105,
less tense and hard ; less heat in the vagina and over abdomen; less head-
ache and restlessness. Continued treatment.
March 24th.-Discharge from vagina still more increased, and of a putrid
Odor; OS uteri softer and slightly patulous; considerable restlessness; pulse
100; had a severe chill, followed by fever and headache ; much tenderness
over the abdomen, and so much of an inflammatory tendency as to cause
me to abandon all idea of dilating the OS uteri and obtaining the placenta,
but to try and sustain the system until the placenta could be discharged
gradually. Ordered beef tea diet.
March 25th.-Still greater discharge from vagina, which is very offensive;
injections give great relief; less nervousness; pulse 100; skin very dry;
thirst excessive, only for a little at a time; great prostration ; chill in fore-
noon again; pale, pinched, anxious look to the countenance. The injec-
tions to be medicated with Carbolic acid, one part of a saturated solution of
the acid to one hundred parts of water. Also changed the China to Arsemi-
cum 3x trit., a powder once in two hours. Bowels were moved naturally
during the day.
From this time until March 31st she continued much the same, the beef.
tea and generous dict keeping up her strength. The chills were controlled,
she obtained considerable rest, the putrid odor becoming less, and altogether
she seemed doing well. Remedies were given as indicated, and embraced
Ars., China, Arnica, Bell. Bry, and Sulph.
April 1st and 2nd—Still improving; pulse 90; appetite returning; skin
more natural; discharges from vagina gradually decreasing, and with but
little odor.
April 3rd.—Discharge stopped; uterus in good condition as far as can
be determined; no placenta to be felt; pulse weaker and irregular ; seems
very weak; voice almost inaudible; no pain; a blur before the eyes occa-
sionally ; a very bad cough set in, dry, hard, distressing. Gave at different
times Bell., Rhus toa., Nua, vom., and Ars.
April 4th.-Feels a little more comfortable; voice stronger, but rather
sighing; pulse intermitting ; cough much the same. IIad had during fore-
noon several loose, watery stools, which weakened her much, as she would
get up on a chamber ; respiration slow and feeble. Ordered the stimulants
to be given oftener and stronger, and that she be made to use a bed-pan.
While still at the house prescribing for her, and only two or three min-
utes after talking with her, she suddenly threw up her arms, and with one
long sigh sank back and expired without a word or a cry.
The case was a peculiar one. Was death caused by a sudden paralysis
of the nervous centre of the pneumogastric nerve, from Septic poisoning?
MA ZZZºZA MAZ ZD/CA.
BY C. DUNHAM, M.D.
POISONING WITH MORPHINE. By PROF. MASCHKA, OF PRAGUE.
F. E., a seamstress, twenty-four years of age, who had a love affair with an
apothecary's apprentice, and was living with his parents, fell suddenly sick,
May 8th, 1867, at eleven A.M., having been quite well before. Utter
unconsciousness and loss of motion were almost the only symptoms
noticed
At two P.M. she was taken to the hospital. The patient was found quite
unconscious; the pulse not to be felt. On auscultating, the second sound of
the heart only was heard, and that feebly and at long intervals, the skin was
cool, the pupils contracted, the face and the extremities cyanotic; there
was moderate meteorism, feeble, oft-interrupted tracheal rattle, no vomit-
ing, no convulsions, no symptoms of paralysis, no signs of external
violence.
In connection with sprinkling with water, frictions, and a vesicant on the
neck, a strong infusion of Ipecac with Liq. ammon. anis., was given, with
black coffee and milk interposed as a drink. At about five P.M. a slight
improvement occurred, the pulse was perceptible, in the dependent part of
the lungs a dense rattle could be heard, the swallowing was easier than
before, but still difficult; the temperature was normal. All this time no
vomiting was observed, no diarrhoea, no urine was passed, and, except a
slight trismus, no contractions were to be seen. At about eight P.M. the
patient, though still unconscious, struggled against taking any medicine,
and it was only by the use of considerable force that she could be made to
take her drinks. At eight P.M. a strong infusion of Rad. Ipec. (two drachms
to six ounces), and half a drachm of Liq. ammon. anis., was ordered again,
while milk was continued as a drink. At about ten P.M. collapse suddenly
set in, with tracheal rattle, and difficult swallowing. These symptoms
continued until six A.M., at which time the patient died.
On examination the body was found to be that of a well-nourished, vigo-
rous maiden, the rigor mortis and the usual discoloration well marked, but
no trace of external violence. The brain and its meninges were perfectly
normal, moderately full of blood; both lungs saturated with a foamy, vesi-
cular (kleinbasigen) serum, the blood dark and fluid; the heart normal,
containing in its right half a rather copious quantity of fluid blood; the
stomach was moderately distended, its membranes firm, in its cavity a
small quantity of a brownish fluid, mixed with mucus and yellow granules
(fat) of the size of a millet seed, liquifying under pressure, the mucous mem-
branc Somewhat reddened in a spot about the size of a thaler, elsewhere
pale and quite normal; liver and kidneys were decidedly hypergemic, other.
wise normal; the uterus somewhat enlarged, with thick, tough mucus in
its cavity; both ovaries were interspersed with numerous cysts,
506 Adźforza!. I}uly,
On chemical examination, Morphine was found in the stomach, and it was
subsequently discovered that the deceased took from six to seven grains of
some Morphine which happened to be in the house.—“Prag. Wierteljahr-
schrift,” 1867, IV. “Allge. Hom. Zeitung,” B, 75. “Monatsblatt,” p. 58,
€t 8ég.
POISONING WITH PHOSPHORUS, BY PROF. MASCIII(A.
1. P. K., a servant girl, twenty years of age, had taken, according to her
own account, on the 19th of May, 1867, with the intention of destroying
herself, the ends of eight packages of matches, dissolved in water. Although
she soon felt some pain in her abdomen, yet she continued her work for
some hours. In about four hours she was worse; acute burning pains in
the abdomen set in ; the patient was faint and ready to fall, and there are
risings, retchings and violent vomiting ; the matter vomited gave forth an
offensive odor. The doctor who was called ordered emetics, and then Mag-
nesia, severe diarrhoea having been added to the other symptoms. During
the night, the patient was brought into the hospital,
She was well-nourished, skin pale, the heat of the body somewhat raised,
the pulse 80. The organs of the chest presented nothing abnormal besides
a catarrh of the lungs, the abdomen was distended, the region of the stom-
ach sensitive to the slightest touch, consciousness not disturbed ; there
were occasional risings, retchings, while vomiting occurred only once;
there was great thirst, and bloody diarrhoeic stools; the dejections passed
in the hospital were neither luminous, nor had they any odor of phos.
phorus.
This state of things continued till May 22nd, at which date the excitement,
the heat of the body, and the frequency of the pulse increased, the diarrhoea
ceased, the pains in the abdomen were very severe, the conjunctiva and the
skin of an icteric tinge; the liver and spleen were sensibly enlarged, and
the coloring matter of the bile could be detected in the urine. As the vio-
lent pains in the abdomen and the almost unquenchable thirst continued, the
size of the liver increased as well as the icterus and the weakness of the
patient; the fever was higher, the apathy increased, and as violent efforts
to retch set in, on the morning of the 24th, the patient suddenly lost con-
sciousness, became very restless, throw herself about in bed, groaned and
cried aloud; the pulse became small, 148 in a minute, and soon disappeared
at the radial artery, the extremities became cool and of a dark hue, and
with rapidly advancing collapse she died about noon of May 24th. While
in the hospital she received large quantities of Magnesia, pills of ice, together
with Aq. Jaurocerasi, and Morphine; cold compresses were also laid upon
the abdomen.
On examination, the body was found well-mourished and powerfully
built; the conjunctiva, as well as the skin, was tinged slightly yellow ; the
rigor mortis well marked, but no signs of external violence; the membranes
of the brain were colored yellow ; the substance of the brain was firm and
moderately full of blood. On the pulmonary pleura, as well as upon the
1869.] Adžtoria!. 507
external surface of the pericardium, several spots of ecchymosis were
noticed of the size of peas; the heart was of usual size, the valves delicate
and tender, the muscles yellowish, friable, and in an advanced stage of fatty
degeneration ; the liver seemed manifestly enlarged, its edges obtuse, its
Capsule Smooth and tense, its substance of a lemon yellow, greasy, far gone
in fatty degeneration; the gall bladder was quite empty; the spleen some-
What enlarged, its substance softened, the kidney affected with fatty
degeneration; the mucous membrane of the bladder presented numerous
ecchymoses of the size of a pea or a kreuzer, while similar, but smaller,
extravasations of blood were found upon the greater mesentery and the
diaphragm; the stomach contained a pound of dark, pappy fluid, its mucous
membrane manifestly enlarged, loosened, reddened, in various places marked
with bloody sugillations; the mucous membrane of the duodenum also was
found swollen and reddened, and here, as well as throughout the intestinal
canal, a dark, tar-like fluid was found mixed with decomposed blood; the
blood was every where fluid and dark red. On opening the abdomen, and
especially the stomach, a well-marked odor of phosphorus was perceived.
On microscopic examination there was a high degree of fatty degeneration
of the heart, the liver, and the kidneys observed.
2. Theresa S., a servant girl, nineteen years of age, had, according to her
avowal, taken, on the 22nd of April, 1866, the heads of several packages of
matches in coffee. Violent pains in the bowels, vomiting; diarrhoeic stools
ensued an hour and a half after taking the poison, and increased under
domestic treatment from day to day, a great degree of restlessness having
been in the meantime added thereto.
On the eighth day, when taken into the hospital, she was unconscious,
delirious, in a high fever, having occasionally bloody vomiting and bloody
stools; ten hours after her admission she died.
On examination, the skin and conjunctiva were found icteric, the rigor
mortis moderate, the meninges of the brain yellowish ; the brain pale.
Upon the lungs, the pleura, the pericardium, the heart, the diaphragm, the
stomach, the omentum, the intestinal canal, were abundant ecchymoses,
from the size of a silver dollar to that of a pea; the lungs were drenched
with vesicular, foamy serum; the heart, liver, kidneys, and virgin womb
were far gone in fatty degeneration; the spleen five inches long and friable.
In the stomach were found about two pounds of a tarry, inodorous, dark
fluid ; the mucous membrane was puffed up, loosened, covered with tough
mucus, reddened near the cardia, about the size of a silver dollar, elsewhere
pale, presenting no erosion nor ecchymosis. The mucous membrane of the
duodenum was puffed up and loosened, and the whole intestinal canal filled
with a dark, tarry fluid.
Microscopic examination showed a high degree of fatty degeneration of
the above-named organs.
3. Anna H., a shoemaker's widow, sixty-seven years of age, took sick
December 18th, 1866, with symptoms of vomiting, pain in the bowels, diar-
rhoeic stools, and was domestically treated. Not till the 22nd, when she
508 Adžforzał. §uly,
became much worse, and her strength began to fail her, did she confess that
she had taken a large quantity of the ends of matches, with a view to end
her life. On the 23rd she died.
On post-mortem examination, the skin was found colored yellow, the
rigor mortis well developed; numerous death-Spots on the back; no signs
of external injury. The meninges looked cloudy and thickened, the ven-
tricles of the brain somewhat distended, filled with serum, the brain tough,
firm, moderately full of blood; the tongue had a brown coat; in the larynx,
the pharynx, and the air-passages, there was a brownish fluid mixed with
flocks; the mucous membrane was pale; the mucous membrane of the
osophagus was deprived of its epitelium in many points at its lower
extremity, and here and there ecchymotic. On the lungs, the pleura, the
pericardium, the heart, the larger vessels, the peritoneum, the omentum, the
mesentery, and even on the mucous membrane of the vagina, there were
numerous ecchymoses, from the size of a bean to that of a silver dollar; the
blood was generally fluid, of normal color; the lungs were drenched with
foamy serum ; the heart normal in size and condition; the aorta inter-
spersed with calcareous deposits; the spleen was somewhat enlarged, soft
and friable; the liver and kidneys were far gone in fatty degeneration; the
stomach was moderately distended, in its cavity there was about a pound
of dark, brown fluid, inodorous, mingled with a dark, crumbling mass; the
mucous membrane was pale, somewhat puffed up, covered with tenacious
mucus; no reddening or ecchymosis was noticed here; the mucous mem-
brane of the duodenum was swollen, minutely injected, having, in its cavity,
a fluid like that in the stomach ; the rest of the intestinal canal was normal ;
the uterus wasted away (marastisch) interspersed with small fibroids,
4. Eva K., a servant girl, twenty-four years of age, took the ends of several
bunches of matches on the 4th of July, in coffee, and on the 5th was admit-
ted into the hospital, presenting symptoms of catarrh of the stomach, and
slight icterus. The symptoms at first did not seem very intense, and con-
sisted of moderate pains in the región of the stomach, loss of appetite, mode-
rate acceleration of the pulse, occasional but seldom vomiting of mucous,
brown-colored, inodorous masses; stools bloody. July 7th an essential
change for the worse took place in the afternoon; the patient became rest-
less, in great anguish; the pulse was very small, scarcely perceptible; the
abdomen was distended, and the patient collapsed sensibly. During the
night there was copious vomiting of a fluid like coffee grounds; great sen-
sitiveness of the abdomen, and delirum, and death followed the next day,
July 8th.
On examination, the body of a girl, twenty-four years of age, was pre-
sented, of slight form, the skin, as well as the conjunctiva, of an icteric hue;
the rigor mortis well marked; the posterior parts interspersed with diffused
death-spots; the genital parts in a virginal state; the membranes of the
brain, as well as the brain itself, were in a state quite normal; moderately
full of blood; the mucous membrane of the cavity of the mouth, larynx and
oesophagus pale; in the latter organs there was a blackish fluid like coſfee
grounds; ecchymoses were scattered here and there on the intercostal mus-
1869.] Aditorial. 509
cles of the size of a lentil seed; the lungs were free, in a normal condition,
moderately full of blood; the heart normal in size, relaxed; it muscles far
advanced in fatty degeneration, the valves normal; in the right side Some
fluid blood. On the greater omentum, the mesentery, and the serous cover-
ing of the intestinal canal, ecchymoses were scattered here and there from
the size of a pea to that of a bean ; the liver was enlarged, its capsule
smooth and tense, its substance entirely degenerated into fat; in the gall
bladder there were but a few drops of thin bile; the spleen was of normal
size, friable, softened; the kidneys swollen, the cortical substance in a state
of fatty degeneration; the stomach appeared much distended, its coats pale,
of normal consistence; in its cavity about a pound of black fluid like coffee
grounds, adhering firmly to the walls; the mucous membrane was tumefied,
of a yellowish grey, with loss of substance here and there as large as a lentil
seed, with a red areola, and blood suffused about it; the mucons membrane
of the duodenum was swollen, reddened, containing, as did the small intes-
tines, a blackish fluid like that in the stomach ; the mucous membrane of
the intestinal canal was normal in the rest of its extent, the blood being gen-
erally dark red, and fluid.—Ibid.
It is alleged by M. M. Personne, Andant, and others, that Turpentine is
an antidote for Phosphorus, but our limits forbid further notice at present.
CHAEMYSTR 7 AAWD AEA/2.S./CAA SC/AEAVCAE.
BY F. A. LORD, M.D., CHICAGO, ILL.
“THE PHYSICAL BASIS OF LIFE.”
NoTHING more remarkable has appeared in scientific literature during the
past year than the address of Prof. T. H. Huxley under the above heading.
The demand for copies has already (May 1st) carried the February number
of the “Fortnightly Review,” in which it first appeared, to its sixth edi-
tion,--a fact significant not only of the high estimation in which the author
is held as a scientific anthority, but also of a wide-spread and growing
interest in the exploration of vital phenomena. This, is undoubtedly, the
field in which the leading modern scientific mind is now at work; and medi-
cal men, above all others, have an immediate and practical interest in watch-
ing the progress of the investigation.
For these reasons, as well as because the main ideas singularly harmonize
with some of the original views of vital processes set forth in the current
Volume of this Journal, we trust no further apology is necessary for giving,
in this place, a full synoptical review of this address, remarkable alike for
the boldness and novelty of the views advanced, and for the clear and con-
clusive manner in which they are set forth and advocated.
By the term “Physical Basis of Life,” is meant that one kind of material
Substance which is common to all living beings—that hidden bond by
Vol. IV.-No. 16. 8.
º
5 IO Adźförðað. [ºuly,
which all are bound together in a physical, as well as an ideal, unity, from
the microscopic fungus to the giant pine of California, from the amoeba to
the man. The scientific name of this substance is “Protoplasm.”
That there is such a physical basis, or matter, of life underlying all the
diversities of vital existence it is the present purpose to show ; and, likewise,
that a threefold unity pervades the whole living world: viz., a unity of
power, or faculty; a unity of form; and a unity of substantial composi-
tions.
That the powers, or faculties, of all kinds of living matter are substan-
tially the same requires no abstruse argumentation to prove. To begin
with the highest, all the multifarious and complicated activities of man are
comprehensible under three catagories. Either they are directed towards
the maintenance and development of the body; or they effect transitory
changes in the relative positions of parts of the body; or they tend towards
the continuance of the species. Even the highest human faculties, the
manifestations of intellect, feeling and will, are known only as transitory
changes in the relative position of parts of the body. Speech, gesture, and
every other form of human action, are resolvable into muscular contrac-
tion, which is but a change in the relative positions of the parts of a
muscle,
The scheme large enough to embrace all the activities of the highest
form of life must cover all those of the lower creatures. The lowest plant
or animalcule, equally, feeds, grows, and reproduces its kind. The animal
also manifests those transitory changes of form which we class under irri-
tability and contractility; and it is more than probable that, when the
vegetable world is thoroughly explored, all plants will be found to possess
the same powers at Some period of their existence. The instances of the
sensitive plant, and the stamens of the barberry readily suggest themselves;
but there are abundant evidences of more general and more subtle mani-
festations of vegetable contractility. The delicate hairs which cover the
surface of the nettle consist of an outer case of wood, closely applied to the
inner surface of which there is a layer of semi-fluid matter, full of innumer-
able minute granules. Viewed with a high magnifying power this proto-
plasmic layer is seen to be in a condition of unceasing activity. Not only
is its whole mass agitated by a progressive wave-like movement, but, inde-
pendent of this, the granules move in relatively rapid streams through
temporary channels in the protoplasm. There is a general current up one
side of the hair and down the other; while, at the same time, partial currents
move in different directions. Sometimes little trains of granules may be
seen swiftly coursing in opposite directions within a twentieth-thousandth
of an inch of each other. Again, these opposite streams come in direct col-
lision, until one or the other finally predominates. These currents seem to
be caused by contractions of the protoplasm bounding the channels. The
comparison of such a protoplasm to a body with an internal circulation
very naturally suggests itself, and has been put forward by an eminent
physiologist. Similar currents have been observed in numerous, and very
diverse, plants; and it has been suggested by high authority that probably
tley ºccur in all young vegetable cells.
*
1869.] Adžtorial. 5 II
The protoplasm of algae and fungi, under some circumstances, exhibits
movements of its whole mass, or is propelled by vibratile ciliae. The condi-
tions of these phenomena of contractility, as far as known, are the same for
both the plant and the animal. Heat and electricity influence both, and in
the same way, though in different degrees. The difference between the
powers of the lowest animal or plant, and those of the highest, is one of degree,
and not of kind, and depends, as Milne Edwards has shown, upon the extent
to which the principle of the division of labor is carried out in the living
economy. The acts of all living beings are essentially and fundamentally
OIl C.
Is any such unity predicable of their forms?
If a drop of fresh blood from the finger be kept at the temperature of the
body, and examined microscopically, the white corpuscles will be seen to
exhibit a marvelous activity, changing their forms, and moving about as
if independent organisms. Within the corpuscle, more or less obscure
during its life, is a small spherical body, called its nucleus. These corpus-
cles are merely little masses of protoplasm; and corpuscles of essentially
similar structure may be found in all parts of the body. Indeed, in its
earliest state, the human body is nothing but an aggregation of such cor-
puscles, and in its perfect condition is a mere multiple of them, variously
modified.
A nucleated mass of protoplasm, then, is the structural unit of the human
body; and here, as in the case of the faculties of living beings, the formula
which expresses the essential structural form of the highest animal must
cover all the rest. Beast and fowl, reptile and fish, mollusk, worm, and
polyp, have all the same structural unity. Some very low animals indeed
are mere isolated colorless corpuscles, leading an independent life. At the
very bottom of the animal scale this simplicity is even further simplified,
and all the phenomena of life are manifested by minute particles of proto-
plasm without any nucleus whatever.
What is true, in this respect, of animals, is also true of plants, their entire
substance being made up of a multiplication of nucleated masses of proto-
plasm, variously modified to meet special purposes. The nettle originates, as
does the man, in a minute particle of nucleated protoplasm. In the lowest,
plant, as in the lowest animal, a single one of these nucleated masses may
constitute an entire individual; or it may even exist without a nucleus.
The fact is, so far as form is concerned, that plants and animals are not dis-
tinguishable; and it is a matter of convention whether we call a given
organism an animal or a plant. The identical body may appear to be both,
in diſferent localities and conditions. The AEthalèum septicum is sometimes a
a fungus, attached to decaying substances, and, under other conditions, is
and actively locomotive creature, feeding as it goes.
Protoplasm, then, simple or nucleated, is the formal basis of life. All
living forms are fundamentally one, as all vital function is essentially the
Sällſ G.
Chemical research has revealed a no less striking uniformity of material
composition in living matter.
[What immediately follows is so apt a refutation of the oft-repeated asser.
5 I2 Adžtoria/. [9 uly,
tion, that chemistry can teach us nothing of the properties of the living
body, that it is quoted entire.]
“In perfect strictness, it is true that chemical investigation can tell us little or nothing,
directly, of the composition of living matter, inasmuch as such matter must needs die in the
act of analysis, and upon this very obvious ground, objections, which I confess seem to me
to be somewhat frivolous, have been raised to the drawing of any conclusions whatever respect-
ing the composition of actually living matter, from that of the dead matter of life, which alone
is accessible to us. But objectors of this class do not seem to reflect that it is also, in strictness,
true that we know nothing about the compositions of any body whatever, as it is. The state-
ment that a crystal of calc-spar consists of the carbonate of lime is quite true, if we only mean
that, by appropriate processes, it may be resolved into carbonic acid and quicklime. If you
pass the same carbonic acid over the very quicklime thus obtained, you will obtain carbonate
of lime again; but it will not be calc-spar, or any thing like it. Can it, therefore, be 8aid that
chemical analysis teaches nothing about the chemical composition of calc-spar? Such a state-
ment would be absurd ; but it is hardly more so than the talk one occasionally hears about the
uselessness of applying the results of chemical analysis to the living bodies which have yielded
thern.
“One fact, at any rate, is out of reach of snch refinements; and this is, that all the forms
of protoplasm, which have yet been examined, contain the four elements, carbon, hydrogen,
oxygen, and nitrogen, in very complex union, and that they behave similarly towards several
re-agents. To this complex combination, the nature of which has never been determined with
exactness, the name of Protein has been applied. And if we use this term with such caution
as may properly arise out of our comparative ignorance of the things for which it stands, it
may be truly said that all protoplasm is proteinaceous; or as the white, or albumen, of an egg
is one of the commonest examples of nearly pure protein matter, we may say that all living
matter is more or less albuminoid. ſº
“Perhaps it would not yet be safe to say that all forms of protoplasm are affected by the
direct action of electric shocks; and yet the number of cases in wbich the contraction of pro-
toplasm is shown to be effected by this agency increases every day.”
This general uniformity in the character of the protoplasm, or physical
basis of life, by no means excludes any amount of specific modification of
the fundamental substance ; but there can be no doubt that under all its
Protean changes it is one and the same thing.
And now what is the origin, and what the fate, of this matter of life?
Modern science affirms most positively that it is built up of ordinary matter,
differing from it only in the manner of the aggregation of its atoms, and
that it is again resolved into ordinary matter when its work is done. Under
whatever disguise it takes refuge, the living protoplasm not only ultimately
dies, and is resolved into mineral constituents, but it is always dying, and,
strange as it may seem, it lives by dying.
All work implies waste; and the work of life, results, directly or indi-
rectly, in the waste of protoplasm. For every word we speak, or act we
perform, a certain portion of the substance of the body is resolved into
carbonic acid, water and urea; and to repair this waste we are accustomed
to take into our system what was once the protoplasm of some other living
being, it may be of mammal or mollusk, of fungus or wheat-plant. These
substances, though dead, yet retain the power of resuming their functions
as matter of life in the laboratory of the body, and are there converted from
dead to living protoplasm, from that of sheep or oyster, of mushroom or
wheat into that of man, whose body, in its turn, may serve to nourish a
Worm or Carnivore, a fish or monster of the deep, a tree or flower of the
1869.] Aditorial. 5 I3
field. Every animal, as far as we know, has the power of assimilating the
protoplasm of every other animal or plant to its own substance. But here
the assimilative power of the animal ceases. An animal can not make
protoplasm. Its highest feat of constructive chemistry is to convert dead
protoplasm of other organisms into that which is appropriate to its own
life. For the origin of the protoplasm we are indebted to the vegetable
world, which alone can feed and thrive on inorganic substances, and from
them elaborate the matter of life.
But the plant, too, has its limitations. It can not live upon the uncom-
bined elements of protoplasm, viz., pure oxygen, hydrogen, carbon, nitro-
gen, sulphur, etc. It would as Surely die if supplied only by them, as
would an animal fed on a solution of Smelling Salts, though, in either case,
the organism would be furnished with all the elementary constituents of
protoplasm.
Those binary compounds into which protoplasm breaks up in conse-
quence of its continual death, viz., carbonic acid, water, and ammonia, are
the forms of ordinary matter out of which the plant builds up the proto-
plasm upon which the animal world lives. Plants accumulate the power
which animals distribute and disperse. Thus we see how it is that con-
tinual death 78 the indispensable condition of vital manifestation3.
Let it be observed, here, that the existence of protoplasm depends upon
the preéxistence of the lifeless elements, carbon, oxygen, hydrogen, and
nitrogen. These combine in certain proportions, and under certain cir-
Cumstances, to form carbonic acid, water, and ammonia, which compounds
are likewise lifeless bodies. These latter, however, brought together under
certain conditions give rise to a still more complex body, viz., protoplasm,
which exhibits the phenomena of life. The language which is applicable
to One step in the series of transmutations is equally applicable to the
others. In the case of the union of oxygen and hydrogen, through the
agency of the electric spark, to form water, we do not doubt that in some
Way the properties of the water depend upon the properties of the com-
ponent elements of the water, although there is no appreciable resemblance
between water and oxygen and hydrogen gases. Indeed they seem wholly
diverse. Yet we do not, in this case, assume that a something called
“aquosity,” having no representative in the constituents of water, entered
into, and took possession of the oxyde of hydrogen, and caused it to become
water instead of some other substance. On the contrary, we live in hope
and faith that, by the advance of molecular physics, we shall by and by
be able to see our way as clearly from the constituents of water to the
properties of water as we are now able to deduce the operations of a watch
from the form of its parts, and the manner in which they are put together.
The case is no way changed when carbonic acid, water, and ammonia dis-
appear, and in their place, under the influence of prečxisting protoplasm,
an equal weight of the matter of life makes its appearance. It is true there
is no parity between the properties of the components and those of the
resultant; neither was there in the case of the water. It is true we can
not explain the agency of the preexisting protoplasm; no more can we
5 I4. Aditoria/. [%uly,
comprehend the modus operand; of the electric spark in the formation of
Water. -
What justification is there, then, for the assumption, in living matter,
of something not to be found in the not-living matter which gave rise to it?
What better philosophical status has “vitality” than “aquosity ?” If the
phenomena of water are its properties, so are those presented by proto-
plasm, living or dead, its propertics. If the properties of water result
from the mature and arrangement of its component atoms and molecules,
there is no intellible ground for refusing to say that the properties of pro-
toplasm result also from the nature and disposition of its component atoms
and molecules.
All vital action may, with propriety, be said to be the result of the molecular
jorces of the protoplasm which displays it.
[The remainder of the lecture is devoted to a masterly defence against the
charge of “materialism" in the advocacy of these views. While utterly
repudiating the materialistic philosophy, the Professor acknowledges the
fact and the necessity of using the materialistic terminology in solving the
problems of nature, as the mathematician may use his x's and y's without
at all regarding them as entities. The further science advances the more
extensively and consistently will the phenomena of nature be represented
by materialistic formulae and symbols.
Prof. Huxley is firm in the faith that natural phenomena are compre-
hensible by the human faculties to an extent which is practically unlimited.]
ELECTRO-CAPILLARITY.
ELECTRO-CAPILLARITY is the heading of a new chapter in natural science,
introduced by a series of new and interesting facts, the number of which
will, undoubtedly, be increased yet considerably. By means of experi-
ments, continued for some time, the celebrated Prof. Becquerel has obtained
results, to all appearance, of the greatest importance on their own account,
as well as in consideration of the inferences likely to be drawn therefrom.
The sum of these experiments, briefly, is as follows:
If the solutions of two different salts are mixed together, the proceeding,
in the majority of cases, is immediately followed by a chemical exchange
by pairs, or a so-called double decomposition; the acids or bases of the salts
changing their places, and two new salts being formed out of the former.
This phenomenon always occurs, and can be predicted if one of the newly-
formed salts is known to be a compound insoluble in water; for, by this
very insolubility, the closer affinity between this pair manifests itself.
Hence, the salt escapes out of the mixture in form of a deposit which,
usually, is amorphous, i. e., does not present crystalline formations. How-
ever, in place of these results, well-known, things take a different course,
according to Becquerel, if the two fluids are not brought in direct contact
with each other, but are poured, each one by itself, into the Separate space
of a vessel, divided into two portions by means of a porous inembrane of
organic texture, for example, by a piece of animal bladder. Now, the
1869.] Bditor ial. 5 I5
chemical effect takes place much slower, and other formations appear. In
place of amorphous deposits, crystals, chemically and physically different
from them, form upon both surfaces of the partition. In this process,
aside from the chemical power, the coöperation of another force can clearly
be demonstrated. In fact, any two chemically unlike fluids brought in
contact with each other, under conditions mentioned above, form a gal-
vanic element, with a positive and negative pole. For example, if we fill
the one portion of the apparatus with aluminate of potassa, the other
with chloride of chromium, we observe crystals of hydrated alumina form-
ing upon the positive surface of the membrane which is in contact with the
former fluid; upon the other, green-colored crystals of hydrated oxyde of
chromium. Something similar we witness with aluminate of potassa
and chloride of antimony. However, if we select silicate of potassa in
place of the first substance, splendid crystals of silica will form, which
possess such a degree of hardness as to cut glass. Crystallization upon but
one side of the membrane will be obtained between a solution of potash and
a solution of a cobalt salt. If we mix those substances directly, we obtain
a blue deposit of oxyde of cobalt however; in the divided apparatus, the
oxyde forms into beautiful crystals.
These, and a large number of other experiments of the same kind, prove
that well-known chemical processes are very essentially changed by the
interposition of an organic membrane, although the latter itself is, by no
means, capable of a chemical but of a physical action only ; and it is quite
natural to draw a parallel between these phenomena and those existing in
the living organisms, both animal and vegetable. Learned men of the
present day have gradually arrived at the conviction, or belief, that organic
nature is governed by the very same laws as inorganic nature, and that
a vital force does not exist; on the contrary, that all the vital phe-
nomena of organic nature must be explained by the coöperation of
chemical, physical and electrical forces. And here Becquerel's electro-
capillarity may be of great service, since both vegetable and animal bodies
almost exclusively consist of membranous partitions which are placed
between different fluids. So long as those textures remain in their normal
state, electro-capillarity exists, and, together with it, the continuance of vital
functions. However, if those textures relax and their pores Unlarge, things
assume a different aspect; for now a direct contact between the different
fluids gradually takes places, and thus ordinary chemistry, so to speak,
comes into play, which, with regard to the living organism, means disease
and death. GARTENLAUBE.
HO OR H2O. THE ATOMIC NOTATION.
DALTon’s atomic theory implied exact numerical relations between the
atoms of different kinds of matter. The theory having been accepted, there
was no labor more urgent among chemists than the determination of the
atomic numbers, for under these numbers lay untold treasures of knowl-
edge. From that time forward the atomic theory and the atomic numbers
516 Aditorial. [july,
have become and will ever remain the foundation of our science and our
art of chemistry. Where would be our chemistry without them?
Dalton made the first effort to determine the relative weights of some of
the atoms. But Dalton was a philosopher, and he had a great work as
reformer and instructor to perform ; he had not the time nor the aptitude
for nice chemical analyses. IIis object was to illustrate and enforce his
atomic theory, and the numbers he gave were sufficiently near the truth
for that.
Shortly afterwards the great Berzelius, than whom perhaps no one who
has ever lived was better endowed by nature and education for the service,
commenced a systematic course of experiment and analyses, with the vic w
of determining with extreme exactness the true atomic numbers. This work
occupied the best part of his long and industrious life. Berzelius' table
of atomic numbers is one of the noblest and most enduring monuments
which the patience and skill of a single man has ever reared.
Dalton supposed an atom of water to be made up of one atom of hydro-
gen and one of oxygen. He used properly all the criteria of judgment he
had, and made a mistake. In his time it was possible to determine, with
considerable exactness, the relative weight of hydrogen and oxygen in
water, but there were not sufficient data for determining the ratio of the
number of their atoms: — It is known that the total hydrogen was to total
oxygen, by weight, as 1:8; but there was then no sufficient reason for
fixing the number of atoms of each. Dalton's atoms, like his analytical
data, were therefore only temporary or provisional, and to be set aside as
soon as the truth could be more exactly stated. Berzelius satisfied himself
that the atom of water is composed of three atoms, viz., two of hydrogen
and one of oxygen, and so he taught. His criteria of judgment were good;
in fact, nearly all that we use at the present day. But his critics, especially
Gmelin, assailed his reasoning with vigor, and they prevailed. To-day this
truth, crushed to earth, has risen again in new strength, and hereafter it
will take its place among our most impregnable doctrines.
The true atomic constitution of water being established, we respectfully
suggest to the teachers that they are unwise and unsafe in persisting in
teaching a false doctrine. Why not cut adrift, with a single effort, all the
text-books which are not based on the true atomic notation ? The chemical
world have been searching for sixty years after truthful atomic numbers,
and now we have them, why should we hesitate to adopt them 2
The atomic notation lies at the foundation of the modern chemical
philosophy. When it is accepted and understood, the doctrine of atom-
icity and the overthrow of dualistic theory follow without an effort. In
the light of the atomic notation, what was mystery beyond the scrutiny
of the greatest intellects becomes simple facts which can be taught to
children.
There appears to be a notion prevailing among those who have not
studied the new chemical philosophy, that the new notation-table is not so
simple as the old, and that the new philosophy in detail is quite abstruse.
The notion is far from being just and true. Those who have developed
1869.] Adžtorial. 5 I'7
the new philosophy, not always seeing their path clear, have sometimes
gone astray, and have magnified the importance of little things, so that to
those looking on, there appeared a great deal of confusion and uncertainty.
There was a great contest, and in it the combatants and the interests
involved were often obscured by the smoke. Moreover, some of the trium-
phant reformers are still so generous and chivalric that they do not demand
the complete submission of their late antagonists; they strive hard to find
apologies for the old numbers and for dualism. They find the old numbers
chemical equivalents, and speak very respectfully of what they call the
equivalent notation, as if it never pretended to be any thing else, and as if
it is remarkable that it should be an equivalent notation, although any
notation founded on chemical analysis is of necessity equivalent. The fact
is, the old notation as an equivalent notation has no point of advantage
over the new ; the atomic notation is the nearest realization of what is
desirable in an equivalent notation.
During the last twenty years the philosophy of the physical Sciences has
been stirred up from its very lowest depths. There has been a revolution
in ideas, and it ought be recognized now in all its consequences. The
reconstruction must proceed; woe to him who stands in the way ſ—[Ameri-
can Supplement, “Chemical News.”]
7'HAZOA’ſ AAVZ) AA’ A CTYCAE.
FUNGUS HAEMATODES, AND CANCER OF THE STOMACH,
CURED BY PHOSPEIORUS.
AccIDENTALLY turning over a few odd numbers of the “Prager Med.
Monatschrift,” 1857, we fell in with the following case, which may be com-
pared with one reported in this Journal, Vol. III., p. 140.
CASE OF A FUNGUS HAEMATODES, BY DR. JoBIN KOMAREK, IN PRAGUE.
A fungus hæmatodes was observed in the inguinal region of the right
thigh of a newly-born child. As this seemed to be a serious matter to the
parents, it was seen by a physician of the city, as well as by a surgeon, before
I was called. It was recognized by both of them as a fungus ha-matodes,
and an immediate operation for its removal was recommended. On one
side the tender age of the child, and on the other the large size of the fun-
gus and its unfortunate location, presented the contra-indication. I thought
it best to delay the operation, and all the more, as I had, as a practicing
Homoeopathic physician, seen similar pathological conditions entirely dis-
appear after the use of specific means, and especially after the use of Phos-
phorus in the 3rd or 4th dilution, two to three pellets given each day. Here,
again, I had a fortunate case; for, after the use of this remedy, the fungus,
after fourteen days, shriveled together, turned pale, and finally, after three
Weeks, was a mere blueish discoloration of the skin. At the end of six
518 Aditorial. [july,
months the child was seen again, and but a slight discoloration of the skin
was apparent.
CANCER OF THE STOMACII, BY DR. BOLLE, OF PADERBORN, GERMANY.
We shall be obliged to condense this case somewhat. It may be found in
the “Allg. IIom. Zeitung,” Band 46, S. L.
Dr. Bolle was an Allopath when he first treated the case, with but little
satisfaction either to himself or his patient. After getting to the end of his
Latin, as he expresses it, counsel was called in, but to no avail. After eight
or nine months of treatment, “the disease progressed all the more rapidly,
the paticnt was reduced to a skeleton, could hardly drag himself about, his
complexion was earthy, while vomiting ensued after taking food, or even a
swallow of water; almost every time a sourish, offensive fluid was ejected
in great quantities, bearing the greatest resemblance to a mixture of water,
ink and coffee grounds; the tongue was coated with a yellowish fur, and
was dry; there was thirst, no appetite, constant nausca, fullness, painfulness
of the stomach, sometimes a fine stitching and gurgling in the pit of the
stomach; the abdomen was fallen in ; the constipation could hardly be
overcome ; the faces were hard, crumbling, blackish brown.”
At this stage it was concluded to try Homoeopathic treatment; so the
patient was sent off to Dr. Nicol, at Hildesheim, to the great content of Dr.
|Bolle, who did not wish to have him die under his hands, “I took leave
of him,” says Dr. B., “with a heavy, anxious heart, wished him success,
but thought, within myself, we shall meet next time above.”
The Doctor was looking daily for news of his death, when a few days
after he says:
“One morning, about ten or eleven o'clock, while I was sitting at my study-table, some one
knocked, and in walked D., in a short, green hunting jacket, his two-barrelled gun on his shoul-
der, his short pipe in his mouth, some hares' legs were peeping out of his hunting-pouch, and
a brace of partridges were hanging on the outside. Over his full, red cheeks his eyes sparkled
full of joyous life, his limbs were well-nourished again, he was atheletic, his gait and bearing
youthful and elastic. “Good morning, doctor,’ he said, in a friendly and cheerful manner.
‘IIow do you do?' I do not know what I said or what I should have said, for my senses left
me. I know that I wanted to sink behind my desk into the earth for shame at my own use-
lessness and insufficiency; I was crushed with shame and joy; that I wrote to Dr. Nicol, sent
him histories of other cases, that I might further prove his remedies; that I visited him,
studied and tested IIomoeopathy, and finally became a Homoeopathist, as one might inſer.”
What the remedy that cured D. was, Dr. B. did not know, but the patient
was well, and continued so for a year and a half. IIe had then a return
of his old symptoms. Dr. Nicol was again consulted, but, from whatever
cause, the remedies had no effect; he was at a distance, too, and not readily
accessible, so the case, which made more rapid progress than before, devolved
upon Dr. Bolle. The condition was as follows:
“Countenance pale and sunken; great emaciation ; depression ; constant drowslness, and
napping. Besides the food, there was frequently sour, offensive, dirty, blackish-brown ſluid
thrown up, looking as if mixed with coſſee grounds. Even after taking a spoonful of water the
vomiting of this fearful quantity (six or eight ounces) took place before my eyes, within five
minutes of the time of swallowing. The tongue had a whitish fur; no appetite; discomfort
1869.] Adžforza!. 5.I.9
and fullness in the abdomen above the navel; frequently rolling and rumbling in the bowels.
In the abdomen, which was sunken, a circumscribed hardness was to be felt. Very obstinate
constipation; stool,dry, hard, very dark-colored. Urine scanty, satulated red, brown or red-
dish, with deep reddish or yellow reddish sediment. On turning in bed sometimes a momentary
pain, passing from the sacrum through the leg. Frequent yawning. After vomiting some
alleviation of the distress above the navel.
“I gave him a nose of Nua. vom. 200. The next day about the same. On the third day a
dose of Wua. oom, 12. After three days no better — rather worse. At the third visit I
took Phosph. 3rd with me, and gave the patient myself a grain, dry, upon the tongue. Beforé
the lapse of five minutes the patient ravsed himself in bed, stared at me very significantly, and
said, ‘Doctor, that has helped me / ‘Well,' I said, ‘we will hope, at least, that it will help
you.’ ‘No,” he replied, “it has helped me already ; I feel it through my whole flame. But,”
said he, raising up still more, ‘do you know what that powder tastes like ’’ ‘Oh,' I replied,
“it might well taste like Sugar of milk.” “No,” said he, “it tastes just as rat poison Smells.”
(I must here state that phosphorus paste is given in this region as a rat poison). And, in fact,
the disease from that moment was brought to an end. The vomiting never returned a single
time, the distress in the stomach disappeared at once, or was combined with the agreeable
sensation of decided improvement; the nausea disappeared, the broths which he took tasted
and agreed with him excellently, and, in short, in scatreely eight days there was no trace of the
disease to be found ! Convalescence progressed very rapidly. The patient took the Phosph.
3rd February 1st, 1849, and since that day he has been as well or better than ever.”
The medicine given by Dr. Nicol, as was afterwards learned, was
Phosph. 200.
Dr. Bolle makes the following “Moral,” as he calls it:
“1. This, accordlng to every symptom, was a real, true cancer of the stomach.
“2. This cancer of the stomach was really cured. It was twice cured ; for the year and a
half of excellent health before the second disease, clearly showed that this second disease was
a méto disease, and no relapse.
“3. This cure was accomplished, in both cases, by one and the 8ame remedy. The first
time by a high, the second time by one dose of a lower potency. Hence, the high potency
cured, indeed, quickly and beautifully, the second as with one blow.
“4 The nerves of the sick are much more sensitive to the right remedy than the nerves of
the well, for the millionth part of a grain of Phosphorus has no taste for a person in health.”
xt * sk :K nºt :: x
DIFFERENTIAL DIAGNOSIS BETWEEN VERMINOUS MENIN-
GITIS AND TUBERCULAR MENINGITIS.
M. LEBOU reports to the Medical Society of Besançon many cases which
he has noticed, some having been cured, others terminating fatally, in
which there could be no dispute that worms were in fact the cause of the
disease, while all the symptoms concurred to lead one to think of tubercular
meningitis. The facts of this kind are not very rare in the city where these
observations have been made, since, in eight years, he has met “thirty-five
cases of meningitis, twenty-nine of which seemed to him to depend on the
presence of worms. All, save one, i. e., twenty-nine, were cured. In the
six other cases three patients discharged worms without any visible improve-
ment in their condition.”
M. Lebou sums up the diagnosis as follows:
“Absence of vomiting, of the cir encephaliqué, an apparently perfect state of health in the
interval of the attacks; the absence of emaciation, coma, and especially of strabismus; coin-
ciding with a contraction or dilatation, a blue color of the sclerotic, have led me to diagnosticate
520 Adžāorial. [Sºuly,
a verminous form — a granular meningitis. No doubt is left, when a dose of Calomel causes
these symptoms to disappear, and when this disappearance coincides with the expulsion of
the worms.”—“Bull de la Soc. de Med. de Besançon,” No. 12, 1862; and “Bull. Gen. de
Ther. Med. and Chirug ,” LXV., 280. tº
M. Lebou's views derive confirmation from the following case, reported
by M. Viguard, of Nantes:
“A child, six or seven years of age, living with its parents, Rue du Sejour, 1, in a room so
dark that one could hardly see there in midday, was taken with symptoms which led me to fear
the near approach of tubercular meningitis. When submitted to examination the child, unhap.
pily, demonstrated the reality of my sad prognosis. With the usual delays the well-known
symptoms of meningitis presented themselves, and soon attained a height truly formidable.
Without going into detail, it suffices to say, that M. Mahot made out the same diagnosis as I
did, and consequently the same unfavorable prognosis. One single symptom failed to make
up the tableau of meningitis. In place of constipation, which is the rule in that disease, there
was diarrhoea. That alone sufficed to give us some hope, and to allow us to conceive of the
possibility of some other disease. Directed by this irregularity I had, before the arrival of
M. Mahot, given Santonin without eſfect. We gave Calomel, but obtained no result, and
were obliged to check the diarrhoea. I had interrogated the mother, but learned nothing
which threw any light upon the subject, when it occurred to me to give an injection of soot,
thinking that these symptoms might well be due to oxyurides. My faith in the worms was
brilliantly rewarded. The oxyurides were discharged in great numbers. The cerebral symp-
toms disappeared in few hours, and the patient, apparently about to die, was restored to
health. And it is this very rapidity in the disappearance of phenomena which finally con-
vinced me of the exclusive influence of the oxyurides, the parasites of my little patient, upon
the development of the disease.”—“Journal de Med. de l'Ouest; ’’ and “Bull. Gen. de Ther.”
LXXVI., 283.
SO/Ae GA2/??'.
By E. C. FRANKLIN, M.D., ST. Louis, Mo.
ETHER IN STRANGULATED HERNIA.—Dr. Simmons, of Sacramento, Cal.,
has recently called the attention of the profession to the employment of
Ether as an anaesthetic for the reduction of strangulated hernia, in prefer-
ence to Chloroform in general use. Within a year he has treated three cases
of strangulated hernia, in cach of which taxis, and other means, had been
tried by himself and others in consultation, while the patients were fully
under the influence of Chloroform, but without success. In each case an
operation seemed imperative, and the patients were laid upon the table for
this purpose. Ether was resorted to as the 8afer agent for long-continued
anaesthesia, and, after its full effect, the tumor disappeared after slight taxis.
In a case of this kind, which occurred in my practice a few months ago,
after the most diligent and unremitting taxis had becn made, and the
patient prepared for the operation, the tumor disappeared under the influ-
ence of a mixture of Chloroform and Ether, one-third of the former to two-
thirds of the latter, with little or no manipulation for its restitution. F
4
WAGINAL CAESAREAN SECTION.—Dr. Henry Ristine, of Iowa, relates an
interesting case of unnatural labor, in which the head was pressed down-
1869.] Faliforial. 52 I
ward so as to be covered by the the vaginal wall. After waiting till there
was no prospect of delivery without surgical interference, he made an open-
ing into the vagina, through which he introduced his hand, and by turning
delivered a child weighing eight pounds. A tent was placed in the fissure
to prevent adhesion, and the woman made a good recovery.
OvARIAN DROPSY CURED BY TAPPING THROUGH THE WAGINA.—Dr. H.
Corliss, of New York, reports a case of ovarian dropsy cured by tapping
the tumor through the vagina, by a long, curved trocar. The first opera-
tion succeeded in drawing off about five quarts of dark, brown fluid. The
tapping was repeated in three weeks, the canula being permitted to remain
to allow constant and free drainage, and to facilitate the injection of weak
alkaline solutions. The discharge became gradually less, and in four months
the patient was perfectly restored to health.
REPRODUCTION OF THE TIBIA—Dr. Cheever, of Massachusetts, reports
a case of excision of the entire diaphysis and lower epiphysis of the tibia
(nine inches in length), for suppurative ostitis, with complete success;
regeneration of the bone, and a useful limb being secured.
This is a rare operation, as is proved by the fact that Ollier, of Lyons,
France, in his great work on “Regeneration of the Bone,” has only col-
lected five cases. “The statistics,” he says, “gives a smaller mortality than
amputations of the leg. Resections,” he adds, “of the bones of the leg, with
solution of continuity, gave three-fourths of complete success, one-fourth
of partial results. Five-sixths of those operated upon lived. The resec-
tions give better results than amputations of the leg, of which one-third die;
and in primary amputations one-half are fatal.” This accords with my
practice, both in the military and civil service, and is verified by the records
of the Surgeon General's Office, the excisions of the tibia and fibula amount-
ing to one hundred and eighty-five, with a mortality rate less than after
amputation. F.
RESECTION OF THE UPPER EXTREMITY OF THE FEMUR.—Professor Mc-
Graw, of Michigan, has recently excised the upper portion of the femur,
embracing the trochanters. The acetabulum was found to be denuded,
but was not interfered with, and the case made a good recovery. The
patient was a lad, and had been affected with morbus coxarius, which with-
stood all previous Allopathic treatment.
PUNCTURE OF COLON FOR TYMPANITES AND FORCAI, OBSTRUCTION.—Dr.
T. C. Allbutt, of Leeds, England, reports a case of obstruction of the bowels,
followed by an enormously distended colon, with intense suffering, cold
extremities, anxious countenance, etc. etc., completely and permanently
relieved, after all other means had failed, by introducing an exploring
trocar into the distended transverse colon. On withdrawing the trocar
offensive air rushed out with a hissing noise, and the abdomen fell slowly.
When the current grew very weak, a second puncture was made with
equally satisfactory results. All unpleasant symptoms subsided, and the
patient recovered.
|
522 Aditorial. [S/uly,
INEw METHOD OF RESTORING ASPIIYXIATED CITILDREN.—Dr. C. Han-
field Jones, has discovered a new way of relieving asphyxia, by alternately
laying the child upon its back and making pressure upon the abdomen,
and then sitting it in the erect position. The diaphragm in the recumbent
position is pushed upwards, imitating the action of expiration, while the
liver and abdominal viscera, in the sitting attitude, draws the muscles down
and produces inspiration.
PHENIC ACID IN SYPIIILIS.—Dr. Minteforte, of Italy, recommends the
application, to syphilitic ulcers, of Phenic acid in water, five parts to one
hundred.
A NEW METHOD OF ADMINISTERING CFILOROFORM.—Dr. A. M. Rose-
brough, of Canada, has published an essay on this process, as follows:
The patient is placed upon his back, and a linen napkin, of a single thick-
ness, is placed over his face. Every thing being ready, the napkin is raised
about one and a half inches from the mouth, so that it does not touch the
nose; Chloroform is now dropped carefully upon the napkin, over the
mouth, a definite number of drops being allowed to fall per minute, begin-
ning with the minimum, and gradually increasing until the maximum is
reached, which is at the third minute. The maximum dose should be con-
tinued from two to six minutes, according to circumstances. To adults,
thirty-five drops per minute have been given as a maximum dose. To
children, eleven or twelve years of age, eighteen drops; and children under
seven, from eight to ten drops per minute. In all cases about one-third the
maximum dose is given the first minute, and two-thirds the second minute,
the maximum dose never being reached until the third minute from the
commencement of the inhalation.
A NEW ANAESTIIETIC.—It has been proved, by experiments, that owygen-
ntaled nitrous oaſide, is not only safe and pleasant as an anaesthetic, but is
capable of being used both in the longest as well as in the shortest surgical
operations. It is made by mixing one part of pure oxygen with three of
nitrous oxide. In its administration, caution must be exercised that no
atmospheric air becomes mingled with it.
CARBOLIC ACID IN SUPPURATING Wounds.—Dr. Kelburn King, of Hull,
England, has recently brought to the notice of the profession, in a paper
“On Carbolic Acid, and the Antiseptic Treatment in Surgery,” a new pro-
cess for the treatment of open wounds. He claims that suppuration is not at
all necessary for the promotion of the healing process; that granulation can
go on without the aid of suppuration; that the germs contained in the atmos-
phere are the most prolific cause of suppuration. Carbolic acid arrests
suppurative action, and favors cell-growth and the formation of granula-
tions. Dr. King employed the remedy in various ways: First, in a solu-
tion; second, the Carbolic oil, one to four; and third, Carbolic putty, i. e.,
whiting mixed with the Carbolic oil, so as to form a cream-like consistence.
It is doubtless an important and valuable remedy in the treatment of ulcers
and suppurating wounds, as can be testified to by myself and others, in the
various uses of this kind in which the agent has been cmployed
1869.] Adžtoria/. 523
*
The following tribute of Prof. Franklin to the memory of Prof. McDowell,
of St. Louis, should have appeared long ago, but was unavoidably crowded
out. Justice to both parties requires its insertion even at this late hour.
S.
DECEASE OF PROF. J. N. McDOWELL, M.D., OF ST. LOUIS.
THIS distinguished surgeon of the West, we are pained to announce, passed
away from earth on the 25th of September, 1868, in the sixty-third year of
his age. The history of this truly great man is one full of interest to the
medical profession. In early life he became interested in the study of medi-
cine, and at the age of twenty-five lectured upon anatomy, in Cincinnati, to
private students, and was esteemed a fluent lecturer and thorough teacher
on that branch. From here he went to Philadelphia, and acquired con-
siderable reputation as an anatomist, having opened a private School where
were gathered together upwards of a hundred medical students. Soon after
this he became connected, as professor, in the Medical Department of the
Cincinnati College, or Drake School, which having been temporarily sus-
pended, he sought the city of St. Louis as the home of his future usefulness
and renown. Here he made his mark as a surgeon of more than ordinary
ability, and raised up a Medical College, over which he presided as its dis-
tinguished head and Surgical Professor. His many conspicuous qualities
of head and heart, his earnest and fearless advocacy of principle, his eccen-
tricity of character and steadiness of purpose, made him many friends; at
the same time it afforded his enemies not a few opportunities for public
and private disapprobation. To the poor and distressed his heart and hand
were ever open to succor and relieve, and he has left behind many evidences
of generosity and kindness long to be remembered. The West hast lost in
him an accomplished surgeon, and medical education an earnest advocate.
F.
CZ/MA 7'OZ OG 2^ AAVD H 7"GZAZAVAE.
BY H. P. GATCHELL, M.D., KENOSHA, WIs.
INDICATION OF LONGEVITY.
WIIEN occupying the chair of Physiology in Cleveland, I was accustomed
to recommend to the classes Dr. Buchaman's work on Anthropology as
authority in relation to cerebral physiology. Several members of the classes
accordingly purchased copies. Among the purchasers was Dr. Beteley,
afterwards Professor of Materia Medica in the Cleveland School.
After he read it, he inquired of me what connection the form and size of
the ear have with cerebral development, and especially the relation of the
lobe of the ear. I replied, that according to Buchanan the development of
the lobe Would correspond to the development of the occiput, the region of
524 Editorial. [Sºuly,
animal force, including vitality or tenacity of life as one mode of that law
of force.
Not long subsequently he told me that he had noticed in almost all old
people, whom he had observed, long lobes to the cars.
Afterwards, when he occupied the chair of Materia Medica, he was accus-
tomed to mention this indication of longevity.
I have often wondered, since Dr. Beleley’s death, that some one who
heard his statement, and who was ignorant of its true source, has not added
another to the numerous literary thefts, and set up as an original authority
in regard to indications of longevity.
Dr. Powell was accustomed to derive his indication of longevity from
the angle subtended by a line drawn from the outer angle of the eye through
the orifice of the ear, and another drawn from the same point to the occipi-
tal tuberosity. But the angle in this case is determined by the depth of
the occiput, and finds its explanation in Buchanan's doctrine of this region
as that of animal force.
At the same time I doubt whether the development of the lobe of the ear
is directly related to that of the occiput, and propose, on hypothetical
grounds, that it is directly related to the medulla oblongata, and only indi-
rectly to the occiput.
But if this hypothesis should prove tenable, it will establish the fact of a
general relation between the development of the occiput and the medulla,
since the development of the lobe of the ear is generally in proportion to
occipital development.
However this may be, the physician can generally assure a patient, in
, the absence of malignant diseases, from which those who have long lobes
are not absolutely exempt, though less subject than others, and barring
excesses which they are quite as liable to commit (if not in virtue of confi.
dence in a strong constitution, a little more liable), of the probability of
long life. For while the length of the lobe indicates conditional and not
absolute results, there is no other indication that is, in my judgment, at all
comparable to this one. t
The physician can also speak with more confidence in regard to recovery
from either acute or chronic diseases, when the lobe is long than when it is
short. Nor will he fail to observe that a large proportion of sickly people
have a short lobe, or none at all. IIe may also notice where a naturally
strong constitution has suffered from excesses, that the long lobe has become
withered and wrinkled. And when one side of the brain, as indicated by a
seated pain, has suffered more than the other, he will find the lobe of that
side more withered than the other. Whatever tends to enfeeble the con-
stitution, whether excessive toil, study, or venery, contributes to that
change in the lobe.
CONSUMPTION AND CLIMATE.
My attention was recently called to a newspaper article, purporting to be
made up from a paper in the “Medical Record,” by Dr. Brewster Mattocks,
President of the Board of Health, at St. Paul, Minn.
1869.] Bdźtorial. 525
Dr. Mattocks advises consumptives to migrate to Minnesota before they
have consumption. This is sound advice.
Probably the most of us would be more successful in treating such cases
if we could have them at the same stage.
Dr. Mattocks also insists on the importance of climate to the consumptive,
and especially of a dry atmosphere. At the same time he attributes the
excess of mortality from consumption in Louisiana, as compared with other
States in the extreme South, to mixture of races. May there not be a little
negrophobia in this? Is Dr. Mattocks ignorant of the fact that Louisiana
is full of swamps and bayous, and that the air is exceedingly damp 2
He also states that one side of the continent suffers terribly from this
Scourge, while the other is comparatively exempt from its ravages. It is
evident that he does not regard the eastern portion of the continent as rela-
tively exempt; since he includes the Atlantic States as far south as to North
Carolina among the consumptive States. The allusion, therefore, must be
to the Pacific side. But according the the census of 1860 the ratio of mor-
tality from consumption in California” exceeded that of the Atlantic coast
in the same latitude. The truth is simply this: It is neither border of the
continent that is particularly exempt from consumption ; it is the dry inte-
rior, lying between the 95th meridian and the Sierra Nevada Mountains, a
region that derives but little moisture from either ocean or from the Gulf.
MZCAPOSCO AE2.
By T. F. ALLEN, M.D., NEw York.
THE "present year witnesses a valuable addition to our literature, namely,
the establishment of the “Monthly Microscopical Journal.” The Royal
Microscopical Society had become dissatisfied with the method of publica-
tion adopted by the “Quarterly Microscopical Journal,” and not feeling
assurance enough to issue their own proceedings, arranged with Mr. Hard-
wicke to publish, and with Dr. Lawson to edit, a monthly journal which
receives their support. The Messrs. Lankaster, editors of the “Quarterly,”
intimate that they shall not lose much, as the proceedings never amounted
to much any way; but we microscopists are sure to gain, for a spirit of
rivalry has stirred the Royals up, and some able papers have lately been
presented and published.
Dr. Thudichum publishes a paper, read last year, endeavoring to ridicule
the results of Prof. Hallier's patient researches.
There is no doubt that many errors may occur in the examination, and
especially cultivation, of fungi occurring in morbid products; but Prof.
Hallier has made most valuable discoveries, and I do not gather, from what
he has published, that he assumes a positive relationship of cause and
effect between fungi found in diseased products and the disease itself.
* The population of Oregon was too small and too recent to afford any test.
Wol. IV. tºº No. 16. 9
526 Aditoria/. [?uly,
There is a class of diseases most certainly causcd by some taint floating in
the air, a something irrelative to its thermometric, barometric, or hygro-
metric conditions. It is certainly probable that germs or spores of certain
living organisms may exert a morbific action, and Prof. Hallier is endeavor-
ing to ascertain if different and Constant forms occur in the atmosphere, and
products of different diseases.
“At a meeting in Dresden, last summer, Prof. Hallier claimed sixteen
different varieties of fungi as specific to as many different diseases. But he
took entirely new grounds by admitting that as yet no connection of these
fungi with the diseased products in which they occurred, had been proved.
The fungus of variola has now become identical with a fungus common on
grass. The urocystis intestinalis, which was to have been a specific inhabi-
tant of the intestines of persons suffering from diphtheria, does not differ
from the urocystis occulta on grain.”
And I will add, that many forms of fungi, now described from different
discascs, are transition forms of Some species of USTILAGO !
Dr. Thudichum thus ridiculously concludes his article: “I ask you,
do you think it likely that a botanist, situated at Jena, with some bottles
of cholera excretion — four obtained from Elberfeld, and one, more than six
months in a bottle, from Berlin — could, at one stroke, with one glance of
his eye, discover the cholera contagion under the microscope? I ask you,
as microscopists, whether that is probable? Now I tell you my own
opinion on the subject. If it were possible that a botanical professor could
make such a discovery, and it could be well established, I, as a medical
man, would to-day abdicate my functions. I would at once retire from the
medical profession. I would lay down the Serpent and the staff which
would have lost their ancient dignity,” etc., etc., for at least six inches.
For the consolation of Dr. Thudichum, I am pleased to receive notice of
the establishment of a journal devoted to this and kindred subjects, viz.,
“Zeitschrift für Parasitenkunde,” conducted by Prof. Hallier, and assisted
by such men as Rabenharst, Richter, etc., in Germany, Anderson, in Glas-
gow, and our countryman, Salisbury, of Cleveland. The journal proposes
to discuss not only vegetable and animal human parasites, but also those
infesting animals and plants. It is to be a bi-monthly, and illustrated.
-*=
COLORING WITH HAEMATOXYLINE.
IN a late number of the “Schultz's Archiv für Mik. Anat,” H. Frey gives
the following directions for coloring:
Of a solution of haematoxyline in absolute alcohol (grs. xx in 3 SS.), two
drachms are placed in a watch glass, which is filled with a Solution of alum
in distilled water (grs, iſ in Žj), a violet color follows; in this preparation
let it lie for about twenty-four hours. It is then treated with absolute
alcohol, and then with a solution of acid. tart, in alcohol, then with benzine,
and examined in ol. ricini, which causes great transparency; it may also be
preserved in glycerine. The nuclei are particularly colored.
1869.] Editorial. 527
IN the February number of the “Monthly Microscopical Journal,” are
some valuable notes on mounting and tinting objects, by Dr. Bastian, which
are so good and practical that I must quote largely. He has become dis-
satisfied in some cases with Canada balsam, as it does not wear well; many
specimens, as sections of nerve tissue, etc., either become too transparent,
or else granular, from a chemical change. Something that becomes hard is
required, and a solution of Canada balsam in benzole is the best. The bal-
sam must be heated some time, carefully, in a shallow pot so as to drive off
the turpentine, then poured into a small bottle and benzole added gradually
so as to get nearly a Saturated solution. This must then be nicely filtered
through very thin filters into a stoppered bottle, and kept for use. There
are two ways of mounting in this fluid. The organs to be examined must,
of course, be hardened before sections can be made. Dr. Bastian gives a
solution of chromic acid (1 pint of acid to 300 of water); but Müller's fluid,
which is in universal use in Germany, is generally to be preferred. It is
kali bichrom, 2 pints, natri Sulph., 1 pint, aquac distil., 100 pints.
“First Method of Mounting.—A section from a hardened organ is allowed
to remain in a watch glass, with some spirits of wine, for two or three min-
utes; then a drop of carbolic acid (deliquesced crystal) having been placed
upon the glass slips on which the specimen is to be mounted, the section is
taken from the watch glass on the tip of a small scalpel, its dependent edge
brought into contact for a moment with a piece of clean blotting paper, and
then gently laid on the surface of the carbolic acid. This renders a thin
section perfectly transparent in about half a minute.
“The superfluous carbolic acid should then be got rid of by tilting the
slide and applying a small piece of blotting paper to the edge of the specimen;
this done, two or three drops of chloroform should be poured over the sec-
tion and allowed to remain in contact with it about one minute, and during
this time the specimen may be properly arranged in the centre of the slide,
A slight tilting of the slide then suffices to get rid of the chloroform, when,
before the specimen becomes dry, two or three drops of the solution of
Canada balsam in benzole should be poured over it from the drop-bottle,
and the covering glass applied. The mounting is thus finished, and the
specimen only requires a certain amount of protection for a time till the
balsam in which it is mounted has become hardened.
“Second Method.—The section having been placed in the watch glass with
ordinary spirits of wine for about a minute (merely to wash it), is then
removed to another watch glass, or small covered capsule, containing abso-
lute alcohol, and allowed to remain in this for five minutes. It is then to
be removed and placed on the slide on which it is to be mounted. The
superfluous alcohol having been got rid of, it is covered with one or two
drops of benzole for about a minute (which renders the section as trans-
parent as if it had been placed in carbolic acid), and then, this having been
tilted off, the additional steps are as before, viz., Canada balsam in benzole,
and covering glass.”
The Doctor finds the varnish medium, for preserving specimens, objec-
tionable (though very simple), from the fact that sections become, after
aw hile, so transparent as to lose their details.
528 Adžforza/. [3 uly,
For preserving very delicate specimens, in which we do not wish to lose
any detail, the mounting is in a solution of bichromate of potash (one part
of kali bichrom. to one thousand parts of water). The cement to be used
is the great cement of Germany, made by thickening a Saturated solution
of gum mastic in chloroform with nitrate of bismuth. This cement is invalu-
able for mounting in fluid. It does not run in, it hardens quickly, and will
not crack. \º
Dr. Bastian gives us his methods of tinting, mounting and developing
fine points in sections of nerve tissue, especially the brain and spinal cord,
which I will give in a future number.
MYS CAE/C/CAM/Z O U.S.
*-*
HOMOEOPATHY IN THE STATE OF NEW YORK.
WE are indebted to Dr. H. M. Paine, of Albany, the indefatigable Secretary
of the New York State Homoeopathic Medical Society, for the following
items of interest, which speak well for the life and vigor of Homoeopathy
in that State :
LEGISLATION HAVING REFERENCE To HomoCopATHY.—During the Ses-
sion of the Legislature just closed, four acts, having reference to the Homoe-
opathic School, have been passed: One for the incorporation of the Mar-
garettsville Retreat for the Insane; an amendment of the charter of the
New York Homoeopathic Medical College; another amending the charter
of the Western Homoeopathic Dispensary, in the city of New York; and an
act requiring the Common Council of Brooklyn to annually levy a tax of
$1,000, to be paid to the treasurers of each hospital and dispensary, both
Allopathic and Homoeopathic, in the city.
The act legalizing the incorporation of the Margarettsville Retreat, situ-
ated at Middletown, Delaware County, New York, is an important one.
The commencement of an enterprise having all the required legal advan-
tages, has now been inaugurated. If supported, as it ought to be, by the
Homoeopathic profession in this State, it will soon be made complete in all
its appointments. This, the first Homoeopathic asylum ever established,
should receive the exclusive support of the Homoeopathic profession in this
and the adjoining States.
ANNUAL STATE APPROPRIATIONS.—The Legislature has made appro-
priations to the following Homoeopathic Institutions:
Albany City Dispensary, $700.
Buffalo Homoeopathic Dispensary, $500.
Brooklyn Homoeopathic Dispensary, $500.
Poughkeepsie Homoeopathic Dispensary, $800.
Bond Street Dispensary, New York, $1,500.
New York Homoeopathic Dispensary, $2,000.
r)
1869.] Editorial. 529
Western Homoeopathic Dispensary, New York, $600.
New York Ophthalmic Hospital and Dispensary, $2,500.
Homoeopathic Infirmary for Women, $1,000.
Homoeopathic Medical College Dispensary, $1,000.
Homoeopathic Dispensary, Tompkins Square, New York, $1,000.
The total amount annually appropriated to the hospital and dispensary
fund is $150,000, of which $120,000 is given to Allopathic hospitals, and
$30,000 to both Allopathic and Homoeopathic dispensafies. There are no
Homoeopathic hospitals in the State. There are thirty-two dispensaries in
the State. Eleven Homoeopathic dispensaries received $12,700; average
amount $1,154. Twenty-one Allopathic dispensaries received $17,950;
average amount $855.
THE following notices have been sent to us, for publication, as we sup-
pose. The matter does need much comment, for whatever difference of
opinion there may be about the right to reprint English works without the
permission of their proprietors—and we never could see much ground for
an argument even there — it must be admitted, we think, by all, that a
“trade-mark” is private property, and no more at the disposal of the public
than one's own sign manual. We think Messrs. Turner & Co. have good
cause of complaint :
PUBLISHERs' NoTICE.-Although our name appears on the title of the
so-called second edition of Hughes’ “Manual of Pharmacodynamics,” it
must not be supposed that we have any connection with it. The name
appears without our permission, and with the author we repudiate it alto-
gether. The facsimile of our trade-mark appearing both on the title-page
and on the binding of the American reprint is also calculated to mislead.
We exceedingly regret being compelled to draw attention to the fact that
the trade-mark registered by us in January, 1867, has been copied, but
owing to its having been so misapplied we have no other alternative.
H. T. & CO.
AUTHOR's NoTICE.-I am informed that a so-called second edition of this
work, with a “Clinical Index” appended, has appeared in America. It
is right that I should disclaim all responsibility for the correctness of this
reprint, which has been undertaken without my knowledge or sanction
The “Clinical Index” I have no desire to emulate. It is foreign to the
scope of the present volume, which is an aid to the study of the Materia
Medica, and not a guide to the treatment of disease. My second volume,
which I hope to complete before the end of the present year, will essay to
provide the latter requisite. Pharmacodynamics and Therapeutics, separ-
ately and consecutively studied, constitute the knowledge peculiar to the
Homoeopathic practitioner. In such distinct, yet complementary, relation
I wish them to stand in this “Manual of Homoeopathic Practice.”
R. H.
WE are indebted to Dr. Reith, of Aberdeen, for a copy of his pamphlet
on “Homoeopathy; Its Nature and Relative Value.” This is, on many
53O Adžāorial. [Sºuly,
accounts, the most remarkable pamphlet which has been published, but its
late arrival makes it necessary that further notice should be postponed to
the next number. At present we can only find room for the following
items:
AT Toulouse the French government has appointed Dr. Arréat as Pro-
fessor of Homoeopathy.
THE Legislature of Ontario, in British North America, has raised the
Homoeopaths to the same level as the Allopaths, giving them five represen-
tatives at the Board of the Medical Council.
IN Rochdale it has been determined to open and maintain a Homoeopa-
thic ward in the new infirmary to be erected there, and this, too, not-
withstanding the fact that twenty of the medical men in the town have
signed a declaration to the effect that they will have no connection with
the infirmary if Homoeopathy is permitted in it.
TIIE “Medical Press and Circular,” one of the London weekly medical
journals, has, at last, demanded a fair hearing for Homocopathy. After
lamenting the downfall of old therapeutics, the editor says: “Truth is
best advanced by struggling openly with error; and we should like to see
the Homoeopathists and others get a hearing. * * * But as it is at
present, our drug-keeping brethren, like the silversmiths of Diana of
Ephesus, will not let the goddess be assailed.”
DR. GEO. H. BLAIR has been appointed surgeon to the United States
Marine Hospital, Cleveland, Ohio. Strong efforts were made to have the
appointment reconsidered, but in vain.
THE American Medical Association, at its late meeting at New Orleans,
refused to recognize Homoeopathy. We shall expect never to hear the name
mentioned again. Query, Did they recognize the Mississippi River?
DISPENSARY AND HospitaLAT CINCINNAT1, OHIO.—The proceeds of the
recent fair at Cincinnati were upwards of $16,000, which will make a hand-
Some nucleus for the future hospital. Among the articles disposed of were
several building-lots, the generous gift Dr. J. H. Pulte. We trust that the
worthy example of the Doctor will be emulated in other cities.
HOMOEOPATIIIC MEDICAL SOCIETY.—The Central New York IIomoeo-
pathic Medical Society convened at the Butterfield House, in the city of
Iſtica, March 16th, 1869, at 10 A.M.
Present, Drs. Boyce, Stowe, Watson, Gardner, Mera, Wells, Robinson,
Southwick, Munger, Palmer, Owens, Stebbins, Van Derburgh, Hawley,
Edward Loomis, D. D. Loomis, Wallace, and Warren.
1869.] Editorial. 53 I
In the absence of the President the chair was occupied by Dr. Stowe,
Vice President.
The minutes of the last meeting were read by the Secretary, and, by reso-
lution, approved.
The meeting was then opened by an appropriate address by the Presi-
dent.
Drs. Gardner, Mera, and Wells, were appointed a Committee on Cre-
dentials, and, on their recommendation, Drs. Watson, Stebbins, and Van
Derburgh, were elected members.
The Treasurer made a report on the state of the funds, which, on motion,
was adopted.
Dr. Boyce read an able paper instituting a careful comparison of Phos-
phorus, the subject for discussion, and Arsenicum, in their special relations
to the diſferent organs of the body.
After the reading of the paper, the matter was fully discussed by all the
members present, with cases illustrating the curative power of the drug.
At one o'clock the Society adjourned for dinner, in the private dining-
TOOI]].
Afternoon Session.—The meeting was called to order by the President.
The Secretary read communications from Drs. Dunham, of New York,
and Kitchen, of Philadelphia, on the curative power of Phosphorus.
Dr. Brown, of Binghampton, reported an interesting case illustrating
the use of this remedy.
Dr Kitchen finds the remedy beneficial for hoarseness in public speakers,
and in eruptive fevers.
Dr. Stowe called the attention of the Society to the valuable effects of the
remedy in the various forms of nervous diseases.
Dr. Watson directed the attention of the Society to the benefit to be
derived from the use of Phosphorus in the treatment of paresis and the pro-
gressive locomotor ataxia.
Dr. Edward Loomis reported a case of affection of the lungs, attended
with repeated attacks of hiemorrhage, which were in every instance
promptly arrested by Phosphorus.
Dr. Wells reported three cases of treatment illustrating the peculiar tem-
perament in which the remedy is especially indicated.
Dr. Boyce reported an interesting case in confirmation of the same prin-
ciple.
Dr. Munger related a case of lumbar abscess, attended with a troublesome
cough, which was relieved by the use of Phosphorus.
Dr. Hawley related a case of painless diarrhoea, of eighteen months' dura-
tion, permanently cured with this remedy.
Dr. D. D. Loomis reported a case illustrating the importance of correct
diagnosis.
Dr. Stebbins reported a case of chronic diarrhoea completely cured by
this remedy.
On motion, the thanks of the Society were presented to Dr. Boyce for his
able paper, and he was requested to prepare a copy for publication in
the “Homoeopathic Quarterly,” at Buffalo.
532 º Aditorial.
On motion, it was resolved that the members of this Society will here-
after decline to fill certificates of health, as attending physicians, for such
life insurance companies as refuse, in all cases, to appoint Homoeopathic
physicians as medical examiners.
On motion, it was resolved that Aconite be the subject for discussion at
the next meeting.
On motion, the Society adjourned to meet at Syracuse the third Thurs-
day in June next. L. B. WELLs, Secretary pro tem.
THE Homoeopathic Medical Society of Kansas was organized April 14th,
1869, the following officers having been elected : President, Richard
Huson, M.D., of Lawrence; Vice President, Jas. A. Rubicon, M.D., of
Atchison; Secretary and Treasurer, Martin Mayer, M.D., of Leavenworth.
THE American Institute of Homoeopathy had a large and interesting
session at Boston, where they were received with the greatest cordiality.
The next session will be held in Chicago, in June, 1870.
GRAUVOGL's LEIIRBUCII.-Our readers will find in the advertisements a
circular in reference to this work, to which their attention is especially
directed. As it has been intimated by some that the circular is not very
clear on this point, it seems necessary to state that the work will not be
published unless subscriptions are received to sufficient extent to guarantee
the translator against loss. He feels that in translating the work, without
any prospect of remuneration, he has done all that the profession or the
cause can require of him; hence those who wish to have the work should
Signify the same at once.
HOMOEOPATHIC DISPENSARY, CINCINNATI.
The following is the monthly report of the Homoeopathic Dispensary,
at 308 Race Street, for the month ending May 31st, 1869, as prepared by
Dr. J. A. Cloud, the resident Physician :
Number of cases remaining from last month, 55; received during the
month, 68; recovered during the month, 72; sent to Hospital during
the month, 1; died during the month, 2; remaining under treatment, 46;
obstetrical cases attended, 2.; office patients, 97; out-door patients, 26;
visits made, 89; prescriptions made, 276; medical cases attended, 120;
Surgical cases treated, 3.
HoMOEoPATHIC DISPENSARY,
308 RACE STREET, CINCINNAT1, May 31, 1869.
To the Honorable Board of Trustees :
GENTLEMEN, -I have the honor to present the following report, for the
quarter ending May 31st, 1869:
Classes of disease and number of patients treated — Fevers, 4; fevers,
eruptive, 9; diseases of the organs connected with the digestive system, 66;
respiratory system, 99; circulatory system, 8; brain and nervous system,
26; urinary and genital organs and venereal affections, 88; serous and
exhalent vessels, 3 ; fibrous and muscular structure, 26; abscesses and
ulcers, 6 ; wounds and injuries, 17; eye, 10; ear, 4; skin, 14; all other
discases not included under the above heads, 21. Total number of pa-
tients, 401.
Visits made, 281 ; prescriptions made, 1037; surgical cases treated, 11;
medical cases treated, 390; obstetrical cases attended, 3; vaccinations per-
formed, 9; deatlıs, 2. Respectfully,
* *-*. J. A. CLOUD, M.D., Resident Physician.
º ：
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