ORGANON lu Jtrt 0f Jfealtttjp SAMUEL BY if A H N E M A N N. A U D E S A P ERE. FIFTH AMERICAN EDITION, TRANSLATED FROM THE FIFTH GERMAN EDITION. BT C. WESSELHOEFT, M.D. PHILADELPHIA: BOERICKE & TAFEL. . = Entered accordinc to Act of Congress, in the year 1876, BY BOERICKE A TAFEL, .a the Office of the Librarian of Congress, at Washington, D. logy), and the endless deviations therefrom A REVIEW OF PHYSIC. 19 occurring in countless morbid conditions (pathology, semeiology). They proceeded to draw conclusions from these deviations re- garding the invisible process of change going on in the inward structure of the diseased human organism, and shaped these con- clusions into a fanciful picture which theoretical medicine mis- took for the prima causa morbi;\\~\ also, for the proximate cause of disease, the inner nature of disease, and, in fact, the disease itself, forgetting the axiom of common sense, that the cause of a thing or event cannot be the thing or event itself. How, then, was it possible, without self-deception, to make this internal, invisible essence their object of cure, and to pre- scribe for it medicines with curative tendencies, likewise most unknown, and above all to make use of several unknown medi- cines mixed together in so-called recipes? But this sublime project of discovering a priori an internal, invisible cause of disease, was changed (at least in the hands of those old-school physicians of wiser conceit) into a search for that cause, however, under the guidance of symptoms; thus by conjectures they tried to determine first the general character of a given case of disease,[2] and then to find if it were cramp, de- bility, paralysis, fever, inflammation, induration, or deposits in one part or another, or plethora, insufficiency or superabundance in the juices of oxygen, carbon, hydrogen, or nitrogen; increased or depressed arterial, venous or capillary circulation ; relative proportion of the factors of sensibility, irritability or reproduc- tion. Such conjectures, honored by the hitherto existing school with the name of causal indication, and regarded as the only possible rationality in medicine, were only deceptive and hypo- thetical assumptions, never destined to be either practical or use- ful. They were unfit, even if they had, or could have been well founded, to indicate the most appropriate remedy in a case of disease ; mere conjectures which, although flattering the self- esteem of the learned author, generally lead him astray in prac- tice. Such were the notions designed rather for the sake of os- tentation than as means of finding curative indications. How often e. g., there appeared to be cramp or paralysis in one part of the organism, while inflammation occurred in another!. Or, whence, on the other hand, could the infallibl "emedie? 20 INTRODUCTION. for each of these alleged general characters come? The most in- fallible remedies could have been no less than specifics, i. e. medicines homogeneons[3] in their action with the morbific irri- tation (Krankheits-Reize). The use of these specifics, however, had been prohibited[4] and condemned, as extremely injurious by the old school ; because observation had taught that such medicines, in the customary large doses, had proved to be dan- gerous on account of the highly increased receptivity in disease for homogeneous irritation. The old school, however, had no presentiment of minute and extremely minute doses. Cures, then, were not and could not be performed in the direct (natural) manner, by means of homogeneous, specific medicines which were, and continued to be unknown in regard to the fullest ex- tent of their effects; and even if this knowledge had existed, such generalizing views would have made it impossible to conjecture the appropriate remedy. But since it began, after all, to appear more reasonable to seek, if possible, another more direct path in the place of circuitous measures, the old school of medicine proceeded to cancel disease directly by eliminating the (alleged) material cause of disease; indeed, it was almost impossible for the common school of prac- titioners, in contemplating and judging a disease, or in seeking the indications for its cure, to free their minds from these ideas of materiality, or to recognize the nature of an organism both spiritual and material, as a being so highly potentiated, that the modification of its life, called disease, manifested by sensations and functions, must alone be regarded as conditioned and effected by means of dynamic (spirit-like) influences, and that such sen- sations and functions could be effected by no other cause. Such morbidly altered materials, abnormal turgescences, as well as secretions, were throughout regarded by the old school as exciters, or, at least in respect to their reaction, as maintaiuers of disease, and they are considered as such to this day. . Therefore that school believed in the achievement of causal cures by endeavoring to eliminate those imaginary and supposed causes of disease. Hence their busy endeavors at removing bile A REVIEW OF PHYSIC. 21 in bilious fevers by vomiting ;[5] hence their emetics in so-called gastro-ataxia,[6 | and their officiousness in purging out mucus, as- carideSj or lumbricoids in pallor of the countenance, voraciousness, colic, and tumid belly of children. [7] Hence their venesections in haemorrhages,[8] and hence, principally, all sorts of bloodlet- ting,[9] considered by that school as a chief indication in inflam- mations, which process they now imagine to exist in almost every morbidly affected part of the body, and the removal of which, by means of a fatal number, of leeches, they consider as their duty, therein following the precedence of a well-known blood- thirsty physician of Paris (like sheep following the bellwether even into the hands of the butcher). They think, in this man- ner genuine causal indications are obeyed, and rational cures performed. Furthermore, by ligation of polypi, by excision of indolent glandular swellings, or by their destruction through artificial suppuration, excited by irritating local applications; by enucleation of fatty (steatomatous, melicerous) tumors; by oper- ating upon aneurisms, lachrymal and rectal fistulae; by excision of scirrhous breasts, amputation of necrosed limbs, etc., phy- sicians of the old school consider that they have radically cured the patient, and have performed causal cures. They persist in this belief, when they make use of their repettentia, when they exsiccate inveterate, ichorous ulcers of the leg \vith astringent applications ; with oxides of lead, copper, or zinc (perhaps mak- ing incidental use of laxatives, thereby producing debility, with- out relieving the fundamental disorder); when they cauterize a chancre; destroy cauliflower excrescences by local applications; dispel the itch from the surface by ointments of sulphur, oxides of lead, quicksilver, or zinc; suppress ophthalmia with solu- tions of lead or zinc, or when they drive rheumatic pains from the limbs by means of opodeldoc, volatile liniments, or fumi- gations with cinnabar or amber. In all such cases they profess to have controlled the disorder, conquered the disease, and to have executed causal cures. But mark the result! Metasche- matisms (metastases), sure to appear sooner or later (but which are then pronounced as new diseases), and invariably more serious than the primary disorder, refute their assertions sufficiently, and could or should undeceive them by disclosing the deeper, imma- 22 INTRODUCTION. lerial nature of the evil, as well as its dynamic (spirit-like) origin, to be combated only by dynamic processes. In modern times (not to say up to the present time) the com- mon school was in the habit of presupposing the existence of morbid matter (and acrids) which, however subtle it might have been considered, they sought to remove from the blood and lym- phatics by the exhalations, the perspiration, and the urinary ap- paratus, or through the action of the salivary glands; to eject them in the shape of sputa from the tracheal and bronchial fol- licles; and by making use of emetics and cathartics to clear them out of the stomach and intestines all for the purpose of expel- ling the material exciting cause of the disease from the body, and thus fulfilling the conditions for a thorough causal cure. By means of incisions into the skin of the diseased body, into which foreign substances were introduced, thereby producing chronic ulcers, fontanels, and setons continued for years, the old school endeavored to draw off the materia peccans from the dis- eased body (always affected only dynamically), as filthy fluids are drawn from a barrel through a faucet. In like manner it was attempted to remove noxious humors by perpetual application of cantharides and spurge, thus only weakening the diseased body to the verge of incurability by all these inconsiderate and un- natural procedures. I admit that it was more convenient for human weakness to assume, in the treatment of diseases, the existence of some morbid matter, perceptible by means of the senses (particularly because the patients themselves easily inclined to such an idea), having discovered which, nothing remained to be done but to procure the requisite quantities of remedies to cleanse the blood and juices, to promote the secretion of urine and perspiration, to assist expectoration from the chest, or to scour the stomach and intes- tines. On this account scarcely anything is found in all works on Materia Medica, from Dioscorides to those of the present time, regarding the individual remedies, and the special, proper action of each; besides references to their supposed utility in this or t hat pathological name, remedies are alluded to only with regard to their properties as augmenting the flow of urine, perspiration, secretions of the chest, or menses; but particular stress is laid A REVIEW OF PHYSIC. 23 upon their power of producing an upward or downward evacu- ation from the alimentary canal; because the only aim and object of practical physicians has ever been the evacuation of some material morbific substance, as well as of several kinds of ficti- tious humors, alleged to form the basis of diseases. But these were all vain dreams, unfounded suppositions, "and hypotheses, shrewdly invented for the convenience of therapeu- tics, according to which diseases were most readily cured by the expulsion of material morbific matters, if such, indeed, existed ! But the essential nature of diseases and their cure, cannot accommodate themselves to such dreams, or to the convenience of physicians; diseases will not cease to be (spiritual) dynamic aberrations of our spirit-like life, manifested by sensations and actions; that is, they will not cease, for the sake of those foolish and groundless hypotheses, to be immaterial modifications of our sen- sorial condition (health). These causes of our diseases cannot be material ones, since the least foreign material substance[10], however mild it may appear to us, if introduced into our bloodvessels, is suddenly expelled like a poison by our vital force; or, where that is impossible, death is the result. Even if the smallest splinter is by accident inserted into our sensitive parts, that vital principle, omnipresent in the interior of our body, does not rest until the offending sub- stance has been removed by pain, fever, suppuration, or slough- ing. How happens it then, for instance, in a case of eruptive disease of twenty years' standing, that this indefatigable, active vital principle should patiently tolerate in the juices for twenty years a foreign, inimical, material eruptive substance (Ausschlags- Stoff) such as herpetic, scrofulous, or gouty humors? What nosologist ever beheld with bodily eyes such morbific matter, that lie should speak so confidently of it, and make it the basis of a medical procedure? Who has ever been able to prove the ex- istence of the poison of gout or of scrofula by ocular demon- stration ?[11] Even if some material substance, brought in contact with the skin or a wound, had propagated diseases by infection, who can prove (as has often been asserted in our works on pathogeny) that some material particle of that substance had mingled with, or 24 INTRODUCTION. had been absorbed by the juices of our body? Washing the sexual organs, even if immediately and carefully done, never is a protection against infection by venereal chancre. A breath of air wafted over from one afflicted by small-pox, can call forth this horrible disease in a healthy child. How much in weight of material matter could have been ab- sorbed in this manner by the juices, in order to produce, in the first instance, if left uncured, a painfully tormenting disease (syphilis), terminating only with the remotest period of life, that is with death, and to produce, in the second instance, a disease, rapidly fatal by its tendency to general suppuration[12] (human small -pox)? ' Is it possible to admit the existence of material morbific mat- ter and its transition into the blood in this and all such cases ? A letter written in the sick-room, and sent a great distance, has often imparted to the recipient the same miasmatic disease. Can material morbific matter be thought of in this case as having permeated the humors of the body ? But why all these proofs? Has not dangerous bilious fever been known to result from a mortifying altercation ? Has not a superstitious prophecy of death been known to come true at the predicted time ; or a sud- den arrival of sad or exceedingly joyful tidings to have caused instantaneous death ? Where, in such instances, is the material morbific substance said to have passed bodily over into the or- ganism, where it is supposed to have begotten and maintained a disease, and without the actual removal and ejection of which substance a radical cure is said to be impossible ? The defenders of an assumption so gross as that of morbific matters, should blush to have so inconsiderately overlooked and misunderstood the spiritual nature of life, as well as the spiritual dynamic power of pathogeuetic causes ; thereby having degraded themselves to the level of medical scavengers (Fegearzte), who, instead of curing, destroyed life by their endeavors to expel morbific matter from the diseased body, where it never existed. Are those loathsome and impure discharges in diseases the source and maintainers of the latter, or, on the contrary, are they not always effete products of the disease itself, that is to say, of a dynamical disturbance and modification of life ? A REVIEW OF PHYSIC. 25 Considering these wrong material views concerning the oiigin and nature of diseases, it was no wonder, that in all ages the efforts of little and great practitioners, as well as the invention of the sublimest medical systems, were invariably and principally directed toward elimination and expurgation of an imaginary morbific substance, and that the indication most frequently to be followed was, to scatter and set in motion the morbific accumu- lation, and to provide for its expulsion through the salivary and tracheal glands, perspiration, and urine; to purify the blood by potions of roots and herbs (Wurzel und Holztranke), regarded as rational and obedient servants in removing morbific matters (acrids and impurities) which never existed; furthermore, to draw off mechanically this fictitious matter by setons, fontanels, and by keeping up constant local discharges from the skin with blis- ters and bark of spurge-laurel ; but the chief indication was to throw off and purge away the materia peccans or noxious sub- stances, as they were called, through the intestinal canal by means of laxatives and purgatives, often dignified by the appellation of solvents (of infarctions?) and gentle aperients, for the sake of seeming more profoundly significant, and giving them a more flattering appearance. Such were the measures employed in the removal of hostile pathogenetic substances, that never were, nor could have been present in the production or maintenance of diseases as they occur in the human organism, living by virtue of a spiritual principle ; diseases that never could have been of other nature than that of a dynamic derangement of life in re- gard to its sensations and functions. [13] Now, if we admit, what cannot be doubted, that no disease (unless occasioned by entirely indigestible, or other hurtful mat- ter, swallowed or lodged in the primse vise, or other apertures and cavities of the body, or caused, e. g. } by a foreign substance penetrating the skin) can be derived from the presence of any material substance, but that each disease is always and only a special, virtual, and dynamical discordancy of our sensorial con- dition (health), how inappropriate, then, it must appear to any reasonable man to make use of a curative method, directed to- ward the evacuation[14] of those fictitious matters, since in the 26 INTRODUCTION. principal diseases of mankind, viz., the chronic, nothing is gainedj but much harm always done by such measures ! In short, it cannot be denied that these degenerated matters and impurities, becoming visible in disease, are nothing but pro- ductions of the diseased organism itself, laboring under abnormal functional derangement, and that they are frequently expelled by the organism with violent and even too violent an action, without the aid of purgatives; notwithstanding which, new quan- tities of refuse matter are formed as long as the organism con- tinues to suffer from this disease. These substances present themselves to the true physician as symptoms of the disease, and aid him in recognizing the nature and image of the same, in order to cure it by means of a similar medicinal morbific potency (Krankheits-Potenz). The modern representatives of the old school, however, no longer wish to appear as if their object in curing were the expulsion of morbific material. They declare their numerous and various evacuants to be employed in accord- ance with a derivative method of cure, as an example of which, they regard the natural spontaneous efforts of the diseased organ- ism to re-establish health, by terminating fevers through per- spiration and urine ; stitches in the side by nosebleed, sweating, and expectoration of mucus; other diseases by vomiting, diar- rhea, or haemorrhage from the anus ; arthritic pains by sanious ulcers of the leg ; inflammation of the throat by salivation, etc., or by means of metastases and abscesses, called forth by nature in parts remote from the seat of disease. For these reasons they considered it their wisest course to imitate nature by approaching most diseases in a circuitous way, after the manner of the vital force when left to itself. For these reasons they employed indirect,[15] stronger, heterogeneous irri- tation in parts remote from the seat of disease, caused evacuations in organs least related (dissimilar) to the diseased structures, and maintained these in order, as it were, to divert the disease in that direction. This derivation was, and continued to be, one of the chief cura- tive methods of the prevailing school of medicine. In this imitation of nature in the act of relieving herself, as others express it, they endeavored forcibly to excite now symp- A EEVIEW OF PHYSIC. 27 toms in structures least affected by the disease, and better able to bear drug effects, with the intention of diverting[16] the pri- mary disease, apparently in the form of critical excreticns, thus permitting the curative powers of nature[17] to perform the gradual resolution (lysis). This was executed by resorting to diaphoretics and diuretics, venesections, setons, and fontanels ; but most frequently by irri- tant evacuants applied to the oesophagus or intestinal canal, acting as emetics in their upward, and as cathartics in their downward action ; being employed most frequently in the latter manner, they were also known as aperients and solvents.[18] By way of assisting this derivative method, the counter-irri- tants related to the former were employed, such as sheep's wool worn next to the skin, footbaths, nauseants; furthermore, the stomach and intestines were tormented by hunger (hunger-cure), or by remedies producing pain, inflammation, and suppuration in proximate or remote parts, such as horse-radish and mustard- poultices, plaster of cantharides, spurge-laurel, setons (fontanels), Authenrieth's salve (tartar emetic ointment), moxa, the hot iron, acupuncture, etc. ; all done in imitation of the crude efforts of nature, who, when left to her own resources, endeavors to free herself from dynamic disease by creating pain in remote parts by metastases and abscesses; by producing eruptions and running sores, all of no avail if the disease is chronic. Obviously, therefore, no rational grounds, but rather the con- venience of curing by imitation, governed the old school in using these absurd, pernicious, and indirect methods of cure, derivative, as well as counter-irritant, and induced its adoption of these unserviceable, debilitating, and injurious processes, by which disease was for a time apparently ameliorated or relieved, inasmuch as another more serious malady was called forth in its place. Can such destructive measures be properly termed a cure ? The old school merely followed the rude instinctive example of nature in her inadequate[19] endeavors at resistance, when directed against moderately acute affections. They only copied the sustaining power of life (Lebens-Erhaltungs-Kraft), which, incapable of exercising reason if left to itself in diseases, and 28 INTRODUCTION. resting entirely upon the organic laws of the body, acts alone according to these laws, without reason or deliberation. They followed crude nature, who cannot, like a skilful surgeon, heal a wound by first intention by coadapting its gaping edges ; who does not know how to adjust and replace the divergent ends of a fractured bone, notwithstanding her ability to furnish (often su- perabundantly) osseous matter ; who cannot tie a wounded artery, but exhausts all her energy in causing the wounded person to bleed to death ; who does not know how to reduce a dislocated humerus, but, on the contrary, prevents human art from accom- plishing reduction by speedily producing a swelling around the joint ; who, in order to remove a splinter from the cornea, de- stroys the whole eye by suppuration ; who, in spite of her dis- play of energy, reduces a strangulated inguinal hernia by nothing less than mortification of the intestines and death ; and who, by transposing morbid processes (Metaschematismen) in dynamic diseases, often increases the misery of the sick. Nay, this unreasonable vital force rashly receives into the body those chronic miasms (psora, syphilis, sycosis), the greatest tormentors of our earthly existence, the source of innumerable diseases, under which humanity groans for hundreds, nay, for thousands of years, and unable even to palliate one of these, this same vital force is utterly incapable of removing such diseases from the organism of its own accord, but suffers them to rankle in the system, until death closes the eyes of the sufferer after a long life of sorrow. How could the old school, calling itself rational, be justified in choosing this unintelligent vital force, this blind guide, as its best instructor in an office of such high importance as that of healing, requiring so much thought and power of judgment? How dared it imitate, without hesitation, all those indirect and revolutionary processes inaugurated in diseases by that vital force, and copy them as if they were the non plus ultra, the best that reason could devise ? Did not God grant us his noblest gift, reflecting reason and unfettered power of deliberation in order that we might, for the benefit of mankind, surpass immeas- urably the effort of the unguided vital power in bringing relief? If, therefore, the ordinary school of medicine, in its rash imi- A REVIEW OF PHYSIC. 29 tation of crude, unreasonable, automatic vital energy, attacks the unoffending parts and organs with its curative methods of counter-irritation and derivation (its usual course of procedure), torturing them with overpowering pain, or, more commonly, by forcing them to waste their strength and substance in evacu- ations, that school strives to divert the morbid vital activity from the originally affected portions to those artificially attacked, thus, |?y means of a circuitous, debilitating, and generally pain- ful process, indirectly endeavoring to compel the natural disease to vanish, and trying to supplant it by a far greater heterogene- ous disease in healthier parts.[20] Indeed, the disease, if acute, and consequently destined to be of short duration, will vanish, even during these heterogeneous attacks upon remote and dissimilar parts, but it will not have been cured. There is nothing deserving the distinguished title of a cure in this revolutionary* treatment, possessing no direct immediate pathological bearing upon the structures primarily affected. It may be confidently assumed that the acute disease would have vanished of its own accord, and certainly sooner, without such serious assault upon sound vital parts, and without after-effects and less waste of strength. Neither the course adopted by crude natural force, nor the allopathic copy of the latter can bear comparison with the direct dynamic (homoeo- pathic) treatment, which, without waste of strength, rapidly ex- tinguishes the disease. But in by far the greatest proportion of cases of disease, known as chronic, these impetuous, weakening, and indirect therapeutic measures of the old school scarcely ever prove to be of the least benefit. For a few days at most they suspend one or another of those troublesome manifestations of disease which return, how- ever, as soon as nature has become inured to that counter-stimu- lus; and the disease will reappear with more violence, because the vital powers have been reduced by the pain [21] of counter- irritation and improper evacuations. * Synonymous with revulsive, a more usual medical expression ; Hahne- mann probably intended to emphasize the idea by using the word " revolu- tio lar." TRANSLATOR. 30 INTRODUCTION. While most physicians of the old school, imitating in a general manner the spontaneous curative efforts of crude nature aban- doned to her own resources, arbitrarily exercised in their practice this nominally useful mode of derivation (whenever an illusory indication seemed to demand it), others aiming at a still higher object, and seeing the incipient struggles of nature for relief in spontaneous and antagonistic metastases, they undertook to ac- celerate and increase these efforts by means of evacuants and de- rivatives, supposing that by virtue of their pernicious measures they were acting under the guidance of nature (duce natura), and that they were entitled to the exalted name of servants of nature (ministri naturae). Having observed that in protracted diseases such evacuations, induced by the vitality of the patient, were frequently attended by brief remissions of severe pains, paralysis, convulsions, etc., the old school regarded these derivative actions as the true way to be followed, and therefore accelerated, maintained, and in- creased them in attempting to cure diseases. But they never dis- covered that all such evacuations and secretions (seemingly criti- cal), called forth by the spontaneous efforts of nature in chronic diseases, only procured palliative and brief alleviation, adding so little to au actual cure, that their influence amounted rather to an aggravation of the original internal malady, by wasting strength and substance. No patient suffering from a protracted malady, was ever known to have regained permanent health by those rude efforts of nature, nor any chronic disease to have been cured by those evacuations, resulting from the action[22] of the organism. But on the contrary, after a brief respite, the original evil in such cases evidently increases; the duration of its remis- sions grow constantly shorter and shorter, while the painful periods of aggravation return with more frequency and violence, in spite of the continued evacuations. The same result may be observed when nature, abandoned to her own resources, in struggling with the dangers of an internal chronic affection, has no other way of safety than that of pro- ducing external local symptoms, for the purpose of diverting the danger from parts indispensable to life, and directing them to structures of les? vital importance (metastasis). Hence, those A REVIEW OF PHYSIC. 31 procedures of the energetic vital force being devoid of reason, reflection, or precaution, will never lead to actual relief or to a real cure; they are mere brief, palliative respites in the danger- ous course of the inner disease, at the sacrifice of much strength ' O and substance, without diminishing the primitive disease in the least degree. These measures, at most, are able to postpone dis- solution which, without the intervention of a genuine homeo- pathic cure, would be the inevitable result. From the allopathic point of view held by the old school, those rude, automatic efforts of nature were not only greatly overestimated, but totally misinterpreted as genuine curative agencies; they were increased and accelerated under the vain hope of destroying and radically curing the entire evil. When- ever, in cases of chronic disease, one or another of the intolerable symptoms of the inner disease appeared to be relieved by efforts of vitality, producing, for example, a moist eruption on the skin, in that case the servant of rude nature (minister naturae) would place a plaster of cantharides, or an exutorium (spurge-laurel) upon the ichorous surface, in order to draw out more humor' (moisture) from the skin (duce natura), for the purpose of assist- ing and supporting the purpose of nature (by removing the mor- bific matter from the body ?). But sometimes, if the effect of the remedy proved to be too intense, the moist eruption too inveter- ate, and the body too irritable, that servant of nature had only increased the external affection considerably, without benefit to the primitive disease. He aggravated the pains, which deprived the sufferer of sleep, and reduced his strength (or even brought on a febrile or malignant form of erysipelas). At other times, by gently acting upon the local disease (perhaps yet recent), by a kind of improper, superficial homoeopath ism, he would thus drive away from its site that local symptom, set up by nature on the skin for the relief of the inner more dangerous evil ; but he thereby increased the latter, and induced the vital powers to institute a more serious metaschematism towards other and more vital parts. In place of those local symptoms, the patient then suffered from dangerous inflammation of the eyes, deafness, cramps of the stom- ach, epileptiform spasms, attacks of asthma, apoplexy, or men- tal disorders, etc.[23] 32 INTRODUCTION'. Acting under the same delusion of assisting the vital forces in their curative endeavors, that minister naturce applied numerous leeches, in case the diseased force of nature caused congestion of the rectum or anus (blind piles), hoping to furnish an outlet for the blood in that place. The result would be a brief and scarcely noticeable improvement, but with loss of bodily strength, giv- ing rise to more violent congestion to those parts, without lessen- ing the original disease in the least degree. In nearly every case where the morbid vitality strove to evacu- ate a little blood by means of ernesis or cough, etc., in order to allay a dangerous internal affection, the old school physician has- tened to assist (duce natura) those supposed curative efforts of nature by copious abstraction of blood from a vein ; but never without evil consequences in the future, or without evident de- bilitation of the body. In order to promote the intentions of nature, the old school physician was in the habit of treating cases of chronic nausea by causing profuse evacuations from the stomach, by administering powerful emetics never with a beneficial, but often with evil result; not infrequently with dangerous and even fatal conse- quences. To relieve an internal morbid condition, the vital force some- times produces violent swellings of external glands, in which event that pretended servant of nature entertains the hope of as- sisting her purposes by inflaming those swellings by all sorts of stimulating ointments and plasters, and then opening the ripe abscess by incision, to allow the escape of the offending morbific matter (?). But experience furnishes hundreds of proofs of the protracted mischief resulting unexceptionally from such proceed- ings. Having frequently observed in chronic disorders slight allevia- tion of great distress, following spontaneous night-sweats, or loose alvine discharges, the old school practitioner considers himself bound to follow and promote these hints of nature (duce natura) by instituting and maintaining copious perspirations, or by sub- jecting his patient for years to a course of so-called gentle laxa- tives, in order to sustain and increase those efforts of nature (the ntal force of the unintelligent organism) leading, as he thinks, A REVIEW OF PHYSIC. 33 to the cure of the entire chronic disorder, and to the more speedy liberation of the patient from his disease (the substance causing the disease?). But the result is always contrary to the intention : aggrava- tion of the original complaint. In accordance with his preconceived, though groundless opin- ions, the physician of the old school persists in his process of promoting[24] those endeavors of morbid vitality, and of in- creasing those ever ruinous and never salutary derivative and evacuant efforts of the patient's system. He does not perceive that all above-named local symptoms, evacuations, and apparent derivative actions (begun and supported by the unthinking, un- guifled vital force in conquering the original chronic disease) are in fact the disease itself, and the signs of the entire disorder, for the cure of which, a homoeopathic medicine, selected in accord- ance with its similitude of effect, would have been the most suc- cessful and speedy remedy. Since the crude efforts of nature for attaining relief in acute, and more particularly in chronic diseases, are extremely imperfect and in themselves a disease, it was readily to be understood that the artificial furtherance of these efforts would only increase the difficulty; to say the least, it would not be an improvement on the spontaneous efforts of nature in the case of acute affections. The vital power in producing its crises, moves in obscure ways which medical art was incompetent to follow; therefore the latter only undertakes to reach its object from without by violent remedies, much less beneficial, but on the contrary, far more aggravating and debilitating than the means employed by the instinctive, unguided vital force left to itself. Not even that imperfect kind of relief, induced by natural derivatives and crises, can be pro- duced by allopathy in a similar manner; that school will find itself greatly outdone, even by curative measures as imperfect as those of vitality left to itself. By the use of lacerating implements it was attempted to pro- duce nosebleed in imitation of the natural kind, for the purpose of relieving, for example, attacks of chronic headache. Although blood was made to flow abundantly from the nasal cavities, de- priving the patient of strength, yet the relief thus obtained 3 34 INTRODUCTION. amounted to nothing, or was, at least, far more insignificant than if, at other times, but a few drops were shed by the instinctive and spontaneous impulses of the vital force. So-called critical perspiration or diarrhoea, caused by the ever active vital force after sudden attacks of sickness, occasioned by mental agitation, fright, strains, or cold, will remove these acute affections, though temporarily, with far more efficacy than all the sudorific? or cathartics obtained from the apothecary-shop, which increase the trouble, as daily experience teaches. The vital force, capable of acting only in harmony with the physical arrangement of our organism, and without reason, in- sight, or reflection, was not given to us that we should regard it as the best guide in the cure of diseases (Krankheits-Heilerfn), having the power of reducing those sad deviations from health to their normal standard ; and still less was that vital force given w7ro^[41] has these remarkable words: fa& rd ofioia vouaos ywETai xai Std TO. oftotet Trpoffpspo/jLsva. ix voffiuvrwv ufiaivovrai^ dtd TO iitleiv errero? 7raueTaj.[42] The truth of homoeopathy has also been felt and expressed by physicians of later times. Thus, e. g., Boulduc recognizes the fact that the purging quality of rhubarb is the cause of its power to allay diarrhea. Detharding conjectures[43] that colic in adults is mitigated by the infusion of senna, by virtue of its analogous effect of pro- ducing colic in the healthy. Bertholon[44] confesses that electricity deadens and annuls, in disease, pain very similar in kind to that produced by electricity. 46 INTRODUCTION. Thiury testifies that positive electricity, though in itself it ac- celerates the pulse, nevertheless retards it when accelerated by discase.[45] Von Stoerck[46] expresses the idea: "If the thorn-apple de- ranges the mind, and produces insanity in the healthy, might it not, by changing the current of ideas, restore soundness of mind to the insane?" Stahl, a Danish military physician, has expressed his convic- tion on this subject most distinctly. He says : " The rule accepted in medicine to cure by contraries is entirely wrong (contraria con- trariis)', he is convinced, on the contrary, that diseases vanish and are cured by means of medicines capable of producing a similar affection (similia similibus)." Thus burns are cured by approaching the fire ; frozen limbs by the application of snow or very cold water; inflammation and contusions, by distilled spirits. In this manner he is in the habit of curing habitual acidity of the stomach most successfully by means of a very small dose of sulphuric acid, in cases where quantities of absorbing powders have been used in vain. So near had the great truth sometimes been approached ! But only a hasty thought was here and there bestowed upon it, and hence the indispensable reformation of the ancient way of treat- ing disease, the conversion of the traditional defective manner of treatment, into a genuine, true, and certain art of healing, remain unaccomplished to the present day. REMARKS EXPLANATORY NOTES TO THE REVIEW OF "PHYSIC," ETC. [1] IT would have been much more in accordance with sound com- mon sense and the nature of the inquiry, if, for the purpose of treating a disease, they had sought for its primary cause as the causa morbi. In that case the method of cure which had proved efficacious in diseases produced by the same cause could have been successfully applied in all those of like origin, as, for instance, the same mercurial which is effec- tual in all venereal chancres is effectual also in any ulcer occurring on the glans penis after an impure connection. Had they discovered the primary cause of all other chronic (non-venereal) diseases to be a re- mote or recent infection by the itch-miasm (psora), and found for all these a common method of cure, one having due regard for the thera- peutics of every individual case, according to which each and all of these chronic diseases could have been treated, then might they have boasted justly of having rightly apprehended and assumed as the basis of cure of chronic diseases, the only true and fruitful causa morborum chronicorum (non-venerorum), and that they could treat these diseases with the best success. But, ignorant of their origin from itch-miasm (first discovered by homoeopathy, and subsequently provided with an effectual method of cure) they have, for many centuries, failed in curing all the countless chronic diseases. And yet they have boasted of aiming at the prima causa, and of following the only rational method in their treatment, although they had not the remotest idea of the only availa- ble knowledge, that of the psoric origin of chronic diseases, all of which they bunglingly aggravated. [2] Every physician who treats according to such generalities, how- ever boldly he may assume the name of a hornoeopathist, remains neither more nor less than a generalizing allopathist, since homoeopathy is absolutely inconceivable without the most precise individualization. [3] Now called homoeopathic. [4] " Wherever experience had taught us the curative power of ( 47 ) 48 REMARKS AND EXPLANATORY NOTES homoeopathic medicines, whose mode of action could not \>e explained, they were straightway declared to be specifics : an utterly meaningless term, by which all further inquiry was lulled to sleep. But the homo- geneous or specific (homoeopathic) stimulants have long been proscribed as most pernicious agents." Rau, On the Homoeopathic Method of Cure. Heidelberg, 1824, pp. 101-2. [5] Dr. Rau (Ueber d. Werth d. homceop. Heilverfahrens. Heidel- berg, 1824, p. 176, et seq.), though not fully initiated into homoeopathy it that time, was so thoroughly convinced of the dynamic origin of even these fevers, that he treated them by one or two minute doses of homoe. opathic medicine without the least resort to evacuants. He relates two remarkable cases. [6] In case of a sudden derangement of the stomach, marked by constant and offensive eructations tasting of tainted food, and usu- ally accompanied by depression of spirits, cold hands and feet, the efforts of the ordinary practitioner have been directed altogether against the vitiated contents of the stomach, using active emetics to effect their complete expulsion. This end has been usually gained by tartar emetic with or without ipecac. But will the patient be found well and cheerful immediately afterwards ? By no means. Commonly such gastric disturbances are of dynamic origin, and are called forth by disturbing emotions (grief, fright, vexation) immediately after even a moderate meal. These two drugs are neither suited to the purpose of subduing this dynamic derangement, nor the revulsive emesis to which it gives rise. But, by producing their peculiar morbific symp- toms, they will have aggravated the patient's condition, and the secre- tion of bile will have been deranged, so that he will find himself suffer- ing for several days from the effects of this pretended causal cure, not- withstanding the violent and complete emptying of the contents of the stomach. But, if in place of using such powerful and injurious evacu- ants, the patient will apply but once, by olfaction, the highly diluted juice of pulsatilla (smelling of a globule no larger than a mustard-seed, moistened with the same), it will relieve the derangement of his condi- tion in general, and that of his stomach in particular, and restore him in two hours. Should eructations still occur subsequently they will be only of tasteless and odorless gas ; the contents of the stomach will no longer be vitiated, his usual appetite will make its appearance with the return of the next meal, and he is well and cheerful. This is a real causal cure ; the other imaginary one is only a pernicious strain upon the patient's constitution. The stomach, even if surcharged with indigestible food, scarcely ever requires a medicinal emetic. Nature possesses the best means of throw- ing off any superfluities by means of nausea, loathing, and even vomit- TO THE REVIEW OF PHYSIC. 49 ing, perhaps with the assistance of mechanical measures, such as tick- ling the palate and fauces, thereby avoiding all the incidental effects of medicinal emetics ; any remaining particles in the stomach will be assisted in passing downwards by a little decoction of coffee. Supposing, however, that after overloading the stomach, its powei of reaction were insufficient to produce vomiting, while, at the same time, the inclination to vomit had become extinct in consequence of ex- cessive pain in the epigastrium, such an emetic would be followed by a dangerous or even fatal inflammation of the bowels, if administered during this paralyzed condition of the. stomach. While a small quan- tity of strong coffee, frequently repeated, would have been sufficient to elevate dynamically the depressed susceptibility of the stomach, and to have enabled it to discharge without other aid, its superabundant contents by the mouth or rectum. Here the so-called causal cure is out of place. In chronic diseases when accompanied by regurgitation of acrid gas- tric juice, the latter is forcibly and painfully removed by emetics, only to be replaced the next or the following days by gastric juice quite as acrid and even more abundant than the former.- This would subside of its own accord, provided its dynamic cause were curatively annulled by a small dose of highly diluted sulphuric acid, or, if the acidity were of frequent occurrence, by the use of some other antipsoric remedy, corresponding to the rest of the symptoms. Of such pretended causal cures there are many in the old school, whose favorite occupation it is to clear out the material product of dynamic derangements by means of cumbersome and deleterious measures, without recognizing the dy- namic source of the disorder, and without curing it rationally and homceopathically together with its products. [7] Conditions which are dependent entirely upon psora, and easily. cured by (dynamic) mild antipsoric remedies, without purging or vom- iting. [8] Notwithstanding that all haemorrhages depend upon a dynamic alteration of vital force of health, the old school takes superabun- dance of blood to be their cause, and cannot refrain from venesec- tions for the sake of getting rid of this supposed redundancy of vital juices. Afterwards the very evident and evil results, the depression of strength as well as the tendency or the actual transition into a typhoid state, is saddled upon the virulence of the disease, which that school too often finds itself unable to cope with. In fact, it persuades itself that it had performed a cure, according to the motto "causam (oZZe," even if the patient does not'recover, and in its way of speaking, all that was possible had been done for the patient whatever the result might be. 4 50 REMARKS AND EXPLANATORY NOTES [9] Regardless of the probability that the human body has uevei contained one drop of blood too much, the old school regards a so-called plethoric condition as the material and chief cause of all haemor- rhages and inflammations, to be counteracted and removed by ven- esections and leeches. That is called rational treatment and causal cure. In general inflammatory fevers, and in acute pleurisy, physi- cians of the old school go so far as to call the coagulable lymph of the blood, the so-called bufty coat, the materia peccans, which they try to expel by repeated bloodlettings, notwithstanding its frequent reap- pearance with increased tenacity and firmness under renewed abstrac- tion of blood. Thus blood is often shed until death is close at hand, if the inflammatory fever will not subside, in order to remove this buffy coat or supposed plethora. It never occurs to them that the inflamed blood is only the product of acute fever ; ?'. e., of the morbid, immate- rial (dynamic) irritation, and that the latter is the sole cause of this great tumult in the arterial system, so easily subdued by the smallest dose of a homogeneous (homoeopathic) remedy, for instance, by one small globule moistened with the decillionth dilution of aconite, at the same time avoiding vegetable acids, so that the most violent pleuritic fever, with all its threatening complications, is converted into health, and cured in twenty-four hours at most, without bloodletting or any cool- ing medicines. (A specimen of the patient's blood, taken from a vein, will no longer show a trace of buffiness.) While a patient afflicted with the same disease treated according to the "rational methods " of the old school, if, indeed, he escapes death for the present, after re- peated bloodletting and unspeakable misery, will have to linger for many a sickly month, before his emaciated frame gains strength enough to stand erect, having narrowly escaped death from typhoid fever, leucophlegmasia, or suppurative disease of the lungs, the fre- quent consequence of such maltreatment. He who has ever felt the pulse of a man an hour before the onset of the chills which always precede an attack of acute pleurisy, will be surprised when, two hours later, after the onset of the hot stage, he is to be persuaded of the necessity of resisting the present enormous plethora by frequent bloodletting, and he wonders by what miracle so many pounds of blood, now to be poured out, may have entered the patient's blood vessels, felt quietly pulsating only two hours ago. Not one drachm more of blood can now roll through those vessels than they contained in times of health, or two hours earlier. An allopathist, therefore, does not rid the fever-patient of a noxious superabundance of blood (which can never have existed), but robs him of his normal quantity of blood, necessary to life and recovery, and hence of strength an enormous, loss never to be repaired by medi- cal aid. In the face of all this, these practitioners persist in the delusion of having acted in harmony with this (ill-conceived) motto, causam TO THE REVIEW OF PHYSIC. 51 l .olle, while in this case the cause of disease could never have c nsisted in a superabundance of blood, a thing without existence ; here on the contrary, the only true cause of disease was a morbid, dynamic inflam- matory irritation of the vascular system, as has been and will be proved in every case of the kind, by the rapid and permanent cure effected as above related, by one or two incredibly fine and minute doses of aconite, possessing the power of homoeopathically allaying such an irri- tation. In a similar manner the old school misses its mark in its treatment of local inflammations by local depletion, particularly by the applica- tion of countless leeches, after the rash manner now inaugurated by Broussais. The palliative relief, primarily observed, is by no means crowned by a rapid and complete cure, because the ever remaining weakness and frailty of the part (often also the entire body) so treated, bears sufficient evidence that local inflammation was erroneously at- tributed to local plethora, and that the results of such local depletion are deplorable ; for this virtually dynamic but apparently local inflam- matory agency can be cancelled and cured by an equally fine dose of aconite, or the entire disorder may, if circumstances point that way, be permanently relieved by belladonna, without this wanton shedding of blood. [10] Life was endangered when some pure water was injected into a vein (see Mullen, in Birch, History of Royal Society, vol. iv). Atmospheric air injected into the bloodvessels proved fatal (see J. H. Voigt, Magazine far den neuesten Zustand der Naturkunde, I, III, p. 25). [11] A girl, eight years of age, in Glasgow, bitten by a rabid dog, had the wound immediately and thoroughly excised by the surgeon, but nevertheless had hydrophobia thirty-six days afterwards, and died in two days. (Med. Comment, on Edinb., Dec. ii, vol. ii, 1793.) [12] In order to explain the origin of the large quantity of pu- trid matter and offensive ichor of sores, often observed in diseases, and in order to declare these appearances to be the exciting and maintaining matters of disease (notwithstanding the invisibility of miasms, or the impossible penetration of material substance into the body during infection), it was hypothetically asserted that the conta- gious matter, even if extremely fine, acted in the body like a ferment ; that it vitiated the juices, changing them into a morbid ferment of its own kind, and maintaining the disease by virtue of its rank growth during the morbid process. What potent and ingeniously conc-octed purifying draughts could effect the elimination and separation from the human body of this inconstant process of reproduction, this mass of 52 REMARKS AND EXPLANATORY NOTES so-called morbific matter, without leaving a vestige behind that might not, according to that hypothesis, again and again deteriorate and transform the juices into new morbific matters ? In that case it were impossible to cure these diseases according to your method. It becomes evident that every hypothesis, no matter how skilfully worded, will lead to the most palpable inconsistencies, when it is not founded on truth. Syphilis of the most inveterate kind, if liberated from its fre- quent complication with psora, will be cured by means of one or two very minute doses of the decillionth dilution and potency of dissolved metallic quicksilver, after which the general syphilitic deterioration of the juices will be found to have been forever (dynamically) annihilated and dispelled. [13] In that case every cold in the head, even the most protracted, must be invariably and speedily cured by careful blowing and cleans- ing of the nose. [14] The expulsion of worms in so-called worm diseases has an ap- pearance of necessity. But this appearance also is deceptive. Some lumbrical worms are perhaps to be found in many children, while the threadworm may be said to infest many others. But all of these, as well as a superabundance of one kind or another, invariably result from a general state of unhealthiness (psoric), combined with an improper mode of living. By improving the latter, and curing the psoric disease homo30pathically, which is most easily accomplished during the period of childhood, no more worms will remain, and chil- dren cured in this manner will no longer be tormented by them, while they are rapidly reproduced in great numbers after the use of mere purgatives, even if these are compounded with wormseed (semen cinse). "But what of the tapeworm ?" I hear them say; "must not this monstrous plague of mankind be expelled with all available force ?" Indeed, it is sometimes driven out, but not without much subsequent pain and danger to life. I would not burden my conscience with the death of so many hundreds of fellow-men, whose lives have been sacri- ficed by the use of the most debilitating, dreadful purgatives intended for the tapeworm ; neither would I be guilty of the protracted illness of those who escaped death by purgation. Though continued for years how seldom this purgative treatment, so destructive to health and life, attains its object, or if it succeed, does not the tapeworm as frequently reproduce itself ? What, if this forcible and often cruel and fatal method of expelling or killing these .parasites were unnecessary ? The various species of tapeworm are only found in cases of psoric disease, and always disappear when that is cured. But before such TO THE KEVTEYV OF PHYSIC. 53 euro can be accomplished, and during a period of comparative health, they do not inhabit the intestines proper, but rather the remnants cf food and fecal matter contained therein, living quietly as in a world of their own, without causing the least inconvenience, finding their sus- tenance in the contents of the bowels. During this state they do not come in contact with the intestinal walls and remain harmless. But when from any cause a person is attacked by an acute disease, the con- tents of the bowels become offensive to the parasite, which, in its writh- ing and distress, touches and irritates the sensitive intestinal lining, thus increasing the complaints of the patient considerably by a par- ticular kind of cramplike colic. (In a similar manner the foetus in the womb becomes restless, twists its body, and moves whenever the mother is sick, but floats quietly in the liquor amnii, without distressing the mother, while she is well. ) It should be remarked, that the symptoms of a patient suffering from the above symptoms, are mostly of a kind that may be speedily (homoeopathically) quieted by the most minute dose of the tincture of the root of the male fern, since the morbid condition of the patient, causing the disquietude of the parasite, is temporarily arrested by the remedy ; the tapeworm is then quieted, and continues to live in the in- testinal contents, without seriously disturbing the patient or his intes- tines, until the antipsoric cure has reached a stage, at which the psora has been so far extinguished that the fecal contents of the bowels cease to meet the wants of the worm, which now spontaneously departs from the convalescent patient forever, and without the least resort to pur- gatives. [15] Instead of directly extinguishing the evil, quickly and without loss of strength and digression, by aiming homogeneous dynamic me- dicinal potencies at the diseased points of the organism, according to the usage of homoeopathy. [16] As if anything non-material could be eliminated by derivatives, directed against a material morbific substance, however subtile it is thought to be. [17] Only moderately acute diseases are in the habit, so to say, of becoming neutralized (indifferenziren), and to terminate quietly with and without the application of the milder allopathic remedies. The vital power having rallied its strength, once more begins its normal sway where health has been disturbed by the storm of disease. But in the highly acute and in by far the most numerous affections of man, the chronic diseases, untutored nature, and the old school will be un- successful. There neither the vital force with its healing power, nor allopathy will effect a resolution ; a truce perhaps may be the result, 54 REMARKS AND EXPLANATORY XOTES giving the enemy time to rally his forces, and (sooner or later to renew the assault with increased vigor. [18] An expression betraying the presupposition and intention of expelling and dissolving some morbific substance. [19] In ordinary practice it was customary to regard the cure of diseases by the spontaneous efforts of the nature of the organism, where no medicine was used, as model cures, worthy of imitation. But it was a great error. The lamentable and very imperfect attempts of vitality at self-redress in acute diseases, presents a spectacle calling for the exercise of compassion as well as of all the powers of our in- telligent mind, in order to put an end to this self-torture by an actual, real cure. When a disease already present in the organism cannot be cured homoeopathic-ally by the power of nature applying another new, similar disease (3 43-46), an opportunity rarely afforded ($ 50), and when the organism is left to its resources to conquer disease by its own strength and without 1 external aid, its resistance being impotent in chronic miasms, we observe that these painful and often dangerous efforts of nature, instituted for the sake of relief at any price, fre- quently terminate by death this earthly existence. As little as we mortals understand the economy of healthy life, and as surely as it must ever remain hidden from us, though plain to the all-seeing eye of the Creator and sustainer of his creatures, so impos- sible it will ever ue for us to understand the internal processes of dis- turbed life in diseases. The internal process of diseases is only mani- fested by those observable changes, complaints, and symptoms, through which alone life expresses its inner disturbances ; so that in every given case we must remain unable to determine which of the morbid symp- toms are primary effects of the morbific agency (Schiidlichkeit), or which are to be considered as the reaction of vital force in its sponta- neous curative efforts. Both are seen to coalesce, and merely represent an outwardly reflected image of the totality of the inward disease, since the fruitless efforts of life, left to its own resources in terminating the disease, are themselves the disease of the entire organism. Conse- quently, more suffering than beneficent relief, often follows those evacu- ations called crises, commonly occurring toward the end of acute dis- eases. Whatever the vital force produces in these crises, and how it is produced, will remain obscure, like all other inner processes of the or- ganic economy of life. It is certain, however, that in all its exertions, the vital force sacrifices and destroys a greater or less proportion of the affected parts, in order to save the reft. This power of self-limitation possessed by the vital force, proceeding in accordance with the organic arrangement of the body, and not with deliberation of reason in over- coming an acute disease, is mostly a kind of allopathy. In order to TO THE REVIEW OF PHYSIC. 55 elieve the primarily affected parts by a crisis, it frequentlj creates an increased and even tempestuous activity in the organs of secretion, for the purpose of transferring the disease from the former to the latter ; the sequel is seen in the appearance of emesis, diarrhoea, flow of urine, perspiration, abscesses, etc., by which excitation of remote structures it is intended to establish a kind of derivation from originally morbid parts, because, under such circumstances, the nervous force dynamically excited, apparently strives to relieve its tension by the formation of material products. It is only by the destruction and sacrifice of the system, that nature unassisted is enabled to rally from acute diseases, or slowly and imper- fectly to re-establish health and harmony of life if death does not fore- stall her efforts. After spontaneous recoveries, all this is pointed out by the great weakness and emaciation of the entire body, or of the parts having been affected by disease. In a word, the whole process set up by the organism, in its self-limi- tation of diseases, exhibits to the observer nothing but suffering, and nothing that he could or should imitate if he truly exercises the art of healing. [20] Daily experience shows the deplorable result obtained by this manoeuvre in chronic diseases. A cure is most rarely the result. But who would call it a victory, when instead of attacking the enemy face to face, weapon to weapon, in order to destroy him and end with one blow his hostile incursions, he finds his cities sacked, his supplies cut off, his sustenance consumed, and everything devastated by fife and sword around him ; by such measures the enemy may be obliged to give up in despair, but the object is not gained, the enemy is not crushed ; he is still in the field, and when he has again obtained forage and supplies, he will lift his head with fiercer threats of vengeance ; the enemy, I say, is by no means crushed, but the poor innocent country is so far ruined, that even time will scarcely restore its former condition. Such is allopathy in chronic diseases when it destroys the organism, without curing the disease, by its indirect attacks upon in- nocent parts, remote from the seat of disease. Such are its non-benefi- cent artifices ! [21] "What good result was obtained by the frequent use of those artificial and offensive ulcers called fontanels ? During the first few weeks, they really may have seemed slightly to check a chronic dis- order by means of their antagonism, and as long as they continued to be painful, but as soon as the body had learned to bear them, they have never failed to weaken the patient, thereby increasing the range of the active chronic evil. It seems incredible that in the nineteenth cen- 56 REMARKS AND EXPLANATORY NOTES tury it is thought possible that an opening could be made by such means for the escape of the materia peccans. [22] Neither was a cure ever achieved by artificial evacuations [23] Such were the natural consequences of suppressing those local symptoms, consequences often represented by the allopathic phyt ician as new and different diseases. [24] Quite contrary to this method, the old school frequently ven- tures upon a directly opposite course, thus, by its repercussions and repellants, it would suppress at pleasure the eiforts of vitality to relieve an inner disease, or troublesome local symptoms appearing on the sur- face of the body, by evacuants ; it did not hesitate to treat chronic pains, sleeplessness, and inveterate diarrhcea with the most reckless doses of opium ; or to suppress vomiting with effervescent saline mix- tures, offensive perspiration of the feet by cold foot-baths, or prepara- tions of lead or zinc ; to counteract uterine hemorrhage by injections of vinegar ; colliquative sweats by alum whey ; nocturnal seminal emissions by excessive use of camphor ; frequent flushes of heat over the face or body by saltpetre, vegetable or sulphuric acid ; to arrest nosebleed by closing the nares with plugs saturated with alcohol or astringent fluids, and to dry up with oxide of lead or zinc ichorous ulcers of the extremities, called forth by vital reaction to mitigate grave internal disease, etc. ; but manifold experiences prove the lamentable consequences of such treatment. By word and pen the old school practitioner boasts of being a ra- tional physician, seeking for the cause of disease in order. always to perform radical cures ; but it is plain that his treatment is directed against a single symptom, always to the injury of the patient. [25] A process termed enantiopathic with much propriety, to which allusion will be made in the text of the Organon (I 59). [26] Deafness was relieved only for a few hours by moderate shocks of tte voltaic battery in the hands of the apothecary in fevers, but these soon ceased to be effective. In order to obtain other results, he was obliged to increase the power of the shocks until these too were unavailing. The strongest shocks at first improved the patient's hear- ing for a short time, but finally resulted in complete deafness [27] Notwithstanding all this, Hufeland, the representative of the old school, exultingly praises these effects of digitalis (v. Homceofathie, TO THE REVIEW OF PHYSIC. 57 p. 22), in the following words, "No one can deny that violent excite- ment of circulation may be reduced by means of digitalis." An asser- tion entirely unsupported by experience. [28] Supported in vain by Hufeland, in his pamphlet (Die Homoeo- pathic, p. 20), for the sake of his inefficient practice (Unkunst). Since allopathy, during twenty-five hundred years of its existence, remained ignorant of the source of most chronic diseases (psora), before the appearance of my book ( The Chronic Diseases), it became necessary to invent a false explanation of the origin (genesis) of chronic disorders. [29] Quellen der Bisherigen Materia Medica. Sources of the old Ma- teria Medica preceding the third part of the " Pure Materia Medica." [30] The absurdity of these drug mixtures has been recognized even by men of the prevailing school, although they followed this change- less routine in their own practice, and contrary to their own con- viction. Thus Marcus Herz (in Hufeland's Journ. der Procf., Arzt. ii, p. 33), expresses his conscientious scruples in the following words : ' When we wish to relieve an inflammation, we do not use saltpetre, ammonia, or vegetable acids alone, but we often mix several, and fre- quently too many so-called antiphlogistic remedies together, or allow them to be used in rapid succession. When it becomes necessary to counteract putrefaction, we are not satisfied with the use of one well- known antiseptic, such as cinchona bark, mineral acids, arnica, or snake-root administered in large quantity, and to await the result ; but we prefer to compound several of these drugs, and to count upon their united action ; or from ignorance of the efficacy of any single drug in a given case, we huddle a variety of things together, and trust that by chance one of them may have the desired effect. Thus one remedy seldom is used to promote perspiration, to improve the blood (?), to liquefy ac- cumulations (?), to produce expectoration or evacuation of the intes- anes ; for such purposes our prescriptions are always complicated, never simple and pure, and consequently we arrive at no definite or pre- cise experiences regarding the effects of the individual ingredients of these prescriptions. We have, nevertheless, arranged our remedies methodi- cally according to their rank, and call that drug to which we ascribe the main action basis; we designate the rest as adjuvants, corrigents, etc. This classification is obviously an arbitrary one. Adjuvants take part in the total effect as well as the principal ingredient, although we have no means of determining the degree of their action ; nor is the influence exercised by the corrigens upon the other drugs, a matter of indifference, since it must increase or decrease their action or give it another direction. We are therefore always bound to regard a cura- 58 REMARKS AND EXPLANATORY NOTES tive (?) effect wrought by snih a formula as the collective result of all its ingredients ; nor can we >btain a clear idea of the separate action of each individual ingredient. In fact, our insight into that condition which determines an essential knowledge of all our remedies, as well as our knowledge of the manifold -relationships into which they enter when mixed together, is far too imperfict to allow us to determine the magnitude and variety of the effects of a drug, however insignificant it may appear if in- troduced into the human body combined with other substances. [31] For truth is of the same eternal origin as the omniscient and beneficent Divinity. Men may leave it long unheeded until its rays of light penetrate with irresistible force the mist of prejudices, like the dawn of approaching day, that shall shine brightly and forever for the welfare of mankind. [32] Examples of this kind may be found in the preceding editions of the Organon of the Healing Art. [33] It was the usual practice to attempt to promote arrested cuta- neous excretions, by prescribing an infusion of elder flowers, to be drank during the chills of a fever occasioned by exposure. This in- fusion by virtue of its similarity of action (homoeopathic), may cure the fever, and restore the patient quickly, and much more successfully without perspiration if taken by itself. Hard and acute swellings, the excessive and painful inflammation of which prevents transition into suppuration, were usually covered by repeated hot poultices, and be- hold, inflammation and pain were speedily diminished by the forma- tion of the abscess, indicated by a yellowish shining prominence and fluctuation. The hardness was then supposed to have been softened by the moisture of the poultice, while actually the higher temperature of the latter had relieved homceopathically the excess of inflammation, thus facilitating the formation of the abscess. Why is the red oxide of mercury, which is known to produce inflammation of the eyes, em- ployed with benefit in some kinds of ophthalmia, in the form of St. Yves salve ? Is it so difficult to recognize the homoeopathic nature of this process V Or, why should a little juice of parsley bring instantaneous relief in cases of strangury, common among young children, or in cases of clap, chiefly marked by frequent and ineffectual efforts to urinate, if this freshlv prepared juice did not produce by itself, in healthy per- sons, that painful and ineffectual straining, which proves the homoeo- pathic nature of its curative effect. Pimpernel root, increasing the mucous secretion of the air-passages and fauces, was effectually used in curing the so-called mucous cramp (bronchial catarrh). The leaves of the Sabina, themselves capable of producing uterine TO THE REVIEW OF PHYSIC. 5? haemorrhage, were used successfully in such cases, without, however, leading to the recognition of the homoeopathic law of cure. In cases of strangulated hernia and ileus, many physicians found a superior and reliable remedy in small doses of opium, which has the property of checking intestinal evacuations ; notwithstanding this circumstance, they did not perceive the operation of the homoeopathic law in such cases. They cured non-venereal ulcers of the throat with small doses of mercury, homoeopathic to these cases ; they frequently checked diar- rhoea with small doses of cathartic rhubarb ; they cured hydrophobia with Belladonna, capable of producing a similar affection, and removed as if by magic the dangerous comatose condition of inflammatory fevers with a small dose of opium, known to be heating and stupefying. And yet they vituperate homoeopathy, and persecute it with a degree of wrath that can only be excited in an incorrigible heart by the ad- monitions of an evil conscience. [34] From these examples, derived from domestic practice, Mr. M. Lux has constructed his so-called curative method according to equals and JfZem, called by him Isopathy, which some eccentric minds have already declared as the non plus ultra of curative methods, without knowing how it could be realized. If these examples are carefully considered, the matter will appear in a very different light. The purely physical forces are of different nature from dynamic me- dicinal powers in their effect upon the living organism. The degree of warmth or cold of the surrounding atmosphere, of water, or of food and drink, do not (considered as warmth or cold] per se, condition an absolute hurtfulness for the healthy body ; warmth and cold in their changes are necessary for the maintenance of health, consequently they are not medicines per se ; warmth and cold there- fore applied to bodily affections do not act as remedial agents by virtue of their nature (not as warmth and cold considered as hurtful things, per se, in the manner of drugs, like rhubarb, bark, etc., even if re- duced to the finest doses), but only by virtue of their greater or smaller quantity, i. e., according to the degree of their temperature ; thus (to use an example of mere physical forces), a large leaden weight would press the hand painfully, not by virtue of its being lead, but by means of its quantity and heaviness in a mass, while a thin leaden plate would cause no suffering. If warirth and cold therefore are beneficial in burns and freezing, they are so on account of their degree of temperature, in the same manner as their extremes of temperature are obnoxious to the healthy body. Accordingly we find that, in these examples of domestic practice, the frozen limb is not restored by the continued degree of cold applied 0*0 REMARKS AND EXPLANATORY NOTES to it (because that would have benumbed and killed it); but it is by a degree of cold (homoeopathy) which is gradually reduced to a comfort- able temperature approaching that of the limb. Thus, frozen cabbage applied to the frozen hand in the temperature of the room will soon melt, and by gradually rising from a temperature of + 1 to 2, and so on to that of the room, say + 10, becoming gradually warmer, will thus re- store the limb homoeopathically. Neither is a hand scalded by boiling water, restored according to the principle of isopathy by the application of boiling water, but only by a lower degree of heat. For instance, if the hand is held in a vessel containing a fluid heated to 60, this will grow cooler every minute, gradually assuming the temperature of the room ; thus the burned part will have been cured homoeopathically. The first cannot be drawn isopathically from potatoes or apples by means of water, which is rapidly becoming ice, but only by water re- maining near the freezing-point. Thus, to use another illusti-ation of physical eifects: the suffering occasioned by a blow upon the forehead by some hard body (of a severe bruise), is soon lessened by pressing the thumb hard upon the place for a while, gradually diminishing the pressure : this is homoeopathic relief; while an equally severe blow upon the sore place, with an equally hard body, would be isopathy ; but it would increase the evil. The same book contains further examples of isopathic cures, such as muscular contractions in the human body and spinal paralysis in a dog, both caused by cold, and rapidly cured by cold bathing. This circumstance is erroneously explained as being the result of isopathy. Disorders resulting from cold have merely the name of colds, but are frequently occasioned in a predisposed person by a breath of wind which was not even cold. Neither can the various effects of a cold bath upon the living body of well or sick persons, be embraced so com- pletely in one principle, that a system could so boldly be at once built upon it. That snake-bites, as there stated, are positively cured by parts of snakes, would be counted among the fables of bygone ages, until such improbable assertions have been established by undoubted observations and experiences, an event scarcely to be looked for. Finally, it is said that the saliva of a rabid dog, given to a man (in Eussia), raving with hydrophobia, cured him. It is to be hoped that such assertions, founded on hearsay, will mislead no conscientious physician to imitate so dangerous an experiment, or to build upon it a so-called system of isopathy, as dangerous as it is absurd in its ex- tended sense, notwithstanding the praises of eccentric enthusiasts (though not of the modest author of the pamphlet entitled, Isopatky of Contagions, Leipsic, published by Kollmann), particularly Dr. Gross (Alli\ Horn. Z., ii, p. 72), who proclaims this isopathy (cequalia cequal- ilms) as the only true principle, while he considers similia similibus TO THE REVIEW OF PHYSIc. 61 merely as makeshift. This is truly ungrateful, since he is .ndebted to similia similibus for reputation and fortune. [35] Feruelius already (Tlierap., lib. vi, cap. 20) considered the ap- proximation of a burnt part to the fire as the appropriate remedy for the relief of pain. John Hunter (On the Blood, Inflammation, etc., p. 218) alludes to the great disadvantage of treating burns with cold water, and gives decided preference to the approximation of fire, not according to transmitted medical' doctrines, demanding (contraria con- trariis) cooling applications for inflammations, but in harmony with the experience, that a similar application of heat is more beneficial (similia [36] Sydenham (Opera, p. 271) says: "Alcohol, frequently applied, is preferable to any other remedy in burns." Also Benjamin Bell (System of Surgery, 3d edit., 1789), pays homage to experience, which shows homo3opathic remedies to be the only beneficial ones. He says : "One of the best remedies for burns is alcohol. During its applica- tion it appears to increase the pain for a moment ( 164), but this soon subsides, leaving an agreeable, quieting sensation. It acts most potently when the parts are immersed in the alcohol ; where that can- not be done, the parts must continually be covered by pieces of linen moistened with alcohol." But I must add : The warm, and even very warm alcohol brings more rapid and more certain relief in these cases, because it is much more homoeopathic than if unwarmed. And this is abundantly confirmed by experience. [37] Edward Kentish, who treated the frightful burns of workmen in the coal-mines, occasioned by inflammable vapors, orders "the ap- plication of heated oil of turpentine, or alcohol, as the most excellent remedy in extensive and severe burns." (Essay on Burns, London, 1798, second essay.) No treatment can be nwre homoeopathic than this, neither is there a more beneficial one. The honest and highly experienced Heister (Institut. Chirurg., torn. i, p. 333) confirms this by his experience, and praises "the application of oil of turpentine, alcohol, and hot poultices, as hot as they can be borne." These (homoeopathic) remedies, capable of producing by themselves burning sensations and heat, undeniably show their wonderful supe- riority over the cooling and cold remedies, if applied to parts inflamed by a burn ; provided, however, the experiment is properly conducted in such a manner that both curative methods are, for the sake of com- p xrison, applied to the same person, suffering from burns of equal de- g :ees of severity. Thus, John Bell (S. Kuhn's Phys. Med. Journal, Leipsic, 1801, June, 62 REMARKS ANI .EXPLANATORY NOTES p. 428), had one arm of a scalded woman moistened with oil of turpen- tine, while the other was immersed in cold water. The first arm wag well in half an hour, but the latter continued to be painful for six hours. If withdrawn from the water only for a moment, the patient ex- perienced far greater pain, requiring far more time for relief than the arm treated with turpentine. John Anderson (Kentish, loc. cit. p. 43) treated a woman who had burned her face and arm with boiling fat. "The face, which was much burned and red, and very painful, was covered in a few minutes with on of turpentine, but she had voluntarily placed her arm in cold water,