'a3AlNlT]\V^ LOS-ANGEL/ .s,V3r-lALirU WB^ U i^>\ § if 'Kn frf* ^- y /' ■ ^/?AyvH8n-iv MEUNIVER^ >;lOSANGEL£i: r- Ik. -^- ^^l■LIBRAR>■fo ^ Lie 1 1 Un |i RI^H § V'^Vv Or- r-!^ i-^o H I STORY OF HOMCEOPATHY: Its Origm ; Its Conflicts. ^if^ an ^ppen6t-e on f^c present sfafe of ^nit)ersifj? "§iTe6tctne. WILHELM AMEKE, M.D. (Of Berlin). TRANSLATED BY ALFRED E. DRYSDALE, M.B. (Of Cannes). EDITED BY R. E. DUDGEON, M.D. <4Eon6on : PUBLISHED FOR THE BRITISH HOMCEOPATHIC SOCIETY, BY E. GOULD & SON, 59, MOORGATE STREET. LONDON : PRINTED BY JOHN BALE AND SON, 87-S9, GREAT TITCHFIELD STREET, MARYLEBONE, W. Biomedicftl Library EDITOR'S PREFACE. n^HE history of homoeopathy is the indictment of the -•■ medical profession. A physician distinguished above his fellows for his services to medicine, chemistry and pharmacology, endowed with quite a phenomenal talent for ancient and modern languages, and well read in all the medical lore of past times, after mature thought and at a ripe age, announces to the profession that, as the result of years of arduous experiment, investigation and reflection, he believes he has discovered a therapeutic rule which will enable us to find the remedies for diseases with greater certainty and precision than can be effected by any of the methods hitherto taught. The reception which this announcement met with, and which was given to all Hahnemann's subsequent efforts to give certainty and scientific accuracy to therapeutics, is described in the following pages, and forms one of the most melan- choly and deplorable episodes in the history of medicine. Homoeopathy having had its origin in Germany, and its founder having spent his long life chiefly in that country, it is natural to expect that the historical events of homoeopathy have occurred chiefly, at all events primarily, in Germany. Hahnemann's active life was carried on in Germany, and his works were written in German or in Latin, which in his early days was the language often employed by medical and scientific authors. 7639S5 iv Editor s Preface. The main incidents of Hahnemann's life and the chief sphere of his activity being Germany, the history of homoeopathy is practically its history in Germany, and the task of writing it could most appropriately be under- taken by a fellow-countryman of Hahnemann. How well Dr. Ameke has performed his self-imposed task, the English reader has now an opportunity of seeing. He has brought into full prominence the labours and industry of his hero before he commenced those investi- gations that led to his discovery of the therapeutic rule which he first enunciated as the general principle of medical practice. He clearly shows that Hahnemann was as far in advance of his chemical contemporaries in their special science, as he afterwards surpassed all his medical contemporaries in their special art. He also brings out the fact that Hahnemann, before his discovery of the homoeopathic rule, had acquired a great reputation for his improvements in the practice of medicine, in pharma- cology, and especially in hygiene, a branch of medicine which he may almost be said to have created. We see in this history the high esteem in which he was held by his contemporaries, and especially by the Nestor of Ger- man physic, Hufeland, who never lost his respect for Hahnemann's genius and services to medicine even when he differed from him in opinion. The high esteem in which Hahnemann was held by the most illustrious of his contemporaries contrasts re- markably with the unworthy treatment he received from the next generation of medical men, who knew him only as the propagator of a medical system, which, if it were true or even only partially true, must upset all the teach- ings and traditions of medicine. However we may regret, we cannot wonder at the desperate efforts of the sup- porters of Galenic medicine to discredit the new system which threatened the annihilation of all their most cher- ished doctrines and methods. Editor's Preface. v It must strike every unprejudiced observer as a very hopeless way of suppressing a novel system of therapeutics, to abuse and calumniate its author, to persecute its ad- herents by criminal processes, coroners' inquests, expul- sion from medical societies, deprivation of hospital ap- pointments, exclusion from periodical literature, and social and professional ostracism. One would think that the right way would be to afford them opportunities in hospitals to test its value side by side with traditional methods, to court discussion in societies and periodicals, to make careful experiments with the remedies and the mode of their employment recommended by its partisans, more especially as those partisans were the equals of the others in social and professional status — integral parts of the same professional brotherhood. That the dominant ma- jority preferred the former plan, only shows that they were doubtful of the superiority of their own methods, which, nevertheless, they constantly vaunted as the only " regular," " scientific " and " rational " ones. Time has shown that Hahnemann was right at least in his condemnation of the cherished methods of tra- ditional medicine, for we have seen them all abandoned one by one by the champions of orthodoxy, until nothing was left but blank nihilism, euphemistically called " ex- pectancy." After arriving at this zero, the mercury of medical opinion was bound to undergo a reaction, which we now see in the search for specifics (which, for the most part, are sought for and found in the homoeopathic materia medica) ; the physiological experiments on man and beasts — but principally beasts — in order to discover the remedial power of drugs ; the germ-theory with its corollary germicide medicines and methods ; the tentative employment of new and powerful drugs, and the use of ice- cold bathing and other "anti-pyretics" in almost all dis- eases with heightened temperature. vi Editoi^s Preface. As our old-school brethren have approximated so much to the teachings of Hahnemann, chiefly by abandoning- what he disapproved, but also, to some degree, by adopting what he recommended, it might be expected that their hostility towards his professed adherents would have ceased. But this is far from being the case. The more they are indebted to homceopathy, the less do they seem disposed to admit its adherents to the full communion of brotherhood. They have so long abused and calum- niated Hahnemann and his doctrines that they seem unable to give up their long-indulged habit. Not being able now to revile us for our disparagement of the methods they have themselves discarded, nor for our belief in the thera- peutic rule of " similia siviilibiis awentui'l' which they now generally acknowledge to be one of the methods of medi- cine, their sole grievance is that we call ourselves homoe- opathists (which we do not any more than they call them- selves allopathists — we only accept the name for want of a better, to avoid circumlocution, and to indicate that we acknowledge a general therapeutic rule which our op- ponents do not), and thus commit the unpardonable sin of " trading on a name," an accusation which is manifestly absurd, as that is but a poor trade in which all the gains of the profession in the way of emoluments and honours are withheld from those who exercise it. What is considered a sin in us does not seem to be so regarded in their own ranks when used by oculists, aurists, gynecologists, ovarioto- mists, laryngoscopists and other specialists, who trade on a name to all intents and purposes, and are quite right in so doing. The objections to homoeopathy being practically re- duced to this fanciful charge, it is evident that the attitude of the representatives of traditional medicine towards their re- forming brethren must soon change, and they must allow homceopathy to take its proper place in medicine. When that is the case, the history of the origin and the conflicts of Editor's Preface. vii homoeopathy will be read with interest by the school which now presents a hostile front to that of Hahnemann, for it will feel that it has purged itself of the reproach of op- posing the truth by its late acknowledgement of its error. My share in the work is that I have carefully revised Dr. Drysdale's manuscript and have superintended its passage through the press ; I have also added an index and a few notes which serve to complete the history in some places where it seemed defective. R. E. DUDGEON. London, September, i88^. AUTHOR'S PREFACE. '"T^HE subject (homoeopathy) becomes all the more im- ^ portant," so Hufeland declared in 1826,* "if the originator is a man who commands our respect. And no one will be able to deny that this is the case with Hahnemann, and least of all one who is in the position of the author of this essay, whose acquaintance with Hahnemann is of long standing, and who, connected with him for more than thirty years by ties both of friend- ship and of letters, valued him always as one of our most distinguished, intelligent and original medical men." The same author writes, four years later -.f '•' The first thing that influenced me was the fact that I held it wrong and unworthy of science to treat the new doctrine with ridicule and contempt . Despotism and oppression are obnoxious to me, especially in scientific matters ; in science, impartiality, careful investigation, sift- ing of evidence, together with mutual respect and strict adherence to the matter in hand, should prevail, and per- sonalities be strictly excluded. Added to this was the respect I had long felt for the author, which was in- * Jour. f. prakt. Arsneik., St. i, p. 7. t L.c, 1830, St. 2, p. 20. X Authors Preface. spired by his earlier writings and the important services he had rendered to medicine ; besides this, the names of many worthy and unprejudiced men who testified to the positive truth there was in the matter could not but carry weight. I will only recall the names of President v. Wolf of Warsaw, Medical Counsellor Rau of Giessen, and Medical Counsellor Widnmann of Munich. " I had subsequently the opportunity of observing many instances of good results from the use of homceopathic remedies, which necessarily drew my attention to this subject and convinced me that it ought not to be con- temptuously pushed on one side, but deserves careful in- vestigation." This judgment of the impartial Hufeland is in sharp contrast with the utterances of the majority of allopathic authors, who, on innumerable occasions, did not hesitate to speak of homoeopathy as " a delusion " and " a system of deception ;" of Hahnemann, its founder, as the " greatest charlatan," and of homceopathic practitioners as "im- postors" or "deceived deceivers," and who do not shrink from expressing themselves in a similar strain even in our own time. There have been numerous replies from the homoeo- pathic side, and it has been shown that much earnestness, study and truth are involved in the matter. Strange to say, no single adherent of Hahnemann has undertaken to describe his pre-homceopathic labours, his studies and achievements at that time, or his intense striving after truth. What position did he previously take among his medical colleagues ? What course of development did he go through before he brought forward his medical prin- ciples ? These questions are of importance in forming a judg- ment respecting the founder of homoeopathy. Many of its adversaries have accordingly hastened to answer these Author'' s Preface. xi questions, and that in a hostile sense. Thus a certain Dr. Simon, whose works serve even to the present day as an arsenal from which most of our opponents draw their weapons, writes thus : " Hahnemann is the same unreli- able ignoramus, whether viewed as a man of science or as a physician."* Further : " what we especially miss in him is acumen. The want of the capacity to seize clearly and to pursue a train of thought, appears unpleasantly in everytJiing he ever wrote." Another opponent. Professor Sachs — who is termed by the Hanoverian physician, Stieglitz, " an author of great talent," and that in reference to his anti-homoeopathic books — holds the following views : " Hahnemann has ahuays shown himself weak in the region of solid thinking. He is incapable of radically grasping and following out thoroughly even a simple thought."! All his opponents seem to be unanimous in the opinion that vanity and avarice were the moving springs of his public career, just as in recent times all agree in the asser- tion that his capacity and knowledge as a physician were of the slenderest description. In the following treatise it is proposed to consider the career of Hahnemann from a non- hostile point of view. After a glimpse at his chemical labours and a short review of his contributions towards the perfecting of the art of pharmacy, we will proceed to a consideration of his medical development, and conclude with a description of Hahnemann as a man. The second part is intended to give the reader an idea of the methods used in combating the new doctrine, by means of which a gap in the literature of the subject will be filled. * AntiJiouwopathisches Archtv, Vol. I., Pt. 2, p. 25. f Versiich zu cinein Schlitsswort iiber S. HaJuiemami^s Jwvi. Syst.. Leipzig, 1S26, p. 57. xii Ajtthor's Preface. and, in conclusion, a short sketch of the present condition of medicine at the universities will be given. AMEKE. Berlin, end of iSSj. CONTENTS. Editor's Preface . . . . . . ' . . . . . iii Author's Preface ix PART I. The Origin of Homoeopathy. Hahnemann's Services to Chemistry and Pharmacy. State of Chemistry in Hahnemann's days ...... i Hahnemann's Translations of Demachy . . . . . . .8 Hahnemann's Arsenka/ Poisoning . . . . . . . -IS Hahnemann's Contributions to Crell's Annalen ..... i8 Hahnemann's Detection of Drug Adulteration . . . . .21 Hahnemann's "Wine Test" ......... 25 Hahnemann's " Mercurius SoUibilis " ....... 30 Hahnemann's Apothekerlexicon . ....... 32 Hahnemann's Translations of Chemical and Pharmacological Works . 39 Acknowledgments of Hahnemann's services to Chemistry and Pharmacy by Contemporaries .......... 41 Hahnemann as a Physician. State of Medicine when Hahnemann appeared 42 Natural Philosophy 46 Contemporaneous Physiological Chemistry 49 Chemical Theories and Systems . . . . . . . -5^ Contemporaneous Therapeutics ........ 53 Pathological Anatomy .......... 5^ Medical Courtesy 57 Appeal for State Help .......... 5^ What medical instruction did Hahnemann get ? . . . ... 58 Hahnemann's work on the Treatment of Ulcers ..... 59 Hahnemann's work on Venereal Diseases ...... 64 Hahnemann's translation of Cullen 65 xiv Contents. PAGE Hahnemann's treatment of Lunatics ....... 67 Hahnemann's views on Venesection ....... 67 Contemporary views on Itch ......... 69 New medicines introduced by Hahnemann ...... 74 Hahnemann on simple prescriptions ....... 78 Hahnemann's attacks on the medicine of his day . . . . -87 Hahnemann's criticism of the treatment of Leopold H. . . . .88 Proving of medicines on the healthy ....... 99 Similia Similibus . . . . . . . . . . .103 Hahnemann's idea of disease . . . . ... . . .112 Hahnemann's mode of preparing medicines . . . . . .117 Hahnemann's attitude towards the sciences auxiliary to medicine . .132 Hahnemann and the Apothecaries . 139 Hahnemann's writings in chronological order . . . . . .145 Hahnemann as a JIan. Birth and Parentage 150 Education 151 Wanderings 152 First Marriage . I53 Removal to Coethen . . . . . . . . . • 155 Personality and Character . , . . . . . . .156 Second Marriage . . . . . . . . . . .165 Death 166 Testimonies of old school physicians to his services to medicine . . 16S PART n. The Opposition to HomcEopatliy. Criticism of Hahnemann's first homoeopathic essay . . . . .172 Der allgemeine Anzeiger del' Deiitsclien . . . . . . .178 Criticism of Hahnemann's Oi-ganoii ... .... 180 Criticism of Hahnemann's Dc Hcllcborisvio Vetcruin . . . .184 Hahnemann's treatment of Prince Schwarzenberg ..... 186 Attacks on Hahnemann in Leipzic . . . . . . . .187 Opinions of various authors on homoeopathy ...... 187 Opinions of the opponents of homceojjathy in regard to bloodletting, emetics and purgatives . . . . . . . . .199 " Scientific " reasons for bloodletting ....... 218 Dietl's experiments .......... 220 Criminal prosecution of homoeopaths for abandoning "scientific" methods of treatment 222 Hahnemann's attack on the blood-letters ...... 228 Behaviour of allopaths to honiceopaths 233 Contents. xv PAGE Cholera and its allopathic treatment 235 The censorship used to suppress homoeopathic writings . . . .251 Death of the Emperor Francis 1 256 Treatment of Goethe 258 Death of Cavour 259 Kopp on homoeopathy .......... 263 Allopathic opinions on the proving of medicines 268 Allopathic opinions on the probable duration of homoeopathy . . . 270 The spread of homoeopathy 275 Appeals for State help 278 Causes of the spread of homoeopathy 282 An anti-homreopathic periodical 285 Hahnemann's alleged avarice ......... 287 " Alkali pneum " ........... 288 Letter to the father of the epileptic 292 Hahnemann's alleged denial of the vis mcdicatrix natiircE . . . 297 Hahnemann's alleged theft of his system from older writers . . . 300 Trials of homoeopathy by its opponents 308 Public trials of homoeopathy by its partisans 312 Recent attacks on homoeopathy . , . . . . . .321 Retrospect 370 APPENDIX. Modern University Medicine, Historical 375 Virchow's cellular doctrine 379 Bacteria 3^9 Symptomatic treatment. .......... 395 Mixture-giving 39^ Frequent change of medicine ......... 39^ Medicines at present in vogue ..... .... 398 Treatment of pneumonia ......... 4^7 Anti-pyretic treatment 4^9 Treatment of diphtheria .......... 421 Conclusion ............ 425 PART I. The Origin of Homoeopathy. HAHNEMANN'S SERVICES TO CHEMISTRY AND PHARMACY. The condition of chemical knowledge at the time of Hahnemann's appearance was briefly the following : — Till Lavoisier's discoveries the teachings of John Joachim Becher (1635-1683), and G. E. Stahl (1660- 1734), especially the doctrine of phlogiston were of fundamental importance to chemists. One of their ardent adherents was Neumann, Professor of Chemistry in the Academy ©f Berlin. In his book on medical chemistry, in 1756,* he writes : " That the earth is the elementary principle from which all things were derived and created, is clear from the descrip- tion of the creation in the Bible where it is written : In the beginning God created heaven and earth, and there is no mention of water." Water is nothing else than a kind of transparent earth called ice, made fluid by warmth. It consists of four elements, {lb. ii. 399). There are three kinds of earth, a terra vitrescens (from which with water the principium salinum and acidum universale are derived), a terra mercurialis and a terra sulphurea or inflammabilis. * Ziillichau, 1756, 2nd edit., Preface to Vol. II. He died in 1737. I 2 State of Chemistry Bcchcr is the first to whom the properties of the principium inflammabile were known. Stahl explained and elucidated Becher's theory, he called the inflammable principle " phlogiston." Without it nothing in the world can burn {ib. II., 979)- Sulphur accordingly consists of sulphuric acid and phlogiston. Phosphorus is composed of phosphoric acid and phlogiston, &c. This work of Neumann's enjoyed a great reputation, was translated into English, and by means of extracts was made accessible to a still larger German public. Although Neumann was often cited as an authority even in Hahnemann's times,* some progress had been never- theless made since his day. In 1783, however, Dahlberg, the president of the Academy of Erfurt, still considered it necessary to undertake some careful experiments with the view of discovering whether water can be resolved into earth.-|- There were even some alchemists still existing. In 1784J authors could still speak of " the hope of our alchemists, among whom there are many incredibly ignorant persons." The great difficulty in the matter of chemical research con- sisted in the fact that few or even no elementary bodies were known and accepted into which the constituents of compound bodies could be resolved. Now the chemist asks of what known elements is this or that substance com- posed. TJien chemists were still searching for the " funda- mental essence " of bodies, they were inquiring : " what unknown something lies hidden in them ? " A few examples will show the great confusion which then pre- vailed in chemistry. The celebrated Scheele, an apothecary at Koping, in Sweden,§ was searching in 1787 for the colouring matter in Prussian blue. The search was still going on in 1796.II * E.g.^ in the New Edinburgh Dispensatory^ translated by Hahne- mann in 1797 and 1798. t Ncio chemical experitnetits to solve the question: Can water be changed into earth ? Erfurt, 1783-4. X Crell's Chcmische Afinalen, I., 236. § Crell's Chem. Ann., I., 184 II lb., I., 45. in Hahnemann's Time. 3 Morveau, in 1787, speaks of the " light principle " and of the "illuminating matter" in phosphorus.* In 1789 the excellent chemist Westrumbt " discovered " that acetic acid was the basis of all vegetable acids. De la Metheriej believes that all vegetable acids can be resolved into one single acid. In 1790 Westrumb looked upon phosphoric acid as the final result of the decomposition of vegetable acids and inquired :§ "Does phosphoric acid perhaps lie concealed in nitric acid ? " Two years before|j he had found the same acid in Prussian blue, " I consider inflammable air," so he wrote in 1791,11 "to be very composite and to be com- pounded of phlogiston, caloric, water, phosphoric acid, &c." " It can be theoretically explained, according to Herr Kir- wan's theory," so wrote a chemist in 1789, "that common mnriatic acid consists of the special basis, phlogiston, and a certain amount of carbonic acid."** Professor Winterl made known at about the same time certain experiments,!! according to which " copper consists of nickel, plumbago, silica and carbonic acid, and of a certain substance which escapes in boiling which unites plumbago, silica, and carbonic acid in the alkaline ley." The same chemist changed muriatic acid into nitric acid.|| Professor Vogt, even in I795,§§ recognises an earthy, a watery, an aerial, an acid, an alkaline, &c., basic element. Lowiz, the principal apothecary and professor of chemistry in St. Petersburg, discovered in 1793III! " true inflamma- bility in the purest acetic acid, and separated phosphoric acid from it by means of inflammable salt gas." We may here insert the following extract from a table of chemical relations by Professor Gren belonging to the year iygi.^% * Crell's Chem. Ann.^ II., 243 i| lb., 1788, I., 148. and 460. 1" lb., I., 146 t lb., preface, 1789. ** lb., II., 136. X lb., I., 276. ft lb., 221, § lb., I., 434. %% lb., I., 319 §§ Trommsdorff s /<7Z/fr. der Pharmacie, II., st. i, p. 187. nil Crell's Ann., I., 220, 223. J. F. Gmelin, Gcsch. d. Chemie. Got- tingen, 1799, HI., 391. ^^ M.o\\xo^s Materia :]Iedica, translated by Hahnemann, Conclusion. 4 Lavoisier s Overthozv of (There were affinities in the wet way and in the drj' way. FIRE. AIR. WATER. RESIN. GUM. ALCOHOL. Fire . . . Accumula- tion. Phlogisti- cated air. Gaseous steam Carbon Carbon Vapour. Air ... Combustion Accumulation Penetrating steam Ash Ash Water. Gaseous steam Water with fixed air (Carbonic acid). Accumula- tion ' Solution Brandy. According to this fire plus gas = phlogisticated air. Fire plus water = penetration. Fire plus gum = carbon, &c. The great Lavoisier was destined to put an end to these vain speculations, but not without the most vehement opposition and long-continued resistance of the upholders of the phlogiston theoiy. The struggle with regard to phlogiston took place at the time of Hahnemann's chemical labours. In 1770 Lavoisier showed that water does not change into earth, but that it is composed of hydrogen and oxygen. In 1774 he proved that the increase of weight that takes place when metals are oxydised is caused by the incorporating of air. In 1777, 1780 and 1783 he published his experiments, which had been made with an exactness hitherto unknown and with the aid of imposing apparatus, and proved that the increase of weight which takes place when phosphorus and sulphur are burnt, is equal to the loss of weight of the air in which the burning takes place. He concluded that that ingredient of air which was transferred to the burnt substances was the constituent common to all acids — hence he called it " oxygen " — translated by the Germans into " Sauerstoff," and which Priestley and Scheele had discovered a short time before as a peculiar kind of air (dephlogisticated air).* The principles of chemistry which had been hitherto accepted were discussed in Crell's Annalen ; in 1874, therefore Comp. Gmelin, I.e. III., 279, ct scq. the Phlogiston Theory. 5 14 years later (I. 95), we find the statement — " Lavoisier and Landriani are said to have converted inflammable air (hydrogen) and dephlogisticated air (oxygen) into water," and this was confirmed by Cavendish {ib. I. 479). In 1786 those celebrated men, Kirwan, Cavendish and Scheele opposed Lavoisier, who disputed the existence of phlo- giston.* In 1787 the prize theme of the Academy of Orleans was " Is water a compound substance, or is it simple and an element ? " (I. 288). Professor Hermbstadt of Berlin spoke against Lavoisier's analysis of water, and held oxygen to be the primary originating matter of fire (I. 296). De la Metherie was opposed to Lavoisier's experiments, "which do not destroy the older view."t Kirwan (II. 156) in Dublin and Dollfuss (II, 162) in London took phlogiston under their protection. The latter speaks of " Kirwan's masterly defence of phlogiston against the already fashion- able theory of Lavoisier." The chemists, Morveau, Ber- tholet, Foureroy, Mongez, de la Place, Vandermonde, Cousin, le Gendre, Cadet, and Hassenfratz met during three months three times a week at Lavoisier's house, in order to decide upon new technical terms and new chemical signs, " by means of which, as is the case in geometry, savants of all nations may be able to understand each other." The results were laid before the Royal Academy of Sciences in Paris {ib. II. 58). 1788: Priestley (II. 49, 50) came forward to defend phlogiston and to oppose Lavoisier's analysis of water. Lavoisier (II. 51) converted phlogisticated air (nitrogen) and dephlogisticated air (oxygen) into nitric acid by means of the electric current. De la Metherie writes : (II. 139) "phlogiston still finds friends in Kirwan and Priestley and in the majority of natural philosophers. The new nomenclature (of Lavoisier and his French adherents) is universally rejected." Lavoisier (II. 262) mentions a method of increasing the effect of fire in chemical opera- * Trommsdorf 's y(9z^r. d. Phariii. II., St. 4, p. 2i7- t Crell's Attnalen, I., 552, and II. 332. 6 Opposition of the Chemists tions by means of oxygen. He gives tables showing " the quantity of oxygen which combines with various metals when dissolved in acids and when precipitated by one another" {ib. 464). According to the opinion of the court apothecary, RUckert of Ingelfingen, the green in plants is derived from phlogiston (II. 513). A prize theme of the academy at Copenhagen requires the analysis of phlogisticated air (nitrogen) and asks " whether phlogisti- cated air loses phlogiston by detonation " (II. 479). 1789 : Professor Klaproth says : (I. 1 1) " I reduced some white manganese calx, which I had precipitated from the solution in phlogisticated nitric acid by tartaric alkali in a crucible and obtained a regulus of finely grained structure. Hardly had I freed it from the adhering coal dust and placed it on paper in an open cup, when I became aware of a distinct smell of inflammable air — on the third day I still perceived by the smell the phlogiston which was escaping from it." Crell writes : (ib. Vorbei'icht p. 2) " Westrumb made the discovery that nearly all metals ignite with emission of sparks in dephlogisticated chlorine, and thereby give a new and strong proof in favour of phlogiston." At a further stage in the controversy the defenders of phlogiston proved that all acids were not compounds of oxygen, and used this as a weapon against Lavoisier. They saw that metallic oxides, if mixed with carbon, could be reconverted into the metals. They had therefore received phlogiston from the carbon which they had lost as oxides. Lavoisier : " Those who attempted to delude mankind into believing that what is new is not true and that all that is true is not new, have made too much of the discovery of the germs of my discoveries in an old author" {ib. II. 149) 1790. Hahnemann (II. 52) urges that experiments should be made for the purpose of deciding this question. The labours of the French chemists were disturbed by the revolution 1791 : Crell writes: {ib. Voi'bcricJit) Herr Lowiz has solved the difficulties concerning the dephlogisticating action of carbon, so also Wiegleb in his pamphlet defends to Lavoisier' s Viezvs. 7 phlogiston, in which he (II. 387 — 469) attributes false statements to Lavoisier. Kirwan announces {ib. I. 425) that he has given up Stahl's system of phlogiston. Professor Gren : (II. 56) " My principal objection to Lavoisier's system is that he opposes obstacles to the progress of natural science." 1792 : Crell (ib. Vorbericht) says : The doctrine of phlogiston divides chemists into two parties ; he dwells on the difficulty of changing the whole method of thought of chemists. Westrumb (I. i) speaks of the system of the " gasists " to avoid giving offence by using the word phlogiston. Hofrath Herrmann writes: (II. 44) "Inflam- mable gas is for me a compound of phlogiston, fire, air, finely divided aqueous vapour, and, if obtained from a metal, some of the metal in solution." Hermbstadt (II. 210 and further) says: " Stahl, that clear-sighted and philosophical physician, would have been, if he had lived, one of the first to recant his opinions Wiegleb, Westrumb, Gren, Gmelin, Crell do not think so. The desertion of Kirwan and Klaproth, at one time earnest and enthusiastic advocates of phlogis- ton, is significant." Professors Hermbstadt, Klaproth and Karsten instituted experiments relative to oxygen which favoured Lavoisier (II. 387). A prize was offered at the academy of Harlem for the best paper on the " Nature of Fire" (II. 480). 1793 : Another prize was offered at Gottingen for an essay "On the Composition of Water" (I. 287). Hermbstadt showed A. v. Humboldt experiments in the Royal La- boratory at Berlin, which favoured Lavoisier's views (I. 303). This enthusiastic partizan of Lavoisier in Germany com- plains : " I often advocated the new doctrine at the expense of my honour and good name, for I was more than once saluted as ' a quack, imbecile, propagandist, and antiphlo- gistic town-crier,' as will be seen by a glance at the Salzburg Med. chir. Journal 2lX\(\ other periodicals" (II. 480). Professor Gren (I. 31) states that if oxygen can be ob- tained from oxide of mercury, he will never again conduct 8 Hahnemann's Translation of an experiment, and consider himself no chemist. Never- theless, he soon adopted the new theory. In 1794, as we all know, the meritorious Lavoisier perished miserably. In order to provide the means for his prolonged and expensive experiments, he had accepted the post of farmer-general, he was thereupon called to account by the blood-thirsty Robespierre, and was guillotined on the 8th of May. Nevertheless, the spirit which he had infused into chemistry survived, and continued his work ; the ranks of the " Phlogisticker " thinned from year to year, the number of chemical text-books written on " antiphlo- gistic principles" continually increased, though among others Priestley still contended against Lavoisier's theory in 1796."* In 1799 Gmelinf states that Lavoisier's system was accepted by the majority of chemists. Hahnemann made his debut as chemist without having had more instruction in the art than other medical men, and without ev^er having been assistant in a laboratory. He was self-taught. In the year 1784 he translated Demachy's '■'Art of Manu- facturing Chejuieal Produets^' two volumes. Demachy was one of the first chemists of the day, a member of the Berlin and Paris Academies. The French Academy published this work because most of the chemical manufactures mentioned in it had been kept secret by their several manufacturers, particularly the Dutch, and it was now desired to introduce their manufacture into France. This was urgently necessary both for France and for Germany, and it was a great service rendered by Hahnemann that he not only made Demachy's processes accessible to his countrymen, but also enhanced the value of the book by suggestions for their improvement and perfection. After he had completed his translation, a translation appeared by the chemist, Dr. Struve, of Bern, also with additions. Hahnemann added Struve's com- ments to his translation, making his own notes upon them. * Crell's Annalcf!, 1798, II. 30S and 376. ■f Gcsch. d. Client.^ III., 278. Demachy zoitJi Notes. 9 The nature of chemicals and the notions with regard to their composition were, in many respects, very defective, as appears from this work. We find here, to give a few examples (I. 54), mention made of a very good blue aqua fortis obtained by distilling arsenic and saltpetre with equal portions of water. Every nitric acid turned white, i.e., a white precipitate resulted when a solution of silver was added to it, owing to admixture with hydrochloric acid (I. 62). The purity of the nitric acid was estimated by the amount of this deposit. Demachy considered it impossible to estimate the strength of hydrochloric acid by means of the areometer (I. 15). Such impure nitric acid must indeed have acted as aqua regia, and it is therefore not astonishing that that excellent chemist, Struve, observed a deposit of gold from a "solution of silver" (I. 55). (Hahnemann calls this idea "an alchemistic fancy.") Demachy divided aqua fortis into that which contains hydrochloric acid only and that which also contains sul- phuric acid (I. t6)). Lime was added to potash in order to remove its "oiliness" (II. 39, 40), and it also rendered it somewhat caustic. According to Demachy, potash contains all the more vitriolized tartar (sulphate of potash) the older it is ; in that case, carbonic acid must have been converted into sulphuric acid. Salts of wormwood, plantain, gentian and centuary was still sold (II. 39, 40). Glauber salt was prepared with the expensive alum. Hydrochloric acid was dearer than even the costly sulphuric acid (II. 32.) Weathered Epsom salt was sold instead of Rochelle salt (tartrate of soda and potash) (II. 47). According to Hermbstadt, milk-sugar consisted of one portion of chalk and three of saccharic acid (II. 77.) Wiegleb has proved, says Struve, that the beautiful red colour of cinnabar depends upon the fatty acid which it has derived from fire (II. 143). Demachy thinks that in red precipitate the corrosive part of nitric acid is retained (II. 162). To add to this confusion, wholesale adulteration was practised, and a narrow-minded secrecy observed. The Dutch, especially, were accused of this. The ethereal oils were 10 Hahnemann's Corrections adulterated with oil of turpentine and balsam of copaiba, &c. (I. 241.242) : lead was mixed with cinnabar, (II. 143) arsenic with corrosive sublimate (II. 146). The prepara- tion of white precipitate was kept secret (II. 165). There were as many secret modes of making lead preparations as there were manufactories. Red lead was adulterated with brickdust and oxide of iron. Dutch white lead was a mixture of one part of pure white lead, and one to three parts of chalk (II. 194). The mode of preparation of verdigris was rigidly kept secret (II. 2Co), as was also the manufacture of vinegar by the Dutch (II. 196). " From time immemorial," says Demachy, " the same family has always refined borax, another prepared corrosive subli- mate, and so on " (II. 217). The Dutch would not com- municate their method of refining borax to his agent. (II. 97) ; he also speaks of antimony works which could not be visited. In his remarks Hahnemann displays an astounding knowledge of all the questions connected in any way with the contents of the book. His knowledge of the literature of the various subjects is exhaustive. He cites, e.g., ten authors on the subject of the preparation of antimonials (II. 129), and quotes a number of works on lead (II. 175), quicksilver (II. 172), camphor (I. 254), succinic acid (II. 82), borax (II. 91), &c. Where Demachy remarks that he knows no work on the carbonification of turf, Hahne- mann mentions six (I. jS) \ where Demachy speaks of a rare Italian book, Hahnemann gives further details concerning it (I. 6) ; where Demachy speaks of a French analyst without giving his name ; Hahnemann subjoins the name and the work. Demachy mentions a " celebrated German doctor." Hahnemann is able to give the name, work and passage ; and so on in many other cases.* Where Demachy touches on a discovery, Hahnemann narrates its history fully. -f- In numerous places he gives more precise information in explanation of the text and explains the * Comp. II., 41, 66, 186, 199, I., 249, &c. t 11., 44, I-, 143, &c. of Donachfs Errors. 1 1 chemical reactions more in detail.* Hahnemann also frequently corrects errors and mistakes.f His notes on nearly every page are almost equal in value to a new work. The following examples show that in addition to botany and zoology he was master of all desirable know- ledge on the subject of physics, and especially of tech- nology which was then beginning to attract attention. Under distillation (I. 200) he shows by calculation that the worm then in ordinary use produced less refrigeration than the cap over the receiver. Now the worm is disused in pharmaceutical labaratories, partly on account of the difficulty in cleaning it, to which Hahnemann also calls attention (I. 202). He speaks of the areometer^ with much knowledge of the subject and experience, and shows in this respect his superiority to Demachy and Struve. He describes, too, an improved areometer invented by himself § Demachy advised among other things blowing with the mouth to increase a flame where there was not a proper current of air. Thereupon remarks Hahnemann (I. 34), " This can be dispensed with either by removing from the furnace the cause that hinders the draught, or if there is nothing of this sort present, by closing all the openings of the laboratory with the exception of one door, or window, especially, however, by placing a tinned iron pipe 4 to 6 feet in height over the smoke hole of the furnace and plas- tering it over with glue, for by this means the ingoing and outgoing currents are at different heights of the column of air, and the draught is increased more than by means of straw, the bellows, or even blowing with the mouth." Hahnemann corrects Demachy's mistake in the matter of scarlet dyeing (I. 69 — 70), and also Struve's mistake with regard to copper engraving. He gives numerous directions to the mason, il and the potter, e.g., (I. 11) for special retorts. * I., 16, 17, 22, 31, 62, 86, 130, 186, 237, 267, 279, &c. t I., 55, loi, II., 44, 48, &c. X I., 281—282, 288—296. § I., plate 4, fig. 6. II Im4, 30, 31, 39, 171, 174, 176. 12 Hahnenianiis Improvements and Hahnemann gives the measures for these, and he is ac- quainted with the cements necessary for various purposes.* He gives precise directions as to how hearths and grates should be made, whether of iron or earthenware, and of what height they should be and how the fire is to be regulated, whether retorts with long or short necks, or whether receivers or intermediate tubes are to be used. He is well acquainted with the manufacture of chemicals in other countries.! Thus he corrects Demachy (I. 21) with regard to alum in Russia, Sweden, Germany, Italy, Sicily and Smyrna. He gives full details (I. 25.26) as to pit coal and coke in England and in the province of Saarbriick. He frequently and with vehemence defends the use of pit coal,| against which there was then a general prejudice, and points out the increasing scarcity of wood. Later, in 1787, he published a special treatise on the Prejudices against tJie Use of Coal as Fnel ; 172>7, Crell's Annalen mentioned as a novelty, (p. 288) that : " at Creusot in Burgundy the smelting and refining of iron is carried on on a large scale by means of coal which has been pre- viously burnt." The translator intercalates various improvements and inventions, e.g., "A special mode (p. 49 — 53) of distilling aqua fortis " in a continuous stove, the retorts of which did not burst, while in the ordinary arrangement mentioned by Demachy, five, six, or more retorts are generally spoilt, and the works must be interrupted at heavy cost. He proposes a method (I. 60) of purifying saltpetre from salt before distillation in the preparation of nitric acid to avoid its contamination with muriatic acid. Hahnemann introduces a new test for muriatic acid. The ordinary method of using lunar caustic might also indicate sulphuric acid, if this was present in a certain degree of concentration, in which case there would be a precipitate of sulphate of silver. This could of course be avoided by * I., 81, 84,99, 154- t 11-, 12, 29, 32, 81, 98, 176, 1S3, 184, &c. t I., 25, 27, 180, &c. Discoveries in Cliemistry. 1 3 the dilution of the fluid. Hahnemann's reagent was a solution of sulphate of silver ; a precipitate of chloride of silver only was thrown down and the sulphuric compounds remained in solution (I. 63). The idea underlying the method is still used in qualitative analysis of employing gypsum water to distinguish lime from baryta and strontia. At the same time Hahnemann gives directions for deter- mining the precipitate quantitatively. Hahnemann uses the same idea for a new test for sulphuric acid, viz., a solution of chloride of lead, since that used hitherto (" a few drops of solution of mercury " would also indicate muriatic acid if this were present in any considerable amount. But he adds another test, which had just been discovered by Scheele, viz., baryta (I. 64). Further Hahnemann calls attention to the amount of magnesia in the brines of salt works, and indicates a method of separating it. He returns later to this subject* We see from Crell's C/iem. Annallen\ that his idea had attracted the attention of chemists. Magnesia was little known in those days. Professor Neumann's work on medical chemistry in 1756^ declared the discovery of magnesia alba a " delusion," and the substance itself " ex- hausted lime." Careful experiments were instituted by Hahnemann§ on the subject of crystallization, on the solubility of salts at different temperatures, and the possibility of separating them by means of crystillization, and he gives many useful hints for the detection of impurities. His remarks on the various preparations of mercury,|| which he had carefully investigated, are especially numerous and suggestive. How earnestly Hahnemann strove to secure accuracy and certainty is shown by his careful determination of the quantitative relation of alum and salt in the formation of glauber salt (H. Preface). Professor Gren had given the * KennzeicJien der Giite^ Szc, p. 174. t 1 79 1, II., 30, note. t Ziillichau, 1756, II., 879. § II., 13, 31,37. li II-, i35> 139— 141, 145) 149—150, 158, 161, 165, 166 168, 171. 14 Criticisms on Hahnemann. proportion of alum to salt as 7 to 12, Professor Gottling as 2 to I, another chemist as i to 2. Hahnemann found that it was 17 to 6. He had to go carefully to work. First he pre- pared soda from common salt, according to his method; he decomposed alum with this pure carbonate of soda and weighed the glauber salt separated by crystallization. In order to ascertain how much common salt was equivalent to this glauber salt, he decomposed glauber salt by means of chloride of calcium into gypsum and common salt. Wiegleb had represented the proportion of 17 to 6 as the most incorrect. Calculation with our present equivalents gives 17 to 6^ and shows therefore the correctness of Hahnemann's statement. He lays great stress on the purity of preparations, since some of the uncertainty in chemistry depended upon im- purity of the chemical preparations. We must not omit to mention, though of course it could not have been otherwise, that Hahnemann was incorrect on many points in chemistry. He shares the mistaken notions concerning phlogiston and the current false views of the origin and composition of many bodies. In the case of borax, e.g., he believes (II. 95) that boracic acid (sedative salt) is composed of fluor spar, phosphoric acid and silica, and he thinks (II. 80) that cream of tartar can be al- most converted into sal acetosellae by the addition of a small quantity of sedative salt. In consequence of Gren's asser- tion that sedative salt will only enter into combination with caustic soda, Hahnemann starts the hypothesis (II. 95) that calcination would be very useful in the refining of borax. In the second part of this work we again find his error con- cerning this substance. The following criticism of the translation appeared in Crell's Annalen (1785. II. yy') : If ever a work was worthy of translation this is one, and fortunately for its readers it has fallen into the hands of a writer who has improved and perfected it. Demachy's original work has long been prized b\' all readers of French. In the second edition, notes were added by Dr. Struve. Dr. Hahnemann translated it with these additions and added a great many notes of his own, by which the scope of this work was increased and its errors corrected. We can affirm that no more com- Hahnemann's Work on Arsenic. 15 plete treatise exists on the subject of the manufacture of chemicals than this work. The author (Hahnemann) has described a special distilHng apparatus for aqua fortis, which well merits attention. In the chapter on the preparation of muriatic acid, the notes are greater in amount than the text, and are more important. In the review of the second part {ib. II. 277), it is men- tioned that Hahnemann has added a special mode of pre- paring salt of amber (succinic acid) in the purest state. In 1 80 1, a new edition appeared. In 1786, he published On Poisoning by Arsenic, its Treatment and jfudicial Investigation. Before Hahnemann, Neumann, the Professor of Chemistry in Berlin, made investigations with a view to ascertaining the presence of arsenic,* but without obtaining any reliable results. He " hesitated about carrying his investigations further, lest he should be the cause of undetectable poison- ings." The last author mentioned as such in works on the history of chemistry, and designated by Hahnemann as the chief writer on this subject, was Navier.f The conceptions of the chemical constitution of arsenic were very hazy. Haller looked upon it as " an extremely narcotic form of sulphur." Gmelin thought its principal component was muriatic acid ; Neumann thought it consisted of muriatic acid and sulphuric acid, and Porner of muriatic, sul- phuric and silicic acids. Navier considered it proved that " arsenic consisted of a volatile semi-metallic earth combined with muriatic acid." "O, holy chemistry, have mercy upon us!" Hahnemann exclaims. He adduced proofs against all these statements. An example of the method then pursued for detecting arsenic is to be found in Crell's Annalen.\ It could not be recognized by the taste, because at first there was no smell of garlic, it was not mercury. The author thought he might conclude that " the drops are nothing but a so-called fixed arsenic." He does not venture to determine the quantity. Crell's Annalen was the best of the chemical journals. * L.c. II., 495 — 501. f P. T. Navier, Antidotes to Arsenic, Corrosive Sublimate, Verdigris and Lead, Paris, 1777. Trans, by Weigel, Greifswald, 1782. X 1784, II., 128-131 1 6 Tests for Arsenic. Hahnemann does not mention any new antidotes in this treatise, but he subjects the large number of those recom- mended to a careful examination, even making physio- logical experiments on dogs, indicates the best remedies, and gives precise directions for their use. The most important part of this work is the chapter on the mode of ascertaining chemically the presence of arsenic, because chemistry, and especially juridical chemistry made thereby an important step in advance. After show- ing that the tests of Neumann, Morveau, Haller, Sprogel ordinarily employed, were unreliable, he gives three tests which appear essential to him : Lime-water, water satu- rated with sulphuretted hydrogen, and ammoniaco-muriate of copper (sulphate of copper recommended by Neumann gave no reaction). Water impregnated with sulphuretted hydrogen had already been used by Navier,* but, and this is the point — without any addition of acid, so that the re- action was extremely uncertain. Hahnemann was the first who recognised and laid stress on the necessity of adding , an acid,t a very important discovery to which we shall again return. Further on (p. 246) he states that : " Deliquesced potash makes the precipitate disappear." Even now chemical analysis knows no other means of separating the metals of the arsenic-antimony group from those of mccury — silver — copper, &c., than that of dis- solving the sulphurets of the first group in an alkaline solution as was done in the above way by Hahnemann. Hahnemann went still further. The precipitate of the sulphide could not be quantitatively determined on account of the change that took place in drying. But the copper precipitate remains unchanged, and, accord- ing to Hahnemann's calculations and repeated experiments, 267 parts of it were equivalent to 165 parts of arsenic. Together with the well-known smell of garlic, this test ap- pears to him decisive. The limit of the reaction with ammoniaco-muriate of copper he gives as at a dilution of I to 5000. The precipitated arsenious oxide is soluble in * L.c, I., 28. t P. 127, 136, 236, 239. Tests for Arsenic. ly 2100 parts of lime-water, and is, therefore, a less sensitive test. It is characteristic that Hahnemann in his chemical writings always endeavours to determine vv^ith the greatest accuracy the limits of the activity of agents. This he does here also. He discovers that exposed to a tempera- ture of 96° F. {i.e., nearly blood heat), for ten minutes, the solubility of white arsenic is i in 816; the solubility of native arsenic (according to the time of boiling), i in 4000 — I in 1 100; of regulus of arsenic i in 5000, of natural orpiment (which, like the two preceding substances, is converted into arsenic by boiling) i in 5000, and so he proceeds with all the chemical bodies mentioned, not with- out drawing conclusions therefrom and estimating their value for his purposes. He earnestly opposes those cheap-jacks and hawkers who are allowed to sell arsenic as " a fever powder," and he makes circumstantial proposals respecting prescriptions of poisonous drugs, which have now been carried out exactly as he proposed. He suggests that there should be a locked chamber for poisons in the apothecary's shop, of which only the owner of the shop or his representative should have the key ; he also demands that a special book should be kept for entering the poisons sold, and suggests that special forms of receipt should be attached to it which should specify the receiver, and which should be submitted to the doctors who examine the shop once a year. This is not the place to discuss the equally valuable medical part of the book. The book is a model of con- scientious work, wide knowledge, and a devoted love of science ; it is well worth studying even now, after the lapse of a hundred years. The remarkable industry of the author is shown by the fact that he quotes 861 passages from 389 different authors and books in different languages and belonging to different ages, and gives accurately both volume and page. The following criticism is taken from Crell's* Aiinalen : — * 1788, I., 18: 1 8 CreWs '' Aiinalen" " As the author starts from chemical principles, and has confirmed them by his own experiments which are here re- counted, this product of exceptional literary industry deserves to be noticed by us." Hahnemann's investigations are then described. The reviewer does not attempt to decide on the question whether Hahnemann's statement that arsenic does not contain muriatic acid, &c., was correct, and thus shows Hahnemann's superiority. In the Neiie lit. Nachrichteji fiir Aerzte, Sic* the work is reviewed at greater length, and the reviewer says, " These last portions (viz., judicial investigation, pathology, chemical tests, determination of lethal doses) give the whole work extreme value." The Councillor of Mines, Dr. Bucholtz, of Weimar,-f- who has rendered so many services to pharmacy, calls this book " The very valuable book of my esteemed friend, Dr. Samuel Hahnemann." Professor Hencke praises in Horn's ArcJiiv fiir medic. ErfaJiriingenX "the classical work (for that time) of Dr. Samuel Hahnemann on arsenic, by means of which the best modes of analysing arsenic w'ere introduced into medical jurisprudence." We must add that Hahnemann not only introduced the best existing methods of arsenic analysis into medical jurisprudence, but also improved them, and discovered the reaction with ammoniaco-muriate of copper, on which fact stress is laid by the historian Wiegleb.§ Hahnemann's Contributions to Crcll's Chemische Annalen. Crell was Professor of Medicine and Philosophy in the Brunswick University at Helmstadt. His Annalen possess very great importance for the history of chemistry.|| They appeared monthly from 1784 and were the first regularly * Halle in Saxony, 1787, 49, 51. t Hufeland'syi9z^r;w/, 1798, Vol. V., p. y]"]. X 1S17, 1., 181. § J. C. \\' iegleb Gcschichtc dcs VVachsthums und dcr Ei-findungen in der Chcinie, Berlin and Stettin, II., 2)72,- II Previously he edited the Chemischcs Journal in six parts since 1778, then, since 1781, the Neueste Entdeckungen^ in 12 vols. Soda from Connnon Salt. 19 appearing chemical periodical, at least, in Germany, and they were soon imitated in the French Annales de Chiniie. Crell met the expenses of his undertaking (as was then usual) by subscription ; the list of subscribers contains many names of princes, academics and students in all countries ; apothecaries are especially numerous. The foremost chemists and natural philosophers, such as Scheele, Bergmann, Gmelin, Gren, Hermbstadt, Kars- ten, Klaproth, Rose and A. von Humboldt were con- tributors ; the last mentioned from the year 1792, after his journey through Belgium, Holland, England and France. French chemists also contributed papers. Hahne- mann published a series of interesting and approved ex- periments and discoveries in ih^sc Annalen ; lyZj (H. 387- 396) he wrote " On the Difficulty of Preparing Soda front Potash and Common Salt." We should be surprised now- a-days if any one used potash, which is much dearer than soda, in the preparation of the latter. Then potash was obtained from the ashes of a good many plants, and soda only from a few sea-shore plants. The amount obtained from the natron lakes was unimportant, because chemists did not then know how to purify it from admixture with foreign substances. Chemists had made numerous pro- posals for obtaining soda from nitrate of soda, or from muriate of soda, as Scheele did by means of oxyde of lead. One pound of soda prepared in some of these ways cost nine shillings. Hahnemann thought that its preparation from common salt was the only means of obtaining cheap soda. In 1784* he stated that he had obtained soda from com- mon salt by means of potash, by crystallization at different temperatures and different degress of saturation ; he gives the amount of heat and quantity of water required for obtaining soda, but dwells on the difficulty of separating foreign salts in this way. Gmelin mentions this process of Hahnemann's in his History of Chemistry (HI. 497), and in Crell's Annalen (1789, I. 416) there was a paper en- dorsing the whole treatise. * Translation of Demachy's Laboraiit^ II., Preface, vii. 20 TJic Gas that causes Fermentation. 1788 : Hahnemann attempted to ascertain what the gas was which converted alcohol into vinegar, and described his investigations in an essay " On the Influence of certain gases on the fermentation of wine" (p, 141-142). He tried the effect of three gases on wine. I, Dephlogisticated air (oxygen). 2. Phlogisticated air (nitrogen), 3. Chalk gas (carbonic acid), i.e.., those gases which were already known to be constituents of the atmosphere. He introduced these gases into bottles, each with four ounces of wine, closed them hermetically, kept them for two months at the same temperature (that of the room), and shook each thirty times at three periods during the day. The result was that the wine in the oxygen bottle " had become pungent vinegar." The method of manufacturing vinegar rapidly by letting alcohol run repeatedly over chips of beech wood was discovered in 1833. Hahnemann discovered in 1788 that it is the oxygen of the air that brings about the change, and that the conversion can be promoted by repeated contact with it. Soon after he published his observations on the effect of lunar caustic as a preservative from decomposition.* He found that it was most useful in a dilution of i to lOOO in the case of indolent ulcers, and stated that he had observed antiseptic effects from a solution of i in 100,000, but this was not confirmed by subsequent experiments-f of others. On various occasions Hahnemann showed his desire to make chemistry useful to medicine, as, for instance, in a special article, " On bile and gall stonesTX He took the fresh bile from a man who had been shot while in full health, and tried the effect of various salts upon it so as to ascertain their value in various liver complaints and ob- structions of the bile. It would not be consonant with the object of this work to discuss all Hahnemann's works ; we shall have occasion subsequently to refer to two other papers of his from this journal. 1788, II., 485—486. t lb., 1792, I., 213. X 17SS, II., 296-299. Tests for Drugs. 21 Detection of tJie adulteration of drugs. By J. B. Van den Sande and Samuel Hahnemann, 1787. Van den Sande, an apothecary in Brussels, published there in 1784, La falsification dcs incdtcaments devoilce. Hahnemann made use of the correct descriptions of roots, barks, &c., given in this book. He mentions in two different passages of later works that the greater part of this work was his, and in the preface he begs " that the discerning critic will acknowledge my rights." The critic will observe that the chemical part is by Hahnemann, so too is the accurate statement of the component parts of the several drugs ; also that the most important parts are from Hahnemann's pen, may be seen by the accuracy and the conciseness of the style and the direction taken by his investigations. The signs for recognising purity and adulteration are given in a masterly manner. Hahnemann gives such a concise, exhaustive and excel- lent account of the tests for the drugs that we are re- minded of the pharmacopoeas of to-day as eg., pp. 293-295 and various other passages. Among these are the tests which Hahnemann proposed in Demachy's Laborantl'^ for muriatic and sulphuric acid, founded on the different degrees of solubility of precipitates usually considered insoluble. The article on ammonia is excellent. He examines (p. 290) it among other things for the carbonic acid it attracts, precipitates this with lime and finds that 240 grains of the precipitate correspond to 103 grains of "fixed air" (carbonic acid). A result which is perfectly correct ac- cording to the calculations of to-day. In this work, too, as everywhere else, Hahnemann shows his earnest efforts to determine the limits of the activity of substances and their solubility. Thus he found (p. 243) that the solubility of the precipitate from solutions of nitrate of mercury by salt (both answering the purposes of tests for one another) was i to 86,000 of water ; in the case * I., 63 and 64. 22 Hahneinamis extreme accuracy of sulphate of lead, i to 87,000 parts of cold water ; in the case of white lead, i grain in 17,000 grains of water of I2|°R, and so on in the case of many other substances (p. 251). Accuracy prevails everywhere, he gives the melting point of metals, the specific gravity of them and of their prepara- tions, the solubility of salts at various temperatures ; in the case of important salts, e.g., sal-ammoniac, also their solu- bility in alcohol at different temperatures. The determina- tion of the specific gravity appears to him especially important in the case of acids ; he introduced dilute acids into medical use such as are now used. He even determines their degree of concentration according to their specific gravity and approaches closely to the methods used now- a-days. In the case of vinegar the strength is to be determined by neutralisation with an alkali just as is now done. Hahnemann complains in various passages of the un- trustworthiness of pharmaceutical preparations, e.g., p. 317, " which no conscientious doctor could prescribe," or, p. 316, " on what can a doctor rely ? " Owing to the extreme care he employed in his labours Hahnemann discovered and published in this work much new matter. White lead was looked upon as a combina- tion of vinegar and lead, because it was prepared by means of vinegar. Hahnemann found that carbonic acid was the essential constituent, and he determined its proportion in 100 parts. In 1784, in Demachy's Laborant (II. 198) Hahnemann did not attribute the film formed by carbonic acid in solutions of sugar of lead to its true cause, but it did not escape his notice. In the treatise on arsenic (p. 288) he was already aware of it, in opposition to other chemists, who falsely attributed it to an arsenical reaction, and even then he pronounced sugar of lead to be a good test for car- bonic acid. He was the first to show that the long known white lead was nothing else than the combination of lead and carbonic acid. Later chemists, as Monro* and Pro- Translated by Hahnemann, I., p. 214. ill Chemical researcJi. 23 fessor Gren,* do not yet know the presence of carbonic acid in white lead. Scheele had declared that the black colour of lunar caustic, which at that time was always black when used, depended on the presence of copper.f Hahnemann showed that the blackness of lunar caustic depended on deficiency of acid, which had evaporated with heat. On p. 274, Hahnemann gives an incomplete, but, for that time, not unimportant method for the detection of Glauber salt in Epsom salts, an adulteration which was then almost universal. He precipitated the whole of the magnesia by boiling with lime water ; Glauber salt remained in solution, and showed the sulphuric acid reaction. The crystalliza- tion of Glauber salt in such a manner that its crystals were of the same size as those of Epsom salt, was a special industry. Some, e.g., Monro, still considered both salts identical. Hahnemann's method of distinguishing them is especially commended in Crell's AnnalenX Further on (p. 283) Hahnemann gives a carefully de- scribed method for refining saltpetre founded on the different solubility of saltpetre and common salt in cold and hot water. This method is still practised. He is opposed to the usual method of preparing tartar emetic, and thinks that it should be obtained by means of crystal- lization, as Bergmann and Lassone had already recom- mended. Tartar emetic used then to be prepared in very different ways, and this difference affected the quality of its preparations. Bergmann's method up to Hahnemann's time lay hidden among a great number of other methods. Monro complained (I. 310) that "three grains of one kind of preparation are often as strong as six or seven of another." Hufeland proposed in 1795 (eight years after the appearance of Hahnemann's book), in Tromms- dorff's Joiwnal der Phavmacie^ that since the prepara- tions of tartar emetic were of such different strength, * Ha7idbuch der Pharmacologic. Halle, 1792, II., p. 274. t Crell's Annalen, 1784, II., p. 124. X 1791, II., p. 30, note.. § Vol. III., St. 2, p. 83. 24 Crystallization of Tartar emetic. it would be better to obtain it from one source in the capital as had before been done in the case of theriac and mithridate. As early as 1784* Hahnemann advocated the crystalli- zation of tartar emetic, " so that we may at last obtain a trustworthy standard of the strength of this remedy for medical use," If his suggestion of crystallizing had been followed in 1784, the subsequent complaints would not have been heard. This remedy is now obtained from algaroth powder by means of crystallization, as Hahne- mann recommended. In other passages he calls attention to the importance of crystallization and advises chemists to buy, if possible, crystallized and not powdered salts, because adulteration can be more easily detected in the former case. Hahnemann advocated the preparation of drugs by the physician himself, in all cases in which the detection of adulteration was not easy. This work was thus criticized : " This book does not need any special recommendation ; from the quotations already given every doctor and apothecary will recognise its importance and indispensable character."! Professor Baldingerl earnestly recommends the work : " This book is extremely important and indispensable to every medical practitioner, but still more so to every physicus whose duty it is to examine the apothecaries' pharmacies There is a great deal of valuable matter in this important and indis- pensable work, and I cannot too strongly recommend it." Eleven years later, in Tromsdorff s Journal der PJiarviacie, the work was recommended to apothecaries who wished for information concerning their wares.§ In the same work Hahnemann first explained his so- called " Wine Test'' ; he gave further details about his discovery in Crell's Annalen.\\ * Demachy's Laborant, II., pp. 118 and 119. + A'eue inedicinsche Litteratiir^ v. Schlegel and Arnemann, Leipzig, 1788, Vol. I., St. 3, p. 34. X Medicmisches Journal^ ^7^9: St. 21, p. jj. § 1798, Vol. v., St. 2, p. 272. II 1788, I., St. 4, pp. 291—306. HaJincnianiis Wine Test. 25 Wine was not unfrequently sweetened by means of sugar of lead, which was supposed to cause not only colics and cramps, but also emaciation and a languishing death. The feeling was, therefore, very strong against the adulterators and they were severely punished. The ordinary test for the detection of lead used in most countries was the " Wirtemberg Wine Test," known since 1707. This was made by boiling or digesting two parts of orpiment (arsenious sulphide), four parts of unslaked lime in twelve parts of water. " Arsenical hepar sulphuris " was thus obtained and added to the wine ; a dark precipi- tate testified against the wine merchant. The lead present caused a turbidity, but so did other metals, e.g., iron. If there was any abnormal amount of iron in the wine as was possible through an iron tool or a piece of chain remaining in the vessel after cleansing, or if the nails projecting in the inside of the cask had been partially dissolved by the acid in the wine, the wine dealer would be unjustly con- demned by this method of investigation. Hahnemann gives an instance in which a certain wine dealer, of the name of Longo, was exposed to a severe exam- ination and heavy costs, and lost his means of livelijiood because there was a precipitate when his wine was tested by the Wirtemberg wine test. Two chemists succeeded after a thorough investigation in proving that there was not a trace of lead, but that there was some iron in the wine. Such errors occurred frequently. A simple test zuas zvmiting by means of which iron might be distinguished from lead in solution, and also all metals in solution from one another. On a subsequent occasion when a large number of wine dealers were to be tried by the Wirtemberg test, Hahnemann determined to make experiments in order to discover a better one. Very carefully observing the degrees of temperature and the conditions of quantity and solubility, he instituted a series of investigations with the substances which caused a precipitation of lead from its solutions and the limits of reaction in order to ascertain the most delicate test. Finally he chose " water saturated with sulphuretted hydrogen 26 HaJinemann's Wine Test gas," which he already knew from his investigations on arsenic to be the best test for metals. Hahnemann took two ounces of wine in which -^^ of a grain of sugar of lead was dissolved and poured two teaspoonfuls of sulphuretted hydrogen solution into it ; the fluid became of a brownish yellow colour. Four drops of sulphuric acid not only did not remove, but deepened the colour. Then he applied the same test to a corresponding solu- tion of sulphate of iron. An " olive green colour with a bluish tinge " was produced, distinctly darker than in the former experiment, but in this case a drop of sulphuric acid removed all the colour immediately, " the wine regains its natural clearness and former appearance." He further ascertained how concentrated the iron solution might be, and yet not interfere with the re-solution of the precipitate of sulphide of iron on the addition of the smallest quantity of sulphuric acid. Other acids had the same effect as sulphuric acid in iron solutions, varying in strength from I in 30,000 to I in lOO. Hahnemann made further investi- gations which we cannot here describe, and arrived at the following important discovery : Acidulated sidpJmretted hydrogen zvater precipitates arsenic, lead, antimony, silver, ■niercury, copper, tin or bismuth, present in a suspected fltiid. (Platina, gold, cadmium, are therefore the only important metals omitted). By the addition of the acid, metals of the iron group in the fluid to be tested remained in solution. This fact was only known by him at first in the case of iron, but it is now well known that nickel, cobalt, chrome, alumina, uranium, manganese and zinc share the same property. This is a great chemical discovery, pregnant with im- portant consequences, which has spread Hahnemann's name far and wide. Hahnemann first applied it to the examination of wine in the following terms : " TJie lead test is acidulated i^'ater saturated with stdphuretted hydrogeny He advised the preparation of sulphuretted hydrogen gas from hepar sulphuris calcareum in order that it might always be freshly made without difficulty. " Dry hepar is pre- pared by keeping at a white heat for twelve minutes a a Test for Metals, 27 mixture of equal portions of oyster shells and sulphur, both in powder. The whitish grey powder obtained is our hepar which can be kept unaltered for years in a properly closed glass bottle, and does not become damp — an advantage which renders it more useful for our purpose than any other hepars." He took two drachms of this and shook it up in a bottle for ten minutes with a pound of water and added ten drops of muriatic acid for every ounce. This acidulated wine test was freshly prepared each time. Now-a-days the muriatic acid is added to the fluid under investigation, which amounts to the same thing. On the application of this test iron remained in solution in the suspected fluid, while lead fell as a blackish precipitate, and the innocent wine dealers were saved ! This is " Hahnemann's Wine Test " — a designation which is too narrow and must give rise to misunder- standings. Our opponents are constantly assuring the public that Hahnemann's test has long fallen into disuse. On the contrary ! It is used every day and is indispensable in every laboratory, though it is no longer necessary in the analysis of wine. It ought not to be called " Hahnemann's wine test," but " Hahnemann's test for metals'' — the analysis with sulphuretted hydrogen water to an acid solution. After Hahnemann's discovery, or as Crell* states at most simultaneously with it, sulphuretted hydrogen was re- commended in France as a test for wine by the celebrated chemist Fourcroy. In the following year, 1789!, it is stated in an extract from the y4/^7;,7/^i- <^^ ^'//zV/^zV, that lead could be detected by this new substance in a solution of i to 1,000. Hahnemann had detected it in the proportion I to 30,000, i.e., in a degree of thirty times greater dilution. His addition of an acid, of which the French knew nothing, brought about this result. The advantages of Hahne- mann's discovery could not be placed in a more favourable light than by a contrast with the French test of lead, des- * L.c, 1788, I., 301. t n., 549- 28 Hahnemann in Advance of cribed in Crcll's Annalen* Three of the foremost French chemists, Thourct, Lavoisier and Fourcroy, propose an arsenicated liver of sulphur, such as had long been found quite inadequate in Germany. The directions for ascer- taining the quantity present are very circumstantial. Forty to sixty pounds of wine are evaporated to dryness ; a furnace is necessary in order to obtain lead in the metallic form ; a part is reduced to ashes, various salts are required, &c. Finally, " in order to be quite sure," this and that must be done. " These experiments must be repeated and comparisons instituted with good wines in order to be able to arrive at trustworthy conclusions." Hahnemann used hardly half a wine glassful of wine and one minute sufficed for a reliable qualitative investigation. He made a quantitative analysis by dropping in sulphuric acid into wine boiled to a fourth to eighth part of its bulk, by which means a sulphate of lead was precipitated. " The dried precipitate is weighed, the amount of sulphate of lead left in solution in the fluid is added, and the calculation is made; 143 grains of this precipitate (sulphate of lead) prove the presence of 100 grains of metallic lead, according to Bergmann. In twenty ounces of fluid one grain of sul- phate of lead remains in solution, which is to be included in the calculation." (The precipitated sulphate was of as little use here as in testing for arsenic, because it is de- composed by drying.) Afterwards he used cream of tartar wuth the addition of tartaric acid instead of muriatic acid ; but he soon returned to his original method. In 1788, Hahnemann discovered the solubility of such precipitates of metallic sulphates in boiling nitric acid. This process is now employed by chemists in order to dis- tinguish the metallic sulphides which are not soluble by alkaline sulphides (mercury, silver, bismuth, copper, cad- mium) from one another ; it is known that sulphide of mercury is not dissolved by heating with nitric acid, while the others are. * 1792, H., 455—461. Contemporary Chemistry. 29 Hahnemann soon turned his discovery to practical account. As early as 1787 he recommended this method for the detection of lead in various suspected liquids.* In Crell's Anuak]i-\-h.c says that chemists will find this method indispensable for the analysis of minerals. He thereby shows that he had realised the importance of his discovery. Recognition on the part of the chemists was not wanting. In 1789 the court physician, Scherf, of Detmold, states that it was intended to introduce Hahnemann's " wine test " in place of that in general use.:}: Professor Eschenbach, of Leipzig, writes in the same year :§ " Among the many new observations and investigations in chemistry, the test for wine invented by Dr. Hahnemann has especially pleased me. I have tried it, and it has fulfilled my expectations," &c. Other authors speak of " Hahnemann's excellent test for wine."]' The volume of Crell's Annalen, with Hahnemann's analysis of metals, was translated into EnglishlF — '' Hahne- mann's infallible test for wine."** " Most of our readers arc acquainted with Hahnemann's excellent test for wine."tt Investigations for the detection of metals by Hahnemann's method of analysis in judicial cases also are to be found in . various places. t| How widely known this was is best shown by the fact that ignorance of Hahnemann's test is quoted in Trommsdorff s Journal derPharmacieW as damning evidence of the incompetence of many apothecaries. " Certainly a proof of true knowledge !" remarks the narrator ironically. * Kennzeichen der Giite, &c., pp. 229, 252, 286. t 1794, I-, St. 2, p. III. X Crell's An?tale?i, 1789, II., p. 222. § lb., 1789, II., p. 516. II lb., 1792, I., p. 185. IF lb., 1793, I-,P- 188. ** lb., 1793, I., p. 246. ft !(>■, 1793, II., p. 124. tt lb., 1794, p- 567. Further: Salzburger Med. Chir. Ztg., 1794, I., p. 103 ; Trommsdorff's yirwr. d. PJiannacie, 1795, H-? St. i, p. 39 ; III.> St. I, p. 115 ; III., St. I, p. 312 ; 1797, v., St. I, p. 82 ; 1798, V., St. 2, p. 129, and in many other places. It was also mentioned in Scherf s Beitr. sum ArcJiiv der Med. Polizei, 1792, III., and in the Iiitelligenz- blatt der Allg. Lit. Ztg., 1793, No. 79. §§ 1795, II., St. I, p. 176 30 Hahnenianii's Soluble Mercury. Mercurius solubilis Hahncvianni. Chemists had long been searching for a preparation of mercury which was less corrosive and " poisonous " than sublimate, i.e., muriate of mercury or turbith mineral, i.e., basic sulphate of mercury.* Hahnemann shared in these endeavours to discover a milder preparation of mercurj^ In Demachy (II. p. 107) he expressed the opinion that a pre- cipitate of mercury from its solution in nitric acid by means of ammonia might be the least " corrosive " form of mercury. The Berlin Professor Neumann! had already dissolved mer- cury in nitric acid and had obtained a precipitate with am- monia, but this preparation had different properties, e.g., it was white, while Hahnemann's mercury was a velvety black. The Edinburgh pharmacopoeia^ contained a mercurius prsEcip. cinereus which was obtained from a solution in nitric acid by means of ammonia ; this, too, had different properties, besides being grey. Hahnemann mentions on the first publication of his mode of preparation,§ that besides Black's mercur. cinereus, Gervaise Ucay had used a precipitate similar to the soluble mercury in 1693. Hahnemann first dissolved the mercury in nitric acid in the cold. II The difference of the solubility of mercury in heat and cold was not as yet known to chemists. Professor Hildebrand even wrote in his exhaustive treatise " On the Solution of Mercury in Nitric Acid :"% " A saturated solu- tion can only take place with heat." Hahnemann tried to obtain pure metallic mercury from a solution of the sublimate by means of metallic iron. The mere mechanical process of refining by squeezing through leather did not content him. He dissolved mercury thus * Comp. Demachy's Laborant, II., p. 168; also Gren's Hattdbuch dcr Pharniakologie. Halle, 1792, II., p. 224. t L.c, II., p. 840. % Translated by Hahnemann, II., p. 246. § Unterricht fiir Wundiirztc abcr die vcncrisclicn Krankheitcn, 1789, Preface. II Crell's Atinalen, lygo, II., pp. 22—28 ; he here gives some modi- fications of the former mode of obtaining pure regains of mercury and the precipitant. ^ Crell's Annalcn, 1796, II., p. 299. Its excellence acknoivledged. 3 1 obtained by nitric acid in the cold, allowed the salt to crystallize, washed the crystals with a very small quantity of water, and dried them on blotting paper. He thus obtained a pure nitrate of the oxide of mercury. Here was a salt which is still retained in the German phar- macopoeia. Even Hahnemann's proportions, the constant excess of mercury, solution in the cold, washing the crystals with a very small quantity of water, drying on blotting paper, without heat, is retained, because all these details are recognised as essential. He treated these crystals with a certain quantity of water, and precipitated the solution by means of specially- prepared ammonia free from carbonic acid, for which he gives exact directions. The precipitate, after having stood six hours, forms a black paste, which is then dried without heat on a filter of white blotting paper. Hahnemann did not neglect to weigh the amount of the mercury obtained by means of sheet iron from the sub- limate. One part of sublimate contains 0.624 of mercury. Hahnemann says 0.634, which, considering the instruments then used, certainly shows the accuracy of his work. Professor Gren* wrote of this preparation : " The problem of Herr Macques, to obtain a preparation of mer- cury which is at once very soluble (in the acids present in the body according to the views and intentions of those days, here in acetic acid), and yet free from corro- sive properties, is fully solved by Herr Hahnemann's ' Mer- curius Solubilis.' " " According to my opinion, mere, solub. is to be preferred to mercurius dulcis " {ib. p. 267). He even wished this preparation to be used for making Ugt. Neapolit. {ib. p. 509), And Gren was no blind eulogist, as was shown by his previous attack on Hahnemann in the matter of his test for metals — a contest which was decided by Professor Gottling and others in Hahne- mann's favour.f Physicians considered that "science had to thank the well- * L.c, II., p. 224. t Salzb. Med. Chir. Ztg.^ 1794, I-, p. 103 ; also. Prof. A. N. Scherer in his Jour. d. Chcin., 1799, II., p. 402. 32 HaJuieinaniis ApotJiekerlexicon. known, and for this immortal, Hahnemann, for one of the most effectual and mildest preparations of mercury."* Kurt Sprengel, the historian : " Hahnemann's mercury,. an excellent and mild preparation, the usefulness of which has been proved."t We could fill many pages with the acknowledgments which Hahnemann received on account of his mercur}^ from non-homoeopathic doctors. Chemists, too, and among them the first of their profession, have written a great deal on the subject of this mercury, but have arrived at the con- clusion that chemically it is not an ideal preparation. Samuel Hahnenianiis ApotJiekerlexicon, published 1793—1799- " I have in this work endeavoured to describe all the simple remedies " — so he says in the introduction — " which have been in use from the beginning of this expiring century up to the most recent times, either ofificinally or otherwise, also those used only by a few physicians and some which have gained considerable repute as do- mestic remedies." He not only mentions the most efficacious and approved drugs — this is what ought to be done in every good pharma- copceia. In an "Apothecaries' Lexicon," the disused, the un- fashionable, and the little used remedies, as well as those that, are inactive, disgusting and superstitious must be included because a great deal may depend even upon these. " And is there not often a great deal of merit in the so-called antiquated remedies, some of which might certainly dispute the palm with many of our fashionable remedies ? From time to time these old remedies emerge from their obscurity. In such cases it is important both for the doctor and the apothecary to know what the ancients knew concerning these drugs. All this must be found in an Apothecaries' Dictionary." * Recepte ttnd Ktt?-artc/i dcr besicii Acrz/c allcr Zcitcn. Leipzig,. 1814, 2nd edit., IV., p. 24. t Geschichte der Arz}2cik. Halle, 1828, Part V., p. 591. Its originality and Excellence. 33 So much as to the scope of this great work. The subjects are arranged alphabetically and it treats of every- thing which could be of use to the apothecary in his work. The style is concise, lively and attractive. A careful description is given of the proper arrangement of a phar- macy and its various parts under the words " Apotheke" " Keller" " Trockenbodenl' " Laboratoriiun" &c. The neces- sary utensils too, are carefully described with full know- ledge of the subject. It is only necessary to read the articles on Evaporating Saucers {Abdanipfschalen) or Vessels {Gefdsse) or Oils {Dehle) to perceive the numerous suggestions derived from his great practical experience. Each of these articles shows how thoroughly well ac- quainted Hahnemann was with the subject, but every other article shows this in no less degree. He often describes new apparatus improved or invented by himself, illus- trating them by diagrams. The apothecary's business of making up prescriptions and his laboratory work are accurately and clearly described. Take for instance what is said under the head " Rc.'^epi.'" Here Hahnemann gives many directions which have now become legal enact- ments. How complete are the articles under the head- ings : Abdampfen (evaporation), Abgiessen (decantation), Abklaren (clarification), Auflosen (solution), Auslaugen (elixiviation), Auspressen (expression), and others in letter A alone. In the matters treated of, detailed instructions for the apothecary are given ; when we read under " Emul- sion," the various modes of making it from seeds, fats, resins and camphor, with gum Arabic, tragacanth, eggs, &c., or turn up " Distillation " or " Crystallization " we see the zeal with which Hahnemann must have worked, and the intelligent use to which he put his experience. The interest too that he displays in seemingly insig- nificant matters that can be of importance only to a man who has worked himself, shows how completely he was master of the subject. This is the case in his remarks on the lining with cement of furnaces (I. iii) on distilla- tion, in the directions for making apparatus that cannot be bought ; in his observations on the various kinds of fuel 34 Hahnemann's iuiprovements in for different purposes (I. 294), on reducing all sorts of substances to powder (II. i, 246), on the construction of the special crucibles required for different purposes (II. 2, 161) and various kinds of furnaces (II. i, 145, 150), &c. A number of Hahnemann's recommendations with regard to the supervision of apothecaries, have now been generally adopted, so too have his proposals regarding the regulation of the sale of poisons, distillation in vapour baths, the construction of tin vessels from pure tin, the inspissation by evaporation of extracts over water baths (I. 223), the distillation of ethereal oils in the steam bath (II. I, 152), the preservation of odoriferous substances, of plants, e.g., valerian, hemlock, &c., in tinned boxes (I. 338 and 411); the necessity of a herbarium in every chemist's shop for instruction and for the purpose of aiding their proper collection (II. 2.1 15). In the case of remedies belonging to the vegetable kingdom, he gives not only their botanical description, but their habitat (II. 2. 115, 119), their time of flowering, the time for collecting the parts useful medicinally, and refers to works containing plates — this he does too with regard to the animals mentioned. The literature here referred to proves how thoroughly Hahnemann had studied the subject. Among the works mentioned are those of the first botanists and zoologists, such as Buffon, Pallas, Dryander, Regnault, Scopoli, Jussieu, Linnaeus, Slaone, Gleditisch, Haller, Bauhin, Rumpf, Kampf, Tabernae- montanus, Tournefort, &c., &c., more than lOO works in different languages, including the most recent books of travel. By his recommendation not to boil the extracts of narcotic plants, but to evaporate them over water baths, he deserves the credit of having contributed largely to the introduction of these important medicines. The advice of Professor Neumann* had been followed only two generally " to boil freely in making extracts, since boiling for a <:onsiderable time with a large amount of water, is the best * Medic. Chciiiii\ I., 661. PJiaymaccHtical Preparations. 35 corrective of too powerful medicaments." Professor Hecker admitted that " the directions given by Herr Hahnemann for the preparation of narcotic plants are the best that we have."* Wc should here remind our readers of Hahnemann's mode of preparing tinctures from fresh plants, which was justly considered to have enriched our therapeutic thesaurus medicaminum.t The chemical part is treated in the same spirit. There is everywhere thoroughness without diffuseness; compare for example the articles on mercury, antimony, phos- phorus, potash, ammonia, sulphur, &c. He gives the history of many important preparations, e.g., sulphuric acid, tartar emetic, phosphorus, sal-ammoniac, &c., at the same time without overlooking the latest achievements of chemistry. In order that medicines should be of a definite character, he insisted upon them being of a fixed specific gravity if they were fluids, as in the case of ammonia, of diluted acids (H. 2.363) and of alcohol. In order to be able to obtain good preparations, the apothecary is to pay attention to the habitat of the plants, if possible to collect them himself and to make the more delicate chemical preparations himself, since this trouble will be compensated for by the good quality of the articles. In the case of a good many medicines he briefly describes their medicinal use. On this subject he writes in the preface : " By mentioning in the case of simple drugs their principal uses and their medicinal properties, I am departing from the practice of many recent authors who omit this as though such information were useless or even injurious to the apothecary, because it favours the practice of counter-prescribing. A short notice of the uses of drugs could not be the means of causing apothe- caries who had a proper sense of the dignity of the calling * Hufeland'syi£?«^'«., 1800, Vol IX., St. 2, p. 83. t Buchholz, Tasckenbtich fur ScJicidekunstler imd ApoiJicker, 1815, p. 57. J. R. Bischoff, Ansichten ixbcr das bisJier. Heilverfahren., &c. Prague, 1819, p. 121. 36 Laudatory reviews of to indulge in unauthorized practice ; they have it in their power to earn far greater renown by faithfully performing their duty. They would not degrade the position of the apothecary upon whose integrity depends life and health, and by whose knowledge should be formed the weapons by means of which the shattered machinery of the human body is restored, to that of an ignorant quack who is as much beneath him as a pestilent bog is beneath the beneficent sun. " Such a short indication of the uses of drugs cannot give rise to dabbling in medicine. If they read that powdered oyster-shells relieves acidity of the stomach, this does not tell them when such acidity of the stomach is present, or by what morbid symptoms it is manifested. " But a short notice of the use of a drug is useful to the apothecary, since he will be much more likely to remem- ber the dry description of the remedy if it be impressed on his memory through its medical properties, whereby it ceases to be indifferent to him, but on the contrary, becomes more interesting and worthy of his attention. Things, the use of which we do not know are indifferent to us, they interest us as little as the mere letters of a word, the sense of which we have forgotten. Only an indication of their utility, whether real or imaginary, gives us an interest in the otherwise useless knowledge of their history, which now acquires life, substance and interest," The Apothekerlexicon appeared in numbers and was thus noticed by the Medicimsch-cliirurgiscJie Journal* " The author has written a work which is of great use to the practical apothecary, and even to the physician. It com- pares favourably with other similar works and enables us to dispense entirely with Fiedler's ApotJiekei'lcxicon. This work is not a mere compilation, but it contains many new ideas, hints and valuable improvements. Some articles are especially good (examples are given). If all apothecaries would attend to what the author says \\ith regard to the extracts (especially of the narcotic plants), * 179.3, HI,, i;!"! Hahnemann' s Pharmaceutical methods. 37 many practitioners would obtain successful results from their employment and would no longer doubt the efficacy of these remedies. The reviewer ardently desires the continua- tion of this work." A distilling apparatus invented by Hahnemann is then spoken of With regard to the next number, complaint* is made that Hahnemann had introduced many disused drugs, and that some articles were inferior. Hahnemann completely refutes these criticisms in a reply he made,-f " Neverthe- less some of the articles are very well done, and the reviewer would pronounce the whole work excellent if they were all equally so. Everything the author says on the subject of fermentation and poisons is to the purpose and convincing." Apropos oi 'CiXQ next number the reviewer writes (i799) n. 411) : "A work of this kind by a man who has made himself a name in Germany, both as a chemist and as a practitioner, deserves especial recommendation. Especially excellent articles in this number are those on the laboratory, precipitation, furnaces, oils, pills, modes of preparation. In the article on phosphoric acid, the author gives a new method, peculiar to himself, of obtaining phosphoric acid and from it phosphorus. Every article gives evidence of having been written with the greatest care." Trommsdorff, Professor in the University of Erfurt, thus criticises the work in his Journal der Pharinacie : ^ " An ex- cellent work which every apothecary ought to procure. Brevity, lucidity, decision and yet completeness, seem as far as we can judge from this first part to distinguish this work from all others of a similar character. (Certain articles are then discussed.) We see from these few extracts that this work is not a compilation of an ordinary character. In examining the work more closely we can find very much new and important matter, and every page shows that the well informed author speaks from experience. We refer our readers to the articles : evaporation, evaporating 1796, I., p. 393. t Z'^., IV., p. 15- X 1794, H-, St. I., p. 185. 38 Hahnemann's services to vessels, clarification, separation glasses, decoction, phar- macies, elixiviation, tartar emetic, distillation, extracts. We only hope that what is said by the author in these articles will be laid to heart. We recommend this work to our readers, and we wish the author leisure and continued health for the completing of this important work, which will be of great service to pharmacy." The critic writes thus of its continuation : * " We present with sincere pleasure to our readers the continuation of this useful work which every apothecary ought to obtain. Some of the articles are extremely well written." As an example, the reviewer quotes the article on " poisons " ver- batim. " Some of the other articles are equally good, and we may, therefore, expect that this work will diffuse much useful information." We hope that this account of some of Hahnemann's works will suffice to give at least a superficial view of his services. Those who wish to understand his mental atti- tude must make themselves acquainted with the litera- ture of the day on the subjects, and then read and study Hahnemann's works ; no one will put them down dis- satisfied and without paying a tribute to his brilliant intellect. He shares with the rest of mankind the fault of having been occasionally in error. All who strive to achieve great things are liable to occasional error. In judging his powers of observation and his accomplish- ments we must not forget that he — a busy practitioner and a private man — had to contend with the foremost apothe- caries, whose calling made a laboratory and chemical investigations a necessity, and with the professors of chem- istry, who obtained pecuniary assistance from the State ; and that he not only showed himself equal to these pro- fessionals, but surpassed most of them in knowledge of the subjects as in the services he rendered. * 1796 III. 2.359 the Manufacture of Chemicals. 39 Finally we quote some more of the reviews of some of his works, and we will also cite the recognition he received from professionals (further on we give a list of all Hahne- mann's works). His translation of Demachy's Liqiieiitfabr leant was inci- dentally mentioned by Westrumb* in an essay on the distillation of brandy. " Few manufacturers have listened to my suggestions to arrange their retorts as Demachy and Hahnemann describe. These writers increased the height of the distillery vessel, gave to the helmet the form of a sugar loaf, provided it with a tube and surrounded it with a Turk's head. They thus saved half the time that would have otherwise been expended, a third of the materials and obtained considerably more brandy (spirit). Distillers should entirely reject the old distillery apparatus and should use the French arrangement clearly described by Hahne- mann." Government should insist on the use of pit coal, "against which there is a deeply rooted prejudice." Hahnemann translated Demachy's Art of manufac- tnring vinegar., in 1787. The Neue MedieiniscJie Literatur\ says : " Compared with the many wretched descriptions of the way to construct vinegar manufactories, Demachy's essay deserves commendation, and is worth being trans- lated into German, especially as Herr Hahnemann has set his author right in many points, flahnemann has taken the opportunity to correct the mistakes in instructive notes. Herr Hahnemann's appendix on the manufacture of vinegar, particularly that from grain is both thorough and clear." The Economic Association of Florence, in 1785, pro- posed as a prize question, " the discovery of the theory of vinous fermentation, as also the description of a method adapted to the capacity of country folks of examining must, in order to treat it in a rational manner by the light of this examination." Fabbroni won the prize and Hahnemann translated the essay, The art of making- wine in accordance zvitJi rational principles, which had * Crell's A}tJiale?t, 1792, I., 490. t Of Schlegel and Arnemann, Leipzig, 17S8, pp. 56 — 59. 40 His translations of Monro and been warmly received in Italy in 1790. In Crell's Annalen (1790 I. 562) is mentioned "the well merited applause," which this work had received on account of its lucid investigation of the process of fermentation. " A trans- lation was all the more desirable, and for this we are indebted to a man who has conferred so many benefits on science, both by his own works and by his valuable translations. Besides the fact that this translation is faithful and successful, Herr Hahnemann has added precious notes which expand and elucidate Fabbroni's principles ; he has thus enhanced the value of the work." Hahnemann's translation of De La Metherie On Pure Air was thus announced by Professor Crell : " All German physicists have cause to anticipate eagerly the translation which we may shortly expect from such a chemist as Hahnemann, a translation which he has enriched with his own notes."* The appearance of the translation was thus welcomed :t " No one will doubt that this wish is realised when we name the translator, who will certainly allow us to do so though he has not given his name himself. It is Dr. Hahnemann, a man who has rendered many services to science both by his own writings on chemistry and by his excellent translations of important foreign works. His services have been already recognised, but deserve to be still more so." The translation of Monro's ]\Iateria JMedica, was thus reviewed in Crell's CJiemiscJie Annalen (1792, 11. 183) : "A translation of this work was very much wanted Herr Hahnemann has added a great many explanatory and sup- plementary remarks which give the translation a great ad- vantage over the original Hahnemann's excellent wine test his excellent soluble mercury his suggestion of obtaining tartar emetic by crystallization, etc., etc. By the thoroughness of his emendations Herr Hahnemann has deserved anew the gratitude of the class who will read this book." * Chcm. Annal., 1790, I., p. 85. f //'. 1792, I., p. 475. tJie Edinburgh Dispensatory. 41 After the appearance of the translation of the Ediii- burgh Dispensatory, the Medicin. cJiir. Journal wrote (1799, I. 154): "Hahnemann has displayed much industry in editing this work and translating it into our language. His notes are short and not numerous, but they serve to explain the text from a chemical, pharmaceutical and practical point of view." In ll\xie.\din7- f K. .Sprengel, Geschichtc dcr Hcilkundc. Halle, 1828, V. I., p. 455 X First edition of his System dcr A'niurphilosop/iie., Jena u. Leipzig- 1799. ScJielling and Steffens. 47 distanced all inferior conceptions. It grappled with and explained all phenomena by the absolute. We may form some conception of its influence on medicine by read- ing the following sentences : " The mouth masticates and the stomach digests by the same process of vegetation ; the difference of these phenomena is only the result of their different mechanism." " Living matter is a print or picture of absolute nature ; and, again, absolute nature her- self is absolute life, and the prototype of the organism." " Life is cause ; phenomenon and existence are its results. Life as cause is immortal, for immortal cause is life." " Life is the infinite, disease the finite, and the cure is to be considered as the synthesis of both (the third power)." " Contagion is the magnetic moment of the dynamic pro- cess reigning in the organism." After the statement that the essence lay in the conception of the magnet, " which is connected with the identical pole," it is further said : " Only in this way do we get a true idea of contagion, and come to a true explanation of this long misunder- stood process."''* One of the most prominent natural philosophers was Henrich Steffens, " a deep and scientific thinker."-f- \\\ Oken's periodical, his (1822, p. 123), he is put on a level with Aristotle, Humboldt, Goethe, Treviranus, Oken, and others. He wrote a book, Elements of Natural Philosophy, Berlin, 1806. This work was "a spring- out of which arose a series of philosophical works," and gave the following information, pages 189- 191 : " Feeling is the identity of external oscillation and internal being, con- sequently, identity of the nervous and muscular systems. Unity of the internal factor and difference of the external gives sensation ; difference of the internal and unity of the external sensation of warmth. " Hearing is the identity of the relative anorganic of the organization and its internal being ; consequently, identit}- of the nervous and osseous systems. " Hunger is internal tension of the assimilation under Comp. Hecker, Lc. f Hecker's Annalen, II., p. y-^-^. 48 Influence of Natural PJiilosopJiy. the influence of the mass opposed to external, hence the feehng of hunger at the cardiac orifice of the stomach." And further, page i86 : " Animahzation is identical with the internal becoming objectiv'e. The manifestation of the internal is sensation. There is no animahzation without sensation. Sensation under the influence of the universal is feeling ; sensation under the influence of individuality is consciousness." Steffens dedicated his work to the " Delphic Temple of Higher Poetry," and in fact most of these persons moved almost entirely in the higher regions of the clouds, and the human being with whom their investigations had to do remained on the earth, but they up there enjoyed a heavenly existence. They were far above all controversy. "True natural philosophy," says Steffens, "puts an end to all contradiction and all controversy of opinions and hypothe- ses with other opinions and hypotheses, and can, therefore, have no opponent." " A true saying," remarks a critic* True natural philosophy knew everything and explained everything. "Natural philosophy has the priority of know- ledge, for it is the knowledge of knowledge, and must be regarded as potentized knowledge."! It is astonishing the assurance with which every pheno- menon was explained without hesitation, " Magnetism is the conversion of oxygen and hydrogen into carbon and nitrogen," says Steffens, page 91, and Schelling knew| that oxygen is the principle of electricity. The whirligig of Natural Philosophy took possession of the heads of the majority of German savants and the most prominent physicians. Very few escaped it, as Hufeland, A. V. Humboldt, Blumenbach, Treviranus, Sommering, We- dekind. There was, however, no system which could be generally followed. There were, indeed, men who knew the direction the medical accessory sciences should take, but they could not obtain a hearing because they were suffering from the spirit of the age. * Heckers Amialen^ II., p. 444. f Steffens, /.r., p. 16. % L.c, p. 24S. spontaneous Covibustion. 49 Rei], in his doctrine of fevers and in his Archiv fiir Physiologie, brought prominently forward the doctrine that disease was not to be conceived as a foreign thing, but depended upon the altered form and composition of the animal substance ; health also depended upon certain rules of form and composition. Disease was departure from normal form and composition, that is, anatomical and chemical change. In what condition was physiological chemistry in those days ? To what conclusions did its appreciation lead ? Let us take an instance from the advanced year 1810 : About this time a book which had newly appeared entitled The Complete Description and Exaininaiiofi of Sponta- neous Combustion was reviewed in Hecker's Annalen.^ "This disease manifests itself," so it says, "by the sudden ignition of the human organism and its combustion with the appearance of flames, so that only ashes or coal, in one case only a spot of grease remained of the whole body.""f We are chiefly interested in the chemical explanation of this phenomenon as given in the work quoted : 1. "The whole body of the consumed persons was pene- trated through all its cells by hydrogen gas, at least in sufficient quantities to suffice for its first ignition and the maintenance of the fire." 2. " An excess of other inflammable matters, as sulphur and phosphorus, was simultaneously present." 3. " The body, thus in a high degree inflammable, was not ignited by external fire, but by an electric explosion in its interior ; the electric spark quickly permeated the body filled with inflammable matter." On this Hecker remarks : " This theory of spontaneous combustion is certainly as satisfactory a one as can be given in the present state of our knowledge and with the imperfectly observed facts." * n., p. 547. t Comp. Justus Liebig 07t the Spo7ttaneous Combustion of the Humaji Body, Heidelberg, 1850, p. 31. By this work the ghosts of forty-eight spontaneous combustions were laid. 50 Views about the Blood. A. von Humboldt with others opposed the " disease- matter " theory. " Disease-matter is really the whole living matter itself, so far as its form and composition are changed and the balance of its elements is disturbed."* Medical men were too impatient to utilise this theory, they w^anted to reap when they had barely finished sowing. The im- mense progress made by chemistry through the discoveries of Lavoisier, especially the newly discovered knowledge of the significance of oxygen, caused researchers to utilise this advance also for medicine. So, according to Humboldt (/.c), want or excess of oxygen is the proximate cause of disease, " because oxygen combines with phosphorus, sulphur, nitrogen, carbon and hydrogen, and produces acids which diminish the energy of the nerves, thereby deranging the functions of the secreting organs." In Hum- boldt's famous work, which was abreast of the knowledge of the day, we read that hydrogen is contained in plumbago and similar views. Although Humboldt opposed the " disease-matter " and " acid-acridities " theories, he never- theless held that " an acid is at work in the production of scrofula," and with Haller discussed the question " whether in convulsions alkaline or acid acridities w^ere irritating the spinal marrow."-f- It was indeed very tempting to utilise the great chemical discoveries in the treatment of disease. About the middle of the eighteenth century Haller thus described the blood : " The blood consists of equal parts, is coagulable and all the redder the better the animal is nourished ; in a weak hungry animal it is yellowish. The white sometimes mixed with it generally comes from the chyle." In 1789, about thirty years later, J. F. Blumenbach, the famous Gottingen professor, teaches : ^ " Blood is a peculiar fluid of a well-known colour, sometimes lighter, sometimes darker, viscid to the touch and warm, and as it cannot be * Versuche uber die gereizte Miiskel und NcrZ'C7ifaser 7icbst Vermu- thungen ilber dc7t chcin. Process dcs Lebens. Posen and Berlin, 1797, n., p. 359- t lb., II., pp. 360 and 379. X Anfangsgiimde der Physiologic Vienna, 1789, § 6. CJieniical treatment of Disease. 5 1 imitated by art, it must be considered as one of the secrets of nature." In all this time no progress seemed to have been made. In 1803 this was taught:* "Blood consists of nine ingredients : odoriferous matter,fibrinous parts, albumen, sulphur, gelatine, iron, potash, soda, and lastly water the elements of the blood are : hydrogen, carbon, potas- sium, chlorine, phosphorus, sulphur, oxygen, calcium and iron." Thus physiological chemistry had made great progress, and this excited so much admiration that an attempt was made to utilise these discoveries. Garnett recommended sulphuret of potash, sulphate of lime and wood charcoal, in consumption. The sulphuret of potash produced sul- phuretted hydrogen, the hydrogen of this combined with the oxygen of the blood and the inflammatory action of the latter was paralysed. J. J. Busch recommends sul- phur and hepar sulphuris in pulmonary consumption ; this produced " a mephitic vapour " in the ulcerated lung, and thereby impeded the destructive action of the oxygen. Girtanner, of Gottingen, followed in the wake of the Eng- lishman Beddoes, in whose method of treatment various gases, nitrogen, hydrogen, &c., were inhaled by means of a special apparatus (an improvement of Menzies's) as a remedy for phthisis, the process being minutely described and illustrated in Hufeland's Journal, 1795, I., p. 199. Others prescribed chlorate of potash in scurvy, syphilis and nervous fever, in order that the oxygen of this salt might be liberated in the body. Alkalies were recommended in dysentery to extinguish the " septic acids ;" carbonate of potash was indicated in puerperal fever to neutralise the " excessive acidity " which was the cause of this complaint. In diabetes, oxygen preponderated ; " all the fluids of the body were saturated with oxygen." Hence the good effects of an animal diet, of milk, of meat, of sulphuretted hy- drogen and of limewater. * F. Kapp, System. Darstellung dcr dierch die neuere Cheinie in der Heilkunde beiuirkten Vcrdnderungeti und Verbesserungen. Hof, 1805, P- 31- 52 Nature of Electricity. Reich considered oxygen the only sure remedy for the febrile state, which he considered dependent upon the un- due development and accumulation of nitrogen, carbon, hydrogen, sulphur, and phosphorus. He was professor of medicine in Erlangen and Berlin ; in various journals, and in a special work,* he recommended a secret remedy for fever which he would only reveal for a large sum of money. This remedy would in a short time, or even at once, cut short a fever. A committee of four doctors instituted ex- periments in the Berlin Charite Hospital, and considered its action proved in a number of cases. After the report of this commission the professor was decreed " an annual pension of 500 thalers, free of tax and stamp duty" by the King of Prussia for the publication of his secret ; in case of his death half of it went to his widow.! This became known before the great remedy against fever was revealed and it was eagerly awaited. Curiosity was at length gratified in the autumn of 1800, It consisted of sulphuric and muriatic acid ; nitric acid was also good in certain conditions.! Baumes, Girtanner and other others founded a system. Most diseases were explained and cured in a chemical way. They arose from excess or want of oxygen, hy- drogen, nitrogen and phosphorus. Accordingly there were " oxygenous " remedies : — antimony, mercury, iron, lead, gold, silver, cinchona, acids, camphor, ether, alcohol, nar- cotics — " hydrogenous " remedies : oleagineous bodies, se- dentary habits, fat meat, fish — " nitrogenous " remedies : meat, and " deoxidizing " agents ; lastly, " phosphoric " re- medies : fish, phosphates of lime and soda, phosphoric acid. Electricity was treated in a similar manner. According to Schelling, as has been said, oxygen was " the principle of electricity." Juch was quite certain that oxygen played the chief role in electricity, while Erxleben considered it to con- * G. C. Reich, Beschreibitng der Diit set7ien 7ieuen Mittd behandelten Krcmkheitsfdlle. Niirnberg, 1800. t Med. Chir. Ztg. Salzburg, 1800, III., 315. X lb., 1799, IV., 189 ; 1800, I., 25, and IV. 292.J Instability of Medical TJieoTies. 53 sist of oxygen, hydrogen and heat. Lciner beHcved it to be composed of hydrogen and oxygen.* These various views and systems, and other ones besides, reigned almost simultaneously in Germany at the end of the last and the beginning of this century. And even if one theory was superseded by another, still something of each stuck in people's heads. Each tried to discover what best suited his views. Many went over from one theory to another. Wedekind,t ex-professor of clinical medicine at Mainz, thus pictures a doctor of that period : " I know a physician who at one time adopted the heating and sweating method. How much essentia alexipharmica, mis- tura simplex and composita Stahlii did he not daily pre- scribe ! He was also a great partisan of bleeding, and I do not doubt that he often by it counteracted the baneful effects of his heating remedies and vice versa. But the triumvirate of Boerhaave, Stahl and Fr. Hoffmann was drawing to an end. Tissot had become the leading autho- rity. Our practitioner now advocated the cooling method. Tamarinds, cream of tartar, saltpetre, oxymel, and barley- water were his favourite remedies. He forbade healthy people to smoke, because Tissot had asserted that all to- bacco-smokers must die in tJieir prime of apoplexy. " When Stoll became the leading authority among physi- cians, we find tartar emetic and ipecac, in most of their pre- scriptions. They were, of course, devoted to the administra- tion of clysters when Kampf wasin vogue. C. L. Hoffmann was called to occupy the place that had been held by this physician. Accustomed to follow the spirit of the age, they now exaggerated what this great thinker taught concerning antiseptic remedies. How can fashionable practitioners understand the meaning of an author ? Enough, our phy- sicians did not observe how the functions of their patients were carried on, in order to ascertain how far these were in- jurious or advantageous to the maintenance of the body, but they proceeded forthwith to cure every disease by means of antiseptics. A few years later Brown became dictator * Comp. Kapp. I.e. t Ueber den Werth dcr Heilkimde. Darmstadt, 18 12, p. 212. 54 Remedies made to fit Theories. in medicine, and ' Methodism ' ruled the fashion. Our practitioners now called those physicians who devoted them- selves to remedy vices in the fluids of the body, or to procure evacuation of depraved humors, murderers ; for to believe in such vices showed the greatest ignorance. Their practice was summed up in four words — sthenia, as- thenia, sthenic influence, asthenic vices. Very few of their prescriptions were without naptha, laudanum, ether, musk, or sal-ammoniac. They were now as much in favour of wine, brandy, and meat diet, as they had been against them at the time when Tissot was the ruling deity. Now they re- turned to purging in order to cure local affections, and tried to unite all these different modes of treatment. Therefore, they now refused to be called Brownians, and insisted upon being called eclectics." The therapeutic text-books for students and physicians were as variously coloured as maps. " Ontology," the idea that a disease is a foreign thing carrying on its evil ends in the system, has met with wide acceptance from the days of Galen. Hence the evacuant method was supreme. Further, there was a stimulating, a strengthening, a weaken- ing, a softening, an antagonistic, a restorative (not to be confounded with the strengthening), an astringent which increased the cohesion, a relaxing which diminished the cohesion, a derivative and a resolving method, and also a specific, antimiasmatic, antiseptic and antigastric method.* The various remedies were fitted on to these methods ; thus there were demulcent, diluent, dissolving, inspissat- ing, blood-cleansing, cooling, evacuating and expectorant, &c., drugs. To order a simple remedy was not the custom. We still find the idea that it is necessary that a prescription should contain a basis, a constituens, an adjuvans, a corrigens and a dirigens. Complex prescriptions contain- ing 8, lo, or more drugs were in daily use. There were so- called " magistral-formulas," complex mixtures composed by " authorities " as remedies for certain diseases, and * See Hufeland, System der prakt. Heilkunde. Jena, iSiS, and others. Antiphlogistic Treatment. 55 sanctioned by " experience." They were kept ready made by the apothecaries, and no one dared to alter them. These prescriptions were changed every day in acute diseases, in chronic every two or three days, as the cases reported in the medical journals show ; and what incredible quantities of drugs were poured into the sick man's body ! All the various systems out-did one another in this practice. The Brownians, e.g., gave in typhus fever, together with other remedies, 10 — 12 drops of opium every quarter of an hour till sleep was induced, when the dose was to be doubled, and was then to be gradually increased " till the health of the patient could be maintained by less powerful stimulants." In "indirect debility," 150 drops of laudanum, which means 0.70 grammes of pure opium, were to be given at once, and in the sequel the necessary doses gradually diminished till the desired result was attained. In difficult labours, the ordinary cause of which was recognised to be "weakness," the parturient woman, according to Brown, was to be supported with wine, and if the labour was tedious and difficult, with opium. Opium (later also cinchona) was with this school the best remedy in all diseases depending on weakness. There were physicians who, according to their own statement, prescribed several pounds of pure opium in the year, " Thousands of sick persons, and among them the most hopeful young subjects, were sacrificed to the rage for opium," as Hufeland said later.* Similar results were produced by the " antiphlogistic method," which was employed by many physicians in inflammations and inflammatory fevers. Bleeding, salt- petre, calomel in large doses till the teeth were loosened, and energetic salivation were the " matadors " of the anti- phlogistic school, supplemented often by evacuating agents, such as emetics and purgatives. Many physicians troubled themselves little about the local affection in " general de- bility;" for this they prescribed simply iron, cinchona, and * Hufeland's/tf?,tr«., XXXII., St. 2, p. 16. 56 Thcrapaitic Confusion. a number of other bitter drugs. There are few diseases in the treatment of which one can say that the physicians of that day did no harm. Pathological anatomy was little cultivated in Germany. The Brownians did not require it for their therapeutics. Those among the remainder who relied upon the results of post mortem examinations allowed themselves to be misled by crude conceptions. If they found congestion of blood in the organs, or even mortification, this confirmed the in- dication for bleeding and the other antiphlogistic means of treatment. Accumulations of bile, depraved humours and mucus, indicated the employment of evacuating agents. Exudations required derivatives, &c. Did physicians feel satisfied wath such a condition of the healing art? Most seemed satisfied with themselves. There were, however, severe critics who were not much better hands at treatment than the others. Marcus Herz, for instance, 1795 (in Hufeland's Jotinml); Girtanner, 1798;* Wedekind, 1812 (I.e.); Kieser, 1819,! and others. Girtanner, who helped to complete the confusion by spread- ing the Brownian and chemical theories, exclaims : "As the healing art has no fixed principles, as nothing is demon- strated clearly in it, as there is little certain and reliable experience in it, every physician has the right to follow his own opinion. When there is no question of real know- ledge, where everyone is only guessing, one opinion is as good as another. In the dense Egyptian darkness of ignorance in which physicians are groping their way, not even the faintest ray of light has penetrated by means of which they can steer their course, I don't care if anyone feels offended by what I say. My object is not to give offence, but to maintain the truth. If any practitioner is not satisfied with my opinions, let him examine his own conscience and ascertain of how many medical truths he is certain. He who can point out to me certainty in medicine may throw the first stone at me." * Ausfiihrliche Darstelliing des Browiischen Systems. Gottingen, 1798, II., pp. 608 — 610. t System der Mediciii. 1819. Professional Courtesies. 57 These critics, however, did not themselves see the deeper lying causes of this confusion. Physicians did not know how to observe. Instead of collecting only facts and draw- ing no further inferences from them than they warranted, they fastened upon single observations, made comparisons, created theories, and cooked the facts so as to suit these theories. The science of natural philosophy lent these speculations wings, and they were raised completely out of the regions of actuality into the blue ether. At the same time with the majority of physicians, the desire for knowledge was very limited. Many complaints were made of this. Professor Baldinger lamented that not only many physicians, but even many professors showed little zeal for study. " I know one professor of medicine, who will not admit more then nineteen books into his library. If a twentieth volume were dedicated to him, and sent to him carriage paid, bound in morocco, he at once sells it to the library of his university."* Of universities, indeed, there was no dearth ; at the end of the last and in the first decade of the present century there were not less than 40 universities where German was the language spoken, among which, however, only a part were able to provide their medical courses with clinical instruction. The state of professional amenity corresponded to the con- dition of medical knowledge. "A savage partisan spirit," writes Professor Roose, in i8o3,t "has taken possession of many minds and seems to be spreading universally. Physicians split into sects, every one of which embitters the others by violent and often unfounded contradiction, and so prevents all possibility of doing good. Dogmatism and a persecuting spirit are becoming commoner and commoner among physicians, and they are only distinguished from the dogmatism and persecution of enraged religious sects of former times by being fortunately powerless to arm the secular authorities with fire and sword arainst their adver- * Medic. Journ. v. Baldinger, 1790, St. 23, p. 16. t Horn's Arckiv f. med. Erf., III., p. i. 58 QiLar ill's influence on Hahnemann. sarics. If the spirit of the age permitted the establishment of a revealed medical art with us as with the Asiatics, there would undoubtedly be a Catholic and a Protestant confession, and there would not be wanting either a pope for the one or a chief pastor for the other." The more uncertain a physician feels of his own skill the more loudly he calls to the State for assistance against the quack and charlatan. It was so in those days. Wedekind {I.e., p. 38) describes a debate among physicians who es- poused the reigning opinions ; one of them shouted out : " The scientific physician will be ruined unless he is favoured in every way by the Government." A sad condition for the said " science " to be in, but which accounts for the embittered disputes related in the course of this work. HaJineinanrCs Services to Medicine. What instruction had Hahnemann in the art of medicine? It cannot be proved that any physician exercised a special influence over him and gave him a particular bent. He himself indeed speaks with great reverence of Quarin. He writes, in 1791, "I owe to him whatever there is of physi- cian in me." It nevertheless seems as if the feeling of a debt of gratitude to Quarin for favours received (see below) was not without influence in inducing him to make this statement. Freiherr von Quarin, born in 1733, was body physician to Maria Theresa and the Emperor Joseph ; he filled six times the post of rector of the university of Vienna, He died in 1812 of "debility." His medical works did not meet with general acceptance among the pro- fession.* Several of his worksf exist, which will well repay * " Under other auspices the General Hospital of Vienna would gain more," was said of Quarin in the Medic. Litteratiir fiir prakt. Aerzte, von Schlegel. Leipzig, 1787, XII., p. 99. f Heibnetliodc der Entzilndiingen. Aus d. Lat. von J. Zadig de Metza, Copenhagen, 1776. Hcilmethodc der Fiebe?: Aus d. Lat. vom Vorigen, Copenhagen, 1777. Aiiiniadversioncs practices in diversos vio7'bos^ II. vols., Vienna, 17S6. Praktische Bemerkimgenueberversch. Krankheiten. Aus d. Lat., Vienna. Dc curandis febribus et injlam- Hahnemann's first Medical Work. 59 careful study if we wish to decide how far Ouarin's influence over Hahnemann extended. That Ouarin was an advocate of bleeding till the day of his death (1812) appears certain. The first considerable medical work of Hahnemann ap- peared in 1784, Guide to the Radical Ctire of Old Sores and Fold UlcersT* Old ulcers of the leg and fistula; were specially meant. In the preface he says : — The majority of physicians would have nothing to do with them, but left them to the bath man, the shepherd and the hangman, more from ignorance than disgust. The fame of practising such heroic treatment smells much worse than the foetid discharge. The mode of treatment of ordinary physicians and surgeons consisted in " purification of the blood," bleeding, cupping, sweating and purging. The chief external remedies used were the lead preparations, especially lead ointments and plasters. Hahnemann even when a young physician seems to have been unaffected by the prevalent belief in authority. The finishing stroke to the treatment of such cases is generally given by old wives, the hangman, the farrier, the shepherd and death. For all that I am not too proud to confess that horse and cow doctors are frequently more successful, that is to say, more skilful in curing old sores than the most learned professor and member of all the academies. Let this not be denounced as mere empiricism ; I would like to possess their workmanlike expedients which are founded on experience, often, it is true, gained in the treatment of animals, but which I would willingly exchange for many medical folios, if they were to be had at that price. But, on the other hand, far be it from me to draw from them general rules for my treatment or to prefer irrational quackery to the well-considered medical theories deduced from the observations and experience of illustrious and honest men. I know the limits of both. The want of any principle for the discovery of the curative powers of drugs was even then a cause of com- plaint with him. Thus much, however, is true, and it may make us more modest, that almost all our knowledge of the curative powers of simple and inationibus^ Vienna, 1786. Ueber den Nutzen und Schadcn der In- secten. Ueber die VerscJiiedenheit der Salzeit.iJirenGebraucJi. Versuche tceber die Ciciita virosa. * Translated in Brit. Jour, of Hom.^ XLII., p. loi, et seq. 6o His love of Air and Exercise. natural as well as artificial substances is mainly derived from the rude and automatic procedures of the common people, and that the wise physician often draws conclusions from the effects of the so-called domestic remedies which are of inestimable importance to him, and their value leads him to adopt simple natural means to the great ad- vantage of his patients. I will spare my readers proofs of this. In pages 43 and 180, he alludes to several shepherds and quacks who were thoroughly rational and obtained good results. If we read this work we shall in many cases see Hahnemann's independent mode of excogitat- ing medical subjects. Naturally he still adhered to the old treatment. In women about the climacteric he still recommended bleeding, as he did in fever under certain circumstances and with caution (p. 79); he, however, blames the usual excessive blood-letting, and commends the action of cinchona in fever "even in severe cases" (p. 69). He was a great enemy to coffee (p. ']%^, but a great advocate of exercise and open air, and also of the beneficial action of change of climate and residence at the seaside, all things which were then little spoken of in medical works. Next to nourishment, exercise is what is most important for the animal machine, by it the clockwork is wound up. These delicate creatures should not be confined to needlework, nor allowed to loiter over the toilet table, to play cards, to pay tedious visits or to read enervating books, whereby they would be reduced to the condition of colourless plants grown in a cellar. Exercise and wholesome air alone suffice to determine all the juices of our body to their proper place, compel the excretory organs to throw off their accumulated moisture, give strength to the muscles, communicate to the blood its highest degree of redness, attenuate the humours so that they can readily penetrate the remotest capillary vessels, strengthen the heart's beats, establish healthy digestion, and are the best means for obtaining repose and sleep, whereby refreshment and renewal of the vital spirits are secured (p. 76). Strengthening diet, wholesome air and exercise, together with amusement to the mind, are indispensable, and everyone knows their power and can employ them. Nourishment suited to the body in appropriate quantity is the only thing required to ensure healthy digestion and to eliminate the bad juices from the primie viae ; exercise promotes the appetite, strengthens the digestion, and better than all purgatives expels the excess of evil humours by the natural outlets of the body every movement of the limbs conduces to the strengthening of the circulation of the blood and to the completeness of the assimi- lation of the nutritive fluids — there can be no health without exercise. The first teacher of Hygiene. 6l Where is the remedy that can more agreeably and more certainly remove the decomposing ferment in our blood-vessels that always tends to destroy our machine than pure air ? With every breath we draw a quantity of it into our lungs, its purest etherial part, the source of our corporeal heat, penetrates by means of the exhalent vessels of the innumerable arteries of these organs into the mass of the blood and expels the unwholesome spoilt air, the air we expire. It is only in the pure open air that we feel refreshed by breathing ; in cellars and close rooms full of living creatures we become weak, faint and die, often in a few hours if the air is much spoilt by the breath of many persons. These different effects of the air we breathe convince us that life and health are not to be expected without pure air (p. 94). Further on he discusses the habits of life, the occupation, the division of the day and the conditions of the dwellings in a short, concise and convincing manner. How seldom was hygiene considered in a therapeutic work in those days ? How many books on therapeutics were written which contained no mention of hygiene ! We do not even meet with the zvord hygiene in its present sense. There were as yet no precautions taken for preserving health. If we consult Hufeland's Journal, which was founded 1 1 years later, and in which the most eminent practitioners wrote, we shall have to search through all its numbers till the year 1830 to be able to extract as much concerning hygiene in several decennia of this much later period as Hahnemann has scattered through his work of 192 small octavo pages on a surgical complaint. Even in the year 1828, the allopaths were reproached by an opponent of Hahnemann's for the small amount of trouble they gave themselves about these important matters compared with him. There were very few exceptions, as, for instance, Hufeland, as his Macro- hiotik, which appeared 12 years later (1796), shows, though we see from his neglect of diet and hygienic measures in his Journal that he had not grasped their importance. Hahnemann prescribes exactly what should be the diet and occupation, the position of the sitting and bedrooms, and frequency of the renewal of their air (p. 98, et seq.). Amusement is necessary; I do not approve of solitary forced labour and exercise. Consequently, I always endeavour, whenever possible, to bring my patients into a state of disposition free from care and worry, whereby alone, as I believe, the wearing friction which the 62 Advocacy of cold-water Treatment. mind and body exercise on one another in our organism may be lessened. Varied, agreeable society, with occasional music, is the best thing for cheering the human soul that is not depressed to the condition of an insensible lump, and even should we meet with persons sunk so low among our patients, they must at first be forced to go into society, just as we force the child to swallow the healing draught. They should even accustom themselves to social converse at the sacrifice of more remunerative occupations, until they acquire a taste for it, espe- cially when morality, temperance, and exercise can be combined with it. How else can we get rid of care or acquire a hopeful view of life except amid a happy throng of our like-minded fellow creatures, amongst whom we can cast off the burdens of life, and mutually bestrew our paths with flowers ? The strictest cleanliness in dress and in the whole mode of life must be maintained, along with exercise, open air, and recreation. Cleanliness is the spice of all the operations of life, and without it the most costly dainties and the finest clothes excite only disgust. Upon the employment of cold water, which, in spite of the efforts of Hahn (died 1773), was greatly neglected, and for the systematic employment of which there was no enthusiasm, Hahnemann writes at length (pages 108 to 126), and gives exact instructions. If there is such a thing as a universal remedy, it is undoubtedly water. [The temperature, duration, and time of day of its employment are given in detail.] I can never cease to marvel how our most eminent physicians, when prescribing a strengthening treatment, have been so remiss in laying down precise directions for the use of the cold bath. They content themselves with telling the patient to take a half or a whole bath in the morning and sometimes also in the afternoon. No word respecting the degree of temperature of the water, the exact duration of the bath, and the other particulars concerning it so neces- sary for the patient to know. We cease to wonder that injury to the health is often caused by cold baths, when we consider how very im- properly the cold water may often be used when the physician gives such meagre, maimed and laconic directions respecting its use. If a weak, delicate patient remain for hours in snow-water, in order to comply heroically with the loose directions of his eminent physi- cian, it is probable that he will be taken out of it in a fainting state, doubled up with convulsions, struck down by apoplexy, or chilled into a low fever, or perhaps stiff and stark dead. Can we find fault with the useful knife with which the infant wounded itself ; should we not rather blame the negligence of its nurse ? In our directions for the use of powerful remedies we cannot be too precise and explicit : His treatment of Caries. 63 patients are only too apt to err on the side of doing less rather than more than we prescribe. This want of precision on the part of physicians is the cause of the great prejudice against cold water ; we meet great numbers of people who regard the cold bath as the most pernicious weapon in the medical armamentarium, who dread it more than death. But the rank and file of medical practitioners who slavishly imitate their betters have brought the cold bath into disrepute by their senseless ways of carrying out the careless prescriptions of our Hippocrateses. He then proceeds to tell us what unintelligible instruc- tions were usually given by physicians. Hahnemann writes exact directions concerning the conditions of the bath and the frictions, ^c, in and after it. When Hahnemann was once convinced of a thing, he enunciated it with the greatest precision, and did not easily allow himself to be turned from it. " I am," he says at the end of this chapter, " borne out by the most extensive ex- perience, and I claim unlimited confidence on this point." His medical treatment of ulcers was as follows : — In- ternally he gave in suitable cases decoctions of woods, therefore compound medicines (p. 86), but he also gave the medicines singly, though in large doses. He completely banished the customary lead plaster and ointment. As the local application he used alcohol (p. 44), solution of corrosive sublimate (p. 40, 44, 153, r/i), lunar caustic (p. 148), solution of arsenic — the latter in the proportion of I to 30,000* (p. 149, 181), and balsam of Peruf (p. 149), each remedy singly and in accurately indicated cases. Where necessary, he recommends energetic treatment. At page 44 he relates a case of caries of the metatarsal bone of the great toe, with burrowing fistuke and unhealthy pus. " I was called in. I enlarged the wound, dressed it a few days with digestive (a mixture of Peruvian balsam, or balsam of copaiba, with two to three parts of the yolk of eggs), I scraped the carious bone clean out, and removed all the dead part, dressed it with alcohol, and watched the result." Later he applied alternately dressings of corrosive * Comp. Kennzeichen der Gufe, &c., p 223. t This he repeatedly recommends, 1791. Trans, of Monro, II., p. 123. 64 Reception of Jus novel methods. sublimate and digestive. Internally he gave tonics, and the patient gradually began to mend. The scraping out of the carious bone is looked upon now-a-days as an achieve- ment of modern surgery. Thus Hahnemann, in his treat- ment of wounds and ulcers, proved himself an excellent surgeon, and was far in advance of his contemporaries. He was not wrong in saying of himself at the conclusion of his book : — I cannot be blamed for insisting on such a generally applicable treatment of old malignant ulcers, and in preferring it with certain limitations to all others ; the most careful and extensive experience is on my side. Anyone who has had the opportunity to make so many observations in such cases as I have made, who is actuated by such a desire to do good to his fellow creatures as I feel that I am, who so thoroughly hates the prejudices and prepossessions in favour of the old over the new, who has as little respect for the authority of a great name as I have, and who as zealously endeavours to think and act for himself as I do, will, I imagine, not easily hit on another and better treatment of old ulcers, he will consequently be able to obtain the same excellent results of his efforts as I have obtained, which is the highest reward that a conscientious physician can expect, results which have hardly ever disappointed me, whereas the different treat- ment of others has almost always belied their expectations. Baldinger, professor in Jena, Gottingen and Marburg, the instructor of Blumenbach, the }"Ounger Meckel, Reil, &c., thus criticises Hahnemann's book : * " The author has treated his subject very thoroughly and well. He shows how mistaken the previous and most usual treatment has been — and teaches a better. The book is written in such a thoroughly practical manner that we cannot sufficiently hope that it will be widely read." The ^^•ork Instructiofis to Surgeons conceTuing the Treat- ment of Venereal Diseases ^''\ which appeared in 1789, re- ceived an equally favourable reception. Baldinger writes : ± " This work is profound and clear." Immediately after a work on the same subject by Professor Fritze, of Berlin, is criticised: "This book, like the other one, also contains much that is good. Both authors have * Medic. Joiirn. von Baldinger. Gottingen, 1785, p. 23. t Translated in Hahnemann's Lesser Writings., pp. i to 187. X Med. u. Phys. Joiirn., 1790, St. 14, p. 76. Appreciation of HaJincinaniis labojirs. 65 thought for themselves, and written not only profoundl}% but also comprehensively and clearly." Kurt Sprengel writes the following criticism : * — Hunter's ideas are the foundation of the theoretical part of a very good book by Samuel Hahnemann. He here recommends his mer- curius solubilis, a mild and excellent preparation whose admirable effects have since been verified. The first important writer, who highly commended this remedy, was Joh. Fr. Fritze, Prof in Berlin, in a workf which is good, though it contains little that is new, neverthe- less it has been approved of in foreign countries in its translations. Another critic writes : + — Our readers will see from the extracts given that this is no ordinary work, but is written with an unusual degree of knowledge, reflection and original thought. The special methods of treatment recom- mended and the maxims laid down deserve trial and attention. In the Aledic. cJiir. Zcitimg,\ we read : — The book is, however, not merelj' the work of a man of intelligence and learning, but is written with an aphoristic brevity to which the learned medical reader will only find a parallel in Hunter, Swediaur, Andre, &c. It is a book that will be of great use for academical lectures, though the author did not design it for that purpose, &c. Soon after A. R. Vetter's book on syphilis appeared : A Nezu Method of Treatment of all Venereal Diseases after Hunter, Girtanner and Hahnemann^ The Medic, cliir. Zeitung^i writes concerning his trans- lation of Cullen's Materia Medica : — HeiT Hahnemann has made this translation most carefully, in spite of the obscurity of the original The comments of the translator are generally very learned, and he has also enhanced the value of this important work by his numerous corrections of the author's errors. The way in which mental diseases were formerly treated * Geschichte der Arziieikimdc. Halle, 1828, V., Part 2, p. 591. t Handb. iiber die vener. Krankh. Berlin, 1790. X Neue Litterar. Nach7'ic1iten f. Aerste, &c. Halle, 1789, p. 785. § Edited by Prof Hartenkeil. Salzburg, 1790, III., p. 345. II Vienna, 1793. 1 1 791, I., pp. 117 and 231. 65 OrtJiodox treat nieni of the Insane. (one need not go so far back as Hahnemann's time) is known to every physician. Physicians treated excitable and refractory maniacal patients like wild animals ; it was thought necessary to cow and terrify them. Corporal chastisement and nauseating medicines were ordinary means used. Furious maniacs were strapped down on a hori- zontal board which could be quickly turned on an axis to a vertical position, or put in the so-called rotating chair. " A well fitted up madhouse was, in certain respects, not unlike a torture-chamber," says Westphal* This method of treatment was adopted by Ernest Horn in 1806 in the insane department of the Berlin Charite, then the largest madhouse in Prussia. He also invented the " closed sack," in which maniacs were tied up, and which compelled them, according to Westphal,to remain lying wherever they were placed. " It is shameful to have to confess," says Westphal in 1 8S0, " what a short time has elapsed since the insane were shown to the Sunday visitors of hospitals and work- houses as a kind of sport, and teased in order to amuse the visitors." As the treatment of the insane depends upon the state of culture, we shall here quote as an illustration of the degree of refinement of the physicians of that day, some remarks from the Medicinische Bibliothek of the celebrated Gottingen professor, J. Fr. Blumenbach. He is speaking of a work on medical jurisprudence of repute in which it is stated that in Baden a parricide could not be brought to confess because torture had been abolished. The critic thereupon remarks! (in the year 17S9) : — The most innocuous and at the same time the most efficacious mode of torture which can be retained without hesitation is, in our opinion, to apply only such a degree of torture to the accused as will set up a slight traumatic fever, and, after this has been set up, to threaten him with it again. The depression of mind, the loss of self- control, produced by the traumatic fever, will bring even the most hardened ruffian to confess. We have more than once found in dealings with criminals, that men who are able to support a severe first application of torture, if they are again tortured after a few days * Psychiatrie ujid psychiatrischcr Unicrricht. Berlin, 1880, t Vol. III., St. 2, p. 282. HaJineniann's treaiment of the Insane. 6"/ when suffering from traumatic fever, become quite faint-hearted and spiritless and they confess everything. Hahnemann's principle in his treatment of insanity was this : "I never allow an insane person to be punished either by blows or any other kind of corporal chastisement, be- cause there is no punishment where there is no responsi- bility, and because these sufferers deserve only pity and are always rendered worse by such rough treatment and never improved."* Retreated and cured in this way in 1792, the Chancellery Secretary Klockenbring of Hanover, a man well known to literature, who had become deranged. After his complete cure from madness this sufferer showed his de- liverer, " often with tears in his eyes, the marks of the blows and stripes his former keepers had employed to keep him in order." Hahnemann, therefore, was a long way ahead of his con- temporaries in the treatment of the insane. That he at first employed bleeding is natural enough, but we alwaj^s see him apply it cautiously, and even as early as 1784 he contended, as has been shown, against excessive bleeding. In 1832, Hahnemann writes, in a letter to M. Muller,-f- that he had given up bleeding, emetics and purging more than thirty years ago. He still bled in 1797, as appears from a paper in Hufeland's JournalX and in 1800 he was not an absolute opponent of it. " In acute sthenic maladies, bleeding and the removal of all kinds of irritants do more good than watery drinks." § Some indications of the treatment resorted to in typhus or nervous fever in those days have already been given. Let us hear one of the greatest physicians of the time, J. P. Frank, on the subject, in his work De Ciirandis Homimuii Morbis, which was completed in 1821 :|| "We should be cautious about blood-letting, but ' an inflammatory nervous fever ' * Deutsche Monatschrift^YQhr\\axy,i7()6. Lesser fF;7Vz>7^i',p.293,note. t M. Miiller, Zur Geschichte der Homdopathie. Leipzig, 1837, p. 31- X Lesser Writings^ p. y]^,. § Arzneiscliatz^ aus dem Engl, tibers. von Hahnemann. Leipzig, 1800, p. 171. II Translated in 1832 by Sobernheim, with commendatory preface by Hufeland. 68 Halinemann's early tjxatment of TypJioid Fever. is a very different matter." " When by venesection we have once succeeded in reducing the complaint to a simple nervous fever." " In gastric nervous fever we must give emetics, because otherwise obstinate diarrhoea is apt to set in towards the end of the illness." "Indeed, sometimes an emetic given even at a later stage is of service." Then comes a chapter on " the treatment of symptoms." For each single symptom there is a different remedy. For diarrhoea : " China, canella, red wine, calumba, contrayerva, catechu, alum, fresh milk, theriac (a brew containing 40 to 60 drugs and 0.25 parts of opium to every 30 parts of fluid), and diascordium, introduced by the mouth or the anus." " For violent abdominal pains following true inflammation, general or local bleeding," besides blisters, baths, " fomenta- tions, anodynes and repeated enemata." In " putrefying crudities" in the bowels: tamarinds, rhubarb and cinchona. In "spastic" affections of the brain : wine and opium; but for congestive cerebral affections : " leeches and cupping in the region of the temples and occiput or behind the ears." " In profuse, purely symptomatic hcemorrhages : cinchona and alum, externally and internall}-, mineral acids with cold water, fomentations of snow or ice, and also sometimes wine and opium." Imagine a medical man sitting with the book of this great authority before him, a book which was trans- lated in 1832 with a commendatory preface by Hufeland, as though it were something ver}- excellent. What pre- scriptions would result from such instruction ? Concerning Hahnemann's treatment of typhoid fever we learn the following in the year 1790 — that is thirty or forty years earlier :* " In nervous fever (the symptoms of which Hahnemann describes minutely), antiphlogistic remedies — refrigerating and laxative salts, water}- drinks, and bleeding act as poisons. Emetics and blisters do harm. Bark and strong wine in large quantities, I have seldom found to fail if I have been called in early enough." Besides repose of body and mind, he orders more espe- ciall}- fresh air. At page 126, he repeats that in nervous * Translation of Cullen, II., pp. 125, 267. Hahnemann's early viezvs on Itch. 6g fever cinchona and wine are " the only good remedies," and on page 267 he again speaks of the benefit of bark in large doses with wine, and against the highly commended and usually employed opium. Brown and his treatment, which reminds one of Hahne- mann's, were at that time not known in Germany. Hufe- land* is of opinion that in 1792 " neither he nor anyone else in Germany had seen any of Brown's writings." With regard to the itch, Hahnemann took a very " advanced " view, which he, however, completely changed thirty years later. With the exception of some hints by older authors, Bonomo, of Leghorn, was the first who cor- rectly described the itch-insect in 1683, on which account Wichmannf justly styles him the founder of the itch theory. Bonomo admits that he received his knowledge from poor women and slaves in Leghorn, who were in the habit of mutually removing each other's itch-insects with needles. The parasitic doctrine was, nevertheless, little ' regarded till Linnseus, in 1757 {ExantJieniata viva), and the above-men- tioned Wichmann, in 1786, drew attention to it. Wich- mann, in his work, held the views of to-day. In England itch was already generally treated as a " living eruption ;" in France the medical faculty still warned people against the external remedies there used by the common people for this malady.t It was much the same in Germany. Wich- mann was disregarded, and the view prevailed that the itch-insect was the result and not the cause of the affection. Thus Joh. Jak. Bernhard§ did not consider the itch-insect and " the microscopic animalcules in other contagious dis- eases " the contagium itself He, however, considered them as important constituents of the infecting material, " like the * Hufeland's/^//r«. V., Intclligenzblaif, No. i, p. i. t Actiologic der Kriitze^ von J. E. Wichmann, Kgl. Grossbritt. Hofmedicus zu Hannover. Hannover, 17S6, with four plates of the itch acarus copied from Bonomo, 2nd edition, 1791. X Wichmann, I.e., p. 118. § Handbiich der allgem. tend bcsond. Contagienlehre. Erfurt bei Henning, 181 5, also under the title Ueber die Natiir Sr'c. des Spital- iyphiis lend der ansteckenden Krankheiten iiberhaiipt. 70 Supposed Seqiielcn of Itch animalcules in semen and vaccine-lymph." Also, similar animalcules might be produced without being capable of conveying contagion, as, for example, the louse disease [phthiriasis]. Friedrich Jahn, 1817, vehemently disputed the truth of the parasitic theory of the itch."* He asserts on the con- trary the " undeniable truth of itch-metastases," and he finally pronounces: "We may, therefore, consider the whole of this theory as unfounded." J. P. Frank entered the lists as a most determined advo- cate of the causa viva in his book, De Ciirandis Honiimtm itfbri^w, completed in 1821. He recommended killing the itch-insect at the commencement of the infection, but after the itch had existed some time he thought " reckless sup- pression " very dangerous. He distinguishes 13 kinds of " symptomatic itch," as, for instance, a scorbutic, a hypo- chondriacal, a critical, a plethoric, &c. ;" also a "psora neoga- morum," a variety which affected newly married persons. Ferdinand Jahn, a talented disciple of Heusinger and Schdnlein, a partisan of the natural historical school, held the following views in 1828:! "Chronic eruptions are usually the outward manifestations of dyscrasias which are deeply rooted in the interior of the organism Itch deprived of its cutaneous blossoms develops its roots that are present in the interior of the organism more strongly, so that those manifestations which are known under the name of itch-metastases ensue." In judging such views, we must remember that in those days itch eruptions with numerous pustules all over the body and extensive cuta- neous ulcerations were no rarity. Autenrieth, known to be a pupil of J, P. Frank, writes under the title. Sequela; which folloio the suppression of Itch, in 1808 :j * Klinik der chron. Krankheiten. Erfurt, 181 7, II., p. 614. \ Ahmmge7i eincr allgem. NaturgescJiichte der Krankheiten. Eise- nach, 1828, p. 201. % Versuche fur die prakf. Heilkitndc aiis dc7i kiln. Annalcn V07t Tiilnn<^en, 1808. Griesselich, Klelnc Fresca^emLildc. Carlsruhe, 1836, i., p. 88. consequent on its Suppression. 71 The most terrible and the most frequent sources of chronic diseases of adults in our neighbourhood are the psoric or itch eruptions which have been wrongly treated with sulphur ointment and fatty outward applica- tions. I have so frecjuently seen the evil results among the lower classes and those who lead a sedentary life that arise from the sup- pression of the itch, and see them still every day in such a variety of sad forms, that I do not hesitate a moment to assert that it is a subject that deserves the attention of every physician, and of even every em- ployer of labour who has the welfare of those under him at heart. According to Autenrlcth, the sequeLns of " suppressed itch " are : ulcers of the leg, pulmonary consumption, a kind of hysterical chlorosis, white swelling of the knee, effusion into the joints, amaurosis with obscuration of the cornea, glaucoma with amaurosis, mental alienation, paralysis, apoplexy, wry neck, &c. In spite of all this, Autenrieth held the parasitic theory to an extent which was uncommon for his time. He even maintained that the itch-insect was the vehicle of a poison which must not be driven by ointments from the surface of the body into the interior, and that, on the other hand, the itch might be the product of an internal disease driven outwards on to the skin. Hufeland shows that he held this view :* But the itch may also appear as a product and symptom of internal diseases — scabies spuria. Here, indeed, it is only a form of another disease, but here also a contagium may develop, and so it may become infectious. To this variety belongs the syphilitic, scrofulous, arthritic, and scorbutic itch, and also the critical, an itch-like eruption by which the critical resolution of both acute and chronic maladies is effected The mites found in pustules are not the cause but the effect — parasites of the itch But in connexion with this (that is to say the treatment) many difficulties and important considerations come into play. Thus we can suppress the diseased action of the skin by a mere local appli- cation of the specific, but the contagium itself, which has already pene- trated deeper, is not thereby destroyed, and the result is either that the itch always re-appears or, what is worse, is thrown on internal parts, and often produces very dangerous and obstinate metastases. Consump- tion, lung-itch, dropsy, cramps of the stomach, stomach-itch, epilepsy, and all kinds of nervous diseases may ensue. The result is still more serious if the itch is complicated with another disease or is a product or crisis of another disease. * Enchiridion Mcdicinn, Vcrnidchtniss eincr 50 jd.Jir. Praxis. St. Gallen, 1839, 2nd edit, p. 293, et seq. 72 HaJuieiiianiis early acquaintance In 1835 the learned Rau* wrote as follows: — The assertion a well-known writer (Kriiger Hansen ?) has recently made, that no evil results are to be feared from quickly suppressing the itch, is confuted by such numerous observations that it is unneces- sary to argue against it. We must at the same time bear in mind that in those days the diagnosis of skin diseases was very faulty, that scabies, eczema, impetigo, prurigo, &c., were not yet distinguished from one another, and were thought various degrees of in- tensity of the same disease. Did Hahnemann know the existence of the itch-insect? and at what period did he become acquainted with it? In his translation of Monro's Materia Medica, 1791, Hahne- mann says in a foot-note (11. 49): — If, in a recent case of itch, we make the patient wash himself several times daily with a saturated solution of sulphuretted hydrogen, and get his linen dipped in the same solution, the affection disappears in a few days, and does not return except with re-infection. But would not it return if it was caused by acridity of the humours ? I have often observed this, and agree with those who attribute the dis- ease to a living cause. All insects [among which the itch-mite was at that time included] and worms are killed by sulphuretted hydrogen. Further on in the same work, in another note (II. 441), he maintains that itch is a " living eruption." In 1795 a treatise by Hahnemann, On Crusta Lactea, appeared in J. N. Blumenbach's MediciniscJie Bibliothek.-\ This periodical did not appear in any regular order. Articles which had been written as early as 1793 are found in this volume. Hahnemann has put no date to his essay, so that we cannot exactly determine the date at which it was written. He, however, remarks in it that he was in the country when it was written. From 1794 to 1796 he lived at Pyrmont and Brunswick; from 1792 to 1794 in Gotha. To the last-named period, therefore, belong the following remarks. In the village (probably Molschlebcn), * Ueber deii Wcrth dcs Itoin. Hcilvc7-fa]ircns^ 2nd edit. Heidelberg and Leipzig, p. ■^1. fill. St. 4, Gcittingen, 1795. Translated in B. Jour, of Horn., XLII., p. 2og. zuith the A can is scabiei, 73 " where my children enjoyed perfect health," there were a great many children affected with so-called milk-crust, and to an unusual degree. As Hahnemann thought he had seen instances of this complaint being communicated, he attempted to prevent intercourse between his own and the infected children belonging to the village. One of the boys thus affected, however, succeeded in gaining access to them. " I saw him playing in close contact with them, I sent him away, but the infection had already taken place." The boy had kissed Hahnemann's children. The complaint began hrst in the child kissed, and then spread to the other three children. "I poured warm water over dry hepar sulphuris (powdered oyster shells mixed with equal parts of sulphur and kept for ten m.inutes at a white heat), and thus made a weak solution. I painted the faces of the two who had the erup- tion worst with this every hour for two consecutive days. After the first application the complaint was arrested and gradually got well." He pursued the same course with the other children with the same success. The remedy when appHed to the skin becomes gradually decom- posed by the action of the air, and sulphuretted hydrogen is developed with a fetid smell, which, as we know, is rapidly fatal to most insects. Is not crusta lactea a cutaneous disease caused solely by infection ? does not the infecting matter contain very small animalcules as a miasm ? I hardly expect to meet in practice with such another oppor- tunity of answering these questions positively in the affirmative as this, which was so completely within my cognisance. My children got no purgatives nor any other medicine, as they were otherwise quite well and well they remained. In a note he says : — I relate here the following case because of its similarity. A servant girl (infected by a servant newly arrived), had had the itch for six days ; one arm and hand were covered with it, and the eruption made its appearance on the other hand between the fingers. I made her wash both arms thrice daily for two days with the above-mentioned solution ; she got well without sequelte ; the girl who communicated it was treated in the same manner, and was cured in eight days. If this complaint is produced by insects in the skin, what harm can it do to kill them provided we do so with medicines that possess no power 74 Appj'eciation of ElectJ'icity. in themselves to do harm to the body ? Physicians have been all too ready to ascribe to the suppression of certain skin diseases effects which were the result of some cachexia, &c., which was coexistent, and which remained uncured ! From what follows it appears that he v/as not free from the opinion that a virus penetrates the whole organism from the itch-insect. " An old case of bone-disease began to heal quickly as soon as I had ascertained that it was complicated with itch. I dressed the sore as usual, but washed the whole body with the above-mentioned lotion." In 1 79 1, he narrates (Monro I. 'j6) that he had cured itch by internal remedies only, which shows that in those days the term '' itch " had a much wider signification than now. He treats the subject of the therapeutic employment of electricity, clearly and intelligently, and he could not conceive how the Academy of Rouen could adjudge a prize to a work of Marat which denied to electricity alm.ost all remedial power (^Arzenikvergiftnng, p. 163). He taught the proper use of many drugs whose actions were little or imperfectly known, and described accurately their sphere of action, which he was better able to ascertain than others, because he always gave only one remedy at a time, and carefully watched its effects. We shall here only mention aconite, belladonna, hyoscyamus, stramonium, conium maculatum, ipecacuanha, Peruvian balsam and arsenic. His numerous articles in Hufeland's Journal, his terse and frequent annotations in his translations of Cullen, Monro, the PZdinburgh Dispensatory and the TJiesaiiriis viedicaniimun, as well as casual 'observations in the Apothekerlexicon, prove what we have said. With regard to Hahnemann's reputation as a practical physician of his day, let us hear his contemporaries. Brunnow relates :* " In fact, even in the beginning of his career as a physician, he succeeded in achieving many splendid cures by his simple method of treatment, and wherever he went he carried with him the reputation of a * Em Blick aiif Halmcmann^ Leipzig, 1844, p. 6. Translated by Norton. Laudatory notices of Hahnanami. 75 careful and successful practitioner." The Medic. cJiir. Zeituiig {lygg, II. 411) writes: "Hahnemann has made himself a name in Germany as a capable physician." In the same periodical* he is described as a physician " to whom we are indebted for many good contributions to the perfection of our science." In the Allg. vied. Annalen des ig Jahrh.xw the number for November, 18 10, Hahne- mann is called a man, " who has been known as a thinking physician and good observer for more than twenty years, and at the same time has continually increased his repu- tation as a clever and successful practitioner." Hufeland, in 1798,! calls him a man "whose services to our art are sufficiently important," and further^: " one of the most distinguished physicians of Germany" "a physi- cian of matured experience and reflection." In 1800 Daniels§ speaks of " Hahnemann, a man ren- dered famous by his writings." In the same year Bernstein writes in the Pract. Hand- hiichfiir Wimddrzte : "Samuel Hahnemann, a very merito- rious physician, is known for his excellent preparation of mercury, namely, mercurius solubilis, and also for his wine test and his chemical and pharmaceutical writings. He has also deserved the gratitude of surgeons. He published for them Guide to the cure of old sores and ulcers, 1784, and Instruction to Surgeons for the treatment of venereal diseases. Leipzig, 1786." In the year 1791, the Leipzic Economic Society elected him a member, hewas next elected a member of the Elec- toral Academy of Sciences of Mainz, and later of the Physical and Medical Society of Erlangen. In 1798 we read this notice in the Medic, chir. Zeitung (IV. 192). "Mietau : it is intended to erect a temporary university here. It is said that it is intended that the medical faculty shall consist of Dr. Samuel Hahnemann of * Ergiinziingsheft^ VII., p. 307. t Huf.>z/r., VI., St. 2. Note. t lb. v., St. 2, p. 52. § /^. IX., St. 4, p. 153- 76 Hahnemann as a Medical Reformer. Konigsluttcr, Dr. Samuel Naumbcrg of Erfurt, and Dr. Frank of Muhlhausen." Let us now pass from Hahnemann's capacity and ac- quirements in medicine to his achievements in the way of medical reform. He was not fashioned out of soft wood, hence his words often seem hard and harsh, and even bitter. We shall see how, with penetrating glance and great store of know- ledge, he saw more and more clearly the utter worthless- ness of the therapeutics of the day, and the disastrous methods of procedure of physicians. Amidst the confusion of hypotheses and speculations, a weak voice would not have been listened to. He had a strong, sturdy and healthy body and a lively temperament. Such natures do not creep about in felt slippers when they have to combat the widely spread follies of their time ; the question whether Hahnemann would have been more prudent if he had written in a more conciliatory tone, does not concern us here. As early as 1784, as we have seen, he speaks con- temptuously of "fashionable physicians." In 1786 he inveighs in his book on Arsenic against the wretched state of medicine at that time, against " that most fruitful cause of death, the bungling of physicians," who, among other things, powdered ulcers over with arsenic, thus often causing the death of the patients, and who gave this drug in poisonous doses in intermittent fever. In 1791, in his translation of Monro, he came across the statement that cantharides eliminated morbid humours ; Hahnemann there- upon remarks (II. 248), "this is the common delusion that the sores produced by vesicating agents only remove the morbid fluids. When we consider that the mass of the blood during its circulation is of uniform composition throughout, that the exhalents of the blood-vessels give off no great variety of matter under otherwise identical con- ditions ; no rational physiologist will be able to conceive how a vesicating agent can select, collect and remove only the injurious part of the humours. In fact the blister under His estiviate of the Practice of his days. "jj the plaster is only filled with a part of the common blood serum, just like that which separates from the blood when it is drawn from a vein. But, according to the insane idea of these short-sighted doctors, venesection, too, draws off the bad blood only, and continued purging evacuates only the depraved humours! It is terrible to contemplate the mischief which such universally-held foolish ideas have caused." In another place (Monro, I. 265) Monro speaks of corrosive sublimate as an " alterative." Hahnemann thereupon re- marks : — " I do not know what our author means thereb}-, though he uses the language of his and my contemporaries. If an alterative is something which does good here, why does he not say so ? But no, an alterative seems to be only a half-and-half sort of remedy. Such a remedy is not re- quired in the whole range of medicine." Further (I. 246). "Alterative is a scholastic term ; it is unpardonable in a medical author to use such a vague expression." In the same way, Hahnemann in many places takes occasion to direct the attention of his fellow-practitioners to the many absurdities of the day, from which he used the most earnest efforts gradually to emancipate himself. In 1790, he attacked the teachers of materia medica of the day (Cullen, I. 58). " The old teachers of materia medica with their puerilities, vagaries, old wives' tales and falsities, arc venerated as authorities, even in the most recent times — with a few exceptions — and neither the originators nor their weak disciples deserve to be spared. We must forcibly sever ourselves from these deified oracles if we wish to shake off the yoke of ignorance and credulit}' in the most important department of practical medicine. It is high time to do so." To ascertain the truth in the wilderness of " observa- tions " and " experiences," he soon hit upon the plan which all great physicians have followed ; he ceased from the fussy interference practised at the sick-bed by his contemporaries, and urged his mixture-loving fellow practi- tioners to adopt instead : — 78 His deminciations of Polypharmacy. Simple Prescriptions, Worthily to appreciate this, we must remember that in those days it was taught that a properly constructed prescription should consist of several parts. Hahnemann was of course taught this, and later he admits that the method of treatment by mixtures " clung to him more obstinately than the miasma of any disease.'' If then we see him in the first few years of his practice, sometimes giving mixtures, generally containing only two drugs, we see on the other hand, that he was gradually emancipat- ing himself from this bad system. As early as 1784,* he advocates a simple method of treatment " instead of the farrago of contradictory prescriptions." In 1791, he asks, when Munro has been recommending a complicated mode of treatment for sclerosis of the liver (]\Iunro, II. 288): "What was it that really did good ? As long as we do not accustom ourselves to use simple remedies throughout and carefully to consider in each case the accompanying circumstances, habits of life, &:c., our therapeutics will remain a combination of guess-work, truth and poetry." In the year 1796, Hahnemann writes in Hufeland's Jciirnal :^, The strangest circumstance connected with this specification of the virtues of single drugs is, that in the days of these men the habit that still prevails in medicine, of mixing together several different medicines in one prescription, was carried to such an extent that I defy Qidipus himself to tell what was the exact action of a single ingredient of the hotch-potch. The prescription of a single remedy at a time was in those days almost rarer than it is now-a-days. How was it possible in such a complicated practice to differentiate the powers of individual medicines .'' Hahnemann, in his treatise Are the obstacles to certainty and simplicity in practical medicine insiirmonntable ? which appeared in the year i797,t pronounces "simplicity the first law of the physician," and further on : * Anleitiing alte Schddctt, &c.. p. 165. B. J. of H. XLII., p. 165. f Versuch iiber cin 7ieues Principe &c., II., St. 3. Hahnemann's Lesser Wriiztigs, p. 310, note. X HnitXimd^s foiirnal IV., St. 4. Lesser U'riiuigs, p. 358. His scorn of complex prescriptions. yg How near was this great man (Hippocrates) to the philosopher's stone of physicians — simpHcity ! and to think that after more than 2,000 years we should not have advanced one single step nearer the mark, on the contrary, have rather receded from it ! Did he only write books ? or did he write much less than he actually cured ? Did he do this as circuitously as we ? It was owing to the simplicity of his treatment of diseases alone, that he saw all that he did see, and whereat we marvel Here the ques- tion arises : Is it well to mix various drugs in a single prescription, to administer baths, clysters, bleeding, blistering, fomentations and inunctions all at once or in rapid succession, if we wish to raise therapeutics to perfection, effect cures, and know with certainty in every case what the remedy has done in order to be able to employ it in similar cases with still greater, or at least with equal success ? The mind can only grasp one thing at a time and can rarely assign to each of two powers acting at the same time on one object its due proportion of influence in bringing about the result ; how can we attain to greater certainty in therapeutics if we deliberately set a large number of different forces to act against a morbid condition of the system, while we are often ill-acquainted with the nature of the latter, and are but indifferently conversant with the separate action of the component parts of the former, much less with their combined action ? Who knows whether the adjuvans or the corrigens may not act as basis in the complex prescription, or whether the excipiens does not give an entirely different action to the whole ? Does the chief ingredient if it be the right one require an adjuvans ? Does not the idea that it requires assistance reflect severely on its suitability ? or should a dirigens also be necessary? I thought I would complete the motley list, and thereby satisfy the requirements of the schools. I think I may venture to assert that a mixture of two drugs almost never produces the effects of each in the human body, but an effect almost always different from the action of both separately — an inter- mediate action, a neutralisation, if I may borrow an expression from chemistry. The more complex our prescriptions are, the darker is the condition of therapeutics. That our prescriptions contain fewer ingredients than those of the Portuguese Amatus will help us just as little as the fact that Andro- machus wrote still bulkier prescriptions will help him. Are our pre- scriptions simple because both these wrote more complicated ones ? How can we complain of the obscurity and intricacy of our art, when we ourselves render it obscure and intricate ? I, too, at one time suffered from this infirmity ; the schools had infected me. This miasma, clung to me before it came to a crisis, more obstinately than the miasma of any other mental malady. 8o His pica foi' siviplc prescriptions. Are we in earnest in our art ? Very well then ! What would be more like Coliunbics's egg than to make a brotherly compact to give only one simple remedy at a time in every single malady, without making any important change in the surrounding's of the patient, and then let us see with our own eyes what the drug does, how far it helps and how far it does not help ? Would it really be more learned to prescribe from the apothecary's shop numerous and variously mixed medicines for one disease (often in one day), than, like Hippocrates, to treat the whole course of a disease with one or two enemata, and perhaps a little oxymel and nothing else ? I thought it was the masterpiece of art to give the right medicine, not the most complex. Hippocrates chose the simplest out of a class of diseases ; these he watched closely and described minutely. In these simplest maladies he gave single simple remedies out of the store of existing drugs which was then small. Thus it was possible for him to see what he saw and to do what he did. It will I hope not be contrary to good taste, to proceed as simply in the treatment of diseases as this great man did. If any one sees me give one remedy one day, another the next and so on, he may conclude that I am wavering in my treatment (for I too am a weak mortal) ; but if he sees me mix two or three drugs in the same prescription (and ere now this has sometimes been done), he would at once say : " The man is at a loss, he does not rightly know what he would be at, he is bungling ; if he were certain that one was the right remedy he would not give a second, and still less a third I " What could I answer? I could only hold my tongue. If I were asked what is the mode of action of bark in all known diseases .'' I would confess that I know little about it, though I have so often given it alone and uncombined. But if I were asked what cinchona would do if administered along with saltpetre, or still more with a third substance, I should have to confess my benighted ignorance and would worship any one who could tell me. Uare I confess that for many years I have never given anything but a single remedy at a time, and have never repeated it till the first dose had exhausted its action, bleeding alone, an emetic or purgative alone — and always a simple never a complex medicine — and never a second till I was quite clear as to the effect of the first? Dare I confess that in this manner I have been very successful and satisfactorily cured my patients, and seen things which otherwise I never would have seen ? If I did not know that there are around me several of the best men who in simple earnestness are striving after the noblest of aims, who by a similar method of treatment have corroborated my maxims, I should indeed not have dared to avow this heresy. Who knows that I should not in (wililco's circumstances have denied that the earth Avent round the sun. But the day is beginning to dawn I His ridicule of complex pvescidptions. 8 1 In the year 1798, in his translation of the Edinburgh Dispensatory, he inveighs against " the physicians who love prescriptions containing many ingredients" (II. 340). " What god could decide what good effects would result from the admixture of three strong things very unlike in their actions (castor oil and preparations of lead and mer- cury externally applied in cancer) The height of empiri- cism is the employment of mixtures of strong medicines " (II. 605). Further on (p. 606), where compounds are again recommended, he observes : " We cannot a priori say what are the powers of a compound remedy. Every drug has its peculiar action. Which way would several balls of different sizes, thrown in different directions and with different degrees of force and striking together, go ? Who could tell beforehand ? " The less successful he was in converting his contem- poraries to the employment of simple medical treatment, the more loudly he raised his voice. In 1800, he translated TJiesmiriis Medicaviinum, a neiv collection of medical pre- scriptions, from the English. The translation was published anonymously, the notes being signed " Y." He wished to prove by his criticisms how the complicated formulas acted in a manner directly opposed to the attainment of the cure desired and of instruction. In the preface* we find the following emphatic words: — Even the best formulas (I should like to convince my countrymen of it) are unsatisfactory and unnatural and act conflictingly and contrary to the object intended ; a truth, which in our time when formulas are so much in vogue, we should preach from the housetops. When shall I see this folly extirpated ? When will it be recognised that the cure of diseases is better effected by simpler but properly selected remedies 1 Must we always have to endure the ridicule of Arcesilases ? Shall we never cease to mix a number of drugs in the same prescriptions, the effect of each of which is only half known or not known at all by even the greatest physicians ? Though Jones, of London, used 300 pounds of bark every year, what do we know of the actual, individual action of this drug ? Little ! What dp we know of the pure and specific action of that powerful drug Mercury, the immense use of which by physicians would seem to imply an accurate knowledge of its effects on * Translated in Lesser Writings, p. 398. 82 He shozus the absurdity of the complex our body? If so great an obscurity reigns with regard to these single drugs, how useless must be the phenomena which appear after the indis- criminate administration of several such unknown drugs together. It seems to me like throwing together a number of various shaped balls with one's eyes shut on to a billiard table of unknown form and many cushions, and attempting to prophesy what effect they will have together, what position each ball will take, and where it will eventually come to a standstill after repeated rebounds and unforseen collisions ! Further, he describes sarcastically the statements which the prescription writers of the day made as to the effects of their basis, their adjuvans, their constituens, dirigens and corrigens. Unfortunately it is not possible to quote all the characteristic passages of Hahnemann's writings. Further on he says : " Nature works according to eternal laws, without asking anyone's permission ; she loves sim- plicity, and effects a great deal with one remedy ; you effect little with many remedies. Imitate nature! To prescribe many drugs mixed, and sometimes even several prescriptions daily, is the height of empiricism ; to give single remedies and not to change them till the time of their action has expired, this is to take the straight road towards the inner holy place of art." In the 412 pages of this work he proves by numerous examples how irrational it is to mix drugs. Here are a few examples: — Page 33: — If the remedy already consists of five ingredients, each of considerable strength, \\'hy should not the whole materia medica be included ? That would be better still. O, how little is the true action of each one of these ingredients known ! What action do we expect from them when they act simultaneously on the body? How shall we attain the knowledge of simple drugs when we only give them mixed ? It seems to me that we are ashamed to know accurately the action of each drug, and that we mix several up together in order, in the resulting confusion, to keep before our eyes the fog we love so dearly. Page 39 : — A qualified doctor is, of course, at liberty to give any- thing he likes, Nature must submit out of respect for his diploma. Page 66 : — Is it not wise to mix a substance like aloes which only acts after twelve or sixteen hours, and then only produces a small, soft stool (given in large doses as a purgative, it produces few stools but causes a great deal of griping) with another substance, such for instance as colocynth which acts in a couple of hours ! It is quite un- known what time scammony takes to purge, and what are the pecu- fornmlcB of high medical authorities. 83 liarities of its action. But all the better ! the more unknown the drugs are, the more scientific is the mixture ! Page 74 : — A formula suffering from an unwholesome mixture of in- gredients! Heating, cooling, purging and other remedies all mixed together. Now we shall know the effects of oxymel of colchicum which we have not been able to ascertain from its use by itself since the days of Dioscorides ! Alas ! Page 81 : — In true dysentery we should avoid such things (senna boiled with rhubarb and tamarinds), and in other cases we can easily find less disgusting compounds, if the evil spirit of mixing will no leave us in peace. Page 86 : — I have observed in all these secundem artem formula that the authors jealously omit to explain why they mix rhubarb with saffron, gentian, serpentary and aloes, why senna leaves with jalap root.'' Did they know that each of all these things had a different ef- fect? Did they think that their combination would produce an inter- mediate action when we only imperfectly know the effects of each singly, and still less in combination 1 Or did all their wisdom event- uate in the itch for compounding, which is an epidemic disease among our physicians ? But sometimes I almost think that higher consider- ations have influenced them in making these mixtures, for they mix rhubarb and aloes with liquorice. A splendid idea ! they will thus be sweetened, and the bitter taste taken away. Difficile est satyram non scribere. Page 91 : — We cannot believe the formula writers when they say, for instance, that the more numerous the diuretics in a mixture the more efficacious is it for the elimination of urine ! The fools ! Usually it is just the opposite, one often hinders the other. Why do they, then, mix so many ingredients ? Because they look upon treatment like in- vesting in a lottery. If I place my money on enough numbers, thinks the weak-minded gambler, I must win ! Too dear a way, my friend, of attaining your object. If you were right, Zacutus Lusitanus, with his fifty ingredients in one prescription, must have been a matador among physicians. Page 97 :— Obstructions of the liver are more easily guessed at than diagnosed, and there are kinds of jaundice which disappear of them- selves in a few days. This explains how such an indigestible brew could have obtained its reputation in such diseases. Of what use was sulphate of potash if dandelion alone would have effected the object desired ? or would the first have been sufficient alone ? or must we give both.'' and why both.-' If it is the result of experience that both must be used in order to do good, then give us the details of your experience where there was no doubt as to the nature of the disease or the good effects of the mixture. An intelligent man must have a reason for each step of his procedure. Page 100. — To the ordinary practitioner, a simple prescription is like a thorn in the eye ! Hippocrates, with his simple drugs, must 84 No useful experience of medicinal action have been a bungler who should ha\-e bought a modern book on the art of prescribing. Page io6 : — In these seven consecutive formute, we shall see squills united with eight different drugs. Was squills alone not sufficient ? What assistance did it receive from its fellow-ingredients? If the added ingredients were all useful in an equal degree, why so many changes ? If they were not, why are we not told which were the useful ones and which the useless and in what cases ? This should be done if we are not to think that changing about is recommended merely for the sake of changing, or even coeco instinctu. But no ! we find many famous physicians recommending prescriptions containing an immense number of ingredients in dropsy, with the excuse : that many substances only excite their full power if mixed together in certain proportions. Then what is the full power ? Occasionally the water is removed, but in what cases 1 They cannot tell us this any more than they can tell us when cream of tartar, when potash, prepar- ations of squills, colchicum, juniper, parsley and foxglove are especi- ally indicated. If they cannot even determine the right cases in which to give simple remedies, all of which in certain cases pro^•e useful singly and remove the water, why do they recommend mixtures and com- plicated mixtures which, if each simple drug is good for its special kind of disease, must have a still narrrower sphere of action and must be suitable in a still more individual case of disease on account of the complicated character of the mixture, in which each ingredient has a new direction and limit The physician who is intimately acquainted with drugs, knows how difficult it is to get only fifty simple drugs in equally good condition ; the condition of the leaves, roots and barks is so much influenced by the habitat of the plant, the time of gathering, the maturity of growth, removal of the damaged parts, the period of drj'ing which varies from a few hours to several weeks, the restricted or unre- stricted access of air, and the warmth or dampness of the places where they are kept. What differences are produced by even the modes of preparation, the infusion in hot or cold water, strong or weak alcohol, for a few minutes or for several weeks ! He further points out the mistakes made in preparing extracts (by boiling) and the negh'gent mode in which they are kept in apothecaries' shops. If we have always such difficulty in getting from, them simple drugs and preparations in equally good condition — if, in one word, it is so unusual to get for our patients simple drugs of uniform quality, what madness is it to expect to have the most improbable of imaginable things, viz. : — medicines consisting of many ingredients alwaj-s iden- tical in character, many of which have undergone complicated pro- cesses (subject to defects and accidents) in their preparation ! can be obtained from medicinal mixtures. 85 Who will consider an uncertain, never uniform mixture of 7, 8, 10 or 1 5 ingredients a reliable remedy ? Only one who knows nothing about the subject. If you send the prescription to ten different res- pectable apothecaries you will get ten preparations differing in taste, appearance and smell (to say nothing of medicinal properties !). But if you have a single remedy you can judge of its ciuality and increase the dose if it is weak. What will you do, if in a complicated mixture one ingredient is 100 times stronger, another 10 times weaker than you have been accustomed to, without your being able to detect it ? Page 112: So one contradicts another, and neither knows how far he is right and the other wrong. They do not sufficiently distinguish their cases and they seek their remedy in mixtures, thus converting even the little light they had into utter darkness. Is this the royal road to the temple of truth ? Page 118 : This mixture can hardly be compounded without the precipitation of part of the saltpetre, but what does our hero care for chemistry in compounding his mixtures.-^ If only grotesque enough things are heaped together so as to seem learned, only the stomach of the patient will suffer. Page 142 : In what kinds of intermittent fevers? and how are they distinguished from those which are cured by bark ? What part was taken by the antimony, what by the potash, and what by the chamo- mile flowers ? Behold ! " The earth was without form and void, and darkness was upon the face of the deep." Page 352 : I call that a satcce au deriiier gout made out of thirteen piquant ingredients which partly neutralise each other's action. This is now (since the banishment of common sense) the highest fashion ! Poor Hippocrates ! with his simple remedies, how ignorant he appears in comparison. We are now in possession of the true savoir fairc^ of the highest culture. God have mercy on the poor souls driven out of their methodically treated bodies ! With similar remarks Hahnemann accompanies the author on every page through the whole book, proving thereby how earnest was his striving after truth and how great his anxiety for the improvement of therapeutics, and how far he surpassed his mixture-loving contemporaries in the gifts of observation and investigation. A year after, in 1 801, he writes in Treatment of Scarlet Fever, page 12 : * " Here we often see the ne plus idtra of the grossest empiricism ; for each separate symptom a par- ticular drug in the complicated formula ; a sight that cannot * Lesser Writings, p. 431. S6 HaJineniann the first advocate of fail to inspire the unprejudiced observer with feelings at once of pity and indignation !" At the same time he attacked Brown on this question in Hufeland's Journal* Brown recommended the employ- ment of several drugs at once, never of one at a time. On this Hahnemann remarks : " This is the true sign of charlatanism. Quackery always goes hand in hand with complicated mixtures, and any one who can recommend (not merely tolerate) them is far removed from the simple ways and laws of nature." In the following years he was never weary of urging on his mixture-loving colleagues that the " chief law for the physician " was simplicity of treatment. In 1805 in Medicine of Experience^ he again writes: " A single simple remedy is always calculated to produce the most beneficial effects, without any additional means, provided it be the best selected, the most appropriate and in the proper dose. It is never necessary to give two at once." " If we wish to perceive clearly what the remedy effects in a disease and what still remains to be done, we must only give one single simple substance at a time. Every addition of a second or a third only deranges the object we have in view." In the same year he writes in j^sculapins in the balance: % This is the general, but most unjustifiable procedure of our phy- sicians : to prescribe nothing by itself- — no ! always in coinbinatio7i •with seva-al other things in one artistic prescription. "No prescription can properly be termed such," says Hofrath Gruner in his Art of Prescribing, "which does not contain several ingredients at once." You might as well put out your eyes in order to see more clearly. In 1808 we read in The Value of the Specidative Systems of Medicine : § But the case is worse still and the proceeding more reprehensible (the prescription of mixtures) when we consider that the action of each or at any rate of most of the ingredients thus huddled together is indi- vidually great and yet unascertained. * Vol. II., St. 4, p. 3 and 4. Lesser Writings, p. 618. f Lesser Writings, p. 534. X Lesser Writings, p. 488, note. § Lesser Writings, p. 567. Simplicity in TJier'apeiitics. 87 Now, to mix in a prescription a number of such strong disordering substances, whose separate action is often unknown and only guessed and arbitrarily assumed, and then, forthwith, at a venture, to admin- ister this mixture, and many more besides without letting a single one do its work out on the patient, whose complaint and abnormal state of body has only been viewed through illusive theories and through the spectacles of manufactured systems — if this is medical art, if this is not hurtful irrationality, I do not know what we are to understand by an art, nor what is hurtful or irrational This motley mixing system is nothing but a convenient shift for one, who having but a slender acquaintance with the properties of a single sub- stance, flatters himself, though he cannot find any one simple suitable remedy to remove the complaint, that by heaping a great many together there may be one amongst them that by a happy chance shall hit the mark. Towards the end of the above-named essay he again breaks out : " Further, let us reflect how extremely pre- carious and, I might say, blind, such a system of ad- ministering drugs must be which fights against diseases, themselves misunderstood from being viewed through glasses tinged ■ with ideal systems, with almost unknown drugs assembled in one or several such formulae ! " No physician has preached this important truth with such energy and such conviction as Hahnemann. No physician has so consistently employed simple prescrip- tions, and he could with truth assert in 1805 that : " No physician on the face of the earth, neither the founders of systems nor their disciples, is accustomed to give in diseases only one single simple drug at a time and to wait till its action is exhausted before giving another." The Organon appeared in 18 10, and it is scarcely necessary to mention that in it he advocates simplicity of treatment, as did also later his followers in numerous periodicals and other works. Hahnemami s attacks on the Therapeutics of his time. We have already shown how Hahnemann attacked deference to authority in therapeutics, as early as 1786 and 1790. He had already pronounced against bleed- 88 HaJincuiann's criticism of tJie medical ing in nervous fever. In the same work (Cullen, II. 1 8) in 1790 he complains, "Bleeding, antiphlogistics, tepid baths, diluent drinks, low diet, blood purifiers and ever- lasting purgatives and enemata are the vicious circle in which the ordinary run of German physicians are always revolving." According to Hahnemann there are few exceptions. He even took occasion to attack his blood-thirsty colleagues in a case which attracted great at- tention. Two years later the Emperor Leopold II., of Austria, died unexpectedly (early in the year 1792J.* The post-mortemf revealed among other things a " semi-purulent " exudation about a pound in weight in the left pleura. In No. 78 (J.c. 31 March, 1792), Hahnemann thus criticises the treat- ment of the physicians : " The report states ' his physician, Lagusius, observed high fever and swelling of the abdomen early on February 28 ' ; he combated the malady by venesection, and as this produced no amelioration, three more venesections were performed without relief Science must ask why a second venesection was ordered when the first had produced no amelioration ? How could he order a third, and good Heavens ! how a fourth when there had been no amelioration after the preceding ones ? How could he tap the vital fluid four times in twenty-four * It was a time of political fermentation. Much anxiety was felt respecting France, which threatened Germany with invasion to punish the emigres. Leopold, in the short period of his reign from 1790 as German Emperor, warded off apparently inevitable war by his pru- dence and love of peace. All hopes were centred in him ; consequently the news of his sudden unexpected death came like a thunder-clap, and filled all hearts with apprehension. Hahnemann at that time resided in Gotha, where Dcr Anzeiger, a newspaper often used for discussions among physicians and for communications from physicians to one another, was published. It appeared afterwards under the title Allgcmcincr Anzciger dcr Deutschen. Hahnemann was acquainted with the editor. Dr. Becker, to whom he had most likely communi- cated his views, and was probably invited by him to take this step in order to clear up matters. The sudden death had already given rise to all sorts of curious rumours. t Dcr Anzciga\ 1792, No. 137 and 138. treatment of the Emperor Leopold. 89 hours, always without reHef, from a debilitated man who had been worn out by anxiety of mind and long continued diarrhoea ? Science is aghast ! " Lagusius (alias Hasenohrl) had called Professors Storck and Schreiber in consultation. "The clinical record of the physician in ordinary Lagusius says : — ' The monarch was on the 28th February attacked with rheumatic fever [what symptoms of a rheumatic character had he ?] and a chest affection [which of the numerous chest affections, very few of which are able to stand bleeding ? let us note that he does not say it was pleurisy, which he would have done to excuse the copious venesections if he had been convinced that it was this affection] and we imme- diately tried to mitigate the violence of the malady by bleeding and other needful remedies [Germany — Europe — has aright to ask: which?] On the 29th the fever increased [after the bleeding ! and yet] tliree more venesections were effected, whereupon some [other reports say distinctly — no] improvement followed, but the ensuing night was very restless and weakened the monarch [just think ! it was the night and not the four bleedings which so weakened the monarch, and Herr Lagusius was able to assert this positively], who on the ist of March began to vomit with violent retching and threw up all he took [never- theless his doctors left him, so that no one was present at his death, and indeed after this one of them pronounced him out of danger]. At 3.30 in the afternoon he expired, while vomiting, in presence of the empress.' " Hahnemann challenged the physicians to justify them- selves. This attack of Hahnemann's was certainly a violent one. On the other hand, if a case with such important issues depending upon it, were to occur now-a- days, how the physicians would be blamed ! Hahnemann plainly saw the perniciousness of the medical treatment. Why should he not do what now-a-days many would do ? Fear was unknown to him, and he was not wanting in knowledge of all branches of science. Moreover, he in this case expressed the general opinion. Before the emperor's physicians answered Hahnemann's challenge, a discussion arose among other physicians in the same journal. The physician to the Court of Saxony, Dr. Stoller,* pronounced Hahnemann's attack improper, unfair and useless, perhaps written for the purpose of making himself known, and stated that he had been * L.c, No. 103, 30th April go Opinions of contemporary physicians convinced by optical evidence of the weakness and ailing condition of the emperor during his sojourn at Pillnitz and had said so. He exclaims : " Good Herr Hahnemann, it was just because the first and second bleeding did not do what was intended that it was repeated ! " He maintains that the doctors left the patient at the command of the empress, which explains their absence at the time of his death. In conclusion, he asserts his impartiality, for he knows Herr Lagusius " by his writings under the name of Hasenohrl," and Herr Hahnemann " also only by his ex- cellent works, especially that on arsenical poisoning, and from what he heard of him in Dresden." A physician who in thirty years' practice " had never had a quarrel with a colleague either at the bed-side or else- where," gives his opinion.* He deprecates this dispute between two physicians, " who are both to be highly honoured for their literary reputation " " It is difficult to believe that Herr Hahnemann had the intention of making himself more famous than he already is. Herr Hahnemann is already so much respected and renowned for his valuable services that he certainly does not require to make himself more popular with the German public by getting up a quarrel with Herr Lagusius, who is himself not better known." He blames the personal character of Hahne- mann's attack, but not its publicity, which only serves to further the cause of truth. " That court physicians are fallible, is sufficiently proved by those of Louis XIV., who slaughtered half his family by bleeding in influenza." He defends the venesections, but would rather have seen them limited to two. Further it was to be remarked that physicians of the older Vienna school " think fevers in the highest degree inflammatory which were perhaps only gastric, as was evidently the case with the emperor," although many patients recovered without bleeding. The author mentions a pertinent article by Dr. Lenhardt, which had been noticed shortly before in the Anzeiger^ to whose therapeutic views he inclined. These were that the L.c, No. 119, i8th May. f No. 112, loth May. on Hahnemann's criticism. 91 emperor was suffering from "inflammatory matters," "im- pure fermenting substances," "acridities" and "degenerated bile " in the primes via;, which substances should have been energetically evacuated, and thereby his life would have been saved. This having been neglected, the in- flammation so quickly got the upper hand that it turned to gangrene. From this article we also learn that two and-a-half hours before his death the doctors gave such a reassuring prognosis that his son Francis II., left the bed- side. Lagusius, according to Lenhardt, was quietly sitting at a gentleman's dinner table, when he received the news of the emperor's death, which must have shocked him not a little. The author then returns to Hahnemann's article and says : — Nevertheless I do not maintain with Herr Stoller that Herr Hahnemann's article is unfair, improper and useless. Not unfair, because in the domain of science every thinking man has a right to judge openly and fearlessly all subjects relating to his science. Herr Hahnemann is ' doctor' and what is more a learned man and may, in this character, just as well take the imperial physicians to task as of yore Dr. Luther, relying on his diploma of doctor, did the Roman curia. Not improper, for every intelligent man may speak his mind on every subject of human knowledge unless he thinks it more politic to hold his tongue. Posterity, however will not do so, and if all contem- porary physicians are silent, it will certainly ask the question, why the emperor Leopold died so quickly ? What was the cause of his death.'' How was his malady treated? Why should a learned man who found himself in a position to speak freely not do so ? Is not every intelligent, unprejudiced, cool and impartial observer a representative or, if you prefer it, a precursor of posterity as the morning star is of the sun? Not useless, if the opinion — 1. That a too energetic mode of treatment is a common cause of serious metastases, and also 2. That the highest criterion of practical skill and prudence — the ability to foresee and avert metastases — can be thereby made to penetrate the minds of physicians more than hitherto. Not useless, 3. If from this incident the difference between true and inflam- matory-like fevers can be more plainly distinguished, and the "92 Post-mortem examination of the latter treated more by attending to the prima: vice than by bleeding- and resolvents, and thereby many valuable lives may be saved. "Attention to the primes vies" was a euphuism for emetics and purgatives. Meanwhile on the nth of June* the emperor's physicians explain : " That the morbid condition was quite different from that which Hahnemann had represented on the re- port of ignorant journalists." (Hahnemann had founded his attack on the report of Dr. Lagusius himself.) Further, we must have a poor idea of Hahnemann's medical know- ledge " if he maintains that a second bleeding should never be undertaken if the first has not given relief" " His majesty when he was taken ill, was not the least in an exhausted condition," (Stoller and also Lenhardt m.aintained the contrary), " but was very strong, and thus was in a con- dition to be attacked by violent inflammation in both the pleural and peritoneal cavities, and this was best combated by venesection. It was not thought to be pleurisy, because no cough was present, but a rheumatic inflammatory fever which was then very prevalent in Vienna. Vomiting came on only at the last because neither flatus nor anything else could be removed by clysters from the distended abdomen." They subjoined the following report of the autopsy Nee thoracis cavitates vitio immunes erant, quippe pulmo dexter nimis flaccidus erat, et cavum pectoris sinistrum continuit serum ex- travasatum, semipurulentum ad lb. i. Superior pulmonis lobus in- flammatus. Pleura eo in loco, ubi dolor acutissimus sentiebatur, spondee membrana obtecta erat. Cor transversim sectum sanum erat attamen nimis flaccidum Ex quibus descriptis pronum est concludere, acutissimam inflammationem optimum Monarchum inter paucos dies e medio sustulisse. So the emperor died from an attack of inflammation of the chest with sero-purulent exudation, and the foremost physicians of Vienna diagnosed "rheumatic inflammatory fever." Even the autopsy did not put them on the right track, the diagnosis remained " a very violent inflamma- * L.c, No. 137. Emperor Leopold. 95 tion " of the peritoneal and pleural cavities. The " signs of inflammation " which they found in the abdominal viscera are omitted for the sake of brevity. The bowel seems not have been opened, of .the condition of its mucous membrane we are told nothing in spite of the chronic diarrhoea which was present. The article concludes : " The medicines which the inquisitive doctor wishes to know consisted of antiphlogistic nitrous remedies and enemata. They were given to arrest the violent inflammation which was clearly shown to have existed by the autopsy, as is shown in the report." Lastly, a minute report was promised by the physi- cian in ordinary Lagusius. Hahnemann on June 14th (No. 140) declared : — 1. That the reply of the emperor's physicians was made with less calmness than the occasion required and that it answered nothing. 2. That Herr von Lagusius should produce the full report of " this remarkable disease " which had been ex- pected for ten weeks. " He will not refuse our request and will tell his ignorant contemporaries the weighty authorities according to whom a patient should be bled a second, third and fourth time, if the previous bleedings produce no amelioration. He will present us with a history of the case which in pragmatic exactitude, lucid description and veracious fidelity will breathe the spirit of the Asclepiades of Cos." Kurt Sprengel* calls this attack of Hahnemann's" fanat- ical," without finding any further fault with it. The defence of the emperor's physicians he calls " very unsatis- factory" and informs us that the promised full history of the case did not appear. That it was not Hahnemann's intention to be-little his adversaries is shown by his defending Storck in 1791 against other physicians,-f- and pronouncing him one of the greatest physicians; though his true should be carefully * Kritische Uebersiclit dcs Ztistandcs der Arziieykitnde ini lctztc7t Jahrzchc?id, Halle, 1801, p. 139. t Translation of Monro II., p. 324. 94 His reductio ad absurdum of the separated from his false opinions; also in Hufeland's Journal {\2>o6, 3, p. 49) he declares him worthy of a statue. In the year 180$ Hahnemann gave utterance to the following sally : * With the exception of what a few distinguished men, to wit, Conrad Gesner, Storck, Cullen, Alexander, Coste and Willemet have done, by administering simple medicines alone and uncombined in certain diseases, or to persons in health, the rest is nothing but opinion, illusion, deception. In 1808 he sharply and truly criticises the actual condi- tion of therapeutics,! and at the same time enumerates the modes of treatment employed by the older and younger practitioners of the time : The method of treating most diseases by scouring out the stomach and bowels : — the method of treatment which aims its medicinal darts at imaginary acridities and impurities in the blood and other humours, at cancerous, rachitic, scrofulous, gouty, herpetic and scorbutic acridi- ties — the method of treatment that presupposes in most diseases a species of fundamental morbid action, such as dentition or derange- ments of the biliary system, or haemorrhoids, or infarctus, or obs- tructions in the mesenteric glands, or worms, and directs the treatment against these — the method which imagines it has always to do with debility, and conceives it is bound to stimulate, and re- stimulate (which they call strengthen) — the method which regards the diseased body as a mere chemically decomposed mass which must be restored to the proper chemical condition by chemical (nitrogenous, oxygenous, hydrogenous) antidotes : — another method that supposes diseases to have no other originating cause but mucosities — another that sees only inspissation of the juices— another that sees nought but acids — and yet another that thinks it has only to combat putridity, iS:c. Imagine the embarrassment in which a physician must be placed, when he comes to the sick-bed, as to whether he should follow this method or the other, in what perplexity he must be when neither the one nor the other mode of treatment avails him : how he, misled now by this, now by that view, feels himself constrained to prescribe now one, now another medicinal formula, again to abandon them and administer something totally different and, finding that none will suit the case, he thinks to effect, by the strength of the doses of most powerful and costly medicines, that cure which he knows not * Aesculapius in the Balance. Lesser Writings, p. 488. t On the present want of foreign medicines, Allg. Anz. d. Dcutscheii No. 207. Lesser Writings, 553. TJierapeiLtics of his time. 95 (nor any of his colleagues either) how to bring about mildly by means of small, rare doses of the simple but appropriate medicine. In the same year 1808 he says in his treatise, On the value of the speculative systems of medicine : * I pass on to patJiology, a science in which that same love of system, which has crazed the brains of the metaphysical physiologists, has caused a like misapplication of intellect in the attempt to seaixh into the internal essence of diseases, in order to discover what it is that causes diseases of the organism to become diseases. This they called the proximate internal caicse After humoral pathology (that conceit, which took especially with the vulgar, of considering the diseased body as a vessel full of im- purities of all sorts, and of acridities with Greek names which were supposed to cause the obstruction and vitiation of the fluids and solids, putrefaction, fever, everything, in short, whereof the patient complained, and which they fancied they could overcome by sweetening, diluting, purifying, loosening, thickening, cooling and evacuating measures) had, now under a gross, now under a more refined form, lasted through many ages, with occasional interludes of many lesser and greater systems — (to wit, the mechanical origin of diseases, the doctrine which derives diseases from the original form of the parts, that which ascribes them to spasms and paralysis, the solid and the nerve patholog}',t the chemical pathology, &c.) the seer Brown appeared, who, as though he had explored the pent secrets of Nature, stepped forward with amazing assurance, assumed one primaiy principle of life (irritability), would have it to be quantatively increased and diminished, accumulated and exhausted in diseases, and made no account of any other source of disease, but ascribed all diseases to want or excess of strength. He gained the adherence of the whole German medical world, a sure proof that their previous medical notions had never con- vinced and satisfied their minds, and had only floated before them in dim and flickering forms. They caught eagerly at this one- sidedness, which they persuaded themselves into believing was genuine simplicity And what was, after all, his one-sided irrita- bility .'' Could he attach any definite and intelligible idea to it .''"Did he not mystify us with a flood of words destitute of meaning ? Did he not draw us into a treatment of disease, which, while it answers in but few instances, and then imperfectly, could not but in the preponderating remainder give rise to an aggravation or speedy death. Nevertheless Hahnemann was not bhnd to the services of others. He shows this with regard to Brown in his * Allg. Anz. d. D. Lesser Writings^ p. 561. t Nerve pathology was the doctrine that attributed disease to a reaction of the nerves against unusual irritations. g6 His appreciation of Brown's system. excellent essay : Observations on the three current modes of treatment* But let us do him justice ! whilst we see that the glory which was to constitute the apotheosis of his original head vanishes, whilst the Titan who sought aimlessly to heap Pelion on Ossa, quietly descends from the rank of heroes — whilst we see that his colossal plan to turn everj'thing topsy-turx'y in the domain of /Esculapius is dashed to pieces, and that the myriads of special diseases cannot be referred by him to one or two causes, or what is the same thing, be decreed by him to consist of two or three identical diseases differing from one another only in degree, nor their infinite varieties be cured by two or three stimulants or non-stimulants — whilst we consign all these arabesque eccentricities to the domain of fable, let us not forget to do him the justice to acknowledge that with a powerful arm he routed the whole gang of humoral, acridity and saburral physicians who, with lancet, tepid drinks, miserable diet, emetics, purgatives and all the nameless varieties of resolvents, threatened to destroy our generation, or at least to deteriorate it radically and reduce it to the lowest possible condition ; that he reduced the number of diseases requiring antiphlogistic treatment to three per cent, of their former amount ; that he determined more accurately the influ- ence of the six so-called non-natural things on our health ; that he refuted the imaginary advantage of vegetable over animal diet to the advantage of mankind ; that he restored to the rank of a remedial agent a judicious regimen, and that he reintroduced the old distinction between diseases from defect of stimulus and those from excess of stimulus, and taught with some degree of truth the differ- ence of their treatment in a general way. This may reconcile us with his manes! Very few physicians — perhaps none — saw as clearly as Hahnemann in those days ; it was his strong hand which first succeeded in putting down the mob of bleeding and purging doctors. Our author continues his criticism :t The transcendental school repudiated the idea of having but one fundamental vital force. The reign of dualism commenced. Now we were fooled by the natural philosophers. For of such seers there was no lack, each devised a new view of things, each wove a different system, having nothing in common but the morbid propensity not only to evolve from their inner consciousness an exact a priori account of the nature and universal constitution of things, but actually to look on themselves as the creators of the whole, and to construct it out of their heads each according to his own fashion. * Hufeland's/(92/r;7a/XI., St. 4, 1S09. Lesser Writings, p. 623. t Lesser Writings, p. 562. Criticism of Contemporary Materia Medica. 97 All the utterances they maundered forth respecting life in the ab- stract and the essential nature of man were — like their whole con- ception — so unintelligible, so hollow and unmeaning, that no clear sense could be drawn from them. Human speech, which is only fitted to convey the impressions of sense and the ideas immediately flowing from them refused to express their conceits, their extravagant fantastic visions ; and, therefore, they had to babble them forth in new-fangled, high-sounding words, superlunary locutions, eccentric rhapsodies and unheard of phrases without any sense, and get involved in such gossamer subtleties, that one felt at a loss to know which was the most appropriate — a satire on such a misdirection of mental energy or an elegy on its ill success. We have to thank natural philosophy for the disorder and dislocation of many a young doctor's understanding. Moreover, their self-conceit was yet too much inflated for them to trouble themselves with the study of diseases or their cure ; they were content to prate about their dualism, their polarization, their representation, their reflex, their differentiation and indifferentiation, their potentiation and depotentiation. This natural philosophy still lives and flourishes in a far-fetched doctrine of the spiritualization of matter, and in ecstatic hallucinations concerning the creation and order of the universe and its microcosm — man. After describing the natural philosophical doctrine of sensibility, irritability and reproduction, and characterising it as a playing with empty words, he continues : * How impossible is it by all these barren a prioris to obtain such a just view of the different maladies as shall enable us to find the remedy suited to each — which ought to be the sole aim of the healing art ! How can one justify to a sound judgment the seeking to make these speculative subtleties, which can never be made concrete and applic- able, the chief study of the practical physician ? In the above-mentioned treatise he also criticises the materia medicas of his time : t And whence do these authorities on materia medica draw their data r Surely not from an immediate revelation ? In truth, one would almost be induced to believe they must have flowed to them from direct in- spiration, for they cannot be derived from the practice of physicians, who, it is well known, hold it beneath their dignity to prescribe one single, simple medicament and nothing more in a disease, and would let the patient die and the medical art ever remain as a no art, sooner than part with their learned prerogative of \\ riting artis- tically compounded prescriptions. * Lesser Waitings, p. 564. f Lesser Writings^ p. 569. 98 Need of a Reform of Medicine. Most of the imputed virtues of the simple drugs have, in the first place, obtained a footing in domestic practice and been brought into vogue by the vulgar and non-professional. Barren information of this sort was collected by the old herbalists, Mattholi, Tabernaemontanus, Gesner, Fuchs, Lonicer, Ray, Tourne- fort, Bock, Lobel, Thurneisser, Clusius, Bauhin, &c., very briefly, super- ficially and confusedly, and interwoven with baseless and superstitious conjectures, intermingled with that which the unciting Dioscorides had in a similar manner collected, and from this unsifted catalogue was our learned-looking mataia viedica supplied. One authority copied another down to our own times. Such is its not very trust- worthy origin. The few books that form an exception to this (Bergius and Cullen), are all the more meagre in data respecting the properties of the medicine ; consequently, as they for the most part, the latter especially, reject the vague and doubtful, we can gain little positive knowledge from them. Similar opinions respecting the allopathic materia medica we frequently find in more recent literature; we might fill a volume with them. But in Hahnemann's time such attacks were unheard of, " audacious " as the allopaths maintained. No physician since Paracelsus had dared to expose with such frankness and boldness the miserable condition of the medical treatment of the period. In an anonymous article,* in the year i8oS, after he had for twenty years past been calling the attention of his contem- porary physicians to the evils wrought by the healing art he writes : — It must some time or other be loudly and publicly said, so let it now be boldly and frankly said before the whole world, that our art requires a thorough reform from top to bottom. What should not be done is done, and what is essential is utterly neglected. The evil has come to such a pitch that the well-meant mildness of a John Huss is no longer of any use, but the fiery zeal of a stalwart Martin Luther is required to clear away this monstrous leaven. No other science or art, or even handicraft, has advanced so little with the progress of time, no art is so behindhand in its radical imper- fection as the medical art. Sometimes one fashion is followed, sometimes another, first one theory then another, and when the new does not seem to answer, the old is again tried (which was found to be inadequate before). Treatment Allg. Anz. d. D., No. 207. Lesser ]l'riti/igs^ p. 573. Provings of Drug in foruier times. 99 is always guided, not by conviction, but by opinion, each new mode of treatment was the more artistic and learned the less it succeeded, so that we are reduced to the wretched and hopeless choice of one of the numerous methods, almost all equally impotent, and have no fixed therapeutic principles of acknowledged value. Each follows the teaching of his own school and what his imagination suggests to him, and everyone finds in the immense magazine of opinions, authorities to which he can refer for confirmation. At the conclusion of his treatise On the value of the speculative systems of medicine, he exclaims :* Such is the fearful but too true condition of the medical art hitherto, which, under the treacherous promise of recovery and health, has been gnawing at the life of so many of the inhabitants of earth. Oh ! that it were mine to direct the better portion of the medical world, who can feel for the sufferings of their fellow creatures, and lon^ to know how they may relie\-e them, to those purer principles which lead directly to the desired goal. TJie proving of dnigs on the healthy organism. It is true that in all ages drugs were proved, and that on the healthy body. On this point Hahnemann says : -f- But in all the works on Materia Rlcdica^ from Dioscorides down to the latest books on this subject, there is almost nothmg said about the special peculiar action of individual medicines ; but, besides an account of their supposed utility in various nosological names of diseases, it is merely stated whether they promote the secre- tion of urine, perspiration, expectoration or menstruation, and more particularly whether they produce evacuation of the stomach and bowels upwards or downwards ; because all the aspirations and efforts of the practitioner have ever been chiefly directed to cause the expul- sion of a material morbific matter, and of sundry (fictitious) acridities, on which it was imagined diseases depended. There were a few exceptions to this, as Hahnemann admits, for instance, Conrad Gesner, Storck, Cullen, Alex- ander, Coste and Willemet. Haller also is honourably mentioned by Hahnemann on account of his proposal to ascertain the effects of medicines by provings on the human organism. But even these men only proved medicines in isolated cases, none of them proceeded systematically. * Lesser Writings, p. 573. t Organon, 5 Edit. Dudgeon's trans, p. 16. 100 H alineviann' s e.vly Hahnemann zuas the first zvho made the proving of medicines a system. As early as 1790 wc sec Hahnemann experimenting with drugs upon himself. In 1796 he writes in Hufeland's Journal* that the search for specific remediesf was the most desirable and praiseworthy undertaking, but he laments the utter want of any principle for discovering them; hitherto experience only has been the doubtful o-uidc. " Nothing then remains for ns hit to test the medicines on our ozvn bodies. The necessity of this has been perceived in all ages, but a false way was generally followed, inas- much as they were only employed empirically and capri- ciously in diseases." In this way, he continues, no certain results could be gathered, more especially as medicines were given mixed together. " The true physician whose sole aim is to perfect his art can make use of no other information concerning medicines than — " First, what is the pure action of each by itself on the healthy human body. " Secondly, what do observations of their action in various simple or complicated maladies teach us ? " In order to ascertain the actions of drugs on the health}- body, he recommends proving on ourselves and the study of records of poisoning. " A complete collection of this kind of information with estimation of the degree of reliance to be placed on their reporters would be, if I am not very much mistaken, the foundation stone of a materia medica, the sacred book of its revelation " * II., St. 3, p. 465. Lesser lVrifi72g-s^ 309 ef. scq. t In this place we may observe that the word specific has a difterent meaning in liomceopathy to what it has among allopathic therapeutists. The latter understand by specific remedies such as are employed for a certain disease ; thus for them quinine is a specific for ague, mercury for syphilis, &c. The physician who seeks for one medicine for a form of disease, falls into routine practice. Homceopathists understand by specific remedies such as are capable of influencing under certain con- ditions, certain organs and tissues, these and none other. P roving s of Medicines. lOl He zealously occupied himself and others who devoted themselves to it with the proving of medicines, the collec- tion of cases of poisoning and the formation from the results thus arrived at of a materia medica which should be free from all assumptions and founded only on experiment. His great endeavour was to found a physiological materia medica. His first essay of this kind was called, Fragnienta de vit'ibits iiiedicamentonini positivis,\Ji^?A?^, 1805, wherein he arranged systematically the results of his provings and of his studies. He himself says of it in the preface : " Nemo me melius novit, qiiam manca sint ct temiar Nevertheless a merely superficial glance at this collection will show with what devoted diligence and earnestness of conviction he worked at it. The book consists of two parts, of which the first contains 269, the second with the repertory of the first, 470 pages. The drugs in this work whose effects he partly proved on himself and partly gleaned from the toxicological observa- tions of others, are the following in their order : Aconitum napellus, tinctura acris (Hahnemann's causticum), arnica, belladonna, camphor, lytta vesicatoria (cantharides), cap- sicum annuum, chamomilla, china, cocculus, cuprum vitriolatum, digitalis, hyoscyamus, ignatia, ipecacuanha, ledum palastre, helleborus niger, mezereum, nux vomica, opium, Pulsatilla, rheum, stramonium, Valeriana, veratrum album. In the same year, 1805, he says in his Medicine of Expej'ience : * " those substances which we term medicines are unnatural irritants, only calculated to disturb the health of our body, our life and the functions of our organs, and to excite disagreeable sensations, in one word to render the healthy — sick. There is no medicine whatever which does not possess this tendency, and no substance is medicinal which does not possess it." Therefore he required the most exact proving of drugs on the human body in order to ascertain their powers. In * Lesser Writings^ p. 514. 102 Siibsiitiites for foreign drugs. the following year, 1806, Hahnemann contributed another essay on drug provings and minute individualization to Hufcland's/^?/nz(^/.* Two years later he discoursesf in his article On substitutes for foreign drtigs and on the recent announcement of their superflHOUsness^ in the following manner : — Let us only teach physicians principles of universal applicability according to which the powers of drugs may be ascertained and tested with certainty, as to what each is incontrovertibly useful and suitable for, to what cases of disease each is unexceptionably adapted, and what is the proper dose But we are by along way not so far advanced as this. No principles are yet universally recog- nised, according to which the curative powers of medicines (even of such as have never yet been employed at the sick bed) can with certainty be ascertained a priori^ without first subjecting them to the infinitely tedious process of testing them in haphasard fashion at the sick bed, which is almost never convincing and is usually attended with injurious effects. This obscure mode ab cffectii in niorbis whereby little or nothing is determined, has, moreover, the cruel and unpardonable disadvantage that the individual, naturally so irritable when diseased, is apt to be made worse by so many blindly instituted experiments, and may even fall a \'ictim to them, especi- ally since the recent fashion of prescribing large doses of powerful medicines has been adopted. But as long as the former better method is not established in the State, and the latter mode only is so, which has been from the beginning acknowledged to be unserviceable and insufficient — so long will contradictory opinions of physicians relative to the curative powers of medicines continue. A glaring instance of these " contradictory opinions of physicians " had just been given : the Vienna medical faculty had pronounced cascarilla quite superfluous,^ while * On Substitutes for China^ xxiii. St. 4, p. 27. British fourtial of Homaopathy, xlii. 212. t AUg. Anz. d. Z*., No. 237. Lesser IVi'i tings, p. 574. X In consequence of the continental blockade there occurred a sensible deficiency of foreign drugs, particularly for the immoderate doses of medicine then in vogue. That most keenly felt by physicians was the want of cinchona bark, for which a vast number of substitutes, mostly complicated mixtures of bitter drugs, was proposed. (Hahne- mann repeatedly declared that there could be no surrogates in the sense attached to the word by his colleagues, and in 180S advised as the best help out of the difficulty that it should be noted that when the Mode of Action of Bark in Ague. 103 the well-known Professor Hecker, of Berlin, in No. 221 of the Allgemeiner Anzeiger der DeiitseJien maintained — " Cascarilla is not only equally efficacious with cinchona bark in intermittent fever, but is even preferable." Hahne- mann showed that this was an unwarrantable assumption, because Hecker never employed cascarilla alone, nor does he mention in what kind of intermittent fever he rave it. Similia Siinilibus. m order to learn what that " better method " referred to is we must go back some years. In the Instruction to sti.r- geons concerning venereal diseases* 1789, Hahnemann speaks of the mode of action of mercury, which he alleged to be a counter-irritant action on the body, gave a description of in its most developed form, and called " mercurial fever." He had thus already left the beaten track, for it was the fashion to believe that it acted by removing the " miasma " by means of salivation, sweat, diarrhoea or urinary secre- tion. Hahnemann considered the production of his " mer- curial fever" necessary for the cure of syphilis. In the following year, 1790, Hahnemann translated Cullen's materia Medica. Cullen (II. 108) explains the efficacy of cinchona in intermittent fever by the " strength- ening power it exerts on the stomach," and adds, " that he has never met with anything in any book which made him doubt the truth of his view." Hahnemann rejects this explanation in a note, and adds : — Let us consider the following : — Substances such as strong coffee, pepper, arnica, ignatia and arsenic, which cause a kind of fever, extin- guish the periodicity of intermittent fevers. For the sake of experiment, I took for several days four drachms of good cinchona bark twice a day ; medicine was suitable such large doses were not required). Difficul- ties were also experienced from the failure of the supply of other drugs which the Vienna Faculty sought to overcome by publishing in the Allg. Ans. d. Deufschcn, 1808, No. 305, a list of foreign medicines which they alleged to be " quite superfluous," as for instance Peruvian balsam, copaiba, cina, colocynth, sarsaparilla, senega, tamarinds, &c. * Lesser lVriii?j(^s^ p. yy. 104 HaJiiieniann's first proving of Bark. my feet, finger tips, &c., first grew cold, I became exhausted and sleepy ; then my heart began to palpitate, my pulse became hard and rapid ; I had intolerable anxiety, trembling (but not rigor), prostration in all my limbs ; then throbbing in the head, flushing of the cheeks, thirst, and in short all the ordinary symptoms of interm.ittent fever [Hahne- mann had suffered from ague in Erlangen, Monro^ II, 396] appeared one after another, but without actual febrile rigor. In a word, even the special characteristic symptoms of intermittent fever, dulness of the senses, a kind of stiffness of all the joints, and in particular the disagreeable numb sensation which seemed to be located in the periosteal covering of all the bones of the body, made their appear- ance. This paroxysm lasted two to three hours each time and returned when I repeated the dose, otherwise not. On leaving off the drug I was soon quite well. On page 115 he mentions that a kind of artificial fever must be produced by ipecacuanha in order to cure certain forms of intermittent fever. In 1 79 1 his translation of Monro appeared (1794, a second unaltered edition). Here, also, he holds the view (II. 333) that "in insidious fevers from unknown causes in which the vital force is sluggish, a new, strengthening and efficacious fever " must be excited. In the chapter on cinchona, he again declares against "its tonic action" as the cause of its febrifuge property. (II. 378) " If, how- ever, we accept the view given at length in my note in Cullen's Mat. Mcdica, that bark in addition to its tonic action, overpowers and suppresses the intermittent fever chiefly by exciting a fever of short duration of its own, it will not be difficult to explain this paradox. All other substances capable of exciting counter-irritation and artifi- cial fever, given shortly before the paroxysm, check inter- mittent fever quite as specifically, but they cannot be relied upon with such certainty." " Sinnlia simililms " had not been pronounced, though he remarks (II. 181) that the mercurial disease resembled that of syphilis, without making any application of the resem- blance. He started with the idea of aiding the inherent recuperative power by a medicinal excitant acting directly on the part affected, while his contemporaries were talking of resolving obstructions, expelling aci-idities and evil hu- mours, removing the " morbidly over-produced, accumu- Contraria contrariis curentur. 105 lated inflammatory blood " from organs, remedying poverty of blood, counter-irritating, altering, strengthening, astring- ing, giving tone, &c. As a therapeutic axiom, he first alludes to the simile in the year 1796, in the well-known article in Hufeland's Journal: Essay on a nezu principle for discovering the curative pozuer of drugs* In the first place he speaks of the several ways adopted in practical medicine for treating the pathological changes of the body. TJie first way^ to reinoiie or destroy the fitndaniental cause of the disease, was the most elevated it could follow. All the imaginings and aspirations of the best physicians in all ages were directed to this object, the most worthy of the dignity of our art. Further on he speaks of this method as above all criti- cism, but says that the drugs chosen were not always those best adapted for the purpose. I shall now take leave of this roj'al road, and examine the other two ways of applj'ing medicines. The author then mentions the drugs which act according to the principle contraria contrariis, for instance, purgatives in constipation, venesection, cold and saltpetre in inflam- mations, alkalies in acidity of the stomach, opium in neuralgia. In acute diseases, which, if we remove the obstacles to recovery for but a few days, Nature will herself generally conquer, or if we cannot do so, succumb ; in acute diseases, I repeat, this application of remedies is proper, to the purpose and sufficient, as long as we do not possess the above-mentioned philosopher's stone (the knowledge of the fundamental cause of each disease, and the means of its removal), or as long as we have no rapidly acting specific. In chronic diseases, he contends, the mode of treatment according to contraria contrariis must be rejected ; it is improper to treat constipation by purgatives, the excited circulation of hysterical, cachectic and hypochondriacal pa- tients by venesection, acid eructations by alkalies, chronic pains by opium, &c. And although the great majority of my medical brethren still adhere to this method, I do not fear to call it palliative, injurious and destruc- tive. * Lesser Writings, p. 295. loG The Search for Specifics. I beseech my colleagues to abandon this method (contraria con- trariis) in chronic diseases, and in such acute diseases as tend to assume a chronic character ; it is the deceitful bye-path in the dark forest that leads to the fatal swamp. The \ain empiric imagines it to be the beaten highway, and plumes himself on the wretched power of giving a few hours' ease, unconcerned if, during this specious calm, the disease plant its roots still deeper. But I am not singular in warning against this fatal practice. The better, more discerning and conscientious physicians have from time to time sought for remedies (the tJiird way) for chronic diseases and acute diseases tending to chronic, which should not cloak the symptoms, but which should remo\e the disease radically, in one word for specific remedies But what guided them, what principle induced them to try such remedies ? Alas ! only a precedent from the empirical game of hazard, from domestic practice, chance cases in which these substances were accidentally found useful in this or that disease, often only in peculiar unmentioned combinations, which might perhaps never again occur ; sometimes in pure simple diseases. It were deplorable indeed if only chance and empirical hap-hazard could be considered as our guides in the discovery and application of the proper, the true remedies for chronic diseases, which certainly constitute the major portion of human ills. In order to ascertain the actions of remedial agents, for the purpose of applying them to the relief of human suffering, we should trust as little as possible to chance, but go to work as rationally and as methodically as possible. He then demands provings of drugs on the healthy organism, as he had ahxady mentioned. By them alone can the true nature, the real action of medicinal sub- stances be nietJiodically discovered ; from them alone can we learn in what cases of disease they may be employed with success and certainty. But as the key for this is still wanting, perhaps I am so fortunate as to be able to point out the principle under the guidance of which the lacunae in medicine may be filled up, and the science perfected by the gradual disco\'ery and application on rational principles of a suit- able specific remedy for each, more especially for each chronic disease, among the hitherto known (and among still unknown) medicines. It is contained I may say in the following axioms. Every powerful medicinal substance p7'oduces in the huniaii body a peculiar kind of disease, the more powetful the medicine, the jnore peculiar, marked and violciit the disease. IVe should imitate natu7-e, which sometimes cures a chronic disease by superadding another, and employ in the (especially chronic) disease 7VC wish to cure, that medicine which is able to produce another very Different modes of Drug- Action. 10/ similar artificial disease, and the former will be cured ; siinilia siiiiilibiis. We only require to know, on the one hand, the diseases of the human frame accurately in their essential characteristics and their accidental complications, and on the other hand, the pure effects of drugs, that is, the essential characteristics of the specific artificial disease and attendant symptoms caused by difference of dose, form, (S:c., and by choosing a remedy for a given natural disease that is capable of producing a very similar artificial disease, we shall be able to cure the most severe diseases. This axiom has, I confess, so much the appearance of a barren, analytical formula that I must hasten to illustrate it synthetically. Before he enters upon this he makes a few more remarks on the mode of action of medicines. Most medicines have more than one action ; the first a direct action, which gradually changes into the second (which I call the indirect secondary action). The latter is generally a state exactly the opposite of the former. In this way most vegetable substances act. But few medicines are exceptions to this rule, continuing their primary action uninterruptedly, but of the same kind, though always diminishing in degree, until after some time no trace of their action can be detected, and the natural condition of the organism is restored. Of this kind are the metallic (and other mineral ?) medicines, e.g., arsenic, mercur)', lead. If, in a case of chronic disease, a medicine be given whose direct primary action corresponds to the disease, the indirect secondary action is sometimes exactly the state of the body sought to be brought about. Palliative remedies do so much harm in chronic diseases, and render them more obstinate, probably because after their first antago- nistic action they are followed by a secondary action, which is similar to the disease itself. In the " elucidation by examples " of his therapeutic principle, he cites a number of drugs. Hahnemann here commits a great error, the greatest possible under the cir- cumstances. He leaves the method by induction too soon, and assumes the truth of many effects of drugs which he should first have tested. Various hypotheses are quoted instead of evidence, while other examples are very unsatis- factory. If he had only made use of unassailable demon- strations as he did with belladonna, mercury, arsenic, aconite, veratrum album, ipecacuanha, rhus, and discarded all doubt- ful matter, he would have much better served his cause. io8 Examples of howucopathic medication. We shall here quote some of Hahnemann's evidence, we must, however, not forget that he was a child of his times and could not have the knowledge of our day. Belladonna excites mania and convulsions, therefore it is effectual in certain cases of insanity and epilepsy. " Its great tendency to paralyse the optic nerve, renders it, as a similarly acting substance, an important remedy in amaurosis, in which I have myself seen very good results." It produces a kind of sleeplessness and cures it. Bella- donna has been found useful in serous apoplexy, and it produces similar states. Hyoscyamus produces and cures a certain kind of mania. It excites convulsions and is, therefore, beneficial in epilepsy. For similar reasons it sometimes cures chronic sleeplessness. Mercury produces rodent ulcers and caries of the bones ; " experience has confirmed the usefulness of this specific." Arsenic, according to Hahnemann's own experience, is very apt to excite febrile rigors and a paroxysm recurring daily, each time weaker. It is there- fore a curative drug in intermittent fever. Hufeland remarks thereupon in a note : " I must here remark with all due deference to the author, that I cannot yet accept the internal use of arsenic in intermittent fever." Arsenic causes many chronic skin eruptions and also cures them under certain conditions. Rhus causes erysipelatous skin eruptions and can heal them. Rheum causes diarrhoea and cures certain kinds. Every physician who studies Hahnemann's writings in an impartial spirit, must come to the conclusion that with many faults he was honestly anxious to find in the mighty chaos of assumptions, guesses, theoretical speculations and bewildering variety of experience, a firm footing on the ground of natural science for the foundation of medicine. From some remarks of Hahnemann in the following years, we see that he was quietly and incessantly occupied with the construction of a therapeutics according to his principles. In 1799 he remarks in his ApotJickcrlexicon (in which he gives observations on the action of single drugs) with regard to sabina, that the leaves and oil of this plant have the power Siniilia shnilibus an-enUir, 109 of exciting haemorrhages especially from the uterus, and may be successfully employed in such affections under certain circumstances. Also apropos of hyoscyamus he alleges that its toxic effects greatly resemble diseases which can be cured by it. In the following year he recommends belladonna in scarlet fever on the same therapeutic principle. In 1805 the Medicine of Experience appeared, in which Hahnemann pursues the following train of thought* Eveiy disease is owing' to some abnormal irritation of a peculiar character, which deranges the functions and healthy state of our organs. To this main maxim he adds two " maxims of experi- ence " : First viaxini of experience. When two abnormal irritations act simultaneously on the body, if the two be dissimilar, then the action of the one (the A\"eaker) irritation will be suppressed and suspended for some time by the other (the stronger). Secojid maxim of cxperic7tce. IV/icn t/te two irritations greatly resemble each other, then the one (the weaker) irritation, together with its effects, will be completely extinguished and annihilated by the analogous power of the other (the stronger). He supports these axioms by examples from daily prac- tice and concludes : In order therefore to be able to ewe, v.e shall only require to oppose to the existing' abnormal irritation of the disease an appropriate medi- cine, that is to say, another morbific power whose effect is very similar to that the disease displays. Further on he says : It is only by this property of producing; in the healthy body a se?'ies of specific morbid symptoms, tJiat medicine can cure diseases, that is to say, remove and extinguish the morbid in-itation by a suitable counto- irritation. Every simple medicinal substance, like the specific mor- bific miasmata (small -pox, measles, the venom of vipers, the sali\a of rabid animals, &c.) causes a peculiar specific disease — a series of determinate symptoms, which is not produced precisely in the same way by any other medicine in the world * Lesser JJ'ritings, p. 510. 1 1 o One single remedy at a time. In order to follow still further this natural 5,^uide, and to penetrate more profoundly into this source of knowledge, we administer these medicines experimentally, the weaker as well as the stronger, each singly and uncombined, to healthy individuals with caution and care- fully remov'ing all accessory circumstances capable of exercising an influence ; we note down the symptoms they occasion precisely in the order in which they occur, and thus we obtain the pure result of the form of disease that each of these medicinal substances is capable of producing, absolutely and by itself, in the human body. In this way we must obtain a knowledge of a sufficient supply of artificial morbific agents (medicines) for curative implements, so that we may be able to make a selection from among them. My Fmg- menta de viribus medicanicntorum are something of this sort. From this method of employing drugs he distinguishes the palHative method, according to which purgatives are given in constipation, opium in pain, cold in inflammation, &c. We cannot refrain from quoting the following paragraphs, though we may be accused of repetition. If we observe attentively we shall percei\e that wise nature pro- duces the greatest effects with simple, often with small means. To imitate her in this should be the highest aim of the reflecting mind. But the greater the number of means and appliances we heap together in order to attain a single object, the farther do we stray from the precepts of our great instructress, and the more miserable will be our work. With a few simple remedies, used singly one after the other, more frequently however with one alone, we may restore to normal harmony the greatest derangements of the diseased body, we may change the most chronic, apparently incurable diseases (not unfrequently in the shortest space of time) into health — whereas w^e may, by the em- ployment of a heap of ill-selected and composite remedies, see the most insignificant ailments degenerate into the greatest, most for- midable and most incurable diseases. Which of these two methods will the professor of the healing art, who strives after perfection, choose ? A single simple remedy is always calculated to produce the most beneficial effects, without any addi- tional means : provided it be the best selected, the most appropriate, and in the proper dose. It is iicvcr requisite to mix two of them together. We administer a medicine in order if possible to remove the whole disease by this single substance, or if this be not completely practicable, to obserxe from the effect of the medicine what still remains to be cured. One, two, or at the most three simple medicines are sufficient for the removal of the greatest disease HaJincniann's Precursors. ill and if this result does not follow, the fault lies with us ; it is not nature, nor the disease, that is to blame.* Now, as in e\eiy case, only a single simple medicinal substance is necessar)', no true physician would ever think of degrading himself and his art and defeating his own object, by giving a mixture of medicines. It will rather be a sign that he is certain of his subject if we find him prescribing only a single medicinal substance.f In this work he attempts to support his therapeutic principle by quotations from the writings of the older phy- sicians. Occasionally, however, physicians suspected that it was that property of medicines (now confirmed by innumerable observations) of ex- citing (positive) symptoms analogous to the disease, by virtue of a tendency inherent in them, which enabled them to effect real cures. But this ray of truth, I confess, seldom penetrated the spirit of our schools, enshrouded as they were in a cloud of systems. Thus Hippocrates or the author of the book riept t6-kwv twv kot' avepwirov (Basil. 1538, frob. page 72, lin. 35) give utterance to the re- markable words : Sia ra Ojjioia vovcros yiverai, Kai Sia. to, Ofxoia irposrpepo/j.fva €/c vosevvTcijv vyiaivovTai, &C. He adds the names of Detharding, Major, Brendelius, Dankwerts, and in the Oj-ganon he also mentions Bertholon, Thoury, Storck and the Dane Stahl. In Hufeland's Jonrnal\ he says in 1807 : Though here and there a wise man was found who had the courage to oppose the general ideas and to advocate " similia similibus,'' this proposition did not find general acceptation. Hahnemann adds later on in the Organon : § I do not bring forward the following passages from authors who had a presentiment of homoeopathy as proofs in support of this doctrine, which is firmly established on its own merits, but in order to avoid the imputation of having suppressed these foreshadowings with the view of securing for myself the credit of the priority of the idea. He might well say, however :|| " None has as yet taiigJit this homoeopathic therapeutic doctrine ; " emphasis being placed on the word " taught." * Lesser Wntzjtgs, p. 533. t Lesser Writings., p. 536. X Vol. XXVI., St. 2, pp. 5 and 6. § Dudgeon's translation, p. 106. II Organon, ist edit., p. 5. 112 Contempt for syniptomatic treatment. In the year 1807, in Hufcland's Jourjial, he attempts to support his therapeutic principle by very numerous quota- tions of the observations of earher physicians,* in addition to his former instances. But here again he allowed himself to be carried away by his zeal ; the selection of his evidence was not sufficiently careful, so that his opponents in many cases easily discovered inaccuracies Hahnemann's viezvs respecting' disease and his examination of the patient. As early as in 1786 Hahnemann blames the treatment of single symptoms of a disease instead of the disease itself, the " white-washing " of symptoms as he calls it (Preface to Arsenical Poisoning). He speaks to the same effect in various other places, as e.g., in 1800, in the preface to the ArzneiscJiatz!\ And thus as though they were independent beings endowed with free vohtion, each ingredient in a complete prescription has its task allotted to it, velinvitissima Minerva Hygciaque, and many other things are ex- pected of it; for there are many learned considerations in a regular classi- cal prescription. This indication and that one must be fulfilled, three, four and more symptoms must be met by as many different remedies. Consider Arcesilas ! how many remedies must be artistically com- bined in order to make the attack at once from all points. Something for the tendency to vomit, something else for the diarrhoea, something else for the evening fever and night sweats. And as the patient is so weak, tonic medicines must be added, and not one alone, but several, in order that what the one cannot do (which we don't know) the other may But what if all the symptoms p7-oceeded from one cause, as is a/ most always the case, and there wet'e one single drug that would meet all these symptoms. In order, however, to obtain an accurate picture of the disease, he insisted on a minute examination of the patient and all his symptoms. He thus writes in 1805 in Medicine of Experience :\ — * Fingerzeige aif den hom'oopathischen Gebrauch der Ar::neien in der bisherigen Praxis, vol. XXVI., St. 2, p. 5 — 43. This is given in Dudgeon's translation of the Organo7i. t Lesser Writings, p. J 02. + Lesser Writings, p. 505. Examination of the Patient. 113 The internal essential nature of every malady, of every individual case of disease, as far as it is necessary for us to know it for the purpose of curing it, expresses itself by the syniiptonis as they present themselves to the investigations of the true observer in their whole extent, connexion and succession. When the physician has discovered all the obscr\able symptoms of disease that exist, he has discovered the disease itself, he has attained the complete conception of it requisite for the cure. To enable us to perform a cure, we require to have a faithful picture of the disease with all its manifestations, and in addition, when this can be obtained, a knowledge of its predisposing and exciting causes, in order, after effecting the cure by means of medi- cines, to enable us to remove these also, by means of an improved regimen, and so prevent a relapse The patient relates the history of his ailments, those about him describe what they have observed in him, the physician sees, hears, feels, &c., all that there is of an altered or unusual character about him, and notes down each particular in its order, so that he may form an accurate picture of the disease. In the following pages he gives ample instructions as to what questions should be asked the patient and how he should be examined. He himself kept a very minute record of the cases of his patients. In each case he noted exactly the history and course of the disease down to the very minutest symptoms and deviations from health. For this purpose he often spent hours examining his patient. He also informed himself of the hygienic conditions of the abode, mode of life, preparation of food, occupation of his time, &;c. ; * all this at a time when physicians, with few excep- tions, limited their energies to writing prescriptions. These investigations of the disease were more and more minutely conducted by him as he became more and more convinced in the course of time that every disease had a special individual character. We very soon find him an enemy to all classifications and generalisations as the reader is already aware from his own words.f Here we may * Comp. Hahnemaiiifs Leben von Albrecht, Leipzig, 1875, P- 9°? also Elias, Horn. Giirkeiimonate^ Halle, 1827, p. 29. t Comp. Apothekerlexicoii, II., p. 88 ; then II., part 2, pp. 62, 99, loi, 123, 151, 152. "The physician who for every pain, every cough, every diarrhoea, has recourse to opium, is an out and out quack," pp. 206, 244, 282, 327, 330, 350, 356, 358, 364, 393, 399, 432, 450, 469- 8 114 Criticism of the ordinary practice quote a few of Hahnemann's characteristic remarks in the ArzneiscJiatz, of 1800, in which he insists upon the exact diagnosis and investigation of individual varieties of disease : " I think it a pity that no distinction has been made between the many varieties of dropsy, and that only one dropsy is spoken of The division into leucophlegmatic and inflammatory is not nearly adequate, any more than that of insanity into mania and melancholia. What should we think of a botanist who recognised no division of plants except into trees and herbs?" (page 71) When pareira root is recommended, Hahnemann exclaims : " Must it then be given in all cases of renal and vesical disease without exception ? What a noble remedy it must be if it can cure them all ! " (page 227.) Cinchona bark is recommended in a particular minutely described case. Hahnemann says : — " A single accurate description of a case, such as this, in which a drug should be employed, is worth a whole bulky volume of empirically jumbled prescriptions, though componded secunduin arte?n." (p. 202). The time of administration and the duration of the action of cinchona are spoken of, and the contradictory views of the best physicians, CuUen, Werlhof, Morton, Talbor, &c., given. On this Hahnemann says : " How exact must have been the observations of the physicians who after their employment of one of the most extensively used medicines, bark, for more than 160 years in a disease marked by characteristic symptoms of the most well-defined kind, neither knew the proper time for its administration nor how long its action lasted. (I found that its action ■ended twenty hours after its administration.) How can they presume to give reliable instruction with regard to the action of more rarely employed drugs in less characteristi- cally defined diseases?" (p. 245) A mixture of chamomile, myrrh and potash is recom- mended in ague. Hahnemann : " These one-sided modes of procedure cannot lead us to the discovery of the truth. In the empiric powder described above, chamomile flowers were by far the most powerful ingredient, and they possess of giving inixtiires of 7inknozvn drugs. 115 a far _