Google
This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project
to make the world's books discoverable online.
It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject
to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books
are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover.
Marks, notations and other maiginalia present in the original volume will appear in this file - a reminder of this book's long journey from the
publisher to a library and finally to you.
Usage guidelines
Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing tliis resource, we liave taken steps to
prevent abuse by commercial parties, including placing technical restrictions on automated querying.
We also ask that you:
Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for
personal, non-commercial purposes.
Refrain fivm automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the
use of public domain materials for these purposes and may be able to help.
Maintain attributionTht GoogXt "watermark" you see on each file is essential for in forming people about this project and helping them find
additional materials through Google Book Search. Please do not remove it.
Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner
anywhere in the world. Copyright infringement liabili^ can be quite severe.
About Google Book Search
Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web
at|http: //books .google .com/I
IL^^aaiBj
Zbe Sodet? of the mew SDovh Ibospltal,
/Darcl), 1898.
STANFORD UNIVERSITY
MEDfCAt CENFEH
STANFORD. CALIF, '54^05
4.
ESSER WRITINGS
lAMUEL HAHNEMANN
OOLLBCTBD
E, Dl' DfJZO N, H. n.
PRKFAOK AND NOTBS,
Eiramis. KrunUng In Ari a! CoBgreH. In Oii! yiml IBS), bj
WILLIAM RADDE,
rMl>> (Iffim u.- tin DlMMM Ootirt tor tks Ssohara DIMrlul V Nrnr-rnrk.
Lfcd
AMERICAN PREFACE.
br presen^g to the Ameiioan public, at » veiy moderate price,
# reprint of Hahnemann's Lesser Writings, the Publisher has been
IMtuated by an earnest desire to make generally kziown to laymen,
00 well as to medical men, the yast knowledge, the genius, and the
l^uine philanthropy of the illustrious founder of Homoeopathy.
Hie present yolume, comprising as it does, many clearly expressed
articles of general interest to all dasses, commends itself to the atten-
tion of aU who fed a true interest in the advancement of the healing
art
On rising from the perusal of almost any portion of tliese pages,
die reader will not £ul to be impressed with the noble b^aevolenoe,
aa well as the natural and acquired talents of Hahnemann.
Commencing, as tke Tolume does, with papers which were written
while our author still belonged to the Old School, and at a period
several years previous to the discovery of the homoeopathic prindple
of cure, we are enabled to appredate in the fullest manner his great-
ness even as an allopathic writer.
The most intelligent critics of all schools who are familiar with his
literary works, entertain the opinion that he was one of the most pro-
found thinkers, and one of the most learned and intelligent writers of
his day, even when he is judged by those productions which have
no special bearing upon Homoeopathy. His descripticms of disease,
his thorough knowledge of ancient languages, and of the medical
literature of the past, his wonderful powers of observation, his critical
acumen, and above all, his acknowledged benevolence and integrity,
would have seciHred for him a position among the great men of his
century under any droumstances. But as a reformer of the opinions
and practices of a class of men whose influence has remained pre-
eminent for more than two thousand years, he has met with the most
violent and determined opposition from the commencement to the
termination of his career. His earlier essays, however, published in
IT AMSRIOAK PBEFAOK.
Hufeland's Journal, and in pamphlet form, attracted universal admi-
ration from all sources, for their great originality, comprehensiveness,
and justice. Eminent among his cotemporaries as a classical scholar,
and for his profound knowledge of the lore of the ancients, his trans-
lations from the Syriac» Hebrew, Greek, Latin, French, and English,
were looked upon as becai ideals of what such works should be, and
were appreciated and used accordingly.
No sooner, however, had he announced a doctrine of cure which
dashed with the stereotyped dogmas of his brethren, and which threat-
ened to impair their pecuniary interests, than, a system of opposa-
tion and persecution of the most dishonourable character was insti-
tuted by both physicians and apothecaries. Not content with circu-
lating bitter denunciations, and the most unfounded calunmies vrith
respect to Hahnemann and his doctrines, they appealed to several
European governments for legislative enactments, which should re-
press their promulgation and practice, in order that they might still
continue to dictate to the public what should be their medical faith.
For a time, this arbitrary course was partially successful, and
victims were drugged as usual with poisons, to swell the coffers of the
doctors and druggists ; but gradually honest minds were directed
to the subject, and notwithstanding the almost certain risk of losing
caste with their friends, and of sacrificing, to a greater or less extent^
their general influence and their business interests, nearly all who
had the candour to investigate, became convinced of the truth of the
homoeopathic theory and had the moral courage to adopt it in prac-
tice. As time has rolled on, the system has continued steadily to ex-
tend, always among the most intelligent classes, until at the present
time, every civilized nation on the earth hails it as the most impor-
tant discovery, and the greatest blessing to suffering humanity of
modem times.
All must concede that but few medical writers have appeared since
the days of Hippocrates, whose opinions have stood the test of half
a century so triumphantly as those of our author. In a subject so ex-
tensive and difficult as that of the healing art, it is of course impos-
sible for any single man, however exalted his genius and talents, to
arrive at absolute perfection, or to remain entirely free from errors ;
but in the instance of Hahnemann, we might almost daim an excep-
tion to the rule, were it not for two or three minor, and really unim*
portant matters of opinion which are of but little importance in a
AMXBIOAN FREFAOX. V
practical point of view. His great law of cure similia iimilibua cu-
ranlur, stands forth before the world, and will ever continue to stand,
an immutable and glorious truth.
His doctrine of applying remedies which operate specifically upon
iiisecued parts alone, rather than upon those which are healthy ^ must
ever commend itself to the sound judgment of all thinking men.
In like manner, the discovery that the subdivision of crude sub-
stances, and the diffusion of their atoms through an inert vehicle, de-
veloped in them new and previously unappreciated curative powers,
^wheQ properly administered, is in itself sufficiently important to im-
mortalize its author.
So also, the introduction into medicine, of drug-provings for the
purpose of ascertaining the pure specific action of each article upon
the healthy organism and thus of enabling the practitioner to apply
Ills remedies in disease knowingly and efficiently, is another feature in
modem medical science which has already conmianded the attention
and admiration of the whole scientific world.
But while we claim for Hahnemann so exalted a position among
the good, the wise, and the great benefactors of modem times, we
are not so devoid of common sense as to claim for him infallihiUty,
The wisest and best men of all ages, have had their faults and their
errors, and it would be folly on the part of the homoeopath, to attri-
bute to the discoverer of similia, absolute perfection in every thing
pertaining to the theory and practice of medicine. By so doing we
should follow in the footsteps of the allopathists who for so many centu-
ries have adopted the views and practice of Hippocrates, without ques-
tion and without comment. Hahnemann has laid the foundation of the
true healing art on a firm and incontrovertible basis. The great fun-
damental principles to which we have already alluded, have been
thoroughly tested for more than half a century, with the most grati-
fying results ; and it is now very generally conceded by impartial
observers who have investigated the subject, that upon these princi-
ples alone can a rational system of medicine be founded.
But if this solid and glorious foundation has been laid for us, let it
not be supposed that the edifice is complete, and that nothing more
remains to be accomplished. Let it not be supposed, that with the
death of the venerated Hahnemann, the genius of Homoeopathy per-
ished also ; but let us give a just meed of praise to the many noble
spirits who by their labours have contributed so much towards the
VI AMSRIOIK PEOBrAOI.
vancement of our art. We need only mention the names of Jabr, Bau,
BcBKNiNaHAnsEK, NoAOK, Trinks, Hbrino, Henderson, Hartmann,
Staff, Gross, and Ruckert, to call forth a cordial response to our sen-
timents. Our School at the present time, contains a large number of
gentlemen of the highest order of talent, who are labouring assiduously
to perfect the system in all its details, and it becomes us as seekers
after truth, to avail ourselves of their experience and industry. We are
aware that there is a limited number of intolerant and contracted per-
sons, who would gladly repress all further original thought, and stifle all
future investigations upon the subject of Homoeopathy. Bigoted,
weak of intellect, and incapable of generating an original idea them-
selves, they have the presumption to set up a doctrine of infallibility,
for the present as well as* for all future generations, perfect in all re-
spects, and ever to be blindly worshipped. Forgetting the old maxim
that " to err, is human, but that perfection belongs only to Grod,"
they would inculcate a fixed standard of belief and practice for all
ooming time, regardless of all new discoveries and improvements.
Such men are a curse to any system, and were the great Master him-
self living, — he who passed his whole life in patiently seeking after
new facts, in order to modify and correct his erroneous ideas upon
medical subjects — he would be the first to condemn such an illiberal
policy. The author of Homoeopathy, throughout the whole of his
glorious carreer, was remarkable as a man of facts. Without a
particle of bigotry or prejudice in his composition, and possessing no
special reverence for the heathen dogmas which had been handed
down from generation to generation, his aim was truth alone, to ar-
rive at which, his eflbrts were untiring, as the manifold facts he has
put upon record amply prove. May all of his disciples follow in
his footsteps, and by exercising the same industry, the same libera,
lity, and the same devotion to science, seek to advance Homoeopathy
to that state of perfection which it must eventually attain.
TRAKSLATOR'S PREFACE.
To fonn a jost estimate of the genius and learning of Hahnemann,
and of the gradual and laborious manner in which he developed and
perfected his great Medical Reform, it is necessary to study not only
his more finished and larger works, the Organan^ the Pure Materia
Medica and the Chronic diseases^ but also his miscellaneous medical
writings, which I have here collected into one volume. In these we
traoe the gradual and progressive development of the homoeopathic
doctrine, and of the peculiarities of its practice ; we perceive that from
the very earliest period of his career, Hahnemann felt dissatisfied with
the practice of medicine as it had hitherto existed, and that, casting
from him as much as possible the prejudices, dogmas and false as-
sumptions of the schools, ¥rith which we know from his own confessions
he was deeply imbued, he sought by various ways to improve the
most important of all arts, that of medicine, until at length, abandoning
the time-honoured by-ways of vain speculation, he entered on the only
true but hitherto almost unbeaten track— of interrogating nature
herself; with what success, the wonderful results furnished by the
practice we owe to his genius and labours, testify.
It is not my intention to enter here into a critiea) analysis of the
writings contained in this volume, they must be read by every student of
homoeopathy who wishes to become acquainted with the Master-mind;
suffice it to say I have thought fit to include in this collection, an elab-
orate work ( On Venereal Diseases) of a date antecedent to Hahnemann's
first notion respecting the homoeopathic principle, which will be found
to contain many original ideas, and most important innovations on
the common practice ; the date of its publication sufficiently accounts
for its old-fashioned pathology and chemistry. I have also included
a work of a popular character, consisting chiefly of Essays on subjects
connected with Hygiene, which will well repay a perusal. The re-
Eoainder of the Essays in this volume bear more or less upon the re-
formed system of medicine, with the exception of the " Dissertation
on the Helleborism of the Ancients,''^ which could not have been omit-
viii trafblator's frxfacb,
ted from a collection of Hahnemann's works, as it shews the extent of
his acquaintance with the writings of the ancients, and is a masterly
specimen of critical acumen, medical knowledge and philological re-
search. It will be observed that I have arranged the writings as much
as possible in the order of their appearance. I may mention, that
this volume, besides containing all the Essays in Stapf 's coUection,
includes upwards of twenty that are not to be found there, some of whidi
were only published after Stapf 's volumes appeared (1829), but (Others
were either over-looked, or purposely omitted by that editor.
The notes I have added between brackets [ ] are simply such as I
have deemed requisite, in order to explain certain passages which
seemed to require elucidation.*
The remainder of Hahnemann's lesser writings which, from their
not referring strictly to the subject of medicine, from their antiqua-
ted character, or from other causes, I have not introduced into this col-
lection, I shall now briefly enumerate.
L Orioikal Works. —
1. DissertaHo inauguralis medica^ ConspectuB adjhctuum gpasmodu
corum aetiologicus et tkerapeuticus. £rlangae» 1779, p.p. 20, 4to.
2. Some small writings in the second part of Krebs' Medic, ^fieo-
hachtungen^ Quedlinburg, 1782. I have been unable to lay my hand
upon these, but from a reference in the next work, I find that one of
them relates to a mode of checking salivation a^ its commencementt
probably by means of liver of sulphur, or sulphuretted hydrogen gas,
as described in the Venereal Diseases.
8. Directions for curing radically old sores and indolent ulcers, with
an appendix, containing a more appropriate treatment of fistulas, caries,
spina ventosa, cancer, white swelling and pulmonary consumption,
Leipzic, 1784, pp. 192, 12mo. This work contains a good many use-
ful observations on the management of the system in general, and o^
old ulcers in particular: it shews up the absurdities of many
of the usual modes of treating disease, illustrated by exam-
* The " Case of Ck>lioodyiiia'' was translated by Dr. Ruseell, and the two Kfleay.),
" JSsculapius in the Balance," and " On the Value of the Speculative Systems o^
Medicine," originally appeared in an incomplete form in the BritUh Journal of
Homctopathy^ by whom translated I am unable to ascertain ; I have adopted these
IzanslatioDs, supplying their omissions, and making many alterations so as to consti.
tute them more exact renderings of the originals. For these translations, therefore, I
hold myself as much responsible a? for the rest^ which were^entirely translated by
myselC
niAirsLATOR^e pbxfaos. ix
ple8 chiefly deriTed from the author's own practice at 'Hermanstadt
in Transjlvania. He gives a very naive relation of several cases
mrhich he had treated according to the most approved methods
of the schools, with no other result but that of rendering his patients
'worse, and he mentions how they were cured by some fortuitous
circumstance, such as a total change in their habits of life, dec. In
this work he mentions that he has invented a certain ^' strengthening
balsam," for the treatment of old ulcers, whose composition he does
not reveal, but whidi he offers to supply genuine to any one. Per-
baps, like Shakspere's starved apothecary, it was his poverty and not
hiB will that consented to this unprofessional bit of retail trade — ^but
l>e this as it may, this is probably the circumstance that has. given
rise to the accusation, magnified by transmission through a host of
eager calunmiators, of his having sold a nostrum for all diseases. As
r^ards the medicinal treatment recommended in this book, it is just
what might satisfy the Edinburgh College of Physicians, but what
Hahnemann himself, afler a period of reflection and labour, some
years of which were spent in retirement from practice, subsequently
inveighed against with all his might ; and we know that every dis-
covery he afterwards made in medicine, and every improvement he ef-
fected in its practice, he immediately revealed to the world, so that
all might derive from it the benefit it was capable of affording ; though
as he himself observes in his preface to the Chronic Diseases, with
perhaps the slightest suspicion of a reminiscence of the old balsam
speculation, his discoveries would have been much more profitable to
himself had they been kept secret until after his death.
4. On Poisoning hy Arsenic , the remedies for it, and its medico-legal
investigation, Leipzic, 1786, p. p. 276, 8vo. This is a most learned
work and displays great chemical knowledge. I would willingly
have translated it for the present collection, but chemistry is a science
that has advanced with such gigantic strides of late years, that a work
upon the subject written upwards of fifty years ago would be scarcely
intelligible now a-days.
5. On the difficulties of preparing soda from potash and kitchen salt.
(In CreWs Chem, Annd., 1787, pt. 2.)
6. Treatise on the prejudices existing against coal fires, on the modes
of improving this combustible^ and on its employment in heating bakers*
ovens, Wiih an appendix, containing M, M, Lanoix and Brunts prize
essays on this subject. With three copper-plates. Dresden, 1787, 8vo.
7. On the injiuente o/sotm hindt 6/ gas im the fetm$MaHt>f$ of
(In CreWs Chan, AnnaLy Vol. i, 1788^ pt. 4.)
Sn On the tests for iron and lead in mne. (In CreWs Chsm* AnnaUf
Vol. i, 1788, pt 4.)
9. On ^ hik and gallstones. (In OrelTs Chem. AnndL^ VoL ii,
1788, pt. 10.)
10. On an uncommonly powerful means fir cheeking putr^tetion,
(In CrelPs Chem. AnnaL, Vol. ii, pt. 12^ 1788.) This was translated
into French bj Cruet, in the Journal de Medecine^ T. Ixxxi, Paris,
1789, Nov., No. 9.
11. Unsuccessful experiments with some pretended new discoveries.
(In CrdVs Chem. Annal.^ 1789, Vol. i, pt. 8.)
12. Letter to L, CreUj respecting heavy-spar, (In CreWs Annal.^
Vol. i, 1789,
Id. Discovery of a new constituent in plumbago, (In CreWs Chem,
Annal., 1789, VoL ii, pt. 10.)
14. Some observations on the < astringent principle of plants, (In
CreWs Beiir&ge zu den Chem, Annal,, iv, x, 1789.)
15. Ihsact mode of preparing the soluble mercury, (In the Neuen
literarischen Nachrichten fur Aerzte^ for the years 1788 and 1789, 4th
Quarter, Halle, 1789 ; and in Baldinger^s Neue Magazin f. Aerzte^
Vol. xi, pt. 5, 1789.)
16. Complete mode of preparing the soluble mercury, (In CrtUVs
Chem. Annal, Vol. ii, 1790, pt. 8.
17. Insolubility of some metals and (heir oxydes in cattstic ammonia
(In CreWs Chem, Annal,, VoL il, 1791, pt. 8.)
18. Means fir preventing salivation, and the disastrous effects of
mercury, (In JBlumenbacVs med, Bibliotheky Vol. iii, 1791, pt. 3.)
19. Contributions to the art of testing wine. (In Scherf^s Beitrdge
zum Archiv der med, Polizei und Volksarzneik,, Vol. iii, Leipzic,
1792.)
20. On the preparation of Glauber^ s salts according to ^ method of
Ballen. (In CrdPs Chem. Annal, 1792, pt. 1.)
21. Pharmaceutical Lexicon^ First vol., first part. A to £.
Leipzio, 1793.— First vol., second part. F to E. Leipzic, 1795. —
After the publication of these two parts the work ceased. It contains
as far as it goes a great deal of useful information, though the plan
adopted does not seem to me to be the most felicitous that could
be devised : thus the objects of natural history, in place of being
moraLAxbft't nunrAOi. zi
treated of imdflr iheir wdl-knowii sdentifio appellatioiia, are amnged
alphabedoally under the most barbaroua, break-jaw oompound Qer-
man worda, invented for the oocadon : for example the him; wmUca
here appears under tllie hideona name of JtrMentmgmudimnddbtmm^
ikkeJUuf ARM is metamorphosed into M&imlrifiwwrmH^^Jarn^ and die
tmmUka crupahaUiBlumaifkopkraitBemiinMe^ which nomendiftlure, al-
though it may be very euphonious to a G^erman ear, and very ezpres-
siwe to a German understanding, is oertainly &r from sdentifici and
neoeesitates the separation of things that ought to have beoi found
together. The principle of the arrangement will be best understood
by likening it to a Directory arranged alphabetically according to the
fshriatian names in place of the surnames of individuals
22. Semarki on tk$ Wirtemberg and Haknemann^t tsitt fof vtfie.
(In the InidUgewtblatt of the AUg. Ui. %., 178a Na 70, p. 080.)
28. FrqHMralum o/Uu CoMBdl ydhw. £rfi2rt» 1798^ 4to. (It is
sdflo published in the AtL Academ, ScitnL Erford ad ann. 1704)
24L On Raknemann^8 tut fit io«m and the new liquor probaiariui
JarHor. (In Tromtdorfa Jaumalder PkarmoMie fiut Ajtrzk. Vol. ii,
pt. 1, 1704.)
25. FTOgmenta dt virihu medieameniorum po9iihi$^ 8%v€ m iono cor-
pare humano obtervatU. 2 vols. Leipiic^ 1805. This is the germ
of the Pure Materia Materia.
IL Translations from various lanouaoss, oensrallt with
ADDITIONS AND NOTES Bt HaHNSMANN. —
1. Physiological essays and observations^ by John Stedman* Lon-
don, 1760.— Leipsdc, 1777.
2. Nugent^s essay on the hydrophobia. London, 1758, — Leipzic,
1777.
8. W, Falconer on the waters commonly used at Bath, 1775. 2
vols. — Leipzic, 1777.
*4. BalTs modem practice of physic — 2 vols. Leipzic, 1777 and
1780.
5. Procedes chimiques^ ranges methodiquement et d^finispar M, Dc
maehy. On y a joint precis d*une nouvelle table des combinaisons ou
rapport p, s. de suite d Vlnstitut de Chimie. 1760, reimprime avec des
annotations de Struve dans les descriptions des Arts et Mitiers. Neuf-
chatel, V. xii, 1780.— In 2 vols. Leipzic, 1784.
6. L'Art du destiUateur liquoriste^ par Dmachy et Dubuisron^ w r«
Xii translator's FR£FACS.
des annoUUioM du Dr. Struve, Paris, 1775. — In 2 ^ols. Leipzic,
1785.
7. L'Art du vinaigrier^par Demacky, avec des annotations de Struve
dans les descriptions des Arts et Metiers, Neufchatel, V. xii, 1780. —
Leipzic, 1787.
8. Les falsifications des medicaments devoilees, ouvrage dans lequel
on enseigne les moyens de decouvrir les tromperies mises en usage pour
falsifier les medicaments tant simples que composes^ et oii on etablit des
regies pour s^assurer de leur bonte. Ouvrage non settlement utile auz
medecins, chirurgiens, apothecaires^ droguistes, mais aussi aux malades,
A la Haye et a Bruxelles, 1784.— Dresden, 1787.
9. The history of the lives of Abelard and Heloisa^ comprising a
period of eighty four years^from 1079 to 1163, vjith their genuine letters
from the collection of Amboise ; by Sir Joseph Barrington. Birming-
ham and London, 1787. — Leipzic, 1789.
10. Inquiry into the nature^ causes and cure of the consump-
tion of the lungs, with some observations on a late publication on the
same subject; by Michael Ryan, M, 2>., F.R.A,S, Edin, London,
1787.— Leipzic, 1790.
11. DeW arte di fare U vino ragionamente di Ad. Fabbroni, pre^
miato delta Reals Academia economica di Firenge. Florence, 1787, 2d
edit. 1790.— Leipzic, 1790.
12. Advice to the female sex in general, particularly in a state of
pregnancy and lying-in, to which is added an appendix, containing
some directions relative to the management of children in the first
part of life, by John Origg, accoucheur and surgeon to the Bath Work-
house, London, 1789. — Leipzic, 179L
13. Annals of agriculture and other useful arts, by Arthur Youngs
F.RS. London, pts. 1 to 30, 1786.— Leipzic, 2 vols., 1790 and 1791.
14. A treatise of the materia medico, by William Cutlen, M. D,,
Professor of the Practice of Physic in the University of Edinburgh,
Edinburgh, 1789.— Leipzic, 2 vols., 1790.
15. A medical and pharmaceutical chemistry and the materia medico^
by Donald Monro, M. D,, physician to St. George'* s Hospital, F.R.C.J
Land, d; F.R.S. London, 1788.— Leipzic, 2 vols., 1791.
16. Essai anaJyt?que sur V air pur et les differentes especes d^air
par De la Metherie, doet. med,, membre des Academies de Dijm e,
Mayence. Paris, 1758. — Leipzic, 2 vols, 1791 and 1792.
17. Chemical observation^^ on sugar, by Edward Ringby. London
1788.— Dresden, 2 vols., 1791.
trasblator's frsfaoi. ziii
18. /Vuic^pef A«r.«r.JKotttieoiiftrrMiO(ilm
Han nor b eanMrvaHtm du tnfamU^ %t twr Itmr Uiaeaiitm pkjftigtte
cf morale^ depuU km' maummee /u$qu^d P^po^ue d$ lewr emitk
dam» let keok» noHmwhi. Ouwrage indiqui pour k etmeourM^
mnvamt It dient ife 2bi Comvemtkm natUmdU du 9 PIvwom dernier.
A Paris, Pan 2 de la B6publiqae frangaise. — ^lUs, which was publish-
ed at Leipzic in 1796» under the titl^ifHamdbuch/hrJIBUieriUothBr'B
Manual), is usuallj inserted among the original works of Hahnemann,
but a careful oomparison with the work whose title I have given enaUes
me to state that it is nothing more then a translation of that work,
with a few additions and one or two alterations by the translator. It
therefore properly belongs to this list
18, Tkesawrwe medicamimum. A new eoUeetkm of medieal preecrip-
Hone^ dittribuied mio iwehe elateee^ and aeeompanied wUh pharmaceu*
Heai and praeHeal remarket exhSbiting a view of Ae present eiaUt of the
wuiiena mediea and praetieefifpkpeic^ both aihme and abroad, na
second editum^wUh an appendix and other addiiiane* By a member of the
Zandon College rf phyeiekme. London, 1794. — ^Leipzio, 1800. Hah-
nemann published this translation anonymously ; I have given his
preface to it, whidi is a masterly satire on the contents of the woiiE
itself at p. 344 of this volume.
20. ne materia medica of Albert von Sailer. Leipzic, 1806.
Besides the above, many translations from the English and Latin
were made by EUmemann for the Samndung der auserleeeneten und
neuesten Abhandlungen fwr Wunddrzte, Leipzic, 1788, 1784, 1787.
Loodm, July, 1861.
Appended as a fac-simile of Hahnemann's handwriting, which may
be interesting to his admirers. The little note possesses no particular
interest in itself, beyond being a good specimen of his minute and
beautiful writing at the age of 86, and shewing the affectionate style
be had of addressing his friends. The following is a translation of it.
•* To Hofrath Lehmann,*
•* Dear friend,
'* I beg you to send me the third trituration in powder of the
* Dr. Lehmann of Cdtlien, to wbom Hahnemann entrusted the preparation of all
hia medicinea up to the latest period of his life, and to whom J am indebted fat thb
autographic relks.
xjv translator's prefacx.
medicines in the aopompanying list, which you have not yet sent me,
and to give them to Amelia,* she will bring them with her to me,
along with a few lines from your pen, so that I may see that you are
still alive, and that you are well and happy, and also how your dear
family are.
^' Both of us here are well, and send you all our hearty regards.
" Yours,
*' Sam. Hahmbmanh.
"Paris, 23d March, 1841."
* One of Hahnemaim's daughters, Madame liebc^ fonnerly SQbs.
Fwsinufe of HaJttumunn's wriHnq .
1^ A.>^tU^ ^r
^^ <6j;i ^?s^ w^.yO^ ^M.^1;^
>«>>/
CONTENTS.
. . . . ii
IVmuktoc's PKeiMe • • • rll
99C riinila of Hwhnwmmtfs writing, to hm page • • . • • sir
iMtnictMn fcr 8aigeoi|B rwpeetn^ VioewdL Dimati (1199) • . • . 1
Tl.oftkodofH«.W,P«L(m«) I . . . .IW
T1ioRi«idofHMdth,PtetIl<17»6)f ^^^ *^ ] • . . 300
PoMriptioQ of Bockenbrii^ dnriiy hit IhMnity (1796) ... . 84S
BMftj on a New Prinoqila fiv aaoertalsBig the Oiaalivia Powws o^
afew^^bnoeaattlioaefaitliefifeoenpkTedcnoe) S49
Oaie of lapidlj cued Oolieod^ (1797) SOS
Aie the Obstadea to (Je^aint J aod Simplio^7 m Fkw^
aUet (1797) , . . S07
Antidotes to aome Heroie Vegetable Sabatances (179S) 8d2
Some kinds of CVntinaed and Remittent Fevers (1798) 826
Some Periodical and Hebdomadal Diseases (1798) . . . . S41
A IVefi¥» (1800) .... 844
Fmgmentarj ObserratioiiB on Brown*s JSIements of Medicine (1801) • . 860
View of Professiooal libemlily at the eommenoement of the Nineteenth CJentocy
(1801) 862
Cure and Prerention of Scariet^fever (1801) 869
On the Power, of SmallDoses of Medicine in General, and of Belladonna in partir
cubr (1801) 886
On a proposed Remedy for Hydrophobia (1808) .889
On the EfledaofOoffee, from original Obaervalions (1808) . . . . 89;i
.^EsculapinsintheBaUmoe (1806) 410
The Medicine of Experience (1806) 486
Objections to a proposed Sabstitnte for Cinchona Bark and to Suocedanea in
general(1806) 476
ObserFattoQBonthe Scarlet-fever (1808) 479
On the present want of Foreign Medicines (1808) 484
On the Valoe of the Speculative Systems of Medicine, especially as vieved in
connexion with the usual methods of practice with which they have been
associated (1808) 488
XYl C0KTBNT8.
On Substitutes for Foreign Drugs, and on the recent announcement of the
Medical Faculty in Vienna relative to the Superfluousness of the latter
(1808) ,....*.. 606
Extract from a letter to a Physician of High Standing on the great Necessity of
a Regeneration of Medicine (1808) 611
Observations on the Three Current Methods of Treatment (1809) . . . 62S
To a Candidate for the Degree of M. D. (1809) 66S
On the Prevailing Fever (1809) 666
Signs of the Times in the Ordinary System of Medicine (1809) . . . 666
Medical Historical Desertation on the Helleborism of the Ancients (1812) . . 669
SjMrit of the Homoeopathic Doctrine of Medicine (1818) 617
Treatment of the Typhus or Hospital Fever at present prevailing (1814) . 681
On the Treatment of Bums (1816) 686
On the Venereal Disease and its ordinary improper treatment (1816) . . 646
Nota bene for my Reviewers (1817) 669
Examination of the Sources of the ordinary Materia Medica (1817) . . 664
On the Uncharitableness towards Suicides (1819) 696
Treatment of the Purpura Miliaris (1821) 696
On the Preparation and Dispensing of Medicines by Homoeopathic Physicians
themselves :
L Representation to a Person high in Authority (1820) . . 696
XL Tlie Homoeopathic Physician is prevented by no existing Laws regu-
lating medical practice, from himself Administering his Medicines
to his patienU (1821) 708
IIL How may Homcsopathy be most certainly eradicated? (1825) . 706
Contrast of the Old and New systems of Medicine (1825) . . . .712
The Medical Observer (1825) , 724
How can Small Doses of such very Attenuated Medicine as Homoeopathy em-
ploys still possess great power f (1827) 728
On the Impregnation of the Globules with Medicine (1829) . . . 786
Allopathy: a word of Warning to all Sick Persons (1881) .... 786
Oure and Prevention of tlie Asiatic C!holera (1881) 758
Appeal to tliinking Philanthropists respecting the mode of Propagation of the
Asiatic Cholera (1881) • . .766
Remarks on the extreme Attenuation of Homoeopathic remedies (1882) . 768
Oases illustrative of Homoeopathic Practice (1888) 766
Two cases from Hahnemann's Note book (1848) .... 778
*
INSTRUCTION FOR SURGEONS
KESPECIINO
VENEREAL DISEASES,
TOGETHER WITH
A NEW MERCURIAL PREPARATION.
By SAMUEL HAHNEMANN, Doctor of Medicine.
FiBST PUBU8HED AT I^BIFZIQ, IN 1789.
PREFACj:.
My intention in this book is to make the medical public familiar
with a wholesome theory and an improved treatment of the diseases
herein spoken of.
Hunter, Schwediauer, Hecker, Andr6, Simmons, Peyrilhe, Falk,
and some other, known and anonymous, older and more recent authors
have assisted me, partly by supplying me with what I did not know,
partly by enabling me to arrange my matter. I have made grateful
mention of their names or books.
I therefore trust my labour is not superfluous, for to the construc-
tion of a building belong not only beams and pillars, but also parti-
tion walls and buttresses ; not only stone blocks, but small stones to
fill up the intervening spaces ; and well is it if they fit.
It is in every way a ticklish undertaking to propose a new remedy
or to bring again into notice a neglected or little known one. The
person who attempts this must cither be a man of high repute, or be
entirely free from any suspicion of mean objects.
Although destitute of the former, I am quite at ease respecting the
latter. I give an accurate account of the mode of preparing an ex-
cellent remedy. Any one who has been in the habit of prepai-ing
other chemical drugs, can unhesitatingly prepare this one, assured oi
the result ; I conceal no step, no manipulation in the process. The ex-
cellence of the remedy is obvious from the very nature of the thing,
and is further proved by the observations of myself and niy friends,
who have seen similar advantage from its employment. Any one who
knows a better, is at perfect liberty to make it known and give it the
preference to mine.
When I call it mine, I only mean thereby to say, that I show a
purer and more certain mode of preparing it than my predecessors,
and give more definite instruction regarding the precautions to be at-
tended to in its use and .its mode of action, and not that no one has
ever thought of employing anything similar.
1
2 ox VENEREAL DISEASES.
A precipitated luercury, very similar to the " soluble mercury,"
{prcccipiiatum mercurli carnei colons, qui ex soluiione mercurii vivi
la aqua forti puratnr^ aJFuso volatili itrhur sinritu) was first used inter-
nally with the hest effects in syphih's, IrtO.I, by Gorvaise Ucay, made
into pills with equal parts of oxydised mercury and some honey — the
dose, two or three grains several times a day. I refer the reader to
his TraiU de la maladic v/'n^rie/inr, Tuuk>use, 1693, chap. 9, though
the preparation could not liavc been entirely free from turbith and
white i)recipitate.
This excellent remedy, however, subsequently fell into complete
neglect, until in recent times the progress of chemistry suggested
similar mercurial preparations; but we can hardly say that their em-
ployment was ever greatly in vogue, with the exception perhaps of
Black's pulvis cinerevs. Prepossession in favour of what was old, al-
though less efficacious or even prejudicial, combined with no small
]>rejudice^ against all that could be called new and untried in mercu-
rial preparations or other remedies for venereal affections, induced
practitioners not to give the latter a trial, but rather to stick to their
calomel, sublimate, and Neapolitan ointment.
And yet the more recent pharmacopoeias furnish us with remedies
which bear a striking resemblance to mine, and may have occasionally
been used.
Such a pri'paration is the mercury precipitated from nitric acid by
ammonia, ^;?//i'/» mercurii cinereus^ E., turpethum albvm, O., mercw-
rlus pra:ci2)i(atu8 dulcis^ O,, as also the (urpelhinn nigrum or mercuriu4
prcccipitutus niger^ precipitated by ammonia in vapour from the same
acid. 1 long made my preparation in the latter way, until I corrected
its imperfections by the changes mentioned below.
Dr. Black is said to be the in venter ^ of the pulvis mercurii cine'
reu8^ which he directs to be made in the following way. " Take equal
parts of weak nitric acid and mercury, mix together and let the mer-
cury dissolve, dilute it with pure water, add ammonia until the mer-
cury is completely separated, wash the powder with pure water and
dry it."
I may here allude to the merctirius lirascip. fuscus Wu^rzii^ a pre-
* The many db^appointcd hopes respecting tlic more recent specifics fur syphilis,
which their qiiackish vendors announced Tcith the most exaggerated recommcnda>
tiun<t, and kept secret to the great advantage of their pockety hare served to raider
practical physidans very shy of such remedies. They did not observe any of the
boasted effects of these costly nostrums, but often the injurious results from their
use ; and the discovery of their composition often revealed some mercurial prepara-
tion that had long been known.
* Gervaise Ucay, as I have shewn above, prepared it long before him fiir the same
object
PREFACE. S
cipitate from nitric acid by potash, merely because it bears some re-
semblance to mine.
All the authors of the remedies I have named sought to obtain a
pure oxyde of mercury free from corrosive acids, especially from
sulphuric and muriatic acids, and from the disadvantages of the white
precipitate and turbith ; let us see if they attained their object.
The purest saltpetre is never used for the preparation of nitric acid *
it is always adulterated with earthly muriates or neutral salts. Even
the most purified is not free from these. When mercury is dissolved
in this, heat is usually applied by means of a sand-bath, in order to
hasten the solution. The liquid is at first clouded white but soon af-
terwards aU becomes dear, that is to say the white precipitate at first
formed is redissolved and retained in solution in the acid in such a
way that even dilution with water cannot precipitate it, and this can
only be done by an alkaline solution. If the mercury be now pre-
cipitated from this solution by any alkali, the liberated white precipi-
tate falls at the same time, and the precipitate is thus adulterated by
no small quantity of a very poisonous medicine.
If we take any one of the mercurial preparations I have named, put
it into a medicinal bottle of considerable size, and place this in a sand-
bath in such a way that it lies almost inverted, but so that the powder
rests upon the side ; the neck of the bottle being completely buried in
the hot sand, and the bulging out part of the bottle wherein the pow-
der lies completely surrounded by the sand. If heat be now gradual-
ly applied, a white deposit will take place in the uppermost part of
the glass, composed partly of corrosive sublimate, partly of calomel
these being the two preparations into which the white precipitate is
resolved by sublimation. The weight of both together will indicate
the quantity of white precipitate contained in the mercurial prepara-
tion, and every one can easily convince himself of the truth of my as-
sertion. If we employed purified and redistilled nitric acid for its
preparation, we should certainly be much more sure of the result, but
greatly increase the price of the substance. But even this will not
suffice to free it from sulphuric acid.
But as the ordinary nitric acid is procured by the action of ordinary
vitriol on nitre, it has frequently an admixture of sulphuric acid. It
must first be rectified over fresh nitre, before we attempt to purify it by
redistillation, and this will increase still more the value of the dissol-
vent. Who could trust to avaricious apothecaries paying attention
to all these particulars 1
I now pass on to the precipitating agent, and it is a matter of
indifference which of them be used, (whether volatile or fixed alkali or
alkaline earths), provided only it be pure.
Common chalk, marble, oyster-shells furnish, when calcined and
4 ON YEKEBEAL DISEASES.
dissolved so as to form lime-water, a verj good precipitant in many
cases but I may here observe that all are products of the sea, con-
sequently, as experiment likewise demonstrates, not free from
muriatic acid.
Ordinary fixed alkali is usually obtained from potashes, which in
many cases contain an admixture of sulphuric acid, (oflen designedly
added to it for the sake of adulteration) but chiefly of magnesia, and
also ordinary kitchen salt. The water usually employed for its
purification contributes not a little to this impurity.
The potash prepared from tartar w^ould be much more serviceable
for the purpose, if it were prepared by burning pure crude tartar and
extracting the salt therefrom by means of distilled water ; but even
this has the disadvantage of containing too much carbonic acid, and
when, in a watery solution, it should precipitate the mercurial
oxyde from the nitric acid, it redissolves the greater part of it
again.
The carbonate of ammonia and ordinary spirits of hartshorn
possess the same disadvantages, from their excess of carbonic acid.
But caustic ammonia and that distilled with alcohol have not this
fault, but both of them, as well as the dry carbonate of ammonia and
the ordinary fluid spirit of hartshorn, contain no small proportion of
muriatic acid ; as we may perceive, by saturating them with acetic
acid and adding nitrate or sulphate of silver, when the chloride of
silver is precipitated.
It is not indifferent what water we employ for the necessary
dilution. Well water almost always contains a proportion of
muriatic acid and will not do for this purpose. Many spring-waters
also are not free from it.
It is well known that much depends on the purity of the mercury,
which is frequently adulterated with lead and bismuth. A mere
distillation of the suspected metal will not suffice ; much of the mixed
metals would pass over along with it. Still less will the mere
mechanical purification by squeezing it through leather suffice; a
certain proportion of bismuth liquifies the lead in the mercury so
much, that it will also pass through the pores of the leather. A
much better plan is to get the metal by the reduction of cinnabar,
especially that in the massive form, which may be mingled with
potash, lime, or iron filings, and the metallic mercury obtained there-
from by diBtillation.
If a saturated solution of the mercury of commerce in nitric acid,
diluted with equal parts of water, be boiled for half an hour with
twice as much suspected mercury as there is in the solution, ^e
mercury will lose all traces of foreign metals and be as pure as that
obtained by reducing cinnabar.
PREFACB. 6
PreparaHan of the Soluble Mercury.
Mercury purified in the latter manner I placed in a deep cellar,* and
poured upon it as much nitric acid of an inferior kind (distilled with
ilamina or otherwise) as was necessary for its dissolution, and stirred
this several times a day, for the heaviest portion of the solution floats
closely above the mercury and soon puts a stop to its fnrther dissolu-
tion unless we adopt this manipulation.
After the lapse of eight days we may be certain of the saturation
of the acid, though there should always remain some undissolved
mercury at the bottom.
This solution should now be decanted off from the sediment, evapo-
rated and crystallized ; the crystals are to be taken out, the fluid shaken
off them, and after being dried upon blotting paper they are to be
dissolved in as small a quantity of pure alcohol as possible. By this
means they will be completely freed from all admixture of turbith and
white precipitate. The solution must now be filtered, and it will then
be serviceable for use.
The precipitating agent is prepared in the following way : carefully
washed eggshells are exposed to a red heat for a quarter of an hour ;
they are then slaked like quick-lime, with distilled water, and the
resulting powder is put into a well stopped bottle.
When we wish to prepare the soluble mercury, we take a pound of
the fine slaked lime prepared from the eggshells, and mix it in a
large new cask with GOO pounds of distilled water, heated to 100° or
150^, stirring well for some minutes till we are assured of the most
perfect solution.
After allowing it to remain at rest for a quarter of an hour, by
means of a tap two inches from the bottom of the cask, we draw off
the pure and clear lime-water (if it be thought necessary through an
outstretched woolen cloth of close texture) into a similar cask of equal
dimensions, which must either be new or only used for this purpose,
and which must be very even and smooth inside.
Into this clear lime-water we pour without delay, and stirring con-
tinuously, a quantity of the above mercurial solution, containing two
pounds of the metal.
The black liquid soon settles, we then draw off the clear water,
wash out the heavy black sediment with distilled water into glass jars,
allow it to settle for twenty-four hours, pour off the water, mix up
the Sediment with as much fresh distilled water as we have poured off,
let it again settle completely, decant the water, place the glasses in a
large pot, (filling up the intervals betwixt them with ashes or sand)
* If thecoW was intcn:^ (in winter), I let the solution take place at a temperature
of40=Fahr.
6 OK YEKEBEAL DISEASES.
and put it in an oven just warm (200*^) until the deposit is completely
dry. This may be more quickly effected by spreading it out on white
paper and heating it gradually on tin pans over a moderate charcoal
fire, taking care not to singe the paper.
This dark greyish-black powder is the soluble mercury^ ; which
name I give it because it is completely dissolved in all animal and
vegetable acids, and in water impregnated with carbonic acid ; also in
the gastric juice with great speed, as every practitioner may observe
from the rapidity with which it causes the mercurial fever.
Zockawizt near Dresden,
29th September, 1788.
Just as I had laid down my pen and was about to send my book to
press, Girtanner's work ( Treatise on the Venereal disease, by Christo-
pher Girtanner, Gottingen, 1788) reached me and gave me great plea-
sure. He has well thought over his plan and his subject. I was glad
to observe that he adopts Hamilton's excellent treatment of gonorr-
hoea in its essentials, and shews up the ordinary irrational mode in its
true colours ; that he combats the a priori dread of an obstruction af^
ter such a rapid suppression of the discharge, and denies the possibili-
ty of a metastasis of the gonorrhoeal matter in sympathetic chemosis ;
he gives the distinctive signs of the various secondary gonorrhoeas,
shews where the venereal differs from other leucorrhoeas, and the scro-
fulous from the venereal glandular swellings, and gives very useful
instructions for preventing the suppuration of the latter. I was re-
joiced to find that he perceives that the antivenereal metal can only
destroy the venereal poison by a previous alteration in it, produced by
the reactive powers of the animal digestive and assimilative functions ;
that is to say, not by mere contact or chemical affinity, I was pleased
to observe that he is deeply impressed with the hurtful character of
corrosive sublimate, a poison which has been so imprudently deified :
that he strongly recommends the strengthening plan before, during
and after the mercurial treatment, and generally rejects the French
debilitating system, and that he convincingly exposes the harm of all
excessive evacuations during the mercurial treatment. I was delight-
ed to see that he unmasks so beautifully the absurdity of talking
about ** masked " venereal diseases, and shews up the worthlessness
of preservative remedies against infection. I was glad to find that
he refutes the assertion relative to the innocculation of the child by
the semen and in the uterus, as also by the nurse's milk, and advises
* [For an improvement on the above mode of preparing the Soluble Mercury, see
Postscript to the Venereal Diseases. This complicated preparation was afterwards
superseded in homceopathic practice by the mercuriua vtime. Sec Jieine Arzneimit-
Ullehre, 3d edit^ voL L]
CONTENTS. 7
the treatment of even children with the antisyphilitic metal — all max-
ims which are of the utmost importance for the weal of humanity.
How often have I wished for the concurrence of some physician of
eminence on these very points ! I always hoped to obtain it, believing
that observations conducted by really practical minds must eventual-
ly unite in truth, as the radii of a circle though ever so far asunder at
the circumference, all converge in a common centre.
What else I deemed it expedient to extract from Girtanner, as it
was no longer possible to incorporate it with the text, I have subjoin-
ed in the form of notes.
Uth October, 1788.
CONTENTS.
Pur ACE.
l5Tioi>ucnow, § 1 — 11.
PART FIRST.
miOPATfflO LOCAL VENEREAL AFFECTIONS.
FIBST CLASS. Idiopathic local yenereal afifections on secreting 8iirfifu:e9 of the
body destitute of epidermis.
FiKST Divisiox. Primary GoDorrhoea.
Chap. L Grooorrhoea in the male, g 12 — 58.
Chap. XL Treatment of gonorrhoea in the male, § 54 — 126.
Chap. IIL GonorrhcBa in tlie female, g 127—135.
Chap. IV. Treatment of Gonorrhoea in the female g 136—147.
Seoo5d Division. Sequekc of Gronorrhcea.
Chap. L Chronic btrangury and its treatment, g 148—152.
Chap. IL Chronic chordee, § 153—158.
Chap. IIL Induration of the testicle, g 159 — 165.
Chap. IV. Secondary gonorrhoea, in the male and its treatment, g 1 66 — 1 99.
Chap. V. Secondary gonorrhff*a in the female and its treatment, g 200 — 206.
Chap. VI. Stricture of the urethra and its cure, g 207 — 245.
Chap. VIL Induration of the prostrate gknd, g 246 — 256.
SECOND CLASS. Idiopathic local venereal affections on parts of the body pro-
vided with epidermis.
First Dmsiox. — Chancre.
Chap, L Chancre in general, and especially that in males, g 257 — 271.
Chap. II. On the ordinarj- treatment of simple chancre, g 272 — 286.
Chap. 111. Treatment of simple cliancre, g 287- 293.
Cliap. IV. Contraction of the prepuce (phiraosLs) and constriction of the
glans (paraphimosis), g 294 — 801.
Chap V. Treatment of phim<»>is and paraphimosis, g 302 — 311.
Chap. VL Chancre in the female, g 312—318.
8 ON VENEREAL DISEASES.
Chap. VIL Treatment of chancre in the female, §819 — 826.
Chap. VIIL Treatment of the accidents resulting from improper treat-
ment of the chancre, § 327 — 389.
Chap. IX. Venereal warts and excresences, §340 — 851.
Chap. X. Treatment of venereal warts and excresences, § 352 — 361.
SsooND Division. Buboes.
Chap. I. Diagnosis of inguinal buboes, § 862—383.
Chap. IL Observations on the treatment of buboes hitherto practised,
§384—399.
Chap. Ill Treatment of buboes, § 400—410.
PART SECOND.
SYPHILIS.
First Division. Diagnosis of Syphilis.
Chap. 1. Introduction to the Diagnosis of Syphilis, § 411 — 426.
Chap. II. Diagnosis of the symptomatic local venereal affections of the
more proximate kind, § 426—448.
Chap. IIL Diagnosis of the symptomatic local venereal affcctioDS of the
more remote kind, § 449 — 459.
Second Division. Anti venereal remedies.
Chap. L Mercurial preparations in general, § 460-473.
Chap. II. Particular mercurial preparations, § 474 — 540.
Chap. IIL Non-rnercuriid remedies, § 541 — 563.
Tuian Division. Removal of the obstacles to the mercurial treatment
Chap. L Observations upon the ordinary preparatory and accessory treat-
ment, § 564-672.
Cliap. IL Preparatory treatment, §673 — 590.
Chap. in. Prevention of the dLsagreciible effects of mercury, § 591 — 613.
Fourth Division. Nature of the soluble mercury, and its employment in vene-
real diseases, § 614-635.
Fifth Division. Local affections after the treatment for syphilis.
Chap. I. Local affections that remain after a suitable treatment for syphilis
and their removal, §636 — 647.
Chap. II. Local affections and secondary sufferings that follow the abuso
of mercury, §648 — 662.
APPENDIX.
Venereal affections of new-bom in^EUits § 668 — 693.
Postscript
INTEODUCTION.
1. Thebe is much that is puzzling and inexplicable in the nature
of the venereal virus.
2. It has this peculiarity, that once communicated to the body it
increases indefinitely, and that the forces of the corporeal life of the
human being possess no power of overcoming it, and of expelling it by
their own efibrt, like other diseases and even gonorrhoea. Its seat ap>
pears to be in the lymphatic system.
3. We find that neither the breath, nor the perspiration, nor the
exhalation, nor the urine of persons affected with the venereal disease
are capable of communicating either the local or the general affection.
The semen of a person affected with general syphilis does not, according
to the testimony of the most experienced observers, beget syphilitic
children ; mothers affected with general syphilis only do not seem to
bave any power of infecting their offspring, nor can nurses
affected with syphilis communicate the poison by their milk.
4. Usually the venereal diseases consist only of local affections ;
a general malady accompanying these is something merely acci-
dental.
5. The most remarkable thing about them is the difference betwixt
the first and the second infection.
6. The first infection gives rise only to independent local diseases
or idiopathic venereal local affections, gonorrhoea and chancre ; in
their essential character buboes and condylomata belong to these, yet
as regards the period of their occurrence, they constitute the transition
into the second infection, in which the absorption of the hitherto merely
local virus of the gonorrhoea, chancre and buboe into the general
fluids, proiluces a state of the system that only makes itself known by
lo?aI affections of another description, which may therefore be called
**jmpto?rtafic venereal disease, and the individual or collective
j'henornena of which are usually termed general venereal disease or
srj.hilis.
7. Many experiments shew that true gonorrhoeal matter when
:r:«Kulated produces chancre, and that matter from the latter gives
"iv? to true gonorrhrra, that consequently both of these affections
apr-arently so different arise from the same virus, which only exhibits
diiferent phenomena according as it is applied to different sur-
fk-es. *
' [HuLnemann, in common with the whole medical world at this period, entertained
*li€ of/uiion that the syphilitic and gonorrhceal poi-<ons were identical His views
Jf'-n :LL* jxunt, as well as up(»n others of higher importance, were subsequtntly
dttoged.] — Am, Pub.
10 ON VENEREAL DISEASES.
8. Parts of the body destitute of epidermis designed for the
secretion of natural fluids, when the virus is brought in contact with
them, become subject, as Hunter demonstrated, to abnormal fluxes of
mucus and pus without loss of substance ; this phenomenon is called
gonorrhoea. On the other hand when applied to, or rather rubbed into,
surfaces of the body provided with epidermis, it excites specific ulcers,
which on account of their corroding character are termed chan-
cres (iilcera cancrosa). In agglomerated glands it gives rise to
buboes.
9. As long as the virus continues in the form of these local
aflections at the seat of the first infection (or in its neighbourhood, as
in buboes) it retains unaltered the power to cause local infections and
to excite («. g. by inoculation) similar idiopathic venereal aflections
according to the nature of the part acted on. Should, however, these
local affections disappear without treatment, or should a small portion
of their matter pass into the circulation (the second infection) this
virus is thereby altered in such a manner, that along with the
development of the general malady, besides other local affections, ulcers
arise, the matter of which, according to Hunter's careful researches,
can neither, when applied to moist surfaces, produce venereal gonorr-
hoea, nor when introduced into wounds develop chancre, and hence is
incapable of producing syphilis in healthy organisms.
10. The matter absorbed by the lymphatic vessels from chancre
gives rise to buboes, but the matter of the ulcers of the general
affection when driven inwards produces none. As little can the virus
of syphilis produce chancres on the genitals or gonorrhoea from within
outwards ; if it break out on parts destitute of epidermis, as for instance
on the alae nasi, it forms only general venereal ulcers, whilst the
chancre virus applied to the same part produces a nasal blennorr-
hoea.
11. The virus of chancre and gonorrhoea inserted into general
venereal sores or into suppurating buboes, does not aggravate either
of these, neither does the chancre become more malignant than it was
previously by the application of gonorrhoeal matter, nor the gonorr-
hoea by that of chancrous matter.
PART FIRST.
IDIOPATHIC LOCAL VENEREAL AFFECTIONS.
<|tntCUfl.
UMOPAIHIC LOCAL VZHKEKAL AFFECnOMB 09 gnSXTCVa SOKFACEB
or THE BODY DMTrnJTE OF XPimEUCia
FIRST DIVISION.
PRIBIARY GONORRHCEA
CHAPTER I.
GONORRH(EA> IN THE MALK
•
12. Ordinarily not long, oflen immediately after connection with a
▼Oman affected with venereal leucorrhoea, or who has in the vagina
TeDereal matter, the male experiences a notable, not miplcasant^ itch-
ing in the orifice of the urethra, sometimes resembling a fiea-bite, ac-
companied by a not disagreeable sensation of heat in the genitals ; a
kind of formication is felt in the testicles ; the lips of the urethral ori-
fice become somewhat swollen. Every gonorrhoea is ushered in by
this irritation, — the Jlrst stage of the disease.
13. The transition of the first into the second stage is accompanied
hj a greater or less degree of tension of the penis, the sensation of a
constriction in the urethra, and of a twisting formicating motion in the
testicles. By pressing in the region of the specific seat of the gonorr-
bcea. some mucus appears at the mouth of the urethra.
1-L The second stage. The tickling sensation changes, usually after
one or two days, into a painful feeling, into a shooting and intolerable
burning in the urethra when the patient makes water, the usual seat
d which is under the fraenum, namely in the navicular fossa'' of the
mucous membrane, behind the glans (the usual primary seat of the
gonorrhoea).
' The Gennan name for this disease, Tripper ^ is derived from the principal pheno-
BenoD, the dropping frc»n them^thra. Common people say, "cs trippt," instead
rf-es tropfelt ** — it drope.
' Sometimes it spreads all over the glans, causing erection of the penis and semi-
osl emLsedon, and seems to incite to an abnormal excercise of the sexual function.
^ the sensation is sometimes less pleasant
' I believe Cockbom, in 1717, was the first who demonstrated gonorrhoea to be an
■ftctioD of the mucous follicles, and its original seat this spot ; hence he explained
tike nature of the disdiarge much more correctly and naturally than his predecessors
and many of his successors, who alleged that a large quantity (the gonorrhocal dis-
^fcargt sometimes amounts to 4 oz. in the twenty -four hours) of semen and prostatic
ftiid Ajwed from the seminal vesicles and prostate gland, thereby giving an expLi-
Batiro of this phenomenon directly opposed to all sound physiology.
12 ON VENEREAL DISEASES.
15. As long as the gonorrhoea, as in this stage, retains its specific seat,
the patient experiences no pain in making water until the urine comes
to within an inch or an inch and a half of the orifice of the urethra.
1 6. The natural white viscid mucus of this canal, which is scarcely
observable in health, now exudes by drops. The lips of the.glans
are more than usually congested with blood ; the glans is shining,
cherry-red, and transparent. The whole penis, or at least the glans,
appears fuller and thicker than it is naturally when unerected ; it
seems half erected. The urine^ commences to be of a dark-yellow
colour. There occur frequent, painful erections,^ especially at night,
occasionally accompanied by emission of semen.
17. Usually a short time after the occurrence of the scalding^ on
making water, there occurs a discharge* of a watery white fluid, as if
it were mingled with milk.
18. The patients point to just behind the glans'* in the urethra, as
the seat of their pains, which they feel most intensely when the penis
is erected ; on looking into it, we observe that is has a raw appearance
near the orifice.
19. During the continuance of this discharge, the scalding diminish-
* On account of the swelling of the penis, probably also on account of contracdon
of the urethra by the inflammation, perhaps also because the patient, on account of
the pain, dreads to let his water come freely, the urine flows in a smaller stream
than usual ; sometimes it splits on emerging from the urethra, probably on account
of the unequal contraction internally.
* The painful erections and the scalding of the urine distinguish the primary from
secondary gonorrhoea and other discharges fit)m the urethra.
' Which, with its concomitant symptoms, continues until the irritating poison is ex-
pelled with the discharge, from a few days to several weeks. If it continue some
time without any discharge, this troublesome and sometimes dangerous condition is
usually denominated by the contradictory name of dry gonorrhcea.
* The interior of the urethra in the healthy state is always kept covered with a
fine, mild, viscid transparent mucus, that spontaneously exudes from the exhalent
vessels and from the excretory ducts of the mucous glandules, so that the acrid urine
may flow over without irritating it But when irritated by the venereal poison, these
excretory ducts are compelled to pour out more of their moisture ; a bountiful pro-
vision of nature to dilute and carry off the injurious poison. The contractile power
of the urethra suffices to expel the gonorrhoea matter by drops.
* The usual scat of gonorrhoea is from one to one and a half inches behind the
orifice of the urethra, (in some anomolous cases of a worse description the inflam-
mation extends throughout the whole urethra, and seems to be of an erysipelatous
character.) How it is that the gonorrfaceal matter should always find its way into
exactly that spot of the urethra, it is not easy to determme ; perhaps it first lies at
the orifice, and thence gradually runs backwards till it reaches the spot which is
most susceptible of its irritation, and where it can be least readily washed away by
the urine.
PBIMABY GONORBHCKA. 13
es graduallj.* In the course of time, and often alternately, this
watery mUky discharge changes into a tiiicker fluid, resembling melt-
ed lard, becomes yellower, exactly like pus,^ and has a peculiar disa-
greeable odour.
20. When the pains and inflammatory symptoms have subsided,
the third stage commences. The simple gonorrhoea is tljen usually
disposed to heal spontaneously without artificial aid f all pain ac-
' There are dape almost without scalding, in which the dischai^ge is copious, and
ottierB in which the painful sensations precede the discharge some weeks. There
are eyen some, although these are rare, where the disease remains quite stationary
at the second stage (ffonarrhee 8eehe\ where the scalding and even some dysuria
eadsts withbut heing followed by a gonorrhceal discharge, and among these are some
that are cured without this latter phenomenon «yer occurring. If such a dry clap be
of a bad kind, the membranous portion of the urethra may become inflamed, and if
Dot speedily relieyed, a perinseal fistula be the result.
' The porulent character of the gonorrhceal discharge seems to indicate the existence
of an ulcer in the urettuB ; this is not the case however, in the ordinary simple gonorr-
hcEa. Tliere are several instances in which pus \b produced without loss of substance,
without ulceration. The outer surfiEUic of ^e lungs, the costal pleura, also the ab-
dominal viscera have been found surrounded by pus without the slightest trace of
uloeratioii of these parts. In ophthalmo-blennorrhfiea of scrofidous or other kinds, as
afeo in cases of severe catarrh, there occurs a discharge of true pus, without a suspi-
cioD of the presence of an ulcer. Were we to attribute the ordinary yellow gonnorr-
hceal discharge to an ulcer, it is obvious that if the whole internal soxfACG of the ure^
fhra were ulcerated, the size of tlus suppurating surface would not suffice to produce
tiie quantity of pus that sometimes comes away in gonorrhoea. And moreover as the
ordinary gonorrboBa depends on a true venereal miasm, it is impossible, if it arose
frum an ulcer, that any case could be cured without mercury (without which no
venereal ulcer <aui be radically cured) ; but we find that a simple clap is often cured
by the power of nature or with some slight unmcrcurial remedy. In persons who
have been cured of clap, tJic urethral mucus often suddenly comes away yellow and
puriform after being heated, after the abuse of spirituous drinks, frequent sexual in-
tercourse, &c It is especially in the inflammatory stage of the clap that the dis-
chai^ comes away of a purulent character, whereas ulcers only secrete pus after
their inflammatory stage is past What we have stated is superabundantly corrobo-
rated by innumerable dissections of the urethra, both in cases which died during the
<^p ^id in such as had clap long before their death. In the latter no cicatrices were
found, with the exception of a few rare cases ; in the former, however, it was observ-
ed that the seat of the discharge was not ulcerated, but only very red and raw-look-
ii^, and the coloured matter could be often pressed out of the lining membrane.
whilst the gonorrhceal pus lay free in the mucous cavities (/acu7Mt), that is to say in
the depr^sions caused by the mouths of the excretory ducts of the urethral glan-
dules, without the slightest loss of substance being discoverable ; tlie lymphatic ves-
sels were congested, as if injected with a white fluid. Pott, Morgagni, Hunter, StoU
and others are the authorities for these facts.
* [The £Eu;t that simple gonorrhoea has a tendency to subside spontaneously, whai
not aggravated and complicated by drugs, is of much importance. K this opinion,
which was announced by the founder of homoeopathy more than fifty years ago, had
been appreciated by his cotemporarics, and by his successors, a vast amount of un-
necessary sufiering would have beea spared the human race.] — Am, Fttb,^
14 OF YSNEBEAL DISEASES.
company ing erections is gone ;Hhe power of retaining the urine, 4nd
of discharging it in a full stream and without discomfort, is restored ;
the acrid, coloured discharge takes on gradually a whitish colour, and
at length becomes colourless (in rarer cases it remains yellowish to
the last), similar in character to white of egg, viscid (it can be drawn
into strings betwixt the fingers), transparent, mild.*
21. It continues to decrease more and more in quantity, accom-
panied by a tickling sensation and a sort of not disagreeable itching
of the glans and urethra, exciting erections, until at length only
fibrous flakes are perceived in the urine, and even these at last disap-
pear along with the cessation of the tickling alluded to. The gonorr-
hoea is cured, usually from four to five weeks after it first broke out.
22. The above is the usual course of the gonorrhoea, but there are
innumerable varieties.
23. When the irritation from the gonorrhoeal matter advances
nearer to inflammation, the sensations of the patient are not confined
any longer to the original seat of the gonorrhoea.
24. Weakness in the whole pelvic region, disagreeable sensitive-
ness in the scrotum, testicles, breast, hips, shooting extending into the
glans and great scalding on passing the urine, dark redness of the
latter, frequent painful erections and difRcult passage of the fax^es are
the general concomitant symptoms usually observed. The inguinal
glands are oflcn at the time swollen.
25. If the inflammation be more intense, the whole urethra seems
to be affected in an erysipelatous manner ; it is as if shortened, in
consequence of which the frequent sometimes continued priapism
crooks the penis downwards, (chordee), causing the most excruciating
pain, and oflen the discharge of some drops of blood.* The emis-
sions of semen that sometimes ensue *are agony. The urine is dark
red, acrid, hot ; the patient is forced to emit it every moment by tea-
spoonfuls or even drops, accompanied by the most violent cutting and
with involuntary contortions of the features, especially as the last
drops flows out. Sometimes the patient cannot remain a quarter of
an hour on his legs (and then complete retention of urine oflen en-
sues). The penis is externally very painful, the lips of the urethra
gape ; some swelling of the glandules along the urethra, and a pain-
ful tumefaction of the perinaeum are observable, frequently conjoined
' This fluid seems to be coagulable lymph, and its imiocaousness is known by this
(besides the cessation of all painful sensations) that it dries only upon one side of
the linen, and the spot it makes may be rubbed completely off without leaving be-
hind a coloured place, while the prerioos, more acrid discharge, stains and wnlm into
(helinea
* Which comes from some distended or lacerated bloodveasel of the inflamed mem-
hnuneof the nretlira, orer-flAretcfaed by the onectkna.
PBIMABY GOHOBBHCEA. 16
with tenesmus ; the gonorrhoeal discharge is then acrid, discoloured,
greenish, or greyish,* sometimes even mixed with streaks of blood ; it
sinks into the linen where it makes marks of a similar colour. The
pain' is great, it excites the pulse ; rigour and heat are present, especial-
ly towards evening ; blood drawn from the arm presents occasionally
tiie bufiy coat.
26. The above course which is never the normal one, and whose
violence is often dependent on a bad constitution, but more frequent-
ly on improper treatment of the patient by himself or his surgeon, or
ED accession of febrile disease, a chill, fright, anger, vexation, riding,
dancing, coition, heating liquors, purgatives, corrosive injections, &c.,
does not remain stationary at these symptoms, but, if efifcctual aid be
withheld goes on to the most dangerous results.
27. The priapism readily passes into mortification, the inflamma-
tion of the glandules along the urethra into suppuration, which opens
into the urethra, more rarely outwards ; the tumefaction of the peri-
nseum, probably in Cowper's glands, forms an abscess which in course
of time gives rise to a fistula perinsei, whereby an abnormal outlet for
the urine in this region is constantly maintained. The prostrate gland
passes into inflammation and induration, less frequently into suppura-
tion. The foreskin inflames, chiefly in consequence of the contact of
the acrid gonorrhoeal matter which penetrates betwixt it and the glans
(diancres under the foreskin and gonorrhoea preputials are not unfre-
quent consequences) ; it swells and gives rise to phimosis or paraphi-
mosis. The discharge may sometimes stop suddenly (chaude-pisse
avortee) and sympathetic inflammation of the testicles or inguinal
glands ensue.
28. Along with the sensation of a colicky pain in the abdomen and
a weakness in the loins and pelvis, along with the pains in the coccyx
and the whole urethra, and along with inclination to vomit, the effe-
rent duct of one testicle, then the epididymis, and at last also the
body of the testicle, seldom of both testicles, begins to swell, accom-
panied by symptomatic fever, quick, full and strong pulse. The tes-
ticle gets soft, full and swollen, (chaude-pisse tombie dans lea bourses),
by and by it becomes hard, yet the epididymis on the top of it is
harder to the touch ; it is sensitive, full of a dull pain, sometimes ac-
companied by shooting. It appears to the patient to be intolerably
heavy.
29. The spermatic chord also frequently swells and its bloodvessels
are distended so as to become varicose, the spermatic duct becomes
hard and painful.
30. In the meantime the gonorrhoeal discharge diminishes, and, ex-
cept in a few cases, stops completely ; the scalding of the urine
* Both <x>lourB may be owing to the admixture of small quantities of blood.
16 ON VENEREAL DISEASES.
ceases. On the other hand, there occurs a more frequent call to
urine, a strangury, as the region of the neck of the bladder appears to
be now affected; the formerly superficial inflammation penetrates
deeper into the substance of the urethral membrane. Sometimes the
swelling goes alternately from one testicle to the other.
31. Other viscera also suffer, as has been said, from sympathetic
irritation ; indigestion flatulence, colic, tendency to vomit are the
usual symptoms.^
32. Resolution is the most frequent termination, scirrhus the more
rare,* and mortification or suppuation the most rare.^
33. In like manner, along with the cessation of the scalding and the
occurrence of strangury, as also of the most of the other symptoms,
there sometimes arises a swelling of the ingumal glands which has but
a remote resemblance to true venereal bubo, as it is only caused by
sympathetic irritation. (Slight swellings of the inguinal glands are a
usual and unimportant symptom in every gonorrhoea of any severi-
ty, without the discharge thereupon ceasing. They go off without
further inconvenience on the cessation of the urethral irritation.)
34. Resolution or scirrhus is the most frequent, suppuration the
rarest result.
35. Rare but much more dangerous is the ophthalmia that occurs
under similar circumstances.* After a diminution or sudden cessation
* Excitement of the nervous system by passions, over-heating of the whole body
or of the genitals in particular, astringent injections,^the rude emplovmcnt of bougies,
purgatives, perhaps also a not sufficiently understood predisposition of these parts
may give rise to these swellings of the testicles and inguinal glands, which with few
exceptions are not venereal [syphilitic]. A mere sympathetic irritation of the lym-
phatic vessels in the urethra and caput gallinaginis seems to excite the remote swell-
ing of these glands. A proof of this is to be found in the frequent reappearance
and disappearance of these swellings, and in their curability by antiphlogistic, seda-
tive remedies, without mercury, which is never the case with true venereal buboes
and swellings of the testicle. It is very rare that with moderate care either pass in-
to suppuration, and if this do happen the ulcers formed are as Hunter has shewn,
not venereal, and may be cured by non-mercurial means without being followed by
syphilis. Not to mention that true venereal buboes and swellings of the testicles
produced by a real metastasis of the miasm are much larger and more painful than
those arising from sympathetic irritation in cases of suppressed gonorrhoeal diachaige.
* Induration occurs especially when the discharge cannot be re-established, and
the swelling of the testicle does not diminish.
' Girtanner says^ *'it never passes into suppuration," contrary to Hunter's obser-
vations.
* There is certainly a sympathy known to exist betwixt the visual organs and the
genital apparatus, but whether that is sufficient to account for this phenomenon I
cannot decide. Although this blennorrhceic ophthalmia is usually attributed to a
true metastasis of the gonorrhoBal matter, this assertion remains improbable and un-
proved as long as the venereal nature of the matter dischaiiged from the eyes is not
PRIMABT GONORRHCEA. 17
of the gonorrhoea (frequentl j from two to three days after its suppres-
flion) in consequence of severe chill of the whole body or of the geni-
tal oi^ns, by the intemperate or excessive employment of cold ap-
plications, by draughts, dec, a violent inflammation attacks the eyes,
which very soon (in a few days) usually inevitably results in incura-
ble blindness. At first the conjunctiva becomes inflamed, swells and
presents the appearance of a mass of raw meat, from which a copious
purulent fluid runs, soon causing inflammation of the lower eyelid.
Every glimmer of light is intolerable to the patient. Most of the
conjunctiva of the sclerotic inflames and swells over the cornea to such
an extent that the latter appears as if sunk in a pit. A production of
pus is observed to take place behind the cornea, which becomes whit
ish and opaque, scales ofl*, and at length projects forward and bursts
from the pressure of the suppuration of the eye. The destroyed con-
tents of the eyeball escape, and the visual organ is forever destroyed.'
30. Ulctrs in the urethra are certainly of rare occurrence, at least
they are far from being an essential portion of the ordinary gonorr-
hoea when left to itself. The end of the pipe of an injecting syringe
of the catheter, or of a hard bougie in the hands of an incautious per-
son, may readily cause a wound in the urethral canal ; a chancrous ul-
cer is the consequence. The laceration of a bloodvessel in the ure-
thra (by priapism, onanism, coition) may give rise to something simi-
lar. An internal ulcer may also often arise from the bursting of aa
abscess of the external urethral glandules.
37. A severe pain on passing water, in a circumscribed spot in the
urethra, which is renewed on introducing a catheter or bougie, as also
by external pressure on the same spot, betrays the presence of such
an ulcer. Ordinarily some blood escapes before the ulcer occurs.^
38. In such a case though all the inflariimatcry symptoms of the
gonorrhcea may have subsided, yet the pain persists in the suspected
spot even during the secondary gonorrhcea, and does not cease until
a proper course of mercury puts a stop to it and its source, the ure-
thral ulcer. If, in place of the antivenereal specilic, astringent injec-
tions are employed, general syphilis is the result.
39. Sometimes, though rarely, (almost never in those who have a
short foreskin, and never in those who have got none) connexion with
a diseased woman causes a sort of external gonorrhoea. With a tickling
and burning smarting sensation, there occurs, chiefly in the region of
demonstrated, as long as chancres have not resulted from inoculating it In the
m#yn time we shall hesitate to allow it the name of eye-clap. I perceive that
Qirtanncr holds the same opinion as myselfl
* Sometimes in from four to five days after the commencement of the disease, aa
Girtanncr remarks.
• And, as Girtanncr alleges, sometimes true pus mingled with blood is dischaiiged
akxig with the ordinary goDorrhoeal matter.
2
18 ON VENEREAL DISEASES.
the junction of the prepuce and glans, on the corona of the latter and
inside the lower part of the former, a secretion of an acrid viscid matter,
without our being able to detect any abrasion of the skin, or visible
ulceration ; occasionally we may observe through a magnifying glass
that the affected part seems as if covered with aphthae. This abnor-
mal secretion on the spot indicated, is termed preputial gonarrhosa,^
40. Sometimes it involves the whole inner surface of the prepuce and
the whole extent of the glans, at least I have noticed it also on its apex.^
41. Indubitable observations shew that the gonorrhoeal matter
may in some rare cases be absorbed, and produce general syphilis.^
But the special conditions under which this may occur are not very
clear. That this may arise from urethral ulcers, which date their origin
almost invariably from some violence from without or injury received,
is self-evident and requires no further proof. But under what cir-
cumstances the gonorrhoeal virus may, without injury of the lining
membrane of the urethra, be absorbed into the general circulation, is
all the more doubtful ; whether by too full living, or on the contrary,
by inordinate blood-letting and purgatives, or generally by a debili-
tating regimen and internal and external relaxing remedies, the local
' Sydenham seems to be the first that observed it
* Perhaps this last phenomcDoo is a not unfrequent commencement of urethra]
gonorrhoea. The following case seems to throw light upon this assertion, and to give
rise to some inferences. A man who had never had clap, after an impure, half-com-
pulsory connection, was affected by an almost raw, dark red spot, three lines in
diameter, at the distance of two lines from the orifice of the urethra, which exuded
but little, and caused very little uneasiness ; he was otherwise free from venereal
disease. Under these circumstances he had connection with a lady who was quite
healthy in every respect She got from him a very violent clap, and a sympathetic
buboe in the right groin, besides an abscess in the fold betwixt the greater lip and
nympha of the same side. The man now ceased to have connexion with her, and
commenced bathing the exuding spot with warm milk, whereupon the disease gra-
dually changed its seat and in a few days reached the orifice of the urethra, the
lips of which commenced to inflame. Some fluid had already commenced to flow
from the orifice of the urethra, when he first put himself under treatment, and in the
course of six days he was perfectly cured without further accident merely by the
rapid and vigorous use of the soluble mercury. Subsequently he did not again
infect the lady, and he is still, (after one year and three-quarters) in perfect health.
The lady recovered by the external and internal use of antiphlogistics, and her ab-
scess yielded to mercury.
Preputial gonorrhcea seems to give evidence of a peculiar tenderness of the
epidermis of the glaas ; at least it is never met with in persons whose prepuce is shorty
cut offf or always retracted behind the glans. The epidermis of such a glans be-
comes thicker, and is therefore only inoculable by the venereal poison with chancres.
Perhaps the apthous coating of the glans in these external claps consists of small
chancres. Many observers, among others Gardane, have observed an alternation of
urethral and preputial gooonixBa, the one appearing when the other ceased, and
vice verscL
' [During the latter years of his life, Hahnemann abandoned this idea, and advo-
cated the opinioD thai the two poisona were distiiict and diwrimilir.] — Am, Pub*
PRIMARY GONORRHCBA. 19
employment of mercurial ointments and plasters, dec. ? Perhapa
aometiraes by some peculiar morbid diathesis, an accidental fever,^
or habitual general indisposition. All this lies in obscurity, and there
is but little probability that any metastasis of the gonorrhceal matter
is possible, except when there is a urethral ulcer.
42. Thus much is certainly true, that it is not so much the mild-
ness or malignancy of the infecting matter, as the various suscepti-
bility^ of the constitution of the different subjects exposed to the in-
fection, that makes slighter or more severe gonorrhoea ; but still it it
going too fiur^ to deny all modifying power to the different degrees of
the poison, as Hunter does, who also maintains that it is the same
with respect to other miasms.^
43. In most persons the first gonorrhoea seems to be the moal
severe, especially when it occurs in a sensitive or ardent temperament.
44. Repeated attacks of gonorrhoea seem to fortify the urethra
against a new irritation of the same kind ; each time it generally be-
comes unsusceptible for a new infection for a considerable time (always
longer and longer.)
45. Persons who have what is called an unhealthy skin, are not on
that account more difficult to cure of gonorrhoea ; and again, those
who are insensible to many irritants have often the most obstinate
gonorrhoeas.
46. Long continued scalding of the urine without the occurrence of
a discharge, indicates a bad form of gonorrhoea, which before it breaks
forth is often preceded by an anxious sort of restlessness ; and yet s^
vere scalding does not always prognosticate a great discharge, nof
slight scalding a moderate one.
47. Men rarely communicate gonorrhoea before the discharge ap^
pears; women do so more frequently. Yet the poison is not inactive
between the period of infection and that of the appearance of the dia.
diarge ; it always in the interim causes sensations in the urethra.
4S. On surfaces of the body which are destitute of epidermis and
which are naturally moist, the gonorrhoea! virus can excite similar
' J. Foote saw oo the occurrence of the small-pox a gonorrhoea disappear and
gcDenJ syphilis follow thereupon. Was it £Eiirly ascertained that no urethral uloer
vac present!
' Instances are not wanting where one woman has communicated clap of the mo8|
▼anxis degrees to sereral men, and yet has not given it to those with whom she
w in the habit of having most frequent connexion.
* In this Girtanner agrees with me.
* Is it perfectly indifferent whether the variolous virus be taken from mild
of small poK or from children who have died of confluent small pox t In ao
mic of putrid fever, I saw ten individuals who frequented the same room at*
iatked with almost exactly the rame symptoms, whilst in other fiunilies. including
the dnmeartcs, quite difiennt modificatioos of the disease obtained, and were trane-
■itted from ooe membef to another with almost no diflferenoe.
20 OK VENEREAL DISEASES.
discbarges. It must therefore be carefully kept from the anus,* mouth,
nose,^ eyes ;^ but in such situations also, as it is constantly washed
away and diminished, it cannot be easily absorbed, the same as when
it is in the urethra (consequently it can rarely give rise to general ve-
nereal symptoms), and hence is not to be cured by mercury.
49. But when introduced into wounds, it seems to act exactly like
the chancre virus, and to infect the body with the venereal disease*
(which is curable by mercury only.) J. Hunter innoculated the glans
of a healthy man with gonorrhoeal matter, who thereupon was attacked
by chancre, then buboes, and, lastly, had general syphilis.
50. Who knows but that many chancres on the glans and prepuce
might be avoided, if the gonorrhoeal matter that flows out were care-
fully kept from those parts ?
51. If the ordinary gonorrhoea be venereal, as cannot be denied,
there are not a few other gonorrhoeas whose infecting properties can-
not be disputed, which are of a gouty, scrofulous, or other nature.
These latter can often be very quickly cured, and an inexperienced
practitioner might be apt to suppose the remedy he employed to be
a specific for gonorrhoea, until its inefficacy or hurtful character in
true venereal gonorrhoea shall convince him and others of the contrary,
52. Any one who wishes for information upon the subject of the non-
venereal ones, which do not fall to be considered here, will do well to
consult Hecker's work.
53. The infecting power of a venereal gonorrhoea does not cease
until the discharge has completely ceased, and erections and the emis-
sion of semen takes place without the slightest pain, scalding, or ab-
normal tickling sensation.
CHAPTER II.
TREATMENT OF GONORRHCEA IN THE MALE
54. The mildest (rarest) kind of gonorrhoea requires, besides a
good diet and regimen, almost no artificial aid, although the time
required to effect the cure may thereby be much shortened.
55. The more severe (the ordinary) kind will no doubt ultimately
yield in most cases to the efforts of nature, but it will give way more
happily, more quickly, and more easily with some assistance ; the
chief points to be attended to in furnishing that assistance being the
' I saw goDorrhceal matter which had been introduced into the rectum by one of
the most unnatural of vices, give rise to chronic gonorrhcea of the rectum.
* Duncan observed it accompanied by violent inflammation of the-Schneiderian
inembrane.
* Swicten saw a true case of gooorrhoBal ophthalmia. — ^A common symptom in
children, which during bhih are infected by the local virus in their modicre' geoi''
tais, is among others a gonorrhoea of the eje.
[* HahnexDMm nndottbtedly imbibed this ettauowm notion tttm tndttbn.I^
Am. Pub.
PBIICABY GOKORRHOEA. 21
following: %o allay the inflamination and pain ; to oheok the oonsequenoea
of the morbid irritability ; to second the efforts of nature in its endeav-
ours to throw oil the poison ; and in some cases to rouse to increased
acdon the indolent fibres. We should not have so many points to at-
tend to, did we know of any specific antidote to the gonorrhoei&l matter.
56. If we are consulted immediately after infection, or in the first stage
of the disease, we may succeed in preventing many cases of gonorrhoea by
counselling diligent ablution of the penis, and injections of tepid milk ^
into the urethra, which have oflen been attended with complete success.
57. But we are usually consulted only when the pains compel the
patient to seek advice in the second stage.
58. Under these circumstances, we should advise a mild -vegetable
diet, forbid the employment of acrid salts, of spirituous liquors and
spices, (especially pepper, brandy, pickled or smoked meat), of pork,
of &t, and all indigestable articles, and all excess in eating. The
penis should be frequently bathed or washed in tepid milk.
59. For the proper treatment of the gonorrhoea, however, in order
to remove the superficial inflammation of the urethra and to make it in-
sensible to the irritation of the venereal matter, (the most important
consideration in the second stage,) we should inject as oflen as possi-
ble into the urethra as far as the seat of the gonorrhoea, a fluid which
possesses the power of doing both these. Three grains of opium
are to be dissolved in 30 drops of sweet spirits of nitre, and the solu-
tion mingled with lin ounce of water which contains three grains of
acetate of lead in solution. The thin tube, an inch and a half long, of
the small tin syphon here delineated,
is to be carefully inserted into the fore
part of the urethra, whilst the penis is
allowed to hang down ; the funnel shap-
ed part of the instrument is to be held
betwixt the fore finger and thumb of
the left hand, and the tepid fluid above
described dropped into the funnel-shaped
opening of the small syphon, ten or
twelve times a day, each time for a min-
ute or longer. The fluid overflows out
of the narrow end, exactly at the ordi-
nary seat of the gonorrhoea, and forces
its way down by the side of the instru-
' Or, still better, according to Oirtanner, by injections of lime-water, whereby
aooortling to him, the gonorrhoBa is stifled in its germ. Does the power posssessed
by Uua remedy give evidence of an acid character of the venereal poison t In place
of lime-water, he employs also a weak solution of caustic potash.
22 OK YENEBEAL DISEASES.
ment, and out of the mouth of the urethra; wherebj only those parts of
it are moistened which require the application of the remedy. The
patient performs this little manoeuTre himself most readily when stand-
ding. He can thereby do no harm. All the inconveniences of the ordi-
nary syringe are obviatedby this contrivance. (The patient should pre-
viously make water each time.) Even when there is great sensitiveness
of the urethra, so that the syringe dare not' be employed, this opera-
tion may be performed, and that without difficulty. The rounded
end of the tube should be moisted with milk or cream, before being
introduced into the urethra. We may increase the opium and acetate
of lead in the one ounce of water gradually to five grains of each.
60. Diluent drinks should at the same time be employed. An
emulsion made with three to six pounds of water and six to eight
ounces of hemp-seed, and sweetened with two ounces of syrup of pop-
pies and an ounce of syrup of lemons, may be drunk daily ; and
this drink, in the inflammatory stage of the gonorrhoea, will do instead
of any other internal remedy.
61. If the bowels are constipated, clysters of honey and water should
alone be used, and to render these as seldom necessary as possible,
fruit may be eaten.
62. In order to diminish the nocturnal erections, a tepid foot bath
for half an hour and a few drops of laudanum, taken just before going
to bed, lying on the side upon an elastic mattrass, light bedclothes
and a cool apartment will be found advantageous. •
63. In the course of an ordinary gonorrhoea the patient goes on in
this manner until the scalding of the urine changes into slight itching,
until the glans loses its red colour and shining transparency, and the
thin discoloured discharge changes into a viscid, colourless mucus,
small in quantity.
64. Under such treatment, this result would happen in from seven
to eight days.
65. This mode of treatment is, however, far from that generally
adopted. In ordinary gonorrhoeas much work is made with many
dificrent remedies and a great deal is done, only not what is necessary ;
and by a variety of manoeuvres a simple gonorrhea is changed into a
complicated and malignant, or at all events a chronic one.
66. Judging from the maxim that gonorrhoea arises from venereal
poison, mercury was from time to time looked upon as the peculiar
antidote for gonorrhoea.
67. Physicians did not consider, and would not be taught by ex.
perience, that, there being no specific for gonorrhoea, mercury could
not possibly be one, as long as this poison acts upon a moisture-secre-
ting surface of the body, such as the interior of the urethra is, where it
causes, so to speak, only a mechanical irritation, and on which conse-
PRIM ABY QOKOBRHCBA. 28
qaenUy, seeing that it lies as it were beyond the sphere of the circu
lation, the.anti-y^iereal specific cannot act. (Gonorrhcea is a merely
local disease,)'
68. Some facts prove this superabundantly. A man that had just
got rid of chancres and a buboe by means of mercury, was infected
anew and got clap, which would not have been possible, if the go-
norrbceal irritation could have been acted on through the circulation ;
for as long as the juices are filled with this metal, there is no possibil-
ity of a penetrating venereal infection, such as a chancre, occurring.
During the mercurial treatment, cured gonorrhoea has been known to
break out again, and to remain for a long time as secondary gonorrhoea.
69. In cases of simple gonorrhoea, not the slightest use has ever
been observed from mercury ; and, therefore, any unnecessary exhaus-
tion of the patient's strength by this metal is quite contra-indicated,
often ev^i hurtful : thus, for instance, a large dose of calomel, as of
any other drastic puigative, has often been found to be followed by
increased irritation in the genitals, wide-spreading inflammation, swell-
ing of the testicles and inguinal glands, and so forth.
70. Peyrilhe has recommended his volatile alkali as a specific in
venereal diseases, and especially in gonorrhoea. Observations are
wanting to corroborate this statement : in the meantime, I may re-
mark, that Murray has seen stoppage of the gonorrhoea and orchitis
strangury and hsematuria follow its internal employment.
71. Now as we possess no specific remedy ^ for gonorrhoea, there
remains nothing for us to do but to remove all obstacles to, and to
second the eftbi*ts of nature, which generally performs the greater
part of the cure alone, though in a somewhat tedious manner.
72. Nature herself will usually establish a copious discharge of fluid,
probably for the purpose of gradually washing away the firmly adhe-
rent gonorrhoeal poison, and of rendering it innocuous by extreme dilu-
tiom
73. This effort of nature is however oflen insufficient and difficult,
at all events disgustingly tedious, since along with the increase in the
secretion of the urethral fluid, the gonorrhoeal poison is simultaneously
reproduced, and continues to exercise its specific irritation, until the
seat of the gonorrhoea, grown accustomed to the irritation, becomes at
length insensible to it, whereupon the poison (from want of the objective
■ [This remark appears to clash with what has just before been advanced, thus
causing some coofusioo in regard to the real idea of Hahnemann at this period. It is
erident, however, that he is inclined to break away from the then prevalent belief
opoo this subject] Am. Pub,
• Otherwise the in^oduction of the before- mentioned (§ 69), or of some similar
jSoid into the anterior part of the urethra, wliich has been employed by modem physi-
dans with such incredibly rapid success, must be regarded as such a specific.
2i OK YSNEBBAL DI9BASES.
specifio irritant) diminishes and goes awaj completely, whilst the
sensitiveness in the urethra vanishes, and the discharge decreases or
becomes mild.
74. Honc^ it is no wonder that this process of nature is tedious
and accompanied by much pain, often by swelling, inflammation, and
spasm ; symptoms that all demand the succours of art. It is only a
pity that the best plan has not always been pursued in these cases,
that the first of all the indications has been missed, namely to destroy
the local irritation and the local inflammation at its very seat. The
poisoi), or at least the inflammation, was short-sightedly enough sought
for in the general circulation, in the primse viae, in the whole urinary
system, &c.
75. It would occupy volumes to record the sometimes useless, often
hurtful remedies, usually employed in this view.
76. Laxative salts, saltpetre, baths and venesections, appear at first
sight to be advisable, and yet their employment cannot bo allowed as
a general rule, and only very rarely and exceptionally.
77. For since in the pure inflammatory state of a gonorrhoea, the
whole mass of blood seldom takes part in the inflammation, it follows
that it is only in these few cases that it is admissible and beneficial
to open the vein, and none but an experienced practitioner can deter-
mine this.
78. Therefore, I know not what can be said for the frequently re-
peated venesections usually employed for every case of gonorrhoea ;
but this I know, that in ordinary often mild-looking gonorrhoeas, the
system is thereby unnecessarily weakened, and the foundation for the
most obstinate secondary gonorrhoeas is laid ; and that in more severe
cases, when irritabilty from weakness produces an accumulation of the
most dangerous symptoms, venesections, and still more repeated vene-
sections, usually increase the symptoms to the most frighful extent.
Local biood-letting, on the contrary, can, as will be shewn- below, be
more frequently and certainly employed with benefit.
79. Warm baths, be they fur the entire body or for the half only,
should likewise not be uselessly lavished in simple gonorrhoeas, as they
rob the patient of much of his strength ; even in inflammatory symp-
toms, their employment is a matter of doubt, whenever these arise
from pure morbid irritability.
80. Nitre is another favourite remedy of the French physicians in
gonorrhoea; every one that has a clap must swallow a quantity of the
universal cooling remedy, nitre. Whatever truth or untruth there may
be in the cooling virtues of this salt, experience teaches, that when
taken in the inflammatory stage in considerable quantity, it invariably
does harm, on account of the great irritation of the urinary passage it
causes, not to mention that it is almost a specific weakener of the sya-
PBIH4&T GONORRHCEA. 26
<
tern, and thus contributes to aggravate the symptoms due to that state.
I have seen dyspepsia, low fever, and obstinate secondary gonorrhoea,
result from its abuse in gonorrhoea.
81. Very nearly the same may be said of the other neutral salts.
The use of laxative salts must, therefore, (likewise on account of the
irritation to be feared and the weakness to be expected from their use,)
be confined to cases in which clysters of honey-water fail to kvep the
bowels open. Glauber's salts given in drachm doses until an effect is
produced, will suffice. In cases of impurities in the stomach, a mode-
rate emetic will be serviceable, and diminish the irritation of the geni-
tals caused by the use of laxative salts.
82. Still more dangerous are the drastic purgative medicines, so
frequently used in gonorrhoea. Their usual effects are, — increase of
the inflammation of the genitals, suppression of the gonorrhoea with
all its dreaded concomitants, such as swelling of the testicles, inflam-
mation of the perinoeum, chordee, &c. Jalap root and resin, gamboge,
scammony, agaric, colocynth, the purgative extracts (extr, ^mnchim,
cathoL), but above all, aloes and its preparation, are apt to produce
these results.
83. Thre is still another sort of empirical remedies that are said to
remove the gonorrhoeal discharge rapidly. Such are, the os sepice, olive
oil with citron juice, alum, sugar of lead, &c., given internally. The«e
things must, on the one hand, be very injurious to the system, whilst
on the other they can oflen do no good to the disease.
84. In like manner, in the second stage of gonorrhoea, all kinds of
balsams, and all irritating and very astringent injections into the ure-
thra, must be avoided, as hurtful and dangerous.
85. But more horrible still than all 1 have mentioned, is the menda-
cious counsel, which has been devised by wickedness, — that a person
affected by gonorrhoea should have conn(.'.\ion with a pure virgin, and
that he would thereby get quit of his disease. — In this case, the un-
hjippy wretch inoculates the poor girl with the same poison that per-
vades his own genitals, and sensibly aggravates his disease by an ac-
cession of inflammation, while he has the fearful reflection that he has
added afresh crime to the original cause of his malady.
SQ. Finally, in the third stage of an ordinary claji, after the com-
plete cessation of the scalding and all other painful sensations of these
parts, especially the troublesome erections, when the discharge has
become lessened, almost colourless, mild, and viscid so as to be drawn
into strings betwixt the flngers, nature may be assisted in following
manner.
87. I refer now to a gonorrhoea neglected under the ordinary treat-
ment, which most certainly requires such aid, for if the best antiphlo-
gistic and sedative local treatment have been vigorously employed
26 OK V£N£B£AL DISEASES.
from the commencement, all the discharge ceases of itself either in
a week or a little longer.
88. On account of their calefacient and stimulating, but at the same
time also their diuretic, inspissating and strengthening powers, the na-
tural balsams of Copaiba, Tolu, Canada, but especially the Rackasira-
balsam^ and the other turpentine-like substances are of use in these
cases. They may be given alone, or rubbed up with sugar, or dissolv-
ed in water by means of yolk of egg, or in the form of pills to the
extent of 50 or 100 grains daily .^ Care should be taken not to give
them before this stage, when the irritability has ceased.
89. This is the time when linseed tea, the Thebaic tincture, and
the bathing of the genitals must be left off, but the diet must be
allowed of stronger and more nutritive articles.
1)0. If, however, we have to do with very lax systems, or such as
have been treated with remedies of a too relaxing character, in which
the third stage of the gonorrhoea comes to be of a tedious character,
and in which, though the disagreeable sensations in the urethra have
all gone oflf, the discharge still continues in considerable quantity,
yellowish and of some consistence, it is necessary to abridge this
stage energetically, in order to avoid the occurrence of gleet.
91. Besides the internal use of tonics and balsams, the inner se-
creting surface of the urethra must be roused ^ from its inactivity,
as old skin diseases are cured by blisters, chronic catarrhs by sternu-
tatories, or habitual perspirations by a flannel shirt.
92. One, two or four grains of caustic potash or corrosive subli-
mate dissolved in eight ounces of water will form the best injections
for this object The frequency of their repetition should be regu-
lated by the degree of irritation that these injections manifest on the
affected parts ;* if it be slight, they may be repeated the oflener.
' As early as 1695 Job- Vicrzigman makes mentioo of these and similar remedies
with the greatest approbatiotu See Disp. de Phimosit Cor. 22.
^ The most certain sign that the balsams have been given too soon is the occur-
rence of retention of urine, the rencval of the scalding, Ac ; in that case their use
is to be discontinued.
* These stimulating injections have many things in common with tonic remedies ;
when they rouse to activity the lax fibres, the latter gain a tone, whereby they are
put on a par in point of strength with the imrelaxed fibres ; they then react with a
power peculiar to the natural tense fibres. We may therefore reckon these artificial
stimulating remedies among the number of tonics, just as in certain respects carda-
moms and ginger deserve to be called tonic stomachics, as much as the bitter and
astringent vegetable substances.
* We f>hould take care to ascertain beforehand that the organism has no tendency
to morbid irritability and erysipelatous inflammation, which will be perceived from
the characteristics of this kind of constitution given below, and will be known not to
exist if the previous painful sensaUons in the urethra were confined to the actual seat
of the gbnorrhflBa.
PBIMARY GONORRH(KA. 27
93. In this way we may eradicate this malady in a short space of
time irjom those organisms that are apt to entertain chronic gonorrhoea
(from five to seven days of injection usually suffice) ; we must only
take care not to excit« any inflammation by means of the instru-
ment ^ used, by diluting or concentrating the injection to keep up the
stimulation in a moderate yet sufficiently great degree. But this is
a matter requiring some skill which the beginner is rarely possess-
ed of.
94. These stimulating injections properly employed, are at the
same time a good preservative against secondary gonorrhoea, which
usually depends on weakness and laxity of the urethral fibres and of
the excretory ducts or the mucous glands.
95. On the other hand, in those systems in which the inflammatory
gonorrhoeal symptoms were of an erysipelatous character, and which
possessed a high degree of that irritability from weakness, they must
not be used, nor yet in those cases where after a long-lasting dry go
norrhoeal irritation the discharge is with difficulty established, or
where tendency to strangury, to sympathetic buboe, and hernia humo
ralis, or to abscess of the perinseum exists ; and in general not as long
as the discharge continues thin and watery.
96. Along with these irritating injections and the internal use of the
balsams, the part should be frequently bathed with cold water, and
bark taken in order to aid in the complete recovery of the body.
97. By such means an ordinary gonorrhoea usually terminates soon
and without further ailments.
98. But this is not always the fortunate result. A bad constitution
of body and other circumstances often give rise to the above men-
tioned violent and even dangerous symptoms, the relief of which will
now occupy our attention.
99. Persons who are of weakly constitution and who have a liabi-
lity to a number of nervous complaints, spasms, and erysipelatous in-
flammations, are very often subject to the most severe gonorrhoeas.
100. In such cases the malady is not limited to the special and
ordinary seat of the gonorrhoeal virus. The inflammation extends in
an erysipelatous manner along the urethra, and frequently extends to
a considerable distance over the adjacent parts, accompanied by the
most violent and serious symptoms, such as I have described above
(§ 23 — 25) as occurring in the worst form of gonorrhoea. The whole
array of malignant gonorrhoeal symptoms may ensue without the
* If the practitioner will not employ the small syphon (§ 59), but will make use of
the unsafe syringe, he would do well to have the end of the pipe made quite round
azkI two lines in breadth, increxising in thickness rapidly from the end backwards,
eo that it cannot be introduced more than half an inch ; if this be done, no injury
can occur to the iDtemal part, without the greatest want of caution.
28 ON VENEREAL DISEASES.
virus that entered the urethra necessarily being, as some think, of a
peculiarly bad nature. The corporeal constitution which is so unfa-
vourable in this case has besides other evils a peculiar morbid irrita-
bility resulting from nervous weakness, the characteristics of which 1
shall point out more accurately below.
101. In consequence of this kind of constitution, the frequent or
even persisting erections (priapism) and curvature (chordee) of the
penis, the pains in the whole organ on urinating and on being touched,
the redness of the penis and of the perinceura and even of the adjacent
parts, the strangury, the discharge of a green or grey matter, and all
the other obvious inflammatory symptoms, have this peculiarity, that
by the relaxing antiphlogistic treatment not only are they not re-
moved, but they are very often thereby aggravated.
102. Repeated venesections, purgatives, nitre, and the other em pi-
rical remedies, do harm in such cases, even in those to all appearance
most purely inflammatory; and laxative salts, relaxmg fomentations
and drinks, are not admissible.
103. The only things that do good in such cases, are derivative
irritants applied at a distance, and tonic antiphlogistic sedatives em-
ployed locally and internally,
104. To this end we may, in a case where there is a constant in-
crease in the violence of the erysipelatous inflammatory symptoms
of the above described kind, apply a blister or mustard sinapism on
the sacrum ; bathe the affected parts with a lukewarm fomentation,
made by boiling one-part of oak-bark in 30 of water, and on removing
it from the fire, infusing in it half-a-pint of elder-flowers and a third of
opium ; and make the patient drink elder-flower tea, mixed with from
15 to 20 drops of a'/ic^. /Ae6a/c/. We should also use the injection
into the urethra described in § 59, but should, according to circum-
stances, diminish the quantity of sugar of lead in it.
105. Rest on a horizontal hard couch, moderate coverings over the
body, a well-aired not too warm room, and a nutritious easily di.
gestible vegetable diet,^ consisting of barley-water, oatmcal-gruel,
sago, rice, groats, and farinaceous puddings, will be of use. Clysters
of asafcetida, prepared by rubbing it up with water into the appear-
ance of milk, will serve to keep the bowels open.
106. But if the morbid irritability of the body, its abnormal ner-
vous weakness, and its tendency to this kind of bad inflammation, is
' We must take especial care to forbid the use of the very diuretic vegetables, aa
water-cresses (tiaymbr. ncuturt), parsley (ap. petroseL), hops {humul. Inp.), and an
^cess of asparagus ; as also the hard husked seeds, as lentils, beans and peas, cspe*
dally if cooked sour ; and, as a general rule, much vinegar and strongly fermented
liquors are to be avoided, on acooont of their irritating e£fects on the urinary organs-
PRIMARY GONORRHOEA. 29
lieveloped in the highest degree* and if by this treatment the symp-
toms become if not aggravated at all events not ameliorated, we
should adopt another method.
107. We must endeavour to discover if bilious impurities of the
primaj viie are not the cause of this aggravation (which is sometimes
accompanied by febrile symptoms), in which case it will be necessary
to give one, or, according to circumstances, several emetics.
103. Besides this, cold half baths, or foot baths, must be used once
or twice daily for two or three minutes at a time, and cold compresses
frequently renewed must be kept to the affected parts (of the same
kind as the above described tepid ones, only stronger), and the em-
ployment of a sufficient quantity of bark in wine, in some cases, par-
ticularly towards night, combined with laudanum, as also the acid
elixir of Haller taken several times a day in doses of 40 drops, are of
the greatest service. The patient should lie only on the side, not on
the back. Above everything, we should diligently employ the care-
ful injection (§ 59) into the urethra of a fluid, which without possessing
any astringent power, shall most rapidly remove the irritation. Ac-
cording to the experiiince of myself and others, from five to ten grains
of opium, with as much gum arabic, dissolved by tritunation in an
ounce of water, is the most suitable preparation f6r this object. In
addition to these means, clysters of a similar solution of opium in
water are of excellent service, after we have procured a copious
evacuation of the bowels, according to the counsel of Schwediauer.
100. Under such treatment all the ])ad symptoms usually yield,
the gonorrha^al irritation commences to limit itself to its circumscrib-
ed specific seat in the anterior part of tiie urethra, and there again
ensues a simple, mihl clap, which is easily removable by nature or
flight artificial aid. However, the patient must, during the remainder
^»f the treatment, remain entirely in bed, or at ail events confined to
one room, he must not lay aside the suspensory bandage, and must
keep to low diet, as the disease is very apt to return.
110. But as good and extensive acquirements are required in
order to judge of the nature of the malady and of the patient's
constitution, as well as of the suitable remedies, a physician will be re-
quired, and the attendant surgeon will not fail to call one in in such a
case, for the sake of his own reputation. He will determine whether,
*»pium, blisters, <fcc, are to be used along with the strengthening re-
medies.
111. Persons of strong, robust systems, wnth firm tense fibre, swart
animated countenance, of violent disposition, and in the habit of
' In such cases there iR generally rapid pulse, much pain, and copious thin dis-
charge.
80 ON VENEREAL DISEASES.
taking much exercise, are more disposed to pure inflammatory gonor-
rhoea than others.
112. Moreover, violent and long continued exercise (especially
during great heat and cold), dancing, riding, the ingestion of indiges-
tible or strongly seasoned dishes (especially with pepper), and heating
or spirituous liquors, anger, very hot rooms, late lying in bed, violent
purgatives, irritating injections, the incautious introduction of bougies,
onanism, coition, &c, especially in the above described constitution,
are very apt to change a slight, mild gonorrhoea into a very inflam-
matory one.
113. The symptoms, which in the above described constitution are
to be regarded as purely inflammatory, and to demand antiphlogistic
treatment, are : violent scalding on making water ; the escape of some
drops of blood after the operation of urinating ; "great pain on touch-
ing the urethra, especially in the region of the peculiar seat of
gonorrhoea, from one to one and a half inch* behind the orifice of the
urethra ; the discharge of a greenish or greyish thin ichor ; frequent
tension of the penis, especially its curvature downwards ; and some-
tiiped a febrile attack.
114. I put in the same class, because it demands the same treat-
ment, the dry, scalding clap (ganorrhee seche)^ which occurs after an
impure connection in some individuals, and often lasts several weeks
before the discharge sets in, and may even be cured without any dis-
charge occurring, especially by the diligent injection of a watery
solution of opium into the urethra.
'115. In general it will be found useful in all such aflections to
employ a tepid foot-bath, especially at night, emollient poultices of
linseed meal, or bread-crumb with boib'ng milk, combined with a
little saflron, well mixed together into paste and applied luke-warm;
as also injections^ of warm milk, with infusion of saflron or opium ;
together with the most cooling diet, linseed tea, strict abstinence
from exercise, a horizontal, quiet, hard, cool couch ; rarely venesection.
* The most characteristic pathogDomcHuc sign that the gonorrhoea! symptoms be
they ever so intense, are of a purely inflammatory character, and do not depend on
irritation from weakness or an erysipelatous constitution, J. Hunter rightly alleges
to be the limitation of the scalding of the urine to the special seat of gonorrhoea ; a
fiurt we would do well to remember in practice.
* The small syphon described at § 69 should be employed for the injection, or if
there be a prejudice against using it, we may employ the syringe described in
the note to § 93 with caution, taking care, while we regulate the piston-rod of the
eyringe with the right hand, to compress the urethra just in front of the scrotum
with the left thumb and forefinger, so that the gooorrhoeal virus may not be
carried by the injected fluid beyond the special seat of the disease, and thus to
give rise to fresh inflammation, which is dangerous in proportion as it extends
nearer the bladder. Some deny that the goDorrhoeal virus can produce inflam-
mation beyond the proper seat of the disease.
PRIKABY GONORRHCBA. 81
116. The priapism, the painful curvature of the penis, the micturi-
tion of blood, the phimoses and paraphimoses, demand, in addition to
the above, the application of leeches to the affected parts, a poultice
with a good quantity of opium in it (often a fiflieth part), steam
fomentations from an infusion of elder flowers, as also the internal
use of laudanum, especially at night.
1 17. The same treatment is to bo adopted for the violent pain in
passing water, the painful inflammation of the perinseum, and the dry,
Maiding of urine. We may, in addition, employ in these cases frequent
injections of equal parts of opium and isinglass, or gum arabic, dis-
solved in 60 parts warm (80*^ Fahr.) water.
1 18. The febrile symptoms decline spontaneously when the pain is
diminished, so that we need not use any means specially for them.
119. If on the diminution or suppression of the gonorrhoeal dis-
diarge (§ 28, 29), the testicles swell, they must be put in a suspensory
bandage, and held up thereby sufliciently, yet gently. The testicles,
in their suspensory bandage, should be dipped every half hour or
every how for some minutes in quite cold water,' and at the same
time a tepid (§116) poultice should be applied around the penis.
The same cold applications should be made to the inflamed perinseum,
or the groin, when under similar circumstances the inguinal glands
(§ 33) are swollen.
120. In these cases, a cautions injection into the urethra of warm
infusion of saflron or of opium (§ 108) may be of great use in restor-
ing the discharge, whereupon the tumefaction disappers spontaneously *
We may for the same end employ as an enema hall' a drachm of
opium dissolved in a pint of water, which is also often effectual in re-
moving the accompanying strangury.
121. The repeated exhibition of a gentle emetic, even though
the stomach be not affected with the bile or dyspepsia, in addition to
the above mentioned topical applications, and an occasional opiate at
night, will often succeed in restoring the discharge and dissipating the
swelling of the testicles. But when all other means fail, a few doses of
soluble mercury will often restore the discharge, as I can attest from ex-
perience. The introduction of a bougie covered with ammonia^ will
seldom be required to bring back the gonorrhoea.
122. Until this has taken place, there is always danger of the oo-
' Care should be taken not to use warm applications for sympathetic buboes.
' The sfwelling of the testicle ia seldom capable of being resolved before the sixth
day after its appearance.
* I would not advise (seeing that along with otlier irritations of the urethra,
the mere introduction of a common bougie excites inflammation of the testicles,)
this mode of restoring the clap, especially with fresh gonorrhceal matter, and
in the inflammatory utage of the disease.
32 OK VENEREAL DISEASES.
currence of complete retention of urine, which will demand im-
mediate relief. The appliances described in § 120 being continued,
we may order a tepid half-bath with chamomile and soap, and apply
leeches to the perina3um, or a blister to the sacrum. Every thing of
a diuretic jcharactcr should be avoided in the food and drink.*
123. If, as seldom happens, the discharge cannot be restored, and
swelling of testicles or inguinal glands continues, we must then change
the compresses of cold water for vinegar and sal-ammoniac, or en-
deavour to bring about a revolution by rubbing Naples ointment into
the scrotum or buboe, as soon as all the inflammatory symptoms of
the gonorrhcea are gone ; but not before, otherwise the irritation in
the buboe is readily transferred to the testicles, or from one testicle to
another, or we may expect other annoying symptoms.
124. Still more rarely do these sympathetic swellings proceed,
under this treatment to suppuration; if this do take place, it is* a
simple abscess with usually nothing of a venereal nature in it. It
will become quite healthy in character, if it be not so already, under
the diligent employment of bark externally and internally. The inflam-
mation of the perinaeum also does not always yield to the repeated
application of a cold (50°) decoction of oak-bark, which is usually so
effectual, but sometimes passes on to suppuration. If the abscess bo
not connected with the urethra,^ and no urine escape by it, it also ia
of a simple character, and curable without mercury.
125. It still remains to speak of the treatment of that rare but
dangerous attendant of suppressed gonorrhoea — the purulent oph-
thalmia (§ 24), which goes on rapidly to complete blindness. The
first and most important point is to restore the gonorrhoeal discharge*
We must make use of all the procedures spoken of (§ 119 — 121), ex-
cept the cold compresses, as early and vigorously as possible ; the tepid
narcotic injections into the urethra, frequently repeated small emetics,
the plentiful internal adminstration of opium, and even, if all other
means fail, the introduction of a bougie covered with ammonia. At
■-- , ,1 I _ IB ■!■ IIIMIBIWB^
* If DotATithstanding all these means the retention of urine continues with it9
threatened fiital consequences, we should carefully introduce a catlieter (a gum elas-
tic one Ls preferable), and draw off the water. If this, perhaps in consequence of
swelling of the prostate, be impossible, we must have recourse to perforatioii of
the bladder through the rectum with the trocar (taking care to avoid the seminal
vesicles), or to opening the neck of the bladder from the side.
2 In order to prevent this, it must be opened as early as possible ; that is to say,
whenever the inflammation presents a shining, soft elevation, m which the general
paiuM are concentrated to a mere throbbing. If this he neglected, abscess usually
bursts also internally into the urethra, whereby a serious disease, the urinary fistula
occurs ; which requires, besides the internal employment of mercury, goo<l external
applications and the use of the elastic catheter, through which we must allow thb
urine to flow each time it is passed until the cure is effected, which generally
takes a long time.
FRIMABT GOK0KRHIKA« 91
the 8une time we must constantlj apply to, or still better, baUie the
«je in water cooled with ice, mixed with a thousandth-part of sugar
of lead. Tepid foot baths, or half baths, venesectioiis, blisters to the
saenim, scarifications of the conjunctiva, leeches to the temples, must
not be n^ected, nor indsions in the oomea if pus be accumulated
betwixt its layers. But I will advise in preference to this operation,
lool ivmigations with cinnabar,^ and Uie application of a poultice of
mnidrigora root. Some say they have seen advantage from the em«
ployment of hemlock and monkshood.
126. As regards preputial gonorriicea (§ 39), Uie symptoms it
oeetsions are of no great importance — sometimes a moderate degree
of ptimosis, ilnd a slight discharge jfrom the inferior part of the glands
ind prepuce ; frequent washing with a mucilage of gum arabio k
almost of itself sufficient to cure every case of this affection in a short
space of time. But if it penetrate deeper, or if it be obstinate, it
requires the internal use of mercury like other venereal affections,
€Qiijoiiied with cold and astringent applications.
CHAPTER in.
GONORRHGBA IN THE FEMALK
127. As the genital organs of the female are less composite in their
dnneter, generally less sensitive and of laxer tissue than those of the
male, it follows that gonorrhoea in the female should also present less
complicated, less violent, indeed, often unrecognizable symptoms. —
And such is the case.
128. The simple venereal leucorrhoea, when the vagina is only af- '
fected by it in a minor degree, is often so painless, and the functions as
well as the appearance of the genitals appear to be so natural, that even
experienced persons might often take the dischai^e merely for a symp-
(om of weakness, scrofula, chlorosis,' &c., did not the general consti-
tution of the patient testify plainly to the contrary, or should we not
have ascertained that she infected one or more men with gonorrhoea. —
Did we possess any specific antidote to gonorrhoea, its discovery
would be very easy, and on the other hand the frequent spread of this
affection occasioned by the difficulty of detecting* the venereal charac-
ter of a simple gonorrhoea in the female, might be prevented.
' As kng ago as 1556, Gabriel Fallopius {De morbo Gallico, Batav. 4ta 1564,
«qL 99) observe this sympathetic metastasis of gonorrhGea (lippitudinem rcbellem,
fut >dfBitwm inflammat membranam et oonicam ezcoriat), and cured it with
t^mt^y^r fomigatioDs.
' A leaootffaaea araiiig from ooanism is as obstinate as any of a yenereal origin.
' Girtamer mentiaiis some droumstanoes that should senre to distinguish the vene-
ml from the unveoereal leucorriKBas ; the liUter appear at first only before the
kCDoemcnt of each menstrual flax, afterwards they also eontinue a few days
ita eeflsalioD, and then cease for from eight to fourteen days; they cause tha
3
84 ON y£N£B£AL DISEASES.
129. But the oase is quite different with the gonorrhoea of a com-
plicated character in the female. It comes on with a sensation of
warmth in the genital organs, and a tickling sensation causing desire
for coition, with frequent erection of the clitoris, lliese premonitory
symptoms, however, soon give place to pains accompanied by some
discharge from the vagina.
130. The patient experiences in a few days a fulness, tension and
burning in the vagina and labia, which along with increased heat and
swelling, especially towards the lower commissure, are intolerant of
the slightest touch. The urethra is inflamed at its orifice, in worse
cases throughout its whole extent ; the scalding on making water is as
painful as in males. The clitoris is excessively sensitive.* Coition or
contact is impossible ; walking, sitting and making water almost un-
endurable.
131. An acrid ichorous discharge of various colours issues from the
whole inner surface of the vagina, or at least from beyond its sphinc-
ter muscle, and from the myrtiform rugse, and in more severe cases
from the urethra.
132* When exercise or over-heating of the body or of the genital
organs is not avoided, or when injurious irritating remedies are given
internally, there occurs also, as in males, sometimes a sympathetic
swelling of the inguinal glands or inflammation of the perineum,
along with diminution of the discharge. In bad cases there may also
occur retention of urine, likewise dependent on sympathetic irritation,
133. When the disease is of a more violent character, we perceive
deep seated glandulaf inflammations in the body of the labia majora,
which become painful, increase in size, and generally form abscesses
betwixt their inner surfaces and the nympha^^ which burst.
134. Gradually the discharge from the vagina becomes thicker and
more like pus ; the scalding of the urine begins to diminish, and
afler a longer or shorter time at length ceases, along with the other
troublesome and painful symptoms.
135. If the gonorrhoea be near its termination, (nature frequently
takes many months to cure it), the discharge becomes, as in men,
colourless, mild and viscid before it completely ceases.
dimiznxtioQ and at length gradually the total disappearance of the catamenia, where-
npoD the leaoorrbcoa begins to flow oootmoally. They are alao generally aooompa-
Died b]r, pains in the loins, a dragging in the thiols, debility of the legs pale complez-
ko, dyspepeiaand hysteria, and at length stenlifyt all whidi serve to distiBgaishthem
pretty well from venereal gonorrfacea.
> De Home observed almost in the same plaoe in the ialemal surfiMe of the
great and small lips and in the vagina, oocaaunally some pomts (perhaps the orificea
of similar glandular sappuratioQs) which poured out a laige quantity of watery pus,
and might ooeariofially be regarded as seoocidarygooorrhfBa in the female. Hecured
it by opening these small fistukoi docta.
FBDCABT GONOBRHCBA. 35
CHAPTER lY.
TREATMENT OF GONORRHCEA IN THE FEMALE
136. In general its cure is attended with fewer difficulties than in
the male, but so much the more tedious is it.
137. In mild cases of gonorrhoea in the female, we have little else to
do than to remove the irritation in the vagina and to strengthen Uie
relaxed parts.
138. We fulfil all these indications by the simple treatment of
making eight or ten times daily, repeated injections into the vagina of
fifteen grains of sugar of lead, and eight grains of opium dissolved in
an ounce of water. (§ 59. )
139. If this be not strong enough we may use in place of the sugar
of lead, from 10 to 15 grains of sulphate of zinc, which will certain-
ly prove effectual. About a fortnight is require^ to effect a cure.^
140. We must treat with contempt the old bugbear of the dangers
of suppressing a gonorrhoea, which goes off without leaving behind it
scalding of urine, strangury or other inconvenience. Everything
that removes the local irritation and alters the specific gonorrhoeal dis-
position, cures the ordinary gonorrhoea. But only locally, some one
may retort ; to which 1 reply, certainly, and most properly too, for
it is merely a local malady.
141. These remedies will not be found to be too strong when com-
pared with those for gonorrhoea, in the male, more especially as the
texture of the vagina, especially in the case alluded to, is astonishingly
lax, spongy and unirritable, and not to be compared with any part of
the male genital organs.
142. The more severe kind of gonorrhoea in the female, however, re-
quires a different mode of treatment. Of the remedies proposed in
the treatment of gonorrhoea in the male, the only admissible ones
are the opiated linseed tea and the local sedative antiphlogistic com-
presses, as the excessive pain of the inflamed parts renders all injec-
tions impossible.
143. In this case we must make frequent applications of tepid poul-
tices of linseed-meal, combined with saffron, to tlie external parts, and
these must be repeated until the diminishing inflammation and tume-
fiu^tion of the vagina admits of the injections at flrst of tepid and at
length of cold infusion of saffron, which should be continued until the
scalding of urine and the pain of the other parts of the genital organs
> Oirtaimer advisee fresh lime water, or an equally strong solution of caustic pot-
Mh to be injected from six to eight times daily into the vagina, by which process, he
tflKris, goDorrhcBa in the female wiU be cured in five or six days ; a period of time
■o short, as if experience corroborates the assertion, would point to an almost sped-
fie power of these antacid remedies against the gonorrhiBal virus.
36 ON YBNEREAL DISEASES.
are completely removed. Injections of ten grains of opium with
gum-arabic in an ounce of water, will also be of the greatest service.
144. On the occurrence of the glandular abscesses (§ 133) on the in-
ternal surface of the labia majora, we have nothing particular to do.
The swelling will be resolved if that is possible by the external fomen-
tations, or burst from the same treatment We must in that case
take care to keep open the ulcer, which is always somewhat deeply
seated, and when the gonorrhoea has lost all its inflammation, give the
soluble mercury till slight mercurial fever is produced, partly in order
to prevent the serious effects of the absorption of the virus into the
general circulation, partly to effect the most speedy healing up of the
ulcer ; which according to my experience is most surely and easily
effected by this means.
145. During the inflammatory stage of the disease, we should pre-
scribe, as in the case^f males, a mild v^etable diet, a general cool
regimen, and the strictest rest. The only other things required are an
enema of honey -water to keep the bowels open, a mild opiate at night,
and, in the purely inflammatory state, a few tepii foot-baths. Vene-
section is seldom requisite.
146. When the injections of the opium solution (§ 143) have re-
moved the violent irritation, the inflammatory symptoms and the pains,
we should go on with the narcotic astringent injections (§ 138, 139)
until the cure is perfect.*
147. A syringe with a pipe at least two-thirds of an inch thick and
with a rounded end perforated with several small holes, but having a
narrow canal, is best for such injections ; we are sure not to injure the
internal parts with it, and the fluid is propelled far in and made to re-
main as long as possible. The thickness of the pipe dilates the myrti-
form folds of the mucous membrane and the fluid comes in contact
with the whole surface, thereby relieving the irritation and washing
away the virus. The patient can herself most effectually perform the
injections by lying on the back with the shoulders elevated, and the
knees drawn up and separated ; in this way the injected fluid can re-
ms&iL longest in the vagina, act longest on the affected parts and deve-
lope the greatest power.^
' Orwe may employ for this end the lime-water bo strongly recommended by
Girtaimer.
* StiU more ooovenient is Girtatmer^s instrmnent, which consistB of an india-rubber
bag loitead of Ibe waal syriDge^ adapted to the cylindrical pipe.
SIQITBLJB OP GOKORRHOSA. 87
SECOND DIVISION.
SEQUELS OF GONORRHCEA.
CHAPTER I.
CHRONIC STRANGURY AND ITS TREATMENT.
148. In cases of obstinate gonorrhoea, especially in the male, when
the bladder and neighbouring parts have been implicated in the erysi-
pelatous inflammation and unskillfully treated, there sometimes re-
mains a frequent painful inclination^ to make water, a burning or
shooting pain in the urethra, often as far as the glans, pressure on the
bladder after the evacuation of the urine, and a disagreeable sensa-
tion in the perinseum ; a pitiable disease that in course of time lays
the foundation for thickening of the walls of the bladder, ulceration
of it, urinary calculus, and even dOatation or suppuration of the pelvis
of the kidneys.
149. If these symptoms be not owing to stone in the bladder, or
stricture of the urethra, which may both be ascertained by means of
the catheter, or swelling of the prostrate gland, which may be ascer-
tained by the catheter and the introduction of the finger into the rectum,
they depend on the above mentioned cause ; but the patient need not
therefore fear, as he often does, that there still exist imeradicated remains
of the venereal disease in his system, to occasion these sufferings.
150. These grave symptoms may often be removed by frequent
bathing of the genitals in cold, and even the very coldest water,
(whereby the weak parts are strengthened and their irritability dimin-
bhed), and by the injection of a solution of opium. (§108.)
151. If this remedy be used for several weeks without effect, (which
very seldom is the case), the employment of opium internally and ex-
ternally (in topical applications and clysters) is, according to my ex-
perience, of excellent service.
152. If this do not suffice, besides the last named remedy, the ap-
plication of a blister to the sacrum, or the introduction of a seton into
the perinseum will produce the desired effect.
CHAPTER II.
CHRONIC CURVATURE OF THE PENia
153. The curved erection of the penis (chordee) sometimes per-
sists after the removal of the gonorrhoea and its attendant symp-
' These sufiferings are usually caused by a renewed irritation, resulting from spasm
and weakne$«, and an irregular reaction of the bladder against the urethra. In the
betlthy state, before the evacuation of the urine, the neck of the bladder and the ure-
tbra are contracted and the bladder is relaxed, but when the urine is to be passed, the
bbdder eootracts, and first the neck of the bladder and then the urethra relaxes, and
after the urine has flowed out the two latter contract before the first becomes relaxed ;
vhereas in this case the oatural operatioiis of these jiarts are reversed, or at Ifiaai take
pbee m a perrcrted order.
88 ON VENEREAL DISEASES.
toms. It renders coition painful, often impossible, or at all events un-
prolific.
154. An induration of the membrane of the urethra, or thickening
of a part of the corpora cavernosa is usually the cause of this affection.
155. Recourse is usually had to venesections and purgatives, al-
though they cannot be of the slightest benefit, and often do much injury
to the system.
156. The internal use of hemlock is said to be of use ; the extract
may at the same time be applied outwardly. If this do not succeed,
mercury should be rubbed into the affected part, and bark taken in-
ternally as Schwediauer advises. Good results may be anticipated from
the employment of electricity.
157. These things may prove serviceable when the symptom does
not depend on too great induration and adhesions of the corpora ca>-
vemosa, or of the substance of the urethra. In worse cases, however,
when the remedies just n^entioned are inefficient against the cartila-
ginous adhensions, De la Peyronie has found the baths of Bardges use-
ful. (These baths greatly resemble the other warm alkaline mineral
waters containing sulphuretted hydrogen, at Aix, Baden, Toplitz,
Kirchberg, Wolkenstein, <Sz;c.) In order that they may do more good
than the other remedies, I believe they ought to be used in the form of
douche on the affected parts.
158. Peyrilhe asserts that he has cured those almost osseous indu-
rations by the internal employment of volatile alkali, and by applica-
tions of diluted soap lie.
CHAPTER III.
INDURATION OF THE TESTICTLK
159. In general this only remains after injudicious treatment, of the
sympathetic swelling of this gland ; it is worst when at the same time
the spermatic chord is thickened, varicose and scirrhous. This affec-
tion is often very tedious, often incurable. If the epidydimis only be
Indurated, it is of less importance, it does not interfere with the re-
productive faculty.
160. In cases of induration of the testide that is not of too long
standing, the application of a compress imbibed with a strong decoc-
tion of oak-bark has proved of excellent service in my hands. Others
have recommended the internal use of hemlock and local fumigations
with cinnabar, along with repeated emetics ; I have never seen the
slightest utility from any of these means in any kind of indura-
tion.
161. Some have advised, in addition, the rubbing-in of Neapolitan
ointment ^ into the scrotum and perinsum, together with the internal
' Girtanner advises that ammoDia dntment be nibbed in aeveral timee daily at the
pennaiim and scrotum. I have eiqperieiiced its eflSca^ in other glandular sweDinQa
' SBQUEUi OF GONORBH<BA. 89
use of mercury (but as no lymphatics proceed from the scrotum to the
testicles, this does no good, unless from the mere friction) and the ex-
tonal and internal employment of decoction mezereum. Poultices
with belladonna leaves have also been enjoined. Where nothing else
succeeded, good effects have been perceived from electricity (espe-
oally from the electrical bath and the simple spark, or very small
shocks from the Leyden jar). Acrel has seen good results from the
internal use of a decoction of an ounce of ononis-root in water.
i62w Some redcon amongst the best remedial means the inoculation
of an artificial gonorrhoea (by the introduction of gonorrhoeal matter
by means of a bougie, or by the injection of diluted ammonia ^) ;
others ^>eak disparagingly of it.
163. Sdiwediauer advised a warm poultice of fresh mandragora root
to be applied to the scrotum. Van Swieten trusted to a medicament
composed of two ounces of crabs^eyes and a pint of Austrian wine,
four tablespoonfuls to be taken night and morning. Aepli of Dies-
senhofen completely cured a peasant of scirrhous and ulcerated testicle^
by the administration internally of fifleen or sixteen green lizards,
raw, cut into pieces. We frequently have to alter the constituticMi
before resorting to local remedies.
164. If the cure progresses favourably, the hardness of the epidy-
dimis is the last to disappear. Before the body of the testicle decreases,
it first becomes soft, and softer ^ than in the natural state, as Himter
observed and 1 can testify.
165. If all attempts prove fruitless, and the testicle remains very
sensitive to touch, or traversed by agonizing shoots, grows rapidly in
volume, &c., we may perform castration without tying the spermatic
cord. If however the latter up into the abdominal ring be thickened,
knotted and hard, this operation is inpracticable. Still it rarely passes
into cancer. ^
•CHAPTER IV.
SECONDARY GONORRH(EA IN THE MALE AND ITS TREATMENT.
166. The mucous discharge* from the urethra, which continues un-
diminished from a primary gonorrhoea long after the cessation of the
scalding of urine and of the painful erections, is termed secondary
gonorrhoea (gleet).
' Girtaxmer reoommends a simple, clean bougie for this purpose.
* Almost pappy.
> Glrtanner is of opinion that induration of the testicle never passes into cancer.
* Perhaps I should add *Vithout venereal miasm," but the infecting power of clap
and of gleet has not yet been accurately determined by observers, especially as in
realitv there are gleets whose continuance, as will be seen, depends on their vene-
real nature, I mean those arising from ulcers in the urethra.
'40 OK VBNBREAL DI8BA8SS.
167. The same appellation may be given to the discharge that re-
eurs afler excitation of the passions, after severe exercise, excesses in
fermented liquors, or after repeated coitus. ^ All these re-exciting
causes tend to change the mucous colourless gleet into a puriform
discharge.
168. Seeing that there is no universally efficacious remedy for gleet,
and seeing that things that do good in some cases, do manifest injury
in others, it follows that this aflfection may arise from several causes.
169. Sufficient for practical purposes may be the division into gleet
from irriiabilUyy gleet from heal or general toeakness, gleet from
halnty gleet from ulcers of the urethra, and gleet from strictures of the
urethra ; although there may also be some from scrofulous and gouty
causes, as would seem to be shewn by some cases.
170. The cure of these kinds of gleets would often not be attended
with such difficulty if it were easy to ascertain the cause ' in every
case with certainty. But the following distinctive marks will suffice
in most cases.
171. The gleet from irritability chiefly aflects those persons who
are subject to irritable weakness of the nerves and frequent indisposi-
tion, and in whom during the primary gonorrhea the pains extend
beyond the special seat of gonorrhoea to the neighbouring parts, and
give rise to the above described bad symptoms.
172. Along with this gleet there is usually a disagreeable irritating
sensation in the urethra, which however is not fixed to any particular
spot ; the distinctive features of the other gleets are not present, and
their remedies manifestly aggravate it. ^
173. It has this peculiarity, that when it is getting better it is ag-
gravated by the use of mercury, irritating clysters and purgatives, by
drinking much tea, by anger and other passions, or by slight excesses
in venery, in eating and in drinking, and after it has ceased for some
time is brought back again by such causes.
174. If we can remove the irritability from the system, or from the
genitals if they only are the seat of irritability, then the gleet will go
off of its own accord. Therefore the method I recommended (^150
— 152) for the irritation of tlie bladder and the accompanying pains
in the urethra remaining after gonorrhssa should be adopted.
175. The genital parts are to be bathed in cold astringent fluids, rs
' That the gleet occaaioaed by excessive coition is not produced by a new infecti* a»
we know from this, that it comes on immediatily after the act, that it is accompanied
by scarcel J any pain, and from other circumstances.
* Sometimes it appears to be quite bexplicable, as is obeenred in tiiose gleets
that cease of their own accord after the fruitless employment of the most approYed
remedies.
* In this land of gleet we mustinetther employ irritating nor styptic injectiooi if
we would avoid aggraTatiDg it and exciting erysipelatous ii
SSQUSUB OF 60N0BBHCEA. 41
• strong decoction of oak-bark, a solution of common vitriol or of
mlum in cold water, and the like, and a tepid solution of opium in
water (in the proportion of one to sixty) should be injected^ into the
urethra, if that can be done without causing irritation.
176. Should there be no opportunity of doing all this, the continu-
ed and repeated dipping of the genitals in plain cold water will often
answer the purpose alone ; especially conjoined with moderate exer-
cise in the open air and a cold foot-bath for some minutes every day.
177. A general tonic treatment of the whole system, especially in
obstinate cases, will contribute much, often more than anything else,
to the removal of this kind of gleet, which is usually caused by an
improper treatment of the original gonorrhoea by the abuse of Nea-
politan ointment, venesections, purgatives and irritating injections
during the inflammatory period.
178. Oleeifrom habit. Excessive coition and the unnecessary use
of the bougie during the third stage of gonorrhoea, frequent infections,
and other causes, may bring the excretory ducts of the mucous glands
into a state of insensibility and induration, whereby they lose the
power both of expanding and contracting themselves. Through their
oallons orifices they permit the escape of a quanlity of the mucus con-
creted in the glands which would else be taken up again by the absor-
bent vessels. The discharge becomes almost like an issue, like that
in chronic ophthalmo-blennorrhoea.
179. Astringent^ or relaxing injections have no effect on this kind
of gleet.
180. The discharge is not so copious or so watery as that in gleet
from w^eakness: the urethra is painless and will readily bear the in-
troduction of a bougie ; but that arising from weakness may in course
of time degenerate into this kind, if treated too remissly or not at all.
181. This kind of gleet must be treated, at least in the first place,
with stimulating injections, for which a solution of a grain of corro-
sive sublimate in four ounces of water will suffice. The injection
must be performed for the first two or three days, twice, afterwards
three or four times daily. We may then, if the urethra bears this in-
jection without any sensation, diminish the quantity of the water for
the solution, in order to make it stronger.
182. If we suspect that the injection does not penetrate to the af-
fected part (for the fluid rarely goes more than four or five inches in-
to the urethra), we may introduce a bougie covered with onion-juice
and dipped into the solution of sublimate. In obstinate cases we
* By means of a email syphon (§ 59).
■ If this Idnd of gleet arises from Icng-lasting gleets from weakness, styptic in-
jectiofB may frequently cause inflammation of the urethra, sympathetic swelling of
the testicles and other inconveniences.
42 ON ySNEREAL DISEASES.
may roll the bougie in finely pulverized red predpitate, and leave it
but an instant in the urethra.
183. If, as ought to happen, the discharge hereupon increases, we
cease and wait until the discharge diminishes to less than its usual
quantity. We may then employ a solution of turpentine in water by
means of yolk of egg, gradually increasing its strength until the cure
is cx)mplete, or if it be delayed make use of strong astringent injec-
tions (§ 188).
184. These are the cases, especially when the disease is obstinate,
in which the internal use of cantharides-tincture* has sometimes ap-
peared to produce wonderful effects. We may try it in obstinate
cases. Frequent horse exercise has also proved of use.
185. Gleet from weakness, notwithstanding its frequency, has been
denied by some^ who were unable to reconcile the idea of weakness
with increased secretion, but as weakened glands and excretory vessels
do not throw out an increase of humours from their own energy, but
because, when weakened, they yield to the impetus of the bloodves-
sels, and are thus compelled, as it were, on account of the diminution
of their reactive force, to receive a quantity of fluid, which they per-
mit to flow in excess 'from their excretory orifices almost crude and
but half concocted, in consequence of their inability to ofier any re-
sistance. We may therefore say that in this increased secretion they
are rather passive than active. This is sufficiently evident from the
mode of action of the remedies that are efficacious.
18). Ordinarily this kind of gleet occurs in persons of phlegmatic
constitution who have weakened the genital organs by excessive venery
or onanism,^ or by the abuse of relaxing drinks and baths, or in those
in whom the primary gonorrhoea was accompanied by little irritation,
but much discharge. Probably the relaxing method of treatment
continued till the third stage, and the use of a quantity of laxative
salts, or of saltpetre, and repeated venesections, contribute in no small
measure to its production, as also the employment of sedative injec-
tions continued after the cessation of the scalding.
187. These gleets have this peculiarity, that almost no pain accom-
panies them, or at most only a sense of weakness in the loins and
testicles, which hang do?m loosely. The discharge of a thin fluid is
' As early as 1698 this was recommended by Martin lister {ExercU. chs, 12) in
goDorrfaiBa, but if used at the commencement it might prove injurious.
* Particularly Hunter.
* The itching in the genitals that usually occurs towards the termination of a
gonorrhcea, causes frequent erections, and if the patient, as might be anticipated,
do not resist this sensation by abstinence, exercise and temperance, but if he rather
obey what seems to him a healthy call of nature, by onanism or repeated coitus, he
will often bring on this kind of gleet We must take care to warn him against this
erroneous OQuduct
BXQUSL^ OF GONORRHQBA. 48
more oopious than in the other kinds. It often diminishes and in-
creases again aLoiost without any caase, but the latter occurs usually
after venereal excitement, the former sometimes after the inordinate
use of wine, dsc.
188. The genitals should frequently be bathed, for a minute at a
time, in very cold water in which some common vitriol has been dis-
solved, and a similar footbath may be used for several minutes. Along
with this, injections of a strong decoction of oak-bark may be em-
ployed, and the strength gradually increased. If all this fails, a solu-
tion of one part of white vitriol in thirty parts of water may be
injected.
189. The internal administration of bark, horse exercise, the open
air and nourishing diet, with a little wine, may greatly further the
core. Finally we may have recourse to electricity, t. e. small sparks
drawn from the genitals.
190. Venereal gleet. Modem authors go too far when they allege
the presence of ulcers in the urethra to be so excessively rare in gon-
oniioea, although they are quite right in asserting that they are quite
non-essential* to venereal gonorrhceas, and do not frequently occur.
191. These ulcerations may arise from the laceration of considerable
bloodvessels in the urethra during spasmodic erections and coitus, from
blows and otber injuries from without, and from wounds of the inter-
nal lining membrane by the syringe, the catheter, or the bougie, &c.
TTie gonorrhceal matter transforms these wounds into true chancres.
In some rare cases they are formed by an abscess of an external ure-
thral gland bursting into the canal.
192. We know this to be the cause of a gleet when during the
gonorrhoea pure blood has flowed from the urethra, or when one or
other of the exciting causes we have indicated above has occurred, but
especially when, after the cessation of the inflammatory period of the
gonorrhoea, the bougie touches a small raw, painful spot, causing a pain
that is felt exactly in the same situation on touching the urethra ex-
ternally. Hence it happens that even after the judicious treatment of
Uie original gonorrhoea the discharge continues to flow, though in less
quantity ; and it may occur that after the employment of astringent
injections symptoms of lues venerea may begin to shew themselves.
193. It is self-evident that after the recognition of the cause of these
gleets, the last-mentioned remedies should not be made use of. Even
the internal employment of balsamic remedies is contra-indicated.
194. The only remedy we can have confidence in is a good prepara-
* It may well be that cicatrices are bo seldom discovered in the urethra after
death, for we often can scarcely observe in the glans or prepuce a trace of the
diancres that formerly existed, provided they were not very large or deep, and were
only cured by the internal use of mercury, and not by caustics.
44 ON VENEREAL DISEASES.
tioB of mercury (such as the soluble) given in gradually increasing
doses until mercurial fever (§ 290) is developed. By this medicine
alone, without the employment of any injection, this kind of gleet,
with all traces of general venereal symptoms, will be easily, certainly
and radically cured, and this remedy tends to aggravate every other
kind of gleet.
195. Gleets from strictures in the urethra seldom occur immediately
after the gonorrhoea; they often appear twenty or thirty years thereafter.
They consist of a scanty, almost colourless, mild, mucous discharge,
with retention of urine, or at least diminished size of the stream of
urine.
196. The bougie is the only way to detect their cause, by revealing
the strictured spot.
197. It ceases spontaneously after removing the stricture, without
any additional aid, wherefore I must refer the reader to the treatment
of the latter* affection (§ 207—245).
198. If the body have much predisposition to scrofula or gout, gleets
often become complicated thereby.
19i). The internal use of crude antimony, of burnt sea- weed, of
purple fox-glove, and bathing in sea water, will perform in the case of
the first what the remedies recommended for the other gleets are una-
ble to effect, and extract of monk's-hood, cold baths and electricity
will do the same for the last.
CHAPTER V,
SECONDARY GONORRH(EA IN THE FEMALE AND ITS TREATMENT.
260. The usual seat of this is the vagina, rarely the uterus, and still
more rarely the urethra. To all appearance it does not differ from
ordinary leucorrhoea ; its very origin is undiscoverable if it have not
continued to flow immediately after the venereal gonorrhoea. Its
varieties are much less numerous than those in the male.
201. If it is already of long standing, it belongs to the gleets from
habit, and must be treated entirely by stimulating injections (^ 181)
gradually increased in strength.
202. After pursuing this treatment for ten or twelve days we should
pause, in order to see whether the discharge will decrease in a few
days ; in which case, the strong astringent cold injections, recommended
above for primary gonorrhoea in women, especially a strong decoction
of oak-bark combined with alum, must be employed until the discharge
ceases, and even for a couple of weeks thereafter.
203. But as in women we are unable to determine accurately in
every case whether it be a gleet from habit or from weakness, we
* Ab urethral calculi only cause gleets when they have produced strictures in the
urethra, as they often do^ thuir treatment does not belong to this place.
SEQUSUB OF QONOBBHOBA. 46
would do well in most cases (seeing that on account of the loose tex-
ture and inferior sensibility of the parts we have less to fear than in
the case of the male urethra) .to combat the malady at once with in-
jections possessing both a stimulating and strengthening character. —
An injection of an ounce of blue vitriol dissolved in a pint of watert
or of Uiree or even four oimces of white vitriol in Che same quantity
of water, will be found very serviceable.
204. Should we, on the first injections of this fluid, meet with any
disagreeable, painful and inflammatory symptoms, we will know from
that that the gleet belongs to those arising from disability. We must
leave them ofi* and treat the case only with injections of cold, even
ioe-cold water ; and at length we may have recourse to a decoction of
oak-bark. If the irritability be excessive (which will be ascertained
by other symptoms, the rapid pulse, the character of the primary
g(H)orrhoea, 6ic.) we may substitute injections with tincture of opium.
205. If along with gleet of this kind there be symptoms of a gouty
or scrofulous disposition, they must first be eradicated as far as possi-
ble by suitable remedies for these states, before we proceed with the
local treatment.
206. If, however, on the introduction of the syringe a painful inter-
nal spot should be observed, without any induration of the mouth of
the womb or other signs of internal cancer (the acrid nature, dis-
coloured appearance or specific odour of the ichor discharged, the
diootings from the hips into the pelvis, dec.) being present, we may
suspect a venereal ulcer in the vagina ; for which the internal use of
mercury (§ 614 et seq.) without any local means, is alone efficacious.
CHAPTER VI.
STRICTURE OF THE URETHRA AND ITS CURK
207. All the phenomena of obstructed flow of urine, when no stone
was present, were formeriy attributed to cicatrices and excrescences
in the urethra, which without examination were termed carunculae
and collosities, and in conformity with the prevalent notion, were held
to be the relics of ulcers in the urethra, which were taken for granted
to exist in every case of gonorrhoea.
208. This opinion was for long the general one, until by an enor-
mous number of autopsies it was proved that cicatrices and fleshy
excrescences in the urethra were of very rare occurrence, and that in
the great majority of instances all the symptoms ascribed to that
cause arose from narrowing and constriction of the urinary canal*
without actual thickening of its substance.
209. Although we do not allege that these strictures are always the
eflect of gonorrhoea, this at least is certain, that they are chiefly to be
found in men who have been affected by this fashionable complaint ;
46 OK YElfEBEAL DISEASES.
but yet a disposition to rheumatism ^ may contribute not a little
towards this, especially as they usually occur only in the middle or
advanced periods of life (oflen 20 or 30 years after the patient has
had gonorrhcea). What a distance betwixt the probable cause and the
effect ! Hence it happens that strictures are very rarely met with in
the place where the gonorrhoea has its special seat ; usually further
backwards : whence we may infer, at least thus much, that it cannot
be with propriety ascribed to simple ordinary gonorrhoea. Severe
strictures have been met with in persons who had had very slight
gonorrhoea) or even none at all), and those who have had the most
violent gonorrhoeas have remained free from strictures. Neither can
they be ascribed, as it was formerly supposed they might, to the use of
the bougie or of injections in the treatment of gonorrhoea ; for, ac-
cording to Hunter, strictures have occurred when gonorrhoeas have
been removed without these appliances. Be this as it may ; as the
actual exciting cause is still involved in obscurity, and as the general
opinion has hitherto attributed strictures to a previous gonorrhoea, I
feel myself necessitated to say what is essential regarding them.
210. Probably any severe irritation of the urethra (t. c, by urethral
calculi) or any inflammation of it, more than merely superficial, is
capable of making it liable to strictures.
211. Moreover it is subject to this affection in common with other
canals of our body ; as examples of continued strictures I may instance,
constrictions of the oesophagus (I had recently an opportunity, at an
autopsy, of observing a great contraction of the middle portion of
the stomach) and those of the bowels, especially of the colon ; the
spasmodic strictures of the nasal duct at the lacrymal sack, of the
gullet and of the bowels, have also some resemblance to urethral
stricture.
212. Strictures are constrictions, or narrowings of the urethra as if
it were drawn together by a thread, which are most frequently met
with in the vicinity of the bulbus, much more frequently anterior to
it, (from five to three inches from the orifice), and very seldom behind
it ; they either constrict the canal more or less uniformly all round
towards the centre, or only at one side more than the other.
213. In consequence of the bladder reacting against the constriction
of its excretory canal, and not being able to get rid of its contents
easily, there oflen occurs a frequent anxious call to make water ; the
coats of the bladder become thickened, the posterior part of the
> A man, 68 years old, had for many years been troubled with pain in the hips,
especially after drinking a fitUe wine. His hitherto unnoticable urethral stricture
once increased suddenly, and the most fearful retention of urine took place. Whilst
thia dji^ffiMfe jNTeTailed and I sought to relieve him from it, he bad not the slightest
attack of his iheumatic sufferings, not even when I let him drink wine ; only the
•tricture appeared to be aggravated by ti
SKQUELiB OF GONORBHCBA« 47
urethra, as &r as the stricture, gradually dilates (often also the ureters
up to the kidneys, sometimes the pelvis of the kidneys ^ themselves)
in proportion to the degree of the stricture ; and the internal mem-
brane of this portion of the canal, distended and irritated by the
stagnating urine, exudes a gleety looking mucus, or its coats inflamed
or corroded by the acrid urine, if the stricture continue or contract
fllill further, form an abscess which opens externally and usually gives
rise to a perineal fistula, whereby nature is forced to provide a new
passage for the urine.
214. The patient does not in general notice his malady, or think fit
^ seek advice for it, until the stricture has attained a serious height.
Hie stream of urine commences to grow smaller and smaller, the
demre to pass water more frequent, and still he apprehends nothing
bad. Inflammation may occur, and even an abscess in the course of
the urethra, still he r^;ards it only as a local affection that will go off
of itself, and does not suspect that it arises from the diminished flow
of urine (which he may at that time have not deemed worthy of no-
tice), or from the slow and unnoticed advance of the constriction of
the urinary canal. It is often only when the urine passes by drops,
or when complete ischuria has occurred, along with anxious desire to
pass water, that he applies for aid ; when inflammation, mortification
and death are at the door.
215. Strictures that gradually increase to the highest pitch without
intermission, in which the urine does not pass at one time more at
another less freely, are termed persistent or continuous. On intro-
ducing the bougie we find at one time just the same amount of resis-
tance as at another. The contraction remains under all circumstances,
under every regimen the same, only that it goes on imperceptibly
increasing until at last it will not permit even the smallest bougie to
penetrate into the bladder. It is diminished neither by antispasmodic
nor yet by derivative irritating remedies.
216. Externally the afiected part generally presents a whiter ap-
pearance than the other parts of the urethra, and it frequently appears
as if drawn together. The contracted part is seldom an inch in length,
usually not more than a line ; there is rarely more than one present
in the urethra.
217. This persistent stricture never comes on immediately afler
gonorrhoea, and usually only attains its acme at the end of the middle
' A presBive dull pain in the region of this organ (one kidney is usually the worst)
indicates this affaction, and the same pain with a roundish elevation in the side,
ipeedOy followed by the passage of a uniformly mixed whitish urine, with puriform
sediment and diminution of the sweUing, indicates an abscess of the renal pelvis
OQomiOQ in severe ehronic strictures, which often comes on in consequence of serious
tamm of regimes, aa I have frequently had an opportunity of observing.
48 ON YEKEBEAL DISEASES.
period of life (between 48 and 60). It alone is accompanied bj tha»
sort of gleet (§ 195—197) that goes off spontaneously after the curt
of the stricture.
218. The spasmodic stricture is the very opposite of the persistent
It does not remain in exactly the same spot, but sometimes moves as
inch forwards or backwards. The bougie that would formerly paai
easily, becomes all at once impeded in its passage or completely
stopped ; occasionally also it is pushed back again, after lying then
for some time.
219. In these cases the urethra is very irritable and sensitive, and
vrith difiiculty bears the introduction of the bougie or its continuance
in the urethra, but more readily after the passage of the urine, although
this is denied by Hunter, and after the local or internal employment
of antispasmodic remedies. It is increased by the use of astringent or
stimulating medicines.
220. It has the greatest similarity to the irritation of the bladder
(§ 148 etseq,), and the spasm of the neck of the bladder accompanying
that state, and apparently contributes much to aggravate that affeo^
tion. It is the only kind of stricture that can occur soon after bad
gonorrhoeas ; it may also have much to do with the retention of urine
(§ 25) that often accompanies them.
221. Very rarely (at most only after the removal of persistent
strictures) it is the sole affection of the urethra; most frequently it is
merely the concomitant of the persistent contraction caused by an
urethral calculus, or of inflammation of the neck of the bladder. I am
unable to say with certainty whether it may not in course of time
assume the persistent form. ^
222. It almost never happens that a persistent stricture exists
without a spasmodic one, and if it do it can only be a very slight
one. The narrower the persistent one is, and the more it obstructs
the exit of the urine, the more frequently does the spasmodic one ac-
company it, and the more intense it is.
223. Hunter is unable to determine whether the spasmodic stricture
is behind or in the persistent one. I believe I have always noticed the
former ; for I have frequently only required to press upon the stric-
ture with a bougie too large to enter it, in order by this remote
irritation to remove in a revulsive manner the spasm behind it, where-
upon I could easily penetrate through the spasmodic stricture mth
a smaller bougie, whidli before this manipulation could not pass
through it.
224. We may always recognise the complication of the persistent
stricture with the spasmodic one in this way : a bougie not too large
for the first two or three inches of the urethra cannot penetrate to the
neck of the bladder* but when pushed in from four to six inches it
SSQURUB OF OOKORBH(BA. 49
meets with an insuAnountable obstacle (the persistent stricture) at a]l
tunes, which, however, a smaller bougie (except in the worst cases)
passes with ease, except occasionally (the spasmodic stricture) when its
passage is more or less difficult.
225. Hiree modes are known of curing the persistent or permanent
stricture (whereby no attention is at first paid to the accompanying
spasmodic contraction), of which the two first are adapted to the case
in whidi a small sound can still be passed, but the last is required
when even the smallest bougie cannot pass. The first consists in the
gradual dilatation of the stricture ; the second in causing ulceration of
it ; the third in burning through it with caustics. All three are prac-
ticable if the contraction be not seated exactly in the curvature of the
urethra, in which case perhaps there is no remedy but the knife.
226. By the first method,' we endeavour to pass the largest bougie
that can be made with a little force ^ to pass through the stricture,
and allow it to remain a few minutes in the urethra, or as long as the
patient can bear its presence there without great discomfort. If he
can bear it for an hour at a time, we then take a larger one, with
a point of a conical shape, and try to introduce it. We press it
in cautiously, and for a short time also in an intermitting manner,
and with a slight twisting movement. If it spring back, either we
have not hit the opening of the constriction, or it is too narrow to ad-
mit the instrument, and we must use a smaller one. But if it pene-
trates in and remains fast we are certainly in the stricture, especially
when the introduction has caused no pain and the point of the bougie
is squeezed flat. We remove it again when the patient can bear it
no longer, and endeavour on a subsequent occasion to make it pene-
trate further. If it pass through the stricture, we next try a larger
one, and then again one still larger, until we have overcome the con-
traction; that is to say, until we are able to -introduce into the
bladder a bougie of from two to two and a half lines in diameter ;
for should there be obstacles farther backwards, we must proceed as
witb the first stricture.
227. The bougie must be neither too soft else it will easily bend,
nor too hard, otherwise we might readily, as oflcn happens with the
catheter, especially when due caution is not exercised, push through a
fiklse passage near the stricture in the spongy body of the urethra.
' This mode of curing strictures of the urethra by the pressure of bougies, was
known m early as the year 1 660, when a physician of Nimes whose name has been
kst, (see the 22d of the 87 observations appended to Laz. Reverii Obt, Med,
Logd 4, 1669.) cored them with leaden sounds.
* Hie stricture is often so narrow, that bougies sufficiently small to pass through
it at first, and at the same time of adequate strength, cannot be procured : in this
eaae we make use of catgut harp-strings of gradually increasing thickness, making
their extremity rocmd, and mtiodiicing them covered with oiL
4
60 ON YJ&NILW^ i>IW.4J9«8.
Yfe become awure of this having ooourred, whea^in introduoing the
instrumeiit, we make way, with much suffering, to the patient, with*
out at all facilitating the passage of the urine; and we avoid this
accident in the case I speak of, by the employment of elastic bougies
and carefulness. We ought also to withdraw the bougie from time to
time, in order to observe whether or no its point be bent up. Should
we allow the bougie to remain some time in the urethra, especially at
night, it ought to be bent over about an inch at the top, and &stened
with a thread behind the glans, in order to prevent its slipping into
the bladder; an accident that could only be remedied by opening the
bladder by the lateral operation to extract this foreign body, which is
attended by much danger. The bougies ought not, as they usually
are, to be made conical throughout their whole length, but they should
be uniformly of the same thickness, consequently cylindrical, and
should only be somewhat narrower at their point. The patient must
soon learn to introduce the bougie himself; he will be best able to
pass it with facility into himself; he will be best able to feel the^^ait
that is to be dilated, and will not be liable to make a false passage
near the stricture, even with a harder bougie.
228. We should not discontinue the use of the bougie in conse-
quence of the presence or occurrence of a swelling of the testicles, as
in the case under consideration this swelling is usually the effect of
the stricture of the urethra, of an urethral calculus, *or of an abscess
of the glands of the canal, and by the employment of the bougie
would in the first case be removed, in the second relieved, and in the
third not aggravated.
229. Sometimes, especially in cases of irritable nervous weakness,
and when the stricture already causes troublesome symptoms, as dif-
ficult passage of the urine, irritable bladder, dca, there is usually pre-
sent, along with the persistent stricture, as has been said, also a spas-
modic contraction, generally behind the former. This is an obstinate
and frightful malady. In this case, if the ordinary bougie will not
pass, we must resort to all sorts of expedients in order to gain our
object. We press a large bougie against the persistent stricture for
a minute, and then try the smaller bougie which ought to be intro-
duced. Jf this do not succeed, we must tickle or gently rub the peri-
naeum, whilst with the other hand we press the bougie against it. If
this too fail, we should try the inmiersion of the whole genitals in
cold water, and the einployment of a tepid foot-bath. If the spasm
be frequently in the way,, .we may place a seton in the perinaeum. In
this case, certainly the best time for introduoing the bougie is imme*
diately after making water.
280. We must besides ascertain aiid. make the patient avoid all t}|iajt
increases the spasm^ fi^fi^^^fi^xj^ 4»vff^jf^ t^idimuist^ tb^imta^
SEQUEUB OF GONOBRHGSA. 51
bilitj, the patient should frequently pass his water, should use cold
baths, take exercise in the open air, shun spices and heating, as well
as relaxing drinks, and take internally quassia-powder. Astringent
tonics, as bark, iron, dsc, increase the spasmodic constriction in my
experience.
231. This mode of removing persistent strictures by gradual dilata-
tion, is certainly the easiest, but at the same time the most uncertain
method. Even though by advancing to the very largest bougie, we
have got so far that ihe dilated constriction of the urethra allows the
free passage of the urine, the patient is notwithstanding not yet per-
fectly cured, nor guaranteed against a relapse. For a long time to
come he must still introduce the thick bougie from time to time,
every eight hours, at least, and let it remain there some hours, other-
wise the place where the stricture is gradually contracts again, so aa
not to allow the passage of the largest bougie, and so on. He
must never travel without providing himself with bougies in case of
necessity, as the tendency of the dilated part to contract again is not
radically cured.
232. If the patient take upon himself to assist in this dilatation, he
can, after some smaller bougies have been passed, rapidly go to larger
and much larger ones, and by means of the irritation produced in the
afiected part, create a small amount of inflammation and suppuration
(the second method) which gradually rids him completely and radi-
cally of his malady. The texture of the contracted part is always a
morbid abnormality, and hence it is much more readily brought into
a state of inflammation and suppuration than the healthy portion of
the urethra.
233. In order more certainly to attain this object, the forcible
pushing through of the stricture with a bougie of large diameter has
been advised, and this manoeuvre has sometimes been wonderfully
successful ; probably in this case a small part of the internal mem-
brane in the stricture was thereby torn, and thus suppuration was
produced, or the forcible stretching might have caused a contusion
and thereupon inflammation proceeding to suppuration, or the circular
fibres of the contracted urethral muscle might have been paralyzed by
the force applied, or even torn, whilst the dilatable part of the stric-
ture yielded. The last is the most probable, for cases have been ob-
serr^ in which, after this forcible manoeuvre, the stricture disap-
peared suddenly and without relapse.
234. In spite of all this, this operation is attended with much un-
certainty, and its performance is not advisable. With the force em-
ployed, it may easily happen, as we work in the dark, that we misg
the stricture, or its central point, which is often far from being in the
axis of the urethra, and so form a false passage.
52 ON VENEREAL DISEASES.
235. In order to attain the same object with eertaintj, we take a
horn staff, of the thickness of a bougie that fits the commencement of
the urethra, we bend this by means of heat into a slightly curved
form, and scrape down half an inch of its end, till it has almost uni-
formly the thickness of the bougie that hitherto readily passed through
the stricture. This smaller end will form a sort of process to the rest
of the staff (of which we smooth down somewhat the abrupt point of
junction), just as if a smaller staff projected from a larger one. We
first insert this smooth round honi staff into the urethra, in such a
manner that its smaller end (up to the larger portion) passes through
the persistent stricture, and if wc can rely on the patient's steadiness,
we allow him to push it in further himself, until the thicker portion
passes through the stricture. It will at once be seen that in this way
the smaller terminal portion shews the way, and guides the whole
horn-staff, so that it must accurately follow the direction of the ure-
thra, and cannot take a false direction. In this way we shall attain
our object with much greater certainty. Should we think the horn-
sound too inflexible, we may before using it let it soak for some time
in linseed oil.
236. More peculiarly belonging to the ulcerating method is the
destruction of the stricture with corrosive substances, with which we
may arm the bougie we introduce, or the instrument itself may be en-
tirely* composed of irritating matters.
237. For this purpose, we select the largest bougie of uniform size
throughout that can pass into the anterior part of the urethra, in the
abruptly tnmcated extremity of which we make a circular excavation,
and fill this with red precipitate, firmly pressed in. This is to be
moistened on the sides with oil, and passed up to the stricture, and
pressed against it for a minute. This is to be repeated once daily,
until the stricture, having gradually passed into suppuration, will easily
admit the thickest bougie. Then, until the healing process is finished,
we insert twice a day into the urethra, and allow to remain there a
quarter of an hour, a large sized bougie, not armed with red precipitate,
but moistened with a solution of myrrh in yolk of egg, in order that
the cicatrix which is formed may be sufficiently wide. This trouble-
some operation is somewhat tedious, but it effects a radical cure.
^ Philip, a Portuguese, (see A. Lacuna, Method. Extirp. earunc. Rom, 1551, 12,
p. 84,) was the first who, in the middle of the 16th century, destroyed strictures of
the urethra, by means of a corrosive mass, composed of verdrigris, orjHmeiit, ia^
wherewith he armed the end of a bougie. A similar treatment^ variously modified,
coDtinued to be used from time to time, until Le Daran, a few years before the
middle of this century, began to trumpet forth tJie excellence of his secret bougies,
which were composed entirely of corrosive ingredients, and ocnsequently they fre-
quently excited inflammation and suppuration in healthy parts of the urethra, b«-
aideB a number of other iU-effiectB, wkicfa rendered their use inadmissible, before hit
object^ the destruction of the stricture, was attained. Guerin improved them.
SBQUELJS OF GONOBRHiBA. 68
238. By this method we may in most cases (even in those in which
tlie smallest sound or harp-string cannot get through the stricture) be
independent of the third mode, which Hunter teaches, for burning
trough the narrowest strictures, and which, as far as my experience
goes, may be best performed in the following manner.
239. We take a tube of Bne silver of the size of the thickest bougie
and slightly curved, and we introduce this, the opening at its extremity
being closed by a plug at the end of a wire, which runs backwards
and forwards in the cavity of the tube, so that we may remove this
ping whenever the extremity of the tube has reached the stricture.
Were the tube unprovided with this plug, the mucus of the urethra
would enter its cavity. As soon as we have removed the wire with
the plug, we push in, in place of it, another wire of fme silver, at the
end of which a piece of lunar caustic is fastened in a small forceps.'
By means of the wire we press this caustic into the stricture for a
couple of seconds, draw it back into the tube, and remove both ; and
this operation we repeat every second day ,2 until we can pass through
the stricture with the tube. It is well to inject tepid milk immediately
after the operation, in order to avoid the irritation which the caustic
that flows from the cauterized part might produce on the adjoining
healthy urethra. It is obvious that this method needs great caution.
240. Both these latter methods are of service when there is scarcely'
any opening remaining in the stricture, and where consequently the
first method is not suitable In case of inflammatory symptoms
manifesting themselves, we ought to allay them by means of cold
applications, tepid foot-baths, &c.
241. When an urethral calculus may have occasioned the stricture,
a passage for it outwards may be made in cither of the two last men-
tioned ways. If the stricture be still permeable, and if the stone be
seated in the region of the scrotum, the symptoms it gives rise to
might easily be confounded with those of a spasmodic stricture, if we
neglect to ascertain its presence by the use of a metallic sound, which
as soon as it touches the stone, communicates to a delicate touch a
peculiar grating sensation. I have seen, after retention of urine from
strictures owing to this cause, the urethral calculus discharged by the
efforts of nature through a dangerous abscess in the perinopum.
242. It is rare that the spasmodic stricture (§ 218 — 224) remains
long after the destruction of the permanent one, so as to demand
special treatment. On the other hand, in the treatment of strictures
' In the mode ia which a 8iiiaU piece of drawing-chalk is fastened at the end of a
ixxte-crajon ; a simall pair uf pincers, which embraces Uic caustic or chalk in itd
koUow blade-*, whilst a ring piu^lied from behind effects the approximation of the
blades, aod holds fast the substance they enclose.
* Id moet strictures we do not require to do it more than twice.
64 ON VfiNBJEtSAL . DI8SASJS0h
of the urethra merely by dilatation, the spasm persists as long, and
recurs from time to time, until all the tendency of the part (where
the permanent stricture was seated) to contract again has gone off;
which may sometimes last all the patient's life, if we do not perform
the radical cure of the stricture after the second or third manner.
243. Before the spasm afler the destruction of the persistent sbrio-
ture goes off, we would do well, especially if i|; closes the urethra very
suddenly after the withdrawal of the bougie, to employ a hollow
catheter of gum-elastic/ which the patient should bear about with him^
in order to draw off his urine at any time.
244. Frequent immersion of the genitals in cold water will com-
pletely dissipate the spasmodic stricture, especially if we endeavour to
remove the morbid irritability of the organism by the use of external
and internal tonic remedies. If it be already of long standing and if
this method do not suceeed, a seton introduced into the perinaeum will
greatly diminish and in course of time remove the malady.
245. Those subject to this affection must frequently pass their urine,
and never retain it long. They must guard against chills, excessive
passions, heating liquors and spices, and debauchery.
CHAPTERVII.
INDURATION OF THE PROSTATE GLAND
246. When neither paralysis of the bladder nor inflammation of its
neck (in bad cases of gonorrhoea), nor a stone in the bladder, is the
cause of the retention of urine, and when the introduction of the
bougie or sound into the urethra detects no stone nor stricture, and
yet the urine will not flow in spite of every effort, we may suspect a
morbid condition of the prostate gland.
247. A finger moistened with oil is to be introduced into the rectum
and directed towards the pubic region. If this be the cause of the
retention, we shall here detect a hard body pressing in upon the rectum,
often of such a size that we are obliged to pass the finger from one
side to the other in order to ascertain the whole magnitude of this
indurated prostate gland.
Ji48. We may easily imagine to what a considerable extent thia
tumefied body must compress from both sides, and block up the com-
mencement of the urethra, and how dangerous retention of urine may
result therefrom.
249. In such cases the ejaculation of the semen is very painful.
250. A bougie^ or catheter carefully introduced will easily draw off
' These are also the best we can ose when a retentioD of arine is produced by a
merely spasmodic stricture. It shotild be introduced by suitable mampolatioiis into
the bladder, and helped into the neck of the bladder by a finger placed in the rectom.
* The urine usually flows oif by the side of it) but not without some effort of the
bladder.
saqvjom of eoKossHCBA. 66
the urine ; but this is only * tranaieiit remedy. The best plan is to
insert an elaetic catheter and to assist its passage through the neck of
die bladder bj introducing a finger into the rectum.
251. If we could with certainty disperse this glandular induration,
we should then be able to promise ourselves permanent benefit, a cure.
But as yet we know no remedy that can be relied on.
252b The internal use of hemlock has sometimes been of use, also
burnt sponge, but especially burnt sea-weed and sea-bathing, as this
afiection is often of a scrofulous nature. Poultices of mandragora
root frequaiUy applied to the perinaeum are said to have proved very
^icacious in dispersing this indurated gland. Purple foxglove, crude
antimony, hartshorn and electricity, perhaps also local fumigations
with cinnabar, might be tried.
253. A seton inserted and long maintained in the perinaeum the
openings of which were two inches distant, once succeeded in reducing
to a great extent an indurated prostate.
254. The best palliative remedy is, immediately after withdrawing
the bougie to insert in the bladder, according to Pichler's plan, a cathe^
ter of gum elastic (without any spiral wire in its cavity) to let the urine
flow through it, to fasten it in front of the glans and close up its
extremity, only removing it about once a week in order to remove the
calculous concretion that may be attached to it.
255. !( in a case of swelling of this sort, the urine do not flow
on Uu) introduction of wa. ordinary catheter, and if the instrument en-
counter an obstacle just behind the neck of the bladder (a rare affec-
tion which Hunter has best described), it is to be apprehended that a
small swollen portion of the indurated prostate projecting into the
bladder forms here a sort of valve, which lies upon the mouth of the
bladder and obstinately prevents the egress of the urine.
256. In this case a very much curved, large-sized bougie introduced
into the bladder has sometimes proved serviceable, the urine flowing
past it. If this should not be effectual, we should carefully introduce
a catheter, and whenever it has reached this valve-like projection, press
it with the handle downwards, whereby its further bent extremity will
almost always slip past and to the outside of the abnormal body into
the bladder, and permit the urine to flow off.
66 OK YSNKBBAL DI8KA8S8.
IDIOPATHIO LOCAL TKNIBXAL AVFBCnOlfa OIC PAKT8 OW TBI BODY
PBOYIDXD WITH EPXDEEMIB.
FIRST DIVISION.
CHANCRE.
CHAPTER I.
CHANCRE IN GENERAL AND ESPECIALLY THAT IN MALES.
267. The venereal infection is most readily communicated to sur-
faces of the body that are destitute of epidermis ; hence the much
greater frequency of gonorrhoea than all the other venereal symptoms.
Next in point of frequency are the affexjtions that occur on parts of
the body provided with a delicate epidermis ; in the latter case there
occur ulcers which are termed chancres. The thinner the epidermis
the more easily does the infection take place and the more does the
chancre thus produced extend.
258. The most usual seat of the venereal infection is the genital
organs ; hence chancre in the male generally makes its appearance in
the fossa where the glans unite with the prepuce, especially on either
side of the insertion of the frenum, next in point of frequency on the
internal surface of the prepuce and its border, on the glans, and some-
times on the external surface of the genitals, e. g, on the scrotum.
269. Should the lips of the mouth, the nipple, or a wound on any
other part of the body be touched with this virus, chancre will be the
result in either sex.
260. A small dark-red elevated spot appears, in some cases thirty-
six hours, rarely several days after the impure coitus, and with painful
itching it forms a hard, inflamed pimple filled with pus, that rapidly
developes itself into an ulcer. When the chancre first appears it is
raised above the surface of the skin ; but its hard, light-red (or dirty
yellowish-white) base is a little sunk below the suety whitish borders
whose periphery is inflamed and indurated, but yery defined. When
touched the patient experiences severe pains, and we can feel that the
hardness of the whole ulcer extends very deep. The matter that
exudes is of a greenish yellow colour. Such is the chancre, which
gradually increases in superficial extent and depth, accompanied by
pains more of a gnawing than shooting character.
261. Those chancres that have their seat in the inner surface of the
prepuce are much more painful and inflamed, and generally larger
than those that occur on other parts ; the induration in and surround-
ing these chancres is more perceptible and more considerable than
when they occur on the glans.
262. At the junction of the prepuce with the glans they are at first
CHANCRE. 67
often no bigger than millet seeds ; their most frequent seat is on either
side of the frenum, where they readily eat around them and rapidly
destroy this part.
263. Chancres on the glans are rare ; the inflammation, pain and
hardness of the small abscess is not so great as in those on other
parts ; their borders do not usually project like those on the prepuce for
example, but the whole ulcer is as it were excavated in the body of the
glin&
264. More painful and more inflamed are the chancres occurring on
those parts of the genitals covered with a thicker epidermis, on the
penis, or on the anterior part of the scrotum. In these situations they
appear in the form of pimples that become covered with a slough, on«
thefidling off of which a larger one is produced. The same is the case
with chancres produced by the inoculation of the virus in wounds or
parts covered by a firm epidermis.^
265. All chancres on a given spot would probably always present
the same phenomena,^ as the inoculating virus is perhaps of only one
and the same nature, and seldom milder or more malignant in itself,
if the various corporeal constitutions did not themselves cause those
great varieties in the malignancy of the chancre (gonorrhoea, buboes,
^), by the numerous modifications of their reaction.
266. It follows from this, as experience also teaches, that to treat
these idiopathic veneral ulcers with the greatest success, we should
pay particular attention to the peculiar constitution of the body in
every case, which with proper attention wc can soon learn from the
course of the chancre and its accompanying symptoms.
267. In a diathesis that has a more than ordinary tendencv to in-
flammation, the chancre will inflame to a considerable extent round
about, and acquire great depth ; the reverse will happen in cases of
an opposite character. In a system peculiarly liable to irritability,
the chancre will cause great pains, will have a blackish and discoloured
appearance, and excrete a thin ichor.
26S. The earlier the chancre begins to form sloughs, the greater is
the tendency to sphacelus,^ whereby the whole penis is often lost. We
may apprehend great haimorrhage in such ulcers, when they erode the
parts about them much.
' Thv inoculatioD with diancre vims on parts covcrtnl by a tluck epidermis (by
meaDii of wounds in the arms, tliighs, <tc.) produces more painful and sserious symp-
ttms r in AammatioQ, swelling, viitlent pains) than in the glans, lips, prepuce, A*c.
* Andre observes that the worst clumcres affect in a verj* niild degree those per-
HQs who are only liable to the mildest infections, and tliat the interval betwirt the
infection and appearance of the chancre is of the same length in most pen>oDs who
have been several times inoculated with very different viru>e."*.
* The inflammatioa of the chancre is usually of an erysipelatous character, hence
the great tendency to sphacelus, as Girtanner has also observed.
68 ON VEl^B&BAL DISSASBS.
269. In general the chancre appears later than the gonorrhcea from
the same infection (perhaps they often are primarily caused by the go-
norrhoea! discharge remaining on those parts), and its virus may there-
fore be frequently removed by merely wiping the part or washing it
with lime-water ; they also appear more rarely, for we may reckon
that gonorrhoeas occur four times as often as diancres. They occur
more rapidly on the prepuce ; still more rapidly betwixt the junction
of the prepuce and glands, especially at the frenum ; most slowly on
the other parts, probably because the epidermis is thicker.
270. The earlier a chancre breaks out after infection, the more is it
disposed to inflammation ; the later it appears, the more readily will
the blood be inoculated by the poison, and lues venerea produced.
271. There are but few diseases of the body that haVe not been
occasionally overcome by the efforts of nature. Chancre and lues
venerea are to be reckoned amongst those few. If circumstances do
not occur to produce the absorption of the virus out of the ulcers into
the general mass of the circulating fluids (whereon buboes and lues
venerea, diseases of still greater gravity than chancre, ensue), they
may remain in the same place for several years without the least
change, except perhaps growing somewhat larger.
CHAPTER II.
ON THE ORDINARY TREATMENT OF SIMPLE CHANCRE.
272. It is generally assorted that next to inveterate syphilis that
has fastened on periosteum, ligaments and tendons, no veneral affec-
tion is more hard to cure than a chancre of considerable size and depth.
The most skilful practitioners rejoice if they are able to cure a deeply
rooted chancre within four to six weeks, by means of a host of exter*
nal and internal medicaments, that inconvenience the patients not a
little, and if they can be certain that in the course of treatment the
virus has not slipped into the general mass of the circulating fluids^
wandering about there undestroyed.
273. The most distinguished masters of our art are unable to pro-
mise to themselves that they will succeed in expelling it from its in-
trenchment in less time, assuredly not without the local employment
of corrosive remedies. Without the latter, which are regarded in the
light of an open assault, whilst the treatment by inunction or the in-
ternal use of the ordinary mercurial preparations is looked upon as an
attack from behind, without these local corrosives, I repeat, they con-
sider the art as impotent to eradicate this virulent ulcer.
274. now uncertain they are upon the subject, is evident from this^
that some hold the local employment of mercurials as useless, whilst
their opponents know besides Uie antivenereal metal no efficacious
CHAKCBX. 69
tapkal applioAtioii for dmicra, but yet neither can adduce sufiicient
TCMons based upon fitcts for their contradictory assertions,
1^5. Did the latter know that their local mercurial remedies have
BO efiect on chancres if thej be not of a corrosive nature, or at least
beoome such in the sore, that consequently no form of mercury un-
prepared in the general circulation is capable of eradicating the vene-
ml rirus ; and were the former avrare that their non-mercurial sceptics,
equally with their mercurial caustics, possess the undoubted power of
eidting the lymphatic glands to absorb the local venereal poison (and
thus give rise to general lues, which can then only be eradicated by the
internal use of mercury), that they moreover cause much pain without
being of any material service, they certainly would not at the present
dty be quarrelling with one another, they would amicably discard their
errors on either side.
276. All the objects we would propose to obtain by the employ-
ment of local caustics would certainly be best obtained by the use of
lunar caustic It coagulates and destroys with the rapidity of fire,
and with the least possible inflammation, all moist animal parts. But
bow much pain does not the use of even this substance occasion ! It
mikes a slough, 'beneath which the remainder of the virus cannot
escipe ; when this falls off the ulcer looks clean ; we flatter ourselves
that recovery is at hand ; it dries up, and behold the inguinal glands
becomes painful, a buboe appears — the premonitory symptom of lues ;
or suddenly the curative process is arrested, the pain the caustic oc-
casions prevents its further use, proud flesh shoots up, which must now
in its turn be destroyed. Frequently things do not go on so well with
the employment of caustics ; under this treatment the edges of the
chancre we wish to destroy turn over, tubercles appear round about
it, the ulcer commences to bleed readilv, it is the seat of constant
pain, it eats all about it incessantly, and become a true cancerous sore.
277. Instances are recorded of small chancres having been burnt
away by the repeated vigorous application of nitrate of silver, without
bein;; followed by lues venerea ; but so rare as such cases (Simmons
has obser\'ed some, I confess 1 have not been so fortunate), that it is
highly dangerous to reckon on such a piece of good luck.
278. But even let us take for granted tliat with proper care no evil
results ensue. Supposing the clumcre to disappear without these bad
effects, still (I need only refer adepts in the medical art to their own
experience) caustics are cruel remedies in chancres, which from the tor-
ture they occasion in most cases, change the local virus into a general
affection,' consequently do more hann than good.
' Girtaooer asserts that the abetorption of tho virod is so rare an event under
■Mrelj lucal treatmeot, that I can scarcely believe my own eyes when I read the
faUowmg wards of his : " Of the many chancres,"' says he, ** which I have treated
60 ON YENEBEAL DISEASES.
279. If my enemy remains in front of me, I remain always on my
guard, I am convinced I have not yet conquer^ him ; but I cannot be
said to overcome him if I drive him into an inaccessible corner.
280. There is not a single one of all the so-called corrosive sore-
cleansing remedies,^ from calomel to blue vitriol, from lunar caustic
to sugar of lead, which does not at the same time possess astringent,
vessel-contracting properties ; that is to say, the ppwer of exciting
the lymphatic vessels to absorb, and which does not display all this
power in the local treatment of chancre. Could we find any remedies
that would more certainly transform a chancre into lues venerea than
these ?
281. The universal embarrassment that prevails in the treatment of
a chancre concealed beneath a phimosis, when the patient will not
submit to theof ten dubious operation, shews how ill ordinary practi-
tioners can dispense with the employment of caustics.
282. But in order to cure chancre, local caustics are not the only
things they use, they have recourse also to the internal employment
of the anti venereal metal ! That this is done proves that the former
are insufficient of themselves ; perhaps, also, it is had recourse to be-
cause experieucc suggested that the ill effects of th© local applications
should be prevented by the internal remedy. Of a truth they re-
quired to introduce all the larger quantity of mercury into the interior
of the body, in order to endeavour to destroy the virus that had been
driven into the system by these local applications (for that this takes
place all are agreed); and on the other hand they found it necessary
merely by local remedies, without employing any internal medicines, not more than
two cases have occurred in which after the treatment was completed, lues venerea
broke out." Truly an incredibly small number only to be accounted for by a per-
haps almost specific power in the caustic potash, which was his local remedy (which
I confess I have not yet tried) ; but still too large, when we consider that under the
appropriate treatment by the best preparation of mercury given internally, it is im-
possible that in any case lues can occur after the chancre has disappeared under its
use. I do not therefore understand what he says further on : " Supposing the virus
were absorbed (from the chancre), the mercury would not prevent this absorption, and
could not hinder the occurrence of the general disease. Mercury never prevents lues ve-
nerea ; but it cures it when it has occurred : it never destroys the latent virus, (is it more
latent in idiopathic chancre tlian in general syphilitic ulcers?) but it eradicates the
poison when it has developed its external effects.'* As if it did not exhibit its effects
in cases of merely local chancre. In what a dilemma does he not place himself also
with his lime-water or solution of caustic potash in phimosis I Still I have such oon
fidence in the unprejudiced mode of thinking of this author, that lam sure be would
strike out the greater part of this chapter, if he had for some time cured chancree
with the mercurial fever produced by soluble mercury. No external treatment cores
so easily, certainly, and quickly.
* Pulverized glass even, certainly a powerful remedy for cleansing sores, which acts
by mechanical irritation without any corrosive power, scarcely forms an exoeptico, bat
it has not yet been employed in chancre
CHAKCBE. 61
to come to the aid of the slow, sleepj efficacy of the mercurial treat-
ment hitherto employed, in order to do something for it in a reason-
able time.
283. But when are we sure that we have conquered the enemy by
tUs double assault ? We are answered : 1st, when the local affection
» gone and the chancre cured ; 2d, when as much mercury has been
introduced into the body as will suffice to affisct the mouth, until the
commencement of ptyalism, and a little beyond ; 3d, if afler this,
idgns of syphilis appear, we must have recourse to a new course of
mercurv.
m
284. The third point shews sufficiently the want ofconfidencetobe
placed in the ordinary mode of treatment ; the second is undecided
as we sometimes witness a very rapid action of mercury on the mouth,
and on the other hand there are cases in which it is impossible to
i«nse salivation by the greatest amount of mercury, (so«>ner would
the vital powers succumb), and yet neither in the one case nor the
other is the venereal virus eradicated. The first is of no value as a
diagnostic sign, for every chancre disappears when its poison has re-
itded into the body by the use of external, astringent, irritant, or cor-
rosive substances. The mere application of blotting-paper will cure
chtDcre equally well.
285. 1 shall shew further on,the great disadvantages attending the
coDcomitant employment of the different mercurial preparations in
this case, the danger of the Balivation accompanying them, that can
never properly be guarded against, and the ruinous effects on the sys-
*em of the long continued use of mercury, (until the mouth is affect-
386. Could ^e discover an easier and surer mode of curing chancre
vith certainty, I imagined it must supersede that hitherto in vogue,
and be much more acceptable both to physicians and patients. I hope
to be able to shew such a method in the following pages; but I have
my doubts whether the prejudice in favour of the old method will al-
low it to gain a footing.*
CHAPTER III.
TREATMENT OF SIMPLE CHANCRK
287. I shall be very brief on this point, as I would be merely an-
ticipating what I have to say when treating of syphilis, were I now
> The mechanical expulsion of the venereal vims by the infinitely divisble and
ezoeseively heavy globules of mercury is a whim long since exploded, which is forced
to take for granted that the hurtful salivation is alone efficacious ; it is completely
refuteil by the power of a few grains of oxydiscd mercury in deeply rooted syphilis^
and by the efficacy of as few grains of sublimed mercury in the less severe venereal
•ymptoms.
92 OK YENSRSAL PISEASES.
to describe the better mercurial treatment I shall, therefore, saf
nothing more than this : in order to cure a chancre radically, the sqIh-
ble mercury must be given in increasing doses, imtil the mercurial
fever that supervenes has completely cured the chancre, without the
employment of the slightest topical application. From seven to
fourteen days are sufficient in ordinary cases.
288. I shall merely mention what I mean by mercurial fever, and
what is the appearance of a cured chancre. The special metJiod of
using the mercury to be employed for chancres, is the same as that
for syphilis, to which I refer the reader at § 614—635, and which
should be followed in every respect, even in regard to the removal of
all unfavourable symptoms that should be avoided during mercurial
treatment.
289. I am unable to determine whether the eradication of the vene-
real virus by mercury depends on a chemical decomposition,^ or per-
haps I should say neutralization (something after the manner in which
the corrosive oil of vitriol instantaneously becomes tasteless and mild
when combined with lead, or like arsenic with sulphur), or as the ex-
pression is, on the specific irritation which it excites in our body—
which b not to be confounded with the injurious irritation (irritability
from weakness, chronic trembling, dec.) which the long continued use
of mercury creates, even without destroying the venereal poison ; —
but this is certain, that the true destruction of the miasm depends neither
on stuffing the greatest possible amount of mercury into the body in the
shortest space of time, as has hitherto been imagined, nor in the a£>
fection of the mouth (in salivation, which oflen does so little good, it
is certainly affected), nor on any other copious evacuation that the
metal is liable to produce in some cases, as ptyalism, diarrhoea, di-
aphoresis (as Sanchez alleges), or diuresis, but rather on that spedfio
alteration of the body which may not inaptly be termed mercwrial-
Jwer^ in which a disagreeable sensation in the mouth is a common but
only accidental symptom.
290. The following is a description of the mercurial fever. — The
patient gets a metallic taste in the mouth, a disagreeable smell in the
nose, a painless, audible rumbling in the bowels, an earthy complexion,
a pinched nose, blue rings round the eyes, pales leaden-coloured lips,
an uninterrupted or frequently recurring shuddering (always getting
stronger) that thriMs deeply, even into the interior of the body. His
pulse becomes small, hard and very rapid ; there is an inclination to
vomit, or at least nausea at everything, especially at animal diet, but
* In imitotioQ of Scfawedianr, BarrisoQ rq^eatodly inoculated recent diancnnis
mati^ which he had preriqialy nuzed with Pleock'e mndhiginout preparation of
OMrawy, i^^diflbrent parte of the body of a hesUfay peiSQi^ vitiboot ever htiog ahla
to eanoe A veaereal uloer or loee Tenerea.
GHAKCBX. 68
cUeflj ft very violent headache of a tearing and preaaive character,
w^uh aometimeB ragea without intermiaaion in the occiput or over the
root of the noae. The nose, ears, hands and feet are cold. The thirst
la inoonaiderahle, the boweb constipated, great sleeplessness, the short
dreamaof a fisarfiil character, accompanied by frequent slight perspira-
tbna. The weakness is extreme, as also the restlessness and anxious
i^ppresMon which the patient thinks he never before felt anything like.
The eyea become sparkling as if full of water, the nose is as if stuffed
from catarrh ; the muscles of the neck are somewhat stifi^ as from
ihenmatism ; the back of the tongue is whitish. At this period the
patient experiences, if all goes on well, some discomfort in swallowing,
a ibooting pain in the root of the tongue, on both sides of the mouth
a looseness or setting on edge of the teeth (the gums recede a little
towards the root of the teeth, become somewhat spongy, red, painful,
swollen) ; there is a moderate awelling of the tonsils and sub-maxil-
Ivy glands, and a peculiar rancid odour from the mouth, without the
oeeorrence, however, of a notable increase in the secretion of saliva,
and without diarrhoea or immoderate perspiration. Four days seems
to be the usual favourable period of duration of a fever of this sort,
and iti best crisis consists only in the permanent disappearance of
ereiy venereal symptom and the complete extirpation of the miasm.
Tids picture is taken from an exqiusite case of very severe mercurial
fever.
291. For the eradication of the venereal poison a sufficient amount
of the febrile action just described, in degree proportioned to the ob-
stinacy of the venereal affection, is required. The result of the treat-
moit depends on this, not on the copiousness of the evacuations. Ac
oompanying slight, inconsiderable febrile action, there may often occur
imoontrollable perspirations, a flow of fetid urine, a choleraic diarrhoea,
or a salivation to the extent of ten pounds daily ; the venereal symp-
toms cease for the time, but they return again, not because the latter
are too strong, but because the former was too weak. We may always
pronounce such evacuations during the mercurial fever as injurious, but
only as regards their debilitating effects on the body, for they cannot
prevent the cure of the venereal affection, if there have only occurred
febrile action of the kind alluded to, of sufficiently strong character,
on which all their efficacy depends. If we can prevent the violent
evacoalions, as I will attempt to shew how when I come to speak of
the treatment of syphilis, we shall thereby increase the intensity of the
fever which is so efficient, and spare the patient^s strength.
292. While giving the soluble mercury for the cure of chancre un-
til this action is developed, we should dress the ulcer with tepid wa-
ter or leave it without any application.
293. Whilst the above de8aribeda£bctio& of the organism, the mer-
64 ON YENSBSAL DISEASES.
curial fever, pursues its course, the chancre commences without the aid
of local remedies to assume the appearance of a clean suppurating sore»
and heals up in a few days, that is to say, there is formed (without
subsequent occurrence of lues, and without pain or swelling of the in-
guinal glands) a healthy cicatrix, of the natural colour and consistence
of the neighbouring parts ; it presents indeed at first a somewhat deep-
er red colour, and on several parts small elevations if the chancre was
very old, but gradually both these appearances disappear. In general
the ulcer is healed up before the mercurial fever is completely gone.
It is a matter of indifference whether there were one or several chan-
cres, whether they were old and large or small and recent, if only the
intensity and completeness (§ 290) of the mercurial fever be propor^
tioned to them.
CHAPTER IV.
CONTRACTION OF THE PREPUCE (PHIMOSIS] AND CONSTRICTION
OF THE GLANS (PARAPHIMOSIS).
294. Phimosis is not a frequent symptom accompanying gonorrhoea
if the prepuce was not previously naturally too narrow, in which case
the gonorrhccal matter that insinuates itself betwixt it and the glans
can readily produce inflammation or chancre.
295. This symptom occurs most generally when one or several
chancres seated on the inner surface of the prepuce become considerably
inflamed, thereby violently irritating the loose cellular tissue, and
causing it to swell and become thickened, and its occurrence, if it be
not evidently produced by other violent causes (such as over-heating
the parts by walking, dancing, nding, coitus, onanism, ardent drinks
and spices), always depends on a particular predisposition of the
system to irritability, as this inflammation is usually of an erysipela-
tous character.
296. In this affection the prepuce projects over the glans in the form
of a shining, transparent, inflamed,^ tense, painful swelling, so that the
dilatation and retraction of this skin, and the exposure of the chancres
for the purpose of their local treatment is impossible, and even passing
water is a matter of difficulty in consequence of the narrowing of the
urethral opening ; this condition is termed phimosis.
297. The matter from the ulcer becomes accumulated in the interior,
and increases still more the swelling, irritation and inflammation ; it
may even, if not relieved, bore through the prepuce, and thus efi*ect 8
passage outwards. The abscess thus opened outwardly is often so
* Andat the same time it is of a pale ooloor. Tliis drcunutanoe Bhoold not allow
08 to regard the danger as lets, as Qirtanner rightly remarks.
iOHANORS. 65
ooQsiderable in siie that the glans forces itself oat through it, and the
remainder of the prepuce at the opposite side forms a distinct swelling.
298. This catastrophe will be so much the more rapidly brought
about, when, as is sometimes the case, there was in the healthy state
a natural contraction of the prepuce, consequently an impossibility of
retracting it behind the glans.
299. But if the prepuce be accustomed to retract itself easily, spon-
taneously, behind the glans, or to remain habitually behind it, and if
in this state of affiiirs it be affected by the chancrous inflammation ; or
it, when the prepuce is already contracted by inflammation, we bring
it behind the glans, regardless of the impossibility of again drawing it
over ; or i^ after retracting the prepuce aflected by chancres, for the
purpose of dressing the ulcers on it or on the glans, wo imprudently
leave it so retracted until the inflammation and distention render its
replacement impossible ; or if under similar circumstances the act of
ccNtion be performed, there will occur the troublesome and dangerous
affection termed S^nuh collar^ paraphimosis^ or constriction of the
300. We can easily perceive that it must be accompanied by much
more violent symptoms than phimosis (which is often its producer)^
for in it the prepuce compresses itself, and its tension and swelling are
soon so increased that it, together with the glans whose afllercnt vessels
are thereby completely constricted, is affeeted by gangrene. It re*
sembles a tumour composed of several rings.
301. This gangrene not unfrequently extends to a part of the corpus
cavemosum of the penis.
CHAPTER V.
TREATMENT OF PHIMOSIS AND PARAPHIMOSIS.
302. If chancres be the cause of either of these two affections, it
will be requisite, while resorting to external measures, even though we
should be called in late * to the case, immediately to commence the
chief means, which is to destroy the poison as quickly as possible by
the internal use * of soluble mercury.
303. As soon as the mercurial fever commences, which may be
brought about on the second, third, or at latest the fourth day, all the
inflammatory swelling caused by the chancre poison disappears, in
consequence of the miasm being exterminated, as also what there is
' I have found the beneficial cffecta of rapidly employing soluble mercury even
wkeo gangrene had already oommenoed, if the most powerful local means were at
the nme time made use o£
* In urgent ca^es we should commence with half a grain of Bolnblc mercury, and
iacrease the dose by a grain every twelve hours until the artificial fever sets in. We
woold do well to combine the mercurial with half ita weight of opiiim.
5
66 ON YENBRBAL DI8EA8S8.
of an erysipelatous oharacter in it, by the revulsion caused by the
febrile commotion. In the case of paraphimosis the mercurial fever
also removes the chief stumbling-block : the chancres heal.
804. I said, this should be done during the employment of external
means. Before the soluble mercury can perform even its most rapid
service, the most powerful local means must be used as soon as
possible, in order to avoid the urgent danger.
305. In all cases of inflammatory contraction or retraction of the
prepuce, we must enforce strict rest, lying on one side on a horse-hair
or straw mattrass in a cool room and with light coverings, and the
abstinence from all exciting passions, drinks and spices.
306. In phimosis we should frequently inject with caution beneath
the prepuce tepid milk in which 100th part of saffron has been steeped
for some time, in order to bring away or at least dilute the acrid pus,
so as to prevent it bursting through the substance of the prepuce like
a pent-up abscess. To the base of the inflammatory swelling we should
apply several leeches, and therewith draw off an adequate quantity of
blood. Some advise the application of warm emollient poultices ; but
they are injurious : they relax the part, and make it less able to resist
the pressure of the blood ; the swelling and inflammation are thus
increased. We should rather apply to the affected part, immediately
after the leeches are removed, ice-cold water mixed with a twentieth
part of extract of lead or sugar of lead and a fiflieth part of laudanum,
renewing the application every minute. A few tepid footbaths may
not be disadvantageous.
307. We should proceed in very much the same manner in cases
of constriction of the glans by the retracted inflamed prepuce. We
may omit the leeches, but the ice-cold compresses or immersion of
the penis in water of that temparature should be repeated as frequently
as possible. After a few hours, when the greater part of the inflam-
mation has subsided, we must grasp the swollen glans in the hand,
and by means of a gentle gradual pressure, attempt to press back the
blood, accumulated in it, and thereby diminish its size to such a degree
that, seizing the prepuce with the nails of the thumb and foreflnger of
both hands, we may, by exercising some force, be able to draw it over
the glans. This will succeed in most cases.
308. It is only after we have several times tried this manoeuvre
without success that we should proceed to the operation. In order
that we may not be induced to have recourse to it at first, before
every other means has been tried, we should consider that there are
very few cases in which the operation is indispensable, partly because
it cannot be done without great care and diflliculty, partly because it
usually increases the irritation still more, and usually is followed by
sloughing, partly because the patient rarely submits to it at the right
CHANCRE. 67
time. In «mple gonorrhoeas it is also injurious for this reason, that
the wound is almost inevitably infected bj the miasm, and turns into
a chancre.
309. In all cases where the operation is unavoidable, we must search
St the neck of the swelling for the part of the prepuce that presents
the greatest resistance to dilatation, which will be found to be its
interior border ; beneath this we insert the point of a curved bistoury,
and sKt it up to the extent of a quarter or a third of the whole length
of the prepuce. Ha^'ing removed the constriction in this manner, if
the prepuce cannot be easily drawn over the glaus we may leave it
behind the glans until the cure is completed.
310. If it can be drawn over, we must take care, during the healing-
op of the chancre under the mercurial course, and during the closing-
np of the wound, to push it frequently backwards and forwards over
the glans, partly in order to prevent the prepuce uniting with the
gbns, partly also in order that the orifice of the prepuce may not con-
tract daring the healing, and thus form a phimosis. A similar ma-
DSQvre is necessary also in the case of venereal phimosis, when the
dmcres beneath it commence to heal under the internal use of mer-
cury, in which case the prepuce is apt to unite with the glans if this
movement be not employed to prevent this taking place. The oede-
ma often remaining after the operation is best dissipated by a strong
satumine lotion or decoction of oak-bark.
311. If however, in the case of paraphimosis, gangrene have already
set in, relief must be given as speedily as possible. In such a case
the following mode of procedure affords almost immediate relief; at
Jeast it is the best of all expedients. — Two ounces of finely powdered
oak-bark are to be boiled slowly in two pounds of river-water for five
hours, down to one pound of fluid, strained through a cloth, the strain-
ed sediment diluted with four ounces of white wine and this also
strained ; the two fluids are then to be mingled together, and sofl rags
moistened with the decoction when perfectly cold, to be applied cold
and fresh every half hour. I have observed that by this procedure all
odour has gone off by the fiflh hour. From that moment the gan-
grene ceases and the sphacelated part will be thrown off by healthy
suppuration in the course of four days. The requisite manual aid
should not be neglected, the operation on the prepuce will sometimes
be indicated if there be still time for it. The same decoction, only
ice-cold, may also be employed when, after the operation for paraphi-
mosis (§ 309), the prepuce cannot be drawn over the glans.
68 ON YENXBSAL DISEASES.
CHAPTER VI.
CHANCRE IN THE FEMALE.
312. la the case of woraen we may very readily conviDce ourselves of
the truth of Hunter^s maxim, that the idiopathic venereal pobon pro-
duces gonorrhoea when applied to surfaces of the body destitute of
epidermis that in the healthy state secrete moisture, and chancres
when applied to those parts that are naturally dry and covered by
epidermis. We cannot find any chancres in the female genital organs
where no epidermis exists.
313. The ulcers that occur on the inner surface of the genitals of
females when they are affected by gonorrhoea differ very much from
chancres. They are usually seated in the folds betwixt the labia ma-
jora and nymphce, are formed slowly out of inflamed hard swellings,
have a deep, concealed seat in the body of the labium, probably in its
glandular parts, and have very minute openings which must be art!-
^cially enlarged and kept open. They always secrete a muco-puru-
lent fluid until they heal up ; in all their external characters they diflfer
from the chancre. They resemble the ulcers of the glands along the
urethra in gonorrhoea in the male. They have only a partial resem-
blance to chancres in this, that they cannot be cured without mercury,
because by the contact with the gonorrhoeal matter they become vene-
real.
314. Chancres,^ on the contrary, are seated, in their usual form,
only on those parts of the female genitals which are invested with
epidermis, and generally just where that is about to cease; in persons
who do not make a trade of voluptuousness, right in the border of
the labia majora, at the inferior commissure and on the prepuce of the*
clitoris in rarer cases, and in such as have a more delicate skin, also
on the external surface of the larger lips, on the mens veneris, on the
anus and the perinaeum. In public prostitutes, on the other hand, and
other persons of a similar description, the chancres are seated from
the above reason sometimes deep * in the vagina, on the nympha^, 6ic
L^rge chancres on the labise cause these to swell considerably.
315. The chancres on the external parts invested with a thicker
epidermis, as the mons veneris, perinaeum, dec, resemble those of
males which are observed on the penis, scrotum, dsc, and are, like
these, usually covered by a scab, beneath which a larger one is always
formed when the first falls off; they are excessively painful.
316. Probably the latter sometimes arise when the matter from
chancres on the internal border of the genitals, where they always
remain moist, repeatedly comes in contact with these external parts,
'They are of the same nature and same appearance in the female as in the male
CHANORE. 69
•ad tkus gndvally complete the innocoktion through the thicker epi-
dermia At any rate, this is often the case with respect to those on
the fourdiette and on the anus.
817. The simple construction of the female genital organs, in those
parts where the chancre can occur, does not allow of any sudi com-
plex symptoms as occur in the more complicated male genitals.
318. The only chancres they are subject to that men are not, are
those on the nipples, which they generally get by suckling those chil-
dren whose lips are affected by true chancres. Tliey eat rapidly about
them, and if not speedily checked by the anti-venereal specific, they
soon destroy the nipples.
CHAPTER VIL
TREATMENT OF CHAK^CRE IN FEMALES.
319. As the parts are not of so complex a character as in the male,
we have as a general rule less serious symptoms to combat
3^. The external treatment has hitherto been the same as that of
dancres in the male, by local remedies of corrosive, astringent, irri-
tating character, precipitate ointment, saturnine lotions, solution of
corrosive sublimate, ^c. Such treatment is as prejudicial in females
18 in males, and even more so, because the absorbmg surface is
larger, and they have frequently several chancres at the same time.
Just as, in males, the employment of irritating and corrosive reme-
dies, whether mercury enter into their composition or not, always
increases the absorbing power of the lymphatic vessels, so from
the same reasons this happens all the more readily in females ; per-
haps also because the whole vascular system in females is more irrita-
ble. Astringent substances* are injurious in proportion to their
energy. These topical applications, moreover, cause a great deal of
local mischief: they alter the chancre, as in males, into ulcers that
eat round about them, into spongy excrescences, into sycotic condy-
lonuita, dec
321. We ought, therefore, to abandon this destructive method, and
daring the proper treatment by internal mercurial remedies dress the
chancre, either not at all, or with something quite indifferent.*
322. As regards the internal treatment, practitioners are much more
at a loss than in the case of chancres in the male. We are advised to
* Ezpfrieooe teadies that of all remedies that promotothe abaorptioD of; the poi-
na k) chancres, none act so powerfully aa the preparatiooB of lead ; thej are there-
fore of aQ the most hurtful in such cases.
* AB(ir6 also advices that nothing but tepid water be ap{^ed to diancrcB dnring
hii ahentnre mercurial treatment.
70 OK VENEREAL DISEASES.
continue the treatment an extraordinary ^ long time, and to use twice
as much mercury as we do for the male sex.
323. This destructive method will be easily superceded by the em-
ployment of a better mercurial preparation and the requisite circum-
spection. I have not found it necessary to employ longer time nor '
to use more soluble mercury for the cure of chancres in females than
in^males.^
324. Attending to the rules to be hereafler (§ 591 et seg.) laid
down for preventing violent evacuations, (ptyalism, diarrhoea, ^sc^)
I likewise in their case rose from a very small to a larger dose of the
soluble mercury, in order if possible to bring on a sufficiently strong
mercurial fever betwixt the fourth and seventh days, reckoning from
the commencement of its employment ; and during that time I caused
the chancre to be dressed only with tepid milk or water. In ordi-
nary cases from ten to twenty days sufficed to complete the cure.
325. If the chancres spread very much, and extend deep into the
vagina, we should fill that part with charpie during the treatment,
so that the granulations, when they cicatrize, shall not contract the
vagina.
326. We should proceed in the same way with chancres on the nip-
ples, that is to say, we should treat the body only internally, without
the employment of any external means ; but here we must endeavour
to produce the mercurial fever as quickly as possible, in order to pre-
vent, if possible, the rapid destruction of these soft parts by the viru-
lent ulcer.
CHAPTER VIII.
TREATMENT OF THE ACCIDENTS RESULTING FROM IMPROPER
TREATMENT OF THE CHANCRR
327. The chronic phimosis (from induration and thickening of the
prepuce) that remains after the cure of the chancre, especially when
* Andr^ and some others advise the use of internal mercurial remedies for nine or
ten weeks before we can with certainty pronounce the chancres in the fenude cured,
and aU the virus eradicated out of the body. It would probably be a matter of
difficulty to determine when this had occurred, if they employed local remedies. Hie
beet indication would be wanting to them (the spontaneous cure of the chancre) if
they repelled it locally. Moreover, the weakness and uncertainty of their mercurial
preparations required that they should employ for to long such a large quantitg of
mercury^ frequently without any real result, and to the certain injury of the
constitution.
* A woman who for some days had a buboe, and for a year several chancres on the
inner border of the labium majus of the same side, the largest of which measured
from four to five lines in diameter, but who was otherwise healthy, took, without
employing any local remedy, three grains of soluble mercnry in five days. The
artificial fever came on strongly and characteristicaUy; four days afterwards, after
aU the pams in the head and aU the fever were gone, the chancres, together with
the small buboe, had completely disappeared ; for a year and a half she has remained
perfectly free from all complaints.
CHAKCRX. 71
performed in the ordinary manner, increases with the lapse of time,
e^>edall7 if the orifice be too small for the full stream of urine. It
becomes schirrhous, and lays the foundation for a number of disagree-
able symptoms.
S28. In order to remove this evil, we draw the thickened portion
of the prepuce over the glans, grasp it tightly, and cut it off cau-
tiously, without injuring the glans. While the wound is healing, the
prepuce must be frequently pushed back over the glans, in order to
prevent the cicatrix, and thereby the orifice of the prepuce, from con-
incting again.
329. Where the scirrhus pervades the whole prepuce, it must be
cut away entirely, or it may be merely slit up at a convenient point
in order to allow the patient to perform the act of coition.
330. Hunter alludes to a kind of false chancre, that seems to result
from the previous improper treatment of a true one. Its diagnostic
marks are as follow : — It is only met with in persons who liave pre-
Tiousl)' (^frequently only four to eight weeks before) been affected
with real (idiopathic venereal) chancres ; it never occurs exactly on
the cicatrix of the healed up chancre, but close beside, or at least not
&r from it ; it does not extend so rapidly nor so extensively as the
true one ; is not so painful nor so inflamed ; has not such a hard base,
ud does not cause buboes by absortion, like the true chancre.
331. Of quite a different nature arc those chancres that by a long
abuse of mercury, and perhaps also by the use of improper external
remedies, have degenerated into malignant ulcers. Such ulcers se-
crete much thin acrid ichor, are excessively sensitive and painful, their
borders are very elevated, violet-coloured, and hard ; in a word, they
resemble old scrofulous ulcers, and are of a similar nature.
332. In these cases there may be no longer any venereal miasm in
the system. The abuse of mercury and other debilitating methods
have caused the whole body to take on the scrofulous disposition, and
have produced a cachexia of morbid irritability, and the ulcers do
not effectually heal up before this condition of the organism is im-
proved.
333. A further employment of mercury aggravates them percepti-
bly. The most powerful antidotes to this cachexia, cold baths,
country air, bark, opium,^ exercise, ammonia, and local tonics are of
ier\ice.
334. When, in cases where there is an original predisposition to de-
bility, nervous diseases and erysipelas, the chancres, which have in
auch states of the constitution already a tendency to abnormal inflam-
Mt k io such cases that Tumbull's external employment of the opiate solution
(degenerated) cbaneres has sach excellent effecta
72 OK y£N£BfiAX< DISEASES.
matioD, are treated with irritating local remedies and with an ezoea-
flively long employment of mercurials, purgatives, and tepid baths, it
sometimes happens that the morbid irritabUity of the system increases
to such a degree, that even afler the healing up of the dbaneres, in-
jBammation of such intensity is developed on the genitals, that a dan-
gerous affection occurs, which some have improperly termed cancer
of the penis.
S35« The swelling of the whole organ is great, the heat considerable,
the colour bright red. Suppuration beneath the whole of the skin
and prepuce rapidly ensues, and ulcerations break out here and there.
I9 such cases a portion or the whole of the glans is not unfrequently
lost ; sometimes also the urethra, and even the whole of the penis, are
destroyed by the suppuration, if the disease be not arrested in time.
330. Here also mercury will be found injurious. I have found no
good results from anything besides the free internal employment of
bark with ammonia and opium, and a very strong and ice-cold decoc-
tion of oak-bark, (if we are called in good time, strongly impregnated
with opium) applied fresh every hour or half hour. When the danger
is past and the ulcer commences tp heal, we must, in order to prevent
a reli^se, make use of the other remedies usually employed for irrita-
bility with weakness.
887. Those chancres which have only been aggravated by the abuse
of corrosive remedies, of which the borders become suddenly everted,
very sensitive and excessively painful, which bleed easily, eat around
them, and are beset with tuberculous indurations (a sort of cancerous
ulcer), demand speedy aid. The affected part is to be constai^y
bathed with a lotion composed of one part of laudanum with twenty
or ten parts of water, and bark largely combined with opium is to be
given internally until the pain begins to yield. The ulser will then
begin to assume a more healthy character, and may now be cured gene-
rally with mild digestives (of cocoa-nut oil, yolk of egg and Peru-
vian balsam, dec.), if the venereal miasm have been previously de-
stroyed by an appropriate mercurial course,
338. It is usual to stop the profuse haemorrhage of an old chancre
(when the miasm has. not yet been destroyed from within) when it
throws off an artificial or self-generated thick slough, by means of ap-
plications of turpentine. In many cases the local employment of
opiates as palliatives is indispensable, especially when the recurrence
of haemorrhage is kept up by irritability from nervous weakness.
339. The spongy excrescences that protrude from chancres that have
been treated with local remedies of an irritating diaracter belong to
the class of degenerated chancres among which I reckon the sycotio
condylomata, of which I am about to treat.
CHAKGBX. 78
CHAPTER IL
VENEREAL WART9 AXD EX0BE9GEKCES.
S40. Very little of a positive character has been written concerning
the nature of the condylomatous warts, and the place they should
hold among venereal affections is still so undetermined, that I must
take leave not to regard them as a symptom of syphilis, but to place
them among the idiopathic venereal affections.
841. They certainly never appear, like gonorrhcea and chancre, im-
mediatelv ailer local inoculation, but in this thev resemble buboes ;
bat still the humour they exude possesses, like the pus of inguinal bu-
boes, the power of producing local infection,^ a property that seems
only to belong to the idiopathic venereal symptoms.
342. Their power to cause local inoculation, and the fact that when
iH)t of a homy hardness, the internal use of mercury can alone eradi-
Cite them as I have frequently observed, amply suffice to refute Hun-
ters opinion, that they are mere consequences of the venereal malady,
iDd not themselves of venereal nature.
343. Thus much is certain, that they are not a primary symptom of
immediate infection, but that they onl v appear from the neglect or im-
proper treatment of the proper chancre. Usually when the latter are
treated only by external remedies of an irritating and astringent cha-
ncter,'the chancre, without losing its idiopathic venereal virus, gra-
daallv changes its appearance, the irritated sensitive fibres attain a
luxuriant growth, and excrescences arise on the former seat of the
chanercs : at least I have never seen a case where the chancres were
#
healed according to my plan, only by the internal employment of the
best mercurial preparation without the slightest topical application,
▼here anv such excrescence remained. We would therefore not be
wrong in regarding this as a degeneration of the chancre, standing in
the same relation to that as a gleet does to the primary gonorrhoea.
344. Their seat therefore is the locality where chancres may occur
after an impure coitus; the prepuce, glands, clitoris, the orifice of the
urethra, the labia, &c., and in those places most generally where the
epidermis is thickest, round about the anus, in the perinzcum, on the
scrotum, &c.
345. Their appearance is various; they are sometimes broad and
famished with a pedicle, in which case they are termed ^^r warts ; or
they are long-shaped, and resemble a cock's comb ; or their head
sprouts out enormously, giving them the appearance of cauliflowers,
^'•; and writers have classified them according to their resemblance
' Andr^ saw a venereal wart upon the glans oommunicate genorrhcea to a fenude*
' The pofver thete remedies poflseaB of causing the lymphatic vessels to absorb is
the NasoQ why we seldom observe condylomata unaccompanied by some symptoms
of irphiliflL
74 OK YEKSBKAL DISEASES.
to buttons, onions,' strawberries, mulberries, and so on, without reflect-
ing that these names indicate no difference of nature, but only depend
upon an accidental conformation, consequently are of no essential utili-
ty and cannot influence the mode of treatment. More interesting is
a knowledge of their nature and of their course.
346. The warts on the prepuce, glans, clitoris and labia, are gene-
rally harder and drier than those on other parts ; sometimes they are
painless, and then they not unfrequently wither and disappear sponta-
neously (probably when the venereal poison they contain retreats in-
wardly into the general circulation); sometimes they inflame, and
then usually degenerate into cancerous ulcers.
347. In addition to these, immediately afler improper treatment of
chancres with local irritating substances, spongy growths shoot out
rapidly on the penis and in the vagina, which sometimes have little or
no sensibility.
348. The condylomata on the nates and perinssum are also spongy,
and the hollows and furrows in the skin betwixt them are usually ulce-
rated and painful. In this condition their surface appears full of chaps,
which exude a fetid ichor. They are attended by gradually increasing
inflammation and painful burning, until they in the course of time de-
generate into flstulous ulcers of the rectum, &c.
349. But hard growths of this kind are also met with in this posi-
tion, which are often covered with scales and inflamed, and even accom-
panied by violent pains; injudicious local treatment (without eflicient
internal assistance,) readily transforms them into cancerous ulcers.
350. The non-venereal warts and excrescences on the genital organs
of both sexes are distinguished from the venereal ones by this : that
the former have their roots in soft healthy skin, that they are usually
of soft texture, dry and flesh-coloured, also that no venereal symptoms
either have preceded or accompany them ; whereas the base of the
venereal ones is upon a hardened part, they are inflamed, and are al-
ways preceded by other idiopathic venereal aflections, and generally
accompanied by several symptoms of syphilis ; more particularly there
usually exist betwixt them ichor-secreting venereal Assures.
351. If the excrescences are only seated on the anus, before we can
pronounce them venereal, or treat them as such, we must pay atten-
tion to their diagnostic marks, and also endeavour to ascertain whether
they do not result from sodomy, or from some acrid discharge from
hemorrhoids, or from leucorrhoca, as not unfrequently happens, or
whether they are not relics of external piles.
CHAPTER I.
CURE OF VENEREAL WARTS AND EXORESCENOEa
352. If we have convinced ourselves of the venereal nature of the
condylomata, from the above signs and from the history of the case^
CHANCRB. 76
we proceed to the treatment, which divides itself into external and
interaaL
353. As a general rule, these excrescences must not be primarily
treated bj local remedies,* for the same reason as I have given for
oondemning the topical treatment of chancres. If, as we have every
reason to believe is the case, these excrescences be malignant trans-
fennations of the chancre owing to local treatment, the injudiciousness
of such applianees will be more palpable, and the usual bad effects of
tbeir employment afford ample corroboration of this assertion.
354. We must consequently discard what made them from chan-
cres into condylomata — the irritating and styptic local remedies, and
make use of a judicious and internal administration of mercury ,2 un-
less which had been neglected they had not degenerated into that con-
dition ; in a word, in order to cure them radically, we must do what
ought to have been done long ago.
355. The administration of (soluble) mercury serviceable in this
ctte, and the rules for its employment, are the same as for the more
remote degree of syphilis (for they belong to the most obstinate local
a&ctions), to which latter I refer Uie reader, in order to avoid unneces-
aiy repetition.
356. I may merely observe that a properly developed (and rather
strong) mercurial fever (§ 290) cures all true venereal warts and
excrescences ; that is to say, they dry up and fall off whole or in
fragments, or (but this is rare) they put on a healthy suppurative pro-
cess and ulcerate away.
357. Those warts that do not fall off nor suppurate away, nor
gradually disappear by this internal destruction of the virus, are
usually of a horny character ; at all events are innocuous and non-
i'enereal.
358. If, notwithstanding, we wish to get rid of them, they may, like
all other non-venereal warts, according to circumstances, be removed
^7 ^y^^S them with a wax thread and gradually drawing it tighter, or
they may be burnt off with lunar caustic, or cut off with the scissors.
Sume have also advised to apply onions boiled in oil until the warts
become soft, and then sprinkle over them powdered mezerium, whereby
they are changed into mucus, that may easily be scraped off.
359. But as it nevertheless sometimes happens (although very
* Tbey produce syphilis, if that be not already present, or cause them to degeoe-
ate into epreading ulcers.
* When Dease adduces as proof that mercury b of no use for warts, and that they
eongequcntly contain do Tcnereal virus, that they sometimes have remained uncured
sltboGgfa the patient has long used the metal and been salivated almost to death, he
ibooki have remembered that 8uch abuse of mercury often leaves uncured other local
ifffictkos evidently dependent on the venereal poison, which a rational administratioo
fd mercory eradicates rapidly and radically.
76 ON VENEREAL DISEASES.
rarely in the ease of the non-venereal remains of formerly yenereal
excrescences) that they again grow after removal by the ligature or
scissors, we would do well, immediately after their removal by these
instruments, if we observe any disposition on their part to grow again,
to touch the part once or twice with lunar caustic ; except in such
cases, when, in spite of the radical destruction of the venereal miasm
by the mercurial fever, such a wart still remains inflamed and painful,
in which very rare case^ we must abstain from all topical applications,
and content ourselves with destroying the cancerous or scrofulous
constitution of the humours by hemlock, cold baths, opium, ammonia,
setons in the neighborhood, dsc.
360. Peyrilhe recommended, in order to destroy the large spongy
excrescences in the vagina, to apply butter of antimony with great
caution, and immediately thereafter to cleanse with injections of lime-
water the parts where this easily spreading caustic may have touched
the healthy tissues. He prefers it to the lunar caustic, because the
slough formed by the latter does not fall off under 36 hours ; which
would allow sufficient time to renew the excrescence beneath it. We
may act in a similar manner by excrescences on the male genitals. I
would not however advise any beginner in surgery to resort to this
method. The judicious internal employment of mercury must always
precede it.
861. llie rectal and perineal fistulco arising from condylomata, are
hardly ever benefitted by the ordinary employment of mercurials in
the shape of calomel, Neapoliian ointment, <kc. The soluble mercury
is, as it generally is, more powerful in such cases, when all the morbid
irritability of the body, which is almost always present, is subdued
before its employment, and when at the same time topical fumigation^
with cinnabar, dec, are not neglected.
SECOND DIVISION.
BUBOES.
CHAPTERI.
DIAGNOSIS OF INGUINAL BUBOES.
362. The swelling produced in the inguinal glands by the dessication
of a chancrd that has been treated only locally, that is to say by the
absorption of the idiopathic venereal poison, is the most ordinary kind
of buboe. We need not here dwell on the diagnostic marks of the
«wellings in the groin occasioned by the sympathetic irritation of .the
gonorrhoeal inflammation, as they are not of a venereal nature, and
have been already discussed when treating of gonorrhoea.
* Morbid irritability must be the caufie of this phenoineiioD.
fiUBOSs. 77
363. Seeing that the lymphatic system consists partly of single
absorbent vessels and trunks, partly of glands, that is, as &r as we at
present know, of the division, reunion and interlacing of their smallest
branches, we might easily suppose, a priori^ that the former would be
less frequently afieoted, irritated and inflamed, by the passage
through them of the virus ailer its absorption from chancres than the
glands.
864. And this opinion is corroborated by experience, which teaches
08 that the simple lymphatic vessels are seldom affected and almost
odIt after the small glands along their course have already been
swollen.
365. When such an occurrence does take place, if, for instance, the
seat of the absorption was a chancre on the prepuce or the glans, a
lymphatic vessel in the neighbourhood along the dorsum of the penis
wfll be found thickened and indurated, apparently terminating at the
root of the penis beneath the pubis, or it will be felt to run into the
inguinal region, interrupting in its course by elevated tubercles (small
hnboes).
366. Something similar, it is alleged, occurs from the absorption
of gonorrhoeal matter. A cord-like thickening of a lymphatic vessel
with small knots upon it is formed upon the penis, usually taking its
origin from an indurated part on the prepuce, which frequenly pre-
sents a raw appearance on the inner surface, a sign that it should be
regarded as something more than an immediate metastasis of the
gonorrhoeal matter) which appears to me to be quite incomprehensible).
The same thing happens, though more rarely, from the absorption
of the chancre virus from the female genitals. The vessel leading to
the gland feels like a cord, and is painful ; small glandular swellings
are also produced in its course.
367. Usually however, as has been said, this does not occur ; the
absorbents opening into the chancre generally convey the poison,
without being affected themselves, to the nearest larger gland, where
the angles of the anastomoses and the interlacings of the finer
lymphatic branches retard the passage of the humours, and thereby
allow the poison time, and give it the opportunity of exercising its
irritant power.
368. Here the idiopathic venereal virus is arrested * on its way to
mingle with the mass of the blood, whilst it, without in the meantime
' The glandular swelling however does not appear at any time to arrest with ccr-
tamty the venereal poison from passing into the mass of the fluids, not even when it
goes CD to sapporation ; which fact may bo alleged in opposition to those who say
we slioald regard the buboe as a critical metastasis, and who therefore direct all their
efibrts to cause it to suppurate ; certainly in most cases a meaflure of very doubtful
utility.
78 ON VANEREAL DISEASES.
altering its nature, develops that specific painful inflammation and
tumefaction in the lymphatic gland, termed buboe, the immediate
result of the absorption of the virus from a chancre, more rarely from
a primary gonorrhoea, and still more rarely from the uninjured skin, and
the proximate source of lues venerea by its further absorption by the
lymphatic vessels into the general circulation.
369. The absorbed poison usually settles in the nearest gland to-
wards the centre of the circulation ; in the case of chancres on the
prepuce or the glans, ordinarily in the groin of the same side ; from
chancres of the frcnum however, and from absorbed (gonorrhceai 1)
virus from the urethra, on either side without distinction, and often on
both sides. But as the situation of these glands varies, so there are
buboes which are seated pretty deeply under Poupart's ligament in
the thigh, others close to the os pubis, and others again that are
located in the abdomen right over or above the ligament indicated.
•If the absorbed poison be in greater activity, several glands may be
affected at onceJ
370. In women affected with chancres of the genitals on the clitoris,
on the mons veneris, <kc., they occur also on the same side, but at the
commencement of the round ligament of the womb, whence they pass
into the abdomen ; probably these are lymphatic vessels inflamed by
chancre- virus only. If the chancres be seated quite far back, at the
posterior part of the labia or on the perinaeum, buboes are developed
along the furrow formed betwixt the greater labium and the thigh. The
other seats of buboes in the female are the same as in the male.
371. If the chancres be seated on the hand or arm (by the intro-
duction of the chancre-virus into wounds, ulcers, dec), the absorbed
virus is also transplanted into the nearest lymphatic gland towards
the heart, usually not far from the elbow at the inside of the biceps
muscle, but also occasionally in the axillary glands.
372. Chancres on the lower lip in one instance gave rise to buboes
on both sides of the neck over the submaxillary glands.
373. The infection of the glands proceeds rather slowly ; they
have been observed to swell afler from six days to several weeks
subsequent to the local destruction of the chancre.
374. Chancres that are not treated at all impart their poison mudi
more rarely and slowly to the glands than those treated by local
corrosive, irritating substances. Of twenty chancres treated solely
' Some cfaancres on the prepuce of ao officer of very dindute habits, who had at
the same time gononrboBa, were merely covered by him with falotting-paper, and not
otherwiM attended to. He continued hiB dissipation, and got not only a buboe in both
groins and suppuration of Ckywper's glandsi causing^a perineal flsUUa, but also a
aindhur ailbctioii hi each aadlla.
BUB0S8. 79
U^callf / probably not one case oocurs in which absorption does not
take place ; whereas I haye seen many chancres that were subjected to
DO treatment persist for years on their seat, without the occurrence of
buboes or lues yenerea.
375. Venerereal buboes commence with a sh'ght pain in the groin
an almost characteristic anxiety in the chest, and a small, hard
swelling, which if it be not restrained by a scrofulous diathesis, by
eitemal remedies, the inunction treatment, &c., soon rises up (and
tiien the swollen gland is from the first yery painful), inflames, and
passes on to suppuration.
876. At first and when still small, this venereal glandular swelling
may be pushed hither and thither in the cellular tissue ; we observe
that but a single gland is affected ; its boundaries are very circum*
•cribed. It is only when inflammation has perceptibly set in (the
inflamed part is bright red) that its size increases considerably, and
then suppuration soon ensues.
377. An abscess occurs, which only differs from the chancre as to
iiie, in other respects its nature is exactly the same.
878. Occasionally an erysipelatous inflammation accompanies the
■welling, or watery fluid accumulates there (oedema), and the sup-
paration advances tardily.
879. If we take into consideration all these signs, and if we are
eooyinoed by the history of the disease of the venereal origin of the
buboe, we shall very readily be able to distinguish it from others of a
similar character.
380. Buboes from other causes arc usually sofler, and generally more
easily dispersed. There are usually several glands swollen at once; in
acrofulous affections, glands in other parts of the body are likewise
affected. Non-venereal buboes are commonly less painful, and often
complicated with catarrhal or hectic fever, in such a way, that the
fever was already there before their appearance. They are so far from
being amenable to mercury, that they are rather aggravated by its use
(and can only becombatted by means of tonics, especially the cold bath,
rubbing in of volatile ointment, burnt sea-weed, small doses of
ipecacuan not pushed to emesis, shower baths, dsc.) Non-venereal
buboes increase more slowly, or even should they swell more rapidly,
they do not readily pass into suppuration. If they do suppurate,
more than one gland takes on the process, and sinuses are more apt to
be formed, which is not the case with true venereal buboes.
381. A species of unhealthy suppurating venereal buboes sometimes
remains after the treatment by mercurial inunction ; the irritating
qualities of the large quantity of mercury rubbed in seems to be the
> Qirtanner^B caostic alkali must be considered an exception, and must possess a
■pecific aotiveiieresl power which destroys the poison, and thus .eradicates it directly.
80 ON VENSBSAL DISEASES.
cause of this phenomenon. A more dilatoiy employment of the
inunction treatment, on the other hand, is apt to change enlarged but
not suppurated inguinal glands into scirrhus.
382. In young persons buboes are apt to become scrofulous, in old
persons they tend to become, cancerous.
383. A surgeon who exercises a due amount of attention will not
easily mistake a hernia, an abscess in the groin, or aneurism in the
thigh for a venereal buboe.
CHAPTER II.
OBSERVATIONS ON THE ORDINARY MODE OF TREATING BUBOES. •
384. When satisfied from the symptoms present of the real vene-
real character of the buboe, it is almost universally the custom to at-
tempt to disperse the inguinal swelling, discarding the ancient notion
that they are critical metastases of the poison and real beneficial pro-
cesses of nature, and that the way pointed out by nature ought to be
followed, which seeks to convert them into abcesses, in order thereby
at once to get rid of the venereal virus in the best manner.* This de-
lusion has, as I have said, been discarded and it is now sought to dis-
perse them.
385. To accomplish this object no better method was known than
to rub in mercurial ointment (lard rubbed up with an equal weight of
the quick metal) in the region situated betwixt the place of absorption
(the chancre) and the deposit in the gland (the buboe) ; that is to say^
the mercury was introduced into the system in the same way in which
it had received the poison, in order that this metal should pass through
the gland, and thus, as was imagined, destroy the poison at the
diseased place.
386. This treatment, founded merely upon the course of the lym-
pathic vessels, seems highly advisable in an anatomical point of view,
and Hunter takes great credit to himself for the discovery ; it involved
the d priori unproved (and certainly groundless) supposition that
mercury (it mattered not whether in the form of oxyde, solution or
salt)* chemically destroys, as mercury, the venereal poison by mere
contact ; and if under the inunction treatment, it passed through the
swollen gland, it must necessarily come in contact with all the poison,
and therefore destroy it in its seat.
387. I admit the propulsive power of this metal, whereby it
removes mechanically some obstructions . of the glands — ^for in truth
perhaps not above the two-hundredth part of tkie metal is oxydised in
' Hence the injurious advice given by ignorant practitioners even of the present
day, as soon as an inguinal swelling appears to indulge in disaipatioDi, drinkbg and
venery, toiide, and in a word to do eveiy thing to cause these parts to inflame and
BUfyqrate. Nothing oocdd be advised more repugnant to sense.
* QrmiitedwiththefiittyaGidintheformofaBalt
BUBOSS. 81
the Nei|M>litaii ointment , the result of the inunction treatment more.
over shews that the virus located in the inguinal gland really yields
to this ointment ; but the inefficacj of all applications of mercurials to
cbncres, and tiieir injurious power (especially that of the mercurial
oiotmoit) in hastening the absorption of the poison from chancres into
tbe general circulation, might have taught that the mercury does not
destroy the venereal poison as mercury, not ex cpere operaiOj but that
a previous reaction of the powers of the whole system (the mercurial
ierer) is required to do that, either by directing the action of the
mefcury dissolved in the fluids of the body to lay hold of the poison,
Qfhj extinguishing the venereal irritation through the instrumentality
of the specific irritation excited in the whole sensitive system, or by
means of a peculiar change effected upon the metal during its con-
eoction in the secundie vise (probably by its combination with some
anmikting substance from the animal juices) to render it capable of
fSdc^tmg a chemical neutralization of this virus.
388. lliis preparatory action of the animal organism on the metal
before it is capable of eradicating the venereal virus, should not have
been overlooked ; its oversight has been the cause of so many false
steps in the treatment of venereal diseases, that the history of this
^rine antisyphilitic specific leaves us in uncertainty whether it have
Utherto done more good than harm to suffering humanity.
389. The innumerable instances of buboes and of general lues caused
by tbe merely local treatment of chancres by mercurial topical
spplications,* and of buboes by the merely propulsive force of the
quick mercury contained in the ointment , would have diverted the
observer from a prejudicial theory to one of a more beneficial character,
hsd he not been led astray by certain accessory circumstances.
390. The internal employment of the mercury, namely, was com-
bined with its external application (to the chancre) ; hence it followed
as a natural consequence, that from the efficacy of the former, the
injurious character or inefficacy of the latter could not be perceived.
Buboes were dispersed by rubbing Neapolitan ointment into the groin,
but the effects of the propulsion of the venereal virus into the general
circulation which inevitably follow this treatment were not waited for.
hot the rubbing-in process was persisted in much longer, and in some
case* the patient was actually cured, and thus general (undeveloped)
lues was produced, to be cured if so be it might.
* If the virus be not abmrbed into the circulatioa from the chancre under the
appbcatkn of the mercurials, it will remain for ever undestroyed under their local
anploynient ; this is an incontrovertible maxim of experience : otherwise the infi-
nilelv rare case must occur, in which the mercurial applied to the small surface
voald be absorbed in suflBcient quantity to produce the same effects as arise from
<W intenial use of the metal (mercurial fever, <Scc.)
6
82 ON YEKEBXAL DISEASES.
391. If it were possible for the general lues venerea to break forth
during the employment of th^e very minutest portion of mercury, it
would certainly always be observed in the interval betwixt the dis-
appearance of the buboe and the termination of the rubbing-in treat-
ment ; and in truth it was always noticed, if any considerable period
of time were allowed to elapse after the disappearance of the buboe
before resuming the' rubbing-in (a convincing proof that the virus was
not destroyed by direct contact with mercury as mercury) ; or if after
ever so long a continuance of the rubbing-in, the action of a sufficiently
intense mercurial fever did not ensue, consequently the treatment was
left incomplete, the lues broke out some time thereafter ; in this case
the buboe had long disappeared, and yet the lues broke out.
392. The observation, that the same quantity of mercurial ointment
rubbed into parts whence the lymphatic vessels do not pass through the
swollen inguinal glands, although it did not dispel the latter so rapidly,
yet ejected a cure as often, might have taught medical men that as
in these cases the disappearance of the buboe depended on the radical
destruction of all the venereal poison, it was foolish to deprive them-
selves of this most certain criterion of the true destruction of the virus
contained in the inguinal tumour, by the useless local dispersion of
the buboe. For immediately after the local dispersion of the buboe by
the Neapolitan ointment, the venereal virus still exists in the system
as intact as when during the internal mercurial treatment the venerea]
inguinal buboe is still present, only that in the latter case the persistence
of the buboe gives me the full assurance that the cure is not complete;
but this is wanting in the first case, and the physician deceives both
himself and his patient with a vain hope. For how is it possible to
demonstrate to both immediately after the inunction treatment that
the patient is not cured ? It is only after the lapse of several months,
that the breaking out of the lues venerea will shew them how greatly
they have been deceived ; every unprejudiced person will perceive
how foolishly the physician has acted, in himself extinguishing the
light which alone could guide him along the dark path to this desired
goal.
393. Let it not be alleged that recent lues venerea requires no more
time nor mercury for its cure than buboes and chancres, and that,
consequently, it is a matter of indifference whether we have to destroy
the local or the general virus. For even though it should in general
require less time and mercury for the cure of lues, it will always be
much more difficult (at all events for the ordinary treatment) to cure
lues, when it presents itself under such an obscure form, and often
takes such a long time before its presence can be ascertained by
indtihi^able signs ; and even these indubitable signs are often removed
from the observation of the physician by the smallest dose of mercury.
BUBOES. 88
long before we can entertain an idea of the radical cure of the disease.
Hie employment of mercary should be persisted in until the complete
care is accomplished. But when is it accomplished 1 by what sign
sh^l we recognise the extinction of the virus ?
394. How then can it be a matter of indifference whether the vene-
real virus be treated in the form of lues or of buboes and chancres,
seeing that the latter especially and only ^ draw the in&llible boundary-
tine betwixt the complete and incomplete extinction of the miasm,
when MTithout local treatment and by the sole internal employment of
mercury they are cured and disappear without leaving a trace behind,
whereas the undeveloped or concealed lues has nothing of the sort
to shew.
895. But on the other hand, how useless was the anxious direction
of those who insisted on the necessity of rubbing in the mercurial
ointment exactly upon the part where the metal must by means of the
absorbent vessels pass through the swollen gland, seeing that in many
cases there does not exist a sufficiently extensive surface of the kind
required for effecting this rubbing-in ; as, for example, when the bubo
is seated near the body of the genital organ or close to the pubic
region in males, or on the round ligaments of the uterus or betwixt
the labiA &Qd thigh in females.
896. But even this result of doubtful value could often not be
effected by the rubbing-in process performed on the most convenient
spot, (for example, on the thigh when the buboe was seated below
Poupart's ligament), it often remained hard and swollen without going
on either to resolution or suppuration ; lues venerea might thereupon
ensue or not. The virus often only lies latent in this indurated gland,
and often breaks out visibly when the inunction treatment, which
debilitates by long-continued irritation and violent evacuations, is
discontinued, and the scrofulous diathesis excited by it is removed.
397. If however it be frequently powerless to cure a single buboe,
how often must this be the case where there is a buboe on each side,
where even the most zealous advocate for the rubbing-in system
would not venture to rub in as much mercury as would suffice to dis-
perse the buboes and destroy the virus in the whole system, as the
quantity of mercury that would be required for such a purpose would
ruin the constitution.
396. Moreover, the rubbing-in of the Neapolitan ointment at a
distance^ will at the utmost only succeed in dispersing a slightly in-
* I hare elsewhere shewn the deceptive character of the sign of the extinction o{
the Tims drawn from the severe affection of the mouth by mercury.
' In cases where there is no surface of the body betwixt the place of absorption
of the poison and the buboe fitted for the rubbing-in, it has been the custom of some
to perfcrm the <^p6ratioii oo the buboe itself; but they did not oonsider that the
84 ON VENEBEIAL DISEASES.
flamed buboe, but not one of any considerable size that is on the point
of suppurating, far less one that is already in a state of suppuration;
on the contrary, a long continuation of the inunction not unfrequently,
makes the buboe, when at length it suppurates, an unhealthy, fistulous,
corroding ulcer.
399. Now as every physician who has skill in his profession has
recourse to the internal exhibition of mercury when there is betwixt
the place of absorption and the buboe no suitable place for rubbing in
the ointment, or when two buboes are present at once, when suppura-
tion has already commenced in the buboe, or when after repeated
employment of the inunction method for buboes and their consequences
there still ensue symptoms of lues, what is it that prevents him from
employing it alone at the very commencement, in every case of
buboe^, if it be not partly that he has overlooked those objections to
the rubbing-in system, partly that he has sometimes found his calomel,
his corrosive sublimate, &c., inefficient and uncertain, or in a word, if
it be not because he has not been acquainted with such an excellent
preparation as the soluble mercury is 1
CHAPTER III.
TREATMENT OF BUBOES.
400. The same reasons* that have induced me when treating of
chancre to refer to the treatment of lues, lead me to do the same in
the present case in reference to the employment of the soluble mercury,
as neither more nor less is required for the cure of the one than the
other, namely, a sufficiently severe mercurial fever (§ 290), taking
care to avoid all the hindrances to the cure, as I shall hereafter (§ 573
— 613) endeavour to show how.
401. For the reasons given above we must avoid all external reme-
dies, all lubbings-in of ointment ; we must discard all other mercurial
preparations which are either inefficient or uncertain in their operation,
and make use of the soluble mercury in preference to all others. We
can employ it in all stages of the inguinal swelling, at its onset, when
ointment cannot in such a case p^ietrate through the lymphatic vessels directly to
the empoisoned gland, and that the friction on this place would tend to piomote that
inflammation and suppuration that was sought to bo avoided.
' In order to mamtain the excellence of the ointment at the expense of the
internal employment of the mercury, instances are adduced where, during the use of
the latter means, buboes are said to have appeared, without the chancre being
removed by local remedies. A careful examination of such cases, however, wfll
shew ihat the chancres were not left without local applications, to which however
the mjurioua power of increasing the absorbing faculty of the lymphatic vessels wa«*
not ooDsidered to be attributable.
' In order to avoid repetition.
BUBOSS. 85
it swells, and eyen when it is suppurating.^ In the first and second
cise, on the occurrence of the factitious fever the buboes decrease and
disappear (the sole and most certain sign of the true cure and complete
extinction of the miasm) ; in the third it has often, contrary to all
expectations, produced its dispersion,' and even when this was no
longer possible it hastened the concoction of the pus, and the abscess
was a pure healthy ulcer that soon healed up, almost without pain and
without any ulterior consequences, for in this case the virus was at the
flune time destroyed, which is the final aim of all treatment for venereal
maladies.
402. When, in such cases, I was convinced of the impossibility of
resolation, I first excited a slight commencement of mercurial fever.
I then discontinued the medicine, and as soon as the buboe, afler having
krst in a healthy manner, commenced to heal up, I excited by means
of rapidly increased doses of soluble mercury, a second more severe
mercurial fever, which effected the cicatrization and the complete
eradication of the virus. Lint dipped in milk is the best compress to
employ.
403. If called on t^ treat a buboe of long standing that is already in
a state of unhealthy suppuration,^ we must first ascertain the cause
of its malignant character before we proceed to the administration of
the soluble mercury. If it have been mistreated with emollient local
remedies, we must einploy balsamic digestive remedies (composed of
mjrrh, yolk of egg and cocoa-nut oil) or a mixture of decoction of
oak bark with wine ; if the ill-effects were caused by irritating and
corrosive substances, we must have recourse to the local use of opium ;
' When Girtanner eajs, ''During the suppurative process mercurial preparations
irehigUj mjmious. As long as the patient is taking mercury, not only does the ulcer
not heal up, but it becomes aggravated and more virulenf*, he either means — ^but
this ooQstruction the sentence will not bear — an ancient buboe degenerated under an
excessive employment of mercury, or, as that cannot be his meaning, he intends to
disoomtenance an irritating, ineffectual mercurial treatment of the ordinary ^tamp.
Be iroold inroWaWy have seen the reverse from a mercurial fever rapidly developed
hj soluble mercury. In that case he would not have needed to expose his patients
to the risk of having lues venerea, as he now does, when he forbids the employment
<tf mercury not only during the suppurative process, but even after the buboe is
healed up, " until symptoms of syphilis display themselves." Why this delay if his
fcrmer maxim (p. 250) be correct, as it undoubtedly is, " that syphilis always super-
venes if we allow the buboe to come to suppuration** I If given before this period
(previous to the appearance of the syphilis)," he says further on, ** it has absolutely
00 ether efifect than to debilitate uselessly the patient's system.** How I pity every
booest man whom the badness of his mercurial puts in such a fright that may be so
prejudicial to his patients.
* Certainly the most desirable termination of the venereal glandular swelling, if
it can be effected along with the simultaneous eradication of the miasm (§ 420).
' In all cases of abscesses of glands, especially in unhealthy ones, we should take
tspecial care to avoid the use of emollient and relaxing applicatioDS.
86 OK VEKEREAL DISEASES.
but if the whole constitution be ruined, this obstacle must be previouslj
removed as much as possible, in the manner detailed below (§ 573^-
585), if we would obtain rapid and radical aid from the mercurial
treatment ; above all we should seek to remove the debility and the
irritability, which has probably been caused by the long-continued
employment of an excessive quantity of mercury and by the accessory
treatment usually employed in conjunction with it.
404. We have to remove almost the same obstacles, and to employ
almost the same preliminary treatment, where a long-continued inunction
of Neapolitan ointment or other inappropriate external remedies have
produced induration of the inguinal tumour. We should endeavour
to remove the irritable, weak and scrofulous disposition by means of
bark, opium, cold bathing, exercise in the open air, gentle emetics, burnt
sea-weed and volatile alkali, and we may employ externally with
advantage douches of sal-ammoniac dissolved in vinegar, dry cupping,
and sea bathing,' in order to disperse the induration. If there be still
relics of the virus present, the internal administration of the soluble
mercury, after the system is improved, will hasten, the resolution.
405. Multiplied observations have established it as a maxim, that it
is best to let a buboe that has suppurated^ burst of itself. It is the least
painful process ; the opening that is formed allows a free passage to
the pus, prevents the suppurating buboe from closing up too soon, and
leaves the most inconsiderable cicatrix.
406. Should we deem it advisable to make an artificial opening, we
ought, according to the advice of the most eminent authors, to give a
preference to the caustic potash, which is said to give much less pain
and to make an opening of a more lasting character than the knife*
The wound that remains is said to degenerate into an unhealthy state
much more readily when the knife is used than when the caustic is
employed. But be that as it may, the caustic makes an opening
much more suitable for the discharge of the pus, and one through
which we can more readily observe the internal character of the ab-
scess, and manage it more conveniently, as Franz Renner^ long ago
taught.
407. It is only in cases where the opening of the buboe from other
' Girtanner recommends volatile ointment to be rubbed in.
* We may hasten the process, if it should advance too slocwly, by applying warm
roasted onions, boQed in soap water ; or where the inflammation is greater by vene-
sections, leeches to the part, and emollient fomentations impregnated with saffitn.
' ''When the buboe is rod and soft to the fieel it should be opened. I seldom do
this with fleam, lancet or knife, but generally by the application of lapis caustic, so
as to make a pretty large opening, in order to allow the waste and impurity to be
the better diacbaiged ; and in this way we can obtain a much better view of what is
going on in the interior than by any other method, and can evacuate and cleanse the
abscess more oonvemently,'* <{sc. {Mn new HandUoMin, 4toL, NOrxiburg, 1559» p 940
BUBOES.- 87
important reasons 1)66011168 a matter of urgency, and when the abscess
is ripe and ready to burst, that the knife should be preferred to the
ouitieL
406L But as thesnitable employment of mercury often succeeds in re-
nlring buboes after suppuration has commenced, or when that js not
possible^ fiualitates and hastens their bursting, I scarcely ever find it
nquifflte to open them*
409. I have never required to make use of the resolvent power of
emetics, useful though they undoubtedly are, along with the soluble
meieary.
410. When it is doubtful whether a buboe arises firom the sympa-
tMc irritation of a declining gonorrhcea or from the true metastasis
of yie venereal poison from chancres, it is always advisable, before
lesQitiiig to the employment of mercury, to try the effects of com-
piOBes moistened with ice-cold water, which speedily disperse that
arising from the sympathetic gonorrhoea! irritation, but have no effect
on the true venereal one, or at most will prevent it from anticipating
the resolvent powers of the soluble mercury by too rapid inflammation
ffid sappuration. If we should consider it still practicable to disperse
a Teoereai buboe, we may employ some other expedients in addition
to the administration of the soluble mercury. A cool, hard couch,
leedies applied near the swelling,^ and ice-cold water compresses will
be found serviceable.
PART SECOND.
SYPHILIS.
FIBST DmSION,
DIAGNOSIS OF SYPHILIS.
CHAPTER L
DrrRODUcnoN to the diagnosis of syphilis.
411. When the virus that produces the local affections of chancres
gonorrhoea and buboes, is absorbed into the general circulation, it
gives rise to an universal disease of the body, whose visible effects
may shew themselves on all the external parts ; with the exception
probably of the seat of the previous gonorrhoea and the situation of
the former chancres and buboes.
412. When thus assimilated to the body, the virus changes its
Mtnre almost entirely : from being previously a violent, rapid, pain-
ful, inflammatory (very infectious) virus, it becomes (with the excep-
' Girtaonier advises the mbbing-ia of volatile ointment beneath the gland
88 ON VENEBEAL DISEASES.
r
tion of the affections of the tendons and bones) almost painless, slow
and insidious, and the more insidious tl)e longer it has lain latent in
the body ; it no longer gives, rise to chancre, gonorrhoea or buboe,'
either in the same body or in that of another individual, by innoculation.
413. The venereal virus cannot be communicated to and incorpora-
ted into the general fluids of the body otherwise than by absorption
from one of the two local affections that are caused directly by local
infections (gonorrhoea ? and chancre), and from them alone can buboes
(the precursors of lues) arise ; some rare cases excepted, where the ab-
sorption occurs from an unaffected part, that is to say, where the chan-
cre-virus penetrates into the circulation without injury to the epidermis.
414. According to Hunter, out of 10,101 persons affected with
lues, in one case at the very moist might the virus applied to the glans
have been absorbed into the system without giving rise to local symp-
toms. A hundred of these might be infected by the absorption of the
poison from gonorrhoea, whilst 10,000 receive the lues venerea by
the absorption of the virus from chancres, almost always in conse-
quence of their merely local treatment.
415. In the stomach the chancre virus is digested without infecting
the system, as Huhter found. Neither the breath nor the perspiration
of individuals affected with the venereal disease communicates syphi-
lis to healthy persons.
416. Where the disease has been communicated to mothers by
persons employed to suck out the milk, and to nurses by strange in-
fants, this happened by means of chancres on the lips, which produced
similar ulcers on the nipples, then buboes in the axilla, and thence
syphilis. Nurses, by giving their breasts on which are chancres or the
chancre virus to their infants, cause the latter to have chancre on
the lips, 6zo, Mothers inoculate their children in the act of
parturition ; the chancres or gonorrhoeal matter in their genitals is
rubbed in through the tender epidermis of their bodies, or penetrates
into the genitals, mouth, eyes, nose, or anus of the little creatures.
The virus of general lues is not communicated to the foetus either by
the semen of the father or by the blood of the mother ; and just as little
is the pus from general venereal ulcers capable of producing either
syphilis or idiopathic venereal local affections by moculation, accor-
ding to the observations and experiments of Hunter and some others.
417. Simple wounds in persons affected with syphilis may be treat-
ed and cured by the ordinary vulneraries ; the general venereal virus
in the system apparently does not complicate them, perhaps because
the syphilitic poison itself determines the places where it shall break
out.
* The caises that seem to shew it can do this are not quite clear ; on the contrary
they admit of a good* many obj^ctioos and doubts.
DIAGNOSIS OF SYPHILIS. 89
4 IB. Hie nmture of syphilis consists in a peculiar irritation of a
^pedfio diameter distributed throughout the whole organism,^ which
gives rise to divers local changes and symptoms that are accompanied
by an insidious, scarcely observable inflammation, and which shews
itsd^ but only in sensitive individuals, by a slight fever with uneasi-
neas,* sleeplessness, anorexia, headache, and so forth. This fever ap-
pears at first to be of a rheumatic character, and then gradually de-
generates into hectia The fever may be present before the local af-
fections break out (and then it is easily curable by mercury), or vice
versa.
419. Syphilis may be disposed to break out more rapidly by all
torts of derangements of the system, chills, overheatings, fevers, and
the like ; and on the other hand, scrofula, gout, rheumatism, erysipelas,
dEC, may be excited by its irritating action.
420. The tendency of this disease to 'be roused into activity and to
luive its symptoms aggravated, in an especial manner, by cold, is
diewn partly by this, that in hot countries it is far from spreading so
r^idly, and does not attain nearly the height, and can also be more
readily cured than in colder climates ; partly also by this, that the
symptomatic venereal local aflections appear only on the external sur-
&ee of the body, and chiefly on those parts that are most exposed to
the cold air.
421. Although, as has been observed, all parts of the body seem to
be infected by the lues venerea at once, yet some local aflections ap-
pear usually sooner than others. The former may be called those of
a proximate^ the latter those of a more remote kind ; the latter general-
ly occur at a much later period than the former, often only after these
are healed, and then the susceptible part is probably, before their out-
break only, in a state of simple infection.
422. Before proceeding to an enumeration of the local affections, I
must observe that the older authors, and even those of the most re-
cent period, indicate such a large number of symptoms and modes of
breaking out of syphilis, that one is uncertain whether they have been
deceived or have sought to deceive others. All kinds of cutaneous
eruptions, ulcers, indurations and swellings of the fluid, soft and firm
parts of the bones and ligaments, all conceivable diseases of the
brain, nerves and viscera, in a word, all maladies of the body that
did not yield to a slovenly system of treatment were pronounced
to be venereal.
— J - m m - — iri---— r---
' Perhaps only in the lymphatic system ?
* There ia usuaUy an anxious solicitude about the incurability of the enemy within
and iti deraating progress. With grief they see the poison that nature is unable to
•fmdicate gradually preying upon their organism, nor is it possible to allay their
anxiety by reaaoning with them, nor to comfort them.
90 ON VENEREAL DISEASES.
423. This multiplication of pretended venereal symptoms dates
from that remote period when no proper attention was paid to the
course of this disease, and when ignorance of the diagnosis and treat-
ment of chronic diseases was concealed under an array of names that
were either pure inventions or had no definite meaning attached to
them: they were attributed to magic, to the omnipotent influence of
sidereal influences or of the Archaeus, to the morbific principle of the
acids, to hypochondriasis, to piles, to spasms, to the venereal disease, to
infarctus, &c., for the purpose of enabling physicians to include them,
with a good grace, in the list of diseases excessively diflicult to cure,
and so to obtain for an uncertain art a surer footing with the uninitiated,
to give it a more important air and to increase the profits of its
professors.*
424. In addition to this, everything that did not yield to the
general mode of treatment by purgatives and venesections, but
was cured by salivation, was said to be of a venereal character, be-
cause it was assumed that the latter alone were amenable to salivation.^
Dropsies, hydrocephalus, cutaneous aflections, old scrofulous ulcers,
pulmonary consumptions, inveterate agues, dec, were cured by saliva-
tion, and thereupon these maladies, by this mode of reasoning, were
pronounced to be venereal affections.
425. In order to escape from this labyrinth of opinions which com-
plicated to such an extent the true nature of syphilis, and so effectu-
ally ef&ced the boiindary line betwixt truth and error, we shall
proceed upon the safe path of scepticism, and only describe those
symptoms of syphilis the genuineness of which is not called in ques-
tion by any writer of eminence or practitioner of experience, but shall
pass over in silence all other alleged symptoms, until indubitable facts
shall remove all doubts as to their hitherto assumed origin.
CHAPTER II.
DIAGNOSIS OF SYMPTOMATIC VENEREAL LOCAL AFFECTIONS OP
THE MORE PROXIMATE KIND.
426. The most certain symptoms and local affections of syphilis of
the more proximate kind are the venereal spots y among which we may
include venereal pimples, ulcerations of the skin and mouth, onychia
and rhagades on the hands.
427. From six weeks to several months, at most — and that rarely
' [These remarks indicate the lack of oonfidciice entertained by Hahnemann, at this
early period (1789), reelecting the valne of allopathic theoiy and practice.] — Am, P.
' Hence the work made about so-called masked syphilitic diseases and their
vaunted ctu% by mercorials, generally by salivation. How were they recognised
beneath this mask ? Was not the inference drawn from the efficacy of ihe remedy f
By a similar process of ratocination obscure diseases may henceforth be considered
of a scorbutic character if they are curable by water-cresses.
DIAGNOSIS OF SYPHILIS. 91
u months after the presumed absorption of the idiopathic venereal
poiflOD, the skin of the anterior part of the body, first on the pit of
the stomach, then on the forehead, &oe, and so on, is observed to pre-
sent s bright coloured, spotted appearance. These spots become in
eonne of time of a definite form, rose-red and darker. On those
pirts the skin shines through the epidermis as if semi-transparent,
c^wdsUy in warm weather or when the body is otherwise very warm.
Tbese spots do not however project above the general surface of the
dm where they are located, nor do they occasion pain or itching.
There the lightest coloured spots gradually disappear, the darker ones
raniin and assume a round form of from four to ten lines in diameter,
h coarse of time the epidermis covering them scales off, and the spot
leems to be scarcely red any more. We might suppose it was going
iiraj entirely. But soon afterwards it appears again, the epidermis
again scales off, and this takes place several times successively.
The more frequently this takes place the more elevated (though but
ilig^tly so) the rougher, the more yellowish red^ and hard is the
epidermis that comes off; the spots then begin to be surrounded by a
vhiti^ circle. The warmer parts of the body, betwixt the nates and
betwixt the l^s, present redder spots than those exposed to the air.
428. The more frequently the spot throws off its epidermis, the
rougher, harder and thicker does it become, and then it is termed a
■cab (schorf).
4*29. Every scab that comes off is replaced by anew one of larger size.
430. At first the spot beneath the scab that falls off is dry, but at
last, when it becomes too thick to allow the exhalations to escape, a
humour is formed beneath the scab, which rapidly dries and forms a
scalj base.
431. Beneath the latter the skint)efomes corroded by the acrid humour,
and after several scabs have been thms thrown off there occur open vene-
real ukers,
432. These spots are frequently seated at the borders of the hairy
parts of the body, on the chest about the hairy part of the axilla, on
the temples, round the forehead and behind the ears, at the border of
tbe hairy scalp, at the circumference of the hairy parts of the genitals,
and so forth ; also betwixt the shoulders, and then the hairs fall out
from those parts ; also on the beard, the eyebrows, &c.
433. In the palms of the hands and soles of the feet they also throw
off one layer of epidermis after another ; on account of the natural
thickness of the latter no scabs are formed in these situations, but the
furrows in the skin termed the lineaments at last crack, the epidermis
^llts and forms raw chaps, which go by the name of venereal rhagades,
434. On other parts of the body also, as has been said, there occur
no dry scabs of the above described kind. If, for instance, the spots
^ Tliey are Uieo called n»t ipots (copper-coloiired spots).
92 ON VENEREAL DISEASES.
are on parts that are usually covered by other parts of the body op-
posite to them, betwixt the nates, betwixt the scrotum or the labia
majora and the thigh, in the popliteal space and under the arms, where
the transpiration is more copious, they do not become covered by a
dry bark, but are invested with a moist greyish white substance,
through which a humour exudes.
435. When, as is not unfrequently the case, venereal spots occur
beneath the nails of the fingers, they also shine through of a red co-
lour. Gradually the root of the nail is affected, the nails fall off, and
a new, irregular, imperfect one appears. If no remedial means are
used, then venere^il ulcers are formed at the root of the nails, which
are called venereal onychia.
436. All these cutaneous affections, even afler their transformation
into scabs and ulcers, are wonderfully free from pain.
437. The so-called venereal pimples or venereal itch are just as little
sensitive ; they arise from small, reddish spots, much less raised above
the skm than other pimples ; they have not such dark areolse, and
neither itch nor burn. They appear mingled with the copper-coloured
spots on the forehead and other parts. Some are deeply seated in the
skin, and these produce bran-like scales ; others, though also seated
deeply in the skin and in like manner small and red, possess a hard-
nees like small buttons, and there exudes from their apices a small
drop of reddish coloured lymph.* It is only on those parts of the
body that are covered by other parts, in the flexures of the elbows and
knees, 6z;c., that they are somewhat painful and exude more moisture.
Just as, on the external surface of the body, the general venereal ul-
cers above mentioned gradually arise from venereal spots, so is it with
the ulcers in the throat and mouth,2#which on account of their earlier
appearance I shall treat of before the ulcers of the skin, although they
resemble each other in their essential nature.
^ They may be distinguished from so-called heatspots and other pimples on the
skin by the latter forming small abscesses, or soon dispersing and disappearing wiQh
out causing any change in the skin, as Girianncr rightly observes.
' Andr^ docs not regard ulcers of the tonsils as a sign of general lues, but as m
idiopathic venereal affection or something similar, that, is to say, as a transference of
the chancre to these parts, because he says that the chancre on the genitals manifeelij
declines when the ulcers on the tonsils appear ; that the latter occur bood after
the disappearance of the former ; that tonsillar ulcers frequently occur without any
other symptom of syphilis, and that, like chancres, they are capable of produdng
local infection, as for instance by kissing. The first proofs are of no value, eveo
though they were correct, if the power of causing local infection be not certain wfaiGh
we have great reason to doubt Moreover, this does not agree with the observation
that chancres, whenever the poison for the production of a buboe (meet assuredly an
nicer very analagous to the chancre) has been absorbed, are not always thereby in
the least ameliorated ; they may cause all this and still go on increasing. Now aaall
DIAGNOSIS OF SYPHILIS. 98
488. The dark-red, painless spots on the tonsils of the throat, at
the back part of the inside of the checks, on the palate, on the lateral
aspect of the tongue(in the angles of the lips ?) are oflen, on account of
their want of sensitiveness, not observed, until, afler frequent, gene-
rdly unnoticed throwing-off of the thin epidermis, they become some-
whtX elevated, and until a moist, whitish crust covers the part, which
caimot be wiped off, becomes thicker and thicker, and eats more and
more into the subjacent substance.
489. In these soil, warm, moist parts covered with such a thin
epidermis, the venereal spots pass much more rapidly into ulcers than
vfaen they are seated on the more external surface of the body, and
their transition into tonsillar ulcers is at first so little observed, both
(m that account and because they are not particularly perceptible to
the feeling or the sight.
440. When their tough crust falls off from the motions of these
ptrts, swallowing, d^., or from an impulse from within, we observe
somewhat excavated round ulcers, with well-defined whitish borders.
441. These venereal ulcers of the throat are so little sensitive that
they do not cause any actual pain, but only on swallowing a feeling
of rawness and slight shooting as if the outer skin of that part had
Qome off; the part whereon they are seated too is neither swollen nor
hofci their circumference and base is not hard, as is the case in other
ulcers of the tonsils, quinsy, (Ssc. Still these ulcers spread more
rajudly and are a little more sensitive than the other general venereal
cutaneous ulcers on the surface of the body. In some few cases they
' impede speech a little.
442. The tonsils^ are usually the first (and in most cases the only)
parts of the mouth that are affected by venereal ulcers.
443. Sloughs or ulcers in the throat that do not occur till a year
afler the disappearance of the idiopathic venereal local affection (e, g,
a chancre) do not seem to be of a venereal character.
444. Venereal spots on the skin last several months before they
form scabs, and these again some months before they penetrate suffi-
tbe drcumstanoes whence the physician must draw his inferences of this kind, in gene-
nl ioTQlye to such a degree the honour of the patient, our mquirics will often clidt
the most downright falsehoods on the part of persons otherwise of most trust-
worthj character. The ulcers of the tonsils are of the same nature as other symp-
tooatie Tenereal ulcers, whoso great difference from chancres may be readily per-
esved by comparing the description of chancres (§ 260) with that of ulcers of the
toBBlB (§ 438—447).
* Scorbutic ulcers usually attack first the gums, which then bleed very easily, be-
foR ih/ej reach the tonsils ; they are not like the venereal ulcers of a defined round
fcnn, (hey have no whitish borders, no whitish grey excavated bottom ; on the con-
trary, they are angular, bluish and filled by spongy looking flesh ; scorbutic ulcers
an ■ooompaoied by other symptoms of scurvy, and renereal ulcers usually by
cynptoms of syi^iilifl.
94 ON VKNEREAL DISSA8BS.
cienti J deep to constitute open cutaneous ulcers, so that the latter often
only appear from ten to thirty months after the absorption of the
chancre poison into the general circulation.
445. Although the venereal cutaneous ulcers usually arise only
from the scabs of the venereal spots and from the venereal pimples,
appearing as discrete ulcers, from six to ten lines in diameter, chiefly
confined to the anterior surface of the body, first in the forehead and top
of the head, in the face, alse nasi, on the muscles of the neck, &c., but
afterwards also on the legs, principally over the tendinous expansions
(fascial) ; yet this is not always the case, for when the spots are seated
very closely together, the small ulcers unite to form a larger one whioli
has sometimes a diameter of six inches, as I have not unfrequently
observed upon the vertex and forehead, on the sides of the neck and
other parts, as also on the legs. But even when as large as this they
retain as much as possible the rounded form.
446. On other parts also where spots are but rarely observed, e. g,
on the body of the penis, we see venereal ulcers occur, which however
differ from those lying on muscular parts or bones in being somewhat
more sensitive and painful; they increase more rapidly in extent, and their
red bottom, covered with small elevated fleshy granulations, becomes
raised, like a cancerous growth, almost above the borders, which are
however neither everted nor discoloured, nor hard, as they are in
cancer.
447. On the other hand, the other general venereal ulcers on firmer
parts already alluded to, have some, though but a shallow depth,
oflen only one line,* still oflener but half a line of depth. Their
bottom, which is rose-coloured, smooth and firm, spreads out in an
undulating manner, is raised slightly towards the borders, that are
almost level with the sound skin ; there is no perceptible inflammation
nor hardness about the borders nor surrounding them. They have
this peculiarity, that they almost always retain their round form. They
are distinguished by the indolence of their course : they arise gradually,
without any previous symptoms of inflammation, itching, burning, &o.,
out of copper-coloured spots and venereal eruptions, are accompanied
by very insignificant pains, even when of considerable extent ; they
secrete a thickish not viscid matter, like melted tallow, and of a pale
green colour ; they are sometimes covered with a cheesy substance. .
They may sometimes be healed up by means of astringents; but then
others occur in other parts. As a general rule the general venereal
' Besides the skb they appear to destroy only the cellular strocture wmt^nwy
the £Eit» at all events the depressed, hard, shining cicatrix appears to be close^
united to the underlying solid parts, e. g, the musde, and the latter loses its power
of movement The haizs upon the seat of the ulcer do not again grow, an their
roots are destroyed.
DIAGNOSIS OF SYPHILIS. 96
ulcers on the head, ^sc (the parts nearest the heart), heal up before
those on more distant parts, e, g. the legs, just as at first they appeared
sooner on the former than on the latter parts. Does the healing up
of a portion of such ulcers give evidence of a diminution of the syphi-
Dtic Yims (I believe it remains the same), or does the cause of the
phenomenon consist in this, that these parts have at length become
insensible to the venereal irritation, whilst the newly attacked parts,
imaociistomed to this irritation, have more susceptibility for it? The
first general venereal ulcers, for example those on the tonsils, are
more sensitive and spread more rapidly, and the other symptomatic
venereal ulcers become all the more indolent in their extension, and
ill the less sensitive the longer the virus has existed in the body.
(Even gonorrhoeas become all the milder the oftener they occur in
^ same individual, and he becomes less susceptible to infection.
lliese are facts that demonstrate a predisposition for the poison, which
the above serves to explun, at least to illustrate). General venereal
vkers do not propagate by inoculation either idiopathic venereal virus
or lues venerea. All these circumstances are sufficient to distinguish
them fiom all other kinds of ulcers.
448. Pulmonary phthisis occuring without haemoptysis and during
the existence of evident local afiections of syphilis that has not been
treated medicinally,^ should be regarded as venereal in its nature. —
When 1 said that lues venerea only attacks external parts (according
to the best observations), venereal phthisis is no exception to this.
The lungs have, in reference to the air that surrounds us, a great re-
semblance to the external cutaneous surface ; their transpiration is
even greater, and they are oflener exposed to the cold of the atmosphere
(on account of the frequent respirations) than the skin ; why then,
seeing that the lungs are obnoxious to similar diseases,^ should we
hesitate to believe that in this case they will also follow the nature of
tike skin, and on account of their frequent exposure to the cold air be
liable to venereal eruptions and ulcers 7^
* We migfat add : which, along with the syphiUs may be rapidly and radically
oved \rj aiinple mercarial fever, without any need for Balivation. It has also some-
timei cored noo-reoereal phthisis by reTulaion.
' Tarious cotaiieoQB emptions are accompanied by chest diseases, and the driTing-
in of the former is often followed b^ the occurrence of the latter.
' A poor woman, forty years of age, had had for some years seyeral venereal ul-
cat OD the hairy part above the forehead and on its upper part, also occasionally a
<^ OQg^ Id the year 1787, these ulcers having been healed up by means of mer.
cvial plMters, the anterior part of the thigh and leg became affected with many ul-
<A of the same kind. She also applied various things to these parts, and a number
<if than healed np^ She now became affected by a more violent cough, great dys-
poiBa and moderate fever, that was ameliorated on the occurrence of pmiilent ex-
P^ctontioa Hie ezpectoratioii was very copious ; her strength did not, however
96 ON YENSRBAL DISEASES.
CHAPTER III.
DIAGNOSIS OF THE SYMPTOMATIC VENEREAL LOCAL AFFEOTIONB
OF THE MORE REMOTE KIND.
449. I have already stated that these affections usually occur many
months and even some years after the absorption of the idiopathic ye-
nereal virus, oflen after all the affections of the proximate kind are
healed and gone, sometimes by topical applications, sometimes by the
internal employment of mercury in quantity sufficient to cure them,
but not to eradicate the infection in distant parts. Sometimes they
occur along with affections of the proximate kind, seldom without any
pre-cxistence of the latter so as to constitute the sole local symptoms
of lues venerea.
450. Li all cases the symptoms of the more remote kind testify to
the greatest obstinacy of the syphilitic virus, which has become as
chronic and insidious as possible.
451. In this case also the nature^ of the poison betrays itself by its
usual course of selecting those parts of the body for its seat which lie
nearest to the cold atmosphere.
452. The tendinous expansions (fasciae) and the periosteum on
those bones that are of the hardest structure and not covered by mus-
cle (consequently the coldest), on the bones of the skull, especially
the most projecting parts of the parietal and frontal bones, on the dor
sum of the nasal bones, on the anterior flexure of the clavicle, on the
coracoid process, on the external protuberance of the elbow (more
rarely on the internal one), on the anterior surface of the tibia, seldom
on the ribs, become gradually enlarged by a hard swelling, which either
extends without any well-defined limits, or is of a circumscribed round
shape (venereal nodes). It is, especially in the former case, so hard,
and is so closely attached to the bone, that one would take it and it
has been considered as an osseous tumour.
453. These tumours and nodes are at first unaccompanied by pain,
and are usually not noticed until with the lapse of time pains occur
in them, that gradually increase in severity, so that it seems to the
patient as if the bone were hacked to pieces or crushed, as if it con-*
sisted of two dry pieces that were rubbed against one another, or as if
dimioish proportionably ; the ulcers on the legs were still present in considerable
numbers, but, as she said, without pain. I made her lay aside the plasters and take
in the course of eight days six grains of soluble mercury in increasing doses. She
became affected by severe sickness, disgust at food, and a feeling of illness that she
could not describe, but without a trace of ptyaUsm. She was at the same time ooe-
tiye in the bowels. In the mean time the cough and expectoration went ofi^ the
breathing became as free as if she hadnever ailed anything in that respect Hie
ulcers were healed up in the course of fourteen days after the first dose of the reme-
dy, and for fourteen months she has been quit« free from all venereal and chest af-
fSoctioDs.
DUiQNOBIS OF STPHILI& 97
sometluDg were gnawing therein. Thej oooor in greatest intensity at
aigiity espeoiallj towards the morning, but in some rare cases they
are equally severe during the day.
454. At this period the swelling is very painful on being touched.
At first there does not seem to be any inflammation ; but in this later
stage it sets in and increases ever more and more, until at length the
swelling gradually — often some years after its first appearance — bursts
and discharges an albuminous-looking matter.
455. In these circumstances the subjacent bone is almost always
corroded, on account of the destruction of the periosteum, or at least
it is very nearly approaching to a carious state and is swollen.'
456. It IS, however, difficult to determine the time when the node
' Id Older that we may be able to treat these swellings in time, we most be satis-
fied of their yenereal nature, which is sometimes difficult In order to aid our diagr
nods, the foDowing drcumstanoes should be attended to. — Rheumatic swellings of the
boDSB. and pains, usually occur at the joints where the osseous structure is spongy ;
ftej ire preceded by redness and inflammation of the superincumbent soft parts,
puD snd ferer,aDd when these symptoms, which are usually of a sudden diaracter
lie put, then only does the node commence to deposit its calcareous matter ia the
jgMttfnts ; gradually it becomes free from pain. Cold baths, frictions and aoooite
dimmdi and remore commencing rheumatic nodes. Bj warm applications to parts
iftcted with rheumatic pains» the pain is ameliorated ; cold baths are a good remedj
iiortbem. They are not only not diminished (permanently) by the most violent mer-
cund ferer, on the contrary, they are thereby aggravated and rcndured more obsti*
uMie and incurable. Distilled spirits cause fever, but no pain in the rheumatic
oodes.
Tenereal nodos and periosteal swellings, on the other hand, are seated in the parts
iDificited above (§ 452) of the bones of densest structure, probably never on the
capnks of the joint& At their first appearance they are quite destitute of pain ;
it it only afterwards that they are accompanied by it, without any perceptible local
roftunmstion, without swelling of the skin, and it increases so progressively that it
attaiiB at length such a d^ree of severity that the pains of the nodes not only con-
tinoe to gnaw uninteniptcdly (especially after midnight) but even merely touching
the part becomes quite intolerable. The contents of the swelling, when it is cut into
ire of an albuminous character. External warmth increases these pains in the
booes ; they are also aggravated by cold baths, by friction, and by partaking of ^•
rituogs liquora. Aconite and bitter vegetable extracts afford no relief. An adii*
^oately strong mercurial fever removes the pain speedily and permanently.
If a faithful confession of the previous infection be made, or if there are present
ie?eral symptoms of syphilis, we can the more speedily beo(Hne convinced of the true
latere of thfue nodes and pains in the bones.
The harometrical pains of the elevated cicatrix (callus) of an old .fracture of a
bone cannot easily be oonfiounded with the pains of venereal nodes, partly on ao-
omt of the difierenoe in the shape of the swelling, partly because the history of •
Ue ctte given by the patient helps us m our diagnosis, parUy also because the pains
of the callus usually occur when the weight of the atmosphere is diminished, and
iR more of a tearing and drawing than of a gnawing and boring character, and are
Mki ameliorated by the cold shower-batii, which increases those of venereal
aodo,
7
98 ON V£NSBSAL DISSABBflb
changes into the abscess which is fraught with so much danger to the
bone beneath. There is little inflammation present, and that which
may exist is too slight to produce a properly elaborated pus ; a thick
mucous albuminous matter is formed that lies close upon the bone and
corrodes it. This circumstance and the hardness of the node prevent
us perceiving any fluctuation.
457. But if wo carefully consider the inflammation, slight though
it be, and the throbbing and shooting pains experienced by the patient
in the centre of the node, it will not be impossible to discover the
formation of this kind of abscess.^
458. On no part of the body do the bones lie nearer to the atmos-
pheric air, in other words are covered with so b'ttle and such soft parts
as in the nose. Hence the delicate nasal bones are usually the first
that are acted upon by the venereal virus afler the soft parts cover-
ing them (the Schneiderian membrane) are completely or partly de-
stroyed. Generally the ethmoidal and turbinated nasal bones, that is
to say the most delicate ones, are the first destroyed ; then the vo-
mer, the palatial bones, and lastly the maxillary bones.
459. But as has been 8aid before, the bones beneath the venereal
nodes become also corroded, and necrosis is the result, which does not
differ from ordinary caries from other causes, except that it is more
rapidly cured by the aid of mercury.
SECOND DIVISION.
ANTI VENEREAL REMEDIES.
CHAPTER I.
MERCURIAL PREPARATIONS IN GENERAL.
460. Ever since the wide diffusion ^ of the venereal disease, imme-
diately afler the discovery of America, when mercury was apparently
at the first used for this disease, no one has been able to deny with
reason the specific curative powers of this metal in that fearful dis-
ease; although from the year 1515 until the middle of that century,
medical men having been frightened by the murderous employment of
* GaitUne includes among the symptoms of syphilb that scnsitivenesB of the
month of the womb which is increased to intolerable pain on the occurrence of the
catamenial period, on the introduction of the finger or of the male organ, and which
is frequently the cause of miscarriage (probaUj also of cancer of the womb.) I my-
self have frequently observed this affection, but am unable to determine if it is vene-
real as I have had no opportunity of treating it. Gardane recommends the use of
cinnabar fumigations for it
' Girtanner, by adducing the original authorities, renders it highly probable that
it first came from America in the year 1498, and was first brought to Barcelona by
the ships of Columbus.
AKTITSNSRSAL RXMBDIEa 99
that drag by empirical practitioners, sought to replace it, first by
goaiac, then by aarsaparilla and bark.
461. Bat as this liquid metal can only be brought by artificial pre-
paration into a fit state to be taken into intimate combination by the
flaida of our body ^ in sufficient quantity, so an infinite number of mer-
curial preparations were invented, the almost endless list of whose
names in the ancient dispensatories, especially those of Falk and Bald*
ingen, and in the London pharmacopoeia, fills us with astonishment.
ft would be sad indeed if only those who had extensively tested all
these mercurial preparations in their own experience were qualified to
treat the venereal disease properly. A long series of generations wore
not sufficient to do so. Strictly speaking, we require but one, the best
preparation. Had medical men always had in view the attributes of
such a one, based on true physiological and therapeutical principles,
they had not fallen into such adventurous speculations.
4&SL Now, how can we ascertain which among the innumerable
mercurial preparations is the most efficacious, the most certain, and
the mildest, seeing that in this pitiable disease wo should regard
Celsus's maxim of cito, tuto et jucunde as our highest aim, much more
than in almost all other corporeal JUs, which beneficent nature alone
it often able to conquer without any aid from man ?
463. I think I do not err, if, as an answer to this, 1 lay down the
following maxim, that that mercurial preparation is the most efficacious^
the most certain and the miidest, which is completely soluble m our juices^
can readily he taken up by the system of absorbent vessels, and not ren-
dercd corrosive by combination with any chemical substance^ is capable
of exciting the pure and simple specijic powers of this metal. Such a
preparation will possess the virtue of producing definite eficcts, which
it will be in the power of the physician to regulate, diminish and in-
crease with certainty.
464. The farther all known preparations diverge from these attri-
butes, so much the more inefficacious, so much the more injurious are
* Mercury does Dot act on the venereal virus until it is dissolved in our juices, and
then it develops its effects in a pretty uniform manner in the Becundse viae. Mer-
cnrial preparntiom that are not powerless all act upon the mouth, but with different
degrees of intensity ; pure quicksilver and corroiuve sublinuite letm powerfully than
the otherSb All produce the same taBte when dissolved in the saliva ; the saliva of
dme that are salivated has a similar odour, by whatever preparation the ptyalism
may have been produced. The greatest difference among them that is notice<l by
the superficial observer, consists partly in their greater or less solubility in water,
vhidi diflerH widely from the property they possess of being assimilated by our
joioe*, MB they possess this property in very various degrees, quite independent of
their mlnbility (thus the sublimate is much less assimilable by our juices than oz.
ydiaed mercury); partly in their action on the primie vixe (thus corrosive sublimate,
the yellow, white and red precipitates act chiefly in a poisonous manner oo the sto-
uiadi, calomel diiefly on the bowels.)
100 ON ymxxsKAL tmausKk
thej ; cinnibar and tnrbith may aenre aa examples. I shall briefly
pass in review the most ordinarj preparations judged by thia
standard.
465. As regards the corrosive mercurial medicines, it will readily
be granted that it is impossible there can exist in the mineral adda
to which they owe their excessive acridity, anything curative of the
venereal virus (for the dessiccant and antisceptic power that they dis-
play in wounds and elsewhere does not come into play here.) Among
these corrosive preparations I include the nitrate of mercury, the cor*
rosive sublimate, the various white precipitates,^ the red precipitate^'
calomel and turbith.^
466. If greater efficacy in this disease has sometimes been observed
from the use of these preparations than from the less active ones, thia
arose from the accidental irritant qualities of the acids combined with
them, but only in the same manner as other not specific irritant reme-
dies act, such as the volatile alkali, the acrid resin of guaiao, mezereum,
lobelia and cantharides — also from their exciting an accidental fever,
which sometimes promotes the cure of syphilis by mercury, by rous-
ing the activity of the nervous power, increasing the force of the dr*
culation, and thus as it were facilitating the detection of the recondite
virus by the only specific drug, or because, by setting up an irrita-
tion of a different kind, they silenced the venereal irritation, as rheu-
matic pains are subdued by blisters, dysentery by ipecacuan, or inter-
mittent fever by arsenic ; these substances thus remove afiectiona
without possessing any spedfio action upon the diseases just named.
467. But, as 1 have said, the borrowed irritation of these prepara-
tions is far from contributing materially to the cure of the venereal
affections ; it often smothers the spedfic power of the metal to such
a degree, and is so uncertain in its action, that it not unfrequently
happens that we may kill, but are unable to cure a patient affected by
inveterate syphilis, with calomel, sublimate, nitrate of mercury,- white
and red precipitates and turbith.
468. Were it easy to prepare mercurial salts with v^etable acids in
a ponderable definite form, it would be much preferable to adminis-
ter these than those just described. But this cannot be done, and,
moreover, such salts in a concentrated form have something in them
that exdtes the sensitive fibres of the prinue vise much more readily
to evacuations upwards and downwards than to absorp^on into the
' ' MayenMfWM, I bdiere, the first wbo in 1669 reeommended the inftemal use of
ordimury white predpitAte.
' Ahont the year 1686, Mattlnoli fini reoammended the intenud usecf red pre-
dlpitate (cskined sod washed a seoood time) fire gnins lor a dose. Aeoording to
OirtaDDsr, it was Joh. Vigo who firet emplojed it as early as 1618.
• WiUiam Ckiwes, was, I imagine, the first who in 1676 oonnselled the btvul
use of tuihith in syphilia
AXnyXNEKKAL SKKEIHSS. 101
secuiidBVUB, wliere alone the mereory is tnilj efficacioaa. Experience
also •hews that they readily cause nlivation, and still frequently iail
to effeet the cure.
469. On the other hand, as might be supposed, it is inadvisable to
employ internally for the treatment of syphilis the almost insoluble
mercurial preparations, such as cinnibar, Ethiops mineral, prepared by
the humid process, {puhit hypnolicus) or by the dry process, for they
usually produce no perceptible action, and then perhaps all at once,
though rarely, cause ptyalism.
470. The cause of this uncertainty may be, either that we are un-
able always to determine how much there is in these preparations ca-
pable of being taken up by our fluids, or what quantity there is in
ihem capable of penetrating into the secunds vias ; but this well-
grounded objection of uncertainty of action applies also to Plenck^s
mudlaginons preparation of mercury, and to those preparations in
winch the quicksilver is extinguished by sugar, honey, crab's-eyes,
fAtj substances, balsams, ^cc
471. If it is sought to lay the blame in such cases on the great
variety in the susceptibility of the absorbent vessels of the primse
vie, 1 reply that this very circumstance is to be attributed to these
preparations, that they are not of such a character as to enable them
to be uniformly received into the system by every degree of suscep-
tibility of these vessels, and I am fully convinced that the fault of
this occurrence lies in the infinite variety of the solubility of these
preparations in the gastric juice, and the extraordinary variety of
their capability for being taken into the secundse viae, and not in the
great difference of the solvent and absorbent powers of our system,
(whidi it is not possible to conceive can exist to such an extent.)
472. What there is of a servicable character in these latter prepa-
rations, consists in the proportion of mercury that has been oxydized
in them during their preparation ; but as this varies so much (accord-
ing to the nature of the medicine, the temperature of the atmosphere, or
the force, time and skill of the preparer) that sometimes the twentieth
part, but often scarcely the two hundredth part of the metal employed
is oxydized, it follows that we can never reckon confidently on obtain-
bg a certain effect ; these preparations must sometimes be almost in-
crt, while at other times, when the physician expects a moderate effect,
be finds the most violent action occur from their use.
473. Of equally uncertain effect are the mercurial fumigations,
vbether cinnabar, calomel, or amalgam be employed for this end,
partly on account of the difficulty of applying them equally to all
parts of the body at once, whilst avoiding a respiration of them, partly
on acoount of the very various absorbent power of the cutaneous
vessels. In the employment of this, as in that of the other merca-
102 ON YENERBAL DIBKAfllS.
rifils we hftTe mentioned, we are not in a position to oaloulate the
quantity of Uie metal introduced into the body, and yet we should
have a positive knowledge of the dose of the remedy as well as of its
potency, in order to allow us to make an accurate repetition of a
medicinal experiment.
CHAPTER II.
PARTICULAR MERCURIAL PREPARATIONS.
474. Mercurial ointment has been employed since the thirteenth
century in various forms, and with various admixtures, for the cure of
leprosy, itch, and other cutaneous diseases. At the end of the iifleenth
century it was at once employed to combat the venereal disease that
had then gained a fearful height, as it was held to be a similar cuta-
neous disease.
475. Its use has never been quite abandoned ; and notwithstanding
that attempts have been made from time to time to replace it by some
better internal remedy, as occurred in preceding centuries as well as
especially about the middle of the present century, yet it has at all
times been resorted to in extreme cases. In recent times also, afler
the fond dream of the omnipotence of corrosive sublimate was dis-
pelled, the ointment was again promoted to the rank of an antisyphi-
litic remedy.
476. The chief reason for the preference given to it, I believe, lies
in this, that it is imagined ; "1. That the greater the quantity ^ of
mercury that can bo introduced into the body in a given time, the
greater is the certainty of curing the venereal disease. 2. That the
metal when rubbed into the skin does not incommode the primjc vi®
like the preparations of mercury given internally : and, 3. That by
means of frictions we can apply the mercury exactly to the spot where
its presence is most required, in order to be efficacious."
477. It is very easy to refute these three maxims that have served
to obtain for inunctions such a great preference in practice. The first
is overthrown by the experience that the smallest quantity of mer-
cury, if it do but excite a sufficiently strong mercurial fever (§ 290) is
capable of eradicating the greatest degree of the most deeply rooted
syphilis, and that the subtle exhalation proceeding from the saliva of a
salivated person, which is certainly impregnated with a scarcely pon-
derable quantity of the metal, has sometimes succeeded in curing the
venereal disease. On the other hand, we often find that some almost
incurable diseases are the result of a larger quantity of mercury
gradually introduced into the body ; such as, irritability from weak-
ness, hectic fever, chronic trembling, scrofula, caries of the bones, and
' No other way was known of introdudng the largest quantity of mercniy into
the body but by meaoi of the ointment
AKnVSNXRKAL REKEBIES. lOS
90 forth, witlioiit the venereal poison being thereby eradicated. The
MooBd point it weakened by the observation that colicky diarrhoeas
not unfireqaently result from frictions with mercury. As regards the
tMrd maxim I have •already expressed by opinion (§ 887), where I
diewed that the mercury must first permeate the whole mass of the
Uood, and undergo a sort of digestion or intimate assimilation, before
it is capable of overcoming venereal affections, that, consequently, the
local power of this metal over the venereal poison is illusory, and often
does more harm than good.
478. But the following maxims, deduced from experience, irrefra-
gably demonstrate the doubtful propriety of employing frictions. 1 .
The quantity of metallic or oxydised mercury that can be introduced
into the body by rubbing in the ointment can not be determined, and
is entirely uncertain. 2. There are often obstacles that prevent the
nibbing-in. 3. The frictions are oflen not suitable for the disease.
4. They are frequently injurious.
479. In reference to the first point, it should be remembered, that
the power of the person who rubs in the ointment can never be de-
termined, can never be relied on. If strong rubbing-in favours the
the absorption, if it be done more weakly the absorption will be much
less. But if, as some allege, stronger friction prevents the absorption,
the same variety in reference to the quantity of mercury that pene-
trite* into the body will occur, but in the inverse ratio of the force
employed in the rubbing-in.
480. Be this as it may, however, this at least is certain, that when
the force employed in the rubbing-in is less, the oxydation ^ of the
minute mercurial globules, and consequently the solubility of this
metal in our juices, is not favoured to such an extent as by stronger
frictions. The same undeterminable variety in the demetallization^
of the mercury occurs also in the preparation of the ointment itself,
which is considered good when we can no longer see metallic globules
in it. How deceptive is this sign ! There are ointments of exactly
the same appearance which, according to the different manner in which
* I cumot say with certainty whether the rubbing employed in the preparation of
the mercnnal ointment oxydises the metal, or whether a combination of the latter
vith the £itiy adds occurs ; the Utter appears to me the more probable. This
t»veTer is certain, that it is only that part of the mercury that has become noo-
aennic in the ointment that is the really senriceable part against the venereal
nna
' Hie warmth or coldness of the ingredients, the hardness or softness of the &tfy
iubitaMe, the parity of the mercury or its adulteration with other metals (in the
hutr cate it is more easily nibbed down^ the employment or withholding of turpeo-
tiK, the force exerted l^ the preparer, his skill, and the time he expends oo its
pRpmtkm, render different specimens of the Neapolitan ointment extremely different.
tisiof^ they hare all the same appearance.
10^ OK ySNSBJBAIr JOB^J^EBi
they are prepared, contain from a two-hundredth to a thirtieth' part
of the metal in the non-metallie form. But in the Neapolitan ointment
it is only the mercury that has been oxydised by friction that is effi*
cacious against the venereal poison, whereas the metallic globules, even
though they be invisible to the eye, are absolutely insoluble in onr
juices, and only possess a mechanical propelling power. Who can
fiul to perceive here an infinity of unavoidable causes which may render
the power of the ointment on our system extremely various 1
481. The absorbing power of the cutaneous vessels is inconceivably
various, and caimot be relied on. There are skins so constituted that
they will not take up the ointment at all, and yet the physician is
unable to detect them accurately ; and on the other hand there are
some individuals on whoso skin if we but lay the ointment,' we cause
the most severe ptyalism. £ven in the same individual the skin la
more susceptible to the ointment under certain ou'cumstanoes than
under others ; and even one part of the skin may be more susceptible
than another.^
482. But admitting we always knew with certainty (although this
is incredible) what proportion of oxydised mercury the ointment con-
tained, and what quantity of it entered the system, how can we know
what length of time the vessels of the skin will take to deliver up their
contents into the general circulation, seeing that they are more active
at one time than at another, in order that, when the absorbent vessels
have scarcely brought their contents that just suffice to produce sali-
vation into the general circulation, we may not, by a fresh rubbing-ui
of the ointment excite an uncontrollable attack of this fearful excretory
process, before the mercury first rubbed in has commenced to act ?
483. With regard to the second point (§ 478) the frictions not un-
frequently cause, especially in delicate and sensitive individuals,
erysipelatous inflammations, desquamation of the epidermis or painful
itching herpetic eruption, ^ rendering their further employment im-
possible.
' A bealthy, veiy senatiye man was aftected with pecficoli on the hairy parts of
the genitals, and anointed that portion of his skin with a piece of Naples ointment,
the ose oi a hasel not, only once, and that quite enfierficiallj, without rubbixig it in
in the least Soon afterwards he had to make a jouniey during'Uie prsYalenoe of a
odd, moist wind. After the lapee of twenty-four hours he was attacked by nnooir
trollable ptyalism that lasted four weeks.
' What a quantity of ointment must remain on the patients linen, and on hSs skuii
and on the hand or glove of the person who performs the frictions, that we cannot
weigh, and thai must diffior in every case.
' These eflecte are not produced only by ointments mixed with turpentine.
Bandd fiitty matters produce them; and in all mercurial omtments the frtty matter
is already randd, probably because the metal absorbs its adds. The sudden oocor-
renoe of ptyalism prevents their further employment, and not lees frequently an yn
obliged to desist on account of their long cootmued inutili^.
ABnVZNSREAL B8MEDIX8. 106
484. Bat even were thie not the ciise, the cLreamstances of every
patient do not admit of our uBing this method. Not only its trouble-
■ome and repolsiye diaracter, neither of which are inoonsiderable, but
also its auspieioua diaracter ofVen forbids its employment, for the
prooesa of rubbing-in and the presence of venereal disease are so in*
timately associated in people's minds, and this operation is so difficult
to be concealed from all observation, that it exposes every patient,
whose good name should be a matter of inviolable sanctity to the
physician, to injurious reports of this kind.
485. With respect to the third point (§ 478) ; in cases of deeply
rooted syphilis that has existed a loug time, whose symptoms have be>
eome in the highest degree insidious and chronic, and are seated no longer
in the soft superficial parts, but in the tendinous expansions, or have
even attacked the pert«)steum or bones themselvss, where the virus is
obstinately concentrated, the rubbing-in of the ointment is very rarely
able to extirpate the disease.
486. In reference to the fourth point, or the injurious effects of the
mercurial ointment, we must bear in mind, that the frictious must be
continued for a long time in order to be of any considerable service ;
nd in that case the long-continued irritation exercised by such a large
qniDtity of mercury on the fluids and solids of the body, gives rise
tot number of chronic and oflcn incurable diseases, that are sometimes
worse than the venereal disease itself.
487. The fluids of the body become acrid, its fibres are thrown into
abnormal vibrations and relaxed, and the vital force is gradually
melted down to such a degree, that impaired digestion, sleeplessness,
debility, flying heat, hectic fever, chronic ulcers, caries of the bones,
tumours, scrofula, irregular rheumatic pains, and chronic trembling,
are the most ordinary results of this employment of mercury.
488. The equivocal repulsion of the local virus from buboes into
the general circulation, and the lues venerea that not unfrequently
thence arises may justly be attributed, as experience shows, to mercu-
rial ointment, when it is rubbed into parts where, as has been shewn
above, the mercury must be conducted by the absorbent vessels
through the buboe.
4S9. It is by no means a rare thing in practice to meet with buboes
that, by the long-continued employment of such frictions, have become
>chirrhous, and ultimately cancerous.
490. According to Fabre's observations, of twenty patients treated
▼ith frictions, fifteen became affected with ptyalism, which oflen comes
on so unexpectedly, and in spite of every precaution is so uncontrollable,
that cither the life of the patient is thereby endangered, or those parts
that arc aflected by this disgusting, weakening and painful discharge
^ seriously injured. Corroding ulcers in the mouth and on the
106 ON YEirSBEAL DISBA8BS.
tongue, loss of the palate and uvula, caries of the alveoli and of the
spongy bones of the nose, are common results. The more modem,
almost playful employment of the ointment seems to be a modified
copy of this frightful picture ; but it is ou the whole the same thing;
the terrors of the salivation are somewhat more Carefully avoided,
without on that account curing more cases of the venereal disease, and
the terrible effects (§ 649) are almost more frequent than before.
491. Inunctions of the ointment when gonorrhcsa is present
frequently transform the latter into an almost incurable gleet, probably
in consequence of the excessive relaxation of the lymphatic system
and the morbid irritability they occasion.
492. What can I say of the hurtful nature of frictions when they
are employed in those cases in which a previous injudicious employ-
ment of mercury has already complicated the venereal affection with
an accession of those chronic non-venereal diseases (§ 487) ?
493. The treatment of venereal diseases by frictions is usually
commenced^ with vcne^ctions, purgation and tepid baths. By these
means it is imagined that the system is best prepared for this mode
of using the mercury. Then two drachms or a dram and a half, seldom
only one drachm of the ointment (composed of one drachm of the
fluid metal, rubbed up with the same quantity by weight of lard) is
slowly rubbed in beside a coal fire, upon the lower extremities, usually
every other day ; by and bye the same process is repeated on the
upper extremities ; the patient is required to keep his room and drink
frequently of some thin warm drink. This process is continued until
salivation commences, which is sought to be checked by discontinuing
the medicine and by the employment of the purgatives, baths, diuretic
remedies, ptisans and clean linen. When the mouth has again returned
to a state of quiescence, the frictions are again continued with the
same or even increased quantities of the ointment, until fearful symp-
toms forbid their further employment, or until the venereal symptoms
disappear and the patient appears to be cured. Finally, venesections,
purgatives and baths are again made use of. During the whole treat-
ment no solid food is allowed. However great the hunger may be,
the patients dare not partake of anything but soups.
494. On an average, thirty -two drachms of ointment and about
forty-five days are required for a moderate degree of lues venerea,
but sometimes forty-eight drachms^ of ointment (three ounces of
mercury !) have been rubbed in, and above three months employed in
the treatment.
495. The treatment of syphilis by fumigatums with mercury is,
* In accordance with the alteratiye method usually adopted at Mootpellier.
* Girtanner says hem twelve to thirteen ounces of ointment ; six and a half
ooDoesof mercuiy!
A2fTIYSNER£AL BSMKDIS8. 107
ifter the rabbing^in treatment, the most ancient^ mode of treating
this disease, and for this purp>oso cinnabar is used. In later times it
fell into oblivion, except that it was still employed by some rude
people (as I found to be the cose among the Wallachs of Transylvania).
Recently experiments with *it have been instituted (Lalouettc^ is
the principal person who has revived it), expedients being devised for
keeping the vapour away from the mouth during its use, and in place
of cinnabar, the vaponr of volatilized calomel, or of mercury amalga-
mated with tin, has been selected.
496. Although this vapour is very penetrating, wound -clean sing and
deasicative,and moreover when the inspiration^ of it is avoided, does
not readily cause salivation or diarrhoea, yet its employment for the
complete eradication^ of syphilis is scarcely advisable.
497. It should be bonie in mind that the quantity of mercury that
on each occasion penetrates into the organism in the form of vapour
ia quite undeterminable, and can never be relied on, as will be suffi-
ciently obvious without my testimony ; experience al:(o shews that this
method of treatment is only of some utility in slighter coses of syphilis,
in cutaneous affections and the like, as an accessory means along with
the employment of other mercurial remedies ; and it not unfrequently
becomes injurious when there is too great sensitiveness and inflamma-
tkm of the sores, in dry and spasmodic asthma, great emaciation of
the body, in ulceration of the womb and the like.
498. I have also sometimes noticed, from its local employment,
chancres pass into buhoe^*, and the local virus thereby driven into the
general circulation. An immense number of authors'* have observed
convulsions, gcnenil trembling and fatal apoplexies result from the use
of cinnabar fumigations.
490. In the modem employment of mercurial fumigations, it is the
custom to prepare the system, as in the case of frictions, by baths,
venesections and purgatives. Tlien according to Lalouette's method
the patient is placed in an apparatus (usually a box made expressly,
where the head of the person who is seated therein, in a state of nudity,
projects through the lid, and his neck is so enveloped and all apertures
are so closed that no vapour can escape) in which the whole body is
played on by the vapour, but the mouth is not touched by it. The
' Oataoeos first brought it into use in 1606.
* He has however had few imitators.
' Which the older physiciaofl did not always employ proper precautions to prevent,
uA bj the dreadful accidents that their rude practice gave rise to, they brought this
meuM into great discredit
* The local employment of mercurial fumigations with proper care will always
remain one of the most excellent remedies for the removal of obstructions and the
improvement of malignant diseases.
* From Joh. Benedict (1610) up to the most recent times.
108 OK YENSBBAL DISBABBS.
calomel is made to evaporate in a sublimating apparatus introduced
beneath the seat.
500. The fumigation is repeated usually every other day, and from
half a drachm to one drachm and a half of calomel is employed (oiii*
nabar or mercury amalgamated with tin is seldom used), and . the
patient is at the same time made to drink frequently some warm th&i
ptisan.
501. On an average about three ounces of one of these substaQces
are required to complete satisfactorily the treatment of a moderate
syphilis (with symptoms of several Icinds) in thirty days or thereabouts.
502. Attempts are often made with success to cure or to ameliorate
malignant venereal ulcers or slight pains in the bones by means of
small local fumigations.
503. The employment of corrosive sublimate in venereal diseases is
also pretty ancient,^ but it was previously avoided by regular physicians
as a dangerous method of treatment, or it was confined chiefly to the
practice of the mystic physicians, until, about the middle of the present
(18th) century, a more convenient mode of administering it with safety
was discovered.
504. It has this advantage, that it can be introduced into the sys-
tem in a determinate small quantity, that it does not frequently ez^
cite salivation, at least not long-continued salivation, and in obstinate
gleets does more good than harm. It has oflen succeeded in curing
children affected with slight symptoms of syphilis, in whom the other
preparations of mercury could not be employed with safety. It has
also proved of service in some slight symptoms of syphilis in adultSi
and another especial advantage it possesses is that during its use pa-
tients do not require to be so strictly confined to their room as during
the employment of frictions and calomel, because it seldom excites
salivation, and because it does not produce such excessive debility
' Richard Wiseman {Sev. chir. treatiiet) was the first who in 1676 alluded to the
employment by empirical practitioners of a watery solution of corrosiye sublimate in
water for syphUis ; and according to Malouin it was about that time very much med
as an internal remedy under the name of remide du cavalier. Stephen Blaokaart IB
1690 also made mention of its employment. Thereafter, in 1717, Turner alluded to
its empirical employment against this disease. The better method of using it, however,
remained unknown until in 1742 Sandiez heard from a Gtirman physician who had
been some time in Siberia that it was the custom in that country (as travellers have
mentioned since 1709) to give in syphilis sublimate dissolved in brandy, ooigoiiied
with the use of vapour hatha Saochei instituted experiments with it^anda few
yean afterwarda communicated the results to the oelebratod Van Swieten^who
promulgated this method about the year 1764 in letters to Benvenuti and Handat^
mark, and subsequently at greater length in the fifth volume of his Oommeataries»
and, without making mention of the vapour baths (according to Saochea the most
efficient part of the treatment), praised it above ita merits, having been deceived by
the mendacious eulogiumsof his flatterers
ASTXYENERBAL BEHEDIS8. lOd
the other ordinary mercarial preparations, with the exception of the
mercurins nitratus and the oxyde of mercury.
505. This is, however, all the good I can say of it, for on the other
hand it is, 1st, of^n inefficacious to effect any considerable amcliora-
tioQ, and 2d, its use is attended by peculiar ill effects and disadvanta-
ges.
506. As regards the first point, it has seldom, when given internal-
ly, been of much use in chancres, in buboes, especially such as are of
long standing and have hard borders and a cancerous appearance, in
condylomata and other venereal growths, in swellings of the bones,
and generally in inveterate symptoms of syphilis. I have employed
it without success in chancres and general syphilitic ulcers, notwith-
standing that I have gradually increased it to the very largest doses.
507. It has besides this deceptive character, that the adventitious
acridity it derives from the muriatic acid combined with it, enables it
to excite an irritation foreign to the mercury it contains, which (by
oounter-irritation), lulls for a time the venereal symptoms ; which,
however, when the patient thinks himself cured, usually again burst
forth with redoubled violence. During its use the ulcers in the throat
are cored in an almost miraculously short space of time ; but this
eare is generally of a deceptive character, for on leaving it off, simDar
sjmptomatic venereal affections arise, or the same disease appears
tod spreads with greater rapidity than before.
508. With regard to the second point (§ 505), it is one of its great
&ults, that its acrid character^ obstinately prevents its entrance into
the lymphatic vessels of the prima) vice. Besides this, its taste is hor-
rible ; a sensitive stomach cannot bear it at ail. Oppression of the
stomach, inclination to vomit, colic, inflammatory eruptions on the
skin, are often the accompaniments of its use. Hectic fever has been
laid to its charge, which is produced by small ulcerations in the stomach
caused by its corrosive properties. Brambilla, a respectable witness,
has observed it give rise to blindness and deafness, spitting of blood,
phthisis, hectic fever, and abortion.
509. As a general rule, its employment is contraindicated where
there are, slow fever, derangement of the alimentary canal, tendency
to haemoptysis, fluent haemorrhoids, melancholic temperament, dispo-
' Bardnuen has misled Girtanner to apprehend the presence of arsenic in the cor-
roHTe sublimate made in Holland. I doubt if arsenic be more poisonous than corro-
iKre sublimate, but still more do I doubt (although Bergman has shewn the posaibilUy
of die onioD of these two substances in the process of sublimation) if corrosive sub-
limate be ever really adulterated with arsenic. With the exception of Barchusen,
vboie chemical knowledge cannot be very implicitly trusted to, no diemist has ob-
■ored this mixture. The modes Girtanner employs for detecting the presence of
anenic in corrosive sublimate are either dangerous or unsatisfiactory. Those men-
tkoed io my work On ArtmietU Poisoning are easier and surer.
110 OK YBNEBBAL DISEAfiES.
sition to violent mental emotions, gout, spasmodic affections, or other
symptoms of an irritable, nervous system, and a dry constitution.
510. After preparing the body in the good French style, by means
of purgatives, venesections and baths (but these are not so absolute-
ly insisted on for the corrosive sublimate treatment, as for that with
other mercurial preparations), it is usual to commence the treatment
with the daily dose of a quarter* of a grain dissolved in two pints of
fluid, and to increase the dose until it amounts to one grain in the day,
fn the case of children an eighth of a grain is at first given daily, and
increased to one fourth of a grain in a pint of fluid.
511. On an average, twenty- eight grains and about forty days
were required to remove moderate venereal symptoms in adults.
From six and a half to ten grains were sufficient for children.
512. Sanchez, who revived the use of corrosive sublimate, em-
ployed conjointly with this remedy, after the Siberian method, frequent
Russian Vapour-baths, and by this combination he cured an immense
number of internal and external chronic maladies, which he, without any
proof, asserted to be masked venereal affections, (for there is scarcely
any tedious or complicated malady that he does not consider as a
consequence of syphilis). These affections were usually cured,* as
might be expected, from the powerful diaphoretic means (the vapour
baths) alone ; but they were not always venereal diseases because a
plan of treatment succeeded wherein a mercurial remedy was at th'f
same time used. lie makes infinite confusion with the symptoms of
syphilis ; it is certain that the maladies so cured were seldom of that
nature, or only a small proportion of them, in which corrosive sub-
limate and diaphoretic remedies can, as is well known, prove service-
able, or if they were syphilitic then the cure was not permanent, and
only in appearance.^
513. Calomel has for a long time,* but especially since the com-
mencement of this century (the 18th), been one of the most frequently
used mercurial remedies for syphilis, and that especially on this
' Swieten gave twice a day a fifth of a graia dissolved in half an ounce of brandy.
1 may mentioa here, incidentally, that Girtanner is wrong when he says of this so-
lotion, that corrosive sublimate does not dissolve well in brandy.
* The sublimate did not need to contribute more than its irritating powers.
' I do not make mention of the corrosive sublimate clysters of Royer, or of the
analogous baths of Baum6, as the former caused painful tenesmus, and both are un-
tterviccable, as experience has shewn.
* The surgeon David de Planis Campy (la verolle recogneue. 8. Paris, 1623) seems
to be one of the first who gives the recipe for the Pilules de la violette (p. 174), whidi
along with purgatives, wore at that time much used in syphilis, and he lauds in
i-ather an empirical manner their efficacy in this disease ; ^ey contain calomel, a
scruple for a dose. Mayeme followed in 1660 with his pultnt eolomelanictu. (Oswald
Croll, in 1608, was perhaps the first who described, though obecurely, the mode of
making this mercurial preparation.)
ijn!iyXKSBEAL REMBDIE8. Ill
Booount^ that the supposed poisonous acridity of the motal was pre-
sumed to be corrected and sweetened^ in it, and experience taught
that this preparation, of all the internal remedies then known, had the
least corrosive qualities.
514. The following maxims, deduced from experience, however, arc
imposed to its reputed mild nature and much vaunted eflicacy in the
treatment of syphilis. 1. The ordinary semitransparent lanceolatcd
calomel in the form of cakes contain no mean proportion of sublinuite.
In this form it of^en occasions violent vomiting. If this bo not the
case^ and if it be purer, still it causes almost specifically enormous alvine
evacuations, which are accompanied by pains and great weakening of
the body. 2. If it be quite pure, it is an almost insoluble mercurial
salt, in which the small quantity of muriatic acid (oden less than a
sixth of the whole) is saturated with so much mercury, that but very
little of it is dissolved in the gastric juice and passes into the absor-
bent vessels, the whilst coliclike irritation of the bowels it produces expe-
dites its expulsion. 8. The portion of it that penetrates into the secundie
Tke excites almost uncontrollable ptyalism, a fault that seems to be most
peculiarly attached to it of all mercurial preparations next to the oint-
ment. It possesses all the powers inherent in the latter, of causing
weakness of the body ani innumerable chronic maladies thence
aecruing (§ 649) ; or if possible it even excels the ointment in this.
515. Attempts have been made in vain to deprive calomel of its
irritating effects on the bowels, by subjecting it to repeated subli-
mation. The excess of its purgative property is best removed by
boiling it in a large quantity of water along with a tenth part of sal-
ammoniac, as has been the custom in recent times, or by mere boiling
in water (as F. Hoffman used to do), with the intention of thereby
depriving it of the corrosive sublimate adhering to it; it is also
sometimes combined with opium.
51 f5. Of late years^ it has been used as a chief remedy for syphilis
in combination with some earthy powder, or made into pills with dias-
coridium. Afler a methodic preparatory treatment by venesections,
purgatives and baths, the patient being strictly kept to one well
warmed room, and partaking especially of warm drinks, first, two
grains were given, and the dose increased daily by about a grain,
aod if still no ptyalism occurred the dose was elevated to a scruple
' The white precipitate sweetened by boiling with sal-ommonic has the same action
a» the calomel Girtonnor gives the preference to Hermbst&dt's white precipitate
before all others (I do not know why), and proclaims him as the discoverer of the
sweet mercury prepared from turbith and kitchen salt^ although ho has done nothing
more than make some improvements on the mode pointed out in the Laborant
^2dpLppl56,l6d).
^ In olden times it was sought to remove the disease by large doses, often from a
half to a whole drachm givcnat once. A dangerous procedure I
112 OK VENEREAL DISEASEa'
daily, and thereafter the dose was decreased daily in the same mao^
ner in which it had been increased.
617. If it was wished to perform the treatment without aalivatioQi
as has been atterly the custom, either the doses were not increased m>
rapidly, or when the disgusting evacuation occurred, strong puigativea
were given, which oflen did not, but sometimes did, stop it, though
with but small advantage in regard to the eradication of the venereal
virus, but with such manifest loss of strength (§ 648, 649), that this
so-called alterative method of treating syphilis usually lasted longer
than that by salivation, and was often not so efficacious in destroying
the virus as the latter.
518. All the ills that can arise from the employment of any irritating,
debilitating mercurial treatment (§ 648, 649) have been observed from
even the gradual administration of calomel ; the production of scrofiila
and erysipelas, the gouty diathesis, obstinate ulcers in the mouth and
on other parts of the body, caries of the nasal bones, wasting fevefi
and, in short, every malady that can be produced by long-continued
mercurial irritation and depression of the strength. Even in this
case physicians failed to perceive that mercury loses its effect upon
the venereal virus in proportion as it causes any increased evacuation,
be that ptyalism or diarrhoea, or whatever other inordinate excretion.^
519. Still more celebrated in modem times is the so-called mix§d
method^ of curing syphilis by means of frictions and corrosive subli-
mate at the same time ; whereby it was thought to unite the advanta-
ges of both, after the frequent insufficiency of both used separately
had been perceived.
520. I shall not dilate upon its disadvantages, as they are the same as
1 have pointed out relative to both methods separately ; except that
they affected the system more severely than the employment of a
single mercurial preparation, and that lees of the ointment was used,
consequently the excessive salivation caused by it was to a certain ex-
tent avoided. Indeed it was often possible to do more by the combi-
nation of the two than by either separately.
521. For this purpose it was usual, after the ordinary preliminary
treatment, either to give these two remedies in alternation, adminis-
tering at one time the corrosive sublimate alone, and at another the
frictions without the corrosive sublimate, or both were employed at
once, from one to two drachms of ointment every third or fourth
day, and from a quarter to a whole grain of corrosive sublimate dis-
solved in two pints of water daily.
* Glare's method of rabbiiig4Q the calomel oo the interior of the month does not,
it is true, inoommode the bowels, but it readily produces salivation, and is incapabla
of eorii^ syphilis of any great intensity.
Oardane is said to have invented it
AHXIYENSREAL BEUSDUS. 118
522. In order to remove syphilis in this manner, twelve drachms
to four ounces of ointment, and from one drachm to fifteen grains of
corrosive sublimate, according to circumstances, and a period of from
dnrty to one hundred days were required ; on an average, nineteen
drachms of ointment and twenty-eight grains of corrosive sublimate
in forty-eight days, in moderately deep-rooted cases.
523. To gain the same end, especially for symptoms of the prox-
imate kind, recourse was also liad to fumigatioM combined with frio>
tioDs ; in which case a smaller quantity of ointment, or less calomel
for fumigating was required than when either process was employed
alone.
524. Three ounces of ointment and twelve drachms of cinnabar, or
calomel, were on an average the quantity required for the eradication
of moderate venereal afiections.
525. I shall not describe the still more mixed methods, in which
more than two different mercurial preparations were given at onoe,
plainly proving, if I mistake not, that frequently neither the employ-
ment of a single one of the mercurials ordinarily used, nor yet the
mixed employment of two of them at once, sufiiced to cure a high
degree of syphilis.
526. I may here mention the not very new preparation, the so-called
Ikrcuriut nitratus ^ {Solutio mercuriality Edin., Mercurius Hquidus^
Aqua mercurialiSy Paris), or the solution of mercury in nitric acid. I
admit that in some cases it acts in a milder and more antiseptic manner
than corrosive sublimate, and for that reason sometimes does more for
the cure of syphilis than the latter ; also that it equally seldom ex.
cites ptyalism. I will also admit, that by employing it wo ecu sub-
stitute the uncertain form of the mere solution for the more defined
one of the crystallized nitrate of mcrcur)'' ; also that it has this ad-
vantage, when the solution has been prepared by the heat of a sand-
bath, that it is not decomposed by the muriatic acid in the priniie vine
into the pernicious white precipitate, like that dissolved in vegetable
acids ; certainly a great recommendation ! But all this does not
make it into a good preparation ; it always remains a corrosive me-
tallic salt, with which we must, as with all the preparations of mercury
with mineral acids, on account of its accidental corrosive properties,
frequently go much more cautiously to work than the obstinacy of the
venereal affections will admit of. Its acridity easily excites vomiting
' As early as 1676 Charas employed a similar solutiou of mercury {essetUia tner-
CMfialiM), respecting which it has been asserted, without reason, that it was powerless,
■od resembled a weak dilution of aqua fortis, because the greater portion of the mer-
CVT has precipitated from it by the large quantity of water used ; distilled or pure
iping^-water has not this e^ect ; well-water precipitates white precipitate and changes
the liberated nitric add into nitrate of soda, but not into aqua Ibrtis.
8
114 ON YSNSaSAL DISEASES.
in sensitive stomachs ; colics and oppression of the stomach are no
unusual concomitants of its employment, and if we are thereby ne-
cessitated to give it in smaller doses we shall seldom obtain our object
of a radical cure. Profoundly roote^l syphilis is as seldom cured by
it as by corrosive sublimate, because, like every other mercurial salt
formed by a mineral acid, it is, on account of its irritating property*
taken up by the absorbents of the bowels and brought into the genenl
circulation, only in the smallest undeterminable quantity. It deceives
us by the adventitious irritation it excites, which smothers the venereal
symptoms by its greater intensity, or by a mere superficial cure, aa^
for instance, a deceptive amendment iu the ulcers of the mouth.
527. A third of a grain is given at first and the quantity gradually
increased until from two to three grains are given daily, dissolved in
two pints of liquid.
528. Mercury changed into powder by laborious * shaking, then
calcined, dissolved in vinegar, and made into pills with manna, waa
the composition of Keyset s Drag^es, of which from 1000 to 3000 often
had to be taken before the desired effect ensued. This expensive*
remedy has gone out of fashion, as it also occasions diarrhoea and
salivation, and is very often unable to cure deeply-rooted syphilis.
From forty to seventy days were usually required for the treatment.
529. The limited character of my design does not require that I
should attempt the thankless task of describing the remaining mer-
curial preparations of this kind, which bear a great resemblance to
those already treated of.
530. More nearly allied in nature to the best preparation of mer-
cury is on the one hand, PlenISs mucilaginotis mercury^ a remedy that
is indebted for the efficacy it possesses to the oxydation of the mercurj'j
by being rubbed up with mucilage. In this oxydised state the metal
is very mild and not at all irritating, at least to the primse viae ; it is
readily dissolved by the gastric juice, and brought without difficulty
into the general circulation, where it destroys the venereal poison with
the greatest power. This is the ideal excellence of this remedy.
531. We may bestow the same commendation on Belloste^s pills,'
the mercurial pills of the London and latest Edinburgh pharmacopceifti
or the trituration of mercury with honey, sugar, or crabs' eyes. These
preparations owe their mildness to the absence of mineral acids, and
^ Kcyser's remedy b nothing new. Bemhard Pcnot had (before 1618) a shorter
mode of preparing this remedy. Theatr. Chym. lib. I, p. 654.
' Tweoty-seveD livres* worth of these pills were required for the (often fruitlesi)
treatment ParalHU des diff. m^th. de tr. la mal. v^n. Amst 1794, p. 178 — 272.
' The first pills of this sort that were used in Europe (in 1587) for syphilis were
the Barbaroesa piUs (almost the first preparation that was much given internally for
this disease), the dose of which was one pill daily, which contained about four gnuns
of mercury, extinguiahed by rubbing.
AHnVSNERSAL REMEDIES. 115
their efficacy to the portion of oxjdised mercury they contain that is
10 soluble in our fluids, and that is produced by rubbing up mercury
with any of these substances.
5S2. But how much is the value of such preparations diminished
when we know how unequal, how indefinite is the small portion of
oiyde of mercury that is produced by rubbing up with mucilage, &c.
The temperature during the operation, the strength uf the mucilage,
hut more than all the strength and skill exercised by the operator
during the rubbing-up process, are subject to such great varieties, and
render these and the other preparations I have mentioned, such uncer-
tun, I had almost said such useless, remedies, that we may well he-
atate before bestowing on them even a moderate amount of praise.
533. I shall not dwell upon the fact, that in Plenk's solution the
greater part of mercury falls again to the bottom, and that it cannot
be kept above eight days in summer ; for this objection he has ob-
liated by his pills, which, however, on the other hand, become exces-
avely hard, and pass undigested through the bowels if they be not
prepared fresh every day. The greatest disadvantage attendant on
die employment of these preparations is, that they sometimes cause
ndden salivation, sometimes diarrhoea, sometimes they produce no
effect, and seem to be quite powerless ; a plain but unnecessary proof
of the truth of my assertions. They contain often scarcely the eightieth,
but sometimes again the twentieth part of the mercury rubbed up in
them, in the oxydised form.
534^ Pure oxyde of the mercury alone^ without the slightest. admlX'
Ure of anything acrid^ that, without cans' ng any inconvenience to the
primce vi(B, is unobservedly, easily and certainly assimilated by the
juices of our body, and may be given in determined quantities, is the
most powerful and surest mercurial preparation, and is superior to all
others, which, either from the quantity of active matter they contain
being undeterminable, or from their corrosive acridity, or also from
their insolubility, arc injurious or untrustworthy.
535. In this important respect the mercury oxydised^ per se, has
become justly celebrated, and it is certainly among the preparations
hitherto employed, the one best calculated, with proper precautions,
for removing the highest degree of inveterate syphilis, speedily, easily,
and surely.
536. Of this oxydised mercury, (mere, calrin,, Lond.) one grain is
given daily, and the dose gradually increased up to three grains daily,
until amendment ensues or the mouth becomes affected. It does not
* lliere is an extremely ancient though previously seldom used rem(»iiy that was
^hly reoommendcd for the treatment of syphilis by Anthony Qallus, in 1540, un-
do liie name of praseipitatum rvbrwn solare^ but itp mode of preparation was first
made known in 1693, by Genraise Ucay.
116 OK VJB^BSiAh PiaKASSa
80 readiij (for what reason is not known) produce true aaliyatioii,
and seldom diarrhoea or vomiting, if it do not encounter any muriates
in the stomach. As this last circumstance was not understood, it was
usual to mix it with some preparation of opium in order to guard
against this effect.
537. The mode of preparing this substance is well known, but tlia
experienced professional man must be aware how extremely diffioolty
intricate and tedious is its true preparation. These difficulties in jts
manu&cture are so excessive that it is one of the dearest medioa-
ments. Now, as in the matter of pharmaceutical preparations the
frequency of the adulteration of a remedy is always in the direojt
ratio of its price, I shall not be discredited in asserting that this drug
is very seldom to be obtained genuine* The corrosive red precipitate^
is probably the substance most frequently used for its adulteration,
538. I cannot tell why such an expensive, untrustworthy and cir-
cuitous mode of preparing a pure mercurial oxyde has been soug^
to be retained. I know not why medical men did not undertake more
frequently to precipitate a pure metallic oxyde from the solution fai
nitric acid, and to bring it into general use In the treatmoit of vene-
real diseases, it has been prepared, but assuredly a number of se-
rious accidents^ have been observed from its administration, the
source and remedy of which it was thought impossible to discover.
539. Chemistry should have taught them that their solvents, as alao,
all their precipitants, were contaminated with muriatic or vitriolic add
which imperceptibly adulterated their precipitate with those dangerous
mercurial precipitates (see preface). As regards turbith, it is well
known to have frequently caused death, and I once saw a strong per-
son die in strong convulsions from taking two grains of white precipi-
tate.
540. We can expect the best effects only from a mercurial oxyde
precipitated from pure nitrate of mercury by lime free from all ad-
mixture ; we may expect that well-prepared soluble mercury will re-
move the most deeply engrafted syphilis easily and surely. But of
this more below.
CHAPTER III.
NON-MEROURIAL REMEDIEa
541. The dreadful effects of injudicious mercurial treatments, and
' We may ooDTiDce ounelyes of its presence by boiling with acetic add ; H >»-
maim undiBMlYed wfaOst the oo^dised mercury is taken up in eolatioo.
* The mere, prmip. futcue WtuntU has, according to Girtanner, fallen into disaaeL.
Bladc't pulv. meratr. ctfK (Certainly one of the best of the ordinary preparatiooB) stiU
letaim its poettaoiL It is giren at fint in from one to two grains daily, and gradnallj
inoreased to six-grains. It is CtffroBoi being free from fiuilts, as I hare shewn in the pra-
Cmc, but it approaches near to my solnble mercury.
AMnVVMCUBAIr ' ttXlCSDIXB. 11 7
Mr frequent inefiksaoy, has from time to time diverted the attention
•f practitioners from the diyine metal, the true antisyphiliUc specific,
ind their conscientiousness led them to resort to remedies from the
.-egetable and animal kingdoms, in order to avoid the poisonous effects
:hit, according to them, every medicine in general, and mercury in
particular, exercises on the human body.
542. It is probable tiiat the venereal disease at the commencement
of its extension over Europe spread much more rapidly, and in its ra-
pid course produced more disastrous symptoms than are now observed.
Hie inexperience of physicians that then prevailed might have ren.
dered them unable to meet the horrible effects of the virus, and pa-
tients were readily abandoned to the practice of rash empirics ; the
diigrace of the disease also might have the effect, as is still the case,
of driving the sufferers to these nameless vagabonds, partly seduced
bj thdr wonderful promises, and partly in order to recover their health
ia privacy. These unconscientious advisers, who were always pro-
Tided with the most active medicines, had as usual no object but to
fin their purses quickly, and in a short time to bring about the decep*
tire semblance of a cure without caring for the afler effects. Hence
it happened not unfrequently that from their furious salivation the
noft dangerous dilapidations and maimings of the body resulted,
vhkhwere often more horrible than the venereal disease itself; many
died from these effects, whilst the lues venerea more rarely proved
fatil. What could be more natural than that physicians generally
fadd the blame upon the mercury, and hesitated to employ it? What
ooold be more natural than that from an early period (from 1515^)
they looked about for non-metalic remedies, which, as they believed
were more suited to the human body ?
543. Guaiac wood was the first lucky hit in this way, which the
Chevalier von Huttcn, before any one else, undertook to praise in a
book specially written for that pui7>osc,^ alleging that it had worked,
miracles on him afler the fruitless employment of the most dangerous
mereurial treatment. He died nevertheless of syphilis.
544. The an ti venereal plants probably first derived their reputation
from America; for want of mercury the inhabitants of tliat continent
tried their most potent plants for this disease, and in many respects
they may have caused at least alleviation of the disease.
545. After guaiac wood, cinchona bark,^ sarsuparilla,^ and, finally,
oesnothos and lobelia, gradually obtained a reputation in Europe.
Prom the resemblance of their mode of action to that of these plants,
' Oirtaimer eays ag early a 1509.
' After him an enormous number of others.
' Aoooivling to Girtanner in the year 1625.
* Aooording to Girtanner m 1580.
118 ON YENEBEAL DISSA8E8.
we added to them mezereum, conium, walnut-husks and dulcamara.
Ammonia, opium and lizards completed the list.
546. Guaiac wood was and is still given in a strong decoction in
water of from one to several ounces per diem, drunk warm ; it is aa
acrid vegetable substance, possessing much power to act on the skia
and urinary secretion. The small green twigs of this tree, which the
Americans use, arc probably still more powerful than the hard, dry
wood employed by us. It is most useful in soft, spongy systems.^
547. Sarsaparilla fell gradually into complete disrepute, until later^
physicians again commenced prescribing it to the extent of three
ounces daily in. strong watery decoction.^ Cinchona bark underwent
the same fate, but has as yet found no resuscitator.
548. Of lobelia, which was so much recommended by the North
Amerians, a handful of the dried roots is boiled in twelve pints of water
down to sLx or nine pints, and half a pint of this is given to the patient,
at first twice, thereafter four times a day, until the diarrhoea it causes
becomes intolerable. It is then left off for three or four days, and again
given until the cure is completed.
549. Mezereum^ has been considered to possess similar proper-
ties.* Two drachms of this were boiled in three pints of water down
to two pints, and half a pint drunk from twice to four times daily.
The stalks of dulcamara were prescribed to the extent of two drachms
daily, boiled in water, and mixed with milk. A much larger quantity
could be given by increasing the dose gradually.^ The green husks
of walnuts are said to have been not less efficacious.''
^ Oirtaimer alleges that it speedily causes incurable consumption in weak and thm
persons.
' Especially W. Fordyce. Oirtanncr has never soon any good effects from its uae.
' As much as fifteen pounds of this dear medicament were used for one treatment
* I find as early as 1653, in the works of Augerius Ferriftre of Thoulouse {De
pudendagra lue hispan. lib. duo. Antwerp, 1664, p. 26), this shrub much recom-
mended fur this disease in the form of decoction.
* Especially in pains of the bones and venereal cutaneous diseases.
* So that it shall not occasion convulsions or vomiting, as Girtanncr remarks, who
recommends this plant highly in this disease. *
' Girtanner speaks very highly of tliis remedy, to the extent of two ounces daflj
in decoction, when it is fircsh, and in the form of extract for the most inveterate
symptoms. This writer also recommends a perfectly new non-mercurial remedy, the
Astragalus exscapus (he gives an engraving of it), from the reports of his firiendB in
nodes of the bones, venereal cutaneous eruptions, venereal warts, <i:c. Winterl fizvt
mentioned it as an ordinary domestic remedy for this disease in Hungary ; after him
Quarin spoke highly of it ; Huncczovsky has seen good effects from it in gout, but not
in venereal affections. It causes pui^ng, diueresis, most frequently copious diapho*
resis, and a kind of cutaneous eruption. One ounce boiled in a pint of water down
to three-fourths is given daily.
The ledum palustre may probably act in a somewhat similar manner, espedaUy
in venereal skin diseases ; of this we should give, daily, at first half an oimce, gradu*
ally increasing the doee to an ounce in infiiskm.
jUfinVXNSBBAL BS1C£DIES. 119
550. I have elsewhere observed that many very different irritant sub-
fltanoes are capable of producing amelioration in venereal affections,
inaamuch as the counter-irritation caused by them alters the morbid
disposition of the primarily affected parts, and the pains they are sub-
ject to (e. g^ the venereal pains in the bones) are alleviated by the
greater irritant efiects of the drug.
551. It is in this way that the most of these plants appear to have
acted when they have done any good ; at all events, this is the case
vith the purgative herbs, lobelia and mezereum, and the diuretic and
diaphoretic ones, guaiac, walnut shells and dulcamara. In this respect
tUs good effect resembles that of turbith, corrosive sublimate and
blisters (applied to swellings of the bones. The mucilaginous diu-
retic sarsaparilla, may contribute not a little to the diminution of the
morbid irritability.)
WL If they be given in conjunction with the mercurial treat-
mtot, their irritating power may also assist the action of the metal,
bat ovdy in the manner in which ginger assists in strengthening the
itomach when given along witli bitters, which it is unable to do of
itaelf. Perhaps idso, when by a long-continued, fruitless use of mer-
<Diy, the body has become insensible to the curative stimulus of Uiis
metal, the new, unaccustomed irritation of these drugs may have
called amelioration, and on this account they were regarded as anti-
venereal.
553. The last-mentioned plants may often, when given quite alone,
in consequence of their great depurative power, have cured a number
of external diseases, even such as arc of a painful character, which
from want of pathological knowledge had been considered as venereal.
With respect to mezereum and guaiac, at least, it is certain that they
cinnot cure the most indubitable incipient sign of syphilis, e, /?., the
copper-coloured spots ; how then could they remove inveterate lues ?
554. But more than this, it was the custom formerly (and is so
still) for physicians, in ignorance of venereal semeiotics, to look upon
diseases arising from the long use of mercury, such as caries, tu-
mours, rheumatic symptoms, scrofula, &c., as of a true venereal na-
ture, and when guaiac, mezereum, and the like, lemoved these affec-
tions, to laud these plants, as antisyphilitic remedies.^ The foreign
irritation of these drugs, especially of guaiac, has not unfrequently
been of great service in those after sufferings resulting from the long-
eontinued use of mercurial treatment, which had arisen from mor-
bid irritability and dissolution of the humours : obstinate ulceiB,
trembling, febrile states, and the like, the first of which are still some-
times mistaken for venereal.
' Sfjme of the andents were more diBceniing than these ehort-siglited persona
when thcnr said : /im« venn<e mercuriui antidatutn, mercurii ffuaieum.
ISO OK VXNEREAIf DISlABia
555. I may be permitted to eBtertain almost the same notions
q>ecting Peyrilhe's^ antidote to venereal disease, ammonia. With
the exception of cariee and nodes of the bones^ aphthse of the >yagina*
schirrhous buboes and urinary fistulaB, he alleges that it is specific iSw
all other venereal symptoms. Of ammonia obtained from sal ammo-
niac by means of potash, he directs from fifleen to eighteen grainji
(and in bloated individuals as much as thirty grains) dissolved in
four or five ounces of fluid, to be taken early in the morning and four
hours afler dinner, and this to be continued for about eight days, thea
to be left off for the same time and again used as long, again omitted
and again used, until the affection is removed I believe this sab-
stance to be really a powerful adjuvant in the treatment of venereal
diseases, and I go so far as to believe, that if any medicine can be ct
use in syphylis, besides mercury, this is the one.
550. Plenk, Murray and others aflirm that they have seen foUow-
ing its employment increased inflammation of the venereal ulcers. In-
flammatory suppression of gonorrhoea with swelled testicle, strangoiy
with hematuria, and several other disagreeable effects. It 'has proTsd
of much service in my hands in chronic affections resulting- from •
long course of mercurial treatment, and has materially aided in dimia^
ishing the morbid irritability.
557. Before all other remedies, however, opium^ owes its reputatkm
to this virtue. Hunter could not succeed in curing the slightest ven&'
real symptoms with opium, although he gave it in increasing, and at
length in the very largest doses, whereby he once killed a man with-
out previously curing his disease. He and Grant, like myself, found
it a chief remedy in the morbid irritability resulting from the abuse
of mercury.
558. Hemlock has probably just as little specific virtue in syphilis^
and all the action it has may be owing to its peculiar irritant power,
and even when it has proved serviceable for supposed venereal after-
sufferiogs, it might have acted by virtue of its sedative and anti-scro-
fulous powers.
559. The lizard, which was first employed in America, and subse-
quently also in Europe, according to report with extremely h^py
effects, in inveterate syphilis with nodes, pains in the bones, ulcers
and slow fevers, besides other diseases, is the lacerta agilis^ L., a large
(greenish coloured) species ; the smaller varieties also are useful,
though in a less degree. They reside in old walls, and prey upon
spiders, flies, ants, earth-worms, crickets and locusts.
' Lemcrj and Sjlvius had already recommended ammonia in syphilis, as Girtan-
ner remarks.
* It is DO novelty to give it in venereal diseases. I found that Femel freqiieiiflj
employed it hi syphilis as early as 1660. Willis and SimoD Panli followed ha ex-
ample, as Qirtanner obserree.
AinnmrxREAL bemsdibs. 131
MO. We take the liYfng animal, quickly out off its head, tail and
1^8, extract the Ti8oe^^ akin it, and cut it into a number of small
hite, which we make the patient swallow with some liquid, while still
afire and warm^ either alone or covered with liquorice powder, or
ToBed np in a wafer, but without further preparation. Of the larger
kh-], the flesh of one or two is to be swallowed daily ; of the smaller
Und that of several. From twenty to one hundred are required to
complete the treatment.
561. The chief effects resulting from their use are, increased
heat of the whole organism, a certain amount of nausea, a (frequently
eoplous) flow of yellowish opapue saliva, occurring afler twelve or
twenty-one have been taken, sometimes sooner, a (sometimes profuse)
fetid diaphoresis, fetid urine, and also occasionally copious bilious al-
Tine evacuations.
562. According to the observations of some writers, they are pro-
bibly not less efficacious when the flesh is minced fine, made into
pUs by means of flour, and so swallowed. This, however, remains
to be determined by experience. This remedy dcsen^es attention, as
it it in itself so harmless. Its chief efficacy seems to reside in the vo*
Iitile alkaline component parts. It may be very powerful, but we
ire unable to determine if it can radicaUy cure true syphilis.
563. But whilst the other reputed antisyphilitic remedies are for
die most part only able to cure accessory symptoms, heterogeneous
mnnants of the venereal disease, and the various affections produced
by the irritation occasioned by the abuse of mercury, all of which
hive been considered to be venereal merely on account of their co-
existence with syphilis, it always remains an established fact that
mercury is the only thing that removes all sorts of venereal affections
with certainty, so that we have no need to look about us for any other
remedy for venereal diseases, provided the preparation we possess be
of the very best kind.
THIRD DIVISION.
REMOVAL OF THE OBSTACLES TO THE MERCURIAL
TREATMENT.
CHAPTER I.
OBSERVATIONS ON THE ORDINARY PREPARATORY AND ACCESSORY
TREATMENT.
564 Those to be subjected to the mercurial treatment (with very few
exceptions) are prepared, after the French fashion (§ 493), by purging.
122 ON ySNSREAL DIBEA8ES.
venesections and tepid baths ;' the last, moreover, are employed often
during the whole treatment and during the after treatment (Haguenot
was the first who sought to make their use general), but the first aze
used at various intervals. At the same time a watery, non-nutritioua
diet is given, consisting chieHy of a multitude of tepid and warn
drinks ; and all this is {lone in order to guard against any symptom of
the venereal disease inimical to the cure, and to make the mercury all
the more efficacious.
565. 1 have oflen puzzled myself in vain to determine how this prepar-
atory treatment could have the effect of preventing all ill consequences
during the treatment, and I believe I have found that all this is done
under the erroneous impression that all possible disagreeable symptoms
occurring during the mercurial treatment, even the salivation that espe-
cially ensues under this method, arc of a purely inflammatory nature,
and depend solely on tension of the fibres and an excess of red blood.
This must have been the indication that guided the originators of this
method, or they must have chosen it for want of something else to
do, for in no other case, except to remove the most violent pure in-
flammatory diathesis of the organism, is it capable of doing the slight-
est good ; in all other states of the body whatsoever it is quite the
reverse of beneficial.
560. Now as pure inflammatory diseases and symptoms are rare
amongst us now-a-days, especially among the inhabitants of large
towns, and all those symptoms in this kind of diseases that can be re-
garded as inflammatory are chiefly of scorbutic, erysipelatous, scrofu-
lous, rheumatic, or of that character which I have termed irritability
from nervous weakness, and as all strength-destroying, debilitating
and enervating treatment aggravates all the symptoms in the latter
case, as experience teaches, we perceive on the one hand how inappro-
priate that common treatment by the so-called alterative, emol*
lient, attenuating, relaxing and antiphlogistic method is, and on the
other hand how much of the frequently disastrous results of that French
plan of treating lues venerea must be ascribed to this abominable
weakening system.
567. There are few constitutions so good as to be able to bear up
against the force of this strength- wasting method,^ and not very many
in which the amendment produced by the mercury does not suddenly
*The number used in the preparatory treatment atMontpeUier is usually thirty,
without reckoning what are employed when salivation sets in and after the treatmeot.
* This method, which in the opinion of its defenders is best calculated to check
the salivation and to point out to the mercury the direct way of eradicating the vima^
is termed the alterative treatment. The Spanish physician Almenar, as Girtaimer
observes, was one of the first to insist on the use of purgatives and baths for this
purpose ; Chikoynean reiterated his maxims, and Haguenot increased the number of
baths to be used.
BKMOYAL OF OBSTACLES TO MEBCUBIAL TBEATMENT. 128
oome to A stand-still in the middle of the treatment, in which an ener-
Tating, uncontrollable salivation^ does not occur, which cats away the
nasal and palatial bones and gives rise to corroding, often sloughing
ulcers of the mouth and tongue ; in which the borders of bubonic ab-
scesses do not suddenly become everted, spread in a cancerous man-
ner, pour out fetid corrosive ichor, and terminate in mortification ; in
which cutaneous ulcers and condylomata do not take on an unhealthy
suppuration, become painful, and degenerate into deep sinuses and
fistulous ulcers ; in which swellings of the periosteum do not occasion
more speedy caries of the bones beneath, and in which sinking of the
strength, uncontrollable diarrhisas, debilitating perspirations, and the
vhole array of symptoms of hectic fever, do not occasionally effect
the deliverance of the unhappy sufferer from the methodical, urtificial-
Ijr produced disease, by conducting him prematurely to the Anal goal
of all mortals (^ 648, 649).
508. This French folly of pretending to assist the action of mercury
bj enervating the body is cat ried to such a height, that when in the
treatment of venereal diseases the last named disagreeable symptoms
occurred, which were chiefly produced or at least aggravated by the
debilitating accessory treatment, frequently nothing more was done
than to renew^ or to increase the anti-phlogistic method, to the destruc-
tion of the patient.
569. Physicians did. not observe that the serious symptoms that
occur during the use of mercury in this disease are seldom of a purely
inflammatory character, and that when thoy will not yield to the anti-
syphilitic metal, an ext-css of corporeal strength and of pure strong
blood is certainly not the cause of this phenomenon ; in a word, they
imagined they had to do with savage Gauls and rude Germans whose
seething blood required to be drawn ofl*, whose flaming nervous force
hid to be smothered by pouring in streams of water, and whose over-
tense fibres needed to be relaxed by soaking in a succession of warm
baths, so as to prevent the irritating metal exciting the most uncon-
trollable inflammatory symptoms; whereas they really had only to
deal with their degenerate descendants, their mere shadows, whose
already weak blood they draw off in large quantity, in order to make
it still more watery by deluging it with ptisans ; whose delicate
stomachs and bowels they weakened into dyspepsia by mucilaginous
fluids and laxatives, and whose skin, that was already fre(][Uently too
' Amhu: mentiona that Morond employed on five soldiers the same kind of frio-
tkns; of three of these \pho got no batlu ono only had slight salivation, but the two
othen who daily employed baths at the same time were salivated violently and for
tloDg time.
• As may be seen in the fourth part of Ohaervationa faites et publieia 9ur Us
Sfirtntet nttkodes cTatbniniatrer le tnacure darts les maladies vineriennes, par de
J70nie.-.Pari8, 1779.
IH OS YEirSREAL DI8EA8SS;
sensitive to every change of weather, thej weakened by heated aptr^
ments and repeated baths, to the highest degree of irritability and
extreme susceptibility to take cold. Experience teaches often enough
that those cases in which this method was employed to its full
extent on the most approved principles had almost always the saddest
termination. We cannot readily conceive of anything more inappro*
priate than to weaken fibres that ought to be strengthened, to abstract
vital force that ought to be multiplied, and to diminish the tone of the
nerves that require strength for the due performance of their operations!
570. If it be alleged that this method is directed more against the
venereal affections than against the symptoms to be dreaded from the
employment of the mercurial treatment, why, it may be asked, should
the venereal disease, whose nature is the very opposite of purely
inflammatory, be combatted with antidotes calculated for subduing the
most violent inflammatory fever of a sunburnt savage ?
571. If it be contended that the bad symptoms and obstinate after>
sufferings during the treatment of venereal diseases may arise from
the irritating metallic poison used, I will readily grant that they occur
even where the French preparatory and accessory treatment has not
been employed, but I am all the more astonished that the latter can
be prescribed along with the mercury, seeing that it is productive of
equal injury, and thus lends a helping hand to the devastations of the
mercury.
572. If it be asserted that the venesections, the confinement to a
heated room, the streams of warm drinks, and the baths, constitute a
diaphoretic treatment, which is to keep the mercury from irritating the
bowels and salivary glands, I ask, what is the object of the anti-
diaphoretic purgatives ? I ask, has not experience shewn that such a
sudorific treatment most frequently creates a tendency to take cold,
whose effexits are worse in proportion to the weakening tendency of
the diaphoretic treatment ?
CHAPTERII.
PREPARATORY TREATMENT.
573. If there be any general method whereby those who enter into
a venereal hospital must be artificially prepared for the mercurial
treatment, the very nature of the thing shews us a directly opposite
system should be adopted, since laxity of fibre and nervous weakness
have come to be the chief ingredients of all the chronic diseases of
our age.
574. In most cases of old-standing syphilis' we observe a general
weakness of the body, a pale countenance, a dull eye, relaxed muscles,
> Also in cases of idic^thio Tenereal diseases, especially those fiar which meraoij
has alreadj been employed in vain.
BEMOYAL OF OBBTACLES TO MSBCURIAL TREATMENT. 126
and frequentlj, on aooount of the low fever kept up by the venereal
irritation, a weakened digestion, a smal], unsteady, very rapid pulse,
toidency to cramps, and all the signs of increased morbid irritability of
the whole nervous system.
575. All these symptoms indicate tonics fbr the preparatory treat-
Bent, which are all the more necessary because without them the
nercury increases the delicate state of the constitution, or thereby is
prevented from exercising the requisite power over the venereal \'irus.
576. If they be neglected, then the low fever and tendency to
scrofulous inflammation increases, and, what is worst, on the adminis-
tntion of the smallest quantity of mercury a dysenteric diarrhoea, an
uncontrollable diaphoresis, or most commonly an irrepressible saliva-
tkMi, breaks out, that consumes all the strength, and frequently leaves
behind it the afler-sufierings often alluded to, frequently without having
mdicated the syphilitic virus.
577. Not unfrequently a tendency of the system to rheumatic and
gouty acridities, to scrofula and to scorbutus, forms an impediment to
the mercurial treatment; and these diatlieses must previously be
nmoved if we would not see these affections uncommonly aggravated
during or after the venereal treatment, or if we would employ the
mercury with certainty and efficacy.
578. Accordingly, in order to diminish beforehand the morbid
lialnlity to the above (§ 576) evacuations, and to eradicate the un-
iiTourable diatheses alluded to, it is, for the reasons given, indispensably
necesisary to employ the strengthening preparatory treatment according
to circumstances, with special regard to the removal of the scrofulous,
scorbutic or other disposition, according as the one or the other betrays
its presence by its diagnostic marks.
579. Among general tonic remedies 1 reckon footbatlis, half, and at
length whole baths of cold (50°) water, each used for a few minutes,
once or several times a day, combined with energetic friction^ of the
parts bathed. For internal remedies, at first the bitter vegetable
extracts (if the morbid irritability is very great), before proceeding to
the astringent bitter medicines, as cinchona and the like, if the body
ifi bloated and full of indolent juices, we may at first combine them
with carminative and stimulating things, as cardamoms, peppermint
oil, and so forth, in order to accelerate their action. Among the best
of strengthening remedies I reckon the use of moderate exercise in
the open air. Great irritability from weakness, with urgent, painful
symptoms, demands the cautious external and internal employment of
opium, combined with the strengthening treatment. But if the irrita-
tftbiility from weakness be not excessive, we may soon have recourse to
bark, iron -filings and sulphuric acid as internal tonics. I now come to
I I ■ ■ ■■•II I.I
' With woollen towole.
126 OK ySNBBEAL BISEASSS.
the accessory treatment of the prevailing morbid concomitant diathesis.
580. It is only in the case when previous to or during the employ-
ment of the strengthening method the tongue becomes white, and
thirst for cold water, severe headache, a full, hard pulse, &c, occur,
without any bad taste in the mouth, fulness of the abdomen, indigestion,
or commotion of the bile, then and then only must we make a moderate
bleeding, which paves the way for the tonic treatment, which may
then be gradually increased.
581. If we combine the tonic treatment with the fresh expressed
juices of the cochleara, the arum root, and the water-cress, and aid it
by fermented liquors, fresh fruits, and exercise in the open, dry air,
we shall subdue the scorbutus, which offers the greatest impediments
to the cure of sy philis. For if, without this precaution, we proceed at onee
to the employment of the mercurial treatment on a scorbutic venereal
patient, there occur, in the midst of the most energetic action of this
metal, rapidly spreading foul ulcers, which give sufficient evidence of
their non-venereal nature by their being worst at this particular time*
582. The strengthening method alluded to, combined with the
employment of carbonate of ammonia and small doses of ipecacuan^
or burnt sea- weed, will prevent the scrofulous diatheses interfering
with the cure of syphilis.
583. In like manner guaiac resin dissolved by the combined action
of potash and alcohol, but especially the extract of aconite conjoined
with the tonics indicated above, more especially with the cold bath, is
generally sufficient to destroy the gouty diathesis in the system.
584. Steel filings will remove the chlorotic disposition, and along
with the other tonic remedies, help to increase the red parts of the
blood.
585. A tendency to erysipelas demands great moderation in the use
of meat and similar articles of diet, and the plentiful use of fruit and
whey combined with the general strengthening method.
586. Ilaller's or similar acid elixirs will moderate or remove inflam-
matory dispositions of unknown, indefinite or composite character.
587. It is only after having strengthened the fibres in this or some
similar manner, thereby bringing the tone of the nerves into more
uniform and powerful vibrations, and afler having dimininished or re-
moved the obvious accessory disease,^ that we should undertake to
attack the syphilis with mercury.
588. Let it not be objected that such a preparatory treatment would
' So that for a couple of weeks every foreDooQ is passed in constant nausea and
alight heaving.
* Also where hysteria is present we must adopt some similar preparatory treat-
ment, or at least be always on our guard for fear of the occurrence of couvulaioos.
The occurrence of the catamenia demands the intermission of the mercury until it is
post; bleeding hemorrhoids demand a similar precaution.
BEMOYAL OF OBSTACLSS TO KSROUBIAL TREATMENT. 127
consame much time and put off for a long period the employment of
the mercury. If the morbid accessory diathesis be strong, and the
diief ingredient of the composite disease, then nothing more expedi-
ent, nothing more appropriate can be conceived, let it last ever so long.
But even in the very worst cases we shall have advanced so far with
the general or special strengthening treatment (if it were at all appli-
cable) in from three to five weeks, that we shall be able to commence
the use of the metal.
589. Sometimes it is requisite to continue the tonic treatihent along
with the mercury, which, with the exception of the cold baths, may
be done without restriction^ in the most of such cases.
590. It is only when the symptoms of syphilis arc very violent and
urgent, and when they constitute the major part of the composite dis-
ease, whilst the accessory morbid diathesis constitutes its minor part,
only in such cases can we employ the mercury at once, combined
with the tonic treatment.
CHAPTER III.
PREVENTION OF THE DISAGREEABLE EFFECTS OF MERCURY.
591. It has been proved by thousands of observations that no deep-
ly rooted venereal virus can bo expelled by any visible, far less ex-
cessive evacuations, diarrhoea, salivation,^ diuresis and diaphoresis, and
that these rather have the effect of palpably hindering'' the metal in
its antisyphilitic action, and ought consequently to be avoided.-*
592. Whether the threatened salivation can be kept back by the
use of powdered sulphur, my experience has not yet tauglit me ; still
the trials of others lead us to anticipate much advantage from it, as
also the expectation deduced from chemical science, that the sulphur,
penetrating the mass of blood, effects a mineralization of the dissolved
metal (Ethiops mineral), and suddenly renders it inefficacious.
593. Some advise that the patient should be exposed to severe cold,
others that he should be kept very warm, both with the view of check-
ing the salivation ; but both frequently fail of their object, especially
when the exciting cause that could indicate one or other of them is
lost sight of
^ Only that the Btrengthening remedies should not be giyen all day, but only two
hours before and two hours after dinner.
* It is remarkable that as early as the conunencement of the sixteenth ccntuiy
(1502) the Spaniard Almenar sought to prevent and remove salivation by every pos-
sible means, in order the better to cure this disease.
' At all events by diminishing the mercurial fever.
* Sydenham says, in liis £pist. resp. ad Henr. Faman, tliat a remedy must destroy
the venereal poison in the body directly, without evacuation, in order to deserve the
namie of an antisyphilitic spedfic.
128 ON VSKSBEAL DiaSASKS.
504. If A previous chill have caused an inoonaiderably small qtuuti*
tj of mercury, that has been given, to act on the salivary glands withr
out there being present any plethora, a diaphoreticy moderately warm
treatment may be of service. If plethora and an inflammatory fever
be the cause of the rapid salivation, then sometimes a venesection, but
most certainly a general cool treatment, cold air» dsc., will tend to
check it.
595. But what are chiefly relied on are drastic purgatives,^ under
the supposition that the salivation will thereby be suddenly brought to
a stop, although many thousands of cases demonstrate the improprie-
ty of this treatment. The salivation is not thereby restrained ; oil
the contrary, it often increases still more when the action of the pur-
gative is over, especially when, as is often the case, irritability was the
cause of the sudden ptyalism. Moreover, who is ignorant of the de-
bility that such a powerful evacuant medicine, or the repetition of such
purgatives as are usually prescribed, leaves behind it, each of whidi
is equivalent to a venesection in its weakening efiects ? In a word,
experience and reflection are equally opposed to this proceeding, as
hurtful as it is useless.^
596. Were we better acquainted with the nature of camphor than
we are, much might be expected from its use. But both the constitu-
.tion that indicates it in this case, and the dose in which it can be of
service, are still uncertain. I have often experienced the opposite from
its use, and sometimes maintained in full force, for certain purposes,
ptyalism persisting from irritability, by the daily administration of
six grains of camphor ; but the salivation that occurred was destitute
of smell. Perhaps it is most powerful as an antidote to salivation,
when the latter has resulted from suppressed perspiration.
597. Linnoeus observed chronic salivation cured by an infusion of
\ white horehound ; the infusion prepared with wine likewise merits
attention. Sanchez lauds the eflicacy of vapour baths for preventing
^ salivation ; they do not, however, prevent it, as the Chevalier von
Ilutten piteously relates.
598. Morris found contrayerva, in the dose of two scruples twice a
day, efiicacious in obstinate cases. Others have advised blisters to
the nape.
■ 599. I mention these things in their proper place, but believe that
we shall always meet with more success if we prevent the ptyalism
beforehand, than if we rely upon checking it when it has already com-
menced.
■ - ■ — — - - — I - 1 -ji 'i „^_^— .
' Desault brought them into great repute lor this eTAoufttioo, about the year 17 SO.
* [It is ioterestiiig to remark the diasatiaiactioQ of our author, respecting most of
the prevaleot notions of this period, upon medical topics. Fnm the multitude of em-
pirinl methods, he is earnestly seeking for something cf reason and truth.]— liiin. P.
REICOYAL OF OBSTAGLSS TO MERCURIAL TREATMEIH'. 129
dOO. For this end it will be most expedient, in all the states of the
system above spoken of, whether a general weakness and irritability,
or any other accessory disposition, constitute the obstacle to the mer-
curial treatment, to regard the genea»l (§ 578, 579) or specially direct-
ed (§ 580 — 585) tonic treatment as the chief preventive remedy of
Mlivation, and by no means to neglect its employment. Still we
would do well, in obstinate cases of composite venereal disease, to
precede the use of the mercury by a local treatment of the mouth,
which shall communicate the greatest possible tone to the salivary
glands, and give them sufficient firmness to resist the too facile pene-
tration of the mercurial irritation.
601. For this purpose I have found in my experience that the best
tiling to do, is for some days previously to hold in the mouth or
move them frequently hither and thither, substances that are strongly
attringent without causing nausea. I have oflen found of service an
electuary of catechu or kino, mixed with a portion of alum, and with
the addition of some syrup. I have employed a cold solution of
sulphate of zinc, and also alum and sulphuric acid, with much benefit,
to gargle or rinse out the mouth.
60^2. If we have to do with some (rare) cases of syphilis accompa-
nied by such urgent symptoms as to require the immediate use of
the mercury, we must immediately after the first dose of the
mercury, proceed to strengthen the mouth (§ 601), and if that will
not suffice to prevent those hurtful evacuations, we must have recourse
to external remedies also. A strong solution of alum or sulphate of
zinc in water, frequently applied, quite cold, (or cooled by ice), round
the whole neck, has proved uncommonly useful to me.
603. In very irritable, emaciated, debilitated subjects, especially in
such as have already suffered salivation from a previous employment
of mercury, the early administration of this metal is always of doubt-
ful propriety. In spite of every precaution we shall sometimes, es-
pecially if the obstinate symptoms of syphilis demand large doses of
the antivenercal metal, be completely unable to prevent salivation by
these external remedies.
604. If this take place we must immediately discontinue the mer-
cury, and besides the external use of the ice-cold compresses (§ 602 )
frequently renewed, we should uncover or shave the head, pour over
it cold water, and again dry it, whilst we envelop the feet in warm
coverings, or place them every four hours in a tepid (96°) foot-bath
for a quarter of an hour. The patient must rest in a cool dark room,
in a sitting posture, with a light covering over him. His attention
fihould be engaged with amusing stories, with music, &c.
605. As chewing greatly excites the salivary glands, we should not
allow at this time any other articles of diet besides thin soups, or
9
- »•
ISO ON y£NEB£AL DISEASES.
easilj digestible vegetables in the fonn of pur6e, with beer, milk and
the like ; but solid food, tasty and sweet things, especially coffee, as
also everything that excites disgust, must be avoided. If the thirst is
great, we may give sour drinks and food.
60 1>. We may at the same time continue assiduously the use of the
astringent electuary gargle (§ 601), combined with an eighth part of
laudanum. It is under these circumstances that I have also found
good effects from the internal employment of opium ^ (sometimes
combined with Minderer's spirit.)
607. If the bowels are constipated, they should be opened by one
or several clysters of vinegar.
608. I think I have been able to convince myself, by some experi-
ments I have instituted, that drinks saturated with sulphuretted
hydrogen gas do in a short time remove all the irritation produced by
the presence of mercury in our fluids, as this remedy rapidly penetrates
all the vessels, and instantaneously mineralizes the mercury wherever
it encounters it. We should give from six to eight grains of some
good preparation of hepar sulphuris in the form of pills within twelve
hours, and cause the patient to drink thereader a large quantity of
warm tea, made sour with lemon juice or cream of tartar.
609. But the surest way to prevent salivation is always a gradual,
cautious employment of mercury, and especially the selection of such
a preparation from which such an injurious effect is least to be appre-
hended. I have already sufficiently pointed out that the ordinary
mercurial preparations (especially the insoluble precipitates combined
with mineral acids, the turbith mineral, the red and white precipitates,
and calomel, as also Keyser^s drag^es, frictions, dec.) possess this
disadvantage in a high degree, with the exception of corrosive sublimate
and nitrate of mercury, also Plenk^s mucilaginous mercury, but al-
most only when it is least powerful, but especially the mercury
oxydized per *«, partly because it is not very apt to excite this eva-
cuation of itself, partly and chiefly however because it can be given in
determinable small doses that we may rely upon penetrating into the
fluids, which is not the case with the mucilaginous. I have found that
the soluble mercury uncommonly seldom produces salivation, not only
on account of its peculiar nature, but also particularly because it acts
in such small, such definite doses, so very uniformly, and far more
certainly and mildly than that oxydised per ae. If we commence its
use in very small doses, and only increase it gradually, paying great
attention to the state of the mouth, and if we employ at the same time
the accessory treatment pointed out, we shall very rarely be surprised
by salivation, even in those urgent cases in which it is requisite to
give it at the very commencement, or if it do come on it may readily
> Aocording to the experienoe of Hunter, Oirtanner and myselt it has certainly
great power in nlivatiaoi, although Blodi deniea it
BEKOYAL OF OB8TACLS;3 TO MERCUBIAL TREATMENT. 181
be checked bj some of the means indicated. So much is this the case
that when I deemed salivation of use in certain non- venereal affections,
I never thought of employing the soluble mercury for its production ;
In such cases calomel best answered my purpose.
610. Viol^it diarrhoeas are not easily avoided during the employ-
ment of the ordinary mercurial remedies, for either the preparation
itself is a purgative, such as calomel, or it becomes such from the
muriates that are present in the primse viae (white precipitate), like the
mercury introduced into the system by the rubbing-in process, the
nitrate of mercury prepared in the cold, Keyser's drag6es, and Plenk's
preparation ; substances of which the first and last, if perchance they
be very well prepared, contain an unexpected quantity of oxydised
mercury, which may be transformed by the muriates in our system
into a quantity of white precipitate sufficient to excite all at once vio-
leat diarrhoea ; the other preparations named are always ready, the
moment they come in contact with a gastric juice impregnated with
muriates, to change entirely into that strong, noxious purgative, white
precipitate. The addition of opium to these remedies is of little use.
611. Regarding the soluble mercury we may be sure, that even
yiongfa we neglect the rules for diet given below, it will excite no
purgation, but only one or a couple of loose stools, because the small
dose of it prescribed, even were it all changed in the stomach into
white precipitate, is not sufficient to cause drastic evacuations.
612. If, as sometimes happens, a violent continued perspiration
disturb the action of the mercury, a cool regimen and the employment
of sulphuric acid, will speedily check this evacuation. Some have
fbnnd bark very useful.
613. The diuresis that is more rarely observed, may be stopped by
a diaphoretic regimen and the intercurrent exhibition of cinchona bark,
as long as we know of no remedy that possesses the power of speci-
fically checking this evacuation.
FOURTH DIVISION.
THE NATURE OF THE SOLUBLE MERCURY AND ITS
EMPLOYMENT IN VENEREAL DISEASES.
614. Well prepared soluble mercury (see Preface) is of a blackish
grey colour and tasteless. It may be dissolved in vinegar, and in
water impregnated with carbonic acid, without leaving behind a trace
of turbith mineral or of white precipitate.
615. The rapidity of its action shews that it is almost instantly
dissolved in the gastric juice. It very quickly combines with the
132 ON YEKEBEAL DISEASES.
saliva in the mouth, and then immediately produces the peculiar
mercurial taste. *
616. When the proper diet is observed (§ 619) it causes no dis-
agreeable sensation in the stomach or in the bowels, no vomiting, no
diarrhoea, but passes directly, and in the course of a few hours, dis-
solved by the process of digestion, into the mass of the fluids.
617. It is only when there are muriates in the primae vise that there
is an exception to this ; in that case there occurs slight nausea, or one
or two loose stools. But it is usually taken so rapidly into the
general mass of the fluids, that even in this case there is seldom time
for its complete conversion into white precipitate.
618. As it is in every case the duty of a patient to avoid over-
loading his stomach, which he cannot transgress with impunity under
any moderate treatment, we may safely expect from any man whose
nature is not quite bestial, that in the treatment of such an important
disease as syphilis is, he will observe a slight restriction in diet whidi
will cost him such a small sacriflce and have so much influence on the
well-being of his future days.
619. In order to obtain this object and to remove all traces of mu.
nates from the primee viae, if the antivenereal remedy is to be taken, as
is usually the case, in the morning, we let the whole supper of the
previous evening consist of some uncooked fruit. The following
morning we allow the dose of soluble mercury to be taken as early
as possible in some distilled water, and nothing to be partaken of for
four or six hours thereafter ; then if there be great thirst ^ the patient
should take a little more distilled water, or cow's milk, or If there be
weakness, a draught of good wine ; so that during a period of twenty
hours nothing shall enter the stomach that contains a trace of muriate
of soda. At dinner time (noon) he makes an ordinary or moderate
meal of anything ^ that comes to table, excepting the flesh and fat of
geese, ducks and pork. We may allow those accustomed to it a glass
of wine.
620. We may give the soluble mercury either alone, or in order
to make the dose appear larger, rubbed up with some liquorice or
mallow root. If we have to do with persons who are not to be trusted
to in the observance of dietetic rules, we may add a half or whole
grain of opium.
' This shoiild be endeavoured to be avoided ; for during its cootinuaoce there
seems to be developed in the gastric juice, or to be deposited therein fix>m the blood,
an ammoniacal or muriatic acridity. The distilled water may be used either cold, or
in the form of tea, made with liquorice and linden flowers, provided we dispenss
with the use of sugar. The thirst may also be quenched in the morning by means
of fruit
* Meat may be partaken of along with the vegetables as long as the former is not
contraindicated by the advent of the mercurial fever or any other inflammatoiy
state. «
NATIJBE OF THE SOLUBLE MEBGUBY, ETC. 188
621. Although in the case of very sensitive but healthy persons
who are very obedient in respect to diet, I have sometimes not had
occasion to use more than one grain of soluble mercury in all, in order
to cure moderate idiopathic venereal symptoms and commencing
syphilis, yet I have met with cases in which sixty grains were ne-
cessary.
622. This extreme variety depends, as far as I have been able to
oheerve accurately, on this, that in the first case the mercurial fever
(g 290) occurred as rapidly as could be wished for. But when I was
Ibroed to use such a large quantity, the reason was, that either some
circumstance suddenly occurred that frequently interrupted the em-
ployment of the medicine, or that previously much mercury had been
used ID vain, or that (in the case of persons of good constitution who
could not, on account of their avocations, omit appearing in public
every day) I had to excite and maintain a gradual (slow) mercurial
fever.
623w On an average however I have found, that in order to era-
dicate a moderately severe syphilis, not more than ei^ht grains were
required, while for a severe and deeply rooted case, about twelve
grains were needed.
624. But if we wish and are able to excite, 1st, a rapid mercurial
fever {febria murcurialis dcuta), a still smaller quantity is necessary
in the very severest cases ; but if, 2dly, on account of the circum-
stances that may arise, we must divide the mercurial fever into two
or three small attacks, then more, sometimes much more, than
the quantity indicated is required ; but much the largest quantity is
necessary when from the above reasons we have to excite, 3dly, an
unnoticeable mercurial fever {febris mercurialis lento). I beg that
these three cases may be carefully distinguished.
625. In the first case I must be satisfied that no tendency to saliva-
tion exists, or that the patient has previously used mercury without
having incurred this evacuation. In that case 1 gave from the very
first lai^e doses of the soluble mercury, and increased them rapidly,
in order to excite quickly a severe mercurial fever, — (probably from
a half to one, two, three grains ; or in robust subjects and severe cases
of lues, one two, three, four grains.)
626. In the second case (§ 624), usually when there was present a
tendency to salivation, or when this evacuation had already occurred
during a previous employment of mercury, I increased the quantity
of the soluble mercury very gradually, so that I could leave it off on
the slightest appearance of salivation, employ measures to combat it
(in the progressive scale of from \ to ^, j^, }, 1, \\ grain). I calmed
the irritation of the mouth and recommenced after an interval of
from eight to fourteen days, to increase the dose (from about ^ to 1,
18i OK VENEBEAL DISEA^ISS.
1^ up to 2 grains), and so on until the syphilis had completely dis-
appeared.
627. In the third case (§ 624) I used for eight or ten days only
one quarter of a grain^ daily, then for about the same period one grain,
then two, then four grains, until all traces of the lues were destroyed.
Patients of this sort must either be otherwise of very healthy robust
constitutions, or else they must be unremittinsly treated with tonics
at the same time, in order that the long continued irritation shall not
injure them. On the slightest affection of the mouth the mercury
was discontinued for one or even several days, and the precautions I
have described employed to combat this accident.
628. As a rule it is good, after the complete disappearance of the
venereal symptoms, and the occurrence of a proper mercurial fever,
especially in the rapid treatment (to which, when it is admissible,
I give the preference), at once to discontinue the soluble mercury,
and to wait and see whether or no the same symptoms do not reap-
pear after four or five weeks. If nothing occurs we may, even in
cases of deeply rooted syphilis, rest assured that a cure has been
effected (even without waiting till this time has elapsed, we can be
perfectly sure of the cure, if a sufficiently severe mercurial fever made
its appearance) ; but should the same symptoms shew themselves, the
mercurial fever must have been too weak, an error we must seek to
repair by endeavouring, after the lapse of this time, to develope a new
and much more severe mercurial fever than the first was (which is
done with more trouble and by means of doses increased more rapidly),
whereby all remains of the venereal poison will be certainly eradicated
to the very last trace. But this is a very rare case, that can only
happen to an inexperienced practitioner.
629. Recent buboes, simple chancres, and commencing lues, require
almost the same degree of mercurial fever ; but lues with symptoms
of the more remote kind, with nodes, &c., as also condylomata and
old degenerated chancres and so forth, require the more severe fever.
630. If we wish to prevent a painful and inflamed buboe from sup-
purating, by the speedy destruction of the venereal virus, or timeously
avert the threatened danger in phimosis and paraphimosis from
chancres, a severe mercurial fever must be quickly excited. Accord-
ingly directing our attention to the preservation of the salivary glands,
of which I have treated in the previous chapter, we should here
increase the doses of soluble mercury from 2 to 3, 4, 5 grains,
and whenever the fever shews itself of sufficient severity, call a halt,
and then terminate gradually what we were forced to commence
violently.
* This dose given for four or five successive days without increase, frequently suf-
ficed with sensitive individuals to produce an adequate artificial fever, and thereby
to effect a perfect cure.
KATIJBE OF THE SOLUBLE MERCUBY, ETC. 185
631. All the doses spoken of in this chapter are to be understood
as daily doses, as it is well always to wait for twenty -four hours, and
during that time to observe the effects of each dose.
632. In cases where I have found no special preparatory means
requisite, e. ^., in otherwise healthy, robust subjects, not only are no
venesections, baths, or diet drinks prescribed, but not even a dose of
laxative medicine, even should there be plenty of time for all this, (of
in the medical art nothing unnecessary should be done. When cir-
comstanoes demand it, I prescribe not only every one of them, but 1
even give previously, or during the course, emetics, when obstinate
impurities of the stomach, derangements of the bile, and so forth,
present obstacles to the treatment.
633. As mercury does not cure syphilis by causing evacuations
(§ 591) (but often thereby makes it more obstinate), but as it rather
only cures the disease by the gradual or sudden antipathic irritation
of the fibres of a specific nature (I do not deny that there may be a
diemical neutralization or destruction of the venereal virus by the
mercury dissolved and assimilated in the fluids of the circulation) ; it
£)llows, that the physician, carefully avoiding all severe mercurial
evacuations (salivation, diarrhoea, &c.), should direct his especial
attention to develope the above (§ 290) described mercurial fever* in
the manner indicated, in a degree accurately proportioned to the inten-
sity and age of the lues, and of the idiopathic venereal aflection.
634. Thus, when all circumstances are favourable, the most inveterate
lues may be radically removed in the course of a few days by a severe
mercurial fever, while a slighter degree of recent syphilis, a single
chancre, &c, may require a long time for its cure (let alone an old
standing case of syphilis) if we do not produce an obvious mercurial
fever, but administer the mercury in too weak doses, and do not increase
them sufficiently when the symptoms are about to disappear.
635. If during the latter mode of treatment, which is of very
doubtful propriety, the system should, from the long-continued mer-
curial irritation, have become very sensitive and weakly, as often
happens if the tonic treatment have not at the same time been em-
ployed, it must be resorted to immediately after the termination of
, the mercurial treatment, or still better, immediately on the appearance
of the debility and symptoms of irritability, and be energetically
continued until the body can be pronounced sound in every respect.
' I lay it down as an already proved axiom, that tlie effect of the mercury on the
Teneieal poison stands in direct relation to the intensity of the mercurial fever, and
b diverted by any attack on the mouth; the bowels, and other excreting organs ; but
the mercurial fever is so much the greater, the less mercury there has previously been
osed: and the milder and more soluble the mercurial preparation employed is, the
more rapidly it b introduced into the system, and the more completely all evacuations
are avoided during its use.
136 OK YEKEBEAL DISEASES.
On this account also we must beware of a too sleepy employment of
mercury, as it only tends to make the virus more obstinate, and even
disposes the system to let it break out still more virulently,^ when the
metal is no longer in the fluids.
FIFTH DIVISION.
LOCAL AFFECTIONS AFTER THE TREATMENT OF
SYPHILIS.
CHAPTER I.
LOCAL AFFECTIONS THAT REMAIN AFTER A SUITABLE TREATMENT
OF SYPHILIS AND THEIR REMOVAL.
636. There are few local affections dependent for their morbid
character on the virus of syphilis that should remain in the body
after a rational employment of soluble mercury.^ I shall only make
mention of the warts, the periosteal and osseous swellings, and the
caries of the bones.
637. The venereal warts must be uncommonly hard and old if thej
^ I gave a peasant, who was affected with some ooodylomata on the anus, scaroelj
observable pains in the bones of the shoulder, and small ulcers in the tonsils of Hib
throat, in the course of seven weeks, 12^ grains of soluble mercury, divided into equal
small doses. In the first two or three days all the symptoms were aUeviated, withoal
his having experienced the slightest mercurial fever : the ulcers had disappeared firom
the mouth, the pains in the bones were gone, and the condylomata were painless and
dry. His amelioration remained in this state until after this small number of pow-
ders had been used. He thought he required no further aid, discontinued attendance*
and only returned after the lapse of four weeks. His mouth was now covered to the
lips with ulcers ; an ulcer 2^ inches in length and half as broad, had eaten away the
upper surface of the penis, the anus was beset with similar ulcers, humid fissures^
and a number of moist condylomata ; ihe pains in the bones were intolerable, and the
patient seemed to be weary of life. X now gave him 12 grains of soluble mercury, to
take the first day 8, the second 4, and ihe third 6 grains. He had a very seyere
fever without salivation, and after five days not a trace of hb venereal malady re-
mained. The ulcers were healed, the pains gone, and the warts dried up and gradually
fell oft At the present time, after 2i years, he is as well as ever. From this it
appears Ist^ that a sleepy employment of mercury rather excites than cures the
venereal disease ; 2d, that the point of importance is not the quantity of m^ncuiy*
introduced into the system, but the adequate intensity of the mercurial fever.
* We have still greater advantages in the treatment of chancres and buboes ; for if
we have once cured them by internal mercurial remedies only, we may be assured of
the eradication of the idiopathic virus. But in syphilis, especially when it is of loog
standing, the local affection is often so masked, so very similar to other diseases, that
we cannot be immediately certain of the cure, if we cannot be convinced of the in-
tensity of the previous mercurial fever ; but especially difficult is it to decide, when
local affections remain that present the appearance of uncured venereal ones, for
then the eradication of the virus becomes a matter of only doubtful probability.
NATURE OF THE SOLUBLE MERCURY, ETC. 187
do not wither and fall off, or otherwise disappear, under a mercurial
fever of due intensity, or, as more rarely happens, terminate in healthy
suppuration.
638. If afler complete extinction of the virus there remain some
old, homy, large warts, they may be removed by surgical means.
Hiey may either be tied with a waxed thread, by drawing which daily
tighter and tighter, they will be gradually perlectly dried up and so
fall oSj or they may be cut off close to the root, and the wound touched
once or several times with lunar caustic, and when the last slough falls
off the wart is completely removed.
6^9. But if they are in situations where they do not cause any
inconvenience, if they are not very large or elevated, we may in
many cases allow them to remain. They are innocuous, and generally
disappear gradually of their own accord.
640. It is almost the same with the periosteal and osseous swellings.
They usually diminish gradually of themselves after the complete
eradication of the lues venerea. The parts exposed to the more remote
kinds of local diseases are affected by a perceptible swelling whose
removal we should not attempt to obtain by pushing the employment
of the mercury too far. Even were the virus not completely eradi-
cated in them, it cannot be again absorbed into the system from them,
and so- cause fresh symptoms of syphilis; but it will be destroyed,
provided the mercurial fever was of sufficient intensity. In the latter
case the swelling and induration will usually remain stationary, shew-
ing that the virus has been destroyed ; after some time it declines
spontaneously if it be not too hard, and if the patient be not too aged.
641. I have already said that such nodes usually pass spontaneously
into a mucous suppuration, which on account of the ensuing destruc-
tion of the periosteum, becomes dangerous for the bone beneath.
Under the adequate mercurial fever the unhealthy pus already formed
becomes changed, and not unfrequently resolved ; a true cure, which
at the most only leaves behind it a painless elevation of the node. If
the result be so fortunate, it often remains a matter of uncertainty
whether an abscess was previously formed, as its existence is so diffi-
cult to discover while the lues is still uncured. It is however a
matter of great indifference ; it suffices if the cure is effected.
642. But if the abscess have gone too far, if the mercurial fever
have indeed deprived it of its venereal character, but is unable to
effect its resolution, then there is always danger of the bone being
corroded after the destruction of the periosteum. We must ascertain
the exist<ince of the abscess in order to be able to treat it locally.
643. It is moreover not difficult to discern the presence of this non-
venereal abscess (however difficult the discovery of the venereal ab-
«CC8S may be), as its existence caimot be doubted if during the adequate
138 ON YENEBEAL DISEASES.
mercurial fever, or a few days thereafter, a throbbing pain continues
or occurs in the centre of the periosteal node ; a sensation that differs
widely from the agonizing pains of the still venereal node.
644. We should then make a sufficiently deep and extensive incision,
evacuate the pus, clean the ulcer, taking care not to remove any of the
sound periosteum, and we should treat the wound like an ordinary
ulcer. When we make this opening we perceive a pus of a mucous
character certainly, but mostly well concocted, whereas what existed
before the mercurial treatment was merely an albuminous fluid.
045. This it is that after corroding the periosteum causes caries of
the bone. If the mercurial treatment is at an end, and the node, on
account of the persistence of the pains, opened and cleaned, we shall
soon be able to discover the caries, if it exist. It is now no longer
venereal, if the mercurial fever was of sufficient intensity, and, like all
other caries from external causes, it will take on the healing procesS}
and will require to be treated by similar remedies.
646. If the caries be superficial, advantage will be derived from
scraping the bone, from the employment of the actual cautery, from
sprinkling it with cuphorbium powder, from touching it with a solution
of nitrate of silver, and so forth. If it penetrate more deeply, and
be already seated in the interior of the hard tubular bone, it is gene-
rally accompanied by slow fever, brought on by the acrid ichorous
secretion. We should bore holes in different parts of the bone, and
deep enough to allow of the escape of the matter, and then treat the
interior with a solution of lunar caustic or nitrate of mercury,* die
Caries of the spongy bones, e, g, of the nose, requires a cautious in-
jection of the latter remedies,^ and the moderate introduction of the
vapour of a small portion of cinnabar into the nose.^ If all these
kinds of caries are mere remains of the cured syphilis, they will be
susceptible of cure without much difficulty ; but much more destruc-
tive and obstinate, as also more frequent, is the caries produced by the
irritation of mercury and from the morbid condition of the fluid and
solid parts thence resulting, of which more anon.
647. The swellings of the ligaments, tendons and tendinous aponeu.
roses that remain are very obstinate. If, as is however seldom the
case, they have not yielded on the extinction of the venereal virus by
mercury, we must combat them by the application of blisters. If this
prove ineffectual, and they still remain painful after the mercurial fever
^ One part of each dissolved in from 800 to 400 parts of water, to which should
be added thirty parts of tincture of myrrh or aloes.
' Girtanner recommends strongly the repeated injection of a solution of caustic
potash, or the same remedy used as a gaigle.
' Without however drawing in air by the nose, in order to prevent the vapour from
getting into the lungs.
LOCAL AFFSCnONS AFTER TH£ TREATMENT OF SYPHILIS. 189
(a sign tliat they have become non-Tenerea] abscesses), they must be
opened. They must then be treated with proper vulnerary (one part
of corrosive sublimate dissolved in from 400 to 500 parts of water)
and balsamic remedies.
CHAPTER II.
LOCAL AFFECTIONS AND SECONDARY SUFFERINGS THAT FOLLOW
THE ABUSE OF MERCURY.
t>48. We might d priori suppose that a drug like mercury, which
produces such tremendous effects on the body (such as mercurial fever,
salivation, dec are), must by a long>continued and too frequent em-
ployment weaken the strength to a great degree, and set the fibres into
morbid, irritable vibrations, the source of all sorts of chronic diseases
that are difficult to cure, of rheumatic, erisipelatous, and especially o^
scrofulous (scorbutic) and chlorotic character, of trembling, of low,
wasting fevers, of malignant, corroding ulcers of the soft and hard
parts of the human body, &c. And this is just what we find from ex-
perience, which presents us with thousands of lamentable instances of
this sort, produced by the immoderate use of inunctions, mercurial
jdasters, calomel and the like.
W9. Gonorrhoeas are transformed into gleets, and those already
eared again commence to discharge ; buboes take on an unhealthy sup.
puration, become deep and excavated, excrete a large quantity of acrid
fetid ichor, evert their hard borders, and eat about them in a cancerous
manner, accompanied by agonizing pains ; close to the seat of the pre-
viouslv healed chancre numerous ulcers break out ; the constitutional
syphilitic ulcers break out again, or become altered in their nature ;
they inflame, excrete much matter, get a hard base, a cancerous look,
and are painfully sensitive ; condylomata discharge much ichor, and
jtfe corroded into deep, painful fistulous ulcers ; others grow into sen-
sitive, spongy swellings, almost impossible to be got down ; we per-
ceive on different parts the periosteum thickened and painful ; vene-
real ulcers in the throat that have healed up again break out ; the ton-
sils swell again and become sore ; the palate also becomes affected by
intolerable shooting pains, studded over with small ulcers, and at
length perforated ; the uvula sloughs off, a fetid smell proceeds from
the nose, which, along with the antrum Highmorianum (in the worst
cases) arc gradually eaten out ; the body becomes pale and lax, the
digestion is deranged, the catamcnia disappear, the legs swell some-
times, the patient is excessively sensitive to all impressions, to heat
and cold ; there is great weakness and despondency ; his nights, full
of pains and restlessness, are martyrdom to him ; the bowels are at
one time constipated, at another purged : towards evening he has tran-
sient debilitating heats, and his pulse usually ranges fron\ 100 to 130
140 ON YENEEEAL DISEASES.
in the minute ; only for a few, often fixed, hours during the day do
his agonizing pains lessen somewhat ; at other times they prevail con-
stantly, especially during the night. There are stiffness of the joints
and chronic trembling. One or both eyes are affected by amaurosis.
650. There are various causes for these ill effects of mercury, which
have mostly been already mentioned in the former parts of this book.
It has been usual to lay down the following pernicious maxim for the
treatment of venereal disease: that as much mercury as possible must
be introduced into the system — though modern physicians have wisely
added this limitation (which however is unsatisfactory and, on account
of the nature of the ordinary mercurial preparations, impracticable) —
in as short a time as possible without causing salivation. Had they
been aware that success depends upon the adequate intensity of the
mercurial fever, and not on the introduction of an enormous quantity of
the metal into the system, they had forborne to lay down this perni-
cious rule. Moreover, as the nature of the ordinary mercurial pre-
parations rendered it impossible to know whether much or little of the
active part of the metal got into the circulation in a given time, it
could not but happen that sometimes too much was imperceptibly dis-
solved in the juices, and occasioned horrible devastations. Besides
this it has hitherto been the custom to employ the irrational French
weakening system, both during and after the treatment, which did all
that was possible to assist the irritating and debilitating power of the
mercury.
651. But what did more than all the causes I have mentioned to
render the ordinary mercurial treatment so injurious, was the un-
pardonable inattention to the connexion betwixt cause and effect, for
the symptoms that arose during the treatment from the mercurial ir-
ritation were considered to be genuine venereal symptoms, and were
combattcd anew with a still longer continuance of the mercury, to the
injury of the patient, who thus became the victim of stupidity. Weak,
chlorotic, scrofulous, or scorbutic subjects, those, namely, who had be-
come affected with spreading ulcers in the mouth, from the quantity of
mercury they had taken, were dosed with still larger quantities of this
irritating metal, and caries took possession of the nasal and palatial
bones ; these were still held to be venereal, the consequence of which
was, that the malady increased to the most horrible, often fatal ex-
tent. Buboes that had, by a succession of errors, degenerated under
the long continued employment of mercury into spreading ulcers, were
treated by an increased administration of mercury, and mortification
or cancer (or whatever this sloughing diathesis may be called), hectic
fever, hemorrhages, diarrhoeas, night sweats and death, were the
result.
652. And yet what opportunities presented themselves for deducing
LOCAL ATFECmONS AFTEK THE TREATMENT OF SYPHILIS. 141
this maxim, diat the very first day when the amendment of the venereal
symptoms stood still under the jridiciously increased administration of
the mercury — that the very first hour, when, under the mercurial treat-
ment, new affections, new pains, new abnormalities presented themselves,
or the previous genuine venereal symptoms were aggravated — we should
pause ; and that state of the body that presented these obstacles to the
venereal treatment, be it scrofula, chlorosis, erysipelas, gout, scorbutus,
or only weakness and irritability, should be combatted, and the {fre-
quently irritating) mercurial preparation, the usual exciting cause of
such morbid diathesis, should be discontinued immediately. All the
pains that remain, increase, or arise during the mercurial treatment,
all local affections, further, swellings, ulcers, caries of the bones, 6ec.,
that break forth anew, increase or occur for the first time during the
use of mercury, are no longer of a purely venereal nature, they are
often of a totally non-venereal character, and can never be cured* by
the further administration of ever so large doses of this metal — ^but
will, on the contrary, be aggravated. If this maxim had been kept
in view, there would not assuredly be so many unfortunate beings
whose health has been undermined and destroyed by misdirected
mercurial treatment
653. I say, no longer of a purely venereal nature, for all those whose
Bufferings have been aggravated by the continued or renewed mercu-
rial treatment, are not therefore free from all taint of the venereal
Tims. In deeply rooted syphilis occurring in scrofulous, scorbutic,
gouty, erysipelatous, chlorotic, or otherwise weakly irritable indivi-
duals, the ordinary inappropriate mercurials may, after a debilitating
preparatory treatment, or along with a similar accessory treatment,
be given in such a drowsy fashion, that this metal can scarcely do
more than exercise its weakening irritation, but not its antisyphilitic
power ; and then it will happen that the concomitant morbid diathesis
gains so much the upper hand, that when wo would endeavour to de-
stroy the venereal virus (which is now almost concealed beneath symp-
toms foreign to it, so as scarcely to be cognizable) by means of a fur-
ther or increased employment of mercury, the slow fever, the scrofu-
lous ulcers, &c., arising from the concomitant diathesis, increase to
such a height that the patient is in danger of losing his life, or a chro-
nic dyscrasia is the result, and still all remains of syphilis may not
thereby have been eradicated.
654. The traces of the venereal virus in the system are not at once
cognizable amid these exacerbations, and amid these obvious injurious
effects of the mercury. It is only when, by an energetic (often te-
dious and lengthened) treatment of another kind, the patient has jo^r-
fectly recovered from his accessory diseases, and has regained his
' A cure might occasionally have been effected by a dangerous salivatioD.
142 ON YENEBEAL DISEASES.
health, then only does the syphilis again rear its head in an unmistake-
able manner, the symptoms proper to it still remain, which may not
be removed by any remedy in the world, any tonic, anti-scorbutic,
anti. scrofulous, and anti-chlorotio drug — ^but only, and that easily, by
the renewed employment of a good mercurial preparation alone. This
event alone (we have no other mode of proving it) demonstrates by
the result, that during the former unfortunate mercurial treatment the
syphylitic virus was still undestroyed.
655. This is the place to dispel the delusion that after such an ex-
cessive administration the mercury still remains almost ineradicably
in the system, and gives rise to all the horrible devastations, the hectic
fever, corroding ulcers, caries of the bones, trembling, wandering
pains, &c.
656. The metalic mercury occasionally found in the cavities of the
bones proves nothing ; we may carry this about with us without our
health being thereby affected. How can an insoluble substance be-
yond the circulation- act upon the latter 1 But, it is replied, this fluid
metal is a proof of the probable coexistence of a dissolved portion of
mercury in our fluids ! As long as we are unable to prove its exist-
ence in our fluids more accurately than by supposition in those chronic
diseases, so long may we be allowed to ascribe their obstinacy to
other causes, which as I have shown in many places, are not fiu* to
seek.
657. The fact of gold growing pale and brittle when worn by those
who have this metal in their fluids, the destruction of the vermin on
their head, but chiefly the non-infecting power of their chancres, &c.,
gives us distinctly to understand that where these phenomena are
wanting, there can be no question of the existence of mercury in the
circulation. According to accurate observations we may with cer-
tainty assert that the portion of mercury dissolved in the circulation
to-day will be no longer present after the lapse of four weeks, but will
be indubitably expelled by its own constant irritation through some
excretory channel. We may perhaps' at first find traces of the metal
in the saliva of a person undergoing ptyalism ; but shall we be able
to detect any after the lapse of three weeks from the last dose of
mercury 1
658. Should it be still time to suspect an excess of this metal in
the secundce viae, in order to remove the secondary suflerings from a
mis-directed mercurial course, sulphuretted hydrogen as a drink
(§ 608), or used as a bath in a similar form, may prove of service.
659. The removal of the other symptoms, cccasioned or aggravated
by the mercurial treatment, is to be conducted on nearly the same
^ CniikBhank's experiments do not allow that any mercury exists either in the
saliva or in the urine of a person undergoing saliTation.
LOCAL AFFECTIONS AFTEB THE TREATMENT OF SYPHILIS. 143
principles as I have laid down in regard to the preparatory treatment
(§ 579— 586). We may employ in addition, country air, sea voyages,
the diligent use of cold bathing, especially in the sea, and in many
oaaes the use of the Pyrmont waters. The sores should be dressed
with cleansing and strengthening remedies, especially with a solution
of lunar caustic, with the addition of essence of myrrh and tincture
oi opium, the latter of which, both externally and internally, must be
the chief remedy in many of these cases.
660. Hiis same medicament, consisting namely of one part of ni-
trate of silver dissolved in from 500 to 600 parts of distilled water, to
whidi is added 30 parts of laudanum, and 40 parts of essence of
myrrh^ will be the very best injection^ for the carles of the bones,
produced or aggravated by the same cause. All that surgery requires
to do besides, consists in an appropriate extension of the fistulous ori-
fices that occur, in order to remove the dead pieces of bone con-
veniently and without employing any force, and in making suitable
opoungs at the most dependent points, in order to allow the matter
to escape. A numb sensation of the external integuments of the
olieeks, and the severe pain inwardly at that part, enables us to disco-
ver a collection of matter shut up in the antrum Highmorianum,
which we should endeavour to let out by extracting the third molar
tooth of the same side, and boring through the alveolar cavity, and
through this hole the injections should be performed.
661. But besides these operations the chief thing we have to at-
taid to in such cases of caries of the bones, which are generally kept
tip by irritability from weakness, is the general constitutional treat
ment. If any other accessory diathesis be present at the same time,
we should bear it in mind. The remedies serviceable for the latter
should therefore be continued with the general tonic treatment, which
should be gradually increased to the very utmost extent. Cold steel
bath» for the whole body, exercise in the open air, bathing the shaven
head in ice cold water, general frictions, steel, bark, wine, &c. With
these tonics we must combine opium, wherewith we shall best be able
to soothe the sleepless painful nights, and we should also give it in
combination with tonics as a general rule, in order to moderate the ir-
ritability for which it is almost specific in this combination, as Grant
has remarked, and 1 have had opportunities of observing. In this
combination I have also employed ammonia with the best effects.
662. Sarsaparilla in strong decoction ^ taken to the extent of three
ounces daily, and lai^e doses of assafoetida or hemlock, are said to be
of great use in this caries of the bones.
' Should the disease, as usually happens, have its primary seat in the back of the
palate, the nitrate of silver mixed with 8000 parts of water, and used aa a gargle
(also oombiaed with laudanum), will prove the beet remedy.
APPENDIX.
VENEREAL AFFECTIONS OF NEW-BORN INFANTS.
663. The venereal affections of new-born infants have very rarely
been an object of investigation on the part of medical men, partly
because they have seldom come under their cognizance, partly because
these poor creatures often survive their birth but a few months, partly
because their disease has oflen been mistaken. Doublet^ has given
us the best information on this subject ; I shall follow him in many of
the subsequent remarks.
664. Most authors hold them to be an infection in the mother's
womb ; others, but few,* consider the venereal affections of infants to
be local inoculation,^ and degenerations and extensions of the disease.
I must confess that I incline to the latter opinion, for several reasons.
665. That the cure of the pregnant mother of the venereal disease
is followed by the birth of healthy children proves nothing, as no one
can be cured of syphilis without at the same time losing the local and
idiopathic venereal affections. On the other hand, syphilis may seem
to be born with the children, because in them all symptoms foDow
each other more rapidly, and local affections pass«o rapidly into general
maladies ; their bodies are more tender and irritable, their skin is
much more delicate, and the circulation twice as rapid as that in adults.
But has any one ever observed in infants immediately after their births,
the copper-coloured spots or the ulcers of the tonsils, or genuine open
syphilitic ulcers on the surface of the body, or even the venereal itch?
That these are found after several weeks or months proves nothing.
On the other hand, we find those parts of the bodies of new-bom
infants affected with the venereal inoculation, which, either on account
of their being destitute of epidermis, are capable of being inoculated
in adults also, or are most pressed upon or rubbed in their passage
through the female parts. Their epidermis is still so delicate (so
much the more so, as these children on account of the mother's ind»-
position can seldom be carried to the full term, or are otherwise weakly
and delicate), that on those parts the poison can penetrate through the
* And now Qirtanner.
' Among these, more especially Qirtanner.
' The inoculation of healthy nurses by venereal infemts is no rare occurrence*
How could the latter however communicate chancres to the nipples when sucking, if
they had not themselves chancres seated on the outer or inner surOEice of the lips, that
is to say, idiopathic venereal ulcers, which oonstitutioDal syphilis can never prodooe t
VSNEBEAL AFFSCTIONS OF N£W*BOBN INFANTS. 145
e{udermis» wMdi, from an opposite reason, cannot occur in adults.
But I shall admit all these affections to be of a general syphilitic
character, whenever any one shall shew me such a child was bom of a
mother that had been infected with syphilis, but who was completely
free from all local idiopathic venereal affections on and in the genitals,
from gonorrhoea, chancres, and condylomata.
666. We find, 1st, the following affections on parts where adults
also may be inoculated without any previous injury. The eyelids,
especially the upper ones, are swollen ; the eyes are at first i^ected
by dry inflammation, subsequently they usually discharge an acrid,
purulent whitish-green, oflen copious matter (blennorrhoea of the eye
fiom local inoculation) ; during sleep the lids stick together. (This is
one of the chief diagnostic marks of this sad disease in children.)
Spots on the cornea, hypopyon, blindness, are not very frequent
effects of it. The ears also are apt to discharge similar matter.
667. The comers of the mouth, the frenulum of the tongue, the an-
terior part of the gums, are studded over with small ulcers, which are
Tery hard at their bottom and all around them — true chancres. Bu-
boes in the parotid gland, at the angle of the lower jaw, &c., ensue.
668. The nostrils discharge a purulent matter (nasal blennorrhoea)
tliey are also stopped up with masses of hardened pus.
669. Inflammation of the genitals, chancres in the glans and labia;
strangury, swelling of the scrotum and of the external labia, and
fbaures and pustules at the anus, are common symptoms. Gonor-
riicBa, however, is not found in male children ; but from the female
genitals there exudes a yellowish matter, that may easily be distin-
guished from the discharge of a natural fluid, to which all new-bom
female infants are subject.
670. The affections of new-bom infants, 2dly, on parts where adults
are not infected without being wounded, are most frequently regarded
as signs of syphilis communicated to them in the womb, although
they are manifestly quite the reverse ; they are infiammations of the
skin on parts of the body where the skin alone is stretched over pro-
jecting bones, which have been during delivery particularly rubbed
against the genital parts of mothers that are covered with the chan-
erous discharge, and thus have been inoculated (per diapedesih)
through the thin epidermis. They]^are of the following kinds :
671. The region of the coronal suture, the protuberance of the pa-
rietal and occipital bones, the shoulders, the region of the sacrum and
hip bone, the ankles and the heels, are externally reddened and inflamed
The epidermis soon falls off, the sore places extend and become covered
with a white crust, beneath which an acrid fetid ichor exudes.*
* Or these parts rise up in inflamed, brown, soft swellings, which usually pass
duigerouB suppuratioD.
10
146 ON YSKEBSAL PISSASES.
When these parts become black, mortification is nigh, the sign of
approaching death.
672. A similar inflammaiion of the' skin and ulceration attacks from
the same cause the neighbourhood of the navel, in consequence of this
part being very much strained during the process of delivery ; and
moreover the natural inflammation that takes place in infants before
the navel string falls off may favour the action of the virus on that
part.
673. The affections that constitute the transition of the idiopathic
virus into the general circulation in adults are also not unfrequently
met with in infants some time after birth, I mean the glandular
swellings. These buboes occur in them in the cervical glands, in the
parotid gland, and in the auxiliary glands, either from the chancres on
the lips or from similar ulcers (§ 671) on the head and shoulders —
in the groins from chancres on the genitals or from similar sores on
the sacrum and hip bones, the ankles, 6ec. — or also, in any of these
situations, from the direct penetration of the chancre poiscm through
the external integuments, without any previous chancres ; and this
occurs much more frequently in these delicate creatures than in
adults. These glandular swellings, like those in adults, usually ter-
minate in suppuration if the virus be not destroyed by mercury.
The suppuration of the parotid gland has a great tendency to involve
the bony structure of the mastoid process.
674. The symptoms of general lues always occur only afVer several
weeks,' sometimes (according to some authors) not before eight
months after birth. The skin becomes covered with bluish spots,
which, as in adults, become in course of time somewhat elevated, and
gradually are covered with a greyish dry crust. Or there are at first
merely excoriations. Subsequently there are formed at these parts
venereal ulcers, which arise most rapidly in the axilla, betwixt the
thighs and betwixt the nates, and have a white, suety-looking ap-
pearance. The whole skin is also sometimes covered with bran4ike
points. General venereal ulcers also appear in the mouth and on the
tonsils. Single elevated pustules are formed on the dorsum of the
fingers and toes, which rapidly pass into ulcers and cause the nails to
fall off by the roots. Running chaps appear at the anus. Swellings
of the bones, however, and gonorrhoea in the male, are not met with in
infants.
675. Such children are usually very weak and emaciated; their
skin, especially that of the face, is of a bluish colour, shrivelled and
full of wrinkles, like an old person's.
676. The usual mode of treating the venereal diseases of new-born
infants at Vaugirard consists in treating the mothers before they are
' QirUimer Bays, in from ten to fourteen daysr
YSKSRBAL AFFECTIONS OF NSW-BORN INFAKTS. 147
bom or while they are at the breast. None of the metal is given to
the infant directly.^
677. If the mother be subjected to treatment before her confine-
ment, she is treated with diluent drinks, bitters, mild purgatives, baths
and mercurials, so as to alleviate her disease and to facilitate her de-
liTery ; but after delivery, from the twelfth day onwards, she is made
to rub in every other day from one to two drachms of mercury at
a time, so as that she shall use from three to four ounces in the course
of five, twelve, or even twenty weeks. During this course she suckles
the infected infant, or even a couple of them, in order to impregnate
them with the antisyphilitic specific along with the milk.
678. It is observed that children whose mothers have been treated
with mercury before their confinement suffer little inconvenience from
the ti ercurialized milk (they are already used to the metallic im-
pression) ; those, however, who have experienced none of the influence
of the mercury on their fluids before their birth, on using this milk be-
come pale and get belly-ache, heat and loss of appetite, especially if
they are kept not warm enough or too warm. In this case the fric-
tions are discontinued, and soothing medicines, mucilaginous drinks
lod clysters are employed.
679. Very soon the putrid hospital apthse attack and carry oflf a
laige number of these children.
680. In course of time, about the sixth week, slow fever, diarrhoea,
dsc, usually set in, whereby many are destroyed.
681. The rest gradually escape the danger; the venereal symp-
toms disappear, and there only remains a greater or less liability to
the common diseases of children.
682. From all this we learn nothing more than that the venereal
affections of new-born infants are curable, for as regards the mode of
treatment, it is burdefted with such a vast number of evils that it
cannot be recommended for imitation. Let us for a moment consider
how much injury the health of the pregnant woman must at first suffer
from the five to twenty weeks of mercurial irritation, and how aimless
such a treatment is, as not only are they not cured by it, but it is
not intended for their cure ! If the mother have syphilis in a great
degree, this treatment, continued for a considerable time, affords no
relief either to the mother or to the infant ; the latter usually dies.
Rendered liable to various diseases from the treatment during preg-
nancy, or from ordinary ailments, or from other circumstances, the
mother is often not in a position to suckle her child, and then the wet-
nurse who takes it gets venereal fissures and ulcers on the nipples
' Now, aooording to Qirtanner, they are subjected to the fumigation treatment —
or they get eighty drops of Swieten's solutioD of corrosive sublimate every night
both oi thsM are either uaeleM or hurtful procedures.
148 ON ySNEB£AL DISSASB8.
from the chancrous mouth of the child, whereupon inflammation of
the mamma, stoppage and drying up of the milk, usually ensue. The
chancres on the lips and frenulum lingus of the infant impede or pre-
vent its sucking. But besides this, how tedious is this treatment^
how often does not the death of the little sufferer anticipate its ter-
mination, or if that does not happen, how many are carried off by the
hospital air, how many (if some few do go through all this), how
many, 1 repeat, of these few, by the instrumentality of this long-con-
tinued mercurial irritation that makes their fluids acrid, their fibres
weak and irritable, are rendered liable both to dangerous maladies
and to chronic dyscrasias, to which death itself is oflen preferable I
Of the injury that accrues to the mothers and nurses from such a
treatment I shall say nothing further, as I have already spoken of the
disadvantages attending the inunction treatment.
683. From an institution so conducted I can imagine no real ad-
vantages to society which could outweigh all the sacrifices connected
with it ; but this we see, that the French nation ^ probably surpasses
all other civilized^ people in delicacy of sensibility for suffering
mankind.
684. I shall not stop to consider the other mode commonly prac-
tised of curing children of the venereal disease, as they usually only
come under treatment when they are a year and a half old or still
older, and are ^treated with sollution of corrosive sublimate, as in
adults, only with smaller doses. A tenth, an eighth, a quarter, and at
length as much as half a grain is given them daily in different kinds
of mild fluids, frequently with greater success than in adults. But
how many of them die before they attain this age, before they are
brought under the action of this remedy, be it ever so efficaciously
administered! Besides, my business at present is with new-born
infants.
685. The medical police could arrive at a much shorter way for
attaining this object ^ of preserving these young citizens of the state,
if they kept in view the maxim that I have been induced from a mul-
titude of observations and reasons to propound as an axiom ; if they
were convinced that syphilitic children have only become so by their
' The only hospital for syphilitic children that I know of is the Hotpice de Charii4
of Vaugirard, which requires enormous sums of money lor its maintenance.
■ * Gknnans.
* Girtanner says, **a venereal mother is i^enerally (on account of the bad state of
her lymph, whereby she is unable to nourish the foetus) confined in the sixth or
seventh month, without any other exciting cause, and the child is usually dead : or
the movements of the foetus cease in the sixth or seventh month, and at the end of
the pregnancy the child is bom dead and half decayed. If it is alive it has a very
thin and emaciated appearance, and soon dies." What a loss for posterity ! How
necessary is the cure of the syphilitic mother in her pregnancy, to prevent the state
experiencing a great loss !
YENSBEAL AFPSOTIONS OF NEW-BORN INFANTS. 149
local infeotioQ in the genitals of their mothers during parturition,' and
that pregnant women are not more difficult to cure of their venereal
aSecdons, without injury or premature labour, than other weak per-
sona are to be freed from this disgraceful malady.
086. If the first point is conceded to me, all the greater objecdons
are made to the last. Let it be remembered however that to dread
ill effects from a radical mercurial treatment for pregnant women and
their offspring, and on that account to leave both uncured till after
birth,' implies that the treatment is more dangerous than the disease
itselfl If the inunctions, calomel, &;g, are of this character, 1 am sorry
for it. As far as I am aware the cautious administration of soluble
mereory indicated in this book is not so ; I am indebted to it for the
lives and health of many mothers and their offspring. I must refer
to what I have already said as regards its employment in this case.
A physician who is such in the true sense of the word, will understand
liow to supply what is necessary for the accessory circumstances.
687. If however we are called on to treat a new-born infant affected
with venereal symptoms, there is very little hope for it if the symp-
toms are in their highest degree, if the child is much emaciated and
euinot take the breast, or if its mother cannot suckle it. But even in
ncli circumstances we ought not to despair.
688. In the last case we shall not be able to do much without a wet
nnrse, as the poor creature will hardly be able to contend with the
process of accustoming it to unnatural food and the attacks of such a
dangerous malady, without succumbing. We may however attempt
to nourish it (and this we roust at all events do if it be unable to suck)
^th goat's milk for drink, and in the commencement without any
other food, until the case takes a favourable turn (and then it will be
able to partake of pounded biscuit, &c.), and on the very first day we
are called in, afler purging the primae viae of their impurities, com-
mence with the soluble mercury,^ which is the only preparation that
from its mildness, certainty and rapidity of action, holds out to us
any hope, where no other remedy is admissible.
689. In most cases not more than one grain of soluble mercury will
^ lo public Ijing-ia institutions no woman affected with syphilis should be allowed
to be confined without being cured of all her venereal symptoms. If little can be
done, we should at least treat and cure their genitals by the local application of a
•Iraig solution of lead, in order to prevent the child being infected during delivery.
Tike syphilitic virus can afterwards be eradicated by an appropriate mercurial treat-
ment after parturition. But the latter may also be done during pregnancy, and that
ii the preferable course to pursue
' Who can reckon the number of abortions that occur in those unfortunate beings
who are with methodical over-cautiousness designedly left unciu'ed of their syphi-
litic oomplainte until after delivery.
* Girtanner also considers it best to give the child mercury.
160 ON VSKERSAL DISEASES.
be required. We may rub it up with a drachm of liquorice root
powder, and of this mixture give the first day (for we should give but
one dose daily) five grains, the second seven grains, and so on, until
we observe a marked alteration in the complexion, restlessness, rumb-
ling in the bowels, fetor of the breath, heat in the eyes, dsc, the signa
of the mercurial fever. If the signs are but of moderate intensity,
and the change in the venereal symptoms not striking, we may repeat
the last dose ; otherwise not, for if the mercurial fever was sufficiently
strong it would fully perform its service, and remove the venereal
affection. The infant may take the medicine in its goat's milk, and
not partake of anything else until the cure is effected.
690. If the child can, immediately after birth, take its infected
mother's breast, we should only treat the latter with soluble mercury,
in the doses above indicated for adults ; but we should commence
immediately after being called in and attend to the accessory treat-
ment and precautions^ required in such cases. The child will recover
by partaking of her milk, if any adequate mercurial fever is developed
in her.
691. Similar doses of the antisyphilitic metal and similar precautions
must be employed in the case of the nurse (even though she be per-
fectly well) who suckles the child in place of its mother, partly in order
that she may not be infected herself, partly in order that the child may
be restored to health by partaking of her medicated milk, which will
be the case if she get a sufficiently intense mercurial fever.
692. If the child cannot or will not take the breast, or if there be
none to give it, we must endeavour, afler its recovery, to send it into
the country and allow it to be reared by some experienced person.
693. During the treatment the child must be bathed and gently
washed twice a day in a tepid decoction of marsh-mallow root, for a
few minutes. The sores and excoriations should be dusted with lyco-
podium powder, or dressed with lint. Its linen should be changed
twice a day until it is quite recovered ; it should be carried about,
and the air in the apartment should be renewed as often as possible.
If there be constipation, soap and water injections should be used ;
the aphthae may be cured by frequently touching them with water
acidulated with from rJ^ifth to y^th part sulphuric acid.
' If the circumstances are not urg^t we may delay the treatment until the twelith
day after confinement
POSTCRIPT.
(Whilst these sheets were going through the press I have been
enabled to make the following additions and corrections.)
As r^ards the preparation of the soluble mercury (see Preface), I
have found that in order to deprive the nitrate of mercury of all traces
of muriate of mercury, there ought to be no free acid at all in the
metallic salt before the precipitation is performed. Accordingly I find
it requisite to wash the crystallized mercurial salt with about a tenth
of its weight of distilled water, and then dry it on bibulous paper before
proceeding to dissolve and precipitate. I have further observed that
ammonia carefully prepared contains but an inconsiderable quantity of
munatic acid, and may consequently be appropriately used instead of
tlie ege shell lime to precipitate the (in this case white) soluble mercu-
ry. But as no acid is more frequently met with in nature than this
muriatic acid which is so prejudicial to our object, and as it may» in
ipite of the greatest carefulness on the part of the operator, exist in a
nnall proportion in our preparation, we would do weU to change
by a simple operation the white precipitate that may be present into
^ much more innocuous calomel. For this end we boil the crude
precipitate, in place of sweetening it, in fifty times its weight of distil-
led water for an hour, then pour off the water and dry the sediment
on bibulous paper for use.
If it be objected to (^ 619) that muriates exist even in the cleanest
stomach, which, let the oxyde of mercury thus prepared be ever so
free from white precipate, would soon decompose it, and change it in
the alimentary canal into something similar, my observations teach
me, that the ingestion of white precipitate already prepared, in conse-
quence of its forming small, insoluble, corrosive masses, causes much
more poisonous effects than that which is only changed in the stomach,
by decomposition, into amazingly fine heavy particles of white precipi-
tate, which only cause a slight griping, and enveloped in the mucus
of the bowels are soon expelled. But even this need not be dreaded,
if in place of any other fluid, a couple of glasses of Selters or Piilna
water be drunk, for as 1 have found by numerous experiments, the car-
bonic acid redissolves the white precipitate that has already been form-
ed, and even the turbith mineral, and retains it in solution until this
gas is driven off by a considerable amount of heat, so that the metal
(in that case it must have been prepared with lime-water, or with
caustic potash) cannot be precipitated from the fluid. If this precau-
tion be adopted in taking the medicine, even the iuconsiderable grip-
152 ON YENEBEAL DISEASES. ^
ing that occurs from the oxjde of mercury may be prevented, if that
be deemed necessary.
Among the most powerful antidotes to the ulcers that d^enerate
into corroding sores (§ 331, 381, 403, 648, 649,) or are caused by the
abuse of mercury, I must, from my experience since the foregoing was
written, place the sulphuretted hydrogen gas, spoken of at § 608, as
it is preferable to all other remedies for removing all affections aria-
ing from the long continued irritation of mercury, the pains in tbe
limbs, the low fever and night sweats, and the exhausting salivation.
A young man was, on account of a gonorrhcea and small chancre,
so mistreated by a barber-surgeon with enormous quantities of calo-
mel for six weeks, that besides having an immoderate salivation, he
got also severe hectic fever, profuse night sweats, tearing pains in the
limbs, trembling, and large pustules all over the body, which, being
aggravated, (and these aggravations the quack considered to be vene-
real symptoms) by additional quantities of mercury, degenerated into
large deep ulcers (some were an inch and a half in diameter,) 8ur>
rounded by inflamed elevated borders, and covered with a suety look-
ing substance. The worst symptoms were the ulcerations in the throat,
at the posterior nares, in the tonsils, on the palate and uvula ; in this
situation on|| large ulcer seemed to be eating away all the parts ; from
the mouth and nose bloody pus flowed ; he could not utter any intel-
ligible sounds ; he was emaciated and excessively feeble. All the re-
medies used were of no avail until 1 gave him ten grains of hepar sul-
phuris^ within twenty-four hours, which produced a rapid amelioration
of all the symptoms, so that the other remedies required, the sulphuric
acid for the low suppurative fever, and a solution of lunar caustic for
the foul ulcers in the mouth were speedily beneficial. He was soon
so well as to be able to enjoy the open air, and whilst he was out hia
room was thoroughly aired. This course was attended by increasing
benefit for some weeks, and he had almost completely recovered when
he one day by staying out too long in severe weather, took cold, and
was confined to the house in a febrile state. The precaution of open-
ing the window was omitted, without my being aware of it. Hia
former symptoms now rapidly returned, the ulcers in the throat and
on the other parts of the body broke out with increased violence,
and even the glans penis was rapidly perforated by deep, rapidly
spreading ulcers here and there, but not on the seat of the former
chancre. The fever with the night sweats, the pains in the limbs
and the salivation returned, and increased daily in violence. I
made use of every thing that had previously proved serviceable, but
1 ■ I I ■ ■ i_ - - *• ~
' I had also to give the healthy persoD who slept in the same room the same re-
medy for salivatioQ and night sweats, that had arisen spontaneously, so saturated
mm the air of the room with mercurial exhalntinnB.
POSTSCRIPT. 163
without success ; in the course of a few days he was brought to the
verge of the grave. He would take nothing more, had frequent hic-
cough, recognized his friends no longer, and could not move himself.
I now began to suspect that the confined atmosphere of the room
might perhaps be loaded with mercurial vapour, which had again
penetrated his system, and thus caused a recurrence of these suffer-
ings. I ventured to give the half-dead patient three grains of hepar
sulphuris every hour, with such good results, that in the course of
twelve hours I observed some traces of amendment, and by continuing
this and the former remedies, I gradually restored him to life and
health, and I did not neglect to place a solution of hepar sulphuris for
some weeks in his room, in order completely to mineralize and to
destroy the mercurial vapour in the room, by the evaporation of tlie
milphuretted hydrogen. I leave every thinking man to draw his own
inferences from this striking case.
KNO OF THB VBNERKAL DI8KA8E8.
THE FRIEND OF HEALTH.
BT
SAMUEL HAHNEMANN,
Doctor of Medicina, ICombar of tho Acadsmy of Science! of IConU,
and of Um Eoonomioal Society of Lelpsl^-
PART I.^
PREFACE.
When we behold the large family of mankind acting as they
do, when we see with what perseverance they go through their
more or less important spheres of action, which some wretched
passion often traces out for them, when we see how they all
strive after the attainment of some kind of happiness, be it ease,
rank, money, learning, amusement or excitement, scarcely
deigning to cast a single glance towards the real blessings of this
world, -vsdsdom and health, which beckon them back into Eden,
we can scarcely refrain from pitying a race of such noble origin
and high destiny. My mission permits me not to point out the
means of ennobling the mind ; it behoves me only to preach upon
the greatest of corporeal blessings, health, which scarcely any
take the trouble to seek after, and few know how to value until
it is lost. It will scarcely be credited when I assert that nought
is shunned more earnestly, nay is held to be more disgracefiil,
than rational care about the health. We indeed hear it occasion-
ally remarked that this or the other article of diet is wholesome
or hurtful, that this or that remedy is a specific for this or that
disease, this or the other habit is injurious ; in the higher and
lower circles of society, people interest themselves with fashion-
able modes of treatment, marvellous diseases, cases of sudden
death, beautifying remedies, and anecdotes about physicians.
But all this is only vain trifling.
* Published at Frankfort oo the Main, in 1792.
156 THE FBIEKD OF HEALTH.
The lover of highly spiced dishes exclaims against the
indigestible nature of puddings ; the tea-drinker can speak like
a book about the evils of spirit-drinking; the lady who has a
weakness for coffee talks learnedly on the coarse juices of her
who has a liking for beer ; and the guzzler of puddings declaims
upon the poisonous nature of mushrooms.
Hearken to that gouty fellow how well he can describe the
hurtful character of the day-labourer's life ; to that young gen-
tleman with his pimpled face, how he depicts the disadvantages
of a sedentary life ; hear how that lady who sticks close to her
tapestry work inveighs against the dangers of dancing ; and how
the dancing nymph points out that much sewing causes green-
sickness. All know something, only not what is wholesome
for tJiemselves,
To take ourselves to task about our pernicious habits, to study
our own system, to follow the regimen most appropriate for our
own constitution, and heroically to deny ourselves everything
that has a tendency to undermine our own health, or that may
already have done so, to bestow a thought upon all this, is held
to be puerile, old-fashioned, and vulgar. The courtier rebels at
the idea of attending to the advice of his physician on dietetic
points; the young lady who excels in dancing would think it
beneath her to listen to the warning voice of her mother ; the
romance-reading damsel scorns to be corrected by the sarcasms
of her old-fashioned uncle ; and the wild student will not be
persuaded by his banker to frequent better company.
I readily grant that excessive concern about one's health is an
evil ; that there is no occasion for an active lad to trouble him-
self about fur-boots, for a rosy-cheeked lass to interest herself
in the various kinds of obstetric forceps, or for the pleasure-seeker
to concern himself about hospitals ; but everything has its proper
bounds; every human being his particular sphere, which he
ought to be thoroughly conversant with, and which he should
blush to be unacquainted with.
If the minister of state were to possess no thorough knowledge
of medical police, the chief municipal magistrate no accurate
notion respecting the arrangement of prisons, workhouses and
hospitals, if the general officer were to know his hospitals only by
plan, if the student who has completed his studies were to bring
away with him from the university no knowledge of physiology or
anatomy, if the laughing girl were to enter into the married state
PREFACE. 167
without everliayiiig heard of amother^s duties, if the governess can
do nothing but descant on silly gentilxtieB to her chlorotic pupils,
and if the pedantic usher, enveloped in a mist of phrases, elegances
and verbiage, were unable to perceive how numbers of hopeful
boys entrusted to his care fidl victims to the most enervating
vices, how unfit for their respective spheres these persons would
be. Indeed I should like to know if there is any condition in
life, where some medicA knowledge and some care for our own
and our neighbour's health are not necessary, or if it is ridicu-
lous or degrading, beyond the mere rude routine of our actual
business, to devote some time to the finer but often not less im-
portant study of the structure and modes of preservation of the
human body.
Of course I do not mean to say that the works of Frank, or
Howard, or Fritz, or Haller, or Levret, or Whytt, are for such
persons as these, and I should commit a most egregious blunder
were 1 to recommend a total reformation in the plan of educa-
tbn to those who have made it their special study. But, jesting
apart, for all these there are studies of general utility, springs to
which all may resort with profit, for they flow only to supply
the wants of all the conditions of life.
Oh I that in the following pages I were so fortunate as to be
able to contribute something to the happiness of mankind, if they
would listen to the voice of a warm friend of his fellow creatures,
as if it ^ere the voice of a friend ! In a few years, nay days,
and we have reached the termination of our earthly life ; would
that I could now and then prolong it were it but for a
few hours, would that I could improve it were it only in trivial
things I
THE FRIEND OF HEALTH.
THE BITE OF MAD DOGS.
The disease that results from the bite of rabid animals, most
frequently of mad doga, is of such an extraordijiarj and teniWe
character, that we are struck with horror on beholding a patient
affected by it, and the mere description of his sufferings causee
us to shudder. Among a thousand persons affected by real
hydrophobia, often not one ia saved. The moat vigoroua
constitution, the best physician, the most recondite remedies, and
tho most implicit obedience of the patient and his friends, are in
moat cases ajl of no avail ; in the possession of perfect conscious-
ness the unfortunate being is usually, amid the moat fearful
symptoms, hurried off in a few days to an untimely end.
The patient feels an accession of pain in the bitten part, which
may either be perfectly healed or still an open wound, it becomes
auiTOunded by a blue border ; a creeping sensation proceeds
from it up to the throat, which feels as if contracted. The
patient has pain in the bead and stomach, and sometimes bilious
vomiting. His sleep is disturbed by frightful dreams, he becomes
reatlesa, the bands, feet and tip of the nose grow cold, the
features distorted. He thinks he seea fiery sparks dancing
before his eyes. He feels neither hunger nor usually thirat, the
tongue is moist but covered with viscid mucus, stools and urine
suppressed, or he passes them of natural colour, but with pain.
The pulse ia weak and jerking, but not inflammatory. He cannot
THE BITE OF HAD POQS. 159
bear the approacli of any liquid without trembling all over, with
wild, anxious, sad expression. In like manner he cannot bear
anything glittering, bright or white, anything approached sudden-
ly towards him, loud talking, a draught of air, &c. In the lucid
intervals he speaks rationally, but in a more timid rapid and
nervous manner than usual; a hacking cough, sometimes
combined with hiccough, interrupts his speech. His face becomes
always paler and more distorted, the anxiety that dominates over
all his actions is expressed also by the cold clammy sweat on
his fece and hands, his eyes are tearful and the pupils dilated.
He tosses convulsively about in his bed. He seeks to run
away. At length he* hides his face, becomes quieter and
expires.
The post mortem examination exhibits usually nothing abnor-
mal.* The extreme tension and excessive irritability of the ner-
vous system and the sense of self preservation shewn in the
anxious dread of approaching dissolution, these are the sole
characteristics of this fearful disease.
I shaU not here enter into a description of the countless reme-
dies that have been proposed for it ; their enormous quantity is
of itself to a certain extent a proof that no sure mode of cure
is yet known, otherwise that would be adhered to. I shall mere-
ly endeavour to remove some erroneous notions prevalent on
the subject, and thus if possible endeavour to render this dis-
ease of less frequent occurrence.
The Jirst and most prejudicial of these is the great confidence
reposed in certain remedies said to be infallible, among which I
allude chiefly to internal remedies. Some persons are bitten by
a dog supposed to be mad. They use with all speed the re-
nowned specific, and none of them takes the hydrophobia ; all
recover from their wounds without any serious consequences
following ; and in all the country round nothing is talked of
but the wondrous curative virtues of, it may be, the may- worm
electuary,* or whatever else these patients used. It foUows, of
course, that in similar cases occurring in this district nothing
' [In two instaDces, a medical friend of ours has niade very thorough and careful
(fineetioDS of dogs which bad died of hydrophobia, but in neither case could any
morbid changes be discov^ered which would in any way account for death. In one of
these examples, portions of the brain, spinal-cord and nervous apparatus, were sub
nutted to microscopic examinations, but without throwing any new light upon the
nbject] — Am. P,
* [A nostrum for the hydrophobia purchased at an extravagant price by the Pros
Mn Ooremmeiit]
160 THE FBIEND OF HEALTH.
more will be done than to give the bitten individuals the may-
worm electuary. ' One of these, however, dies of hydrophobiai
but the vaunters of the nosti-um can furnish reasons for its inu-
tility in this case, at all events this single unfortunate case is Ttr
garded as the exception, against the many successful ones.
Should it happen a third time that some one or other in the
neighbourhood is inoculated with the poison of a mad dog, bo
that in the course of nature he must be affected by the hydro-
phobia, the electuary is at once confidently administered to the
unfortunate individual, and it is only by die sad termination of
this case that the remedy falls into disrepute.
Had the first cases of reported success been more carefully
investigated, it would have been found that these first patients
had received no true virus of rabies into their wounds, and that
(Consequently the electuary had no difficulty in curing, as there
was nothing to cure. The subsequent unfortunate cases might
then have been prevented, had not such implicit confidence been
placed in this internal remedy, but the far more trustworthy ex-
ternal preventive remedies been employed.
But what are the best external preventive remedies, and how
can we confidently pronounce on the madness of an animal ?
These questions shall be answered farther on.
Thus much is certain, that the commencement of the malady
is at first merely local. The poisonous saliva of the animal lies
at first inactive in the bitten woimd. The wound heals, and not
the slightest inconvenience is experienced, until, after a longer
or shorter period, symptoms of irritation of the nervous system,
and along with them the fatal hydrophobia make their appear-
ance. Could we at first extract the poisonous saliva fix)m the
wound as completely as we can a splinter or a bullet, it would
be impossible that rabies could result from such a bite. But if
it be already present we know no remedy whereby it may be
certainly cured. Hence all trusting to such specifics is imsafe
and injurious if we have not already frequently tested their ef-
ficacy on fiiUy developed hydrophobia.
The second error which may prove injurious, is the belief,
that a dog has communicated the poison by its bite if he die
within a few days of rabies, and has not communicated it if he
continue alive ; consequently that a dog that soon dies with the
symptoms of this disease, which fear magnifies excessively, was
mad, but that one that recovers could not have been mad. In
the former case (and who can deny it, as we know as yet so lit-
THE BITS OF MAD DOeS. 161
tie of the maladies of the domestic animals) it might have been
quite a different disease that the dog had which inflicted the
Utes, and the remedies employed for these bites thus falsely ac^
quire a reputation as specifics for hydrophobia. In the latter
case in spite of all the danger, none is apprehended ; the only
oseM remedies for the parts infected by the vims are neglected,
and the fatal disease is in all certainty allowed to break out
We find in the records of medicine many instances ^ in which
the severe bite of a dog that afterwards died with all the signs
of rabies, infected some persons but not others, without the
latter employing anything, and on the other hand there are un-
deniable instances shewing that dogs of whose bite persons have
died of hydrophobia have remained alive.
To refer to but one case of the latter sort, I may mention
that Martin Lister, in the 13th vol. of the Philosophical Iransac-
UonSf relates the case of a robust young man, who, six weeks
after being bitten, became affected by hydrophobia, of which
he died fourteen days thereafter. At the same time, the same
dog bit a little dog, which died the day following of rabies ; but
tbe large dog itself recovered, and was quite well eight weeks
after it had been mad.
A similar instance of a rabid dog which recovered, some
ehfldren, at the risk of their lives, diligently washing its
wounds, is to be found in the 20th volume of this instructive
collection, where we also meet with the cases of two young
men, related by Dr. Kennedy, who recovered /ram the hydro-
phobia without employing any means. Had any of the renowned
specifics been used in these cases, would not the cure have
been infallibly ascribed to it? Can a medicine be extolled as
in&llible for this disease, or even as verj useful, that has not
cored at least ten cases of developed hydrophobia? — Where is
there such a medicine ?^
The third error is the delusion entertained even by physi-
cians, that the virus of mad dogs can only cause infection when
> Yaugfaan saw from twenty to thirty persons bitten by a Aiad dog, of whom only
one amoDg them, a boy, died of hydrophobia, the rest escaping unaffected.
* Unlen it be perhaps the root of belUdonna. Might not a very strong extract of
blick henbane, prepared toUhotU heat, administered in sufficient quantity in the fonn,
of piUa, be able to cure this disease ? A number of theoretic reasons lead us to ha¥e
•InQg hopes that it might But the extract must be so strong that two grains of
it are suffident to cause in a healthy individual, troublesome symptoms, atupefiio-
tnB,Ac
11
1^ THE FRIEITD OF HEALTH.
introduced into the wound caused by a bite, or some other open
wound.
As a proof of the incorrectness of this, cases are not rare
where mad dogs have merely licked the external skin, and yet
have communicated the disease. Two boys, as we learn frttm
De la Prime, in the 20th vol. of the Philosophical Transactiom^
frequently cleaned with their hands the wounds of a dog that
had been bitten by a mad dog ; many months afterwards unth-
out ever having been wounded^ they both were attacked simulta-
neously by hydrophobia, which lasted a week, when the eldest
recovered, and said timidly to his father, "I am well." The
same happened to the other. They remained well three or fiwr
days, then again had violent attacks of hydrophobia for a weeik^
and thereafter recovered without relapsing. * Likewise in the
23d vol., we find the histoiy of two servants, who frequendj
inserted their fingers into the throat of a dog (that had been
bitten by another rabid dog, and did not die for three weeks
afterwards), in order to feel if there was anything the matter
with it. Both were affected by hydrophobia without having
been wounded; the stronger of the two recovered without
using any medicine, but the younger died of hydrophobia on
the third day.
I myself knew a boy whose feice was licked by a dog that
was going mad, and who died of hydrophobia.*
' [These are probably cases of fympathetie hydrophobia. The painful mental
impressioD which continued to prey upon their imaginations for so loi^ a period,
finally induced pschychological phenomena^ yiz., symptoms of the very malaii^
which they had so much dreaded. An instance of tlds kind occurred in oar own
knowledge, several years^ since, in the person of a nervous girl of 16 years. She fand
been bitten about a year previously by a dog, which was at the time supposed to bt
rabid, and which was immediately killed. The idea that she should have the lij-
drophobia continued to tormont her, and to wear upon her health and spirits, unlfl,
fimdly, all the symptoms of hydrophobia made their appearance. Tliese symptomt
continued at intervals for two days, when the dread of water, the convulsive mo-
tioDs, the anxious and wild expression, ^ disappeared, leaving only a general sora-
ness throughout the body, and a sense of debility.
We fully believe- that there is such a disease as genuine hydrophobia, from the ab-
sorption into the system of the virus of rabid dogs ; yet, it is quite probable that
cases not unfrequently occur, and terminate fatally, in which there has been no a6-
forpiion of the otrtw, but simply a painful and intense action upon the imagini^tym,
thus inducing pschychological phenomena, somewhat analogous to those produced by
the mesmeric processes. It would not be difficult for a mesmeriser, or a pschycho-
logist, to mduoe in his subject a temporary conditioa doecly aimilntipg hydrophobia.]
—Am, P.
* Ocslius Aurelianus, Pahnarius, Van Hilden, Callisen, Odhelius, Oruner, and
Morando have recorded similar cases.
VBX BITE OF MAD DOGS. 188
It is in general tlie safest plan to consider the bite of an nn-
irritated dog as that of a mad dog, and to treat it accordingly.
This is the surest way to guard against hydrophobia.
The wound should be immediately washed out with water in
which a quantity of potash has been mixed, and this should
be repeated firequently, and until the surgeon arrives, who
should bring with him a piece of caustic potash, and touch the
open wound therewith until a slough the thickness of the back
of a knife is formed, whilst the moisture that eludes should be
removed by blotting-paper. The pain is not very severe, the
dough fisills off in a few days and the clean wound soon heals.
If this is done first of all and very quickly, we may feel quite
at ease, and do all in our power to comfort and console the pa-
tient^ ^ and tranquilize his circulation. A moderate blood-let-
ting in plethoric individuals, or a glass of wine given to per-
sons of an opposite constitution, will suffice for this purpose.
If this frightfol disease can by any means be prevented, it is by
nch means ; but not by any internal medicine hitherto known.
The part of the skin which, although not broken, may have
been wetted by the saliva of a dog which has become suspicious
fiom having bitten others, must be diligently rubbed with potash,
and washed continually for an hour witli the solution of the
alkali. If a blister be afterwards applied to the spot, then all
danger will be more than warded of.
No dog should be trusted that bites people unirritated, and
has a gloomy wild expression. It is far better to kill too many
of these often useless beasts, than to allow one actually rabid to
Toam at large ; man*s life is too precious, and should be held
paramount to every other consideration. Merely to shut up for
a few days dogs bitten by a mad one, is always dangerous, as
examples are not wanting where they only became mad several
weeks after being bitten. They must either be killed, or be
kept in safe custody for at least four weeks, before they are
trusted ; the former must absolutely be done in case the dog that
inflicted the bite was very suspicious.
A dog may be suspected of commencing rabies when it ceases
to be fiiendly, will scarcely wag its tail on being patted by those
it likes best, appears very tired and lazy, is cross and dejected,
' A defgyman was affected by chronic hydrophobia merely from imiigining that
tdog that had bitteo him was mad. He would have died had not a physician pointed
cot to him the errooeouB nature of his idea. He soon recovered after the physician
bvl noceeded in conyindng him, and without taking any medicine.
164 THE F&UBND OF HXALTH.
dreads the light, and creeps into dark oomers, where it lies down
without sleeping. It never barks, not even when there is the
greatest cause for it doing so ; it merely growls at any thing
approaching it suddenly, and springs out at it The eyes are
dim, the tail and ears hang done. At this stage the bite com-
mences to be dangerous.
This state lasts but half a day, or a whole day, and then the
second stage of rabies breaks out. The animal no longer knows
its own master, eats and drinks no more, becomes restless, growls
with a hoarse whine, without ever barking, goes about threatening^
ly with dependent head, red watery eyes, having a sad expression
and directed towards the ground. It involimtarily moves the
lower jaw in a mumbling manner ; its leaden-coloured tongoei
dripping with saliva, hangs out of the niouth ; the taU is stuck
betwixt the legs ; the hairs of the whole body stand out ia a
disorderly manner. It tries to run away, snaps at every thing
before it, and runs along, irrespective of the road, without ap-
parent object, straight and crooked, at a quick, usually unsteady
pace. Other dogs run away from it.
The wood-cut at the head of the article represents a dog in
this state.
THE VISITER OF THE SICK.
If it be not from want of something better to do or from mere
curiosity, which, as the story goes, is among the attributes of the
fair sex — if, in a word, it be not from some important object thftt
Mrs. X. visits Mrs. Z. in her serious febrile disease, if she does
it out of christian, sisterly, or cousinly affection and friendship,
I fear I should be denounced as a bad man were I in this last
case to forbid such visits. And yet it must be done ; I must
forbid them, but I beg to be heard before being condemned.
Malignant fevers that spread among the people have usually,
at all events often, a coAtagious character, notwithstanding that
some of my colleagues have endeavoured, most learnedly, to
prove the contrary. It is safer to consider them so, as it is in
all cases safer to believe in a little too much hell than too little,
in order that we may take greater precautions to preserve our-
selves from it, whether it be a reality or only a sort of a woodcut
in rerum natura. It is likewise quite praiseworthy to make our
children believe that the brook that flows by is somewhat deeper
and more fearful than it actually is.
THB VISITER OF THB BICE. 166
The very probably contagious nature of prevalent fevers being
ecmoededy it must be highly criminal, at least very imprudent,
for the healthy lady to sit b^de her deadly-sick gossip for hours
at a time without the slighiest necessity.
"She would be very much offended if I did not visit her;
what would the relations say to my impoliteness ? I am told
she longed to see me — ^if she should die without me seeing her
once more, I should never forgive myself I" Such excuses might
probably be considered as valid by a gallant man ; but they
have no weight with me, for I am not a gallant man. Admitting
die had a real affectionate desire to see her friend once more,
this good intention must remain unfulfilled, just as many good
tilings in this world must remain undone because they cannot
be done, or at least not without great injury or palpable danger.
If you wish to save your friend from drowning you must be
ible to swim ; if you cannot, do not jump into the water after
him — for any sake don't I but run for assistance, and if he is
drowned by the time assistance arrives, then help to drag the
water for him; help with all your might to bring him back to
life, or if all is of no avail, follow his body to the grave. There
are in like manner cases where you can do nothing but pray
when your neighbour is being burnt to death in the fourth story
and your heart is bleeding for him.
Your sick friend most probably knows you no longer in her
delirium ; but supposing she would know you, you may, when
fihe recovers, make up in many ways for this neglected service
of love, as such unnecessary and dangerous visits to the sick
are commonly called. (Would that we poor creatures began to
testify our friendship more in deed and in truth than in empty
compliments and visits ; there is already enough of the empty
and windy in this world of ours !)
No one requires fewer persons about him than a dangerously
rick person, himself nearly related to death, which slumbers in
aohtude beneath grave-mounds, as we learn from friend Hain.
Who does the patient who is seriously ill prefer having near
him ? none but the necessary person, at the most a father, a
mother or a spouse, but best of all the sick-nurse and the doctor
(two persons ordained by God and placed, like Uriah in the
battle, in the thickest of the fight — forlorn hopes quite close to
the advancing enemy, without any hours of relief firom their
irksome guard— two very much misunderstood beings, who
Bacnfice- themselves at hard-earned wages for tlie public weal.
166 THE FBIKND OF HEALTH.
and, in order to obtain a civic crown, brave the life-destroying,
poisoned atmosphere, deafened by the cries of agony and tl^
groans of death).
Let patients affected with contagious fevers be left to these
two, the only necessary, the only useful individuals, and to a
beneficent Ghod ; they alone can attend to them properly, from
their hands must they expect all the good that we can wish for
them, life and health.
The anxious lady that visits her sick firiend can do her no
manner of good ; all she can do will be to shew her a pocket-
handerkchief which she has moistened with her sympathizing
tears, irritate her morbid nerves with chattering, help to spoil
the air of the close sick-room with her breath, increase the noise
that is often so hurtful to patients, disarrange the good order by
her officious interference, give well-raeant but erroneous advice,
and, what is of still greater consequence, carry back the disease
with her into her own house.
Let it not be alleged that the sick nurse and the doctor must
run the same risk if the doctrine of contagiousness be true.
They do so no doubt to a certain degree, as the death of many
doctors and nurses shew. But they do not do so much as Madam
Gossip, and this is the reason.
The Creator of mankind has so ordained that haint shall be a
protector against many dangers. Thus the chimney-sweeper
gradually accustoms himself to the smoke from wood, which
would choke any one else, and he can, if it be not too intense,
easily exist in it. The glass-blower, from gradual custom with-
stands the most intense heat of his furnace, and goes much closer
to it than other persons can. The Greenlander, a man like our-
selves, laughs and jokes in a degree of cold that would freeze to
death those unused to it. The courier who travels many himdied
miles in a few days, and the runner who makes a day's journey
in a few hours ; the fisherman who spends much of his life in
the water without taking cold, and the Scotch miner who lives
to the age of a hundred years in his unhealthy occupation, are
all proofe of this.
In like manner some stout-hearted men can gradually accustom
themselves to the exhalations of the most infectious diseases,
and their system in course of time becomes quite insensible to
them. There are some layers-out of dead bodies in large cities
who attain a great age, and have breathed the exhalations from
thousands of corpses that have died of infectious diseases. There
PBOTEOnOK AGAINST IKF£CTIOKy £TC. 167
have alao been graye-diggers who in the time of a pestilence have
buried the last inhabitant of ^eir district.
But it is only cautious nurses and physicians that can rejoice
in this immunity from infection ; they must accustom themselves
to it very gradually, continue to habituate themselves and em-
ploy various precautions in order not to be destroyed by the
murderous exhalation.
A casual visiter cannot pretend to such advantages, she must
be totally imused to the insidious miasm, and in all probability
she runs the greatest risk to her life. She may be happy if her
imprudence does not make orphans of her children, or even
eaase the death of all of them, without any &ult of theirs.
PROTECTION AGAINST INFECTION IN EPIDEmC DISEASES.
For every kind of poisonous exhalation there is in all probabi-
lity a particular antidote, only we do not always know enough
about the latter. It is well known that the air of our atmosphere
ccmtaina two-thirds of a gas that is immediately fatal to man and
beast, and extinguishes flame. Mixed up along with it is its
peculiar corrective; it contains about one third of vital air,
irliereby its poisonous properties are destroyed; and in that state
only does it constitute atmospheric air, wherein all creatures can
live, grow and develop themselves.
The suffocative and flame-extinguishing exhalations in cellars
in which a quantity of yeast or beer has fermented, is soon
removed by throwing in fresh slaked lime.
The vapour developed in manufectories where much quick-
silver is employed, together with a high temperature, is very
prejudicial to health ; but we can in a great measure protect
ourselves against it by placing all about open vessels containing
firesh liver of sulphur.
To chemistry we are indebted for all these protective means
against poisonous vapours, after we had discovered, by means
of chemistry, the exact nature of these exhalations.
But it is quite another thing with the contagious exhalations
from dangerous fevers and infectious diseases. They are so
subtle that chemistry has never yet been able to subject them to
analysis, and consequently has failed to furnish an antidote for
them. Most of them are not catching at the distance of a few
paces in the open air, not even the plague of the East ; but in
dose chambers these vapours exist in a concentrated form and
168 THE FBIBND OF HEALTH.
then become injurioas, dangerous, fatal, at a considerable dk*
tance from the patient.
Now as we know of no specific antidotes for the several kinds
of contagious matters, we must content ourselves with general
prophylactic means. Some of these means are sometimes in the
power of the patient, but most of them are solely available by
the nurse, the physician, and the clergyman, who visit the sick.
As regards the former of these, the patient, if not too weak,
may change his room and his bed every day, and the room he
is to occupy may, before he comes into it in the morning, be
well aired by opening the doors and all the windows. Khe have
curtains to his bed he may draw them to, and let the firesh air
circulate once more through his room, before the physician or
clergyman comes to visit him.
The hospitals used by an army in a campaign, which are often
established in churches, granaries, or airy sheds, are for that
reason much less liable to propagate contagion, and also muoh
more beneficial for the patients than the stationary hospital^
which are often built too close, low, and angular. In the latter,
the nurses, physicians, and clergymen often run great risks.
And what risks do they not constantly run in the half under-
ground damp dwellings of the lowest class of the people, in the
dirty cellars of back courts and narrow lanes that the sun's re-
viving rays never shine in, and the pure morning air never
reaches, stuffed full with a crowd of pauper families, where pale
care, and whining hunger seem for ever to have established their
desolating throne !
During the prevalence of contagious diseases the poisonous
qualities of the vitiated air are concentrated in such places, so
that the odour of the pest is plainly perceptible, and every time
the door Ls opened, a blast of death and desolation escapes.
These are the places fraught with greatest danger to physician
and clergyman. Is there any mode whereby they can efiectu-
ally protect their lungs fix)m the Stygian exhalation, when the
crying misery on all sides appeals to them, shocks them, and
makes them forgetful of self? And yet they must try to dis-
cover some preventive I How are they to do so ?
I have said above, that wc may gradually accustom ourselves
to the most poisonous exhalations, and remain pretty well in
the midst of them.
But, as is the case with accustoming ourselves to every thing,
the advance from one extreme to the otJier must be made with the
PBOTEOTION AGAINST INFECTION, ETC. 169
utmost caution^ and hy very smaU degrees^ so it is especially with
this.
We become gradually accustomed to the most imwholesome
prison cells, and. the prisoners themselves with their sighs over
the inhuman injustice of their lot, often, by their breathing and
flie exhalations fix>m their bodies, gradually bring the few cubic
feet of their atmosphere into a state of such pestilential malignity,
that strangers are not unfrequently struck down by the most
dangerous typhoid fevers, or even have suddenly died by ven-
turing near them, whilst the prisoners themselves, having been
gradually accustomed to the atmosphere, enjoy a tolerable health.
In like manner we find that physicians who see patients la-
bouring under malignant fevers rarely and only occfusionally,
and clergymen whose vocation only requires them to pay a visit
now and then, are much more frequently infected than those
vho visit many such cases in a day.
From these facts naturally proceeds the first condition for
those who visit such sick-beds for the first time, "that they should
in the commencement rather see their patients more frequently,
but each time stay beside them as short a time as possible, keep
as fer away as possible from the bed or chamber utensil, and
especially that they should take care that the sick room be tho-
roughly aired before their visit."
After these preliminary steps have been taken with proper
caution and due care, we may then, by degrees, remain some-
what longer, especially beside patients with the slighter form pf
the disease, and of cleanly habits, we may also approach them
sufficiently close to be able to feel their pulse and see their tongue,
taking the precaution when so near them, to refrain from breath-
ing. All this can be done without any appearance of affecta-
tion, anxiety, or constraint.
I have observed, that it is usually the most compassionate j young
physicians, who, in epidemics of this sort, are soonest carried off,
when they neglect this insufficiently known precaution, perhaps
fix)m excessive philanthropy and anxiety about their patients ;
that on the other nand, the hard hearted sort of every -day doc-
tors who love to make a sensation by the large number of patients
they visit daily, and who love to measure the greatness of their
medical skill by the agility of their limbs and their rapidity,
most certainly escape infection. But there is a wise middle path
(which young clergymen who visit the sick are counselled to adopt),
170 THE FBIEND OF HEALTH.
whereby they may unite the most sensitive and warmest phi-
lanthropy with immimity to their own precious health.
The consideration **that a precipitate self-sacrifice may do them
harm but cannot benefit the patient, and that it is better to spare
one's life for the preservation of many, than to hazard it in order
to gratify a few," will make the above first precaution acceptablei
viz. — hy very gradually approaching and accustoming ourselves to
the inflammatory rnaterial of the contagion^ to blunt hy degrees our
nerves to the impression of the miasm (morbid exhalation) otherwise
so easily communicahle. We must not neglect to impress the same
precautionary measures on the attendants of the sick person.
The second precaution is "that we should, when visiting the
patient, endeavour to maintain our mind and body in a good
equilibrium." This is as much as to say, that during this occa-
pation we must not permit ourselves to be acted on by debili-
tating emotions ; excesses in venery, in anger, grief and care,
as also over-exertion of the mind of all sorts, are great promoters
of infection.
HcQce to attead either as physician or clergyman a dear
friend sick of the prevalent fever is a very dangerous occupa-
tion, as I have learnt from dear-bought experience.
We should endeavour moreover to preserve as much as
possible our usual mode of living, and whilst our strength is
still good we should not forget to take food and drink in the
usual manner, and duly apportioned to the amount of hunger
and thirst we may have. Unusual abstinence or excess in eat-
ing aud drinking should be carefully avoided.
But in this respect no absolute dietetic rules can be laid down.
It has been said that one should not visit patients when one's
stomach is empty, but this is equally erroneous as if it were to be
said, one should visit them with an empty stomach. * One who
like myself is never used to eat anything in the forenoon, would
derange his digestion and render himself more susceptible of
infection were he, following the old maxim, to eat something
for which he had no appetite and visit his patients in this state ;
and vice versa.
On such occasions we should attend more than ordinarily to
our desires for particular articles of diet, and procure if possible
that for which we have most appetite, but then only eat as
much as will satisfy us.
All overfetigue of the body, chills and night-watchings,
should be avoided.
PBOTEOTIOK AGAINST INFECTION, ETC. 171
Every physician who has previously been engaged in practice,
eyeiy dergyman and nurse will of course have learned to get
over the unnecessary repugnance he may feel.
Thus we become gradually habituated to the occupation of
tending patients suffering from malignant fevers, which is fraught
with so much, danger and cannot be compensated by any
amount of pecuniary remuneration, until at length it becomes
almost as difB.cult to be infected at all as to get the small-pox
twice. If under all these circumstances we retain our courage,
sympathizing compassionate feelings, and a clear head, we be-
come persons of great importance in the state, not to be recom-
pensed by the favour of princes, but conscious of our lofty
destiny and rising superior to ourselves, we dedicate ourselves
to the welfare of the very lowest as well as the highest aniong
the people, iwe become as it were angels of God on earth.
Should the medical man experience in himself some com-
mencing signs of the disease, he should immediately leave off
visiting the patient, and if he have not committed any dietetic
or regiminal error, I would recommend, notwithstanding I have
endeavoured in this book to avoid anything like medicinal pre-
scriptions, the employment of a domestic remedy, so to speak,
empirically.
In such cases I have taken a drachm of cinchona bark in
wine every three quarters of an hour, until all danger of infec-
tion (whatever kind of epidemic fever the disease might be)
was completely over.
I can reconomend this from my own experience, but am far
from insisting upon the performance of this innocuous and power-
fol precaution by those who are of a different opinion. My
r«asons would be satisfactory if I could adduce them in this place.
But as it is not enough to protect ourselves from infection,
but also necessary not to allow others to come in the way of
danger through us, those who have been engaged about such
patients should certainly not approach others too nearly until
they have changed the clothes they had on when beside the
patients for others, and the former should be hung up in an airy
place where no one should go near them, until we again need
them to visit our patients. Next to the sick-room, infection
takes place most easily by means of such clothes, although the
person who visits the patient may not have undergone any
infection.
A highly respectable and orderly individual who for years
172 THE FRIBND OF HEALTH.
had never walked anywhere, but only to his oiBce at the fixed
hours, had a female attendant with whom he was on very friendly
terms, an old good-natured person, who without his knowledge
employed all her leisure hours in making herself useful to a
poor family living about a hundred yards from his house, who
were lying sick of a putrid fever, the prominent character of
which was, a malignant typhoid fever. For a fortnight all
went on well ; but about this time the gentleman received some
intelligence of a very annoying and depressing character,
and in a few days, although to my certain knowledge he had
seen no one affected with such a disease, he got, in all proba-
bility from the clothes of his attendant who was oflen very
close to him, exactly the same kind of malignant fever, only
much more malignant. I visited him as a friend with unre-
served sympathy as I ought, and I fell sick of the same fever,
although I had been already very much accustomed to infection.
This case, together with many other similar ones, taught me
that clothes carry far and wide the contagious matter of such
fevers, and that depressing mental emotions render persons sus-
ceptible to the miasm, even such as are already used to its influ-
ence.
It would appear that the lawyer who draws up a will, the no-
tary and the witnesses would, on account of not being habitua-
ted to such impressions, run much greater risk of being infected
in these cases. I do not deny it ; but for them there are modes
of escape which are not so accessible to the other persons of
whom we have spoken.
Where there is nothing, the sovereign has lost his rights,
there is no will to be made. But when wealthy persons wiah
to make their last will and testament on their sick bed, there
are two circumstances in favour of the lawyer and his assistants.
As in the formalities of a legal testament, the patient's bed of-
ten cannot remain in its usual situation, and as moreover it is
essential for such a testament that the testator should be in full
possession of his intellectual faculties, it follows that for those
patients wJio are not absolutely poor another room and another
bed may be got ready, thoroughly aired and free from infectious
atmosphere. They do not need to remove thither until all this
has been properly performed a short time before.
The weakness of the intellect in such patients generally keeps
pace with their corporeal weakness, and a patient who possesses
PROTECTION AGAINST INFECTION, ETC. 17S
sofflcient strength of intellect to make his will would not allege
that he is too weak to be removed to another bed and room.
How little chance there is of the legal officials catching the
infection under these circumstances (provided they take moder-
ate care not to approach the patient nearer than necessary), I
need not dwell upon.
I should mention that after one has once accustomed himself
to any particular kind of miasm, for example the bloody flux,
the nerves remain for a considerable time, often for years, to
some degree insensible to the same kind of disease, even though
during all that time we may have had no opportunity of seeing
patients affected with that disease, and thus as it were of keep-
ing the nerves actively engaged in keeping up this state of spe-
cific unsusceptibility. It gradually goes off, but more slowly
than one would suppose. Hence with moderate precaution a
nurse, a physician, or a clergyman, may attend dysenteric pa-
tients this year if they have had to do with similar patients
several years previously. But the safest plan is to employ even
in this case a Kttle blameless precaution.
But as the superstitious amulets and charms of our ancestors'
times did harm, inasmuch as full credit was given to their medi-
cinal virtues, and better remedies were consequently neglected,
80 for like reasons the fumigations of the sick room with the va-
pour of vinegar, juniper-berries and the like, is inadvisable, al-
though the majority of my colleagues highly recommend it,
and assert that the most infectious miasms of all kinds have
thereby been overpowered and driven away, and thus the air
purified.
Being convinced of the contrary, I must directly contradict
them, and rather draw upon myself their disfavour than neglect
an opportunity of rendering a service to my fellow-creatures.
But as the spoiled (phlogisticated, foul, fixed, &c.) air can never
be restored to purity or turned into vital air by means of these
fumes, and as there is not a shadow of a proof that the subtle
contagious exhalations, whose essential nature is quite unknown
to us and not perceptible to our senses, can be weakened, neu-
tralized, or in any other manner rendered innocuous by these
ftunes, it would be foolish, I would almost say unjustifiable, by
recommending such fumigations for the supposed purification
of the air, to encourage ordinary people in their natural indo-
lence and indisposition to renew the air of their apartments,
and thereby expose every different person who comes in con-
174 THE FBIEKD OP HEALTH.
tact with them to a danger to bis life, which shall be all the
more obvious and great, the more confident he has been made
by the futile representation that, without driving away the dis-
ease-spreading miasm by means of repeated draughts of air,
the pestilential atmosphere of the sick room has been converted
into pure healthy air by means of simple fumigations with vine-
gar and juniper berries. That is just like the old superstition
of hanging an eagle-stone at the hip of the woman in labour,
at the very moment when all hopes of saving her, even by the
forceps, are over.
When a physician or clergyman enters an unfumigated cham-
ber he can at once tell by his sense of smell whether his need-
ful order to air the room has been obeyed or not. All sick
people make a disagreeable smell about them. Therefore the
freedom from smell of a chamber is the best proof that it has
previously been aired, but if fumigations have been had re-
course to, the latter becomes doubtful and suspicious. Neither
the physician nor the clergyman, neither the sick-nurse nor'the
patient, require perfumes when they have to think and speak
seriously concerning a matter of life and death. They should
never be used I
IN OLD-WOMEN'S PHILOSOPHY THERE IS SOMETHING GOOD, IF WE
ONLY KNOW WHERE TO FIND IT.
I hope by this section, at all events by the title of it, to have
made my peace for all future times with that, please heaven,
small portion of my fair readers who suspect me of heresy from
the faith of our grandmothers, and I should be sorry to fall out
with these respectable old people, certainly I should.
So let us hasten from the preface to the main point of our
matter. I once lived in a place where the midwife, who was
there called emphatically the vnse moman, gave to all newly con-
fined (peasant) women a good large quantity of brandy. Even
I had to submit to this inevitable fate, and I did it without a
murmur. For who dare say a word against the Parcae, especial-
ly against the the third and last of them ?
I was assured that this fiery spirit did great good in many
cases. With folded hands I held my peace, as was reasonable,
and looked on, and I foimd that in this locality there were ac-
old-women's philosophy. 175
toallj many puerperal women who when left to themselves had
serious symptoms arising from weakness or excessive irrilabili-
ty of the nervous system, accompanied by impurities of the
stomach and bowels, or by plethora — in these the brandy did
real service, but these were exactly the cases in which we find
opium (a very analagous thing) of use.
Here then the old-woman's philosophy was really right for
once. But what became of the other cases in which the bran-
dy was poured into the poor creatures in a useless and hurtful
manner ? I shall say nothing about that, because at the pre-
aent time the third fate is still much too intractable, and has
even become fearful to the sons of -^Esculapius.
" If you are a woman, tie a man's stocking round your swol-
len neck, and it will subside ; say, I said it." This good coun-
sel of the old dame is true in so far as slightly swollen cervical
glands in lymphatic constitutions only require a warm covering
in order to dissipate the swelling, more especially a covering which
(as will readily be done by a woollen cloth on the tender skin of
a lady's neck) shall cause friction and produce irritation and red-
ness. Thus far the old women's philosophy is again correct. But
why a dirty stocking? might we not use flannel — and howl in
troe inflammations of the throat what good will a dry, wool-
len, heating covering do I — Here the old witch holds her tongue,
and so do I, for it is advisable to do so in her presence.
Swollen cervical glands are cured by the lucky hand of some
wise woman or midwife, who must each time that the moon is
on the wane, in silence press thrice upon the swollen glands
with her thumb, in a crucial manner. Superstition places much
confidence in this semi-magical remedy, which sometimes is ac-
tually of great service. Thus much is certain, that glandular
swellings in middle-aged individuals of lymphatic constitutions
who have not much general scrofulous disposition, not unfre-
quently disappear rapidly by rubbing and moderate pressure.
Thereby is produced an increased circulation of the blood and
a greater activity of the lymphatic vessels, and even an inci-
pient inflammation, whereby the swelling is removed. In so
fiaff the vaunted petticoat wisdom is right.
But what the period of the wane of the moon has to do with
the matter, we,- who belong to the inferior class of untranscen-
dental doctors, are too dull to perceive, because, alas, we are
not endowed with the super-subtle sixth or perhaps seventh
sense ; were it otherwise we might see the great importance of
176 THE FRI£ND OF HEALTH.
the triple and crucial pressure, more especially if the exoes-
sively lucky precaution is observed of commencing and carry-
ing out the operation from beginning to end without ^peaking a
word^ which indeed it were almost too much to expect firom an
ordinary woman.
THINGS THAT SPOHi THE AIR.
It cannot be indifferent to those of my readers who wish to
enjoy a long and healthy life whether the air of their roomB
possess the necessary degree of purity or not.
There are many familiar things that render the air that we
breathe more or less unsuitable for the maintenance of life, so
my readers must listen to the warnings of a friend.
Flowers are an ornament to a room, and if we are content to
deck one room with but a few of extreme beauty, and very
feWy on account of their perfume, it will not much signify ; it is
rather praiseworthy than blameworthy. The more we refresh
our senses in an innocuous manner the more lively and easy
does our power of thinking become, the more capable and dis*
posed for business are we, and the delight of the sight and the
smell in flowers, the pride of lovely nature, is especially of this
character.
But an excess does harm in all things, so it does likewise
here. A large bouquet of lilies, tuberous plants, love-floweis,
centifolia, jasmine, lilac, and so forth, makes such a strong per-
frime in a small room that many sensitive persons have occa-
sionally been made to faint by them. This does not depend so
often on the antipathy of the nervous system to such odours as
it does on the injurious property of such strong-scented flowers
of quickly spoiling the air and rendering it unfit for respiration.
Other writers have already called attention to this &ct, so that
I need not dwell longer on it, and will content myself with
having repeated the warning.
People who wish to be very genteel, love to bum in the
evening more candles than are necessary; and if they are
entertaining company, they light up chandeliers, sconces and
all the other receptacles for candles they may possess, in order
that the fashionably dressed ladies and gentlemen may see each
other welL It is considered a capital holiday spectacle to see
so many candles burning at once ; it dazzles one's eyes so bril-
THIiraS THAT SPOIL THE AIB. 177
liantlj that we scaicelj know where we are ; it also costs a
good round sum.
But if we view all this display of candles in the proper light,
we shall find that they spoil the air in a very ugly manner.
Considering that they are only lighted for a nimiber of guests
who are to be well feasted, who, seated in close rows, pollute
the atmosphere for each other by their breathing and exhaJa^
tions, in one word that they are only lighted for feasts and
balls, considering this, I say, I know not what sort of compli*
mentary speech I can make to my entertainer for purposely
depriving me of the little bit of pure God's-air, and giving me
the very worst sort instead, in which an animal could with dif-
ficulty sustain life. Amid how many attacks of faintness will
ixyt yon lady express her thanks to him, after having worked
away for hours at her toilette, preparing for the festivities, in
the endeavour to diminish by one third the capacity of her
chest by means of a whalebone apparatus, until, drawn in so
tightly as to look like a wasp, she could scarcely take in air
enough to support life in a pure atmosphere ! Belish it who
may — I must say, for my part, that I have no wish to be
regaled with so many candles in a room.
He who wishes to act wisely will not tarry in the room where
he has dined, and where the vapour from the warm food has
deteriorated the air, until it has been thoroughly aired.
It is very unwholesome to sleep in rooms where, as is often
the case among the lower classes, there is a store of green fruit
A quantity of phlogiston that exhales from the fruit in the form
of their odour soon approximates the pure atmospheric air to
the condition of phlogistic and unhealthy air.
Also store-rooms of other kinds, where domestic articles and
food from the animal and vegetable kingdoms arc kept in
quantity, such as oils, candles, lard, raw, boiled, and roasted
meat, pastry, &c., are not healthy places for people to dwell in.
It should be observed that everything that emits much smell,
perceptibly vitiates the atmosphere.
In foul linen the excretions from the skin are present, and no
rational person would submit to have them kept or washed in
his room for similar reasons, but also for delicacy's sake.
No one who can avoid it should sleep in the room in which
be remains during the day. The beds part very gradually
with the exhalation they have received from the sleeper during
the night, and continue to vitiate all day long the air of the
12
178 THE FBUCNB OF HEALTH.
room, even though it ^ad been thoroughly aired in the morn-
ing.
Six busy watchmakers do not spoil the air nearly so much as
two workmen engaged in sawing wood. I would thereforo
advise that the workshops in manufactories, especially where
much corporeal exercise is employed, should be built rather too
high than too low, rather too airy than too dose, and be they
ever so cleanly and well situated they should be frequently
aired. It is incredible in how short a time in such cases the air
of the room becomes vitiated and unfit for respiration. The
miserable, sick aspect and the great mortality of the workmen
of many manufactories renders further proof of my propoaitioii
superfluous.
Working with unclean wool, with oil-colours, or with thingB
for which burning charcoal is employed, is for other reasons
not innocuous.
But even though the air should not be altered in its compo-
sition, it may become hurtful in another way by the mixture of
something extraneous. Such is especially maiaiure.
Reservoirs attached to chamber-stoves, wherein the water is
kept hot for domestic use, are in this respect injurious. For
this reason also, workmen who are engaged in drying wet
things in highly heated rooms, cabinet-makers, turners, potters^
bookbinders, &c., are very liable to swellings and other affec-
tions proceeding from relaxation of the absorbents.
A person who from an idea of extreme convenience should,
notwithstanding the vicinity of a water-closet, keep a night-
chair in his sleeping apartment, should bear in mind that the
disgusting exhalation from it spoils the air uncommonly, and
renders the bed-chamber in which we pass a third of our life (if
it be not very roomy) a very unwholesome place of abode.
There are however many houses so ill-arranged as either to
have no water-closet at all, or where it is at such a distance as
as not to be very accessible in the night.
K this is the case, and cannot be remedied, we should have a
small closet constructed of stone in the comer of some public
room near the bed-chamber which has a good opening to the
outside of the house, and a well fitting door to enter at In
this place we may, under such circumstances, place the night-
chair, and have it carried out afterwards, without having to
fear any vitiation of the air or bad smell.
We should not permit large thiddy-leaved trees to stand
THINGS THAT SPOIL THE AIR. 179
dose to the windows of a house. In addition to their prevent-
ing the access of daylight and of the pure air, their exhalations
in the evening and at night are not very favourable to health.
Trees at a distance of from ten to twelve paces from the house
admit the air much more readily, and cannot be sufficiently
recommended, as well on account of their beautiful appearance
and their pleasant shade, as on account of the wholesomeness of
their exhalations by day. If we have the choice we should
have the windows of our bed-room to the east, where the view
15 quite free, uninterrupted by very close trees, and unpoisoned
by the febrile exhalation from a marsh.
Poverty has brought many injurious habits into this world,
one of the worst of which is that where persons in the lower
ranks of life, especially women, sit over a vessel filled with red
hot charcoal, in order thereby to save themselves the expense
of a stove in winter. The closer the room is shut up in such
circumstances, and the more the external air is excluded, the
more dangerous and fatal is this habit, for the air inside will
thereby soon become a stupifying poison.
We feel a pressive, stupifying headache, that seems to bore
through both temples, at the same time we experience an incli-
nation to vomit^ which however is soon suppressed by a rapidly
increasing comatose state, in which we sink helplessly to the
ground and generally die without convulsions.
When the person falls down the clothes are apt to catch fire
from the burning charcoal, and indeed fires have oflen origin-
ated in this manner, which arc all the more dangerous because
it is only when they have fairly burst forth that they will be
observed by strangers, seeing that the person who originates it is
too stupified to be able to extinguish the first flames.
Not less dangerous to life is it to close the valve in the chim-
neys of stoves that are heated from within, as long as the stove
continues full of glowing cinders. From motives of economy
people often like to retain the heat in the room. An economy
that is very ill-directed. The more glowing charcoal there is in
the stove, and the tighter the valve is closed, the quicker is the
air vitiated, just as it is by a brazier full of red hot charcoal
standing free in the room, and there ensue accidents just as bad
as those above described, and not unfirequently fatal.
The valves in the chimneys of stoves are solely intended to
moderate the draught of air into the stove and the violence of
the fire, or in the event of the soot in the chimney catching fire
180 THS FBIEND OF HEALTH.
to prevent a destructive conflagration by entirely ahntting tb9
clihnney. If this latter should happen, every sensible p^Bon
will as soon as he has shut the valve at once open the doors and
windows in order to remove the air of the room that has been
deteriorated by the confined fire.
We should rather seek to save wood by using well construct*
ed stoves, than, by stopping up every hole and cranny in the
doors and windows, exclude every breath of air, as is done by
many persons of slender and of moderate means. Such persons
must be ignorant of the incalculable value of air, who paste up
with paper every chink and hole, and even hang up cloths be-
fore their doors, and thus retain all the unwholesome exhala-
tions from the pores of the skin and from the lungs in their
small rooms, so as to respire, instead of life and health, disease
and death. I have seen melancholy examples of this nature^
and I fear that my warning will have some difficidty in pene-
trating to the miserable cellars they have themselves selected.
Deathly pale and spiritless they feel an unknown poison per-
meating all their bloodvessels, they feel their health gradually
being undermined, just as the water that runs down from their
windows rots the window-frames ; cachexy, dropsical awellings
and pulmonary consumptions carry them off after having seen
their children die around them of low, wasting diseases, which
they attribute principally to teething or bewitchment, or reduced
by rickets to cripples. Where is the compassionate man w^ho
will teach them something better ?
IHERE IS GOOD EVEN IN HURTFUL THINGS.
It is well known that the tailor s trade is not one of the
healthiest of occupations. We find in these good folks, if they
are diligent workmen, usually emaciated legs, knock-knees, a
dragging of the left leg, round shoulders, the head bent for-
wards, drawn-in abdomen, and so forth. Their complexion
shews very plainly the unhcalthiness of their occupation : loss
of appetite, piles, constipation, weakness of the body, itch, &c^
are things quite common among them, and yet there are cases
in which this mode of life has been favourable to health.
A young man in England was born with the feet turned in-
wards. A surgeon whom his mother consulted pronounced the
deformity incurable* When he grew up, he could only walk
THERE 18 GOOD EVEN IK HURTFUL THINGS. 161
with difficxQiy upon the outer border of his feet and heels, he
always knocked one foot against the other, and frequently fell :
the musdes of his thighs and calves were extremely attenuated,
and the tumed-in feet were so deformed, that shoes of a particu-
lar shape and tie had to be made for him.
The poor-house authorities bound him apprentice to a tailor
thinking that this was the only trade that his deformity permi?
ted him to follow.
In this work, whereby one usually sits at the shop-board, as is
well known, with the legs crossed, he observed a gradual
change in his limbs, which, without the slightest employment of
external or internal remedies, continued to turn outwards. In
the course of three years they attained their natural position,
flo that he could wear ordinary shoes, they were indeed directed
more than usually outwards. The muscles of his legs grew
stout, xuid his body was so well formed that he enlisted in the
marines, and thenceforward remained in the service.
Probably in this case a peculiar stiffness (rigidity) of the mus-
des that adduct the foot was the cause why the abductor mus-
des could not maintain the balance of power, and so allowed
ihe foot to be drawn inwards. The strain upon the former,
when the legs were crossed at his work, stretched and relaxed
them more, and thus the abductor muscles of the leg and foot
were enabled gradually to attain their natural opposing power ;
indeed the latter gained in this way an excess of power, and his
feet were turned outwards more than is usuaL
Joiners and cabinet-makers usually have the right shoulder
higher than the left, because they exert the former most during
their work. It might be tried whether individuals whose left
shoulder was the highest, would not become straight by follow-
ing these trades.
In like manner, to give another example of the good effects of
hurtful things, there have been eases where by a stab of a sword
in the chest, purulent deposits in its cavity that threatened a fatal
result, have been opened, and where, after the murderous wound
was healed, general health was the result.
So, also, persons who were paralysed on one side of the body,
on being struck by lightning, have recovered the perfect use of
their limbs.
I knew a melancholic gentleman who in a fit of the spleen
wounded the veins in his neck, and after losing several pounds of
blood, recovered from his melancholy madnesa
182 THE JTBIEND OF HSALTH-
Cases have been recorded of patients who, in order to put a
period to their sufferings, swallowed large doses of opium, and
attained their object in this way — that they did not indeed die,
but were completely delivered from their disease.
And how many instances might be cited where persons have
become wiser and better by disease, or have grown healthier by
•calamity, misery and hunger, and have become more useful
members of society ! I know a physician, to whom the world
owes much, who would never have adopted this honourable
profession, had not the delicate state of his health when a young
man almost compelled him to do so.
He who has made a narrow escape from drowning learns to
swim, and by this accomplishment is enabled to save the lives of
others.
The police-inspector has his house burnt down, and the fire-
engines of the place are put by him into a state of perfection.
Yon prince would not have placed the lands of his subjects in
a state of security against inundations, had not some of his own
estates been feaiiully inundated ; and had not his throne been
several times shaken by the thunderstorm, he would not have
introduced the valuable lightning-conductor into his domioions. '
Pfeffel and Euler must lose their sight in order to surpass the
most of their fellow-beings in poetical and mathematical talent ;
and if we had space, we might adduce many other examples
of benefits derived from injurious things, to the glory of the
Creator.
DIETETIC CONVERSATION WTTH MY BROTHER, CHIEFLY ABOUT
THE INSTINCT OF THE STOMACH.
He. Are you not ashamed of yourself to be eating pears early
in the morning ? you will chill your stomach, and then you can't
say I did not warn you.
/. Certainly not, for I have no fear of such a catastrophe. But
tell me, at what time of day should one eat fixiit?
He. After dinner, and as a rule, after having taken something
warm into the stomach ; such was the opinion of our ancestors,
and they were no fools.
/. But we moderns on the contrary are of course ? and this I
would almost concede to you for the sake of peace, if this ver-
dict only applied to some of us. But tell me, can the stomach of
MRSnC OONVSBSATIOV. 188
diflEbrent indiyidualB be regulated by <Kie general role, even were
it as old as the twelve oommandmenta. Is not every one's sto-
mach as peculiar as every person^s foot, which the shoe of
another iirill not and cannot fit?
Ek, Yes, I grant you that ; but we can take the measure of
the foot^ it is something visible and tangible, but who can tell
the exact and peculiar condition of' the stomach ? Would wb
not act more wisely, by following in its proper place, the gene-
ral rules for it laid down by wise men ; and not attempting to
speculate further on such a ticklish subject ?
/. Did then the wise men of former generations know every
individual stomach, its condition and requirements, so clearly as
to enable them to lay down those general rules for their postcrty,
which were suited for each one of the innumerable varieties of
stomachs ? Is that possible ?
He. Not that exactly 1 but you modems have apparently been
more lucky in finding a general rule for the stomach {dietetics as
it is commonly termed), as I guess &om your eating fruit in the
morning.
/. Just so, I just wished you to tell me that the modems were
diet-mongers. They are but too much so, to reply seriously to
your irony. In their law-giving mania they imagine themselves
just as wise, and make just as many mistakes, as the ancients.
He. In what horrible uncertainty, brother, would we be grop-
ing about in a matter of such importance for preserving the
proper standard of health ! how unlucky would we be were
what you say correct 1
/. Neither unlucky, nor yet in horrible uncertainty, I should
ihink.
This article in our vital breviary is of such great importance
that it is certain the beneficent Creator could not have founded
it upon the shifting standard of the professional dietists ; he must
have given us an infallible guiding principle to direct us in the
selection of food and drink. Could any one seriously attempt
to bring up good children according to the literal principles of
a pedagogic book ? What think you ? the good Claudius will
cut oflf his finger if this be true.
He. And what then is your infallible guide to the only saving
system of dietetics 7
L Just what you yourself usually follow, without thinkinis
about it ?
He. And what is that I demand, you tantalizing fellow ?
184 THS FBIEND OF HEAIAS.
/. I should suppose, ''Moderation and attention to what best
suits your individual constitution in every condition." I will
allow a finger to be cut off if this be not the natural religion of
the stomach and the only infallible dietetic rule for every one.
He. No doubt, if we had the instinct of beasts, you might be
right.
/. What mutilater of the rights of man could have told yon
that our beneficent mother Nature has not endowed ns with just
as much instinct as we require ? Who teaches the infant to pre-
fer its mother's milk to pastry ? Who instructs him that is sunk
in grief and distress to take a glass of wine ? Who tells the patient
ill of a bilious fever to avoid meat ? the dysenteric patient to
pant for grapes? Who tells us when we are hungry, when
thirsty ? A rotten ^g is just as repulsive to us as it would be
dangerous to life, and arsenic is as abhorrent to a delicate tongue
as it is &tal to t^e stomach.
But all these are only striking fragmentary reasons for the
reality of a beneficial instinctive principle in us. I am incapable
of erecting a scholastic system upon it, irrefragable though it be
in itself.
Do not retort by referring me to the appetite with which the
parched brandy -drinker pours in his murderous liquor ; to the
ravenous hunger with which the glutton fills the very last cubic
line of his stomach with hurtful chef-d'oeuvres of the culinary
art ; to the greediness wherewith the hypochondriac swallows
his malt liquor, which has frequently before caused him dange-
rous colics ; to the coffee-drinking woman who will give her last
fitrthing in order to purchase the enervating drink, although she
is just about to lose her last pair of black teeth, or must sigh
over her unfruitful marriage amid the reproaches of her husband.
To retort in that way would be as if from the innumerable
daily examples of want of conscientiousness we should seek to
prove that there was no such thing as conscience.
Oh my brother I he who has preserved this delicate, never-
deceptive feeling for the good and the noble, in all its simplicity
and innocence, aftd exercises it with the readiness of an unso-
phisticated child, for his own and his brother's benefit ; he asks
not if there be human beings so degenerate as to presume to de-
monstrate away the conscience to a mere shadow, who assert
knavery to be a necessary fiishion, and a Sybarite's life to be a
lawful recreation. In like manner he who, moderately enjoy-
ing the gifls of God, has made it lus study to discover the reality
BUTKTIC 00NVEB8ATI0N. 186
of his desires for articles of food, and has by degrees acquired a
ftcility in being able to determine before he sees it, and firoin
the mere name alone, whether this or that food, this or that
diink would agree with him at the time, — he does not inquire
if there be men who bid defiance to all nature's wholesome hints,
turn a deaf ear to all her wanings, confound the mere tickling
of the palate with a sufficiency, and repletion with the satisfac-
tion of their wants, and acknowledge no dietetic rule besides the
gratification of their taste, their indolent habits, and the exam-
ple of their neighbours. He inquires not about them, I repeat,
nor does he imitate them in the crowd of ailments and maladies
that from time to time endeavours harshly enough to call them
back to resolutions of temperance. Do not, however, take up
my observations as though I imagined that the instinct of our
stomach should in all cases indicate even particular varieties of
nutritious articles which we must especially partake of in order
to keep in good health ; this would be foreign to the purpose of
the Creator.
In its healthy state the human stomach only needs an instinct
to direct us to certain classes of food, which we should partake
of firom time to time if we would continue in' right good health.*
Thus, for instance, the peasant who has overworked himseli^
says to his vnfe when she is about to set before him cheese and
eggs, " I wish you would make me a little salad ; if you have any
sour milk, give me a little of the wlicy in place of any food, or
something else sour." Or if, during a couj)le of holidays, he
has not had an opportunity of working at all, he only asks for
weak soup for supper, or will not eat any thing at all. Or, if
he has been dissipating for several days, he asks her for some-
thing strong, something tasty, a bit of bacon, cheese, peas, and
the like. In this case he would feel as if he wanted something
more were he to get nothing but a dish of milk ; he does not
name any article of food in particular that he must absolutely
have, he only wishes something of a verj^ nutritious character.
In like manner many persons of from eighty to ninety years of
' [This is true, aud the reason is quite obvious. When the palate, or, as our Au-
thor terms it, the " instinct of t/w Btomach^ calls for certain articles of food, the sa-
lirmiy gUnds, the ptomach, the pancrca<i, and the liver all pour out their secretioDB
abandantly, and thw« produce the conditions essential to healthy digestioa If| how-
ever, food or drink be taken which is repugnant to Die palate, the digestive secretions
are not furnished, and, as a consequence, chylification is imperfectly performed, and
iodigesUoii, with its concomitants obtain. The ideas advanced by our great master
upon this snbjeet are of great importance in a dietetic point of view.] — Am. P.
186 TBI FBISVl) OF HIAIAH.
age, oommenoe fiom mere instinct to live upon honey, sugar
and milk. Who infonns them that such substances only will
keep their fibres in a pliant condition?
But whenever we jget into a morbid state, and accustom our-
selves to attend dispassionately to the wants* of our stomachy
then the voice of this true guardian of our life becomes louder
and more audible. We perceptibly lose our appetite for certain
classes and even varieties of food, and a desire for other classes
and varieties is developed, without our knowing why. The
pleuritic patient calls for water, cold water, the patient ill of pu-
trid fever demands beer ; soups and the like are intolerable to
both.
The delicate woman in the family way puts chalk into her
mouth, and if we keep it from her she scrapes the lime from the
wall and consumes it. She knows not that she has an intolera-
ble acid in her stomach, and still less does she know the chemi-
cal property of the chalk of neutralizing and removing adds.
What teaches her to swallow greedily this specific for her ail-
ment ? What else but the awakened wise instinct implanted by
the infinitely wise Creator?
The man who is extremely exhausted from starvation desires
a spoonful of wine ; what tells him that a supply of meat and
bread which an ignorant person would endeavour to force him
to swallow, might prove fatal to him ?
I saw a lying-in woman, who, after a difficult labour, suffered
from intolerable after-pains and a great loss of blood. She cried
for coffee, although when she was well she could scarcely en-
dure it. Who told her that her haemorrhage resulted from ato-
ny of the womb, and this from diminished irritability of the
fibres, and that the specific remedy for this was coffee? A few
cups of very strong coffee were given to her, and hsemorrhage
and pains ceased suddenly ; opium would have had no effect in
such a case.
A person who has contracted a bilious fever from anger and
vexation, longs for nothing so much as fruit, who tells him that
this is almost the only thing that can do him good ?
And so I might give you many more examples of the expres-
sion of the instinct of the stomach, did I not fear to weary yoiL
We understand it under the terms appetite and repugnance,
two very important but much neglected monitors for our well-
being I
If we would only study this voice of nature often enough,
DUBTSTIG OONVSBSATIOK. 187
and in a perfectly unprejudiced manner, we would obtain a
gpeat &cility in understanding its feeblest manifestations ; we
should be enabled thereby to escape a large number of diseases,
and in many cases to attain to long life without difficulty.
But we find (as a proof of all I have said) that this small
voice of nature is only audib^ to persons who live upon very
simple articles of food, and that they come at last to understand
it in a very remarkable manner ; almost just as the cattle,
which we allow to range at large over the fields, never swallow
a plant that would hurt them, but only those that are suitable
for them ; but when they are ill they often recover, if we drive
them out to the meadows where they can instinctively select
the food that will do them good.
But how often does it happen that cattle before whom we place
hurtful plants, mixed with good hay, are gradually induced
to swaUow the former along with the latter, and so grow ill ?
Just as often (let me be permitted to employ this appropriate
comparison as regards animal nature in general) as a gentleman
gets ill at the richly furnished table by the artistic mixtures of
his cook ; the taste of the healthy person decoys him into eating
unwholesome things without knowing they are so; or the
viands become unwholesome by the contradictory mixtures, and
the palate is seduced, deceived.
But as the Creator did not wish to limit our appetite when in
health specially to one single particular kind of food or drink,
and only directed our stomach's instinct to general classes of
nutriment, in order that we might remain healthy and useful
members of society in every condition, under various relations,
in all degrees of latitude, and under all circumstances of for-
tune, so he sought to avert all injurioiis consequences that might
arise £rom this instinct of the stomach, that is so much less
limited than is the case with the lower animals, by endowing
us with an accurate, definite sense of when it is time to leave off
or to partake of food and drink.
This sense, which we term hun{fer, thirsty and satiety, is in the
case of healthy persons who have not much choice of food, al-
most the only guardian of their health. This feeling, this in-
stinct, as I may term it, is in persons who regard moderation
as one of the greatest of virtues, so watchful, so active — ^they
hear this internal voice as distinctly as any animal to which we
especially attribute instinct, so distinctly, that they can deter-
mine to a mouthful when they have taken enough for their
188 THB FBISKD OF HEALTH.
health ; that they would deny themselves half a glass of wine or
beer beyond what would agree with them. (The sick man, how-
ever, whose imagination has got a wrong direction, does not be-
long to this class.) And ii is this last kind of bodily sensation,
(hunger, thirst, satiety,) dear brother, that I, as a physician,
cannot sufl5ciently recommend 1^ be kept in an active state.
Moderation, strict moderation, that is not to be bribed by a
pampered, corrupt palate, is a sublime corporeal virtue, with-
out which we cannot become healthy nor happy.
This virtue, which is nothing more than faithful obedience to
the internal voice of our digestive organs, relative to the proper
quantity of nutriment we should take in, has the most percep-
tible influence even over all other virtues (which, in feet, do
also consist mainly in some kind of moderation or another) —
and just as certain is it that excess is always accompanied by at
least one vice.
We may readily attain sufficient proficiency in this attention
to ourselves, but, on the other hand, it is much more difficult
to maintain in an active and understandable condition, under the
various circumstances of life, that instinct, those secret hints of
our digestive organs which beckon us to certain classes or even
certain varieties of nutriment that are most wholesome for the
particular state of our system for the time being. If you desire
it, however, you may acquire even this latter art, but only after
having perfected yourself in the former one.
But where is the wise man to be found who is capable of
rightly dictating to me in a book once for all what and how
much I ought to eat and drink? To me, an isolated individual,
with a peculiar constitution, in all the daily varying relations of
my life, and the circumstances of my health ? I must judge by my
own sensations what and how much will suit me ; / must know
it, or no one else can, unless, perhaps, my ordinary medical
attendant.
Do not blame me, therefore, brother, if I am somewhat pre-
judiced against those general dietetic rules for sensible persons ;
do not blame me if I eat or drink this or that at this or that
time, and again pass over whole periods for meals without tak-
ing anything, as I do all this only when I am so inclined.
He, But tell me what is meant by depraved appetite, which
makes so many people ill ? Most derangements of the stomach
seem to me to proceed from that cause.
/. Tell me, on the other hand, whence do most of the moral
DIKTETIC CONVEBSATION. 189
defonniiies come into the world ? is it not from misguided, per-
verted feeling for the good and the desirable ? And these erro-
neous directions of our moral faculty, whence oomc they, if not
from a seared conscience and ignorance of what is good and
desirable 7
J%. Ignorance you say, and I take you at your word. Con-
sequently in order that your analogy should hold good, we re-
quire, in order to carry out a rational system of diet, a his-
torical knowledge of wholesome and unwholesome articles of
food ; and hence the dietists should be most acceptable to us.
/. There is not and cannot be any thing which as a general
rule is absolutely unwholesome or wholesome. Just as bread is
useless to him that has an inflammatory disease, and to him
that has his belly full, and as belladonna can in certain cases re-
store the health, so none of the other general maxims of the
dietists can be accounted good —such as, veal is the most whole-
some butcher's meat, chervil is a wholesome vegetable, &c.
How can a thing that we can swallow be, under all circum-
stances and in every condition of the body, universally whole-
some healthful, innocent, hurtful, or poisonous? There is a
time for every thing, says the king-sage, and to my mind he
speaks much more sensibly than most of the dietists.
It is, however, very good and laudable (and in this respect
you are right) to have some knowledge of the various articles
of food, their nature and propcilics, before entering on the great
world, in order that we may avoid mistaking toad-stools for
mushrooms, or swallowing a solution of corrosive sublimate for
liqueur. But I should like if our dietists were more careful
and exact in respect of these matters, I should like them to
enter more into details, and that their maxims in regard to the
particular constitution of the body in which this or that article
of food makes this or that peculiar impression, were derived
more from trustworthy and select authorities and from their
own experience, than from mere hear-say. But this is a hercu-
lean task, and a useful system of diet of this kind will long
remain ideal only. And with this, adieu, dear brother. Think
over the subject and tell me on some future occasion where
you think I am wrong.
AN OCCASIONAL PURGATIVE, SURKLY THAT CAN DO NO HARM.
My dear Doctor,
I have been advised to apply to you, as you have the
190 THE FRIEin) OF HEALTH.
character of always telling people in a pretty straightforward
manner what they ought to do. It occurs to me, and my
fiunily-surgeon also has often reminded me, that it is surely
high time for me, my wife and my children, to take a good dose
of purgative phj^sic. " Your honour," he is always saying, " only
think what a quantity of dirt must accumulate in the abdomen
in the course of half a year, if the refuse be not swept out and
cleansed away at least once a month." The like of us, to be
sure, do not understand it, but one would think, that of all the
food and drink we take, somewhat must occasionally stick in
the body, though it may not be so desperately bad as my suiv
geon alleges. Thinks I to myself, if everything collects in the
body in that way, then my shepherd, who is in his seventieth
year, and has never taken any medicine in his life, must carry
about with him in his belly an accumulation of impurities
enough to fill a barrel. But my surgeon ought to know more
about the matter than I do. The fellow has, as he assures me,
had great experience during the seven years* war ; he has am-
putated a fearful number of arms and legs in the military hoe-
pitals, and helped to extract many bits of broken skulls. Do
not blame me, doctor, for adopting his views ; the chap makes
an impression on one with his talk. He looks as fierce as a
savage, stammers out horrible Latin and Greek words, gesticu-
lates with his arms, and distorts his features to such an extent
that one cannot help being moved when one listens to him.
And what he says may be perfectly correct ; and is there any
greater blessing than health? What a lot of diseases with
Greek and Latin names one might get in one's gullet by neg-
lecting the proper precautions ! My wife and children are very
precious to me ; they are all lively and ruddy, and as sound as
a nut. May God keep them so ! But all my household must
lend a hand, and work according to their abilities. After being
busy all day in the open air they get a brave appetite for their
meals. None of them ail in the least, that is true. If we could
but prevent their suffering hereafl;er ! If you should think a
good purgative advisable for us, please to send us our portions,
and say how we should take them. The chemist will tell you
the ages of myself and family. You may send the stuflF to us
by the brewer's cart. I am, Ac,
W. von TEUTON,
Sdilo88 Bergbauaen, Reiirtd Oapiain,
1st October.
AN OCCASIONAL PUBOATIYE. 191
Ansioer.
My dear Captain,
It is well that you have not given the preference to
the idle talk of jour Bramarbas of a surgeon over your sound
judgment, as so many in your situation do.
You appear to appreciate the truth of that very sensible
Tnaxim, '* The whole need not the physician, but they that are
sibk." Who would take medicine if there was nothing the
matter with him? Is there any better preventive of diseases
than a good robust state of health ? That you enjoy, as I pei^
ocive from your letter, along with your femily ; do you wish
for anything better ?
It 18 only in cases of excessive over-loading of the stomach in
delicate persons, and such as are afflicted with chronic diseases,
that the circumstance occurs of nature being too weak to expel
the ordure at the right time, and we require to assist her by
meuis of a purgative medicine. But in the healthy state, nature
18 able of herself to evacuate the useless refuse of the food, and
that infinitely better than can be done by our good art.
Therefore, trust me, take no physic, neither you nor your
fimnlj. Anything else that you have to ask I shall be happy
ta infimn you o£ Let your barber-surgeon stick to your beard ;
the inferior class of these gentry usually only understand the art
of making healthy people less healthy, and the sick worse than
they were ; they bring nothing out of the military hospital with
them but disregard for the sufferings of others. Farewell.
ON MAKING THE BODY HARDY.
Modem instructors and other clear-headed men have deeply
felt the necessity of making young persons destined for various
pursuits and for fighting their way in the great world, hardy, as
they term it, and thereby rescuing them from that effeminating
and coddling mode of rearing which has for long been the pri-
vilege of fjBishionable people, in which' they have been en-
couraged by the ordinary class of physicians, who arc accus-
tomed to reap a golden harvest from the fur-coats, fur-boots,
fur-caps, the heated rooms, the intemperance, the warm drinks,
and the destructive passions of their clients.
The many unfruitful marriages, the delicacy and bad health
of the richer classes have excited attention, and it has been
found that these &vourites of fortune have been changed into
192 THE FBIBND OF HEALTH.
the most wretched specimens of humanity by the habits of
life they adopt, that many of their families gnwiually die out
inevitably, and that the delicate members that may still remain
of some, encompassed by a host of diseases and pains, joylessly
drag out their existence, without any pleasure in life, in the
midst of their abundance of the good things of this world, like
the fabled Tantalus of heathen mythology.*
The open air was never warm enough, it chilled the young
ambassador; the comfortable travelling carriage was altered a
dozen times in order to exclude every breath of air.
The prince was not allowed to walk, for how easily might he
not get his feet wet, and in consequence die suddenly of appoplexyl
The young count, destined to be a general, slept in beds of
the softest eider-down, was fed upon sweet cakes, coffee, highly
seasoned dishes, two servants must wait on him to assist hinn to
dress, but not before ten o'clock in the morning, because tlie
tender plant might have withered if exposed to the rude morn-
ing air. And so he grows up, enters upon his important post^
and must now play the iron denizen of camps ; only imagine I
In like manner there are king's messengers who would be
suffocated in a peasant's heated cot, and rangers of the royal
forefets who would catch their death if they were forced to wade
through the snow.
How many toothaches and diarrhoeas has not last night's
opera occasioned ! what an amount of colics, rheumatisms, sore-
throats and erysipelas will not our to-morrow's illumination give
rise to I
I said before, that effeminacy is the privilege of the rich
fashionable classes ; I am wrong! This privilege has been said
to belong to the nobility. In order to appear fashionable, the
manners of hrnit ton have been assumed by the very lowest
classes. A merchant's wife, nay a hair-dresser's lady, would
think it a disgrace not to be able to talk about vapours, perte
blanche and digestive lavements from her own experience. The
son of the poor secretary takes his afternoon nap on soft pillows,
and the ostler's daughter eats her Swiss biscuits with her sugared
coffee ; she would blush to wash her own clothes.
These depraved habits have crept in, even among country
people : for the farmer's daughter can undoubtedly not consider
' [We are here reminded of the remark since made by Majendie, ** that Paris
would become depopulated io two or three generations, were it not for the robuat
recruits who constantly come in from the country as residents."] — Am, P.
OS ICAKma THE BODY HABD. 198
Iienelf thoroogUjeducated until she has acquired the blanched
complexion of the French lady. She carries on an affected
eourtship with the downy-bearded young squire, Fritz, with his.
fidae calves, artificially enlarged thighs, and coat padded with
leathers; a striking contrast to the shirt of mail of his great-
grandfather. Siegwart, Idris, Musarion, Grecourt, and Ecole deft
Filles ! are you not partly to blame for this climax of enervation?
But the phUanthropic genius of the last quarter of this cen-
tury saw all this abomination and destructive degeneracy, and
deplored it. It resorted to bathing in cold rivers.
In these the tender sprouts of gentle lineage were immersed;
they were forced to tramp over the frosty ground, bare-footed ;
bare-headed and with uncovered chest, and to rest for but a few
hoQiB on a hard bed.
Of thy good intention, dear genius, there could not be a doubt^
even though the poor children from these experiments got their
hands and feet frostbitten, died of consumption and catarrhal
fevers, or in other ways shewed in lamentable manner that a
hot-house plant should not be transplanted in November in order
to accustom it to the northern climate.
Thy good intention, I repeat, could not be doubted, only the
interpreters of thy counsels did not quite enter into thy spirit^
and by their imperfect execution of them caused thy name to
be reviled among the heathen.
Allow me (if I understand thee better) to translate thy hea-
venly ideas into the common language of mortals, and if not to
inculcate doctrines, at least to throw out hints, as to how the
effeminate race may be changed into men bearing at least a
distant resemblance to the rock-like bodies of the ancient Ger-
mans ; how they may, if engaged in business, manfully encounter
the dangers of their calling, regardless of all variations in the
weather, undergo the labours of life with courage and strength,
and see their great grandchildren play like young eagles around
their untottering knees.
Father Hippocrates, whose knowledge of mankind was of the
most profound, remarks in one part of his writings that changes
finom one extreme to another cannot be undertaken without
danger and caution, and I cannot too strenuously insist upon the
truth of this observation. Nature does nothing without prepa-
ration; all her operations are performed gradually, and the more
complex and artistic the work is that she performs, so much the
more cautiously and gradually does she do it.
18
IM THE FBISNB OF HXALTH*
She never goes from summer to winter without interposing
the transition period of autumn.
The cherry tree loaded with fruit would immediately wither
and die if January followed immediately after June. She knowm
better how to prepare it for the winter's frost. She first causes
the tree to drop its fruit, protects the buds for the next year by
means of hard barks and balsamic resins, and during five months
diminishes the circulation of its juices so gradually that the sap-
tubes contract and tlie moisture in them is evaporated almost to
dryness by Jaimary ; she sends cold and ever colder nights
and days, so that the biting frost, when it arrives, finds the tree
prepared to encounter its tyranny. In an equally gradual
manner does she put the sap again into circulation, until its ac-
tivity, fostered by the increased warmth of spring and its rains,
is in a condition to bear the full glow of the dog-days.
Let us unitate nature — let us never make January to follow
close upon June, nor July upon January, if we do not wish our
tender plants to be blasted and withered by both of these ex-
tremes.
The hardening of the human creature in respect to heat and
cold no doubt is commenced with greatest safety in childhood
(with older |)ersons it is more difficult to eflfect such clianges,
just as it is more difficult to transplant an old tree to a new
soil), but we require to exercise the greatest caution at first with
these tender creatures, in order to prevent nninbers of them
firom remaining behind, withering and fading during the transi-
tion to a mode of life to which they arc unvused !
When the sunshiny days coniniencc, the gardener removes
the shutters from the windows of his forcing frames; when the
air becomes warmer he opens the windows to allow of the
entrance of fresh air : he opens them more and more as the
warm weather becomes more constant, and only transfers per-
manently to the open air the tender plants which he has thus
accustomed as it were to the atmosphere, when he no longer
dreads the occurrence of night-frosts.
The modern hardening methods seem to bear a great resem-
blance to the incautious transference of hot-house planto to the
open air in February.
It is incredible what man can endure if ho be gradually habit-
uated to it. The Russian leaps into the ice-covered Neva the
instant he creeps out of the stewing-hot sweating bath; the
llalle brewer plui^es into the Saale after roasting half naked
ON MAKING THE BODY HABDY. 105
beside his brewing vat ; the negro readily endures the heat of
the equator, and works under it like a horse ; the Greenlander
goes forth to hunt the bear by moonlight in a cold of which we
can form no conception, and returns to his lowly hut, which is
£lled by the exhalations Irom the large oil-lamp, and from his
own and other families, with a deteriorated air that would
almost suffocate a. stranger; here he is cheerful and gay, and
gratifies his palate with things that disgust would prevent us
bringing near our lips.
If it be supposed that there are peculiar varieties of the
human .■>pecics, that would be to make a great mistake ; they
h^TP come from their mother's womb as delicate and soft as
any of ourselves.
All these people, however, give their children no other cdu»
cation but their own example ; they abandon them to their own
will until they have attained a good age.
The young creature at first creeps on all fours after his father
as far as he can, in heat and in cold, and cree£)s home again
when he can go no farther. This he docs day after day, until
he can bear it better and go farther ; no one forces him, he turns
back again when he has had enough, but he is always acted on
by that most jx)werful of all agents in education, the imitative
faculty, the desire to act as like his father as possible ; this is a
stimulus that will not easily induce him to do anything that
miglit (*ndangcr his life, because lie can unrestrainedly atteu
to Ills sensatioiu* of pain, and of his own free-will return to
place of security. The stronger of the children of the^c people
(theiryoungolVspring know not the j)lcasiire of mischief, as ours
do) assist the weaker, pull thcni out of the snow, fetch them
away from the burning sanil-desert, or rescue them l>y swim-
rain^r when they I'all into the water, and thus the cliild learns
gradully (but only gmdualb/^ be it observed) to endiu'e as much
as his father can.
The objection might fairl}^ be made to what I have said tha
this kind of gradual accustoming to heat and cold, and so forth
is not applicable to our education .and to our mode of living.
This cjbjection is a fair one, I repeat ; but only partially so.
True, the father and the mother among us cannot become Samo-
jcdes or Ethiopians, but the teacher of the children (be he a
peasant, a schoolmaster or a tutor) must have brought this kind
of hardening process to a certain degree of i)erfecti(m in his own
person, he ought to have several children at once under his
t96 THB FRIEND OF HEALTH.
taperintendence, for the parpoae of ezcittng emulation among
them. Here it is much worse on the part of the teacher to err
on the ^de of doing too much than too little. He may leave it to
the free-will of the children to inure themselves ; he does it be-
fore them, they imitate him, each according to his strength, and
none must be forced to overstep the latter.
The teacher cannot put himself in the situation of the boy,
cannot enter thoroughly into his feelings, consequently the boy
must be allowed to draw back when he wishes to do so. He
will rather have sometimes to keep him back, for imitation ia
often too powerful a spur.
It is best that these exercises should be carried on in the pre-
sence of the pupils only, without any other spectator, for then
all present would be animated by the same mind.
But to send one's children with bare feet, head, chests and
arms through the crowded streets of a town, accompanied by a
well clothed tutor, amid the jeers of the boys in the street, and
the audible expressions of cx)mpassion from the windows, would
be to turn to ridicule an affair of great seriousness, and to inspire
the children with an invincible repugnance to the hardening
system generally.
When the children have played long enough in their ordinary
clothing in the cold or in the heat, and if they have advanced
so &r as to be able in such guise to bear both extremes readily,
we may proceed to diminish the amount of their clothing some-
what and by degrees, and even allow them to go with sundry
parts of their person uncovered when they are alone.
But this should not be done in the severest winters, for the
bodies of children will not be able to stand so much cold ; there
is besides no possible case when their being habituated to it
would be necessary. Even beggar-children find rags to put their
feet in, when they have no shoes; and we should only seek to
prepare our children for the positions in which they may chanoe
to be placedl
Here I must refer to what I should long since have spoken
about The new hardening-system commits the usual fault| of
seeking to harden the body only in reference to the enduranoe
of cold. But would it not be just as delicate, to be unable to
endure heat? Persons who cannot bear the heat of the sun, or
of very warm rooms, are liable' to the most serious, even fatal
Incidents ; why are they not accustomed to this also ? To be
able to endure cold, will not require much effort on the part of
OK MAJUNa THE BODY HARDY. 197
the Buaman, but the alternations of heat and oold and vice vena
(this great promoter of diseases in the delicate denizens of
towns), these he endeavours to learn to endure by his alternate
sweating and ice- water baths ; to these he seeks to become quite
indifferent He attains his object, as we well know, and is the
hardiest soldier history makes mention o£
But in the case of children this habituation to heat must also
take place only gently and by degrees, and we should take care
that they have not too much given them to do at first. They
should have for their instructor a wise man, who knows the
capabilities of each of his pupils, and he must not urge them on
but rather keep them back, if he sees that his example is likely
to make them go too far.
Frequent recreation (without witnesses, or among suitable
companions) in the open air, in summer, will furnish many
opportunities for this.
For pupils of more mature age, there can be no better oppor-
tunity for hardening them against the variations of temperature,
than little pedestrian excursions. Here imder the rational
gaidance of their master, they have at the same time an op-
portunity of habituating themselves to other inconveniences
and dangers of the world; I allude to fatigue, the various
atmospheres of different houses, to draughts, and damp.
One may be able to bear very well the pure, dry, cold air of
winter, and the heat of summer, but readily get ill in a damp
cellar-like room.
Draughts of wind are something quite different from the open
air, and a damp stocking in cold weather may often cause one
who is used to swimmiug to be laid on the bed of sickness.
And yet all these are incidents occurring in human life, which
can scarcely be escaped by him who mixes with the world, or
who does not dread dangerous consei^uences to his health from
such every -day trifles.
In all these exercitationsit is necessary to employ caution when
accustoming ourselves to them, beginning with the less and
going on to the greater, but always only gradually^ interruptedly
and by progressive advances.
Very young children, that Ls, such as are not above seven years
of age, cannot become very habituated to the deteriorated air of
rooms. If we carry things too fiir with them we render them
liable to become ricketty.
But since if we wish to render ourselves useful for business,
ISfff tHE FBIEND OP HEALTH.
we must also live in unhealthy deteriorated air, and be particu-
larly anxious to preserve our health in it, so we must endeavour
to render growing children capable of living not only in puro
country air, but also in rooms ; in rooms filled with people they
must be able to exist at first for half an hour at a time, then for
a whole hour, for several hours, and at length for whole days ;
and the hardening process must put them in a condition to re-
main well in spite of this, the most pernicious of all situations
in which man can be placed. If their habituation be performed
gradually, they will be able to do this bravely. Those children,
however, should not be under ten or twelve years of age if we
do not wish the whole plan to fail.
Pedestrian expeditions aftbrd many opportunities for this also ;
these the teacher should direct, limit and define with wisdom
and forbearance.
A teacher who is acquainted with the habits of life of the lowest
dass of peasants' children, and has observed how they have to
bear all the discomforts of life, and to get a hardy body thereby,
will 'be enabled to employ many of their practices upon his
pupils.
When the peasant-lad, for instance, falls through the ice and
gets wet up to the knees, he commences to jump about more
vigorously than his companions ; in order not to be laughed at,
he carries on this process of warming himself by moving about
until either he becomes quite dry, or until he can bear it no
longer ; he then goes home and dries his stockings. If he has
got himself chilled, he docs not much care, he only waits till he
is dry and then runs out again to play with his companions.
If he has the care of horses he gains courage, if of oxen he
learns patience, if he has to cart dung he learns to overcome his
feelings of disgust, if he is engagt^d in mowing grass he acquires
caution in handling sharp instrument**, the rigour of the school-
master tends to make him docile, listening to a wretched sermon
teaches him to be silent— from going barefoot his feet lose their
tendency to get corns, gout and dropsy, climbing make^ him lose
his liability to turn giddy. His black bread needs no layer of
butter, and his water requires not the addition of sugar and
lemon-juice.
To unite the good that is to be found in this station of life
with the cultivation of the mind, such is, in my opinion, the ne
plus ultra of a rational and suitable education.
Gleaning corn in August, sheep-washing, crab-catching, tend-
ON MAKING THE BODY HABDT. 199.
ing the cattle in all kinds of weather in the open fields, as well
when he remains motionless beside them as when he runs after
them over the hills, fetching wood from the distant forest in all
weathers, the damp school-room^ the fair that excites disgust at
the excesses committed, the three-hours' sermon in the cellar-like
church — all these are excellent exercises and modes of hardening
the body, which would be serviceable to a person in after lifd|
whatever position he might occupy.
In the centre of a great and populous city it is utterly impos-
sible to bring up healthy childreu, and equally so to harden
their frames. Should they walk all through the town in order
to get into the oj)en country, they would be tired before they
could escape from the depraved air of the city. Tired children
could not endure any of the exercises we have proposed without
getting ill ; they would require strength, I might saj'^ a super-
lative degree of strength, to stand heat or cold, wind, damp, &c.
Should they drive out of town, there are several difficulties in
the way ; to endure all sorts of weather seated in an open car^
riagc can only be done by robust, grown-up people. Should
they only drive out in good weather, theu, during bad weather,
confined to the air of the town rooms, they would go back fiur-
ther than they had gone forward from the few exercises in the
country. In shut-up carriages the space is so confined that the
depravation of the air by breathing soon attains to a great height
If the carriage windows be let down, a draught is produced
which the poor hot-house plants cannot bear.
In small towns of about a couple of thousand of inhabitants,
or in the environs of larger towns, it is more possible to rear
healthy and hardy children witli proper care, provided we with-
draw them gradually and as much as possible from the ener-
vating influences of genteel life, and allow them to pass at least
one-third of the day in the open air, mindful always of their
relative strength and of the necessity of accustoming them gra-
dualh' to all that is strange and unusual to them.
Children Ccan be brought up healthy and hardy mo^t easily
and certainly at a distance from towns, for example on an estate
or in a village residence, but the circumstances of all parente do
not admit of this, and equally certain is it that we may, even
in the most healthy villages, make our children delicate and
puny. To do tliis wo need only to deprive them of their free-
dom, to leave them usually shut up in the low, damp, hot room,
to overload their stomachs, and to let them sleep in hot, soft
feather beds, to encourage uncleanhness, and so fortli.
800 THX FBIXND OT HEALTH.
Bat on tbe other hand the propinquity of a town ofifefs so
many advantages for the ealtiyation of the mind of growing
ehildren, that we should make the greatest sacrifiees in order
that, in all the circumstances in which we parents may be placed^
we may give or cause to be given to the bodies and minds of
our children the development most suitable for their destined
situation in life.
PART 11/
SOCRATES AND PHYSON-
ON THE WORTH OF OUTWARD SHOW.
Socr. I am pleased that thou comest nearer me, Phj'^son ; I
have been admiring thy beautiful garment at a distance.
PA. It cost me a great many drachmas ; thrice must the purple
shell-fish yield its costly dye to produce this rich colour. Now
none can compare with mc ; the greatest in Athens envioualy
makes way for me, and, only think! before 1 inherited my pro-
perty, nobody cared an iota for me.
Socr, Then I presume thou art now worth infinitely more, art
infinitely happier, than formerly, when thou usedst to dig my
little garden for a scanty hire.
Ph. I should think so indeed ! He that can regale himself for
hours together at the most richly furnished table with the most
delicious viands, that can set before twenty guests wine firom the
Cyclades fifty years of age, and complete their intoxication with
the music of the lute and the sweet voices of female choristers,
that can drive over great estates as the sole possessor, and can
issue his commands to a hundred slaves — should such an one
not be deemed happy ?
Socr, But thou wast formerly a healthy, sensible man before
thou inheritedst the property; thou hadst thy house, wast beloved
by thy wife, thy children and thy neighbours; thou camedst thy
bread, together with an excellent appetite and robust health. —
At what dost thou value thy fortune?
i%. — At five millions.
Socr. How much richer dost thou esteem a man with a sound
reason than that unfortunate maniac Aphron.
Ph. The greater richness of the former is to be measured by
no amount of wealth.
' Publiiihed at Leipag, in 1796.
ON THS WOBTH OF OITTWARD SHOW. 201
Soer. At what price woldat thou part with thj five children ?
PA. Certainly not for all my wealth. Physicians would be
kings could they make women fruitAil or save children fix)m
death.
Socr. Thou art right, but in that case thy wife could not have
been much less valued 7
Ph. By Juno ! I would not part with her for millions if she
still liv^ I The charming woman, with whose fidelity and
thriftiness and goodness, and excellent manner of bringing up
children when I used to live u])on boiled beans, all the treasures
of the earth were not to be compared.
Socr. But blindness, lameness, a pair of deaf ears, and a linger-
ing fever, thou wouldst suflFer for an inconsiderable sum ?
Ph. Zeus forbid ! Dost thou imagine that this prospect of
the sun gilding the mountain tops as in the morning it issues
finth from the misty ocx^an, diffusiug life and joy over all the
habitable globe, that the melting song of Apollo's rival, the
nightingale, that my warm blood, the healthy breath of my
Inngs, my strong stomach and my refreshing sleep, could be
bartered by me for any amount of gold ?
Socr. Hygieia preser\'e them to thee ! But it seems from thy
calculation that thou hast not become richer by thine inheritance
than the sea-shore would become by the addition of a spoonful
of sand. What arc thy boasted five millions when compared
with the innumerable millions of thy former blessings ! Of a
truth, when thou conuuencest to esteem thyself happy only after
thou hast got this little addition, when thou lookcst down so
contemptuously on thy former apparently poor condition, I must
pity thee ; thou shewest thereby that thou luust never rendered
the thanks due from thee to the immortal gods ! 1 am sorry
for thee, thou that was formerly so brave a man ! Did they former-
ly regard loss beneficially thy well-meant offering of salt and
roasted flour, than they do now thy proud siicrifice of a bull ?
I am sorry for thee !
Go into the dark at midnight and feel the costliness of thy
purple garment ; thou sccst nought, thou fcelest nought but that
thy nakedness is covered, and was not this also the case when
thou perforniedst thy hard manual labour for a few oboli. Are
the flatteries of thy fawning guests dearer to thee than formerly
was the pressure of thy master's hand when he was pleased with
thee ? Dost thou really walk softer on thy gold-embroidered
carpets than thou usedst to do on the uupaid-for green turf?
20S THE FBIEKD OF HEALTH.
•
Perhaps the dark Persian wine now quenches thy thirst better
than the spring that formerly trickled forth beside thy moss-
grown cottage ; perhaps thou risest now more refreshed from
thy soft Ixid at noon, to which time a splendid supper causes
thy sleep to be prolonged, than thou didst formerly from thy
not very soft straw matniss, which the fatigues of the day^s
work made welcome to thee? Probably flamingoes' tongues
served on gold plate, though from rcfjcatcd repletion thou hast
but little hunger left, are much more relished than milk and
bread after hard work ! Perhaps the thouwmd forced and
artificial endearments of the hired girls tiiat hover round thee
now afford a purer, more permanent enjoyment to thy senses,
nearh^ worn down to obtusencss, than did formerly the artless,
trusting embrace of thy true and hearty wife in rare 'moments
of happiness, when the unadorned black hair fell artlessly upon
her neck browned by the sun, her constant heart throbbed for
thee alone, and love for thee alone streamed forth from her dark
eyes. Perhaps we live more secure from diseases, lightning and
thieves, in marble pillared palaces, filled with numbers of dear
bought slaves, in beds inlaid with ivory, and beside bags filled
with the precious metals, than in the lowly cottage covered with
ivy, provided with the necessaries of life for several days to
come, among honest neighbours and friends ? Physon ! Physon !
mistake not the destiny of man, forget not the happiness of thy
former days which the gods granted to ihcc, and which were
dear to thee. Only a.>k thyself, if ever thou hast an hour to
spare for this purpose, whether thou hast not more cause to en-
vy thy former lot, than others have to euvv thee thy present
life !
Knowest thou the man that hsus just passed us clad in a coarse
woollen garment? In his venerable aged form beams universal
philanthro[»y. That is p]umencs, the physician. The many
thousands that he yearly makes by the j)ractice of his art, he
does not spend on fine country houses and on the other vain
trifles of the luxurious. His happiness consists in doing good!
About the tenth part of his large income he uses for his limited
wants, the rest he puts out to interest in the state. Ajid how ?
thou askest me. To the f>oor he gives his aid, his medical skill.
With his stores he supports the convalescent families until they
can again help themselves, and with the costliest of his wines
he revives the dying. He seeks out the miserable in their dirty
hovels, and appears to them as a beneficent divinity ; yes, wheu
PI^NS FOR ERABICATIKG A MALIGNANT FEVEB. 208^
the all- vivifying sun, the image of the unknown God, rcfraina
from shewing the dying its life-bestowing face, and even at mid-
night, he appears in the huts of the miserable to assist them^
and lavishes on them consolation, advice and aid. They wor-
ship him as our ancestors worshipped the beneficent demi-gods,
Osiris, Ceres and ^Esculapius. Wilt thou soon commence to
envy him ? Go, Physon, and engage in some better pursuits,
and then count on mv esteem.
PLANS FOR ERADICATING A MALIGNANT FEVER.
IM X LETTER TO THE MINISTER Of POLICE.
You will, no doubt, yourself, see tlic results that the
infection that was brouglit to * * * lour weeks ago might
produce if its farther spread be not arrested, still I consider it to
• be a duty, as I have, here and there, had eoiLsidcrable experience
in extensive epidemics, to offer my mite at the altar of father-
land, in the form of some unpretending propositions.
Taking into account the malignancy of this fever, if the epi-
demic be left to itself, it may, in the course of half-a-year, at this
season, and in the present condition of the town, sweep away
about 250 individuals, a considerable luinian capital, seeing that
it is especially adults, the most useful class, that will first and
most e^rtainh^ be cut off by it. Should it. as scx^n will happen,
once penetrate into the damp dirty houses of the i)Oor, who arc
alread}'' often rendered lial)le speedily to catch the disease, by un-
healthy miserable fare, by sorrow and depression, it is diHicult,
very difficult, to extinguish it in these situations. In addition to
this, there is the carelessness of the common people, who incline
to Turki.sh fatalism, as tlu^ most convenient of all creeds respect-
ing Pro\'idence, and their want of reflection in only considering
as dangerous what they can see with their eyes, such as a flood
or a conflagration. From these they will flee, but they are in-
different to a murderous pestilential vapour, because it does not
&1I within the recognizance of their coarse senses. So the igno-
rant person fcarle^ly approaches a charged electric battery, and
smilingly enters tiie pit filled with poisonous gases, though his
predecessor may just have been brought out of it dead. Every
one thinks he possesses enough strength to resist the enemy of
204 THE FBIEND OF HEALTH.
lifi3. Bat vain are his expectations ; the giant himself if
breathed on by the breath of death sinks down, and the wisest
loses his consciousness. Resistance is not to be thought of. In
flight, in flight alone, is safety.
The only means on which we can rely for checking epidemics
in their birth, is the separation of the diseased from the healthy.
But if it be left to the public to preserve themselves from in-
fection, every one for himself, even with the help of published
advice, experience teaches us that all such recommendations do
little good — and oflcn, in spite of the best intentions, cannot be
carried out
But just as the police, when a conflagration breaks out in the
town, does not leave it to the caprice of the possessor of the
house, to extinguish the fire in the way he thinks fit, but makes
itself the necessary arrangements, and erects the fire-stations to
be employed without delay, if necessary in opposition to the will,
and even in spite of the resistance of the owner of the tenement —
acting upon the just principle, that the security of the commu-
nity ought to weigh infinitely more than the property of an in-
dividual— in like manner, I assert it ought not be left to the indi*
vidual's caprice to nurse his relatives afiected with infectious dis-
orders, in his house, since it is not to be presumed that he has
either sufficient power, or judgment, or opportunity, to prevent
the spread of the disease, and no amount of wealth on his part^
no damages expressible in figures, can compensate for the life of
one, not to speak of many families, fathers, mothers, husbands,
wives, children, endangered by him.
Of a truth if ever the better part of the public ought anx.
iously to look to the authorities and to the police for protection
it is in the case of the invasion of epidemics, if the protecting
divinities of fatherland do not stretch forth their powerful hands
on that occasion, where else can wc look for deliverance from the
danger?
I could easily exhibit a picture of the most frightful scenes,
that still haunt me from similar epidemics, whereby the most un-
cosmopolitan soul must be deeply moved — but to you, sir, such
things are not unfiimiliar, and you require not such reasons to
induce you to put your hand to the work.
Taking for granted, then, that you concede the above pre-
mises, I make bold to make the following preliminary proposals,
for whose efficacy experience is my warranty, and thereon I
stake my honour.
PLANS FOB KBABICATIKG A MALIQKANT FEYER. 205
They may all be set in action in the course of a few days ; in
this case speed saves expense and human life.
1. Let a hospital or other public building without the gates
of the town be prepared, solely for the reception of such patients ;
the court-yard must be surrounded by a stone or wooden fence,
as high as a man.
2. From twenty to thirty cheap bedsteads are requisite, pro-
Tided with straw matrasses and frieze coverings.
3. The male and female nurses — of whom there should be one
forevery four or five patients — must always remain in the house
with their patients, and should never go outside the door. The
fixxi and medicines they require should be brought to them daily
in the open court by persons who should immediately afterwards
retire, so that the two parties shall not approach within three
paces of each other, and nothing should be brought from the
house into the town.
4. In order to enforce this regulation, place a guard of two
soldiers before the outer door, which they only are to open, and
oommand them to let none but these persons and the physician
and surgeon in and out.
5. A small sentry-box formed of boards will protect them
from the weather, outside of which should hang a linen (or, still
better, an oil-cloth) cloak for the physician and surgeon, which
fiiey should put on when they enter the house and lay aside on
leaving it
6. The medical officers should get a written notice of the
mode in which it is desirable that they should protect themselves
and others from infection, and the attendants of the sick should
get instructions of a similar character.
7. All who fall ill of this malignant nervous fever in the town
(the police officers should get a gratuity for all they detect) should
be removed to the hospital by their friends in a covered sedan
chair, kept for this purpose in the court-yard of the hospital, and
there they should be taken care of and cured — (at the expense
of their friends ?).
Persons so dangerous to the community cease to belong to
their friends ; from the nature of their malady they come under
the surveillance and care of the state, like a highwayman, a
madman, a murdering quack-doctor, an incendiary, a robber, a
poisoning courtesan, &c. They belong to the state until they are
rendered innocuous. Hzlus publica pertclitatur is the simple
standard for determining all the wholesome regulations of a
S06 THE FBIEND OF HEALTH.
philauthropic police in such cases. To forbear pulling down
neighbouring houses during a spreading conflagration, in oon-
soquence of the unreasonable request of their owners, this is %
&ult that no police now-a-days would commit. In the case wd
allude to, however, there is no pulling down, but on the con-
trary, building up. Men's lives, not houses, are to be saved.
Should my patriotic general pro{K>sitions meet with your ap-
probation, I shall not fail, if no one else does it, t^> treat of the
subject in greater detail, and to furnish, in writing, the additional
plans for the general weal, as circumstances prevent me taking a
personal share in them.
If I could thereby prevent some misfortune, I should feel my-
self richly rewarded. But the reason why I, a private indi-
vidual, occupying no official post, and not intimately connected
with this country, wish to lend my aid in this matter, is owing
to this, that I think that in such public calamities the motto
should hesauve quipeut! and hence I am wont to exert myself
to the utmost, and to save what can be saved, be it friend or foe.
I am, &C.
Db. H.
More particular directions.
The police officials ought to ascertain where any person haff
been Fuddcnl y taken ill in the town, or hfus suddenly complained
of headacho, rigour, stupefaction, or has rapidly become very
weak and d(»lirious ; they should rei)ort what they learn to the
api)ointcd j^hysician, who, after a rapid but careful examination,
during which he attends to the directions below for avoiding
infection, sees that the i>atient is couveyod to the hosjrital. At
the same time the j)olice officer receives his fixed remuneration.*
^ The large hall of the hospital should be divided longitudi-
nally by means of a partition of boards ; the one part so divided
to form the i)atient\s ward, whilst the other and much narrower
division forms a kind of passage, into which the bedstead of
each patient, which should be placed on castors, may be pushed
through a trap-door in the partition, in such a manner as that
only the patient in the bed shall qome inU) the i)assage, where
» If this remuneration be ccmsiderable (about a tlAcr \Z». 6(i] for the discoveiy of
every case of this kind), the progress of the epidemic will be <»peedily checked, then
will soon be no more sick to be separated from the healthy. Tlie sick will be db-
eoTcrcd in time, before they can (easily) communicate the infection. Again in ho*
man life and in the smalJer sum required, will be the manifest result
PLANS FOH SRADICATING A HALIONANT FEVER. 207
on the trap-door falls to again. Here the physician examines
the external and internal condition of the patient, in the pre-
sence of the surgeon, then he causes him to be pushed back
into the ward, and the next patient to be brought forward, and
so on.
But before performing this examination, and indeed before
the arrival of the physician, all the windows of the passage should
be opened in order to air it. Before the patients are brought in
they must be closed.
The physician, accompanied by the surgeon, both covered
with the oil cloth cloak,* visit*^ the patients twice a day, and
questions them at a distance of throe pace.-?. If he require to
feel their pulse, he must do this with averted head, and imme-
diately afterwards wash his hand in a ba^^^in containing water
and vinegar. If the patient's face be directed towards the light,
it is not difficult to observe the state of the tongue at a distance
of tliree paces. At a less distance it is scarcely possible to avoid
the danger of inhaling the patient's breath,-* whence the conta-
gious principle spreads farthest and most powerfully.
When the patient has a clean tongue,^ as is found in those
who arc most dangerously ill, it is often advisable to give him
large quantities of bark and wine, in place of any other medi-
cine ; and as it is to be apprehended tliat the nurse might make
away with the wine, it is better to j)roscribc the bark and wine
mixed, or fur the j)hysician to mix it himself. Aft(T every
visit the medical oHicers should wash their hands and faces in
vinc^rar and water.
The nurses must also bo warned no" to hold their faces near
the patient's mouth, and after every time they raise up, turn or
touch the patient, they should immodiatoly wash their hands
and faces. It is advisable to use a mixture of vinegar and
water for the purposes of ablution.
Each lx)d should be provided with a linen matrass, well
stuffed with straw,* over which is spread a linen sheet, and on
' When the dUe-ost* i:^ particularly malignant in itn character, it is advisable to hav^e
t hood attached to the cloak, which the medical officer may draw over his head when
he makes hi^ risit, for it haH been obfierrcd that the contagious matters nXtuch them-
BeWes n»oRt readily to wotA and liair.
• The odour of the contagiou^iiuiim of malignant typhu;; fever is a kind of earthy,
moaldy smell, like that fn)m old gravc»s newly opened. It lias little or no ref^emblance
to the Oilour of putrid flef»h.
• Tliis difvase was chiefly a goal- fever without anything in the first |)iissage3.
• 3fatrAtaCR equally, smotvthly and fijrmly stuffed with some yegetablo subetance,
208 THE FBIEND OF HEALTH.
this a piece of oilclotji* about three feet in length, whereon the
nates and back of the patient lie.
There should be two frieze-coverlets for each bed, in ord^
* that the one may hang all day long in the open air, whilst the
other is covering the patient. They should be washed once a
week by the nurses, together with the rest of the patient's linen,
either in the open court yard, or beneath a shed only covered
at top. They should first be washed clean in merely tepid
water with soap, and subsequently scalded with boiling water,
care being taken to avoid the steam that rises, and they should
not be washed a second time until the whole is almost quite
cooled down.^
The oil-cloth should also be frequently wiped with a wet
cloth.
Every day at noon all the windows of the sick-room should
be opened, and a draught of air kept up for an hour, during
which the patients' beds should be pushed through into the
ante-room, and remain there all the time.
In the centre of the ward should stand a stove, heated fixmi
within.^
The most trustworthy of the nurses must be responsible far
the accurate carrying-out of these directions, as well as those of
the physician.
as barley Htraw, hay or moes, are for this object preferable to feather beds. Tht
ftiriner allow the exhalations to pass tlirough, do not retain the miasm so long, and M
they are not so yieldmg form no wrinkles, and are cooler : they prevent the farmatkn
of those often fatal bed sores {spacelui a dccMtu) so often met with io malignmt
fevers.
' By its smoothness it prevents the formation of bed-sores, and catdiea the {mem
that often pass involmitarily in patients seriously ilL They may be easily remowd
without soiling the bed linen or matrass, which has a very bad effect on the parii^
of the air.
* A washcrw(Mnan in America had to wash some dirty clothes that had been
brought over by a ship from England (among them were some that had been won
by a person wIk> had recently recovered from small-pox in London), and she was im*
mediately thereafter infected with malignant smallpox, from the hot steam thatavoM
from the wash- tub. Boerhaave has brought forward abundant proof of the frequen^
and facili^ with which washerwomen are infected. He recommended soap not to
be used in washing, probably because he thought thai the miasmatic matter wm
mare apt to be vohitihxed by it; but this danger is only to be apprehended from tbft
employment of hot water.
' Stoves heated by a fire in tiieir interior, and liill more open fire-places, rentw
the air of the room very effectually as loiig as the fire bums (and also to a fwrtmn
extent at other times), because the fiame must always have fresh nourishment horn.
the air which it draws through the vent-hole of the stove in large quantity. At tbft
«une time puro froth av peoetimtea through tkM chinks of the windows, or through tha
the air-holes above them, into the room.^
PLANS FOR KRADICATIKG A HAI.iaNANT FEVER. 209'
Those nuTBes who have already attended patients affected
with the complaint', are more secure from infection than those
who have not To the former should be assigned the duty of
the more immediate attendance on the patients. A new nurse
should during the first days only be employed in work at some
distance from the patients, such as scrubbing, sweeping, Aa^
until she is gradually habituated to the miasm.
The state of the health of the whole household should be
every day carefully investigated by the physician, even though
they consider themselves to be quite well. They should each
day be reminded of the directions for their own preservation.
The excrements of the patients should be carried in well-
covered night-stools to the most distant part of tlie court or gar-
den, and there emptied in such a way that the wind shall blow
the exhalations from them away from the bearer. This should
be done b^ those of the nurses who are most habituated to the
contagious virus (not by the new-comers), upon a thick layer of
nw-dust, and the ordure immediately covered with one or seve-
nl bundles of lighted faggots or straw, whereupon the nurse
should withdraw, and allow the excrement to be consumed by
the fire.
Two of the attendants who have been longest in the service
should be api)ointed the bearers of the sedan-chairs, for the pur-
pose of fetching new patients from the town. For this purpose
they should each time put on clean cloLhos, and apply to the
eentrv, who will give them from a chest in the sentry-box a
clean linen cloak, which they arc to put on, leaving their house
doak hanging up on ihc outside of tlie sentry-box ; they fetch
the patient in the chair, and whenever they have brought him
within the inner door (whence he is removed by others into the
sick ward), they take oil' their clean cloak and return it into
the custody of the sentry.
All the attendants, male and female, should wear a linen
doak in the hoiLse, reaching down to the feet ; this should be
washed at least once a fortnight.
The attendants cook the meals for themselves and the conva-
kflcents, but they ought to be sui)plied daily with fresh meat
and vegetables ; half a pound of the former sliould be reckoned
as \jpLe daily allowance of each person. The male attendants
should get about three j)ints of good beer a-piece, the females
somewhat less.
They should get double the amount of the daily wages usua]
14
SIO THE FBIEND OF HEALTH.
in the town. It would be well to promise them additional re-
mimeration in the event of the happy termination of the epi-
demic It is inconceivable the power to prevent infection poa-
fiessed by the beneficent emotions, hope, content, comfort, &o^
as also by the strengthening qualities of good living, and of
that liquor that is so refreshing to such people, beer I
They should, moreover, have no lack of wood, soap, vinegar,
lights, tobacco, snuflF, &c.
If a clergyman is wanted for any of the patients, his visit
must be paid in the presence of a physician, and the same for-
malities must be gone through as when the latter makes his
visit, namely, the passage must be well aired before the bed
containing the patient is pushed through the trap-door. . The
physician instructs him how near and in what manner he maj
approach the patient.*
When a patient dies he must be immediately pushed through
on his bed into the passage, and left there until the physician
has convinced himself of his decease. The corpse is then to be
covered with straw, and carried out on his bed into the court-
yard or dead-house, where he is to be put, along with the clothes
in which he died, into a coffin well stuffed with straw ; the corpse
should be covered with straw, and in the presence of the physi-
cian and clergyman, conveyed to the churchyard in silence. The
grave should be four feet in depth, and the coffin should rest
upon a layer of faggots, and straw piled upon the top of it up
to the level of the top of the grave. After the lapse of three days
in this manner, the grave should either be covered over with
earth, or, still better, the straw ignited and the miasmatic virus
consumed along with the corpse, or at least dried till it is render-
ed innocuous. This is a precautionary measure that cannot be
too forcibly recommended.
When a patient recovers so as to be able to be restored to his
fiiends, he should be taken into a clean room, the key of which
should be kept by the physician alone, and there put into a bath
and well washed over all the body, not excepting the hair, at
first with clean warm water, and then sprinkled all over with
vinegar before being finally dried. He is then to put on the
clean clothes which his friends have sent him ; and all his old
clothes, without exception, are to be burnt in the court-yarc>, in
* By incautiously approaching the beds of such patients, I have frequently seen tlw
moit promising young clergymen infected and die.
PLANS FOR ERADICATING A MALIGNANT FEVKR. 211
ihe presence of the physician/ and finally he is to be accompan*
led home by the physician and surgeon.
Whenever a patient has recovered or died, the wooden close-
stool he has used must be burnt in the open air, and the pot-de-
chambre broken and the fragments thrown into the fire.
After the epidemic has been subdued, the male attendants
should not be dismissed until they have whitewashed the whole
of the interior walls of the house, not only the sick ward, but
every other room, and the females not until they have thoroughly
scrubbed all the floors, all the wood-work and all the utensils.
The sick-ward should then be heated in the early morning as
much as possible, at least up to 100° Reaum., and after this heat
has been kept up for two hours, all the windows should be opened
and kept so till night.
Before they quit the house, both male and female attendants
diould bathe themselves, each sex in seperate apartments, and
all their articles of clothing and the linen they have used during
their residence in the hospital should be placed in an oven of
about the temperature of a baker's oven after the bread has been
removed (about 120® Keaum.), and kept there for at least a
quarter of an hour,* the vent-hole being duly regulated the time.
After this is done, all the other linen or woolen articles which
have been used by the patients, the straw matrasses (after taking
out the straw), the towels, sheets, &c., should also be exposed
for fuUv an hour to the same heat in the oven, and thereafter
the bedsteads, aft«r they have been well scoured, should be put
in the oven and left there till it cools.
The straw out of the matrasses, the accumiilated sweopingsi
rags, bandage-s, scrubbing cloths, brooms, and other articles of
small value, should be burnt in the court-yard in the doctor's
presence.
* Too much care cannot be taken to secure the destruction of such things, as the
paltry lore of gain of the nuriJOd induces them to keep them for themselves, in
ipite of the danger to themselves aod others of doing sa
' The pestiferous miasmata which have become attxu^hed to clothed, linen, beds, Ac^
can according to my observations be expelled from such things and dfstroycd by do
meain more certainly than by a heat of upwards of 100* Reauin., the higher the
temperature the better, even should the articles suffer a little from its effects. The
celebrated Oook expelled in thb manner the morbific vapours that had become air
tached to the cabins of his ships and infected the walls ; the efficacy of this measure
is well known. The earliest physicians discovered the wholesome effect of fire and
heat in deetroying the plague virus, and their excellence is corroborated in our infee.
tioQB epidemics by Howard, Lind and Campbell It is moreover remarkable that all
the iiifectioD of typhus fever ceases when ships are under the line.
213: THE FRIEND OF HEALTH.
In his presence the attendants should leave the house all to-
gether and the sentinels should be withdrawn.
The house may be allowed to stand empty, and reserved for
similar purposes on a future occasion, one of the best-deserving
male attendants, with liis wife, being allowed to live in it gratui-
tously as housekeeper. Their business would be to see that the
building is kept in good repair (in case it is required for another
epidemic).
. A house of this description and so arranged might subse-
quently be used with the greatest advantage, with some slight
modifications, in epidemics of small-pox, measles, dysentery,
and other infectious maladies dangerous to the population, and
might be the means of preserving many useful citiisens to the
Btate.
There might be a few beds kept there permanently for the
reception of all sick journeymen, beggars and trampers from
the inns and lodging houses (a fine being imposed for the con^
eealment of such cases), whereby a source of epidemics of no
small importance, but one that is frequently overlooked^ might be
effectually checked at its origin.
This should be the duty imposed upon the housekeeper in
return for his free dwelling, but at the same time he should re-
ceive an adequate (not paltry') remuneration for each patient
who recovers, whenever he leaves the house.
SUGGICSTIONS FOR THE PREVENTION OF EPIDEMICS IN GENERAU
ESPECIALLY IN TOWNS.
A well-ordered police should take care that rag-gatJiercrs are
not allowed to live anywhere but in isolated houses near the
paper mills,^ nor should they be permitted to have in any house
in the town a place where they may deposit the rags by little
and little, only to remove them when they have collected a
large quantity. The regulations prevalent in Electoral Saxony
should be adopted, viz. : that the rag-gatherer should keep in
the open street with his barrow or cart, by some signal summon
* If the rcmuDcration be not very Kmall, he and his frieudR take good core to be
trer oo the watch for any such patients that may have slipped into the town, aa4 ht
will do his utmost to i)btain it as speedily as possible by the rapid recovery of the
patientk to the great advantage of the state (and of the patients).
* Which should never be built dose to towns and villages.
PREYEHTION OF EPIBEMICB IN TOWNS. !2l|
iuoimd him those who have rags to sell, and not remain in the
town with his collection of rags, but go into the country, and
when he puts up at a country inn, leave his cart in the open
court-yard, or before the door of the inn ; in a word, leave it in,
the open air. lie should be forbidden, under penalty of im-
prisonmeht, to pick out from his heap of rags and sell to others
for their use any articles of clothing that may be still fit for
wear.
They should also be forbidden to wear such articles them-
selves or put them on their children, which they will often do,
to the great detriment of their health, as I have often observed.
I have seen 'a malignant epidemic of small-pox spread over the
country from so doing.
The paper-miUs should be so arranged that the supply of the
crade rags should be kept in well ventilated buildings far away
fix>m the dwelling houses, and the reception of the rags from
the gatherer, and the weighing of them, in order to determine
flie sum he is to receive, should be carried on in a shed only
covered at top.
' The dealers 'in old clothes should only be allowed to carry on
(heir trade in open shops, and should not be permitted to sell
diem in their houses imder penalty of imprisonment. All the
linen and articles of clothing they have for sale in their shops
should be previously washed, not excepting even the coloured
and woollen articles ; and a police officer should be charged to
examine if they be washed, who should overhaul the whole
contents of the shop on undetermined days. Every article that
he finds still dirty should become his property after having
shewn it to the inspector of police in the presence of the
dealer.^
It should only be permitted to the burghers of the town to
deal in old clothes. Jews engaging in this trade should be de-
prived of their letters of protection. Women found carrying it
on should be put in the House of Correction.
The civic-crown merited by him who improves the prisons
has been gained from us Germans by an Englishman — Howard.
Wagnitz follows in his steps. It is inconceivable how often the
most destructive vapours are concentrated in these dens of
' Should it be feared that such an article of clothing, probably worn by a sick
fenon, might prove dan^rous to the policeman, it should be coasidered that th«
poor broker, in order to avoid such a loss, will most certainly take care to have none
hot clean washed things in his shop, and thus the police agent will have little or
nothing to ooofiecate.
214 THE FBIEND OF HEALTH.
misery, fraught with death to those that enter them ; how often
their visiters are prematurely sent to the grave by fatal typhua.
Destructive epidemic diseases often have their origin in these
death-laden walls.
There are several kinds of prisons. I shall here allude only
to those where the imprisonment is for life and to those gaols
where prisoners guilty of capital crimes are kept until the ter-
mination of their trial, often for several years, the visitation or
inspection of which is not unfrequently the cause of infectious
diseases. Even when the prisoners themselves have not been
ill of such fevers, their exhalations, their breath, and the miasm
lurking about their dirty clothes, have often occasioned malig-
nant fatal fevers. Heysham, Pringle, Zimmermann, Sarcone
and Lettsom adduce a number of cases of this kind.
Now as in the true spirit of laws that are free from all bar-
barity, even the punishment of death should have (and can
have) no other aim than to render an incorrigible criminal
innocuous, and to remove him from human society, what else
•can both these kinds of imprisonment be than rendering the
prisoner harmless, in the former case, for life, in the latter for a
certain time pending the duration of the trial. None but Syra-
cusan tyrants could dream of uniting a more inhuman object
with such prisons.
If then the gaol even for capital oflfendcrs can and ought to
be nothing but a means of depriving them of all opportunity of
injuring society, in that case every torture that is unnecessarily
inflicted on them when thus in custody is a crime on the part cf
the police, I only allude here to the pain inflicted on them by
unhealthy (disease-producing) prisons. In order to avoid this^
prisons should never be raised less than four feet above the
ground, and the openings of the windows, while they are sufEl-
ciently narrow, should be always so long as to allow the fi'ee
access of fresh air. Where two windows opposite each other
cannot be obtained (which is the best plan), there ought to be
at least three windows for each small cell. The floor should
either be paved with slabs of stone or better, with rounded
stones, so that it may be deluged and scrubbed, once a week,
with boiling water. The walls and roofs should be lined with
woodei boards, like the peasants' houses, in order to allow of
their being also washed with hot water,* as is customary with
' The ezlialaUon from these wretched creatures, that ooDstautly tends to decom-
position, and the animal poison developed from their breath, whereby the air of tbdr
FBSYIMTION OF SPIDSICIG8 IN TOWNS. 215
the country poople. By these means these dismal habitations
are at all events rendered dry residences, and the cachexias and
tumours so frequently met with in such as have undergone a
long imprisonment are in a great measure prevented. If it
were possible to construct an air-hole for the purpose of carry-
ing off the deteriorated vapours into the open air, gaols would
thereby lose much of their dangerous aptitude to generate pests.
The prisoner should have at least once a week a bundle of
fresh straw for his bed. llis bed-cover, together with his
clothes and linen, should be washed at least once a week in hot
¥ater. He himself should be forced, before putting on his
clean clothes, to wash his body all over. His chamber utensil
should be emptied daily, and rinsed out with boiling water.
He should be allowed to walk about in the open air at least
once a week, for at least an hour at a time.
When he is removed from prison, his cell must be prepared
for the reception of future prisoners by washing anew the floori
the walls and the roof with hot water, and by placing a small
ftove in it, the funnel of which goes out at the window. With
this the cell is to be heated very highly, so that the heat shall
almost take away one's breath (up to 120° Reaum.), and then
the stove should be again removed, supposing it is not allowed
to have one in the cell.
If not, an iron tube communicating with the open air should
open in the floor of the cell, passing in winter through a heated
stove, in order to conduct in a supply of fresh warm air.
It is great cruelty to shut up many prisoners together without
aUowing at least 500 cubic feet of space and air for each. If
this be not allowed, the better ones among the prisoners are ex-
posed to much annoyance by the bad behaviour of the worse
ones; and it is incredible the rapidity with which that most
destructive of all animal poisons, the virus of the most fatal
pestilence, is generated. Police authorities, be humane !
I scarcely need to remark, that the (often long-continued) im-
prisonment of debtors who are frequently deserving of compas-
sion, ought to be made at least as innocuous for the health of
the prisoners, of the turnkeys, and of those who visit them, &e.,
as that of criminals.
When foreign prisoners or field hospitals are introduced into a
cells is deteriorated, attaclies itself in great quantity to the waUs of gaols,
md in course of time degenerates into a pestilential miasm ; by t)ic process abov«
described it is removed and washed away by the boiling water.
216 . THB FRIEND OF HEALTH.
healthy country in time of war, whether temporarily or perznat-
nently, the authorities, if they have it in their power to act^
should take care that an epidemic is not thereby brought into
.the country.
Prisoners of war, who are not unfrecjucntly suffering from
typhus and putrid fevers, in their transit through a country, wm,
generally, when remaining for the night in towns, lodged in the
town-halls, apparently in order that they may be kept more se-
curely. But how often has this practice given rise to the spread
of epidemics !
It would be safer to quarter them in large coach-houses, sta-
bles, bams, &c., outside the town, to make them lie undressed on
straw matrasses, keeping them warmly covered in winter, and
in this manner retaining them until their march can be renew-
ed.* If the season of the year admit of it, they must be com?-
pelled to wash each other's clothes and linen with hot water^
and to dry them in the open air.
The mo.^t destructive pestilences are most easily engendered
by military -hospitals. It would be the most disgraceful barbart
ty even in an enemy, to erect them in the middle of towns.
But if, nevertheless, this is done, there remain for the poor
town's-man, if tbev bring pestilence along with them, as they
usually do, very few means of preserving the life and health of
himself and family, and these he should carefully attend to.
If he will not or cannot leave the town, he must at all events
avoid all intercourse and communication with the sick, with itt^
fected houses, and even with those who frequent such houses.
If they bring him any thing he should take it from them at his
house-door or in the open court. Should it be articles of cloth-
ing or linen, he should not make use of them before he has
plunged them into hot water mingled with vinegar, in the opeik
court, or thoroughly fumigated them with sulphur. Should it
be articles of food,^ let him not partake of them before prepare
ing them on the fire, or otherwise heating them.
' On the march they have plenty of air and exercise; in this way they get rust and
warmth, and are uioipacitated fn)m making Uieir escape.
* A person who is exposed to the danger <»f infection, should not allow his coufa|;»
to sink, should not leave off any of his accustomed comforts, rest, exercise, iuod» or
dniik ; but he ^.hould also carefully avoi<l all excess in any of these thing}*, aa aIm in
passions, venereal excitement, <fec. Tlie other prophylactic measures that should \m
adopted will be found in Uie first part of the '* Friend of Health." A slight increMa
of stimulants^ such us wine, tobacco and bqu£^ is said to be a powerful propl^laolia
against infectious disorders.
PREvmsnoN OP epidemics in towns. 217
Infectious diseases have even been communicated by monej
and letters ; the former may be washed in boiling water, the lat-
ter fumigated with sulphur.
Although the animal poisons called infectious miasmata aro
not infectious at the distance of several paces in still open air,
80 that we may (with the exercise of great care) preserve our
house free from infection in the midst of houses where the
malady is raging, we should remember that a draught of air can
carry the miasm arising from a sick person to a distance of
many paces, and then occasion infection.
On that account we should avoid traversing narrow lanes
where we should have to pass close by a sick person, and for a
amilar reason we should shun narrow passages througli houses.
Above all we should refrain from looking into an open winduw
and conversing with people in whose house or room cases of in-
fectious disease may exist.
Acquaintances kiss each other or shake hands ; this ceremo-
ny should be omitted when the danger is so iminent, as also
drinking out of another's glass. We should particularly avoid
making use of a stranger's water-claset, or allowing a stranger
to use ours.
At such times we should never bring second-hand furniture*
into our premises.
Domestic animals that arc given to rove, such as dogs and cats,
often carry about with them in their hair the virus of infectious
diseases. For security's sake it is advisable to get rid of them
at such times, and not to allow strange dogs or cats to approach
OS.
The drying up of marshes and old ditches close to human
dwellings has frequently been the occasion of the most mur-
derous pestilences.'*
If the fosse surrounding the town is to be cleared out or dried
* I have seen putrid fevew occur periodically for many years in the country, mere-
ly by old furniture, which had beUmgcd to persons who liad died of such affectiona^
ttmiag into other families by purchai^.
' I saw the fortieth pert of the inhabitant:) of a large town dio of typhus, in come-
qoeoce of tlie mcaut'.ous draining of tlie town fosse.
Whenever the shnie of such a town fosse, which may hivvc been accumulating for
ntDy, pcrfaape hundreds of years, is deprived of the fresh water covering it, tho
kdf putrified animal matters contained in it immcdLvtely pass into the last stage of
^feoompufiition. This last stage of decomposition of animal substances is infiuitelj
potscoous than all the previous ones, as we may see in the rapid fatality of the
frmn ccss-pools which have not been cleared out for thirty yeiurs or more.
Of this more hereafter.
218 THK FRIEND OF HEALTH.
up, 03 is highly desirable for the health of the inhabitants of all
towns, this work should only be undertaken in the depth of win-
ter. The water should be carried off in the form of ice-layera|
and the ice that forms again in a few nights should next be taken
away, and so on till no more water remains.
But as the removal of the mud from town-ditches is much
preferable to letting it gradually dry up, seeing that throughout
the whole time required for the latter, noxious vapours are con-
stantly exhaling, there is no better time for removing it than in
severe cold. The mud which is always in a state of putrefaction
is always warm, and never freezes so much as to prevent its
being easily dug out in winter. We can also more readily dia-
pense with draught-cattle on account of the excellent condition
of the roads in severe frosty weather.
After great inundations on flat land, the spontaneous drying
up of which cannot be expected to take place in a short time, it
is requisite that all should lend a hand to cut ditches through
and roTind about the inundated country ; but if it is impossible
to drain off the water into the river on account of its low level, a
number of small wind-mills must be erected in order to pump olDF
the water as quickly as possible and dry the land ; for if this be
not done the water readily takes on the putrefactive process,
giving rise from spring to autumn to dysenteries and putrid
fevers.
The hw'lying houses that have been inundated by the water are
a fertile source of epidemic diseases (see Kiockhoff). The police
authorities must see that every householder digs a deep ditch
round his premises, and especially round his dwelling-house;
that he has all his windows and doors open for the greater part
of the day ; that he occasionally lights fires even in summer ;
and that in winter, at all events before he rises in the morning
all the doors and windows are left open, for an hour at a time.
There are places thatare destitute of the (often unacknowledged
benefit of a sufficient supply of fresh flowing water, in place of
which the inhabitants are obliged to make use of spring or rain-
water brought from a distance, or to put up with rain-water only.
In all such cases they collect their supply of water for along time
in large reservoirs, in which it becomes stale in a few days and
furnishes a very unwholesome drink, the source of many dis-
eases. Soon, it again becomes clear and inodorous ; but in a
short time the putrefaction recommences, and so it goes on until
the water is all consumed, the greater part of it in a very bad
PREVENTION OF EPIDEMICS IN TOWN& 219
state. I sliall not here attempt to determine whether these dis-
advantages might not be obviated by the construction of arti-
ficial aqueducts on no very expensive scale, or of (very deep)
wells ; but I am convinced that in flat localities on firm soil it
is possible to resort to one or other of these plans, whatever may
be alleged against it by the paltry parsimony of many corpora-
tions, who look on unmoved whilst many such communities
gradually die out. In the absence of such a radical cure, I
would advise every householder to keep his supply of water in
casks, in which for every 400 pounds of water one pound of
powdered wood charcoal should be thrown, which, according to
the discovery of Lowitz, possesses the power of preserving v^ater
from putrefaction and of making stale water sweet. The clear
fluid may be drawn off when required through a tap provided
with a tight linen bag.
A similar precaution against the production of disease is
adopted in large $/iips that go to sea, which are often reduced to
great straits on account of a deficient supply of fresh water. But
many causes conspire in ships to produce destructive* diseases.
Among these are the mode of feeding the crew so much in
rogue, ^ith often half-decayed, dried and salted meat, with un-
wholesome fatty substances of various kinds ; the want of fresh
air when during continued storms they have to pass many days
together below deck with the port-holes closed, when the exha-
lations from their bodies increase to a pestilential fetor ; the ex-
haustion of the sailors when kept at work too long, during which
their wet clothes check the perspiration. These causes engender
and keep up scurvy, dysentery, and other maladies.
The risk of such disorders may be avoided by the following
measures : supplying vegetable food, and in the absence of green
herbs, dried legumes that so easily ferment ; sour-crout ; some-
times brown sugar in place of oil ; brandy for strengthening ;
meat-soups boiled down and dried, in place of kept meat ; malt-
liquor to drink in addition to water ; the division of labour into
eight-hours' work ; care that the crew have always dry clothes to
pat on, and that their habits are cleanly ; frequent pumping out
of the necessary ; and the purification of the air between decks
by means of large braziers of burning charcoal according to
' llAJar Nantc observed during the war betwixt England nnd North America a
pestilential gaol-fever break out on board the fleet lying off the Havana, of such
Mverity that numbers of men who seemed to be in perfect health died after an illness
of not mure than from three to four hours.
220 THE FRIEND OF HEALTH.
Cook's method. The frequent \vashing with sea- water of tlie
various utensils, the floor, the walls and the decks, must not "be
neglected. If powdered charcoal be mingled with the sea- water
used in scrubbing, the stench of the walls will be effectually gat
rid of In addition to all this care should be taken not to take
on board sick persons, or such as have scarcely recovered from
iUness; and all the utensils and furniture should be frequently
exposed to the air on deck when the weather is good.
By the employment of Sutton's method of conducting leaden
pipes into all parts of the ship which all terminate in the
kitchen fire-place, the deteriorated air will most certainly bb
drawn off by the fire. But Cook's braziers do much more, tot
they heat the walls, and thus destroy the contagious matter mucb
more elfectually. Hale's ventilator (a kind of wooden bellows)
are little used in ships. Would not the so-called garden-cresB
{lepulium sativum) be a valuable vegetable, or at all events be
useful on board ship as a medicine, in order to diminish the
noxious matters in the first passages ? The fiicility with whidi
its seed grows is well known. We only need to strew it upon
a piece of old wet sail cloth, and cover it with unravelled pieces
of old moistened tow.
In towns where no rapid stream of water can be conducted
through even the small streets wherein the animal excrements,
the washing- water, the urine and other impurities of men and
animals can be carried oflf without doing any harm, covered
cess pools cannot be dispensed with.
These cess-pools are always a bad thing for the health of maUi
from their aptitude to engender, or at least to promote, pestilence.
In order to render them as innocuous as possible, they should
be built up with masonry, not only on the roof and walls, but
they should also be paved on the floor with stones cemented
together, in order that the putrefying impurities may not sink
into the ground, but be capable of being taken clean away.
They must be frequently cleansed out, and the odour removed
quickly.
The time selected for cleansing them should be during the
prevalence of a strong wind, more especially one from the north,
north-east, east or south-east, and those days should be avoided
when a long period of warm rain, calm and foggy weather, with
a low state of the barometer prevails.
Though we are not able to adduce any instances in which the
-exhalations from old privies have spread a pestilence of any dn-
PBEVKNTION OF EPIDEMICS IN TOWNS. 221
ration, yet no good police which attends to the health of tho
oommunity should permit them ; and moreover, cases have oc-
curred where workmen suffocated in such places have spread
such a virulent exhalation from their clothes, that manv of those
approaching them have been cut off by typhus fever.
In order to avoid the pestilential poison proceeding from ani-
mal substances in tlie last stage of putrefaction, the most destruc-
tive of all poisons, the removal of such murderous pits should
be advised, and no sensible person will object to this.
But when they are already in existence and require to be
cleared out, we must not go to work incautiously. The simplest
method of freeing such pits from their poisonous exhalations is
always the lowering into them of small loose bundles of ignited
straw attached to a wire, since there is rarely in them any in-
flammable gas that might endanger the house by its ignition.
These bundles are to be let down to the depth at which they
will almost be extinguished by the vapour, and then they should
be allowed to burn out. This process is to be repeated with
lisu^ger and larger ignited bundless until the stratum of gas is re-
moved to the very floor of the pit, and atmospheric air occupies
the place of the lire-extinguishing gas. But our precautionary
measures should not cease here : for it is not only want of at-
mospheric air that kills the workmen in such situations, but still
more the vapour that rises, though not to any great height in con-
sequence of its weight, from stirring uj) the human excrement that
has entered on the last stage of putrefaction, in order to render
this as harmless as possible, a quantity of dry faggots ignited
should be thrown into the pit, suAicient to cover all the bottom
of it, and there they should be left till they are totally consumed.
The heat thus generated will, after the lapse of an hour, have
rendered the odour innocuous to at least a loot in de])th. This
quantity should then be removed by the woi-knien ; faggots are
then to be burnt as before on what is beneath, wheieuj)on the
next layer is removed, and so on until it is all cleared away.
Should it really prove true, that the most of our police authori-
ties have abolished burials in churches, we should not be thereby
set quite at our ease. Tlte old graves still exist in our churches,
in which the la.st and most poisonous stage of decomposition
of the dead bodies has not yet ceased to emit its destructive
emanations.* Hence alterations and building o])eratlons in the
* It >houId be b<>riic in mind that the most fatal fi;n^ gcncr;it<5d by the last stage
of putrufoctioii docH not readily rise, but is heavy, and not unfrcqucotly reposes in »
222 THE FRIEND OF HEALTH.
floors of such churches are fraught with manifest danger to the
life of the workmen and the congregations in the churcheSi
whence diseases may spread over a considerable portion of the
population.
In June, 1773, a grave was opened in the church of SaulieU|
Burgundy, and church-service performed soon afterwards, in
conscciuence of which, 40 children and 200 grown-up people, to-
gether with the clergyman and sexton, were assailed by the ex-
halation that arose, and carried off by a malignant disorder.
Moreover, it has not yet been perfectly ascertained how many
years the contagious principle may remain attached in undi-
minished virulence to the buried corpses of those who have died
of malignant diseases.
In many countries, die lying in state of all bodies is very pro-
perly forbidden. But in others where not so much enlighten-
ment prevails, infectious diseases are often propagated by the
exposure of such poisonous bodies, of which I could adduee
many examples from Saxony.
In 1780 a girl brought a putrid fever with her to Quenstadt
from Aschersleben. All her numerous brothers and sisters and
her parents took ill of it, one after the other, but they all gra-
dually recovered except one grown-up daughter, who died of
bed-sores. I took the greatest pains to prevent the disease be-
ing propagated to others from this house. I succeeded in this
for five months until this girl had to be buried. The young
men of the village bore the body in a coffin nailed up accord-
ing to my directions, to the grave. Here, from their attach-
ment to the deceased, they disobeyed the strict orders given
by my friend, the clergyman ; they forced open the lid of the
coffin, in order to see the corpse once more before it was let
down into the grave. Others, moved by curiosity, approached.
The third and fourth day thereafter, all those that had been
guilty of this excess, lay mortally sick of this fever, as also all
those who had come near the grave (some of them from neigh-
bouring villages,) to the number of eighteen, of whom only a
few escaped death. The epidemic of putrid fever spread around
at the same time.
It is not desirable that those important personages in the state
called inspectors of the dead and corpse washers, whose business
it originally was to form a silent judgment respecting the kind
low stratam above the carrupting matter, iiotil it is stirred up, and is thus rendered
dangerous to life.
PREVENTION OP EPIDEMICS IN TOWNS. 228
of death that had occurred, and to verify the decease, should
receive from the juridical medical oflScer accurate instructions
on this by no means easy point, before undertaking such an im-
portant, such an exceedingly important duty ? How many lives
of those apparently dead might they not be instrumental in re-
storing, how many cases of murder might they not detect, and,
what interests us peculiarly in this place, how often might they
not discover that some who have died without having been seen
by any physician, might have laboured under contagious dis-
eases?
We should not be too rash with bodies brought to the dissect-
ing roomSj not receive such as we may suspect to have died of
contagious diseases, nor keep the subjects until they are in the
last stage of putrefaction, nor, for the sake of bravado, have too
much to do with macerated parts in a state of extreme decom-
position, and often melting away under our touch, which can no
longer teach us anything. Examples are not wanting of the
students who were merely looking, on being rendered danger-
ously ill thereby.
But chiefly are the contagious pestilences in towns harboured,
renewed, promoted, and rendered more contagious and more mur-
derous, in the small low, old houses^ situated close to the town-
walls, huddled together in narrow damp lanes, or otherwise de-
prived of the access of fresh air, where poverty dwells, the mother
of dirt, hunger and despondency. In order to save firing and the
expensive rent, several miserable families are often packed close
together, often all in one room, and they avoid opening a window
or door to admit fresh air, because the cold would enter along
with it. He alone whose business takes him into these abodes
of misery, can know how the animal matters of the exhalationfT
and of the breath are there concentrated, stagnant and putrefy-
ing ; how the lungs of one are struggling to snatch from those
of another the small quantity of vital air in the place, in order
to render it back laden with the effete matters of the blood ; how
the dim, melancholy light from their small darkened windows
is conjoined with the relaxing humidity and the mouldy stench
of old rags and decayed straw ; and how grief, envy, quarrel-
someness and other passions strive to rob the inmates com-
pletely of their little bit of health. In such places it is where
infectious pestilences not only smoulder on easily and almost
constantly, when a spark falls upon them, but where they take
their rise, burst forth and even become fatal to the wealthy
citizens.
224 THE FRIEND OF HEALTH.
It is the province of the authorities and the &jbhers of the
country, to change these birth-places of pestilence into healthy,
happy, human dwellings. Nothing is left for me but to turn
my face away from them, and to keep my compassion to mysel£
If, howxver, the inmates of them be not without employment^
their systems, accustomed to meagre fare and hard work, resist
infections tolerably well ; but when they are out of work, when
dearness of the first necessaries of life and famine prevail among
them, then, from these dirty sources of misery and woe, diseases
of malignant character and pestilences perpetually issue. It is
only since the fearful years 1771, 1772 and 1773, that some
rulers have learned, from the dangers to which they themselves
were exposed, to provide for the safety of their many thou-
sand subjects, by establishing corn-granaries and flour-magazines
against seasons of scarcity.
. I must make the general observation belonging to this placey
that most of our towns are not adapted, not calculated, to pro-
mote health. High town-walls and ramparts are now generally
acknowledged to be useless for towns that are not fortified.
That they are injurious by preventing the access of fresh air,
will also be readily conceded. But that the masses of houses of
most towns are too closely huddled together is not yet generally
seen, and when it is, it is attempted, but without success, to be
excused, by the greater facilities offered for business and trade
by having everything within a small circle.
In towns about to be built, it should not be allowed to build
houses higher than two stories, every street should be at least
twenty paces in width, and built quite straight, in order that
the air may permeate it unimpeded, and behind every house,
(the corner houses perhaps excepted,) there should be a court-
yard and a garden, as broad and twice as long as the house. In
this way the air may be readily renovated, behind the houses in
the considerable space formed by the adjoining gardens, and in
front in the broad and straight streets. This arrangement would
be so effectual for suppressing infectious diseases and for pre-
serving the general health,^ that if it were adopted most of the
• Tlie deteriorated air in closely built t^wns with high houses is especially injunoiis
to childreo and gives ri^e to thosKi defbrmitcs of the beautiful human figure denumip
Dated racliititfi, which consists of a softening of the bones, combined with laxn^aa of
muscle^ inactivity of the lymphatic system, and a high degree of irritability. The
Don*medical observer docs not readily notice the large number of these pitiable little
momtrositics in closely built towns, partly because a great many of them sink into
tlw grave in the first years of tlieir lite, partly because the cripples who
oooceal themselves lur shiune from the public gaze.
PBXVENnON OF KPIDEMICS IN TOWNS. 226
precantioiiary measures against pestilence I have inculcated
above would be rendered to a great degree superfluous. What
advantages in this respect do not Neuwied, Dessau, &c., possess!
The handsome, roomy, high and airy hictfiers* shops we meet
with in some towns, {e, g, Dresden) are not so good as the open
butchers' stalls standing in market places, and only covered by
a roo£ A putrid stench is always concentrated in the shops built
lor the sale of meat
The shops for the sale of stock-fish and herrings should be
atoated in the open air, at the outside of the city -gates ; the
disgusting stench that proceeds from them is sufficient evidence of
their imwholesomcness.
Were it possible to banish entirely from the interior of towns
all the manufactories and warehouses of the butchers, soap-
boilers, parchment-makers, catgut-spinners, glue-boilers, and all
other trades that are engaged with animal substances that become
readily decomposed, and to transfer them to special buildings
outside the town-gates, this would be a great advantage as
regards infectious diseases. I have seen many butchers' houses
in narrow lanes completely cleared of their inmates in epidemics,
whilst the houses in the neighborhood suffered much less severely.
It is astonishing how the indolence of that class of men who
cherish their prejudices, inspires them with such deep respect for
some things that appear horrible to thorn, so that there is with
them but little difference^ betwixt them and things that arc holy.
It can only be attributiible to this unaccountable prejudice that
the bodies of il^fui flnmnstic ani'mah^ as also those persons who
liave todo with them, have been considered as not to be meddled
with and as exempt from the regulations of a good police.
Owing to this, great confusion and injuries to the health of the
community have resulted. In this place I shall only complain of the
custom of leaving the bodies of dead domestic animals in the open
air, on greens and commons not far removed from the dwellings of
man, a custom so opposed to all ideas of the preservation of
health.^ If, as is assuredly the case, all putrefying animal sub-
' It k curious that in olmoet all languages the same expressions arc applied to the
ffioti hccrible as well as to tho most revered things — ttchaudervoU^ sacfr^ awful, are
hwUinrfu in point
' Does this custom originate in the vanity of man, who thinks to vindicate his right
to the title of sole lord of creation by assuming to be ulone wortliy of the high honour
of being buried beneath the ground, and to shew his supreme contempt for animala
(even of toch as are most useful and most valuable to us), gives them the vileai
names and leaves them unburied in the open air, in defiance of nature which seeka
^ io ooDoeal all putrefying processes from the public gaze t
15
226 THB FBISND OF HEALTH.
Stances make a horrible impression on our senses, i^ moreover,
all contagious diseases are hatched in corruption, how can we
imagine that such large masses of putrefying flesh of horses
and horned cattle, particularly during periods of great mortalitj
among cattle, can be a matter of indifference as far as human
health is concerned. The thing speaks for itself 1
It is in large well-i:egulated towns only that I have met with
some (although seldom sufficient) attention directed to the sale
of spoiU'/ood, especially animal food. In districts where fish
abound, many kind, especially smaller ones, are brought to mar-
ket with all the signs of putrefaction upon them. They are
chiefly purchased by poor people, because they are cheap —
nobody gives himself any concern about the matter, and the la-
bourer when he is taken ill throws the blame of his sickness on any
cause but the right one. Nobody concerns himself; the seller
of this pernicious food returns home after having pursued his
avocation unimpeded. The authorities who may perchance
hear of it, say to themselves : Where there is no complainant,
there is no judge. Can such be called Fathers of the town?
Other kinds of spoilt food can also produce infectious typhuH
fever.
In large manufactories and work/iouses where the workpeople
live in the house, those who fall ill should, whenever they com-
mence to complain, be immediately separated from the healthy
workmen, and kept apart until they have completely recover^
their health. And even where the workmen reside out of the
house but come to work together in large workrooms, it is the
duty of the master manufacturer, especially at the time of the
prevalence of epidemics, to send home immediately such of the
workmen as begin to complain of illness. Great care should
be taken always, but especially when disease is about, to have
the workrooms and warerooms well aired and clean.
Public schools are generally places for the diffusion of contagious
diseases, such as small -pox, measles, scarlet fever, malignant sore
throat, miliary fever, (hooping cough ?) and many skin diseases.
K schoolmasters in general were given to attend more to the
physical and moral training of their pupils than to cranmiing
their memories, much mischief of this character might be pre-
vented. It should be impressed upon them not to admit any
sick child to the classes, whose altered appearance betrays the
oommencement of a disease. Besides, a sick child can learn
nothing.
ON THX aATS3FACnON OF OUB ANIMAL REQUIBEMSNTS. 227
In times of prevailing sickness tbe clergymen should publicly
warn the members of their congregations, not to come to churdi
when they are feeling indisposed, and thereby expose their
neighbours to danger.
I cannot here enter into details regarding the power of bad
arrangements in poor houses^ houses of correclion^ orphan asylums
and invalid hospitals^ as also of ordinary hospitals and infirmaries^
in producing and promoting infectious diseases, and still less can
I describe the best plans for such institutions designed for the
relief of the most miserable classes of society. The subject is
too important, and in many respects much too vast to be dis-
missed here with a few words.
ON THE SATISFACTION OF OUR ANIMAL REQUIREBiIENTS, IN
ANOTHER THAN A MEDICAL POINT OF VIEW.
Man seems manifestly created for enjoyment. This is the
language of the infant when it cries for its mother's breast ;
this is the language of the shivering old man as he pokes the
fire ; this is the language spoken by the child playing with its
doll, of the girl eager for the dance, of the youth disporting
himself in the bath, of the matron preparing for the domestic
festival, of the delighted look of the father returning home from
his daily work, as old and young run out to meet him.
All creation around him is happy and rejoices; why should
man, endowed as he is with finer sensibilities, not do so likewise?
Certainly he ought to do so. But in his choice of enjoyments
and in the quantity of them he indulges in, he alone transgresses
the bounds of moderation ; he alone of all living beings. No
animal living in a state of a freedom partakes of any food except
what is suitable for its nature and health ; it consumes no more
than what it requires for its well-being ; it drinks not after its
thirst is quenched ; rests itself only when it is weary ; and in-
dulges in sexual pleasures only when the period for the propa-
fjatio': of its species has arrived, and when its matured irresistible
instinct attracts it to the delightful object of its desires.
The satisfaction of our animal requirements has no other object
than the preservation of our life, our health, our species ; the
pleasure accompanying it is lively and great in proportion to
the strength and completeness of the requirement, but in the
happiest class of human beings (those who live in conformity
with nature) it instantly assumes a shade of indifference as soon
228 THE FBISND OF HEALTH.
as the requirement has received the appropriate degree of satb-
faction.
When we pass the boundary line beyond this moderation, as
is so frequently the case among the higher and middle ranks of
society, luxury, gluttony and depraved sensuality commence.
Persons in easy circumstances are apt to imagine that the exces-
sively multiplied indulgence in excitement of the senses of all
kinds is to live in the true sense of the word. " / liave lived
mitch^^^ says the enervated voluptuary ; to me it seems that he
has lived little.
To every human being only a certain amount of corporeal
enjoyments has been allotted, which his nervous system is capa-
ble of partaking of and of indulging in only to that amount
without prejudice to the health. The temperate man easily
discovers these limits assigned to his organization by experience
iminfluenced by partiality, and in the observance of the laws he
has discovered he is happy, happier than the intemperate man
can have any idea of.
But if, seduced by bad cxa«nple or by the flattering advantages
of fortune, I should exceed the measure of indulgence consistent
with my health, I shall find that this excess Ls at first repugnant
to my senses. There occur satiety, disgust — the warnings of
nature in her wisdom ! But if I go on undeterred, making it
my business to force more indulgcncies uj)on 1113^ body than is
consistent with its well-being; if J employ ingenious methods,
by means of stimulants of various kinds, to coax the nerves
fatigued by the excess, to the recc])tion of new and immoderate
enjoyments, I shall doubtless at length be enal)led to indulge in
debauchery, that is, to burden my nerves with an unnatural
number of impressions, which the temperate man could not bear ;
but this is only a semblance of greater enjoyment. There is no
reality in it.
In proportion as we seek to increase to multiply our animal
enjoyments by unnatural means, our other senses become blunted,
and commence to derive less and less pleasure from a number
of enjoyments.
By spices, condiments, and fiery wines, the gourmand onust
seek to keep the nerves of his tongue up to the mark to
enable them to allow still more food to pass down his throat,
and at length he comes to such a state that even his higlily
seasoned dishes are relished no more, and he must stir up his
respected chef de cuisina to invent something new to tickle the
OK THE SATISFACTION OF OUR ANIMAL BEQUIBEMENTS. 229
languid palate of his poor master, and so to over-stimulate the
cardiac orifice of his stomach that it shall forget its office to re-
ject what is superfluous. If his honour have fully satisfied his
appetite with the first two dishes, the omnipotent genius of
his cook must follow these up by one or more dozen dishes, which
by their elegant appearance, their enticing odour, the dissimilarity
of their taste, and their stronger seasoning, shall deceive, ever
anew, ever more powerfully, the sister senses, and particularly
the sense of taste.
But this is only a vain artifice, an imaginary greater enjoy-
ment, not a real enjoyment, accompanied by inward entire
gratification. It is all vain, vain pitiable imagination.
The thresher regales himself with his black rye-porridge,
with his potatoes and salt, much more than his worshipfiil
lord and master, though his meal may not perhaps have cost a
thousandth part of the latter's sumptuous repast The fbrmer
is gay and happy over his frugal fare, and sleeps soundly until
the cheerful mom wakes him up refreshed and vigorous ; whilst
the latter in his satiety finds the world too small for him, and
his dull, dream-beset slumber scantily fills up the long hours of
nighty until he rises unrefreshed from his soft down bed, with
oonAised head, foul tongue, and spasmodic yawning.
Whose repast was worth most ? which of the two had the
higher, the more genuine enjoyment, the greater sensuous
pleasure ?
The ploughman who only drinks his pot of beer in an ale-
house on a Sunday afler church, has in the few hours he spends
over it perhaps twice as much enjoyment for his few half-pence
as my Lord Mayor who can boast perhaps of having swallowed
during the week a thousand times as much money in luscious
Constantia wine. The former quenched his thirst on working-
days at a spring behind his cottage, and was refreshed whilst
the latter was made hot, sleepy and stupid, by the excessive
quantity of his costly liquor.
Which of the two best enjoys life ? which has the higher
enjoyment ?
In vain does the libertine imagine that the disgusting dissipa-
tion of hus faculties that were created for higher objects can
procure him great pleasure and real enjoyments. Not to speak
of the enervation and the innumerable sufferings that must result
from his head-strong folly ? not to speak of how incapable he is
rendering himself for future paternal joys, or of the deep lamenta-
2S0 THB FRIEND OF HEALTH.
ble furrows ? lie is ploughing in his youthfiilbrow ; not to mention
these and a thousand other considerations (which I purposely
avoid touching upon) ; he is the unhappy slave of a habit which
from the falsely dazzling, inebriating goblet confers on him fer
more pains than pleasures. Poor fellow I he knows not the
ecstatic feeling of a rare, an ardent embrace of the fisdthful wife,
whose virtue -and modesty inspire the deepest respect, and can
conjure love of the real sort into her enraptured husband.
But he who has a fancy for the dregs of beastly lust may
drink them to satiety in the shameless intercourse with mercen-
ary courtesans. Soon will all his fine feelings be blunted in such
laudable society ; true love, that daughter of heaven, is to this
deluded being a ridiculous absurdity. Soon does his sexual
passion become deadened to such a degree, that, in order to
excite it, he must resort to a number of coarse stimulants and
aphrodisiacal arts, revolting to every chaste imagination.
Exhaustion of body and mind, self-contempt, disgust for life,
and a wretched and premature death, such are the natural
results of this destructive intemperance.
The wealthy classes in other respects seek to distinguish them-
selves by the refinement of their manners, of their appearance,
and of all the things wherewith they are surrounded ; why do
they in the gratification of their animal requirements sink so
far beneath the poorest classes of the people, and I might say
still lower ? Apparently for this simple reason, that they are
bent on having much enjoyment here below, and this they might
have, if they knew the proper, the true, the sole means of
attaining it it? that genuine mother of ecstatic, inexhaustible
enjoyments, that rich awarder of pleasure — moderation I
A NURSERY.
I lately paid a visit to one of my relations. Our conversa^
tion soon turned upon my favourite subject, children. My fair
cousin (her husband very properly left her to speak) talked like
a book about physical education, and made me very desirous to
see her j'oung fimiily.
She led me to the corridor at the back of the house that abut-
ted on the court-yard, and opened the door of a dark, low re-
ceptacle full of disgusting smells, which she informed me was
her nursery.
A steaming tub in which dirty linen was soaking stood in the
A NURSSBT. 281
&3nt of the room, surroimded by some low washerwomen, whose
umnannerlj chattering polluted the ear, as the vapour from the
dirty hat water did the lungs. The steam condensed into drops
ran down the window panes.
I expressed to my feir cousin my incredulity as to the utility
of this arrangement, and hinted how much the emanations
from the clothes that were being washed must deteriorate the
air the little ones had to breathe, how the excessive humidity
thereby engendered relaxed all the fibres of our bodies, and
must consequently be doubly injurious to children of a tender
age.
" Do you really mean to say," cried she, "that washing causes
any pollution? I'm sure I see no dirt made by it, and a little
mdstare can't do much harm."
" I allude to the invisible, but very injurious, deterioration of
the air, the bad effects of which on such delicate creatures as
diildren arc, you must have heard of."
" Oh," she replied, " I fumigate occasionally with juniper ber-
ries, and they soon remove all impurities."
I now perceived that a learned demonstration of the difference
betwixt the properties of azotic gas and pure oxygen, although
they differ but slightly in odour, and not at all in appearance,
would have been quite incomprehensible to my dear cousin, nor
eould I hope to make her understand how a prolonged sojourn
in impure, air acted as a slow poison on animal life, especially at
a tender age, and how impossible it was that children could en-
joy even tolerable health in such an atmosphere, and so forth.
Neither did I venture to speak of the quantity of humidity that
was imperceptibly taken up by the warm air of the room from
the scalding water, and equally imperceptibly absorbed by the
open mouths of the absorbent vessels in the child's soft body,
whereby the natural exhalations were obstructed. Nor did I at-
tempt to prove to her by the syllogysm in Barbara^ though I
had it on my scholastic tongue, that fumigation with juniper
berries and such-like things would rather tend to plogisticate
and deteriorate the air, but could never transform the impure air
into vital gas. —However, as I have said, I luckily suppressed
my spirit of logical refutation that was about to burst forth,
and endeavoured to bring forward some argumentum adhominem,
" It is possible," I said, **that I may be mistaken, and that
you, my esteemed cousin, contrary to all expectation, are in the
right in supposing that the frequent repetition of a washing fes-
1^ THE FBISND OF HEAI/TH.
tival in a nuraeiy, together witt the exhalations that arise fiom
the blankets hung to dry near the stove there, may be without
any unfavourable influence on the health of children, and I shall
give up my point at once when you produoe me your dear little
children, who doubtless are very lively and stout."
" Produce them," she replied, " I cannot, but you may see
them yourself back there. I don't know what ails my poor
Freddy, yonder ; he is nine years old, but cannot walk well
without his crutches."
At these words a little miserable looking figure crawled to-
wards us with diflBculty. His knees were bent inwards, and hia
legs completely destitute of muscle. His head drawn back-
wards, stuck betwixt his shoulders; his face was pale and
withered ; his eyes dull, but projecting beyond the prominent
forehead. His large ears stuck out; his nostrils were ex-
panded; his broad tongue always hung partially out of hia
half-open mouth. His emaciated arms could scarcely support
him on his crutches.
He soon returned panting to his little arm-chair, to rest lum*
self after this slight exertion.
I involuntarily shrugged my shoulders, and heaved a deep
sigh.
A mixed feeling of gratitude to God and profound pity took
possession of me, as I called my own rosy cheeked Fritz to my
side and bade him shake hands with this innocent victim of a
fisilse and injurious method of bringing up children. My little
urchin kissed this poor object affectionately, and asked him
what was it he drank out of the large jug beside him. "My
afternoon coflfee" — was his reply, and at the same time he
poured out a cup for my boy, who, however, refused it, as he
was not in the habit of drinking things he was not acquainted
with.
'* You do not seem to approve of that," said my cousin, " but .
what else can the child drink, it is the only thing that seema to
do him good ; he cannot enjoy any thing else."
" Do him good?" I hastily asked, in a paroxysm of half-sap-
pressed, but extreme anger — and I turned away from the odious
sight.
Oh I what an inclination I felt to give this unhappy mother
a severe lecture, and to shew her that a drink which sets our ,
blood in agitation, whilst it exalts the irritability of our muscu-
lar fibre to such a degree as in course of time to render it quite
A NUBSERY. 2S$
lax, and to weaken it so that it trembles - which gradually ex-
hausts our vital heat — which, possessing no nutritive properties
in itself unnaturally stifles hunger and thirst, and which com-
municates a false overstrained liveliness to its votaries, who are
often reduced to the last stage of weakness, that like a transient
intoxication leaves behind it an opposite state of the nervous
system, — how injurious such a drink must be for the delicate
child, endowed as it is with great irritability, and how impossi-
ble it is that such a badly treated creature can become any thing
but rachitic and cachectic in the last degree — a shrivelled dimin-
utive of a human being, for whom death were the most desirable
k)t
With all these evident truths I should have wished to fan the
smouldering spark of a mother's love in her breast, but I re-
findned from so doing because it occurred to me that coffee was
the fevourite beverage of mamma herself, so suppressing niy feel-
ings, I mildly gave her to understand that in my opinion coffee
should only be an occasional beverage of persons above forty
years of age, or employed in certain cases as a medicine."
"I suppose, my censorious cousin," was her reply, "you
would be for depriving the little creature yonder at the table
of her fiivourite food ?"
It was some kind of confectionery which the girl three years
old, who could not stand on hef legs and could not be taught to
walk, was swallowing wdth a degree of greediness that excited
my disgust and horror. This pale, bloated creature had a rat-
tliiig at the chest, slavered at the mouth, had a dull look, a pro-
jecting abdomen, and, as I learned, little sleep, and a perpetual
diarrhoea, whereby, my cousin assured me, all impurities of the
body were discharged.
I begged her to try whether she herself would remain in good
health if she were constantly eating sweet things, and if she
would not get sour eructations, worms, deficient or excessive ap-
petite and diarrhoea, and if so, how much more the delicate
stomach of a child who was incapable of taking exercise, and in
whom there was a natural tendency to acidity.
This seemed to make some imj>ression on her, especially when
I begged her to try the strength of my home-made vinegar,
which was made of sugar and yeast alone.
" I wish you would advise me what to do for the miserable
skeleton yonder in the cradle at the side of the stove ; it has con-
stant cold sweats, it does not sleep, and is always crying as if it
234 THE FRIEND OF HEALTH.
were on the rack. It has fits occasionally. I wish God would
mercifully take it to himself its sufferings are so heart-rending
to witness. I have already buried three boys, peace be with
them I they all died teething. The little fellow has been about
his teeth these three months; he is always putting his litd©
hands to his mouth. I only trust he has not got into this state
from the evil eye of some bad people, as my mother-in-law con-
fidently asserts must be the case ; it was she tied the scarlet ragjB
round its little hands. They arc said to be good for bewitchment
She also often fumigates with nine kinds of wood."
" What harm," I replied, " could the poor innocent child have
done to the bad people ? where are these Bad people that possess
the power to make ill by a few words a healthy child fed mode-
rately on wholesome food and strengthened by exercise in the
open air and cleanliness ? I am perfectly con\Tinced," I con-
tinued, with some bitterness, caused by the sight of so much
misery, " I am convinced that if you left off letting the poor
child suck such a quantity of chewed bread from that bag,
whereby its stomach is made sour and overloaded, if you would
clean and dry it oft«n enough so that all the stench I observe
about its cradle were removed, if you would not cover it up so
warm, would wash it all over every day with cold water and
take it away from the unnatural heat of the stove, if you would
send it, or, better, take it yourself frequently into the open air,
would never give it unwholesome food, nor overload its stomach
with the most wholesome — the little creature might still be
able to enjoy life, it would not have to whine so much at all the
misery you heap upon it and which you attribute to teething
and witchcraft ; it would become healthy and lively, in a word it
would be to you a source of joy, and not as now, one of sorrow.
Believe me, teething diseases arc almost impossible, almost un-
heard of among quite healthy children ; this name is a mere in-
vention of ignorant persons, and is applied by them to children's
diseases which they know nothing about, and the blame of
which they lay upon nature, whereas they are in reality the
fault of the mothers, the nurses and the doctors ! None of my
six children have manifested any serious illness when cutting
their teeth ; when I looked into their mouths I usually found
their teeth as I expected, planted along their gums in an even
row. Why do we hear those everlasting complaints about the
pretended teething diseases of children, for which we have ovLt-
selves to blame ?"
A NURSERY. 286
I went on in my overflowing zeal to give her to understand,
in the most decided manner, what a poisonous atmosphere the
air of this low, dark, hot room was, filled as it was with exhala-
tions of all kinds, and so often with the emanations from the
dirty clothes washed in it — ^how well children were worth the
trouble of giving them a roomy, high, bright, frequently aired
and extremely clean room to stay in during those hours of the
day which they do not spend in the open air, which is quite
indispensable for little children.
" Come, Fritz," I added, " let us quit this wretched children's
hospital and clear our lungs in the autumnal breeze outside
from this bad air. God will provide -for these helpless children
in the cold earth, including the poor cripple whose sad state
causes your tears to flow. Come away 1"
My cousin was much affected, wished to have more advice
from me, wished to thank me, and so forth. But I hastily took
my leave, exclaiming that she had got quite enough to do for
the present if she made those changes which my compassionate
seal had induced me to suggest, and away I went with my
stout and healthy little Fritz.*
' [Be«pectii^ the fate of this same Fritz or Frederick Hahuemann, the only son
of the founder of Honusopatliy, nothiDg is known for certain. To those conversant
with EUdiiiemann*B Materia Medica his name is very familiar, as it constantly appears
among the early proved medicines, and indeed he seems to have been one of the
oiOBt devoted and daring among those who were the pioneers of our pathogenetic
knowledge. In 1811 he wrote an aihnirable reply to Heckcr's attack upon the
Organon, which may still be read with interest and profit.* After taking his degree
io Leipzig, he contracted a matrimonial alliance with a widow, who I believe still
lifea in Dresden with a daughter, but who, according to what I have heard, was not
well quali6ed to make his nuuried life Imppy. This marriage gave great offence to
his father, and led to an estrangement between them which was never removed.
FMerick left the paternal roof and set up in practice in Wolkenstein, a small town
JD the Saxun Erzcbirge where his success obtained him great celebrity, so much so
tbU it is said his house was beset with crowds of patients. The jealousy of his pro-
iwBimal brethren was aroused, and by some intrigue a letter was obtained from the
Medical College of Saxony forbidding him to practice. Young Hahnemann on this
WM obliged to remove, but before doing so he wrote a most contemptuous letter to
the College which gave great offence, as it was intended it should. What became of
lam for a long time after that is not known. I find it stated in the Augsburg Allg,
Ztg. f. Horn, that he went to Edinburgh and staid there several years, but I am
■»ble to ascertain the truth of this statements In the same journal it is mentioned
that eome years previous to 1 880 a traveller calling himself Frederick Hahnemann
had visited the interior of Pennsylvania and cured many people by means of small
powdeni. Since that time no authentic traces of him have been met with, and I
WM last year assured by his sister, who cherished his memory with a sister s love,
that she knew not whether he was dead or alive, never having heard any tidings of
\aak nnce he quitted his native country.]
* This wort U entiUed ** Friedruk H^nemann'§ dea Soknes fTidtrle/fung ier AnfmlU Htckm^t
M/iM Orgmtm Ur ratiiuUtn Utilknnde,^ Dresden, 1811.
286 THE FRIEND OF HEALTH.
ON THE CHOICE OF A FAMILY PHYSICULN.
Dear Doctor,
Since I left your neighbourhood I have felt a want, to
supply which I am sure you are able, and I now write to
request you to do so. "When anything happens to me I know
not what doctor to apply to ; and yet you have repeatedly and
urgently recommended me to pay more than ordinary attention
to my health. "We have here many doctors whom you know,
and also some with whom I presume you are not acquainted.
Some of them have pressed their services upon me, have got
themselves recommended to me in various ways, and some
have even recommended themselves. Now I know very well
what recommendations are, especially to a person of my rank.
It is the most forward, the most insolent, I might say the most
impudent, that gets the best recommendation, though he may
be the most ignorant and most immoral of the lot. Either
monstrous vanity (and you know full well that this is always
allied to ignorance) trumpets forth that its important possessor
is the mighty hero he thinks himself to be, who can boldly
oflFer himself for the most important posts without fear of jA
repulse ; or a mixture of self-satifaction and avarice makes him
fertile in all kinds of devices in order to enlist in his interest
those whose recommendation may be serviceable, whilst the
latter are weak enough to bring all their influence to bear in
his favour.
Such is the character of most recommendations, and he who
trusts to them will have to put up with sorry trash ; I have no
faith in them, and must be perfectly satisfied in my own mind
before I can make my choice.
But tell me, dear Doctor, how can I become satisfied in my
case ? On what principles must I choose a physician in order
to avoid the bait of the ordinary run of recommendations, in
which we are not always sharp enough to perceive the point of
the hook ? Pray give me your advice.
Yours, &c.
Prince of * * *
My dear Prince,
You are right in supposing that I am not well ac-
quainted with the medical men of your capital ; I know none
of them sufficiently well, and I perceive with pleasure that you
ON THE CHOICE OF A FaKILY PHYSICIAN. 287
have a decided objection to receive the recommendations of
those who are unknown to you.
• Without being oneself a very great physician, it is impossible
to form an immediate judgment respecting the scientific attain-
ments of another physician ; therefore you as a non-medical
person must, in order to be able to select a really good man of
this profession, have recourse to some circuitous methods, which
ahall guide you to your object with not less certainty than the
knowledge attained by school learning can bestow. Certain
trivial things in their outward appearance, a certain mode of
conducting themselves when i)rofessionally engaged, and some
other accessaries characterize the difl'erent classes of medical
men.
Look how A. walks into the assemblage that reverentially
expects him, with carefully measured steps, with expanded
chest and elevated head ; how he announces the dignity of his
great person by a gracious, slow inclination of his body, and
how he decides the most important questions with a few short
words and a disdainful air. He only honours the great people
in the company uvith his notice, he flatters them in high soimd-
ing phrases, in order to be entertained by them in return, and
he talks about the highest personages in the land and the great-
est savants, as he would about the most ordinary trifles which
may be estimated with the fifth part of a glance. Merit
rewarded or neglected, heart-breaking domestic occurrences,
danger and delivery, life and death, arc all the same to him ;
nothing produces any change in his frigid manner, or at the
most they elicit from him a witty remark, which the crowd of
his admirers do not omit to acknowledge with their plaudits.
He talks the modern languages with the most refined accent ;
his house is the model of fashion and the furniture in the best
taste.
You surely would never be so foolish. Prince, as to seek to
make a display by selecting such a Khan among Doctors. Such
an eccentric part must engage the whole mind of the best actor ;
it has to be learned, rehearsed, played. Who can be surprised
that the details of a case of disease are tiresome to him, and that
he defers till to-morrow doing anything for the urgent symp-
toms of some poor man, the sole support of a wretched family,
because he must go and leave his card on some lord who is
passing through the town. His medical wisdom must, in the
face of all these fashionable accessaries, be but a thin coating
288 THE FRIEND OF HEALTH.
which he has enough to do to keep well polished, so that all
uninvited inquiring glances may be arrested by its mirror-like
gloss, and be repelled without having penetrated its shallow
depth.
Should I advise you to select B. I felt half inclined to do so!
See : by half-past four in the morning he is in his carriage, for
this morning he has thirty visits to pay to patients. His horses
foam with the rapidity of the pace, and have to be changed for
fresh ones in a few hours. Whilst he drives along he is seen to
bend in deep meditation over a long clearly written list, wherein
the names and abodes of the patients who are sighing for him,
and the minute at which he believes he will be at each of them,
are carefully marked. He looks at his watch which indicates
the seconds, he calls to the coachman who instantly draws up.
Out he jumps, says a few words to his servant and runs up the
stairs. Doors fly open at his approach, three steps bring him to
his patient's side. He feels his pulse, asks him a couple of
questions, and without waiting a reply he calls for pen, ink and
paper : and after deep reflection for two seconds in his chair he
suddenly dashes off the complex prescription, politely hands it
to the patient for his iminterrupted use with a few solemn words^
rubs his hands together, makes his bow and disappears, in order
to be with another patient six seconds afterwards, on whom also
he bestows his two minutes of advice ; for his presence is in
such great request that he is perfectly unable to devote a longer
period to each patient. He wipes the perspiration from his
brow, complains of having too much to do, makes his servant
call him half a dozen times out from a party where he stays
altogether only half an hour ; beckons to him every surgeon
he meets, in order to whisper a few important words in his ear,
pointing at the same time to some houses or streets. At his
consultation hour his ante-room teems with the friends of pa-
tients, sick-nurses, midwives, surgeons, and patients. There he
dispenses in proftision, prescriptions, recommendations, advice —
like tickets for the theatre.
Do you still hesitate, prince, to select this the most renowned
practitioner in the to^n, whose residence every child knows,
who according to the unanimous opinion of the whole public
owes his great and wide-spread reputation to his indefiitigable
industry, his enormous experience and knowledge of disease,
which must of necessity procure him such an extensive practice ?
Methinks I hear you insinuate that with such a superabundant
ON rn^ CHOICE OF A FAMILY PHYSICIAN. 239
practioe the man cannot attend to any of his patients properly,
cannot in a few minutes maturely reflect upon all the circum-
stances of each case, and still less find the proper remedies for
it^ seeing that the greatest and best physicians sometimes require
half and whole hours for the consideration of similar cases.
You will doubtless consider him to be some delusive, fleeting
phantom, whose charlatanism consists in having too much to do,
and whose only recommendations are a light hand, agile legs,
and fleet horses. Well, I presume you will be inclined to look
out for some one else.
Possibly your approbation may be bestowed on the next most
celebrated practitioner. Dr. C, late surgeon in the army. He
unites in his person to perfection all the arts that can enhance his
superiority as a physician. His very appearance gives an aristo-
cratic dignity to our science. His dress is in the last style of
fiushion. The cloth of his coat — which by the way is not yet
paid for — could not have cost less than thirty shillings the yard,
and the pattern of his gold-embroidered waistcoat excites the
admiration of every lady. Those ambrosial curls on his hair,
which are dressed thrice a day, are the work of the greatest
artist in town. Look how elegantly he sticks out the little finger
of his left hand, and how neatly he advances his foot — calumny
asserts that he does so in order to show off his diamond rings
and sparkling buckles. See with what grace he kisses the lily
hands of dames and damsels, how charmingly he seats himself
beside them on the sofa in order to feel their pulse in his in-
imitable manner, with what sweet words he commences the
conversation, how fascinatingly he carries it on, and liow art-
fully his philanthropic spirit revives it when it commences to
flag, with scandalous half-invented anecdotes about other fami-
Ues, who had unfortunately made him their confidant. In order
to charm the ears of his curious auditors he never forgets to tell
them about all the false teeth, stuffed backs, and pertes blanches^ of
all their friends and neighbours ; but all this he does in mysterious
whispers and imder the solemn promise of inviolable secresy,
which he had not omitted to swear to observe in all the other
houses. If he is ever at a loss for something else to talk about,
he delights to pass his colleagues in malicious review. This one
has no knowledge of the world, that one is deficient in anato-
mical knowledge, the other has a repulsive appearance ; a third
wants genius, a fourth has got a bad pronunciation, a fifth has
.no skill in dancing, a sixth has little practical talent ; and so he
240 THE FRIEND OF HEALTH.
goes on to a seventh and a tenth, ascribing to them all, heaTen
knov^s what faults. Every unsuccessful case of his colleagues
is retailed from house to house, and he takes care at the same
time, by delicate insinuations, to extol the wonderful powers of
his own far superior genius. To the wife who complains of her
husband he gives ingenious reasons to confirm her suspicions;
and on the other hand, he expresses to the husband by a few
dexterous shrugs of his shoulders the honest sympathy he feels
for him on account of the unhappiness the conduct of his wife
must occasion him. Those who employ him must prefer him
to all his colleagues, for he launches out into praise of every-
thing about them. Thus any ordinary looking children are
darling angels, the new furniture of the room is in the best pos-
sible taste, the pattern of the knitted purse has not its equal for
ingenuity of invention, the cut of the new gown forms an epoch
in fashion, the favourite daughter's wretched strumming on the
piano is the music of the spheres, her stupid remarks are sparks
of the most brilliant genius. He has the conplaisance to allow
his patients to drink their favourite mineral waters, and to take
their favourite medicines as often as they choose, and deferen-
tially conforms to their fancies with regard to having their me-
dicine in the form of powders, pills, draughts, or electuaries.
He can also give it them as liqueur, lozenges, or confections.
He whispers many a sly word in the chamber-maid's ear ; and
no one gives more in christmas-boxes to the servants who bring
him his annual presents. He is perfectly conscious of his own
talents ; before ladies he parades his profound knowledge of the
Greek and Hebrew languages, and his nocturnal studies of the
Latin author Hippocrates ; to the police magistrate he exhibits
his botanicol lore ; to the clergyman his anatomical acquire-
ments ; and to the mayor his skill in writing prescriptions.
*'In a calumnious mind no love for mankind can dwell," me-
thinks I hear you say "and he whose head is occupied in trying
to ingratiate hinself by the elegancies of the toilette, by indirect
self-praise, and all sorts of dishonourable practices, cannot possess
any real merit.' ^
The fear of wearying you, my prince, prevents me pursuing
further the disagreeable occupation of displaying more of these
caricatures composed of fragments, and which are by all means
to be shunned. Thank God ! their number is daily diminishing
and it cannot be a matter of much difficulty for you to find a
good physician if you will only be guided by your own feelings.
OK THE GHOICK OF A FAMILY FHYSICIAK. ' 241
Search for some plain man of sound common sense, who takes
great pains to ascertain the truth of all he hears and says, and
does not merely look to its passing muster, who knows how to
give clear and condensed information respecting everything that
belongs to his art, and never obtrudes his opinion unasked or
it an improper time, and who is no stranger to everything else
important for man as a citizen of the world to know. More
eepecially let the man you choose be one who does not shew
temper nor get angry, except when he beholds injustice, who
never turns away unmoved from any except flatterers, who has
but few friends but these men of sterling principle, who listens
tttentively to the complaints of those who seek his aid, and does
not pronounce an opinion without mature reflection, who pre-
•cribes but few, generally single, medicines in their natural state,
who keeps out of the way until he is sought for, who is not silent
respecting the merits of his colleagues, but does not praise him*
•elf; a fiiend to order, quiet and beneficence.
And when, my prince, you have found such a person, as is
not so very difficult now-a-days, no one will rejoice more than
Yours, &c.,
S. H.
P. S. One word more I Before you finally fix on him, see
how he behaves to tlie poor, and if he occupies himself at home
unseen with some useful work I
CONTENTS OF THB FRIEND OF HEALTH.
PART I.
Litroductioo 156
The bite of mad dogs 168
The visiter of the sick !•*
Protection against infection in epidemic diseases • • - ' 197
In old women's philosophy there is something good, did we know where
to find it IH
Things that spoil tlie air !*'•
TTiere is good even in hurtful things ..---- 180
Dietetic conversation with my brother, principally respecting the instinct of
the stomach -- 18S
An occasional purgative, surely that can do no harm t • - - 189
On making the body hardy !•!
PART II.
Socrates and Physon. On the worth of outward show ... 800
Plans for eradicating a malignant fever, in a letter to the Minister of Police 201
More particular directions on the same subject . . . > 206
Suggestions for the prevention of epidemics in general, especially in towns 211
On the satisfaction of our animal requirements in another than a medical
point of view 22t
A nursery 280
On the choice of a family physician 286
DESCRIPTION OF KLOCKENBRING
DURING HIS INSANITY.*
After having bpen for several years much occupied with the
treatment of diseases of the most tedious and desperate character
in genera], and with all sorts of venereal maladies, cache.\i8D|
hypochondriasis and insanity in particular, with the assistance of
the excellent reigning duke, I established three years ago a con-
valescent asylum for patients affected with such disorders, in
Oeorgenthal, near Gotha. Hither the privy secretary of the
chancery, Klockenbring, of Hanover, who lately died from the
efl^ts of a surgical operation iu the 53d year of his age, was
brought and placed under my care. He was a man who in his
days of health attracted the admiration of a large portion of
(Jennany by his practical talents for business and his profound
fagacity, as also by his knowledge of ancient and modern lore,
and his acquirements in various branches of science.
His almost superhuman labours in the department of state
police, for which he had a great talent, his constant sedentary
life, the continued strain upon his mind, together with a too nu-
tritious diet, had, five years before the mental alienation oc-
curred, brought on a deranged state of the system, which gra-
dually assumed the form of offensive whimsicality and intolera-
ble ill-humour; I am' unable to say how much his copious in-
dulgence in strong wines contributed to bring on this state.
His hypochondriasis had already attained a considerable
height when that most disgusting satire of a petulent and dege-
nerate wit, BartJi mit der eisemen Stirne^ appeared, wherein he
found himself held up to ridicule in a manner that would have
set even the coldest philosopher on fire. His mind, that was
almost too sensitive to honour and fair fame, sank deep into the
dust beneath this hail-storm of abusive accusations, which were,
for the most part, without foundation, and left it to his disordered
nervous system to complete the sad catastrophe.
In the winter of 1791-2, the most fearful furious madness
burst forth, that for half a year completely baffled all the most
* From the DeuUche Monatttehrift, February, 1796.
244 D£SCRIPTION OF KLOCKENBBma
assiduous treatment of one of the greatest physicians of our age,
Dr. Wichraann, physician to the Hanoverian court
He was brought to me towards the end of June, in a very
melancholy state accompanied by the strong keepers.
His bloated body, which in his days of health was somewhat
unwieldy, now exhibited a wondrous agility, quickness and flexi-
bility in all its movements. His face was covered with large
reddish-blue elevated spots, was dirty, and bore an expression
of the greatest mental aberration. Smiles and grinding of the
teeth, inconsiderateness and insolence, cowardice and defiance,
childish folly and unlimited pride, desires without want — such
was the admixture of traits displayed by the patient.
For the first fortnight I only observed him without treating
him medicinally.
Incessantly, day and night, he kept on raving, and was never
composed for a quarter of an hour at a time. When he sank
down exhausted on his bed, he rose to his feet again in a few
minutes. He either pronounced with the most threatening ges-
tures capital sentences on criminals, which he often declared his
former superiors to be; or he lost himself in declamations of a
heroic character, and spouted, as Agamemmon and Hector, entire
passages from the Iliad ; then he would whistle a popular song^
roll about on the grass, and sometimes vary his amusements by
singing a stanza from Pergolese's Stabat mater. Anon it would
occur to him to relate to his honest keeper, Jacob, the bargain
made by ancient Jacob with Esau, about the birth-right, in the
exact words of the Hebrew text ; but he finished nothing that
he began, for some new idea constantly led him into a diflferent
region ; thus he would sing an ode of Anacreon, or of the
Anthologia, to what he imagined to be an ancient Greek melody,
or he would burst forth in an agony of weeping and sobbing,
oft«n throwing himself at the feet of the amazed attendant. But
all at once he would often suddenly arise and with the most ex-
traordinary hideous roars, hurl imprecations at his enemies,
mingled with passages from Milton's Paradise Lost and Dante's
Itifemo ; or he would mutter a form of exorcism for evil spirits
in the Vandal tongue, point with any stick he could lay his hands
on to the four quarters of heaven, write magical characters on
the sand at his feet, make the sign of the cross, &c., and then he
would burst out into inmioderate fits of laughter, or recite an
amorous rhapsody from some play, and, in the fire of his de*
luded imagination, he would warmly embrace one of his cold
keepers, taking him for his beloved Daphne.
SURINa HIS INSANITY. 246
The most wonderful thiDg was the correctness with which he
delivered all the passages from writings in all languages that
ooconed to his memory, especially all that he had learnt in his
youth. The fEurago he uttered was certainly a proof of his
great acquirements in languages, but was at the same time a
kind of ostentatious display of learning, which shone through all
his extraordinary actions.
But nothing equalled the confidential friendship in which he
pretended he had lived with emperors and queens, the love a£.
fidrs he had had with princesses, his relationship to the highest
peraonages in the world, &c., of which he often talked under the
seal of the strictest confidence to his keepers, with laughably im-
portant gestures and half-whispered words.
In his worst period he called every one thou^ and would not
allow any one to address him otherwise.
When he was awake and alone he always kept talking to
himself.
If his oonversation was disordered, his other behaviour was
not less so.
In spite of all remonstrances he tore and hacked to pieces his
attiTe and his bed, generally when unobserved, with his fingers,
or with fragments of glass and the like.
Every instant he had some urgent desire, he wanted to eat or
to drink, or he wished for some article of dress, or some piece of
furniture, or a musical instrument, or some one of his private
friends, or tobacco, or something else, although at first aJl food
was rejected, laid aside, thrown out or dirtied, and in spite of his
rapid pulse and white tongue, all drink was put aside, ^ spilt,
mixed with all sorts of impurities, and at length poured out.
He never waited till he got one thing before ordering another.
By taking his piano to pieces and setting it together again in
an absurd manner, he endeavoured in the midst of the most tre-
mendous noise and the most absurd tricks, to discover the an-
cient complementary tone of harmony, the ir^«rA«iK««foV;T«f, he
drew up algebraic formulas for it, explained them and his im-
portant projects to his keepers, and day and night he was al-
ways exce^ngly busy.
At first he ran about and bellowed, mostly at night
He exhibited a great inclination to dress himself up, so as to
' At the wont period his Denroua system was so powerfully influenced by the initft-
lioQof his disordered imsginatioo, that 25 grains of tartar emetic onlj^cauied him
woaUj to voniii moderately fhree times, ■ometiiiiet eTeo lem frequentl/.
248 DESCBIFTION OF KLOCKENBRING
give himself an amazingly majestic or half heroic, half Merrj«
Andrew-like appearance. He painted his fece with variously
coloured dirt, fat and such-like things, curled his hair, drew up
his shirt collar and pulled down the rufHes of his shirt, scaroelj-
ever went without a wreath of hay, straw, flowers, or something
similar on his brow, never without a kind of girdle over his hip%
a pathognomonic sign that he felt gome disorder in the organs
seated there' that required attention ; but what kind of atten-
tion ? his instinctive somnambulic sensibility did not teach him
feo much.
But he once put my metaphysical learning fairly at iault, when
one evening, in the midst of the most extravagant paroxysm of
folly, he hastily called for pen, ink and paper, and though on
bther occasions he would not listen to anything about corporeal
diseases, he now wrote a prescription^ which he wished to he
made up immediately. The extraordinary ingredients of this
were so extremely well arranged and so admirably adapted to
the cure of an insanity of this sort, that for the moment I was
almost tempted to consider him a very well instructed physician,
had not the ridiculous direction he gave as to how it should be
used — namely, with a few bottles of burgundy as a vehicle, to
be followed up by lard — ^given another turn to my thoughts.
But how was it^ that in the midst of the very hurricane of its
most extravagant passion, his mastlcssand hclraless mind lighted
on a remedy so excellent for insanity and unknown to many
physicians ? How came he to prescrrbo it for himself in the
mos: appropriate form and dose?
• Scarcely less remarkable was the circumstance that in the
very worst period of his insanity he would, when asked, tell not
only the exact day of the month (that one could understand,
though he had not an almanac), but even the true hour by day
or by night with astonishing accuracy.
As he began to improve, this faculty of divination became
always more and more vague and uncertain, until at last, when
his reason was completely restored, he knew neither more nor
less about the matter than other people.
When he had completely recovered I begged him, in a friendly
manner, to explain this enigma to me, or at least to describe the
Sensation that used to teach him this knowledge.
' He never foii^ this appendage, even when he ran or rolled ahout naked,
•ometimee coold not be prevented.
* Hie oommenc^ment was : R. Sem, Datura^ gr. ij. ^
' He had DO aooe« to booka or writidgt of any iort
DURING HIST INBANITY. 247
I
*'I sliudder, and a cold chill comes all over me," he replied,
** when I think about it ; I must beg of you not to remind me
<yf this subject" And yet at that time he was able to talk with
perfect sang-froid about his whole previous madness.
The first and worst period of his insanity he described as a
deathlike state, and indicated the day on which he iblt as if he
awoke.
From time to time, especially when he commenced to improve,
he used to give me things that he had written, among which I oflen
found some subjects which must have cost him much profound
meditation. The chief part of these consisted of sonnets and
elegies in various languages upon his present state, or addressed
lo his friends, odes to God, to his king, to me, to my family, &c.
The language of these was usually correct, and they were inter-
spersed with quotations from the ancient poets and philosophers,
or the Bible, of which book, chapter and verse were given with
great accuracy, although, as I before remarked, he had not a
single book at his command.
Whilst he was still very ill he wrote his autobiography in
classical Latin, composing a portion each day, and although he
kept no copy he always resumed the thread of his tale exactly
where he had left off.
But all these prose essays, odes, romances, ballads, elegies, &c.^
though in themselves often irreproachable, always bctn\yed their
origin by something ludicrous about them. They were either
written on pieces of paper torn into a triunguUir form, or if on
square pieces tliey were written so that the lines ran obliquely
across the sheet, the writing commencing in one of the corners.
Or he drew various kinds of geometrical figures, in which he
childishly wrote in a small hand these compositions, which
sometimes consisted of the most sublime dithyrambics.
His w^him was to apply the triangular figure and the number
three wherever he could ; thus he folded his bed-clothes and
laid his pillow in a triangular manner, he disenchanted his drink,
his food and his clothes by spitting thrice, by makingthe sign of the
cross thrice, &c., and this folly he kept up partially until very near
the period when he had almost recovered his full reason, and in
every other respect could be perfectly well trusted by himself.
His propensity to compose verses^ was remarkable, and this
' He played very well on Uie flute, but even nftcr his reason had been considerably
restored I could not allow him to do so, uur yet to play the organ, which he did in
A most mantcrly style, as both of these instruments throw him into paroxjtamyt
S4d DltSCBIPTION OF KLOCKSNBBINa
waa especially the case when his reason was somewhat restored;
these chiefly consisted of popular songs conveying a moral lesaoiii
oombating popular prejudices, &c., illustrated by examples, many
of which were excellent^ in the style of ancient times. He set them.
them to simple appropriate melodies, in the same style, and often
sang them, accompanying himself on the piano, wUchhe played
with great skill.*
In the midst of all these sometimes very pleasing performanoes;
to which I did not in the least incite him, the rest of his beha-
viour, especially when one noticed him unseen, was very foolish,
adventurous, grotesque.
But I must do him the justice to say, that in all his oral and
written communications, and even when he was not observed,
both during the periods of his greatest insanity and afterwards,
he never shewed the slightest traces of any unbecoming behaviour
in regard to sexual morality, but very frequently the very reverse.
On this -point he was certainly no saint in the strict meaning of
the word, still he was much better than most men of the world
His body in this respect was in the most untainted and healthy
pondition ; he must have therefore felt all the more deeply the
calumnies that had been spread concerning him, and especially
the satire alluded to above.
Loyalty to his sovereign and affection for his family and for
some of his deceased friends, was perceptible through all the
stages of hLs malady.
Much as he loved^ and esteemed me, even in the height of
his madness, as also after his complete recovery, and though he
madness. Even during the height of his mania he was uncommoolj sensitive to
certain things. Althoogfa mj presence was always very agreeable and oonsolaloij
to him, yet he often begged me, especially when he was still considerably insane^ not
to put my hand on his arm or to touch his bare hand ; it went through his marrow
and bones, so he expressed himself, like an electric shock.
' I repeatedly requested him, when he was completely restored, to compose me a
small poem by way of a souvenir. He tried to do so, but was unable to produce aoy
thing tolerable, justas previoas tohis malady he had but little talent for making rhyBM.
* I never allow any insane person to be punished by blows or other painM
eorporeal inflictions, since there can be no punishment where there is no sense of
responsibility, and since such patients only deserve our pity and cannot be improved,
but must be rendered worse by such rough treatment He often however diewad
me with tears in his eyes the marks of the blows and stripes his former keepers had
employed to keep him in order. The physician of such imfortunato creatores oqghi
to behave so as to inspire them with respect and at the same time with confidence ;
he should never feel offended at what they do, for an irrational person can give ne
oflfence. The ejdiibition of their unreasooaUe anger should only ezdte his f ympatlqr
and alfannUtB his philaothropy to relieve their sad cooditioD.
BUBIKQ' HIS IK&UfnT. %t^
obliging and pleasant to every one after his recovery, yet
lie became malicious, deceitful and offensive as he was passing
horn the first state into the last, I mean when his reason was
just b^inning to dawn, when he was able to entertain himself
with visitors for half-hours at a time, and when he could behave
himself quite well as long as he was noticed. A most puzzling
phenomenon 1 This perverted state of the disposition, in which
head and heart seemed, so to speak, to have mutually lost their
equilibrium, was accompanied in a corresponding degree by an
astonishing canine hunger, or to speak more correctly, insatiable-
ness.' They both went away together gradually, when, under
the medicines used, health and reason were completely restored.
His friendship, which 1 enjoyed for two years after his comiT
plete restoration, has richly repaid me for these and thousanib
of other sad moments I passed on his account.
Before he quitted my establishment he shewed to the publioi
l^ his translation pf a statistical work of Arthur Young, his
ngeoerated intelligence in a very advantageous manner, and
after he quitted me, the government of his native land bestow(^
on him, in place of his former too toilsome office, the directiou
of the lottery, which he continued to hold till his death, whicli
was caused by a retention of urine.^
Peace be with his ashes I
ESSAY ON A NEW PEINCIPLE FOR ASCERTAINING
THE CURATIVE POWERS OF DRUGS,
WrrH A FEW GLANCES AT THOSE HITHERTO EMPLOYED**
At the commencement of this century, the unmerited honour
was conferred on chemistry, more especially by the Academy
of Sciences of Paris, of tempting it to come forward as the dis-
coverer of the medicinal virtues of drugs, particularly of plants.
They were subjected to the action of fire in retorts, generally
' He was not aatisfied with ten pounds of bread daily, besides other food. When
k» had reoorered his health he ate very nxxkrately, I might almost say extreaui^
Kttle.
* [Where among modem authors, can be found so clear and masterly a descriptioa
«f a case as this of Klockenbring I Surely not in any of the medical records of tha
Iflh century.]— ilm. P.
)60 suoGEsnoifs for ascsrtainiko
without water, and by this process there were obtained, fton
ihe most deadly as from the most innocent, yery much the sanq^
products, water, acids, resinous matters, charcoal, and from tfaJB
last, alkali ; always the same kind. Large sums of money weri
thus wasted on the destruction of plants, before it was perceived
that none of the important component parts of vegetables coold
be extracted by this fiery ordeal, &r less that any conclusioii
respecting their curative powers could be come to. This foily,
which was, with divers variations, perpetrated for nearly half a
century, gradually produced an unfavourable impression on die
minds of modem physicians, \frhich had been in the mean tim^
more enlightened respecting the chemical art and its limits, so
that they now almost unanimously adopted an opposite view^
and denied all value to chemistry in the search for the medicinal
powers of drugs, and in the discovery of remedial agents for the
diseases to which humanity is liable.
In this they palpably went too far. Although I am far from
conceding to the chemical art a universal influence on the ma-
teria medica, I cannot refrain from alluding to some notable
discoveries in this respect which we have to thank it for, and
to what it may hereafter efifect for therapeutics.
Chemistry informed the phyaiciau who sought a palliatiye
remedy for the evils occasioned by morbid acids in the sto-
mach, that the alkalis and some earths were their remedies. If it
was desired to destroy in the stomach poisonous matters which
had been swallowed, the physician applied to chemistry for the
antidotes that should speedily neutralize them, Ijefore they should
injure the alimentary canal and the whole organism. Chemistry
alone could tell him that the alkalis and soaj) were the antidotes
of acid poisons, of vitriol, of aquafortis, of arsenic, as well as of
-the poisonous metallic salts ; that the acids were the counter-
poisons of the alkalis, of quicklime, &e., and that for speedily
oounteracting the effects of all metallic j)oisons, sulphur, liver of
sulphur, but especially sulphuretted hydrogen, were effectuaL
It taught him to remove lead and tin from a cavity of the
body by living quicksilver, to dissolve iron that had been swal-
lowed by acids, and ingested glass and flint by fluoric and phos-
phoric acids, in the way it is seen to take place, with respect to
the last substance, in the stomach of fowls.
• Chemistry produced vital air in its purity, and when the
physiologist and clinical observer perceived its peculiar power
of maintaining and increasing the vital energy, chemistry showed
THK ousAnyx powbbs of drugs. 861
Aat a part of this power lay in the great specific caloric of this
sir, and furnished a supply of it, which neither the therapeutio
materia medica nor clinical experience could do, {rom many
different sources, in greater and greater purity.
Chemistry alone could supply a remedy for those suffocated
by fixed air, in the vapour of caustic ammonia.
What would the Galenic school have done in cases of suffo-
cation frora charcoal vapour, had chemistry not pointed out vital
air, the second component of atmospheric, as the proper thing
wherewith to inflate the lungs ?
Chemistry discovered a meanrf of destroying the remains of
poisons which had penetrated the system, by administering sul^^
phoretted hydrogen in drinks and baths.
What but chemistry taught us (with nitrous ether and acetate
of potash) how to dissolve those gall stones that often give rise
to so many most troublesome diseases?
For centuries, chemistry has been applied to by medicine for
a remedy fi)r stone in the bladder, and with what result? Those
that applied to it know best. It has at all events done some-
thing, since it has brought soda saturated with fixed air into
repute. A still better remedy will be found in the employment
of phosphoric acid.
Were not all sorts of medicinal agents applied to mammsB in
which the milk had curdled and caused pain? This was a
hopeless, fruitless way. Chemistry showed a true remedy in
fomentations of hartshorn, which renders curdled milk once
more fluid.
Chemical experimentation with Colombo root and morbid bile,
showed that that vegetable substance must be a remedy in de-
ranged biliary secretion in the human body, and medical expe-
rience has confirmed the accuracy of chemical induction.
Does the practitioner seek to know if a new remedy is of a
heating description ? Distillation with water, by showing the
presence or absence of an ethereal oil, will with few exceptions
BoiBce to jsolve the problem.
Practice cannot always tell by sensible signs if a vegetable
Bubstancc possess astringent properties. Chemistry discovers
that astringent principle, sometimes of no small use in practice,
ind even its degree, by means of sulphate of iron.
The science of dietetics alone cannot tell if a newly-discovered
plant possess anything nourishing in its composition. Chemistry
diows this, by separating its gluten and its starch, and can, fixmi
16t «0aOS8nONS fob ASOIBTAIKINa
the quantity of these ingredientSy determine the degree of iti
nutritive quality. ' ^
• Although chemistry cannot directly point out medicinal poweirSi
yet it can do this indirectly, by demonstrating the powerlessnen
of medicines, in themselves powerful, from being mixed; or the
noxious properties of mixtures of medicines, in themselves iai
nocuous. It forbids us, when we seek to produce vomiting by
means of tartar emetic, to add to it substances containing gallio
acid, by which it is decomposed ; it forbids us to drink lime
wa'er when we seek to obtain benefit from the astringent prin-
eiple of cinchona bark, by which it is destroyed ; it forbids us,
if we do not wish to produce ink, to mix bark and iron in the
same potion ; it forbids us to make the Goulard lotion powerles
by adding alum ; it forbids the mixture of an acid with those
laxative neutral salts having cream of tartar for their bases^
which remove acids from the primaB vi© ; it forbids us to render
poisonous, by admixture, those otherwise innocuous substanoeSi
diaphoretic antimony and cream of tartar; it prohibits the use
of vegetable acids during a milk diet, (whereby an insoluble
curd would be formed,) and when acids are required for diget*
tion, it points to the vitriolic acid.
It furnishes the tests for detecting the adulteration of remedieSi
extracts the deadly corrosive sublimate from calomel, and teaches
the difference betwixt the latter and the poisonous white preci-
pitate which it so closely resembles.
These few examples may suffice to show that chemistry cannot
be excluded from a share in the discovery of the medicinal powers
of drugs. But that chemistry should not be consulted with respect
to those medicinal powers which relate, not to hurtful substanoes
to be acted on immediately in the human body, but to change!
wherein the functions of the animal organism are first conoemed|
is proved, inter alia, by the experiments with antiseptic substanoeSi
respecting which, it was imagined that they would exhibit ex-
actly the same antiputrefactive power in the fluids of the body,
as they did in the chemical phial. But experience showed f^^
saltpetre, for instance, which out of the body is so highly anti-
septic, shows exactly opposite qualities in putrid fever and in
tendency to gangrene ; the reason of which, I may mention^
though out of place here, is, that it weakens the vital powers.
Or shall we seek to correct the putrefiatction of matters in the
etomach with saltpetre ? An emetic will remove them at onoe.
. Still wone for the materia medica was the advioe of thoee wbo
THS OXTBATiyS POtnERS OT DBUGS. 258
sought to asoertain the medicinal powers of its various agentSi
bjf mixing the unknown drug unth newly-drawn bloody in order to
see whether the blood grew darker or lighter, thinner or thicker;
just as if we could bring the drug into the same immediate coor
lact with the blood in the artery, as we can in the test-tube ;
just as if the drug must not first undergo an infinity of changes
in the digestive canal, before it can get (and that only by a most
drcuitous method) into the blood. What a variety of appear-
ances does not the blood itself present when drawn from the
vein, according as it is taken from a heated or a cool body, by
a smaller or larger opening, in a full stream or by drops, in a
oold or warm room, in a fiat or a narrow vessel.
But such paltry modes of ascertaining the powers of medicines
bear on their face the stamp of their worthlessness.
Even the injection of drugs into tfie bloodvessels of animals is
for the same reason a very heterogeneous and uncertain method.
To mention only one circumstance, — a teaspoon full of concen-
trated cherrylaurel-water will most certainly kill a rabbit, when
tskea into the stomach, whereas, if injected into the jugular
vein, it causes no change, the animal remains lively and well.
Bat at all events, some will say, the adminstration of drug$
A^ animdb by the mouth will furnish some certain results respect-
ing their medicinal action. By no means I How greatly do their
bodies diflTer from ours I A pig can swallow a large quantity
of nux vomica without injury, and yet men have been killed
with fifteen grains. A dog bore an ounce of the fresh leaves^
flowers, and seeds of monkshood ; what man would not have
died of such a dose ? Horses eat it, when dried, without injury.
Yew leaves, though so fatal to man, fatten some of our domestic
animals. And how can we draw conclusions relative to the
action of medicines on man, from their effects on the lower
animals, when even among the latter they often vary so much ?
The stomach of a wolf poisoned with monkshood was foimd
inflamed, but not that of a large and a small cat, poisoned by
the same substance. What can we infer from this ? Certainly,
not much, if I may not say, nothing. Thus much, at least, is
oertain, that the fine internal changes and sensations, which a
man can express by words, must be totally wanting in the
knrer animals.
In order to try if a substance can develope very violent or
dangerous effects, this may in general be readily ascertained by
experiments on several animals at once, as likewise any general
164 8U0GSSTI0NS FOB ASCEB^AINnm
manifest action on the motions of the limbs, variations of tem>
peratnre, evacuations upwards and downwards, and the like, but
never anyihing connected or decisive, that may influence our
conclusions with regard to the proper curative virtues of the
agent on the human subject. For this, such experiments are
too obscure, too rude, and if I be allowed the expression, too
awkward.
As the above-mentioned sources for ascertaining the medicinal
virtues of drugs were so soon exhausted, the systematizer of tho
materia medica bethought himself of others, which he deemed
of a more certain character. He sought for them in the drugi
themselves ; he imagined he would find in them hints for his
guidance. He did not observe, however, that their sensibU
external signs are often very deceptive, as deceptive as the phy-
siognomy is in indicating the thoughts of the heart
Lurid-coloured plants are by no means always poisonous;
and on the other hand, an agreeable colour of the flowers is far
from being any proof of the harmlessness of the plant The
special qualities of drugs, which may be ascertained by the
smell and the taste, will not allow us to form any trustworthy con-
clusions respecting untried substances. I am far from denying
utility to both these senses in corroborating the probable pro-
perties of drugs which have been ascertained in other ways, but
I would counsel, on the other hand, great caution to those who
would form their judgment from them alone. If the bitter
principle strengthens the stomach, why does squill weaken it 7
If bitter aromatic substances are heating, why does marsh rose-
mary diminish the vital temperature in such a marked manner?
If those plants only are astringent that make ink with sulphate
of iron, how is it that the highly astringent principle in quinces^
medlars, &c., cannot furnish ink ?
K the astringent taste gives evidence of a strengthening sub-
stance, why does sulphate of zinc excite vomiting? If the acids
are antiseptic, why does arsenious acid produce such rapid
putrefaction in the body of one poisoned by it ? Is the sweet
taste of sugar of lead a sign of its nutritive properties? If the
volatile oils, and everything that tastes fiery on the tongue, are
heating for the blood, why are either, camphor, cajeput oil, oil
of peppermint, and the volatile oil of bitter almonds and cherry^
laurel, the very reverse ? If we are to expect a disagreeable
odour in poisonous plants, how is it so inoosiderable in monks-
hood, deadly nightshade, and foxglove ? why so imperoeptible
THX CURATIVX FOWSB8 OF DBUOS. 26B
m nox vomica and gamboge 7 If we are to look for a disagree*
able taste in poisonous plants, why is the most deadly juice of
the root of jcUropha manihot merely sweetish, and not the least
acrid? If the expressed fatty oils are often emollient, does it
follow that they are aU so, even the inflammatory oil expressed
irom the seeds of the jalropha curcas ? Are substances which
have litUe or no smell or taste destitute of medicinal powers?
How is that ipccacuan, tartar emetic, the poison of vipers, ni-
trogen, and lopez-root, are not so? Who would use bryony-
root as an article of diet, on the ground that it contains much
starch?
Poi haps, however, botanical affinity may allow us to infer a
rimilarity of action ? This is far from being the case, as there
are many examples of opposite, or at least very different pow-
ers, in one and the same family of plants, and that in most oi
them. We shall take as a basis the most perfect natural system^
that of Murray.
In the family of the caniferoe^ the inner bark of the fir-tree
{pinus sylvestris) gives to the inhabitants of northern regions a
kind of bread, whereas the bark of the yew-tree (taocus baccifera)
gives — death. How come the feverfew {anlhemis pyrethrum^
with its burning root, the poisonous cooling lettuce lactuca vtro-
m\ the emetic groundsel {senecio vulgaris)^ the mild scorzoner%
the innocuous cudweed {jnaphalium arenarium), the heroic ar-
nica (a. montana), all together in the one family of the compo^
mkel Has the purging globularia alypum anything in common
with the powerless statice^ both being in the family of the aggre-
gatae / Is there any similarity to be expected betwixt the action
of the skirret root (sium sisarum) and that of the poisonous
water-drop wort {cenanthe crocata), or of tie water-hemlock {cicur
ia virosa)j because they are in the same family of the umbelli'
ferce ? Has the not harmless ivy (hedera }ielix\ in the family
hederaceoe^ any other resemblance to the vine {vilus vinifera)^ ex-
cept in the outward growth ? How comes the harmless butcher's-
broom {ruscus) in the same family of the sarmeniacece with the
stupifying cocculus [raenispermum coccuhis\ the heating aristo-
lochia, and the dsarum europceum ? Do we expect any similari-
ty of effect from the goose-grass (jalium aparine) and the often
deadly spigeUa marylandica, because they both belong to the
itaUatce ? What resemblance can we find betwixt the action of
the melon {cucumis melo) and the elaterium (momordica elaterium)^
in the same &mily of the cucurbitacecB t And again, in the
266 -BVOQEaciosawoB AaoEBTAJJsmfQ
SBOxdly solanacea^ how comes the tasteless great mullein {verba$-^
(Bum ihapsus\ along with the burning Cayenne p^per {capri-
turn annuum) ; or tobacx^, which has such a poweri'ul spaamr
exciting action on the primss viae, with nux vomica, which inL-
pedes the natural motions of the intestines? Who would cosi-
pare the unmedicinal perriwinkle {vinca pervinca) with the sto-
pifying oleander {nerium okander)^ in the £Banily contarke f Does
the lY&tery moneyvrort (lysimachia nummulafna) act similarly to
the marsh trefoil {menyanthes iri/oliata), or the powerless cow-
slip {primtda veris), to the drastic sowbread (cyclamen euro-
pceum), in the family of the rutacece f From the strengthening
effects of the bear-berry {arbutus uva ursi) on the urinary ap-
paratus, can we infer the heating, stupifying acti6n of the rho^
dodendron chrysanthum^ in the family hicomest Among the
verticillatoBj can any comparison be made betwixt the scarcely as*
tringent self-heal (prunella vulgaris) or the innocent bugle {ajuga
pyramidalis)j and the volatile germander {teucrium marutn)^ or
the fiery majoram {origanum creticum)f How can the powers
of the verbena {v. officinalis) be said to resemble those of the
active hyssop (gratiola officinalis) in the family personatae f How
different are the actions of the glycyrrhiza and geoffroya, althou^
in the same family of the papUionaceoe I In the fiimily of the
lomentacece^ what parallel exists betwixt the properties of the
oeratonia silliqua and those of the fumatory {fumaria officinalis)^
ef tlcLG polygala senega and the Peruvian balsam {myroan/lon pe*
ruiferum) ? Or is there any likeness in properties amongst the
nigeUa saiiva^ the garden rue {rata graveokns), the peony {pasonia
offficinalis\ and the ccllery-lcaved crowfoot {ranunculus scelera*
tus), although one and all are in the family of the muUis^iliquce f
The dropwort {spiroea filipendula) and the tormentil {tormentiUa
erecta) are united in the fiimily seyiticoscPj and yet how different
in properties ! The red currant {ribes rubrum\ and the cherry-
laurel {prunus laurocerasus), the rowan {sorbus aucuparia), and
the peach {amygdalus pirsica)j how different in powers, and yet
in the same family of the pomacece I The family succutenim
unites the wall-pepper {sedum ojcre) and the portulaca oleracea^
certainly not because they resemble each other in effects 1 How
is it that the stork's-bill and the purging-flax {linum catfiarticum\
the sorrel {oxalis aceiosdla)^ and the quassia {q. amara\ are in
the same fistmily ? Certainly not because their powers are simi-
lar I How various are the medicinal properties of all the mem'^
Wrs of the &mily ascyroideael and of these of the dumosce I and
TBM CURATIVK POWBB OF DRUQB. 2ST
of those of the trihibUoe I Id the family tricoccce^ what has th^
oorrofiiye sparge (euphorbia officinalis) in common with the box
(jktxua sempervirens), which has such a decided influence on the
nervous system? The tasteless rupture- wort {hemiaria glabra\
the acrid phytolouxa decandra^ the refreshing goosefoot {chenop^
dium ambrosioide$)j and the biting persicaria {polygonum hydros
fiper\ what a motley company in the femily oleraceas I Hoir
dissimilar in action are the scabridcB I What business has the
Biild, slimy, white lily {lilium candidum) beside the garlic {allium
9iUivum)j or the squill {scilla mariiima) ; what the asparagus (cl
officinalis) beside the poisonous white hellebore {vercUrum alburn)^
in the &mily liUaceoR f
I am fiur from denying, however, the many important hinti
the natural system may afford to the philosophical student of
the materia medica and to him who feels it his duty to discover
new medicinal agents; but these hints can only help to confirm
and serve as a commentary to facts already known, or in ihm
case of untried plants they may give rise to hypothetical con-
jectures, which are, however, far from approaching even to
probability.
But how can a perfect similarity of action be expected
amongst groups of plants, which are only arranged in the so-
called natural system, on account of often slight external simi-
larity, when even plants tliat are much more nearly connected,
plants of one and the same genus, arc sometimes so different in
their medicinal effects. Examples of this are seen in the spe-
cies of the genera impatiens, serapias, cystmis^ ranunculus^ cakh
muSj hibiscus^ prunus^ sedum^ cassia^ polygonum^ convaUaricL
Unum^ rhus, scseli^ coriandrum^ aithnsa^ sium, angelica^ cheno-
podium^ asclepias, solanum^ lolium^ allium^ rhamnus, arnygdalusL
rubuSj delphinium^ sisymbrium^ polygala^ teucrium^ vaccinium^
cucumiSj apium, pimpinella^ aneUium^ seandia^ Valeriana^ ary-
themisj artemisia^ ccntaurea, juniperus, brassica. What a differ-
cnce betwixt the tasteless tinder amadou {bolatus igniarius) and
the bitter, drastic boletus laricis ; betwixt the mushroom {agari-
cus deliciosus) and the agaric {agaricus muscarius) ; betwixt the
woody stone moss {lichen saxatilis) and the powerful Iceland
moss {lichen Islandicus I)
Though I readily admit that, in general, similarity of action
will be much oflener met with betwixt species of one genu^
than betwixt whole groups of families in the natural system.
and that an inference drawn from the former will have a muoli
17
1^ SUGGESTIONS FOR ASGSBTAININ0
greater degree of probability attaching to it, than one from the
Ijitter; yet my conviction compels me to give this warnings
that, be the number of genera ever 80 many whose species jej
semble each other very much in their eifects, the lesser number
of very dilTerently acting species should make us distrustful of
this mode of drawing inferences, since we have not here to do
with mechanical experiments, but that most important and dif^
ficult concern of mankind — health.'
As regards this method also, therefore, we come to the con-
clusion, that it cannot be considered as a sure principle to guida
us to the knowledge of the medicinal powers of plants.
Nothing remains for us but expeninent on the human body.
Put what kind of experiment ? Accidental or meihodicalt
The humiliating confession must be made, that most of the
virtues of medicinal bodies were discovered by accidental, empin
rical experience, by chance ; often first observed by non-medi*
qal persons. Bold, often over-bold, physicians, then gradually
made trial of them. •
I have no intention of denying the high value of this mode^
of discovering medicinal powers— it speaks for itself. But in it
t^ere is nothing for us to do ; chance excludes all method, all
voluntary action. Sad is the thought, that the noblest, the
most indispensable of arts, is built upon accident, which always,
pre-supposes the endangering of many human lives. Will the
chance of such discoveries suflBce to perfect the healing art, to
supply its numerous desiderata ? From year to year we become
acquainted with new diseases, with new phases and new com-
plicatipns of diseases, with new morbid conditions ; if, then^ we
possess no better method of discovering the remedial agents
around us than chance allows, nought remains for us to do but
to treat these diseases with general (I might often wish with no)
I'eraedies, or with such as have seemed to be of service, in what
we imagine, or what appear to us to be, similar diseased states.
l^ixt how oft«n shall we fail in accomplishing our object, for if
there be any difference, the disease cannot be the same I Sadly
*■ — ■ — I ■ ■ »
•
' ' CkmclusioDs relatiTe to umilAiity of action {betwixt species of a geDus beooM
§lXIX more hazardous, when we consider that one and the same species, one and tbt
■ame plant, frequenUy shows very various medicinal powers in its diffemit paiiik
How different the poppy head from Uie poppy seed ; the manna that distils from tlM
leaves of the larch from the turpentine of the same tree ; the coolii^ camphor in thi
fpot of the cinnamon laurel, from the burning cbnamon oil ; the astringent juice i^
t^ fruit of several of the mimose, from the tasteless gum that exudes from .tlHil
^ip ; the oorrotiTe stalk of the ranunciilus from its mild root I
TXX OURATIVS FOWEBS OF DRUGS. 260
we look forward into future ages, when a peculiar remedy for
this particular form of disease, for this particular circumstance^
may, perhaps^ be discovered by chance, as was bark for pure
Hitermittent fever, or mercury for^syphilitic disorders.
Such a precarious construction of the most important science
— ^resembling the concourse of Epicurian atoms to make 9
world — could never be the will of the wise and most bountiful
Preserver of mankind How humiliating for proud humanity^
did his very preservation depend on chance alone. No! it is
exhilarating to believe that for each particular disease, for each
peculiar morbid variety, there arc peculiar directly -acting rem^
dies, and that there is also a way in which these may be tne-
ihodiraUy discovered.
When I talk of the methodical discovery of the medicinal potaer$
9tiU required by u$^ I do not refer to those empirical trials
usually made in hospitals, where in a difficult, often not accu-
nitely noted case, in which tliose already known do no good,
recourse is had to some drug, hitherto either untried altog^ther^
or untried in this particular affection, which drug is fixed upon
either from caprice and blind fancy, or from some obscure no»
tion, for which the experimenter can give no plausible reason,
either to himself or to others. Such empirical chance trials are,
to call them by the mildest appellation, but foolish risks, if not
something worse.
I speak not here, either, of the somewhat more rational trials,
made occasionally in private and hospital practice, with reme-
dies casually recommended in this or that disease, but not fur-
ther tested. These, also, arc performed, unless under the gui-
dance of some scientific principle, to a certain degree at the
peril of the health and life of the patient ; but the caution and
practical skill of the physician will often avail to smooth much
that is uneven in his half-empirical undertakings.
As we already possess a large number of medicines, which
are evidently powerful, but concerning which we do not rightly
know what diseases they arc capable of curing, and moreover,
otbeis which have sometimes proved serviceable, sometimes
not, in given diseases, and concerning which we have no accu-
rate knowledge of the exact circumstances under which they
are applicable, it may not at first sight appear very necessary to
increase the number of our medicinal agents. Very probably
all (or nearly all) the aid we seek lies in those we already
MO ^SrOGESTIONS FOB ASCEBTjClNINa
. Before I explain myself further, I must, in order to prevenj^
misapprehension, distinctly declare that I do not expect, and
do not believe, there can be a thoroughly specific remedy for
any disease, of such and such a name, burdened with all the
ramifications, concomitant affections and variations, which, in
pathological works, are so often inconsiderately detailed as
essential to its character, as invariably pertaining to it It is
only the very great simplicity and constancy of ague and
syphilis that permitted remedies to be found for them, which
appeared to many physicians to have specific qualities ; for the
variations in these diseases occur much more seldom, and are
usually much less important than in others, consequently bark
and mercury must be much more often serviceable than not so.
But neither is bark specific in ague, in the most extended sense
ot the term,* nor mercury in syphilis, in its most extended
sense; they are, however, probably specific in both diseases,
when they occur simple, pure, and free from all complication.
Our great and intelligent observers of disease have seen the
truth of this too well, to require that I should dwell longer on
this subject.
Nqw, when I entirely deny that there are any absolute spe*
cifics for individual diseases, in their full extent, as they are
described in ordinary works on pathology,^ I am, on the other
* Pity it is, that it was not observed wht/, for example, of the seven-fifteenths of all
the so-called agues in which bark was aseless, three-fift«cnths required nux vonuoi
or bitter almonds, another fifteenth opium, another fifteenth blood-letting, and still
another fiftcentli small doses of ipecacuan, for their cure ! It was thought sufficient
to say, " Bark was of no use, but ignatia cured ;" the tr Ay was never satisiactoril/
answered. Were it a case of pure ague, bark must be of service ; where there were
eomplications, with excessive irritability, especially of the primss viae, however, it
was no longer a pure case of ague, and it could not do good ; here were now reotoiu
ibr choosing as a remedy, or as an auxiliary means, ignatia, nux vomica, or bitter
almonds, according to the different conditions of the system ; and it could not and
should not have been wondered at, tliat bark was not useful.
' The liistory of diseases is not yet advanced so far that we have been at pains to
■eparate the essential from the accidental, the peculiar from tlie adventitioufl^ tlia
foreign admixture, owing to idiosyncrasy, mode of life, passions, epidemic constitn-
tioDs, and many other circumstances. When reading the description of one diseaae^
we might often imagine it was a compound admixture of many histories of
with suppression of the name, place, time, Ac, and not true, abstractedly pure,
ted characteristics of a disease separated from the accidental (which might be altar-
wards appended to it, as it were). The more recent nosologists have attempted to
do this: their genera should be what I call the peculiar characteristics of each dii
ease, their s|>ecie3 the accidental circumstances.
Before all things, we have to attend to the chief disease ; its divergencies and
eomitaot drcumstancea only domand particular aid when Uiej are aerioua^ or
THE CURATIVS POWERS OF DRXTOa tdi
band, convinced that there are as many specifics as there are
different states of individual diseases, t. e., that there are peculiar
q)ecifics for the pure disease, and others for its varieties, and
for (ther abnormal states of the system.
If I mistake not, practical medicine has devised three ways
of applying remedies for the relief of the disorders of the hu-
man bcxly.
The first tvay, to remove or destroy the fundamental caiLse of the
disease^ was the most elevated it could follow. All the imagin-
ings and aspirations of the best physicians in all ages were
directed to this object, the most worthy of the dignity of our art
But, to use a Spagyrian expression, they did not advance be-
yond particulars ; the great philosopher's stone, the knowledge
of the fundamental cause of all diseiises, they never attained Jto.
And as regards most diseases, it will remain for ever concealed
from human weakness. In the mean time, what could be ascer-
tained respecting this point, from the experience of all agea^
was united in a general system of therapeutics. Thus, in cases
of chronic spasms of the stomach, the general weakness of
the system was first removed ; the convulsions arising from tape-
worm were conquered by killing that animal ; the fever arising
from noxious matters in the stomach was dissipated by power-
fid emetics ; in diseases caused by a chill the suppressed perspi-
ration was restored ; and the ball was extracted that gave rise to
traumatic fever. This object is above all criticism, though the
means employed were not always the fittest for attaining it. I
shall now take leave of this royal road, and examine the other
two ways for appl3'ing medicines.
By the second way^ the symptoms present were sought to be
removed by medicines which j>roduced an opposite condition ; for
example, constipation by purgatives; inflamed blood by vene-
section, cold and nitre ; acidity in the stomach by alkalis : pains
by opium. In acute diseases, wliicS, if we remove the obsta-
cles 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
•bdUcles to recover? ; they demand c»ur chief attention, and the primary disease
may be less reg:irded, when the latter, by passing into the dironic state, has become
•f lew importance, and is less urgent, whilst the former has graduaUy become the
dirf dtaease.
30S suoGEarioNs fob AacEBTAjjsnjsa
each disease, aud the means of its removal,) or as long as we
havo no rapidly-acdng specific, which would extinguish the var-
riolous infection, for instance, at its very commencement In this
case, I would call such remedies temporary,
, But if the fundamental cause of the disease, and its direct
means of removal are known, and we, disregarding these, com*
bat the symptoms only by remedies of this second kind, or
employ them seriously in chronic diseases, then this method
of treatment (to oppose diseases by remedies that produce aa
opposite slate) gets the name of palliative^ and is to be reprobat-
ed. In chronic diseases it only gives relief at first ; subse-
quently, stronger doses of such remedies become necessary,
which cannot remove the primary disease, and thus they do
mQre harm the longer they are employed, for reasons to be spe-
cified hereafter.
I know very well that habitual constipation is still attempted
i/o be cured by aloetic purgatives and laxative salts, but with
what melancholy results! I J^now well that efforts are still
made to subdue the chronic determination of blood of hysteiical,
cachetic, and hypochondriacal individuals, by repeated, al^
though small venesections, nitre, and the like ; but with what
untoward consequences I Persons living a sedentary life, with
chronic stomachic ailments, accompanied by sour eructations, are
still advised to take repeatedly Glauber salts ; but with what
disastrous effects ! Chronic pains of all kinds are still sought to
be removed by the continued use of opium ; but again, with
what sad results I And although the great majority of my
medical brethren still adhere to this method, I do not fear to
call it palliative, injurious, and destructive.
I beseech my colleagues to abandon this method {contraria
contrariis) in chronic diseases, and in such acute diseases as take
on a chronic character ; it is the deceitful by-path in the dark
forest that leads to the fatal swamp. The vain empiric imagines
it to be the beaten highway, and plumes himself on the wretch-
ed power of giving a few hours' ease, unconcerned if, during
this sjxjcious calm, the disease plants 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 t/iird loay) for chronic
diseases, and acute diseases tending to chronic, which should
not cloak the symptoms, but which should remove the disease
radically, in one word, for specijic remedies ; the most desirable.
THE CHBATiyS POWERS OF BBUGS. 86^
most praiseworthy undertaking that can be imagined. Thufl^
for instance, they tried arnica in dysentery, and in some in-
stances found it a useful specific.
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 whicli
these substances were accidentally found useful in this or that
disease, often only in peculiar unmentioncd combinations, whicli
might perhaps never again occur; sometimes in pure, simple
diseases.
It were deplorable, indeed, if only chance and empirical
apropos 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. We have seen, that
for this object the aid of chemistry is still imperfect, and must
only be resorted to with caution ; that the similarity of genera
of plants in the natural system, as also the similarity of species
of one genus, give but obscure hints ; that the sensible proper-
ties of drugs teach us mere generalities, and these invalidated by
many exceptions ; that the changes that take place in the blood
from the admixture of medicines teach nothing ; and that the
injection of the latter into the bloodvessels of animals, as also
the effects on animals to which medicines have been administered,
is much too rude a mode of proceeding, to enable us therefrom
to judge of the finer actions of remedies.
Nothing tlien remains but to test the medicines we vnsh to investi-
gate on the human body itself. The necessity of this has been
perceived in all ages, but a false way was generally followed, in^
asmuch as they were, as above stated, only employed empirically
and capriciously in diseases. The reaction of tlie diseased or-
gacism, however, to an untested or imperfectly tested remedy,
gives such intricate results, that their appreciation is impossible
for the most acute physician. Either nothing happens, or there
occur aggravations, changes, amelioration, recovery, death— r
without the possibility of the greatest practical genius being able
todivine what part the diseased organism, and what the remedy
pn a dose, perchance, too great, moderate, or too small) played
in efifecting the result. They teach nothing, and only lead to
IM SUGOESTIONS FOB ASCSBTAINIKe
iilae conclusions. The everyday physicians held their tongaea
about any harm that ensued, they indicated with one word only
the name of the disease, which they often confounded with ano-
ther, in which this or that remedy appeared to do good, and
tiiuswere composed the useless and dangerous works of Schro-
der, Eutty, Zorn, Chomel, Pomet, &c., in whose thick books are
to be found a monstrous number of mostly powerless medicineSi
each of which is said to have cured radically this and at least
ten or twenty other diseases.*
The true physician, whose sole aim is to perfect his art, can
avail himself of no other information respecting medicinea,
than —
First — What is the pure action of each by itself on the human
hody?
Second — Wfiat do ohservations of its action in this or that simple
or complex disease teach us f
The last object is partly obtained in the practical writings of
liie best observers of all ages, but more especially of later timea
Throughout these, the, as yet, only source of the real knowledge
of the powers of drugs in diseases is scattered : there we find it
fiiithfully reLated, how the simplest drugs were employed in ao
curately described cases, how far they proved serviceable, and
how far they were hurtful or less beneficial. Would to God
iuch relations were more numerous 1
But ev^en among them contradictions so often occur, one con-
demning in a certain case what another found of use in a similar
ease, that one cannot but remark that we still require some natu-
ral normal standard, whereby we may be enabled to judge of
the value and degree of truth of their observations.
This standard, methinks, can only be derived from the effeots
that a given medicinal substance has, by i self in this and that
dose developed in the healthy human body.
To this belong the histories of designedly or accidentally
swallowed medicines and poisons, and such as have been pur-
posely taken by persons, in order to test them ; or which have
been given to healthy individuals, to criminals, &c. ; probably^
' To me, the strangest circumstance connected with tliesc specubititms upon the
▼irtues of single drugs is, that in the days of these men, tlie habit that still ul
in medicine, of joining together several different medicines in one prescription,
carried to such an extent, that I defy CEdipus himf^elf to tell what was tlie exact ae*
tlon of a single ingredient of the hotch potcli ; the prescription of a single remedy
ai a time was in those days almoMt rarer than it is nowadays. How was it posribl*
ii vueh a complicated practice, to distinguish the powers of individual medicines t
tHB GURATITE POWEBS OF DRUGS. 266
also, those cases in which an improper powerfully acting sub-
stance has been employed as a household remedy or medicine, in
slight or easily determined diseases.
A complete collection of such observations, with remarks on
the degree of reliance to be placed on their reporters, would, if
I mistake not, be the foundation stone of a materia medica, the
sacred book of its revelation.
In them alone can the true nature, the real action of medici-
nal substances be metliodically discovered ; from them alone can
we learn in what eases of dis.-ase they may be employed with
Bucces.s and certainty.
But as the key for this is still wanting, perhaps I am so fortu-
nate as to be able to point out the principle, under the guidance
of which the lacunae in medicine may be filled up, and the sci-
ence perfected by the gradual discovery and application, on ra-
tional principk^^ of a suitable specific' remedy for each, more es-
pecially for each chronic disease, among the hitherto known
(and among still unknown) medicines. It is contained, I may
Bay, in the following axioms.
Eoery powerful medicinal suhstance produces in the human body
a kind of peculiar disease ; tiie more powerful tJie medicine^ the more
peculiar^ marked^ and violent tfie disease,'^
We should imitate nature^ which sometimes cures a chronic
disease by superadding another, and employ in the (especially
chronic) disease ice wish to cure^ that medicine which is able to pro-
duce anotlier very similar artificial disease^ and the former will be
cured ; similia similibus.
We only require to know, on the one hand, the diseases of the
human frame accuratelv in their essential characteristics, and
their accidental complications ; and on the other hand, the pure
eflfects of drugs, that is, the essential characteristics of the spe-
cific artificial disease they usually excite, together with the ac-
cidental symptoms caused by diftercnce of dose, form, &c., and
hy 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 obstinate diseases.^
' In this Essay my cbief object i3 t<» discover a permanently acting specific remedy
fcr (especially) chronic diseases. Those remedies which remove the fundamental
caofte. and the temponiry acting remedies for acute disteases which in some cases re-
cove the name of palliiitive modicines, I shall not touch on at present
' * Non-meilical |)eople c:dl those medicine:* w^hich produce the most powerful spe-
cific di<<eaM8, and whicii therefore are actually the most serviceable pouon*.
* Hie cautious physician, who will go gradually to work, giTOs the ordinsi7
266 SUGGESTIONS FOR ASC£RTAINnr€(
This axiom has, I confess, so much the appearance of a barren,
analytical, general formula, that I must hasten to illustrate it
synthetically. But first let me call to mind a few points.
I. Most medicines have more than one action ; the first a cK-
rect 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.
II. But few medicines are exceptions to this rule, continuing
their primary action uninterruptedly, 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, mercury, lead.
III. If, in a case of chronic disease, a medicine be given,
whose direct primary action corresponds to the disease, the indi-
rect secondary action is sometimes exactly the state of body
Sought to be brough about ; but sometimes, (especially when a
wrong dose has been given) there occurs in the secondary action
a derangement for some hours, seldom days. A somewhat too
large dose of henbane is. apt to cause, in its secondary action,
great fearfulness ; a derangement tliat sometimes lasts several
hours. If it is troublesome, and we wish to diminish its dura-
tion, a small dose of opium affords specifically almost immedi-
ate relief; the fear goes off. Oj)ium, indeed, in this case, acts
only antagonistically, and as a palliative ; but only a palliative
and temporary remedy is required, in order to suppress effectu-
ally a transitory affection, as is also the case in acute diseases.
rcinedv only in such a (iose as will scarcely perceptibly developc the expected aiti*
ficiul disease, (for it acts by virtue of its power to produce such an artificial disease,)
and gradually increases the dose, so that he may be sure that the intended internal
changes in the organism are produced wiUi sufficient force, although with phonomena
vastly inferior in intensity to the symptoms of the natural disease; thus a mild and
certain cure will be effected. But if it is sought to go rapidly to work, with the oth-
enn'ise fit and properly chosen remedy, the object may be certainly attained in this
iray too, though with some danger to life, as is often done in a rude manner bj
quacks among the peasant^ and which they call miraculous, or horse curesi, a
disease of many years* standing being thenthy cui*ed in a few days ; a proceeding
that testifies to the truth of my principle, while at the same time it shows the haatfd-
ous nature of this mode of effecting it
' Opium may serve as an example. A fearless elevation of spirit, a sensation of
strength and high courage, an imaginative gaiety, arc part of the direct primary ao
lion of a moderate doiie on the system : but after the lapse of eight or twelve honn
an opposite state sets in, the indirect secondary action ; there ensue relaxation, dejeo-
tion, difiidence, peevLihness, loss of memory, discomfort^ fear.
THB CUBATIYS POWEfiS OF DRUGS. 267
ly. Palliative remedies do so much harm iD chronic diseases,
and render them more obstinate, probably because after their
first antagonistic action they are followed by a secondary action,
which is similar to the disease itsel£
V. The more numerous the morbid symptoms the medicine
produces in its direct action, corresponding to the symptoms of
the disease to be cured, the nearer the artificial disease resem-
bles that sought to be removed, so much more certain to be
&vourable will the result of its administration be.
VL As it may be almost considered an axiom, that the symp-
toms of the secondary action are the exact opjx)site of those of
the direct action, it is allowable for a mas:er ojtlie art, when the
knowledge of the symptoms of the direct action is imperfect, to
supply in imagination the lacuna) by induction, i. e, the oppo-
site of the symptoms of the secondary action ; the result, how-
ever, must only be considered as an addition to, not as the basis
of^ his conclusions.
After these preliminary observations, I now proceed to illus'
treUe by examples my maxim, that in order to discover the true
remedial poioerg of a medicine for chronic diseases^ ive must look to
the specif artificial disease it can develope in tlie human boily, and
emplot/ it in a very similar morbid condition of die organism which
ii is wished to remove.
The analogous maxira, that in order to cure radically certain
Aronic diseases j we must search for medicines iliat can excite a
similar disease {tlie more similar the Letter) in the human body —
will thereby almost become evident.
In m}' additions to Cullen's Materia Mcdica, I have already
ob:3erved that bnrk\ given in large doses to sensitive, yet healthy
iDdividuals, produces a true attack of fever, very similar to the
intermittent fever, and for this reason, j^^obably^ it overpowers,
and thus cures the latter. Now after mature experience, I add,
not on\y probcd)ly^ but quite certainly,
I saw a healthy, sensitive person, of firm fibre, and half way
through with her pregnancy, take five drops of the volatile oil of
Aamoniile {Matricaria cliamomilla) for cramp in the calf of the leg.
The dose was much too strong for her. First there was the loss
of consciousness, the cramp increased, there occurred transient
convulsions in the limbs, in the eyelids, &c. A kind of hysteri-
cal movement above the navel, not unlike labour pains, but
more annoying, lasted for several days. This explains how cha-
momile has been found so serviceable in after-pains, in excessive
268 SUGGESTIONS FOR ASCERTAJ^TESQ
mobility of the fibre, and in hysteria, when employed in doses
in which it could not perceptibly develope the same phenomenal
that Li, in much smaller doses than the above.
A man who had been long troubled with constipation, but
was otherwise healthy, had from time to time attacks of giddi-
ness that lasted for weeks and months. Purgatives did no good*
I gave him arnica root {arnica monlana) for a week, for I knew
that it causes vertigo, in increasing doses, with the desired result.
As it has laxative properties, it kept the bowels open during its
employment, by antagonistic action, as a palliative ; wherefore
the constipation returned after leaving oft' the medicine ; the
giddiness, however, was effectually cured. This root excites, as
I and others have ascertained, besides other symptoms, nausea^
uneasiness, anxiety, peevishness, headache, oppression of the
stomach, empty eructation, cutting in the abdomen, and
frequent scanty evacuations, with straining. These effects,
not Stollen's example, induced me to employ it in an epi-
demic of simple (bilious) dysentery. The symptoms of it
were uneasiness, anxiety, excessive peevishness, head-ache,
nausea, perfect tastelessness of all food, rancid bitter taste on the
(clean) tongue, frequent empty eructation, oppression of the
stomach, constant cuttings in the abdomen, complete absence of
faecal evacuations, and instead, passage of pure grey or trans-
parent sometimes hard, white, flocculent mucus, occasionally
intimately mixed with blood, or with streaks of blood, or
without blood, once or twice a day, accompanied with the most
painful constant straining and forcing. Though the evacuations
were so rare, the strength sank rapidly, much more quickly,
however (and without amelioration, but rather aggravation of
the original affection), when purgatives were employed. Those
^ffe^'ted were generally children, some even under one year old,
but also some adults. The diet and regimen were proper. On
comparing the morbid symptoms arnica root produces with those
developed by this simple dysentery, I could confidently oppose
to the totality of the symptoms of the latter, the collective action
of the former. The most remarkable good cftccts followed,
without it being necessary to use any other remedy, l^efore the
employment of the root, I gave a powerful emetic,^ which I had
occasion to repeat in scarcely two cases, for arnica sets to right
' Without using Uic nmica root, the emcticij took awuy the raiicid bitter tu8te for
but one or two duys ; all the other symptoms remained, tliough they were ever so
dfieu repeated.
TEX CUKATIVE POWERS OF DRUGS. 269
the disordered bile (also out of the body,) and prevent its de-
rangement The only inconvenience resulting from its use in
this dysentery was, that it acted as an antagonistic remedy in
regard to the suppression of fajces, and produced frequent,
though scanty evacuations of excrement ; it was consequently
a palliative ; the effect of this was, when I discontinued the root,
continued constipation.^
In another less simple dysentery, accompanied by frequent
diarrhoea, the arnica root might be more useful and suitable, on
account of this latter circumstance ; its property of producing
frequent faecal evacuations in its primary direct action would
constitute it a similarly acting, consequently, permanent remedy,
and in its secondary indirect action it would effectually cure the
diarrhoea.
This has already been proved by experience ; it has been
found excellent in the worst diarrlirras. It subdues them,
because, xoWiout weakening Vie body, it is capable of causing
frequent evacuations. In order to prove serviceable in diarrhceas
without foecal matter, it must be given in such small doses as
not to produce perceptible purgation ; or in diarrhoeas with acrid
matters, in larger purgative doses ; and thus the object will be
ittainecl.
I saw glandular swellings occur from the misuse of an infusion
of flowers of arnica ; I am mucli mistaken if, in moderate doses,
it will not remove such altbctions.
AVe should ea<leavour to find out if the milljoil {achiUea
milh/olium) cannot itself produce lia3morrhages in large doses,
as it is so efficacious in moderate doses in chronic hemorrhages.
• It is not to be wondered at that valerian {Valeriana officinalis)
m moderate doses cures chronic diseases with excess of irritability,
since in large doses, as I have ascertained, it can exalt so remark-
ably the irritability of the whole system.
The dispute as to whether the hrooklime {anagallis arverisis)
and the bark of the misletoe {viscum album) possess great curative
virtues or none at all, would immediately be settled, if it were
tried on the healthy whether large doses produces bad effects, and
' I bod to increase tlie dose daily, more rapidly than is necessary with any other
powerful medicine. A child of four years of ago got at first four grains daily, theo
•eren, eighty and nine grains. Children of six or seven years of age could at first
«d1j bear six grains, afterwards twelve and fourteen grains were requisite. A child
ftrae quarters of a year old, which had taken nothing previously, could at first bear
hA two graiot (mixed with warm water) in an enema ; latterly six grains werf
270 SUGGESTIONS FOB ASC£BTAIKUra
an artificial disease similar to that in which they have been
hitherto empirically used.
The specilic artiiicial disease and the peculiar affections that
the spoiled li^mlock {coniuni viaculatam) causes, are not nearly so
well described as they deserve ; but whole books are filled with
the empirical praise and the equally empirical abuse of this
plant. It is true that it can produce ptyalism, it may therefore
possess an excitant action on the lymphatic system, and be of
permanent advantage in cases where it is requisite to restrain
the excessive action of the absorbent vessels.* Now as it, besides
this, produces pains (in large doses violent pains) in the glands,
it may easily be conceived that in painful induration of the
glands, in cancer, and in the painful nodes that the abuse of
mercury leaves, it may be the best remedy, in moderate doses, not
only for curing almost specifically this peculiar kind of chronic
pains, in a more effectual and durable manner than the palliative
opium and all other narcoctic remedies which act in a different
manner, but also for dispersing the glandular swellings them-
selves, when they cither have their origin, as above described, in
excessive local or general activity of the lymphatic vessels, or
occur in an otherwise robust frame, so that the removal of the
pains is all that is required in order to enable nature to cure the
complaint herself. Painful glandular swellings from external
injuries are of this description. ^
In true cancer of the breast, where an opposite state of the
glandular, system, a sluggishness of it, seems to predominate, it
must certainly do harm on the whole (it may at first soothe the
pains), and especially must it aggravate the disease when thj
system, as is often the case, is weakened by long-continued suf-
fering ; and it will do harm all the more rapidly, because its
continued use produces, as a secondary action, weakness of the
stomach and of the whole body. From the very reason that it^*
' If uiuployud in inactivity of tliese vessels, it will first act as a palliative ; alter-
wards do little one way or other ; and lastly, prove injurious, by the productitjo of
the opposite conditiim to that wislied for.
* A healthy peasant child got, from a violent fiiU, a painful swelling of the under
lip, which increased very much in the course of four weeks in hardness, size, and
painfulness. Hie juice of the spotted hemlock applied to it, effected a cure without
any relapse in fourteen days. A hitherto uncomnionly healthy, robust girl, had
■everely bruised the right breast, whilst carrying a heavy burden, with the strap of
the basket A small tumour arose, which for six months increased in violence of
pain, in size, and hardness, at each monthly period. The external application of
■potted hemlock juice cured it within five weeks. This it would have dune soono;
bad it not affected the skin, and produced there painful pustules, in cuid^t^^uenoe of
which it had frequently to be disouotinued for leveral daya.
THE GUBATIYE POWERS OF DRUGS. 271*
like other umbelliferous plants, specifically excites the glandular
system, it may, as the older physicians remarked, cure an ex-
cessive secretion of milk. As it shows a tendency to paralyse
the nerves of sight in large doses, it is comprehensible why it
has proved of service in amaurosis. It has removed spasmodic
complaints, hooping cough, and epilepsy, because it has a ten-
dency j:o produce convulsions. It will still more certainly be of
ijse in convulsions of the eyes and trembling of the limbs, because
in large doses it dcvelopes exactly the same phenomena. The
same with respect to giddiness.
The fact XhdX fooVs parsky {cetliusa cr/napium), besides other
afiections, as vomiting, diarrhoea, colicky pains, cholera, and others
for the truth of which I cannot vouch (general swelling, &c.),
produces so specifically imbecility, also iinbecijity alternately-
with madness, should be of use to the careful ])hysician in this
disease, otherwise so diflScult of cure. I had a good extract of
it prepared by myself, and once, when I found myself, from much
mental work of various kinds coming upon me in rapid succcs-
rion, distracted and incapable of reading any more, I took a grain
of it. The effect was an uncommon disposition for mental labour,
which lasted for several hours, until bed-time. The next day,
however, I was less dis{x>sed for mental exertion.
The icater hemlock {cicula vhvsa) causes, among other symptoms,
violent burning in the throat and stomach, tetanus, tonic cramp
of the bladder, lockjaw, erysipelas of the face, head-ache, and
true epilepsy; all diseases for which we require cflicient remedies.
one of which, it may be hoped, will be found in this powerfully,
iMSting root, in the hands of the cautious but bold physician.
Amatus the Portuguese observed that coccubcs seeds {nienis-
permum cocculiis\ in the dose of four grains, produced nausea,
hiccough, and anxiety in an adult man. In animals they pro-
duced a rapid, violent, but when the dose was not fatal, a transi-
tory stupefaction. Our successors will find in them a very
powerful medicine, when the morbid phenomena these seeda
produce shall be more accurately known. The Indians use tho
root of this tree, among other things, in malignant typhus (that
accompanied by stupefaction).
The/ox-grapc {paris quadrifolia) has been found efficacious in
cramps. The leaves cause, in large doses at all events, cramp
in the stomach, according to the still imperfect experience wo
of the morbid phenomena they are capable of developing*
Ck^ec produces, in large doses, head-aches ; it therefore curea^
272 BU60ESTI0NS FOB ASC£RTAINIHa
in moderate doses, head-aohes that do not proceed from derange-
ment of the stomach or acidity in the primsB viae. It fitvoure
the peristaltic motion of the bowels in large doses, and therefore
cures in smaller doses chronic diarrhoeas, and in like manner
the other abnormal effects it occasions might be employed against
eimilar affections of the human body, were we not in the habit
of misusing it. The effects of opium in stupifying the ^ensea^
and irritating the tone of the fibres, are removed by this berry
in its character of an antagonistic, palliative remedy, and that
properly and effectually, for here there is no persistent state of
the organism, but only transitory symptoms to be combated.
Intermittent fevers, too, where there is a want of irritability and
inordinate tension of the fibres, precluding the employment of
otherwise specific bark, it apparently suppresses in large doaea^
merely as an palliative remedy ; its direct action, however, in
Buch large doses, lasts for two days.
The hitter-sweet {sohnum dulcamara) producers, in large dosea^
among other symptoms, great swelling of the affected parts and
acute pains, or insensibility of them, also paralysis of the tongue
and of the optic nerves ?). In virtue of the last powerful action,
it is not to be wondered at that it has cured paralytic affectiona,
amaurosis, and deafnass, and that it will render still more speci-
fic service in paralysis of the tongue, in moderate doses. In
virtue of the two first properties, it is a main remedy in chronic
rheumatism, and in the nocturnal pains from the abuse of mer-
cury. In consequence of its power of causing strangury, it has
been useful in obstinate gonorrhoea, and from its tendency to
bring about itching and shooting in the skin, it shows its utility
in many cutaneous eruptions and old ulcers, even such as arise
firom abuse of mercury. As it causes, in large doses, spasms <rf
the hands, lips and eyelids, as also shaking of the limbs, we may
easily understand how it has been useful also in spasmodic affeo-
tions. In nymphomania it will probably be of use, as it acts so
specifically on the female genital organs, and has the power of
causing (in large doses) itching and pains in these parts.
The berries of the black nightshxidc {solanum nigrum) have caused
extraordinary convulsions of the limbs, and also delirious ravings
It is, therefore, probable that this plant will do good in what are
called possessed persons (madness, with extraordinary, empbalifly
eften unintelligible talking, formerly considered prophesying and
the gift of unknown tongues, accompanied by convulsions of the
limbs), especially where there are at the same time pains in the
THK CURATIVE POWEBS OF DRUGS. 278
region of the stomach, which these berries also prodace in large
doses. As this plant causes erisypelas of the face, it will be use-
fhl in that disease, as has already been ascertained fix>m its ex-
ternal employment As it causes, to a still greater degree than
bitter-sweet, by being used internally, external swellings, that
iSy a transient obstruction in the absorbent system, its great diu-
retic power is only the indirect secondary result; and hence its
great virtue in dropsy, from similarity ofdction, is plainly percep-
tible ; a medicinal quality of so much the greater value, as most
of the remedies we possess for this disease are merely antagonis-
tically acting (exciting the lymphatic system in a merely tran-
(dtorj manner), and consequently palliative remedies, incapable
of effecting a permanent cure. As, moreover, in large doses it
causes not only swelling, but general inflanmiatory swelling, with
itching, and intolerable burning pains, stiffness of the limbs,
pustular eruptions, desquamation of the skin, ulcers, and spha-
celus, where is the wonder that its external application has
cured divers pains and inflanmiations ? Taking all the morbid
symptoms together that the black nightshade produces, we can-
not mistake their striking resemblance to raphania, for which it
will, most probably, be found to be a specific remedy.
It is probable that the deadly nightshade {atropa belladonna) will
be useful, if not in tetanus, at least in trismus (as it produces a
kind of lockjaw), and in spasmodic dysphagia (as it specifically
causes a diflSculty of swallowing) ; both these actions belong to
its direct action. Whether its power over hydrophobia, if it do
possess any, depends on the latter property alone, or also on its
power of suppressing palliatively, for several hours, the irrita-
biUty and excessive sensitiveness that are present in so great a
d^ree in hydrophobia, I am imable to determine. Its power of
soothing and dispersing hardened, painful and suppurating glands,
is owing, undeniably, to its property of exciting, in its direct
action, boring, gnawing pains in these glandular swellings. Yet
I conceive that it acts antagonistically, that is, in a palliative and
merely temporary manner, in those which proceed fi:om excessive
irritation of the absorbent system (with subsequent aggravation,
$B is the case with all palliatives in chronic diseases) ; but, by
virtue of similarity, that is, permanently and radically, in those
arising from torpor of the lymphatic system. (Then it would be
serviceable in those glandular swellings in which the spotted
hemlock {conium macuhtum) cannot be used, and the latter will
be useful where the former does injury.) As, however, its con-
18
S74 8UOOES1TOKS TOB AflCEBTAINnfO
turned employ ment ^7 reason c^ its indirect secondttry action)
ezhanfits the whole body, and when given in too large, or too often
repeated doses, has a tendency to produce a gangrenous feircTi
its good eftects will sometimes be destroyed by these secondaij
bad consequences, and fatal results may ensue (especially in the
case of cancerous patients, whose vital powers have been ex-
hausted by the sufterings of many years), if it be not cautiously
employed. It produces directly mania, (as also, as above de-
scribed, a kind of tonic cramp) ; but clonic cramps (convulsions)
it only produces as a secondary action, by reason of the state of
the organism that remains after the direct action of belladonn*
(obstruction of the animal and natural functions.) Hence its
power in epilepsy with furor is always most conspicuous upoa
the latter symptom, whilst the former is generally only changed
by the antagonistic (palliative) action of belladonna, into trembling^
and such-like spasmodic affections peculiar to weakened irritable
systems. All the spasmodic symptoms that belladonna produces
in its direct primary action are of a tonic character ; true, the
muscles are in a state of paralytic relaxation: but their deficient
irritability causes a kind of immobility, and a feeling of health|
as if contraction were present As the mania it excites is of a wild
character, so it soothes manias of this sort, or at least deprives
them of their stormy nature. As it extinguishes memory in its
direct action,^ nostalgia (home sickness) is aggravated, and, as
I have seen, is even produced by it.
Moreover, the increased discharge of urine, sweat, menses^
feces, and saliva, which have been observed, are merely conse*
quences of the antagonistic state of the body, remaining aftev
an excessive exaltation of the irritability, or else sensilivenen
during the indirect secondary action, when the direct primaij
action of the drug is exhausted, during which, as I have seve-
ral times observed, all these excretions are often completely sup-
pressed by large doses for ten hours and more. Therefore, in
oases where these excretions are discharged with difficulty, and
excite some serious disease, belladonna removes this difficultj*
permanently and completely, as a similarly -acting remedy^ if it
be owing to tension of the fibres, and want of irritability and
sensibility. I say purposely, serious disease^ for only in sueh
cases is it allowable to employ one of the most violent of medi*
cines, which demands such caution in its use« Some kinds cf
dropsy, green sickness, Ac, are of this nature. The great ten-
' It wiU, Uierefine^ be useful in weaknets of mcmoiy.
THB omu^vnrs powsbs of bbuob. 875
dency of belladonna to paralTBe the optic nerve^ makes it im-
portant^ as a similarly-acting remedy, in amaurosis.^ In its di^
rect action it prevents sleep, and the deep sleep which subi^
quently ensues is only in consequence of the opposite state pro*
duced by the cessation of this action. By virtue, therefore, of
this artificial disease, belladonna will cure chronic sleeplessness
(firom want of irritability) more permanently than any palliative
remedy.
It is said to have been found beneficial in dysentery ; proba-
bly, as in its direct action it retards the stool, in the most sim-
pie cases of diarrhoea, with suppressed faecal evacuations, and
imre motions, but not in dysentery ¥nith lienteric diarrhoea,
where it must do positive harm. Whether, however, it is ap-
propriate for dysentery, by reason of its other actions, I am un-
able to say.
It produces apoplei^ ; and if it have, as we are told, been
found serviceable in serous apoplexy, it is owing to this pro-
perty. Besides this, its direct action causes an internal burning,
with coldness of the external parts.
Its direct action lasts twelve, twenty-four, and forty-eight
hours. Hence, a dose should not be repeated sooner than after
two days. A more rapid repetition of ever so small a dose must
lesemble in its (dangerous) effects the administration of a large
dose. Experience teaches this.
The feet that henbane {hyoscyamits niger) in large doses dimi-
nishes remarkably the heat of the body and relaxes its tone for
a short time in its direct action, and therefore is an efficacious
palliative remedy when given in moderate doses inwardly and
outwardly in sudden attacks of tension of the fibres and infiam-
mation, does not fall to be considered in this place. This is not
tibe case, however, witli the observation, that this property only
enables it to palliate very imperfectly, in any dose, chronic af-
fections with tension of the fibre ; in the end, however, it rather
increases than diminishes them by its indirect secondary action,
which is exactly the opposite of its primary action. On the
otiier hand, it will help to assist the power of the strengthening
ranedy in chronic relaxation of the fibres, as in its primary ac-
tion it relaxes, and in its secondary action it tends all the* more
to elevate the tone, and that in a durable manner. In large
doses it likewise possesses the power of produdng haemorrhage,
specially bleeding of the nose, and frequently recurring cata-
* I baye myself aeeo the good efifocti of it in this disease.
270 , 8UQOESTI0N8 FOR ASCEBTAIimrO
menial flax, as I and others have ascertained. For this reason
it cures chronic haemorrhages, in small doses, in an extremely
effectual and lasting manner. The most remarkable thing is
the artificial disease it produces in very large doses, suspicioiu^
quarrelsome, spitefully -calumnious, revengeftd, destructive, fear-
less,^ mania (hence, henbane was termed by the ancients aUar-
cum)j and this is the kind of mania it specifically cures, only
that in such cases a tenseness of fibre sometimes hinders it ef-
fects from being permanent. Difficulty of moving, and insen-
sibility of the limbs, and the apoplectic symptoms it produces^
it may also very probably be capable of curing. In large doses^
it produces, in its direct primary action, convulsions, and is con-
sequently useful in epilepsy, probably also in the loss of memo-
ry usually accompanying it, as it has the power of producing
want of recollection.
Its power of causing in its direct action sleeplessness with
constant tendency to slumber, makes it in chronic sleeplessnesB
a much more permanent remedy than the frequently merely
palliative opium, especially as it at the same time keeps the
bowels open, although only by the indirect secondary action of
each dose, consequently in a palliative way. It causes dry cou^
dryness of the mouth and nose, in its direct action ; it is, there-
fore, very useful in tickling cough, probably also in dry coryza.
The flow of mucus from the nose, and the flow of saliva observed
from its use, only belong to its indirect secondary action. The
seeds cause convulsions in the facial and ocular muscles, and by
their action on the head, cause vertigo, and a dull pain in the
membranes lying under the skull. The practical physician will
be able to take advantage of this. Its direct action lasts scarcely
twelve hours.
The thorn-apple (datura stramonium) causes extraordinary
waking dreams, unconsciousness of what is going on, loud delirious
talking, like a person speaking in sleep, with mistakes respecting
personal identity. A similar kind of mania it cures specifically.
It excites very specific convxilsions, and has thus often proved
useful in epilepsy. Both properties render it serviceable in the
case of persons possessed. Its power of extinguishing reoolleo*
tion should induce us to try it in cases of weak memory. It is
most useful where there is great mobility of the fibre, because
its direct action in large doses is increased fibrous mobility. It
' Hie sabsequent iodirect Beoondaiy action is a kind of fiunt-heartedneai and ter-
falnwi.
THB CVRATINS POWBBS OF DBUQ8. 277
/
eaoses (in its direct action ?) heat and dilatation of the pupil, a
kind of dread of water, swollen, red face, twitching in the ocular
musdea, retarded stool, difficult breathing; in its secondary
jKStion, slow, soft pulse, perspiration, sleep.
The direct action of large doses lasts about twenty-four hours ;
rf small doses, only three hours. Vegetable acids, and apparently
citric acid in particular, suddenly put a stop to its whole action.*
The other species of datura seem to act in a similar manner.
The specific properties of Virginia tobacco (nicotiana tabacum)
consist, among other things, in diminishing the external senses,
and obscuring the intellect ; it may therefore be useful in weak-
ness of mind. Even in a very small dose, it excites the muscular
action of the primae via) violently ; a property which is valuable
as a temporary oppositely-acting remedy (as is well known,
though it does not fall to be considered here ) ; and as a similarly-
acting remedy it is probably serviceable in chronic disposition
to Tomiting and to colics, and spasmodic constriction of the
(Bsaphagns, as indeed experience partially corroborates. It
din^nishes the sensibility of the primae viae ; hence its palliative
power of lessening hunger (and thirst?) In larger doses, it
deprives of their irritability the muscles of voluntary motion,
and temporarily removes from them the influence of the cerebral
power. This property may give it as a similarly-acting remedy,
curative powers in catalepsy ; but this very property makes its
constant employment in large quantities (as with tobacco-smokers
and8nuflF-takers)so injurious to the tranquil state of the muscles
belonging to the animal functions, that a tendency to epilepsy,
hjrpochondriasis, and hysteria, are in course of time developed,
lie remarkable fact, that the employment of tobacco is so
agreeable to insane persons, arises from the instinct of those un-
fortunates to produce a palliative obtuseness in the sensibility of
their hypochondria^ and brain (the two usual seats of their
complaints). But as it is here an oppositely-acting remedy, it
gives them but temporary relief; their desire for it increases,
but the end for which it is taken is not attained, — on the whole
' A patieni, who was always Tiolciitly affected by two grains of the extract of the
pbat^ oDce experienced not the slightest effects from this dose. I learned that he
kad partaken of the juice of a large number of red currants ; a considerable dose of
pulTerized oT^r-shells at once restored the full efficacy of the thorn apple.
' To tills belongs the fiseling of insatiable hunger, which many insane persons
from, and for which they generally appear to use tobacco ; at least, I have seen
, who had no desire for tobacco^ especially such as were affected with melancholia^
who had rerjr little himger.
278 0UGOESnON8 for ASCSRTAIKIKa
the oomplaint is thereby increased, as it renders no permanent
service. Its direct action is limited to a few hours, except in
the case of very large doses^ which extend to twenty-four houiB
(at the farthest).
The seeds of the poison tree {strychnos nux vomica) are very
powerful ; but the morbid symptoms it produces are not yek
accurately known. The most I know concerning them is derived
from my own observation. They produce vertigo, anxiety,
febrile rigour, and in their secondaiy action a certain immobility
of all parts, at least of the limbs, and a spasmodic stretchings
according to the size of the dose. Hence they are useful, not
only, as is already known, in intermittent fever, but in cases of
apoplexy. In their first direct action, the muscular fibre has a
peculiar mobility imparted to it, the sensitive system is morbidly
exalted to a species of intoxication, accompanied by fearfiilneas
and horror. Convulsions ensue. The irritability seems to exhaust
itself during this continued action on the muscular fibre, first in
the animal, then in the vital functions. On passing into the indi-
rect secondary action, there occurs a diminution of the irritability^
first, in the vital functions (general perspiration), then in the ani-
mal, and lastly in the natural functions. In the latter, especially,
this secondary action lasts several days. During the secondary
action, there is a diminution of sensibility. Whether in the
primary direct action the tonicity of the muscle is diminished,
to be proportionately increased in the secondary action, cannot
be accurately determined; this much, however, is certain, that
the contractility of the fibre is as much diminished in the secon-
dary action, as it was increased in the direct action.
If this be true, nux vomica produces attacks similar to hysterical
and hypochondriacal paroxysms, and this explains why it is so
often useful in these complaints.
Its tendency to excite, in its primary direct action, the contrac-
tility of the muscles, and cause convulsions, and then again in its
secondary action to diminish to an excessive degree the contrac-
tility of the muscles, shows such a resemblance to epilepsy, that
from this very circumstance we must have inferred that it would
heal this disease, had not experience already demonstrated it.
As it excites, besides vertigo, anxiety and febrile rigour, a kind
of delirium consisting in vivid, sometimes frightful visions, and
tension in the stomach, so it once quickly subdued a fever in a
laborious reflective mechanic in the country, which began with
tension in the stomach, followed by a sudden attack of vertigo,
80 as to make him fall, that left behind it a kind of coiifusion of
XHS CUBAraVK FOWBBS Or DBXSQB. 279
tiieundenrtaiidiiig,withfrightftd, hypochondriacal ideas, anxiety,
and exhaustion. In the morning he was pretty lively and not
exhausted, but in the afternoon, about two o^clock, the attack
commenoed« He got nux vomioa, in increasing doses, one daily,
and improved. At the fourth dose, which contained seventeen
grains, there occurred great anxiety, immobility and stiffness of
the limbs, ending in a profuse perspiration. The fever and all
the nervous symptoms disappeared, and never returned, although
for many years previously he had from time to time been subject
to such attacks suddenly occurring, yet unaccompanied by fever.
Its tendency to cause cramps in the abdomen, anxiety and
pain in the stomach, I availed myself of in a dysenteric fever
(without purgings), in persons living in the same house with
dysenteric patients. In these cases it diminished the feeling of
discomfort in the limbs, the feverishness, the anxiety, and the
pressure in the stomach ; it produced the same good results in
some of the patients, but as they had simple dysentery without
diarrhcBay it made the evacuations still rarer, from its tendency
to cause constipation. The signs of deranged biliary secretion
shoved themiselves, and the dysenteric evacuations, though rarer,
were accompanied by just as great tenesmus as before, and were
of as bad a character. The symptom of loss of taste, or per-
verted taste, remained. Its tendency to diminish the peristaltic
movements was therefore disadvantageous in the true simple
dysentery. In diarrhoeas, even such as are of a dysenteric
character, it will be more serviceable, at least as a palliative
remedy. During its employment, I witnessed twitching move-
ments under the skin, as if caused by live animals, in the limbs,
and especially in the abdominal muscles.
St, Igiuitliis' heart (ignalia aniara) has been observed to pro-
duce trembling of several hours' duration, twitchings, cramps,
irascibility, sardonic laughter, giddiness, cold perspiration. In
aimilar cases it will show its efficacy, as experience has paitly de-
monstrated. It produces febrile rigour, and (in its secondary ac-
tion ?) stiffness of the limbs, and thus it has cured, by similarity
of action, intermittent fever, which would not yield to bark ;
probably it was that less simple form of intermittent in which
the compUcation consisted of excessive sensitiveness and in-
creased iaTitabilityt(cspecially of the prima) vise). But the other
symptoms it can produce must be more accurately observed, be-
fore we can employ it in those cases for which it is exactly suited
from similarity of symptoms.
The purple foxglove {digitalis purpurea) causes the most ex-
280 SUQGESTIONS FOB AfiCEBTAIKIKa
oeasiye disgust at food; during its continued use, therefore,
ravenous hunger not unfrequentlj ensues. It causes a kind of
mental derangement, which is not easily recognisable, as it onlj
shows itself in unmeaning words, refractory disposition, obsti-
nacy, cunning, disobedience, inclination to run away, &o., which
its continued use frequently prevents. Now as, in addition to
these, it produces in its direct action violent headaches, giddi-
ness, pain in the stomach, great diminution of the vital powers,
sense of dissolution and the near approach of death, a diminu-
tion of the rapidity of the heart's beats by one half, and reduc-
tion of the vital temperature, it may easily be guessed in what
kind of madness it will be of service; and that it has in &ct
been useful in some kinds of this disease, many observations
testify, only their particular symptoms have not been recorded.
In the glands it creates an itching and painfrd sensation, which
accounts for its efficacy in glandular swellings.
It produces, as I have seen, inflammation of the Meibomian
glands, and is a certain cure for such inflammations. Moreover,
as it appears to depress the circulation, so does it seem to excite
the absorbent vessels, and to be most serviceable where both are
too torpid. The former it assists by virtue of similarity, the lat-
ter by virtue of antagonism of action. But as the direct action'
of foxglove persists so long (there are examples of its lasting
five or six days), it may, as an antagonistically acting remedy,
take the place of a permanent curative agent. The last observa-
tion is in reference to its diuretic property in dropsy ; it is anta-
gonistic and palliative, but nevertheless enduring, and valuable
on that account merely.
In its secondary action it causes a small, hard, rapid pulse ;
it is not therefore so suitable for patients who have a similar
(febrile) pulse, but rather for such as have a pulse like what fox-
glove produces in its direct action — slow, soft. The convulsions
it causes in large doses, assign it a place among the anti-epileptio
remedies ; probably it is only useful in epilepsy under certain
conditions, to be determined by the other morbid symptoms it
produces. During its use, objects not unfrequently appear of
various colours, and the sight becomes obscured ; it will remove
similar affections of the retina. (Its tendency to produce diarr-
hoea, sometimes so adverse to the cure, is counteracted, as I have
have ascertained, by the addition of potash.
As the direct action of foxglove lasts occasionally several
days (the longer its use is continued, the longer lasts the direct
action of each dose ; a very remarkable fact, not to be lost sight
THB dTRATIYE P0WKB8 OF DBUOa 281
\
of in practice), it is evident how erroneously those act, who, with
the best intentions, prescribe it in small but frequently repeated
doses, (the action of the first not having expired before they
have already given the sixth or eighth), and thus in fact they
give, although unwittingly, an enormous quantity, which not
anfrequently causes death.* A dose is necessary only every
three, or at most every two days, but the more rarely the longer
it has been used. (During the continuance of its direct action,
cinchona bark must not be proscribed ; it increases the anxiety
caused by foxglove, as I have found, to an almost mortal
agony.)
The pansy vioht {viola tricolor) at first increases cutaneous
eruptions, and thus shows its power to produce skin diseases,
and consequently to cure the same efl'ectually and permanently.
Ipecacuanha is used with advantage in affections against which
nature herself makes some eflForts, but is too powerless to eflFect
the desired object. In these ipecacuanha presents to the nerves
of the upper orifice of the stomach, the most sensitive part of
the organ of vitality, a substance that produces a most unconge-
nial disgust, nausea, anxiety, thus acting in a similar manner to
the morbid material that is to be removed. Againsrt this double
attack, nature exerts antagonlstioally her powers with stUl greater
energy, and thus, by means of this increased exertion, the mor-
bid matter is the more easily removed. Thus fevers are brought
to the crisis, stoppages in the viscera of the abdomen and of the
cjjest, and in the womb, put in motion, miasmata of contagious
diseases expelled by the skin, cramp relieved by the cramp that
ipecacuanha itself produces, their tension and freedom restored
to vessels disposed to hemorrhage from relaxation, or from the
irritation of an acrid substance deposited in them, &c. But most
distinctly does it act as a similarly acting remedy to the disease
sought to be cured, in cases oi' chronic disposition to vomit with-
out bringing anything away. Here it should be given in very
small doses, in order to excite frequent nausea, and the tendency
to vomit goes oflf more and more permanently at each dose, than
it would with any palliative remedy.
Some benefit may be anticipated in some kinds of chronic pal-
pitation of the heart, &c., from the administration of the rose-bay
' A womao in Ediubui^h gut for three successive days, each day, three doees. each
doM ooosistiiig of only two grains of the pulTerized leaves of foxglove, and it was a
Qatter of surprise that she died from such small doacs, after vomiting for six daya.
It must be remembered, however, that it was the same as if she had taken eighteen
gmins at one dene.
282 SUGGESTIONS FOB ASCSBTAIKINO
{nerium oleander\ which has the power of causing palpitation,
anxiety, and fainting. It causes swellings of the abdomen and
diminution of the vital temperature, and seems to be a most powr
erful vegetable.
The morbid symptoms produced by the nerium antidysenierv'
cum are not sufficiently known to enable us to ascertain the
cause of its real remedial powers ; but as it primarily increases
the stools, it apparently subdues diarrhoeas as a similarly acting
remedy.
The bear''s herry {arbutus uva ursi) has actually, without pos-
sessing any acridity perceptible to the senses, not unfrequently
increased the difficidty of passing water, and the involuntary
flow of urine, by some power peculiar to itself; thereby show-
ing that it has a tendency to produce such aiFections, and hence,
as experience also testifies, it is capable of curing similar disor^
ders in a permanent manner.
The gohlerirjlowered rhododendron {rhododendron chrysanthum)
shows, by the burning, formicating, and shooting pains it pro-
duces in the parts affected, that it is certainly fitted to relieve^
by similarity of action, pains in the joints of various kinds, as
experience also teaches. It causes difficulty of breathing and
cutaneous eruptions, and thus it will prove useful in similar dis-
orders, as also in inflammation of the eyes, because it produces
lacrymation and itching of the eyes.
The marsh-tea (ledum palustre) causes, as I have ascertained,
among other effects, difficult, painful respiration ; this account
for its efficacy in hooping cough, probably also in morbid
asthma. Will it not be useful in pleurisy, as its power of so
greatly diminishing the temperature of the blood (in its second-
ary action) will hasten recovery ? It causes a painful shooting
sensation in all parts of the throat, as I have observed, and
hence its uncommon virtues in malignant and inflammatory
sore throat. Equally specific is, as I have noticed, its power of
causing troublesome itching in the skin, and hence its great
efficacy in chronic skin diseases.
The anxiety and the faiutings it occasions may prove of use
in similar cases. As a transitory and antagonistically acting
powerful diuretic and diaphoretic remedy,.it. may cure dropsies;
more certainly however, acute, than chronic.
On some of these properties depends its reputation in dysen-
tery. But were they real cases of dysentery, or some of those
painful diarrhoeas so often taken for it ? In the latter case it
THE CITRATIYE P0WSB8 OF DRT7GB. 288
may, as a palliative remedy, certainly hasten the cure, and even
help to complete it; but in true uncomplicated dysentery, I
have never seen it of any use. The long-continued weakness it
occasions was against its being used for a length of time, and it
ameliorated neither the tenesmus nor the character of the excre-
tions, though these became more rare. The symptoms of de-
ranged bUiary secretion were rather worse during its use, than
when the patients were left without medicine. It causes a pe-
culiar ill-humour, headache, and mental confusion; the lower
extremities totter, and the pupils dilate. (Do both the latter '
symptoms, or merely the last, belong to the secondary action
cmly ?) An infusion of ten grains once a day was a. sufficient
dose for a child six years old.
The primary direct action of opium {papaver somniferum) con-
sists in transitory elevation of the vital powei-s, and strengthen-
ing the tone of the blood-vessels and muscles, especially of those
belonging to the animal and vital functions, as also in excitation
of the mental organs — the memory, the imagination, and the
organ of the passions; — thus, moderate doses are followed by a
disposition to work, sprightliness in conversation, wit, remem-
brance of former times, amorousness, &c. ; large doses by bold-
ness^ courage, revenge, inordinate hiliarity, lasciviousness ; still
larger doses by furious madness, convulsions. The greater the
dose, the more do the individuality, the freedom, and the vol-
untary power of tlie mind sufter in sensations, and in power of
judgment and of action. Ilence, inattention to external disa-
greeable circumstances, to pain, &c. This condition, however,
does not last long. It is gradually followed by loss of ideas,
the pictures of fancy fade by degrees, there supervene relaxation
of the fibre, sleep. If the use of elevated doses is continued,
the consequences (indirect secondary action) are, weakness,
deepliness, listlessness, grumbling, discomfort, sadness, loss of
memory (insensibility, imbecility), until a new excitation by
opium, or something similar, is produced. In the direct action,
the irritability of the fibre seems to be diminished in the same
proportion as its tone is increased ; in the secondary action, the
latter is diminished, the former increased.* ^The direct action,
Btill more than the secondary action, prevents the mind from
' There occurs a marked sensitiveness, especially for things that produce disagreea*
Ue effects, for fright, grief^ fear, for inclement weather, ^c If the mobility of the
fibre which occurs secondarily is called increased irritability, I have nothing to objed
Id the tenn ; lis sphere of action, however, is but small : it is either that fhe fibre ii
too relaxed, and cannot contract much, or that it is in a too ooDtracted oooditioo, end
284 SUGOESTIONS FOB ASGSBTAINIKa
taking cognizance of sensations (pain, sorrow, &c.), and henoe
its great pain subduing power.
(In cases where only the direct action as a cordial is necessarji
it will be requisite to repeat the administration of it every three
or four hours, that is, each time before the relaxing secondary
action, which so much increases the irritability, ensues. In all
such cases it acts merely antagonistically, as a palliative remedy.
Permanent strengthening powers are not to be expected from
it used in this manner, least of all in chronic weakness. This,
however, is a digression.)
But if it is wished to depress permanently the tone of the
fibre, (I give this name to the power of the fibre to contract and
relax completely), to diminish permanently the deficiency of
irritability, as is the case in some cases of mania, in such circum-
stances we may employ opium with success, as a similarly act-
ing remedy, given in elevated doses, and making use of its indi-
rect secondary action. We must consider the treatment which
consists in giving opium in true inflammatory diseases, e. g.
pleurisy, to be according to this principle.
In such cases, a dose is necessary every twelve or twenty-four
hours.
It appears that this indirect secondary action has been made
use of on the principle of a similarly acting remedy ; which, as
far as I am aware, is not the case with any other medicine.
Opium has, for instance, been given with the greatest success,
(not in true venereal diseases, for that would be a delusion,) but
in the disastrous efibcts that so often arise from the abuse of
mercury in syphilis, which are sometimes much worse than the
syphilis itself
Before illustrating this employment of opium, I must say
something appropriate to the subject, concerning the nature of
syphilis, and introduce here what I have to say concerning
mercury.
Syphilis depends upon a virus, which, besides other peculi-
arities that it developes in the human body, has an especial ten-
dency to produce inflammatory and supj)urating swellings of the
glands (to weaken the tone?), to make the mechanical connex-
ion of the fibres so disposed to separation, that numerous
spreading ulcers arise, whose incurable character may be known
IB relaxed easily indeed, but not sufficiently, consequently is incapable of making ukj
powerful eSSxxt In this condition of the fibre, the tendency to chronic inflammatinn
it unmistakable.
THE CUBATIVE POWERS OF
DRubl 286
by their round figure ; and lastly, to increase the irritability.
Now, as such a chronic disease can only be cured by a remedy
capable of developing a disease of similar character, no more effi-
cacious remedy could be conceived than mercury.
The most remarkable power of mercury consists in this, that
in its direct action it irritates the glandular'system, (and leaves
behind its glandular indurations as its secondary indirect action,)
weakens the tone of the fibres and their connexion, and disposes
them to separation in such a manner, that a number of spread-
ing ulcers arise, whose incurable nature is shown by their round
form; and lastly, increases uncommonly the irritability (and
sensibility). Experience has confirmed it as a specific ; but as
there does not exist any remedy similar to the disease, so the
mercurial disease (the changes and symptoms it usually produ-
ces in the body) is still very different from the nature of syphilis.
The syphiltic ulcers are confined to the most superficial parts,
especially the deuteropathic ones, (the protopathic ulcers increase
slowly in extent,) they secrete a viscid fluid in place of pus, their
borders are almost level with the skin (except the protopathic
ones), and are almost quite painless (excepting the protopathic
ulcer, that arising from the primary infection, and the suppura-
ting inguinal gland). The mercurial ulcers burrow deeper,
^rapidly increase in size,) are excessively painful, and secrete
sometimes an acrid thin ichor ; sometimes they are covered
with a dirty cheesy coating, tlieir borders also become everted.
The glandular swellings of syphilis remain but for a few days ;
they are either rapidly resolved, or the gland suppurates. The
glands attacked by mercury are stimulated to increased action
by the direct action of this metal, (and thus glandular swellings
from other causes disappear rapidly under its use,) or they are
left in the state of cold indurations during the indirect secondary
action. The syphiltic virus produces induration of the perios-
teum of those bones which are nearest the surface and least
covered with flesh ; they are the seat of excessive pains. In our
days this virus, however, never produces caries, notwithstand-
mg all my researches to discover the contrary. Mercury de-
stroys the connexion of the solid parts, not of the soft parts
only, but also of the bones ; it first corrodes the most spongy
and concealed bones, and this caries is only aggravated the more
rapidly by the continued use of the metal. Wounds which
have arisen from external violence are changed by the use of
mercury into old ulcers, difficult of cure ; a circumstance that
286 BUGGESTIONS FOB ASGEBTAININO
does not occur with syphilis. The trembling, so remarkable in
the mercurial disease, does not occur in syphilis. From the uae
of mercury there ensues a slow, very debilitating fever, wiih
thirst, and great and rapid emaciation. The emaciation and
weakness from sj'^philis come on slowly, and remain within
moderate limits. Excessive sensitiveness and sleeplessness are
peculiar to the mercurial disease, but not to syphilis. The most
of these symptoms seem to be owing mther to the indirect
secondary action, than to the direct action of the mercury.
I have been so circumstantial on this subject, because it ia
often very difficult^ for the practitioner to distinguish the chronic
mercurial disease from the symptoms of syphilis ; and thus he
will be apt to consider symptoms as belonging to that disordeii
whilst they are only mercurial, and go on treating them with
mercury, whereby so many patients are destroyed ; chiefly, how-
ever, because my object is to depict the mercurial disease, in
order to show how opium can cure it, by -virtue of similarity
of action.
Opium raises the sinking forces of patients suffering from the
mercurial disease, and allays their irritability, when its direct
action is kept up, that is, when it is given at least every eight
hours; and this it does as an antagonistically -acting rem^y.
This happens, however, only when it is given in large dose8|
proportioned to the degree of weakness and irritability, just as
it is serviceable only in large and oft-repeated doses in the ex-
cessive irritability of hysterical and hypochondriacal patients
and in the excessive sensibility of exhausted individuals. The
normal condition of the body seems thereby to be restored; a
secret metamorphosis seems to take place in the organism, and
the mercurial disease is geadually conquered. The convalescent
patient can only bear smaller and smaller doses. Thus the mer-
curial disease seems to be vanquished by the palliative antago-
nistic power of the opium ; but any one who is aware of the
almost uneradicable nature of the mercurial disease, the irresisti-
ble manner in which it destroys and dissolves the animal frame
when it is at its height, will be convinced that a mere palliative
could never master this excessively chronic malady, were it not
that the secondary effects of opium were very analogous to the
mercurial disease, and that these tended to overcome the latter.
* StoU (Rat M«d. Part iii, p. 442,) doubts if there arc certain signs of a peifecUj
eared tiyphilitie disease, t. «., he himself knew not the signs whereby this ilinpioo k
diitingnirfisHe from the merccuial
TBE CUBATIYE FOWSBS OF DRUGS. 287
The seoondarj effects of the coDtinued use of opium in large
doses, increased irritability, weakness of the tone, easy separa-
tion of the solids, and difficult curability of wounds, trembling,
emaciation of the body, drowsy sleeplessness, are very similar
to the symptoms of the mercurial disease; and only in this do
they differ, that those of mercury, when they are severe, last for
years, often for a lifetime whilst those of opium last but hours
or days. Opium must be used for a long time, and in enormous
doses, for the symptoms of its secondary action to last for weeks
or longer. These brief secondary effects of opium, whose dura-
tion is limited to a short time, arc thus the true antidote of the
mercurial secondary effects in their greatest degree, which are
almost unlimited in their duration ; from them alone, almost, can
one expect a permanent, true recovery. These secondary actions
can develope their curative power during the whole treatment,
in the interval betwixt the repetition of the doses of opium, as
soon as the first direct action of each dose is passed, and when
its use is discontinued.
Lead produces, in its primary action on the denuded nerves
(belonging to muscular action?) a violent tearing pain, and
(thereby?) relaxes the muscular fibre to actual paralysis; it
becomes pale and withered, as dissection shows, but its external
sensibility still remains, though in a diminished degree. Not only
is the power of contraction of the affected fibres diminished, but
the motion that still remains is more difficult than in other similar
relaxations, fi'om almost total loss of the irritability. ^ This, how-
ever, is observed only in the muscles belonging to the natural
and animal functions, but in those belonging to the vital func-
tions this effect occurs without pain and in a less degree. As
the reciprocal play of the vascular system becomes slower, (a
hard, slow pulse,) this satisfactorily explains the diminished
temperature of the blood attending the action of lead.
Mercury also diminishes the mutual attraction of the various
parts of the muscular fibres, but increases their susceptibility for
the stimulus, so as to impart to them an excessive mobility.
Whether this effect be the direct or the indirect secondary action
it Buffices^that it is very enduring ; and hence, even if of the
latter character, it would be very efficacious, as an oppositely-
' The ooDYulfliye vomiting and dysenteric diarrbcea which sometimes follow the
■gestioD of large quantities of lead, must be explained on other principles, and do
not fidl to be ooosiderod here ; neither does the vomiting that ensues from lai^
doMi of opinm.
288 8U60ESTI0NS FOR ASCSRTAINIir0
acting remedy in the lead disease ; if of the first character, how-
ever, it will act as a similarly-acting remedy. Bubbed in ex-
ternally, as well as given internally, mercury has an almott
specific influence over the lead disease. Opium increases in its
direct action the contraction of the muscular fibre, and diminishes
its irritability. By virtue of the former property, it acts as a
palliative in the lead disease ; by the latter, however, perma-
nently, as a similarly-acting remedy.
From the above idea of the nature of the lead disease, it will be
seen that the service this metal (lead has afforded, when cau
tiously used in diseases, depends entirely on its antagonistic^
though uncommonly long-lasting, action, the consideration of
which does not belong to this Essay.
The true nature of the action of arsenic has not yet been ac-
curately investigated. Thus much I have myself ascertained,
that it has a great tendency to excite that spasm in the blood-
vessels, and the shock in the nervous system, called febrile rigour.
If it be given in a pretty large dose (one-sixth or one fifth of a
grain) to an adult, this rigour becomes very evident This tendency
makes it a very powerful remedy as a similarly-acting medicine
in intermittent fever, and this all the more, as it possesses the
power, observed by me, of exciting a daily-recurring, although
always weaker, paroxysm, even although its use be discontinued.
In typical diseases of all kinds (periodical head-ache, &c.), this
type-exciting property of arsenic in small doses (one-tenth to
at most one-sixth of a grain in solution) becomes valuable, and
will, I venture to guess, become invaluable to our perhaps bolder,
more observant, and more cautious successors. As its action
lasts several days, so, frequently-repeated doses, be they ever
so small, accumulate in the body to an enormous, a dangerous
dose. If, then, it be found necessary to give a dose daily, each
successive dose should be at least a third smaller than the
previous one. A better procedure is, when we have to treat
short typical diseases with, say, two days' interval, always to
prescribe a dose only for one fit two hours before it is expected,
pass over the following fit without giving any arsenic, and another
dose only about two hours before the third fit It will be best
to act so even in the case of quartan fever, and only commenoe
to treat the series of the intermediate paroxysms when we
• have attained our object with regard to the first series of parox-
ysms. (In the case of longer intervals, as seven, nine, eleven,
and fourteen days, a dose may be prescribed before each fit)
THk CUBATnrE POWEBS OF DBUGS. 289
The eontinued iLse of oraenic in large doses gradaall j causes a&'
almost constant febrile state ; it will thus, as indeed experience
has, to a certain degree, taught us, prove useful in hectic and'
and remittent fever, as a similarly-acting remedy ; in small doses,
(about one-twelfth of a grain). Such a continued employment
of arsenic, however, will always remain a masterpiece of art, as*
it possesses a great disposition to diminish the vital heat and the
tone of the muscular fibre. (Hence the paralyses from a strong
dose, or a long-continued and incautious employment of it)
These latter properties will enable it to prove of service as an
antagonistic remedy in pure inflammatory diseases.) It dimin-
ishes the tone of the muscular fibre, by diminishing the propor-
tion and cohesion of coagulable lymph in the blood, as I have
convinced myself by drawing blood from persons suffering from
the effects of arsenic, more especially such as had a too inspissated^
blood before the use of this metallic acid. But not only does k.
diminish the vital heat, and the tone of the muscolarfibre, but also,;
as I think I have fairly proved to myself, the sensibility of the
nerves. (Thus, in cases of maniacs, with tense fibre, andinspissatfed
blood, a small dose of it procures quiet sleep, in its character of aii
antagonistically -acting substance, where all other remedies fail.
Persons poisoned by arsenic are more composed about their state,.
than might be expected. Thus it generally seems to kill more by
extinguishing the vital power and sensibility, thanby its corrosive
and inflammatory power, which is only local and circumscribed*
This being borne in mind, the rapid decomposition of the bodies
of those poisoned by arsenic, like cases of death by mortification,
will be readily comprehended.) It weakens the absorbent
system, a circumstance whence, perhaps, we may one day derive
some curative power (as a similarly or as an antagonistically-
acting remedy ?), but which must be always a powerful ob-
jection to its long continued use. I would direct attention to
its peculiar power of increasing the irritability of the fibre, es-
pecially of the system p{ the vital functions. Hence cough,
and hepce the above-mentioned chronic febrile actions.
When arsenic is used for a length of time, and in pretty large
doses,- it seldom fails, especially if diaphoretics and a heating
diet be used simultaneously, to cause some chronic cutaneous
disease (at least desquamation of^he skin). This tendency ren-
ders it an efficacious remedy in the hands of the Indian physi-
cian, in that frightful skin disease, elephantiasis. Would it not
abo be serviceable in pellagra ? If it be truly (as isconfidenfllp
19
^ BUGOKSnONS FOB ASGBBTAI9IK&
affirmed) of servioe in lijdiopliobia, it nmst act by yirtae of ita
power to dimiTiiBh (the influence of the nerves on) the attractioa
of the parts of the muscular fibre and its tone, as also the senai-
bilitjr of the nerves, therefore antagonisticallj. It produoea
acute, continued pains in the joints, as I have seen. I shall not
attempt to determine how we may avail ourselves of this pro*
perty in a curative point of view.
What influence the arsenic disease, the lead disease, and the
inercurial disease, may have over each other, and if the one
may be destroyed by means of the other, future observationa
can alone decide.
Should the accidents produced by a long-continued use of
arsenic become threatening (besides Uie employment of sulphur-
etted hydrogen in drinks and baths to extirpate what still re*
mains of the substance of the metal), the firee use of opium in
the same manner as in the mercurial disease (see above) Will bq
qf service.
« I revert again to vegetable substances ; and first, I shall men-
tion a plant, which in violence and duration of action, deserves
^ be placed alongside the mineral poisons ; I allude to the yew,
i^taaiis bdccata). Great circumspection must be employed in the
use of its various parts, more particularly of the bark of the tree
when in flower ; the cutaneous eruptions, with signs of gangre-
nous decomposition of the fibre, which sometimes occur several
weeks after the last dose, the ^tal catastrophe that sometimes
takes place suddenly, sometimes several weeks, after the last
dose, with symptoms of mortification, &c., teach us this. It
produces, it appears, a certain acridity in all the fluids, and an
inspissation of the lymph ; the vessels and fibres are irritated,
and yet their functions are more impeded than fS^ilitated. The.
scanty evacuations, accompanied by tenesmus, the dysuria, the
viscid, salt, acrid saliva, the viscid foetid sweat, the cough, the
flying acute pains in the limbs after perspiration, the podagra^
the inflammatory erysipelas, the pustules on the skin, the itch-
ing and redness of the skin, underneath which the glands liSi
the artificial jaundice, the horripilation, the continued fever,
&C., it produces, are all proo& of this. But the observatLooA
^re not accurate enough to enable us to determine which is thei
primary, which the secondary action. The direct action seema^
to continue for a considerable time. A lax, unexcitable state
of the fibres and vessels, especially of those belonging to the,
absorbent system, which seem partly deprived of vital power,.
TBJt CURATiyX POWXBS OF DRTT08. 29f
appean to be its seoondary action. Hence the perspiration, the
flbw of saliva, the frequent discharge of watery nrine, the
haBmoirhages (a dissolv^ state of the red parts of the blood) ;
and after large doses, or too long-continued employment, the
diopsy, the obstinate jaundice, the petechise, the gangrenous
decomposition of the fluids. Employed cautiously in gradually*
increased doses, it may, as indeed experience has partiy shown,
be employed with lasting advantage in a similar derangement
of the fluids, and in a similar state of the solids ; in a word, in
sfanilar morbid states to those it is capable of producing. In
induration of the liver, jaimdice, and glandular swellings, with
tense fibre, in chronic catarrh, catarrh of the bladder (in dysen-
tery, dysuria, tumours, with tense fibre?), in amenorrhoea with
tense fibre. (On account of its long-enduring, direct action, it
may sometimes be of permanent service as an antagonistically-
actmg remedy in rachitis, in amenorrhoea with relaxation, &c.
But this does not belong to our subject)
The monkshood {acomium napeUus) excites formicating, also
aeate tearing pains in the limbs, in the chest, in the jaws ; it is
a prime remedy in pains of the limbs of all kinds (?) ; it will be
servioeable in chronic tooth-ache of a rheumatic character, in
pleurodynia, in &ce-ache, and in the consequences of the im-
plantation of human teeth. It causes chilling pressure in the
stomach, occipital head-ache, shootings in the kidneys, exces-
sively painful ophthalmia, cutting pains in the tongue; the
practitioner will be able to employ these artificial diseases in
similar natural diseases. It has a peculiar tendency to produce
giddiness, feintings, debility, apoplexy, and transient paralysis,
general and partial paralysis, hemiplegia, paralysis of particular
limbs, — of the tongue, of the anus, of the bladder, obscuration
of vision and temporary blindness, and singing in the ears. It
is also just as serviceable in general and partial paralysis of the
parts just mentioned, as experience has in a great measure
proved ; — as a similarly-acting remedy, it has in several cases
cured incontinence of urine, paralysis of the tongue, and amau-
Toms, as also paralysis of the limbs. In curable marasmus, and
partial atrophies, as a remedy capable of producing similar
morbid symptoms, it will certainly do more than all other
known remedies. Successful cases of this kind are on record*
Almost as specifically does it produce convulsions, general as
well as partial, of tiie facial muscles, of the muscles of the
lips on one side, of the muscles of the throat on one side
an SUOaSSTIONS FOB ASCSETAIKIKO
of the ocular muscles. In all these last afiEections it will
prove iiseful, as it has also cured epilepsies. It causes asthma;
how, then, can it be wondered at, Uiat it has several times
cured different sorts of asthma? It produces itching, formica-
tion in the skin, desquamation, reddish eruption, and is henoa.
so useful in bad cutaneous affections and ulcers. Its pretended
efficacy in the most obstinate venereal sufferings, was probablj
only founded on its power over the symptoms of the mercury
that had been previously employed in that disease ; and this
conclusion is justified by what we know of its action. It ia
valuable to know that monkshood, as an exciter of pain, cuta-
neous affections, swellings, and irritability, — ^in a word, as a
similarly-acting remedy, is powerful in subduing the similar
mercurial disease, and is even preferable to opium, as it leaves
behind it no debility. Sometimes it causes a sensation about
the navel, as if a ball rose up thence, and spread a cold feeling
over the upper and back part of the head ; this would lead ua
to use it in similar cases of hysteria. In the secondary action,
the primary coldness in the head seems to change into a burn-
ing sensation. In its primary action are observed general cold*
ness, slow pulse, retention of urine, mania ; in its secondary
action, however, an intermitting, small, rapid pulse, general
perspiration, flow of urine, diarrhoea, involuntary faxjal evacua-
tion, sleepy intoxication. (Like several other plants that pro-
duce a cooling effect in their primary action, it resolves glanda*
lar swellings.) The mania it causes is a gay himiour alternating
with despair. As a similarly-acting remedy, it will subdue
manias of that sort The usual duration of its efficacy is firom
seven to eight hours, excepting in cases of serious effects from
very large doses.
The black heUebore {heUeborus niger) causes, if used for a long
time, severe head-aches, (hence, probably, its power in some
mental affections, also in chronic head-aches,) and a fever;
hence its power in quartan fever, and hence also, partly, its
efficacy in dropsies, the worst kinds of which are always accom-
panied by remitting fever, and wherein it is so useful^ aided by
its diuretic power. (Who can tell whether this belongs to its
primary, or, as I am inclined to think, its secondary action 7
This power is allied to its property of exciting to activity the
blood-vessels of the abdomen, rectum, and uterus.) Its power,
of causing a constrictive, suffocating sensation in the noflOi
would lead us to prescribe it in similar cases (as I once did in %
rem curative powbbs of dbuob. 2M
kind of mental disease). The frequency with which it is oon*
founded with other roots is the reason why we arc only in pos-
session of these few true data of its effects.
The boring, cutting pain that the internal use of the meadow
anemone {anemone pratensis) causes in weak eyes, led to its suc-
cessful employment in amaurosis, cataract, and opacity of the
oomea. The cutting headache caused by the internal employ-
ment of the inflammable crystalline salt obtained by distillation
with water, would lead us to employ this plant in a similar
case. Most likely it is on this account that it once cured a case
of melancholia.
The doue gilUftower {geum urbanum\ besides its aromatic qua-
lities, possesses a nausea-exciting power, which always causes a
febrile state of body, and hence its service in intermittent fever^
when used as an aromatic along with ipecacuanha.
The principle that constitutes the medicinal power of the kernel
of the cherry {prunus cerastis), of the sour cherry {prunus padu8\
ijiihepeach {amygd/dus persica\ of the bitter variety of the aJr
mond {amygdalus comm^mis) and more especially of the leaves of
the cherry-laurel {prunus laurocerasus), possesses the peculiar pro-
perty of increasing the vital power and contractility of the mus-
cular fibre in its direct action, as notably as it depresses both in
its secondary action. Moderately large doses arc followed by
anxiety, a peculiar cramp of the stomach, trismus, rigidity of the
tongue, opisthotonos, alternately with clonic cramps of various
kinds and degrees, as its direct action;* the irritability is gra-
' If it is sought to deny the primary action of the principle of bitter almond,
vldcfa I haTe represented as producing the phenomena of increased power of coo-
tnctioD in the muscular fibre and exaltation of the vital power, on this ground, that
in some cases of monstrous doses, death occurs almost instantaneously without any
perceptible reaction of the vital power or pain, as great a mistake would be made,
M if all pain should be denied to death by the sword, and it should be affirmed that
tlie stroke of the sword did not produce a peculiar condition different Ifroni tlie death
that followed it This pain will be just as intense, although perhaps less than mo
meotary, as the sensation of anxiety and torment will be indcscrilAble, which may
and must follow a fatal dose of cherry-laurel water, though its action lasts scarce a
mmute. This is proved by the case recorded by Madden, of excessive anxiety in the
region of the stomach (the probable region of the chief organ of the vital power) of a
perMn killed in a few minutes by a large dose of cherry-Iuurel water. That in this
brief space of time, the whole series of phenomena that follow a not fatal dose, can-
not make their appearance, is easily understood ; yet it is probable that changes
and impressions, similar to tlioec of the direct action I liave described from na-
tare, do actually take place in the animal organism, in this short time (until a few
BStants before death, t, e^ the few inf^tants that the indirect secondary action lasts.)
Hun, electrical phenomena may be seen, when they can be gradually passed before
the eyea; hut in the lightning rapidly flashing before us, we scarce can teU what we
or hear.
SM SUGCUBSnONB FOB ASOBBTAUnOHk
dually exhausted,' and in the secondary action the oonl
of the muscular fibre and the vital power sink in the same degree
that they had previously been exalted. There follow cold, re*
laxation, paralysis, — which also, however, soon pass ofE
(Cherry-laurel water has now and then been used as a domeslio
analeptic, in debility of the stomach and body, that is, as aa
oppositely-acting palliative, and, as might have been guessed,
with bad effect The result was paralysis and apoplexy.)
More remarkable, and peculiarly belonging to our subject, k
the curative power of its direct action (which consists in a kind
of febrile paroxysm) in intermittent fever, especially, if I mistahe
not, in that kind of intermittent depending on a too great oon-
tractility of the muscular fibre, which is incurable by bark al<nie.
Equally efficacious has black cherry water proved in the 0091*
vlioi^ofcluldreQ. As a similarly acting remedy, chenylani.!
water will prove efficacious in diseases from too tense fibre, (nt
generally where the contractility of the muscular fibre fiur ex-
ceeds its relaxing power ; in hydrophobia, in tetanus, in the
spasmodic closure of the biliary excretory ducts and similar tonie
spasmodic affections, in some manias, &c,^ as several observatioBS
have shown. In proper inflammatory diseases it also desenres
attention, where it would, to some extent, operate as a similarly-
acting remedy. If the diuretic property observed fix)m the bitter-
almond principle lies in its indirect secondary action, we may
hope much fi-om it in dropsy, with a chronic inflammatory con-
dition of the blood.
The power of the bark of the sour chister-cherry {pnmiu padui)
over intermittent fever lies likewise in the bitter-almond prin-
dple it contains, by means of which it comports itself as a simi-
larly-acting remedy.
Of the sundew {drosera rotundifolia) we know nothing certain,
except that it excites cough, and hence it has been of use in most
catarrhal coughs, as also in the influenza.
The curative principle in the flowers and other parts of the
^ A email lixard {lacerta agUi9\ that bad moved about pretty npidly for a mionte
ID diluted cberry-laurel-water, I placed in ooDoentrated cherry-laurel water. Hm
motions became instantly so ezcessiyely rapid, that the eye oould scarcely IbQov
them for some seconds ; then there occurred one or two slow conTulsioos, and thai
total loss of motion : it was dead.
* Tonic (and clonic) spasms without an inflammatory state of the blood, and wbMi
the consciousness is little aflbcted, appear to be the peculiar sphere of actkxi of tha
principle of bitter almonds, as it» as fiur as I know, does not elevate the villi
tempenture^even in its direet actioo, and leayet the Moaitifa tyiAaia wnathctwt.
TBfe- CnraULTITX P0WXB8 OF DBUQflL SOS
Met {foanivieuB niger)^ appears to lie in its primary direct aotioii
of exalting the oontractiTe power of the mnscolar fibres belonging
ehieflj to the natural and vital functions, and of raising the
temperature of the blood, whilst, in.its indirect secondary actioni
it brings down the strength of the muscular fibre, lowers thd
temperature, relaxes the vital activity, and diminishes sensatioii
itMl£ If this be the case, as I think it is, the good that it does
in the true spasm of the finest extremities of the arteries, in
dineaaes firom a chill, catarrhs, erysipelas, is in virtue of its simi*
iarity of action. Have not the elder species the power ot pro-
doeiiig transitory erysipelatous inflammation?
Various kinds of sumach^ considered to be poisonous, e. g.^ rkus
fodieana^ appear to possess a specific tendency to produce erysi*
pelatons inflammation of the skin and cutaneous eruptions. May
it not be useful in chronic erysipelas, and the worst kinds of skin
diseases? When its action is too violent, it is checked by elder,
(a similarly-acting remedy ?)
OaimphoT in large doses diminishes the sensibility of the whole
aenrous system; the influence of the, as it were, benumbed vital
qpirits (if I may be allowed to use a coarse expression), on the
lanses and motion is suspended. There occurs a congestion in
the brain, an obscuration, a vertigo, an inability to bring the
muades imder tiie dominion of the will, an incapacity for thought,
for sensation, for memory. The contractile power of the mus-
eular fibres, especially of those belonging to the natural and
vital functions, seems to sink to actual paralysis ; the irritability
is depressed in a like degree, especially that of the extreme ends
of the blood-vessels,* that of the larger arteries less, and still less
that of the heart There occur coldness of the external parts,
■mall, hard, gradually diminishing pulse, and on account of the
di£ferent state of the heart from that of the extreme ends of the
bloodvessels, anxiety, cold sweat. The above condition of the
fibre causes an immobility of the muscles, e. g., of the jaws, of
the anus, of the neck, that resembles a tonic spasm. There en-
sue deep slow breathing, fainting.^ During the transition to the
secondary action, there occur convulsions, madness, vomiting,
trembling. In the indirect secondary action itself, the awaken-
*- ■ — - I I I I _ - - ■ — ^
* Hw noTotu power and its condition seems to have most influence on these,
lew CD the larger veMels, least of all on the heart
* ▲ proo( according to Oarminati, that Camphor, far from extinguishing the irri-
Iriflitj, oolj suspends it so long as the muscles are in connexion with the benumhed
•lile of the nenree— is, that when all sensation b extinguished b/ means of camphor,
At hMit^ if cot oot^ contmoes to beat all the more stronglj for hours alterwank
S96 aUOaSSSlONS fob ASOSRTAimNA
ing of the sensibilitj, and if I may be allowed the expiesaon,
the mobility of the previously benuiiibed nervoius spirit fiiBt
commence; the almost extinguished mobility of the extremities
of the arteries is restored, the heart triuQiphs oyer the previous
resistance. The previous slow pulsations increase in velocity
and in fiilncss, the play of the circulating system attains, or in
^ome cases (from larger doses of camphor, from plethora, &c»)
surpasses, its former state, — the pulse becomes more rapid, and
more full The more motionless the bloodvessels were previr
ously, the more active do they now become ; the temperature
of the whole body becomes increased, with redness, and unifonn,
sometimes profuse, perspiration. The whole process is ended in
six, eight, ten, twelve, or at most twenty-four hours. Of all the
muscular fibres, the mobility of the intestinal canal returns
latest In every case where the contractile power of the musr
cular fibres greatly preponderates over their power .of relaxation^
camphor, as an antagonistically-acting remedy, procures rapid
but only palliative relief; in some manias^ in local and general
inflammations, of a pure, of a rheumatic, and of an erysipelatous
character, and in diseases arising from a chilL
As in pure malignant typhus, the system of the muscular
fibre, the sensitive system, and the depressed vital power, prer
sents something analogous to the direct primary action of cam*
phor, it operates as a similarly-acting remedy, that is, perma*
nently and beneficially. The doses must, however, be suffi-
ciently large to produce the appearance of a still greater insensi-
bility and depression, but given seldom, only about every thirty-
aix or forty-eight hours.
If camphor actually removes the strangury caused by can?
tharides, it docs this as a similarly -acting remedy, for it also
causes strangury. The bad elTccts of drastic purgatives it re-
jpaoves, chiefiy as a suspender of sensatiou, and a relaxer of the
fibre (consequently an antagonistic, palliative, but here, admira-
ble remedy). In the bad secondary efiects of squill, when they
are chronic — a too easily excitable action of the contractile and
relaxing power of the muscular fibre — it acts only as a pallii^
tive, and less efficaciously, unless the doses be frequently re-
peated. The same may be said with regard to its efiects in the
chronic symptoms caused by the abuse of mercury. As a simi-
larly-acting remedy, it is eminently serviceable in the long-con-
tinued rigour of degenerated (comatose) intermittent fevers, as an
adjunct to bark. Epilepsy and convulsions dependent on relax-
TBS CURATIVE |»OWSB8 OF DBUGa 297
ed fibre deprived of its irritability, are rapidly cured by the
fimilar action of camphor. It is an approved antidote to large
doses of opium, in which it is chiefly an antagonistic palliative,
but efficacious in consequence of the symptoms being but tran-
sitory. In like manner, opium is, as I have ascertained, an ex-
cellent antidote to large doses of camphor. The fi^rmer raises
the sunken vital power and diminished vital tem{)erature caused
by the latter, antagonistically, but in this case effectually. A
carious phenomenon is the action of coffee in relation to the di-
rect action of large doses of camphor ; it makes the stomach,
whose irritability was suspended spasmodically mobile ; there
occur convulsions, vomiting, or when given in clysters, rapid
^acuation ; but neither does the vital power become raised, nor
do the nerves become relieved from their stupified state, they
lather become more stupified, as I think I have observed. As
the most striking effect of camphor on the nerves consists in this,
that all the passions are lulled, and a perfect indifference to ex-
ternal things, even of the most interesting character, occurs, as
I have ascertained, it will accol'dingly be of service as a similart-
ly-acting remedy in manias, whose chief symptom is apathy,
with slow, suppressed pulse, and contracted pupil, — also, accord-
iDg to Auenbrugger, reti'acted testicles. It is by no means ad-
visable to use it in manias of every description. Used internal-
ly, camphor removes acute general and local inflammations, and
also such as are chronic, in a few hours ; but in the fpnner case,
the doses must be very often repeated to admit of anything ef-
ficacious being performed, L e., always a new dose before the
secondary action comes on. For in its secondar)'' action, cam-
phor does but the more strengthen the tendency to renewed in-
flammation, makes it chronic, and predisposes the organism
chiefly to catarrhal diseases, and the bad effects of a chill.
Used externally for a length of time, it can do more good, and
its bad effects may be easily remedied in another manner.
The patrons of new medicines generally commit the error of
carefully but injudiciously concealing the disagreeable effects of
the medicines they take under their protection.* Were it not
for this suppression of the truth, we might, for instance, from
the morbific effects the bark of the horse-chesimt {aesculus hip-
' Thi» wc often read, that this or that powerful mediciQe has cured so manj hun-
dred ctses of the worst duwases, without causing the slightest bad effects. If this
IhC be oorroct^ we may certainly infer the perfect inefiicacy of the drug. The mort
•erious the symptoms it causes, the more important is it for the practitioner.
SM tUGOBSnOHB fOK ASCBRTAINIMQ
jM9CG»fonum) is able to produoe, form a just* estimate of itt
medicinal powers, and determine i^ for instance, it is soitabto
for pure intermittent fever, or some of its varieties ; and if 80^
which. The sole phenomenon we know belonging to it is, that
it produces a constrictive feeling in the chest It will accordii^
ly be foimd useful in (periodical) spasmodic asthma.
The symptoms produced on man by the phytohcca decandra
deserve to be particularly described. It is certainly a very
medicinal plant. In animals it causes cough, trembling, convul-
sions.
As the bark of the ehn (ulmvs campestris), when exhibited inr
temally, produces at the commencement* an increase of cutar
neous eruptions, it is more than probable that it has a tendency
to produce such afifections of itself consequently, that it will
be serviceable in them, which is amply proved by experience.
The juice of hemp leaves {cannabis scUiva) is, it would seem, ft
narcotic, similar in action to opium. This is only in appear-
ance, however, and owing to the imperfect accoimts we have of
its pathogenetic action. I am much mistaken if it do not poa^
sess differences indicative of peculiar medicinal powers, if we
but knew it sufficiently. It produces dimness of vision ; and
in the madness caused by it there occur many phenomena, genA-
rally of an agreeable character.
It appears as if saffron {crocus saMvus), in its direct actioDi
brought down the circulation and vital heat. Slow pulse, pale
£EU^e, vertigo, exhaustion, have been observed. In this staged
most probably occur the melancholy and headache that have
been observed &om its action, and in the second stage (the indi-
rect secondary action), occur the senseless, extravagant gaie^,
the stupe£EU)tion of the senses, the increased action in the arte-
ries and heart, and lastly, the haemorrhage which have been ob-
served from its use. For this reason it may be useful in restor-
ing flows of blood that have been checked, as a similarly -acting
remedy, as its power of increasing the circulation occurs first
in the secondary action ; consequently, the opposite must take
place in its direct action. It has been found useful as a similar-
ly-acting remedy in vertigo and headache, with slow pulse. In
* In order to draw a fisiYourable inductioo firom the aggravaiiDg action of a dmg hk
a diseaae, thii aggrayatkn must occur at the oommeucemeDt of its use, that is, in ita
direct action ; in socfa cases only can it be considered a similarly-acting efficadooa
remedy. The morbid aggravations occurring so often subsequently (in the indiraflft
tecondary atiliQii) piova the oontxtiy la iU-choien remedies
THE OUBATITX P0WSB8 OF DBUGB. 299
aome oaaeB of melancholia with alow pulse, and in amenorrhoea,
it ^>pean also to be of service as a similarly-acting remedy.
It has (in its direct action) produced death by appoplexy, and
IB said to have proved efficacious in similar affections (probably
in relaxed organisms). The phenomena of its secondary action
point to much increased irritability of the fibre, hence probably
the cause of its so readily producing hysteria.
The damd {loUum temtdentum) is such a powerfhl plant, that
be who knows its pathogenetic action must congratulate the age
when, for the benefit of humanity, its application shall be known.
The chief phenomena of the direct action of the seeds are cramps,
apparently of a tonic character (a kind of immobility), with re*
laacation of the fibre and suspension of the vital spirits, great
iiudety, exhaustion, coldness, contraction of the stomach, dysp-
ncBa, difficult deglutition, rigidity of the tongue pressive head-
ache and vertigo (both continue longer than is known firom any
other drug, in the greatest degree, for several days), noises in the
ears, sleeplessness, insensibility, or weakness of the external
senses, red &oe, staring eyes, sparks before the eyes. In the
tnuudtion to the secondary action, the cramps become clonic,
there occur stanmiering, trembling, vomiting, diuresis, and (cold)
perspiration (cutaneous eruptions, ulcers on the skin ?) yawning
(another kind of cramp), weak sight^ long sleep. In practice,
cases of obstinate vertigo and cephalalgia present themselves,
which we are inclined to avoid treating, from their incurability.
The darnel appears to be made expressly for the worst of such
cases, probably also for imbecility, the opprobium of medicine.
In deafness and amaurosis something may be hoped from its use.
SquiU (sciUa maritima) appears to possess an acrid principle
that remains long in the body ; the mode of operation of which^
from want of accurate observation, cannot be very well separa-
ted into primary and secondary action. This acrid principle
possesses a tendency to diminish for a long period the capacity
of the blood for csJoric, and hence to establish in the organism
a disposition to chronic inflammation. Whether this power can
be applied to useful purposes, instead of being, as hitherto, a
stumbling-block to the use of the drug itself I am unable, on
iooount of the obscurity of the subject, to determine. As, how-
ever, this power must certainly have its limits, at least in the
oonmiencement) it has only an acute inflammatory action, and
afterwards, especially afl;er long-continued use, leaves behind it
the slow chronic inflammatory action ; so it seems to me to be
800 BUGOESnONB FOB ASClBTAlinKO
rather indicated in pure inflammations with tense fibre, when itB
nse is otherwise required, than in a cold or hectic infiammatory
condition of the fluids and mobility of the fibre. The incom*
parable aid derived from squill in infiammation of the lungs, and
the extraordinary injury infiicted by its continued employment
in chronic purulent consumption of the lungs, as also in pituitoiu
consumption, prove this satisfactorily ; there is no question here
of palliative relief. This acrid principle puts the mucous glands
in a condition to secrete a thin, instead of a viscid mucus, as ii
the case in every moderately inflammatory diathesis. Squill
causes a great degree of strangury, shewing thereby that it must
be very useful in restoring the secretion in the suppression of
the urine accompanying several kinds of dropsy, as daily expo*
rience confirms. Rapid, acute dropsical swellings appear to be
its chief sphere of action. It has cured some kinds of tickling
cough, because it can of itself cause cough.
That most incomparable remedy, white hellebore {verairum^
albmn\ produces the most poisonous efiects, which should inspire
the physician who aspires to perfection with caution, and the
hope of curing some of the most troublesome diseases that have
hitherto usually been beyond medical aid. It produces in its
direct action a kind of mania, amounting from larger doses to
hopelessness and despair ; small doses make indifferent things
appear repulsive to the imagination, although they are not so in
reality. It causes in its direct action, a. heat of the whole body;
6. burning in different external parts, e, g., the shoulder-blades,
the face, the head ; c. inflammation and swelling of the skin of
the face, sometimes (from larger doses) of the whole body ; (L
cutaneous eruptions, desquamation of the skin ; e. a formicating
sensation in the hands and fingers, tonic cramps ; / constriction
of the gullet, of the larynx, sense of suffocation ; g. rigidity of
the tongue, tough mucus in the mouth ; h, constriction of the
chest ; t. pleuritic symptoms ; k. cramp in the calves ; L an
anxious, (gnawing ?) sensation in the stomach, nausea ; m. gripes,
and cutting pains here and there in the bowels ; n. great general
anxiety ; o. vertigo ; p, head-ache (confusion of the head) ; q,
violent thirst. On passing into -the indirect secondary action^
the tonic cramps resolve themselves into clonic cramps ; there
occur, r. trembling ; s, stammering ; t. convulsions of the eyes ;
u. hiccough ; v. sneezing (from the internal use) ; w. vomiting
(when at its height, black, bloody vomiting) ; x. painful, scanty
evacuations^ with tenesmus ; y. local, or (firom large doses) ge^
«HX CUBATIYfi POWXBS OF DBU6S. SOt
neral oonyukdons : z, oold (from large doses, bloody) sweat ; aa^
watery diuresis ; bb. ptyalism ; cc. expectoration ; dd. general
coldness ; ee. marked weakness ; ff. fainting ; gg. long profound
sleep. — Some of the symptoms of its direct action, I. m. n. p. q.^
wovQd lead us to use it in dysenteric fever, if not in dysentery.
The mania it causes, together with some symptoms of its direct
iction, «./ g, g. h. n. j., would lead us to employ it in hydro-
phobia, with hopes of a good result. A dog to which it was
given had true rabies, lasting eight minutes. The ancients speak
of it with approbation in hydrophobia. (In tetanus?) in spas-
modic constriction of the guDet, and in spasmodic asthma, it will
be found specific on account of/ and h. It will prove of per-
manent advantage in chronic cutaneous diseases, on account of
e. and d. as experience has already shown with regard to herpes.
In so-called nervous diseases, when they are dependent on tense
fibre or inflammatory symptoms, (a. q.) and the symptoms in other
respects resemble the veratrum disease, it will be of benefit ; so
also in manias of like character. — The landlord of a country inn,
a man of firm fibre, robust make, red blooming countenance, and
somewhat prominent eyes, had almost every morning, soon after
waking, an anxious feeling in the stomachic region, which in the
course of a few hours involved the chest, producing constriction
there, sometimes amounting to complete loss of breath ; in the
course of a few hours the affection attacked the region of the
larynx, and suffocation became imminent (swallowing solids or
flaids being impossible) ; and as the sun declined it left these
parts, and became confined to the head, with timorous, despair-
ing, hopeless suicidal thoughts, until about ten o^clock, when he
fell asleep, and all the morbid symptoms disappeared. The mania
resembling that peculiar to veratrum, the firm fibre of the pa-
tient, and the symptoms / g. A. I, w., induced me to prescribe
three grains of it every morning, which he continued for four
weeks, with the gradual cessation of all his suffcriags; his
malady had lasted four years or more. — A woman, thirty -five
years of age, after having had many epileptic attacks during
her pregnancies, was affected a few days aft^r her last delivery,
with furious delirium and general convulsions of the limbs. She
had been treated for ten days with emetics and purgatives, with-
out effect At midnight every night she was attacked by fever,
with great restlessness, during which she tore all the clothes off
her body, especially what she had about her neck. Cinchonai
hsrk always made the fever a few hours later, and increased the
801 evQSEBFiom rom AscnerAnmre.
thitst and anxiety; the expreased juice of Btramomtnn, uaed ao-
cording to Bergius' method, soon quelled the convulsions, and
produced some rational hours, in which it was ascertained thail
her worst symptom (except the fever) was the suffocating feeling
in the throat and chest, besides pain in all her limbs. MorOi
however, it could not do ; on the contrary, its continued use
seemed rather to increase the last mentioned serious symptoms;
the face was swollen, the anxiety infinite, the fever greater.
Emetics did no good ; opium caused sleeplessness, increased the
restlessness; the urine was dark -brown, the bowels much con-
stipated. Blood-letting, which was evidently not adapted to
this case, was, moreover, contra-indicated by the excessive
weakness. The deliria returned, notwithstanding the extract of
stramonium, with increased convulsions and swelling of the
feet. I gave her in the forenoon half a grain of veratrum pow-
der, and a similar dose in the afternoon at two o'clock. Deliria
of another kind made their appearance, along with viscid mucus
in the mouth, but no fever returned, the patient slept, andin ihe
morning passed white cloudy urine. She was well, quiet and
rational, except that the great weakness continued. The suffoca-
ting sensation in the throat was gone, the swelling of the &ce fell,
as also that of the feet, but the following evening, without her
having taken any medicine, there occurred a constrictive sensa*
tion in the chest. She therefore got another half grain of vera-
trum tlie following afternoon; this was followed by scarcely
perceptible delirium, tranquil sleep, in the morning copious dis-
charge of urine and a few small evacutions. For two more
days she got half a grain of veratrum in the afternoon. All
Jier symptoms disappeared, the fever vanished, and the weak-
ness yielded to a good regimen.
I ^lall on a subsequent occasion^ record a case of spasmodic
colic still more rapidly cured by it. As a producer of mania
and spasms it has shown itself useful in cases of persons pos-
sessed. In hysterical and hypochondriacal attacks, dependent
on tense fibre, it will be usefiil, as it has been practically proved*
Inflammation of the limgs will find in it a powerftil remedy.
The duration of its action is short; limited to about five, at
most eight or ten hours, inclusive of the secondary action ; ex-
cept in the case of serious effects fix>m large doses.
SabadiUa seed causes conftision of the intellect and convulsions^
which it can also cure ; the peculiarities of its action, however^
> SeeDO^artiGle.
THE OUBATJYM POWBBS OF DBUGS. 80t
aie not yet known. It also oanses a creeping sensation through
all the limbs, as I have experienced, and is said to produce pain
m the stomach and nausea.
The agaric {pgaricua muscariua) produces, as far as I can as-
certain, a furious and drunken mania (combined with revenge-
fiilf bold resolves, disposition to make verses, to prophesy, &c)|
exaltation of the strength, trembling and convulsions, in its pri-
mary direct action ; and weariness, sleep, in its secondary action.
It has therefore been employed with benefit in epilepsy (caused
by fiight), combined with trembling. It will remove mental
affiections and possession, similar to those it causes. Its direct
action lasts from twelve to sixteen hours.
The nvtmeg (myristica aromatica) diminishes the irritability of
the whole body, but especially that of the prim® vise, for a con-
siderable time. (Does it not increase the contractile power of
the muscular fibre, especially of the primaa vias, and diminish
its capability of relaxing ?) In large doses it causes an absolute
inaenaihility of the nervous system, obtuseness, immobility, loss
of reason, for its direct action ; headache and sleep for its sec-
ondary action. It possesses heating properties. May it not be
QseftQ in imbecility, combined with laxness and irritability of the
primae vi» 7 — agidnst the first as a similarly, against the second
as an antagonistically-acting remedy ? It is said to have done
good in paralysis of the gullet, probably as a similarly-actiDg
remedy.
Rhubarb is useful in diarrhoeas without faecal evacuations,
even in the smallest doses, more in consequence of its tendency
to promote the action of the bowels, than on account of its
astringent power.
The topical pain-producing applications, as catharides, mus-
tard plasters, grat^ horse-radish, spurge-laurel bark, crushed
ranunculus acris, the moxa, allay pain often permanently, by
producing artificially pain of ano^er kind.
CASE OF RAPIDLY CURED COLICODYNIA.'
L ^is, a compositor, 24 years of age, lean, of a pale and
earthy complexion, had worked at the printing-press a year and
^ FmuL Hafriuid'* Jwmal dtr praelMym Atmfffktmiii. VoL in. 1797.
8M 8UGOESTION8 FOB ASCBBTAmilia
a half before he came to me, and then for the first time sud-
denly felt great pain in the left side which obliged him to keep
his bed, and which after several days went away under the use
of ordinary medicines. Ever since that, however, he had ex-
perienced a dull disagreeable sensation in the left hypochondrium.
Some months afterwards, when he had overloaded his stomach
with sweet beer-soup flavoured with caraway, he was attacked
with a severe colic, the violence of which he could not express^
but at the same time could not say whether it corresponded
with the colicodynia which succeeded it.
The attack passed off this time, I don't know how, but he
observed, that after it he could not bear certain kinds of food.
The mischief increased imobserved, and the colicodynia with
its distinctive symptoms took firm root.
The worst kinds of food for him were carrots, all sorts of cab-
bajge, especially white cabbage and sour-crout, and every species
of fruit, but pears in particular.
If he were so incautious as to eat any of these things within
eight days after an attack which had been brought on by thenii
the liability was so increased that he could not eat even »
morsel of a pear, for example, one or two weeks after without
bringing on another severe attack.
The course of a severe attack was as follows. Four hours or
four hours and a half ailer eating of such food — having previous-
ly felt quite well — a certain movement was felt about the
umbilical region ; then there took place suddenly, always at
the same place, a pinching as if by pincers, but attended with
the most intolerable pain which lasted half or a whole minute^
and each time suddenly went away with borborygmus extend-
mg to the right groin — about the region of the coecum. When
the attack was very bad the pinching came back, and the
subsequent borborygmus more and more fi^quently, until in
the worst attacks they were almost constant. There occurred
also the sensation of a constriction above and below, so that
flatus could pass neither upwards nor downwards. The
uneasiness and pains increased from hour to hour, the abdomen
swelled and became painful to the touch. Along with all this
suffering, which resembled a fever, there came an inclination to
vomit, with sense of constriction of the chest, the breathing was
shorter and attended with more and more difficulty, cold sweat
broke out, and there came on a sort of stupefaction with total
exhaustion. At this period it was impossible for him to swallow
GASK or RAPIDLY CURSD OOLIOODYKIA. 806
a drop of liquid, much less any solid food. Thus he lay stupi-
fied and unconscious, with swollen face and protruded eyes, and
without sleep for many hours; the attack of spasmodic colic
gradually subsided by diminution of the pain, then followed some
escape of flatus either upwards or downwards, and so the attack
went off^ (sometimes only . after sixteen or twenty -four houiB
from its conmiencement). The strength only returned after three
or four days, and thus he was again like a person in health,
without any other uneasiness except the dull fixed pain before
described, and general weakness and sickly appearancie. He
oould not positively say whether this dull pain went off during
the severe attacks or not, but he thought it did.
In these circumstances he could not retain his situation at the
printing-press; he became a compositor. The attacks always
recurred under the condition described, and had continued
to do fK> for more than a year when he put himself under my
care.
It might easily be supposed that the attacks arose ftom flatu-
lenoe ; this however was not the case. He could take, without
the least inconvenience, a good meal of dry peas, lentils, beans
or potatoes, and he was obliged to do so moreover, as his position
did not allow him the opportunity of getting much else.
Or it might be supposed to arise from some kind of fermenta-
tion in the primse vi», or from some idiosyncrasy in respect to
sweet things. But nothing was further from the case. He
could take cakes baked with yeast, and sugar and milk as much
as he pleased, even to satiety, without the slightest threatening,
of colic, although the first attack, seemed^ as I have said, to be
oocaaioned by the beer soup. ^
Or could an injurious acidity have occurred within the four
hours (for the attack never occurred sooner, after partaking of
the above things)? This was not the cause. Lemon-juice and
rinegar were both innocuous. Neither did he ever vomit sour
matter, either during the retching that occurred with the attack
<ff when ordered an emetic. None of the absorbent earths or
alkalis were of any use to him, whether taken during or before
die attack.
A physician had suspected tape-worm, and subjected him to
Hermschwand^s treatment,^ without any result. Neither before
aor aft«r he had passed anything which had the smallest
' II I n . ^ — ^ ^ ^ — M-^^^^^^^
' [H«nii8diwind*s method coaaisted chiefly in the emploTinent of the powder of
VktU-fem root^ fbUowed fay purgatives, principaUy castor^oiL]
20
306 CASE OF RAPIDLY CUBED COLICODnOA.
resemblance to a tape-worm or indeed to any kind of worm at
all.
When he came to me the idea of tape-worm had taken so
tirm a hold of his mind that I was obliged to order him all that
was peculiar in the methods of Nuflfer* and of Clossins.* He
used all the medicines with patience, and pressed me to try every
means with this view. Tartrate of antimony, gamboge, scam-
mony, male-fern (four ounces daily for four hours together)
charcoal, artemesia in large quantities, colocynth with oils, cas-
tor oil, tin, iron, sabadilla, sulphur, petroleum, camphor,
assafcetida, and laxative salts — nothing was left untried; but
they were given, as I have said, rather on account of his urgent
request than to satisfy my own conviction, for besides the fiict
that no worms were ever seen, tHe two symptoms which I have
so often observed to attend worms were absent, viz., the deeply
wrinkled countenance and the sensation of a cold stream winding
itself towards the back immediately after a meal.
• Immediately after the sabadilla, which produced a creeping
sensation like ants upon the skin (formication) and a heat in the
stomach and over the whole body, I let him try the test of eating
a piece of pear. It appeared indeed as if the attack had returned
quite mildly, but afl«r I had left him without medicine for eight
days and again tried him with a small piece of pear, the ooUc
came on just as bad as ever.
I have forgotten to mention that I had already previously
tried all sorts of powerful so-called antispasmodic remedies at
the commencement of the paroxysm. Small doses of ipecacuanha
taken dry, lukewarm foot-baths and larger baths, opium and
•ajeput oil, without any result, even without any palliative
effect. I only sought to palliate the symptoms at that time in
order that he might continue without molestation to use cinchona
bark and to wash with cold water, to get the better of his
weakness.
As his condition required immediate help, inasmuch as the
colicodynia began to appear even upon the use of the smallest
quantity of vegetable food, and as all I have done at his entreaty
> [Madame Nuffer's method, which was purchased by the French Oovanment for
1 8 000 livres, consiBted mainlj of the adminstratioD of the powder of the male-fern
root, aooompanied by a number of complex directions which were to be implicitly
followed to ensure success.]
* [CloBsius* method was to feed the] patient during four weeks on salted meat
cheese, and a good allowance of wine, ^and thereafter to giye drastic purgatiTW
coDsisting chiefly of gamboge.]
CASE OF RAPIDLY CURED COLICODYNIA. 807
had been of no service whatever, I determined to give him a
medicine which produced very similar morbid symptoms. The"
similarity of the griping pain, anxiety, constriction of the chest,
fever, los^ of strength, &c., produced by veratrum album appear-
ed to me calculated to give permanent relief
I gave him four powders, each containing four grains, and
told him to take one powder daily, but to let me know at once
if any violent symptoms appeared. This he did not do. He
did not return imtil five days thereafter. His unlimited confi-
dence in my aid had nearly played him an awkward trick. The
benefit I had promised from the powders had induced him to
take two instead of one daily. After the second powder, with-
out his having eaten anything injurious, there began an attack
which he could no£ otherwise describe than as his spasmodic
oolic, or something very like it. This did not prevent him, how-
ever, from taking the third and fourth powder the following day
(taking thus sixteen grains in rather less than two days), upon
which, this artificial colic, if I may so speak, increased to such
a dreadftil extent, that, to use his own expression, he wrestled
with death, covered with cold sweat and almost suffocated. He
had required the remaining three days to recruit, and had re-
tamed for fiirther directions. I reprimanded him for his impru-
dence, but could not avoid notwithstanding comforting him with
the prospect of a good issue. The result confirmed it; under
the use of tolerably good diet he regained his strength, and he
has not had for half a year even a threatening of an attack, al-
though from time to time lie has eaten of the food which befon^
was so injurious to him, but in moderation, as I impressed upon
him he should. Since this event he has taken no more medi-
cine, and no tapeworm was passed after the use of the veratrum.
The dull pain in the left hypochondrium likewise went at the
j^aine time.
ARE THE OBSTACLES TO CERTAINTY AND SIMPLICITY
IN PRACTICAL MEDICINE INSURMOUNTABLE ? »
Dr. Herz's essay " On the Medicinal uses of the Phellandriuin
'jquaticum,^^ &c., in the first part of the second volume of the
Journal der practischen Arzneykunde^ plunged me into a sort of
* From Bu/elafuTi ^humaldtr practUe/un Armeykundey Vol. iy., Part iy.,page
lOe. 1797.
306 ABB THS OBSTACLES TO CEBTAINTY AVD SIMPLICITY'
melancholy, which only by dint of long continued r^eotioD
has given place to a remote but lively hope.
Here one of the most thoughtful physicians of our timCi afieir
twenty years of active practice, finds himself obliged repeatedly
to make the open, but most melancholy acknowledgment : (p. 40l)
" That we can lay no claim to the attainment of the ideal of
simplicity in medical treatment"
"That the hope of ever arriving at perfect omplicity in
medical practice, cannot be otherwise than very feeble" (p. 47).
The obstacles to pure observation of the effects of medidneB
in the various diseases, he enumerates with most overwhehning
fulness of detail, and there he leaves us alone in the old well-worn
path of imcertainty, almost without a cheering glance at a better
futurity, a simpler, surer method of cure ; unless we are to reckon
his very complaints as foreshadowing coming improvements^
just as the impassioned warmth of the sceptical casuist has al-
ways appeared to me a proof of that immortality he would deny.
I myself felt the external hindrances to our art more than I
could have wished; they continually beset my sphere of acticm ;
and I, too, long considered them insurmountable, and had almost
made up my mind to despair, and to esteem my profession as
but the sport of inevitable accident and insuperable obstacles,
when the thought arose within me, " are not we physicians pardy
to blmrvefor the complexity and the uncertainty of our art f "
OBEDIENCE OF PATIENTS.
I have seen medical men take under their care patients who
had only half confdence^ and from whose demeanour any one
might perceive that they put themselves under the physician
whom they had chosen, not from any enthusiastic regard fi>r
him, nor from a stnmg desire to be relieved from their sufferings.
How could implicit obedience be expected from such persons?
And even when they spoke of, and commended in common-
place terms, strict attention to the physician's orders, could he
trust them, and with confidence ascribe the issue to his prescrip-
tions, his medicines ? By no means !
DIET AND REGIMEN.
It is a constant complaint of physicians that patients will not
observe the prescribed diet " Who shaU give them assuranoe
of such compliance ? and how impossible, then, is it to determine
the issue of a disease, or the effect of the remedies employed,
since on this point in no case can any certainty be attained? ^
.or FEACTICAI^ MMDIOUSE IKBUBMOUNTABUB ? S09
Paidon me 1 We may be perfecUj sure of such as with im-
plicit confidence entrust themselves to the care of their aknost
vorahipped physician. Of course, others are less to be relied upon.
Methinksi however, that medical men when thus complaining,
do not draw a sufficient distinction between, 1st, the errors of
diet which produced and kept up the patient's disease ; 2d,
their ordinary ind^erent diet ; and, 8d, the new dietetic regtdatiam
laid down by the physician.
I^ with reqpect to the first of these (the correction of the
enors of diet), the physician thinks that he does not possess
snfficieiit authority with his patient, who ¥rill not pay strict at-
tention to rules, radier let him dismiss such fickle-minded persons ;
better no patients at all than such I
Who, for example, would undertake to cure a drunkard of
induration of the liver, who merely consulted 'the physician en
paaaanif beeause, perhaps, he met him in the street ; or had some
bosLness-matters to arrange with him ; or, because the physician
has come to reside in the neighbourhood ; or has become a con-
nexion of his; or for some other trifling reason, but not from
having implicit confidence in his skill ? What immense influence
ihe medical man must have with such a confirmed debauchee,
to &el assured that he will pay attention to his orders, and daily
liiminiali his allowance of the poisonous liquor I
A patient with such bad habits, must show by some considera-
ble sacrifice, that he intends to submit himself entirely to the
will of the physician. The physician would do well to try to
dissuade him from submitting to treatment ; to represent to him,
in strong terms, the difficulties which his ruinous vice throws in
the way, and the magnitude of the disease. If he return re-
peatedly, and express his willingness to make any sacrifices,
then, what should prevent the physician trusting him, so long
as he sees indubitable proo& of his resolution? If he cannot
withstand temptation, then let him go his way ; he will, at any
rate, not bring discredit on the art,^ nor disappoint the hopes of
the much-deceived physician.
Are there not enough of patients, who, when solicitously ad-
vised by a universally esteemed physician, will, for example,
scrupulously abstain from eating pork during a quartan fever,
and for months afterwards ; who will carefully avoid potatoes,
if they are asthmatic or leucophlegmatic ; sedentary occupations,
if they are gouty ; and sour wine, if sufiering from the wasting
diseases of youth brought on by venereal excesses?
310 ABS THB OBSTACLES TO CEBTAINTT AND 8DIFLIGITY
In the case of a woman affected with a nervous disorder,
should not a good physician be able to effect a gradual diminu-
tion in the quantity of coffee taken ; or, if otherwise, will he not
be able to perceive that she will not follow his advice? From
my own experience I can say, that it is no uncommon circum*
stance to meet with both these cases ; and in each the physician
may reckon with certainty on his observation.
If we go to work in this manner, we shall attain to a high
degree of empirical certainty. Is this not certainty ? Or does
the statesman, the teacher, the lawyer, the merchant, the general,
possess any other than empirical certainties ? Or is there any
other positive rule to guide us, in any imaginable profession in
which the free-will of man is involved ?
But is the ordinary diet of those classes of the community
who are not altogether corrupted, of such an objectionable na-
ture, that we are compelled, in every disease, to prescribe a new
one ? This is one of the rocks on which so many physicians
split. In every acute or chronic disease that comes under their
notice, they earnestly insist on a very complicated artificial system
of diet, withholding many things, and ordering a host of odiers.
Do we physicians, however, know with such extreme preci-
sion, the effects of all kinds of food, as to be able with certainty
to say, in this case such and such an article of diet is to be tak-
en, and this and that other to be avoided I How does expe-
rience refute our fancied omniscience !
For what a length of time did our forefathers insist in their
so-called acute (putrid) fevers with diminished vital power, on
watery drinks, tea, &c. ; and exclaimed against beer and wine
as little better than poison — which, however, the patients long
for so much, and which is now the main support of our practice !
How long did we forbid fresh meat in cases of haemorrhage from
passive plethora, in wasting pulmonary complaints, in scurvy,
and in most other chronic non-gastric diseases, where it is now
reckoned, if not a perfect panacea, at any rate indispensable !
A universal diet, like a universal medicine, is an idle dream ;
. but speaking generally, nothing is more wholesome than fruit
in abundance, and green vegetables ad libitum ; and yet they fre-
quently oppress the stomach of those who have poverty of the
blood, of exhausted persons, and those suffering from the effects
of a sedentary life, and increase in them the disposition to acidity,
flatulence and diarrhoea I Boast beef and raw ham are consid-
ered more difficult of digestion for a relaxed stomach than veal
nr PRAoncAL iubdicine insurmountable 7 811
boiled to rags. Cofiee has the reputation of strengthening and
assisting digestion, and yet it only hastens the expulsion of half-
digested food firom the bowels. I have seen children deprived
of the breast-milk, crammed to death with wafer-biscuits, and
perishing in numbers of jaundice. My expostulations on the
indigestible nature of this unleavened and hard-baked mass of
dough, were of no avail against the plausible folly of my col-
leagues— *'it is impossible to imagine any thing lighter (in
weight), or more delicate (to the touch) I "
I once knew an ignorant over-ofl5cious practitioner prescribe
such a severe diet to a healthy young woman after a favourable
first-labour, that she was on the eve of starvation. She held up
for some days under this water-gruel diet — all meat, beer, wine»
coffise, bread, butter, nourishing vegetables, &c., were denied
her ; but at last she grew excessively weak, complained of ago-
nising after-pains, was sleepless, costive, and, in short, danger-
ously ill. The medical attendant attributed all this to some in-
fraction of his dietetic rules. She begged to be allowed some
coffee, or broth, or something similar. The practitioner, strong
in his principles, was inflexible : Not a drop ! Driven to despe-
ration by his severity and her hunger, she gave way to her inno-
cent longings, drank coffee, and ate in moderation whatever she
fiuicied. The practitioner found her, on his next visit,, much to
his surpirse, not only out of danger, but lively and refreshed ;
so he complacently noted down in his memorandum-book
the excellent effects of slop-diet in the treatment of lying-
in-women. The convalescent took good care not to hint to him
her natural transgression. This is the history of many, even
published observations ! Thus the disobedience of the patient
not unfrequently saves the credit of the physician.
Is the error cakuh\ in such a case, the fault of the art or the
patient, or is it not rather the fault of the physician ?
The artificial diet prescribed by the physician, is frequently
much more objectionable than the accustomed diet of his patient ;
or, at least, he frequently does wrong in rejecting the latter all
at once.
As the physician would do well, in order to observe more
distinctly and simply the course of the disease and the effects of
his medicines, not to give any orders at all about the diet, ex-
cept with regard to articles of which he possesses a positive
knowledge, and these will be but few ; he would also be consult-
ing the good of his patient by not depriving him of any thing which
long habit had rendered innocuous, or perhaps indispensable.
812 ABX THB OBflTAOLKB TO CXBTAINTY AHD SIMFLICnT
A country midwife fell sick of a gastric fever. I purged her.
I ordered her for drink, water and weak beer, and extreme
moderation in eating. At first, things went on very well ; but,
after a few days, a new continued fever, with thirst, wakeful-
ness, weariness, confusion of ideas, came on to such an extent as
to render her state dangerous. I left none of the ordinary rem-
edies untried. All in vain. I now left off every thing, firom
the sulphuric acid to the soup (at the time I was not sufficiently
acquainted with the properties of opium), and promised to pre-
scribe something on my return. I informed the relations of the
danger I apprehended. The following day I was told that the
patient was recovering, and that I need not give myself any
further trouble. To my astonishment, I saw her pass my win-
dow, a few days afterwards, perfectly recovered, I subsequently
learned, that when I had discontinued the medicine, a quads:
had been called in, who had given her a large bottle of essence
of wood, his universal medicine, and told her to take so many
drops of it No sooner had she tasted the brandy in it than she
gained, as it were, new life. She took the drops by iable-spoon-^
Jttls, and, after a good sleep, she rose completely cured.
This happened when I first began practice, else I should have
ascertained at the commencement that, when in health, she
could n9t live without her daily dram, consequently could not
recover without it.
It is far less frequently necessary than most physicians think,
to make a material alteration in the diet of patients suffering
from chronic complaints, at least in ordinary cases ; in acute
diseases, the awakened instinct of the patient is oft;en considera-
bly wiser than the physician who does not consult nature m
his prescriptions.
I do not now allude to cures effected by dietetic rules alone,
which, if simple, are not to be despised, and which are very ser-
viceable in many cases. What I particularly call attention to
is, the frequently useless change of diet, when treating a case
with medicine, whereby the simplest method of treatment is
rendered complex, and a composite result is produced, of which
I would defy (Edipus himself to guess what part was owing to
the new diet, and what to the medicine.
We must certainly prohibit what we know to be hurtftd in
this or that complaint ; but this can at the most be but two or
three articles of diet in chronic diseases ; the gradual disuse of
which (for sudden suppression is always dimgerous in such
or FBAOnCAIr ICSDICINE INSUBMOUNTABLX 7 818
aflfootioDs), oannot produoe an j great revolution in the system ;
cannoty thereifore, have much effect in deranging the pure action
of the medicine we are using.
If it be necessary to make considerable changes in the diet and
reffimenj the ingenious physician will do well to mark what
effect such changes will have on the disease, before he prescribes
the mildest medicina
A deeply rooted scurvy can often be cured by the united ac-
tion of warm clothing, dry country air, moderate exercise,
change of the old salted meat for that freshly killed, along with
sour-crout, cresses, and such like vegetables, and brisk beer for
drink. What would be the use of medicine in such a case ? To
mask the good effects produced by the change of diet 1 Scurvy
is produced by a system of diet opposite to this, therefore it may
be cured by a dietetic course — the reverse of that which pro-
duced it ; at any rate, we may wait to see the jesult of this
method, before we begin with our medicines.
Why should we render the syphilitic patient, for example,
worse than he is by a change of (Het, generally of a debilitating
nature ? We cannot cure him by any system of diet, for his
disease is not produced by any errors of the sort. Why then,
should we, in this case, make any change f
Since this occurred to fny mind, I have cured all venereal dis-
eases (excepting gonorrhoea), without any dietetic restrictions,
merely with mercury (and, when necessary, opium) ; the metal
has not a debilitated constitution to act upon, and my patients
recovered more rapidly than those of my colleagues. I also
knew for certain, that every change that took place, either for
the better or the worse, was owing to the medicine.
An old colonel, with "fair round belly," and apparently fond
of the pleasures of the table, had suffered for the last forty years
firom ulcers almost all over the legs, and issues on the thighs.
His food consisted of the strongest and most nutritive materials
— he drank a good deal of spirits, and, for several years past, he
had been in the habit of taking a monthly purge. Otherwise,
he was vigorous. I allowed the issues to heal up, made him
keep his legs rolled up in a narrow flannel bandage, and im-
merse them daily a few minutes m cold water, and afterwards
dress them with a weak solution of corrosive sublimate. I made
not the slightest alteration in his diet ; I even did not forbid the
soonthly purge, as he was so constantly in the habit of taking it
In the oouise of a year his legs gradually healed, and his
814 ABS THE OBSTACLES TO CERTAINTY AlTD SDCPLICITY
vigour rather increased tlian diminished in this his seventy-third
year. I watched him for two years, during which he remained
perfectly well, and I have since had good accounts of his health.
The legs have always continued completely healed. Can I sup-
pose that he would have recovered more rapidly or permanently
had I deprived him of his eight or ten dishes, and his daily
allowance of liquors? Had I changed his diet, and had he
grown worse, would I have known whether this unfavourable
turn proceeded from the food so much lauded in works on die-
tetics, but so different to what he had been accustomed to, or
from my external applications, for I gave nothing intemaUy ?
It would have been easy for me to conform to the schools, and
sacrifice my patient methodically to the ordinary dietetic regu-
lations ; but how could I at the same time abide by my convic-
tion, my conscience, and that prime guiding principle of the
physician, mnpUcity !
I have no intention of exalting myself at the expense of my
brethren, when I acknowledge that I have cured the most dif-
ficult chronic diseases, without any particular change of diet.
I consider that I do quite enough if I advise moderation in
all things, or diminish or forbid altogether particular articles of
diet, which would be prejudicial to the object I wish to accom-
plish; as, for example, acids, when I am employing stramo-
nium, belladonna, foxglove, monkshood, or henbane (the effects
of these medicines being entirely counteracted by vegetable
acids) ; or salted meats^ when I prescribe oxyde of mercury ; or
coffee^ when I am giving opium.
Thus, if my treatment fail, I know that I have done no harm
by an artificial system of diet (how much that is dangerous and
hypothetical is there not in our dietetic regulations !), I know
it is owing to the medicine used that the case grew worse, or, at
least, did not improve.
If amendment ensue, then I know that the medicine produced
it, as it certainly was not owing to any change in the diet.
Hippocrates, himself, if I recollect right, hints at something
similar in his aphorisms, when he says, that medicine and the
vis naturce produce much more considerable and profound
changes in diseases than any small irregularity in diet.
. How near was this great man to the philosopher's stone of
physicians — simplicity I and to think that after more than two
thousand years, w:e should not have advanced one single step
nearer the mark I on the contrary, have rather receded from it !
IK FBAOTICAL MADICIKE INSUBHOUNTABLX ? 315
Did he only write books ? or did he write much less than he
actually cured ? Did he do this so 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.
CLIMATB, WEATHER, STATE OF THE BAROMETER, ETC.
■
Should we abandon ourselves to despair^ because we do not know,
to a nicety, whai is the exact influence which a slight change in geo
graphical position^ a sTnaU variation of the hygrometer, the barome-
ter, the anemometer, the thermometer, dc, exercises upon the action
of our medicines or our patients ?
According to many observations of the first medical men, it
is not so very difficult to arrive at a pretty accurate general
knowledge of the differences produced by a warmer or colder
climate on the nature and treatment of or(£nary diseases. They
are, for the most part, merely differences in degree. The most
(^posite climates never produce a completely opposite code of
medical laws. Is not bark as efficacious for the cure of pure
intermittent fever in Mexico as in Norway; in Batavia and
Bengal (the only difference being in quantity), as in Scotland ?
The venereal disease is cured in China by mercury, just as it is
in the Antilles. In our country, we have inflammations and
suppurations of the liver of the same nature as in the tropics ;
although, in the latter regions, they are twenty times as nume-
rous as here, that makes not the slightest difference in the treat-
ment, as in both situations mercury and opiimi (or something
better still) are serviceable. Typhus, and similar fevers, are
here as there fatal, if treated by bloodletting and nitre (not, in-
deed, so rapidly here as there) ! They must also be treated in
our country with bark and opium (not, indeed, in such large
doses as there), in order to increase the strength. These varie-
ties of climate do not change the treatment in nature, but only
in degree, and such differences are determinable.
But that the powers given by nature to man and habit will
triumph over all variations of climate, to the preservation of
life and health, is proved by there being inhabitants in the
island of Terra del Fuego, as well as on the banks of the
Ganges, in Lapland, as well as Ethiopia, in the seventieth a^
well as the third degree of latitude.
And are we so ignorant of the other influences which the
nature of the soil and country have upon diseases; so very
316 ARE THS OBSTAOLES TO OEBTAIKTT AHD flEniVLICITT
ignorant that we cannot reckon the infinence they would have
on our practice ? Do we know nothing of the different effects
produced by a residence in a hilly country and on the sea-coast^
on haemoptysis and phthisis ; notiiing of the action of the effla*
via from marshes and seething intramural grave-yards in the
production of intermittent fever, and diseases of the liver and
lymphatic system ; nothing of the power of pure air on those
affected with rickets and those debilitated by sedentary occupa-
tions ; nothing of the advantages of a level country over con-
fined Alpine valleys, the cradle of cretinism, goitre, and idiocy ;
nothing of the peculiar power of certain winds and seasons in
the production of inflammatory, or asthenic diseases, or of the
effect of a low state of the barometer on the apoplectic ; nothing
of the influence of the air of hospitals in the production of gan-
grene and typhus ?
And it is only these, and similar great and important difiSsr-
ences, which exercise a marked influence on health and life
itself, which it is necessary for us to know in our treatment of
diseases. We do know them, and can calculate their influence.
The influence of the finer shades of these differences is too
insignificant to prevent us treating successfully the ordinary
diseases. The vital power and the proper medicine generally
obtain the victory over any influence which such very fine
shades of differences could exert.
What might be said of the Creator, who, having afflicted the
inhabitants of this earth with a vast host of diseases, should at
the same time have placed an inconceivable number of obstacles
in the way of their cure ; to discover the influence of each of
which would defy the greatest efforts of the physician — a know-
ledge of which in their full extent (if they were of such great
importance) could not be attained by the greatest genius ?
We cure diseases in pestilential dungeons, although we can-
not, at the same time, impart to the patient the vigour of the
mountaineer. Who would desire us to transform the delicate
city lady into the buxom peasant girl ? We remove, however,
most of the ailments of the former. The sedentary man of
business seeks at our hands only tolerable health, for the nature
of things denies us the power of giving him the strength of the
blacksmith, or the ravenous appetite of the porter.
" But," objects some one, " look what a perceptible influence
a slight variation of the temperature, moisture, or relative pro-
portion of oxygen and nitrogen in the atmosphere, a slight
nr PRAonoAL msdiciki insubmountable ? 817
change in the wind, a higher or lower state of the barometer, a
greater or less quantity of atmospherical electricity, and a thou-
sand other physical powers, small though they may be, which
are perhaps, as yet unknown to us, sometimes have upon dis-
eases, at least upon the nervous, hysterical, hypochondriaca],
add asthmatic 1"
Shall I speak out what I think 7 It appears to me much lesH
[Hrofitable to endeavour to ascertain (which is moreover impos-
sible) all the degrees and varieties of the influence of those phy-
sical impressions, when they approach the minute, than to do
our endeavour to fortify the sufferers against all these innume-
rable impressions, by implanting in them a certain degree of
strength, whereby their system will be enabled to resist these,
and many other still unknown physical impressions ; just as I
consider it much more practicable to dispel the morose ideas of
the melancholic by medicine, than to abolish for him the count-
less evils of the physical and moral world, or to argue him out
of his &ncies.
Or could all the physical and moral adverse circumstances of
the atmosphere, and of human life, be more effectually pre-
vented exercising their pernicious influence on the gossamer
nervous system of yon nervous, spasmodic, chlorotic girl, did
wc, with angels' understanding, completely investigate and ma-
turely weigh, in quality and quantity, all these impulses in
their fiill extent, than if we should restore her monthly periods?
I do not believe that it is the smallness of our knowledge,
but only the fiiulty application of it, that hinders us from ap-
proaching, in medical science, nearer to certainty and sim-
plicity.
A young man twenty years of age, the son of an oil manu-
&cturer, thin and weakly, had been from his childhood subject
to a spasmodic asthma, which used always to increase from the
commencement of autumn until the depth of winter, and gradu-
ally decline from that period until the mild weather in spring.
Every year he had grown worse, and this autumn he hoped
might be his last. Already (I saw him first at Michaelmas) the
attack commenced more violently than the last year at this time.
The probable issue was evident. Last year, and for years past,
every fall of the barometer, every south-west, and more particu-
larly north wind, every approaching Ml of snow, every storm
of windy had brought on an asthmatical fit of hours and days in
duration, when he not unfrequently passed the night with both
818 ABE THE OBSTACLES TO CERTAINTY AND SIMPLICITY J*
liands grasping the table, exerting all his strength to draw the
smallest quantity of breath, and every moment in dread of suf-
focation. The intervals between such fits were occupied by
slighter attacks, brought on by a draught of air, the vapour
from the heated oil-cakes, dust, a cold room, or smoke. He
i()ld me of these symptoms with the utmost difficulty of utter-
ance, elevating his shoulders to draw a scanty breath, and this
at a season of the year when his condition was as yet pretty
iDlerable.
I could expect no good effects from a change of place. So 1
allowed him to remain in his father's house, exposed, as it was
to every wind, and all the inclemencies of the weather;
I let him take his usual diet ; I only advised that his &Te
should be, if anything, more nutritious than otherwise ; I let
him occupy the same sleeping apartment, and continue his work
in the oil manufactory, and, as far as his strength allowed, en-
gage in agricultural employments.
The first medicine I administered was ipecacuhan, in {he
smallest doses ; they produced no nausea, neither did doses of
live grains; the latter quantity caused purgation and relaxation
i>f the system. The submuriate of antimony and the sulphate
i)f copper, in quarter of a grain doses, produced no better re-
sults. Both of these substances, as well as asarum root, each
used singly, caused the same bad effects.
I shall refrain from stating what other medicines, celebrated
in asthma, did not eflect ; and shall only mention that squills
and bark, each employed separately, did — what they often do —
they increased the difficulty of breathing, and made the cough
more frequent, shorter and drier.
A medicine was procured which could produce anxiety, and
diminish the easy action of the bowels. The choice fell natu-
rally on 71UX vomica. Four grains, given twice daily, removed
graduall y, but perceptibly, the constriction of the chest ; he re-
mained free from the spasmodic asthmatic attacks, even in the
worst autumn weather — even in winter, in all winds, all storms,
all states of the barometer, all humidity of the atmosphere, dur-
ing his now increased domestic, manufacturing, and travelling
business, in the midst of the oil vapour, and that without any
important change in his diet, or any in his place of abode. He
had been in the habit, when there was but small prospect of
cure, of rubbing his whole body every night with a woollen
clotih. Although it did not seem to do any good, I did not let
IN PBAOnOAL HSJDICIKE INSUBMOUNTABLB ? Sid
him discontinue it while taking the last medicine, as he had
been so long accustomed to it.
He now slept comfortably at night, whereas formerly he had
passed the whole night in an arm-chair, bent forwards, or lean-
ing against the wall, or coughing without intermission. During
this season, which had threatened to be so dangerous to him, he
gained strength, agility, cheerfulness, and capacity of resisting
inclement weather. It was only severe attacks of cold that
could cause the slightest return of asthma, and these he speedily
got rid of.
Besides this medicine, nothing at all was employed.
Should I, instead of adopting this treatment, have observed
attentively all the meteoric changes, and scrupulously calculated
their effects on his most susceptible frame? And had I been able
to do this, could I have added weight to the diminished atmos-
pheric pressure, supplied the loss of atmospherical electricity,
maintained an equilibrium between day and night, dried up
the moisture in the air, changed the north into the south wind,
reined in the storms, and warded off the attraction of the moon ?
And had I been able to do all this, should I have better attained
my object?
MEDICINES.
Here the question arises. Is it well to mingle many kinds oj-
medicines together in one prescription ; to order batJis, clysters^ ve-
iiesectianSy blisters^ fomentations and inunctions all at once^ or one
after tlie other in rapid succession^ if we wish to bring Hw science
of medicine to perfection^ to make cures, and to ascertain for certain
in every case what effect the medici7ies employed produced, in order
to be able to use them witli like, or even greater success in similar
cases?
The human mind is incapable of grasping more than one
subject at a time — it can almost never 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, then, can we
ever expect to bring medical science to a greater degree of cer-
tainty, if we deliberately combine a large number of different
powers to act against a morbid conditition 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
oomponent parts of the former, much less with their combined
action?
Wlio can say for certain, that the adjuvant or the corrective
SSO ABB THB OB8TACLB8 TO CESTAnffTT ABD SDIFLlCITr
in the complex prescription does not act as the base, or that the
exdpient does not change the whole character of the mixture ?
Does the principal ingredient^ if it be the right one^ stand in need
of an adjuvant? Does it say much for its fitness if it require
a corrective? or why does it require the aid of a director?
"I thought I would complete the motley list, and thereby
satisfy the requirements of the school !'' exclaims the Doctor.
Does opium mingled with ipecacuan cause sleep, because the
excipient in the recipe has been invested with the dignity of
the principal ingredient ? Does the ipecacuan here perform the
part of base, adjuvant, corrective, director, or excipient? Does
it cause vomiting because the prescriber wills it ?
I have no hesitation in asserting that whenever two medicines
are mingled together, they almost never produce each ilB own
action on the system, but one almost always different from the
action of both separately — an intermediate action, a neutral
action, — if I may be allowed to borrow the expression from
chemical language.
The more complex our receipts^ the more obscure will ii he m
medicine.
That our prescriptions are composed of a smaller number of
ingredients than those of Amatus Lusitanus, avails us just as
Uttle as it availed him that Andromachus framed still more
complex prescriptions than he. Because the mixtures of both
these worthies are more complicated than our own, does that
render ours simple ?
Why should we complain that our science is obscure and
intricate, when we ourselves are the producers of this obscuritv
and intricacy ? Formerly I was infected with this fever ; the
schools had infected me. The virus clung more obstinately to
me before it came to a critical expulsion, than ever did the virus
of any other mental disease.
Are we m earnest with our art ?
Then let us make a brotherly compact, and all agree to give
but one single, simple remedy at a time, for every single dis*
ease, without making much alteration in the mode of life of our
patients, and then let us use our eyes to see what effect this or
that medicine has, how it does good, or how it fails. — ^Is not this aa
simple a way of getting over the difficulty as that of Columbus
with the egg?
Is it really more learned to prescribe from the chemist's shop
a number of complicated combinations of medicines fi>r one dis*
m
.^M9{gftliBin QW 4«jX tbw with HippoccatCB to treat &e wfaol«
tfmr^ of ^ d]9QiMW with one Of two dysters, perhaps a littb
iif^yvf^l mi iiothiqg e}fle ? Methinks to give the right, not the
qiMij-iiuziBd, werie the stroke of art I
Hippocrates sought the simplest from out an entire genus <rf
iifl/^^fxf» ; (;)ii|i he c$u»fally observed and accurately dascribed.
ij^ tb^fO fp^ipl^ diseases he gave single sim{de remedies fix>m
tljif t]^ scanty sto^ Thus tie was enaUed to see what he
m» <P 4p wM )ui did.
I hPP^ i^ WjUl AOt be considered un&shionable to go to work
^{h disease^ i^s simply as did this truly great m^ft.
JkJDLj one who should see me give one m^cine yesterday,
liigtbi^r to-49y, and ja third diffiareot from either to-morrow,
i:9iild o]bpfirye ^hat I was irresolute in my practice^finr I pxa but
a weak mortal) ; but should he see me combine two or three
9l(kvst9mQepi|i0^epi;eflcriptioni(and eaoe now this has sometimes been
40P^X ^® would lit onQejaayi "The man is at a loss, he does not
IjgjhlLy know what he wijil be at" — ^'^ He is wavering" — '^ Did
ll§ kMW whudi one of these was the proper remedy, he would
not add to it the second, and still less the third I"
What could I rejoin ? Nothing.*
Should any one ask me what is the mode of action of bark in
in fH known diseases, I would confess that I know but little
oonoeming it, notwithstanding the number of times I have used
it alone and uncombined. Should any one ask me, however,
what bark would do if combined with saltpetre, or still more
widi some third substance, I would at once acknowledge my
tienighted ignorance, and would bow before any one as befo^
a very divinity who would enlighten me on the subject
Dare I confess, that for many years I have never prescribed
anything but a single medicine at once, and have never repeat*
ed the dose until the action of the former one had ceased ; a
venesectionalone — a purgative alone — and always a simple, never
' lllf HMMpi which has be«n looqueiitily gixeo, that we roquire, by pleasant addi^
t^ to tlpa medjcfpe,^ render it more agr^e^^ to the patieDit» or togire it.anwiY
o^pvcniefli form for admioistratioo, and conceal the disagreeable tas^, amell, ap|l
€okor, k entvely without weight Qrown up patients, whose confidence is ready in
OM aoala of. Ihe balance to kick the beam when a bitter, nauseous powder is placed in
H^^ifl^M^^TB V^ 4C«nty a/mpply qf that quantity fiv my taate. I wonli
jflppion^MB t9 ifym needy traders, who, /or the n^isaraible f^ YiU presccplbie ti^
■oit dainty sweetmeats, and are willing to submit to alltheairs and *^»y*Kydiijyi|i
«f tfMir patients. We all know how to manage children in radi case without
Wtiq^ fbem.
SI
SSS AXmDOTES TO SOKE
ft compoTind remedy, and never a second until I had got a clear
notion of the operation of the first ? Dare I confess, that^ in this
manner, I have been very successful, and given satis&ction to m j
patients, and seen things which otherwise I never would have
seen?
Did I not know that around me there are some of the wxnrthi-
est men, who in simple earnestness are striving after the noblest
of aims, and who by a similar method of treatment have cor-
roborated my maxims, assuredly I had not dared to confess thia
heresy. Had I been in Galileo's place, who can tell but that I
might have abjured the idea of the earth revolving round the
aun!
But the dawn begins to glimmer in the horizon I — ^who can
tail to perceive a feeble ray of it in our Herz's commentary on
his two cases, to which we alluded above?
What would he not now give that in both instances he had
prescribed nothing but the phellandrium, and had met with the
same success he did I I, for my part, would willingly give the
best^ the most satisfactory of sdl my observations that he had
done this.
ANTIDOTES TO SOME HEROIC VEGETABLE SUBSTAN-
CES.1
Cases of poisoning often put the practitioner in great straits*
It is necessary to administer the specific antidote without delay.
But where are the particular antidotes to be met with ?
From the time of Nicander to the 16th century, when, if I
mistake not, Pard first set his &ce against them, grand plans
were formed by medical men for discovering nothing less than
an universal specific for every thing they called poison ; and
they included under the denomination of poison, even the
plague, philtres, bewitchment, and the bites of venomous ani-
mals. This extravagant object they sought to obtain by equal-
ly extravagant mixtures, such as their mithridate, theriac, phi-
Ionium, diascordium, &c., and then again, there was a time when
all these unimportant compounds were thought to be surpassed
by the powerless bezoar and the electuary of jewels. We now
know how ridiculous all these efforts were.
* From HirfelanS9 Journal der pracL Arsneykumde, VoL ▼, p. 1, 17M.
HXBOIO VS6ITABLI SUBSTANCB. Sit
The more rational spirit of modem times did not, howeyer,
oompletely abandon this illusory idea of the possibility an oni-
Tersal antidote' for all poisons. Among other things, it was
sought for in yin^ar. But in place of giving us a fidthful de-
tail of the cases in which it was truly useful and those in which
it did no good, they endeavoured to persuade us that it was
qpeoific against everything that bore the name of poison, and
yet it is, e. g.^ of no use in poisoning by opium, and of little or
none in that by camphor.
Others saw in milk and &tty substances a supposed universal
antidote for all kinds of poisons, but no good can be effected by
ihem, except in cases where inflammatory and mechanically ir-
ritating substances have been swallowed.
Emetics seemed to be more generally useful in cases where
poisons had been swallowed ; but they are by no means so in
all cases. They are only serviceable when the quantity of in-
jurious matter, that has been swallowed and is to be evacuated,
is considerable in amount Besides their unadvisableness in cases
of poisoning by arsenic, as I have elsewhere^ shewn, tiie follow-
ing cases will suffice to dispel the illusion of their being tmiver-
sal antidotes.
The efforts of our age to discovera peculiar antidote for eadi
individual poison, or at least for particular classes of poisons,
are not to be mistaken, and I give in my adhesion to them.
Powerful, heroic, medicinal substances, without which the
medical art would be as completely paralysed as the tnechanical
arts would be without steel and fire, are apt to give rise to vio-
lent effects, even in a very small excess of dose, in certain states
of the body, as also in idiosyncratic or otherwise very irritable
tabjects, and these effects the physician must know how to re-
move in order that the cause he advocates may not suffer.
Antidote to camphor — opium. Antidote to opium — camphor,
1. A girl, five years of age, had swallowed a quantity of
* Tliere are at least four kindi of antidotes bj meaoB of which the hurtfiil substanc*
■ajbo—
I. Removed:
1. By evacuatum (vomiting, purging, excising the poisooous bite).
2. By enveloping (giving suet for pieces of ghiss that have been swaUowtd).
VL AUered:
1. Chemically (liver of sulphur for corrosive sublimate).
2. DynamieaUy {%. e. their potential influeooe on the living fibre remorad)
(Ooflbe for opium;.
^[UAeriUAfmUkvergiftwng, HSe.]
Mi idnmftom to mmx
amnphor^ joalculated ai ftom eight to ten grmm. Aho9tt ten
wbrates afierwards abe grev pak, became oold, Imt lode 6Mdj
then she hoesmfb &int, apeechleas, and aenadeaik Ija a jdioct
time the head becaoae drawn to the right ahonlder, and laamak
«fll in that positioa ; the rest of the body was lamp; die aenaaa
eKtingoiflhed. OooaaionaUy the anna vere moved iQ^oinnitiKiljc.
The eyes were tamed upwards. These waa foam at^he nootfeu
The tareathiiig was aoaroelj peoeeptible.
Placed in a warm bed, she occasionallj aeeiQed toimoirer Imth
mU a little. Strong ooiee was given hi&r ; but ik&o&nfismi the
eenseleaaneas obvioualj increafied. Violent voniiting aet ia, j^lb^
camphor was in part ejected) bait no relief ensiaed therefe>m, th^
death-agony seemed to ineuea^ always more and mom.
I poured four drops of tincture of opium into her oaottidi, but
eouM not observe if they w&fe swallowed, but as I iniagined i
peroeired some signs of amendment after watching careAiiiy tar
aovne minutes, I oont^ued to ply h^ with opium by the moath|
anil also (aa much aeemed to flow out of the mo«th again, en
aoeount of the inactivity of the oesophagus) by dya^aca of water
mixe^ with some "drops of thebaic tincture.
As far as I could reckon, she might have taken by both
methods nearly two grains of c^ium, (a quantity that under
olher ciFCumsttuaees would certainly have killed a child of that
age) when she recovered perfectly without the employment of
any other remedy.
A tranquil sleep of some hours, accompanied <by general per-
spiration, restored ail her former liveliness.
In t^ case it was remarkable how greatly theooffee inereaaad
the too powerftd action of the camphor.
In other cases I have observed that these two substaneea
taken soon after one another, or together, caused a great and
rapid tendenoy to vomit, a circumatance tbat jx^ht parhape be
turned to account in practice.
The great specific power of opium in removing so speedily the
^hmgerous efiects of too large doses of camphor, seems to justify
me in regarding camphor , on the other hand, as one of the moat
powerful watidoies of opiimif as Halle also observed in some de-
glee. Andf if we examine the affidr acnnvsately, did Jaot the
enormous dose of opium that I gave in the above case become
innocuous in consequence of the camphor previously swallowed.
Camphor is known, from the observations of others, as an
antidote to cantharides and 8gv/ifi$,
HSROld VMRTABLS S0BRANCB8.
AntSd&k to arnica — tiwMsrar.
%. A man of m irritaUe system, in the prime of his life «nd
Mkenrae healthy, during the prevalenee of the influenza im
April of this year, took, lor a headache of several days duift-
tmi, oeoaaioDed probably by this epidemic, six grains of araiA
raoly a diose that he deemed inconsiderable, as he had previotii^
fy taken with the greatest benefit, for autumnal fevers, firom 1&
to 17 grains daily and even twice a day. After the lapse of
about eij^ minutes, he was attacked by frightful palpitation of
die hearty which at length became so violent that he could onkf
otter a few words with great difficulty. His look was staring
and anxious. A general coldness pervaded his framte, and ver-
tigo almost deprived him of hearing and sight. The open air
seemed to revive him, but the effect was not lasting. He tried
to promote vomiting, but the efforts to vomit only increased his
slapefeotion, his anxiety, and his vertigo. His lower jaw fell
He was scarcely able to indicate his desire for vinegar (by this
time three quarters of an hour had elapsed). Strong wine-
vinegar was brought him, and he felt revived. He drank seve-
nl ounees at once, but soon perceived that he experienced
most relief when he did not drink a draught but only took a
ttttte eveiy instant In the course of half an hour after com-
menciiig to use the vinegar he was restored without further
Inces of these accidents.
If there be any remedy that we require to regulate carefully
by the actual constitution of the subject whom we are treating,
it is that tremendous irritant arnica, which may be given in the
leucophlegmatic cachexies of children of ten years, especially
in autumnal diseases and when the pulse is soft, in doses of
tirelve grains without the slightest bad results ; and on the other
handf in certain states of the body where there is already present
a general and exalted irritability, eight grains of it in a dose
will kill the strongest man in a few hours, as I have known to
occur in some instances.
The pathognomonic discrimination of the cases, and when it
is at hand, vinegar,, will in future prevent such accidents.
Antidote to cocculus indicxis — camphor,
8. A druggist, of fine sensibility and otherwise healthy, al-
though but recently convalescent from an acute disease, some
years ago wished to ascertain the taste of the cocculus seed, and
as he considered it a powerful substance he weighed out a single
giainof itybutdid not take quite the half of this into his mouth,
rolled it about with his tongue over his palate, and he had not
826 ASTn>0TB8 TO 80MX .
swallowed it two seconds when he was seized with the mo0l
dreadful apprehensireness. This anxiety increased every mo-
ment; he became cold all over; his limbs became stif^ as if
paralyzed, with drawing pains in their bones and in the back.
The symptoms increased from hour to hour, until, after the lapse
of six hours, the anxiety, the stupe&ction, the senseless stupidity,
and the immobility had risen to the greatest height, with fixed,
sullen look, ice-cold sweat on the forehead and the hands, and
great repugnance to all food and drink. At the slightest increase
or decrease of the temperature of the air (75° Fahr.) he ex-
pressed his displeasure ; every loud word put him in a passion.
All that he could still say was that his brain felt as if constricted
by a ligature, and that he expected speedy dissolution. He gave
no indication of inclination to vomit, of thirst, or of any other
want in the world. He wished to sleep, as he felt a great incli-
nation to do so, but when he closed his eyes he immediately
started up again, so frightful, he asserted, was the sensation he
felt in his brain on going to sleep, like the most hideous dream.
The pulse was very small, but its frequency was not altered.
In these frightful circumstances I was called in. A few drops
of thebaic tincture appeared not to agree with him. This led
me to fix upon a strong camphor emulsion, which I administered
to him, a tablespoonful about every minute. I soon observed a
happy change in his expression, and after he had thus taken fif-
teen grains of camphor, his consciousness was restored, the
anxiety gone, the heat natural — in something less than an hour.
He perspired a little during the night, slept pretty well, but the
following day he was still uncommonly weak, and all the parts,
which during the direct action of the cocculus were yesterday
painful internally, were to-day uncommonly painftil externally
to the slightest touch. The bowels remained constipated for
several days. It is very probable that all these after-suflferings
could have been prevented if, in place of giving fifteen grains
of camphor, I had at once given thirty.
During the increase of the symptoms from the cocculus, he
a;ttempted to smoke tobacco with considerable aggravation;
they also increased from taking coffee, though not so strikingly
as from the other.
Antidote to gamboge (and other drastic gum-resins) — salt of tartar^
4. I saw a child of three years old take a tincture containing
two grains of gamboge, prepared with dissolved salt of tartar,
HSBOIO YIBGCTABLB SUB8TANCB8. 827
.without tke slightest sickness or evaeuation, with the exception
of an uncommonly profuse, flow of urine.
AlWliAtt probably destroy the drastic property of other pur-
gative gum«>resins, especially if the latter are still present in the
stomach, but not as in the other cases I have adduced, dynami*
cally, by an opposite influence upon the sensitive and irritable
fibre, but chemically, by decomposing the resin.
Antidote to dqtura stramonium — vinegar (and citric acid).
. 5. In a woman rather advanced in life, there occurred from
two grains of the eoctract of stramonium^ taken in two doses
within eight hours, stupe&ction, anxiety, convulsions of the limbs
and involuntary weeping; symptoms that were frightfully in-
creased by partaking of cofiee. They rapidly disappeared after
taking a few ounces of strong vinegar.
Besides vinegiur, citric acid is also a specific antidote to strsr
monium, as I have shewn in another place, from the use of
eunrants, which contain the latter, and I am very much mistaken
if tiie true antidote of all the solana/xe be not vinegar, cUrvr
vAmaiicacid.
Antidote to ignalia — vinegar.
6. A paralytic stiflhess in the lower limbs, with involuntary
twitchings in them, great anxiety, coldness of the whole body,
wiUi dilatability of the pupil, &c., were the symptoms pro*
duced in a youth of 20 years, by an over-dose of ignatia.
BBs head was free, his consciousness perfect ; but on account of
the anxiety, he could not express himself properly. Intelligence
of a somewhat unpleasant nature aggravated his condition ; the
same was the case with coflFee and smoking tobacco.
For this unpleasant state I gave some camphor, but no good
was thereby effected. But on letting him drink very strong
vinegar, eight ounces in the course of half an hour^he was restored
so completely that the same afternoon he was able to make one
of a party of pleasure.
In poisoning with nux vomica I would also advise vinegar,
as it is nearly allied in the natural order of botany to the former.
Antidote to veratrum album — coffee.
7. I had the greatest difficulty in restoring two children, the
one a year and three quarters old, the other five years old, who
had both taken white hellebore by mistake, the former four grainy
the latter seven grains. Those conversant with such matters
will consider both to he of Hiemselves fatal doses, and as long as
no antidote is known, absolutely &tal.
nS 'iM¥li)Oi*ils itb Midi
Bat few MBiitte ^apMd hOdfte^ gte^im dttftgM iNMf iMbr-
aervable in both childr6il. Thej be6wi6 quite 6Mi\3My iM
dbtm, fh^ eyes p)rojecti% like ti suffocating peif&cni% ItttriiidiyE
ran ooAtinually fircfm tbeir mouthy and thej deeined devoid df
<Mi8ck>usne88, when I saw them half Ati hour aifker the adeidtifli
It had! ahreadj been tried to incite iheni lo Toimt bjr xddAtt
of' a feather, without succedB, indeed ^th aii Itggi^tstiott of
their sjmptoms, as I was told. Milk administered hf dyster
and poured down the throat in large quantities had had no efBdot^
except the production of seanty vomiting, which did no good,
but only increased the faintness.
When I arrived both seemed to be at the point of death.
Distorted, projecting eyes, disfigured, cold countenanoe, lax
muscles, closed jaws, imperceptible respiration. Thein&at was
the worst
The impending death by apoplexy, the failing irritability, al
once induced me to combat the symptoms if possible with strong
6offee. I introduced, as far as the clenched jaws would allow
me, the warm coffee into the mouth, but I chiefly sought to give
it in large quantity by means of the enema. It was successful.
In the course of an hour all the danger was gone. The heat,
ttie consciousness, the respiration returned. A sleep of several
hours, during which the breathing was slower than Usual, re-
freshed them. All the operations of the animal economy were
again almost in good order. But the children remained weak^
emaciated, and every night before midnight were attacked with
a kind of fever, that threatened to prove fetal in a chronic man-
ner. Peruvian bark given for a fortnight, however, removed
this sequela, and as I am informed, they are still (a year and a
half have since elapsed) in the enjoyment of good health.
I may here observe, that in the case of severe poisonings we
have not unfrequently to combat a remnant of chronic affeotiona,
because the antidote of the noxious substance even though it be
specific, only acts in a contrary sense, consequently, belongs to
the class of palliatives which are unable to remove the secondary
effects of the poison that has been swallowed, especially if it
has had time to make some inroads on the system. Moreover,
we must not imagine that an antidote can be such a perfect
cOunterJ)oisou of the poison as that all the Symptotiis of ih0
tatter shall be covet^ by it, as two triangles with equal side!
khd angles cover otie another ; nor can it, consistently with all
analogy, be denied, that the noxiouid isubstance, in ooihbinatl6b
raEBOIO YSe^ETABUi SUBBTJUTCBS. St9
Willi an antidote ever so appropriate, must derelope a new aotiori,
wfajeh Miikl iK>t hare h^n anticipated firom each singly, and
wkieh will play its part in the body for a longer or shorter time.
Tfan after poisoning by opiom, which has been removed Jbijr
giving a considerable quantity of coffee, we perceive an extra-
eiduMury secretion of urine, even in persons in whom the accus-
tomed coffee did not produce this effect of itself; and a grainof
(^mn in an infiomon of from one to one a half ounce* of coffee,
taken once or several times a day, gives perhaps the most sure
and powerful diuretic that the medical art possesses.
Antidote to mezereum — camphor.
8. An otherwise robust man took mezereum internally for
some complaints that he had. But as he continued the use of
this drug even after the disappearance of these complaints, he
became affected with intolerable itching over the whole body,
which did not allow him an hour's sleep. He discontinued the
medicine, came to me thirty-six hours afterwards, and assured
me that he could no longer endure the itching, which increased
eveiy hour — the first direct action of mezereum lasts very long.
I gave him thirty grains of camphor, six grains to be taken
eveiy six hours, and before he had taken it all, his itching had
disappeared.
SOME KINDS OF CONTINUED AND REMITTENT FEVERS.*
The actual number of genera and sj^ecies of sporadic and epi-
demic fevers is probably much greater than is laid down in the
works on pathology and nosology. Indeed the morbific agen-
cies that act on the human body are so numerous, their intensity
and duration of action so various, that the diseases they give
rise to must present a great variety of character.
Although the great epidemics have been more frequently de*
scribed than the small ones, the sporadic diseases, still these
diseases, which present such very different characters, have been
confounded under the same name, so that I may be permitted
to inquire if they are not quite distinct.
Sporadic fevers are still more diverse and still less known,
and it is just from this latter cause, and in conse(]ftience of theiif
' Aooording as the patient was more or less accustomed to the use of coffee.
^ Ynmfixiidm&sJaufnalderpracHteKmAnneyku^ Voir. 1V98.
880 SOKE DNM OF OONTIirUKD AKD BXMHTEHT FEYXUL
fteqnencv, that ihej in general make as many yictims as qui-
demic fevers. Sporadic fevers are no doabt more difficult to
describe than the latter, for the fewer the number of obsem^
tions, the more difficult is it to deduce fix>m them a specific
diaracter.
The following fects, imperfect though they be, may however
serve as a contribution to the history of these fevers.
L In January of this year, a kind of sporadic fever, apparently
more of a continued than a remittent character, at least in its
first stages, prevailed among children. In spite of the heat of
skin, the patients experienced continual rigours and great lassi-
tude ; the memory was impaired. The respiration was excess-
ively short and spasmodic ; some of them had a troublesome
cough ; the urine was high-coloured, and sometimes deposited a
red sediment ; there was scarcely any trace of gastro-intestinal
derangement ; there was an evacuation of the bowels every day,
almost quite regularly ; the brow was often covered with oold
sweat
Evacuant remedies weakened the patients without producing
any amelioration; cinchona bark also produced an injurious
effect The younger the children the worse was the disease.
Many sunk beneath it, chiefly those in whom the continued
fever no longer presented, towards the last, marked intermissions.
A few grains of arnica root produced a rapid change. Al-
though there was in general no amelioration, the fever which
till then had appeared to assume a continued character changed
into an uninterrupted series of paroxysms of intermittent fever,
the rigour of which lasted an hour, and the heat (with very short
respiration) a little longer, terminating in general perspiration.
On the cessation of the perspiration the rigour presented itself
anew, so that this state continued day and night
On the one hand the shortness of the stages, and on the other
the congested state of the chest, the dyspnoea and suffocating
cough, contra-indicated the employment of cinchona. &. Iqna-
tiu£ heart, on the contrary produced effects that were truly sur-
prising. I gave it in large doses, every twelve hours ; to chil-
dren from nine months to three years of age, from ^ to -f of a
grain ; to those between four and six years, from one grain to
\\ grain ; to those between seven and twelve years, from 2 to
8 grains. In general this remedy appears to be more suitable
than cinchona in intermittent fevers characterised chiefly by a
longer duration of the heat The fever terminated at the end
801UE KIHM OP OQNTIKUED AND REMITTKKT FEYXBa 881
of two or three days without leaving any traces or any weakness.
Ignatia also removed completely, or nearly so, the dyspnoea
and suffocating cough in those that presented these symptoms.
n. In the commencement of March of the same year, many
children, my own among the rest, were attacked by a fever
which also affected adults, though to a much less extent In
addition to the actual paroxysms I noticed the following symp-
toms : tension and pressure in the forehead just above the orbit
<m one side, extending in severe cases to below the parietal re*
gion ; pressure at the stomach as from weight ; tension at the
flcrobiculus cordis and violent tensive pains (colic) round the
navel, accompanied by clay-coloured diarrhoe, the stools being
very fetid, or by consumption alternating with fetid flatus;
constant coldness of the limbs without rigour ; humour very bad
(morose, disagreeable); rapid emaciation without great debility ;
absence of signs of derangement of the bile or of other impuri-
ties in the first passages, at least in the stomach ; tongue clean,
moist, rarely covered with a somewhat whitish fur ; taste in the
mouth natural, sometimes sour ; feeling of tension througbout
the body, pupils slightly contracted, not dilating in the dark.
At noon precisely the paroxysms were always renewed with
a very distinct rigour, lassitude, somnolence, sopor, and lastly the
cheeks burning, but without thirst. Even when the fits were
not very severe the patienta felt an unconquerable aversion for
all kinds of food.
Exactly at midnight a slight attack of a similar character
made its appearance : the patient cried out, tossed about in bed ;
the limbs were cold. There was rarely at night general perspi-
ration, after which all the symptoms disappeared until the fol-
lowing day ; but in that case the fever reappeared the third
day, and so it went on.
The greatest freedom from fever was found in the morning.
When the patient rose, the headache, the tension throughout the
body, and the abdominal pains reappeared, but the appetite con-
tinued good ; the same was the case in the evening.
During this apparent remission the patients expressed a great
desire to eat pork. On satisfying this desire to satiety, there
occurred more relief than aggravation.
The essential nature of this fever appeared to consist in a
diminution of the sensibility and a kind of clonic spasm of the
fibre.
The fever shewed itself in the greatest intensity when the
wind blew a long time &om the east.
Stt 8om vxfDB 07 ocnrmrnED Ain> sncnMOPP fivttft
' It was not dangerous, bat it was obstinate and troftblesOfi^.
; . Enietics scarcely produced amelioration fot one day; not-
withstanding their employment, the following day the f9f«»
continued its nsual course. Laxatires and the remedies nsHadly
employed for acridities completely failed.
Cinchona and ignatia, given in small or large doses, ag^va-
ted the patient's state. Arnica, though it palliated the bud
humour, the headache, &0w, had only an antisymptomatic efliM^
it did not produce permanent amelioration.
The immobility of the pupil, the pressive, tensive pain in tifn
jcrobiculus and around the umbilicus, together with the geae^
sensation of tension throughout the body ; the sopor, the i^
parently insignificant diminution of the strength, and the reli^
afforded by the occasional perspirations, the benefit produced
by the ingestion of pork, which exercises a great influence on tiiie
dOntractility of the fibre, and finally the aggravation occasion^
by the east wind, all these symptoms led me to regard opium as
the remedy indicated. The fetid stools and flatus, whilst the
slomach continued in a normal state, contra-indicated its employ-
ment all the less as the clay-colour of the evacuations betrayed
a spasmodic state of the excretory biliary ducts. I accoindingly
give this remedy in the morning before the fit, in the dose of
%%h of a grain to an infant of five years, ^|,oths of a grain to One
(rf seven and another of eight years, 'Iwths of a grain to one rf
ten years. I took myself half a grain. The symptoms disap-
)[>eared completely in the course of the day. Twelve hours
afterwards, in the evening, I gave a still weaker dose, and the
fever did not return either the following day or on any subse-
quent day ; the constipation likewise ceased. The patients were
eured.
III. Ill the month of April there prevailed an influenza essen-
tially different from that which had been obser>'ed five years
previously. I know not if the studies that were made of it at
that time were correct, or if I am mistaken in my appreciation
of the disease. I shall therefore only draw attention to one single
point of dissimilarity and leave to mV readers the trouble of
Comparing the others.
In the epidemic of 1782 there was scarcely a third or even a
fourth of the inhabitants who were not attacked by a fever pre-
senting all the symptoms of a catarrho-rheumatic fever, though
it only lasted seven days. In general they were all affected in
the same degree ; though there was not danger except to debili-
aom. JHNM Of QQUTi»v]si> jlvo BsicinsNT nvna. SM.
ta^ sobjastfli to 43id people, aAd tbose suffering fiom pulmonary
Pfttwuyxption. In the influenza of the present jear, on the con-
tsaiy, nifie-tenUis soarcely had Miything more than slight traces
of the malady, without fever; the other tenth, on the contrary,
were attacked by fever, and danger was imminent
FatientB who had none of the febrile symptoms did not usually
$fgk advice, and were not considered to be affected by the epi-
demic It was difficult to observe them, and their symptoxns
were not perceived by unobservant medical men. All their
fiiaotions went on regularly ; the only characteristic symptoms
tbey presented were drawing and paralytic pains in some part
of the body — some had them in the nape, others only in the ex*
t0mal parts of the neck, or only in one half of tiie chesty ii^
others they were confined to the back, one arm, a thigh, or a
finr fijagers. These fixed pains troubled the patients for weeks,
iiid all the resources of domestic medicine, as the infusion 43f
dder-flowers, the juice of elder-berries, fumigations and emetios,
were of no use* When, on the contrary, recourse was had to
the appropriate remedy for influenza, the pains ceased quickly
w. die course of two days or even less.
Qdier patients had pains in several limbs at once, accompanied
bj fever.
Those who had at the same time febnle symptoms experienced,
before the hot stage, for several hours, and even for some days,
a rigour that recurred from time to time, that was aggravated by
€9Mry movement^ and was accompanied by ill-humour, pxisiUajnimity
and despair. The patients complained at the same time of weight
in the head and dulness, symptoms which they did not consider
as headaches, and a difficulty of swallowing, which soon shewed
ilaelf on the external parts of the neck and on the nape, or which
ohaoged into insuflerable tension that did not permit of the
slightest motion of IJie neck, and was aggravated by the touch.
\si the back they experienced a disagreeable drawing ; on the
dieat a similar very painful sensation, and throughout the body,
espeeially in the thighs, a well marked paralytic stiffiiess. The
fiatients Mt the sensation of laziness and lassitude most when
seated.
After another and more violent rigour (sometimes accompanied
bj very great anxiety at the heart) whidi generally appeared in
ihe evening, and in bad cases sooner, the most violent tensive
and preasive headache came on just above the orbits and, is^
many of the patients, in the^oooiput also. The anxiety inoieagoi,
884 80MX KINDS 07 OONTmUSB AKD BBMimffT tWHBUL
tbe face became swollen, the eyes red ; added to these was a
violent heat which lasted six, twelve or more hours, and in
some cases till death, which occurred on the fpurth, seventh or
fifteenth day.
In the mild cases, when the heat diminished, it passed every
day (for the paroxysms were usually quotidian, towards the
evening, although latterly without rigour) after midnight into
general diaphoresis, often characterized by an excessive fetori
and which, in the most favourable cases, only lasted till six
o'clock in the morning, but beyond that time in the bad cases.
When the perspiration was not very copious, and when it ceased
at the time first mentioned, there ensued, throughout the day, a
great amelioration of all the pains and the headache ; if, on the
.contrary, it lasted longer and was more abundant, there occurred
more disagreeable affections ; the head again became confused,
and was from time to time affected by pains ; the^pains on the
external parts became twice or even four times more severe
during the perspirations that occurred by day, and there was
reason to dread the supervention of a continued, a deadly fever.
During the first days there was obstinate constipation ; in the
most severe cases there was suppression of the urinary secretion
that continued sometimes even till death ensued ; in these cases
there was no perspiration during the greatest severity of the
heat of body, and there occurred delirium and tossing about,
premonitory symptoms of approaching death. In the most fii-
vourable circumstances, the day following the first febrile heat,
the urine, small in quantity, was of a greenish-black colour^ opaque,
passing the following days, until the recovery was complete,
into green and light green.
In the worst cases the tongue was dry and brown to its very
point, or when it was slightly moist it was brown or covered by
a black coating, and it was yellow in the less serious cases. Not-
withstanding the dryness of the tongue, the thirst was not great,
and the patients generally expressed a wish for acidulated drinks,
rarely for pure water. When amendment ensued they asked
for beer. In the mildest cases they felt a bitter taste on the
tongue ; in less favourable circumstances this taste was very dis-
agreeable ; it was not present at all in those cases that presented
the most dangerous character. All alleged that they perceived
the natural taste of solid and liquid food, though it excited the
greatest repugnance in them. The first stools were black, fetid ;
afterwards they became of a greenish-brown oolour.
tOKB KINDS OY CONTINUED AND BSMITTXNT FXVSBa. 886
After a oonstipated state of the bowels had lasted several days,
there generallj oeourred a diarrhoea, similar to that attending
oolic, with aggravation of the symptoms.
In the bad cases, there was sleeplessness that lasted until death
took place ; nothing approaching to sleep was observed except
a sort of drowsiness, that lasted a few minutes, with delirium and
tossing. As the disease diminished, the patient got some sleep
before midnight ; but even in the most favourable circumstanoea
it only lasted until three o'clock.
The most troublesome symptoms were : dejection and despair,
paralytic stiffness, drawing and tensive pains in the external
parts, especially in the tendinous and membranous aponeuroses,
as it seemed, and in the periosteum of the affected parts ; weight
i& the head, alternating with tensive, drawing and pressive head-
ache, and loss of memory.
The character of the adSTection seemed to betray pain and irri-
tation of the sensitive fibre. Cory za, properly so called, never
occurred. In some cases, stitches in the side with expectoration
of blood were added to the array of symptoms, but these stitches
in the side were not attributable to inflammation.
Sometimes the fever was accompanied at night by attacks of
suffiocation.
There was never either swelling or redness in the part, even
in cases where the pain was excessive, with the exception of
some cases where the fingers were sensitive, swollen and red ;
in one single case the hepatic region was tumefied.
The most annoying drawing headache was often accompanied
by nausea that lasted several hours, by faintness and rigours. The
catamenia were generally premature and degenerated into me-
trorrhagia.
The most powerful emetics did not cause vomiting, but some-
times nausea, that lasted for whole days, alternating with syn-
cope ; sometimes a single abundant stool occurred, with aggra-
vation of all the symptoms ; or again, very small doses of these
emetics brought on excessive vomiting for several hours, as oft;en
as twenty times, and in severe cases even thirty -six times, always
succeeded by obvious aggravation. (Sometimes spontaneous vo-
miting occurred for twenty-four consecutive hours, and the dis-
ease went off entirely.) If| as very seldom happened, the
emetics occasioned moderate vomiting, the matter vomited usa<
ally consisted of a black, fetid substance, resembling in ap-
pearance the grounds of coffee ; and, when that was the case, all
tU flOMK KIHDB or OOHTUTOKD ASB BnORiaT 11 MMWi
the odier sTmptonui became speedily aggfa>yfUb»jL All atteiopto
i^ade to provoke yomiting bj iickluig the booes wilh ift feather
only produced loss of str^ogth and increase of thepem.
A similar effect was produced by every kind of laxativt, even
the mildest kinds, especially when there wi|s [N!ffBent ^ predie-
poaition to diarrhoea. Thus I saw four grains of rhubarb pinor
duce, in the case of a boy of eleven yeaiv of age, more 42iaD
fixrty stools in the course <^ two days, and increase the intew^
of ^e symptoms. Many patients sank beneath th6 eoaet^
diaarrhcea.
When diaphoretics, which were emj^oyed by tha pooiW
classes, sometimes produced the desired effbct, excessiye pen^-
ration came on, causing an aggravation of all the sy]Qapt<HDS. Ib
jome patients an abundant uniform transpiratioa QU^pifeeted i^
self imtil death.
Y^etable acids, which were employed by the «iedjeal prac-
titicmers in great quantities, occasioned vomiting and diarrhm^
followed by aggravation. Taken by the potieiits apcording 99
their feelings dictated, they seemed to refisesh tjiem, btt( tj^ey
could only take a very small quaatily at a time. In the moat
-violent attacks, they only desired to moieten tibeir lips^ Hfid
found themselves refreshed thereby.
Mineral acids seemed not to be useAil,
Venesection was hurtful in every stage of the diseasei but
eq)ecially when the fever was severe ; death then often ensued
about the fourth day. Even when the fever seemed slight at
ihe commencement, bleeding^ was instantly followed by fiiint-
dng, prostration of strength, increase of the pauoi, and agc^vatioi?
^ the disease.
Opium subdued the heat and the excessive perspiraligiQi f^
the delirium and tiie somnolezu;^ ; but it increased the consti-
pation ; in geneml, it did not ei^fifn tp rcpipve the o^bMj ^^'
JC^y.
Oamplior, on the contrary, surpassed aU ji^e e^peptftt^pn^ AM
^uld have been IcMined of it j \t was effiQfuuov,s, ji^x^ Xj^J a^Jj
jQiecific, in all the stages of the disease, aocompanie4 or npt by
* The loqal practitionere constaiiUj had reooune to bleediog ; the j thus caiaed
die death of many patients. U, by chance, a Tigorous subject surriyed after a fawd
atroggle, they liaised shouts at triumph, and psetended diey-had WTed hkii by nrinns
j^f « welUyned Jbleediog, or hf their refiqlTeQts f^ gYjUdwi/fl. Qi^e qf thcHoafviBp
9Vik under a fiimllAr treatment too ejM^ followed out, though ercay dBbct ^^d
Jl^aen made to dissuade him froip it
mmMiWiwuk or -ooiinDrvBD abd Rnfmmr ravnod M7
fimTi a^)e(aAlfy whea^it was given as earlj aa poaaible and in
lacga^loaear A large ^nnmber of patients reGoyeaeed by its use
in tfaeqMwe <^ four days^ in spite of the gravity of thecr
symptomsj • ' ■
: . At.the'oommenoeinent I was very eautions in its use, and did
not give to adults above from fifteen to sixteen grains per diem,
iBtabiond-milk ; but I soon perceived Ibat in order to produce
a:jpeedy J recovery, it was necessary to give, even to we^k sub-
jacfe^itkirty grains, and to more robust individuals^ forty grains
m the twenty-four hours. The fiivourable resuH was never long
delayed; the constipation 'Ceased; the bod, or at least the bilious
taate^irapidly went ofi^ leather with the nausea and diseom-
Art ; 'the weight and pain in the head diminished fipom hourto
hour; the febrile rigotir was smothered in its birth; the heat
diminished, and in those cases where there had been no perspi*
nation, orwhere it had' been abundant^ there occurred a general
tmild^iaphoTeflis,' with diminution of all the drawing tensive
;pains in- the external parts. The strength soon returned, along
^witli appetite and sleep; the despondency changed into strength
and hcpe) and the patient recovered his health without a draw-
-iMKSk-.--
. I am afraid that this rapid disappearance of the symptoms,
^tlie.yeUow,' brown, or black coating of the tongue, the nauseous
and bitter taste, the constipation, and the sickness, removed
•olten within the twenty-four hours by the use of camphor alone,
•given in large doses, will not please the orthodox partisans of
the aaburral school. Nature, to be sure, often refuses to conform
to the requirements of sj^tems: the more's the pity for the
dogmatic physician who attempts to fight against her I
When I had been summoned in time, and the disease, in spite
of the gnmty of its commencement, had radically disappeared
ftt the end of four days, or six at the most, there did not remain
a single morbid symptom, not even lassitude.
J... A nervous lady of great spirit, could not be consoled during
^tho JS|8t days for the loss of her betrothed, whom she loved ten-
derly 4 he- had died of the disease^ and she it waes who had
tended him. She lost her appetite and refused all food. I was
edvised to^ prescribe an emetic for her, in order to restore the ap-
.petite, but I refused to do so ^ she was threatened with an attack
ofriBflujenBa, and I merely ordered a glass of wine and sought
U>. raise her spirits.
. Her numerous avocations, BBd still more, : her inteUigeUt
8S8 SOIIB KINDS OF CONTINUED AND BXMnTEBPT WKTKBB.
mind and the consoIa4ion8 of her firiends, assuaged ber grief;
the next week she was more cahn, felt her appetite retamiiig,
and obtained a little rest in sleep. She only felt some vague
pains in the bones, for which she neglected to consult me. Fif>
teen days after the death of her Mend she was seized with a
febrile rigour that lasted ti¥o hours, and with all the signs of
the most violent form of the prevailing epidemic. As regarded
her disposition, she was a prey to the most profound despair ;
day and night she only spoke of her lover, calling him by name,
and promising that she would soon join him. Her resdessness
was excessive, the tongue was covered with a black coatiiig^
she had disagreeable eructations, with bitter taste in the moatL
The heat, the pains in the neck and limbs, the violent headache,
filled me with well-grounded apprehensions as to the result. I
prescribed from fifteen to eighteen grains of camphor the first
two days, and an emetic, in consequence of the persistence of
the eructations and the bitter taste. The only effect the emetic
had was to cause nausea, which lasted several hours ; a fresh
dose of camphor was given to remove the spasm, and then she
had slight vomiting of mucus. Still she felt no relief, and every
thing seemed to prognosticate a &tal termination. She spoke
of nothing but her lover ; her whole body was burning, the
lace puffed, the pulse 180. Thirty grains of camphor within the
twenty -four hours produced a slight moisture of the skin, and
diminished the heat and bitter taste of the mouth. The follow-
ing day she got thirty-six grains, and the day after forty ; she
slept quietly, spoke no more about the deceased, felt consoled,
and regained her courage. She got up and asserted that she
felt nothing now except little or no pain in the head and limbs,
and she asked for something to eat Thirty more grains of
camphor given on the two following days, re-established her
health completely, and fix)m that time she was able to resume
her usual occupations.
I only know one case out of more than a hundred where the
camphor fiadled* A lady of rank, very hysterical, subject to
hysteria firom her youth, had been attacked by influenza. She
had taken with good effects twenty grains of camphor in the
twenty-four hours, and I prescribed for her fifteen more, to be
taken in the space of twenty hours, against some inconveniences
that remained. She immediately experienced profuse perspira-
tion, which, in the course of sixteen hours, increased to a very
violent degree, with intense heat^ faintness and anxiety. The
son KINDS OP COKTIKUED AND BEMITTENT FXVEBS. 889
State of the patient was very serious, but half a grain of opium
aDayed the anxiety, heat and sweaty in less than an hour. I
prescribed it anew in much larger doses with much success, and
the cure was complete.
The nature of the influenza which generally goes on to copious
evacuations (and on the other hand, sometimes to an excessive
suppression of the evacuations,) in this case resisted its own
speci&Cf probably in consequence of having undergone a modi-
fication from the hysterical constitution of the patient
Before I had ascertained all the efficacy of camphor in this
extraordinary disease, I was forced to content myself with
opium and cinchona; the first during the hot and sweating
stages, and second during the remission. Troublesome and diffi-
cult as were these cases, nevertheless the employment of these
substances sufficed to remove (although only after several days)
the coating of the tongue and bitter taste, and by degrees all the
affection. But after it had been subdued, the convalescents
could no longer bear the bark ; no sooner was it taken than it
was ejected. In the epidemic of 1782, 1 find among the large
number of remedies employed by physicians, camphor mentioned
iocidentally, but no effect superior to that of the other thera-
peutic agents is attributed to it
What induces me to believe that on that occasion these vari-
ous medicaments were employed in a blind and arbitrary manner,
is, that among many other remedies arnica* is equally recom-
mended for this affection. This substance, though efficacious in
many other diseases, is very dangerous in this one. I have seen
a robust man affected with influenza, and already convalescent,
die in the space of twenty-four hours and a half with all the signs
of poisoning, after having taken eight grains of arnica-root, the
fisital effects of which shewed themselves by coldness, vertigo,
palpitations, anxiety, and loss of voice. Had I at that period
known the specific remedy for this kind of poisoning, viz., vine-
gar, I might have saved this patient's life. The extract of
aconite' employed in the same way in this epidemic, is equally
prejudicial.
This last influenza, in common with all others, as I have had
opportunities of convincing myself presents as a characteristic
fbkture the power of affecting indiscriminately all persons, what-
ever their constitution may be, a power which the plague of the
' limguUi, Dtu. hUtor, catarrh, eptdan^ 1782, Helmstadt) p. 15t.
* C^cttp.l4i.
MQ 80K& KINDS OF CQNTINUSI> AND RSKQTBVI^ nEWtt*
Levant scarcely possesses in such a high degree. . Most epi-
demic diseases attack chiefly persons in good health; but there
are persons affected with chronic diseases, among which I may
merely mention severe nervous affections and mental alienation,
who are not affected by them ; or if so^ the old affection is sus-
pended in its course and the. new one takes possession of the
system ; or finally, and this happens tolerably often, the first is
cured by the second. It is not so with influenza. Not only
does it attack indiscriminately all individuals affected witli
chronic maladies, but it complicates itself with them and tLggm-
vates them. It is when it remains latent itself that it stirs up
and aggravates any ancient disease which may perhaps have
slumbered for a long time, and the chronic symptoms dius ag-
gravated no longer yield to the remedies formerly employed
with success against them, but only to the specific for the ii^u-
enza. It reproduces deafiiess, ophthalmia, cough, asthma, pains
in various parts, especially in the chest, head, viscera or limbs,
ancient spasms, hypochondriasis, melancholia, all those suffer-
ings that had long been cured ; the epidemic constitution and
the presence of a few of the symptoms of influenza alone lead
us to recognise the existence of influenza, masked by these
chronic maladies. Sometimes it has occasioned paralysis, either
by metastasis, or in parts previously painful.
A child of twelve years of age, in a district where this epi-
demic was raging, was seized with characteristic tearing pains
in all the limbs, with tensive headache and intolerable pains in
the eyes. Having taken a chill, all the signs of the disease dis-
appeared, but the 'child lost its sight. The pupils were much
dilated and unaffected by the strongest light. The employment
of fifteen grains of camphor daily, continued for a fortnight,
rapidly restored vision without the employment of any other
remedy.
About the same time in the mother of this child there was
reproduced a melancholia with despair and tendency to suicide,
a disease which had disappeared several year? previpusly. Be-
sides tensive pains in the head and anxiety in the precordial
region, she complained of drawing pains in the lioabs. Of all
the remedies given, camphor chiefly contributed to her cure,
A month after the termination of the epidemic there >yas ob-
served a chronic remission of this fever haying a spoi;adic char-
acter. It had this peculiarity, that the pains experienced by
individuals in whom convalescence had set in after the influenza.
80KS KINDB OY^o6lrTlKU8D JiaTD BEmTTENT FSVSBS. 841
reenrred eHber wtthotit fever, or accompanied by a kind pf
istarmittent fever, witK quotidian or tertian type. The great
laasitiide, the prostration, the faintness and the sweat, charao-
tfltistic of influenza, were entirely wanting. The heat was
moderate,' th^ ooM all the more obstinate, though not inducing
much shivering.
Gitlchonl^ but still better, ignatia, removed the febrile symp-
taHDs^-but the pains became constant Camphor failed com-
{dfltely ; the hdum pcduatrCj on the contrary, in doses of fh)m
ax to seven grains, three times a day for adults, produced per-
manent relief.
In some obstinate eases I was forced to have recourse to aop-
mte, whieh cured them rapidly. I am sorry that I only had
an opportunity of treating a small number of those cases that
praKnted themselves at the end of the epidemic, so that I am
anable to judge if this plant, whose medicinal properties ftre
much greater than those of ledum, would not have enabled me
to attain my object much more rapidly in all the cases that pre-
lented themselves to my notice.
SOME PERIODICAL AND HEBDOMADAL DISEASES.'
L A young man, xecently recovered from a spasmodic asth-
ma^ having drunk some wine, contrary to. the dietetic rules I
had laid down for him, was heated by it and began to quarrel
and fight with his companions. After violent muscular exer-
tion he was seized with an attack of asthma, which became
worse and worse, and towards the end of the night reached its
greatest intensity. The following day and some days after-
wards he felt great lassitude. A week afterwards, without ap-
preciable cause, a similar attack came on, also followed by las-
situde. From that time the fits, together with the consequent
weakness, came on regularly every Monday afternoon. Eight
grains of St. Ignatius' bean once diminished the attack in a
marked manner and the weakness did not occur ; but strangely
enough, the following Monday this attack came on again with
lenewed force. Cinchona-bark given the following Monday, in
1 From 'Hufcbuid'd Journal dor pract A rzneykunde. Vol y. PL 1 1798.
342 80HS P£aiODICAJ« ajsd
K
the doae of half a drachm in the moming and a drabhm after
dinner, completely suppressed the fit, and after two more doeee
all traces of the affection had disappeared.
A circumstance worth mentioning is^ that previously the cin-
chona had always failed in the same person against his asthma
when it was continued and not periodical.
n. A lying-in woman, aged 40, one Sunday met with a
severe mortification, when confined of her fifth child. Besides
other disagreeable symptoms, there came on a sensation of for-
mication that gradually extended from the sacrum up to be*
twixt the scapulae, so tfiat by Friday it reached the nape. A
sudden stiffiiess occurred at tliat spot. The patient experienced
at the same time a violent febrile rigour which lasted several
hours, followed by diaphoresis which continued till late at night
and terminated in profuse sweat The following day she com-
plained of nothing but lassitude, and on taking the least repose,
even if seated, she had general sweat, somewhat cold, during
the whole day. A disagreeable sensation of formication, ex-
tending firom the nape to above the occiput, came on every
afternoon and lasted till bedtime. There was no bad taste in
the mouth, the tongue was clean, but the appetite almost
absent. From that period the same fit of intermittent fever,
characterized by the same symptoms and by the same termina-
tion, occurred on the Thursday and the following Thursdays
for several weeks.
When the patient came to consult me she concealed the ex-
citing cause of her disease, viz., the mortification. The normal
taste and the cleanness of the tongue contra-indicated the use of
an emetic.
There was evidently in this case an intermittent fever with a
quotidian type, and another with a hebdomadal type. The
employment of ignatia continued for a week, until the Thurs-
day, entirely removed the febrile symptoms affecting the head.
GKven also on the Thursday the hebdomadal attack far fix>m
diminishing, reappeared, on the contrary, with more violence,
but was not followed by lassitude. I discontinued the treat-
ment during the subsequent week; indeed all the corporeal
functions were performed regularly, the febrile commotion in
the evening and the perspirations by day had disappeared,
gaiety, appetite and sleep were restored. From that time I
administered every Thursday, with great success, a suitable
dose of cinchona. The hebdomadal fever did not return and
the patient was cured.
HSBDOKADAL DI8SA8I. 848
m. A very hypochondriacal man auflfered in the spring of
last year from a periodical hematuria, the type 6f which he
oould nol remember. There was at the same time fever, great
debility and sleeplessness. He had a relapse of his disease in
the month of May of this year. I combatted the accessory
febrile symptoms with remedies adapted at the same time for
the h»morrhage, to wit, ipecacuanaha given oh an empty sto*
mach in the morning, so as to occasion nausea for four hours,
and in the evening sulphuric acid. The accessory febrile symp-
toms sensibly diminished, but the hematuria reappeared the
fourth day at seven o'clock in the morning, immediately after
awaking, as on the first occasion, and twice on the seventh day
thereafter at the same hour. Notwithstanding all the preju-
dices against the employment of cinchona-bark in haemorrhages
I gave a suitable dose of it eveiy evening before going to bed,
fearing to miss the hour in the morning when it ought to be
given.
Not knowing if the fit^ in place of offering a hebdomadal
type, would not recur eveiy three days and a hal^ as frequently
happens, and if an attack might not be expected on the aft;er-
noon of Thursday, I prescribed a dose of cinchona for that day
at noon, at the same time continuing the evening dose. But
before the patient could take it^ an attack of hematuria, though
not a very severe onej occurred on the Thursday morning about
eight o'clock.
I had thus learned : Ist, that the curative power of the even-
ing dose did not last till the following day ; 2d, that the semi-
hebdomadal type was not bound to precisely the first hour of
the second half of the fourth day, but that it could also occur
at the regular hour of the hebdomadal paroxysm. I conse-
quently altered my treatment : I thereafter gave every morning
a dose of cinchona, taking care to have the patient awakened an
hour before his usual time of waking, at six o'clock, permitting
him either to go asleep again, which he generally did, or to get
up. In the course of a fortnight the hematuria was quite
eared.
The hebdomadal type which diseases smoetimes observe, re-
curring towards the middle of the fourth day, (the fourth day ?)
the seventh, fourteenth, twenty-first, thirty-first days (the mid-
dle of the fourth week), &c., appears to differ essentially from
the daily aggravation of most diseases which we observe to
take place in the evening, and from the types of quotidian, ter-
tian: ttid: qiiflrten lulenukteiilr&TaEni. : * BxperioAo&lMfrlkiij^ill'iii
thatStL Ignativs' bean, does not. suit the ftrst of ikeMtTpoB^
wldoh. i Beans : peosHar to hjnsterkal^ .liypookoiidriiGal md^flpM*-
medio diseases. ' ■•- .i>
I . < t
A PBEFAOEJ
I have translated the book entitled " Thesaurus Mediearninuml,
a new collection of medical prescriptionsy distributed into tweht
dosses, and aceompamed wiA pharrruju^eiU^
eochibiting a view of the present state of the materia medica Ondproe^
tice of physicy both at h&me and abrdad. The second edition^ wiA
an appendix and oAer additions. By a member of the London
CoUege of Physicians. London: F. Baldwin, 1794, 8vo.,"iiittio*
dueing into the body of the work fbrmnlas derived' 'from' the
London and Edinburgh Pharmacopodias and from Lewis, a!td
adding some notes, under the signature of Y., which to ^ome of
my readers 'may facilitate if it do not altogether enable them t6
dispense with the journey to Anticyra.
If, as the preface to the original informs me, even in' London,
medical frankness requires the sDgis of anonymousness, in order
to escape being chid; I need not say a word as to itd expe*
diency for some time past in our own dear fatherland ! If I,
the German editor, would not be less frank, what other course
was there for me to pursue ? However, as truth can neither be
more true nor less true, whether it be said by a rtian with ati
imposing array of titles or by one perfectly unknown to fame;
die indulgent reader will please to regard merely what is said.
It will be perceived that the original is one of the most re-*
eondite collections of selected, at least of elegant presfcriptions ;
but it will also be observed that the writer of the notes is no
friend to compound medicines. But how, it will be asked, did
he come to edit this work ? To which I answer, solely for th&t
very reason 1 I wished to shew to my countrymen that the very
best prescriptions have a hitch somewhere, arc unnatural, cdntradicloty-^
and opposed to Hie object for which they are designed.' This is s
-ft
' The work to which this is prefixed was translated bj Hahnemanii, and pnMiihaji
anoajmouslj in the year 1800, under the title of ArzneUehtUz odet'Smmhm^ §fh
itAA^Jtenpto, ansdem Bnglisdwn; Leipzig, bei G. PleiBcher.
tratli that should be proolaimed from the hoHsetope in bur
pneeriptioQ-loving times. When will the time come when I
8haU see this follj eradicated? When will the physician learn
that the cure of bifi eases requires few, quite simple, but proper,
perfectly femitable remedies? Will they for ever deserve the
ridicale of such as Arcesilas? Will they never cease to mingle
together) a: heap of remedies in one prescription, each of which
{far in the general use of compounds it is impossible to investigate
the nature of the several ingredients) remains to the greatest
physician often but an imperfectly known, often a whole un-
known, thing? If Jones, in London, uses every year three
humked pounds of cinchona-bark, what accurate, what perfect
knowledge do we obtwn of the peculiar mode of action of this
powerful remedy? Very little indeed I What do we know of
liie pom special mode of action of that powerful substance, mer-
eoiy, the monstrous consumption of which in medical practice
wouM seem to imply a thorough knowledge of its relation to
our bodies? Very Utile! Little besides the empirical apo-
thegm that was enunciated 300 years ago: ^4t cures the
venereal disease," all else are untrustworthy fragments. What
oertain knowledge do we possess respecting opium that could
iead u» to such a frantic abuse of it? Little or nothing of a
eiire character I What of Camphor ? Scarcely anything I
Would that Arcesilas were still alive to know that physicians
are still at variance as to whether mercury is capable of produ-
cing a change in the strength, mobility and sensibility of the
fibres (and in the pulse), in a word, can cause a peculiar kind
of fever or no, whether bark in antipyretic, merely by virtue of
its being a bitter astringent substance like a mixture of gentian
and polygonum, or by some peculiar inherent principle — whe-
ther opium strengthens or weakens — whether camphor is cooling
or heating, and that those who contend for the one opinion as
well as those who defend the other, have both forgotten to state
the special conditions of their conclusions. But if the power of
these substances of every-day use be so undetermined, how
much less known must not those of rarer use be !
If such remarkable obscurity prevail respecting single medi-
cinea, to what a zero in point of value must the phenomena rtink,
which result from the ordinary tumultuous employment of seve*
nriof such unknown drugs mixed together^ in diseases — in diseases,
those abnormal states of the human body — ^the most intricate of
aD oiganissed beings — ^that are in truth not easily cognizable in
846 A PKBFAOS.
individual caaesl It is as though one should throw blindfold
a handM of balls of various sizes upon an unknown billiard
table with cushions of various angles, and should pretend to
decide beforehand what effect thej would all conjointlj produoe^
what direction each would take, and what position they would
finally occupy after their many deflections and their unforeseen
mutual concussions 1 And yet the results of all mechanical
forces are much more easily determined than those of dyna>
mic forces.
''In a mixed prescription the case is far otherwise," methinki
I hear it contended, ''for there the prescribing physician deter-
mines for each ingredient the part it shall play in the human
body : this one shall be the base, this other the adjuvant, a thii^
the corrective, that one the director and this one the exdpientl
It is my sovereign command that none of these ingredients ven-
ture to quit the post assigned it in the human body 1 I com-
mand that the corrective be not backward in concealing the
blimders of the base, that it cover all the delinquencies of this
principal ingredient and of the adjuvant, and direct them {<xt
the best ; but to go out of its rank and situation and to take
upon itself a part of its own contrary to the base, I hereby posi-
tively forbid it! Now, adjuvant I to thee I assign the office
of Mentor to my base, support it in its difficult task ; but mind,
thou art only to take it by the arm, but not to do anything else
of thine own accord, or dare to act contrary to the order which
I have given to the base to cause a certain amount of vomiting;
but thou must by np means presume in thine ignorance to un-
dertake any expeditions on thine own account, or to do any-
thing different &om the intention of the base ; thou must, thou^
thou art something quite different, act entirely in concert with
it ; that I command thee I I assign to you all conjointly the
highly important business of the whole expedition : see that
you expel the impure humours from the blood, without touch-
ing in the slightest degree the good ones ; alter, transform, what
you discover to be in improper combination, in a morbid statew
Bemember that the conmiission to alter and to transform gives
you unlimited authority to change, God knows or knows not
what (just as in warlike tactics it is usual for the general to
possess more knowledge than his sovereign lord). You are to
diminish the irritability of the muscular fibre, to lessen the sen-
sibility of the nerves, to procure sleep and rest Do you see the
convulsions in yonder arm ? I wish them to be quieted, an4
▲ PBSFACS. 847
the spasm in the sphincter muscle of the bladder to be removed I
That fellow there has the jaundice ; I command jou to bleach
him and to deobstruate his biliary ducts, whether their imper-
meable condition be owing to spasm or to a mechanical obstacle,
or to some degeneration of the liver. In that hysterical woman,
and in those old skin diseases, all my long years of treatment
and my employment of extracts of spring herbs have proved
useless, from which I infer that there are obstructions in the capil-
lary vessels of the abdomen — ^my &vourite way of accoimting for
morbid affections. Now you, most worthy base I were, only a few
days since (and that is a great thing in my estimation), accredited
to me in one of the latest pamphlets as a sure deobstruent I
therefore give you a commission to resolve those iudurations
(though I myse^ am unacquainted with the invisible indurations
and know not what menstruum can dissolve them, what liquifiier
can meU them, or whatever else the comfortable expressions of
our school may be) — enough, you will know quite well what is
to be done when you yourself get upon the spot. Sdmmering,
to be sure, says that hard, swollen glands do not consist of con-
staicted vessels, but on the contrary of unnaturally dilated ves-
sels. But what care we for what that dreamer says. We physi-
cians have been in the habit of deobstruating for so many cen-
turies. Suffice it to say, I command you, base I to deobstruate
for me. See yonder typhus patient, my dear base salpetre ! I
pray you to advance and check the putrefSactive process, as you
did a year ago to my pork ham. Do not attempt to excuse your-
self by alleging that hitherto you have always been unfortunate
in all your expeditions : I give you for ally the sulphuric acid,
to support you in all your attacks, although those fantastic
chemists would try to persuade us that you do not agree with it,
that neither of you remain what you were, that you mutually
change into nitric acid and sulphate of potash. What nonsense I
just as if such a thing were possible without the permission of
the physician who presides over prescriptions I Enough that I
command you to extinguish the putrid fever ; for that purpose
you have received from me your diploma of base. Moreover, I
put at your service a troop of auxiliary, corrective and directing
sabstances. — My dear base, opium I here I have an obstinate,
painful cough to combat. You, who have received from the
Asclepiades the office of subduing all spasms and pains, be they
ever so different in character, just as the seven planets were
commissioned in the almanacs a century ago to preside over
M6 A-norAos.
this and that part of ont body — to yoa I give the^totimMM
sanetioned by tradition. But I have been infonned ihatyov.
have often a bad propensity to constipate the bowels. But in
order that this may not happen I give you as auxiliarieB tliife
and that laxative ingredient, and that your action -may not h6
disturbed by these, is your own look out ; why else should I
constitute you the base I Moreover as you sometimes oceamoD
heat, and are given to check exhalation, I give you camphor ai
a eorrective, in order to counteract this bad habit of yoUnl
Some one lately asserted that you lost all your prbpertieB wheii
camphor was given along with you. But do not let that lead
you astray. How can the saddle-horse allow himself to be ob-
structed by the draught horse ? Each of you must d6 your duty
as it is indicated for you in the authorized Mateda Medici{
whence our opinion is derived. It has also been told me thiKi
the stomach is deranged by you, but to prevent you playing this
trick I have included in the prescription along with you several
stomachic remedies, and will allow a cup of coffee to be dnint
after you are taken, which assists digestion, as the Writings df
practitioners allege — ^regardless of those newfangled persons who
assert of it that it destroys your J)ower : but you must not allow
yourself to be rendered powerless ; for that reason I have ap-
pointed you the base."
And thus, as though they were independent beings endowed
with free volition, each ingredient in a complete prescription
has its task allotted to it, vel tnviitssima Minerva Hygetaque, in
many other respects also. For there are many learned cond-
derations in a regular classical prescription. This indication
and that one must be fulfilled : three, four and more symptoms
must be met by as many different remedies. Consider, Arcesi-
las ! how many remedies must be artistically combined in ord^
to make the attack at once from all points. Something for thd
tendency to vomit, something else for the diarrhoea, something
else for the evening fever and night-sweats, and as the patie)it ia
so weak, tonic medicines must be added, and not one alone, birt
several, in order that what the one cannot do (which we donH
know) the other may.
But what if all the symptoms proceeded from one cause, as is air
most ahoays the case, and there were one single drug that ivould meet
all these symptoms f
" That would be a very different thing. But it would be in-
convenient to search for such a one ; we put in one presorip-
A PBBPAOS. 8^
tknpt BometbiBg to meet every indication, and thua we f alfil the
fequiiementa of the sohool."
. But do you thereby satisfy the requirements of the art, of the
pfedoia8:hunian life ?
; ** No man can serve two masters."
But do ,you seriously believe that your kotc/i-patch will do
what you ai^gn to each of its ingredients, just as if they were
thingB that did not mutually react upon each other, that did not
influence each other, or that would refirain from doing so at your
ooBimand? Does it not occur to you that two dynamic ageate
given together can never effect that which both, given separately
at different times, would do — that an intermediate action must
easue which could not have been foreseen beforehand — and that
this must be still more the case when several are given together I
Who oould tell beforehand that opium given along with co£Eee
would in most cases exert merely a strong diuretic action ? who
oould have predicted it of th^o two remedies ? Will opium
still stupify if ipecacuan be combined with it ? You perceive
that they do not act according to your will, nor according to
your atonic principles I The combination of these two dyna-
mic powers causes anxiety and perspiration.
*• But tartar-emetic will be more apt to excite vomiting, if on
account of the weakness of the stomach I combine with it cin-
chona bark ?"
Very little or not all, my short-sighted friend !
" Why had the white hellebore so little effect on that pa-
tient?"
Because you gave at the same time a clyster of chamomile!
*' What terrific effects ought not a good extract of stramonium
to have ! according to medical authors. They are a pack of
liars I A short time ago I gave it to a very sensitive patient in
a strong dose in a draught. It had no effect, not the slightest"
Probably you mixed it with oxymcl ?
" Yes, I did ! But what harm can that do ? It was only the
ex^pient; only four ounces."
Several ounces of that vegetable acid 7 Well, you need not
wonder that no effect was produced. — Did I not see you the
other day prascrilye salt of tartar mixed with gamboge? What
, was your object in doing so, and what effect had the powder?
'* The first was in order to loosen the muous, and the seoond
to expel the worms forcibly ; but to my astonishment it did not
cause a single evacuation of the bowels."
3S0 FRAOMENTABT OBSKBVATIONS OK
That does not surprise me I Enow that two, not to speak of
three or more substances, when mingled together do not piodooe
the same result that might be expected from them if given m^
gly and at different times, but a different dynamical intermediate
action, whether you wish it or no. In that case the systematic
arrangement of your ingredients is of no avail, nor the part you
allot to the base and bases^ to the adjuvant and adjuvantSj to yoor
corrective^ director and exdpient Nature acts according to eter-
nal laws, without asking your leave ; she loves simplicity, and
effects much with one remedy, whilst you effect litSe with many.
Seek to imitate nature !
To write very composite recipes, and several of them in the
course of the day, is the climax of parempiricism ; to adminis-
ter quite simple remedies, and not to give a second before the
action of the first has expired — ^this and this alone is the direct
way into the inner holy place of art Make your choice I
FRAGMENTARY OBSERVATIONS ON BROWN'S
ELEMENTS OF MEDiaNE.'
In section xviii he politely apologises for being obliged to
make use of the plirases, dejicient, exhaustedj consumed^ aocumth
kUed^ superfluous excitability, owing to the novelty of the doctrine
and the poverty of common language. But this is no excuse
for the man who boasts (cccxii) of having now reduced the art
of medicine to an exact science which will at no distant day
receive the appellation of Doctrine of Nature (note to dclxxvii),
and of being the first who has made it a demo7istra4ed science (see
end of the Prefiioe). He who would teach a new science for
which he must employ new ideas, ought to employ for them
new, appropriate, imequivocal terms, or make use of the old
* From HufelafuTt Journal der pracL Artneyhunde^ VoL v. Pt2,p. 62,1801.
[Hufeland himflelf pots the foUowing note to this masterly criticism: — ^"Thew
observations are from the pen of one of the most distiDguished of Gennan phTsidaai^
whoyhowever, as he himself expresses it, * as long as literary chouanerie makes the
highways unsafe,* will not permit his name to appear, which, in my opinion, is a good
plan, in cases where reason aed not the authority of names are to decide. I mart^
however, observe thatthe author has read nothing either for or against the Branooian
system, and thereibre we may be all the more certain that we have here the m^Nnqa*
diced opinion on this subject of a practical physician of matured eiperienoe and
reflection."
BBOWV'S XLSMXNTS OF HEDIOINB. 861
woidSj attaching new meanings to them, for the new expressionfi.
But as Brown employs the old expressions unexplained and''
without attaching to them new meanings, he must permit the
reader to understand them in their old si^iification, and when
we read, that excitability^ a certain quantity or certain energy of
which has been assigned to every being upon the commencement of its
living state (xyin.), may be zoom out by stimtUi (CGClx) and yet
afierwards be dravmforih by new stimuii^ he must not be offended
if we belieye that we have read nonsense.
XXL {, f^ " Emetics and purgatives, fear, grie^ &c., diminish
the sum-total of excitement, and are debilitating; — ^but firom no
other reason, not because they are other than stimulating agents,
~they are stimulants but are debilitating, that is, weakly stimu-
lant, owing their debility (he should have said, dAilitating power)
to a d^ree of stimulus greatly inferior to the proper one."
If all excitement, all the conditions of life and health, are
owing to stimulus, and to no other cause (xxii.) no stimulus is
of itself capable of diminishing the excitement. Either the
external condition for life and health does not solely depend
upon what is termed *' stimulus," or if it do, then a stimulus, be
it even a weak, an insufficient one, cannot debilitate. It is only
(but Brown does not make this proviso) when it is the sole
stimulus acting upon the body for a long time, all other greater
stimuli being in the meantime excluded, that a debilitating effect
can be produced, not^ however, in consequence of the smallness
of the acting stimulus, but in consequence of the absence of the
greater (accustomed) stimuli. K it were otherwise, a man in
good health, who would feel still more enlivened by drinking
four ounces of wine, would be tremendously debilitated if at
that time in place of four ounces he should take but four drops
in his mouth, and would be debilitated four times as much if he
took only one drop.
An addition to the condition of life, be it ever so small (a weak
simple stimulus), can never become aminus^ can never debilitate.
I^ however, it do debilitate (as purgatives, fear, grief, and so
forth do), whilst the sum-total of the usual means requisite for
sustaining life (heat, food, &c.) remains undiminished, in that
case its debilitating power must be owing to quite a different
cause than the smallness of the stimulating power.
Who can fidl to perceive the justness of these conclusions?
A healthy, excitable girl, in the fiill possession of all stimuli
lequiflite for health, dies instantaneoudy on suddenly hearing
S62 FBAOMSNTABY ojmsMYJtaofm OB
tt
the tragical intelligence that her lover had beenietdbbed. rlf
this was merely a simple but only a small stimulufl^ it moat
haye^ been just a small addition to the not defective nun of all
the other stimuli How could this small addition do harm, lioir
could it destroy life, and that instantaneously, if it merely acted
as a simple stimulus and in no other manner.
Who can Ml to perceive the correctness of these inferenoesl
He carries out his delusion so fieur as to assert (xxi, «), that
" fear and grief are only lower degrees of confidence and joyi7
Were I to dare to make such allegations^ I could make anything
out of everything, for it is very easy to be a scholastic aophisL
No, my dear friend I there are two scales ; at the top of the one
stands indifference, and below that come vexation, grie;^ de^air.
The other scale has indifference at its lowest: par^ whence it
mounts up to confidence, to joy, to rapture.
If it is allowed to Brown to infer from identity of effects,
identity of causes, we may be. permitted to infer &om opposite
effects, opposite causes, and to consider cold and grief, warmth
^^d joj) ^ opposite powers (because they exhibit opposite
(effects), yet in such a way as that the strengthening property cf
the latter, like the debilitating property of the form^ cannot
depend on their common attributes as stimuli, but must depend
upon attributes that in the former are of a directly oppodite
nature to those in the latter.
In XX and xxi Brown reckons poisons and typhus contagioiis
among the above powers (whose debilitating power depends oa
the smallness of the stimulation that they produce on the body.
Well now, if a man in the fuU possession of all the bealth-
sustaining external stimuli (the sum-total of which is firom 8000
to 8010 daily) should choose, after drinking his last glass of
wine, to get into a pit filled with carbonic acid, and if ill ten
minutes thereafter he is brought out dead, irrecoverably dead,
what is it in this case that prevents the continusmce of life? Is
it the addition of the too small and therefore debilitating stimulug
of the fixed air ? Let us compute the sum of its stimulatixig
energy at 1, or if you will a^ ^|i/»o.ooi>th, in th^it case the sum of
all the stimixli that have acted upon him during the lasli twenty-
four hours, inclusive of the carbonic acid ii^spired, ^1 amount
to 8001 or 3000 M^AXMKoth. He has been acted on every preoediog
day by as many (more or fewer) stimuli, there has occujgred in
this last day neither diminution nor incre^a^ of the stjiiiuU up
to the moment of his death. . . What th^ii pjiev^nled: him, til
brown's SLXICBNTS OF lOEDICIKX. 858
It is evident that it was an agent that proved so excessively in-
jorions to him, not in consequence of the smallness of its stimu-
lating energy, but on account of its enormous power of quite a
different nature.
He tries to get over the difficulty (xxi, C) by saying that the
debilitating stimuli produce their debilitating effects partly by
means of a dtsagreeable relation to the excitability, or by ikeir caus-
ing a disagreeable sensation. But he is very inconsistent to boast
in one page that he has reduced physiology and pathology to
one or two. principles, and in the next page quasi aliud agendo,
to put a couple of qualitates occuUce in the corner, which, in case
of necessity, when the defects of the vaunted chief supports of
his system are exposed, he may bring forward as already es-
tabli^ed principles, and attach to them, according to his fancy,
any meaning they may be required to bear. But through all
these parts assigned to auxiliaries, accessory springs of action,
and accessory agents, the boasted simplicity of his so-called
system vanishes into nothing. Now all the specific effects of
poisonSi contagions, &c., when it suits the purpose of Brown and
his followers, and the omnipotent words, '^ stimulants, weakly
stimulant," will not do, can be referred to " a discordant combi-
nation of powers," and the specific remedial powers of this or
that medicine, sometimes to the ^' agreeable relation that the
exciting power bears to the excitability," sometimes to an
"agreeable sensation;" and thus his retreat is covered I How
artful I but at the same time how disingenuous !
To his overstrained objections to cold in asthenic diseases —
(dcxcii) " In diseases of great and direct debility, cold must be
most carefully avoided, as it is always of a directly debilitating
operation, and never of service but in sthenic diseases, and those
that are in a progress to indirect debility" — which is repeatedly
alluded to, I must oppose my experience, which is the same as
that of many others, that during many years when I was still
ignorant of any specific remedies for old chronic diseases, I have
frequently combatted them successfully solely with cold washing,
cold foot-baths, and also with immersion for one minute at a
time in water of from 50° to 60° Fahr. One case however
among many others is so remarkable that I cannot refrain from
detailing it A man somewhat advanced in years, but still
possessing considerable strength, had had for five years from
unknown cause a paralytic affection of his left arm. The move-
ments he could perform with it were very weak and small, and
23
854 FBAaMENTABY OBSEBYATIOKS OK
the sensibility of it also was much diminished. Once upon a
time when he was on a visit to a relation, and there was no one
to fetch the fish for the supper out of a frozen tank, he
gets up quietly, breaks the ice, leans over it and passes near-
ly one hour with both anns in the ice-cold water before he
can get out the required number of fish. He comes and brings
them to the great delight of his host, but immediately complains
of pains in the affected arm, which in the course of a few houTB
inflames. The following day the pain and inflammation were
gone, and his arm had acquired its healthy sensibility and all
the powers of health. The paralysis was cured and remained
30. Should he have remained uncured to support Brown's erro-
neous maxims?
Brown, like all short-sighted, unpractical physicians, always
looked only to the primary and incipient action of the remedy,
but not to the after effect, which is, however, the chief thing.
ccxcviii. "In spasms and convulsions, in the internal, in lie
external parts, in bleeding discharges, in the direfiil delirium of
fevers and other very violent diseases, in asthenic inflammation;
when those stimuli, which have a more permanent influence^
fail, or act to no good purpose ; the virtue of the diffusible sti-
mulants, the principal of which is apiuniy is eminent." What a
general way of speaking, and how empirical ! What an im-
mense deal the man can do with opium ! I only wish I could
do the like. To cure internal and external spasms with opium
better than with any other remedy, any one else would find
somewhat difficult.
ccxcix. "When the action of all the other powers by which
life is supported, is of no effect, they (that is, wine, brandy,
opium) turn aside the instant stroke of death." No one took
them more copiously and more variously than the Master who
wrote this ; how is it that they did not turn aside the stroke of
death from himself (at his moderate age), and so avert the stigma
from his doctrine?
ccci. "A higher place in the scale is claimed by musk, volatile
alkali, camphor; — ^however, in every respect the preparations of
opiimi are sufficient for most purposes of high stimulating."
According to this, opium ought to be quite adequate for the cure
of most chronic diseases, and of others that he ascribes to a high
degree of debility, as poisonings of all sorts, &c. In that case it
would be a real panacea, and we should scarcely require any
other remedy. He could certainly have seen and treated bat
few chronic diseases, and assuredly no cases of poisoning with
brown's slemekts on hedioinx. 856
white hellebore, arsenic, &c., otherwise he would not have
asserted snch fiJsehooda
AxxK>rding to this paragraph, camphor should possess the same
powers as opium, only in a somewhat less degree ; and jet €u:hial
experience shows that their effects are exactly opposed ; the one
removes the effects of the other. How little Brown knew about
the things whereof he speaks so confidently !
oocn. "In diseases depending upon great debility [conse-
quently according to him, in acute typhus, putrid and biHous
fevers, the Levantine plague, &c] animal soups should be given."
But animal soups are utterly abhorred by them ; will he in spite
of the disgust they occasion force them upon the patients ? They
would agree with them admirably I
ccciii. In the case of a convalescent in whom stimulants should
be continued, he recommends that '"in his movements he should
first use gestation,'^ The old school, profoundly ignorant of na-
ture, with whose &bles Brown, the reformer of medicine, is still
80 chokefull, also considered riding without succussion as coming
onder the category of strengthening remedies, and ranged this
passive motion alongside the active ones (such as walking, dig-
ging, and other manual exercises), and yet the former acts anta-
gonistically to the latter, and is antiphlogistic, antisthenic, debili-
tating (at all events in its primary effect), greatly diminishing
the pulse, causing vomiting and nausea, &c. The reader will
easUy perceive how opposed this is to truth and nature.
ccc?Vil, ^," The remedies of asthenic diathesis, to whatever part
rtiey are applied, stimulate that part more than any other." This
is also one of his maxims that carries us away by its god-like
simplicity. Pity that it is fundamentally fiJse — that it is com-
pletely opposed to all true experience. Tincture of opium ap-
plied to the pit of the stomach causes no sensation on the spot to
which it is applied, but speedily relieves hysterical vomiting.
When applied there, or to the neck, or to any other sensitive
part of the body, it checks (in a palliative manner) some diar-
rhoeas, removes the apoplectic death-like coldness, stiffness and
unconsciousness caused by large doses of camphor, the abdominal
pains produced by belladonna, and the sopor of typhus, though
at the seat of its application no perceptible change is observable.
And I could adduce a hundred other examples opposed to the
generality of the maxim **that medicines act more strongly at
the part where they are applied than elsewhere." This is a pure
invention of his own.
366 nUOMSNTABY OBSSBYATIOKB 09
oocvuL " Inanition of the vesseLs (penury of blood) takes place
in asthenic diseases in an exact proportion to ihdr degree." In
pestilential typhus fevers, where sometimes only a few hours
elapse in the transition from health to death, or in the sudden
fiital cases caused by cherry-laurel water, by carburetted hydro-
gen, by exposure to the exhalations from cesspools, by the yapour
of charcoal, by carbonic acid, by flight, where the interval be-
twixt health and death often scarcely amounts to a couple of
minutes, how could such an enormous deficiency of blood ^Hn an
eocaci proportion to the degree of these asthenic diseases" have
occurred in such a short time ? Whither has the blood gone 7
It would be ridiculous to expose still further the absurdity of
this assertion on which he prides himself so much.
According to this paragraph he considers the most ^fficadous
remedy for asthenic diseases to be (artificial) filling of the vessels
with blood I Just as if healthy blood could be prepared in a
diseased body, just as if blood could be manufectured all at onoe
by means ol o^irl, wine, and foiced-down animal soups, in saoh
diseases, in the same way as butter is made in a chum, or beer
in a brewing vat I What sort of blood? How different is
chlorotic blood fi*om that of phthisical subjects 1 Astparva non
curat phUosophus.
OCCix. "When the excitability is worn out by any one sti-
mulus, any new stimulus finds excitability and draws it forth,
and thereby produces a further variation of the eflfect" The feot
is no doubt true, that a second medicine again acts when the one
just given no longer does any thing. But the cause of this phe-
nomenon, what is it ? It is impossible that it can be as Brown
says.
If stimulants do not differ among each other in kindj but anfy
in degree and strength (an unconditional main dogma of Brown's,
000X11, cccxiii), then it is impossible that the second stimulant
could act anew, after the first stimulant has ceased to be able to
act An increased dose of the first must necessarily effect all
that could be expected fix)m the second stimulant, if they differed
fix>m each other only in degree and strength ; but the first, even
when given in a stronger dose, now does nothing more, whereas
the second acts anew, consequently they cannot differ merely in
degree, they must differ in kind (rnodo). K however, this be the
case, the whole Brunonian system fidls to the ground.
Moreover, how can the second stimulus still find excitability
and draw it forth, as he here asserts, when it has been already
brown's slemknts of msdiginb. 867
irom out by the first? Whence came the new excitability 7
from his &ncy, or firom the resources of the animal economy,
whose existence he will not acknowledge? Tertium non datur.
If it oome fix>m the latter source, then indeed it may sometimes
flow more slowly and with greater difficulty, sometimes too
quickly and impetuously. But then the second and only re-
maining mainstay of his system breaks down. Behold there a
more natural origin of diseases, which these words of his betray
against his wilL Had he wished or been able to be consistent^
he would not have ventured to touch this ticklish point, which
gives him a slap in the &ce.
That all this nonsense is his actual meaning, is evident from
the following assertions in
Gccxii, cccxiiL " The effects of all external powers upon us
do not differ among themselves ; they produce life, activity,
health and disease, by the same operation, by the same stimulus.
Hence it follows that things which restore health cannot act other-
wise than by one and the same stimulus.^'
"Several things that produce the same effect are then identical
with each other, are one and the same thing."
This is &Lr from being the case when the action is complex; for
even according to Brown, the medicines do not establish health
in the system so very immediately, so unconditionally, so inde*
pendently of the corporeal powers, so entirely without previous
reaction, as the apple-tree lets the apple fhll on the grass.
But if the effect be brought about by composite actions, the
prime agent on which the action depends may certainly be very
different
Windmills, horse-power, steam-engines and capstans worked
by men, may all empty a reservoir of water; the dry atmospheric
air also that extends over the reservoir empties it ; but does it
therefore follow that wind, horses, fire, men and the dry atmos-
phere are one and the same thing? There are also many powers
that exercise a double action, a primary and a secondary, and
several among them that resemble each other in their primary
action, and not a few that do so in their secondary action. If
then the careless observer looks only to the resemblance of ihe
primary action of some powers (as Brown often did), or only to
their secondary actions, or to similarity of actions, be th^ pri-
mary or secondary, he may often be misled to infer an identity of
cause from some similarity, of these one-sided actions, as usually
happened to Brown. In making deductions from similar f^iae
368 FRAGKENTARY OBSBBVATIONS ON
premises, I might with equal justice say, that a watery yegetable
diet, and strong animal soups were one and the same thing, for they
both (in their primary action on the body) cause satiety. The same
effects have the same cause, therefore watery yegetable nutriment
and beef-tea are one and the same thing. And thus the fiJse
scholastic deduction is made.
GCOXIY. '' In asthenic diseases the administration first of dif-
fusible stimulants, for the purpose of bringing back the appetite
[even in every diseased body ?] for the greatest remedy, food, tm
well as keeping the food on the stomach and assisting in the
digestion of it [will they do so in every diseased body?], then
the application of heat, then the use of less diffusible and more
durable stimulants : as animal food, without and with seasoning;
wine, gestation, gentle exercise, moderate sleep, pure air, exertion
of mind, [can the mind of one affected with melancholia be ex-
erted?] exertion in passion and emotion, [even in idiots and
raving maniacs?] an agreeable exercise of the senses; all those
reproduce health, by no other operation but that of only in-
creasing excitement."
This then sums up all Brown's therapeutics for diseases o^
and accompanied by, weakness I That kind nature and youth
will, assisted by such an appropriate regimen, (for it is nothing
more) and even by itself, cure diseases having far other pro-
ducing causes than deficiency and excess of excitability, is a
phenomenon daily witnessed by the unprejudiced observer,
which, however, must be explained away or denied by Brown
in order to support his scholastic system.
But without reckoning this divine power, and granting that
all these diseases depended on a morbid degree of excitability,
and could only be removed by the remedies indicated by him
(but which were used long before his time), what becomes of the
myriads of diseases that cannot be cured by these remedies ? It
avails us little that he ascribes them all also to deficiency or ex-
^^ess of excitability. All that we want is that he should cure
them. We shall see if by this regimen, the large number of
mental diseases, the epilepsies, the venereal lues, the mercurial
NV^eting, the pellagra, the plica polonica, (I reject the name of
local diseases, the refuge of the Brunonians, for these affections)
./ill be cured. Sic Rhodus I hie saUal
Or will this regimen, whose curative effect cannot be looked
» »r under a considerable time, cure asthenia which often kills
li«>althy individuals in a few hours or even minutes (the bad
BBOWK'S ELSIUCNTS OF ICEDICINX. 869
kinds of lypliiis fevers, the Levantine plague, apoplexy, the ac-
ddents caused bj lanrocerasus, azotic and carbonic acid gas, car-
baretted hydrogen, veratrum album, arsenical vapour, &c.)?
DCLXXVII. " As it now happens, that either direct or indirect
debility proves hurtful, hence we have a third case given, where
we have to combat both sorts of debility."
Who could have believed that a scholastic pedant who plumes
himself so much on his logical forms, who reckons for us in
figures on a scale of his own exactly the degree of the exciting
power and excitability, would have so far forgotten himself, as
Master Brown does here at the end of his immortal work ? How!
both kinds of debility conspiring to make one disease in one
body?
In the first place, I should like to know, as he (notes to XLVii
and Lxxxii) fixes the standard of health at 40 degrees of ex-
citability— the predisposition to direct debility in the degrees be-
low 40 down to 25, — complete and extreme direct debility from
26 to 0, — ^the predisposition to sthenia in the degrees from 40 to
56, — sthenia itself in the degrees from 55 to 70, — and indirect
debility in the degrees from 70 to 80; — I should like to know
in what part of this scale (which he is so proud of) he could
place the mixed form of debility he speaks of, by what figures
he would expound this supposed excitability ? Here he says
nothing about the figures of his table, which he is so fond of
putting forward elsewhere.
Here he prudently ignores them and attempts in a note, by
means of mere words, I know not whether I should say to con-
ceal or to increase the hiatus. He brings forward many exam-
ples where in one disease direct debility occurs along with indi-
rect, indirect with direct debility. Granted that the man whom
he there supposes to be afiected with typhus had got thereby a
direct debility of 10 (30 degrees below 40) that is 40—30, but
in the meantime, by means of great corporeal motion, had con-
tracted an indirect debility of 70 (30 degrees above 40) that is
40 30, can the man thereby have aggravated his state and be
now labouring under indirect and at the same time direct de-
Inlity ? K Brown's excitement theory be not entirely false and
his scales not the mere offspring of his fancy, must not instanta-
neous health or the degree of 40 ensue, since 40 minus 30 and
plus 30, gives 40, the sum of excitability ?
If this be not the result of the meeting of the two opposed
debilities, I should like to know what it is then ? What part of
his excitability-scale is not already occupied ?
860 raAOKSNTABT OBSKRYATlQJStB OK
Either there is not a spark of truth in his excitement theoiy
or his scale of excitability, or the man must, although already af-
fected by typhus, be instantly restored completely to health or
nearly so by the added corporeal exertion, according to Brown's
whole theory and his vaunted scale. But i^ as must naturallj
happen, the man visibly aggravates his malady by this &tigue^
as Brown himself confesses, this circumstance overthrows his
whole system.
If the extraordinary accumulation of excitability in a case of
typhus, imagined by Brown, can and must be aggravated by
corporeal exertion, as experience teaches and as he here admits^
then either the corporeal motion cannot remove the excitability,
otherwise in this case health would ensue or almost ensue, or
there can be in typhus no accumulation of excitability. Plus
and minus cannot co-exist without mutually annihilating one
another.
It is impossible that a state of accumulation of excitability
can be aggravated by a power that diminishes excitability (ac-
cording to his whole theory), therefore the aggravation that en-
sues is a refiitation of his whole beautiful excitement theory and
his tabularly expressed accumulation and exhaustion of excita*
bility, to which, according tp him, all the conditions of life may
be referred.
Brown gives us no information as to the state (and degree) in
which we must suppose the excitability to exist when the two
debilities meet together. That he himself did not know how to
conceive this state is obvious firom his extraordinary and am-
biguous assertions relative to this point.
Thus, as the direct debility of the man affected with typhus
must amount to at least 70 degrees of accumulation of excita-
bility, to what height did the degrees rise since his state was ag-
gravated by corporeal exertion ? The degrees of the accumula-
tion could certainty not be the least diminished, otherwise the
disease had not been aggravated, at all events it had been trans-
formed into a sthenic disease (at 60) ; the state must then have
sunk suddenly and far below 40 into indirect debility, in order
to be able to express the great aggravation that has ensued at
least by the degree 10. In the former case, seeing that for the
commencement of the treatment of the simple direct debility
Brown prescribes ten drops of laudanum, he must prescribe for
its cure eight drops or less ; in the latter case, however, as he
orders for the conmiencement of the treatment of the simple in-
/
BSOWK'S 'SL£M£NTS OF MEDICINE. 361
direct debility 150 drops, he must for a worse degree have ad-
ministered 200 drops and upwards. But no I his vaunted con-
sistency forsakes him here.
"When the affection," he says (dclxxxvi), " is more a mix-
ture of both sorts of debility, these proportions of the doses
must be blended together."
Though this is purposely worded so as to be incomprehensible,
it can only have this one meaning, that we should from the two
select an intermediate number betwixt the dose increasing from
a few drops and that decreasing from many drops. Therefore a
medium proportion betwixt an increasing and decreasing pro-
gression. Very strange I In this case, from the beginning to the
end (if both debilities were j)retty equal in point of strength) 80
drops should be given uninterruptedly, which is contrary to his
other modes of treatment and opposed to the nature of the thing.
And how if the direct debility was greater than the indirect, or
the latter greater than the former, what state is present, what is
to be done for it ? He himself does not actually know what he
should direct to be done for cases which he can make clear nei-
ther to himself nor to others, and what would he advise to be
done in this dilemma? He prudently forbears giving any de-
tailed information on the subject, and merely in the note to
DCLXXVii cunningly says, (possibly in order to escape observa-
tion in the confusion?) " A judicious physician will find plenty
of scope for the exercise of his judgment in thase mixed states."
In a word, he leaves us, with a bow to the reader, in the lurch,
not only here but in the treatment of all asHienias^ " becaicse,^^ as
he assures us in this paragraph, " there is scarcely any astJienic
disease where such a mixed state is not present,^ ^ So almost all
asthenic diseases consist of an unknown mixture of both debili-
ties, whereof he knows not how to impart any information in re-
ference to the change therefrom resulting in the body, and to the
accompanying state of excitement and excitability, nor to give
us any advice on the subject ! Heaven help us ! throughout the
whole transparent work he has dazzled as with a flaring straw
fire, here it sinks down into ashes, and he leaves us, with a smile,
surrounded by a howling wilderness in the darkness of night
862 VIEW OF PB0FS8SI0KAL LIBERALITY AT THS
VIEW OF PROFESSIONAL LIBERALITY AT THE
COMMENCEMENT OF THE NINETEENTH CENTURY.'
I do not here refer to that low, envious trading spirit, for
which the pressure of want is often the cause that can best be
pleaded in excuse ; I wish to say a few words about the pro-
fessional jealousy of medical men among themselves, which is
the prevalent custom in Germany (in the southern more than
the northern parts), a helium omnium contra omnes, which has
had a most injurious influence on the prosperity of one of the
noblest arts, and the one which stands most in need of im-
provement— ^medicine. For no sooner has a colleague made a
suggestion that must be for the general good, put forward a per-
haps useful proposition, discovered something profitable, than in-
stantly the professional jealousy of his colleagues (with very few
exceptions) falls foul of him in order to bury in oblivion, or if
possible, to destroy the novelty by spoken or written deprecia-
tions, insinuations, sophistries, or even injurious aspersions, and
all because — it did not originate with themselves? Instead of
seeing, as we do in England and Scotland, fraternal meetings,
and societies of physicians and surgeons, animated by the desire
to promote the welfare of himianity, and investigating medical
subjects for the purpose of mutual improvement and perfection,
without party-spirit, without seeking self-aggrandisement, with-
out ministering to individual vanity — we see the German medi-
cal men (with few exceptions) completely divided among
themselves, each acting by himself, pro modulo ingenii, occa-
sionally appropriating the useful discoveries of others, but quite
silently, without betraying by the slightest sign that any one
else has any thing to recommend him, or that they were in-
' From the Allgemeiner Ameiger d. D. No. 32. 1801. [This article is interest-
ing in reference to the history of the discovery of Belladonna as a prophylactic for
scarlatina. It will be seen that in the first instance Hahnemann did not reveal the
name of the remedy he employed for that purpose, which may possibly aocount in
some deg^ree for the unwillingness of his colleagues to test the efficacy of the remedy
he furnished with them, but they had not this excuse after 1801, for in that year he
announced the prophylactic to be belladonna, as will be seen in the next essay, and
yet many years elapsed before they put his prophylactic to the test, whereby ita
utility was, as is weU known, signally verified by some of the best physicians of the
day.]
' [May these remarks of the illustrious master ever be remembered by American
physicians, and whenever envy or other unworthy feelings prompt them to calumni-
ate their brethren, may this lash of TTnhnAmnni> fall upon their unworthy backa.]
—Am.P,
ooxiaNCEiCBirt of thb nineteenth centuby. 868
debted for anything whatsoever to this one or the other. Not
only do they make use of the propositions and inventions of
others without betraying the least thankfulness, but they often
throw out spiteful insinuations against the originator, at all
events always (few are the exceptions!) without taking any
public part in promoting and perfecting the proposition or dis-
covery, particularly if it proceed from a German physician ; far
more likely are they to do so if it belong to a foreign physician.
How much this egotistical professional jealousy prevents the
shooting forth and vigorous growth of our divine healing art,
which is still in the condition of an undeveloped bud, must be
evident to every non-professional person. Were it not for this
paltry self-seeking spirit, of a truth Germany alone, with its
great intellectual t^ents, could affect a regeneration of the
great art
How spitefully Wichmann was assailed when he exposed the
prevalent fidlacies respecting diflBcult teething! How infa-
mously the same clique calumniated that imenvious favourite of
die Asdepiadean muse — Hufeland, whose soul is animated by
truth alone! How was Tode, how was Sommering treated!
Were the men that could act in this manner exclusively devo-
ted to the beneficent art whose aim is the weal of humanity ?
Ever sadder, ever more gloomy are the prospects of the de-
velopment of our art in the new century ; without friendliness
and good-fellowship among its professors, it will remain but a
bungling art for another century.
Let it not be retorted that there now exists, at least among
the followers of the Brunonian system, an esprit de corps. The
rallying motto of a sectarian name is incapable of exciting to
sober, calm scientific investigation ; it only rouses the explosive
q>irit of accusations of heresy to a fierce volcanic flame. Truth
and the weal of humanity should be the only motto of the genu-
ine elucidators of the art and the watch- word of their brotherly,
peaceful bond of union, without slavish adherence to any secta-
rian leader, if we would not see the little good that we know
completely sacrificed to party-spirit and discord. In these
times^ when accusations of heresy are so rife, the most important
question that is ever put is, "Art thou of Paul, art thou of Ce-
phas or Apollos ?" Would it not be far better to say, ** Brother !
what is the peculiar mode of action of cinchona bark on the
healthy individual ? so that we may at length learn how to em-
ploy it with confidence in diseases, seeing that we have hitherto
364 ynW of professional libera lity at the
blindly wasted many thousand hundred-weiglits of it^ at one
time doing good, at another harm, without knowing what it was
we did." Would it not be better to say, "Dear colleague I let
us together investigate and observe the niiany and various kinds
of intermittent fevers, and let us unite in laying before the
world the discoveries we thus make, as to wHch kind among
them may be, caeteris paribus, always cured by cinchona, which
by sal-ammoniac, which by chamomile, which by ignatia, which
by capsicum, &c." — " God forbid I who would consent to such
kn exposure of himself as to confess to his colleagues or to the
public that he did know everything? Those around me must
be impressed with the belief that I am infallible, that I embrace
the whole sphere of the art, as I hold a ball in my hand, that
the inmost secrets of medical science lie clearly open to my all-
seeing eye, like the sced-recepticle of an apple cut through the
middle. I dare not say one word that could betray that some-
thing was still to be discovered or that there was any room for
improvement. But the notion that another and more especially
a German colleague could teach us something more, or could
make any fresh discovery, must not be uttered, must be to the
beat of our ability scouted."
Such is the spirit that has prevailed in Germany during the
latter half until the end of the bygone century ; the bene&ctors
of their race, and with them the good spirit that inspired them
with aeal for the common weal, were sought to be kept down
and set aside. Just as theological polemics have never produced
a desire for truth, a perception of the high object of our exist-
ence or genuine virtue and devotional feeling — just as the per-
sonal squabbles of literary men have never succeeded in devel-
oping the love of art, the true aesthetic feeling, enlightened taste^
and artistic skill — in like manner it needs no great sagacity to
xmderstand that the mutual detractions of medical men can have
no other result but the depreciation and obscuration of their art>
which is, without that, the most obscure of all arts.
Honourable, non-medical friends, endowed with a desire to
promote the well-being of mankind and who have had. the ad-
vantage of a scientific education I — the energies of my life, which
have been devoted to promote the welfiire of the community,
have also been cramped and kept under by this unpatriotic
spirit of many of the medical men of Germany.
As soon as I stepped forth among my colleagues, not without
nearly twenty years of preparation, not without many long
OOMMXNOKMXNT OF THE NINETEENTH CENTITBY. 386
yeaiB of Pjrthagoiean silence, to contribute here and there some-
thing to the improvement of our art, I found that I had lost my
accustomed peace and quietness, and had fallen among a crowd
of profeasional brethren, who (with few exceptions) regard noth-
ing impartially ; I was maligned. And how easy it is to perse*
cute, to malign an art, which has hitherto been founded on ever-
changing maxims, in which by the force of authorities, learned,
empty terminology, sophistry, scholastic, stereotyped dogmas,
and imaginary experience, black was made to appear white, just
as any one pleased, especially where the judgment was perverted
by depravity of heart, egotism and illiberality.
It is undoubtedly true that truth penetrates even through the
thickest clouds of prejudice, but the often too tedious conflict of
the opposing elements conveys a disagreeable, a discouraging
impression to the mind. Thus at the commencement of my
career, on account of my discovery of the best anti- venereal
medicine, the soluble mercury, I was abused in the most vulgar
manner in a journal notorious for its outrageous vituperations,
and also elsewhere, but the common experience of Europe in a
few years removed the slander from this remedy and worthily
i^reciated a discovery that I had unselfishly revealed for the
px)d of humanity, in order to make amends for the death of
thousands who had been literally dissolved by the abuse of the
feebly anti- venereal preparations of corrosive mercury. The
same thing happened when I was afterwards again (to pass over
the bad reception some other useful truths met with) abused in
the same vituperative journal on account of my " neio principle^"
where I taught a mode of learning to look at diseases from a
point of view that directs us almost unmistakeably to the appro-
priate remedy for every case — shewing how to discover from
the positive nature of medicinal agents the diseases for which
they are suitable. But because this kind of system differed so-
much from the ordinary one, because it was so simple, so unarti-
ficial and (purposely) so free from the sacred arabesques of the
learned language of the schools, it made very little impression,
it was not cultivated by German medical men, but was sought
to be quietly shelved by them.
Now, once more, at the end of the century that has just
expired, my zeal for the welfare of mankind misled me to
announce a prophylactic remedy for one of the most destructive
rf children's diseases, scarlet-fever. Scarcely a fourth part of the
homber I might have expected subscribed for it This luke-
366 yiSW OF PROFESSIONAL LIBERAUTT AT THK
warm interest shown for sucli an important affair discouraged
me, and I arranged that the subscribers should recdve a portion
of the medicine itselfj in order to satisfy them, in case my book
on the subject should not be published. The subscribers con-
sisted chiefly of physicians* who had epidemics of scarlet-fever
in their neighbourhood. At least thirty of these, whom I beg-
ged by letter to testify to the truth, and to publish the result
(be it what it might) in the Reichs-Ameiger^ made no reply.
Two others, unsolicited by me, Dr. Jani in Gera and Dr.
Miiller in Plauen, wrote something on the subject, but, good
heavens I in what a spirit ! Is this the way ojie colleague treats
another in Grermany ? Is an affair of such importance for man-
kind to be so readily dismissed?
After the latter had said in No. 215 of the R.A., 1800, " that
in the epidemic he witnessed no child took scarlet-fever who
had used this medicine for two or three weeks," he repents of
his honesty and feels himself compelled in No. 239 " to deny
the truth of his former declaration (the facts brought forward
by himself!) because one child took the scarlet-fever. This case
proves more against the efficacy of the remedy than 500, where
the individuals seem to have been protected by it, prove for it"
What monstrous logic! Mercury is, as is well known, the
best and sole remedy in the venereal disease ; thousands have
been cured by its means. " No," quoth Bavins, " I could shew
you at least twenty cases where it did no good. Mercury is of
no use ; these twenty cases certainly prove more against the
efficacy of the remedy than your thousands of successful cases
prove for it. Therefore we should rather let ourselves be eaten
up by the venereal disease than have it cured by mercury, be-
cause out of many thousand cases there are twenty where it
does no good." — " A single case in which cinchona bark fedled
in intermittent fever proves more for the worthlessness of this
bark than 500 cases in which it was efficacious for it." What a
deliriimi of logic ! The good Dr. Miiller has once upon a time
heard of the deduction a minori ad vmjuSj and seeks to apply
that here. In like manner the wag made the deduction a mi-
nori ad inajus in the Miillerean fashion : " Since it feels hard to
lie upon a single feather on the bare floor, this proves more
against the softness of feathers than a bed filled with millions of
' A good many private indiyidoalB got the medicine sent them ; but the
mendacious ioBinuations of their ordinary medical attendants prevented them from
mning their children by its means.
»^.i) • • ^0(»J
OF THE NINETEENTH CSNTUBT. 867
eider-featheiB for their softness ; I will therefore never more
deep upon feather-beds after having lain so hard upon one
feather."
But perhaps Dr. Muller invented this pleasant piece of sophis-
try only in order to eradicate from the minds of the uniniated,
by one (phDanthropic) blow, this German invention, not pro-
oeedingfrom himsdfi Be it so, my friend I But have you any-
thing better to substitute for the remedy ? Is there to be found
in medical writings a single mode of treating scarlet-fever on
which we may rely? We shall not say a word about a pre-
ventive remedy. According to the directions usually given,
there is not a single symptom that can be removed without
several worse ones being excited. It may be said of the old
mode of treatment of every acute disease : '' Witii our medicines
sad without our medicines the primary fever goes oflF in twenty-
one days, or the patient dies in the meantime, he might not
have died had he not taken our medicines."
Dr. Jani, on the other hand, says in No. 255, that his scarlet-
fever was complicated with malignant typhus-fever and acute
herpetic-fever, and very rarely ran a regular course.
He then seeks to prove " that my preservative does not pro-
tect unconditionally." He might have spared himself the pains.
Ood himself cannot create a remedy that sliall be unconditionally
ffficadouSj that wJien used wrongly^ at an inappropriate time, in an
improper place, or under adverse circumstances, shall yet of neces-
sity do good.
" After it became universally prevaleiit, and was raging among
them like an evil demon, he allowed ten families, consisting of
thirty-six children, to use my remedy. Three children in one
&mily were attacked by scarlet fever whilst using it (?). Of
the thirty children of the remaining nine families who used it
for a month, none was attacked by scarlet-fever. But as far as
fjffos known none of them were exposed to infection^
Therefore it was no merit of Hahnemann's prophylactic that
just those nine families with their thirty children remained free
amidst all the others. This miracle is owing solely to the fiust
that they were not exposed to infection {scilicet) at a period
when, as he asserts, scarlet-fever was universally prevahnL
When an epidemic of scarlet-fever (which generally does not
wgne two out of a hundred children in the place) is universally
prevalent, does the mere circumstance " of not having been ex-
posed to the infection as £»* as was known" suffice to preserve
868 VIEW OP PROFESSIONAL LIBERALITT, ETC.
jBrom infection ? Were that the case, it were impossible that
any epidemic of scarlet-fever could ever arise, because no child
of sensible or at least of timorous parents would ever be know-
ingly exposed to infection I
'' But because it was not I, but another, and what is worse, a
German physician who discovered the remedy, it must be
allowed us, in order that the honour may not be given to the
preservative, to ascribe the wonderful, ui^eard-of exemption of
the nine families, to a notoriously inefficient cause, in order
that we may be enabled to shelve Hahnemann's prophylactic
remedy before the very eyes of the all-seeing public"
Here are striking features of the professional liberality among
the physicians of our time ! Here is a fine specimen of zealous
endeavour to clear up the truth, of warm interest in promoting
an affair of infinite importance to humanity.
The furtherance of every means, be it ever so small, that can
save human life, that can bring health and security (a Gtod of
love invented this blessed and most wondrous of arts !) should
be a sacred object to the true physician ; chance, or the labour
of a physician, has discovered this one. Away, then, with all
grovelling passions at the altar of this sublime God-head, whose
priests we are !
We all strive after a common, holy object ; but it is not easy
to be attained. It is only by joining hand in hand, only by a
brotherly union of our powers, only by a mutual intercommu-
nication and a common dispassionate development of all our
knowledge, views, inventions and observations, that this high
aim can be attained : — the perfecting of tfie medical art
« « « «
But why the most trustworthy remedy sometimes does not
answer in our private practice — ^this every observant physician
who has grown gray in his profession, and who possesses at the
same time a knowledge of mankind, can easily account for firom
his own experience. Hospital patients, whom the unprejudiced
clear-sighted physician never loses sight of, are certainly much
more favourable for determining the truth, though even with
them, deceptions, mistakes, insufficiency, and a thousand other
opposing accessory circtmistances, are unavoidable.
But how we may fail to attain our object in private practice,
particularly as regards my preservative, and how failure is to
be avoided, I shall explain in my forthcoming little work.
« « « »
Physicians of Germany, be brothers, be fidr, be just I
OUBB AKD PREVSNTION OF BOARLBT-FEYEB. 889
CX7RE AND PREVENTION OF SCARLET FEVERS
PREFAOE.
Had I compiled a large book upon scarlet fever, I should
have obtained, through the usual channels of publication, at
least as much in the way of honorarium as by the subscription
for this little book. But as, according to CaUimachus, a great
book is a great evil, and is soon laid aside, one of my chief aims,
to wit, to excite a great interest in a subfect of so much importance
to humanity as this is^ in order dearly to ascertain the truth^ by
bringing the observations of many to bear upon it — could not have
been fulfilled so well by the l^ge book as by the mode I have
adopted.
Up to this period it is impossible that the corroboration of
my assertion could be complete. The extract of belladonna,
which I caused to be delivered to my subscribers, might have
lost its power by the great distances it was sent, and by the long
period it had been kept. Occasionally it fell into the hands of
some who had neither the ability nor the good will to administer
its solution in an appropriate manner. The precautions laid
down in this book could not all be enumerated in a small paper
of directions, where on account of the danger of misusing the
medicine, it was necessary to direct that only the very small-
est dose should be administered. Moreover it is probable,
that the tJiorough admixture of the few drops with a sufficient
quantity of the fluid in which it should be taken, was generally
neglected ; a circumstance the neglect of which makes this and
every other medicine many hundred times less powerful than
they would be were they properly combined with the diluting
fluid. The hurry and inaccuracy of young doctors of the pre-
sent day are well known, and we know also how little depend-
ence we can place on our private patients.
In addition, very inclement toeatJierj and in general what is un-
derstood a chill (which I have forgotten to allude to in the text),
present obstacles, by no means slight to the power of belladonna
as a preventative of scarlet-fever. Children should be carefully
preserved from it, without however completely excluding them
fix>m the open air, and if this precaution be neglected, the dose
of the remedy should at all events be increased.
There may also be many other circumstances unknown to me
* TfaoB was pobliBhed as a pamphlet at Ootba» in 1801.
870 OtJBB AKD FBETBNTIOK OF SCABIiBir-raFtt.
to diminish the power of belladonna. The philanthropic phy-
sician ought to endeavour to discover and to avoid them.
It is only in accordance with my well known maxim (the
new principle) that small-pox, to give one example firom among
many, has an important prophylactic in the cow-pox, which is
an exanthematous disease, whose pustules break out after the
sixth day of innoculation, with pain and swelling of the axillaiy
glands, pain in the back and loins, and fever, and surrounded by
an erythematous inflammation — that is to say, constituting altoge-
ther a disease very similar to variola. And, in like manner, a
medicine which causes symptoms so similar to those of the inva*
sion of scarlet-fever, as belladonna does, must be one of the beet
preventive remedies for this children's pestilence. It should
however be put to the test with candour, carefulness and impar-
tiality— not cursorily or hurriedly, not with the design of depre-
dating the originator of it at the expense of truth.
But if its efficacious prophylactic power has incurred and
may still incur opposition from prejudiced, ill-disposed, weak-
minded and cursory observers, I may be allowed to appeal
against their conduct to the more matured investigation of the
clear-sighted, dispassionate portion of the public, and to trust to
time for a just verdict. I should esteem myself happy if I
should see, some years hence, this scourge of mankind in any
measure diminished by my labours.
CURE AND PREVENTION OF SCARLET FEVER.
At the commencement of the year 1799 small-pox came from
the neighbourhood of Helmstadt to Konigslutter^ which spread
slowly around, and though not mild in character, the eruption
was small, warty looking, and accompanied with serious symp-
toms, especially of an atonic kind. In the village it came from,
the scarlet fever was prevalent at the same time, and, mixed up
with the latter, the small-pox made its appearance in Konigs-
lutter. About the middle of the year the small-pox ceased
almost entirely, and the scarlet-fever then commenced to appear
alone and more frequently.
HISTOBY OP THE SCARLATINA EPIDEMIC.
In this as in all other epidemics the scarlet-fever shewed itself
to be the most spreading and contagious of all the maladies
that befid children. If a single child was affected with it, not
< I .^.^___^_^^_^_^_^_^^__^__«»__^_
* [Wliera H>linwnann at that time reoded]
CriTBX Ain> PBBVINTION OF 8CARLST-FXTSB. 871
<me of its brothers and sisters remained exempt^ nor did it &il
to eflfeot other children who came too close to die patients, or to
things that had come in contact with their exhalations.*
Parents above thirty years of age who are in the midst of many
children affected with scarlet fever, usually in dirty damp rooms,
get now and then in place of the general eruption a very painful
pustular erysipelas of the &ce, or the peculiar scarlatina sore-
throat^-always along with some degree of fever.
In its main symptoms this epidemic of scarlet-fever resembled
the scarlatina of Plenciz.^ In some families the disease was of
a mild form, but generally it was of a bad kind.
When it occurred in the mild form it generally remained
mild in the whole family living together. There occurred a
slight feeling of weariness, a kind of faint-heartedness, some
difficulty of swallowing, some fever, red face and hot hands.
There then appeared, usually the very first day, alone with
slight itching, the spots of various shape, and sometimes paler,
sometimes redder, on the neck, the chest, the arms, &c., which
disappeared again in firom three to four days, and the desquama-
tion that followed was scarcely observable on the fingers, and
almost nowhere else. Towards evening only the patients laid
down in bed for a short time, but the rest of the day they went
about. The sleep was pretty tranquil, the bowels usually some-
what less open than when in health, the appetite usually not
much diminished.
Very different was the course of the had form of scarlet-fever
that prevailed in most families. OeneraUy^ the seventh day after
the infection had been communicated it broke out suddenly and un-
expectedly, without any previous feeling of illness seldom was it
that horrible dreams on the previous night served as a prelude to
it All at once there occurred an unusual timidity and fearful-
nesSj rigour with general coldness, especially in the face, the hands
iind the feet, violent pressive headache, especially in the forehead,
above the orbits. Pressure in the hypochondria, chiefly in the region
* Anxng children under fifteen years of age that may be exposed to contagion
B epidemics of scarlatina, hardly one in a thousand escapes the disease, though they
may only be a£Eected by the specific sore Ihroat, or a oombinatioQ of some of the other
■ymptoms; firom fifteen to twenty years of age scarcely one in five hundred., is
spared ; firom twenty to thirty years the infection becomes always rarer. It is very
seldom that persons above thirty are affected by the perfect scarlet-fever exanthema,
aod Hien only in the most malignant and fiital epidemica.
' Opera medieo-pkyiica, Tnust iii, Sect iiLVindob. 1762.
* nxMe symptoms not described by Flenda I have had printed in tto/icff^biitthme
that oofrespood with his are in the usual Roman type.
872 OUBX AND PBEYENTIOK OF 8GABLXlVnE?SB.
ofthestomach; in most cases there occurs a very tinea^pflct^
ofviclent vomiting^ first of TnucuSj then ofbile^ Oien of water recur-
ring at intervals of &om twelve to twenty-four hours, accompanied
by an ever increasing weakness and anxiety, wHk trembUng. The
parotid and snIhmaociUiary glands sweU and become hard and pom-
ful^ swallowing becomes very difficult, wUh shooting pains. After
rigours that last from twelve to twenty four hours, the body becomes
excessively hot, dccompanied tvith itching burning, the head, nedc,
hands (forearms) and feet (legs) are hottest, and swollen so as to
present a shining appea/rance, which lasts to the end of the disease}
{Almost every paroxysm of heat terminates in profuse sweat, whiA,
however, only affects the rest of the body, but not the head, hands and
feet,) On these swollen parts, but first in the pit of the throat,
then on the arms and legs, there appear about the second day
variously shaped cinnabar coloured spots of various sizes that
readily grow pale on any slight (Mil; these spots are scarcely
raised above the level of the skin, and are always accompanied
by smarting, itching, burning; as the disease advances ih^
spread out into a connected, but less vivid redness. On the
• outburst of the eruption, the fever does not diminish ; on ffie eon-
trary, the greater the redness the more violent is the fever. In the
meantime the sore-throat increases, swallowing becomes very
painful, in the worst cases almost impossible. The interior of
the mouth, the tongue and the palate are inflamed, very painful,
raw, arvd as if ulcerated all over. In very bad cases the swelling
of the cervical glands almost closes the jaws, and from between
the teeth, which can be but slightly separated^ there flows almost in-
cessantly a very viscid and very fetid saliva, which can scarcely
be expelled firom the mouth in consequence of the tongue being
BO painj^. In like manner, in the worst cases the lining mem-
brane of the nose is ulcerated. At this i>eriod the voice be-
comes weak, suppressed and unintelligible, and respiration dif-
ficult. The taste in the mouth is putrid ; the stools, which are
usually rarely passed, have the odour of assafcetida. A drawing
pain in the back and cutting bellyache are characteristic symp-
toms, which, together with pressive headache, in bad cases per-
sist in alternation day and night, but in less dangerous cases
^ The Budden disappearance of ifae redness with the fatal termlnatian without
obrious cause observed in some of the epidemics of 1800, 1 had doI ao opportuDity
of seeing. Probablj this depended on a pecoliar complication, and I am not aware
if my preserratiTe, which is odIj for pure scarlatina^ would hare the poww of avert-
OUBS^ AND raXVEHTION OF SCABLET^FSVKR. 87ft
<mly recur ifi the evening after mmset^ along with increase of a&x-
ietj and timidity. In the yeiy worst cases there are alternate
paroxjms of agonising tossing aboutj raving, groaning, grinding
of Ae ieeth, floceitationSj general or partial convulsions and coma-
tose stope&ction or sopor, with half-shnt eyes and head bent
baekuxMrds. The nrine, which is light-coloui^ and the feces,
are passed involuntarily, and the patient sinks down to the bot*
torn of the bed. The grumbling^ complaining disposition increases
firom day to day. The smallest quantity of food, even in the
dighter cases, perceptibly and immediately increases the anxiety,
mart than in any other disease.
From the fourth to the seventh day, if death do not ensue,
the skin rises up, or rather the pores of the skin on the reddest
plaoes become elevated, especially about the neck and the arms, ^
in small, dose, pointed miliary vesicles (somewhat resembling
goose's skin), which at first, as the redness of the rest of the
skin declines, appear extremely red, but afterwards, or when
cold is applied, grow pale and at length quite white ; they are
howevOT empty, and contain no fluid.
Neither the greater intensity nor the more general extension of
the redness of the skin, nor yet the occurrence of these empty
miliaiy vesicles, diminish the fever after the manner of a critical
eruption ; the former indeed is rather a sign of an increased
intensity of fever which can only subside as this redness decreases.
The bad form of scarlatina lasts from nine to fourteen days,
and the disgust at food lasts about the same time. As the appe-
tite returns, the patient first wishes for firuit, then meat, he
generally prefers pork.
As the convalescence progresses, there is, in addition to the
uncommon emaciation, a stiffness, causing the patient to go half
bent, that lasts several days, sometimes weeks ; it is a kind of
eontraetion of the joints, especially the knees, vrith a feeling of stiff
mess m the abdomen.
During the fever, blood-red spots now and then appeared on
the sclerotic ; in some the cornea of one or both eyes was com-
pletely obscured ; others (probably badly treated patients) were
rendered imbecile.
At length the epidermis gradually peels off on the places
where the redness appeared, and even where there was only
burning itching without subsequent redness ; on the hands and
feet it comes off in large pieces, like pieces of a torn glove, but
on the other parts only in larger or smaller scales. In one case ^
874 axms and pbevsntiok of bcablbt-tbtbr.
the nails of the fingers and toes also fell oS. The fiilling off of
the hair only commenced some weeks or months after the fever;
in one case it went the length of total baldness.
Among the after-sufferings the following were prominent:
long-continued debility, a very disagreeable feeling in the back,
as if it were asleep (narcosis), pressive headache, a painful sen-*
sation of constriction in the abdomen only felt on bending back-
wards, abscesses in the interior of the ear, ulceration of the lining
membrane of the nose, ulcerated angles of the mouth, other^
spreading ulcers in the &ce and other parts of the body, and
generally a great tendency of the whole skin to ulceration
{unhealthy skin as it is termed). In addition to the above, a great
hurriedness in speaking and acting, fits of sleepiness by day,
crying out in sleep, shuddering in the evening, puffiness and
earthy colour of the countenance,^ swelling of the hands, feel
and loins, &c.
TREATMENT OF SCARLETFEVEB.
Any one who chooses may read for himself in the works of
the various authors the infinity of medicines and modes of treat-
ment invented for this disease (from blood-letting and leeches
to bark, firora gargles and clysters to blisters, from antispas-
modic, derivative, antiseptic to refrigerant, resolvent, purgative,
involvent, humectant>, alexiteric, incitant, asthenic, and God
knows what other ingenious modes of treatment) intended to
meet the thousand imaginary indications. Here we often see
the ne plus ultra of the grossest empiricism : for each single
symptom a particular remedy in the motley, mixed, and repeated
prescriptions ; a sight that cannot fail to inspire the unprejudiced
observer with feelings at once of pity and indignation I
For my own part, when summoned to cases of the fully de-
veloped disease (where there was no question of prevention oi
suppressing its commencement), I found I had to combat two
different states of body that sometimes rapidly alternated with
one another, each of which was composed of a convolute of
symptoms.
The first : the burning heat, the drowsy stupe&ction, the
agonising tossing about with vomiting, diarrhoea, and even con-
vulsions, was subdued in a very short time (at most an hour)
by a very small quantity of opium, either externally by means
' Neither Plenciz nor I obRerred the jaundice symptomB that were noticed in loine
of the epidemics of 1800.
OinUI AND PBEVSNTIOK OF SGABJiST-FSYXB. 876
of a piece of paper (according to the size of the child, fix)m a
half to a whole inch in length and breath) moistened with strong
tincture of opium, laid upon the pit of the stomach and left
there until it dries;' or if there is no vomiting, interruiUy^ by
giving a small quantity of a solution of opium.
For external use I employed a tincture formed by adding one
part of finely pulverised crude opium to twenty parts of weak
alcohol, letting it stand in a cool place for a week, and shaking
it occasionally to promote the solution. For internal use, I
take a drop of this tincture and mix it intimately with 500 dix^ps
of diluted alcohol, and one drop of this mixture likewise with
odier 500 drops of diluted alcohol, shaking the whole welL Of
this diluted tincture of opium (which contains in every drop
one five-millionth part of a grain of opium) one drop given in-
ternally was amply sufficient in the case of a child oi tour years
ci age,^ and two drops in that of a child of ten years, to remove
the above state. It is unnecessary to repeat these doses oftener
than every four or eight hours, in some cases not more than
every twenty-four hours, and that sometimes only a couple of
times throughout the whole fever, for which the more firequent
or more rare occurrence of these symptoms must be our guide.
Where also, during the further progress of the disease, the
same symptoms appeared accompanied by constipation of the
bowels, opium so applied externally, or given internally in such
doses,^ never fiuled to produce the desired eflFect The result,
by no means of a transient character, appeared at most in an
hour, sometimes witliin a quarter of an hour, and just as rapid-
ly from the external application as &om the internal adminis-
tration.
Larger doses than the above, occasion raving, hiccough, unap
peasable peevishness, weeping, &c. — an array of factitious sym]»
toms which, when they are not severe, disapj^ear spontaneous!;.
' For infimts and other children who will not lie still kog enough, we should huli
(he paper on with the point of the finger until it is dry, (which requires about :i
minute) and then we should throw away the paper, in case they swallow it.
* For younger children I mixed one drop of this with ten teaspoonfuls of watc*
and gaTe them, according to their age, one, two, or more spoonfuls.
* The smallness of the dose in which the medidne that acts upon the whole 8\ -
tem of tlie liTing organism, when it is suitable to the case, produces its desired efie< .
is incredible, at least it is incredible to my colleagues, who think it requisite to gi .-
to infants at the breast opium in half-grain doses, and who are ready enough to s
tribute the sudden death by poisoning that often ensues to a multitude of otl.. r
causeB. Tlie drops for internal use must be intimately mixed with from one to flu
taUespooofiiLi of fluid (water or beer) just before they are
876 CUBS .AND TBSVEKTIOK or SOASUlfP-WXfmL
in a few hours, or may be more speedily remoyed by BmeDing
at a solution of camphor.
T?ie second morbid condition that oocurs in the course of this
disease : the increase of fever towards evening, the sleepless-
ness, the total loss of appetite, the nausea, the intolerable laoiy-
mose peevishness, the groaning, that is, the state where opium
does and must do harm, — this state was removed in a few qxiar-
ters of an houf by ipecacuanha.
For this end, immediately on the occurrence of this state^ or
during its persistence, I gave, according to the age of the child,
ipecacuanha, either in substance in the dose of a tenth to half a
grain in fine powder ; or I employed the tincture prepared by
digesting in the cold for some days one part of the powder with
twenty parts of alcohol, of this one drop was mixed with a hun-
dred drops of weak alcohol, and to the youngest children a
drop of this last was given, but to the oldest ones ten drops
were given for a dose.
I found these two remedies as indispensable as they were gen-
erally compUidy sufficient^ not only to ward off the £Bital termina-
tion, but also to shorten, diminish and alleviate the scarlet-fever.
I cannot imagine a more suitable mode of treatment, so rapid
and certain in its results I found it
As regards moral and physical accessory dietetic means in the
treatment of a fully developed case of scarlet-fever, I would ad-
vise that we should try to dispel all fear by means of kind and
cheering words, by nice little presents, by holding out hopes of
a speedy recovery — and on the other hand, we should allow the
patient a free choice of all hinds of drinks^ and warmer or cooler
coverings to suit his feelings. The^ patient's own feelings are a
much surer guide than all the maxims of the schools. We must
only take care kindly to keep the patient from taking solid nu-
triment too soon, or in too great quantity during his convalesence.
PROTECTION AGAINST SCARLET-FEVER.
I. Prcphykucis.
But even under the most appropriate and certain medical
treatment of developed scarlatina of a bad type there is always
^ Even in the very wont cases I never employed either gaiglea, or fomentations,
or vesicatories, or sinapisms, or clysters, or venesections, or leeches. When the ur-
.':ent fehrile symptoms in their whole connexion were fuUy met, the result which is
■'oifdy) son^t to be obtained by each of these appliances occurred spootaneonsly.
he illusory and meddling, pedantic oput operatum should, in this enlighteDed oen-
ary, never conttttate the Mef bunnem of tiw earnest practitioDer.
CXrW AND FRiyENTION OP SCABLET-FKVKR. 877
risk of death, of the most miserable death, and the amount of
the countless sufferings of the patients is not unirequently so
great that a philanthropist must wish that a means oould be dis-
covered by which those in health might be protected from this
murderous children's pestilence, and be rendered secure from it,
more especially as the virus is so extremely communicable that
it inevitably penetrates to the most carefully guarded children
of the great ones of the earth. Who can deny that the perfect
prevention of infection fix)m this devastating scourge, and the dis-
covery of a means whereby this divine aim may be surely at-
tained, would offer infinite advantages over any mode of treat-
ment, be it of the most incomparable kind soever?
The remedy capable of maintaining the healthy uninfeciable by the
miasm ofscarkUina, I was so fortunate as to discover. I found
abo that the same remedy given at the period when the symptoms in-
dicative of the invasion of the disease occurs^ stifles the fever in its
very birth; and, moreover, is more efficacious than other known
medicaments in removing the greater part of the after-sufferings
following scarlatina that has run its natural course, which are
often worse than the disease itself.
I shall now relate the mode in which I made the discovery of
this specific preservative remedy.
The mother of a large family, at the commencement of July,
1799, when the scarlet-fever was most prevalent and fatal, had
got a new counterpane made up by a semptress, who (without
the knowledge of the former) had in her small chamber a boy
just recovering of scarlet-fever. The first mentioned woman on
receiving it, examined it and smelt it in order to ascertain
whether it might not have a bad smell that would render it
necessary to hang it in the open air, but as she could detect
nothing of the sort, she laid it beside her on the pillow of the
sofe, on which some hours later she lay down for her afternoon's
nap. — She had unconsciously, in this way only (for the family
had no other near or remote connexion with scarlatina patients),
imbibed this miasm. — A week subsequently she suddenly fell
ill of a bad quinsy, with the characteristic shooting pains in
the throat, which could only be subdued after four days of
threatening symptoms.
Several days thereafter, her daughter, ten years of age, in-
fected most probably by the morbific exhalations of the mother
or by the emanations from the counterpane, was attacked in tiie
evening by severe pressive pain in the abdomen, with biting itch-
. 378 CUBX AND FBEYENTIOX OF SGABIiET-I^ByjOU
ing on the body and head, and rigour over the head and arms,
and with paralytic stiffness of the joints. She slept very rest-
lessly daring the night, with frightful dreams and perspiration
all over the body, excepting the head. I found her in the morn-
ing with pressive headache, dimness of vision, slimy tongue,
some ptyalism, the submaxillary glands hard, swollen, painful to
the touch, shooting pains in the throat on swallowing and at
other times. She had not the slightest thirst, her pulse was
quick and small, breathing hurried and anxious; though she
was very pale, she felt hot to the touch, yet complained of hor-
ripilation over the fitce and hairy scalp ; she sat leaning some-
what forwards in order to avoid the shooting in the abdomen
which she felt most acutely when stretching or bending back the
body ; she complained of a paralytic stiflSiess of the limbs with
an air of the most dejected pusillanimity, and shunned all con-
versation; " she felt," she said, " as if she could only speak in a
whisper." Her look was dull and yet staring, the eyelids inor-
dinately wide open, the face pale, features sunk.
Now I knew only too well that the ordinary fevourite reme-
dies, as in many other cases, so also in scarlatina, in the most £ei-
vourable cases leave everything unchanged, and therefore I re-
solved in this case of scarlet-fever just in the act of breaking out,
not to act as usual in reference to individual symptoms, but if
possible (in accordance with my new synthetical principle) to
obtain a remedy whose peculiar mode of action was calculated
to produce in the healthy body most of the morbid symptoms
which I observed combined in this disease. My memory and my
written collection of the peculiar effects of some medicines, fur-
nished me with no remedy so capable of producing a counter-
part of the symptoms here present, as belladonna.
It alone could fulfil most of the indications of this disease,
seeing that in its primary action it has, according to my obser-
vations, a tendency to excite even in healthy persons great de
jected pusillanimity, dull staring (stupid) look, with inordinately
opened eyelids, obscuration of vision, coldness and paleness of
the face, want of thirst, excessively small, rapid pulse, paralytic
immobility of the limbs, obstructed swallowing, with shooting
pains in the parotid gland, pressive headache, constrictive pains
in the abdomen, which become intolerable in any other posture
of the body besides bending forwards, rigour and heat of certain
parts to the exclusion of others, e. ^., of the head alone, of the
arms alone, &c. I^ thought I, this was a case of approaching
CUB! Ain> PBSYBNTION OF SCABLST-rSVSB. 379
scarlet-fever, as I considered was most probable, the subsequent
effects peculiar^ to this plant — ^its power to produce synochus^
with erysipelatous spots on the skin, sopor, swollen, hot face,
&C. — could not feil to^be extremely appropriate to the symptoms
of fully developed scarlatina.
I therefore gave this girl of ten years of age, who was already
affected by the first symptoms of scarlet-fever, a dose of this
medicine, (*\4RA»th part of a grain of the extract, which, ac-
cording to my subsequent experience, is rather too large a
dose.)^ She remained quietly seated all day, without lying down ;
the heat of her body became but little observable ; she drank
but little ; none of her other symptoms increased that day and
no new ones occurred. She slept pretty quietly during the night,
and the following morning, twenty hours after taking the medi-
dnei most of the symptoms had disappeared without any crisis,
the sore throat alone persisted, but with diminished severity, un-
til evening, when it too went off. The following day she was
hvely, ate and played again, and complained of nothing. I now
gave her another dose, and she remained well, perfectly well —
whilst two other children of the family fell ill of bad scarlet-fe-
ver without my knowledge, whom I could only treat according
to my general plan detailed above ; I gave my convalescent a
smaller dose of belladonna every three or four days, and she re-
mained in perfect health.
I now earnestly desired to be able if possible to preserve the
other five children of the family perfectly free from infection.
Their removal was impossible and would have been too late.
I reasoned thus : a remedy that is capable of quickly checking
a disease in its onset, must be its best preventive ; and the fol-
lowing occurrence strengthened me in the correctness of this
conclusion. Some weeks previously, three children of another
fkmHj lay ill of a very bad scarlet-fever ; the eldest daughter
alone, who, up to that period, had been taking belladonna in-
ternally for an external affection on the joints of her fingers, to
my great astonishment did not catch the fever, although during
the prevalence of other epidemics she had always been the first
to take them.
' At least, if given for a preventive object, too large a dose for a child of this age,
bat probably ezactlj appropriate for the so far advanced symptoms of scarlet-fever,
but this I do not know for certain. I cannot therefore advise an exact imitation of
tint case, but yet neither can I advise that it should not he copied, for the scarlet-fe-
Tcr it a much more serious evil than a few troublesome symptoms produced by a
■omewfaat too laige dose of beUadonna.
380 OUBX AND PBBVENTION OF SGARUnSFXTUt
This circumstance completelj confirmed my idea. I now hed-
tAted not to administer to the other five children of this nume-
rous femily this divine remedy, as a preservative, in veiy small
doses, and, as the peculiar action of this plant does not last
above three days, I repeated the dose every 72 hours, and they
all remained perfectly well without the slightest symptoms
throughout the whole course of the epidemic, and amid the most
virulent scarlatina emanations from their sisters who lay ill with
the disease.
In the mean time I was called in to attend in another feonilyi
where the eldest son was ill of scarlet-fever. I found him in the
height of the fever, and with the eruption on the chest and
arms. He was seriously ill, and the time was consequently past
to give him the specific prophylactic remedy. But I wished to
keep the other three children £ree from this malignant disease;
one of them was nine months, another two years, and the third four
years of age. The parents did what I ordered, gave each of the
children the requisite quantity of belladonna every three dayS|
and had the happiness to preserve these three children fk^e
from the pestilential disease, free fr^m all its symptoms, although
they had unrestricted intercourse with their sick brother.
And a nimiber of other opportunities presented themselves to
me where this specific preventive remedy never &iled.
In order to prepare this remedy for preventing the infection
of scarlet-fever, we take a handful of the fresh leaves of the
unld^ belladonna {airopa belladonna^ Linn.) at the season when
the flowers are not yet blown ; these we bruise in a mortar to a
pap, and press the juice through linen, and immediately (with-
out any previous purification) spread it out scarcely as thick as
the back of a knife, on flat porcelain plates, and expose it to a
draught of dry air, where it will be evaporated in the course of
a few hours. We stir it about and spread it again with the
spatula, so that it may harden in a uniform manner until it be-
comes so dry that it may be pulverized. The powder is to be
kept in a well stopped and warmed bottle.
K we now wish to prepare from this the prophylactic remedy,
we dissolve a grain of this powder (prepared from well preserved
belladonna extract evaporated at an ordinary temperature) in
* For my experimento I haye only employed the wild belladoima gathered in its
natural habitat, but I doubi not that the cultiyated sort will display the same powen^
f it be grown in a situation yery analogous as to soiland positioa to the natural ooe^
yide HahnemanrCt Apotheker Lexiean. Art BeUadonna-tehlaf-beeryi.
CUBB AHD FBSYSNTIOK OF SCABLBT-FSYBB. 881
one hundred drops of oommon distilled water, by rubbing it up
in a small mortar ; we pour the thick solution into a one-ounce
bottle, and rinse the mortar and the pestle with three hundred
drops of diluted alcohol (five parts of water to one of spirit), and
we then add this to the solution, and render the union perfect,
by diligently shaking the liquid. We label the bottle strong
tohxtiion of belladonna. One drop of this is intimately mixed
with three hundred drops of diluted alcohol by shaking it for a
minute, and this is marked medium solution of belladonna. Of
this second mixture one drop is mixed with two hundred drops
of the diluted alcohol, by shaking for a minute, and marked
toeak soluticn of belladonna; and this is our prophylactic remedy
fir scarlet-fever, each drop of which contains Ihe twenty-four
millionth part of a grain of the dry belladonna juice.
Of this weak solution of belladonna we give to those not
iffiscted with dcarlet-fever, with the intention to make themunin-
faiabk by the disease^ — to a child one year old, two drops (to a
younger child one drop), to one two years old, three — to one
three years old, four — ^to a child four years old (according to the
strength of his constitution), from five to six, — ^to a five years
dd child, from six to seven, — to a six years old child, from seven
to eight, — to a seven years old child, from nine to ten, — ^to an
eight years old child, from eleven to thirteen, — to a nine years
old child, from fourteen to sixteen drops ; and with each suc-
cessive year up to the twentieth, two drops more (from the
twentieth to the thirtieth, not above forty drops) — a dose every
Beventy-two hours (well stirred for a minute with a teaspoon in
any kind of drink) as long as the epidemic lasts, and four (to
five) weeks thereafter.*
Should the epidemic be very violent, it would be safer, if the
children could bear it, to let the second dose be taken twenty-
fijUT hours after the first, the third dose thirty-six hours afl«r
the second, the fourth forty-eight hours after the third, and
thereafter to let the subsequent doses be taken every seventy-
two hours until the end, in order that the system may not at
first be taken by surprise by the miasm.
This course of m^cine does not disturb the health of the
children. They may and indeed ought to follow the mode of
life c^ healthy individuals, and keep to their usual drinks, food,
* It Metnt to me tom«what pcobaUe that a mnilar employmeot of **<>Wfiiiimna
would alio preaenre firam fiitfM^
882 CUBE AND FBEVENTIOK OF SCABLBT-nVlB.
iEmd ordinary recreation and exercise in the open air^ but they
must take care to avoid excess in any of these things.
The only thing I must prohibit is the use of too much v^eta-
ble acid, of sour fruits, of vinegar, &c. The action of belladonna
is thereby enormously increased, as my experience (contrary
to the assertions of ancient writers) has taught me.
In case of the occurrence of such a case of the injurious and
too violent action of belladonna (from this or any other cause),
we should make use of its peculiar (according to my observa-
tions specific) antidote, opium, externally or internally, in doees
similar to those I have above indicated, for the external or in*
temal treatment of natural scarlatina.
There are, however, cases in which we are forced to give the
above doses of belladonna oftener than every seventy-two hours.
A delicate girl, three years of age, who was successfully using the
belladonna as a preservative, in the above dose, beside her sister
who had scarlet-fever, bruised her hand severely one day with
the door of the room, and thereby fell into a mental and bodily
condition so favourable to the reception of the infection, that,
notwithstanding that she had taken the prophylactic the day
before, she presented in a few hours all the signs of approach-
ing scarlet-fever ; but two drops of the weak solution of bella-
donna given immediately removed these symptoms just as
quickly, without any ftirther efiects. From that time forward
she took the medicine only every three days (as previously),
and she remained quite free fix)m the scarlet-fever and well.
We would therefore do w«ll in the event of such sudden ac-
cession of violent menial depressioris, occasionally, when requisite,
to give one or two extra doses. We will also sometimes meet
with children who possess naturally such timorous, tranquil dis-
positions, that in them the dose above indicated for children of
their age will not suffice to protect them firom scarlet-fever ; the
physician may therefore be allowed to increase it somewhat, and
to stir the drops up with somewhat more fluid, and for a minute
longer. I may observe, that it is scarcely credible how much
this and every other medicine loses in power (so as even to be
unserviceable for protecting fix)m scarlet-fever), if we allow it to
be licked simply and unmixed with anything from a spoon, or
give it only on sugar, or, though dropping it into a fluid, ad-
minister it without stirring it well up with it. It is only by
Btirring, by brisks long-continued stirring, that a liquid medicine
obtains the largest number of points of contact for the livinjg
OUBX AKD FREYSNTIOX OF SCABLET-FEVflB. 888
fibre, thereby alone does it become right powerful. But the
well stirred dose should cot be allowed to stand for several
hours before it is administered. Water, beer, milk, and all such
excipient fluids, when allowed to stand, undergo some decom-
position, and thereby weaken the vegetable medicinal agent
mixed with them, or even destroy it completely.
I would, moreover, advise that the medicine bottle should be
locked up after every time of using it. I once saw a little girl
of four years old fill up a medicine bottle with brandy, whence,
as she confessed to me, she had previously drunk out all the
medicine, which was also made with spirit and colourless. She
had mounted on the table, had taken the bottle down fix)m a
high cupboard in the wall, and was about to fill it up with
what she supposed to be a similar fluid, in order that her pa-
rents might not discover what she had done, when I entered the
room.
n. Suppression of the Scarlet-fever in its first germs.
Although a practitioner will seldom be so fortunate as to ac-
oomplish this extinction of the fever in question in its birth by
means of belladonna, because it is not usual to send for him at
the very beginning when the miasm attempts its first partial
onslaught, and when uneasy dreams, paralytic stiffness of the
limbs, pressive headache, rigour over one or other limb and
over the head, constitute almost the only symptoms of the still
feeble reaction of the system, yet it is a rejd fact, and, according
to my by no means small experience, beyond all doubt, that it
is capable of extinguishing the approaching fever with all its
concomitant symptoms in the course of irom twenty-four to
forty-eight hours, and of restoring the previous state of health
without the slightest bad consequences. To accomplish this
object I found it best in this case to administer the half of the
dose recommended above as a preventative every three hours,
until all the symptoms had disappeared, and then to continue
giving a full dose only every seventy-two hours in order to pro-
tect the patient from all further infection.
I have, indeed, even in cases where there was already shoot-
ing pain and swelling of the cervical glands and increased heat
<tf skin,^ that is, when a more considerable degree of natural re-
action against the miasm was present, always succeeded in
attaining my object by similar doses given at similar intervals
* But without increased radneai.
S84 CUBE AND PREVENTION OF SCAELST-JEYKB.
of time, but I cannot recommend this practice to any practioner
who is not a most accurate observer, because should he chance
to overlook symptoms of a more advanced stage that may be
present, it mu^t always remain a doubtful matter, whether, in
such a case, by the addition of a new and powerful agent, the
advanced disease would be suppressed and extinguished, or a
tumultuous commotion be excited in the diseased system with*
out any good result.
But least of all is it probable that our object would be attained
by giving belladonna, and it is certainly not advisable to attempt tuf,
if there are present greater heat, redness of face, great thirsty
inability to leave the bed, vomiting and cinnabar-coloured erup-
tion, in other words, fully developed scarlatina. It does not
seem suited for administration in the height of the fever, just as
Peruvian bark cannot be given in the middle of the hot stage of
a paroxysm of intermittent fever with advantage or without
producing a bad effect on the system.
AFTER-S UFFERINGS.
On the other hand, belladonna displays a valuable and spe-
cific power in removing the after-sufferings remaining from
scarlet-fever — an object that our forefathers, as we know, vainly
strove to attain. Most medical men have hitherto regarded the con-
sequences of scarlatina as at least as dangerous as tlie fever itself^
and there have been many epidemics^ where more died of the afbcr-
affections than of the fever.
The puffiness of the face, the swelling of the hands and feet,
&c., the cachexy, the slow evening fever with shuddering, the
stifl&iess of the limbs, the sense of constriction of the abdomen
on holding the body erect, the formication and sleeping {narcosis)
in the spine, the inflammation of the glands, the suppuration
inside the •ars, the ulcers on the face, on the lining membrane
of the nose, at the angles of the mouth, &c., the extraordinary
debility of the whole body, the sleepy, dull disposition, alterna-
ting with excessive hurry in talking and acting, the calling out
in sleep, the pressive headaches, &c., will be specifically and
rapidly removed by the same doses of this remedy as suffice (v.
supra) for prophylactic purposes, or accordingly as the practi-
tioner judges expedient by smaller or larger doses of it Some*
times all that is required is to give the doses somewhat more
frequently.
It is only in some particular cases, where the original disease
was very violent, and advice has been sought for the after-
OBT sn rowxB of shall doses oe mmcDSHL f886
mfferings too late, that I have witnessed what is termed the
uahealthj ddii, that is, the tendency to a solution of continuity
in the solid parte, to ulceration, sometimes to such a degree, that
belladonna is no longer of service. In such and other similar
jCBoes the most excellent remedy was the inspissated juice of the
mabricaria chamomiUoLy dried at a natural temperature in the air
—of this a grain was first of all dissolved in 600 drops of water
and mixed intimately with 500 drops of alcohol, and of this
solution one drop was mixed wiUi 800 drops of diluted
jloohol-^f liiis last diluted solution one drop (Tii9<nr^h of a
grain of the inspissated juice) was given every day to a child of
a &w years old, two drops to one of ten years of age, and so
Ibrfii ; the medicine being well mixed with any liquid, and in a
few days all tendency to ulceration of the skin was removed,
the 60-called xmhealthy skin was cured — a disease in every case
much dreaded by every medical man who does not know of this
excellent but very heroic remedy.
The sufEbcating cough lihat sometimes follows the disease is
also removed by chamomilla, especially if there is at the same
time a tendency to flushing of the face, accompanied by horipi-
lation over the limbs or back.
ON THE
POTfER OF SMALL DOSES OF MEDICINE IN GENERAL,
AND
OF BELLADONNA IN PARTICITLAR.*
Ton ask me urgently, what effect can ^ |ioo.ooo^ part of a grain of
Idladonna have ? The word can is repugnant to me, and apt to
lead to misconceptions. Our compendiuias have already de-
cided what medicines and certain doses of them can do, and
have told us exactly what we are to use ; they have determined
these matters so decidedly that we might consider them to be
symbolic books, if medical dogmas were to be believed as articles
of fidth. But, thank God, they are not yet ; it is well known
that our materia medicas owe their origin to anything but pure
experience, that they are often the inanities of our great-grand-
&11iers, uninquiringly repeated by their great-grandsons. Let
not^ then, interrogate the compendiums, let us ask nature :
' From ffufeland'i JawmaL YoL yI Ft. 2. 1801.
25
886 OK THX FOWEB OF SHALL DOSES OF ICXDIODrB.
iffhat effect has ^\ioo/KiotA of a grain of leUadannat But even in
this shape the question is too wide, and it can only become moie
definite and answerable bj stating the vbiy yuomodOj guando^
qmbus auxiliis,
A very hard dry pill of extract of belladonna produces in a
robust, perfectly healthy countryman or labourer usually no ^ect
But from this it by no means follows thatagrain of this extract
would be a proper, or too weak a dose for this or a similar stout
man if he was ill, or if the grain were given in soliUion^ — certainly
not I On this point let tiie pseudo-empiricism of Uie oompeu-
diums hold its tongue ; let us hear what experience says. The
most healthy robust thresher will be affected with the most
violent and dangerous symptoms from one grain of extract of
belladonna, if this grain be dissolved thoroughly in mudi (e. g.
two pounds of) water by rubbing, the mixture (a little alcohol
being added, for all vegetable solutions are rapidly decomposed^)
made very intimate by shaking the fluid in a bottle for five
minutes, and if he be made to take it by spoonfrds within six or
eight hours. These two pounds will contain about 10,000 drops.
Now if one of these drops be mixed with other 2000 drops (six
oz.) of water (mixed with a little alcohol), by being vigorously
shaken, one tea-spoonfdl (about twenty drops) of this mixture
given every two hours, will produce not much less violent
symptoms in a strong man, if he is iU, Such a dose contains
about the millionth part of a grain. A few tea-spoonsful of
this mixture, will, I assert, bring him to the brink of the grave,
if he was previously regularly ill, and if his disease was of such
a description as belladonna is suitable for.
The hard grain-pill finds few points of contact in the healthy
body ; it slides almost completely imdissolved over the sur&ce
of the intestinal canal invested with a layer of mucus, until it
(in this manner itself covered with mucus), completely buried in
excrement, is speedily expelled in the natural manner.
Very different is it with a solution, and particularly with a
thorough solution. Let this be as weak as it may, in its passage
* Plain water eyen is liable to constant fermentation, especially when yegvCable
substances are mingled with it, and these loee their medicinal power in a few boon.
Without the addition of a little spirit we cannot preserve them half a day m tlitir
integrity. Exposed vegetable juices go on to fermentation a minute after their «z-
posure. We might drink a large quantity of hemlock juice without injury if it baa
stood for twenty-four hours in a moderate temperature ; it then is changed into a
kind of vinegar. To some vegetable juices I have had to add one-third, to othera aa
much as equal parts ot spirits of wine, in order to prevent their fermeotatioik
OK THE FOWSB 07 SHALL DOSES OF HEDIOimS. 887
through the stomach it comes in contact with many more points
of the living fibre, and as the medicine does not act atomically
bat only dynamically, it excites much more severe symptoms
than the compact pill, containing a million times more medicine
(that rests inactive), is capable of doing.
But how is it, I am asked, that excepting yourself no other
pbymdan has ever observed that remarkable action from bella-
donna (and other medicines) in so small a dose? The answer is
not difficult In the first place, because many may only have
experimented with watery solutions, whose medicinal power, as
above stated, is gone in a few hours, destroyed by the internal
fisnnentation of the water; secondly, because many physicians,
ignorant of the purely dynamical action of medicines, are pre-
vented firom instituting any experiments of this nature by Uieir
invincible prejudiced incredulity ; thirdly, because no physician
designs to observe' and to study the positive and absolute efiects
of medicines, most of them being content to learn by rote the
traditions in the works on materia medica, in other words, the
general, often imaginary, use of the medicines — ^^ belladonna is
fif tue (and is of no use) in hydrophobia " — " is of use (and is of
no use) in cancer of the yacc," &c. " We don't need to know any
thing more." What organs it deranges functionally, what it
modifies in other ways, what nerves it principally benumbs or
excites, what alterations it efiects in the circulation and digestive
operations, how it affects the mind, how the disposition, what
influence it exerts over some secretions, what modification the
muscular fibre receives firom it, how long its action lasts, and by
what means it is rendered powerless ; all this the ordinary phy-
sician wishes not to know, and therefore — he does not know it.
Such being his ignorance, he often regards the peculiar efiects
of small doses of belladonna as natural morbid changes, and
thus he will never know what small doses, not to speak of the
very smallest doses, of belladonna do, since he does not know
what effects belladonna produces, nor does he desire to know
them.
To the ordinary practitioner it is incredible that a given per-
son, when sick, needs only to take a millionth part of the same
drug that he swallowed when well without it having any par-
ticular effect, in order to be violently acted on ; and yet this is
undeniably the case. It is a fact, that in disease the preservative
power, together with all the subordinate, nameless forces (some
ii them almost resemble the instinct of animals), is much moi«
88S OK THE POWEB OF SMALL DOSKS 07 JCXDIdmL
excitable than in health, when the reason and the ^wep of the
animal machine being in their complete integrity stand in no
need of such anxious guardians. How well the patient distin-
jguishes betwixt drinks that will do him good, and such as would
be prejudicial to him I An individual affected with an acute
fever, smells from afar the approach of an animal soup, to which
his now wakeful, still unknown life-preserving &culty evinces
the greatest repugnance. He would vomit violently were we
to bring it too near him.
If lemon-juice is good for him — see I at the very mention of
ity his countenance expresses pleasure and desire, and yet when
he was well how indifferent were they both to him !
In a word, all the powers, whose very names we are ignorant
0^ which have reference to the preservation of life and the
avoidance of destruction, are infinitely more excited in disease.
What an enormous quantity of freshly made soup it would take
to excite a healthy stomach to violent vomiting I But look, the
patient ill of an acute fever does not require a drop for this
purpose ; the mere smell of it, perhaps the millionth part of a
drop, coming in contact with the mucous membrane of the noee,
suffices to produce this result.
Will medical men ever learn, how smaU, how infinitely small,
the doses of medicines may be in order to affect the system
powerfully when it is in a morbid state ? Yes, they affect it
powerfully when they are chosen improperly ; new violent symp-
toms are added, and it is usual to say (whether correctly or not,
this is not the place to decide), the disease has undergone an
aggravation. They affect it equally powerfully when they are
suitably selected ; the most serious disease often yields in a few
hours. The nearer the disease approaches the acute character,
the smaller are the doses of medicines ) I mean of the best se-
lected one) it requires in order to disappear. Chronic diseases
also combined with debility and general derangement of the
health, do not require larger ones. It is only in cases where
'along with alocal affection, the general health seems to be good that
we mu3t proceed from the at first small doses to larger ones,
to the very largest however in those cases where the medicine
only can act in a palliative manner.
Those who are satisfied with these general hints, will believe
me when I assert, that I have removed various paralytic affections
by employing for some weeks a quantity of diluted solution of
belladonna, where for the whole treatment not quite a hundred-
Oir A PROPOSED BXHEDf FOB HYDROPHOBIA. 8S9
tfaonfiandtli part of a grain of the extract of belladonna was
required, and that I have cured some periodical nervous diseases,
tendency to boils, &a, by not quite a millionth of a grain, for
the whole treatment
If the appropriate medicine in solution is efficacious in such a'
small dose, as it assuredly is — ^how highly important on the other
hand is it, that in the event of the remedy being improperly
sdected, such a small dose can seldom excite such serious symp-
toms (ordinarily termed aggravations of the disease) as that they"
shall not soon disappear spontaneously, or be readily removed*
by some trifling antidote.
THOUGHTS SUGGESTED BY THE RECOMMENDATION
OF A REMEDY FOR THE EFFECTS OF THE
BITE OF MAD DOGS.*
Sdtce the most remote times a number of remedies have been
recommended as preventives of this horrible disease, accompa-
nied by numerous certificates to attest their efficacy for several
geaerationa The arcanum generously purchased some years ago
by the Prussian government, which received the sanction of a
medical commission and was at last authoritively disclosed — I
mean the worthless electuary of the 7neh'e majaUs may serve as
a specimen of all the rest.
All were at length found to be valueless, one was worth just
as much as another, that is to say, worth nothing I What a
fearful condition to find one's self at a moment of such imminent
danger to life, left in the lurch by a remedy publicly and uni-
versally vaunted as infallible ! The drowning man clutches at
the rope thrown to him — the only one at hand — ^it breaks, and
see, he sinks to rise no more I
But how is it that men have been so universally, so completely
deceived in all these nostrums for rabies ?
Had the real cause of the deception in all these cases been
known, the ir^i^^f ^svi»i — assuredly not the slightest attention
would have been paid even at their first announcement to any
of these nostrums, which have now been proved to be powerless
— ^we should, on the other hand, have long since discovered a
true remedy for the disease.
■■■_IJ __■ ■- - -- '- ^-^^^^—m^^^^^^^^^^^^^m^^^^^^^m.
From the B^eha-Anxeiger. Na 71, 1808.
890 ON A PB0P08SD BBKEDT FOB HTBEOPHOBIA.
The source of the delusion that contributed to the celebiit]r
of all the nostrums hitherto advised,, was the circumstance that
is was deemed sufficient to bring forward proo& thai the remedy
in question preserved from hydrophobia so many persons who had
been bitten by supposed mad dogs.
But of ten dogs that have bitten persons and animals, and
which, from dread of injury, people are more disposed to consider
mad than not, frequently not two are really rabid. But it is
yery rare that any one takes the trouble to obtain a regular
verification of the fact of their being really rabid, they are pur-
sued, slaughtered, and all the ten are held to be mad. Whether
the dog really had the disease, remains in most instances unde-
cided and improbable.
Now out of a hundred persons bitten, who can prove that a
single one among them was wounded by a really rabid dog ?
And on the other hand, it is well known that of persons bitten^
nay, lacerated by dogs really mad^ it is very far from the case thai
all will be affected by hydrophobia. Instances are known of twenty
persons haying been bitten by a rabid dog, of whom only (me
or two were seized with the disease, whilst the eighteen or nine-
teen used no medical or surgical preventive and yet retained
their health, (^ad the nostrum been given to these latter
eighteen or nineteen, many would have sworn that the remedy
had destroyed the virus and preserved them from the disease.)
Both these circimistances — the frequency with which dogs are
considered and killed as mad (i. e., the rarity of really mad dogsj
and the rarity of the inoculation of the really rabid saliva, have
furnished the material for the thousand empty testimonials as
to the prophylactic power of those vaunted nostrums. We
should now, however, once for all cease to pin our faith on such
remedies, for which a mere (delusive) prophylaetic power is
alleged ; we should once for all cease to grasp at shadows in an
affair of such importance, and fraught with so much danger to
mankind I
If the vapour of nitric acid, in a state of ebullition^ were not
at the same time one of the most trustworthy remedies for the
jail-fever. Smith would have exerted himself in vain to assert its
prophylactic power for the contagion of this typhoid fever.
In like manner there cannot be smy prophylactic of hydropho-
bia, that does not prove itself to be at the same time a really
efficacious remedy for the fuUy developed hydrophobia.
Let us begin at this as our starting point. Let a remedy be
Oir THB EFFBOrS OF COFFXX. 891
dneoyered that liias already cured at least ten persons, really
affeetod with hydrophobia, without exception and permanently ;
IhiB will, this must be, likewise the best prophylactic; but any
sabstance that cannot stand this test, can never, in the eyes of
reason and experience, be considered as a trustworthy prophy-
lactic. Let the best extinguisher of burning wooden buildings
be discovered (be it vitriol or potash) and this will also be the
best preservative of wood from fire.
If the remedy of the schoolmaster of Schoneiche, announced
by the philanthropic Wiesand of Pretzch, had only made a
commencement such as I have indicated, and had only cured two
persons really affected with hydrophobia, his secret would be
worth, a considerable reward, and had it cured a number without
ever fidling, his reward should be very large and his memory
diould always be held in honour. Then we should at lengUi
possess a genuine remedy for one of the most fearftil of diseasea,,
hydrophobia.
ON THE EFFECTS OF COFFEE.
FROM ORIGINAL OBSERVATIONS.*
- In order to enjoy a healthy and long life, man requires foods
which contain nutritious, but no irritating, medicinal, parts, and
drinks which are either merely diluent, or diluent and nutritious
at the same time, but which contain no medicinal and irritating
component parts, such as pure spring water and milk.
In the way of accessaries to stimulate the taste, the only sub-
stances that have been found to be harmless and suitable for the
human body are kitchen salt, sugar and vinegar, all three in
small, or at all events, moderate quantities.
All other accessaries, which we term spices, and all spirituous
and fermented liquors, bear a greater or less resemblance to
medicines in their nature. The nearer they resemble medicines,
the more frequently and the more copiously they are taken into
our bodies, the more objectionable are they, the more prejudicial
to health and long life.
Most objectionable of all is the frequent use of purely medici-
nal substances of great power as articles of diet.
Among the ancients, wine was the only purely medicinal
drink, but the wise Greeks and Komans at least never drank
it without diluting it plentifully with water.
* Leipsicl808.
39S' oix THB EFFBORr OF comm
Li modem times many more purely medicinal drinkB andi
condiments haVe been added to our diet : snnfiSng and smokiiiflr
tobaooo, chewing tobacco and hemp-leaves, eating opium and
agaric, drinking brandy, several kinds of stimulating and medioi*
nal beers, tea' and coffise.
Medicinal things are substances that do not nourish, but alter
the healthy condition of the body; any alteration, however, ia
the healthy state of the body constitutes a kind of abnormal,
morbid condition.^
Coffee is a purely medicinal substance.
AUmedidL have, in strong doses, a noxioim »stion on tl>»
sensations of the healthy individuaL No one ever smoked to*
bacco for the first time in his life without disgust ; no healthy
person ever drank unsugared black coffee for the first time m
his life with gusto— a hint given by nature to shun the first
occasion for transgressing the laws of health, and not to trample
so frivolously under our feet the warning instinct implanted in
us for the preservation of our life.
By continuing the use of these medicinal articles of diet
(whereto fashion and example seduce us), habit gradually ex-
tinguishes the noxious impressions that they at first made upon
us ; they even become agreeable to us, that is to say, the dis-
agreeable impressions their ingestion at first produced do not
strike us so much as we go on using them, and their apparentlj
agreeable effects upon our organs of sensation gradually become
necessary to us. The ordinary run of mankind esteems even
fitctitious wants as happiness, and gradually associates with
their satisfaction the idea of relish.
Perhaps also, inasmuch as by their use we become to a oer*
tain degree sickly, our instinct tries from time to time at least
to alleviate this indisposition occasioned by the continued use
of these medicinal articles of diet, by means of the palliative ze^
lief which they are capable of affordiog to the malady produced
from time to time by themselves.
' Chocolate belongs to the nutritious articles, when it is not too highly ^[liced:
otherwise it is objectionable, or even hurtful
' In proportion as the substances we call medicines can make the healthy bod^
sick, so are they calculated to remove the abnormal states dangerous to life, wfakk
go by the name of diseases. The sole end of medicines consequently is, to change
the abnormal, the morbid state, that is, to transform it into health. Used by them-
selves, and when no disease is present, they are absdutely hurtful things for bealtll
and normal life. Their frequent use as articles of diet deranges the harmonious ooo-
cordance of our organs, undermines health and shortens life. A wholesome mtdknm
for a healthy individual is a contradiction of terms.
ON THK S7FSCTB OF COFFSE. 89K
In order to tmderstand this proposition, we mnst take into
consideration the fact that all mec^cines produce in the hodj
conditions the opposite of one another. Their commencing ac'
iim {primary action) is the direct opposite of their secondary
action^ that is, of the state they leave behind in the body when
their primary action has ceased some hours.^
Most medicines produce, both in their primary and secondary
action, disturbances in the healthy body and disagreeable sen-
sations and pains, a certain set of these in their primary action
and another opposite set in their secondary action, and even
flieir prolonged employment excites no agreeable effects in the
healthy individual.
Only the few medicinal substances that the refinement of a
sensuid world has chosen to introduce among articles of diet,*
ftwrm in some degree, an exception to this, at least in their pri-
mary action. They possess the peculiar property, when con-
tinued to be used in moderation, to create in their primary ac- .
tion a sort of artificial exaltation of the ordinary state of health,
an artificial exaltation of the life and almost only agreeable sen-
sations, whilst the disagreeable effects their secondary action
tends to develop remain for some time of little importance, €t$
hng as Ae individual is pretty iveU in heaUhj and leads in othet
rtipects a healthy and natural mode of life.
To this small class of medicines introduced into our dietary
belongs coffee, with its partly agreeable, partly disagreeable
effects, both of which, strange though it may appear, are but
litUe known.
Its irregular, unrestricted use in ordinary life, at almost all
times of the day, its employment in such various strength and
quantity, its preparation under the most dissimilar conditions,
its general use by persons of the most various ages and consti-
totions, of the most different health and habits of life, deprives
the observer of all means of seeing its action aright, and makes
it excessively difiicult to ascertain its true action, and thence to
draw pure inferences. So a disk may be covered with the
dearest characters and words, but all will be unrecognizable if
tbe disk be whirled round with great rapidity ; in that case
everything runs together, even to the eyes of the most sharp-
sighted.
1 For iiwtancft, to-daj jalap powder purges, aod to-morrow and the next daj tbera
tSkfWM ooostipatioD.
* Those are, as before said, wine, spirits, opium, tobacco, tea, coffee, Ac.
8M OK THE EFFECTS OF COFFEE.
It is only by accurate, prolonged, unprejudiced ob8ervati0ii,
83 free as possible from all source of deception^ and by carefully
tracing back the phenomena to their cause, that we can obtaiii
accurate knowledge respecting the most important of all beyer-
ages, coffee.
Its primary action is in general a more or less agreeable ex-
altation of the vital activity ; the animal, the natural, and the
vital functions (as they are called) are artificially exalted by it
during the first hours, and the secondary action that ensues
gradually after the lapse of several hours is the opposite — dis-
agreeable feeling of existence, a lower degree of vitality, a kind
of paralysis of the animal, natural and vital functions.^
When a person unaccustomed to the use of coffee drinks a
moderate quantity, or one accustomed to its use drinks an im-
moderate' quantity, for the first hours the self-consciousness, the
feeling of his existence, of his life, becomes more lively. He
gets a circumscribed redness of the cheeks, a redness which
does not become gradually lost in the surrounding parts, but
which presents the appearance of a well-defined red spot The
forehead ^ud palms of the hands become warm and moist He
feels warmer than before; he feels agreeably, yet uneasily
warm. There occurs a kind of voluptuous palpitation of the
heart, somewhat resembling that occurring during great joy.
The veins of the hands swell. Externally also he is warmer to
the feel than natural, but this warmth never comes to the
length of heat, even after a large quantity of coffee (it sooner
turns into general perspiration) ; none ever become burning
hot.
Presence of mind, attention, sympathy b^fcome more active
than in the healthy natural state. All external objects appear
to excite a feeling of pleasure, they take on, if I may be allowed
the expression, a joyous varnish, and if the quantity of coffee
' " When I awake in the moming,"* writes a genteel, consummate oo£fee-driiildqg
ladj, " I have the power of thinking, and the activitj of an oyster."
' The expressions moderate and immoderate must only be understood in a relatiTe
and individual sense ; they cannot be defined by fixed magnitude and figures of
nniversal acceptation. Thus a certain prince, H. C ▼. C, reared in luxury, who ia
now dead, required for an allowance, every time he drank coffee, an infusion of four-
teen ounces of the roasted bean, whereas we meet with persons who are rmj
strongly affected by a quarter of an ounce. Each person must fix his own standard
according to his peculiar corporeal system. One can bear more than another. Mon-
over the whole series of agreeable sjrmptoms of the primary action of coffee I hsTe
here described does not appear in every one, at all events not all at once, but onjty
one at a time, some in one, others in another, in this one more, in that fewer.
ON THE EFFECTS OF UUFFSX. 885
taken was very great, they assume an almost over-pleasing lus-
tre.^ During the first hours the coffee drinker smiles contented
with himself and with all external objects, and this property it
was that mainly tended to make coffee a social beverage. All
the agreeable sensations communicated are speedily increased to
enthuaasm (though only for a short time). All sorts of dis-
agreeable recollections, or disagreeable natural feelings cease
during this kind of blessed fever.
In the healthy natural states of the human being, left to
themselves, disagreeable sensations must alternate with agree-
able ones ; this is the wise arrangement of our nature. During
the primary action of this medicinal beverage, however, all is
delight, and even those corporeal functions which in the natural
state of health are accompanied by an unpleasant sensation
ahnost bordering on pain, are now performed with extreme
ease, almost with a kind of pleasure.
In the first moments or quarters of an hour after awaking,
particularly when this takes place earlier than usual, every one
who is not living completely in a state of rude nature, has a
disagreeable feeling of not thoroughly awakened consciousness,
of confusion, of laziness, and want of pliancy in the limbs ; it is
difficult to move quickly, reflection is a labour.
But, see, coffee removes this natural disagreeable sensation,
this discomfort of the mind and body, almost instantaneously ;
we suddenly become completely alive.
After completing our day's labour we must, in the course of
nature, become lazy ; a disagreeable feeling of weight and weari-
ness in our bodily and mental powers make us ill-humoured
and cross, and compels us to give ourselves up to the requisite
rest and sleep.
This crossness and laziness, this disagreeable weariness of
mind and body on the approach of natural sleep, rapidly disap-
pears on taking this medicinal beverage, and a dispersion of
sleepiness, a factitious liveliness, a wakefulness in defiance of na-
ture occurs.
If the quantity of coffee taken be immoderately great and the body very ezd-
table and quite unused to ooffee, there occurs a semilateral headache, from the
iqpper part of the parietal bone to the base of the brain. The cerebral mem-
branes of this side also seem to be painfully sensitiTc. The hands and feet become
cold; CD the brow and palms cold sweat appears. The disposition becomes irritable,
and intolenint ; no one can do anything to please him. He is anxious and trembling
reetlea^ weeps almost without cause, or smiles almost involuntarily. After a few
boon, sleep comes on, out of which he occasionally starts up in afiight I have seen
this lare ittate two or three times.
S96 ON THE EFFECTS OF COFFXX.
In order to live we require fixxi, and see I nature compels us
to seek it and replace what has been lost, by hunger, or gnawing
uncomfortable sensation in the stomach, a tormenting longiiig
for food, a quarrelsome crossness, chilliness, exhaustion, &c
Not less uncomfortable is the feeling of thirst, nor is it less U
wholesome provision of nature. Besides the longing desire for
liquids which our body needs for its restoration, we are tor-'
mented by a dryness of the throat and mouth, a dry heat of the
whole body, that to a certain extent impedes the respiration, a
restlessness, &c.
We drink coffee — and see I we feel but little or nothing moie^
of the painful sensations of hunger, nor of the anxious, longing
sensation of thirst. Genuine coffee-drinkers, especially those
ladies addicted to its use, who are deprived of the opportunity
of recovering from the bad effects of this drink by oocai^onal ex-;
ercise in the open air, experience little or nothing more of the real
sensations of hunger and thirst. In this case the body is cheated
of its nutriment and drink, and the cutaneous vessels are at the
same time unnaturally forced to absorb from the atmosphere as
much moisture as is requisite to carry on the frmctions of life;
Confirmed coffee-drinkers pass much more urine than the quan-
tity of fluids they drink. The most natural demands of natui^
are stifled. (Thus they gradually approach — thanks be to the
divine beverage I —to the condition of the blessed spirits above;
a true commencement of beatification here below.)
The all-bountiful Preserver of all living beings, made the
healthy man feel uncomfortable on taking exercise immediately
after haviug satisfied his appetite with food ; this uncomfortable
feeling was intended to compel us to leave off our business and
to rest both the body and the mind, in order that the important
function of digestion might be commenced undisturbed A las-
situde of body and mind, a constriction in the region of the sto^
mach, a kind of disagreeable pressure, a fulness and tension in the
abdomen, &c., on taking exercise, remind us when we attempt to
exert our energies immediately after a meal, of the rest that is
now required — and if we attempt to exercise our thinking Acui-
ty, there occurs a lassitude of the mental powers, a dulness of
the head, a coldness of the limbs, accompanied by warmth of
the face ; and the pressive sensation in the stomadi, combined
with a disagreeable sensation of tension in the abdomen, be>
comes still more intolerable, proving that exerting the mental
powers at the conmiencement of the process of digestion, is more
unnatural and more hurtfiil than even exertion of the body.
ON THE SFFECTS OF COFFEX. 897
Coffee puts a sudden stop to this lassitude of mind and body,
and removes the disagreeable sensation in the abdomen after a
meal. The more refined gourmands drink it immediately after
dinner — and they obtain this unnatural effect in a high degree.
They become gay, and feel as light as though they had taken
lilile or nothing into their stomach.
The wise Begulator of our nature has also sought to compel
US by disagreeable sensations to evacuate the accumulated excre-
ment. There occurs an intolerable anxiety conjoined with a no
leas disagreeable feeling of straining, whereby all the agreeable
sensations of life are put a stop to, and, as it were, swallowed
up in ity until the evacuation is commenced. It is a necessaiy
part of our nature that there should be some effort in the ex-
pulsion of the excrements.
But this has been provided against by the refining spirit of
jOur age, which has sought to elude this law of nature likewise.
In order artificially to promote and hasten the time required for
4igestion, which in the order of things is several hours, and to
cpcape the anxious, frequently slowly increasing call to stool,
the degenerate mortals of our times, who strain aft;er enjoyment
and have a childish dread of all uncomfortable sensations, find
their means of escape in coffee.
Our intestines excited by coffee (in its primary action) to
more rapid peristaltic movements, force their contents but half
digested more quickly towards the anus, and the gourmand
imagines he has discovered a splendid digestive agent. But
the liquid chyme which serves to nourish the body, can in this
short time neither be properly altered (digested) in the stomach,
nor sufficiently taken up by the absorbents in the intestinal
canal ; hence the mass passes through the unnaturally active
bowels, without parting with more than the half of its nutritious
particles for the supply of the body, and arrives at the excre-
tory orifice still in a half-liquid state. Of a truth a most excel-
lent digestive agent, far surpassing nature I
Moreover, during the evacuation itself the anus is excited
by the primary action of the coffee to more rapid dilatation and
oontraction, and the fasces pass out soft, almost without effort^
and more fi:equently than in the case of healthy individuals
who do not partake of coffee.
These and other natural pains and disagreeable sensations,
which are a part of the wise ordering of our nature, are dimi-
nished and rendered almost unnoticeable by the primary action
398 ON THE EFFBCrrS OF COFFER
of coffee— land the disastrous effects of this are not peiceiyed,
or even dreamt of
Even the sexual desire, which in our age has been exalted
into the chief of all pleasures, is excited by the primary actioa
of coffee more than by any other artificial means. As quick as
lightning there arise voluptuous images in the mind firom very
moderate exciting cause, and the excitation of the genitals to
complete ecstacy become the work of a few seconds ; the ejacu-
lation of the semen is almost irrestrainable. The sexual desire
is excited by coffee from ten to fifteen years too soon, in the ten-
derest, immaturest age in both sexes ; a refinement^ that has the
most perceptible influence on our morality.and mortality — ^not
to speak of the earlier impotence that follows as a natural con-
sequence therefrom.*
In an individual of very irritable temperament, or who has
already been enervated by the copious use of coffee and a se-
dentary life, the effects I have mentioned appear in a still moie
prominent light. Every unprejudiced person must perceive in
the corporeal derangements and sensations effected by co£fee,
something unnatural, an over-stimulation. An excessive sensi-
tiveness, or a gaiety greatly disproportioned to the object of it^
a tenderness almost partaking of a convulsive character, an inor-
dinate sorrowfulness, a wit that is not altogether under the
restraints of reason, an excessive distortion of the features ap-
proaching to caricature, under circumstances where a mere
smile, a little joke a slight perplexity, a moderate expression of
grief or sympathy, would have sufficed.
Even the muscles of the rest of the body exhibit an imna-
tural excessive activity — all is life, all is motion (though there
may be but little cause for it) during the first hour after partak-
ing of strong, or (to use the often inaccurate language of the
world) good coffee. The ideas and the pictures of the fimcy
flow in rapid succession and in a continuous stream before the
seat of the imagination and sensation in the brain — an arti-
ficially accelerated, artificially exalted life 1
' Enjoyment 1 enjoyment ! is the cry of our age — quicker, uninterrupted eqjoy-
ment of life at whatever cost ! and this object is to a certain degree attained by
means of this beverage, that accelerates and squanders the vital powen.
* [Who, among all the medical writers of this period (1808) has thought lo justly,
and written so wisely, as Hahnemann f Who among his ootempofaries has pramal-
gated so many fJEurts which have been oonfirmed by modem inveatigationa aa tfaa
founder of bonuBopathy t] — Am, P,
ON THE EFFECTS OF COFFEE. 399
In the nataral state we require some effort to remember clearly
things long past'; immediately after taking coffee the stores of
memory spring, so to speak, into our mouth — and the conse-
quence often is loquacity, hurried chattering, and letting things
escape from our lips that we ought not to have spoken about.
Moderation and purpose are entirely wanting. The cold
considerate earnestness of our forefathers, the firm stead&stness
of will, of resolve, and of judgment, the endurance of the not
rapid but powerftil movements of the body, adapted to the ob-
ject in view, that used to constitute the original national charao*
ter of the Germans — ^the whole sublime original stamp of our
descent disappears before this medicinal beverage, and changes
into over-hasty disclosures, hurried resolves, immatured judg-
ments, frivolity, changeableness, talkativeness, irresolution,
flighty mobility of the muscles, without the production of any
durable impression, and theatrical behaviour.^
I well know that in order to revel in the dreams of fency, in
order to compose frivolous novels, and light, playful witticisms,
the Gennan must drink coffee — ^the German lady requires strong
coffee in order to sparkle with wit and sentiment in fashionable
dides. The ballet dancer, the improvisator, the conjurer, the
juggler, the sharper, and the keeper of a faro-bank, all require
coffee, as likewise the fiashionable musician for his giddy rapidity
of execution, and the omnipresent fashionable physician, to en-
able him to rush through his ninety visits in a forenoon. Let us
leave to these people their imnatutal stimulant, together with its
evil effects to their own health and the welfare of mankind 1
But this much is at least certain, — the most refined sensualist,
the most devoted debauchee, could have discovered on the whole
sur&ce of the globe no other dietetic medicinal substance besides
coffee^' capable of changing our usual feelings for some hours
into agreea))le ones only, of producing in us for some hours,
rather a jovial, even a petulant gaiety, a livelier wit, an exalted
* Who can tell what eneryatiog dietetic practices it was by which those admirable
heroic Tiitues of patriotism, love of children, inviolable constancy, unshakable integ>
ritj, and strict fulfilment of duties (the well-known attributes of by-g^e times)
fatre in our days almost dwindled down into paltry egotism ! likewise the single
hflroic Tirtiies of the middle ages and of remote antiquity, the antagonists of those
filtiiesy are now-a-days (by what enervating dietetic practices t) split up into petty
intrigiies, ooocealed trickeries and artifices, and distributed over myriads of individuals
—compelling the unoontaminated person to exercise much caution every step he
\akm I Which is the more injurious, a single bomb-shell, or a million df iDyinhle
hookup distributed every where to catch the feet of the unwazy t
* And to a certain extent tea also.
#00 ON THE £FFSCIS OF COFFU.
imagination above what is natural to our temperament^ of quick*
ening the movement of our muscles to a kind of trembling acti-
vity, of spurring on the ordinary quiet pace of our digestive and
excretory organs to double velocity, of keeping tl^e sexual prieio-
tice in an almost involuntary state of excitation, of silencing fhe
useful pangs of hunger and thirst, of banishing blessed sleep
from our weary limbs, and of artificially producing in them even
a kind of liveliness when the whole creation of our hemisphere
fulfils its destiny by enjoying refreshing repose in the silent Up
of night
Thus we despotically overthrow the wise arrangement of 7is^
ture, but not wUhout injury to ourselDes I
When the first transient effect of coffee has departed after a
few hours, there follows gradually the opposite state, the secondary
action. The more strildng the former was, so much the mare
observable and disagreeable is the latter.
All persons do not suffer equally from the abuse of a medi-
cinal beverage such as coffee is.
Our systems are so admirably arranged that tf toe live agreeab^
to nature in other respects a few errors in diet, if they be not too
great, are tolerably harmless.
Thus, for instance, the day-labourer or peasant in Germany
drinks brandy, which is so pernicious in itself, almost every
morning ; but if he only take a small portion at a time, he will
often attain a pretty considerable age. His health suffers little.
The excellence of hisX5onstitution and his otherwise healthy mode
of life counteract the injurious effects of his dram almost without
letting a trace appear.
Now, if instead of brandy the day-labourer or peasant drink
a couple of cups of weak coffee, the same thing occurs. His
robust body, the vigorous exercise of his limbs, and the quantity
of fresh air he inhales every day, repel the hurtful effects of his
beverage, and his health suffers little or nothing in consequenoe.
But the bad effects of coffee become much more perceptible
when these favourable circumstances are not present.
Man can, no doubt, enjoy a kind of health, though his oooa*
pation confines him to the house — or even to one room — even
though he has to live a very sedentary life in the room, and his
body is delicately constituted, provided he live in other respects
conformably with his state. Under the moderate use of only
easily digestible, mild, simple, purely nutritious, almost unspioed
food and drink, along with a prudent moderation of the paaaioDs
OV THX SFFSOIS OF COFFXX. 401
and frequent renewal of the air in the rooma, even women,
without any great exercise,^ enjoy a kind of health which doubt*
las can be readily oompromified by external causes, but which,
if iheae are avoided, may still be termed a moderate degree of
health. In such persons the action of all morbific substances,
that is^ of all medicines, is much more striking and severe than
in robust individuals accustomed to labour in the open air, who
are able to bear some very hurtful things without particular
injury.
TluQse weakly dwellers in rooms live in the low levd of their
health but half a life, if I may use the expression ; all their sen-
sations, their energy, their vital functions, are somewhat below
par, and they eagerly resort to a beverage that so power&lly
exalts lor some hours their vital energy and their feeling of ex-
istence^ unconcerned about the results and the secondary action
of this palliative.
This secondary action resembles their state before partaking
of the coffee, only it is somewhat stronger.
When the few hours of the above described primary action of
this medicinal beverage, that representation of artificially exalted
vital energy, is gone, there then gradually creeps on a yawning
drowsiness and greater inactivity than in the ordinary state, the
movements of the body become more difficult than formerly, all
the excessive gaiety of the previous hours changes into obtuseness
of the senses. If, during the first hours after drinking the coffee,
the digestion and the expulsion of the excrements were hastened,
now the flatus becomes painfully incarcerated in the intestines,
and the expulsion of the faeces becomes more difficult and slower
than in the former state. If, in the first hours, an agreeable
warmth pervaded the fiame, this fectitious vital-spark now gra-
dually becomes extinguished, a shivering sensation is felt, the
hands and feet become cold. All external agents appear less
agreeable than before. More ill-humoured than ordinarily, they
more given to peevishness. The sexual passion which was
by the coffee in the first hours becomes all the colder
and more obtuse. A kind of speedily satiated ravenous hunger
takes the place of the healthy desire for nutriment, and yet eat-
ing and drinking oppress the stomach more than previously.
They have greater difficulty in getting to sleep than formerly,
and the sleep is heavier than it used to be before they took
* Under sudi circumstanoeft pri&ociers alio
2S
402 ON THS ETFECra OF COFFEJIL
ooffoe, and on awaking they are more sleepj, moreduKxnxragedy
more melancholy than lusual.
But look I all these evils are rapidly driren away by a re-
newed applicatiou to this hurtfal palliative — a new, artificiallifb
oommences — only it has a somewhat shorter duratioa than the
first time, and thus its repetition becomes ever more fiequendy
necessary, or the beverage most always be made stronger in
order to enable it again to excite life for a &w hoursr
By such means the body of the person whose occupation con-
fines him to his room degenerates all the more. TW injurious
effSdcts of the secondary action of this medicinal drink spread
fturther around, and strike their roots too deeply to allow of their
being again effaced, if only for a few hours, by a mere repetition
d the same palliative more frequently or in stronger doses.
The skin now becomes generally more sensitive to the oold,
and even to the open air though not cold ; the digestion becomes
obstructed, the bowels become constipated for several days at
a time, fiatulcnce occasions anxiety and causes a number of pain*
fill sensations. The constipation only alternates with diarrhoea,
not with a healthy state of the boweb. Sleep is obtained with
difficulty, and bears more resemblance to a slumber that causes
no refreshment On awaking there are remarkable confusion
of the bead, half- waking dreams, slowness of recollecting him-
self, helplessness of the limbs, and a kind of joylessncss that
throws a dark shade over all God's lovely nature. The bene-
ficent emotions of the hearty warm philanthropy, gratitude, com-
passion, heroism, strength and nobility of the mind, and joyous-
ness, change into pusillanimity, indifference, insensible hardness
of heart, variable humour, melancholy.
The use of coffee as a beverage is continued, and sensitiveness
alternates ever more \rith insensibility, over-hasty resolves with
irresolution, noisy quarrelsomeness ^^dth cowardly compliance^
affectation of friendship ^yith malicious envy, transient rapture
with joylessness, grinning smiling with inclination to shed tears
— symptoms of constant hovering betwixt excitement and de-
pression of the mind and the body.
It would be no easy task for me to indicate all the nfuiladiesy
that under the names of debility, nervous affections and cdironic
diseases, prevail anwng the coffee-drinking set, enervating hu-
manity and causing degeneration of mind and body.
But it must not be imagined that all the evil results I have
named occur to every coffee bibber in the same degree I No,
ON THE KFFEGTS OF COFFlfil. 408
one su£Feis more from this, another from that symptom of the
secondary action of coffee. My description includes the whole
coffee-drinking race ; all their maladies which arise from this
source I have arranged together, as they have from time to time
come under my notice.
The palliative agreeable sensation which the coffee distributes
for some hours through the finest iibres, leaves behind it, as a
secondary action, an extraordinary susceptibility to painful sen-
sationsi which always becomes greater and greater, the longer,
the oflener, the stronger and the greater the quantity in which
the coffee is drunk. Very slight things (tliat would make scarce-
ly any impression on a healthy person not accustomed to the
use of coffee) cause in the coffee diinkiug lady megrim, a frequent
often intolerable toothache, which comes on, chiefly at night,
with redness of the face and at length swelling of the cheek — a
painful drawing and tearing in dilforcnt parts of the body, on
one side of the face, or at one time in one limb, at another in
another.^ The body has a special tendency to erysipelas, either
in the legs (hence the frequency of old ulcers there) or (when
suckling) in the mammas, or on one half of the face. Appre-
hensiveness and flying heat are her daily complaints, and nervous
scmilateral headache her property.^
> Tbis drawing tearing in the limbs caused by cofToc in its secondary acticxi and
when its use is persisted in for a long tinie, is not in the jointn, but from one joint to
the other. It appears to bo more in the Aedi or cellular tisftuc than in the boneA, is
unattended by swelling or other abnormal ap|)carancc, and there is scarcely any
tenderness oo touching the part Our nosulogisti know nothing about it
' The ni^rim above alluded to, which only uppcar^ after tuome exciting cause,
overloading of the stomach, a chill, ix., generally very rapidly and at all
of the day, difr<>r9 entirely from the so-called nervous hemicrania. The latter
oocum in the morning, soon or inmiediately after waking, and increases gradually.
The pain is almost intolerable, often of a burning cliaracter, the external coverings of
the skull are also intolerably sensitive and painful on the least touch. Body and
nund seem both to be insufferably Bensitive. Apparently destitute of all strength,
cbey seek a solitary and if possible dark sp)t, where, in order to avoid the daylight
they pass the time with closed eyes in a kind of waking bluniber, u:»uaUy on a couch
raided in the back, or in un arm cliair, quite motioidcss. Every movement, every noise
increases their pains. They avoid speaking themselves and listening to the couver-
HiliuD of others. Tlieir body is colder than usual, though without rigour ; the hands
and leet in porticidar are very cold. Kverything is distasteful to them, but chiefly
eating and drinking, for an incessant nausea hinders them from taking anything. In
bad cases the nausea amounts to vomiting of mucus, but the headache is seldom
•iUevinlcd thereby. The bowels are constipated. This heiKluche alnitrnt never goes
(iff until evening ; in very bad cu-es I have ?ocn it 1u.m. iluriy-&ix hours, ho tlmt it mily
Ji-apjxured the following evening, lu sli^iiicr case.-> iin origiiml producer, uofiee,
iJiorteU;.^ its duration in a palliaiive nmuuor, but it e(.:niiiuiiicates to the system the
404 OK THE KFFSOTB OF GOFFKK.
From moderate errors of diet and disagreeable mental emotioiici
tiiere oocor painfol affections of the chest, stomach and abdomen
(known by the inaccurate name of spasms) — ^the catamenia oome
on with pains, are not regular, or the discharge is less oopionB
and at length quite scanty ; it is watery or slimy ; leucorrhoea
(generally of an acrid character) prevails almost the whole time,
from one period to another, or completely supersedes the men-
strual flux — coition is often painful. The earthy, yellowish or
quite pale complexion, the dull eye surrounded^ by blue ringB,
the blue lips, the flaccid muscular tissue, the shrivelled breasts,
are the external signs of this miserable hidden state. Sometimes
the abnost suppressed menses alternate with serious uterine he-
morrhages. In males there occur painM hemorrhoids and noc-
turnal emissions of semen. In both sexes the sexual power be-
comes gradually extinguished. The normal exuberant energy
of the embrace of a healthy couple becomes a worthless bagatelle.
Impotence of both sexes and sterility, inability to suckle a ohildf
ensue. — ^The monster of nature, that hollow-eyed ghost, onanism,
is generally concealed behind the coffee-table (though indul-
gence in the perusal of meretricious novels, over-exertion of the
mind, bad company and a sedentary life in close apartments,
contribute their share).
As an inordinate indulgence in coffee has for its secondary
effect to dispose the body greatly to all kinds of disagreeable
sensations and most acute pains, it will be readly comprehended
how it, more than any other hurtful substance we are acquainted
with, excites a great tendency to caries of the bones. No error
of diet causes the teeth to decay more easily and certainly than
indulgence in coffee. Coffee alone (with the exception of grief
aud the abuse of mercury) destroys the teeth in the shortest
space of time.' The confined air of a room and overloading
the stomach (especially at night) contribute their share to this
effect But coffee by itself is quite capable of destroying in a
short space of time tJiis irreparable ornament of the mouth, this
indispensable accessory organ for distinct speech and fiir the in-
timate mixture of the food with the digestive saliva, or at least
teodeocy to produee it after a still shorter interroL It recnrsat undetennioed tiiiM^
crery fortnig^t^ three, four weeks, dbc It comes oa without anj exehiog canss^qoito
unaqpectedlj; eren the night previouslj the patient seldom feels anj premooilarj
signs of the nervous headache that is to come on tlie next morning.
I have never met with it excepting aitwng regular cuffee drinherM.
I tWiMmmmmt^i^^m gQ ^hjch I QMXi dcpcnd have ooovinoed me of this.
OH TEX XFFKOTS OF 007FSX. 405
of rendering them black and yellow. The Ices of the firont (in*
dsor) teeth is chiefly due to tlie abuse of cofifee.
If I except the true spina ventosa, there occurs scarcely a
sin^ case of caries of the bones in children (if they have not
been over-dosed with mercury) &om any other cause than from
ooflEee? ^ Besides these, there are in chUdren other deep-seated
flesh abscesses that take a long time of bursting and then have
but a small orifice, which are often solely to be ascribed to the
action of the coffee.
As a rule, coffee acts most injuriously on children ; the more
tender their age, the worse its effects. Although it is incapable
of itself of producing true rickets, but can only accelerate them,
in conjunction with their special exciting cause (food composed
of unfermented vegetable substances, and the air of close, damp
rooms), yet it of itself excites in little children, even when their
other food is wholesome and the air in which they live good, a
kind of infimtile hectic, which is not much less sad in its results.
Their oomplexion becomes pale, their muscles quite flaccid. It
is only after a long time that they learn to walk a littie, but then
thdr gait is uncertain, they easily fidl, and wish always to be
carried. They stammer in their speech. They wish for a great
variety of things, but relish nothing heartily. The drollery, hap-
piness and liveliness that characterize the age of childhood are
changed into indolent dejection ; nothing gives them pleasure,
nothing makes them contented ; they enjoy only a sort of half
lie£ They are very easily startied, and timid. Diarrhoea alter-
nates with costiveness. Viscid mucus rattles in ineir chest as
they breathe, especially when they are asleep, which no amount
of coughing can remove : they have always got a wheezing at
the chest. Their teeth come with much dii&culty and with con-
vulsion fits; they are very imperfect, and fall out decayed before
the period for changing them arrives. Mostly every evening,
just before bed-time or after lying down in bed, they get redness
and heat on one or both cheeks. They sleep very imperfectly,
toss about at night, oflcn want to drink ; they then perspire, not
only on the forehead, but also on the hairy scalp, particularly
at the back of the head, and whine and moan in their sleep.
ulcerations of the bones, which lie concealed beneath clcTated, hard, bluish-
red swellings of the soft partfi, exude an albuminous looking mucujs mixed with some
cheese-Kke matter. It has wvrj little smelL The pains of tlie affected port are werj
thxfting Id their character. The rest of the bud/ presents a pure picture of tha
406 OV THE EFFECTS OF COFFEE.
They get through every disease with difficulty, and their leoo-
very is very slow and imperfect
They are frequently subject to a chronic inflammation of the
eyes, not unfrequently accompanied by an eruption in the tauoe,
along with a peculiar relaxation of the upper eyelid, which pre-
vents them raising it, even when the redness and swelling of
the lids are but moderate. This kind of ophthalmia, that often
lasts for several years, making them frequently lie upon the fece,
with constant peevishness and crying, or conceal themselves in
a dark place where they remain lying or sitting in a stooping
posture ; this ophthalmia, I say, chiefly affects the cornea^ covers
it with red vessels and at last vrith dark spots, or there occur
phlyctenulre and little ulcers on it, that often eat deeply into the
cornea and threaten blindness.
This ophthalmia and that rattling at the chest and the other
ailments above described, attack even infants at the breast, who
take nothing but their mother's milk, if the mother indulges in
coffee and inhabits a close room. How penetrating must not
the hurtful power of this medicinal beverage be, that even in-
fiuits at the breast suffer from it !
After children, coffee acts, as I have said, most injuriously on
the female sex, and on literary people whose occupation is se-
dentary, and confines them to their rooms. To these may be^
added workmen engaged in a sedentary trade.
The iMid effects of coffee are, as I have above mentioned, most
effectually diminished by great activity and exercise in the open
air, — but not j)ermaneiitly removed.
Some imlividuals also find out as if by instinct, a sort of anti-
dote to coffee in the use of spirituous liquors. It is impossible
to deny that they do popsess some antidotal jwwcrs. These are,
however, mere stimulants, without any nutritive quality ; that
is to siiv, they are likewise medicinal substances, which, when
daily used as articles of diet, produce other injurious effects, and
yet are unable to prevent the hurtful action of the coffee from
taking effect, — what they cause are artificial ameliorations^ of
the vital functions, followed by morbid effects, though of a dif-
ferent, more complex nature.
Leaving offthfC use of coffee^ is the chief remedy for these insi-
-^ -- ■__ III- '- — ^
* It is by no means easy to do aw.iy with on inyotcnitc bnlnt of n$tng coffee. — I
fir-tt viKlc^-ivour U> convince my pzitient:? werioiHy of t)ic nrgi'Kt aiwl iBtlispoiBiahU''
m.>c<^-Miy of (U*rcuntinuing its use. Truth groumled oaobviuuB expeiimc4 •eUbivi
Oir THE BFPECTB OF COFFBE. 407
dions and deeply penetrating injurious effects, and corpoTeal
exercise in the open air tends to promote the subsequent reco-
very. If however body and mind be sunk too low, there are
some medicines very useful for that state, but this is not the
proper pkce to enumerate them, as I am not at present writing
lor medical men. When I describe the daily use of coilee as
very prejudicial, and when I shew from observations and ex-
perience of many years that it relaxes and withers the energy
of our body and mind, some may retort u]X)n me the appellation
^'medicinal beverage,'' which I must unlicsitxitingly bestow upon
coffee.
" Medicines are surely wholesome things,^ says the aninitated.
They are so ; but only under certain iDdis^wiisable conditions.
It is only when the medicine is suitable for the case that it is
wholesome Now no medicine is suitable for health, and to
employ a medicine as a beverage in tlic ordiuary healthy state,
is a hurtful procedure, a self evident contradiction-
I prize them edicinal powers of coi&c when it is appropriately
employed as a medicine, as much as those of any other nicdica-
ftik to produce eatviction — almost never, vlien it is urged from the philanthropie
bemrt of a pbysidaii, who, ooovinced himself of the goodness of his cause, i» thuroughlj
penetrated by the truth of his maximo. Nothing will tlutii prevent their reoeptioo,
fliere is no question of nny private interest on tlie part of the doctor ; aud nothing
Vat pure gain on the side of the party he wirfies to -convince.
If we have attained iim object (whotlier this is the case or no, he who has a knoW"
ledge of hmnon uatiirc can ttfil by the way the patient receives liis advice), we may
advise that (he quantity of coffee talfcii be reduced by a cup every thnje or ftiur days,
mad allow the hist bre:ikfai<t-cup to be continued for a week longer, until this can
ciCher be kaft off at oocc,or it may be continued oo every alteniatc day for another
vcek, according to circumstances.
If we have to do with persons on wliom wc cau rely, tlie affair in managed in the
eonne of four weeks. But should some faint licjirtetlncss or iiidccisioD on tlio part of
fliavea to ooffipe make its nccompHMnnoiit diffkuH, or should the weak state of the
health make its disoontinunDce be too severely felt, we wiHild do well fnr every cap
-of coffee we take away, to allow a cup of tea to be druak, until in tlic course of a
week nothing but tea (a tiimilar but Lessor evil) is drunk, and tliis, as it has not had
ihne to become a habitual beverage, may be more easily diminished, until at last
nothing more of the sort is taken^ bat only a coiuplo of cups of warm milk for
hreakfiMt, in plaec of oofii'c or tea.
Whilfit thus bneaking off the habit, it is indispensable tliat the body be refreshed
and strengthened by daily walks in the op<'n air, by amusements of an innocejit
charater. nn»l by ;ipprtj|iriafe AmmI, if we \vi«b tli:i2 tlw iiyiu<«>u» effects of tlie coffee
should disnppcfir. and the in;livirInAl be c<;nfiniici1 in Ins re^ohitidi to give it up.
Aivl If all £««H.'« oa wvW. ir witl iK»t hv a biul plan for tike dtictor, <»r a friend in
hiM i^tead, tu a><^ure hinistrlf Ironi time to time of tlio tiue convulsion of Jiis pa-
iient, and if neee^aiy, uphold bUie.'olution wJLt>n t}xr t^ucijof exnmj>lo in compnny
aeeini to caiMs it to vavei;
408 ON THE XTFSCTB OF OOFFKK.
ment Thiaze is nought saperfluons in God's crestion ; everf
ihing is created for the weal of mankind, particularly the moBt
powerftd things, to which class coffee belongs in an especial de^
gree. But let the following &cts be borne in mind.
Every single medicine develops in the healthy human body
some special alterations, that are peculiar to itself exclusively.
When these are known, and when the medicine is employed in
cases of disease that have an almost exact similarity with the
alteration that the medicine is capable of itself producing (in the
healthy body), a radical cure takes place. This employment of
the medicine is the curative one, the only one to be relied on in
chronic diseases.
In speaking of this power of a medicine to alter the human
body in a manner peculiar to itself, I allude to its primary or
initiatory action. I have said above that the primary action of
a medicine (for some hours after it has been ts^en) is the direct
opposite of its secondary action, or the state in which it leaves
the body whenever its first action is past
Now if the primary action of a medicine be the exact opposite
of the morbid condition of the body we seek to cure, its employ-
ment is paUuxtive. Almost instantaneous amendment ensues, —
but a few hours afterwards the malady returns and attains a
grater height than it had before the employment of the remedy,
the secondary action of the medicine, which resembled the ori-
ginal disease, aggravates the latter. A miserable method of
treatment when we have to do with a chronic malady.
I shall give an example. The primary action of opium in
the healthy system is to cause a stupiiying snoring sleep, and
its secondary action — the opposite — sleeplessness. Now if the
physician will be so foolish as treat a morbid, habitual sleepless-
ness with opium, he acts in a palliative manner. The stupid,
snoring, unrefi-eshing sleep speedily follows the ingestion of the
opium, but its secondary action, as I have stated, is sleeplessnessi
an addition to his already habitual sleeplessness, which is now
accordingly aggravated. Twenty -four hours afterwards the pa-
tient sleeps still less than before he took the opium ; a stronger
dose of the latter must now be given, the secondary action of
which is a still greater sleeplessness, that is, an aggravation of
the malady, which the foolish man imagined he was curing.
In like manner, coffee proves a bad palliative remedy when
it is used as a medicinal agent, for example, in cases of habitual
Oir IS! XFFEOTB OF OOFFUL 409
ocmsfcipalion prooeeding firom inactivity of the bowels^ — ^as is
often done by medical men. Its primary action is, as I have
before stated, the reverse of this state, — it therefore acts here as
a palliative, and if it be used for the first time, or only on rare
occasions, it speedily produces a motion of the bowels, but the
following days, under the secondary action, the constipation be*
comes all the greater. If we again seek to remove this in the
same palliative manner by means of coffee, more of it must be
drunk, or it must be made stronger, and still the habitual con*
stipation is not thereby eradicated, for it always returns more
obstinately on the recurrence of the secondary action of the
oofiee, whenever this palliative administration of the coffee is
discontinued, or stronger and more frequent potations of it are
not taken, which always aggravate the disease and entail other
maladies.
It will be found that the medical excuses offered by coffee*
drinkers in justification of this habit almost all rest on some
such palliative reUef it affords them, and yet nothing is more
certain than the experience that a long-continued palliative em*
ployment of a drug is injurious, but the palliative employment
of drags as articles of diet is the most injurious of all.
Therefore when I, whilst deprecating its abuse as an every-
day beverage, commend the great medicinal virtues of coffee, I
do the latter merely in reference to its curative employment for
chronic ailments that bear a great resemblance to its primary
action,' and in reference to its palliative employment in acute
diseases threatening rapid danger, which bear a great resem-
blance to the secondary effects of coffee.^ This is the only
rational and wise mode of employing this medicinal beverage
which is abused by hundreds of millions of individuals to their
* At is umallj the case with those who lead a sedenterj life in their room.
* For example when, in a person unaccustomed to the use of oofiee, there is present
0k oaj be a habitual) indisposition, composed of a frequent, painless evacuation of
nft fmca and frequent inclination to go to stool, an unnatural sleeplessness, ezoes-
■T8 irrHabilitj and agility, and a want of appetite and thirst, but without any dimi-
■ntioa of the perception of the flavour of food and drink, in such a case coffee will^
waai effect a radical cure in the course of a sliort time. In like manner it is, in the
fteqneoftly dangerous symptoms brought on by a sudden, great, joyful mental
<— y?tf«»^ the most suitable, trustworthy, curative medicine, and also in a certain kind
of Uboar-pains, which bear much resemblance to the primary effects of coffee.
* Tlie fidlowing are examples of the excellent palliative employment of coffee in
ifaranns that come on rapidly and require speedy relief : sea-sickness, poisoning by
opinm in thoae unaccustomed to the use of coffee, poisoning by vcratrum album, the
ipparent death of drowned, suffocated, but eapeciailly of frozen persons, as I have
fteqaently had the satisfiictioo of witnessing.
410 iBSCULAPIUS IK TBS BAIiAKOB.
hart, is understood by few, but whioh is extremelj wholeaonie
when used in its proper place.
iESCULAPIUS IN THE BALANCE.'
Aiit autem tani conjccturalis cum Bit (praeeertim quo nunc hftbetur modo) loenm
amplioruin dedit non solum errori verum etiani imposturac. — Baoo dz Y
Attffin, Scient,
After I had discovered the weakness and errors of my teachers
and books, I sank into a state of sorrowful indignation, which
had nearly altogether disgusted me with the study of medicine.
1 was on the point of concluding that the whole art was vain
and incapable of imj)rovement. I gave myself up to solitaij'
reflection, and resolved not to terminate my train of thought
until I had arrived at a definite conclusion on the subject.
Inhabitants of earth, I thought, how short is the span of your
life here below ! with how iijany difficulties have you to contend
at every step, in order to maintain a bare existence, if you
would avoid the by-paths that lead astray from morality. And
yet what avail all your dear-bought, dear- wrung joys, if you do
not possess health ?
And vet how often is this disturbed — how numerous are the
lesser aud greater degrees of ill-health — how innumerably great
the multitude of diseases, weaknesses and pains, which bow man
down as he climbs with pain and toil towards his aim, and
which terrify and endanger his existence, even when he is sup-
porti^d by the rewards incident to fame, or reposes in the lap of
luxury. And yet, oh man! how lofty is thy descent! how
great and God-like thy destiny ! how noble the object of thy
life 1 Art tliou not destined to approach by the ladder of hal-
lowed impressions, ennobling deeds, all-penetrating knowledge,
even towards the great Spirit whom all the inhabitants of the
universe worship ? Can that Divine Spirit who gave thee thy
soul, and winged thee for such high entcr])rizes, have designed
that you should be h(dpU'.^di/ and irrewfUuhly oppressed by thoee
trivial boclilv ailments which we call diseases?
All, no! The Author of all good, when he allowed diseases
' Publi:«hcd at Loipzic in 1805.
JBCVLAFIUS IN THE BALANCE. 411
to injure his ofbpring, must have laid down a means by which
those torments might be lessened or removed. Let ns trace the
impressions of this, the noblest of all arts which lias been de-
voted to the use of perishing mortals. This art must be possible
— ^this art which can make so many happy ; it must not only be
possible, but already exist. Every now and then a man is res-
cued, as by miracle, from some fatal disease ! Do we not find
recorded in the writings of physicians of all ages, cures in which
the disturbance of the health was so great that no other termi-
nation than a miserable death seemed possible? Yet such
cases have been rapidly and effectually cured, and perfect health
restored.
But how seldom have these brilliant cures been eflxycted when
they were not rather ascribable, either to the force of youth
over-mastering the disease, or to the unreckonod influence of
various fortunate circumstances, than to the medicines employed.
But even were the number of such perfect cures greater than I
observe them to be, does it follow from that that we can iniitnte
them with similarly happy results? They stand isolated in the
history of the human race, and they can but very seldom, if at
all, be reproduced as they were at first occasionecl. All we see
ifl^ that great cures are possible : but how they are to bo effected,
what the power, and the particular circumstances by which they
were accomplished, and how these are to be controlled so that
we may transfer them to other eases, is quite beyond our ken.
Perhaps the art of healing does not mhsiM in avrh transferences.
This much is certain : an art of medicine exists, but not in our
heads, nor in our symptoms.
"But," it is urged in reply, " are not people cured every day
in the hands of thoughtful ])hysicians, even of very ordinary
doctors, nay, even of most egregious blockheads?*'
Certainly they are; but mark what happens. The majority
of cases, for the treatment of which a pliysician is called in, are
of acute diseases, that is, aberrations from health which have
onlv a short course to run before thev terminate either in re-
ml .
covery or death. If the i)atient die, the physician follows his
remains modestly to the grave ; if he recover, then must his
natural strength have been sufficient to overcome both the force
of the di.sease and the usually obstructing action of the drugs
he took; and the powers of nature of\en sulfiee to overcome
both.
Ill epidemic dysentery, just as many of those who follow the
412 JKCULAPIUS IV THE HAT,AKflK.
indications afforded by nature^ without taking any medicine ai
all, recover, as of those who are treated according ip the method
of Brown, of Stoll, of C. L. Hoffman, of Eichter;sif Vogler, or
by any other system. Many die, too, both of those treated by
all these methods, and of those who took no medicine ; on an
average just as many of the one as of the other. .. And yet all
the physicians and quacks who attended those y^o recovered,
boasted of having effected a cure by their skill. .^ What is the
inference ? Certainly not that they were all right /n their moda
of treatment ; but perhaps, that they were all equally wrong.
What presumption for each to claim, as he did^ the credit of
curing a disease, which in the milder cases uniformly recovered
of itself, if gross errors in diet were not committed I
It were easy to run through a catalogue of similar acute dis-
eases, and show that the restoration of persons wh^ in the same
disease were treated on wholly opposite principles could not be
called cure, but a spontaneous recovery. ^
Until you can say, during the prevalence of an ^idemic dys-
entery for example, ^^ Fix upon those patients whom you mi
other experienced persons consider to be most dangerously ill|
and these I will cure, and cure rapidly and withoi|^ bad conae*
quences." Until you can say this, and can do it, you ought not
to vaunt that you can cure the dysentery. Your cures are
nothing but siwntaneous recovery. t,
Often — the thought is saddening 1 — ^patients recin^er as by a
luiracle when the multitude of anxiously changed and often re*
l)eated nauseoiLs drugs prescribed by the physiciaa'is suddenly
left off or clandestinely discontinued. For fear of giving offence^
the patients frequently conceal what they have done, and appear
before the public as if they had been cured by the physician.
In numerous instances, many a prostrate patient I^as effected a
miraculous cure upon himself not only by refusing the phy-
sician^s medicine, but by secretly transgressing his arti£cial and
often mischievous system of diet, in obedience to his own caprice^
which is in this instance an imperious instinct impelling him to
commit all sorts of dietetic paradoxes. Pork, sour-crout, potato*
salad, herring, oysters, eggs, pastry, brandy, wine, pjpinch, coffee^
and other things most strongly prohibited by the. physician^
have effected the most rapid cure of disease in patients, who, to
all appearance, would have hastened to their grave had they
.submitted to the system of diet prescribed by the schools.
Of such a kind are the apparent cures of acute diseases. For
^nOULAFIUB IN THE BALANCX. 418
those benefidiil and nseftQ regulations for the arrest of pestilen-
tial epidemios, by catting off commnnication with the affected
district, by separation and removal of the sick from the healthy ;
by fbmigation of the affected abodes and fiimiture with nitric
and muriatic add, &c., are wise police regulations, but are not
medicinal cures.
In the infected spots themselves, where a further separation of
the inlected'^m the healthy is not to be thought of, there the
nullity of medicine is exhibited. There die all, if one may be
allowed the expression, who can die, without being influenced
by Galen, Boerhave, or Brown, and those only who are not ripe
&rdeath recover. Nurses, physicians, apothecaries, and surgeons,
are all alike borne to their grave.
At the same time it is undeniable, that even in such calamities,
80 hnmiliating to the pride of our art, occasional, but rare cures
oocor, effected obviously by medicine, of so striking a character,
that one is astonished at so daring a rescue from the very jaws
of death ; these are the hints afforded by the Author of life,
"that thebe is a healing art."
But iow did it act here? What medicine did the real good?
What were the minute particulars of the disease, in order that
we may imitate the procedure when such a case recurs ? Alas !
these particulars are and must remain unknown ; the case was
either not particularly observed or not reported with sufficient
exactness. And the medicine ? No ; a single medicine was
not given ; it was, as all learned recipes must be, an elixir, a
powder, a mixture, &c., each composed of a number of medicinal
substances. Heaven knows which of them all did good. * "The
patient also drank an inf\ision of a variety of herbs ; the com-
{K)sition of this I do not recollect, nor does the patient remember
the precise quantity he took."
How can any one imitate such an experiment in an apparently
similar case, since neither the remedy nor the case are accurately
^ Let it Dot be asserted *' that all the substances only did good because of their
oombnuition, that nought must be added to nothing tiiken from it, to enable us to re-
peat ihe fiKt.** But many ingredients are never of equal goodness and power in any
two flipfnittfl* ihopa, not even in the same shop at different times. Even the same
nuiture will bo different in the same shop to-morrow to wliat it was toniay, according
It one ingredient was added sooner than the other, more fully pulverized, or rubbed-
vpmonatroDgly with the other ingredients, according as the atmwpheric temperature
was lower to-day, to-morrow higher, the ingredients more accurately measured to-day
ttan to-morrow, or according as the preparer of the prescription was more attentive
UhUj, leea to-mocrow ; and many other drcumstances may occur to roar human
cafedatkni.
414 JE8CULAPIUS IN THE BALANC&
known? Hence all the results attempted by future imitators
deceptive; the whole fact is lost for posterity. All we see i^
that cure is possible ; but how is it to be effected, and how an
indefinite case can tend to perfect the art of medicine, that we
do not see.
"But," I hear exclaimed, "you must not be too severe upoii
physicians, who are but men, amid the hurry and bustle which
iniectious diseases in circumscribed spots bring with them."
" In chronic diseases he will come off more triumphant ; in
these he has time and cool blood at his service in order to exhibit
openly the truth of his art ; and in despite of Moli^, Patin,
AgL'ippa, Yalesius, Cardanus, Eosseau and Arcesilas, he will show
that he can heal not only tliose who would get well of themselves^
but that he can cure what he will and what he is asked to cure."
Would to Ileaven it were so ! But as a proof that physiciana
feel themselves very weak in chronic diseases, they avoid the
treatment of them as much as possible. Let a physician be
called to an elderly man, paralyzed for some years, and let him
be asked to exhibit his skill. Naturally he does not openly avow
how impotent this art is in his hands, but he betakes himself to
some by-way of escape — shrugs his shoulders— obser\'es that
the patient's strength is not sufficient to enable him to undei^
the treatment (in general, a very exhausting, debilitating proce-
dure in the hands of ordinary practitioners), sj)eaks with a com-
passionate air of the unfavourable season and inclement weather,
which must lirst be over, and of the healing herbs of spring,
which must be waited for before the cure can be attempted, or
of Ri^riic far-distant mineral waters where such cures have been
made, and whither, if his life be spared, the patient will be able
to proceed in the course of six or eight months. In the mean-
time, not to expose himself, he orders something, of the cflectB
of which he is not sure ; this he does in order to amuse the
patient and to make a little money out of him at the same time ;
but certain relief he cannot give. At one time he wishes to
remove the asthenia by internal or external stimulants; at
another fortify the tone of the muscular fibre with a multitude
of bitter extracts,* whose effects he kno\rs not, or strengthen the
digestive apparatus with cinchona bark ; or he seeks to purify
and cool the blood by a decoction of equally unknown plants,
' Wv t>iU'n H'ud iu the hUtcxies of cases, even of di^tinguL'ih<Kl plivsioiAn<«. sucli
«iU-ervu(k>us ad tLuc ** I n:>w ^ave the patioDt the bitter extracts'* — as if t]io Utiur
Vf^ctablc fruUntuiices vera uut all very ▼.irious in tlieir peculiar actioi» !
JB0ULAPIU8 IN THE BALANCE. 415
or by means of saline, metallic and vegetable substance of prob-
lematic utility, to rasolve and dissipate suspected but never ob-
served obstructions in the glands and minute ves.sc1s of the
abdomen ; or by means of purgatives ho thinks to ex]>el certain
impurities which exist only in his imagination, and thereby
hasten bya/tw hours the sluggish evacuations. Now he directs
hischarge against the principle of gout; now against a su})pressed
gonorrhoea ; now against a psoric acridity, anon against some
other kind of acridity. lie elfects a change, but not the change
he wished. Gradually, under the pretext of urgent bu.siness,
the physician withdraws from the patient, couifortiiig liimself
and at length the pati<Mit\s friends when thi^y press him for his
i^nion, that in such cases his art is too weak.
And that his so vaunted art is too weak, on tliis comfortable,
soft pillow he reposes in cases of gout, consumption , old ulcers,
oontractions and so-called dropsies, cachexias of innumerable
varieties, spasmodic asthmas, angina pect«.>ris, ]>ains, spasms,
cutaneous eruptions, debility, mental affections of many kinds,
and I know not how many other chronic diseases.
In no other case is the insuQiciency of our ait so strongly and
so unpardonably manifested as in those distressing dis<.'ases from
which hardly any family is altogether free ; hardly any in which
some one of the circle diX'S not secretly sigh over ailments, for
which he has tried the so-called skill ori)liyMeiaiis lar and near.
In silence the alHicteJ sutl'erer steals «.)U his nielaiieholy way,
borne down with miseral»le sulUring, and, desjjairiiig in human
aid, seeks a solace in religion.
•'Yes," I hear the medical seho<;l whisj'er with a s^vming
compassionate shrug, '* Yes. these are notoriously incurable evils:
our books tell us thev are incurable." As ii' il could eum fort
the million of sullerers lo be told of the vain impotence (»t' ouv
art! As if the Creator of these sullerers iiad not j»rovided
remedies for tliem also, and as if for them the s(»uree of b«nin(l-
less goodness did not exist, eom])ared to which the teudercst
mothers love is tis thick clouds beside the glorv of the noon-
day sun !
"Yes,'' I hear the school continue toapolui/i/.o, '* the thousand
defects in our civic constitution, the artilieiah eouiplieated mode
of life so far removt^d from, nature, the chauieleon-like luxury
enervating and deranging our natural coiLstitutii>n, are answerable
for the incurable chara<tter of all the.se evils. (.)ur art is tj[uite
excused for being incapable of the cure ^A .-a-, li casv.s.''
Can you then believe that tlie Preserver ol' our uiee, ihe All-
416 .S0ULAPIU8 IN THE BALAITOB.
wise, did not design these complexities of our civic oonstitatian
and our artificial mode of life to increase our enjoyment hera^
and to remove misery and suffering? What extraordinary
kind of living can that be to which man cannot accustom him*
self without any great disturbance of his health ? The fiU of
the seal and the train-oil eaten with bread made of dried fiih
bones as little prevents the Greenlander from enjoying heallii
in general, as does the imvaried milk-diet of the shepherds oa
the Swiss mountains, the purely vegetable food of the poorar
Germans, or the highly animal diet of the wealthy Englishman^
Does not the Vienna nobleman accustom himself to his tweaty
or thirty covers, and does he not enjoy just as much health aa
the Chinese with his thin rice soup, the Saxon miner with no-
thing but potatoes, the South Sea Islander with his roasted bread-
fruit, and the Scottish highlander with his oatmeal cakes?
T am ready to admit that the contest of conflicting passions
and of many other enjoyments, the luxurious refinement^ and
the absence of exercise in fresh air that prevail in the labyrinth*
ine palaces of great cities, may give occasion to more numercyoi
and more rare diseases than the simple uniformity that obtains
iu the airy hut of the humble villager. But that does not nift>
terially alter the matter. For our medical art is as impotent
against the water colic of the peasant of lower Saxony, the
Tsonier of Hungary and Transylvania, the Radesygeoi Norway,
the Stbbem of Scotland, the Hotme of Lapland, the Pdagra of
Lombardy, the Plica Polonica of certain Sclavonic tribefl, and
various other diseases prevalent among the simple peasantry of
various countries, as it is against the more aristocratic disorders of
high life in our large towns. Must there be one kind of medical
art for the former, and another for the latter: or if it were only
once discovered, would it not be equally applicable to both?
I should think so !
It may not certainly exist in our books, nor yet in our heads,
nor be taught in our schools, but there is such a thing for aU
that; it is a possibility.
Occasionally a regular brother practitioner stumbles by a lucky
hit upon a cure which astonishes half the world about him, and
not less himself; but among the many medicines he employed
he is by no means sure which did good. Not less frequently does
the neck-or-uothing practitioner, without a degree, whom the
world calls a quack, make as great and wonderful a cure. Bnt
neither he nor yet his worshipful brother practitioner with a
JBCVLAPinS m THE BALAKCX. 417
diploma knows how to eliminate the evident and fruitful truth
which the core contains. Neither can separate and record the
medicine which certainly was of use out of the mass of useless
«nd ohstructing ones tbey employed ; neither precisely indicates
the case in which it did good, and in which it will certainly
benefit again. Neither, knows how to abstract a truth which will
hold good in all future time, an appropriate, certain, unfailing
remedy for every such case that may occur hereafter. His ex-^
perience in this case, remarkable though it seemed, will almost
never be of service to him in any other. All that we learn is,
that a helpful system of medicine is possible; but &om these and
a hundred other cases it is quite manifest that as yet it has not
attained the rank of a science, that even the way has yet to be
discoYered how such a science is to be learned and taught. As
fiu" as we are concerned, it cannot be said to exist.
Meanwhile, among these brilliant but rare cures there are many
(vulgarly called Pferdecuren [horse cures], which, however great
the noise they might make, are not of a character to be imitated,
M&i TnortaU^ madly desperate attempts by means of the most
powerful drugs in enormous doses, which brought the patient
into the most imminent danger, in which life and death wrestled
for the mastery, and in which a slight unforeseen preponderance
on the side of kind nature gave the fortunate turn to the case :
the patient recovered himself and escaj^ed from the very jaws of
death.
A treatment with a couple of scruples of jalap-resin to the
dose is by no means inferior in severity to the helleborism of the
ancient Greek and Eoman physicians.
Such modes of treatment are not very unlike murders, the
result alone renders them uncriminal, and almost imparts to
them the lustre of a good action, the saving of a life. *
This cannot be the divine art, that like the mighty working of
nature should effect the greatest deeds simply, mildly, and un-
obeervably, by means of the smallest agencies.
The ordinary practice of the majority of our practitioners in
Uieir treatment of diseases resembles these horrible revolutionary
cures. They partially attain their object, but in a hurtful way.
Thus they have to treat, for example, an unknown disease ac-
' Thu3 a cruel uniirjxir vibratos betwixt tlic scvilfiild aiiJ tho tliruuu, a small un-
fortunate accident brings hi«5 head to the block, ami he «lics auiiiUt the curses of the
or a small moment of luck tliat did not enter into his calculations puts the
en his fattid, and the same nation ialls down and worships him.
27
418 jkscxjImAfivb in the balance.
oompanied by general swelling. On account of tbe swelling it
is in their eyes a disease of daily occurrence ; without hesitaiti(m
they call it dropsy (just as if a single symptom constituted tbe
essential nature of the whole disease I), and they briskly set to
work with the remark : ^Hhe water must be drawn off, and then
all will be right." Away they go at it, attacking it with a fi^
quent repetition of drastic (so-called hydragogue) purgatives, and,
see ! what a wonderful event takes place — the abdomen faik, the
arms, the legs and the face grow quite thin I ^^Look what I can
do, what is in the power of my art; this most serious disease^
the dropsy, is conquered! with only this slight disadvantage,
that a new disease, which nobody anticipated, is come in its plaoe
(property, has been brought on by the excessive purgation), a
confounded lientery, which we must now combat with new
weapons."
Thus the worthy man comforts hiniself from time to time, and
yet it is impossible that such a procedure can be called a cur^
where the disease, by means of violent unsuitable medicines^
only loses a portion of its outward form and gains a new one ;
the change of one disease for another is not a cure*
The more I examine the ordinary cures, the more I am con-
vinced, that they are not direct transformations of the disease
treated into health, but revolutionizings, disturbances of the order
of things by medicines, which, without being actually appro-
priate, possessed power enough to give matters another (nK>rbid)
«hape. These are what are called cures.
'^The hysterical ailments of yonder lady were successfully re-
moved by me !"
No! they were only changed into a metrorrhagia. After some
time I am greeted by a shout of triumph : "Excuse me ! I have
also succeeded in putting a stop to the uterine hfemorrhage.'*
But do you not see how, on the other hand, the skin has be-
come sallow, the white of the eye has acquired a yellow hue,
the motions have become greyish-white, and the urine orange-
coloured.
And thus the so-called cures go on like the shifting scenes of
one and the same tragedy I
The most successful cases among them arc still those where
the revolution effected by the drug developes a new disease of
such a sort, that nature, so to speak, is so much occupied with
it as to forget the old original disease and let it go about its
but^iness, and is engaged with the artificial one until some luckj
uBSOULAFIUS IN THE BALANCE. 419
ciTcmiistanoe liberates it from the latter. There are several
kinds of such lucky circumstances. The leaving off of the me*
didne — ^youthful vigour — the commencement of the menstrual
flow or its cessation at the proper periods of life — a fortunate
domestio occurrence — or (but this is certainly of rare occurrence,
still it sometimes happens like a ternion in the game of lotto)
among the many medicines prescribed pell mell^ there lay one
that was appropriate and adapted to the circumstances of the
case— ^ in i^l these instances a cure may occur.
In like manner, mistakes of the chemist respecting the medi-
cines and sig^ in prescriptions have often been the occasion of
wonderful cures. But are such circumstances recommendations
for the (till now) most uncertain of all arts ? I should rather
think not
By treatment the ordinary physician often understands nothing
more than a powerful, violent attack upon the body with things
that are to be found in the chemist's shop, with an alteration of
the diet, sfcundnm artem, to one of a very extraordinary, very
meagre character. "The patient must tirst be powerfully afiect^
before I can do him any good ; I wish I could but once get him
regularly laid up in bed !" But that the transition from bed to
the straw and the coffin is so very easy, infinitely easier than to
health, he says nothing about that.
The physician of the stimulating school is in the habit of pre-
scribing in almost every case an exactly opposite diet (such is
the custom of his sect) : ham, strong meat soups, brandy, &c.,
often in cases where the very smell of meat makes the patient
sick, and he can bear nothing but cold water ; but Jie too is by
no means sparing in his use of violent remedies in enormous
doses.
The schools of both the former and the latter class authorise
a revolutionary procedure of this sort : " No child's play with
your doses,'' say they, "go boldly and energetically to work,
giving them strong, as strong as possible!" And they are right
if treating means the same ihing as knocking down.
How does it happen that, in the thirty-live centuries since
ifisculapius lived, this so indispensable art of medicine has made
so little progress? What was the obstacle ? for what the phy-
sicians have already done is not one huTi<]ro<ith part of what they
might and ought to have done.
All niitions, even jemotcly api)ro:icliing a state of civilization,
perceived, from the first, the necessity and iiiestimable value of
420 jISOUlapius in ths balanoi.
this art; they lequired its praotioefix)in a caste who caQedtheoi'
selves physicians. These affected, in almost all ageB, when they
came in contact with the sick, to be in perfect possession of this
art ; but among themselves they sought to gloze over the gaps
and inconsistencies of their knowledge by heaping system upon
system, each made up of the diversified materials of conjectures,
opinions, definitions, postulates, and predicates, linked together
by scholastic syllogisms, in order to enable each leader of a sect
to boast respecting his own system, that here he had built a
temple for the goddess of health — a temple worthy of her — in
which the inquirer would be answered by pure and salutary
oracles.
It was only the most ancient times that formed an exception
to this rule.
We were never nearer the discovery of the science of medidne
than in the time of Hippocrates. This attentive, unsophisticated
observer sought nature in nature. lie saw and described the
diseases before him accurately, without addition, without colour-
ing, without speculation.^ In the faculty of pure observation he
has been surpassed by no physician that has followed him. Only
one important part of the medical art was this fiivoured son of
nature destitute of, else had he been completely master of his
art; the knowledge of medicines and their application. But he
did not affect such a knowledge — ^he acknowledged his deficiency
in that he gave almost no medicines (because he knew them too
imperfectly), and trusted almost entirely to diet,
AH succeeding ages degenerated and wandered more or less
from the indicated path, the later sects of the empirics — worthy
of all respect — ^and to a certain degree, Aretaeus,* excepted.
Sophistical whimsicalities were pressed into the service. Some
sought the origin of disease in a universal hostile principle, in
some poison which produced all maladies, and which was to be
contended with and destroyed. Hence the universal antidote
which was to cure all diseases, called Uieriaca^ composed of an
innumerable multitude of ingredients, and more lately the
mithridatium^ and similar compounds, celebrated from the time
* The Bpeculative writings tmder his name are not his, neither are the three iMt
hooHa of the aphorisms. The want of the Hippocratic loQicisms, the absence of
the Tery peculiar language of this man, must oonrince any one of this, who knova
any thing about such matters.
* Graphic as are hia descriptions of disease, ho yet only described them amalga-
mated together in complete classes, from many individual cases of disease : thk Hip-
pocrataa did not di\ birt modem pathologists do it
r
.SSOUIiAPIUS IK THE BALANCE. 421
of Nicander down almost to our own day. From these ancient
times came the unhappy idea, that if a sufficient number of
drags were mixed in the receipt, it could scarcely £ul to con*
tain the one capable of triumphing over the enemy of health —
while all the time the action of each individual ingredient was
little^ or not at all known. And to this practice Galen, Celsus,
the later Greek and Arabian physicians, and, on the revival of
the study of medicine in Bologna, Padua, Seville, and Paris, in
the middle ages, the schools there established, and aU succeed-
ing ones, have adhered.
In this great period of nearly two thousand years, was the
pure observation of disease neglected. The wish was to be
more scientific, and to discover the hidden causes of diseases.
These once discovered, then it were an easy (?) task to find out
remedies for them. Galen devised a system for this purpose, his
four qualities with their different degrees ; and until the last
hundred and fifty years his system was worshipped over our
whole hemisphere, as the nonplus tdtra of medical truth. But
these phantoms did not advance the practical art of healing by
a hair's breadth ; it rather retrograded.
After it had become more easy to communicate thought, to
obtain a name by writing hypotheses, and when the writings of
others could be more cheaply read — in a word, after the dis-
covery of printing — the systems rapidly increased, and they
have crowded one on another up to our own day. There was
now the influence of the stars, now that of evil spirits and
witchcraft ; anon came the alchymist with his salt, sulphur, and
mercury ; then Silvius, with his acids, biles, and mucus ; then
the iatromathematicians and mechanical sect, who explained
every thing by tlie shape of the smallest parts, their weight,
pressure, friction, &c. ; to these succeeded the humoral patholo-
gists, with certain acridities of the fluids ; then the tone of the
fibres and the abnormal state of the nerves was insisted on by
the solidists ; then, according to Eeil, much was due to the in-
ternal composition and form of the most minute parts, while the
chemists found a fruitful cause of disease in the development of
various gases. How Brown explained disease with his theory
of excitability, and how he wished to oiiil>race the whole art
with a couple of postulates, is still fresh in our recollection ; to
say nothing of the ludicrously loit\% gigantic undertaking of the
natural philosophers !
Physicians no longer tried to see diseases as they were ; what
422 JBSCULAPIUS IN THB BALAKCS.
they saw did not satisfy them, but they wished by a priort rea-
aoning to find out an undisooverable source of disease in regions
of speculation which are not to be penetrated by terrestrial
mortal. Our system-builders delighted in these metaphysical
heights, where it was so easy to win territory; for in the
boundless region of speculation every one becomes a ruler who
can most effectually elevate himself beyond the domain of the
senses. The superhuman aspect they derived from the erection
of these stupendous castles in the air concealed their poverty in
the art of healing.
" But, since the discovery of printing, the preliminary scieneeB
of the physician, especially natural history and natural philoso-
phy, and, in particular, the anatomy of the human body, phy-
siology, and botany, have greatly advanced."
True : but it is worthy of the deepest reflection how it comes
that these useful sciences, which have so manifestly increased
the knowledge of the physician, have contributed so little to the
improvement of his art ; their direct influence is most insignifi-
cant, and the time was when the abuse of these sciences ob-
structed the practical art of healing.
Then the anatomist took upon him to explain the functions
of the living body ; and, by his knowledge of the position of
the internal parts, to elucidate even the phenomena of disease.
Then were the membranes, or the cellular tissue of one intestine^
continuations of the membranes or cellular tissue of another or
of a third intestine ; and so, according to them, was the whole
mystery of the metastasis of diseases unravelled to a hair. 14"
that did not prove sufficient, they were not long in discovering
some nervous filament to serve as a bridge for the transpor-
tation of a disease from one part of the body to another, or some
other unfruitful speculations of the same kind. After the ab-
sorbents were discovered, anatomy immediately took upon her-
self to instruct physicians in what way medicines must permeate
them, in order to get to that spot of the body where their reme-
dial power was wanted ; and there were many more of such
material demonstrations put forward^ much to the retardation
of our art. It often reigned despotically, and refused to ac-
knowledge every physician who handled his scalpel otherwise
than according to the mode taught in the schools — who eould
not, without hesitation, give the name of each little depression
on the sui'facc of a bone, who could not, ou the instant^ give thu
JBBOULAPIVS IN* THE BALANCS. 423
<nigiii and infiertion of every smallest muscle (whick sometimes
<ml7 owed its individual existence to the scalpel). The exami-
Bation of a physieiaa for a degree consisted almost solely iu
aoatomy : this he was obliged to know off by heart, with a
most pedantic precision ; and if he did this, then he was pre-
pared to practise.
Physiology, until Haller's time, looked only through the
spectacles of hypothetical couceits, gross me(Aianieal explana*
tions, and pretensions to systems, until this great man under*
took the task of founding the knowledge of the phenomena oi
the human body upon sensible observation and truthful experi-
ence alone. Little has been added since his time, except so far
as newly-discovered products, newly-discovered physical pow-
ers and law^ have conspired to explain the constitution of our
frame. But from these, little has been incontrovertibly estab-
lished.
In general, natural philosophy often offered its services, some-
what presumptuously, to explain the phenomena in the healthy
and diseased body. Then were the manifest laws which, in the
inorganic world, regulate the extrication, confinement, and dif-
fiision of calorio, and the phenomena of electricity and galvan-
ism, applied, without change and without any exception, to the
explanation of vital operations ; and there were many prema-
ture eonclusions of a similar kincL
But none of the preliminary sciences has assumed so arrogant
a plaae as chemistry. It is, indeed, a Cict that chemistry ex-
plains certain appearances of the healthy as well as tlie disease<l
body, and is a guide to the pre|>aration of various medicines:
but it is incredible how often it has usairjved the riglit of ex-
plaining all physiologieal and pathological phenomena, and
how much it has distinguished itself l)y autliori.sing this or tlud
medicine. Gren, TromsdorftJ and Lipliardt, may serve as warn-
ing examples of this-
It is, I repeat, a matter for more serioiLS reflection, that while
&ese accessory sciences of medicine (in themselves most com-
mendable) hax- e advanced within these last ten years to a lieight
and a maturity whicli seems not to be capable of much further
advancement, yet, notwithstanding, they Lave had no inarke<i
benefkjial influence on tiie treatment of disease.
Let us consider how tliis has hapj)ened.
Anatomy shews us the outside of every part which can Ixt
iepanaied with the kniie, the j^w. or bj nmceration ; but th^i^
4M iBSCULAPIUS IN THS BALANGl.
deep internal changes it does not enable us to see; even when
we examine the intestines, still it is only a view of the outside
of these internal surfsLces that we obtain ; and even were we to
open live animals, or, like Herophilus, of cruel memory, disseot
men alive, so little could we penetrate the minute structure of
parts lying remote &om view, that even the most inquisitiye
and attentive observer would relinquish the task in dissatisfibo-
tion. Nor do yfe make much greater discoveries with the
microscope, unless the refracting power favour us with optioal
illusions. We see only the outside of organs, we see only their
grosser substance ; but into the innermost depths of their being,
and into the connexion of their secret operations no mortal eye
can ever pierce.
By means of pure observation and unprejudiced reflection, in
connexion with anatomy, natural philosophy, and chemistry^
we have a considerable store of very probable conclusions re-.
garding the operations and vital phenomena of the himianbodj
{phy8iohgy\ because the phenomena in what is called a healthy
body remain pretty constant, and hence can be observed fire-
quently and, for the purposes of comparison^ from all the differ>
ent ppints of view afforded by the various branches of know-^
ledge bearing upon them. But it is no less true, than striking
atad humbling, that this anthropological or physiological know-
ledge begins to prove of no use as soon as the system departa
from its state of health. All explanations of morbid processes
from what we know of healthy ones, are deceptive, approaching
more or less to what is untrue ; at all events, positive proofe of
the reality and truth of these transferred explanations are unat-*
tainable ; they are from time to time refuted by the highest of
all tribunals — experience. Just because an explanation answers
for the healthy state of the frame, it will not answer for the dia-*
eased. We may admit it or not as we please, but it is too true,
that in the moment when we attempt to regard the state of the
disease physiologically, there drops before our previously clear
light of physiology a thick veil — a partition which prevents all
vision. Our physiological skill is quite at fault when we have
to explain the phenomena of morbid action. There is almost no
part of it applicable I True, we can give a sort of fBtr-fetched
explanation, by making a forced transference and application of
the physiological systems to pathological phenomena ; but it is
only illusory and misleads into error.
Chemistry should never attempt to offer an explanation of the.
JUGULAPIUS IN THE BALANCE. 425
limonnal performances of the functions in the diseased body,
flince it is so unsaccessful in explaining them in the healthy
fltate. When it predicts what, according to its laws, must hap-
peOf then something quite different takes place ; and if the vi-
tdity oyennasters chemistry in the healthy body, how much
more must it do so in the diseased, which is exposed to the in-
fluence of so many more unknown forces. And just as little
should chemistry imdertake to give a decision upon the suitable-
ness or worthlessness of medicines, for it is altogether out of its
^here of vision to determine what is properly healing or hurt-
fbl, and it possesses no principle and no standard by which
the healing eflicacy of medicines, in different diseases, can be
measured or judged of.
Thus has the healing artist for ever stood alone — I might say
fiirsaken — ^forsaken by all his renowned auxiliary sciences — for-
saken by all his transcendental explanations and speculative
sjrstems. All these assistants were mute, when, for example,
lie stumbled upon an intermittent fever which would not yield
to purgatives and cinchona bark.
" What is to be done here ? what is with sure confidence to be
set about ?" he inquires of these his oracles. — Profound silence.
— (And thus they remain silent up to the present hour, in most
oases, these fine oracles.)
He reflects upon the matter, and comes, after the fashion of
men, to the foolish notion, that his uncertainty what to do here
arises from his not knowing tlie internal nature of intermittent
fever. — ^He searches in his books, in some twenty of the most
celebrated systematic works, and finds (unless they have copied
from one another) as many different explanations of intermittent
fever as books he examines. Which of them is he to take for
his guide ? They contradict one another.
By this road he finds he will make no progress.
He will let intermittent fever just be intermittent fever, and
turns his attention solely to learn what medicines the experience
cf bygone ages has discovered for intermittent fever, besides
cinchona bark and evacuants. He proceeds to search, and to
his amazement discovers that an immense number of medicines
have been celebrated in intermittent fever.
Where is he to begin ? Which medicine is he to give first ;
which next, and which last ? He looks round for aid, but no
directing angel appears, no Hercules in hiuif^y, no heavenly inspira-
tion whispers in his ear which of all the number he ought to
select.
426 .SSCULAPIUS IN THE BALAHGI.
What is more natural, what more appropriate to the weaknes
of man, than that he should adopt the unhappj resolution (the
resolution of almost all ordinary physicians in similar cas^ 1),
" that as he has nothing to direct his choice to the best, he had
better give a number of the most celebrated febrifuge medicines
mixed together in one prescription. How will he ever otherwise
get to the end of the long list, imless he take several at a time?
As he can find no one who can tell him if there is any differ-
ence in the actions of these different substances, he considers it
better to mix together many than few ;^ and if the operation of
each of these different ingredients really differs fix>m that of the
others, it would certainly, he thinks, be better, in this case, to
collect several and many such reputedly antifebrile substanoes
in one receipt."
" Among the many substances in his elixirs, pills, electuarieSi
mixtures, and infusions, surely (thus he philosophizes) there
must be one which will do good. Perhaps the most effectual
happens also to be the freshest and most powerful medicine
therein ; and perhaps the substances less adapted or even ob-
structive to the cure, are happily the weakest in yonder chemist's
shop. Perhaps ! yes we must hope for the best, and trust to
good luck! ''
Periculosae p>lenum opus aleae I What are we to think of a
science, the operations of which are founded upon perhapses and
blind chance.
But suppose the first or second, or all the trains of mixed
drugs have not done any good, then I must ask, whence did
your authors derive the information, that A or B, or Y or Z,
was useful in intermittent fever ?
" It stands written of each of these remedies in the works on
Materia Medica."
But whence is their knowledge obtained ? Do the authors of
' The learned excuse for the great complexity of our ordinarjjr prescriptioos, ''thai
most of the ingredients were added from rational reasons, that is to say, oo aoooool
of the particular indications in each case— and that regular prescriptions must haT»
an orthodox form, a ban* (fundamental medicine), a corrective (something added m
order to correct the faults of the basis), an adjuvant (an auxiliary substance to sap>
pqft the weakness of the basis), and an excipient (a substance that supplies the form
and yehicle) — Is partly palpable Bch(x>l-cunning, like the latter excuse — partly fiuier,
like tlie former. For why does) Uie opium you odd not cause sleep, why do your
additions of neutral bolts fail to op<:n the bowels, and your aqua sambuci to keep the
skin moitit ? Why does that not happen, as a rule, for which you added each par-
ticular substance, if it was propprly indicated at* you allege !
JBOULAPIUS IN THE BALANCS. 427
these books anywhere assert that they themselves have given
otch of these substances alone and uncombined in intermittent
fever?
" Oh no I Some give authorities, or quote otlier works on
Materia Medica ; others make the statement without any refer-
ence to its source."
Turn up the original authorities !
" The most of these have been convinced not by personal ex-
perience ; they again refer to some antiquated works on Materia
Medica, or such authorities as these : Kay, Tabcrnsemontanus,
Trajus, Fucha, Toumefort, Bauhin, and Lange."
And these?
"Some of them refer to the results of domestic practice; —
peasants and uneducated persons, in tliis or that district, have
found this or that medicine useful in a particular case."
And the other authorities ?
" Why, they aver that they did not give the medicine by it-
self but, as it became learned physicians to do, combined with
other simples, and found advantage from it. Still it was their
impression that it was this drug, and not the other sim})les, that
was of service."
A fine thing to rely on, truly, a most delightful conviction,
grounded upon opinions destitute even of probability !
In one word: the primary origin of almost all authorities for
the action of a simple medicine is derived, cither from the con-
fused use of it, in combination witli other drugs, or from do-
mestic practice, where this or that uni)rofessional person had
tried it with success in this or that disease (iis if an unprofes-
sional person could distinguish one disease from anotlicr).
Truly this is a most unsatisfactory and turbid source for our
proud Materia Medica. For if some of the common people had
not, at their own risk, undertaken experiments, and communicated
the results of these, we should not have known even the little we
do at present about the action of most medicines. For, with the
exception of what a few distinguished men, to wit, Conrad Ges-
ner, Stoerk, Cullen, Alexander, Costc, Willemct, have done, by
administering simple medicines alone and uncombined, in certain
diseases, or to persons in liealth, the rest is nothing but opinion,
illusion, deception. Martin Ilerz thouglit the watcr-hcmlock
cured phthisis, although he gave it combined with various
other drugs.* On the other hand, to nic the statement of Lange
' ThU is the general but most unjustifiable procedure of our medical practitioners:
428 iBScuLAPins in the balabtcb.
(in his Med. DomesL Brunsv,) is of much greater weight, namely,
that the common people have employed it uncombined in thifl
disease, frequently with good effect, than what the worthy doc-
tor thought; and for this simple reason, because he gave it mixed
with other drugs, while the others gave it simply by itself
The Materia Medica of remote antiquity was not worse ftir-
nished. Its sources were then the histories of cures effected by
simples, recorded in the votive tablets; and Dioscorides and
Pliny have manifestly derived their account of the operation of
simple medicines from the rude observations of the common
people. Thus, after the lapse of a couple of thousands of yearB,
we are not a step advanced ! The only source of our knowledge
of the powers of medicines, how troubled is it I and the learned
choir of physicians in this enlightened century, contents itself
with it, in the most serious contingency of mortals, when the
most precious of earthly possessions — ^life and health — ^are at
stake I No wonder that the consequences are what they are.
He who, afl«r such experience of the past, still expects that
the art of medicine will ever make a single step towards perfeo-
tion by this road, to such a one nature has denied all capacity
of distinguishing between the probable and the impossible.
To fill to the brim the measure of deception and misappre-
hension attending the administration of medicine to the sick,
the order of apothecaries was instituted, — a guild which depends
for existence on the complicated mixtures of drugs. Never
will the complicated formulas cease to prevail, as long as the
powerful order of apothecaries maintains its great influence.
Unlucky period of the media3val age, which produced a Nico-
laus the ointmentmaker (Myrepsus), from whose work the Anti'
dotaria, and Codices Medicamentarii were compiled in Italy and
Paris ; and in Germany, at first in Niirnberg, about the middle
of the sixteenth century, the first DispemcUorium was written,
by the well-meant zeal of the youthful Valerius Cordus. Before
these unhappy events the apothecaries were merely unprivileged
venders of crude drugs, dealers in simples, druggists ; (at the
utmost they might have some theriac, mithridate, and a few
ointments, plasters, and syrups, of the Galenic stamp, ready on
demand, but this was optional on their part.) The physician
to prescribe nothing by it$elf — no, cdway* in combination with teveral other ihinf9
in an artifltic prescription ! ** No prescription can properly be termed such,** aays
Hofrath Gniner, m Yob Art of Prescribing, " which does not contain sereral ingre>
dieots at oooe " — so, in order to tee clearer, you had better put out your eyes I
JBOULAPIUS IN TH8 BALANCB. 429
bought only from those who had genuine and fi:esh materials,
and mixed these for himself^ according to his own fancy ; but
nobody prevented him &om giving them to his patients in their
simple and uncombined state.
But £rom the time when then the authorities introduced dis-
pensatories— that is, books full of compound medicines, which
were to be kept ready made — it became necessary to form the
apothecaries into a dose corporation, and to give them a mo-
nopoly (on condition that they should have always a stock of
ready prepared medicinal mixtures), whereby their number was
fixed and limited, in order that there should not be too many of
them, which might cause these costly compounds to hang upon
their hands and become spoiled.
It is true, that after the authorising of the complicated mix-
tores in dispensatories, which was the Urst step to mischief, had
been taken, the second— the granting a privilege of the exclu-
sive sale of these expensive mixtures to apothecaries — was nei-
ther an xmexpected nor an unjust proceeeding; but had the
public approval of these senseless mixtures not preceded it, then
the trade in single medicinal substances would have remained
as it was at first; and there would have been no need of apothe-
caries' privileges, from which infinite injury has gradually ac-
crued to the healing art.
The earliest dispensatories, and those nearly down to our
own time, called each compound formula by an alluring name,
after the disease which it was to remove, and after each, the
mode of its administration was described, and numerous com-
mendations of its virtues. By this the young physician was
led to employ these composititions in preference to the simple
medicines, especially as the former were authorised by the go-
vernment.
The privileged apothecaries did what they could to increase
the number of these formulas, for the profit derived, from these
mixtures was immensely greater than would have been derived
from the sale of the simple drugs employed in their composi-
tion ; and thus, gradually, the small octavo dispensatory of Cor-
dus grew into huge folios (the Vienna, Prague, Augsburg, Bran-
denburg, Wirtemburg, &c., dispensatories). And now there
was no known disease for which the dispensatory had not certain
ready-made compounds, or, at least, the formulas for them, ac-
companied by the most eulogistic recommendations of them.
The professor of the healing art was now prepared, when he had
^ .fiSOULAPIUS IK THE BALAKCaS.
such a receipt-book in his hand, — ^fuU of receipts for every dis-
ease, sanctioned by the highest authorities in the land ! Whst
does he want more to make him perfect as a healer of diaeane?
How easy has the great art been made to him !
It is only quite lately that a change has taken place in the
matter. The formulas in the dispensatory have been shorn of
their auctioneering titles, and the number, especially of those
which were to be kept ready compounded, has been lessened*
StiU plenty magisterial formnte reilutin.
The spirit of the advancing age had at length expunged from
the list of drugs the pearls and jewels, the costly bezoar, the
unicorn, and other things which were formerly so profitable to
the apothecaries ; simple processes for preparing the medicines
were laid down ; no one now required alcohol to be ten times
rectified, or calomel twelve times distilled ; and the establish-
ment of more stringent price-regulations for the chemists threat-
ened to convert their hitherto golden shops into silver ones,
when things unobservedly took a turn more favourable to the
apothecary, and more disastrous to the art of medicine.
The former medicinal laws* had already begun to restrict the
compounding of the mixtures to the apothecaries, and thus, in
some measure,, to impose restrictions on the physicians. The
more recent statutes completed the work, by preventing physi-
cians from converting the simple drugs into compound mixtures
for themselves, as well as forbidding them to give any medicine
directly to the patients, and, as the expression was, " to dis-
pense."
Nothing could have been done better adapted to ruin the
true art of medicine.
Such regulations may have been adopted firom one of three
reasons : —
Ist. Was it owing to the notorious ignorance of the physi-
cians of the present day, which rendered them unable to prepare
a tolerable combination of drugs, or even to measure out the
simple medicines, that they were prevented from executing this
mechanical operation on account of incompetence, as midwives
are not allowed to use forceps ? If this was the case (what a
dreadful supposition !) how could they write a prescription, that
is, directions for combining a variety of substances in a most
proper manner, if they themselves were not masters of the ope-
ration which they descHbed?
' For example, the CansHitUiorus Jhrederiei IL Imperutorit.
jnOULAPIUS IS THE BALANCE. 481
2d Or were they made in order to enrich the apothecaries,
whose incomes suffered by the physicians themselves dispensing
tiieir medicines ? If the whole system of medicine existed for
the benefit of the apothecaries alone, — if people fell sick solely
for the profit of apothecaries — if learned men became physi-
cians, not so much for the purpose of curing the sick, as for the
sake of assisting the apothecaries to make their fortunes — ^then
there would be good reasons why the dispensing of medicines
was forbidden to physicians, and a monopoly of it confirmed to
the apothecaries alone.
8dL Or were they passed for the benefit of patients ? One
would suppose that medicinal laws would be made chiefiy for
the benefit of the sick 1 Let us see, if it were possible that pa-
tients could be benefitted by these laws.
By not himself dispensing, the physician loses all dexterity,
all practice in the manipulations necessary for the compounding
together of various substances which generally act chemically
on each other, and decompose one another more or less in this
process or the other. He gradually becomes less experienced in
this art, until at last he can no longer give any detailed and
consistent directions at all,* imtil at length he gives directions
for compounding that are full of contradictions, and make him
the laughing-stock of the apothecary. He is now completely at
the mercy of the apothecary ; and the doctor and patient must
be content to take the medicine as the apothecary or his assist-
ant (or even his shop-boy) pleases to compoimd it.
If the physician wants to order equal parts of myrrh rubbed
up with camphor in the form of powder, he very likely does not
know, from his want of acquaintance with phannaceutical mani-
pulations, that these two substances never can form a powder ;
but the longer these two dry substances arc rubbed together, the
more they become converted into a greasy mass, a kind of fluid.
Then the apothecary either sends to the patient this soft mash,
instead of a powder, with a sarcastic observation, much to the
annoyance of the physician ; or he deceives the doctor, to keep
in his good graces, and gives the patient something different
from what the doctor prescribed, some brown powder, smelling
* It aoon comes to this, indeed this is almost universnlly the case ; the physidao
DO loiter attempts to invent a prescri})ti()n for himself, be must copy all his prescrip-
tiniB from some well-known prescription manual, in order to avoid the danger of
committing pharmaceutical blunders and contradiction^*, if he attempted to compos*
a prescription for hunself.
482 J»0ULAPIU8 IN THE BALAKOH,
of camplior. Or the physioian, perhaps, writes a preBcription
for haemoptysis, consisting of alum and kitchen-salt rubbed to-
gether. Now, although each of these substances, separately, is
dry, yet out of the triturated combination no powder results,
but a flxiid, which the physician, not himself accustomed to dis-
pense, could never have anticipated. What will the apothecary
do in a case like this 7 He must either annoy or deceive the
writer of the prescription.
Now, can these and a thousand other similar collisions tend
to the welfare of the patient ?
Errors, mistakes of every kind, which the apothecary or his
assistants commit in the preparation of the compound, through
ignorance, hurry, confusion, inaccuracy, or deceit from interested
motives, are, to the man of science and knowledge, who wishes
to test such a combination, a problem, which, when vegetable
substances constitute the ingredients, it often d^es his powers
to solve, — ^how much more so for a physician who has never
had an opportunity of acquiring a practical knowledge of phar-
macy, or of compounding the medicines liimself) indeed is pro-
hibited fix>m dping so ! How is he ever to discover the adulte-
rations or the mistakes which the person who makes up his
prescription may have committed ? If he cannot detect them,
which, owing to such limitations of his knowledge, is very
probable, what mischief must and does thence accrue to the
patient I If he cannot detect them, what an object of ridicule
he must be, when his back is turned, to the apothecary's shop-
boys!
By forbidding physicians themselves to dispense, the apothe-
cary's income is secured in the most satisfactory manner. What
regulations respecting the prices of drugs can check his over-
charges ? And even if the prices of the drugs are fixed by law,
his conscience often does not prevent him from employing a
cheaper substitute {quid pro quo), instead of the expensive one
that is prescribed. Many apothecaries have carried on this kind
of deception to a great extent This practice has been in vogue
for more than fifteen hundred years. We may learn something
of this sort from Galen's little book, entitled in^i «yriC«AA«/Kfv«rf ;
and the multitude of books which treat of the adulteration of
drugs and deceptions practised by the apothecaries, constitute of
themselves no small library.
How well adapted is the whole business of treatment for the
wel^e of the sick I
MBCVhAPlVa IN THE BALANCE. 48S
''But the medicinal regulations do not provide only for the
apothecary, they are for the interest of the physician also I The
latter gets four-pence for every prescription."
So, the same for a prescription which he copies out of a printed
Teeeipt book as for one that takes him an hour to compose I
Since that law was passed, of course he prefers making use
of borrowed, ready -written (t. e.) unsuitable) prescriptions ; he
can write a number of such ones in the course of a forenoon —
but he must write a great many, more than are good for tfie parent,
because he is paid by the number of his prescriptions, and be-
cause be requires many four-pences in order to live, to live well,
to Uye in style I
Alas I we may bid adieu to the progress of the art, to the
core of the sick I
Not to speak of the degradation to a learned man, to an artist
of the highest rank, as the physician ought to be — to be paid by
the number of his prescriptions (like the copyist by the number
of the sheets he copies), or by the number of his courses (like a
common messenger), it seems to me that the result is not com-
mensurate with the arrangement. The physician becomes a
mechanical workman, his occupation becomes a labour that re-
quires the least reflection of all trades ; he writes prescriptions
(it matters not what) for whose effect he is not answerable, and
he pockets his money.
How can he be made responsible for the result, when he doei
not prepare the medicine himself?* The preparation is entrusted
by tiie state to another (the apothecary), who also is not an-
swerable for the result (except in the case of palpable, enormous
mistakes), and over whom we have no control with respect to
many inaccuracies in the preparation of compound medicines,
for after the mixture is made, it is absolutely impossible in
many cases to prove that which ought to be proved against
him.
From the very nature of the thing — it concerns the cure of
the noblest of created beings, it concerns the saving of human
life, the most difficult, the most sublime, the most important of
' Properly speaking, the business of treatment Is a kind of contract which the
pnticnt makes with the phifiician alone ; do ut faciat. The physician solemnly pro-
inii»e!« to give his aid and to administer efficacious medicines prepared in the best way
~ft promise which, with such legal arrangements, lie cannot redeem, and which can
ooly be performed by a third party, the apotliecary, who is not bound by any con
tract to the patient What inconsistency !
28
484 JBOULAFIUS IN THE BALANGI.
all imaginable occupations ! — ^&om the very nature of the thing,
I repeat, the physician should be prohibited, under the severest
penalties, from allowing any other person to prepare the medi-
cines required for his patients ; he should be required, under the
severest penalties, to prepare them himself so that he may bo
able to vouch for the result.
But that it should be forbidden to the physician to prepare
his own instruments for the saving of life — no human being
could have fallen on such an idea a priori
It would have been much more sensible to prohibit authorita-
tively Titian, Guido Reni, Michael Angelo, Baphael, Gorreggio
or Mengs from preparing their own instruments (their expressive,
beautiful and durable colours), and have ordered tiiem to pur-
chase them in some shop indicated I By the purchased colours,
not prepared by themselves,^ their paintings, is^r from being the
inimitable masterpieces they are, would have been ordinary
daubs and mere market goods. And even had they all become
mere conmion market goods, the damage would not have been
so great as if the life of even the meanest slave (for he too is a
man I) should be endangered by untrustworthy health-instra*
ments (medicines) purchased from and prepared by strangers.
Under these ragulations should there happen to one single
physician who should wisely wish to avoid that injudicious
mode of prescribing multifarious mixtures of medicines, and for
the weal of his patients and the ftirtherance of his art should
wish to prescribe simple medicines in their genuineness, he
would be abused in every apothecary's shop until he abandoned
a method that was so little profitable to the apothecary's purse ;
he must take his choice of either being harrassed to death or of
abandoning it and again writing compound prescriptions. In
this case what course would ninly-nine doctors out of a hundred
chose ? Do you know ? I do !
Therefore adieu to all progress in our art I Adieu to the
successful treatment of the sick !
' I ncTer knew any great enamel-painter who did not reqnire to prepare hia own
colours, if he wished to have permanent, brilliant colours, and to produce master-pieces ;
if he be forbidden to prepare his own colours he will not be aUe to furnish any b«i
wretdied dauba.
TBI XXDICINE OF SXPERIBMCB. 485
THE MEDICINE OF EXPERIENCE.'
Man, regarded as an animal, kas been created more helpless
than all other animals. He has no congenital weapons for his
defence like the bull, no speed to enable him to flee from his
enemies like the deer, no wings, no webbed feet, no fins, — no
armour impenetrable to violence like the tortoise, no place of
refuge provided by nature as is possessed by thousands of insects
and worms for their safety, no physical provision to keep the
enemy at bay, such as render the hedgehog and torpedo formi-
dable, no sting like the gadfly, nor poison-fang like the viper ; —
to all the attacks of hostile animals he is exposed defenceless.
He has, moreover, nothing to oppose to the violence of the ele*
meats and meteors. He is not protected finom the action of the
water by the shining hair of the seal, nor by the close oily feathers
of the duck, nor by the smooth shield of the water beetle ; his
body, but a slight degree lighter than the water, floats more
helplessly in that medium than that of any quadruped, and is
in danger of instant death. He is not protected like the polar^
bear or eider-duck by a covering impenetrable to the northern
blast. At its birth the lamb knows where to seek its mother's
udder, but the helpless babe would perish if its mother's breast
were not presented to it. Where he is born nature nowhere
furnishes his food ready made, as she provides ants for the arma-
dillo, caterpillars for the ichneumon fly, or the open petals of
flowers for the bee. Man is subject to a far larger number of
diseases than animals, who are bom with a secret knowledge of
the remedial means for these invisible enemies of life, instinct,
which man possesses not. Man alone painfully escapes from his
mother's womb, soft, tender, naked, defenceless, helpless, and
destitute of all that can render his existence sup{X)rtable, desti-
tute of all wherewith nature richly endows the worm of the
dust, to render its life happy.
Where is the benevolence of the Creator, that could have
disinherited man, and him alone of all the animals of the earth,
of the bare necessities of life ?
Behold, the Eternal Source of all love only disinherited man
. of the animal nature in order to endow liirn all the more richly
with that spark of divinity — a mind — wliicli enables man to
•:li^;it from himself the satisfaction of all Lis requirements, and a
' Publif<he(l at Berlin in 1805
486 THK MEDICINE OF EXPERISNOS.
full measure of all conceivable benefits, and to develop from
himself the innumerable advantages that exalt the children of
this earth fer above every other living thing — a mind thal^ inde-
structible itself, is capable of creating for its tenement, its frail
animal nature, more powerful means for its sustenance, protection,
defence and comfort, than any of the most fevoured creatures
can boast of having derived directly from nature.
The Father of mankind has chiefly reckoned on this &culty
of the human mind to discover remedial agents, for his protection
from the maladies and accidents to which the delicate organism
of man is exposed.
The help that the body can afford itself for the removal of
diseases is but small and very limited, so that the human mind
is so much the more compelled to employ, for the care of the
diseases of the body, remedial powers of a more efficient kind
than it has seemed good in the Creator to implant in the organic
tissues alone.
What crude nature presents to us should not form the limit
for the relief df our necessities ; no, our mind should be able to
enlarge her resources to an unlimited degree for our perfect
well-being.
Thus the Creator presents to us ears of com from the bosom
of the earth, not to be chewed and swallowed in a crude and
unwholesome state, but in order that we should render them
useful as nutriment by freeing them from the husk, grinding and
depriving them of everything of an injurious and medicinal
nature, by fermentation and the heat of the oven, and partaking
of them in the form of bread — a preparation of an innocuous
and nutritious character, ennobled by the perfecting power of
our mind. Since the creation of the world the lightning's flash
has destroyed animals and human beings; but the Author of
the universe intended that the mind of man should invent some-
thing, as has actually been done in these latter days, whereby
the fire of heaven should be prevented from touching his dwell-
ings— ^that by means of metallic rods boldly reared aloft he
should conduct it harmless to the ground. The waves of the
angry ocean reared mountains high threaten to overwhelm his
frail bark, and he calms them by pouring oil upon them.
So he permits the other powers of nature to act imhindered
to our harm, until we can discover something that can secure us
from their destructive force, and harmlessly avert from us their
impressions.
THi KKDICINE OF EXPERIENCE. 487
So he allows the inniimerable array of diseases to assail and
seize upon the delicate corporeal frame, threatening it with death
and destruction, well knowing that the animal part of onr orga-
nism is incapable, in most cases, of victoriously routing the enemy,
withoat itself suffering much loss or even succumbing in the
struggle ; — the remedial resources of the organism, abandoned
to itself are weak, limited and insufficient for the dispersion of
diseases, in order that our mind may employ its ennobling faculty
in this case also, where the question concerns the most inestima-
ble of all earth's goods, health and life.
The great Instructor of mankind did not intend that we should
go to work in the same manner as nature ; we should do more
than organic nature, but not in the same manner, not with the
same means as she. He did not permit us to creatie a horse ;
but we are allowgd to construct machines, each of which pos-
sesses more power than a hundred horses, and is much more
obedient to our will. He permitted us to build ships, in which,
secure from the monsters of the deep and the fury of the tem-
pest, and furnished with all the comforts of the mainland, we
might circumnavigate the world, which no fish could do, and
therefore he denied to our body the piscine fins, branchiae and
float, that were inadequate to perform this feat. He denied to
our body the rustling wings of the mighty condor, but on the
other hand, he allows us to invent machines filled with light
gas, that with silent power lifts us into far higher regions of the
atmosphere than are accessible to the feathered tenants of the
air.
So also he suffers us not to employ the process of sphacelus,
as the human corporeal organism does for itself, in order to re-
move a shattered limb, but he placed in our hand the sharp,
quickly-dividing knife, which Faust moistened with oil, that is
capable of performing the operation with less pain, less fever, and
much less danger to life. He permits us not to make use of the
so-called crisis, like nature, for the cure of a number of fevers ; we
cannot imitate her critical sweat, her critical diuresis, her critical
abscesses of the parotid and inguinal glands, her critical epistaxis,
but he enables the investigator to discover remedies wherewith
he may cure the fever more rapidly than the corporeal organism
is capable of producing crises, and to cure tlicin more certainly,
more easily, and with less suiterinfr, with less danger to life and
fewer after-sufferings, than unassisted nature can do by means
of crises.
488 TEX lEXDIOINX OF XXPEBIIK0I.
I am therefore astonished that the art of medicine has soseldom
raised itself above a servile imitation of thesq crude processes,
and that it has at ahnost all periods been believed that hardly
anything better could be done for the cure of diseases than to
copy these crises, and to produce evacuations in the fi>rm of
sweat, diarrhoea, vomiting, diuresis, venesections, blisters or arti-
ficial sores. (This was and remained the most favoured method
of treatment from the earliest times till now : and it was always
fidlen back upon, when other modes of treatment founded on
ingenious speculations disappointed the hopes they had raised.)
Just as if these imperfect and forced imitations were the same
thing as what nature effects in the hidden recesses of vitality,
by her own spontaneous efforts, in the form of crises I Or as if
such crises were the best possible method for overcoming the
disease, and were not rather proofe of the (designed) imperfec-
tion and therapeutical powerlessness of our unaided nature!
Never, never was it potjsible to compel these spontaneous en-
deavours of the organism by artificial means) the very notion
implies a contradiction), never was it the Creator's will that we
should do so. His design was that we should bring to unlimited
perfection our whole being, as also our corporeal firame and the
cure of its diseases.
This design has hitherto been in part fulfilled by pure surgery
alone. Instead of acting like unassisted nature, which can often
only throw off a splinter of bone in the leg by inducing a fever
attended by danger to life, and a suppuration that destroys al-
most all the limb, the surgeon is able by a judicious division of
the irritable int^uraents to extract it in a few minutes by means
of his fingers, without occasioning any great suffering, without
any considerable bad consequences, and almost without any dimi-
nution of the strength. A debilitating slow fever, accompanied by
intolerable pains and uninterrupted torturing to death, is almost
the sole means the organism can oppose to a large stone in the
bladder ; whereas an incision made by a practised hand frees
the sufferer from it oftdn in a quarter of an hour, spares him
many years of torment, and rescues him from a miserable death.
Or ought we to attempt to relieve a strangulated hernia by an
imitation of the mortification and suppuration, which are the
only means, besides death that nature possesses against it?
Would it suffice for the rescue and preservation of life, did we
not know of any other mode of stopping the hemorrhage from
a wound in a large arterj^ than by causing a syncope of half«an-
VBK XIDICIKE OF SXPSRISlfOB. 489
houi'f doTatioiif as nature does 7 Could the tourniquet, bandage
and compress be thereby dispensed with 7
It has always been a matter worthy of the greatest admira-
tion to see how nature, without having recourse to any surgical
operaiion, without having access to any remedy from without,
does often when left quite unassisted, develop from itself invisi-
ble operations whereby it is able, — often it is true in a very
tedious, painftil and dangerous manner — ^but still really to re*
move diseases and affections of many kinds. But she does not
do these for our imitation ! we cannot imitate them, we ought
not to imitate them, for there are infinitely easier, quicker and
surer remedial means which the inventive faculty implanted in
our mind is destined to discover, in order to sul^rve the ends
of medicine, that most essential and most honourable of all
earthly sciences.
AriAff MhMyi w^kl^n km Xiyt «Kir^«cr«(.
Greg. Mao.
Medicine is a science of experience ; its object is to eradicate
diseases by means of remedies.
The knowledge of diseases, the knowledge of remedies, and
the knowledge of their employment, constitute medicine.
As the wise and beneficent Creator has permitted those innu-
merable states of the human body differing from health, which
we term diseases, he must at the same time have revealed to us
a distinct mode whereby we may obtain a knowledge of dis-
eases, that shall suffice to enable us to employ the remedies
capable of subduing them ; he must have shewn to us an
equally distinct mode whereb}' we may discover in medicines
those properties that render them suitable for the cure of dis-
eases,— ^if he did not mean to leave his children helpless, or to
require of them what was beyond their power.
This art, so indispensable to suffering humanity, cannot
therefore remain concealed in the unfathomable depths of ob-
scure speculation, or be diffused throughout the boundless void
of conjecture; it must be accessible. r<?arZ//y accessible to us,
within the sphere of vision of our external and internal ])ercep-
tive faculties.
Two thousand years were wasted by physicians in endeavour-
ing to discover the invisible internal changes that take place in
440 TH8 MBDICINE OF SXPERIEK08.
the organism in diseases, and in searching for their proximate
causes and a priori nature, because they imagined that they
could not cure before they had attained to this impassible
knowledge.
If the fruitlessness of these long-continued endeavours cannot
be regarded as a proof of the impossibility of this undertaking,
the maxim of experience that they were ufinecessary for the
cure, might suffice to shew its impossibility. For the great
Spirit of the Universe, the most consistent of all beings, lias
made that only possible which is necessary.
Although we never can attain to a knowledge of the internal
corporeal changes on which diseases depend, yet the observation
of their external exciting causes has its uses.
No alteration occurs without a cause. Diseases must have
their exciting causes, concealed though they may be fix>m us in
the greater number of cases.
We observe a few diseases that always arise from one and the
same cause, e. g., the miasmatic maladies; hydrophobia, the
venereal disease, the plague of the Levant, yellow fever, small-
pox, cow-pox, the measles and some others, which bear upon
them the distinctive mark of always remaining diseases of a
peculiar character; and, because they arise from a contagious
principle that always remains the same, they also always retain
the same character and pursue the same course, excepting as
regards some accidental concomitant circumstances, which how-
ever do not alter their essential character.
Probably some other diseases, which we cannot shew to de-
pend on a peculiar miasm, as gout, marsh-ague, and several
other diseases that occur here and there endemically, besides a
few others, also arise either from a single unvarying cause, or
from the confluence of several definite causes that are liable to
be associated and that are always the same, otherwise they
would not produce diseases of such a specific kind, and would
not occur so frequently.
These few diseases, at all events those first mentioned (the
miasmatic), we may therefore term specific, and when necessary
bestow on them distinctive appellations.
If a remedy have been discovered for one of these, it will
always be able to cure it, for such a disease always remains
essentially identical, both in its manifestations (the representa-
tives of its internal nature) and in its cause.
THE MEDICINE OF EXPEBIENGE. 441
All the other innumerable diseases exhibit such a difference
in their phenomena^ that we may safely assert that they arise
firom a combination of several dissimilar causes (varying in
number and differing in nature and intensity).
The number of words that may be constructed from an alpha-
bet of twenty-four letters may be calculated, great though that
number be; but who can calculate the number of those dis-
similar diseases, since our bodies can be affected by innumerable
and still for the most part unknown influences of external agen-
des, and by almost as many forces from within.
All things that are capable of exercising any action (and
their number is incalculable'), are able to act upon and to pro-
' Some of these are, e. ^, the iDnumerable varieties of odours, the more or less
DOiious ezhalatioiis from organic and inorganic substances, the yarious gases that
pfweiw sadi diflerent irritating properties, that act upon our nerves in the atmos-
phere, in our manufactories and in our dwellings, or rise from the water, the earth,
animalB, and plants ; — deficiency of pure, open air, the indispensable aliment of our
ritality, ezoeas or deficiency of the sun's light, excess or deficiency of both kinds of
eleetiicity, differences in the pressure of the atmosphere, in its humidity or dryness,
the stQl unascertained peculiarities of mountainous regions compared with low-lying
plams and deep valleys ; peculiarities of climate or situation on large plains and on
desert* .destitute of f^ants or water, compared with the sea, with marshy districts^
liiU% woods, the various winds; the influence of very changeable or too uniform
weather, the influence of storms and other meteoric phenomena ; too great heat or
cold of the air, defect or excess of warmth in our clothing, in our rooms ; the coo-
strictioQ of various parts of the body by different articles of dress ; the degree of
coldnesB or heat of our food and drink, hunger or thirst, excessive quantities of food
or drink, their noxious or medicinal nature, and their power of causing changes in the
body, which are inherent in some (as wine, spirits, beer prepared with more or less
hurtful plants, drinks containing foreign ingredients, coffee, tea, exotic and indigenous
spioesi and highly seasoned viands, sauces, liqueurs, chocolate and cakes, the un-
known, noxious or health-deranging properties of some vegetables and animals when
UMd as food), and are imparted to others by careless preparation, decomposition!
fidsificatioD or adulteration (e. g. ill-fermented and imperfectly baked bread ; under-
done animal and vegetable viands, or other articles of diet spoilt in various ways,
deoomposed, mouldy or adulterated for the sake of gain ; liquid and solid food pre-
pared or kept in metal vessels ; made up, drugged wine ; vinegar sharpened witii
acrid substances ; the flesh of diseased animals ; flour adulterated with gypsum or
land ; coni mixed with injurious seeds ; vegetables mixed with or changed for dan-
gerous plants, fit>m malicious motives, ignorance or poverty) ; want of cleanliness of
the body, of the clothing, of the dwelling, hurtful substances which get into the food
during its preparation and keeping firom want of cleanliness or from negligence ; dust
of various unwholesome kinds arising firom the substances used in manufactories and
workshops ; the neglect of various police arrangements for the protection of the weU-
being of the community ; excessive weakening of our corporeal powers ; too violent
active or passive exercise ; inordinate excretions fSrom various organs ; abnormal ex-
ertion of certain organs of the senses ; various unnatural positions and attitudes
attendant on different kinds of work ; neglect of the employment of various parts, or
general inactivity of the body ; irregularity in the periods devoted to rest, meals and
442 THX XBDICOTE OF XXPBBIElfOA;
dace changes in our organism which is intimately connected
with and in conflict with all parts of the universe — and all may
produce different effects as they differ among themselves.
How various must be the effects of the action of these agen-
cies, when several of them at once and in varied order and in*
tensity exercise their influence on our bodies, seeing that the
latter are also so variously organized and present such diversi-
ties in the various conditions of their life, that no one human
being exactly resembles another in any conceivable respect !
Hence it happens that with the exception of those few dis-
eases that are always the same, all others are dissimilar\ and
innumerabk, and so different that each of them occurs scarcely
more than once in the world, and each case of disease that pre-
sents itself must be regarded (and treated) as an individual
malady that never before occurred in the same manner, and
onder the same circimistances as in the case before us, and will
never again happen precisely in the same way !^
labour ; excess or deficiency of sleep ; over-exertion in mental employments g«ne-
ndly, or in such as especially excite or fatigue certain fiiculties of the mind, or which
are of an injurious and forced character ; overpowering or enervating pasaioos pro-
duced by certain kinds of reading, education, bad habits and employment ; abufie of
the sexual function ; reproacbeb of the conscience, imoomfortable domestic affiun^
annoying family relations, fear, fright, vexation, Ac
^ To this head belong a number of diseases which, owing to a want of aocoracj in
the comparison of all their symptoms, have been regarded as identical malm^iiAf^^
merely from the circumstance of some one striking resemblance, e. g., dropsy, aero*
fola, wasting, hypochondriasis, rheumatism, spasms, and so forth. The very circum-
ttance that in one case one mode of treatment was successful that was of no avail in
ten others, should have shewn that the difference was not properly observed. It
might, it is true, be said that there is a middle sort betwixt those specific and theae
dissimilar diseases of a mixed character, e. g., tetanus, prosopalgia, diabetes, poea
mooia, phthisis, cancer, Ac^ and that although a g^eat number of cases of eadi of
these diseases present dissimilar characters, and therefore require a different treat-
ment, yet some cases present so much resemblance among themselves in their symp-
toms and mode of cure, that tlidy should be considered as the same malady. TIda
distinction, however, hxis not much practical, consequently Uttle real, value, for wa
ooght to observe and investigate accurately each case, in order to find out what is the
aoitable remedy. If I have discovered this, it is a matter of great indifference whether
I then become aware that this same disease, with all its symptoms and with tfia
aame curative indications, has presented itself to me before, as this knowledge coold
not lead me to any other or better mode of cure (and the cnre is the aim of all kindt
of diagnosis of disease) than to the efficacious and best adapted one.
* How were it possible to arrange such ineonjnngihilia into classes, orders^ genera,
apecies, varietien and sub varieties, like organic beings, and to give namet to socfa
atates of the extremely composite psychico-corporeal microcosm, subject as it is to
auch varied irritations by such innumerable agencies, states* that are capable of aucb
an infinity of modifications and shades of difference I The millions of morbid eaaea
that occur perhaps but once in the world require no names — ^we only require to em
m xxDioms of xxpsbibnoi. 448
The internal essential nature of every malady, of every indi-
vidual case of disease, as &r as it is necessary for us to know it^
for the purpose of curing it^ expresses itself by the symptoms, 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 observable symptoms
of the disease that exist, he has discovered the disease itself, he
has attained the complete conception of it requisite to enable him
to effect a cure.
In order to be able to perform a cure, it is requisite to have a
fiiithftd picture of the disease with all its manifestations, and in
addition, when this can be discovered, a knowledge of its pre-
disposing and exciting causes,^ jn order, after effecting the cure
by means of medicines, to enable us to remove these also — ^by
means of an improved regimen — and so prevent a relapse.*
In order to trace the picture of the disease, the physician re-
quires to proceed in a very simple manner. All that he needs
is carefulness in observing and fidelity in copying.^ He should
entirely avoid all conjectures, leading questions and suggestions.
The patient relates the history of his ailments, those about him
describe what they have observed in him, the physician sees,
hears, feels, Ac., all that there is of an altered or unusual cha-
racter about him, and notes down each particular in its order,
so that he may form an accurate picture of the disease.
The chief signs are those symptoms that are most constant,
tfaem. Diseases have been associated together according to some merely external
ntemblaiioe, or from some similarity of cause or of one or other symptom, in order
that they might be treated by the same medicine, with a small outlay of trouble I
' In like manner the teacher chiefly requires to observe the actions and conduct of
•D midiscipUned new pupil, in order to lead him in the way of virtue by means of
tiie most appropriate tuition. To effect this reformation it is not necessary either that
he aboald know the ever inscrutable internal organization of his body, or that he should
be able to inspect the equally inscrutable internal operations of his mind. In additioD
to this be certainly requires to know (if he can ascertain it) the cause of his moral
deteriormtion, but only in order to be able to ward it off from him in future— and so
prevent a relapse.
' If no obvious predisposing and exciting causes arc perceptible, whose future
AYoiflaDOe is within the power of man, then all our aims are attained by effecting the
leetoration by means of remedial agents. The physician must neither invent, con-
jectnre, nor extort from the patient any exciting cause.
' If we are not desirous of producing a likeness, we may draw a dozen faces on a
piece of paper or canvass in an hour, but a single stiiking portrait requires just as
much time and a much greater power of observation and fidelity in the repreaen-
tatioa
444 . THB MEDICIKE OF EXPSBISNOB.
taost sinking, and most annoying to the patient The pyhsidan
marks them down as the strongest, the principal features of the
picture. The most singular, most uncommon signs famish the
characteristic, the distinctive, the peculiar features.
He allows the patient and his attendants to relate all they have
to say without interrupting them, and he notes down everything
attentively — he then again inquires what were and still are the
most constant, frequent, strongest and most troublesome of the
symptoms — ^he requests the patient to describe again his exact
sensations, the exact course of the symptoms, the exact seat of
his sufferings, and bids the attendants once more detail, in as
accurate terms as they are able, the changes they have observed
in the patient, and which they had previously mentioned.'
The physician thus hears a second time what he had formerly
noted down. If the expressions correspond with what was al-
ready related, they may be considered as true, as the voice of
internal conviction ; if they do not correspond, the discrepancy
must be pointed out to the patient or those about him, in order
that they may explain which of the two descriptions was nearest
the truth, and thus what required confirmation is confirmed,
and what required alteration is altered.*
If the picture be not yet complete, if there be parts or func-
tions of the body regarding whose state neither the patient nor
his attendants have said any thing, the physician then asks
what they can remember respecting these parts or functions, but
he should frame his questions in general terms, so as to cause
his informant to give the special details in his own words.^
' The physician should never put leading questions in the course of his investiga-
tions. He should not suggest either to the patient, or to the attendants, the symptomt
that may be present, or the words they should use to describe them, in order not to
mislead them to say any thing that may be untrue, half-true, or different finom what
is actually the case, or, in order to please the physician, to reply in the affirmatiTe
to what is not strictly founded on truth, for in this way a fedse idea of the
ease and an unsuitable mode of treatment must be the result*
The greatest reliance is to be placed on the accurate, although occasionally
what coarst expressions of the patient and his attendants, respecting his ailmeDl&
* We cannot rely on the patient or his attendants possessing such an accurate me-
mory, that after a short interval of time they should repeat in eanctly the same
form and manner the expressions that may at first have been inaccurately or hastily
dioscn. There will certainly then occur variations, which must be pointed out to them,
so that they may select more accurate or definite expressions in the descriptioo of their
fiensations and convictions.
* For example : How is it as regards the fracal evacuation t — how does the urine
flow ?— how is it with the sleep by day and by night I — how is his disposition I — how
the thirst? — ^what sort of taste in the mouth t — ^what kinds of food and drink doea
TBM XIDIOINS OF SXPSBISNOI. 445
Whea the patient (for, except in cases of feigned diseases,
moBt reliance is to be placed on him as regards his sensations)
hBSy by these spontaneous or almost unprompted details, put
the phjaician in possession of a tolerablj complete picture of
the disease, it is allowable for the latter to institute more parti-
cular inquiries.^
The answers to these last more special questions however,
which hare somewhat the character of suggestions, should not
be accepted hj the physician at the first response as perfectly
true, but after making a note of them on the margin he should
make fresh inquiries respecting them, in a different manner and
in another order,^ aiid'he should warn the patient and his atten-
dants in their answers to make accurate replies, and to make no
additions, but merely to tell the exact circumstances of the case.
But an intelligent patient will often spare the physician the
trouble of making these particular inquiries, and in his account
of the history of his disease, will usually have made voluntary
mention of these circumstances.
When the physician has completed this examination he notes
down what he has silently observed in the patient during his
visit,' and he corrects this by what the attendants tell him how
he reliflh mosk^ ifbAt agree with him best ?-has each of them its natural perfect taste I
— haft he any thing to state respecting the head, the limbe, or the abdomen ? (be
> For example: How often has he an alvine evacuation, what is the cluiractcr of
it, is it ■ccompanied or not by pains ? Is the sleep profound or light ? — He then asks
more minutely, e. g^ are the sufferings complained of persistent or remitting ? how
often do they occur t only in the room ? only in the open air ? only during rest or
daring motion of the body I at what time of the day or under what conditions \ what
precedes, what accompanies, and what follows them ? — And finally, he addresses quite
specific questions : Does he start in his sleep ? does he groan or talk in his ^leep !
what does be talk about ? was the whitish evacuation mucus or fseccs ? &c.
* For example : How he behaved, what he did in his sleep ? what the motions
onisisted off does the symptom only occur only in the morning, only when at rest
when lying) or when sitting f what happens when he raises himself up in bed ? 6[C
* For example: If the patient tossed restlessly about, and how he behaved;
wfasther be was sulky or quarrelsome, hasty or anxious, unconscious, comatose;
whether he spoke in a low voice, or incoherently or otherwise ; what kind of com-
plexioD be has, what appearance the eyes present, what expression of countenance is
shewn, what is the state of the tongue, the breath, the smell from the mouth, or the
hearing ; how much the pupils are dilated, how rapidly and to what extent they alter
jn the dark and light; the state of the pulse, of the abdomen, of the skin in general,
or ol particular portions of it as regards moisture and temperature ; whether he lies
with his head thrown back, uncovered or closely covered up, whether he liet* only
oo his back, with his mouth open, with the arms above the head, or what other position
he aseomes ; with what amount of exertion he raises himself up ; and any thing elne
diai may strike the physidaD, or is observable by hiuL
446 THE MEDICINE OF EXPEBIEKOX.
much of this was or was not nsiuJ with the patient in his days
of health.
He then inquires what medicines, domestic remedies, or
other modes of treatment have been employed in former times,
and what have recently been used, — ^and especially the state of
the symptoms before the use or after the discontinuance of all
medicine. The former form he regards as the original state ;
the latter is in fistct an artificial form of the disease, which how-
ever he must sometimes accept and treat as it is, if there is any
pressing emergency in the case that will not admit of any delay.
But if the disease is of a chronic character, he lets the patient
continue some days without taking any medicine, to allow it to
resume its original form, until which time he defers his more
particular examination of the morbid symptoms, in order that
he may direct his treatment towards the persistent and unsophis-
ticated symptoms of the chronic malady, but not towards the
evanescent, ungenuine, accidental symptoms, produced by the
medicines last used — as it will be necessary to do in acute dis»
eases where the danger is urgent.
Finally, the physician* makes general inquiries as to any ex-
citing causes of the disease that may be knovm. In ten cases
we shall not find one where the patient or his friends can assign
a certain cause. If, however, there have happened one respect-
ing which there can exist no dubiety, it generally occurs that
has been voluntarily mentioned by them at the commencement
of their account of the disease. If it is necessary to make in-
quiries respecting it, it usually happens that very uncertain
information is elicited on this head.*
I except those causes of a disgraceful^ character, which the
patient or his friends are not likely to mention, at all eveilts not
of their own accord, and which, consequently, the doctor should
endeavour to find out by dexterously framing his questions, or
by private inquiries. With these exceptions it is a hurtful, or at
' Such a query ahould never have a definite character. But even when it is framed
quite in a general fashion («. g. how did the dioease arise, what was its cause \) sucii a
question usually only incites the patient and his friends to imagine or invent
probable cause, which might appear probable to a physician who does not
great knowledge of mankind, and 90 deceive him.
' For example : meditated suicide, onanism, excesses in wine, spirits or food — m
annatural debauchery — indulgence in meretricbus reading ; venereal disease ; morti-
fied pride ; thwarted revenge ; childish superstitious fear ; an evil consdence ; un*
ha|>py love ; jealousy ; domestic quarrels and grief about some family secret^ about
debts — straitened circumstances, hunger, unwholesome food, ^
XEB XEDIOINB OF BXPSBIEirGE. 447
all eyents, a useless task to endeavour to ferret out other excit-
ing causes, bj means of suggestions, especially as the medicinal
art knows yery few of these (I shall mention them in their
proper places) on which we can base a trustworthy mode of
treatment^ regardless of the particular signs of the disease they
have induced.
By exercising all this zealous care the physician will succeed
in depicting the pure picture of the disease, he will have before
bim the disease itself, as it is revealed by signs, without which
man, who knows nothing save through the medium of hia
aenses, could never discover the hidden nature of any thing, and
just as little could he discover a disease.
When we have found out the disease, our next step is to
search for the remedy.
Every disease is owing to some abnormal irritation of a pecu-
liar character, which deranges the functions and well-being of
our organs.
But the imity of the life of our organs and their concurrence
to one common end does not permit two effects produced by
abnormal general irritation to exist side by side and simultane-
ously in the human body. Hence our
If^irst maxim of experience.
When two abnormal general irritations act simultaneously on
the body, if the two be dissimilar^ then the action of the one (the
weaker) irritation will be suppressed and suspended for some
time by the other (the stronger*) ; and, on the other hand, our
Second maxim of expcrie^ice.
When the two irritations greatly resemble each ot/icr, then the
one (the weaker) irritation, together with its effects, will be com-
^ Tlie maxim of experience will be better elucidated by another, namely : when
(as is the case with palliatives) the general (medicinal) irritation that is applied is the
exact opponte of that already existing in the body (the morbific irritation), the latter
wiU be suppressed and suspended with remarkable rapidity — but when the general
(medidiia]) irritation employccl is dissimilar and heterogenmia to that already present
in the body (the morbific irritation) in every other respect (as is the case in merely
revolntioDary modes of treatment, by revulsions and so-called general remedies), the
morbific irritation will only be suppressed and suspended, provided the new irritation
is much stronger than that already present in the system, — and only rapidly when
this new irritation is excessively violent.
If the opposed, heterogenous, dissimilar irritations are diseases, of pretty much the
flune intensity, as however is rarely the case, so that thoy cannot suspend one another
at all, or not for any length of time, then they (when uncurcd) unite to form a single
^Moaflft which may moreover be cured as a single, uniform disease, notwithstandkig
thai this kind has been termed complex disease*.
4A8 THB MfiDICINB OF SZPSSISNOX.
pletely extinguished and annihtlaied by the analogous power of
the other (the stronger).
{Illustration of the first maocim,) If a person be infected at the
game time by, for instance, the miasmata of measles and small-
pox (two dissimilar irritations), and if the measles have appeared
first, it immediately disappears on the day of the eruption of the
smaU-pox, and it is only after the latter is completely gone that
the measles again returns and completes its natural course. The
red rash that had already commenced to shew itself disappeared,
as I have frequently observed, on the eruption of the small-pox,
and only completed its course when the small-pox was dried up.'
According to Larrey, the plague of the Levant immediately re-
miains stationary whenever the small-pox begins to prevail, but
again returns when the latter ceases.
These two corporeal irritations are of a heterogeneous and
dissimilar character, and the one is therefore suspended by the
other — ^but only for a short time.
{Illustration of the second maxim,) If the two abnormal cor-
poreal irritations be of a similar nature, then the weaker will be
entirely removed by the stronger, so that only one (the strongeir)
completes its action, whilst the weaker was quite annihilated
and extinguished. Thus the small-pox becomes an eradicator
of the cow-pox ; the latter is inmiediately interrupted in its
course whenever the miasm of the small-pox that was previously
latent in the system breaks out, and after the small-pox has run
its course the cow-pox does not again appear.
The cow-pox miasm, which in addition to its well-known
effect of developing the cow-pock with its course of two weeks'
duration, has also the property of giving rise to a secondary
eruption of small red pimples with red borders, particularly in
the face and forearms (and under certain unknown circumstan-
ces it produces this effect usually soon after the desiccation of
the pocks), permanently cures other cutaneous eruptions where-
with the inoculated person was already, though ever so long
before, affected, if this cutaneous disease was only tolerably similar
to that cmv-pox eocanthema,'^
^ I saw an infection of the epidemic febrfle swelling of the parotid gland (mumps)
immediately yield when the protective inoculation of the small-pox had taken effect,
and it was only after the lapse of fourteen days, when the areobur redness of the pocks
had passed away, that the mumps again appeared and completed its regular coarse
of seven days.
* That it is this secoodaiy eruption (of pimples), or even the mere tendency of vac-
one to cause this accessory eruption, but not the cow-pox itself which cores tboee
TSB XEDICINE OF EXPSBIEKCE. 449
These two abnonnal imtations cannot exist simultaneonslj in
the same body, and thus the morbific irritation that appears last
removes that which previously existed, not merely for a short
time, but permanently, in consequence of being analogous to the
latter ; it extinguishes, annihilates and cures it completely.
It is the same thing in the treatment of diseases by means of
mediciHes.
If the itch <rf workers in wool be treated by strong purgativesj
such as jalap, it gradually yields almost completely, as long as
the purgatives are continued, as the action of these two abnor-
mal imtations cannot co-exist in the body; but as soon as the
effect of the curtificially excited irritation ceases, that is to say,
whenever the purgatives are discontinued, the suspended itch
returns to its former state, because a dissimilar irritation does
not remote and destroy the other, but only suppresses and sus-
pends it f<Hr a time.
But if we introduce into a body affected by this itch a new
irritant— -of a different nature, it is true, but still of a very similar
mode of action — as for example the calcareous liver of sulphur,*
from which others besides myself have observed an eruption
produced very similar in character to this itch, then, as two
general abnormal irritations cannot co-exist in the body, the
former yields to the latter, not for a short time merely, but per-
manently, as the last introduced was an irritation very analogous
to the first; that is to say, the itch of the wool- workers is really
cored by the employment of the calcareous liver of sulphur
(and for the same reason by the use of sulphur powder and sul-
phureous baths).
Those diseases also which the casual observer considers as
merely local ^ are either suppressed for some time by a fresh irri-
fM ■ - ' " ' ' • ~" ^^ ' ~~ ~ " ' - ~
poAtular exanthemata is evident from this, that tlicsc exanthemata remain almost un-
altered as long as the proper cow-pox is running itscoiu^e, and only disappear when
the di«ea«e oomes to the period correspondiog to the occurrence of the secondary
eroptioB of vaccinia, that is to say, after the cow-pocks arc dried up. But the vaccine
dinftiwe has a tendency to cause not only that secondary eruption of discrete, elevated
pimples, but also another accessory eruption in the form of confluent miliary (and also
eroding) tetters (but as it seems, not on the £ace, forearms and legs), and it is also ca-
pable of caring a similar cutaneous afiTection.
* The baths impregnated with sulphuretted hydrogen gas excite the same itch-like
eruptioii, in the flexures of the joints especially, which itdies most at night, and they
tbere&nre cure the itch of tlie wool-workers rapidly and radically.
* The uaity of the life of all organs, and their eoncurrciice to one oommon end, will
hardly permit of a disease of the body being or remaining merely localj just as the
actkn of no mediciDe can be purely local, iu such a manner tlmt the rest o( the body
flfaall take no part in it It certainly takes a part, although in a somewhat less degree
29
450 THE HKDICU^S OF HXPEBISNCK.
tation applied to this part, where the two irritatioBs are c^ dis-
similar or opposite tendency, as, for example, the pain of a burnt
hand is instantly suppressed and suspended by dipping it in oold
water, as long as the immersion is continued, but it immediately
recurs with renewed violence on withdrawing the hand fix)m the
water — or the first is entirely and permanently destroyed, that
is to say, completely cured, when the last irritation is very ana-
logous to the first. Thus, when the action of the remedy, c jr.,
the artificial irritation applied to the burnt hand, is of a different
nature, it is true, from the burning irritation of the fire, but of
a very similar tendency, as is the case with highly concentrated
alcohol, which when applied to the lips produces almost the
same sensation as that caused by a flame approached to them,
then the burnt skin, if it be constantly kept moistened with the
spirit, is — in bad cases in the course of a few hours, in slighter
ones much sooner — completely restored and permanently ctiied
of the pain of the burn. So true is it that two irritations, even
when they are local, cannot co-exist in the body without the one
suspending the other, if they are dissimilar, or the one removing
the other, if the added one have a very similar mode of actioii
and tendency.
than the place oq which the socalled local affection is most obTiouSi or to which Urn
so-called local medicine is applied. — Persons who suffer from herpes arc, acoordii^
to Larrej, exempted from the infection of plague, and the Europeans in Syria who
have issues and perpetual blisters remain free from the infection of the Levantiiit
plague, as observed in our o^d time by Larrey and in ancient times by G. F. TiD
Hilden and F. Plater. So far are herpetic eruptions and artificial external ulott^
from being purely local affections, that when they are present the system is not sus-
ceptible of such a violent and general irritation as the Levantine plague. But it is only
during the continuance of this corporeal irritation, which is dissimilar to that it wards
offy and no looger, that it can prevent its occurrence. Two children affected witb
epilepsy kept free from this disease (the epilepsy was suspended) as long as an «ni|^
tioD on the head that they both had persisted ; but when this healed up the epilepij
returned (N. Tulpius, lib L obs. 8). In like manner, obviously general doeaset of
the body have been — not cured, but suppressed and suspended by nature, whidi ii
powerleflB to cure them, by means of torpid ulcers of the legs, by the physiciaii bj
means of issues, because both issues and ulcers of the legs, if they have existed bobm
time, are abnormal general irritations ; but the attacks of apoplexy, asthma, A&, recor
immediately when ihe ulcers of the legs and the issues heal up. An epileptic patient
remained for a long time free from his attacks, as long as the issue was kept cypei^
but the epilepsy returned immediately and in a worse shape than before, when it
aUowed to close. (Pechlinus, Ohs. phy%. med. lib. ii, obR. 80). From this it is
that irritations apparently local, when they have existed some time, usually beoome
general irritations of the body, and if they are sufficiently intense, can either suspeiid
or cure general maladies of the body, according as the two opposed irritationB were
of heterogeneous or of analogous character.
TBJt XSDICINS OF £XP£BI£NC£. 401
In order therefore to be able to cure^ we shall only require to
cppaae to the existing abnormal irritation of the disease an appro-
priaie medicine^ that is to say, aiiother Tnmbijk power whose effect
is very similar to thai the disease displays.
As food is requisite for the healthy body, so medicines have
been found efficacious in diseases ; medicines, fioweverj are never
in themselves and unconditionally wholesome, but only relatively so.
The pure aliments of food and drink taken until hunger and
thirst abate, support our strength, by replacing the parts lost in
the vital processes, without disturbing the functions of our organs
or impairing the health.
Those substances however which we term medicines are of a
completely opposite nature. They afford no nourishment They
are abnormal irritants, only fitted for altering our healthy body,
disturbing the vitality and the functions of the organs, and ex-
citing disagreeable sensations, in one word, making the healthy ill.
There is no medicinal substance whatsoever that does not
pcfiseas this tendency,' and no substance is medicinal which does
not possess it
It is only hy OUs property of producing in Uie heaUIiy body a series
of specific morbid symptoms, that medicines can cure diseases, that
is to aay^ remove and extinguish the morbid irritation by a suitable
counter-irritation.
Every simple medicinal substance, like the specific morbific
miasmata (small-pox, measles, the venom of vipers, the saliva' of
rabid animals, &c.), causes a peculiar specific disease — a series of
determinate sjrmptoms, which is not produced precisely in the
same way by any other medicine in the world.
As every species of plant differs in its external form, in its
peculiar mode of existence, in its taste, smell, &c., from every
other species and genus of plant — as every mineral substance,
every salt differs from all others both in its external and internal
physical qualities, so do they all differ among themselves in
' A medidiie which given to a healthy individual alone aiid UDcombinod, in 8uffi-
CMDt quaiitiiyy causes a determinate action, a certain array of symptoms, retains the
imdeney to ezdte the same even in the very smallest dose.
Hie heroic medicines exhibit their action even when given in small doses, to
bealUiy and even strong individuals. Those that bive a weaker action must be given
for tiiese experiments in very considerable doset>. The weakest medicines hdwever
only shew their absolute action in such subject** as arc free from disi'ase, who are
delicate, irritable and sensitive ; — in diseases, in like manner, they all (the weakest
•ft well as the strongest medicines) shew their absolute actions, but so intermingled
irith the symptoms of the disease, that only a very experienced experimenter and
fine observer can distinguish them.
452 THE HEDICnrE OF EXPERISXCB:
their medicinal properties, that is to say, in their morbificpowers ;
each of the substances effects an alteration in our state c^ health
in a peculiar, determinate manner.
Most substances belonging to the animal and regetaUe king*
dorns,' are medicinal in their raw state. Those belonging to the
inineral kingdom are so both in their crude and prepared state.
Medicinal substances manifest the nature of their pathoge*
netic power, and their absolute true action on the healthy hu-
man body, in the purest manner, when each is given singly and
uncombined.
Many of the most active medicines have alrea^ occasionally
found their way into the Imman body, and the accidents they
have given rise to have been recorded.*
In order to follow still farther this natural guide and to pen^
trate more profoundly into this source of knowledge, we admi-
nister these medicines experimentally, the weaker as well as the
stronger, each singly and uncombined, to healthy individuals,
with caution, and carefully removing all accessory circxnn»
stances 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 dis-
ease that each of these medicinal substances is capable of pro^
ducing, absolutely and by itself, in the human body.'
* Those plants and animals which we employ as food, have the advaotage of ooo-
taining a greater quantity of nutritious partf< than the others^ and moreover, their
medicinal powers in their raw state are either not yery great, or if they are great are
destroyed and diss^ted by drying (as in the case of ammroot), by ilie ezpreasioo
of the noxious juice (as in the case of the cassaya), by fermeotatioi], by smokiqg mkI
by the power of the heat in roasting, baking and boiling, or are rendered Bmoeoona
by the addition of salt^ sugar, and especially of vinegar (io sauces and salads). If
we allow the recent expressed juice of the mast deadly plants to remain only for m
single day in some warm place, ft undergoes the complete vinoos fermentatioo and
loses much of its medicinal power ; if it stands several days, it passes throi:^ tfa*
acetous fermentation, whereby it loses all medicinal power, the sediment that it de-
posited from it is then perfectly harmless, and is similar to wheat starch.
* If we compare the occasional happy cores effected by these medicines, the most
prejudiced person meet be struck witii the extraordimuy resemblance that ezislii
between the symptoms caused by the medidnea oo the healthy body, and those
whereby the disease it cures is characterized.
' In order to ascertain the effects of less powerfrd medicines in this manner, we
must give only one pretty strong dose to the temperate healthy person who is the
subject of the experiment, and it is best to give it in solutioa If we wish to aaoer-
tain the remaining symptoms, which were not revealed by the first trial, we may give
to another person, or to the same individual, but only then after the lapse of serenl
days, when the action of the first dose is fully over, a similar or eveo stroogtr por-
tion, and note the symptoma of irritation thence resulting in the same careful and
THE MEDICIKB OF SXFEBIENCX. 458
In this way we must obtain a knowledge of a sufficient supply
of artificial morbific agents (medicines) for curative implements,
80 that we may be able to make a selection from among them.^
Now, after we have accurately examined the disease to be
cured, that is to say^ noted down all its appreciable phenomena
historically, and in the order in which they occur, marking par*
ticularly die more severe and troublesome chief symptoms, we
have only to oppose to this disease another disease as like it as
possible, or, in other words, a medicinal irritation analagous to
the existing irritation of the disease, by the employment of a
medicine which possesses the power of exciting as nearly as
possible all these symptoms, or at all events, the greater number
and severest, or most peculiar of them, and in the same ordeTi
— ^in order to cure the disease we wish to remove, certainly,
quickly and permanently.
The result of a treatment so conformable to nature may be
confidently depended on, it is so perfectly, without exception, cer-
tain, so rapid beyond all expectation, that no method of treat-
ing diseases can shew anything at all like it
But here it is necessary to take into consideration the immense
diCTerence, that can never be sufficiently estimated, betwixt the
positive and negative, or as they are sometimes termed, the
ndical ifwraiive) and the palliative modes of treatment
In the action of simple medicines on the healthy human body
there occur in the first place phenomena and symptoms, which
may be termed the positive disease, to be expected from the
specific action of the medicinal substance, or its positive primary
(first and principal) eflTeet
When this is past, there ensues, in hardly appreciable transi-
•oeptural maimer. For medicines that arc still weaker we require, in addition to a
comiderable doee, individuals ttiat are, it is true, healthy, but of very irritable delicate
eoiHtitatioos. The more obvious and striking symptoms must be recorded in the
list, thoM that are of a dubious character should be marked with the sign of dubiety,
tmtil they have frequently been confirmed
Id the mTestigation of these medicinal symptoms, all Buggestioos must be as care-
fbDy AToided, as has been recommended for the investigation of tiie symptoms of
diseafte. It must be chiefly the mere voluntary relation of the person who is the
subject of the experiment, nothing like guess-work, notliing obtained by dint of crost
qnettlooing, that should be noted down as truth, and still less, expressions of sensa-
that hatve previously been put in tSie ejcperinientcr's mouth.
But haw, even in diseases, amid the symptoms of the original dlHease, the medi-
Bymptoms may be discovered, is the subject f<)r the exercise of a higher order
fi# inductive minds, and must be left to niasters only in the art of observation.
' iij Drojpihemta de viribits medicamtjUonun are something of this kind.
464 THE MEDICINE OP EXPERIENCE.
tions,^ the exact opposite of the first process (especially in the
case of vegetable medicines), there occur the exact opposite
(negative) symptoms constituting the secondary action.
Now, if in the treatment of a disease we administer those
medicines whose primary symptoms, or those of its positive ac-
tion, present the greatest similarity to the phenomena of the
disease, this is a positive or curative mode of treatment, that is to
say, there occurs what must take place according to my second
maAn of experience, rapid, permanent amelioration, for the
completion of which the remedy must be given in smaller and
smaller doses, repeated at longer intervals, to prevent the occur-
rence of a relapse ; if the first, or first few doses have not aliea-
dy sufficed to efiect a cure.^
Thus, to the abnormal irritation present in the body, another
morbid irritation as similar to it as possible (by means of the
medicine that acts in this case positively with its primary symp-
toms) is opposed in such a degree that the latter preponderates
over the former, and (as two abnormal irritations cannot exist
beside each other in the human body, and these are two irrita-
tions of the same kind) the ccnnplete extinction and annihilatioii
of the former is efiected by the latter.^
Here a new disease is certainly introduced (by the ^ledicine)
into the system, but with this diflFerence in the result, that the
original one is extinguished by the artificially excited one; but
the course of the artificially excited one (the course of the me-
dicinal symptoms), that has thus overcome the other, expires in
a shorter time than any natural disease, be it ever so short.
It is astonishing that, when the positive (curative) medicine
employed corresponds very exactly in its primary symptoms
with those of the disease to be cured^ not a trace of the secon-
dary symptoms of the medicine is observable, but its whole ac-
tion ceases just at the time when we might expect the com*
mencement of the negative medicinal symptoms. The disease
' So that ID this transition stage sympioms of the first order still alteraatc
jfjmptoms of the second, until the second order attains the ascendancy and iq[>-
pears pure and unmixed.
* Hius, when a pereoo accustomed to drinking brandj has heated and eiduuirted
himself to the utmost by some rapid, violent exertion, (e. g. putting out a fire or
reaping corn), and oomplaios of burning heat, the most violent thirst and heavineaa
of the limbs, a single mouthful (half an ounce) of brandy will probably in leas thao
half an hour, remove the thirst, heat, and heaviness of limbs, and make him quite
well, because brandy given to healthy persons unaccustomed to its use. usually
causes in its first action thirst, heat and heaviness of the limbs.
THB XIDICINE OF EXPERIENCE. 456
disappears if it belong to acute diseases in the first few hours,
which are the duration allotted by nature to the primary medi-
cinal symptoms, and the only visible result is — ^recovery — a
real dynamic mutual extinction.
In ^e best cases the strength returns immediately, and the
lingering period of convalescence usual under other modes of
treatment is not met with.
Eqmally astonishing is the truth that there is no medicinal
substance which, when employed in a curative manner, is weaker
than the disease for which it is adapted — no morbid irritation
for which the medicinal irritation of a positive and extremely
analogous nature is not more than a match.
If we have not only selected the right (positive) remedy, but
have also hit upon the proper dose (and for a curative purpose
incredibly small doses suffice), the remedy produces within the
first few hours after the dose has been taken a kind of slight
aggravation (this seldom lasts so long as three hours), which the
patient imagines to be an increase of his disease, but which is
notching more than the primary symptoms of the medicine, which
are somewhat superior in intensity to the disease, and which
ought to resemble the original malady so closely as to deceive
the patient himself in iiiQ first hour, until the recovery that en*
sues afler a few hours teaches him his mistake.
In t^is case the cure of an acute disease is generally accom-
plished by the first dose.
I£J however, the first dose of the perfectly adapted curative
medicine was not somewhat superior to the disease, and if that
peculiar aggravation did not occur in the first hour, the disease
is, notwithstanding, in a great measure extiDguished, and it
only requires a few and always smaller doses to annihilate it
ctompletelyJ
I^ under these circumstances, iu place of smaller doses, as
large or larger ones are administered, there arise (after the disap-
pearance of the ori^nal disease) pure medicinal symptoms, a
kind of unnecessary artificial disease.^
' In the more special part I eiudl discuss how fjar it is necessary in the ti^atment
ai efarotnc (fiseases, even after the complete restorabon of health, to continue giving
for some moDths longer a niuall quantity of the same medicine that cured the disease,
hot at erer longer and ktuger intervals, in order U) eradicate every trace of the chronie
disease in the Ofrgaiiism that h;is been for years accustomed to its prcsenca
' Should we observe Uiat the person recovering under the action of the curative
medicine requires to continue taking an equally large or even larger dose in order to
faweat a rebipse, this is a positive sign thai the cause that has produced the disease
456 THE MEDIGINS OF EXPEBISNCB.
But the case is quite different with palliative treatment, where
a medicine is employed whost positive^ primary action is the opposite
of the disease.
Almost immediately after the administration of such a medicine
there occurs a kind of alleviation, an almost instantaneous sup-
pression of the morbid irritation for a short time/ as in the case
cited above of the cold water applied to the burnt skin. These
are called palliative remedies.
They prevent the impression of the morbid irritation on the
organism only as long as their primary symptoms last, because
they present to the body an irritation that is the reverse of the
irritation of the disease ; thereafter their secondary action coin-
mences, and as it is the opposite of their primary action, it eoin-
cides with the original morbid irritation and aggravates it.»
During the secondary action of the palliative, and when it has
been left off, the disease becomes aggravated. The pain of the
burn becomes worse when the hand is withdrawn fix>m the cold
water than before it was inmiersed.
As in the (positive) curative mode of treatment in the first
still exists, and this most W remoTed to render the recoyeiy pennanent — an error of
diet (abuse of tea, coflfee, wine, spirits, <&&), or some other pernicious habit [e.^. pro-
longed suckling of delicate females, the abuse of the sexual functioii, sedentary habits*
continued quarrelling, Ac]
^ See the first maxim of eiqierienee and the obsenratian attached to iL
* Ignorance of this maxim of experience was the cause why physiciaDs haT«
hitherto selected, almost exclusively, palliative remedies for the treatment of diseases ;
the flattering, almost instantaneously ameliorating action that first ensued deceived
them. In like manner the parents of a morally diseased (naughty) child deceive
themselves when they imagine that a sweet cake is the remedy for its peevishness
and rudeness. It certainly grows quiet inunediately after receiving the first cake»
but on the pccasion of another fit of wilfulness, bawling and noi^ from unrulioess^
the palliative cake again given does not prove so efficacious ; we must give it more
cake, and must at last overload it with cakes, and yet at last this produces no good
result The child has, on the contrary, only become more stubborn, naughty and
unruly/ in consequence of the palliative. The poor parents have now recourse to
other palliatives ; toys, new clothes, flattering words — ^until at length these are no
longer of any avail, and graduaUy induce the opposite state, an increase of the original
BQoral disease in the child it was wished to cure, namely, confirmed naughtinesa^
stubbornness, wildnesa It, at the beginning and on the very first occasion in whidi
it beat or scratched its brothers or sisters or attendants, the curative agents of reprimand
and the rod had been employed in adequately strong dose, and repeated a few times
on the occasion of subsequent (assuredly slighter) fits of passion, they would not have
failed to cure the malady positively, permanently and radically. The naughty child
would, it is true, on the first application of the rod, and for the first half hour, prove
somewhat more unruly, bawl and cry somewliat louder^ but it w<iuld subsequeotlj
become all the more quiet and docile.
THX MSDICIKE OF EXPEBISNCS. 467
hour a slight aggravation usually ensues, followed bj an amelio-
ration and recovery all the more durable, so in the palliative
method there occurs in the first hour, indeed almost instantane-
ously, a (deceptive) amelioration, which, however, diminishes
firom hour to hour, until the period of the primary, and in this
case palliative, action expires, and not only allows the disease to
reappear as it was before the use of the remedy, but somewhat
of the secondary action of the medicine is added, which, because
the primary action of the remedy was the opposite of the disease,
now becomes the very reverse, that is to say, a state analogous
to the disease. This state is an increase, an aggravation of the
disease.
If it is wished to repeat the palliative aid, the former dose
will now no longer suffice; it rtiust be increased,* and always
still further increased, until the medicine no longer produces
lehe^ or until the accessory eflTects, whatever these may be, of
the medicine continued in ever increased doses, arc productive
of bad consequences, that forbid its further employment, bad con-
sequences which, when they have attained a considerable height^
suppress the original malady that has hitherto been treated (in
conformity with the first maxim of experience), and, in place
thereof, another new and at least as troublesome disease appears.*
Thus, for instance, a chronic sleeplessness may be frequently
suppressed for a considerable time by means of daily doses of
opium given at night, because its (in this case palliative) prima-
ry action is soporific, but (in consequence of its secondary ac-
tion being sleeplessness, accordingly an addition to the original
' In addition to innumerable other confirmative examples see J. H, Schulze's Dits.
9«a corporiM humani moment atuarum altercUionum spechnina quacdam ejrpenJurUur,
Halae, 1741, § 18. Besides the increase of the dose, we see also tliat recourse ia
had to a frequent change of palliatives, at least in those chronic diseases for which
there are many, as^ for example, in hysterical fits. Tims we sec the changes rung
•o long and so frequently on asafcetida, castor, galbanum, sngapenum, hartshorn,
tincture of amber, and finally opium in ever increased doses (for each of these is in
its primary action only the probable opposite of the disease and not its analogue,
quently only the first two or three doses of them give relief^ but on subsequent
they produce less and at length no amelioration) — in order to give some
alleTiatiGO as long as that can be done — until the store of palliatives is exhausted, or
until the patient is tired of these undurable cures, or is afflicted with a new disease
from the secondary action of these medicines, which now requires another mode of
treatment
* If we are ao fortunate as to succeed in removing this disease cause<l by the
psUiatiye, the first original one generally reap[)eiu's, shewing tliat (according to the
firvt maxim of experience) it lias only beeo pushed aside and suspended by the newly
dereloped, dissiinilarly irritating disease, but that it has not been destroyed or cured
458 THE MEDICINE OF EXPEBIENCE.
disease) that only by means of ever increasing doses, until an
intolerable constipation, an anasarca, an asthma, or other mala-
dy from the secondary action of opium, prohibits its further em-
ployment.
If however, but a few doses of the palliative medicine be em-
ployed for a habitual malady, and then discontinued before it
can excite an important accessory aflFection, it is then speedily
and clearly apparent, that it is not only impotent against the
original malady, but that it moreover aggravated the latter by
its secondary effects. This is truly but negative relief K for
instance, in the case of chronic agrypnia sought to be cured, the
patient only obtained too little sleep, in that case the evening
dose of opium will certainly immediately cause a kind of sleeps
but when this remedy, which here acts only in a palliative man*
ner, is discontinued after a few days, the patient will then not
be able to sleep at all.*
The palliative employment of medicines is only useful and
necessary in but few cases — chiefly in such as have arisen sud-
denly and threaten almost immediate danger !
Thus, for example, in apparent death from freezing (after
friction to the skin and the gradual elevation of the tempera-
ture) nothing removes more quickly the want of irritability in
the muscular fibre, and the insensibility of the nerves, than a
strong infusion of coflfee, which in its primary action increases
the mobility of the fibre and the sensibility of all the sensi-
tive parts of the system ; and is consequently palliative as re-
gards the case before us. But in this case there is danger in de-
lay, and yet there is no persistent morbid state to be overcome,
but whenever sensation and irritability are again excited and
brought into action even by a palliative, the uninjured organism
resumes its functions, and the free play of the vital processes
maintains itself again, without the aid of any further medica-
tion.
In like manner, cases of chronic diseases may occur, for
' If we have to combat a case of excessive sleepiness, opium, being a
irritant, very analogous in its primary action to the disease before us, will remove H
in the very smallest dose, and if some of the other primary effects of this medicaie
(e. g. snoring in a state of comatose sleep, with open mouth, half shut eyes, with the
pupiLs directed upwards, talking in sleep, want of recollection on awaking, inabOiiy
to recognise those around, <&&,) resemble those symptoms present in the diseasi!, (as
is nut unfrequcDtly the case in typhoid diseases) the oi iginal malady is overcome
rapidly and permanently, and without any after-symptom^ the opinion being in this
case a curative and positive remedy.
rati VEBICINE OF EXPEKIENCE. 459
— I
ample, lijsterical convtilsions or asphyxias, where the tempora-
ly assistance of palKatives (as eau de luce, burnt feathers, &c.,)
may be urgently demanded, in order to restore the patient to
his nsnal undangerous morbid state, for the cure of which, the
totally diflferent durable aid of curative medicines is required.
But where all that is capable of being affected by a palliative
is not accomplished in a few hours, the bad consequences spoken
of above commence to make their appearance.
In acute diseases, even such as run their course in the shortest
time, we would better consult the dignity of medicine and the
wel&re of our patients, by treating them with curative (positive)
medicines. They will thereby be overcome more certainly, and
on the whole more rapidly, and loithout afto'-complaints.
However, the bad consequences of the palliative^ in slight
cases of acute diseases are not very striking, not very considerable.
The chief symptoms disappear in a great measure after each dose
of the palliative, until the natural course of the disease comes
to an end, and then the organism, which has not been very se-
riously deranged during the short time by the secondary effects
of the palliative, again resumes its sway, and gradually over-
oomes the consequences of the disease itself, together with the
after-sufferings caused by the medicine.
If, however, the patient recover under the use of the pallia-
tive, he would also have recovered equally well and in the same
gpace of time, without any medicine (for palliatives never shorten
the natural courses of acute diseases), and would thereafter more
readily regain his strength for the reasons just given. The only
ciicumstance that can in some measure recommend the physi-
cian who practises in this way, namely, that the troublesome
symptoms are occasionally subdued by his palliatives, offers to
&e eyes of the patient and his fi-iends some apparent, but no
real advantage over the spontaneous recovery without the use of
medicine.
Hence the curative and positive treatment possesses even in
diseases of a rapid course, a decided advantage over all pallia-
tive alleviations, because it abridges even the natural periods of
acute diseases, really heals them before the time for completing
their course has expired, and leaves behind no after-sufferings,
* This drcomstanco also makes palliatives unserviceable, that each of them is
woally employed to subdue a single symptom only — the remaining symptoms either
rest untouched, or are combatted by other palliatives, which all poi»ses8 accessory ao-
tiooB that stand in the way of recoyery.
460 THB MEDICINE OF SXPERIEKCS.
I
/
provided the perfectly suitable curative agent has been selected.
It might be objected to this mode of treatment, "that physi-
cians from the earliest periods of the existence of the medical
art, have (to their knowledge) never employed it, and yet have
cured patients."
This objection is only apparent ; for ever since the existence-
of the art of medicine, there have been patients who have really
been cured quickly, permanently, and manifestly by medicineSi
not by the spontaneous termination of the course of acute dis-
eases, not in the course of time, not by the gradual preponde^
ranee of the energy of the system, but have been restored in
the same manner as I have here described, by the curative ac-
tion of a medicinal agent, although this was unknown to the
physician.*
Occasionally,- however, physicians suspected that it was that
' III order to determine this, we must select the cases detailed by some perfeetlj
truthful and accurate observer, where some disease not of an acute character, limitad
by nature to a certain short course, but some long-lasting disease, was cured perm^
nently and without any sequelxe,not by a mixture of all sorts of different drugs^bofc
by a single medicinal substance. This we should certainly find to have been a (cunh
tive) medicine very analogous in its primary effects to the disease. Had it beeo a
palliative, given in ever increasing doses, the apparent cure would not have been paiw
manent, or at least, not without some after-disease. Unless by the instrumentality of
a positive (ciurative) medicine, no rapid, gentle, permanent cure ever took place, nor
in the nature of things, could it ever occur.
In the strikingly rapid and permanent cures by means of composite prescriptioiiB
(if indeed tlie mixture of several drugs of unknown properties, in order to accompUA
some eijually unknown end, deserves a scientific notice), we shall likewise find the
remedy tliat strongly predominates in it to be of a positive character — or the mixture
constituted a medicine, of combined interminable action, in which eadi ingredient ^Bd
not perform its own proper function, but was altered in its action by the others, and
where in consequence of the mutual dynamic neutralizations that oocurrod, an ua*
known medicine remained, which effected in this case what no mortal can divint
wherefore it did it, and what, for a variety of reasons (dependent on the frequently
different strength of the individual drugs m different laboratories, on the mode of
mixing the compound, which can hardly be performed in exactly the same way ageing
and on the constant variety that exists among cases of nominally the same diaeeee)
can never be imitated again ; in one of the above mentioned peculiar or miaamatie
diseases that alwa^rs remain identical
* Thus Hippocrates, or the author of the book entitled TUpl r&rotv riip mm*
l^Bof^ma;, (Basil 1638, frob. pag. 72, lin. 35.) has these remarkable words: iikr^ifmm
vovciii yifCTaij Aat ^lu ru Sftoia irpoi^ift6fiC¥a it pocciwriatr vyiit^o^^^^' ***>' «Tp«y|«iifflP
rJ ditrd notUi ovk io^ay^ Koi iuicav ri dvrd iravct* trat/9j){ Kara rd dvro^ wercp 9i ffrpayywvplf
vva r ;^ 'iir •'**' yiwtrai nai iraicrai — ita r8 iftUiv iftcrof iravtrat. — In like manner, SOOM
later physic iuns have occasionally noticed that the power of rhubarb in producing
belly-ache was the cause of its colic-subduing virtues, and that in the emetic property
of ipecacuanha lay the reason why it checked vomiting in small doses. Tliua Dei->
barding {Fph, nai, cur., cent 10, obs. 76) saw that an infusion of senna-leayea^ which
THX KEDICINE OF EXPEBIENCX. 461
property of medicines (now confirmed by innumerable observa-
tions)— of exciting (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 doud of systems.
When the remedy has been discovered by this mode of pro-
cedure, so conformable to nature, there still remains an import-
ant point, namely, the determination of the dose.
A medicine of a positive and curative character, may, without
any feult on its part, do just the opposite to what it ought, if
given in too large a dose ; in that case it produces a greater dis-
ease than that already present.
If we keep a healthy hand in cold water for some minutes, we
experience in it a diminution of temperature, cold ; the veins be-
come invisible, the fleshy parts become shrunken, their size is
diminished, the skin is paler, duller, motion is more difficult.
These are some of the primary effects of cold water on the healthy
body. K we now withdraw the hand from the cold water and
dry it, no long time will elapse before the opposite state ensues.
The hand becomes warmer than the other (that had not been
immersed), we notice considerable turgescence of the soft parts,
the veins swell, the skin becomes redder, the movements more
free and powerful than in the other — a kind of exalted vitality.
This is the secondary or consecutive action of the cold water on
the healthy body.
This is, moreover, almost the greatest dose in which cold
water can be employed with a permanent good result, as a posi-
tive (curative) medicinal agent in a state of (j^ure) debility ana-
lagous to its above described primary effects on the healthy body.
I repeat, the " greatest dose " ; for if the whole body should be
exposed to the action of this agent, and if the cold of the water
be very considerable,* the duration of its application must at
least be very much shortened, to a few seconds only, in order
to reduce the dose sufficiently.
But if the dose of this remedy be in all respects much in-
creased above the normal amount, the morbid symptoms peculiar
oolic in healthy persons, cured colics in adults and he is of opinion that thia
most be caused by analogy of action. I need not dwell on the propositions of others
(J. D. Major, A. Brcndelius, A. F. Daukwerta, <fec.) to cure one disease by means of
mother artificially excited disease.
* In A greater amount of debility 70° may be proportionately as considerable a
degree of cold in the water, as 60° for a less amount
46Si THE ICEDIGINE OF EXPSBIENCS.
to the primary action of the cold water increase to a state of
actual disease, which the weak part it was intended to cure by
its means cannot or can scarcely remove again. K the dose be
increased still more, if the water be very cold,* if the sur£GM)e
exposed to the water be larger' and the duration of its applica-
tion much longer than it ought to be for an ordinary curative
dose of this agent, ^ there then ensue numbness of the whole
limb, cramp of the muscles, often even paralysis ;* and if the
whole body have been immersed in this cold water for an hour
or longer, death ensues, or at least the apparent death from
freezing in healthy individuals, but much more speedily when
it is applied to feeble individuals.
The same is the case with all medicines, even with iutemal
ones.
The reaper (unaccustomed to the use of spirits) exhausted by
heat, exertion and thirst, who, as I have said above, is restored
in the course of an hour by a small dose, a single mouthful of
brandy (whose primary action shews a state very similar to thai
sought to be combatted in the present instance), would hM into
a state of (probably fatal) sy nochus, if under these circumstancee
he wm:e to drink, in place of a single mouthful, a couple of
pints at once ; — the same positive remedial agent, only in an ex-
cessive, injurious dose.
Let it not be supposed that this injurious effect of excessively
large doses appertains only to medicinal agents applied in a
positive (curative) manner. Equally bad results ensue from ex-
cessive doses of palliatives, — for medicines are substances in
themselves hurtful, that only become remedial agents by the
adaptation of their natural pathogenetic power to the disease
» For example, 40*^ Fahr.
* For example, the entire leg.
■ For example, two hours.
* There are, no doubt, exceptions to ^is, where advantage has foUowed from eat-
cessively large doses of the positive (curative) medicinal agent, in Certain cases tluU
occasionally come imder the observation of the master in the art Thus I saw Hm
remedial power of the primary paralysing action of a very large dose of this
strikingly illustrated in the case of a man (in Thuringia) whose right arm had
for many years almost completely paralysed, and always as if numb and odd. In
the Christmas season he wished to get some fish out of a frosen tank, in order to gm
a treat to some of his friends. He could not catch them with his left arm alone ; he
required to employ the lame arm also, which was not capable of so much iiio>t«-
mcnt Ue might have been engaged with it in the ice<x>ld water for upwards of
half-an-hour. The consequence of this was, that soon afterwards the paralysed arm
inflamed and sweUed, but in a few days it got quite well and as strong as the other;
the paralysis was permanently cured.
THE MEDICINE OF EXPERIENCE. 463
(positiyely or negatiyely) analogous to them, in the appropriate
dose.
Thus, to give an example of negative (palliative) medicines,
a hand very much benumbed by cold, will soon be restored in
the atmosphere of a warm room.^ This moderate degree of
warmth is efficacious in this case as an agent of antagonistic
tendency to the numbness from the cold, that is to say, as a
palliative ; but its employment is not attended with any particu-
lar bad effects, because the dose is not too strong and the remedy
need only be used for a short time, in order to remove the mode-
rate and rapidly produced morbid state it is wished to cure.
But let the hand which has become completely benumbed and
quite insensible from the cold (frost-bitten), be quickly immersed
for an hour in water of 120® Fahr., which is not too great for a
healthy hand, and the part will inevitably die ; the hand morti
ficB and &lls o£
A robust man, much over-heated, will soon recover in a
moderately cool atmosphere (about 65^ Fahr.) without expe-
riencing any appreciable disadvantage from this palliative ; but
if immediately after being so over- heated he has to stand for an
hour in a cold river (wherein he might probably have remained
without any bad result wh^n not in a state of heat), he will
dther fall down dead, or be effected by the most dangerous
typhus.
A burnt part will be alleviated in a palliative manner by cool
water, but will become sphacelated if ice be applied to it.
And* the same is the case with internal remedies also. If a
girl, excessively over-heated by dancing, swallow a quantity of
ice, every one knows what usually ensues, — and yet a small
tablespoonful of cold water or a minute quantity of ice would
not do her any harm, although it is the same j)alliative, only in
a smaller dose. But she would be certainly and permanently
cured, even though excessively over-heated, if she were to chose
a small, appropriate dose of a remedy whose primary effect is
analogous (curative) to the state she is in ; for instance, if she
should drink a little very warm tea mixed with a small portion
of heating spirituous liquor,- (rum, arrack or the like), in a
' For example, of 80o Fahr. at a distaDce from the stove.
* Ttia latter example shews at the same time the correctness of the maxim, that
ivlioithe morbid state is in an extreme degree, and we have (mly a few hours to effect
tlie cure, the employment of the positive (curative) medicinal agent in a very small
dose is infinitely preferable to that of the palliative, even thougli the latter be at first
sdmimstered in a very small quantity. Even tiiould the latter do no harm, it is at
464 THB KEDICIN5 OF BXPSBIENG&
moderately heated room, walking quickly about ; — ^but a large
glass of alcoholic liquor would, on the other hand, throw her
into a high feyer.
None but the careful observer can have any idea of the hei^it
to which the sensitiveness of the body to medicinal irritations
is increased in a state of disease^ It exceeds all belief when
the disease has attained a great intensity. An insensible, pros-
trated, comatose typhus patient, unroused by any shaking, deaf
to all calling, will be rapidly restored to consciousness by the
smallest dose of opium, were it a million times smaller than any
mortal ever yet prescribed.
The sensitiveness of the highly diseased body to medicinal
irritations increases in many cases to such a degree, that pow-
ers commence to act on and excite him, whose very existenoe
has been denied, because they manifest no action on healthy
robust bodies, nor in many diseases for which they are not suited.
As an example of this, I may mentiom the heroic power of
animalism (animal magnetism), or that immaterial influence. of
one living body upon another produced by certain kinds of
touching or approximation, which displays such an energetio
action on very sensitive, delicately formed persons of both sexes,
who are disposed either to violent mental emotions or to great
irritability of the muscular fibres. This animal power does not
manifest itself at all between two robust healthy persons, — ^not
because it does not exist, but because, according to the wiae
purposes of God, it is much too weak to shew itself betwixt
healthy persons, whereas the same influence (quite imperceptible
when applied by one healthy person to another) often acts with
more than excessive violence in those states of morbid sensibility
and irritability, — just as very small doses of other curative medi-
' cines also do in very diseased bodies.
It is analogous to the Inedicinal powers of the application i£
the magnet in disease and the contact of a morbid part with the
other metals, to which the healthy body is quite insensible.
On the other hand, it is as true as it is wonderful, that even the
most robust individuals, when affected by the chronic HiflA4fci|^
notwithstanding their corporeal strength, and notwithstanding
that they can bear with impunity even noxious irritants in great
all events certain that it docs no good, 'wbereas the smallest dose of the suitable
curative ageot can save life, though there may be only a few hours for the perfixnumoe
of the cure.
THE lUDIGINX OF XXFJBBIKNGX. 465
quantity (excesses in food aiid alcoholic liquors, purgatives,
&c^) — jet as soon as the medicinal substance positively appro-
priate to their chronic disease is administered to them, they ex*
perieace from the smallest possible dose as great an impression
as if they were in&nts at the breast
There are some few substances employed in medicine which act
almost solely in a chemical manner — some which condense the
dead fibres as well as the living (as the tannin of plants), or
loosen them and diminish their cohesion or their tension (as the
fiitty substances) — some which form a chemical combination
with hurtfiil substances in the body, at least in the prima) vise
(as chalk or the alkalies which combine with some deleterious
metallic oxydes or some acrid acid in the stomach — sulphuretted
hydrogen water with the most dangerous metals and their ox.
jdes); others which decompose them (as alkalies or liver of
solphur do the noxious metallic salts) ; others which chemically
destroy parts of the body (as the actual cautery). With t/ie ex-
eqption of these few things and the almost purely mechanical
operations of surgery on the body, amputation which merely
shortens the limb, and blood-letting which merely diminishes
the amount of that fluid, together with some meclianically inju-
rious and insoluble substances that may be introduced into the
body — all other medicinal substances act in a purely dynamic
mauner^^ and cure without causing evacuations, without produc-
ing any violent or even perceptible revolutions.
' In the change of diseases into health, as rapid and direct as it is powerful
and mild, by means of Uie positive (curatiTo) and dynamic mode of treatment^ all
thone aboonnal assaults on the organism called coostiiutional remedies, rcvulsioiis and
eracaations, aU emetics, purgatives, diaphoretics, and so forth, arc as Ubclesh as thej
are injurious The medicines employed for their production accomplish thevc revolu-
tiooaiy, duturbing, violent effects chiefly by the excessive dosc*8 m wliicli they an>
given Hie various specific medicuial properties of tartar emetic, ip(H.*acuanha,
■Birum, dee, are not perceived during their abuse as emeties but by tliuse properties
they may become much more efficient remedial agents when used m small doses.
Id like manner, the many medicinal virtues of those substances abused as purgatives
(for which object the true physician almost never or very rarely requires them) are
deaigDod for far more useful ends than they have hitherto been used for. It is only
iriiflB they are given in excess that they cause that tumultuous, hurtful efiect — and
almost all other medicines may become omcticR snd purgatives if admiuu:torc<l in
orer-doses. Thr so-called deranged stomach, the so-adU'd sigui^ of fermenting,
impurities in the primse vise, and of disorder or disturbance of the bile, such ns
biUer taste, headache, anorexia, disgust, nausea, stoinach-adie, and conhtipatioii, Uhuallv
indicate a treatment totally different from violent emetics and purgatives ; the dtL
in U$ wkole extent is often completely removed in a few boon by a couple of
80
466 TB£ XKDICINE OF XXFEBnOf OB.
This dynamic action of medicines, like the vitality itoeli^ faj
means of which it is reflected upon the organisnii is almost
purely spiritual in its nature ; that of medicines used in a posir
tive (curative) manner is so most strikingly with this singular
peculiarity, that while too strong doses do harm and ]»roduoe
considerable disturbance in the system, a small dose, and even
the sinaUest possible dose, cannot be inefficacious, if the remedy be
only otherwise indicated.
Almost the sole condition necessary for the full and Lelpfld
action is that the appropriate remedy should come in contact
with the susceptible living fibre ; but it is of little, almost of no
importance how small the dose is which, for this purposOi 10
brought to act on the sensitive parts of the living body*
If a certain small dose of a diluted tincture of opium is eapable
of removing a certain degree of unnatural sleepiness, the hun*
dredth or even the thousandth part of the same dose of such a
solution of opium suffices almost equally well for the same end,
and in this way the diminution of the dose may be carried
much farther without the excessively minute dose ceasing to
produce the same curative result as the first ; of which moie
will be said in the special part.
I have said that the contact of the medicinal substance with
the living, sensitive fibre is almost the only condition for its
action. This dynamic property is so pervading, that it is quite
immaterial what sensitive part of the body is touched by the
medicine in order to develope its whole action, provided the
part be but destitute of tlie coarser epidermis— immaterial
whether the dissolved medicine enter the stomach or merely
remain in the mouth, or be applied to a wound or other part de-
prived of skin.
If there be no fear of its causing any evacuation (a peculiar
vital process of the living organism, which possesses a peculiar
power of nullifying and destroying the dynamic efficacy of the
medicines), its introduction into the rectum or application to the
lining membrane of the nose, fulfils every purpose, e. jr., in the
case of a medicine which has the power of curing a certain pain
in the stomach, a particular kind of headache, or a kind of stitch
drops of Uie appropriate curative medidiie, and all those tbreatening symptooM ai
once dinppear, without eyacuatioDB and in such an imperceptible manner that
knofWB not whither they have gone.
It is only when substaucei of a completely indige8tit>le, or foreign and vi
oua nature, oppre« the stomach and bowels, that it is permitted in some fpw
to effect their expulsion b> such evacuant medicines.
THS MEDICINE OE EXPERIENCE. 467
in the ade, or a cramp in the calves, or any other affection oc*
enrring in some part that stands in no anatomical connexion
with the place to which the medicine is applied.
It is only the thicker epidermis covering the external surf^^
of the body that presents some, but not an insurmountable ob-
stacle to the action of medicines on the sensitive fibres under-
neath it They still act through it, though somewhat less pow-
erfully. Dry preparations of the medicine in powder act less
powerfully through it ; its solution acts more powerfully, and
still more so if it be applied to a large surface.
The epidermis is however thinner on some parts, and conse-
quently the action is easier in those situations. Among these
tile abdominal region, especially the pit of the stomach, the in-
guinal regions and the inner surface of the axilla, the bend of
the arxQi the inner surface of the wrist, the }.x>pli eal space, &c.,
are the parts most sensitive to the medicine.
Rubbing-in the medicines faciliUites their action chiefly on
this account, that the friction of itself renders the skin more
sensitive, and the fibres, rendered thereby more active and sus-
ceptible, more apt to receive the impression of the specific medi
cinal power, which radiates thence over the whole organism.
If the groins be rubbed with a dry cloth until their sensibili-
ty is exalted, and the ointment of the black oxydc of mercury
then laid upon them, the elTect is the same as though we had
rubbed the same place with the mercurial ointment itselj^ or as
though the ointment had been rubbed in, as it is usually incor-
rectly expressed.
The peculiar medicinal power of the remedy, however, re-
mains the same, whether it be cmplo3^ed outwardly or inwardly,
so as to be brought into contact with the sensitive fibres.
The black oxyde of mercury taken by the mouth cures vene-
real buboes at least as rapidly and certainly as the rubbing-iu of
Naples ointment upon the gioins. A loot-bath of a weak solu-
tion of muriate of mercury cures ulcers in the mouth as rapid-
ly and certainly as its internal administration, especially if the
part that is to be bathed be previously rubbed. I'iuely leviga-
ted cinchona powder applied to the abdomen cures the inter-
mittent fever which it can cure by internal use.
But as the diseased organism is altogetlicr much more sensi-
tive for the dynamic power of all medicines, .so also is the skin
ot (liiieaBed persons. A moderate quantity of tincture of ipe-
cacuanha applied to the bend of the arm eftcctually removes
468 THE hkdiohtk of joLmsaastfiM^
tbe teiulencj to vomit in very sick indiyidaals (by means of its
primary power to excite vomiting).
The medicinal power of heat and cold alone seems not to be
so exclusively dynamic as that of other medicinal sabstanoeB*
Where these two agents are employed in a positive manner, the
smallest possible dose of them does not suffice to prodaee the
desired effect. When it is requisite to obtain relief rapidly ihej
both have to be employed in greater intensity, in a larger dose
(up to a certain amount). But this appearance is deceptive;
their power is just as dynamically medicinal as that of other
medicines, and the difference in given cases depends on the
already existing habituation of our body to certidn doses of these
stimuli, to certain degrees of heat and cold. The heat and cold
to be employed in a medicinal manner must surpass this aoGUS-
tomed degree by a little^ in order that it may be employed in a
positive manner with success (fxy a great decUj if it is to be used
in a negative or palliative manner).
The temperature of blood-heat is for most people in our di-
mate higher than the usual degree for the skin, and conse-
quently a footbath of 98^ to 99^ Fahr. is sufficiently temperate
and warm enough to remove positively heat in the head (if no
other morbid symptoms are present) ; but in order to alleyiate
in a palliative manner the inflammation of a burnt hand, we re-
quire to use water considerably colder than we are accustomed
to bear comfortably in healthy parts of the body, and the water
should be, within certain limits, so much the colder the more
severe the inflammation is.^
What I have here stated respecting the somewhat greater
dose of heat and cold for curative purposes applies also to all
other medicinal agents to which the patient has already been
accustomed. Thus for medicinal purposes we require to ad-
minister to persons hitherto accustomed to their use doses of
wine, spirits, opium, coffee, &c., large in proportion to the
amount they were previously accustomed to.
Heat and cold, together with electricity, belong to the most
diffusible of all dynamic medicinal stimuli, their power is not
' At firat we require for this paUiative amelioration, even should the inflamma-
tion be great) only a cool water of about 70** Fahr^ but from hour to hour xn mmt
use somewhat colder water ; at length as much as well-cold (62^ Fahr.) and eren
beyond that, in order to obtain the same amount of relief as at first (and provided we
know no better remedy). We must from time to time mcrease the degree of cold, am
is required in the internal employment of other palliative meansi
nn MjroiGiN£ op kxpsbisxcs. 489
nor amsted by the epidermis, probably because its
physical property serves as a conductor and vehicle for their
medicinid power, and thus helps to distribute thcnu The same
may be the ease with regard to animalism (animal magnetism)
the medicutal action of the magnet, and in general with regard
to the power of the external contact of metals. The galvanie
power is somewhat less capable of penetrating through the epi-
dermis.
If we observe attentively we shall perceive that wise nature
produces 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 ap-
pliances we heap together in order to attain a single object, the
fiutiier do we stray from the precepts of our great instructresSi
and the more miserable will be our work.
With a few simple means, used sin^y 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 ioeurable
diaeaaes (not unfrequently in the shortest space of time) into
health — ^whereas we may, by the employment of a heap of ill-
selected and composite remedies, see the most insignificant
maladies degenerate into the greatest, most formidable, and
most incurable diseases.
Which of these two methods ^vill the jirofessor of the healing
art who strives after perfection, choose 7
A angle simple remedy is always ciileiilated to produce the
most benefieial effects, without any additional means ; pro\nded
it be the best selected, the most appropriate, and in the proper
dose. It is never 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 com-
pletely practicable, to observe from the elleet of the medicine
what still remains to be cured. One, two, or at most three sim-
ple medicines are sufficient for the removal of the greatest dis-
ease, and if this result does not follow, the fault lies with us ; it
is not nature, nor the disease, that is to blaiuc
If we wish to ©erceive clcarlv what tlic remedv effects in a
disease, and what still remiains to be doue, we must only give
one single simple substance at a time. Every addition of a
aecond or a third only deranges the object we have in view, and
470 TH£ MEDICIKR OF JBXPERIENGX.
when we wish to separate the effects of the remedj jrom the
Bjmptoms of the morbid process (seeing that at the most we
may indeed be able to know the symptoms of the action of a
simple medicine, but not the powers of a mixture of drugs^ that
either form combinations among, or are decomposed by, one
another, and these it will never be possible for us to know), we
now no longer see what portion of the changes that have takeu
place is to be ascribed to the disease, — ^^-e are unable to distin-
guish which of the changes and symptoms that have occorred
are derived from one, which from another ingredient of the
compound remedy, and consequently we are unable to deter-
mine which of the ingredients should be retained and which
discarded during the subsequent treatment, — nor what other
one we should substitute for one or other or for all of tbenu
In such a treatment none of the phenomena can be referred to
its true cause. Wherever we turn, nought but uncertainty
and obscurity surrounds us.
Most simple medicinal substances produce in the healthy hu-
man body not few, but on the contrary, a oonsideraUe array of
absolute symptoms. The aj^ropiriate remedy can consequently
frequently contain among its primary effects an antitype of mos^
of the visible symptc»ns in the disease to be cured (besides
many others which render it suitable for the cure of other dis-
eases).
Now the only desirable property that we can expect a medi-
cine to possess, is this, that it should agree with the disease — ^in
other words, that it should be capable of exciting j)er se the
most of the symptoms observable in the disease, consequently^
when ^nployed antagonistically as a medicine, should also be
able to destroy and extinguish the same symptoms in the dis-
eased body.
We see that a single simple medicinal substance possesses in
itself this property in its full extent, if it have been carefully
selected for this purpose.
It is therefore never necessary to administer more than one
single simple medicinal substance at once, if it have been chosen
appropriately to the case of disease.
It is also very probable, indeed certain, that of the several
medicines in a mixture, each no longer acts upon the disease in
its own peculiar way, nor can it, undisturbed by the other in-
gredients, exert its specific effect, — but one acts in opposition to
the other in the body, alters and in part destroys the adioa of
TBJB XXDICINE OF EXPSBIENCE. 471
the other, ao that from this oombinatioa of several powers that
djnamicaUj decompose each other during their action in the
body, an intermediate action is the result, which we cannot de-
aie, as we cannot foreaee, nor even form a conjecture respect-
ingit^
In the action of mixtures of medicines in the body, there oc-
curs what| indeed, must occur according to the maxim of expe-
rience given above (viz. : — that a general irritation in the body
iemovea another, or else suppresses it, according as the one irri-
tation is analagoua or antagonistic to the other, or provided the
one be much more intense than the other) — the actions of sev-
eral of the medicines in the compouud partially destroy one
another,' and only the remainder of the action, which is not
covered by any antagonistic irritation in the mixture, remains
to oppose the disease ; whether this be suitable or no, we cannot
tell, as we are unable to calculate what actually will remain.
Now, as in every case, only a single simple medicinal sub-
stance is necessary; no true physician would ever think of de^
grading himself and his art, and defeating his own object, by
giving a mixture of medicines. It will ratlier be a sign that he
in certain of his subject if we find him prescribing only a single
medicinal substance, which, if suitably chosen, cannot &il to
remove the disease rapidly, gently and j)erinancntly.
If the symptoms be but slight and few in number, it is an
unimportant ailment that scarcely requires any medicine, and
may be removed by a mere alteration of diet or regimen.
But if— as rarely happens — only one or a couple of severe
symptoms be observable, then the cure is more difficult than if
many symptoms were present In that case the medicine first
prescribed may not be exactly suitable, either because the pa-
tient is incapable of describing the extent of his ailments, or
because the symptoms themselves are somewhat obscure and
not very observable.
In this more uncommon ease we may prescribe one, or at
moBt^ two doses of the medicine tliat ap{)ears to be the most ap-
propriate.
It will sometimes happen that this is the right remedy. In
* Thii n the reason why the frequently enorni<mfl dijues of heroic med'ckics of
TBiious kinds in a complex prescription are often taken without any great effect. A
aiogle uneaf fthcsde poweriul iugrediejitdji would oft£U occjijdoo death in the ha^e
472 THE XEDICINB OF XZPKBIBNCaL
the event of its not being exactly suitable, which is most oom-
monlj the case, symptoms not hitherto experienced will reyed
themselves, or symptoms will develop themselves more fbDy,
that the patient has not previously noticed, or only in an ind^
tinct manner.
From these symptoms which, thongh slight, now shew them-
selves more frequently and are more distinctly perceptible, W0
may now obtain a more accurate picture of the disease, where-
by we may be enabled to discover with groater and even the
greatest certainty the most appropriate remedy for the original
disease.
The repetition of the doses of a medicine is regulated by tlie
duration of the action of each medicine. If the remedy acts ia
a positive (curative) manner, the amendment is still perceptible
after the duration of its action has expired, and then another
dose of the suitable remedy destroys the remainder of the dis-
ease. The good work will not be interrupted if the seoond
dose be not given before the lapse of some hours after the oes«
sation of the action of the remedy. The portion of the disease
already annihilated cannot in the mean time be renewed ; and
even should we leave the patient several days without mediciiM^
the amelioration resulting from the first dose of the curative
medicine will always remain manifest.
So far from the good effect being delayed by not repeating
the dose until after the medicine has exhausted its action, the
cure may on the contrary be frustrated by its too rapid repeti-
tion, for this reason, because a dose prescribed before the oeasa-
tion of the term of action of the positive medicine is to be
regarded as an augmentation of the first dose, which from igno*
ranee of this circumstance may thereby be increased to an enor-
mous degree, and then prove hurtful by reason of its excess^
I have already stated that the smallest possible dose of a posi^
tively acting medicine will suffice to produce its full effect. I^
in the case of a medicine whose action lasts a long time, as for
instance digitalis where it continues to the seventh day, the
dose be repeated frequently, that is to say, throe or four times
in the course of a day, the actual quantity of medicine wiU, be*
fore the seven days have expired, have increased twenty or
thirty-fold, and thereby become extremely violent' and injuri-
' The following circamstunoe mast also be taken into coii«ideniti«k We cMumt
weU t«U how it happeon, but it w not the lew tcue, that even one and the Mune
THB KKDICIXE OF EXPERIENCE. 478
ous; whereas lihe first dose (a tweniieth or thirtieth part) would
bave amply sufficed to effect a cure without any bad conse-
quences.
After the expiry of the term of action of the first dose of the
medicine employed in a curative manner, we judge whetlicr it
will be useful to give a second dose of the same remedy. If
tlie disease have diminished in almost its whole extent, not
merely in the first half-hour after taking the medicine, but later,
and during the whole duration of the action of the first dose ;
and if this diminution have increased all the more, the nearer
the period of the action of the remedy approached its termina-
ti<m — or even if, as happens in very chronic diseases, or in mala-
dies the return of whose paroxj^sm could not have been expected
during this time, no perceptible amelioration of the disease have
indeed occurred, but yet no new symptom of imjwrtance, no
hitherto unfelt sufferhig deserving of attention have apiKiared,
then it is in the former case almost invariably certain, and in
die latter highly probable, that the medicine was the curatively
helpful, the positively appropriate one, and, if requisite, ought
to be followed up by a second — and finally even, after the
fiiTGurable termination of the action of the second, by a third
do0e if it be necessary and the disease be not in the mean time
eompletely cured, — as it often is, in the case of acute diseases,
by the very first dose.
If the medicine we have chosen for the positive (curative)
treatment excites almost no sufferings j)reviously unfelt by the
patient, produces no new symptom, it is the appropriate medi-
cament and will certainly cure the original malady, even though
the patient and his friends should not admit that any amend-
ment has resulted from the commencing doses, — and so also
conversely, if the amelioration of the original disease tike place
in its whole extent from the action of the curative medicine,
the medicine cannot have excited any serious new symptoms.
Every aggravation, as it is called, of a disease that occurs
gf mediciiic, which wuuld suffice for the curu, pn)viilcil it were iiol rf{>eatvd l)cforo
the, action of thu remedy had cca.«i><l — acts ton titncR ur ]>owerfulIy, if the dose he
dirkled, and these portions taken at sliort intervals <lunn^ tlie ccintinuancc (if the ac-
taon of the medicine ; for example, if the dose of ten drops, which would have sul^
fioed tor the cure, he divided among tlie five days during which the action of the
medicine laate, in such a manner as that one drop of it sliall be taken twice a-day,
at the end of the five days the wine effect is not produced as wouhl liave occurred
from ten drops given at once every live days, but a f:^ more |>owi'rful, excessive,
violent eSkd, provided that the medicine was a curative and positive antidote to the
474 THE MSDICIN£ OF SXPXBISNOK.
during the use of a medicine (in doses repeated before or imme*
diatcly after the expiry of its term of action), in the form of
new symptoms not hitherto proper to the disease, is owiiig
solely to the medicine employed (if it do not occur just a few
hours before inevitable death, if there have taken place no im-
portant error of regimen, no outbreak of violent passions, no
irresistible evolution of the course of nature by the occurrenoe
or cessation of the menstrual function, by puberty, conoeptioDy
or parturition) ; these symptoms are always the effect of the
medicine, which, oa an unsuitably chosen positive remedy, or ae
a negative (palliative) remedy, either ill-selected or given for
too long a time, and in too large doses, develops them by its
peculiar mode of action to the torment and destruction of the
patient.
An aggravation of the disease by new, violent symptoms dur-
ing the ilrst few doses of a curative medicine is never indicative
of feebleness of the dose (never requires the dose to be increasedX
but it proves the total unfitness and worthlessness of the medi-
cine in this case of disease.
The aggravation just alluded to by violent, new symptoms
not proper to the disease, bears no resemblance to the increase
of the apparently original symptoms of the disease during the
first few hours after the administration of a medicine selected in
a positive (curative) manner, which I formerly spoke o£ This
phenomenon of the increase of what seem to be the pure symp-
toms of the disease, but which are actually predominant medici-
nal symptoms resembling those of the disease, indicates merely
that the dose of the appropriately selected curative medicine has
been too large — it disappears, if the dose has not been enor-
Inously large, after the lapse of two, three, or at most, four hours
after its administration, and makes way for a removal of the dis-
ease that will be all the more durable, generally after the expiiy
of the tenn of the action of the first dose ; so that, in the case
of acute affections, a second dose is usually unnecessary.
However, there is no iwsitive remedy, be it ever so well
selected, which shall not produce one, at least one slight, unusual
suffering, a slight new symptom, during its employment, in veiy
irritable, sensitive patients, — for it is almast impossible that
medicine and disease should correspond as accurately in their
symptoms as two triangles of equal angles and sides resemUe
each other. But this unimix)rtant difference is (in favourable
cases) more than sufficiently compensated by the inherent energy
THK JCSDICINE OF EXPERISNCX. 475
of the vitality, and iA not even perceived except bj patients of
excessive delicacy.
Should a patient of ordinary sensibility observe during the
duration of the action of the first dose, an unusual sensation, and
should the original disease appear at the same time to decline,.
we are unable to determine with precision (at least not in a chronic
disease) from this first dose, whether or no the medicine selected
was the most appropriate curative one. The eifects of a second
dose of equal strength, given after the first has exhausied its
action, can alone decide this point. From the action of this, if
the medicine was not perfectly or exceedingly appropriate, there
will again a^ppear a new symptom (but not often the same tliat
was observed from the first dose, usually another one) of greater
intensity (or even several symptoms of a like character), without
any perceptible progress occurring in the cure of the disease in
its whole extent ; — if) however, it was the appropriate positive
medicine, this second dose removes almost every trace of a new
symptom, and health is restored with still greater ra])idity, and
without the supervention of any new ailment.
Should there occur from the second dose also some new
symptom of considerable severity, and should it not be ix)ssible
to find a more appropriate medicine (the fault of which may
however lie either in a want of diligence on the part of the
physician, or in the smallness of the supply of medicines, whose
absolute effects are known) in the case of chronic diseases, or
acute diseases that do not run a very rapid course, a diminution
of the dose will cause this to disappear, and the cui*e will still
go on, though somewhat more slowly. (In this case also the
energy of the vitality aids the cure).
The choice of the medicine is not inappropriate if the chief
and most severe symptoms of the disease are covered in a positive
manner by the symptoms of the primary action of the medicine,
while some of the more moderate and slighter morbid symptoms
are so only in a negative (palliative) manner. The true curative
power of the predominant positive action of the remedy takes
place notwithstanding, and the organism regains full possession
of health without accessory sufferings during the treatment, and
without secondary ailments thereafter. It is not yet decided
whether it is advantageous in such a case to increase the doses
of the medicine during the continuance of its employment.
If^ during the continued employment of a curative medicine
476 THE MSDICUnB OF EXPBRIBKCB.
without increasing the doses (in a chronic disease,) fresh symp-
toms not proper to the disease should, in the course of tinier
present themselves, whereas the first two or three doses actad
almost without any disturbance, we must not seek for the caoae
of this impediment in the inappropriateness of the medicine, bol
in the regimen, or in some other powerful agency from without
If, on the other hand, as is not unfrequently the case when
there is a sufficient supply of well known medicines, a positiYO
medicine perfectly appropriate to the accurately investigated case
of disease, be selected and administered in a suitably small do86^
and repeated after the expiry of its special duration of action,
should none of the above alluded to great obstacles come inthe
way, such as unavoidable evolutions of nature, violent passions,
or enormous violations of regiminal rules, and should there be
no serious disorganization of important viscera, the cure of acute
and chronic diseases, be they ever so threatening, ever so serious,
and of ever so long continuance, takes place so rapidly, so per-
fectly, and so imperceptibly, that the patient seems to be trans-
formed almost immediately into the state of true health, as if by
a new creation.
The influence of regimen and diet on the cure is not to be
overlooked ; but the physician needs to exercise a supervision
over them only in chronic diseases, according to principles which
I shall develop in the special part of my work. In acute dis-
eases, however (except in the state of complete delirium), the
delicate and infallible tact of the awakened internal sense that
presides over the maintenance of life, speaks so clearly, so pre-
cisely, so much in conformity with nature, that the physician
needs only to impress on the friends and attendants of the pa-
tient, not to oppose in any way this voice of nature, by refusing
or exceeding its demands, or by an injurious officiousness and
importunity.
OBJECTIONSTO A PROPOSED SUBSTITUTE FOR
CINCHONA BARK,
AND TO SUCCEDANEA IN GENERAL.*
In the commercial world the spirit of substitution has been
lately boldly stalking abroad. A large number of substitutes
> From the Reiclu-Anxeigtr, No. 77» 1806.
OBJKCnOKS TO A PROPOSED SUBSTITITTE, ETC. 477
for coffee liave been proposed and offered at low prices — and no
small number of substitutes for hops in beer liave been sought
for.
It would have required no great experience to perceive a priori
that infusions of burnt barley would taste like burnt barley, of
burnt chicory-root and carrot would taste like burnt chicory -root
and carrot, and of burnt cypcrus would taste like burnt cyperus,
and that each would act in its own peculiar way on the health
of man, but that none of them would cither taste like coffee, or
yet be capable of developing on the human organism the effects
to be anticipated from genuine coffee.'
If the substitutes for coffee had injurious effects on the health,
yet they were actually, and in comparison with the injurious
nature of coffee, quite inconsiderable, for before being used as
drinks these substances were roasted, and thereby deprived of
the greater portion of their power of deranging the health of
the body.
Much more important and more objectionable as regards the
health were the substitutes for hops in beer, which have been
proposed and recommended. Notwithstanding that the hop is
undoubtedly a medicinal substance, and that the daily use of its
decoction in beer must affect the health, yet it has long been
observed that this bitter substance in beer (though it would be
better that the more wholesome unhoppcd beer made from air-
dried malt, were generally used, esjx^cially that made from wheat)
agreed better than any other with our constitutions, and if only
a moderate quantity of it enter into the composition of the beer,
it appears at length to become almost quite innocuous to us.
But what excuse can be offered for forcing us to use in our
daily drink completely new medicinal substances, such as worm-
wood, feverfew, and other drugs of still more unknown action,
as psoralia, &c., in the form of unchanged vegetable decoctions,
in place of hops in beer ? What pests in the form of newly de-
veloped chronic diseases are we not thi-eatened with, which must
in^libly result from the use of decociions of medicinal herbs in
such quantities, the effects of which on the human body are quite
unknown I^
* This mistake had however an accidental, important good effect on all the inbabi-
taata of Europe : since then 8ome millions of dollars fewer hare leen drawn frnui
our port of the world, and the vory bad effects of oyer indulgence in genuine ooffbe
00 the health and the morals, have been diminished.
* Medical men imagine, it is true, that thej know the effects of, e. g^ wormvood
478 OBJECTIONS TO A PROPOSED SUBSTITUTS VOB CIKCHOlTAi
We may read the bad effects on the human health from the
frequent use, e. ff,, of wormwood, in Lange {Domestica hrunsv.,
p. 112), and in Vicat {Mat&re med., p. 40). The bad effects of
the other substitutes for hops are not so easily proved.
But what do the projectors of the substitutes for hops they
recommend care about the injury they do, provided they only
taste bitter !
It is fortunate that all these bitters, which the true physician
has reason to suspect, are, when used in the preparation of beer,
suspected also by the drinkers, and are usually rejected by them
from a sort of instinct.
^p ^P ^P ^r
Of a not less injurious tendency are all the so-called sucoedanea
for powerfiil, established medicinal substances, particularly fiwr
cinchona-bark.
I have nothing more to say respecting Breit/ekPs substituie fit
cinchona than the following :
1. That there is no such thing as a succedaneum or substitute
for bark, nor is it possible that there can be ;
a. Because every plant has its own peculiar medicinal
mode of action that is not to be found in any other plant
in the world — and no other plant is cinchona ; therefore
it stands to reason that cinchona can be replaced by nothing
but by cinchona itself.
As little as a willow, an ash, or a horse-chesnut-tree, cor*
responds in external and botanical respects with a cinchona
tree, so little do the medicinal powers of the barks of said
trees resemble the cinchona bark. In like manner a mix-
ture of calmus, gentian and gall-nuts may indeed be much
more aromatic, more bitter and more astringent than cin-
chona bark ; but it can never be cinchona bark.
b. Because all the substitutes for cinchona that have
, hitherto been proposed, inclusive of Breitfeld's, were only
useful where cinchona would have been of no use, and con-
sequently would do no good where cinchona is indicated,
and could do no good — therefore they cannot replace the
latter.
and feverfew. They ctxuudcr them as absolutely wholesome. This ia howeTer a
delusioiL They have employed both these snbstances only in diseases in whidi the
slow recovery was dependent often on quite other circumstances than the mediciiiei
^ven ; they have used them only in combination with other drugs. But few kiMiw
what harm these herbs car io to the human body when given singly in large quan*
.A2n> TO SnOCEDANEA IN QENEBAL. 479
, 2. That Breitfald's is undeserving of consideration because it
is oompoaed of several vegetable substances— a circumstance
that^ owing to the ever- varying quality of the different ingredients,
the different modes in which they are dried and preserved, the
coarser or finer pulverization of the several substances, and even
the impossibility of mingling them always in the same manner,
must always give a different product, as is the case with all com*
pound medicines.
3. That no one has yet determined the accessory medicinal
effects of the several ingredients of his mixture, whereby they
must evidently excite an accessory action different from that of
(dnchona, and of an injurious nature, which the prescribing phy-
sician can not take into calculation, as he does not know what it is.
« ♦ ♦ ♦
Provided the cinchona bark be not employed in excessive
doses, nor given repeatedly where it can be dispensed with, nor
where it can do no good, nor yet where it must do much and
often irremediable injury — not one tenth part of the valuable
bark that has been hitherto wasted will be required. Then it
¥ould not be too dear ; then the two millions and a half of dol-
lars which Europe yearly pays to South America for bark might
be diminished to 250,000, and if we were wiser physicians, to
50,000 dollars, to the great advantage of our patients.
Would it be very difficalt to cultivate this invaluable tree in
Europe, seeing that it grows on the Andes * at a height of 7692
feet above the level of the sea ?
In conclusion I must express my regret that Mr. Breitfeld has
not devoted his well-meant labours to a less thankless subject.
OBSERVATIONS ON THK SCARLET-FEVER.*
The malignant scarlet-fever that has prevailed in (jcrmany for
eight years and proved fatal to many thousands of children and
older persons, often so unexpectedly, so rapidly, and with symp-
toms never before heard of under such circumstances, this mur-
derous disease, termed scarlet-fever by almost every one, is really
anything but scarlet-fever ; it is a new disease never seen in Ger-
' Properly qwaking, on the Cordillenu de lo9 ^/uir«»tlic highest range of moun-
tiiai in the known world, which includes the whole western side of South America.
* From the Allg. Afuteig. der DaUtchm, No 160. 1808.
480 OBSSBVATIONS ON THE SCABLST-FXYXR.
manj before the year 1800, whichy on account of the red rash
that usuallj accompanies it, might be termed purpura miliam^
and which, then for the first time^ spread from the west, over Hesae^
Bamberg, Beyrouth, Thuringia and Yoigtland, to Saxony, and
thence since that time has extended in all directions.
K it can be proved that this is a new disease and is widely
different firom the old genuine scarlet-fever (which old people can
still very well remember to have noticed in their youth in them-
selves and others), we can very weU understand how it happened,
that the medical men did not know how to act in this new dis-
ease, and that at first all who were likely to die, slipped through
their hands ; indeed that their endeavours did more harm than
good, as they were always under the delusion that they had to
do with the old genuine scarlet-fever, and thus they were misled
by this extraordinary confounding of names and things, to treat
the new disease in the same way as they had been used to treat
the true scarlet-fever (by means of keeping the patient warm,
administering elder-flower tea, &c.). Such a mistake, such a
confounding in diagnosis and treatment of two such very different
diseases, must naturally have a very unfortunate result, as ex-
perience has shewn it to have had by the many thousands who
have fallen Anctims to this new disease.
This disease is new among us, I repeat, for there is not the
slightest trace of such a purple miliary fever having ever before
prevailed in Germany.
The epidemic in Strasburg, described seventy -three years ago by
Salzmann, was a white miliary fever— white vesicles on a white
skin — and differed from our new miliary fever in this, that
ijhildren and old people were almost entirely exempted from it,
and it chiefly affected youths and adults between twenty and
forty years of age; sore throat was very rarely met with in it
The miliary epidemic described by Wclsch, of Leipzig, 150
years ago, consisted of a white, millet-seed size dexanthema, and
only aftected lying-in women ; probably it was a disease brought
on by keeping them too warm.
The most recent miliary epidemic which Briining observed
thirty-six years ago, in the neighbourhood of the Lower Khine,
differs also from our new disease in this, that children of five
years and under generally remained free from it, and women
were more frequently attacked than men, — that it had its critical
days, and wa^ likewise a white miliary rash, resting for the first
few days on red spots, which went off (jn the seventh day,
(ansvATiONs on thx scarlet-fxvibb.
481
Jeaying the white miliary rash standing from three to seven
dajB kmger on die white skin.
The epidemics that bear the greatest resemblanoe to our pre-
sent poqde miliary, are those observed by David Hamilton, k>ng
ago (1710) in Indk, and Charles Allione (in 1758) in Turin.
Otiier observers only mention having occasionally observed a
miliary fever in single individuals, which were usually only
brought on by the use of heating) diaphoretic remedies, espe*
dally of opiates, did not prevail epidemically, and are described
by them in a most vague manner.
That our miliary fever is new and very different from the true
aoarlet-fever, the following comparison will shew.
Tkenme red miliary fever
(vUoh fir flw \M8t eight yean has been
odled Bcariet-feyer)
ittMlBi penoM of all «ge8 ;
I of popk^jred ( Jaoi),
«f daik red qiots ' (yeigkig on brown),
vhibh on being preaed with tho finger
do Mi leave a white spot but remain
mohanged, of a dark red colour, {
of flharply d^ned, discrete patches of
always thickly studded with dark-red
ndiaiy p^jp"^, which are not so much
elefated above the level of the skin as
•tack deep in it, yet distinctly percep-
tible to both the eye and the touch. ^
The old genuine teearlet-fner
attacks only children until their 12th
year (Sim. Schulze)— attacks only chil-
dren, almost never adults (Plencix^ Sen-
nert);
the redness of the skin is an erysipelatous
fire-coloored redness (Sennert]^— a bright
scarlet redness, resembling eiysipelas in
colour and in this, that it immediately
disappears on pressure with the finger
and shews a white spot, which however
immediately resumes its red colour (Na-
vier) ; the redness is like the colour of a
boiled lobster {Act. med Berol.) ; — a cin-
nabar redness (Plcnciz).
The smooth shining redness of the skin
runs imperceptibly into the neighbourii^
white parts, in uimoticeable shades, like
erysipelas, and is never well defined ; —
it becomes from time to time, now a littli'
paler, now a little redder, and almost
every instant it spreads imperceptibly
farther, and then retires to its original
seat (Navier).
None of the above-mentioned author»<
allude to miliary elevations of the bright
red parts of the skin ; — the skin of the
reddened parts is- quite even and smooth
(Hulinemann) ; — the red ports uf the skin
arc quite Rmouth and destitute of inequa-
lities or elevations (Plencii, Op, iract.
we may unhesitatingly call it purple miliary (puq>ura milioris). Who
OQold ffmfrnmd this dark red rash with tho bright fiery colour of scarlet cloth ?
31
48Sr
ommii9Miojf(% ON. m acijuuiiy:
Tliai emnthtma tMmdkM m an i&d»«
tflKBMMit* Bumimr.iiow tUi, now tfalRt paHi
of the bqciy— then 10 no part of the body
for wfaiicfa it has a peculuur affectioiv or
to wUch it attaches itself in a peculiar
manner (StiegMtsX Most freqacntfy the
fi^TOvite spots for its attad^ are the com-
entd parts and flexures of the j<HnU;
most rarely the &ce. The rash is usually
scoompanied by swelling (StiegUts;.
OluB eanthematous forer ha» sot a
determined, regular course, like other
exanthematous fevers (Stieglits) ;— the
eruption remains here and there for an
indeterminate period, often sereral
weeks; tbere is no fixed period for its
departare*
TIm red luBaiy rash often disappears
soddenly at indeterminate times, with
inereased danger to Ufe, usually flawed
suddenly by death.
The erupCkn may be eopiouaor al-
most not at all present, the mOdness or
malignancy of the disease not depending
on that (StiegUts)L Where the eruptioo
is almost imperceptible the danger is
often greatest^ the ferer most malignant ;
— ^where there is a general fiill eruption^
the disease is often mild and sKgfat
It is oidy the dark red mffiary
patdies that perspire, and il is onfy
when the whole body k covered with it
that the patient perspires all over, as m
the epidemic at .Wittenibeiip
iii^ pi 4a)> md tm tihit ^.mtfjM/mm^
difen/ivm fiwy kimd. •f mUiarjf fmm
(Plendx, t6, pt 68).
TIms rednesa of the tme aoariet-fofir
prefeis attaekiag flwt the mutunimA
but sligli% coreftd paitf^ nkicb swA
as for aathfr. rednesa extendi At ifit
the redness and swelliog occor oiitka
fooe (De Qorter, Fiends)— «i first id tk»
fooe^ neck, and cheat (Pfood^— iha asfl^
let redness fiisl appaan^. with tmn^
swdling, on the fooe (ne^ and chaaQp^
the hands^ and the outside of the jfoai
and from these parts it spraada oat is
a» erysqjdatena manoer (is liia woak
cases) all orer the body (Hahnemaao^
In eyeiy goMiine scaiiat-fovier tka
rednesa appaaxa on. the parts mami
simultaneously witk the fobrile hai^
and in mild casea is peiceptible for frovai
three to four days (Plendi^ Senneit), ia
bad cases, seven days (Plenritj aad
goes off by beoomiqg gradually palar
tain day to day. The parte that fiial
baaaaae red, heoome font pa&a (PIsMi^
Heoe of the above aathoaa anataa
mentian of the suddeo disappeaianaa of
the rednesa of true searlet fover dusimi
the fever. After the gradaal fodiiv «f
the redness up to the fixed days men-
tioned above, there ooctur apyrexia and
desquamation (Sennert, Pleoda, De
Qorter, Sim. Schulae). Even after
death the hitherto red spots remaio
cdoored and turn violet (Navier.
The fuller and more extended tte
redness of true scarlet-fever i^ the moie
malignant is the fever always (Hahne-
mann).
If one of the reddened parts m fme
scarlet-fever perspire durii^ the dinriaa
(in an this the authors I have meothxied
are agreed), if the skin is moist^it Ssa»
only OD tiie parts that are not yet red-
dened No erysipelas perspires, and aa
little does the scarlatina redness. It ia
only when the fever comes to an end,
and the redness has gradually gene oi(
that Aere eometimee oonifageaenl pep-
omaaofAxwm on tbb sgablvmwxh.
48S
tlib new wSSbrj disease, fidsely said
|0 be scariei-iBFer, which first appeared
about die middle of tbe year 1800,*
aai^Ukff evcty nev ^meflmce; raged as
a nsiBt iimtapsm epidemic where it
ibat appeand (there was no mUd epi-
dsmie of It), and then finom time to time
iteuiiedfOlten seteral times in a year in
piMe (net unfrequently at-
tha ame persona a eeoood time),
dnring the fbni years still attacked se-
Tcral fiunilifls in sDcceasion ^ during the
b^ years did not^ it is true, cease
far any leoigth of time, but did not pre-
ml qpita epidoniica% again, but rather
tttaeked singlfr fiimilies, or even single
iadhridnals, in one place (though it was
Boftlosa firtal)- it seeme in the course of
afcw yiiin to have a tenden^ to be-
eona eartingnidied completely, like the
ftq;lwii BweattDg-sickness at the com-
it of the 16th centuiy.
Beddea Ae diaphareties, elder-flower
tm, dbe^ and the warm beds wherewith
it was aon^t to retain the eruption on
the skin (usually without success), pur-
gatives, especially mercurial medicines,
aas said to bare dene good in this ez-
anethemateui fever ; but (MOfit/tf, along
with a moderately cool regimen saved the
most, it were foolish to judge of the
power of belladonna from its administra-
tion in this new miliary fever, which, as
we see, is anything but scarlet-fever.
spiration, and thereafter desquamatioQ
of the skin (Sim. Schulce), and the dis-
ease may also go off without any pe^>
piratioo.— (^c/. me<L Berol.)
The true scarlet-fever is an old dis-
ease, which has been accurately observ-
ed for two cmturies in Germany and
other countries, always appeared onljf
as an epidemic and pandemic, alwayv
attacked indiscriminately, and with
scarcely any exception, every child that
had not had the disoise (never those
who had already had it), seldom prt'*
vailed in maUgoant, often in mild, some-
times in perfectly mild epidemics (Sy-
denham, De Ckrter, Nenter, Junker),
searcely proving kUA. to one child in a
thousand, never, or very seMom, occnr-
red sporadically, and the reason of this
was, that as it almost always at-
tacked pandemically all children who
had not previouriy had it, there weve
not under 6 or 8 years enough subjeeta
to infect in order to show its epidemic
character, hence it almost never recurred
in less than 6, 8, or 12 years, and on ac-
count of this rarity of its recurrence, thf
oldest practitioners scarcely ever saw it
ofteuer than three times in their lives^
and it was quite unknown to our younger
practitioners.
In this old, true scarlet-fever, beUa-
donna is useful, both as a prophyUcticb
and as a remedy.
* In tlie first half of the year 1800 true scarlet-fever still prevailed, and a couple
cf months thereafter the new miliaiy fever made its appearance.
484 ON THS PRESENT WANT OF FOBXiaK KIDICINEeL
ON THE PKESENT WANT OF FOREIGN MEDICINES.'
The loud complaints that are uttered respecting the want of
foreign medicines, and recently the lamentation on this subjeet
(in No. 176 of the All Am,) from our esteemed philanthropic
Faust, went to my heart, particularly as I recently got fixwa one
of the most celebrated laboratories in one of the most famed
cities in Germany, in place of choicest, best myrrh which I had
ordered, lumps of a gum-resin having somewhat the appearance
of myrrh, but which, on being pulverized, had a most nauseous
odour, apparently the product of some unknown umbelliferooft
plant, and which was anything but myrrh.
*' What will be the result of this blockade of Europe, what
the end of this deficiency of the most indispensable foreign
drugs?" anxiously exclaim both physicians and patients — "par-
ticularly as the most sagacious men consider the substitution of
one medicine for another to be a lamentable mistake, as no sub-
stance in nature possesses the same qualities as any other, nor is
it possible that it can, for they are characteristically different in
externals, and as veal cannot turn into mutton or pork, neither
can quitch-grass be transformed into sarsaparilla."
Of a truth, this daily increasing deficiency of foreign drugs
seems likely to become a great, an inconceivably great want.
We should no doubt find the warehouses of the druggists and
apothecaries as well and constantly filled as before, notwithstand-
ing that there is a real deficiency of most of the exotica, and a
manifest want of foreign medicinal products, but — only with
goods which, thanks to the known abilities of the adulterators,
with the exception of an external resemblance, possess little or
nothing of the actual nature of the genuine drugs, carefully
stored in jars, chests, and boxes, whereon the honourable name
has been for a long time painted in durable oil-colours, to gua-
rantee the genuineness of their contents ! But good heavens I
what a quid pro quo will the connoisseur find in them ! Every
philanthropist must shudder at the effects such fabrications must
produce on the sick.
It is not far from the truth to say, that the connoisseur can no
longer meet with any genuine extra-European medicines.
* From the Allgemeiner Ameiff^r der Deutsehen, No. 207. 1898.
OV TBB PBB8XKT WANT OF FOREIGN MEDICINSS. 485
This want is great and incalculable, but I feel almost disposed
to assert that it is a just judgment of God for the incredible
abuse that has heretofore been made of these drugs. It may
readily happen to the spendthrift that he may suffer from want,
and that justly.
When we consider how many pounds of cinchona alone any
physician in laige practice has hitherto used in his practice (it is
notorious that a London medical man used 500 pounds annually),
and how large the number of physicians is who give large quan-
tities of medicine, we are horrified at the quantities of foreign
drags hitherto consumed.
But, gracious God 1 was this not an abuse of thy noble gifts 7
Was the large number of draughts, teas, mixtures, electuaries,
drops, powders, pills, administered at short intervals by table-
spoonfuls and tea-spoonfuls, often alternated with one another
several times a day^ and the first one scarcely tasted, put aside,
and replaced (or rather supplanted) by two or three other drugs
— ^was the enormous quantity of drugs employed for fumigations,
dry and humid applications, half and whole baths, clysters, &c.
— ^was all this not an abuse of the noble, precious products of
foreign countries brought from such great distances ?
If it could be proved that such a multitude of drugs was ne-
cessary and indispensable for the patients' relief, then it would
be quite a different thing. In that case the blame would rest
with the Buler of the earth, who seeing we require so much,
ought to have supplied these our necessities by making them
grow in larger quantities on our hazel-trees, willows, in our
meadows, woods and on every hedge.
But all honour be to Him, the wise Preserver of mankind !
Such an expenditure, such a waste of exotic and indigenous
drugs was never required in order to cure the sick. It was not
merely a waste (for in that case it would simply have been
analogous to lighting our pipe with a bank note) — no, it was
an actual sin against true art and against the welfare of sick
humamty.
Do not the poor, who use no medicine at all, often recover
much sooner from the same kind of disease than the well-to-do
patient, who has his shelves filled with large bottles of medi-
cbe? The latter often remains much longer poorly after his
treatment is finished, and must often go from one watering place
to another in order to get free from the after-sufferings left in
him by the monstrous quantity of powerful drugs he took.
486 OBf fTHB FBB8BNT WANT Or FDBnOHf JIBBIOINn.
wbich were nsaally totally ina^^nropriate und eonfleqnentlj
hurtful in their character.
It must some time or other be loudl j and openlj dedai^ ;
and so let it now be loudly and unreservedly proclaimed before
the whole world, that the medical art stands in need tifa Amreiu^
T^rmfrom head to foot What ought not to be done has been
done, and what is of the utmost importance has been totsUy
joverlooked. The evil has become so crying thai llie wdl-
meaning mildness of a John Huss no longer avails, but the fieij
seal of a rock-firm Martin Luther is needed to sweep away dM^
monstrous leaven.
There is no science, no art, not even any miserable bandioraft,
that has kept pace so little with the progress of the age; no art
has remained so fixed in its original imperfection as the medical
art.
Medical men followed at one time this fashioB, at asiotlrer a
difEerent one, now this school, now that^ and when tiie mcie
modem method appeared unserviceable they sought to revive
some ancient one (that had formerly shewn itself worthless).
Iheir treatment tvas never founded vpen eonvietums^ hut dwag^
upon opinions^ each of which was ingenious and learned in pro-
portion as it was valueless, so that we are now arrived at this
point, that we have the unhappy liberty of h<^)elessly selectuig
any one of the many methods, all of which halt in an almost
equally grievous manner, but we have actually no fixed stand-
BxA for treatment, no fixed principles of practice that are ac-
knowledged to be the best. Every physician acts according aa
he has been taught by his school or as his fancy dictates, and
each finds, in the inexhaustible magazine d opinions, authori-
ties to whom he can appeal.
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, scrofUlotts^
gouty, herpetic and scorbutic acridities ; — ^the method of treat-
ment that presupposes in most diseases a species of fundamental
morbid action, such as dentition, or derangements of the biliary
system, or haemorrhoids, or infarctus, or obstruction in the me-
senteric glands, or worms, and directs the treatment against
these ; — ^the method which imagines it has always to do with
debility, and oonceives it is bound to stimulate and re«stimulate
(which they call strengthen) \ — the method which regards the
. OS THX PRKlBffT If ANT OF FOBEIOK MEDICINES. 487
diaeaaed body as ■% meve chemically decomposed mass whicli
mut be Mstoied to the proper chemical condition by chemical
^trogenowa, oxygenous, hydrogenous) re-agents; — another
aaelfaod that supposes diseases to have no other original cause
but moooflities — another &at sees only inspissation of the juices
*--^«DDtbdr that sees nought but acids — and yet another that
^lunkB it has only to combat putridity ; — ^the method that ima-
.^inea it must act iqwciaUy and can act absolutely on the skin,
4ha bitaiii, the liver, the kidneys, or some other single organ ; —
4be method ikmX conceives it must search for and treat <Mily
apasm or peralysus in diseases, only a derangement of the anti-
quated junctkmes ncUuraks^ vtiaks, antmafes, or the revival of
this doctrine, the derangement of the irritalnlity, the sensibility,
or the Teproduotive fitculty; — the method that proposes to
"direct its attention to the supposed remote exciting causes of
^diseaae^-Miie method that prescribes medicines indiscriminately
in diseases, in order to be able to discard those that do harm
•and TOtain those that seem to be of use {ajuvanUbns et nocerUi-
^iiif);— 4he method that, according to the mere names that the
^diseaae befisre them seems to have in books, goes to work with
presenptions got out of the self-same books ; — ^the method that
merely attends to particular symptoms in diseases in order to
BupppssB these by some palliative antidote {contmria\ — and that
method tiiat boasts of being able to subdue the disease by assist-
ing and promoting the efforts of nature and the natural crises ;
— ail these modes of treatment, many directly opposite to one
another, have each their authorities and illustrious supporters ;
but nowhere do wc find a universally applicable, efficacious
standard of treatment accredited in all ages.
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 him-
self constrained to prescribe now one, now another medicinal
ifisrmula, again to abandon them and administer something to-
tally different, and finding that none will suit the case, he
thinks to eflGact, by the strength of the doses of the most power-
fill and costly medicines, that cure which he knows not (nor
any of his colleagues either) how to bring about mildly by
means of small, rare doses of the simple but appropriate medi-
cine. All this he does the more readily seeing that the pre-
48B OK THB YALUS OF THX
vailing system derived &om England commands Iiim to aasaO
his poor patients with large, with enormous doses of the most
active medicines. He is thus in the habit ot forcing the disease
to take itself off by administering repeated, firequenlly alternated
and varied mixtures of large doses of very powerful, expensive
medicines. The disease no doubt is removed, it yields to the
force brought against it ; but if death be not the result, iheie
arise other diseases,, new maladies, that entail the neoessily of a
long, expensive after-treatment, because all these numerooi^
dear, strong drugs were for the most part unsuitable^ were not
accurately adapted to the cure of disease in all its partSw •
Thus the ruination of human health goes hand in hand with
the lavish waste of so many costly foreign drugs — ^the way of
destruction I This was assuredly not the intentk>n of the all*
bountiful, wise Creator, who in nature effects many and great
and multi&rious objects with few, simple means, and a{^)arenily
inaignificant appliances, and has certainly so ordained the medi.
dnes he created, that each should have its own mmiutably fixed
uses, ite certain, imvarying curative power, with which it should
be able to effect, in excessively small doses, many and great
things for the weal of (God-bdoved) man, if we, instead of ii^
terminably talking and writing mere empty conjectures and
hypotheses, would but endeavour to become better and more
accurately acquainted with it. Dioci et scUvavi antmatn. Lei
OS become better, and all will soon go better.
ON THE VALUE OF THE SPECULATIVE SYSTEHS OF
MEDICmE,
ESPECIALLY AS VIEWED IN CONNEXION WITH THB USUAI^
METHODS OF PRACTICE WITH WHICH THEY HAYfi
BEEN ASSOCIATED.*
Although it has ever been man's endeavour to discover and
explain the connexion of the various constituents of the living
body, and the manner of their reaction upon each other, and
upon external forces ; to tell how they give rise to those living
instruments (organs) which are requisite to the maintenance of
of life ; and how, out of the necessary organs, a self-contained
> From the ^/fswm. ^fw. <l^ DeWtcAas N«L 268. 180&
SPBGULAnyS 8Y8TBMS OF MXDICINE. 489
irIiold-~a liying healthful individual — is formed and upheld ; it
has been found impossible, though it has been often tried, to
explain these, either on the principles of mechanics, or physics,
or chemistiy, or the laws of liquid and solid bodies in the inor-
ganic world ; or by gravitation or friction, or by impulse, or
via mertuBj or by the laws of the attraction and cohesion of seve-
ral similar bodies touching each other at many points, or the
repulsion of dissimilar ; nor has it been explained by the forms
of the individual elementary substances which compose man's
body, according as these might be described as flat, or pointed,
or spherical, or spiral, or capiUary, or as rough or smooth,
angular or hooked ; or by the laws of elasticity, of the contrac-
tive and expansive power of inorganic substances, or of the dif-
fusion of light and production of heat, or of magnetic, electric,
or galvanic phenomena, or by the mode of operation of sub-
Btanoes containing oxygen, hydrogen, carbon, or azote, or of
the acids, earths, or metals, or of gelatin, albumen, starch, glu-
ten, or sugar.
But though all the component parts of the human frame are
to be found in other parts of nature, they act together in their
organic union, to the full development of life, and the discharge
of the other functions of man, in so peculiar and anomalous a
manner (which can only be defined by the term vitaliti/)^ that
this peculiar (vital) relation of the parts to one another and the
external world, cannot be judged of or explained by any other
rule than that which itself supplies ; therefore, by none of the
known laws of mechanics, statics, or chemistry. All those
theories, to which age after age has given birth, when brought
in contact with simple experience, and tried by an impartial
test, have ever been found to be far-fetched and unfounded.
Yet, in spite (^ the uniform disappointment of these innume-
rable attempts, tnc physiologists and pathologists would still re-
turn to the old leaven ; not because they saw any likelihood of
these hypotheses leading to useful discoveries in the art of
healing, but because t/iey placed the essence of the medical artj and
their oum chief pride, in explaining much even of the inexplicable.
They imagined it impossible to treat scientifically the abnormal
states of the human body (diseases), without possessing a tangi-
6fe idea of the fundamental laws of the normal and abnormal
conditions of the human frame.
This was the first and great delusion they practij^ed on them-
selves and on the world. This was the unhappy conceit which,
•firom Galen's days down to our own, made tke medical ait -a
stage for the display of the most &ntastio^ oftein most aelf-ceft-
tradictory, hypotheses, explanations, demonstratioBS, oonjeetaxies,
dogmas, and systems, whose evil oonaequences afe not to he
overlooked. Even the student was taught to think he was mas-
ter of the art of discovering and removing disease, wh^ lie
had stuffed his head with these baseless hypotheses, which
seemed made for the express purpose of distracting his .braias,
and leading him as far as possible away firom a true oonoe|itiim
of disease and its cure.
From time to time, it is true, an accumulation of &cts, often
of a nature to arrest the least attentive observer, foroed on men
the conviction that the doctrine of the structure and functioBflof
the human body in the healthy state (physiology), and of the
inward changes consequent on die generation of disease (patho-
logy) which deduces them fix>m atomical and ch^nioal princi-
ples, is an erroneous one ; but in avoiding this error, — still mis-
led by the vain fancy that the business of the medicmai prqfiBssimi
ivas to exphxdn every thtng^ — ^they fell into the opposite, but not
less dangerous evil of superstition.
At one time, men created for themselves an imaginary incor-
poreal something, which guided and ruled the whole system in
its vicissitudes of health and disease (Van Helmont's ArchoBus^
Stahl's Animal Soul); at another, they flattered themselves they
had discovered the secret of physical constitutions and t^npeim-
ments, as well as the origin of particular diseases and epidemics,
in the constellations of the stars, in an influence emanating from
the heavenly bodies, many millions of miles distant ; — or {ac
cording to the modem wide-spread notion, based on ancient ab.
surdities), the human body, in agreement with the old mystic
number three, developed itself in triplicity, mjesented a minia-
ture of the universe (microcosm, macrocosm), and thus, by
means of our knowledge of the great whole, miserably defecttve
as it is, was to be explained to a hair's-breadth. That which
had baffled clear chemistry ^id physics, dim, self-unintelligible
mysticism and frenzied fancy were to bring to light: old aetio-
logy was to explain what puzzled modem natural philosophy.
Thus did the leaders of the medical sects and their foUowera,
ivhenever they sought to analyse health and disease and its cure,
deviate more or less widely from the truth ; and the only use of
piles of folios, quartos, and octavos, which cost a lamentable ex-
penditure of time and energy, is to frighten us from indulging
BPECvhunvx iSTaanBXB of ioedicine. 401
in A like expknation^maBia, and teach us that all such immense
«xeitioii8 are nothing but pernicious folly.
But if these phjaological refinements and pathological would-
be ezplanationfl^ as regards their proper object, the cure of dis-
ease, are rather prejudicial than helpful, as no unprejudiced per-
0OD will deny, of what possible use are they?
** Surely the physician," I £Euicy I hear one exclaim, '* requires
A theory at onoe for a clue, a 'Uiread on which to string his ideas
and systematic practice, and a line to direct him at the sick-bed.
Every artist^ who is not a mere mechanic, must desire to have
aome Gonnexioin of ideas in his mind as he works, concerning
ihe oharaeter of the object on which he is to labour, and the na-
ture of the condition into which he is to mould it."
Tme^ I r^y ; but this clue must neither be a flimsy cobweb
nor a fidse g^de : for then it were worse than none.
The materials of the mechanical workman, indeed, have
I^ysicid and chemical properties, and can only be fitly and fully
employed by one who is well acquainted witJi these properties.
But it is quite otherwise with the treatment of objects whose
essential nature consists in vital operations — the treatment,
namely, of the living human frame, to bring it fix)m an unhealthy
to a healthy condition (which is therapeutics), and the discipline
of the human mind to develope and exalt it (which is ediuxUion).
In both cases, the matter on which we work is not to be regarded
and treated according to physical and chemical laws like the me-
tals of the metallurgist^ the wood of the turner, or the cloth and
eolours of the dyer.
It is impossible, therefore, that either physician or teacher,
when caring for mind or body, should require such foreknowledge
of his subject-matter as shidl lead him by the hand, as it were,
to the completion of his work, as, perhaps, a knowledge of the
jdiysical and chemical properties of the materials helps and con-
ducts the metallurgist, the tanner, and other such craftsmen, to
Ae perfection of theirs. The vocation of both those others
demuids quite another kind of knowledge, just as their object,
a living individual, is quite diiFerent.
Nor are they at all more assisted by metaphysical, mystical,
-ind supernatural peculations, which idle and self^suificiont vi-
jionaries have devised respecting the inner absolute essential
•nature of the animal organism ; respecting life, irritability,
sensibility and reproduction, and the essential nature of the
mind.
492 ON THE YALITE OF THB
Which, indeed, of the ontologioal systems regarding the (nn-
discoverable) nature of the human soul promises to afford any
aid to the teacher in the execution of his noble office? He
might well lose himself in the interminable labyrinth of ab-
stract speculations on the ego and the non-egoj on the essences of
the soul, &c., which extravagant self-conceit has in all ages
wrung from the racked brains of hosts of sophists; but no
advantage that will reward his pains will he draw from these
transcendental subtleties. It has not been given to mortal man
to reason a priori on the nature of his own soul.
The wise teacher is aware of this ; he spares hinself this fruit-
less trouble, and, in aiming at as wide an acquaintance as possible
with his subject-matter, confines himself to the a posteriori^ to
that which the mind's own acts have revealed concerning itself, to em-
pirical psychology. More on this subject in this stage of being
he cannot, more he need not, know.
Just so is it with the physician. That which binds in so
wonderful an oi^anization the (may be originally chemical) con-
stituents of the human frame in life — ^which causes them, in
spite of these their original nature, to act in quite an unmechani-
cal and unchemical manner— which excites and impels them,
when thus combined, to such automatic performances (which do
not obey any of the known laws of mechanics, and differ from
every chemical process, and all physical phenomena) ; this funda-
mental force does not reveal itself as a distinct entity ; it can
only be dimly surmised from afar, and is for ever concealed
from all inquiry and observation. No man is acquainted with
the substratum of vitality, or the a priori hidden arrangement
of the living organization — no mortal can ever dive into it, nor
can human speech, either in prose or verse, even fiuntly shadow
it forth : the attempt ends in fiction and sheer nonsense.
Throughout the course of the two thousand years and upwards
in which men have prided themselves on the cultivation of
philosophy and medical science, no single step, not the smallest^
has been made towards an a priori knowledge of the vitality of
the bodily frame or of the intellectual energy (the soul) which
actuates it. All that inflated bombast, passing for demonstration,
abounding in words, but void of sense — ^all the antics and cur-
vets of the sophists, about indiscoverable things, are ever vain,
and to the modest spirit of the true philosopher perfectly in-
sufferable.
We cannot even conceive a path that should lead us to such
knowledge.
SPECULAXiyS 8Y8TBMS OF KEBICINE. 49S
No not a glimpse shall irail mortality ever obtain of that which
lies deep hidden in the sacred recesses of the Divine Creating
Mind, fiir, immeasurably &r, beyond the grasp of human com-
prehension 1
All, therefore, that the physician can know regarding his
subject-matter, vital organization, and all that concerns him to
know, is summed up in that which the wisest among us, such as
Haller, Blumenbach, Wrisberg, comprehended and taught under
the term physiology, and which we might designate the empiri'
eal knowledge of vitality^ viz. ; what the appreciable plienomena
are which occur in the heaJthy human body^ and what their connex-
ion ie ; the inscrutable how tliey occur, remaining entirely excluded.
I pass on to pathology, a science in which that same love of
system which has crazed the brains of the metaphysical physio-
logists, has caused a like misapplication of intellect in the at-
tempt to search into the essential nature of diseases, that where-
by affections of the system become manifest diseases. This they
t^m the doctrine of proximate^ internal causes.
No mortal can form a clear conception of what is here aimed
at, to say nothing of the impossibility of any created intelli-
gence, even in imagination, finding a road to an intimate view
of what constitutes the essence of disease ; and yet hosts of so-
phists with important looks, have affected to play the seer^s part
in the matter.
After humoral pathology (that conceit, which took especially
with the vulgar, of considering the diseased body as a vessel full
of impurities of all sorts, and <jf acidities with Greek epithets,
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
oould 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 iatro-mechanical system, the system which
derives disease from the original form of the parts, that which
ascribes them to spasms and paralysis, the pathology of the
solids and nerves, the iatro-chemical system, &c.) the seer Brown
appeared, who, as though he had explored the pent secrets of
Nature, stepped forward with amazing assurance, assumed one
primary principle of life (excitability), and would liave it to be
quantitively increased and diminished in diseases, accumulated
4fi4j ON THB YALUS OF THK
asid exhausted, made no aoconnt of any othfir aoone of diseaMi
and persisted in coDsidering all disease from the point of view
of want or excess of energy. He gained the adherenoe of tiui
whole German medical world, a sure proof that their previous
medical notions had never convinced and satisfied their mindS|
and had only floated before them in dim and flickering forma.
They caught eagerly at this onesidedness, which they penuaded
themselves into believing was genuine simplicity. All ike othoF
fundamental, vital forces which were supposable enough (though,
at the same time, little serviceable to a true view and cure), they
gladly cast aside, out of love to his subtle doctrine, and foufld
it highly convenient to be pretty nearly exempted fipom all fiir^
ther thought on disease or its cure. All they had now to do^
was arbitrarily to determine, with a little help from the imagi*
nation, the degree of excitability in diseases according to th»
scale of their master, in order, by sedative or exciting measoretf
— ^for all remedies, according to his new classificatievi, were at
once divided thus — to screw up or let down the degree of exci-
tability assumed in each case. And what was after all, this his
onesided excitability ? Coidd he attach any d^nite and intelli*
gible idea to it? Did he not overwhelm us with a flood of
words destitute of any clear meaning ? Did he not draw us infa^
a treatment of disease, which, while it answers in but few in-
stances, and then imperfectly, could not but in the preponderar
ting remainder give rise to an aggravation or speedy death ?
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 sock
seers there was no lack ; each fell on a new aspect of things-—
each wove a different system, having nothing in common but
the morbid propensity, by inward self-contemplation not only
to give an exact a priori account of the nature and universal
constitution of things, but, moreover, to look on themselves as
the authors of the whole, and, according to their own &shion, to
construct it for and out of themselves. Every hint they deemed
themselves to have gathered on life in the abstract, aad the eth
sential nature of man was — like their whole conception — so un-
intelligible, so hollow i^d unmeaning, that no clear sense could
be drawn from it Human speech, which is only fitted to eon*
vey the impressions of sense, and the ideas immediately flowing
from them — generalizations, each one of which is easily insulat-
ed into concrete examples, and thus brought home and typified
SPXCULATIVE SYSTEMS OF XBDICINX. i/M
to the flenae-HrefiiBed to embodjr their ocmoeits, tkeir extrayagaat'
fmiastio yiaioiis ; and, therefore, they had to babble them forth
in new-fiingled, highsounding words, superlnnarj collocationBy
eooentric rhapsodies, and unheard-of phrases without any sense,
and got involved in such gossamer subtleties, that one felt at a
loss to know which was the most appropriate — a satire on such
a xmsdirection of mental energy, or an elegy on its ill success.
We have to thank the natural philosophers for the disorder and
dislocation of many a young doctor's understanding. Moreover,
their self-conceit was yet too much inflated for them to bring
finrward many views on diseases or their cure, except what they
now and then put forth on their dualism, their polarization, and
rqiresentation, their reflex, their differentizing, and indifferent!*
zmg, their potentizing and depotentizing. This natural philo-
sophy stiU lives and flourishes in a forced animation of matter,
and in ecstatie hallucinations concerning the modelling and or-
dmng of the world and its epitome — man. Incorporeal and
ethereal, it still soars aloft beyond our solar system, beyond the
bounds of the actual ; and does not seem likely yet awhile to
dasoend from its super-sublime elevation to the lowly sphere of
practice (the cure of man^s diseases), nor indeed — so far has it
uferBtrained its power— to be able to do so.
Bat lately there has shot out a branch from this tree, that
seemed to have more reference to the medical art. This new
doctrine, to give us an insight into the nature of disease, be-
thought itself of serving up afresh the old functionesy animaUs^
naturaleSy vitales^ though under new names. But what imaginable
expedient have they for ascertaining Uie exact degree in which the
sensilHlity, irritability, or reproduction, they themselves (arbi-
trwrily) d^t out to each of the organs, are, in individual cases,
increased, diminished, or changed in quality — ^to wldch of these,
preferably to the rest — and (for there is scarcely an organ in the
human frame to which any one of these three properties can be
denied) what is the part played by each organ with reference to
these Aree great divisions in any given case of disease, and what
intimate and absolute condition of the whole system thence
arises, whence it may be clearly seen what is the appropriate,
and in every respect suitable, remedy ? What an unsolvable
problem I And yet its solution is indispensable to the practitioner,
if he is to make any use of the system.* And — lest we should,
* 11^ indeed, this laying down of three prime organic functions, means nothing
than aa approzimattve view, on wtich nothing is intended to be boilt^ and least
496 ON THB YALUS OF TH£
after all, be only quibbling about words — ^what do these three
words, sensibility, irritability, and reproduction, precisely stand
for, in concrete ideas?
How impossible is it by all these barren aprioria to obtain
such a just view of the different mala(}ies as shall point out the
remedy suited to each— the sole genuine aim of the healing art I
How can one justify to a sound judgment the seeking to make
these speculative subtleties, which can never be made concnrete
and applicable, the chief study of the practical physician?
It is one of the regulations that most clearly mark the wisdom
of the all-consistent, all-merciful Creator, that what would be
useless to man has been rendered impossible to him.
The teacher is well aware, that as he is shut out from an on-
tological acquaintance with the absolute nature of the soul (since
it would profit him nothing), besides empirical psychology, he
needs to know nothing but the practical aberrations of the
human mind and heart, and the methods whereby to lead each
misguided wanderer back to the paths of virtue — to carry his
noble work to its highest perfection.
Socrates, the instructor of men, with his practical knowledge
of mankind, his delicate moral sense, and fine perception of what
makes the true happiness of man, needed but a historical know-
ledge of the faults of those with whom he had to do, in order,
by the application of the fittest arguments, and his own better
example, to allure thera back to virtue. He was informed of
Aristodemus that he slighted the Deity ; he gathered fix>m some
of his expressions the symptoms of this perversion of mind, and
the particular prejudices that held him back from religious feel
ing ; and this sufficed him to teach him better, and to elicit from
his own confessions, the arguments that were to shut him up to
reverence for the Deity. Assuredly he needed not to institute
any researches on the essence of the human mind, or the nxeta-
physical nature of this or that delinquency of heart to attain the
godlike aim.
And^ in like manner, besides a historical acquaintance imth the
constitution of the human frarrve in a healthy state, the physician
Tieeds biU in the same way to know the symptoms of the particular
malady (further, indeed, he cannot explore, as it would serve him
nothing), in order to remove it, supposing he tJien knows the righi
remedy.
cl all, medical practice^ b this case, I can find no fiiult with this antiquated Bcbemc;
^bidi simply, m a vttfw,is rational and hannlesB enough, though of no practical utility
SPfiCULATiyK SYSTEMS OF KEDIGIKX. 497
Or^afier all, is this all a mistake, and does the design and dig-
nity of the medical art lie rather in vapoury theorizing, than in
ddll in oaring diseases? Then, indeed, those word-mongers,
who neither do nor cure, must bear away the palm I
Yet| if these metaphysical speculations and systems concerning
the essential nature of disease (supposing they possessed some,
though it were the veriest shadow of probability) were of some,
the least possible value to the physician, (and some value, me-
thinksi that| after all, must surely possess, which has been the
cause of ap much ado), then we cannot but conclude that this
race of system-framers and system-followers must, at any rate,
form the better and more successful practitioners, since they are
possessed of that which — to believe them — is the true and only
solid basis of the art of medicine I
But alas I it is these very men who refute, at the sick-bed,
their own bragging boast of being the confidants of Nature ; it
is these very men who are the most helpless, when they are not
the most disastrous, practitioners.
Not a single founder or follower of any of the many medical
systems could or (if he could, as now and then, perhaps, he
might) would dare to carry out his system faithfully and vigor-
ously into . practice, without doing the greatest injury to his
patients ; so that they would have been far better off wanting
medical aid altogether.* They were obliged, if they did not
wish to see all die before them, either to betake themselves to
the do-nothing (expectant system ; or, contrary to the professed
tenets of their school, to return secretly to the least harmless
expedients of earlier times, the revulsive, purgative, and pallia-
tive measures of humoralism and suburralism.
But we need not very particularly examine their method to
perceive, that, at any rate, it did not take its rise in true philo-
sophy, nor lift its aspirations to tlie lofty heights of reason and
consistency.
One might have expected, that, in the cure of disorders which,
in their own opinion, they had right learnedly defined vL priori^
and reduced to most simple principles, they would only have each
time employed a single simple medicine (and watched its effect,) a
substance whose action was quite known to them in exteiiso^ the
best known, most appropriate, only applicable — according to the
' I mAy refer, in place of anj other of the thousaiKl well-known instanoea* to that
initarKiiis instance of the Brunonian treatment, in the case of one of the sons of tlie
noowntd Peter Fnuik, of Vienna.
32
498 OK THE VALUE OF THE
general ruTe binding on all : what may be effected by a simple
remedy one sbould not seek to attain by means of oompomid
ones: quod potest fieri per paiuxij Ac.
But nothing was &rther from tbeir thon^ts. In the main
thing, the application of the beautiful simple theory — in practice
•— ^they kept faithfully to the old beaten track (though with the
constant addition of the newest, most fashionable remedies), a
plain proof that their system was framed for show — for a make-
believe, and not for use.
In direct opposition to plain ccHnmon sense, they attack disease
by complex mixtures of medicines, none of which they are more
than superficially acquainted with, and of these medicinal pots
pourris they often give several together, and many in one day :
"hand leve obstaculum penitiori virium in medicamentis cogni-
tioni objicit, quod rarissime simplicia, sed utplurimum composita^
nee haec soUtj sed aliorum usu interpolata usurpentwrr^
Such a mode of proceeding, of itself, knocks all the pretensions
to philosophical simplicity and consistency of these Orpriorists [a
priori men] on the head. No single physician on the &ce of the
globe, neither the framer of the system nor his followers, uses a
simple unmixed medicamant, and then waits till its action is
exhausted before giving another !
Even supposing the virtues of each single medicine were
exactly known, this employment of the many-mixed, this pell-
mell adminstration of several substances at once, each of which
must have a different action, would in itself be highly absurd,
and produce a blind and confused practice. For how complicated
must the interaction be of so many ingredients ; how impossible
to trace back the combined effect on the patient to them each
individually, in order, in the subsequent treatment, to omit or
diminish the one and increase the other I But this will not do
with these hotch-potch doses ; they produce, thus united, such
a resultant, that no one can tell what is owing to this or the other
ingredient in the combined effect. No one can tell which
ingredient vitiated the action in such and such a manner, or
which altogether antagonized the other, and neutralized its
effect.
But the case is worse still, and the proceeding more reprehen-
sible, when we consider that the action of each, or, at any rate,
of the most of these substances thus huddled together, is indi-
vidually great and yet unascertained.
> Ft. Hoflhiaim, Med. Rat,, toL iii, ■. ii, c. 87, § 10.
SPSGULAnYE SYSTEMS OF MBDICINS. 499
Now, to mix in a prescription a number of such strong disor-
dering substances, whose separate action is often unknown, and
only guessed and arbitrarily assumed, and then forthwith, at a
venture, to administ^this mixture, and many more besides, thick
upon one another, wijbhout letting a single one do its work out
upon the patient, whose complaint and abnormal state of body
has only been viewed through illusive theories, and through the
spedtBcies of manu&ctured systems — if this is medical art^ if
this is not hurtful irrationality, I do not know what we are to
nndeistand by an art^ nor what is hurtful or irrational.
It is usual at this point, for want of anything else to say, to
excuse one's self by saying, '' the several ingredients in a pre*
scriptioa are to be chosen with reference to the various aspects
of tiie (hypothetically assumed) inward condition of the body,
oi^ indeed, of the symptoms."
Just as if one single simple substance, if it were but rightly
kiown, might not conform to several, many, all of the (un-ideal)
aapeets of the complaint, — as if all the nimieroiis symptoms
could be covered by a medley, whose ingredients, so unknown
in their action, in combination counteract and, in an unforeseen
manner, vitiate and neutralize each other I
This motley mixing system is nothing but a convenient shift
for one who, having but a slender acquaintance with the proper-
ties of a single substance, flatters himself, though he cannot find
any one simple suitable remedy to remove the complaint, that
by heaping « great many together there may be one amongst
them that by a happy chance shall hit the mark.
Whether this mode of treatment be successful, or the reverse
in neither case is any thing to be learnt from it, nor can it cause
the medical art to make a hair's-breadth of progress.
Has there been a change for the better — to which of the ingre-
dients of the medley, or the many successive medleys, treading
on each other's heels, is it owing? This must ever remain a
problem.
" All you have to do, in a similar case, is to repeat the same
mixture, or succession of mixtures, in the same order."
Fond fool ! The case exactly coinciding with that will never
occur — can never occur again, ,
Moreover, it is always difficult to prepare mixtures a second
time precisely the same as the first, and how much more so when
a long interval intervenes. The same recipe often brings out a
very dissimilar compound, when it is given to several apotheca<»
600 09 THX YALVm OT THS
caries at the same time to make up. This lesolts firora many
caxises.
It is not likely, either, often to happen that the patient will
take these mixtures, not imfrequend j disgusting both to taste
and smell, in the exact quantity and time prescribed. Are yoa
quite sure that he has even tasted this or that nauseous dose, and
Uiat he has not substituted for it a less disagreeable donieatio
remedy, to which his improvement is due ?
And now, on the contrary supposition, that he is no better for
the medley dose, or even somewhat worse, which ingredient^
among so many, is to be blamed for this result, that it may be
omitted in the recipe on a future occasion ?
^That is what no one can tell, so it is better never to repeat
the whole mixture."
I should regret much thus to throw away the gold with the
dross. Have I not happily cured the disease by the employment
of a singjie ingredient, which I picked out firom the prescriplioo
of my predecessor, which had long been used with bad effeola^
because I knew that it must be the only efficacious one for tlie
case before me 7
How unwise is it, therefore, to prescribe sudi mixture»^-^anin*
viting often to the eye, the smell, and the taste— of drugs, not
one of which is righUf known in itself or in connexion with
jthe rest!
Am I told '^ The properties of the medicines are not unknown ^7
; I ask ' Are the half-dozen words which the Materia Medica
contains regarding each to be called information, exact informa*
tion'^ Often it is nothing more than a list of names of diseases,
in all of which the substance in question is said to have been
ufieful (fiequently a long list, so that the falsehood is manifest.*)
Names of diseases, did I say ? Heaven knows to what states dt
, body these names were given, and what wisdom presided over
the ussigning of them I
* Bow booeitlj our FViedrich Hoftnui 9feak» no Urn
" QiKmagii m artis cxercitio alic est, TerM ci noo ficto* medioMBciitaraii, pto
tain direna oorpirQin et morboniBi nUioBC, jwm mtimius Boase, eo au^li otifst
, doleaduiii, immo miraBduii eai, quod, ■ dieer* Iktt» quod rts est, perpmmcm md
,. remediat<{wwnm virtutes et opentiGOcs ccrto ac recie panpcctac, Md pleimeqne
atque ezpectatknem, canatif fimstrenter, qma 9erm§ pkarmacorum fmemiimim
Dtmocriii fumm ymifeo mikue ImiUent /— paoca certe superaint, quae fidae ti
nrtatiB. plunmm wen mBdk, mitpecU, M^^ (JVAi rol, t iii, t. ii, cl S, 1 1.)
* JM^dbofwdangcraMaiesadifalMhoodil *> In oqUo mcndaciD majui «l {Mrim-
^Jtum^qoam in medko.** {FKn^i^at iV'at Uk ff»c. 1.)
SPKCULATiyS SYflTXMS OF MEDICINE. 501
And whence do these medical authorities draw their data?
Surely not firom an immediate revelation ? In truth, one would
jjmost be induced to believe they must have flowed to them
firom a direct inspiration, for they cannot be derived firom the
practiee of the physicians, who, it is well known, hold it beneath
tiieii dignity to prescribe one single, simple medicament, and
p^bing 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 prescribing artisticaUy campauikded
receipts.
As, therefore, the authorities in materia mediea, if I may speak
out a little, cannot have obtained the greater part of their data
as to the supposed virtues of the pure, simple medicinal sub-
stance fixMn the experience > of learned physicians, since scarcely
> AlthoBgjh it 18 eertain tbat the Katena Medica can aud must be ike daoghter of
«iperieiiee, yet eren it kat giren way to arbitiwj opbions, ideal and dreamj hypo-
tfiMt, and has allowed itself to be moulded to-day into one (atm, aud on the morrow
falD a new liann, exactly as the dominant medical system for the time being com-
■T-**^ The remedies employed by the ancients, as oUxipkaurmaetLt eepkaOc^
Jipieniem^ •tfmntf, had afterwards to undertake the ofioe of antispasmodic and anti-
nenroiis remedieflL When the prerailiag system assumed tension and laxity of the
fibres as te finrndatioB of disease, the Tery same medicines ^^eh had hitherto per-
Ibimed a different pari were foived to be twisted into one of these two direetions. Bat
did iSbe raigaing syitem require blood c-lpanmng or morbid-acridity-destroying means,
than the quondam tonica, or iedantia^ or dtapharetioa^ tr eeeoproUca^ or diurfiiea^
veve quiddy transformed into mundifieantitL^ anttKorbutic^ anii»eropk%dtma, anii-
pkoriea, At, Ilien, when Brown needed for his system only wUmulating and dehUi-
imiing nmedisi, those very remedies which formerly had been marshalled under many
other titles, are immediately enlisted in the two new regiments, and at wiU drafted
into one or the other ; and as he more particularly required diffuniU and permanent
«timnU, unfettered fimcj was not long at a loss— medicines were speedily raised to
tme or IIm other rank, just as if one had but to utter the fiat, and the substances
coold not dioose but obey the commands of the exalted man, at his pleasure to enter
«Q one or the other function. Just as if the primary action of cindbona would spread
more slowly through the system, or its secondary action last much longer than that
of the equally little understood opium ! As matters till then had stood, the system
•laker had only to dictate which new port this or the other medicine had to assume.
whether it was to be an invertent^ a revertent, or a torpen* (Darwin); and, see, it most
aafier itself to be so employed, until for the behoof of a new system, it is christeoed
anew, and is as peremptorily required to discharge another offioe.
"But if you refer the action of the medicines to their chemical bases, as the rery
newest system does," I hear some one reply, ** then, assuredly, you wiU act conform-
ably to nature." In this way some medicioes are (as arbitrarily as before) reckoned
carbooaoeoas and others hydro<;cneou9, and to each of these suinmarily-cKTided classes
paenKar (fictitious) modes of action de^spotically asHigned. But cabbage, roast-beet
and wfaeatcn cakes, contain also plenty of nitrogen, carbon or hydrogen — ^where then
do we «fiflCover in them those properties which were so liberally allotted to these
dementary substances f
Wkai u to become of an art (to which the charge of human life has been committed)
if/amey amd caprice are to have the upper hand in it/
602 Off TEX TALUE ^F TBX
an Jibing of the kind is to be obtained from them, wbenee da
they get it ?
Most of the imputed virtues of the simple drugs haye, in tlie
first place, obtained a footing in domestic practice, and been
brought into vogue bj the vulgar and non-professional, who often
cannot judge of the genuineness of the medicine; oiften do not
give it the right nan>e ; least of all, can correctly determine ibe
state of the body in which it is said to have been useful. I
say ^^d," for even with them, if needs be, now this now ihal^
family recipe has been outwardly or inwardly applied ; so that
at last it is impossible to say whAt has really been beneficial,
granting the complaint itself has bee^ perfectly reoogniaed,
which, however, by such observers, it never is.
Barren infcHmation of this sort was collected by the old herba-
lists, Matthioli, Tabemoemontanus, Qesner, Fuchsy Lonicer, Ray,
Toumefort, Bock, Lobel, Thumeisser, Clusius, Bauhin, Ac, vcly
briefly, superficially, and confusedly, and interwoven with base-
less and superstitious conjectures, intermingled with that which
the unciting Dioscorides had in a similar manner collected ; and
from this unsifted catalogue was our reamed-looking Materia
Afedtca supplied. One authority cc^ied another, down to our
own times. Such is its not very authentic origin/
■■ ^—^"^ ~"^""^"^
' How uniiiquiriDglj our writers on materia medica have adopted the itatemettt^
proceeding firom these hnpure souroes is evident^ amoog other things^ from tlda» tkat
tkey enumerate among the virtues of crude medicines such as w«re originaUy- de-
rived fipom the mere suppositions of our superstitious forefathers^ who had chHdIsUj
enough asserted certain medicinal substances to be the remedies of certain
merely on account oi some external resemblance of those medicines with
appreciable by the senses in tliose diseases (aiffnature), or whose efficacy rested oiiiy
on the authority of old women's tale8y.or was deduced from certain of their properties
that had no essential connexion with their fiibulous medicinal powers. Thos the nieta
of the orchis and of the talocp^ merely because, on aoootuit of their rescmUanoe in
shape to a pair of testicles, the ancients perceived in this an augury of their utiBty
in aiding tho sexual function, are still said to be analeptics and aphrodisiacs. IVe
kypericum is still esteemed as a vulnerary, because the ancients stamped it with this
character on account of the trifling circumstance that its yellow flowers, when nibbed
betwixt the fingers, give out a Uood-red juioe^ which procured lor it the name of
Johv^B (Uood. Whence do the ehelidonium^ the berberis^bark and the turmerie derive
the reputation they enjoy in our Materia Mcdica as remedies for the jaundice, Vol
irom this, f Jiat formerly it was imagined that the yellow milk of the first and the
yellow colour contained in the two last was a sure sign (signature) that they nuai
be useful in a yellow disease ! And iriience does ehelidonivm in particular get ite
name and its &bled efficacy in dimness of vision, if not finom the old story that the
swallows restore the sight of their young ones by means of this plant ! The tastelese
dragwi$-biood is still, merely on account of its name and blood red colour, said to be
good for bleeding gvana and hamorrfaages I Ranunculus Jkaria and scrophulurim
8PSCUULTIYS SYSTEMS OF MEDICIKX. 508
The few books that form an exoeption to this (Bergius and
CuUen), are all the more meagre in data respecting the proper-
ties of the medicine ; consequently, as they for the most part,
the latter especially, reject the vague and doubtful, we can g^
KUk positive knowledge from them.
One enly among thousands, Murray, gives the cases in which
the medicines were used. But on this point the authorities gene-
rally clash with one another, one affirming one thing and
another another, and so the decision still remains frequently
quite doubtfiiL In many of the cases he lamented - oh that he
bad done so in most of the cases I — that the medicine was not
en^j^doyed alone, but in combination with several others, so that
we are once more plunged into darkness.
The authorities cited even here leave the reader often in doubt
as to the nature and exact constitution of the disease in which
they employed the remedy.
■ra «id to be vaeful for piles, merelj because the roots of both these vege-
tables pfeaent a knotty appearance similar to the hemorrhoidal tumours. Maddtr
obtained its reputation as an emenagogue on account of it8 containing a dark red oo-
lour; snd because animals, when fed upon it, hare the red colouring matter deposited
IB their booes, therefore it is celebrated in the Materia Medica as especially useful
m disgSBBi of the bones 1 Saponaria is still always celebrated in our books as a
fifaaUe solvent and detei)gent medicine, because the decoction of its root, when
beaten np, forms a froth like a solution of Roap, although otherwise it is totally dif-
ferent in Its natm« from soap, and it loses ite frothing property not like the latter by
Uw addition of acid, but on the contrary but adding alkali to it. And does soap it-
self derive its reputation for dissolving obstructions and indurations in the body, from
any other source except from the conceit, that as in houseliold operations and chemical
msnipnlations it exercises a solvent property, it must do the same in the living or-
gnisni idsot Because the cabinet-makers make use of three coloured wood? in their
tods under the eommon name of Sanded wood*, they must therefore enjoy in me-
dicine a eommon power (in the so-called blood purifying drinks), although the yellow
(and white) kind (MatUalum album) is obtained from a totally different tree from the
red kind (pterocarpu* tanialiHWt)^ and causes very violent and serious effects, of which,
however the materia medica knows nothing. Because the bark of einchona tastes
bitter and astringent, therefore the bitter and astringent barks of the tuk, horU'
<kianutf wUloWf «&c., were considered to possess the same action as cinchona bark,-^
just as fliough the taste could determine the action I Because some plants have a
bitter taste, especially gentiana centaureum, called /el terrae, for that reason only
pnetitioDers were convinced tliat they could act as substitutes for tlie bile! From the
circnmstance c^ the root of tiie carex arenaria possessing an external resemblance to
mnapariUa root^ it was inferred that the fii>rmer mu^t possess the same properties as
the latter. Therapeutists have attributed to the stellated afii**' the same cx{)ectorant
qualities as ore possessed by anise seedls, merely because the Latter have a resem-
Uance in ta^ and smell to the seed capsules of the former, and yet some parts of
the tree {ilicemn auiiotuim) that bears these capsules Is used in the Philippine islands
u a poison for suicidal purposes. — This is what I cull a plulos(»phicai and experimental
origin oi the materia medica !
604 ON THE VALUE OF THE, ftC.
How little the greater number of these observers are to be
relied on, is evident, were it only firom this, that they common-
ly assert, that ^' the remedy in their hands had never been detri-
mental, never done the least harm, even when it had done no
good f for every powerful medicine must invariably do injury
where it fails to do good ; a proposition which does not admit of
a smgk exoeption. Behold again, then, manifest untriith I
But what is the anxious reader to learn even from this sole
critically sifting and best of all materia mediciMs f Certainly lit-
tle of a positive character I — ^little of a positive character con-
cerning the only implements of healing ! Bighteous heaven I
(Consider how uncertain must be the use of drugs so extreme-
ly imperfectly known, against diseases which are as diverse as
the clouds in the sky, whose recognition, even by the best of
methods, is tedious, and whose number is legion I
Nay more. Consider how extremely precarious^ I might say^
blind, that practice must be, where states of disease misviewed
through the coloured medium of ideal systems^ are attacked by
means of many such almost unknown medicines, mingled to-
gether in such a prescription, or in many such I On this I let
the curtain drop. —
« « « «
Thus we find, spite of the well nigh uninterrupted revolutions
of the physiological, pathological, and therapeutic theories,
during two thousand years and more, according to mechanica],
atomical, chemical, ideal, pneumatical, and mystical theories,
and owing to this infantile state of knowledge as to the real
properties of simple medicines,— we still find— even in this cen-
tury which in every other respect is hastening towards perfee-
tion — we still Jind^ I repeat, Ijhat only a very small proportion of
human ailments can in such a manner be removed as shall leave
the physician the merit of having been the undoubted author
of the cure. £ither the remaining maladies remained as un-
cured as before the days of Galen, or, thanks to medical prac-
tice, in the room of the original ones there have arisen new dis-
tempers of a diflferent aspect : or the energy of the still vigor-
ous life, backed usually by the secret disease of drugs, itself got
the better, in the course of time, of the disease that oppressed
it ; or single symptoms, hitherto stubborn, yielded to some lucky
accident, wherein no one could trace the connexion of cause
and effect ; or else the unfuling termination of all earthly woea
stepped in to settle the matter.
OK BUBSTITirrXS FOB FOBEION DRUGS. 506
Sach is the fearful but too true condition of the medical art
Iiitherto, which under the treacherous promise of recovery and
health, has been gnawing at the life of so many of the inhabi-
tants of earth.
Oh 1 that it were mine to direct the better portion of the medi-
cal world, who can feel for the suflferings of our brethren of
mankind, and long to know how they may relieve them, to those
purer principles which lead directly to the desired goal !
Infiuny be the award of history to him who by deceit and
fiction, maims this art of ours, which is intended to succour the
wretched!
All-compensating, divine self-approval, and an unfading civic
crown to him who helps to make our art more beneficial to man-
kind!
ON SUBSTITUTES FOR FOREIGN DRUGS,
AKD ON THE BECKNT ANNOUNCEMENT OF THE MEDICAL FACUL
TT IN VIENNA BELATIVE TO THE SUPERFLUOUSNESS OF THE
LATTEB.^
When the imperial government of Austria exerts itself to
supply the want of foreign drugs that is to be feared by indige-
nous substitutes, the intention is certainly patriotic ; but when
the medical Faculty thereupon utters an oracular deliverance as
to which of the foreign drugs are quite superfluous, which may
be in some measure dispensed with, and which are quite indis-
pensable, it is in many points decidedly wrong.
The utility or superfluousness of a medicine is not a thing to
be decreed by any medical faculty, just as it was absurd of the
Parisian parliament to take upon itself to forbid the use of an-
timony as a medicine in 1566, and by a contrary edict to allow
of its employment in 1669. Neither parliament nor faculty can
do such a thing. The art of healing the sick remains a free art,
which can make use of all substances in the whole of the great
kingdom of nature, without any exception, for the relief of the
flick.
Let us only teach physicians jmnctples of universal applicabili-
fy, according to which the powers of drugs may be ascertained
and tested with certainty, as to what each is incontrovertibly
Tiseful and suitable for, to what cases of disease each is unex-
' From Uie Allgemeintr Anzciger dtr Ihuticfien, J^o. 821. 1808.
606 OK SUBSTirUTES FOE FORBIGN DBnO&
ceptionably adapted, and what is the proper dose; and then
each physician would naturally only make use of those, which
are most certainly the most suitable for each case of disease and
the most serviceable, whether they come fix)m the east or from
the west,* or are found at home, — and then he would, from his
own perfect conviction, and from irrefragable reasons, of hik own
accord leave many foreign drugs totally unemployed in his
practice, or only use them in a few well defined cases.
But we are by a long way not so far advanced as thi& No
principles are yet universally recognized, 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 aacer*
tained, a priori, without first subjecting them to the infinitely
tedious process of testing them in hap-hazard fashion at the sick'
bed, which is almost never convincing, and is usually attended
with injurious efiects. This obscure mode ah effectu in Tnorhis^
whereby little or nothing is determined, has, moreover, the cniel
and unpardonable disadvantage, that the individual, naturally
so irritable in disease, is readily aggravated by so many blindly
instituted experiments, and may even fall a victim to thenii
especially since the recent fashion of prescribing large doees of
powerful medicines has been adopted.
But as long as the former better way 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 the different medicines continue ; none will
be able to convince the other of the fallacy of his opinion, none
will be able to bring forward irrefragable proofs of the correctneBS
of his own views. Almost every one entertains a diflferent ides
respecting the power of this medicine and of that, and no one
can shew any proofs for his particular opinion. ,
* But if from the obstructioD of our muritime commerce he is deprived of tliit
medicine or the other, he is naturally deprived of what he can no longer ofaiaii^ aad
to he does what he can in diseases with those medicines that are still at his ogbi-
mand, which he mutt alto know accurately at retpectt their internal properiin and
powert. But if he can obtain them, then no Faculty in the world has any right to
prohibit him using them, or decree their r^ection. But if a F^iculty eao sAms am
tatitfactory groundt, e. g., that pearls are exactly the same substance as musde and
oyster shells, in that case no sensible physician who it convinced of the fact will em*
ploy the costly pearls, but will voluntarily use in place of them, oyster and mascle
shells. The identity of salts, eartlis, and metals may, however, be asobrtained by
well-known chemical principles, but the curative powers of vegetable medicines do
not depend upon their chemically cognisable constituents, but upon priodplea of
quite a different sort^ which have not yet been asoertained
OK SUBOTITTTTES FOR FORSIOK DBUOS. 607
So also the present declaration of the fiicultj is nothing more
than the private opinion of certain individuals as to what they
consider to be the probable properties of the medicines in ques-
tion, founded upon what they have heard or read somewhere
about them, or upon what each may have experienced in his
individual practice, wherefrom they pretend to guess that such
and such is the case.
In order that a judgment should be valid much more is re-
quired, generally recognised principles are requisite, to which
^ judicial court may be able to appeal. If it can shew none,
then its judgment must be merely a collective individual
<qnnion, principally of those colleges that act as spokesmen,
which can no more be considered absolute truth, than the pri-
vate opinion of any well educated physician in the country.
The majority of votes cannot in this instance determine the
standard, as many may form erroneous conclusions as well as
one, as long as no recognised principle proves the basis of their
verdict (So, a few years ago, many thousand physicians thought
and maintained that Brown's doctrine was the only true one,
and yet they all were mistaken.)
If a medicine appears to one or several practitioners never to
be useful in the disease for which it has been recommended by
others, no inference can be drawn firom this circumstance. For
it remains to be seen, — 1, whether it was in each case exactly the
Bime disease that had been treated by its eulogist (nature presents
an infinite variety of diseases, that are often confounded with
one another ; it is excessively rare that exactly the same disease
is met with twice) ; 2, whether it was exactly the same drug (the
practitioner often is ignorant of the signs that mark the genuine-
ness of the drug) ; 3, whether the medicine was always given
in these experiments singly and alone, or in combination with
things that were capable of altering its efficacy ; (as long as phy*
Bicians do not treat a determinate disease with a single unmixed
medicinal substance, but, as is done by them all, mingle it with
other powerful drugs, so long it is impossible to draw any, not
' even a probable conclusion from all their assertions relative to
the curative powers of this or that medicament; they all prove
noAing at all) ; 4, whether the medicine was given in the most
appropriate dose ; (have not the doses of most medicines been
lutherto left to mere caprice ! Must there not, from the very
nature of such powerful substances, be a point over and under
which this or that medicine cannot be prescribed, without — on
608 ON SUBSTITUTIBS FOB FORXIOK DBUfiUI.
account of its very quantity — producing this or that effeot^
failing to produce such effect?) 5, whether it was given at ap
per or improper period of the disease ; 6, whether the (dB
nasty tasting, nasty smelling), medicine was taken at all,
taken only in part, or not at all ; 7, whether some importi
external influences, or some circumstances peculiar to the o
stitution of the patient promoted the recovery, and various oil
considerations.
In like manner, one or several physicians may imagine Hi
they have repeatedly cured the same disease with a certain mc
cine, and yet notwithstanding their honesty, this may beuntr
If we carefully investigate the above points, we shall invarial
find that there is some element of inaccuracy, either that 1
cases of disease were different, or that the medicine was gii
either not alone, but in combination with other powerful druga^
very soon after some other medicines. One or other of tb
imperfections, usually both, occur almost always in the ti«
ment, whether the result was successful or the reverse.
Where then shall we be able to find a series of pure obser
tions in the practice, that shall be able to establish the curat
powers of a single medicine on sure principles? And ;
the Vienna Medical Faculty in the first division of its resolutio
decrees that not only the semen cince, but colocynth, copaivaA
8am, qiccuisia, sabadiUa, sassafras, senega, and even cascarilla .
quite superfluous. And yet but lately, the far-famed Hofc
Hecker, of Berlin, asserted in a voluminous essay published
Allg. Anzeiger der D, {No, 221), ** that cascarilla is not only equa
curative virtues to cinchona bark, but is much superior to :
I say asserted, for in a thousand words he did nothing more tl
what the Faculty did in two words ; he only asserted, but pro
nothing. He does not adduce a single case {and coxddiiot add
one) in which cascarilla had been used alone in ague, still 1
does he shew, in which of the infinitely numerous varieties
ague, cascarilla proved serviceable, when given purely and alo
in order that we may see whether it was certainly and rea
alone useful in the same cases in which cinchona is, or whetl
in other cases also, where the latter is of no use, or perhi
might be useful only in certain other (what ?) cases of ague, 1
just not such ones as cinchona is alone suitable for. He h
consequently, just as all the rest of the herd of our medical J
thors are in the habit of doing, deduced with much prolixit
that he has asserted, and not that he has proved and made 1
matter clear ; — transeat cum ca^tsris.
09 SUBSTITUTES FOR FOREIGN DBUOS. 509
Now as both parties, the Vienna Faculty and Hofrath Hecker,
80 flaily oontradict each other, which is in the right '/
Unhappy aart, in which such direct contradictions are possible I
What incalculable evil may not daily and hourly be poured
fi}rth on suffering humanity from thy cornucopia, which is
is Yast as the whole range of opinions !
The Faculty rejects this first class as quite superfluous, '' be-
cause either they are powerless (that they cannot say of the
substances named) or any physician can substitute for them
indigenous drugs, their well known succedanea." What are
these indigenous succedanea ; why does not the Faculty name
them? It says they are well known. But how can such suc-
cedanea be known when they are simply impossihle f
Among vegetable drugs there are no true succedanea, there
can be none. The powers of each of these medicinal substances
locurately speaking (and what friend to humanity would not try
to be accurate when dealing with substances on which depend the
siokness and health, the pains, the death and the life of suffer-
ing mankind?) are so multifarious, so peculiar, so different
firom those of any other drug, that a vegetable medicinal substance
can only be replaced by itself, that is by a plant of exactly the
same genus and species. There are, no doubt, substances which
liave one property or another in common with that which it is
required to replace. But what becomes of the many other pro-
perties that each possesses jtxr{///arZy by itself?
He who is ignorant of the whole range of properties of the
one drug, and likewise of the individual powers of the other
^vrhich is to be used as its substitute, will certainly find it an easy
xnatter to substitute the one for the other I Ilcncc wo see that
apothecaries, because they have no more than a superficial ac-
quaintance with the one and the other drug, in respect to their
power of altering the organism, find it so easy when their own
interests are concerned, to substitute the one for the other in
making up their prescriptions. — Poor patients ! — ** We believe,"
80 the apothecaries have always said in their hearts, ''that
turpentine is the same as copaiba — we believe that gentian is as
good as quassia ; therefore let us substitute the one for the other."
Iff as we know but too well^ in the whole range of medicine^ conjee^
twrecannsurp the place of conviction, if this be a mere matter of belief
and guess-work^ in that case the conscience of such persons is no
doubt satisfied, — before the medical authorities, before the world,
—but is it so likewise before the omnicient Deity to whom
;
610 OK SUBSTITUTES FOB FOBSIGN PBUGS.
human life is so precious, who endowed medicines with their
inconceivable variety of wonderful properties and virtues^ in
order that man should investigate them and apply them for the
relief of his brethren ?
Hear it, our wiser, more conscientious posterity ! now-a-dayB
the substitution of one medicine for another, and the whole doc-
trine of succedanea, which has hitherto constituted the pcartk
hmtteuse of the apothecary system, has even received the sanc-
tion of Faculties ; different medicinal substances are decreed hj
high medical authorities to be all the same, to possess the same
action, not the hundredth part of whose true, peculiar powen
have hitherto been known I
Hear it, our wiser, more conscientious posterity ! to our ooon-
try practitioners, who have never been held to be too richly en-
dowed with knowledge, the talent for careful discrimination, and
a clear spirit of observation, now there is preached an indiffiar-
entism, right welcome to their habitual indolence, in the choioe
of remedies (those important instruments of life and death), an
indifierentism the grave of all philosophy, of all conscientious
discrimination, of all accurate, genuine, estimation of things I
Avaunt thou medical art, still in the babbling infancy thai
confounds all things with one another I Whilst thou still slum-
berest in thy cradle, all around thee the impulse to well-directed
activity has long since been awakened, and has escaped from the
trammels of ignorant credulity. Each of the devoted disciples
of the new school investigates the differences and the specific
properties of the things that belong to his own department;
calmly and on irrefragable principles decides upon the rank that
belongs to each, and assigns to it the accurately defined bounda-
ries of its proper sphere ; in order that out of all this indivi-
dualization a philosophically arranged whole may proceed, in
order that, consistent, incontrovertible, appropriate, living truth
mskj thence arise.
And yet thou still continuest to sleep ? Hitherto crammed to
satiety with the sweet baby -food of hypotheses and pleasant fig-
ments, and stunted in thy growth by the eternal swaddling
clothes of authorities that discountenance all investigations and
stifle all liberty of thought^ thou hast not yet, dear medicine of
the past, entered the ranks of the progressive arts, nor assumed
the decisive language of the other manly studies I
The deep earnest spirit of our age demands that the difier-
ences of things and of their properties should be ascertained in a
XJBTTKB UPON THS KECESSITY, &C. 511
more aocurate and minute manner before we can venture to in.
stitate oompariaons between them, not to speak of decreeing the
substitution of one for another. When we shall have investi-
gated the general array of the properties and most of the powers
of eveiy single medicinal substance, which produce such various
effects on the human organism, and when we shall have them
displayed plainly and in their rich completeness before our
▼iew, — ^then, and not till then, may we be permitted to make
a relative estimate of the nature and properties of the va-
rious BubBtances^ and to institute comparisons between the cu-
latiye powers of the ^different medicines ; — to do this sooner
▼ere presumption, that could not even be excused by the plea
of ignorance.
Suooedanea of the medicines that are not chemical, but that
act specifically, which shall be jper/ec^ substitutes for others, there
aie not and cannot be, for one medicine is not the same as ano-
ther,— and Buccedanea that shall be partial and half-and-half
substitutes for others (if such were necessary), cannot be found
until the medicinal properties of the several drugs accurately
and eompktely displayed before the eyes of the world, are avail-
Able for the purpose of instituting a perfect comparison among
them. Then, and not till then, will it be possible to pronounco
Incontrovertible, irrefragable judgments and verdicts.
:£XTRACT PROM A LETTER TO A PHYSICIAN OF HIGH STANDING
ON THE GRLVT NECESSITY OF A REGENERATION OF
MEDICINL^
Dearest Friend,
It is not in order to * * * you, no ! it is on ac-
count of your intrinsic excellence and the irrisistible attraction
your excellent heart has for me, that I must give myself the
pleasure of exposing to you my whole course of thought and
oonviction, which I have long felt a desire to do publicly.
For eighteen years I have departed from the beaten track in
medicine. It was painful to me to grope in the dark, guided
wdy by our books in the treatment of the sick, — to })rescribc,
Mording to this or that {fanciful) view of the nature of die-
ttttes, substances that only owed to mere opinion their place in
* Frum tlie Aiigettu Ameiger d. 1)^ No. 843. 1808. • [The physician to whom thi?
ktter was addressed is the celebrated Hufeland, with whom Hahnemann was long
on tcfins of intimate friendship.]
612 LETTER UPOK THE NECESSITT
the materia medica; I had conscientious scruples about treating
unknown morbid states in my suffering fellow-creatures with
these unknown^ medicines, which, being powerful substances^
may, if they were not exactly suitable (and how could the phyin-
cian know whether they were suitable or not, seeing that their
peculiar, special actions were not yet elucidated) easily change
life into death, or produce new affections and chronic ailments^
which are often much more difficult to remoye than the original
disease. To become in this way a murderer, or aggravator of
the sufferings of my brethren of mankind, was to me a fearful
thought, — so fearful and distressing was it, that shortly after my
marriage I completely abandoned practice and scarcely treated
any one for fear of doing him harm, and — as you know — occu-
pied myself solely with chemistry and literary labours.
But children were born to me, several children, and in course
of time serious diseases occurred, which, because they afflicted
and endangered the lives of my children — my flesh and blood —
caused my conscience to reproach me still more loudly, that I
had no means on which I could rely for affording them relie£
But whence could I obtain aid, certain^ positive aid, with our
doctrine of the powers of medicinal substances founded merely
on vague observations, often only on fanciful conjecture, and
with the infinite number of arbitrary views respecting disease in
which our pathological works abound ? — a labyrinth in which
he only can preserve his tranquillity who accepts as gospel those
assertions relative to the curative powers of medicines because
they are repeated in a hundred books, and who receives, with-
out investigation, as oracles, the arbitrary definitions of diseases
given in pathological works, and their pretended treatment ac-
cording to hypothetical notions, as described in our therapeuti-
cal works, — who ascribes all the cases of death that occur under
his treatment, not to his own practice of shooting blindfold at
the mark, — who does not attribute the aggravation and prolong-
ation of the acute diseases he treats and their degeneration into
chronic maladies, and the general fruitfulness of his efforts when
he has to treat diseases of long standing, to the uncertainty and
* Respecting many medidDes we have aumbere of oontndictoiy opiniaiM,
have been repeatedly refuted by experience, and a great array of pbyiical, ^^^^^i^X
and natural historical information ; but our books afford us no instruction as to wlal
are the exact cases of disease forwhich they are adapted and in which they may be
confidently relied on as curative agents. They are almost entirely unknown in a spe-
cial medicinAl point of view.
OF A BSOSNERATIOK OF UKDICVXJL 513
impotenoe of his art — ^no I he ascribes death and ill-treated dis-
ease and all, solely to the incurableness of the disease, to the
disobedience of the patient, and to other insignificant circom-
stances, and so accommodating and obtuse is his conscience, that
he satisfies himself with these excuses, though they are in many
ways delusive, and can never avail before an omniscient God ;
and thus he goes on treating diseases (which he sees through his
systematic spectacles) with medicinal substances that are far
fiom being without influence on life and death, but of whose
powers nothing is known.
Where shall I look for aid, sure aid? sighed the disconsolate
fiither on hearing the moaning of his dear, inexpressibly dear,
sick children. The darkness of night and the dreariness of a
desert all around me ; no prospect of relief for my oppressed
paternal heart 1
In an eight years^ practice, pursued with conscientious atten-
tbn, I had learned the delusive nature of the ordinary methods
of treatment, and from sad experience I knew right well how far
Aq methods of Sydenham and Frederick HoJBfmann, of Boer-
haave and Gaubius, of StoU, Quarin, Cullen, and De Haen,
were capable of curing.
" But perhaps it is in the very nature of this art as great men
have asserted, that it is incapable of attaining any greater cer-
tainty."
" Shameful, blasphemous thought," I exclaimed. — What, shall
it be said that the infinite wisdom of the eternal Spirit that ani-
mates the universe could not produce remedies to allay the suf-
ferings of the diseases it allows to arise ? The all-loving paternal
gcxxiness of Him whom no name worthily designates, who richly
si^plies all wants, even the scarcely conceivable ones of the
insect in the dust, imperceptible by reason of its minuteness to
the keenest mortal eye, and who dispenses throughout all creation
life and happiness in rich abundance — shall it be said that He
was capable of the tyranny of not permitting that man, made in
His own image, should, even by the efforts of his penetrating
mind, that has been breathed into him from above, find out the
way to discover remedies in the stupendous kingdom of created
things, which should be able to deliver his brethren of mankind
from their sufierings often worse than death itself ? Shall He,
the Father of all, behold with indifference the martyrdom of
his best-loved creatures by disease, and yet have rendered it
impossible to the genius of man, to which all else is possible, to
83
614 LXlTJilK DTOK TEOB IfBCSBBnhr
find any method, amy eastfy swre^ fyrugtworthy method, wlifartiy
they may see diseases in their proper point of view and wheteby
they may interrogate medicines as to their special tises^ as to
what they are reoSy, surely, smd poeitivdy serviceable for?
Sooner than admit this blasphemous thought, I would huft
abjured all the medical systems in the world I
Not there is a Ood, a good Ood, who is all goodness and wis-
dom ! and as surely as this is the case must there be a way ol
his creation whereby diseases may be seen in the right point iA
view, and be cured with certainty, a way not hidden in endless
abstractions and fantastic speculations I
But why was it never discovered in the two or two and a
half thousand years during which there have been men who
called themselves physicians?
Doubtless because it was too easy — because like the mMxiy^m
in the choice of the youthful Hercules, it was quite simple, and
neither capable nor standing in need of being decked in any oi
the tawdry tinsel of subtle sophistries and brilliant hypotheses.
Well, thought I, as there mtist a sure and trustworthy method
of treatment, as certainly as God is the wisest and most benefr
cent of beings, I shall seek it no longer in the thorny thicket <rf
outological explanations, in arbitrary opinions, though these
might be capable of being arranged into a splendid system, nor
in the authoritative declarations of celebrated men — no, let me
seek it where it lies nearest at hand, and where it has hitherto
been passed over by all, because it did not seem sufficiently re-
condite nor sufficiently learned, and was not hung with laurels
for those who displayed most talent for constructing systems, finr
scholastic speculations and transcendental abstractions. It only
sufficed for me, whose conscience was not of that ordinary prac-
tical character that it would allow me to deliver up to death my
children who were in danger, in order to please any system, any
leader of a party whatsoever. Accordingly I have made no osten*
tatious parade of my simple little book {Medicine (^Experience*)
that teaches this method, quite contented with having found it
myself, contented with having, in the simple style that belongs
to truth, revealed it to my brethren, as far as it was possible lodo
so by writing, that is, withoxd demonstration at the sick-bed m on
hospital.
*' How, then, canst thou '* — (this was the mode of reasoning
' [yideaiite%p.497.]
OF X RBGENGRATIOK OF XSDICINS. SIS
by wluch I ooounenced to find my way) — '^ ascertain what mor^
bid states medidaes have been created &xr? (can this be done by
^aperimenta per tnoties m diaenxs themselves f Alasl the two
Ihousand five hundred years during which this way alone has
been followed, shew that it is beset with innumerable, insur^
mountable illusions, and never leads to certainty^
" Thorn must," thought I, ^* observe how medicines act on the
human body, when it is in the tranquil state of health. The
ahemtioDS that medicines pixxluce in the healthy bod^', do not
ocGur in vain, they must signify somethings else why should
they occur ? What if these clianges have an important, an ex-
tremely important signification^ What if this be the only
utterance whereby these substances can impart information to
the observer respecting the end of their being; what if the
changes and sensations which each medicine produces in the
healthy human organism, be the only comprehensible language
by which — ^if they be not smothered by severe symptoms of
soma ezistiiig disease — it can distinctly discourse to the unpreju>
diced observer respecting its specific tendencies, respecting its
peculiar, pure, positive power, by means of which it is capable
of e&cting alterations in the body, that is, of deranging the
healthy oiganism, and — where it can cure— ^f changing into
health the organism that has been deranged by dLsease I" This
was what I thought.
I carried my reflections farther, " How else could medicines
effect what they do in diseases than by means of this power of
theirs to alter the healthy body ?" — wliicli is most certainly dif-
ferent in every diffensnt mineral substance, and consequently
presents in each a different series of phenomena, accidents, and
aensationa') Certainly, in this way alone can they cure.
But if medicinal substances effect what they do in diseases,
Wy by means of the power |:)eculiar to each of them of altering
the healthy body ; it follows that the medicine, among whose
symptoms those characteristic of a given case of disease occur
in the most complete manner, must most certainly have the power
of curing that disease ; and in like manner that morbid state
' Kftch one of the many thousand genera of plants must possess a different medi-
cmI flctkiD ; in truth, even the several species must differ from each otlicr in this
ntpeet,lbr their permaoeut differences of appearance announce them as things dif-
fering in kiad. Here, then, we have fulness and abundance, here we luive a diviuelj
rich store of curative powers ! Take comfort^ sick humanity I What are still required
tar ywir relief are, free sagacious men, who have the strength to emancipate them-
lehraa firaia the strong alave-ehains of ancient prejudice and theories.
610 LETTER UPON THE JTBCBaSITr
whicb a certain medicinal agent i» capable ot caring, nrast eor-
respond to the symptoms this medicinal 9ub8t4ince is capaUe <^
producing in the healthj human body I In a word, medicineft
must only have the power of curing diseases similap to those
they produce in the healthy body, and only manifest sueh mor>
bid actions as they are capable of curing in diseases I
'*If I am not deceived*' — ^I thought further — '^such is really
the case ^ otherwise how was it that those violent tertian and
quotidian fevers, which I completely cured four and six weeks
ago without knowing how the cure was effected, by means of a
few drops of cinchona tincture, should present almost exactly
the same array of symptoms, which I observed in myself yester^
day and to-day^ after gradually taking, while in perfect healthy
four drachms of good cinchona bark, by way of experiment?'*
I now commenced to make a collection of the morbid pheno-
mena which different observers had firom time to time notioed
as produced by medicines introduced into the stomachs of healthy
individuals, and which they had casually recorded in their works.
But as the number of these was not great, I set myself diligently
to work to test several medicinal substances on the healthy body,'
and see, the carefully observed symptoms they produced corres-
ponded wonderfully with the symptoms of the morbid states
they could cure easily and permanently.
Now, it was impossible for me to avoid regarding as incontro-
vertible the maxim that disease was not to be made the subject
of ontological and^ fanciful speculation as though its cure were
an eternal enigma, but that it was only necessary that every
disease should present itself to the practitioner as a series or
group of particular symptoms, in order to enable him to infallibly
extinguish and cure it by means of a medicinal substance, capa-
ble of producing of itself the same morbid symptoms in the
healthy body (provided always that the patient avoids every
ascertainable external cause of this disease, in order that the cure
should be permanent).
I perceived that this view of diseases-r-regarding them always
according to the sum of all the symptoms presented by each
individual case — was the anly right one, and the only one availa-
ble for the curative treatment, and that the forms of disease
described in our pathological works (those artistic pictures made
' The results I had collected four years ago, will be found in my book : FragmenU
de virilnu medieatnentarum potitivit the in 9ano corpore hurnano obtervatit, lipme
apud Barth, 1806.
OF A SSaBNEEATION OF XSDKXNE. 5iT
up t>f fragments of dissimilar diseases) would in fdtuie be unable
to oonoeal fiom us the true aspects of the maladj as nature pre-
sents it to us at the sick-bed —that the therapeutic doctrines of
the numerous systems, abouixling as they do in imaginary cura-
tive indieations and arbitrary modes of treatment, couLd not
henceforth mislead the conscientious practitioner, and that no
metaphyseal and scholastic speculation respecting the first hid-
den cause of diseases (that &vourite plaything of rationalism)
which can never be ascertained by mortal reason, would hence-
forth render it necessary to invent any chimerical mode of
treatment
I perceived that the only health4)ringing way, without any
admixtose of human inventions^ without any display of learning;
was discovered.
But it had not yet been trodden 1' I had to ti^ad it alone^
depending on my own powers, on my own resources; I did so
with confidence and with success.
''Take the medicines according to the symptoms caieful and
repeated observation has shewn they produce in the healthy
body, and administer them in every case of disease that presents
a group of symptoms comprised in the array of symptoms the
medicine to be employed is capable of producing on the healthy
body ; thus will you cure the disease surely and easily. Or, in
other words, find out which medicine contains most perfectly
among the symptoms usually produced by it in the healthy body
the sum of the symptoms of the disease before jou ; and this
medicine will eflfect a certain, permanent, and easy cure.
• This law, dictated to me by nature herselJ^ I hav^e now fol-
lowed for many years, >vithout ever having had occasion to have
leoourse to any one of tlie ordinary methods of medical practice.
For twelve years I have used no purgatives for bile or mucus,
no cooling drinks, no so-called solvents or dcobstruenta, no ge-
neral antispasmodics, sedatives, or narcotics, no general stimu-
lants or tonics, no general diuretics or diaphoretics, no rubefa-
cients or vesicatories, no leeches or cupping-glasses, no issues,
in fiujt, none of the appliances prescribed by the general thera-
peutics of any system whatever, to fulfil indications of cure thej
have themselves invented- I practised solely in accordance with
the above law of nature, and in no single instance did I deviate
firom it
And with what result? As might have been expected, tJie
mtisfaction I have derived from this mode of treatment £ would noi
txduLngefoT any of the most coveted of eartldy goods.
In tbe eoorse of tlibese inTestigations and obserratioiiB, wUdi
occupied manj yearsy I made the iiew and important disooveiT;
that medicines in acting on the healthy body^ exhibit two modes
of action and two series* of symptoms entirely opposite one to
another, the first immediately or soon after their ingestion (or
shortly after contact with the senti«[it living fibre of any part of
the body) — and the secondy. the very opposite^ soon after the dig*
appearance of the first ; — that moreover, when the medicinea
correspond to the case of disease befi^re us in regard to tVeao
first, primary (medicinal) symptoms, or, in other words, when
most of the symptoms of the disease we hare to combat are to
be met with among those which the medicine selected tends to
develop in the first hours of its action on the healthy subject (in
such a manner as that the symptoms of the disease and the pri*
mary symptoms of the medicine shall present the greatest poe-
nble similarity to one another), then, and then only, will mper^
tnaneni cure result; the morbifioirritation present being, as it were^
overcome, displaced and extinguished by another very amilar
irritation — produced by the medicine — in an extremdy, incre-
dibly short time. This I termed the curative (radical) method
of treatment (which produces permanent health, most certainly^
and without any after-sufferings.)
On the other hand I perceived, — what was now easy to be
foreseen, — that by adopting an opposite method, that is to say, if
(according to the ordinary mode of procedure, contraria centra-
riis citrantur) the primary action of the medicine we employ be
just the opposite of the symptoms of the disease (for instance, if
we give opium for habitual sleeplessness or chronic diarrbcea,
wine for debility, or purgatives for chronic constipation), only a
palliative relief, only an amelioration for a few hours will be the
result, for, after these few hours have passed, the period for the
second stage of the medicinal action comes on, which is the con*
trary of the first action and the analogue of the morbid state it
is sought to cure — consequently, it causes an addition to the dis-
ease and an aggravation of it.
In the ordinary practice, whenever symptoms are attacked
with medicines,' this is always done, according to the prindples
of art now laid down, only in this palliative manner. The
' For ID additioD to the systein of alleriatlog BjmpionM^, tkere ai» m th# oiJiiiiy
practice manj others, if posoible still more arbitrary, and still more vn•nl^K^ modaa
€f trcotcQient.
OF ▲ BXaENERAION OF. ICEDIGUirX. 519
mfldiejil art aa hitherto practiced, knows not the curative treat-
ment pointed out above.
: But this discovery of mine is so important, that if it were
known and acted upon, experience would teach every one that
it is only by the curative employment of medicines (sijnilia
wndUbus) that a permanent cure — this is especially observable
in the case of chronic diseases — can be obtained by the smallest
dosea in a short time ; whereas the ordinary palliative method,
according to which every physician without exception on the
fiioe of the globe, is accustomed to combat symptoms (if any
contrarid whatsoever can be found), can only alleviate them for
a&w hours, and must permit the malady, after the expiry of
tfiese &w hours, to shoot forth more raukly than before, unless
the physician — as is not unfrequently the case — ^prolong the joke
fi>r a few days by giving frequently repeated and always stronger
doBOBL But then, on the other hand, by such large doses of the
—not curative and homoeopathieally adapted — medicine, and
■by the aeeondary action of these large doses, he creates new
morbid states, which are often more difficult to cure than the
original malady, and which often enough terminate in death.
It muflt be plain to all, without furtiier demonstration on my
part, that it is impossible this hurtful palliative system of treat-
ment can avail in the case of chronic diseases, or restore unal-
loyed health to those suffering from them; and this is what ex-
perience also teaches us, namely, that by no system of treatment
hitherto pursued could chronic maladies be removed in a short
time and health be restored ; though occasionally, after a long
period of time, such a happy event might be brought about, and
health be restored by the spontaneous efforts of nature, by some
curatively adapted remedy accidentally prescribed among others,
by some mineral water also accidentally suitable to the an^^ or
by other fortuitous circumstances.
Besides inflicting often irreparable injury on the health of
man, the palliative system wiistes an incredible quantity of
expensive drugs, because they must be given in large, often
monstrous quantities, to the patients, \t%, order to effect some,
though but apparent good results. Thus we see Jones of Lon-
don requiring three hundred pounds of cinchona bark per an-
num, and other physicians using several pounds of opium a-piece
in the course of the year.
Precisely the contrary is the case with the physician who
treats according to the curative method As he only needs the
6S0 LETTER UPON THE KECESSTTr
smallest, but analogous medicinal irritation, in order to extihgoiBh
speedily an analogous morbid irritation, his requirements in the
way of good drugs (even such as are most constantly used) ate
so small that I hesitate to make even a probable estimate of
them, in order not to excite incredulity ; so small that the block*
ade of Europe may be kept up for a long time to come so ftr as
he is concerned.
By pursuing this method of treatment, which differs fiom all
others, which is indeed almost their exact opposite in every le*
spect, the curative phjrsician radically cures with amazing opr-
tainty, and in an incredibly short space of time, even dironio
diseases of the most ancient date, provided among the reme*
dies he is intimately' acquainted with there exists a suitable ona
If the principal, the sole mission of the physician be, as I be*
lieve it is, the cure of diseases^ the deliverance of our brethren of
mankind from those innumerable tortures that disturb the tran<^
quil enjoyment of life, that often make existence unbearable^ or
expose it to danger, and that even obstruct the functions of the
mind ; how can he, if a sensitive heart still beats within him,
or if in his bosom there glows a spark of that holy fire tlial
warms and incites the true man to aspirations for the good of
humanity — how can he hesitate for a moment to choose this
better, this much more efficacious method of treatment, and to
trample under foot the delusions of all former medical sphools^
even should they be three thousand years old ? They have ne-
ver yet taught iis how to cure our fellow-men* in a manner
that shall satisfy our conscience, but only how we may present
to the people an appearance of learned wisdom and deep pene*
' Of medicinefl whose action has been accurately ascertaioed I possess now almoiil
thirty, and of such as are pretty well kziuwn, about the same number, without rei^
oBing these with which I am not entirely unacquainted. Entirely unaided, it wooUl
be impossible for me to make up for all that has been neglected by my (Hredi
in my short life» tliough I have never allowed even the usual pleasures of
to interfere with my work. I would, ere this, have communicated to the world thft
large number of medicines whose properties I have investigated since 1801^ and
hare published the whole in German, were it not that the pubhsber of the Fragw^mdm
^ hegged me to delay duin^ so on account of the bodness of the times.
* The little of a positive character to he found amid ihe enormous mass of medicil
writii^s, consists in the accidentally discovered mode of cure of two or three disemft
which always arise from identical miasmata ; these are, the autumnal marsh agiM^
the lueH> venerea, and the iteh of workers in wool ; to these must be added that motl
fortunate discovery, the protection from variola by means of vaccinatioD. And theM
three or four cures take place only according to my principle mmilia timilibmiL
Nothing more of a positive character can be exhibited in the whole medical art m
the tiine of Hippocrates ; the cure of all other diseases remained unknown.
OF A RSOS17ERATION OF MEDICINE. 621
tration. To the weak-minded alone, injurious delusions and
prejudices are holy and inviolable from the circumstance of their
having been once established in the world — because they are
grown over with the moss of antiquity ; the truly wise man on
the contrary, joyfiiUy crushes delusion and prejudice beneath
his powerful tread, in order to clear the ground for the altar of
everlasting truth, which needs not the rust of antiquity to serve
as a guarantee of its genuineness, nor the charm of novelty or
of &shion, nor any voluminous, verbose system to make it com-
prehensible to us, nor the sanction of imposing authorities, but
which, eloquent with the voice of God, speaks aloud, in accents
never to be forgotten, to the inmost heart of every unpreju-
diced man.
It was requisite that some one should at length beat the way,
and this I did.
The way now lies open. Every attentive, zealous and conscien-
tious physician may freely tread it.
What though this way, which alone leads with certainty and
safety to the goal of health, and which I, setting aside all current
prejudice, discovered by a calm observation of nature, is directly
opposed to all the dogmas of our medical schools, just as the
tiieses which Luther of yore courageously posted on the door of
the Schlosskirche of Wittenberg were opposed to the mind-
enslaving hierarchy — the fault lies neither with Luther's truths
nor mine. Neither he nor I deserved the venom of the pre-
judiced.
" Refiite," I cry to my contemporaries, " refute these truths if
you can, by pointing out a still more efficacious, sure and agree-
able mode of treatment than mine — and do not combat them
with mere words, of which we have already too many.
" But should experience shew you, as it has me, that mine is
the best, then make use of it for the benefit, for the deliverance
of humanity, and give God the glory I"
But you, my dearest friend ! endowed with the mild spirit of
a Melancthon, that would fain unite all opposing parties, bear
with me, — since illusion will not amalgamate ■\\ath truth, bear
with the pure-minded seeker after truth, who is inflexible in his
convictions, incorruptible by the false doctrines and illusions of
systems, even though you may not venture to take a bold glance
into the reddening dawn, that must inevitably usher in the long
wifihed-for day.
(22 OBSSBYATION8 OK THB
OBSERVATIONS ON THE THREE CURRENT METHODS OF
TREATMENT.^
There have been till now but three current modes of treatmenl
(the treatment of diseases having apparently not yet been ^
covered,) viz: the treatment of the name, t/ie treatment of the symp
torn, and the treatment of tlie cause.
TREATMENT OF THE NAMK
Interchangeable remedies^ compound prescriptions.
The method which from the remotest time has always finuicl
the most partisans, which is the most convenient of all, is tlif
treatment of the name. " If the patient has the gout^ give hina
sulphuric acid ; the remedy for rheumatism is mercury ; cin-
chona is good for ague, simaruba for dysentery, squills for dropflj/
Here the mere name of the supposed disease is sufficient to de
termine the parempiric ^ for a remedy which crude, indiscrimi'
Bating experience has sometimes found useful in diseases thai
have been superficially termed gout, rheumatism, ague, dysentery,
dropsy, but have neither been accurately described nor carefuU|i
distinguished from similar affections.
From the very frequent cases of the failure of this quaddab
sort of practice, which is so repulsive to me that I cannot dwell
long upon it, some well-intentioned adherents of this method
were from time to time induced to seek for several remedies foi
each name of a disease ; the rude experience of domestic practice,
the oracles of old herbalist books, or fantastic speculation (sig-
nature), were the gross sources whence these remedies flowed
in abundance.
This was the plan pursued : " If A should not answer, try B^
and if this will not do, a choice lies among C, 1), E, F, G ; I have
often found H and K of service ; others recommend most highly
J and L, and I know some who cannot sufficiently praise M, U
and Z, whilst others extol N, R and T. S and X also are said
not to be bad in this disease. Some English physician recently
recommended Q in preference to all others in this affection ; I
certainly would be inclined to give it a trial."
" How frequently have I formerly cured ague with cinchona^"
says another practitioner, " and yet of late years I have met with
* From UufflandM Journal of Practical Medicine, vol xi, pt 4. 1809.
* Parewpiricitm maj stand fur the evil demon, empiricitm fur tho good genial ol
•zpeiience.
THBBK CUBBSNT KSTHOD8 OY TBEATMENT. 628
aome cases where I could do nothing with it. One of these, in
which bark had long been used in vain, I might almost say with
injury to the patient, an old woman in the neighbourhood cured
with chamomile tea. One of my colleagues cut short two cases
of ague with a few emetics, in which neither chamomile tea nor
bark in the largest doses was of the slightest service. I tried
this method in cases where neither of the two latter medicines
did good, but the emetics did no good in them ; I bethought
myself of giving sal-ammoniac, and to my astonishment the pa-
tients recovered. Yet have I met with cases where, after bark,
chamomile and emetics were tried in vain, sal-ammoniac also
was of no use. Just about that time I read that gentian and
sometimes nux vomica were useful in ague. I tried them. The
former answered in two cases, the latter in three, where neither
gentian nor the other medicines were useful. Belladonna is also
said to have cured certainly and thoroughly some agues where all
other remedies have been fruitless; and some assert they have met
.with the same result from the use of James' powder and calomel.
The bark of mahogany and that of the horse-chesnut have also
been lauded ; but I don't believe they have much power, I can't
tell why. We all know what good eflfects opium oft^n has.
Beoently I was much struck with a case of quartan ague, that
had tormented a robust peasant for a year and a half, in spite of
the employment of every conceivable remedy ; to my astonish-
ment it yielded to a few drops of tincture of ignatia, sent to him
by a foreign professor. And, between you and me, I must give
credit to our hangman for having occasionally effected radical
cures of agues that were ineffectually treated by myself and my
colleagues with the above remedies, by means of some red drops,
which I am credibly informed contained arsenic, although he
caused with it in some cases chronic complaints, dropsy and even
death. So obstinate and capricious are agues sometimes!"
My friend, do you never suspect that all these were different
kinds of agues, or rather intermittent diseases differing completely
from one another ? If it were possible that an ague could be so
capricious and obstinate, wherefore did it yield so readily to one
remedy ? Do you not suspect that there may be more than one,
that there may be perhaps twenty different kinds of intermittent
fever, which parcmpirical imbecility has included under one
head, has asserted all to belong to a single species (intermittent
fever), and has sought to combat all with a single remedy, where-
as each requires its peculiar remedy, without thereby deserving
to be called capricious or obstinate.
524 OBSERVATIONS ON THt
'^Ah ! but the practical physician has neither the inclination
nor the time to draw such fine distinctions betwixt similar diseases
and to assign to each its appropriate remedy. If the patient
tells us he has intermittent fever, I and my colleagues give him**
(you fool I do you not wish to become a bit wiser ?) " at first an
emetic or two ; if that does no good, or does harm, we then give
him cinchona ; if that does not cure in large doses, neither the
common sort nor the royal bark, we then give — "
Just so ; you blindly give one after the other until you hit
upon the right one. But you can only go on with your experi-
ments as long as the patience, the purse, or the life of your pa-
tient lasts I Your obedient servant, doctor !
And thus there arose long lists of simple drugs (mterchangeable
remedies, succedaneums) which were all, without distinction, said
to be serviceable for one disease.
Out of these lists of the names of drugs, the more elegant
physicians, to give themselves an air of rationality whilst they
were guilty of the grossest parempiricism, constructed their com-
pound prescriptions, — ^three, four or six ague remedies, five, six
or eight dropsy remedies, all jumbled together, drawn at hap-
hazard from the list, which were recorded in their manuals under
the name "Intermittent fever," *'Dropsy," and used in practice
by coupling them with some kind of spirit, syrup, &c. In this
case, too, the mere name of the disease was combatted, but, by
your leave, reader, much more methodically! with several
weapons at a time. " If one ingredient in the mixture does not
do any good, then the second and the third, or if all these strings
break, the fourth, the sixth, the eighth, tenth, fifteenth, must
effect the desired object." Thenceforth no one would look so
unlearned as to prescribe only a single medicine.* — Thenceforth
no prescription was given that did not contain a hotch-potch of
simple drugs ; and that not for investigated, definite diseases,
' If Brown could liave the merit, though himself a practical physidan, of hariog
lifted for us the curtain which conceals the secret workings of the organism from oar
art^ yet this merit is reduced to a nullity by that general, injurious and moet
neons maxim of his (EUmenU of Medicine^ § xcii) : ** The cure of any disease of
siderable violence, and scarce of any at all, is never to be entrusted to any one r»-
mcdy; the use of several remedies is preferable to that of one ** — a precept that woaU
alone prove his incapacity as a teacher of medicine. Nothing is less known or \tm
investigated in nature than the powers of medicinal substances, our weapon* ! Haw
can we learn them otber^'ise than by using them singly I Or is a single drug, if it
be the proper one, less powerful to remove a single disease than a mixture of serenl
that counteract each other^s action \
THBBS cn^£2rr methods of tbeatment. 625
but for mere names of diseases I Parempiricism could not ascend
higher, common sense could not descend lower.
TREATMENT OF THE SYMPTOM.
Oeneral indications ; general remedies. Routine remedies.
The impossibility of discovering sure remedies for vague
names of diseases, induced now and then more conscientious phy-
sicians to distinguish diseases more accurately. Those that were
evidently dissimilar were separated, the simUarities of many of
them were investigated^ and those that were considered to be
connected were imited in classes, orders, and species, &c., ^iccor-
ding to the similarity of their exciting causes, the functions that
were deranged, the identity of their seat in the body, the pecu-
liar tone of the fibres, and some conmion symptoms.
By means of this historical view of the apparent relations and
differences, they sought to make us better acquainted with the
nature of flie innumerable diseases, and to persuade us that then
we knew enough about them, to enable us to cure them after
that. Some resorted to generalizing (the ordinary pathologists),
others to subdividing (the nosologists).
But this labour (and that at the hands of men like Rudolph
Augustin Vogel or Wichmann) was only successful in so far as
it had reference to the description of the course of some epidemic
diseases that frequently recurred in pretty well defined charac-
ters, and to the description of endemic diseases of a fixed stamp,
and of diseases whose cause was evident (the symptoms produ-
ced by some poisons — lead, charcoal- vapour — or infection by
some miasms that never altered their character much — sjrphilis,
itch). Still in all these, indescribable varieties occur, which often
alter the whole affair.
(For as all other diseases, whatever be their outward resem-
blance— ^for example, the dropsies and tumours, the chronic skin
diseases and ulcers, the abnormal fiuxes of blood and mucus, the
iofinite varieties of pains, the hectic fevers, the spasms, the so-
caUed nervous affections, &c. — present such innimierable diffe-
rences among themselves in their other symptoms, that everj'
smgle case of disease must as a general rule be regarded as quite
distinct fix>m all the rest, as a peculiar individvxility^ it is evident
that any general descriptions of them in entire classes must not
only be superfluous but must lead to error.)
However, I forbear at present from attempting to estimate
their services to our art, and shall only observe that the patho-
logical and nosological investigators who possessed this kind of
530 OBSEBTATtOKS OK THX
historical knowledge were not much happier^ in their treatmeol
than those who treated mere names of diseases.
These in particular were the persons who (in combination with
the therapeutists by profession), as a forlorn hope, invented the
make-shift of decyphering the appropriate remedy from the de-
scription of the disease, of devising for diseases arranged in ranla
and orders some general plan of treatment that should be suitable
ifor every one of them, that is to say, the method of treataieat
according to general indications, the method of treatment bj
means of so-called general remedies, "The indications of impu^
rities in the alimentary canal demand evacuations upwards and
downwards, heat demands cooling medicines, fluxes demand
astringents, putridity antiseptics, pains sedatives, weakness tonioa^
spasms antispasmodics, constipation purgatives, dysuria diuretieSi
a dry skin diaphoretics." Under the guidance, of the frequently
misunderstood results of experience the evacuants, the coolio^
remedies, the astringents, the antiseptics, the sedatives^ the
tonics, the antispasmodics, the purgatives, the diuretics, ud
the diaphoretics were devised, and here was at once a oonh
plete system of therapeutics, for the over-completeness ot
which some other classes of remedies were invented for symp*
toms that were often but the offspringof fancy, such as indsivefl^
solvents, diluents, &c.
I know not which parempiricism is preferable to the other,
whether the treatment of the name of the disease, or the treat-
ment of the name of particular symptoms. Suffice it to say,
that this method had much greater attractions for the super*
ficially instructed, much greater than most of the other methods
with a trace of rationality in them, hence it was that most gen-
erally pursued by those who wished to be considered really
learned physicians of a better stamp than the common herd.
Of all the false methods of treatment it will undoubtedly have
the longest run, because it does not necessitate much care nor
much thought It is undoubtedly very agreeable for the phy*
' Even the model of grapbio descriptioD, eyen the most natural picture of the
coDstanteslof all dineases, thom of an endemic character, never guides us to the
medy ; — ^the most accurate amount of pellagra, yaws, sibbens, pian, ringworm, tataifir,
water-kulk, plica polonica, Ac^ throws no light on tho specific remedy that ii ca-
pable of removing each of these maladies quickly, easily, and radieaUy ; thb re-
mains still concealed from our eyes in the bosom of nature. What hint^ thcii,eQald
be derived for the appropriate remedy from the general description of those diinaies
whose character was less constant^ which presented more varieties among each otfMr»
and were more vaguet
TERES CTTARBNT METHODS OF TREATMENT. 627
flieiaii to fed himself so powerful, or at all events to appear to
be able to promote perspiration here, urine there, to lull pain
here, to excite there, to bind here, to loosen there, to incise
here^ to expel there, to strengthen here, to cool there, to check
spasms here^ and putridity there, to accomplish all that he com-
mands his cohorts of medicines to do. How often the practi-
tioner cannot do all this, how often he finds himself deceived
in his expectations relative to the medicines which have been
stamped as general remedies by his teachers, he knows full well
himself
But admitting there were such general remedies that would
here and thwe certainly promote perspiration, assuredly cause
a flow of urine, strikingly soothe pain, infallibly strengthen,
andeniably resolve, loosen, purge, and cause vomiting, power-
fiilly act upon the secretion of mucus, in every case cool, allay
every spasm, and check every inordinate discharge, unhesita-
tmgly transfer congestions from a more to a less important seat,
will all this, supposing it went on ever so beautifully, cure the
disease? Oh, no! in most cases not. Something striking has
been performed^ but health has not been restored^ and that was
what had to be done.
At one time the physician soothes with his opium for a few
hours cough and pains in the chest ; after sixteen hours, how-
ever, the painful cough increases to a still more frightful extent
— ^he produces a stupified sleep with it, but the patient is not
refreshed thereby, his sleeplessness and anxiety become all the
greater. The physician does not care for this ; he increases the
dose of his palliative, or he is contented with having shewn his
power to allay cough and to cause sleep, though the patient is
made worse thereby, though he should even die. Fiat justitia
Hpereat Tnundus,
Here is a case of dropsy ; very little urine is passed. Our
doctor wiU promote its flow, llis squill stands at the head of
his diuretic picquet. Beautiful I it instantly causes a great flow
of urine, but on continuing its use, alas I always less and less
▼ater comes. Symptoms of atonic inflammation and mortifi-
cation ensue, the anorexia, debility and restlessness increase
with the swelling. Then if nothing more will avail, he allows
the patient to die quietly, after having shewn that he has the
power of causing a flow of urine for some days.
Squill has been used many thousands of times as a diuretic
(during all the ages it has been employed it was never observed
528 0BSSBYATI0N8 ON THX
that it was only diuretic in a palliative sense) and yet how sel-
dom has dropsy been cured by it I only when a kind of sup*
pressed menstruation was the cause.
The physician who is consulted diagnoses this malady to be
gastric; he purges, and re-purges. But behold the fever in-
creases, the taste becomes more disagreeable, the breath and the
excrements more fetid, the sclerotic yellower, the tongue more
furred and browner, the ideas get confused, the lips tremblOi
stupifying slumber takes the place of sleep, &c. He is sorry to
see his patient hurrying on towards his grave, but he is happy
that he possessed the power of energetically purging away the
impurities. What is the matter with you? "I put myself in
a violent passion, my head is like to burst, I have spasms in
my stomach, the bile rises incessantly into my mouth." Yon
will, perhaps, take a bilious fever, take this emetic immediately.
Look I he throws up bile, he vomits again and again, he wiU
vomit up his very inside — the night of death obscures his sights
whilst he is bathed in cold perspiration. "I have done my
duty," says the doctor to himself; " I have done all I could to
clear away the bad bile.''
And thus it is with the whole array of general remedies
The respectable doctor does much, only not what he ought;—
he produces remarkable effects, but very seldom health.
Thousand-fold experience could teach him, if he would but
let himself be taught, that in dropsy he only requires to remove
the morbid disposition, in order to see the water disappear by
ways which nature knows best how to choose for herself, — but
that his designed removal of the water by the urinary organs^
or by stool, effects a cure as seldom as tapping it off with the
trocar ; when a cure docs ensue, it must be because the diuretic
remedy was accidentally at the same time the proper remedy
for the disease upon which that kind of dropsy depended.
Thousand-fold experience could teach him, if he would bnt
let himself be taught, that no pain can be removed permanent^
and advantageously to the patient except by a remedy thiU
affords relief to the fundamental disease; that, consequently,
opium very rarely allays pains permanently mith desirable resuIUj
and only when it is the true remedy for the disease on which
they depended.
That opium is often the best remedy in diseases most free
from pain, and attended with the greatest amount of sopor, that
he does not and will not know. He is proud of his power of
THBIE OUBBSNT XETHODB OF TBKATXENT. 629
piUiating; and of being able to allay pains for a few hours ; but
the after-effieota — thej do not trouble him. Nil nisi quod ante
pedes est
Where the short-sighted individual thought that it was abso-
lutely necessary to remove bucketfuls of fetid mucus and excre-
ment by means of all sorts of emetics and purgatives, in order
to preserve life, in such a case a single drop of the tincture of
arnica root will often remove, in the course of a couple of hours,
all the fever, all the bilious taste, all the tormina, the tongue
becomes dean, and the strength is restored before night. Short-
sighted being!
But the poisonous bile, stirred up by rage and passion, how
can it be subdued without causing it to be vomited clean away?
My short-sighted firiend ! a single dose, an almost imperceptibly
small quantity of the right medicine^ will, without any evacuor
(m t^bilsj have restored all to the right state before the second
day dawns. The patient has not died as he would have done
a^ your emetic ; he has recovered.
How often are blood-letting and nitre abused, to combat
qrmptoms of heat I Lay aside your life-shortening, temporizing
remedies, remove the disease on which the accelerated pulse de*
ponds, by the appropriate remedy, and the heat ceases of its
own accord. But I perceive you are not concerned about the
core of the disease, to subdue the heat is your object. Then
nther open one of the large arteries until the last drop of blood
is drained off, you will thereby attain your object more surely
and more completely I
And thus it is always with your favourite general remedies.
They render you the service of sometimes shewing you to be a
mighty physician. Only it is a pity that the patient who per-
adventure recovers (slowly and painfully enough 1) seldom, sel-
dom owes his recovery to Hiem.
But the general remedies just as often do not perfonn the
eflSects they desire. Only look, how their antiphlogistic reme-
dies often actually increase the inflammation, how their tonics
increase the weakness, their purgatives the symptoms of impu-
rities in the alimentary canal, their solvents the quantity of
mucus and the hardness of the abdomen, their sedatives the
pains, their derivatives the congestions, their diaphoretics the
dryness of the skin, their diuretics the want of urine and
oodemal
* J'Vfq'n-n<1v t^«.' <•>'»} »*l «?!' rl. :«*.:••■ ."l*
680 OBSXRVATIOKS ON TBI
And if they sometimes sucooed in checking this or that
symptom for a time, or in efFecting this or that striking evacoa^
tion, how comes it that the disease notwithstanding sometiiiMS
assumes a worse turn ? Am I right in asserting thai Aey were
not the proper remedies for the disease f
In like manner, the poor fellow unable to swim, strugg^
away witJi awkward partial movements of his arms and \eg^ to
sink all the more certainly to the bottom.
In ordinary everyday practice, however, it is not required
Uiat we should trouble ourselves with anxiously attending to
single . symptoms. '* When once we have got over the first
irksome years incidental to young beginners — ^years they un-
doubtedly are of irksomeness and care, when we are still anx-
ious to discover the adequate, the helpful, the best for our pa-
tients, and when the tender conscience of youth gives us much
trouble — ^when once we have got over these pedantic years, and
have got some way into the period of divine routine, then it is
a real pleasure to be a practical physician. Then we have only
to assume a dignified mode of carrying the head, speak in a
tenor voice so as to inspire respect, give great importance to the
movements of the three first fingers of the right hand, and pre-
sent a certain authoritative something in the whole manage-
ment of the voice and attitudes of the body, in order to be aUe
to exercise perfectly in all its details, the golden art of the
savoirfaire of the routine physician. Of course the smallest de-
tails of the attire of the equipage, of the furniture, and of the
array of servants, must all be in harmonious keeping.
" If our whole thinking power and memory during the four-
and-twenty hours of each day are completely absorbed in such
matters, this renders us all the more successful as physidana.
Our whole practice, be it said betwixt ourselves, consists in two
or three innocuous mixtures, well known to the chemist, in as
many compound powders adapted for all cases, in an expensive
dnciura nervino-roborans, a few juleps, and a couple of formulaa
for pills, either for acting on the blood or the bowels {tioatrums
and roiUine remedies if you will), and with these we get on capi-
tally. My steaming horses ratUe up to N.'s door, I descend fit>m
my carriage assisted by the respectful domestic, with belpfiil
speed, but with an air of deep thought and dignified mien. The
attendants of the patient throw open both wings of the door of
the sick-room. In silence and with abased head stand esteem,
confidence, and semi-devotion in a row, to allow the deliverer to
THBKE CUBBKirr MBTHODS OV TREATMENT. 681
ipproach die siok bed. ' How did you sleep last night, my good
fUend? — ^your tongue!— your pulse 1 The powders ordered
yesterday may be discontinued. The mixture prescribed here
18 to be taken alternately with the pills indicated below, followed
by the julep every half-hour.' Taking a pinch of snuff with an
air of profound gravity, seizing my hat and stick and making a
practised bow, the degree of which is regulated for every one in
particular according to his supposed importance or rank, this
constitutes the whole of the important comedy (shall I coll it
business ?) for which we are paid as a consultation, and which we
rq)eat as often per diem as the serious looks of the surrounding
fiiends seem to render it necessary ; for they are the barometer
of the danger, since we have neither time nor inclination to as-
certain it for ourselves in all our cases." And how many visits
of this sort do you pay in one day ? '* Do you imagine, you
nmpleton, that I can keep up my establishment with less than
Beveral dozens of visits in a forenoon ?" — What Ilcrculean men-
tal labour I — " Ha ! ha I ha ! to scribble down on a long strip of
piper one of the eight or ten routine prescriptions that I can
reckon up on my fingers, and can seize on in the dark without a
moment's thought, the first, the best that occurs to mc at the
moment^ without the least reflection ; do you call that mental
labour ? It is a much more difficult matter for me to find a pair
of handsome bays to supply the place of my used-up afternoon
horsesi hoe opus, hie labor I
" I have just now also much difficulty in thinking of the appro-
priate dishes for the sixth entrde of the entertainment we are to
give to morrow fortniglit, so that it may be distinguished for its
rarity in respect of the season of the year, for its suitable ele-
gance, and for its brilliant tastefulness. Et hoc ojm^ et hie labor /"
The so-called favourite remedies are in great vogue ; without
being able to give the slightest reason for so doing, one physician
of the ordinary stamp will mix with every prescription, prepared
muscle-shells, a second always manages to introduce magnesia, a
third invariably adds spiritus mindereri, a fourth can scarcely
write a prescription from which purified nitre is excluded, a fifth
brings into all his prescriptions the ins])issated juice of the root
of triticum repens, a sixth thinks he cannot give the extract of
dandelion often enough, a seventh seasons every draught with
opium, and an eighth endeavours to bring in cinchona every where,
whether it is suitable or not, and so it goes on. Most every -day phy-
ociana have, they know nut why, their favourite remedies. Anj •
982 OBSBRYATIONB OK THK
thing more indolent and par-empirical cannot be imagined. How
should all the conntless array of infinitely various diseases, each
of which demands a peculiar mode of treatment, always acoom-
modate themselves to one and the same remedy, which the doe-
tor may happen to have taken under his sublime protection?
Sooner might a cabinet-minister be chosen from mere caprice^
and it be taken for granted that the subjects of the prince will
be sufficiently obedient and intelligent as to make harmony of
the false gamut
To stake constantly on the drawing of one and the sam^.
number always betrays a bad lotto-player. He must certainl]^
occasionally win, but how much, or rather how little can he win
And does he not continually lose, these few miserable
excepted, by not winning? Does he not render himself ridicu-
lous to all the world?
TREATMENT OP THE CAUSE.
Treatment foiinded on the internal essence of the difease.
In a practically useful point of view we may divide diseases
in general into two classes ; diseases having a visible, simply
maierial cause, and diseases having an immaterial dynamic
cause.
The first class, Hie diseases having an obvious^ simple^ material
cause, such as a splinter stuck in the finger, a stone swallowed^
a concretion in the biliary ducts or the bladder, an accumula-
tion of plum-stones in the coocum, an acrid acid in the stomach,
a fragment of the skull pressing on the brain, a too-prolonged
frenum to the tongue, &c., are much less numerous than the dis-
eases of the second class.
The indication for treatment is obvious. All are agreed that
it consists in the removal of the material cause, be that mechani-
cal, be it merely chemical, or a mixture of both. This generally
suffices to effijct a cure, provided no considerable destruction of
the organ has occiirred.
Its consideration does not concern us at present.
We shall occupy ourselves with the mode of curing the second
class of diseases, the countless array of all other diseases properly
so called, of an acute, sub-acute, and chronic character, together
with the numerous ailments, indispositions, and abnormal states,
having an immaterial dynamic cause.
It is the natural tendency of the human mind to seek for the
exciting causes of the phenomena he sees about him, and henoe
^e see, that no sooner does a disease show itself than every one
TERES .OUSaSNT KETH0D8 OF TREATMENT. 683
oooni»6B kunaelf with attributing it to some fiouroe, that which
fleems to him to be the most likely one. But we should be
gFBRtly mistaken ii^ from this irresistible propensity to seek a
cause for an effect| we should infer a necessity for such know-
ledge in order to effect a cure.
For very few diseases of the latter class do we know the
dynamic cause even by name, of none do we know the nature.
lato the secrets of nature no created mind can penetrate. And
yet as regards diseases, it is imagined that both can be known.
The ordinary physician has this in common with the generaUtj
of people^ that he imagines he can assign an exciting cause for
every perceptible alteration in the health, and those physicians
who were apparently the wisest, imagined that they could pene-
trate even to the internal essence of diseases, and that they were
thweby enabled to cure them.
Owing to the very nature of the thing, it is impossible that
the eaaeutial nature of most of the dynamic causes derived from
vithoui can ever be ascertained.
How much have not some attempted to demonstrate to us
fespec&ng the influence of the seasons and of the various states
of the weather, as exciting causes of diseases ! We were told of
the variations in the thermometer and barometer, the various
winds, and the alternations of moisture and drj^ncss of the atmos-
(dieiie for a whole year, or at least for several months, before
the oecorrenoe of an epidemic, and the murderous disease was
attributed quite off-hand and without much consideration to the
weather that prevailed during all that long period, just as if the
disease could be derived from the state of the weather, or as if
chey bore the relation to one another of cause and effect But
granting that there was something in this, at least in the varia-
tions of the seasons, as the cause, or at least partly the cause of
particular kinds of diseases, how little comfort can the physician
derive from these unalteritUe accompaniments of the world's
course, how little assistance do they render him in proving the in-
dications from which lie can bid deflanee to the epidemic actually
prevailing I Were the season of the year and the previous state
of the weather really the cause of the prevailing distemper, it
wovld avail him little or nothing to know this, seeing that from
this cause the speciiic remedy for the pestilence cannot be de-
duced, cannot be decyphered.
Fright, fear, horror, anger, vexation, a chill, &c., are impres-
aona that do not present themselves in a concrete form, that
cannot be subjected to physical investigation.
584 OBSERVATIONS OUT TEE
w
How and to what extent thede impressions derange thelraman
system, what especial kind of disease they produce in it, is so
entirely unknown to ns, that we obtain not the slightest hint
for the treatment of the diseases they give rise to, by being in*
formed of the names of their probable source — ^fright^ fear,
yexation, anger, &c. The most abstract investigation into the
metaphysical nature of fright affords the physician no instmo-
tion relative to the proper treatment of its effects, never ex-
presses the name of the appropriate remedy of the acute symp-
toms arising from fright — the name of opium. This is not the
place to indicate the shorter, more natural way by which this
remedy has been discovered for these accidents.
It is very easy to say, that we may attribute itch to the itch
miasm, the venereal disease to the venereal miasm, variola to the
variolous miasm, ague to the marsh miasm. By pronouncing
these names not the slightest advance is made to obtaining a
more accurate knowledge of these diseases, nor yet to their ap-
propriate treatment. The morbific miasms are as thoroogfalj
unknown to us as regards their internal nature, as the diseases
themselves they produce. Their essential nature is quite beyond
the reach of our senses, and their true remedies will never be
learned from what the schools can teach us regarding their ex-
citing causas. All that has been discovered relative to their
remedies has been discovered by mere accident, by unpremedi-
tated experience. But the way to seek for them purposely and
to find them will never be deducible from aught we can ascer-
tain respecting the internal cause of the disease.
What amount of knowledge respecting the cause and essential
nature of endemic diseases would suffice to reveal to us their true
remedies ? For us weak mortals there will ever remain an im-
passable gulf betwixt such a fancied knowledge and the remedy.
Beason will never discover a logical connexion betwixt the two!
Were even a God to enlighten us in regard to the invisible al-
terations produced in the interior of the minuest portions of our
body by the miasm of that most tedious, periodical endemic dis-
ease that prevails in a portion of Lunenburg and Brunswick —
the waier-kulk (water-colic) as it is termed, which the eye of the
practised anatomist cannot discover, and were our mind, that is
cognizant only of seiisuous impressions capable of understanding
such transcendental instruction, this intuitive knowledge would
never guide us to the discovery of the only specific and in&llible
remedy — ^the verairum album. But this is not the place to shew
TEBME CURBBNT HBTHODS OF TBSATKEMT. 685
the ahorter, more natural way in which the remedy for this dia-
ease may be sought and found.
Neither the name of goitre, nor its probable cause (a residence
in mountain valleys) whispers to our mind the name of its re-
medy which was revealed by mere accident—the burnt sponge.
Why then should toe falsely and proudly pretend tiiat we can cure
imasesfrom our knowledge of their dynamic causes f
For tiie accidents and diseases produced by commercial and
pharmaceutic poisons the appropriate remedies have partially
been discovered, but it was neither speculative investigation
into the internal nature of these diseases nor physico-chemical
analysis of their cause — ^the poisons — ^that taught us these spe-
cific antidotes, but a much shorter procedure, and one much more
consonant with nature. It is not very long since these hurtful
aabatances were attempted to be removed, often with very un-
happy results, by emetics, diluent drinks or purgatives, as if they
oppressed the stomach and bowels in a merely mechanical man-
• ner. Now, we know how to combat many of them like morbific
causes of the second class, of dynamic nature, by their appro*
priate antidotes. They effect an alteration of the whole system
in a peculiar, to us unknown manner, and their effects can never
be cored like mere local mechanical irritations, as was formerly
imagined.
Others went much more learnedly to work, and divided them,
in an entirely apodictie manner, just as though they had been
inspired thereto by a God, into acrids, narcotics, narcotico-acrids,
&a, and agreeably to this arbitrary classification, dictated their
remedies in an equally arbitrary manner ; — a true 2>icture of the
Viode of procedure of the schools^ classifying natural diseases^ and as-
signing t/ie remedies for them ! Arbitrariness, conceited arbitrari-
ness, and self-satisfied pride I
Thus belladonna and nux vomica were, with arbitrary des-
potism, ranked among the narcotic poisons, and the vegetable
acids, lemon juice and vinegar, were cavalierly ap];)ointed their
antidotes. Unfortunately for them, their assumed omniscience
could here be put to an infallible test, and their error detected
in the very act. It was proved that vegetable acids were the
very substances that most aggravated the symptoms. And so it
taiU usually be found, that Oic very opposite of what Ouiy assert is
often the truth,
Sed saeculorum commenta delei dies.
It never could have entered into the imagination of this church
636' OBSKBYAnONB OK THS
beyond whose pale there is no salvation, to aaedgn opium as tiie
antidote of the one, camphor as that of the other of these ix>wer-
fill substances, as experience has shewn to be the case.
But they were not content with dragging in as it were by the
ears, or inventing external causes for diseases, or with arbitnrily
attributing to them some peculiar nature, and, I cannot say
searching for (for one can only search for a thing when there ara
well-grounded traces and indications of its existence), but imther
imagining and inventing remedies directed against this supposed
nature. They went still more learnedly to work, and oonoooted
in their brains all sorts of internal causes of diseases.
The ambitious notion that they were capable of referring moat
diseases to one or a couple of internal causes, now became the
origin of the many sects among physicians, each suooessive one
of which was more fantastic than its predecessor.
One of these, and that not the wOrst, expressed the in scHiie
degree special life and the peculiarities and particular actiona of*
each individual organ, by the figurative name of an Art^asus^ %
kind of particular spirit of this or that part, and imagined that
when this or that part suffered they required to soothe its parti*
oular ArchcmSy and give its thoughts another direction. It ap»
pears to me that they meant to make a confession of the inoom*
prehensibility of all the phenomena of disease, and a confession
of their inability to satisfy the requirements of these supernatural
things.
Others thoughts to persuade us that a predominance of acid
was the proximate cauHC of all diseases, and they prescribed
nothing but alkalies. An attempt to ally itself with them waa
made by the old sect which referred all kinds of acute diseases^
especially the epidemic maladies, to a common poison whic^
they contended often developed itself in the interior of the body,
and sought for the antidote of this poison, which they believed
to be the general excitant of most diseases, in absorbent alkaline
earths, but especially in the stony concretions found in the
stomach of an antelope (bezoar) and in the most heating spices
mixed with opium (mithridate, theriac, philonium, &a). Their
abuse of the earthy powders has extended down to modem times,
and their evil demon, the empirical universal abuse of opium,
has now possessed some sects of the present time, who have
thought of other reasons for their misapplication of this remedy
tor special cases as a positively universal remedy.
C L. Hoffmann imagined that he had an equal right to .aei
THBXX CUBBINT MKTHODS OF TBEATKENT. 687
ibrtli as a aniversal truth hia own particular notion that almost
all diseases arose from a kind of putridity, and were to be cured
with remedies which his school denominates antiseptics.
No one will question his right any more than they will that
of the other leaders of sects, who perceived in diseases nothing
bat acridities in the blood; demonstrated these for our edification
bj &r fetched, scholastic arguments, and in an off-hand manner
«t ooce invented the remedies for the black bile, for the psoric,
irthritic, scrofulous, rachitic, muriatic and God knows what
other kinds of imaginary acridities, until the modems, unmind*
fill of the medio tutissimua, founded a religion equally exaggerated
in the opposite direction, in which the fluids were entirely ban-
ished from the list of morbific causes, and the production of
disease was attributed to the solids alone.
In this way the poor diseases were ascribed now by this pig-
headed fellow and now by that, at one time to this, at another to
that cause. All this time they remained in quiet possession,
«id never suffered themselves to be disturbed.
Let it not be supposed that on the whole more diseases were
«Qred by one sect than by another. To excogitate causes of dia-
bases, speculative modes of their production, and to found systems
thereon, were wbat was aimed at; but not to cure them. The
'former undertaking exalts the artist much nearer the stars than
the latter, and thus diseases remained just as before, uucured,
except such of them as would get as well of their own accord|
that is, under any arbitrary treatment whatsoever.
The doctrine of bad humours long enchained mankind, the
dominion of acridities and perverted juices long prevailed. But
as the specific anti-acridity remedies could not so readily be
found out, the whole joke usually and principally consisted in
producing evacuations. With the exception of a few en^pirical
drinks and several kinds of mineral waters prescribed at hap-
hazard, which the humoral physician commanded to enter the
blood, to sweeten it, to correct it, and to expel by sweat and
arine the impure parts of it separated from the good portion as
if by magic, the principal manoeuvre of the humoral school con-
sisted in the evacuation of the bad blood (bleeding mania) and
in the expulsion of the impure fluids by the mouth and anus
(sterooralism, saburralism.)
How ? did they pretend to let out the impure blood only ?
What magician's hand could separate, as through a sieve, the de-
praved from the good blood within the blood-vessels, so that
588 » OBSERYATIONS ON THX
odIj the bad would be drawn off and the good remain 7 What
head is so rudely organized as to believe that thej could effaci
this? Sufficient for them that streams of blood ytere apilt^ of
that vital fluid for which even Moses shewed so much reqpect^
and that justly.
The more refined humoralists, in addition to the impurities in
the blood, alleged besides, the existence of a pretended, almoBt
universal plethora, as an excuse for their frightful, mensilMi
blood-lettings ; they also gave out that these acted derivatively,
depressed the tone, and ascribed many other subtle scientific ef*
fects to them. They acted, as we see, like other sects, quite a^
bitrarily, but obviously with an endeavour (not indeed to cun^
that would be vulgar, no I) to give to their arbitrary procedures
the highest possible colouring of rationality.
Seasons equally excellent, aims equally sage, had the humoial-
saburral physicians for their innumerable emetics and their
strong and mild purgatives. '^ Consider the quantity of impa-
rities that are thereby purged from the blood, only look at the
contents of the chamber utensil 1 When all that has been re-
moved, then the body will be purified from all bad humoon.
Consider, moreover, what a quantity of impurities must daily
remain and collect in the body from the food and drink we take
in ; — it must be purged away, and that repeatedly, if we do nod
wish the patient to die. Observe also how most patients com*
plain of tense or at all events painful abdomen, or at least of on-
naturally shaped hypochondria, furred tongue and bad taste;
who can fail to perceive from these signs that the germs of all
fevers, the actual cause of all diseases, lie in the impurities of
the first passages? Yes, we must certainly purge, and that fre-
quently and strongly, in order to bring away the material cause
of the.disease. The excellence of our method is shewn by thia^
that we arc in high estimation as skilful physicians. The pa-
tient feels that he gets a good equivalent for his money, he pc^
ceives how the medicine acts on his body, and he sees with lus
own eyes the impurities that are expelled from him I Who can
deny that all this speaks to the convictions of the people, who
can doubt that our church alone holds the true faith ?"
" I cannot quite agree \vith you, brother," says another branch
of the saburral school, " when vou ascribe all diseases to the
bile. I maintain that they all depend upon the phlegm in the
first passages. The phlegm must be energetically cut into, dili-
gently dissolved ; the phlegm, I say, must be properly purged
THBIS CUBBXNT METHODS OF TREATMENT. 689
ftwaj, in Older to extirpate the disease by the roots. All your
bilious and putrid fevers are masked pituitous fevers, all con-
eeivable diseases now-a-days depend upon phlegm, and if pa*
tienta treated according to our method are long in recovering,
we yet can boast of our system that it is radical and lucrative."
• Thus would Blennophilos (in the style of his whole art) des-
cant still more discursively upon the advantages of his system,
whilst Eucholos, greatly displeased at hearing the bile denied to
be the universal cause of diseases, could not refrain from making
an equally vigorous speech in defence of bile, which demands a
general employment of emetics and purgatives. *' Bile, bile
must be expelled," was the conclusion of his philippic, "dili-
gently and imiversally, upwards and downwards must it be ex-
peUed, for it is the originating cause of all diseases I"
Accordingly the poor world was for more than half a century
properly cleared out upwards and downwards, so that any one
must have thought that it was thoroughly cleansed of all impu-
rities. All a mistake, said Kiimpf they are not nearly enough
dissolved and purged, at least they have not had half enough of
the only efBicacious process from below. The source of all dis-
eases has been sought for in an entirely wrong place. Whence
proceed the many hundreds of hypochondriacal and hysterical
nervous diseases, the hitherto mysterious chronic diseases of the
better classes, whence all the pulmonary, hepatic, splenic, cuta-
neous and cephalic diseases, and I may say all other diseases,
whence do they aU proceed if not from infarctus and lodgments
m the abdomen ? By means of solvent clysters in hundreds
must these be dissolved and purged away if we wish to avert
death. Heavens ! how purblind the world has been not to have
discovered before now, this the only possible remedy for the
only possible cause of all diseases! And verily, there could
scarcely be a more lucrative method for the practitioner ; by no
other could he so beautifully get over the difficulties of his indi-
cations as by this, by which, without requiring to give any fur-
ther reason, holding up the fearful talisman of infarctus in order
to work uncontrolled in the dark, beyond the ken of the com-
mon sense of the uninitiated, and with the hocus-pocus of seve-
ral hundred clysters (composed of a number of unintelligible
ingredients) he could — how wonderful I — ^briug bodily to light
the dreaded infarctus in all its hideous deformity. Making
omelettes in a hat is child's play to this.
If, sighed Tyro, I only knew all the external signs by which
540 0BSEBYATI0N8 ON THS
lodgments could be diagnosed in any human being, If I only
knew what in&rctua really is, what part of the intestines (of so
many, of almost all persons I) is constituted so torpid, as to hai^
bour in such an imperceptible manner these Protean massea^
and what causes their greyish colours, their various shapes, C(m«
sistences, and odours, as they are to be found arranged in a tabu-
lar form in Ejimprs work I The difficulties of the subjeet
make me quite ill I since there arc no sure external signs of their
existence, who can tell whether some such horrors do not luik
in my own entrails I
Grieve not, dear Tyro I that your five senses are inadequate
to enable you to discover all tUs. The game of in£Eurctus and
infarctus-clysters is already played out. It was only a financial
manaeuvre, if it was not a pious self-deception of the inventor.
By a succession of clysters we may make the bowels of even
the healthiest peasant into an organ for the production of unna>
tural faeces, of masses of mucus of every variety of form and
colour.
Other modem visionaries attributed almost all diseases they
could not cure to a step-sister of the infarctus, I mean to o\h
struction in the minutest vessels of the abdomen. They have
not mentioned any signs by which this may with certainty be
recognised. Here, therefore, was another subject of panic ter-
ror for the poor easily frightened patients, another rich draught
of fish in the dark! But be comforted! They immediately
discovered in their nightcap the most eftcctual remedies for it
The vast number of mineral waters and baths that still continue
daily to gush forth from the bosom of the earth to the great ad-
vantage of the presiding physicians of each watering-placOi
which, like the waters of Bethesda, are good (we know not
how) for all conceivable maladies, must consequently be alao
capable of clearing away the obstructions of the finest vessels
of the abdomen and of the mesenteric glands — id quod erat cfe-
monstrandum. Moreover, the saponaria, the taraxacum, the
antimonial medicines, especially the antimonial soaps, invented
in defiance of all chemistry, as they become spoilt in an hour,
soap itself, ox-gall, the triticum repens, and above all, ye, our
more than harrow and plough, noble neutral salts, known to us
at least by name I What can resist your solvent powers I
Bravely spoken I
But have you ever witnessed, whether and how they perform
this solvent action? What divine revelation has pointed them
THRXX CUBBENT XETHOBS 07 TBEATMEKT. 641
oot to yoa as aolrent remedies, since experience teaches nothing
thereof to our senses, can shew no proofs of it — since all is hid-
den firom our view? Are you convinced of the existence of
your imaginary obstructions 7 Are you aware that Sommering
found the enlarged glands, which you consider obstructed, ac-
tually the most pervious to injections of mercury ? Do you
know that when you successfully employed muriate of baryta,
or muriate of lime in some cases of scrofulous disease, you did
not dissolve, as you fondly dreamt, but only separated the sac*
charine acid in them, discovered by Fischer, which was the
cause of the tumefaction in the glands? Where, now, are your
obstructions ? Of what value are your solvent remedies, seeing
that there is nothing to dissolve ?
But whence proceed the great number of children's diseases,
that carry off one-half of all that are bom, before their fifth
year? One replies, "I consider the process of dentition as al*
most the sole cause of the diseases and the mortality of children.
We shall find, if we view the matter aright, that from the very
flzst weeks of their existence they begin to suffer from this
troublesome teething, and thus it goes on for several years.
The poor creatures are always engaged in this teething process,
some one tooth or other is always attempting to come through'.
Hence we refer all their whining, their capricious tempers, their
working with the fingers in the mouth, their pallor, their bowel-
oomplaints, their enlarged abdomens, their starting in their
deep, their restlessness, their turning and twisting, their con-
vulsions, all their febrile symptoms, in short, everything that
can happen to them, if wc are unable to cure it, not to our
ignorance, by no means ! — ^but to one sole cause, that is as in-
' evitable as the Turkish fate. The parents have nothing to
blame us for. For if the dear child gets some well-known dis-
ease, hooping-ct)ugh, measles, small-pox, &c., and dies of it, we
always have the capital excuse, that the process of dentition had
Bomething to do with it. We have the same excuse when sec-
ondary diseases occur afler these maladies, as marasmus, cough,
diarrhoea, ophthalmia, deafness, ulcers of this or the other part
For all these tedious convalescences no one is ever to blame,
the troublesome dentition is alone in fault. God bless that
man who invented this difficult teething! For, thank heaven I
it always gives us something to do with children I Only it is
shocking that the stupid peasant children get their rows of
white teeth with no bad symptoms, quite unawares, as it were,
64S OBSEBYATIOKS ON THS
without any aid from ua, or, indeed, any medical assistaiioa.
For it might so happen that the families that employ us mighl
fall upon the horrible idea, that kind nature knows how to
bring through the teeth without the aid of man, and can m>
tually place them quite silently in the mouth, like rows of
pearls, if the awkward officiousness of medical men, and %
town-life, that great.producer of children's diseases, did not hia-
der her," —
This opinion is flatly contradicted by a colleague, who, with
the usual exaggeration, attributes the whole array of children's
diseases to no other cause but worms. He carries this delusLon
so &r as to attribute a number of epidemic fevers prevalent
among children solely to worms, '^ because they so often pas
worms when affected by them.'' I am very much astonish-
ed that he does not begin to seek the exciting cause of small*
pox, measles, and scarlet-fever in intestinal worms only, for in
them also worms often are expelled (in consequence of matten
repugnant to them being present in the bowels). If he cures
children's diseases by means of iron, semen contra, jalap^powder
or calomel, and worms have thereby been expelled, in that case
the disease, according to his notion (/allasia causae, ncn causae
ut causae) must have been produced by worms, and this even if
no worms but only mucus is passed (purging with jalap and
calomel always causes a discharge of mucus). - That must un-
doubtedly have been worm-mucus, he alleges. — What peculiar
kind of mucus have the lumbrici, that it can be distinguished
from all other kinds of mucus ? And the seeds of the Persian
artemesia, jalap, iron, and calomel, can they cure no other dis-
eases besides those that arise from worms? With regard to the
first, experience has shewn me that it can, and as for the others
the whole medical world is convinced that they can.
And are you sure that your worm-symptoms, a distended ab-
domen, bulimy alternating with anorexia, itching of the nose,
blue rings surrounding the eyes, dilated pupils, &c, and even
the discharge of lumbrici, arc incontestible symptoms of vermi-
cular disease 7 May they not rather be symptoms of a state of
ill-health co-existing along with an accumulation of lumbricii
which may be the cause and not the effect of the collection of
worms ? Does not this ill-health persist even after the expul-
sion of many worms, does not this cachexy often last till death,
and yet sometimes no worms may be discovered on dissection ?
Should the intestines sometimes be found to be perforated
THBSS CUBBXNT METHODS OF TBSATME17T. 648
md should we assume that these creatures have themselves
eflEected the perforation (and not rather have merely crept
through it), it seems to be so foreign to their nature thus to bore •
through their place of abode, that we often find them quietly
remaining in liie intestines of robust children up to the period
of manhood, frequently in considerable numbers, without causing
my inconvenience, and apparently doing nothing so unnatural
IS perforating the bowels unless they are excessively irritated by
some totally different disease of the child (which ought to have
been removed in time by other remedies).
" Away with such gross exciting-causes of diseases !" exclaims
the solidist in the narrow sense of the term, ^^ such doctrines are
not suited to our metaphysical age I Nervous debility is alone
the cause of most of the diseases of our degenerated race now-a^
days. Nervous debility and relaxed tone of the fibre, nothing
else. All the diseases of our time may be referred to this \\ —
.And the remedies for this nervous debility, that excludes all
other causes? Tell us, my friend, what are they ? — " What else
except those incomparable remedies, cinchona bark, steel, and
^lihe bitter extracts?" — And how so? — "Why, look you, that
mvery thing that is bitter, as GuUen has justly remarked, acts as
a tonic; whatever corrugates the tongue, like the salts of iron,
must strengthen the fibre, and what can resist baik, with which
we can tan hides ? Now we have almost nothing else to do in
diseases than to remove the nervous debility and to raise the tone
of the fibre, consequently these medicines fulfil all our ends." —
This would be all very fine if it were all true. If only the in-
numerable varieties of diseases did not produce innumerable vari-
eties in the functions and states of the soUdum livum, which
short-sightedness alone could dream of comprehending in a single
word I If you only knew the infinite varieties of the eftects of
the various bitter substances I If cinchona-bark only ceased to
be a powerful remedy when all its tanning properties were ex-
tracted from it by means of lime-water ! If you could but
attribute all the various effects of iron to its astringent pro-
perty!
" Even these causes of diseases," I he^r some one say, " are not
subtle enough for our superfine decennium, but as regards the
mode of treatment, that smells strongly of crude notions. Far
more subtle is the nature of diseases, far more subtle let their
mode of treatment be ! Nothing less forms the basis of both
than substrata of the various gases. The new system of chem-
istry alone opens the portals of life.
Mi OBSEBVATIONS OK THB
" Enow, that all the derangements that occur in otir fanofaoai
arise from a deficiency or excess of oxygen, of caloric, of hydro*
' gen, of azote, or of phosphorus, consequently that they can
only be cured by superoxydating or disoxydating, by superoa-
lonfying or decalorifying, by supcrhydrogenizing or dehydio>
genizing, by superazotizing and disazotizing, by superphospho-
rizing or dephosphorizing remedies."
This sounds very finely in theory and reads well on paper; it
is also in the spirit of the prevailing ideas. But for every
of disease I should require the supernatural existence of a
to make for me all these generalities concrete, in every case to
reveal to me whether the disease depends on deficiency or ex-
cess of azote, oxygen, &c., and what the chemical antidotes of
this particular chemical state are, for these subjects may indeed
be speculatively excogitated with some semblance of probability^
but being mere products of reason are not cognizable by the
senses in individual cases. Every assertion that has same truth at
bottom (all medical systems contain a portion of truth) is not ef
practical utility,
" We must go still higher," insists a celebrated teacher of
dynamology, who has been reared on the ethereal milk of
critical philosophy, "we must mount up to the original source
of diseases. Hie altered composition and form ofmaUer,^ This on-
tological maxim, however near to the truth it may appear a
priori to the thinker conversant with natural science in general^
and with the probable arrangement of our organism, is entirely
useless to the practitioner ; it cannot be applied to the treatment
of individual diseases. In like manner, what Bruce says about
the remotest source of the Nile is of no practical utility at its Delta.
Still this teacher of natural science has approximated much
more closely than we might have expected to what pure expe-
rience teaches, in his special views relative to diseases, and par-
ticularly fevers, and given much less scope to mere probabilities
than his dogmatical and credulous predecessors. Though a love
of system guides all his steps, he always honestly points out
where his deductions run counter to the maxims of experienoei
and has a wise respect for the latter. The medical thinker may
educate himself under him, but when he is at the sick-bed, let
him not forget that these views are mere individual ideas, mere
hints, and that from them no remedial means can be deduced*
The view of the medical art that Wilmans presents to the re-
flecting physician seems to be that most consistent with nature
[three CITBBJBNT METHODS OF TREATMENT. 546
of all others, but if we would not wander from the right way,
we must confine ourselves to his preliminary observations.
The schools have already adopted his classifications. All
ipeculations in medicine, that proceed from pure empiricism,
lead to particulars and not to the philosopher's stone, if I may
be aUowed to borrow a metaphor from a false art
In dialectic sophistries, in bold assertions, (in shameless self-
praise), and in disregard of the infinite multiplicity of nature,
manifested in the varieties presented by diseases and by their
remedies, all known founders of medical sects were, however,
&r surpassed by that deceiving parempiric. Brown, who, though
not himself engaged in the treatment of diseases, limited all
poaaible curative considerations to exciting and diminishing ex-
citement, and presented to the eyes of the world the greatest of
all medical absurdities, '' that there can only be two or three
riiwenfleH, which are distinguished from each other by no other
<iiffer6nce besides a plus and minus of excitement, and a corres*
jK>nding accumulation of excitability." The therapeutics adapted
to this notion were easily supplied : '' seek for stimulating sub-
stances and for such as are as little stimulant* as possible ; these
«re the true remedies.'^ And for the first of these objects I
should imagine, one or two drugs would amply suffice. Had
he wished to avoid contradictions, he should only have named
one of the volatile and one of the fixed stimuli inslar omntum^
and not several ; for if one can effect every thing, what is the
object of having several ?
Perhaps, however, he felt the untenableness of his simplifica-
tions, perhaps he himself had experienced that the drunkard
oould not exchange his brandy for musk or camphor. In order
to complete his edifice, he must have ignored even patent facts
and daily exj)erience.
But I need not enter into all the contradictions he must have
bit within himself, nor what it cost him to deny the most pal-
pable facts, in order to become the founder of a bran-new, im-
heard-of sect; suffice it to say, no medical sectarian, apparently^
knew less about nature than he, but none understood better
' It surprises me that his adherents have of their own accord substituted ao ezpla-
natioD of the latter substances, which was not that of their master, and could not be
his, if he wished to be coiuustcnt He nowhere makes mention of remedies tii^
•bstnict stimulation, ilis stheuia-lessening substances were such as debihtated
lolely by the smalluess of tlicir stimulus {Mlements of Medicine^ g xo, edii).
a5
6i$ OBSEBYATIONS OK THS
than he, by means of illusory syllogistic ratiocination, to ele-
vate a few true (and from the novel point of view in which
he placed them, apparently new) maxims into the only ones, to
weave over all defects ty his obscurity of stating them, and to
assert so despotically the superiority of his subtle mind in seeiir
larizing all other incontrovertible trutha Probably he would
himself have confessed that he had made fools of the world, had
his excessive use of his diffusible stimuli allowed him to live
longer.
There is no absurdity that has not already been maintained
by some sophist, and in all ages the mania for simplification ham
been the chief stalking horse of system manufactures of the firat
rank.
Thus one in his theories asserted that the world was formed
exclusively by fire, another that it was produced by water
only ; — a third contended that all living beings were formed
from one egg ; — thus Descartes ascribed the universe to his ima-
ginary vertebrae ; thus the Alchemists forced the infinite multi-
plicity of chemical substances into the triangle, salt, sulphur
and mercury. What cared they for the numerous varieties of
metals? They prided themselves on dictatorially fixing the
number of metals at seven, and these they fidsely and boldly
referred to a single original substance, their metal-seed. Whi^
else was it but proud simplifying mania, to decree our little ter-
restrial globe to be the end and centre of all creation, and to
imagine the thirty thousand suns scattered throughout space to
be scarcely more than lamps for its illumination ?
Still, I feel provoked at the wiseacre who sought to measure
the great science of medicine with a span, himself acquainted
with hardly any otber diseases than perhaps the gout,* a few
rheumatisms, some catarrhs, some haemorrhages, and the malig-
nant croup.
From his theoretical sins, of which I must not speak in this
place, I revert to those immediately concerning the treatment of
diseases.
There never was a doctrine so calculated to mislead the prac-
tical physician, nor one so dangerous for the beginner.
According to him we must not trust any thing to the powers of
' It is remarkable how BrowD treats of gout with disproportionate prolizitj', I
migfat almost say pragmatically (§ dci, et seq.), whilst he has scarcely a couple oT
empty, superficial words to say about other special diseases of the greatest unpor-'
THBBB OUBBSNT METHODS OF TREATXEMT. 647
nAtare (zcv.), we must never rest with our remedies, we must
always either stimulate or debilitate. What a calumniation of
natore, what a dangerous insinuation for the ordinary half-
instructed practitioner, already too officious ! What a ministra-
tion to his pride to be deemed the lord and master of nature I
" We should never use one single remedy alone, but always
several at once in every disease'^ ! (xcii.) This is the true sign
of a spurious system of medicine. Quackery goes always hand
in hand with complex mixtures of medicines, and he who can
inculcate (not merely permit) such a system, is toto codo removed
from the simple ways of nature and her rule, to effect many ob-
jects by one single means. This single axiom, invented for the
purpose of confusing men's minds and making a mystification
of treatment, must already have cost many their lives.
Henmkes no distinction betwixt palliative and curative reme-
dies. Like a bungler, he always recommends only such as are
of a palliative character,' which, by an action the direct opposite
of the state of the malady (i^xxiii, lxiv), at first subdues the
symptoms (for a few hours), to leave afterwards a state the op-
posite of that produced by the temporary remedy. Thus opium
is his true panacea in all diseases arising from, and attended by
debility. What a climax of parempiricism and what a mistake
— to recommend a medicine as a general strengthener which
after the lapse of a few hours, during which it excites the strength,
subsequently allows it to sink all the deeper, deeper than before
its employment, to prevent which stronger and ever stronger
doses must be given ! And what experienced practitioner is
ignorant of the effects resulting from a continued employment
of opium in elevated doses. This drug that strengthens only in
a palliative manner, but that is, more than any other remedy, in
its after-effects weakening and productive of an increased sensi-
tiveness to pain. Brown could recommend universally and with-
out any limitation as the universal and appropriate remedy for all
sorts of diseases, whose character is weakness, even such as are
of a most obstinate and chronic character (ccci, ccxcvili). He
who fails to perceive in all tliis the perfect picture of a parcm-
piric has lost the use of his eyes. It is only in the special and
very rare cases in which opium is at the same time the specific
' I am not ignorant of the great Taluc of palliatives. For sudden accidents that
Imitc a tendency to run a rapid course, they are not only often quite sufficient, but
tfen possess advantages where aid must not^be delayed on hour or even a minute
Id va/Ai cases and in tuck aUmc are they usefoL
548' OBSERVATIONS ON THB
remedy for the disease, that it cannot debilitate, and when it is'
employed in very small doses as a palliative in robust oonstita*'
tions and along with strengthening regimen, it apparently doe0
not weaken. This is the source of the delusion. But of really
curative drugs, the true weapons of the true physician, — ^whi<^'
remove the disease permanently and radically^ by first exciting an
affection similar to the disease present, — of these he says never*
a word, he does not even know their names. He that knowB
them I term a restorer, a discoverer of the medical art, as he
calls himself. Thus he had hot the most distant idea — to give a
single example — that a burnt finger may be held for a long time
in cold water before it (when taken out and dried) shall cause.
no more pain— indeed vesication occurs all the more certainly
if so-called antiphlogistic, debilitating remedies be applied to thift
local infiammation. He has not the least idea that the opposite
of all this occurs if the burnt finger be held in alcohol.^ Where
now are your palliative anti-sthenic, where your palliative anli-
asthenic remedies ? How liar they are behind I
What true, experienced physician knows not the palliative
debilitating power of cold and of cold water? Brown had no
need to put forward as a novelty the debilitating property of
cold and of the cold bath. But when he announces it to be a
positively debilitating thing, he shews that he does not know it,
just as he views many other things in a false manner. It is only
for the moment during its application fchat it debilitates (pallia-
tively), whilst in its subsequent eftects it manifests itself as one
of the most excellent of strengthening remedies (as a curative
and permanently remedial means). The greatest weakness of a
limb, a frost-bite, is confessedly cured by nothing more quickly
than by cold water. This may stand for one of the thousands
of instances of the curati vely strengthening effects of cold water.
He knows no other cause of diseases besides either a too vio-
lent excitement by means of stimuli (sthenia), the continued
action of which causes indirect weakness, or too little excitement
by means of too weak stimuli (direct debility). The former in-
cludes all purely inflammatory diseases, and the latter all other
diseases that bear the stamp of debility. The former are cured
by venesections, cold, water-drinking, 4Scc., the latter by heat,
' Look at the reaper excessively heated by working in the heat of the sun ; with
what does he allay his tlurst most certainly and most effectually, with what can be
do this better than with a little brandy. Brown's antisthenic palliatives^ cold water,
Ac, could scarcely refresh him for an instant.
THREE CUSSEXT METHODS OF TREATMENT. 649
•
80ups, wine^ brandy, and particularly opium. In this manner
all the countless diseases, varying infinitely in kind, are cured
by him (on paper) or directed to be cured. The crudest parem-
piricism, the most audacious ignorance, could not go further than
this. According to this all epilepsies,^ all dropsies, all endemic
diseases, all melancholias, are to be certainly cured by opium,
brandy, heat and beef tea ! lias any one ever experienced a
oertain, radically good result from such treatment in such dis-
eases? Is he making game of us? Docs he want to consign
oompletely to the tomb the medical art, sunk as it already is down
.to the administration of a few routine drugs ?
But no I he is in the highest degree rational. He permits no
treatment to be undertaken before ascertaining all the inimical
influences that have preceded the disease, whether they could
(Let in a too exciting or in a debilitating manner, and from these
alone he will allow the nature of the disease and its treatment
can be determined (but always only for two objects, viz., whether
we should debilitate or strengthen). But the very circumstance
of his making this investigation the only indispensable indication,
betrays that he has treated disease in his study only, that he
9peaks as a blind man would do about colours. In all the cases
of sudden disease and such as occur among the common people,
who could ascertain in every instance and in the most exact
manner, before commencing the treatment of any disease, what
was the kind of injurious agency (as Brown aflccts to discover
in every case) had occurred long before ; whether the malady
was preceded entirely or only in some degree by an excess of
stimuli, or entirely or only in siMiie degree by too weak stimuli,
or in how far it was preceded by greater stimuli mingled with
deficiency of stimuli (and in what proportion?); whether a
sthenia has changed into an indirect or direct debility, or the
latter into the former, or whether one sort of asthenia has eon-
joined with another, and (what nonsense!) brought about a
mixed state, in which the excitability of eighty degrees, that divine
revelation to the inspired Brown, is exhausted or accumulated ?
Who can always institute a comparison between the strength of
these noxious influences and the sum total of excitability aj?.
signed to the individual, modified as it is said to be by age, sex,
constitution, climate, country, &c.? What experienced practitioner
can assert that a tenth part of his i)atients or tlie friends of his
* He knows of no epilepsy with excess of jjcood blood, no stlienicdropf^y, no sthenic
hfimorriuiges, no asthenic catarrhs, though nature knows them and not unfrequcntly
pnoduces them.
560 OBSERVATIONS ON THS
patients could, would or should give accurate information on all
these hyberbolical or hair-splitting questions, give a detail of all
previous agreeable or disagreeable mental emotions, of the im*
pressions of the various degrees of temperature to which ihej
may have been exposed throughout a considerable lapse of time^
of the exposures to too much or too little sunlight (a stimulus
of no mean intensity !) or to a more or less dry, moist, impure or
pure air for some considerable period, of the divers kinds of
more or less nutritive, sapid, seasoned or unseasoned articles of
food that may have been indulged in, the quantity of more or
less strong, vinous or watery drinks that may have been taken, the
frequency of indulgence in venereal excitement, the d^ree and
quantity of exercise that has been taken, the nature of the
amount, the degree and the frequency of all previous mental
excitement by means of reading, conversation, amusement, mumc^
&c.? And even supposing among many fitmilies one coidd be
found who after some weeks of interrogation (for it is impossible
that such a variety of questions could be asked in one day) was
able and willing (supposing the greater part had not been already
forgotten) to answer the most of these questions, how painfiillyi
how fruitlessly I may say, must not the poor doctor rack his
brains, in order to estimate and compare these hundreds of thou*
sands of various influences, to calculate their exact effect on the
patient whose excitability was at first so and so much, to estimate
the resulting sum total, and to discover the amount in Brunonian
degrees of the excess of the noxious powers of over-stimulation
over those of the deficiency of excitement, of the excess of the
powers of the latter over those of the former, and all this in
connexion with the particular subject before him ! No single
circumstance of importance must remain unascertained, or be
left out of the list, or be omitted in the calculation, neither must
the lesser circumstances (which constitute something considerable
by virtue of their number) be forgotten, unascertained, omitted
or unestimated, otherwise the whole reckoning will turn out false I
I need scarcely remark, how vain, how impossible, how sense-
less, such a mode of procedure (which, according to Brown's
maxims, § xi, xii, Lxxviii, c, &c., cannot be pushed too far, see-
ing that all the investigation of disease depends on it) must
be in every-day practice — what an enormous amount of trouble
and time must be expended in the investigation and considera-
tion, before the treatment of a single case can be commenced;
and in the time thereby lost the disease must unobservedly pass
into another stage, if it do not in the interim terminate in death.
THB» CUBBENT METHODS OF TRXATXSNT 661
A wnBdenJtioiva BrunoniaQ would probably never arrive at the
period when he would eommence the treatment^ with all this in-
vestigation and effort to form a just estimate. And after all,
nothing more would have been ascertained but the point le*
specting the sthenia on which the disease depends, or respecting
the direct or indirect debility I Is this the only thing we require
to know in order to effect acure ? Well then, know that debility
is present in all endemic diseases. Now, quick ? cure me all the
countries affected with ringworm, pellagra, plica polonica, sibbensi
yaws, pian, water-colic, &c. Do you want nothing but fixed and
diffusible stimuli ? Here you have opium, caloric, brandy, bark,
beef-tea. — Cure me them quickly I
God help us I what a mass of nonsense a single unpractical
book-maker can rake together and inflict on weak lamb-like
mortality, in defiance of all common sense I
But let us do him justice I whilst we see that the glory which
was to constitute the apotheosis of this 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 everything topsy-turvy in the domain
cf JEsculapius is dashed to pieces, and that the myriads of spe-
cial diseases cannot be referred by him to one or two causes, kx
what is the same thing, be decreed by him to consist of
two or three similar diseases only varying in degree, nor
their infinite variety 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
liim the justice to acknowledge that with a powerful arm
lie dispersed the whole gang of humoral, acridity, and sa-
hurral physicians, who with lancet, tepid drinks, miserable diet,
emetics, purgatives, and all the nameless varieties of solvents,
threatened to destroy our generation, or at least to deteriorate
it radically, and reduce it to the lowest possible condition, — that
he reduced the nimiber of diseases requiring antiphlogistic treat-
ment to three per cent of their former amount (§ ccccxciii),
that he determined more accurately the influence of the six so-
called non-natural things on our health, that he refuted the ima-
ginary advantage of vegetable over animal diet, to the advantage
of mankind ; — that he restored to the rank of a medicinal agent
a judicious diet, 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 difference
of their treatment in a general way.
562 TO A OANDIDATS FOB TEX DEOBSX OP IL D.
This may reconcile us with his manes I
His disciples, proudly wrapt in the mantle of their Elijah,
, support his doctrine utcunque with much noise (the sign of a not
very good cause), deafen us with the Brunonian cant about de-
grees of excitability, which they consider to be exalted and
depressed by previous noxious agencies just as they please,
prate about simple and compound, direct and indirect debility,
about diotheses and predispositions as (imaginary) distinguishing
(Signs of the general from the local diseases, about (pretended)
, diffusible and fixed stimuli — and treat their patients right and
,left with compulsory soups, wine and opium; they are bec<Hiie
sufl&ciently cunning to engraft from vulgar medicine what ia re-
quisite and indispensable, and when beef-tea, rum and opium do
not suffice, they employ the excellent bark (which their master
decried) in intermittent fever (protesting all the while that they
use it only in its quality of a fixed stimulus), and turpentine oil
in dropsy, but under cover of the Brunonian explanatory for-
mula : ^' that turpentine possesses the exact degree of stimulant
power necessary in this case." Thus have I seen the devout
monks in a monastery dine upon partridges on a Friday, but
not before the prior had made the sign of the cross over theni|
accompanied by the transmuting blessing— ^^^iscis /
TO A CANDIDATE FOR THE DEGREE OF M. D.'
I have read your notes of the lectures on therapeutics of your
celebrated professor. You are quite right to leam all these
things, and to take notes of them. We ought to know what our
predecessors and contemporaries have imagined. In like man-
ner I often allow my patients to tell me what they think their
disease is and what it proceeds from, what sort of witchcraft
produced it and what were the sympathetic remedies and foolish
means they have used for it. I like to know what sort of ideas
people form of things. The same with you in your college,
where you leam the fables those people who imagine themselves
to be sagacious physicians have invented respecting all those
things which they do not understand, and which no one in the
world can know a priori. Of course there will be many extra-
ordinary freaks of imagination and daring maxims that find no
* From the AUgem, Anuig, der Deufchm, Na 227. 1809.
TOA OANBIDATE JTOB THI DEQBXB OF K. D. 658
ixnrroboration in nature, and much more learned stufi^ which at
■bH events Bounds very profound and wise, because it is paraded
in grand, florid and metaphorical language, — there the oxygen
and hydrogen poles in the human body, intensified factors, the
ganglionic system, the centre of vegetative life, a peculiar irritable
or a totally distinct sensitive system within us, must play parts
in the comedy we have ourselves invented. Beautiful shadows
on the wall ! But when they come to the bedside of the patient,
one will see a synochus systeinatis irritahilis, where the other, who
has been taught by the self-same master, firmly and obstinately
asserts he finds the exact opposite, for the signs of the one and
of the other as taught ex cathedra are as non -essential and unde-
oiaLve as they are vague and indeterminate. Now should it so
happen that one of them has divined the real meaning of the
-Bystem-monger, what advantage does the healing art thereby
gain? None at all I No subtle theorizing respecting the essen.
tial nature of fever ever points directly to what should and must
be useful for it. The theoretical house of cards stands quite
isolated in its imposing majesty, but is hollow aud empty within,
and does not even contain an indication for the appropriate re-
medy for the disease, the inspired revelation of whose essential
nature is here solemnly announced. 0 quanta species^ cerdbnim
noihabetl The whole jingle of theoretical flourishes is far from
being of the same use to the directions ai)pended to it as to what
is to be used in the disease, that the premises are to the deduc-
tion in a logical syllogism — no ! they more nearly resemble the
sound of the trumpet and drum in the street wherewith the
mountebank seeks to announce the quid lyro quo which he pro-
poses to juggle before his delighted spectators in the afternoon.
For see, what the professor imagines to be of service in this case
or the other is just as arbitrary, has no firm foundation, and is
not the result of experience, but is inferred pom die most super-
fidal view of the case, and mily asserted witli the satisfactory
«irrW *pm. For a single genus of fevers there will be found al-
most the whole materia medica : give the patient, gentlemen,
draughts of -bitter and aromatic plants (does this mean that we
are to give colocynth, squills, ignatia, nux vomica, aloes ? also
yellow sandal- wood, dittany, abelmochus seeds, rose-wood?), or
saccharine oils in tea (including the oil of laurocerasus and the
distilled oil of bitter almonds ?).
The whole concern with its many definitions of fever and its
superfine pedantry in pulse-feeling — which every one finds to
554 TO A CANDIDATE JTOB THX DSQBXB OF X. IK
vary almost every hour, and wliich feels different at every mo-
dification of the patient's temper — all these are no doubt glitter-
ing things, but they are at the same time utterly vain, affording
no comfort and no assistance, obscuring our vision like a mist
when we seek to cure our patients. On account of the learned
mist which obscures and does not illuminate, we neither perceive
the true state of the patient, nor that wherewith we might afford
him relief
Only ask yourseli^ if you knew all that off by heart, would
you be able by means of it to form an accurate conception of
the disease, and could it aid you to cure the disease ? No doubt
you would be able to treat it with all the array of proposed re*
medics, but whether one of these is the best and most suitable^
and which among them it is that solely and especially can and
must be of service, that you will not laiow; the professor him!*
self does not know it, otherwise be would only have mentioned
this sole best and most suitable remedy, and no other. Wlien
the therapeutic professor can put toge^er a number of general
artistic floweiy, phrases respecting things that none can faiow,
and can dash a learned-looking varnish over the hypothesia of
his own invention, the whole affair appears to be all right ; but
when he attempts to apply it to the relief of disease — ^the proper
object of the medical art — ^his learned, theoretical apparatus
leaves him in the lurch ; he then runs over, in a purely empiri*
cal manner, just like the most unreflecting, routine practitioner,
a number of names of medicines — " there, make what you can
of that ! you may put all the names together into a bag, and
according to your fancy draw out one or several, it is quite im-
material, you may use this one or that one I '' Here, where the
question is to afford relief, we find the most stupid sincretiflm
and empiricism, and there, where theorizing is the question, we
find the most sublime, mystical, and incomprehensible phrases
in use, as elevated as if they had been solemnly delivered by a
divinely inspired oracle fh)m the cave beneath the tripod of the
Delphian Apollo. But cease to entertain a reverential awe tcft
these magic mutterings; they are mere empty sounds that have
no connexion with the simple, certain and rapid delivery of your
fellow-creatures from the pangs of disease ; they are but sound*
ing brass and a tinkling cymbal. [•]
' [Let the students of oar modern medical colleges^ ponder weU npoo theM
just remarks, and ascertain if thej are not applicable to the scfaooli of oar owi
oouotrj.] Am. P.
OK THB PRSVAILINa FSTSB. 566
ON THE PREVAILING FEVER.^
The medical men of the present time, by regarding the fever
that has prevailed for a year past in Germany, and indeed
throughout the greater part of Europe, as a common ague or in^
termittent fever of some other ordinary kind, and by treating it
as such (every one knows with how little success I) have given
a fresh proof of the imperfection of the ordinary medical art, I
might idmost say of its absolute futility.
When one thing expresses itself differently from another,
and exhibits different properties and actions, it requires very
litde discriminating skill to regard it as a thing of a different
character I And when one disease shews itself in its course, its
symptoms and all its phenomena quite different from another
well known disease, surely every person endowed with ordina-
ry reason must perceive that the former must be another, a
peculiar disease, differing completely from the one already
known ; and, as a necessary consequence, to be treated quite
difiisrently, and entirely according to its peculiar properties.
Not so our dear ordinary system of medicine, whose maxim
seems to be to leave every thing in the old way, to take every-
thing quite easily, and to spare ourselves as much reflection as
possible. Our ordinary medical system, I say, felt no hesita-
tion in declaring this new peculiar fever to be an ague and (what
diould prevent it?) treating it accordingly. For mark! dear
reader, the medical art has but a single intermittent lever, what
is called ague in the books ; therefore there must be in nature
no other typical fever. Quasi vero.
And thus the misunderstood fever at present prevailing is
treated by practitioners like the ordinary ague that occurs in
autumn and in marshy districts, — right away with emetics and
purgatives, with sal-ammoniac (opium), millefoil, buckbean,
centoary, and cinchona bark, which has been considered as al-
most omnipotent. By means of the first mentioned, the (imagi-
nary) febrile matter was to be dissolved, or expelled, but by the
last the type was to be extinguished. But what was the effect
of this general plan of o^x^ration (which was long since intro-
duced for the ordinary autumnal marsh intermittent fever) when
■^^M^M^— ^^wi III .mm ■ ■ - ■ — ■■ ^ - — ' ■- I I ^ » — ., ,■ - ., ■■■ I II ■ ■^
* From the AUgtm, Am, der DeiU^ehen, Ka 261. 1809
55$ ON THE FBSYAIUNa EBYSB.
employed against the misunderstood fever at present prevailing?
I appeal to the experience of all countries where it has raged,
if it was not attended with bad eflFects, if it was not often the
case that more disease (even death) and long-lasting indisposi*
tion were not often thereby promoted, than would have been
the case without all those unsuitable medicines, and actoallj
was the case among poor people who used none of them?
These substances, and particularly the bark given in large
quantities, certainly sometimes suppressed the paroxysms (when
they did not change the fever into an acute rapidly fatal one)
for a longer or shorter time, — ^but they did not thereby gen-
erally restore the patients to health ; they generally became in
other respects worse, they became subject to very painful local
diseases in place of the suppressed paroxysms, or they lan-
guished with nervous symptoms and wasting affections, which
were worse than the typical fever itself.
These dangerous mistakes were in the first place owing to
this, that practitioners as usual did not distinguish the disease,
did not examine what particular, peculiar symptoms were
proper to this prevailing fever as distinguished from all other
kinds of intermittent fevers, whereby it was rendered quite a
distinct, peculiar disease; and, in the second place, that they
did not know how to discover the peculiar, specifically suitable
remedy for this peculiar fever.
Can that be termed a medical art which has no power to per-
form its two sole duties — the discriminating observation of dis-
eases, and the discovery of the appropriate, specific remedy ?
In ordinary diseases which (God be praised !) tend to get well
of themselves, the ordinary practice of medicine can contrive to
conceal its incfliciency and hurtfulness — there it can, to use its
own language, dissolve, purge, depress, stimulate, and do what-
ever else it will with remedies, that the most unreflecting caprice
suggests to it ; — some persons certainly get well under the treat-
ment, let the doctor act as madly as he pleases. Good consti-
tutions oflen even then gain tlie victory (not unfrequently with
the aid of throwing away unsuitable, injurious medicinal mix-
tures) not only over the disease itself, but aUo over the newly
added malady — over the blind treatment of the unknown dis-
ease by means of inappropriate, therefore hurtful medicines, and
out of the number of those that die no one can tell how many
who had originally a moderate attack of the disease succumbed
solely in consequence of the interference oi the art.J
OK THE PREVAILIXG FEVER. 567
But in the diseases that do not- soon go ofif spontaneously,
that "will not allow themselves so complaisantly to be overcome
by the dear vw medicairix naturce — such as the fever at present
laging — ^in them it will be quite obvious that the ordinary
medical art is not very far from being a scientifically propped-
ap monster and a misleading phantom, and its practice with
few exceptions a futile injurious procedure. Ahnost all its
efforts' tend but to aggravate (when the reverse does not hap-
pen, as it does sometimes, in consequence of the accidental and
hicky admixture of some addition to the methodical medicinal
compound) or to excite new maladies, often not less to be
dreaded than the original disease. Thus, in the present instance,
by the injudicious suppression of the paroxysms of the prevail-
ing fever there are produced a continued morbid, chronic fe-
brile state, periodical spasmodic nervous affections, asthma, stiff-
ness of the joints, swelling of the glands, constant or periodical
discharges of blood, or long continued suppression of the men-
ses, but particularly excessively painful local diseases, and
many other wasting affections, which no sensible person can
tenna cure.
I shall endeavour to describe the peculiarities of this fever,
as they present themselves, when it has not been altered by drugs^
and then I shall shew what medicines must be suitable for it,
a&rd, relief, and restore health. —
A difference of sex, of constitution, of age and of the imme-
diate exciting cause (whether it was anger, grief, a fright, ex-
cess in sensual indulgence, a debauch, &c., that first caused the
fever to break out), — also, to a certain extent, the climate and
the state of the weather, sometimes occasion at first some vai'i-
ety in the course and form of the fever. But the following is
its general course.
Often for several days or weeks before it breaks out there
are observed, headache in the evening, bitter taste in the mouth,
and heaviness in the legs.
1. In bad cases the fever commences as a continued one, and
goes on without intermission in almost equal violence day and
night, constituting, as it were, a single paroxysm, which ends,
if inadequately treated, the ninth, eleventh or fourteenth day
with death— or it subsides (and this it is very ai)t to do) into a
continued chronic state, wherein certain sulferings are more
tsevere at one time of the day than at another ;
2. Or it resolves itself (either spontaneously or by the com-
558 OK TUB FREYAILINa FSYSB.
mencement of appropriate treatment) into tertian or quotidian
fits. The remissions, however, do not in the most cases consti*
tute a genuine intermission, not a state of absolute freedom jGrom
disease ; a few or many of the sufferings persist (though in a
less degree) and the fever is therefore only to be regarded as a
remittent one, which is especially the case in its worse formfli
the paroxysms of which do not terminate under eight, twelve^
sixteen, and even twenty-four hours.
(It is only a very small minority of these fevers that have
true intermissions, but, notwithstanding this, their nature is the
same, and they require the same mode of treatment.)
In both kinds, which often pass into one another, the skiver^
ing or rigour (which sometimes passes into violent shaking and
chattering of the teeth) is not (as it is in ordinary agues) accom-
panied by real external coldness, but it is a merely internal
shuddering sensation of cold (internal rigour), during which the
patient is hot (in some cases only naturally warm) to the touch
all over, but chiefly so on the hands and feet.
This cold stage commences with thirst, vertigo, and a draw-
ing tearing (mixed with shooting) from the legs upwards, which,
when it according to the patient^s sensation, gets up into the
liead, produces heat of the head, headache, nausea, &a
In the continued kind the sensation of flying heat in the head
alternates almost unremittingly with rigour ; often both are pre-
sent at once (the patients complain of ** internal rigour, and of
their head being at the same time so warm that the heat mounts
up into their head, with nausea"). At the same time the pa-
tients feel hot all over the body, without themselves being
aware that they are so, on the contrary, they wish the room to
be strongly heated, wrap themselves closely up, and only com-
plain of the so-called flying heat rising up into the head.
In the chronic, degenerated kind of the continued fever, the
rigours with external heat of the body and of the hands are not
unfrequently conjoined with actual coldness of the feet, then
the patients complain that after going to bed at night they can-
not get warm, whereas when they waken in the morning they
feel so hot
As a rule, the rigours in the continued variety come on from
very slight causes, on getting up, even on sitting up in bed and
on the slightest movement, often even every time the patient
drinks, even warm beverages.
In the paroxysms of the remitting^sort also, the so-called heat
OK THX PBSYAILINa FEVIB. 669
18, aocording to the patient's description, generally only a feel-
ing of fstrong wannth rising to the head, often accompanied by
burning in the eyes and redness of the &ce (this is the only
heat they feel, not that of the rest of the body), with which is
conjoined a series of other affections of the sensibility and irri-
tability, which together constitute the so-called hot stage.
The most frequent complaint is the headache^ which they
nsoally describe as a tearing pain in the skull, mingled with
shootings, also as a bursting pain, often also as a digging in the
bndn and as if it would be forced out superiorly, whereby a
throbbing in the occiput not unfrequently supervenes, which
deprives them of consciousness, or jerks in the head from before
backwards. They have this headache even while l}ring, but on
rimng up, or even moving the head, either the shoots or the
blows (jerks) in the head increase to an intolerable degree.
Patients c^ a different constitution complain, instead of this
lieadache, that their head feels so heavy, so stupid, so dizzy,
that they are so forgetful and intoxicated, that every thing ap-
pears to them wrong, that there is hissing and roaring in the
Inain. This state in the hot stage often turns into real uncon-
eciousness and loss of reason, that oft;en lasts many hours and
even degenerates into violent mania and raving madness.
But an equally frequent symptom in the hot stage is the
cmxiety (generally combined with palpitation of the heart and
sweat on the brow), which often rises to the most fearful height,
during which the patients complain that they cannot control
themselves, and not unfrequently in these dreadful moments
they commit suicide, either by strangling or hanging them-
fldves.
In the continued variety of this fever, this anxiety usually
becomes aggravated after midnight, especially after three o'clock,
when the patient cannot endure to remain in bed, but must walk
about, until they sink down exhausted. In this kind of fever
the kind of pain which the patient experiences during the day
is at the same time aggravated so as to be intolerable, whether
it be in the head, the chest, one of the limbs, the uterus, the
Tuinary organs or elsewhere. In the slighter degrees of this con-
tinued fever there occur after midnight, half remembered, anx-
ious phantasies, deliria, tossing about of the body and limbs.
The disposition of our fever-patients is also very much affected
by precordial anxiety even when no fit is present. They are
timorous and easily vexed by trifles, and, according to their
660 ON THE PBEVAILIKO FBTSB.
temperament, either very dismal and full of fears of impending
death, or intolerant, impatient and weary of life, occasionally so
much so as to induce them to commit suicide.
A third symptom occurring along with the hot stage of the
paroxysms is nausea, a/adnt/eeling^ such as is apt to accompany
horrible pain, which often tends to increase into retching, tot
several hours, and vomiting of sour, bitter or watery fluid.
In the continued kind the nausea often often comes on in
conjunction with the anxiety, vertigo, £Euntness and trembling.
Even when no actual retching is present the patient has a con*
stant feeling in his stomach as if he could vomit incessantly.
The vertigo is one of the most frequent symptoms of this fever*
It oftien comes on at the comimencement of the rigour, on aay
slight movement, and is accompanied by the nausea, the noiae
in the ears, the obscuration of the vision and the ftuntness. Tha
patients feel as if they would fall rather sideways and forwaids
than backwards. In the chroi;iic continued variety the vertiiio'
happens chiefly ia the morning. ^ ^^
Not less characteristic of this fever and a very firequent phe-
nomenon is the trembling^ especially of the limbs, which some--
times occurs alone, sometimes conjoined with the anxiety, the
heat of head, the attacks of faiutness and vertigo, and also with
the sickness. Most frequently of all, the trembling shews itself
at the commencement of the hot stage. In the chronic, con-
tinued variety it sometimes becomes the most prominent symp-
tom, and then attacks only one limb at a time ; it occasionally
appears only when lying down, and not at all when moving.
The paroxysms of some children are ushered in with clonic
spasms and epileptic convulsions; seldom are they mere tonic con-
tinued flexures of their limbs at the commencement of the heat
The perspiration (which usually smells sour or sourish) usually
occurs in the paroxysms of the remittent kind, not, as is the caae
in the autumnal intermittent fever, during the heat, but (very
characteristically) afterwards, often only some, several or even
many hours afterwards, * often also not until the patients get up,
or move about, or when they fall asleep some hours afi»r the
heat In the mean time the worst symptoms of the fits, the pre-
cordial anxiety, the pains of the head and other parts, the weight
and stupid feeling in the head, the loss of reason, &c, go o£^
but usually not until the perspiration comes on, however long it
Qeaerallj the flow of^urine remains suppreaaed just as long.
09 1SB FBEYAIIiUra FSYEB. 5^1
may delay.^ I& the chroDic ooutinued variety of this fever, the
pmspiration comes on when moving slightly, even when eating,
but especially on the recurrence of the pains, and whenever ih^
patients go to bed and cover themselves up. During the slightest
deep most of them become immediately covered with perspira-
tion.
In the kind of fever consisting of repeated paroxysms, thef
Airst fix)m the very commencement of the fit, even before it
oomes on, until the end, is unquenchable, but though the patients
drink very often, they take but little at a time, for every liquid
becomes repulsive to them the moment they partake of it ; there
abo often occurs immediately after drinking either shuddering
or nausea and retching ; this kind of thirst is also not unfrequent
daring the remissions. If the fever assumes the chronic type,
there sometimes occurs complete adypsia, though not often.
Along with the sinking feeling and retching sickness there is
eoi^oined disgust at all kinds of food, chiefly at meat, butter, &c
Even when, in the fevers that pass into the chronic form, food
and drink begins to taste tolerably, there still occurs after it i^
partaken o^ sinking and nausea — or anxiety, as if from difficulty
of breathing so that there is a desire felt to open the doors and
windows In the chronic continued fever, periods of annorexia
and bulimy sometimes occur alternately.
On taking any food, the sense of taste appears as ifextmguished\
fix>d tastes, even during the remission, just like hay or straw ;
but immediately afler partaking of it the mouth becomes com-
pletely filled with a bitterness like gall, just like after vomiting
from taking an emetic ; and there occur nausea, or bitter or
sourish-bitter eructations. In some there occur even whilst eat-
ings especially eating bread, bitterness in the mouth. More
laiely does it happen that there is constant bitterness of the
mouth, and in that case the bitterness is much increased after
every meaL At the commencement of a paroxysm the bitter or
Utter-sour ^nctations are of frequent occurrence.
The usual sensation in the mouth is dryness of the fauces with
fedingof mucixs upon the tongue, not un frequently combined
with a feeling of rawness in the fauces. Frequently, after awak-.
ing in the morning, the taste in the mouth is bitter, rarely like
that of rotten eggs.
' lliere are some of these fercrs vhere penpiratioQ never eDsues, ooljr durii^ Xtm
mnstj there may be a little on the head -, in these cases the perspiratioa is »ome»
replaced by clonic spasms.
2Q
662 ON THE PBEYAILIKO FXYSB.'
The"urine is generally dark and of a greenish-brown colour.
There often appear burning itching eruptions all over the
body, or on different parts of it ; sometimes a very frequently
occurring cough.
The sleepiness by day in the continued kind of this fever is
great Even in the morning soon after awaking, whether they
are seated or standing, their eyes often close, fi^quently in the
act of talking.
Very characteristic of all the states of this fever is the m-
iolera7ice of movement or of muscular exertion. Immediately on
the occurrence of a fit their limbs appear stiff, as if paralysed;
they must instantly lie down, and even when lying they feel as
if paralysed. If the patients get up during the heat, then shud-
dering occurs, not unfrequently with sudden chilling of the hands
and feet, they feel sinking, the vision becomes obscured, a
feintness supervenes. Also when the paroxysm is not upon
them, the least movement deprives them in a few moments of
all strength. Trembling, vertigo, nausea, obscuration of vision^
roaring in the ears and fainting, these S3rmptoms so characteristic
of our fevers, frequently come on on the least movement, and
the strongest men ofl;en fall to the ground before we are aware
of it. Also in the intermission and in the chronic continued
state, the patients cannot bear to stand even for a short time ;
obscuration of vision and vertigo, shortness of breath, and even
feinting, are the result. All the pains they usually suffer are
especially increased by movement of the body, or of single limbs.
On putting their foot to the ground they feel the shock in their
head, or shootings go through it.
All the symptoms are alleviated by lying.
But still more injurious to them in every condition of this
fever is movement in tfie open air; this deprives them suddenly
of strength, produces in them either shuddering and rigour (fbl.
lowed by perspiration) or shortness of breath, or drawing in the
limbs, or increased tearing shooting headaches ; at the same time
it diminishes the dizziness, maziness and intoxicated feeling in
the head, which however soon recur on coming back into the
room. A kind of pressive pain in the chest, or rather in the scro
bictdus cordis^ with sense of suffocation , is a not unusual symptom
at the commencement of and during the heat ; it often occurs
simultaneously with the precordial anxiety. Pain, like rawness
in the chest, is far from being rare, and the same may be said of
drawing pains in t/ie back, as if from a strain.
OSr THX PBEVAILIKO FEYER. 56S
This fever seems sometimes to cease suddenly of its own ac-
cord, bat more frequentl j by the use of some medicines unsuit-
able for it, especiallj cinchona-bark ; but on the other hand,
fliere occur at the same time vicarious affections, periodical ner-
TDUB maladies, suppression of the menses, or periodical, very
painful discharge of coagulated blood and mucus from the womb
or urinary organs, or anus, and other intolerable painful local
affections, and even aberrations of the mind. In proof of their
origin and that they are only degenerated and masked forms of
this fever, there remain several of the above-named characteristic
affections peculiar to this fever, and the vicarious maladies them-
selves become aggravated at certain times of the day. The ag-
gravations usually occur from four o'clock in the ailemoon until
three or four oVlock in the morning in some, but in others from
three in the morning until four in the afternoon. The other
twelve hours are much more endurable.
For these vicarious maladies (masked fever) the only efficacious
medicines are those that are capable of curing the original fever.
Nothing can do good and restore health but the medicines spe-
dally suitable (specific) for this fever, that is, such as are capable
of exciting similar symptoms in the healthy human body.
Let my readers endeavour to find out in Hahnemann's Frag-
menia de viribiis niedicarnentorum positivis what medicine it is
that causes the following symptoms characteristic of this fever :
Rigiditas artuum — juncturarum mobilitas diminuta — torpor om-
nium membrorum — instabilitas, infirmitas pedum, genuum —
lassitude ingens — ^tremor — tremor pedis alterutrius et genuum —
lapsus virium subitus — syncope — gravitas capitis cbriosa, verti-
. ginosa— ebriosa capitis obtenebratio — vertigo cum scotomia —
nisus in decubitum — impotcntia caput erigendi, in dorso recli-
nati ob vertiginem et scotomiam — respiratio extra lectum angus-
ta, difficilis; in lecto justa — dolor pectoris respirationem suffo-
cana — anxictas ingens — palpi tatio — anxietas autochiriae cupida
—mortis timor — mortem instare putat — anxietas diaphoresin
gignens, ad minimum frontis — post anxietatem nausea, vomitu-
ritio— deliquescentia cordis — horripilatio primo, turn calor ango-
rem creans — ^horrescentia — genae calidae cum horrore intemo —
fiiciei caloris sensus cum horrore corporis caeteri — calor intemus
capitis cum frigorc corporis — ardor in oculis sine inflammatione
— ialor cum Iccti appetcntia — dilaccrans capitis dolor eundo
auctus — pulsationcs vel ictus aliqui in capite — aero libero auctus
capitis dolor et crurum lassitudo— anorexia cibi — anorexia
maxime panis — regurgitatio amari et acidi saporis — impatientia
6M^ ON THS FREVAILINa FSVOI*
panronim malorum — payor — phantasiae npctumae aemi-yigBeB
— ^phantasiae delirae terribiles — eruptio miliaiis ardenti prorieaA
-Mdens pruritus per totum corpus.
The seed* which is capable of producing these symptomai ii
of all known vegetable medicines the only one that is sJso Cfi^
ble of curing a great part of this prevalent fever in a short tsne^
that is, of transforming it into health.' but this is only to ba
done by giviDg at fiiBt about every fourth daj, afterwank eveiy
sixth or eighth day, a very small dose of it. The smallest par*
tide of it in powder, or a small portion of a drop of a solution
of it^ every drop of which contains a trillionth of a grain of Hm
seed, is an amply sufficient dose and suited for the puxpoee; no
other medicine, of course, being used intercurrently, either in-
wardly or outwardly.
It will, however, be noticed, that in the enumeration of the
symptoms of our fever there are some not perfectly contained
in this plant, consequently which cannot be perfectly covered
by it, and this is especially the case with regard to the wont
iform of this fever.
On the other hand, there is a mineral ' which, in its extraor*
din'ary action on the human body, is capable of excitmg thoee
symptoms which make up our fever, in a much more perfect
manner, and consequently of curing it with much greater cer-
tainty and completeness, particularly those kinds in which every
action is followed immediately by shuddering or nausea, or bit-
ter taste ; in which the taste of food and drink is extinguished,
but still there is no constant bad or bitter taste in the mouth,
and in which only whilst eating or soon thereafter there occurs
some bitterness in the mouth for a short time ; in which vertigo,
nausea, trembling, and rapid sinking of the strength increase to
the greatest degree ; in which drink is often desired, but litde
is drunk at a time ; in which perspiration only occurs some time
after the heat, or not at all ; in which paralysis of the irritable
or sensitive fibre prevails, and pains of the most intolerable
kind unite, are conjoined with great anxiety of heart ; for all
these symptoms are completely contained in the sphere of action
of this mineral on the human body, therefore it can cure these
when it is brought to bear upon them, it can cure the greatest
and worst portion of our fevers quickly, easily, and with the
greatest certainty.
' [StrycfaiMM nuz yomioL]
* Especially when the abldi^ of the forces is not so strikii^, the food stifl tastes
Mturallj, and there is odj a oootinual biU^ teste in the mouth.
(Aneaiciim ilUni
OF TBR PSSVAILma FBYXB. 595
But what do I say ? Has not this mineral almost irretrievabl j
incurred the ban of the medical art? But what cares the free
investigator of truth, who only sees in the whole kingdom of
nature the &therly love of God dispensing blessings with a
libeiral hand? Nothing is unconditionally to be rejected ; every-
thing is a beneficent gift of God ; and among God's good gifb,
"tiie greatest are just those that are injurious to the world in iho
hands of fools ; they were only created for the use of the wise,
who alone are capable of employing them for the weal of man-
kind, and to the glory of the beneficent Deity.
How can it be imputed to the very powerful medicinal sub-
stances as a &ult, that when given in our gross medicinal
weights, in drachms, scruples and grains, they are still much too
large for wholesome use ? so that the ordinary drachm, scruple
ind grain practitioners, must almost abandon their employment
in consequence of their enormous powerfulness, whilst the
snuJlest quantity which these shortsighted beings can think of
employing must still be something that they can measure in
ihetr medicine scales.
But if a tenth part of a grain of this mineral was still often
found to be dangerous, in other words, too powerful, what was
to have prevented physicians, if they had but but reflected a
iitde, from trying whether a thousandth, a millionth of a grain,
or still less, was not a moderate dose, and if even such a small
fragment of a grain was found to be too gross a dose of this
meet powerful of all medicinal agents (as it is in feet), what
should have prevented them from diminishing this fractional
quantity still more, until they found that a sextillionth of a
grain in solution becomes a mild and yet sufficiently powerftd
^ our case specifically curative) dose, when administered every
five to ten days? Here also, of course, it must be employed
nngly and alone, and without the administration of any inter-
oiBTent medicine whatever.
In the immoderate perspirations in the worst kind of the
fever, and in the continued unconsciousness when a remedy is
fequired, camphor affords speedy relief, but only in a palliative
Bmnner; it cannot be continued without injury, nor used as a
permanent remedy. The excessive perspirations which it here
suddenly diminishes, it is capable of exciting itself in the healthy
body, but only in its secondary action ; hence its employment
in this case is only palliative.
666 AIGKS OF THE TIMES Vf THS
SIGNS OF THE TIMES IN THE ORDINARY SYSTEM
OF MEDICINE.*
Art of physic is a most appropriate name for designating.the
practice hitherto pursued by physicians, of whom we might say
that they (in place of healing) only physic, that is, give medicines
— ^it matters not what — in diseases.
Such a procedure can never, until it alters for the better, be
termed healing art
But that this drugging business has not altered up to this
time, and gives no sign of wishing to alter and better itseli^ we
learn from innumerable circumstances occurring every day, and
also fix)m the following :
Who would have believed that in the nineteenth century a
physician with a real degree in a university toum (Dr. Becker of
Leipsic) could give a commission to another regular physiciaii
in a university town (Dr. Nothlich of Jena) for the sale of his
quack medicines,^ and coxdd puff off his rubbish as infidlible in
these terms : they effect a certain cure, kc. This has been done
in No. 293 of this journal.
A quack nostrum is a medicinal agent prepared in a certain
invariable manner for public sale, which is puffed off as effica-
cious for several named diseases, or for one disease, whose name
includes several morbid states, differing from each other, each
of which will require for its cure an essentially different pecu-
liar remedy.
Such are Dr. Becker's dental medicines, offered for sale by
Dr. Nothlich.
Now, who would have believed that a physician would have
publicly advertised a spirit for the toothache as certain to cure f
Mark, one and the same spirit as certainly efficacious for the
innumerable array of the very different kinds of pains in the
teeth I
When the toothache does not arise from the effects of an ex*
ternal injury immediately preceding it (for then only is the
toothache merely local and idiopathic), — its aching always re-
presents only the chief symptom of a malady of very various
character distributed throughout the whole system, arising from
' From the Allgenmner Ameiytr 4er Deuiicken, No. 826. 1809.
* Essence for scurvy of the teeth, tioctore for caries of the teeth, tooth-powder and
■pint ior toothache.
OBDIKARY SYSTEM OF HEDICINB. 567
sadi tfainga as suckling a ohild too losg, abuse of the sexual func-
tion, of spirituous liquors, of ooffee or tea, from fright, from
anger, from grie^ from too violent exercises and overheating of
the body, or &om &tigue, from a chiU, from over-exertion of
the mind, from a sedentary life, iVom working among warm
damps things, &c
The toothache is as various in character as are the internal
maladies that produce it Hence as those diflferent kinds of in-
ternal malady cannot be removed by one and the same medica-
ment| neither can the varieties of toothache depending upon
them.
Hence one medicine is useful only in one kind, another in
another kind of toothache ; — one* is only of service in those
toothaches that occur in fits, most violently at night, with red-
ness of the cheek, that during the fit seem to be quite unbeara-
Ue, that do not effect any one tooth in particular, tliat in their
slightest degree consists of formicating pecking pains, when
more severe cause a tearing pain, and in their greatest severity
occasion a shooting pain extending often into the ear, that most
frequently come on soon after eating and drinking, are some-
what relieved by the application of the finger that has been
dipped in water, but are much increased by drinking cold things,
and that generally leave a swelling of the cheek. This kind
affects persons of capricious disposition who are very much dis?
posed to anger, and have been rendered irritable by means of
coffee.
Quite another medicine' is of service in those cases where the
pain in the gum is of a gnawing, fine shooting character, but
that in the nerve of the tooth is drawing, jerking (as if the nerve
were violently drawn and suddenly let loose again) with chilly
feeling, combined with paleness of the face, occuring most fi:e-
quently in the evening, more rarely in the morning, increased
by a warm room and the heat of the bed, relieved by cool air
blowing upon it, not increased by chewing, but brought on by
the use of the toothpick. It effects persons of mild, quiet dis-
position, disposed to shed tears.
Another totally different, peculiar medicine^ is required for
the cure of that toothache that only effects a hollow carious
tooth, with a drawing, boring pain as if it were being forced out
of its socket, and single, rare, coarse shoots, which cause a shock
' Chiiinoinilla. * Pulsatilla. ' Nuz Yomica.
5M SIGN OB" THS TniEBj OC.
through the whole body, with painful, frequently mipputating
awelling (epulis) in the gum. It generally comes on quite early
in the morning in bed, does not permit of chewing, is generally
renewed and aggravated most by opening the mouth in the open
air, and by exertion of the mind in reading or reflecting. It
usually attacks only persons of hasty choleric temper, who reil-
der themselves irritable by the use of spirituous liquors and
coflfee, and are not much in the open air.
Besides these three most common kinds of toothache l3iere are
many other not rare kinds, one of which only occurs in tile
morning on the partaking of warm fluids, another where tlie
tooth only pains whilst chewing, still another which oidy affects
the front teeth with obtuse pain, another where the tooth
aches chiefly when touched which causes a pressive tbrobbing
pain, again another all the carious teeth at once, where the gums are
swollen and painfully sensitive to the touch, whilst single jeifa
dart through the periosteum of the jaw, which, in its slighter
form, consists of jerking pressure, but in its more severe form
of a digging tearing pain and burning stitches, and along with
which the incisor teeth are often painful on respiring througli
the mouth, and yet another kind that occurs only from cdH
air, mostly in the morning, with rush of blood to the interior of
the head, that makes the tooth loose with a formicating pain in
it, and on chewing there occurs a sensation as if it would fiill
out, whilst at the same time there is a tearing pain in the gmn.
When the state of the system otherwise indicates them, hyos-
tyamus is the sole, peculiar remedy of the last form of tooth-
ache, and the north pole of the magnet the sole remedy for the
second last one : but both these remedies are unserviceable in
all other kinds of toothache, which, as peculiar diseases of differ-
ent kinds, require for their certain permanent cure each its own
peculiar appropriate remedy, but they are aggravated or render-
ed more lasting by every other medicine not specifically suitable
for them.
I say remedy^ and do not thereby imply any palliative, whidi
merely deadens the pjiin somewhat for one or more quarters of
an hour, only to return subsequently all the more severely, and
with fresh annoying symptoms in its train, but I imply a medi-
^nal agent which is quite appropriate to the disease, and com-
pletely eradicates and removes the pain in the course of a few
hours, so that for a long time, often as long as life lasts, it does
not again occur. Of such a character must the medicines be,
XEDICAL HISTOBIOAL DISSEBTATIOK, ETC. 500
each of wbicli is certainly and permanently curative for a par-
ticular kind of tootliache, and at the same time for the internal
maladj of the system on which it depends.
What a self-deception, then, it i^, which can only be excused
ly the plea of total ignorance^ for a physician, without knowing
the many essentially different kinds of toothache, to imagine
'that there is hut one iootfiache, and that but a single tootkache-
fnedidne is required (and that /its oum) — and thus by means of
opium (the chief ingredient of all nostrums for the toothache)
he only sometimes, and for a short time, deadens the general
sensibility, whilst he creates many new sufferings — and yet in
his puffing advertisement he dares to assert, that his spirit is a
certain remedy for the toothache I
What a palpable falsehood this is, for it is impossible that
essentially different diseases (in the very nature of things) can
he cured by one and the same medicine, and every medicine
which does not do good, that is, which is unsuitable, does harm.
MEDICAL HISTORICAL DISSERTATION ON THE HELLEBORISM
OF THE ANCIENT&'
INTRODUCnOK.
1. It is my intention to speak of the helleborism of the an-
cients, that very celebrated operation by which the ancient
physicians were accustomed to treat with great daring the
gteater number of chronic diseases of the most obstinate char-
acter by a medicament of excessive violence, the veratrum
oBum^ and not unfrequently effected, as if by a miracle, a radi^
Cat cure. This ancient method is most worthy of attention, and
the more so as in our days the use of this grand remedy has
been more completely abandoned, both in general and in par-
ticular in the treatment of chronic diseases, so neglected by
* [Hie original of this, which ia in the Latin language, and is the thesis presented
}tj HahDemano to the Leipsic Faculty of Medicine in order to obtain the license to
practioe, bears the following title, Diatertatio hi8t4»ico-fnedicade helleborUmo vetenon,
Lipdoft XDooozn. I have thought it best to translate it, because the Latin language
k 10 little cultivated now among medical men, that ihe original would be but litUe
nad by them, and this essay is too yaluable to be cast aside unread, if we would
wi^ to form a just estimate of the learning and genius of Hahnemann.]
670 KXDIGAL HISTOBICAL DISSKRTATIOK
modem physicians who are in the habit of giving any medicme
for any chronic disease.*
2. In this essay we shall proceed in the following order : fint^
we shall inquire into the antiquity of this drug and its primitive
employment; then we shall examine if our veratrum is the
same plant that the ancients used for the production of hellebo-
rism ; then we shall indicate the places which were celebrated
for the growth of the best kinds of this plant, and the signs by
which its good quality was distinguished ; and finally, we shall
speak of the employment of veratrum, both in general, in ordi*
nary cases, and for the great treatment, the helleborism itself
The period when its employment was first introduced, that in
which its use was abandoned, the most favourable season for
the treatment, the circumstances that contra-indicated its uae^
the maladies that demanded helleborism, then the prelioiinaij
treatment to which the patient was subjected, the preparation of
the medicament, its form, its dose, the substances that were com*
bined with it, the regimen prescribed to the patient after taking
the veratrum, the remedies used to obviate and correct the evilB
and dangers that usually accompanied its use, in order to ensure
a safe and perfect cure ; such are the subjects that will come
under our attention. In conclusion, we shall briefly mention
the employment of the lieUeborxis niger among the ancients.
8. In my researches into this ancient mode of treating die*
eases, I shall proceed only up to the middle ages, I shall leave
it to others to treat of the employment of veratrum album and
helleborus nigcr in modem times.
Earliest medicinal employment ofheUebore.
4. In the remotest periods of Grecian history, the people, lo*
bust in body but of uncultivated mind, when oppressed by
calamities or afflicted by diseases, trembling with a vain and
childish superstitious dread of the anger of the gods and with
a fear of demons, were less solicitious about warding off evils
than about ascertaining the will of the gods with respect to the
' Thus Ernst Horn, Medical Vice-Director of the Charity hospital, and Professor of
Physic at the Medioo-Chirurgical College of Berlin, asserts (Anfangtgrunde der
Klinik, pt, il ch. 7) that he knows of only one treatment for all chronic dii
whatsoeyer, which is to remove the debility by any excitant, it matteri not wkat^ tlM
indications for the use of which are left almost to chance (t. e. no account being taken
of the specific quality of such medicine, and of the immense yariety of chronic <&>
eases.) This is the manner in which the rational physicians of our days baye mingldd
together and confounded mcdicmea and diseases, and whilst they pretend to find ai
every mfdidne a remedy for every disease, they actually cure none at aU.
OK THS HSLLKfiOBISM OF THS ASCIENT8. 671
mae of the evil or their future fiite, and only demanded of phj-
ficiaiiB vaticinations and prognostications respecting the periods
of the criseS) the convalescence or death — in those times I saj,
physicians were looked upon rather as augurs than as practical
tartainers of health, that is to say, as men who removed dis-
eases by means of remedies.
6. At that time the art of medicine could scarcely be said to
ezist^ the number of medicaments was most insignificant
6. Among this small number of medicines however, veratrum
album is found, and occupies the first rank, thus being one of
the most ancient as well as efficacious of remedies.
7. Thus, about the year 1500 before our era, a certain Me-
lampus, son of Amithaon, a most celebrated augur and physician,
first at Pylos, then among the Argivans, is said to have cured
the daughters of Proetus, king of the Argivans, who in conse-
quence of remaining unmarried,^ were seized with an amorous
fiiior^ and affected by a wandering mania ]^ they were cured
chiefly by means of veratrum alburn,^ given in the milk of goats
&d upon veratrum, which Melampus had observed to produce
purgative effects on these animals.^ From this circumstance
the great feune of this plant is derived.
8. In later times, it was stated by a certain interpolator of
Theophrastus^ History ofplants^^ repeated in the self-same words
by Rufus the Ephesian,' and Diascorides,^ that this cure effected
by Melampus was due to the hellebonis niger, hence this plant
was denominated Melampodium. But that this is an error' we
shall shew in a few words.
9. I shall not waste time by citing in corroboration the testi-
Appdodor^ Biblioth. Lib. ii, cap. 2.
' ATicenna, Libi ii, de medicamentit gimplicibut. Artie. Charbak, (in Oper. Roim%
IHSi kL p. 269) corroborates thin in these words : —
' Tliey wandered through the woods like cattla
* Galen, in the book de atra bile, cap. 7.
* 0. Plinii sec. Jliat. nat^ lib. zzt, cap. 6, sec 24. He seems to indicate that
Mdampus fed the goats upon veratrum album (in order to render their milk medicinal
fcr the treatment), this we may infer from what he adds : ** nigro (ellcboro) equi,
bof«t» tues necantur, itaque cavcnt id ; cimi candido vescantur."
* See below in the note to § 17.
* Jn Oribasii, Collectorum medicinalium (Vcnet op. Aid 8), lib. vii, cap. 27, p.
261.
" MaUr. Ifed, lib. iy, cap. 151.
* TUs has ahready been suspected by J. H. Shulzo. Vi his JHu. de EUebaritmu
p. 8,4. (Halae, 1717, 4).
59^ IdCBICAL HISTOBICAL DISSEBTATION
Jhonj of fierodoftus, wliotn Sprengel, otlierwise a most w^(^h^
ilnthoritj in medical history, affirms, thougli erroneously,^ t6
liave attributed the cure of the daughters of Proetus to veraintim
album.
10. Suffice to say, that in the earliest period of Cheoigii
history no other evacuant medicine seems to have been knoiiti
to the physicians, who Were still tyros in their art, and therefore
that none other could have been used by Melampus for ihm
treatment except this plant, which is now termed veratram
album, and that it was termed by them hellebore, x«^'^;of\ thei^
by denoting that it was their sole and well known eveunMmi
(purgative.)^
11. But in process of time, a&d if I am not deceived, soon aAor
the time of Hippocrates the son of Heraclides, another evacuant
medicine having been discovered, the physicians of that tidle
seem to have applied to this new purgative plant the name 'that
had been used for the most ancient and hitherto unique purgih
tive (JieUebore), adding by way of distinction the word black, as
though they should say purgans (helleborum)' nignnn. AA
thus in all probability tiie appellation black hellebore arose, as in-
dicating the later discovered plant
12. That such was actually the cose, appears from this : tliat
no writer is found prior to the 100th Olympiad, who makis
mention of black hellebore, because it had not yet been dis-
covered, or, which comes to the same thing, it had not yet come
into use ;* there is no writer, about and before that time, wfco
* Oethichte itr Armeikunde^ pt i, p. 121. The posnge of Herodotas
he cites (lib, ix, cap 88) iajB nothing; but that Melampus was offered a reward fa^
the Argivans to cure the Ar^van women who were affected with maaim, that he
dwiiaiided the half of the kingdom for bis remuneration, and that he at length ob>
tained it Herodotus does not saj a word about the remedj used by MeUmpoi m
the treatment
* The word Jleikbare, the name of the sole and universany known emetk, reeeircd
bj use such an extended signification that it was applied to the operatioQ itaeIC and
•ometimee signifies vomUing. Thus Hippocrates (sect, iv, aph. 18) «f^ t»^
* HelltboruB aud ffelleborttm are used indifferently.
* The Praenoiionei Coacae attributed to Hippocrates, are so fuH of arcfaaimi.
and written in such a hard, rough and abrupt style, that Grimm in the index to hii
German verBion (voL ii, p. 686) suggest* that tliey were probably the writingi
which, long before the time of HippD^ratei, were preserved in the temple of
.^Bsculapius at Co& In this very andeut monument of the art of medicine, there is t^
quent mention made of iXACipor, as the root tliat causes eyacuation by Tomiting (▼•»•
trum album), — but in none of these placesii do we find black hellebore spoken ol^ be-
cause, most hkely, it had not at that time been discovered (as we shall shew heraafter
OK VBM HfiLLSBORISM OF THE ANGI£NTS. q73
^pplits to the plant which was the only one employed by the
ancients fix evacuating (vomiting), anything but the bane tenn,
hellebore.'
13. Thus, as I have stated in a note, the very ancient authors
of the Praenotumes coacae, and also Ctesias,^ who was almost con-
temporaneous with Hippocrates, when they are evidently speak-
ing of the veratrum album, make use of the bare term hellebore
only. Moreover, in the genuine writings of Hippocrates ^ there
]■ not a single passage where he uses the word i>^6*(^ without
meaning the veratrum album, and none in which he adds the
word Afsac^ for this simple reason, that there was as yet no oc-
casion for applying this distinctive epithet to the plant which
was the only evacuant at that period, the black hellebore not
hAviug been discovered, or no name having yet been given to it.
In his genuine writings the expression f AAfC«^«f ^i a«« is never
used, as I shall shew hereafter.
14. Even in the times shortly posterior to the age of Hippo-
emtes, (as we see in the pseudo-Hippocratic writings of his sons
and disciples), though mention is made of l}i>X%fT /k/a««, still
the most ancient veratrum is always only alluded to under the
uaple appellation of heUebore.
is. It is indeed certain, that in almost all human affairs, the
ffimiiive thing is denoted specially by the simple word, whilst
the derived smd compound name is applied to a thing that is simi-
lar, bat that has been discovered later; and is, consequently.
fieic;er than to which the simple word is applied.
16. Hence it is obvious that in the earlier times of Greece
diere was but one single hellebore (and that the veratrum album) ;
aad.that if the so-called black hellebore, after Hippocrates' time,
became known, the word "black" was added to it, but it was
treating of the heUeborua nigcr), nor U the word XtvxdT ever found a ded Ui
fJOUii^, that bemg the only one known.
' Thus Qalen (in Connncut adllippocr., Sccty, aph. l)Bay8: IWiBopoy XtvKdv dvXCir
M«0t CMfi^civ iXhSipoVf otJy, (oaiTip rdv fiiXava^ fitra zftoaO^Kris; ** thcy (the ancients) Were
leemtonicd to caH (the white) hellebore by tliat simple word and not with any
addition, as they did the black hellebore."
* A fragment oi Ctesias in Oribasii. CoUfet^lib, yiii, cap. 8.
• Sect It, aphor.13, 14, 16, 16.--Sectv,aphor.l.--lnthc book, d!c/rac/wrt# (op. edit.
Chail t. xil p. 208 and 267), and in the book, de articulin, (ibid. p. 434) — These two
bm ks arc both genuine writings of Hippocrates or of his grandfather, and are
written in the same unadorned style. As regards the latter book (which is merely a
oootinuation of the book de fiocturU^aH Oalcn has demonstrated in hid preface to the
bo^ de articulia) Ctesias the Coan, refuses to admit it as a work of his relatiye
Hippocrates (a lucid testimony to the genuineness of the book), as Galen also relate!
(Comment iy. in lib. iff ^rficu/ix, Op. edit chartzii,p. 462).
574 XXDICAL HISTOBICAL DI8BKBTATI0K
not tin after tHe lapse of a considerable time, and after the blade
hellebore had long been in nse that the original hellebore oould
and did receive the addition of xtwr.^
17. Another proof of the greater antiquity of the (white)
hellebore is, that in times now remote (when the more reoent
origin of the black hellebore could not be unknown) an author
worthy of all confidence, Theophrastus the Eresian, distinctly
refers Melampus' cure to the veratrum album, when he saySi
>that it could not have been effected by the use of the black
hellebore, which is deleterious to most animals, in consequenoe
of which they will not toucj;i it, but rather by that of the
veratrum album, which the sheep (and also the goats) eat, and
thereby purge •themselves, which led to the discovery of its
medicinal power : «»«if i7» i\ ri* ^f ftixtam^ says he,' »m Oinr^vr, mi
fimir^ MM vr, iio *m •iii vi/uvim r«tfr«v- r«f Aivx^f tt fifttrimrm w^iSmrmf
' The primitlTe significatioo of the word heUtbore in the age of Hippocrmtet
■ome time afterwards, remained so strongly impressed on the memoty of all w1k>
flourished, that the physicians of that age (t. e. the immediate suocessors and diaripiti
of Hippocrates, in the Writmgs termed psendo-Hippocratic) although they
to give the name of black hellebore to the new plant, always continued to
the first one by the simple word iXXittp-Jr, nor did it ever occur to them to distiqgadh
bj any adjective that med e' e which had hitherto been the role and was the moet ">rifiit
evacuant Had the black hellebore been discovered before the time of Hippocrates and
had it long been employed (concurrently with veratrum album) the simple appella-
tion of the primitive hellebore would have long since become obsolete^ and they woold
have been forced immediately after Hippocrates to employ the distinctive appellatni
**vhite'*' but at that time this appellation had not come into use, and was only oom*
menced a centuiy later, after the black hellebore had already been employed tur op*
wards of half a century. Indeed Theophrastus the Eresian (about the year 880 befort
our era) in his hUtory ofplantt often denominates it by the single word, but i
he calls it i\\i$opuf Actrxdr. In like manner it is called Arvcdr in the apoayjdial <
tinuation or the book attributed to Hippocrates, De vietu acutorum^ oommeociqg frooi
the words : KavcoT ii ya^ — (Op^ t. xi, p. 176)by an anonymous author (one of the empiri.
cal sect rendered famous by Scrapion of Alexandria), who in all probability oompoaed
the appendix about two centuries after Hippocrates. At length in more
times the veratrum is more often mentioned with the distinctive adjective,
the name of iWlSjpof Xevc^r and that the more frequently as the use of the heUt-
boms niger became more common.
* Theophrastus, JIUt. plant, ed Stapelii, lib. x. cap, il (In this edition
other marks of haste and error, the fourth and fifUi books are condensed into
the numerical/ ordar of the subsequent books is consequently designated bj low
numbers than they ought, thus that which ought to be the tenth and last is
termed the ninth.)
* In ancient times this word wp6$ara was used to signify aU sorts of cattle,
sheep and goats, as Oalen teaches us (Comment, i, ad Hippocr. lib. do articuli% mL
Chart t. xii, p. 806).
* The appendix to this sentence iu tlie tame chapter of TlieophraBtas— cdUSm U
ON THB HXLLXBORISII OF THE ANOISKTS. 575
18. This passage agrees with the words of Pliny : " alteram
genus (hellebori, Melampodem) invenisse tradunt, capras purgari
paste illo amimadvertentem, datoque lacte earum sanasse
Ph>etLdas fiirentes,''' (although a little further on he again refers
the plant of Melampus to helleborus niger, led into error probably
by his compiling habits.)
19. The observations of Theophrastus are corroborated by
this passage of Haller : " Not only do mules freely eat of this
plant^ but even the cattle feed in spring on the tender leaves of
the veratrum album, whereby they purge themselves, but when
the leaves become more expanded they cease eating them, imtil
the tender leaves again appear the foUowing spriiig."* Pallas'
Tl» fika^i riMT iff rod rtftivTc^ mc dvr«p4yror McAo^v^ior, »$> Utlv9^ wptorov rcfMyr»f'
idlafj^ivtfi Ik vol ior mvru tal wfoSara^ ovptmfSorrif rtva httiiOiPf ffcU ci'r JAX« il irAciv
Xf^nw — h said to be a gpurious painage iotroduced hy some sciolist. For it is
cwitimdicted bj what Theophrastus says before, yix., that hellebore is abhorred hf
Mm# and that it kills them. But if by the word KaBalpowri is to be understood not
a medidnal purgation but a sort of bath by aspersion only — this would suffice to
imfce us reject the passage as spurioun, for it is an expression unworthy of such an
ifaatrioas man (Tlieophrastus) and repugnant to common sense, as must be evident
to every reader. Tlie origin of this old woman's tale is hereby reTcaled,and it is
f^ that Biaekfoai (McXcj/nrovr) could not possibly have employed for the cure any
other than black (fiiXar) hellebore. Certainly a most extraordinary sort of argument I
Ais clumsily attached patch, is then to be rejected, it smells of the mysticism of the
Therapeutists, who piqued themselves on treating diseases by prayers and incanta-
tioDB. This school flourished at Alexandria a century and a half before our era (two
ceBtarifli after Theophrastus), just at the time when the rivalry of the Kings of
ftiypt and Pergamus about their libraries encouraged by hopes of gain the interpo-
ktors of books and the Diascevastas of manuscripts, to manufacture whole books, or
to insert or add supposititious parts to genuine works, in order that they might appear
more eomplete (see Galen, Comment, ii, in lib. iii, Fpidan. p. 411. — Comment, uin
Ub. dia not. ham. p. 127, and his pre&ce to Comment, ii, of the tame book, p. 128.)
llierefore (it may be said en passant) it appears more than pn)bable,not only that
the whole ninth chapter (of the tentli book of Theophrastus*) History of Plants) is
wpanooB, but that it proceeds from the pen of tlie some interpolator. For the fiilsifier
not ooly relates, but actually approves and commends the ridiculous superstitions and
DHigieBl incantations of the doctrines of his own time (which could never have entered
into the imagination of Theophrastus, who was imbued with the philosophy of
Aristotle, and of the author of the Moral Character)^ which proceeded from the fertile
hakm of the Therapeutists, who were nourished on the absurdities of the East In
&ct the whole style of the passage is that of this stomp of mea Moreover, the end
of the eighth chapter is connected with the beginning of the tenth much more
matmaUy and loffieallt/, and passes into it, as it were, in a continuous stream, if we
expunge that jejune ninth chapter, so unworthy of Theophrastus, the production of a
perrerted mind, stuffed full of magic, incantations, and divinations.
■ Butor. no/vr., Kb. xxv, sect 21.
* HiMt. stirp. Uelv. N. 1204 ; and in Yicat's Matitre medicate tir^e de ffalleri hist.
tHrp. Berne, 1776. 8.
* Russisehe Reise. Vol IL 190.
6Zfi ICiSPICAL HISTORICAL DISSJEBTATIQ;Ef
also asserts that in Bussia the horses eat the joiing leaves of tlie
veratrum album, without any other effect than the producti<m
of looseness of the bowels.
20. But the chief thing, and that on which the whole aflSkir
turns, is that goats feed upon the veratrum, which Lucretiua'
testifies to when he dings :
** IVa«toi«a Dobit TcrMfarmii est Acre ^PeBemuu,
Ai otfrit adipei et cdtozmcibai anget"
21. But the most lucid testimony to this &ct is furnished faj
Galen, a most weighty authority on the subject of the history of
medicine among the ancients, and an author worthy of all oon*
fidence. He speaks of the treatment we have related as of a
thing very generally known and admitting oi no doubt. " Un-
til now," he says,' " physicians have attempted to cure melan-
cholia by means of vomiting produced by veratruni album.
Indeed none who is acquainted with Greek literature oouM
have failed to read or hear of the story of the maniacal dang-
lers of Proetus who were cured by Melampus by means of tlut
evacuant ; from which circumstance this evacualion (viz. hdle*
borism) remained celebrated for two or three centuries and
more, but during that time all physicians have employed this
medicine (veratrum album)."
From the description given hj the ancients of the tvhite heUebcre docB
it follow Oiat it is the same plant cw our veratrum album t
22. But we must inquire further if the (white) hellebore^ uaed
by the ancients for helleborism, is indeed the veratrum aOmmf
or not
23. And first let us look at the description* of this plant left
us by Theophrastus, who was an intelligent and learned nattir
ralist, which it is to be regretted is so shorty and buried as ii
were in a corrupted text
« ■ I < III ■ ■ . ■ . ■ . ■ I ■■ - I I . II
* In bis Oarmen de tt^mra rtrum^ lib. iv» v. 642. Tbis oelebratod poet floaaihfld
a oeotury before our era.
firrr'd€JiKoip0if rikr Hf ocrov ^iryaripar fiavtiwasr V9d MfXa^n^oT i^B^wai gaSmpBcSmmf vlvi^Pi
tofTt oi wp6 itOMooitav Irwf i) rfitucSaiutv dXXi in\i wXuoitutv ivi^^ov r^F ««Mf«cwr '■f'V
* Cornelius CeUus already employed thb name in bis JUbri dt Mudicimtk
* Uut,plint. Ubi Zy cap. 11.^
OK THX aSLLSBOBIBM OF THB AKCUSSHS. ^77
24. He treats of both kinds of hellebore in one and the same
chapter. *' The hellebores," he says, ^' both the black and the
white species, bear a common equivocal name, but authors differ
respecting their form and appearance. Some say they are simi-
lar, except as to colour, which in the root of one is white, in
that of the other black, but the leaves of the black kind resem-
ble in colour those of the laurel, whilst those of the white kind
resemble in colour the leaves of the 'pear-tree." Then there
follows a most corrupted text: •l i •»9 i/MUr xiyfrtr^ rnMt
ti^irr*? ifuit9 T^ w f«^l9x«r, ^x«r i;t*' si'^wir, &c. The first
words of this sentence have been very properly changed by
Scaliger and the editor Stapel into u P ku/Auur ?JyfTtr, in order
that they should present a kind of opposition to the words in
the principal period : •i tuf y»^ i/Mtar ihm. As regards the rest
of the sentence, Mivx^f t\ &c., these writers, in other respects
?ery sagacious, suppose it to allude solely to the black helle-
bore, and do not think that in this description Theophrastus
e?er refers to the white, but in this they greatly err, for some
of these words refer to the black, others to the white ; moreover
it is impossible but that Theophrastus must allude in this place
to the white, because throughout the chapter he continually
speaks alternately of the white and of the black, and describe
the one after the other in such a manner as to demonstrate the
distinction between them, and wherein they differ in their vari-
ous parts. Therefore if he wished to be consistent it was neces-
sary that he should in this place insert some description of the
white hellebore before proceeding to describe the black.
25. The following is the mode in which it seems to me pos-
sible to restore the words, mutilated as they have been by the
injury of time, and mixed up among each other in a most con-
fused manner : ^ t' itff*Mn§^ Aiy^fxir, rottitlt ^«tc7» t! fm tv? /u^^«f
P^tiXl^ Ttpttfti ^jAA«f irXaTurxtrrpv^ f«^wr i^'f tvfuufictr,
26. Indeed it is the veratrum album only whose stem, with its
attached flowers, could be likened to the flowery stem of the
asphodel (which Theophrastus himself, lib. viii, cap. 12, calls
mwiigix»9 3): certainly not the helleborus niger, which has almost
' 1 haTe only added thefte two words ; the remainder of the text of llieophnwtiM
I have preserved in iU integ^ty, only somewhat changing the order of the wurda
* Tliem three words have very properly been supplied by Scaliger.
* idiyi9Tȴ a iravTuv (the bulbous plante) h dv^^T, v yif ipBiptnr ^yivr*r. Id
37
678 XSDICAL HISTORICAL DI86XBTATIOK
no stem. But as regards the character of this stem, '' which
singly from the root, and in which moreover the leaves glow
alternately ^ from protuberances," Theophrastus speaks of it
under the general term ferulaceus [like a ferule] or «^m ff
wm^imi (see lib. vii, cap. 2, where he applies this character cajJiTgrfj/
to the hellebore^ that is to say, to the white hellebore.) This is the
character that specially distinguishes the stem of the veratnmi
album, and is not at all applicable to the helloborus uiger, whidi
has hardly any stem.
27. Therefore we see that Theophrastus writes in this manner:
^' Those who allege that they (the white and black hellebore) are
different, thus describe their respective forms: The stem of A$
white hellebore reseinbles (in its florescence) that of the asphodel^ and
(on account of the single stem that ascends from its root, and the
disposition of its leaves) has the appearance of a ferule; butAe
Uack hellebore, on the contrary^ Jias a very shoj't stem^ large leauOf
divided into broad hbes^^ &c.
28. To this rather superficial description of Theophrastus^ let
us add the brief one of Dioscorides, whereby it will be better
apparent, that by their white hellebore the ancients understood
nothing else than veratrum album, and that all the signs thej
mention as proper to it prove it to be the very same plant.
29. The words ^ that bear upon our subject are: 'EWCiffr
%mX»9 wt^t^X»t^»fUUfj «ri mfltrmi ^n^muTitir fil^ati i iwtiTt wXXmi^ Xgtrrm
««-« xt^tOJov fiM^%Z »«i i^tfulfcwfj iiirt^t) x^0/ufcJ«v rvftirtPvxvlmt, These
words, with a slight change, putting, for example, *«>•? after wtft-
f A#i{«ViM», will read thus : ^'The white hellebore has leaves resembling
those of the greater plan tain ^ a stalk a palm in height^ enveloped th
Iflie mnnner Dioacoride* (lib. ii, cap. 199,) gires to the stem of the asphodel, with ill
ilowerB, the name of "dydipiK'^r": dv^cXor— f^*^*' — 'av^^c — ^ctcr tx*^^^ h^ U^
IrOfr^, KaXovnt¥0¥ ivBiputov.
* Not oppOMtcly. Td rapOifCMilcr, he pays, /lo^ov^avXor — &\a9TA¥U St r^cXXAf H
—4 DkXlSipor (<rai & dv0rpirer.) ffUt.pl., lib. 7, C. 2.
* Materia Med., lib.iT,c 160; written as it would seem before Plmy^s
Natural HitAory ; the latter translates and copien whole pasra^^ from
without ever mentioning his name, shewing a kind of envy and rivalry by no
rare anumti contemporaries,
* Murray (Apparat. Mcdicam., toI. ▼, p. 149) doubts whether (he pUntain of te
ancients was Uie same as ours, but he is wrong to do so. for that by the word mnm
fflouu9 Dioscorides really implies our greater />/an^aiii, is obvious from several tha^:
first, because the title of the chapter thai treats of amoglouu* (Dios. MaU Med^ 6b>
ii, c. 158) is, in some ancient numuscripts, vrpt] «iproyXcjatf on lww\tv^9^ i «, on fjU
4Bven-ner9ed plantain (and UuU is precisely the number of nerves the leaf of the i
OV THS HSLLKBOBISM OF THK ANCIKNTB. 579
coats ' (the sheatlis of the leaves), and hollow when it commenceg
to dry. Its roots are numerouSj delicate (the fibrils), Jix^ to a small
and oblong bulb lihe an onion. •
80. If he says that the stalk is only a palm in height, whilst
in reality it often attains the height of a cubit and two cubits,
this error is to be attributed to the writers from whom he has
oompHed. He himself being a Cilician, does not seem to have
known the plant from actual inspection, because (• AiirxW •Xiymx»i
^itrmt^ as Theophrastus in his Hist. Plants lib. x, c. 11, calls it)
it grows in but few parts of Greece. For the same reason, viz.,
not having himself seen the plant, he does not give an accurate
dflBcription of the colour of the leaves. Moreover, it grows, as
he says, in mountainous districts, not j» r^«xf <^< (in rugged places),
bat in the alpine and subalpine meadows and moist plains.*
51. The description which the ancients have left us of the
white hellebore, though very superficial, still proves clearly that
it is the same plant as our vcratrum album, although the ancient
works on natural history generally describe natural objects in a
loose and superficial manner.
52. To the above we may add the very weighty authority of
Aricenna, who describes the Dioscoridean veratrum album un-
der the name of (jdAjl ^J^^^, by which very name, as Forskal
in eye-witness testifies, the veratrum album is still called in
those regions.'
88. But the most important argument to prove the identity
of the white hellebore of the ancients with our veratrum album,
itill remains, viz. —
17ie effects of both are not only similar hut absoliUely identical.
84. Among those who doubt if the plant which the most an-
cient Greeks designated by the single word iAA/C«^«r, but after-
plintaiii poMCoaeo) : second, because tbc Arabic vereion of Avicenna {Lib. de Simp/.
MMhttm. Art Charbak-Abiadh, OpertL, Komae 1698, foL cit.) expresses the word
ipg^X^mvuT by Ju^JI ikfirm ^ —^ ^^rd which to this day, m Arabic, signifie»
our j^^"*^in as Forskal testifies, who saw it Plant, Aegypt. et Arab., p. hai,\ and who
himtelf giTes it that name.
' Jacqaioin, in his description of veratram album, Flora Austriaea, phdo 185.
pt. 18, aaya, "almost all the stem is enveloped in the sheaths of the leaves.
* Tlie description of Pliny Hi^t Nat.^ lib 25, sect 21) is evidently tak^ from that
uf Theophrastus and Dioscorides (thus, for instance, he attributes to the white helle-
bore the leaves of wild beet — bfta ineipiens, as he calls it — thus rendering the vnrXoi
if^l99 of Dioscorides), it is therefore not much to be relied on.
* Materia Mediea Kahirini^ in the appendix to Dtteript. Anim, in itkm^ an'««.
to/i, HafiD. 17*76, 4, p. 162.
689 •WBDICAL SISTOBICAIi PSSB&BTAimK
wards termed white heUeboref was actually our veratuxm allmiiif
the most distiDguished is a man who formerly rendered .gn9$
service to the materia medica,^ohn Andrew Murray/ who omn-
plains ^^thai the arguments to prove t/iat it is the same j4a$U
soiight/or rather in the sinularity of its effects, which may he ik
tical in many different planis, than in the description of the plttt^
which is very imperfect.''
85. As to what relates to the descriptioi^ and deliiieatioB'.qf
the plant by the ancients, we have already seen that it ia noit
absolutely imperfect.
86. But with respect to that doctrine (the unhappy aanio^^
alas I of siiccedanea and substitutes) — ^^ that no plant posieiMB
peculiar properties of its own, but that a host of different planto
produce the same effects on the human body, which are thera^
fore, vague and uncertain,'' here this man, groat and distinguUi*
ed as he was, errs in common with most of the physiciaiis gf
this age.
87. For the great Creator of the universe has implanted in
every medicament a constant rule of action ; to each he has gLVW
peculiar, specific, certain powers, which are of the most constant
and unvarying character, although, unfortunately, medical men
have not investigated, and have almost entirely neglected them
hitherto. The properties that existed in a medicament a thou*
sand years ago are the same as they now possess, and as they
will possess for ever.
38. But I would a«k, what reason have you for afRrming so
confidently, that many diftbrent plants have the same effects,
when it is well known that the peculiar and positive effects of
all medicines have been so little investigated by medical men,
that they are almost unknown to them, and it seems as though
they thought their ignorance on this subject to be something
quite legitimate and meritorious? How do they know then,
tliat many plants possess the name properties? In place of de-
voting themselves to experimental investigation tliey delude
themselves with their vain conceits and preconceived opinioaa
39. No one species of plants has the same external form and
appearance as another, and in like manner, each possesses a cer-
tain peculiar power proper to itselfj which is not to be found in
any other species of the same genus, and still less in any other
* Appar. medicam. YoL v, p. 149. CL Salinasius alvo (in Rxtreit, 4e
.Miia kylta iairieme^ 2Vaj. ad Rhen, 1689 foL) thinks that " the h«)kbar« of the w-
^Dts is lost and does not exist among us."
ov noB B8L£EB0BiBi( OF TBA ANcaaom. 581
jvntM. As die external appearance differs, so also does the in-
ternal medicinal power 1
40. This peculiar and specific jpower of acting on the system,
which the great Creator has implanted in every medicine, is
proved to be of such a constant character that it cannot Ve
doubted — ^that thi^ oxi^Jt of copper^ jEbr example, when taken in-
ternally, excited many thousands ol years ago, when it wuii
iliMi diaoovered, the same anxious vomiting which it caused
eighteen centuries ago,^ and the same which it causes to day, —
that the oxyk of kad and cerussa^ when applied externally,
shewed in the earliest times the same refrigerating qualities, and
Ae' same power of constricting the pores of the skin,' that it
manifests at the present day, — that the cantharis taken by the
moiith caused in ancient times the same dysuria, the same hema-
turia, the same dysenteric aftection of the bowels,^ that it does
atfW, — ^that opium exhibited in the most remote times the same
specific quality, that, taken in a large dose, it caused the skme
proBtration, with chilliness of the external parts of the body,^
IB it does to-day ; and so with all other medicaments.
41. From the collection of the peculiar and specific powers of
any medicine observed from its use in ancient times, are we not
justified in inferring, that a medicine which in our own days
produces the same effects on the human body must be identical
with the ancient one 7 There is certainly nothing that should
prevent us coming to this conclusion.
42. I may here be permitted to compare the properties of the
white hellebore of the ancients with those of our own veratrum
ubum.
4S. T%e properties of the white hrlle-
Amv ct chtened by th§ aneient phyn-
At flnt there oocure heat of the throat
7%« properties of the veratrum alhum at
ol^served by more modem phyeieians*
Internal heatfwith dislike to drinki.*
■id rtortiagh.* Burning about the precordial regioa^
■ DiOM. Mat, Med, lib. y^ cap. 87.
* AfHyiiv fx» ^vrrcr^y, i^^aoriKhv — Dioec, Mat, Med,^ lib. t, cap^ 108.
A«r««^«iei* iroXAoirir ii ai/«i npoitvrat 6i ovpa>y' ^iptrmi i' airoif gmrik KoiXiav i/uum
n^f M imtwrtpiKup. — Dioec, ^i^fi cap* i-
«Vft
* Anif Dot in Orihas., ColUet,, hb. viii,
aifLl. pi Its.
• S. Grasslus, Mi§e. Nat Cur,, dec i,
an. 4, p. 98.
' J. de Muralto, Mite. NaL Cttr,, dec.
ii, an. S, p. 240.
WDICAL mSTOSlCAL DISBKBTAXfCMr
Many are wfoetii^d}
AlUr TioleDt and ineflfectiial efforts to
▼omit^ mtffbeation;* the face ewellfl, the
eyes are promineDt, the tongue protru-
ded from the mouth.
If Tomitmg comes on late, atranguia*
tion,* The face excessiyely red.
Ihe parts belonging to respiration
are constricted, with great difficulty of
breathiqg.*
Often deprived of their voice.*
Loss of the voice and the senses.*
Gnashing of the teeth; the mind
deranged.^
Delirium.*
Heat of the toi«iM and tipost'
Heat of the fiuioea.*
InflammatiOQ in ihe intarior ai dbt
mouth.'
ConstrictioQ of the tfarwi*
StrangulatioD of the fiuioea.'
* StnmgulatioD about the throal'
Strangulation, spasn^ eonstrieliQB cif
the throaC
Swelling of the Gesophagai^ with dna^
of suffocation.'
Loss of breath.'
As if strangled, they are ingveai
ger of sufibcatioo.''
Inspiration veiy labonrad and
cult"
Stammeripg."
Loss of voice."
Loss of vision."
Almost complete kiss at ihe
DeliriunL**
> Ctesias, apud Orib., loc at
* Herodotus, in Oribi, OolUcL, Ub. viii,
cap. 7, p. 284.
' Antyllus, loa cit
* Herodotus, loc. cit
* Antyllus, loc dt, p. 280.
' Antyllu8» loc. dt, p. 281.
* Herodotus, loc. dt
' Antyllus, loc. dt
81
268.
816.
685
C. Gesner, J^ iM, p. 69l
Beigius, Mat, Med, p. 87S.
Greding, VemtuehU 8€kri/Um,pp^
36.
Winter, in Break Sammd^ 1724, fi
Lorry, de MelanehoL, n. pp. $1%
J. de Muralto, loc dt
Reimann, HreaL SanunL, 1724, p^
0. Gesner, loc. dt
P. Forestus, L xviii, oba. 44.
>• I^ Scholdus, ap. P. Schenk, lib ^
obs. 178.
" Benivenius, ap. Schenk, loc. cttoh^
174.
" S. Grassius, loc dt
" Bddder, in Alberti Jwrianr, Mad,
obs. 16.
^ O. Borrichius, Acta Mafn^ t vi, p^
146.
" Vicat^ PlanUi venen. de U Smam,
p. 167.
** S. Grassius, loc dt ; Greding; loe*
it., pp. 86, 41, 42, 48, 49, 61, 54, 66, M,
86.
ON nX HKLL1B0RI8M OF THE AXOOHn.
Jm Alniosk 9T&CJ caM hiocougfa; io
wmitj the month quivera and twitches.'
Omtliimil and Tiolent hioooiigb.*
Hnaciilar oootractioM (cramp), etpe-
fUlj in the mnaeles of the calvea, thigbe,
Md^ eitwinitiea of the feet» and chiefly
iilheteiid^''
AIk> m tfie mmdea of mastioatiao.*
As if 8tnuDigled,he fidls down with his
Ml dindM like a strangled Tietim.*
Fhisintioo of the strength.*
Um of oonscioamesft*
TrrnsHive vomiting.*
Hieooogh.*
Hiooongh for half an hour.*
Hiccough all day."
Spasm.*
Cramp of the calves.*
Spams in the hand% in the lingers.*
Attempts to yomit^ with trismns.*
Ezcessiye weakness.*
Pulse almost extinct, impereeptihle.*
Threatening of syneope.**
Loss of consciousness ^
Enormous efibrts to vomit^ eren to
syncope."
Enormous, horrible, seTore, most vio-
lent Tomiting.*
44. In the face of such a remarkable resemblance of the
Bymptoms caused by these two plants, who can deny that the
Very same plant which now grows in our gardens was that
Whkh the ancients made use of for the production of hellebor-
lam? Where, I ask, can another plant be found which shall
shew these same peculiar effects on the human body that are
produced by the (white) hellebore of the ancients, and our
Tenitrum album ? The external character of the plant resem-
Ues that described by the ancients, the name is the same as
that given to it by the Bomans,* it has the same properties now
* AntyUus, kxx cit, pp. 281, 282.
* Antyllus, loc. cit, p. 282.
* The seoGod day after taking the
hellebore.
* AntyUus, loc. cit^ p. 282.
* Herodotus, loc. dt
* AntyUus, loc. dt, p. 278.
^ AntyUus, loc. dt
' AntyUtts, loc. dt, p. 283.
* Oomelins Cekus, who wrote in the
slwivfs tfmkB of it under the name of
* J. de Muralto, loo. dt; Smyth, in
Medic. Cmnmunie^ toL i, p. 207.
* C. Gesncr, loc. dt
* Orediiig, loc. dt, p. 48.
* J. de Muralto, loc. dt
* ReimauD, loc. dt ; Lorry, loc. dt
* Oreding, loc. dt, pp. 62, 71.
"* Oreding, loc dt^ pp. 82, 88.
* Benevenius, Smith, Vicat^ loc: at
* Yicat, Rddder, loa dt
" Lorry, loc dt
" Forestus, loc dt
Greding, loc dt, p. 68.
Many obsenrations of Forestus, Lor-
ry, Yicat, loc dt, and Lentilius, i/tsc
Not. Cur., dec iii, an. 1, app. p. 130, and
Ettmaller, Oper., torn, ii, pt. 2, p. 485.
time of Augustus in his books on nu^Ait-in^
aiitwm.
n
It
9M icBDicAL BmnoBiaiL DfiunsiTimr
as formerly, there is the same danger attending its use now. as
formerly, it is undoubtedly the same plant
Parts of Oreece where the best grew,
46. The white hellebore grew in &w parts of Greece, and^aa
I have above stated, in the moist plains of high mduntainea*
regions. In the most remote times Theophrastus approved
most of that which grew most abundantly in the Oeta hiUa neat
Pylaea in Pyra;* then that of Pontus ; then that &om Elaaa;
and lastly, that which grew in the bay of Malia;' he diai^
proves of those from Parnassus and Aetolia as being hard and
dangerous in their effects.
46. In later times the two towns of Anticyra were celebrated
for their white hellebore, namely, the town of Anticyra on
the Phocian coast,^ where the helleborian medicine was beat
prepared for medicinal use, and the other town of the same
name in the gulf of Malia near Mount Oeta, and not far fiEom
Thermopylae, which attained much celebrity on acoouni of the
excellence of the hellebore that came from this part.^
47. It is probable that the hellebore did not grow naturaDy
in the country about the Phocian Anticyra, because the range
of Mount Oeta did not extend that length,^ but that it
' Pyra was a plain near Pylaea in the chain of Mount Oeta (whidi, rumitDg
TheiTOopylae to the Arabraeian gnl^ extended as fiur as Doris) whure Hercnlat ii
said to have burned himself on a funeral pile (Pliny, Hut. fuit, libi zizt. capt. 11) Ii
order to obtain the honour of being received among the gods.
* In Stapel's edition of Theophrastus the reading /lamraXcwrirs' (AXffi^or) is irnm§»
There was no place of that name in Greece (for it could not be referred to the rirar
|fftam>1iii. in Crete) ; the Massaliotic country was situated oo the frontiera of Ghuil, of
which there can be no question here. We should read /iaXib>r«r, from the countij
about the gulf of Malia, where excellent hellebore was procured, as Strabo testifier
The derivation of KSXiros- /faXtumr is from the ancient but destroyed city M«>ia jgil
as viMXicurijr is derived fit>m ffureXfo, or /laevaXiwrifs- from /ia<rv«Xi'a, as Strabo leDs w
{Oeogr., lib. iv, 270), a Phocian colony in Gaul, now called Marteillet.
' Situated between the town of Crissa and Marathon (and the Pfaarygfaui prooMi^
tory) (Strabo, Gfoffr., lib ix. edit Amst. p. 640, collated with p. 647), but in D^Aa-
ville's map it is placed wrong.
* Strabo ( Oeopr^ lib. ix, p. 640)— Etra (after the gulf of Crissa) ' Avrf««^ (b Fhocis)
l^aSvo^or ^9 «<*^ rdr^aXiaardr cdXffoy, cac riiw 'Otrqv ' Koi 6h ^a<rii», i<tX rdv iXXff ipsy ^feyisi
rdv dvrxtur, ivravBa 6i OKtva^ceOat /^(Xrior, m| fti roiro dwo6nfu7p 6ti^ iroXXvvr K«Mf«fMr
ri» tfirafor IXUijoor., In like manner Stephanus, the Bysantioe, (Libr. it «rM«t)
•ays : 'Avr<ic«^i vtfXcir ^, h /<'« ^Mrii^rt 4 ^ '» M^Xicitfcr * ivra«9a ^1 r#v i\XiS%fm
fttaSmt row ivrttw.
* The nature of the country about Phocian Anticyra, which Pausantaa {Ormt^
^ner., pu 6ft2, ed. Hanuviae, 1618) describes thus : riiki^ rk hi4f 'ArHn^OT atf^iiJt
' —was such, that the blaok hellaborv might grow there ipswlawwsljfy faai wA
OH 1^ ^iitm!rjM.mw%Ttuni qK THE ANdXlTrS. 6l85
diher farongbt finom there or cultivated by the inhabitantB ia
guEdens^ and proved to them a souree of profit In the time of
Fliny^ the white hellebore used still to be cultivated in the
island of Thasos.
48. In the time of Rufus, a Galatian white hellebore used to
be sold, which, however, he condemns as being very bad.^ Pliny
pronounces the hellebore of Parnassus to be the fourth best^
ind says it used to be adulterated with the Aetolian.' Diosco*
rides tells us that the veratrum of Galatia and Cappadooia was
vhite and resembled a rush, and that it possessed a greater su£>
&CBting power ;^ il does not appear to have been disliked in
his time. After the timQ of Dioscorides, the Galatian veratrum.
•ommenoed to be reckoned one of the good kinds, the Sicilian
kind then also got into notice ; but it was not considered so
good.' Thus in the course of time several kinds of white helle-
bore, some from one country and some from another, were con-
lidered good and sought after, and less care than previously
vaa exercised in their selection.
Signs of its good quality.
49. The ancient physicians selected for employment those
fibres of the roots that were moderately rigid,* friable, soon
causing sneezing when brought near the nose,' fleshy, of equal
thickness throughout,^ and they rejected those that were too
pointed^ like the fibrils of a rush, and from which, when broken,
dust escaped, (for this was a sign that the root was old). They
ought to have a narrow medulla and taste moderately hot.
50. But of all who have described the way to choose the vera-
tirum album the most accurate is Aetius (who seems to have
ikb TOBtnmi album ; the yeratrum of Phocian Anticyra must therefore either have
been brought from Doris, where it grows and where mouut Oeta extendi, or culti-
Tftledfai the garden.
* MuL not, lib. xiv, cap. 16.
* See a fragment in Oribiuii Collect^ lib Tii, cap. 27, pi 249.
' MUL tuMi^ lib zxz, sect 21.
« MmL Med, Ubi iv, cap. 160.
* See a fragment in Orihaaii Collect^ lib. yili, cap. i. p. 271.
' DkMDoridet, in the pUu» already cited, has : /ucrpiur rrra/iiMr, or as other maaa*
•eripti have it: rfrarcM^qr, which Sarrazin renders moderately extended; but this n
eertemlj an obscure if not a iklse reading. Rasarius after Archigenes (ap. Onbmt^
L CL libi Till, €. 2) more clearly renders this quality of the good fibres by the leffm
hpidL AStius likewise makes use of the term : vo^v rtrav:
* Havodotui^ apud Ort6Mi CidUet^ libc Tiii, cap^ 4, p. 27«.
' Hiiwlotiw, loo cii
686 XXDIGAL HISTOBIGAL DIBBEBTATlOar
drawn his description from Posidonius) ; these are
^The best hellebore is that which, from one root, sends toA
many fibres, which are shorty rigid, not rough, nor thin at their
ends, nor ending in a point like the tail of a mouse, veiy wUlt
internally, but externally of a yellowish colour, heavy, having
a friable medulla not so soft as to be able to be bent, but apl to
break across, and when broken, diffusing around a sort of smoky
and pure cloud (i^ however, they emit dust, this is a sign of tlM
oldness of the hellebore). Good hellebore has at first a sweetish*
taste, which then becomes acrid for a short time, and afterwards
excites a great heat in the mouth, causes a great flow of saliva
and deranges the stomach."^
61. Others condemn that kind which produces a copious ti<sfW
of saliva, because it causes too easily the strangulating sensatioa
in the throat; but they are wrong, for this is only a sign of ike
greater medicinal virtue of the hellebore, and indicates that a
smaller dose of it should be given.
62. The earliest physicians preferred that which was gathered
during the wheat harvest, but Aetius rightly gives the preference
to that which has been collected in the spring, for at that
of the year the plant still contains all its juices.'
Medicinal uses of Veratrum alburrL
63. The ancient physicians used veratrum album in two
ferent ways — first, the ordinary use for obtaining speedy and
obvious effect ; the second, the grand cure for inveterate chronic
diseases, the latter they termed helUhorism,
64. In general the ancient physicians employed the veratrum
album for the purpose of exciting vomiting, and the helleboruc
niger for purging.* Throughout the writings of the most ancient
' Archigeoes (loc. dt, liU viii, cap. 2, p. 272,) also says: **aU kinds of hellebia*
have a sweetish taste.
* AStius (lib. iii, cap. 126, ed. Aid.) : Kfari«ror lyyUofo^ hdvi ftir ff^tir Hn wMik
Ixunf «af^i? Ka\ ra%ra VfUKfk uai rirwa Koi dpv^a (read l^wwtf) ««} «<« «v»X4yvrr« tSf
ij^»¥rm tiBfrnnra (read cvOpmrrov) 9^ KU^T6^t9«i iia /laXaWnrr*, iWk varayr^^Mra vcvX^Jli*,
«««y«3^r ri bfT^ ^povm m^tij^owrm r«{ ivUwra^ vat rovr* tmB^f^' ri yhf nvtfrwiiT^'^^^M^
hikwl Ti¥ iWlBjpor' h il iyQis" ^•^unnfitWi wpwrov flv yXwrtfnrrof- tffmmtv wa^j^ttf A^
U i^ii6rnT9r 0pay(ti9f' /i(rA M r*ir* vvpciwtr i^x^P^ i/miet «c^ r6 vrA/ui «al witkm Mym
»»X4r, K*l Ti¥ 9r6fim)(9p ivmrpiwn.
* Loe. cit AcT A i^r d»mXS0$»t fv i\\i$9f9^ In rfr /<(iir iynp^p^^^W'
* See Aretaeaa, Curat ekronie, m^rb^ lib. ii. cap, 18, p. lM,edit BoerfaaTiL — Flaji
(lib. 26, sect 22) says : -* Nigrum purgat per infenia, candidum autem per fmuitui
In like manner Buftis (loc dt, libi vii, cap. 26, p. 250) and many others teatify to tlio
MiDO effect; but the thing speaks for itself in all the vritingsof the MCMMt pl^yir
OH THS HKLLSB0RI8K OF THE AKCnENTS. 687
phyaicianB, vhen they speak of purgmg upwards,^ they always
dlude to the veratrum^lbum, even though the word " hellebore*^
18 not added ; but when they speak of purging downwards either
the Uack hdlebore is understood, or they mention the name of
dba purgative to be administered. But in the latter times' the
nmedy used to produce the one or the other operation is not
vnderatood, but usuidly mentioned expressly.
Ofiht ksser treatment with veratrum album, without jprtparaJtory
treatment of the patient
65. The earliest physicians seem to have employed this medi*
cine, without previous preparation of the patient, in ordinary and
•oate diseases when they wished to procure evacuation upwards,
as they termed it, that is, vomiting.
66. Hippocrates used to give the veratrum album at once,
and without preliminary treatment of the patient in urgent
eases,' and whenever he wished to evacuate quickly by vomiting.
67. The symptoms which he considered to indicate veratrum
were — want of appetite, corroding sensation in the stomach, ver*
tigo with obscuration of sight and bitter taste in the mouth,
without fever ;^ in general he ordered it to be given in cases
where the pains and morbid symptoms were in the upper part
of the body, and when the other symptoms seemed to demand
evacuation.^
One oolj, the author of the pHeodo-Hippocratic book J)e afectilnu intemU
(Opim Hippocr^ edit Foesii, seek, r, p. 118), orders (if the text be genuine) the
UaA hellebore to be used for promoting enuiuation upwards, but he has found no
jmitatarB among all the physicians of antiquity.
' Thua before, during and immediately after the time of Hippocntes the words
IXXil«f«r And vomiting were synonymous terms. Therefore the Latin versions of the
Onek medical writings are wrong, when the question is concerning the evacuation
hf veratrnm album (which was always by vomiting) to render the work Ka0m(ptt¥ bj
"pmr^rt,^ because the Roman physicians never employed this word alone (t. «,
without the addition of **per tuperiora ") to express '* t4> excite vomiting,'' or to e?ao-
by vomiting," although the Greeks could employ ««9at(Kiy alone to cxprew
* From and a little before our era.
* See the book De Fraeturis (ed. Chart t xii, p. 208). Ho there says: I/»im»
AXfgjf w «ivcVk«» aiBfiiupowt 7^ rp vorcptp ; in this pkce he speaks of the employment
if vmiting by hellebore in order to guard m& rapidly as possible against swellings
IrianoB, acute fever and sphacelus from a bruise in the sensitive parts in the vieini^
of the calcaneum. This recommendation he confirms in another place (sect iv, apk.
10) where he lays : foffL^ttiuw Ip rfvt Xiirr i^iviffiv 4pyf avO^^rpey ;|^pori(civ yflf iv
* Seet iv, aphor. 17.
* Sect iv, apbor. 18.
08ft ]aa>KAL HISTORICAL ]>IB8IBTArattV
68. In this jnanner his sucoesscxv up to the time of Oalen of^
dinarily ^nployed the y^iitrum in ordei^to oanse yomiting, m
we find in the peeudo-Hippocratic and other writizigi.
58. That the yeratrum was then giyen in a smaller and
in a yery small dose is a mere eonjecture, for Hippocratx
where makes mention of the dose. It was only at a later perioA
that physicians mentioned the dose of yeratrum album wfaiek
they employed for common use, as well as for the production
of helleborism.
60. As the earliest physicians up to the time of Hippocrates
iseither knew nor employed any oUier emetic besides yerattom
albnm ; when they wished to eyacuate upwards, they could onlj
make use of this medicine for obtaining prompt and immediate
relief by diminishing the dose ;^ they would haye to ^ii^iHffh
the dose whether of the crude root, or of the inftision, or of the
deooeUon.
61. Those physieians who immediately followed Hif^poeratiei^
in order to mitigate the effects of yeratrum in its ordinary em-
pfeyment, imagined yarioua ways of administering it witbool
giying it by the mouth, a mode of administration yery repiig>
nant to the dogmatic sehool of that age, which was more intenl
on theorizing upon the nature of things than on practising ra-
tionally.*
62. Accordingly, Plistonicus and Dieuches, followers of this
sect,' as also Diocles (who flourished thirty years before them)
stroye to excite mild yomiting by means of this medicine intro*
duoed as a suppository by the anus, or as a pessary by the
yulva, or employed as an epithem.*
63. But the principal mode of mitigating the effects of helle-
' TliiB nulder trtednent by diminif^wd doee« seems to be alluded to faj H^»po-
entee bimeelf in the following pkoe {De fineluriM. Openiin edit^ CbaiL torn, si pw
9i7): AXi#<ipnr /i«X4««dv iriwiM xf9 «A64fKpo»r; the eTpresskm Ya>$mMir ■ alight ■
applied to hellebore would seem to indicate a smaller dose of it Alto in anoUier
place (/>e Artie^ torn, xii, p. S62j I^pH xai tiiinsroT h^ iftinp iwd w^ffo^ffi H th»
perwQ vomit easily, he should get a slight emetic (** which does no! fT*»fim4
too mscfa," according to Galen's explanation^
* MneaitbeuB (one of this sect who lived about 820 yean R C.) shews eome
of this kind. Tlte following are his words (in Oriba». Collect, lib. viii. capb •);
"There is great danger attending the drinking of helleboio ; for either the patient m
restored immediately to health, or he is subject to mudi and long-continued suffiBriqg;
remedies of this sort should not there jbre be given unless all the safer modea of trvai-
jnent have been exhausted.**
' Ck>ntemporaries of Mnesithens.
* As Bufus mentions (apud OriboM^ L c lib vii, cap. 27, p. 266).
OK mn HKUEBOBISM OF THE J^OIBNTS. 889
bore wast that invented by Philotimas,* a pliysican of the same
Bchool, and contemporary of the above, which was adopted by
aU the practitioners of the succeeding ages. When it was drsired
to produce a milder and more expeditious vomiting, he intro*
doced A root of veratrum album into a radish,^ and (as we are
ipfiarmed by the physicians who immediately followed him>
having extracted the veratrum the following day, he gave the
Adi^h thus impregnated with the medicinal power of the vera-
trum to be eaten either alone or with oxymel.* '* By this means,''
ajfl Rufus, " vomiting was most rapidly excited, which would
not have occurred so successfully by the employment of helle-
bore alone."
64. Bufus likewise mentions that in his timo evacuations up-
wards were produced by employing footballs of hellebore.*
65. For the same object llerodotus, a pneumatic physidau
oontemporaiy of Bufus, gave two spoonfuls of the decoction of
hellebore to those who did not require violent evacuation.^
66. On the other hand Galen, who gave hellebore with con-
siderable timidity, ingenuously confesses, ^^ that it seemed to him
dangerous'' to give the veratrum album to sick persons in his
time without preparing them for it, as their juices, which had
been rendered viscid by idleness and luxury, required first to be
purified."
67. Antyllus gave to old men, children, &c., a small quan-
tity of the infusion of hellebore."
68. But I shall now proceed to give the more important treat-
ment of chronic diseases by means of veratrum album, to which
the ancients gave the name of
Rufufl, L c.
• AStius (as we leam from Antyllus and Po9i<lonina) gives the following prescrip-
tioo: — ^^Siz drachms of the fibres of the root of ycratrum are to be inserted into a
ndisli which has been pierced with a reed, tlie following day they are to be takeo
oat, care being taken not to leave any of the bark of the veratrum inside ; the radish
ia to be cut in pieces and then eaten along with oxymel.**— (lib, iil c. 120).
• Loc. at. ITie same method is recommended by Pliny (7/»V. nat. lib. xxv., sec.
f4) and Galen (lib. i, de method. mcd.y ad Ghiuc. cap. 12). It is, however easy to per*
Mre that from such a process it is impossible tlmt the medicine can always be the
Mme, or in the same quantity, as Murrray observes {Apparat med, tom. v. p. 158)
* Bufus, loc. cit
* In OriboB.y loc. rit, lib. viil cap. 8, p. 276.
' T^ Toiwvv iii6yai iAXiSopov iviv rov irpoiiairnaat^ (n^a\eoiiv, Ac, Sce Galen, CotH*
ipim/. ii, in Hippocrat lib. de frarturis, (edit Chart t xii, p. 203).
' In Oribat^ L c lib. viii, cap. 6, p. 217.
690 XXDICAL mSTOBICAL DISSKBTATIOK
Bellebarism.^
69. Serious and inveterate diseases in general the
physicians endeavoured to cure bj means of large doses of vc-
ratrum, but they shewed a great deal of caution and care in
their employmont of it, partly because they sought to overcome
a disease, as they imagined, by a medicine of a more violent
character^ than the disease itself; partly because they sought
to produce the least possible amount of inconvenience from
its use.
70. In the earliest times, physicians knew of no other medi-
cine for combatting chronic diseases, with the exception of a
few, except the veratrum album, to which, when all common re-
sources had failed, they resorted as to an anchor of safety.
71. "The white hellebore," says Aretaeus,' "is the most effi-
cacious, not only of the emetics, but also of all evacuant medi-
cines, not indeed by the quantity and variety of the excretions
it occasions (for cholera does the same), nor yet by the intensity
and violence of the vomitings (in this it is surpassed by sea-
sickness), but by the quality and remarkable power with which
it restores the sick to health by means of a slight and far fix>m
violent evacuation. It is moreover the sole remedy of all chronic
diseases which have already taken deep root in the constitution, if
other remedies fail. It resembles the power of fire ; and what is
effected by the combustion of fire, that hellebore does still more
* We find the word lX\t$)pi^etv lued by the anonjmouA continuer of the Hippor
cratic book, De dlaeta acut, (rdit Chart, t zL p. 166), and the author of the Mith
book, De JSpid. (1. c. t. ix. p. 860) ; in these places it refers to the use of heUebora m
diseases as an emetic ; but the substantive iX\t6>pt<ritdi, referring to the grand con
was first employed by Aretaeus {de euratione diutumorum morbonan^ lib. ii, cape 18)
and Liter, Caelius Aurclianus {Chronic. lib.i, cap. 4), in his barbarous language im-
properly applies the term heUeboritmits to the decoction of veratrum,
* Galen explains the operation of the larger doses of hellebore in a much too
mechanical and gro«is manner when (in his Comment, i, on the Epidem, vu of Hippocr.
he says — " If the disease is of very long standing and cannot be eradicated as uitk m
lever, we employ the veratrum album,** {IWcSnpi^nv ftlv iSuf vHvv xp*'^*' I ^^ *^«ri
cai itf 3v litoi TIT t^o^XtliT itSntPov, iif ravra yhp i\^66ot>t j^ptantSa),
* '£>ri h UvkCt (i XA<^'»iror) ei« Ifttrnpiutv (conjecture of Wigan for Ifur^i^p of the
tezt)iytfvtr, iXXi xal (vfindrrotv onu9 Kadaprfipitov i iwarturansr^ ov r<o vXffiti Ktii r§ mirtXIf
rnr UlcpiaiitT* r6U yap rat X'^h^ 'p4"^'<(' *^^ ivrdcn iroi 0iy r^vt M roTn i^iviot * tf r49i
yip vavrfti cai ^ iXoffffa xpiaaop' dXXd iwafti xal iroi6rirt ovrt ^avXi}* Tpircp iytiaT ro^ mif^wrmi
To2lci, naX Iw' dXiy^ Kadapvty Koi hrl cpiKpfl hriirt, 'A,rhp koI icivrtav tQv ;^r(c«r y»6#Mr 4r!
^i^mv iipvfiiyu)¥f ffv dnavifjc^ rA Xoiirik ixta^ r6it fto^pov Irirvptow' wvpi fccXor y^, if ^^yc^y
XnxSf IXXiiopoTt Kai o, ri ittp irdp ipya^trai }KKaiov radit xXiov iXXiiap^^ ciaw wmptMm^
wplienif cfirraiay ftiv U dvmrvoias; i( d'^po(>ir Si evxpoltiv mU jiwd wgtXtrt^Ft fW«prfiyjr. (/Jlf
^yrat, ekronic, lib. ii, capi 10, ecL Boerii., p. 186.)^
09. TBM HSLLSBOBIfiM OF THE ANOISirra. 691
oompletely in the interior of the body, giving to the asthmaii-
ml an easy respiration, to the pale faced a florid complexion,
and to the emaciated a robust body."
When hdUborism began to he practised^ and how hng its use tvas
continued.
72. Before the age of Hippocrates many physicians were
afraid to employ this *' grand cure/' because they were ignorant
of the doses and of the caution necessary to be employed in the
use of Hellebore ; those who used it, however, not unfrequently
did harm by their rude mode of exhibiting it.
78. This we learn from Ctesias, a physician of the Gnidian
school, a relation and almost a contemporary of Hippocrates,
hat a little his junior : " In the times of my father and grand-
fiither/'' says he, "no physician administered heUebore, for
they knew not the proper mode of administering it, nor the
proper dose in which it should be given. It, however, they
sometimes gave a patient a draught of hellebore, they warned
bim that he ran a great risk. Of those who took it many were
loffocated, few benefitted. But now we see it given with per-
fsct safety.
74. After the authors of the Praenotiones Coacae, Hippocrates
lumsel^ who flourished about the year 436 B. c, employed
helleborism boldly, and taught the precautions it was requisite
to take in its use, but as was his wont, in very few words, which
I shall quote when I come to treat of the mode of employing it.
75. In later times helleborism underwent various changes
of fortune. For the medical sects that arose after the time oi
Hippocrates, applied their minds more to obtain a paltry re-
nown for vain speculations and theoretic subtleties, than to the
careful treatment of diseases ; therefore in consequence of their
ignorance or neglect of the precautions requisite in employing
hellebore, the use of this root came to be regarded as dangerous
and fell into disrepute.^
76. Still it was employed by many physicians of those times,
as may be learned from the writings that were given out under
the name of Hippocrates (called pseudo-Hippocratic).^
' Id a frogmcat prcserred by Oribasius, Collect^ lib. yiii, cap. viii, p. 285.
' See above, in Uie note to g 61, the obeervatioa of 31ne8itheus, the dogmatic
pliysician.
* See the apocrjphal continuation of Hippocrates' book, De victu acut, (edit. Chail.
t zi, pp. 166, 176, 180),— as also the peeudo-Hippocratic buoka, D$ Morb, p^puU,
fin ICKDICAL HISTORICAL DSBBBVAVfOir.
77. But it was principally the Anttcyran pbyaidaBS of tMt
period who practiged helleborism, tx profesao^ if I may be aUow«4
to use the expression, and they pursued it Tigoroosly for aovvnl
centuries. A great number of sick persons from other countries
who had been given up by other physicians, travelled to bcrib
Anticyras (towns, as I before stated, in great repute for thii
treatment), in order to be cured of the most protracted and aeii-
ous diseases by means of the potent employment of heUeboilk
78. Afterwards Themison^^ founder of the methodic mq^
began to recommend this mode of treatment by means of laige
doses of veratrum,^ but his books on chronic diseases^ have ban
lost
79. CJomelius Celsus,^ who followed him, says very little ia
his writings respectii^ the use of veratrum album, but he maa^
tions it incidentally ; it is doubtful if he employed it himsel£
80. Thereafter Aretaeus of Cappadocia, a man gifted with the
genius of Hippocrates, who flourished in the reign of Domitiaa,
.wrote a good deal of useful matter relative to helleb<»iBm.
81. Then Rufiis (apparently the Ephesian^) and the pneumatic
physicians, Ilerodotus and ^Vrchigeues, who flourished at the
close of the first century of the Christian era, made great efforts
to propagate and teach the use of hellebore, as the fragments of
their writings preserved by Oribasius clearly testify.
82. But not long after them appeared Claudius Galen* of
Pergamus, founder of a sect, the torch and trumpet of general
therapeutics, a man more desirous of inventing a subtle system
than of consulting experience. Disdaining to learn the powers
of medicines by instituting experiments, he gave the bad example
of generalizing and framing hypotheses.^ He neglected the em.
ttipedaUy the fifth (which was moat probably writteo by a Coon phyaciaa,
by the soq of Diaoo), the sixth (probably written by TheMaliu), and the
(written by several handB)— and linolly, the books Dt affectianilmt and De mfi'rm'i
itfeeiihuM, tn many places.
' About Uie vear 63 bl c.
' Fliny, Hitt, naivr^ lib. xzv, sect. 53.
* Quoted by Caeliiu Aurelianus (Thrd PoMcofium. lib. i, cap. 1).
* In the commencement of our cnu
* That the fragments quoted by Oribasius are from the works of Rufos of EpliHOi
seems to be borne out by this, that a part of them is to be frand in a manoMripl
cwmtaining the anatomical works of Rufus of Ephesus, translated into lAtiD if
J. P. Grassus, in the Prineipet artit Jfediau of Henr. Stephanos, 1667, toL p. ISt.
* This, the ii^rcatest celebrity in the medical schools, and almost the only authonily
for thirteen centuries, flourislied at Rome after the middle of the second century ii
Ha indicated all the powen and qualitiei|af all 8un|^ medicaincBti^ not bf Oh
OH THE HCLLKBORIBM OF THS ANCIENTS. 598
plc^rment of veratrutn album, or rather he dreaded it In very
few places of his most copious writings (which certainly prove
the fecundity and subtlety of his mind) is mention made of this
celebrated medicine. To be sure, in his book, Quos purgare
npoiHeat^ he repeats, principally from Hippocrates and Rufus, the
preliminary precautions and rules for the employment of helle-
bosism, but he adds nothing of his own which would lead us to
infer that he approved of it himself; on the contrary, he says:
"We have sometimes given in oxymel, radishes in which the
fibres of white hellebore had been left for twenty-four hours, in
order to excite gentle vomiting by this means*' ; which is as much
as to say, that he did not employ the grand cure, but only some-
time] used the gentle method of Philotimus. He elsewhere '
lecommends the same gentle use of veratrum. Moreover, in his
commentaries on the Hippocratic writings he now and then says
something about hellebore in a superficial and imperfect manner,
thereby shewing that he had a great objection to the serious em-
ployment of this root. Thus when Hippocrates ' orders, for a
Qontusion of the heel got by leaping from a height, apparently
for the purpose of preventing tetanus and gangrene, hellebore
to be given, that same day or the next, before the fever comes
on, or when it is slight or not continued, Galen confesses that
"he would not dare to give hellebore, even if there was no
fever," ^ so far was he from making use of the helleborism of the
early physicians.
83. I know not whether it was the mere example of Galen, or
the dogmatic style of his writings which were repeated literally
in all medical writings as though they had been the oracles of
an infallible God, or if it was from other causes, that the physi-
cians who immediately followed * him almost entirely neglected
helleborism ; thus much however is certain, that for almost two
centuries it was very little used, until a man distinguished
periinents upon tlic human body, but by mere conjecture : thus ho arbitrarily pUced
both the hellebore!* in thr. third ordt^r of hot and dry tubntancet (in the 11th book De
MMtpl. med.facultate, t, xiii, p. 17S), whereas it is impoesible that tliese two medi-
einea, which have a totally opposite medical action on the human bo<ly, can be of the
mmm quality.
' In the first book of the Method, medend. ad Glauoonem, cap. 12.
* Or his grandfather, who by some is thought to be the author of the books D§
fraeiurU and De artieulii.
' Ufwir ^ ovS' ampirut roXftuftcp iiiikat {iXXii'pop). Comment, u, in librum Bt Fmc-
turit (edit. dt. torn, idi, p. 2<M).
* Caetius Aurelianui^, who 8eems to have been a contemporary of Galen, and not
to have lived after him, recommends the employment of bellebofism in epilepsy (L c>
lib. i, capi 4)l His dialect is African, not pure Roman, but rude and rough.
88
694 XKDICAL HmrOBICAL BIBBEBTATIOV
equally in medicine and in snrgerj, Antillus,^ paid bo mncli at-
tention to this mode of treatment that he is justly regarded as
the greatest authority in laying down the precautions it inas le-
quisite to use in the employment of this means.
84. Shortly after him Posidonius, a physician of no mban re-
putation, as may be seen from the firagments of his writings pre-
•served by Aetiua, rivalled Antyllus in the attention he devoted
io helleborism.'
85. Thereafter the grand cure by hellebore again declined
sensibly and fell into disuse. In fact Oribasius, about the year
862, in his Colkcta, dedicated to the emperor Julian (called the
apostate), has brought together many observations of the andeats
on the subject of Kelleborism, but where he ought to hav^^ven
instructions concerning it himself (in the Synopsis to his son
Eustathius), he does not say a word about it.
86. But in the following century Asclepiodotus, abandoning
in a great measure the doctrines of his fanatical preceptor Ja-
sobus Psychrestus (about the year 460), revived the practice of
helleborism, which had long been neglected and discontinued,
and gained great reputation by his wonderful cures of very ob-
stinate tod serious diseases by means of this medicine.^ But of
all the physicians of antiquity he was the last .who practised this
way, for after him the employment of helleborism fell into ob-
livion, nor was it afterwards restored by any of the Arabian
physicians,.*
' This author flourished about the year 880 of our era ; fragments of his wri&g^
have been pre!ier\'ed by OribAsius^and Adtius; Sprengel has puUished a sepaiat*
edition of them.
' That he wrote in the time of Oribosius, and some time before him (about thp
year 860), is apparent from this, tliat Oribasius in his chapter on epilepsy (Synoftit,
lib. viii, cap. 6), transcribes word for word, without mentioning his authority, Fbei-
dooius' method of treating this di;«ease, which Aetius {Xetrab. ii, Serm. ii, cap IS)
ascribes to Po8idoiiius. But our Posidonius (whom some, for what reason I know not
call ros8idoniuR, though the etymology of the word, as well as the Aldine editkn d
tlie Greek text, and Photius also-^p. 565 — all make the woni Yloau&tavioT) must not
be confounded wiih the more ancient philosopher of the same name, whom Stzab)
calls iha friend of Ptolemy (Geogr., lib. xi, p. 491).
• 'AffuXrjTjrf^artfS row XtvKv^ iWtSiftov wdXat Ttjv^piiffitf riToXwXwar— ««rd$" dvMo/rvn,
Kai ii avrov dvuirovs- v6covf iaaaro (Photii Mvou'^i^Xor, p. 1064, ttdit. Schotti, RothoOUlgi
1663, foL)
* Mesne, who flourished during the reign of the caliph Al Rashid, about the ytax
800, a man of such celebrity that he was termed the evangelist of physidaos, cflio-
tributed much to tJie almost complete abandonment of tlie use of veratrum album-
In his book De Simpl., cap. 80, he aays, "There are two kinds^of heUcbure, the while
OV IBS HBLLKB0SI8X OF THX ASCSXSTB. 695
87. So alflo A^tius the Amidenian, who about the year 645 ^
arranged in sixteen books, with mach order and clear method,
all the writings of the ancients on the treatment of diseases that
remained, carefully extracts from Antyllus and Posidonius what
lelafeeB to helleborism, but adds nothing from his Own ex-
■
penenoe.
88. In like manner Alexander of Tralles, who composed twelve
books in the Greek language on the art of medicine, about the
year 655, in the time of Justinian, was so prejudiced, like the
vast of his contemporaneous colleagues,^ against the use of 'this
root, that he greatly prefers the Armenian stone (fossil oxyde
of oopper) to veratrum album, ''as an evacuant medicine without
the hfiom and danger that attend the employment of. veratrum
album," »
89. Afterwards indeed Paulus of Aegina, who wrote his seven
books on medicine about the year 640, in Greek, describes cur-
iorily the mode of practising helleborism among the ancients,
bat as fiur as can be understood he does not seem to have em-
jdoyed it himself.^
90. Finally Johannes, the son of Zacharias, sumamed Actua
liusi^ only makes mention of veratrum album incidentally ,<* and
only after the description of others.
f^ihe seasons of the year^ tlie diseases^ and the subjects in which tfit
aticients considered heUeborism suitahle or unsuitable,
91. The earliest physicians considered the spring the most
aoitable season for the evacuations by hellebore, next to that the
autumn, and if a choice were capable of being made betwixt
winter and summer, they preferred the latter for the evacuations,
upwards, the former for those downwards."
aod the black ; the latter is more wholcaome than the wliite, wRn^ produces humI
terrible symptoms." 7
' T\m learned Dr. Carl Weigcl {Aetianarum exfreitationem tpeeimen^ I-JpSy 1791.
i, p. 8) profves that AStius floiirirthe<l about the jcarH 640 and 650, but that Alexander
of Tndles u to be referred to the sixth decenium of that century.
* J. Friend {HiM.. de la med^ t i, p. 160) sayn : "Ce medicament, si renomm6 parnii
Ifli andens, etait (du temps d'Alcxandrc de Tralles) dtjik devenu tontk-fait hor^
d'osage.**
' Book i, at the end of the chapter De mehncholicit.
* lib. vii, cap. 10.
* From a passage in Myrcpsus, who wrote about the end of the thirteenth oeDtiAy
quoted troxn Actuarins, it Heems that the latter could not liare flpuridhed after the
1S80 (see Freind, loc cit, p. 468, 464).
* Mttkiod, med^ libr. t, cap. 8.
* H^jpocr., sect iv. aph. 4 and 6.
066 MXDICAL HISTOBIOAL DiaBKBTATlOXr
92. The J prohibited the employment of helleboriam i& asthnuM^
cooghs, and internal ulcers (snch as pulmonary oonsumptiaa '
and suppuration of the liver) ; also in cases of hemoptysis^ ervi
when the patient seemed to be in good healthy they feared kil
its use should occasion the rupture of a blood-vessel in the longi^
especially of those who were thin, had a narrow chest, and a long
neck, i e. were of a phthisical habit (for persons of that desoripi
tion have generally tubercles in the lungs, breathe with difficaUy,
and are harrassed by cough^) ; also in diseases of the throat and
neck, in the pain at the opening into the stomach of those wlifl
had a difficulty of vomiting,^ also of lientery,^ in oommendng
amaurosis, in aifections of the head that were accompanied by
violent pains at intervals, with redness of the &ce and congeation
of the vessels ; and lastly, in the hysterical suffocation.^
93. It was not allowed to use it in any febrile disease, except
some cases of quartan ague.^
94. Moreover, the vomitings provoked by hellebore wero aiH
thought to be suitable for obese persons,^ nor for the plethoxi^'
nor for those subject to syncope.
95. It was with difficulty borne by persons of a timid oi
pusillanimous disposition; this treatment requires a grealM
amount of fortitude than almost any other thing ; wherefore it
was not considered suitable for women, or old men or children.
96. It was chiefly employed in di^ases of long-standing with-
out fever, in insanity,*® melancholia, "in inveterate pains of the
* Hippocr^ Beet, ir, aph. 8. — Rufus quoted by Oribaaiufi, Collect^ lib, fii, capi My p
' Rufua, L c, p. 246.
* Rufua, L c, pp. 244, 245.
* Hippocr. L c^ aph. 12.
* AStiufs quoting from Antyllos and Po9idoniiiA, lib, iii, cap. 1S1.
* Oalen, lib. L, De method, med. ad Glauconem, cap. 12. — Rufu^ L c, cap. 121.
^ Rufus, L c, p. 245. — Hippocrates seems to me to allude to this when he mp
(oect. iv., aph. 16): 'EXXff ipir intKifdwo^ raiai ras" vapxcLT vydasr (as thougfa he had laid
'* fleshy persons ") t-jfcwn^airaa^dv yao c^^juci, — ^whercforc tnr this same reavoD be
fjiders (sect ir., aph. 6) thin pertons to be evacuated upwards: tovt /<r^ra^f — S»»
* Adtius, lib. iil cap, 124.
* Rufiis, L c, p. 245.
** 0. CeUus, De medicina, lib. il, cap. 13, with whom all ancient mcdkal aolbon
" Aretaeus, Curat, diut-t lib. i., cap. 5. — Oalen, De atra bile, cap. 7. Piny, Bid,
HoL, liU xzY., sect 94. — ** Rfficacius elleborum,*' he says, *' ad romttioDea et ad biUm
nigram cztrahendanL**
OK ns HBLLIBOBISIC OF THK AKGUMtS. 697
fnt and liips^ pains of the joints, * the commencement of the
goat,* epilepsy,' spasms of the facial muscles,^ laziness of the
mind,* loss of conscionsness (apoplexy), vertigo which caused
oonfbision of the head, (fanatics,^) inveterate paralysis,^ obsti-
nate headache,* lethargy, vertigo, white leprosy,* and elephan*
tiasis'^ and other cutaneous diseases; also in baldness, falling out
of the beard, nightmare, devel(^)ed hydrophobia,*' renal calculi.
* RnfiH, I c^ p. 26u. A^tius L c, cap. ISl.
* Aretaeii^ Curai,dtut. 1th. iL, cap. 12, xaX y^ r«<rc vc^ypicoiffi iX>i^for r^ ^<ya «<or .
* CSelsufl^ L &— and Caelius AureliaDua, Tard. pou , lib. I, cap. 4, §108 — 111.
« OelMH, lib. iy^ cap. 2.
.' U was not onlj employed lor mental imbecility, but remarkable to relate, it
m alio iBied ftir healthy iiidinduala giveo to literary studies io order to sharpen
tfanr intelltKt^ as Pliny inlunns us {Hitt. %at^ lib. xxr., sect 21): ** Ad penridoida
aerim^*' he says, ** quae commentabantur, saepius sumptitabatur veratrum f as an
emnple, I may mention the case of Cameades the Academician, who (see A. Gel-
fia^ ATodL AU-^ lib. zrii., cap. 15) *'Bcri«turu8 adrersus Stoid Zenonis libros superiorm
coiporis ellebtVD candido purgavit" The same Cameades, we are told by Valerius
Minmiis (lib. tul, cap. 7), " cum Chrysippo disputaturus helleboro se ante purgabat
id exprimeodum ingenium suum attcnthis ot illius refellendnm acrius.** It is to this
coqiloyment of Yeratrum album for the purpose of sharpening the intellect that
Loeiinof Samoeata- refers (jSi'imf rpi<rir, Op., torn. L, p. 664, edit Reitzii): o^^JXir,
jwMbf M^v, |r ^% rpir Iftiiir rH imiapov wiyr — *' thou const not become wiM unless
thon ikric€ usest hellebore f and in like manner Horace, by the wordi» : ** Tribus Au-
tiepia insanabile caput," means to ridicule a dullard wliose stupidity could not be re-
BSfed by three courses of hellebore.
So frequent and so well known was the treatment of mental infinnities by helle-
bore at Anticyra in ancient times that the name of this town was often used to de-
note the process of helleborism itself and the word Anticyra was used when helle>
borion and hellebore were meant Hence that sarcasm which Horace directs againf>t
toamn (Sb. ii^ Sat, iii., y. 82, 88):—
^ Daado est elleboii malto pan maxima aTarin ;
** Nesclo an Anticyram ratio illit dettinet omnem **—
ie. I should think that all the hellebore that con be found should be devoted to the
treatment of misers.
Feraius also says (8aL iv., ▼. 16)—
**■ Antlcyrae mellor •orbere merscas,"
it were better that thou shouldst swallow pure hellebore. — ^This is an imitation of
Hoimoe {£put. ii., y. 137 )—
^ Expulit elleboro morbum bilemque moraco.^
*Rufbi,L e.
^ ACtius, I. c.,cap. 12. Gael Aurelianus, L c, lib. ii, cap. 1.
* Rufus, L c Aretaeus, Cur. diut^ lib. I, cap. 2.
*Rnfu^lc.
» Pliny, L a, lib. xxv., sect 24.
" Rufus, I. c, p. 268, " It cauacs," he says, ** those who already haye a dread of" wa-
ter, to dread it no longer ; and th» fact was anciently known to the peasants who,,
when their dogs became affected by the disease, purged them with hellebore, and
fltia led physicians sometime after to giye hellebore to a man affected with the
598 XlBDICAL H18TOBI0AL DISSKBXATIOir
ancient crudities,^ the coeliac disease,^ leucopUegmasia, diseaaes
of the spleen,^ struma,^ concealed cancer, though it seems to
have been less suitable for the ulcers themselves ;* in a word,
in an almost innumerable multitude, of diseases.^
97. In a disease which from its nature is of a chronic charac-
ter, it was considered much better to administer the veratrum in
the commencement of the malady before it had acquired greater
power, because most such diseases became firom long habit in
the course of time unconquerable.'
98. But in the case of diseases consisting of periodical attacks
and intermissions, it was not thought advisable to employ the
medicament where the paroxysms recurred at short intervals,
but only where the intervals were longer. In diseases, how*
ever, which presented great and regular intermissions, it was
deemed expedient to commence the treatment a long time be-
fore the attack, but if the intermissions were short and irregu-
lar, the hellebore was to be had recourse to after the termina*
tion of an attack, especially in epilepsy .•
Preparatory treatment for IieUebormn,
99. When it was deemed necessary to employ the veratimn,
the patient was put on a regulated diet, which was in general,
according to the advice of Hippocrates,^ for those who vomited
unt^i difficulty that they should before taking the medicine have
their bodies moistened by plenty of nourishment and repose
(the pseudo-IIippocratic books, particularly the sixth book of
Epidemic di.seases, add, **by the bath.'') The doctrine of the
later physicians was — Uiat they should be made to practise artijkial
vomiting,
100. Even those who vomited easily were ordered to vomit
three times before they commenced the great medication ; fiist^
after supper ;»<> secondly, when their stomacb was empty; and
* Rufus, L c. — Pliny, 1. c
* Celsus, L c, lib. iv., cap. 16. — Aretaeus, Cur. diiU., lib. 2, cap. 7.
* Rufus, 1. c., p. 264.
* Celsus, lib. v., cap. 28, § 7.
* Rufus, L c
* Agtius (quoting Antyllus and Posidonius), 1. c, cap. 121: rtf 6i i^a^iOftch Uo*
' Rufus, 1. c, p. 264.
■ Rufus, L a, p. 265.
* Sect, iv., aph. 13. — Also Celsus, libr. ii., cap. 16.
^ After supper, and also when fasting or coming out of the bath, the patients piv-
OK TH£ HXLLSBOBISM OF THE ANGIXNT8. 699
Ittdj, after having partaken of radishes^ (or origanum, or hys-
sop, or rue*). — Others ordered the patients to vomit three times
immediately after supper ;3 and tlien to wait two or three days
before drinking the hellebore.
101. But those who were known to vomit with difficulty,
weie prepared a long time previously, as long as three weeks,^
and on repeated occasions (e. g, every third or fourth day) were
sobjected to vomiting,^ in such a manner that the patient should
be made to vomit more frequently the nearer the time ap-
proached for taking the medicine, attention being paid to the
strength of the body in order that he should not be weakened
more than necessary by these, for this treatment requires more
than any other thing, strength on the part of the patient.^
102. Therefore betwixt the several vomitings three or four
days were allowed to elapse, during which the body was re»
freshed by food easy of digestion, by repose, and by amusement
of the mind.
lOS. After the last vomiting, one or two days^ intervened
before the patient took the veratrum, during which time the
bowels were opened by means of a clyster," baths were used,
and a spare diet
Mode itf exhibiting the veratrum album far the purpose of inducing
helleborism,
104. There were three general methods of administering ve-
ratrum ; in infusion, in decoction, and in substance.
105. The kind that was preferred^ was that iu which the root
foked fomiting, either hj tickling the fkuces with their fiiigero, or with a feather
dqpped in oil
' From a pound to a pound and a half of pungent radishes were eaten after a mo-
derate meal with water for drink ; tlic patient then waited a whole hour until nausea
andemetatioos commenced ; then by means of the finger or a feather introduced into
Ifaa Cuices he provoked vomitmg, and this was called vomiting from radisket, Arcfai-
^tom, dted by Oribasius, L c^ lib. viii^ cap. L, p. 270.
' * Herbs lightly boiled should be eaten." Rufus quoted by Adtiu% lib. iii , cap.
119.
* AStius lib. iii., cap. 1 27.
* Archigenes, L c, p. 267.
* To those that vomited with great difficulty, the most that used to be ordered was
generally four Fomiting.^ after supper, and two after radishes. Archigenes, L c, pp.
2S7— 271.
* Rufiifl, L c, p. 266.
^ Ardiigeiies, t c, p. 268.
' Archigenes, L c. — A^tius, lib. iil, cap. 127.
*Rafufl^Lc.,pL266.
600 . JUDICAL HI8T0BICAL DI88EBTATI0H
was cut with scissors^ into ooarae particles, resembling our coanser '
kinds of groats (which the ancients caUed bruised polenta)^ or
of the form and size of sesame-seeds.^ The coarser particles
were selected when it was wished to produce milder vomiting,'
but care was taken that they should be of equal size, and not
mixed up with the finer dust, lest the vomiting that ensued
should occur at unequal periods.*
106. Some gave as the largest dose to robust patients two
drachms and a half {-— 180 of our grains) of this granulated
preparation ;* others only gave two drachms* (= 144 grains) as
the largest dose, ten oboli (= 120 grains) as the moderate dose,
and eight oboli (= 96 grains) as the smallest dose. It was ^ven
either in water, or in wine, or in raisin wine,' or in decoction of
lentils ; but to persons out of their mind it was given (in order
that they might not be aware that they were taking it) in broth,*
or in oxjrmel,* or in pills. »^
107. This most simple preparation of veratrum album caused
vomiting more rapidly than the others, and for the most part b
less than two hours brought up the bile and the pituita without
much disturbance, 1^ then, after the medicine itself had been
ejected by the vomiting, the evacuation ceased in from four to
five hours.''
' In a passiige in Antyllus presenred by Aetias (lib. iu.,cap. 128), this preparatiijo
of the root is termed rptXiardv (ciU toith wcUwrt). Orib;wiu9 quotes the same pasaagi^
{Collect. I 8, cap. 6, p. 277); but Rasarius renders it incorrectly," in ranienta den-
■ana." — Antyllus, a little further on (Aetius, L c, cap. 181), describes this operation
more at leng^th : rh Kao<pri Xa6hv rl/tvi \f/a\iSi tir dXftrutifi{ of the size of groated wheit)
^yi07 Ji wtrvfHjSti. He orders these partidet cut by the seiMwrs to the tiie of groaii
to be wiped with a cloth, in order to remove the small dust, and thus prevent suflbca-
tioo. Archigenes (L c. p. 272) recommends that the coarse fibres of the hellebore
should have one or two longitudinal incisions made in them before being cut in
pieces.
' Paulus Acgincta, lib. vii., cap. 10.
• Rufus, 1. c, p. 266. These coarser particles oflFered fewer points of contact to the
lining membrane of the stomach, so that the largest dose of this preparation was coo
sidered no more than equal to a smaller dose of the fine powder; moreover tfaii
larger size of the particles prevented their descent into the intestines, and the pro-
duction of purging downwards.
* Arehigenes, I. c, p. 272.
* Aetius (quoting Antyllus and Posidonius), L s., cap. 181.
• Arehigenes, in Oribasius, lib. viii, cap. 2, p. 278.
^ Wine prepared from the dried grapes.
• Arehigenes, 1. c
* Composed of honey and vinegar.
^ Arehigenes, L a, p. 276. The finest powder was employed for the pilU
** ' Avtv voWo^ airapaYfoxif Antyllus, in Aetius, L c, cap. 128.
" Antyllus in Oribas., !• c, p. 277, and in Aetius, 1 c, cap. 128.
OK TBI HSLLKBOBISM OF THE ANCIENTS. 801
108. Another mode was to bruise the root in a mortar, and to
separate the very fine dust by means of a very close sieve.' To
the lx)lder patients the coarser powder^ was given in the dose of
a drachm and two oboli (= 96 grains). This preparation con-
fessedly acted slower,^ vomiting often occurring only after four
or five hours, but it brought away all the bile and pituita,
certainly not without the risk of causing spasms (cramps)^ and
too violent vomiting, on account of the too great abundance of
the evacuation, but it was useful in various ways.
109. For the most part the fibres of the roots were bruised up
along with the medulla, but sometimes the most fleshy fibres
were moistened with a sponge, and the swollen bark split up
longitudinally with a needle ; after drying it again in the shade
it was bruised, and thereby, it was thought, a more efficacious
medicine was obtained.^
110. The infusion of veratrum album was also employed.
Five drachms (= 310 gr.) of the cut particles of the root were
macerated for the space of three days® in half a hemina (= 5 oz.
8 drs.y of rain water ; the liquor was then strained and admi-
nistered warm to old persons, children,® and hectic subjects.*
111. Others considered the decoction the most certain prepa-
ration,'® and they prepared it in the following way : one pound
(== 14 4-5 oz.) of veratrum, cut into small pieces with scissors,*'
' The finest powder being thus removed was made into pills with thickened hooej
(Aittiia, L G^ cap. 131) ; 96 grains of these pills were given when it was deemed
requisite to emj^oy this form.
* AitioB, 1. c, cap. 181.— To the insane this coarser powder was given generally in
cukes or broth, in order to deceive them (Archigcnes, L c, p. 274).
* Adtius, L c, cap 128.
* £vy»Xiri}r, AStius, L c
* Pliny, Ilitt. nat^ lib. xxv, sect 21. — Archigenes, 1. c, p. 272.
* This long maceration in water greatly diminished the power of the veratrum, for
■n parts of plants when mixed with water undergo fermentation, and the longer this
maceration and infusion are continued the more are the medicinal powers weakened,
milesB spirituous fluids, obtained by the distillation of fermented vegetable substances,
are added, which, however, the ancients were not possessed of The root of veratrum
album, imlebs thoroughly dried, is more prone to the decomposition of its constituent
parts than the roots of otlier plants ; its powder is particularly apt to become mouldy
and to ferment, unless perfectly dried. Mouldiness very quickly destroys almost idl
the medicinal power of plants.
"* Massarius, De ponderibua et metuuris, Tiguri, 8, 1584, lib. iii, cap. 14.
' Antyllus, in Oribasius, L c, p. 277 ; in Agtius, lib. iii, cap. 129.
* A§tius, 1. c
*• Herodotus, L c, p. 276.
" *E\paXt(Tnivv, AdtiuB, 1. c, cap. 129.
602 . KKDIGAL HISTOBICAL DISSEBTATIOK .
was macerated for three days in six heminas (z= 64 4-5 oz. of
water, and then boiled down over a slow fire to one-third less ;
the root was then removed, and to the liquor two heminas
(= 21 3-5 oz.) of honey* was added to thicken it,* so that it
should not spoil, ' or, according to Archigenes,* to make it of
the consistence of an electuary. Archigencs gave to a person
prepared for the helleborism a small mystrum* {= 260 to 288
of our grains) of this syrup for a dose ; Herodotus gave to robust
subjects one mystrum, but to those who did not require to be
evacuated two spoonfuls (= 144 grains).^ Others gave the
decoction inspissated with a third of honey, in the dose of a
large spoonful' (108 gr.), to be licked up by Ae patient, whereby
they aflSrmed that the occurrence of spasms and of excessive
evacuation was avoided.® Others formed the inspissated decoc-
tion into pills, which they gave principally to insane persons in
order to deceive them.*
Substances that were mixed with the veratrum. Sesamcides.
112. But the ancient physicians did not always employ such
a (dimple method of administering the veratrum album. Some
added to the infusion origanum, or absinthum, or natrum, others
mixed it with tliapsia,'® and others with the wild grape."
113. But the principal thing that wajs mingled with the medi-
cine white hellebore was a certain kind of seed called sesamoideSj
in consequence of their (oval) form bearing a resemblance to the
seeds of the same;*^ they were also called Anticyran hellebore or
Anticyricon, not because the plant that furnished the sesamoid
' XArchi^^cnes, 1 c., adds double the quantity of hooej (^ 43 1-6 os )
' Tliis long boiling and in<pts6atinn diminished not a little the strength of the
medicine, so that the dose^ of this inspi^^satcd preparation, though not soudl in bulk,
were actually of but little strength.
* Herodotus, L c^ p. 276.
* In Oribaeius, lib. viii, cap. 2.
* See Massarius, L c, lib. iii, cap. SO, 81, compared with ci^. 2. — ^The ootyle oon-
tained 15 3-6 of our ounces of honey ; the large Attic wMfttrum oootained an eighteenth
part of the cotvle, the tmall myslram on the other hand only a tweotj-fourih part
* In GribasiuB, L c, p. 276.
^ MasHirius, 1. c, cap. 38.
* Aitiua, Lc, cap. 130.
' Ardiigenea, L c., p. 276.
** The root of the Tkapna Aicltpium, Una
** The seed of the Delphinium ttaphiwagria^ Linn.
" " Oranum sesamae (sc. simile).** Pliny, Uiai, nat^ hb. zzii, sect 64. Alao
rides, lib. iT, capi 162 : ni^^a if^tiw v^wi^t^
ON THE HSlJiEBORISM OF TBR ASOIXSTS. 608 ■
seed liad any resemblanoe to the white hellebore, but partly
because this seed excited vomiting' like hellebore, partly because
to those undergoing helleborism^ it was given at Antioyra in
Fhocis,^ in order to prevent the suffocation arising from the use
of the veratrum album, ^ — at least so the Anticyrans persuaded
themselves and others.
114. Anticyra in Phocis, was, as I have said, very celebrated
iu ancient times for the treatment by hellebore, the best prepar
ration of veratrum album for the production of helleborism being
made there, wherefore, as Strabo relates,^ a large number of
persons resorted thither for the sake of the treatment There
grew moreover in Phocis a remedy resembling sesame, with
which they prepared the hellebore of Oeta. Thus Pliny says:
"in Anticyra insula — ibi enim tutis^ime sumitur elleborus,
quoniam sesamoides admiscent."®
115. Sometimes, for the purpose of procuring vomiting, the
sesamoides were given alone, in the dose of one drachm (72
grains/, rubbed up with oxymel ; when it was intended to cause
helleborism, one-tliird part of these seeds was added to the dose
of veratrum.*
116. In the earliest times,* this seed which it was usual to
mix with the veratrum album for the production of helleborism,
' AiA rd KaOa(fet¥ miro9 rd cxipjta irapax^netur iXXcfdpw, Galen, De tinipl, mecLfOiC^
mxTiii,cap.l8, §11.
' A<ft r6 itiXncdat Iv rair taBipctct rut \c9ku i^\iS6pto, DkMCOlides, lib iv, cap. 10S.
■ Strabo. L c.
* ^nffa^oniis'^—^vftiiiaYsrai — i\Xt6 ipoivtv^ irml ticaov xviytu See tbe continuatioQ of the
book De vietu acutontm {Opera Hippoerat. et Giileni^ edit Chart, t xi, p. 182.)
*A(«k ToiTQ dvoiiifttiv Ssvpi iriXAiidr KaOap9t<i>S' «<>( ^t^avtiaF x^'*^* yivtvQat yAp ri
0^gmfQtiiT ^lif/iaicov iw r$ ^k%k^^ /mt' o^ aKtv<i^kaBai roy tiraXov iXXiiopovm {Geogr^ lib*
iz» pi 640.)
' HiM. nai^ lib. zxv, sect 21. Plinj is however wrong in here stating Phodaa
Anticyra to be an island^ for it was situate-d on the continent, half a mile from the
port Pausanius (Ocogr^ lib. x, p. 682, edit Hanoviae, 1613) has lucidly described
iti ntoation. Liyy also te8tif.es to the same when he says (lib xr?i, cap. 26) ** breve
Una iter eo (Anticyram) — ab Naupacto est"
^ Pliny, lib. xxii, sect 64. — The pseudo Hippocratic continuer of the book 2>« Diatia
mmUfrum (edit Chart t. zi, p. 182) orders a large dose: 9n<raiioti6it &^ta «a0«i^r i»
vivif q^tuXtov ifaxftfii b ffradftdt (a drachni and a half) i( d^VftiXiTa rtrfuitfiivov
' The same continuer of the book De diaei. acut^ loc cit — Dioscorides teaches a
more definite proportion (lib. iv, cap. 152) : *' As much of the seed as can be hdd
with three fingers, with an obolus and a half (— • eighteen grains) of veratrum album
in hydromel.''
* This word does not occur in the genuine writings of Hippocrates. The first that
mention8 it is Diocles (who flourished twenty years after Hippocrates' death), see the
dictionary of Erotianus {Op. Hipp, et OaUniy edit Chart t ii, p. 188).
901 XSDIOAL HISTORICAL DIS8KBTATI0K
was called by simple term sesamoid, but subsequently it was
called ff^recU sesamoid, not on account of the size of the plant^ but
evidently because it was used in the great cure (helleborism),
and because it was considered superior to another seed of the
same name,* but chiefly in order to distinguish it from a certain
white sesamoid, which was called the ^nalfi sesomoid,
117. It is not certainly known what plant this emetic eeed
sesamoid belonged to, which in those days was mixed with the
veratrum album, chiefly at Anticyra^ of Phocis, in order to di-
minish the suflFocation. Theophrastus says: the seed of a small
plant, Jielleborine, is to be mixed with hellebore when that is ad-
ministered, in order to facilitate its emetic action.* The name
helkborine was probably given to it because it resembled the
hellebore in its emetic action, and its seed seems to have been
the same as what was afterwards termed (great) sesamoid. The
plant whence this was derived bore a great outward resemblance
to erigeron or senecio/ with its white flowers, slender root and
bitter seed.
118. We might, then, say with great plausibility, that this
was the seed of some species of erigeron (acris? graveolens?
viscosus?) seeing that our erigeron acris is highly emetic, as
Stedman^s observations" demonstrate, who saw violent vomiting
ensue merely from the application of the recent plant to the
skin. Cullen' also observes, that the common people make use
of this plant as a powerful emetic. If this be so, how powerful
the seed^ must have been when taken in the form of potion and
brought in contact with the nerves of the stomach, seeing that
' Id the time of Theophrastus {Niti. plant, lib. z, cap. 11), the seed of the black
beUebore also bore the name of sesamoid, and this, as Rufus (in Oribos. Collect^ UK
▼iifCap. 27, p. 261) alleges, resembles the seed of the cnicus (carthamus) and tak€0
Sb the doee of two drachms it purges doumwardi more violently than the root liaM'^
DioKorides asserts the same thing: iv xaX airiv {kookov tov lX\ii6p0v ftiX^vt) c«X«9#ir *2
i¥ 'Arrtxvpa aivafiottHf. (lib, iv, cap. 161).
* The seed of an unknown plant, the dose of which, in order to produce purging
downwards, Dioscorides (lib.iv, cap. 168) and Rufus (I c, p. 266) fix at half an aceta-
bulmn (a measure that can hold nine of our drachms).
* Hence the reason why this sesamoid was termed Aniicyrieon (Pliny, L e.\ and
at Anticyra itself it was even called keUebcre^ though this was an abuse of terms ; bj
•trangers it was termed Antuyran hellebore. See Galen, Defaeult. nmpi^ lib. riil
j[,cap. 11.
* Rufus, I c, p. 260. — Pliny. 1. c, ** caetera,** he says, *" simile erigerooti berbaa." In
like manner Diosoorides says (I c, cap. 162): htttv h w6a ^lyipom-i.
* Edinburgh Medical Ettayg, vol. ii, art. 6.
* Materia Medico, toL ii
09 THX HSLLEB0BI8M OF TH£ AKGIENTS. 806
in general the whole power of the plant is concentrated in the
aeeda, as is seen, for instance, in the seeds of the oonium maon-
latam, and of the helleborus niger.
Begimen to he employed to assist the emetic action of the veratnim
album,
119. As soon as the patient had drunk the veratrum, cold
water was given him to rinse his mouth, and perfumes were em-
ployed to remove and avert a premature nausea.*
120. If the strength admitted of it the patients were desired
to remain seated ; if they were weak they were made to lie
down on a bed on the ground, for two or three hours, to smell
peifomes, and to rinse their mouth with cold water. It was
sought to amuse them with some entertaining story ; their limbs
were rubbed and ligatures were applied to them ; they were ad-
vised to keep quiet, lest the medicine should be ejected by
vomiting sooner than it ought.
121. After two or three hours they were placed in a suspended
or elevated bed and swung about, and thus allowed to vomit
122. At first, the patients in whom the emetic action went on
properly, felt heat in the fauces and oesophagus ; then the saliva
flowed copiously into the mouth, and was often ejected by spit-
ting. Aiter the lapse of some time they vomited part of the food
that had been taken before, and part of the medicine, along
with pituita. This was repeated after some time ; and after
they had ejected the medicine and the food, they vomited first
pituita with a small portion of bile, then pituita with a large
proportion of bile, and finally, pure bile. During that time they
had slight hiccough, very red face, swollen veins, small and
quick pulse.
123. When the vomiting went on right, the countenance re-
sumed its proper colour, the pulse became larger, the hiccough
ceased. They now vomited gradually at longer intervals.^ The
bowels were frequently moved, although the evacuation in other
respects might have been moderate.^
124. If the hiccough was excessively troublesome during the
' Vomiting "which occurreti too soon (before two hours) waff generally considered
to be inefficacious for the removal of the disease, and it was observed that where it
occurred too late (commencing only after four or five hours) it produced great dkm^
tntioD of tlie strength and terrible symptoms.
* Antyllus, in Oribasiu<s Collects lib. viii, cap. 6, pp. 277 278.
* A<(tiu8y L c.
<MW HSDICAL mSTOmCAL DISSKRTAnOK
eT;fteuatk>ii^ melicrat,^ in wliicli me had been boiled, ^^as givm
them to diink. and thereafter a little warm water, which thqr
w«nt made to vomit again.' The body waa rubbed oyer wHh
o&l. ai'id. ai^or the lapse of two hours, thej were made to take a
a2>d appropriate food waa supplied to them.*
Strwviirf i^mph-iyed m cases where the vomiting did not take place
properly.^
\^\ II order to remove the obstacles to the right performanoe
<i tho rtv:iiiT3nxr, the following things were always in readiness :
a hich a:nd swinging hammock and a bed with a soft mattresBi'
^s^-ffiiiWL j\>=*ca,* and melicrats prepared in various ways, one of
wiiicJi conmined decoction of hyssop, another origanum, another
TOO* anotlier thyme ; there were also oils, diluted infusion of ve-
rfetram album, cupping glasses, little wedges, a feather, gloye
lingers, clysters, fomentations, wine, Ac
126. If Ote patients were seized wUh vomiting sooner than they
^*»ighty and there was reason to fear lest the medicine should be
rejected before any advantage could be derived fiom it, cold
water was given to rinse their mouths with incessantly, and if
this did not allay the premature vomiting, diluted vinegar was
employed, the limbs were l)ound with ligatures, and frictions
were applied to them ; they were directed to keep in their mouths
something seasoned with kitchen salt, to keep silence, not to
move, but to sit upright
^ 127. If by thege means the inclination to vomit was not
stopped, cupping-glasses well heated were applied to the back
and scrobioulus cordis, and a small quantity of hot water was
given the patients to drink occasionally ; if however this did
not allay the desire to vomit, a small quantity of the juice or
decoction of wormwood was given. Two or three of these
remedies always sufficed to arrest this inclination to vomit and
to overcome the aversion of the stomach.
128. On the other hand, if tfie vomiting ukls too long delayed^
and the patients did not commence to evacuate ^ thd propep
time, some gave the patient to drink warm hon^ and water in
- --'
' Honied water.
* By putting the finger into the &aoet.
' Antylliu^Lc
* Chiefly from the inptructioq of Antyllns, b OribMras, L c
* Aetiu8,lih. !i,cap. 182.
* Vinegar diluted with water
OK THB HSLLEBOBISM OF THS AKOIENTS. 607
which rue had been boiled, or oil mixed >vilh vater* {hydrelaeum),
others placed the patient on an elevated couch, the head direet^
downwards, and made him put his finger into his mouth and
irritate the uvula and tonsils, so as to excite vomiting. More-
over he was told to flex and extend alternately his back and legs
as much as possible, and to beat with his fists on the abdomen.
129. If the evacuation could not be obtained bj these means,
Ae patient was placed in the suspended hammock and swung
about,' he was at the same time exhorted or ordered to endea-
vour to vomit by introducing into his mouth his fingers covered
with some nauseous oU or with a solution of scammony.
180. If even this would not do, eight or ten feathers firom a
goose's tail, dipped in some nauseous oil (oil of iris or of
cypress^), or fingers of a glove made of soft leather, twelve
finger-breadths long, stuffed in firont with wool and smeared
with some ointment, were introduced into the fences,* and in
this way nausea and vomiting were excited.
Treatment of the bad and serious symptoms occasioned by the action
of veratrum.
131. Those who are in danger of suffocation after they have
drunk veratrum, have a moderate flow of saliva, and, in spite of
the most violent effort to vomit that arises, do not bring any-
thing off their stomach ; their face swells, the eyes project, the
respiratory organs are constricted, with the greatest difficulty of
breathing; in some the tongue is projected and the whole body
covered with profuse perspiration ; in others the jaws are closed,
with chattering of the teeth, and the mind becomes affected.*
182. This feeling of strangulation, which usually occurs in
those who vomit with difliculty, was allayed by the continual
drinking of melicrat in which rue had been boiled or some other
of those substances which have already been mentioned as use-
ful in the irritation of the stomach.
' AStioB, L c., cap. 138» where Cornarius has erroneously translated the words
}[fMt^999in Kodipvcutj hj petseverante votnitUf in place ofcunctante vomihi.
' Hippocrates forbids those who have taketo veratrum to indulge in sleep or
repoee ; he orders that they shall be made to move aboift continually. — '£ir^i> itin
Tit iWiftpoVj v^df filtf rht Ktvijctai rdv abi^aruiv ftaXXov ayCiVj rpoi Si rod; vvvovi ca2 fiii
KtrtiffiaSj fiacov' 6n^oi it Kai 4 vavriXti;, S ri xivTieif ra ciofiara rapdacet (sect. iv, apboT. 14).
-^•'Eirqy ^ovXn judXAov ayciv rdv iWiSopop^ Ktvst rd aufta (8ect'iv» aphor, 16).
* Oil rendered very fragrant by boiling in it the budii of the cypress (an Egyptian
tree).
* Antyllus, L c^ pp. 278—280
* Herodotus, in Oribos., L c, p. 288.
008 MEDICAL HISTOBIOAL DI8BEBTATI0K
138. I^ however this aflfection was of a very urgent characteri
three or four cupfuls* of the diluted helleborine medicine^ w«re
given, which, possessing the same properties as the veratrum
already taken would best procure the emetic action. Other
substances called emetics were prohibited, as they are of a differ-
ent quality, and only irritate the stomach without expelling the
veratrum taken as first^
184. If none of these remedies succeeded in removing the dan-
ger of impending suiSbcation, the bowels were acted on by a very
acrid clyster, in order to give some relief to this symptom and
to afford time to obtain other remedies. Then the patient was
made to swallow three oboli (36 grains) of galbanum, or to drink
three cupfuls of very old urine, these being considered useful
for removing suffocation.*
135. But if this also failed to relieve the suffocation, a power*
ful sternutatory was applied to the nostrils, the patient was assi-
duously swung about in the suspended hammock, and his &uce8
irritated by the introduction of feathers.
136. If there occurred loss of voice and consciousness^ the little
wedges were introduced betwixt the teeth of the patient on both
sides, and feathers or the glove-finger introduced into the fiiuces in
order to excite vomiting and remove the affection. Sneezing
was excited by means of the powder of veratrum itself (or of
euphorbium) ; and it not unfrequently happened that on sneez-
ing a mass of pituita was expelled, which in consequence of re-
maining too long in the stomach had caused the suffocation and
loss of breath.
137. When this means failed, the patient was laid upon a
linen cloth, which was held up by stout young men, and the
patient at one time thrown up into the air, and at another
swung from side to side. If all these commotions and succus*
sions failed to restore him to consciousness, it was thought there
was no other remedy for bringing him back to life.^
138. The hiccough that occurred to every one who took vera-
trum was not interfered with if it was slight and at long intervals ;
it was considered to be useful in exciting the stomach to
' The cup (cjathtu)) contained twelve drachmes (—14 2-5ths of our drachms), see
MassariuB, L c^ p. 43.
* The infusion or decoction of yeratum album.
' An ingenious idea and mode of practice, and perfectly comformable to nature.
* Autjlluis l,a
* Adtiui*, lib.iii, cap. 182.
* A saturated infusion of coffee would be useful here.
OK tm HBLLBBOBSX OF THE AKCmTIB. 000
action.' But when it was very severe, and if the mouth was
afboted with vibration and twitching, meliorat in which rue was
mixed was prescribed to be drunk warm after every hiccough.
189. If this did no good, a sternutatory was employed, and
if the affection still persisted, cupping-glasses were applied the
whole length of the spine, ligatures were applied to the limbs,
and they were heated either by fermentations or by putting
tiiem in warm water. It was endeavoured to frighten or insult
the patient, or he was ordered to keep in his breath a long time, or
to inspire and expire very slowly.'
140. For those symptoms that occurred as fi^uently as the
hiccough, the musmlar contraction and the crampj chiefly in the
legs, in the thighs, in the arms and muscles of mastication^ also
in the extremities of the feet and hands, if they were violent it
was sought to allay them by plentiful inunctions, by the appli-
cation of heat, by frictions and fomentations of the affected parts,
by strongly compressing the muscles with the hands, and by
giving castoreum internally.
141. Moreover if the vomiting was abundant, as it often was
in many of those who laboured under cramp, this affection was
Qsually removed by baths fr^uently repeated.^
142. The vomiting, if excessive, was allayed by the administra-
tion of the hottest drinks, by ligature of the limbs, and violent
frictions, also by the application of cupping glasses now to the
hypochondria, now to the back, and then tearing them forcibly
away. It is stated that wormwood given in drink was excellent
for stopping the vomiting. But if the vomiting persisted, medi-
cines to cause sleep were employed, as it was believed that sleep
had the power of stopping the excretions.*
143. For the loss of strength that ensued recourse was had to
food and wine, and if the patient had been excessively evacuated
he was revived by the administration of bread soaked in old
wine diluted, or in omphacomeL*
» Aiityllu8»Lcp.281.
* AntylluB, L c^ pp. 281, 282.
* Antyllufl, i a, pp. 282, 288.
* AntylluB, 1. c, and A@tiu8,L c, cap. 184. Hippocrates also (sect iy, aph. 16.)
adrised repose and sleep, in order to arrest the eyacuation caused by hellebcnre : htit*
* Hooey, mixed with the juice of unripe grapes, was termed ompkaeanul.
39
610 \ MEDICAL HISTORICAL DISSEBTAXXOIT
CJonchmon.
144. Such was the mode of producing hcUeborism employed
bj the ancients, which was more dangerous in appearance than
in reality, as most of the earliest physicians assert. For besidee
the passage^ in Aretaeus, a very distinguished physician, which
I formerly^ quoted as authoritative, we find the following in
Rufus '? '* The administration of hellebore seems to have been a
very serious matter, wherefore it is that many medical men and
patients eschewed the employment of this medicament ; but he
who is acquainted with the whole art and apparatus of helle-
borism, and administers veratrum, wiU find that there is nothing
more convenient than this medicine, that it is an exceUent re*
medy for procuring evacuations, and that it can scarcely do any
harm." The testimony of Pliny agrees with this, where he
speaks concerning his own time thus : ^' In former times it (vera-
trum) was considered a terrible remedy, but latterly it was so
conmionly used, that many engaged in study were in the habit
of taking it frequently in order to facilitate dieir comprehension
of their studies."*
145. It is not, however, my intention to reconmiend to my
fellow-men that Herculean treatment by which, under the name
of helleborism, the ancients attempted to remove so many and
such serious diseases, by giving large doses of veratrum album,
and whereby they ofien succeeded in doing so in a most mira-
culous manner, for I know not if it could be reconciled with our
habits and modes of treatment. No one is better aware than
myself of the force of habit and of its influence on the art of
healing itself (which however from its very nature ought to be
quite free). If it did not reign despotically over the medical
art, it is very possible that the treatment with veratrum with
some modifications might be now-a-days turned to great advan-
tage in relieving some of the worst and most inveterate ot the
diseases to which man is liable.
146. This much is certain, that the same diseases may be
eradicated with much milder and even with the very smallest
doses of veratrum, provided the medicine is exactly suitable to
the disease, nor could the ancients have cured by helleborism
ahron, curat^ ii, cap. 10.
' In § 71.
' In Oribftsius, L c, p. 268.
* IJi9t. naU lib. xxv, sect. 21.
ON THE HELLEBORISM OF THE ANCIENTS. 611
any other diseases besides those for which veratrum was gene
rally and, in any dose whatever (provided it were not too strong),
adapted.
147. This, indeed, is evident fix>m this passage from the
ancients* " It is not the vomiting whereby the veratrum album
is of use in chronic diseases, for many have taken and digested
veratrum with hardly any purgation, and yet have experienced
not less benefit from its use than those who had been evacuated
by this medicine.''
148. It is to be regretted, therefore, that all those chronic dis-
eases for which this medicine is from its nature the most appro-
priate and, indeed, the only * remedy, should be left uncured by
modem physicians, owing to the aversion to employ veratrum,
which, however, may be given in such minute doses, that whilst
they are powerful enough for any disease, be it ever so chronic,
they are incapable of causing any bad effects worth mentioning
on the human body.
OF THE BLACK HELLEBORE.
149. This medicine is termed hlack on account of the black
colour of its roots externally, which in the veratrum (white helle-*
bore) are extremely white. It remains for me to make a few
remarks upon it, partly on account of its name, partly because
the physicians of Anticyra who, as a rule, devoted themselves to
the practice of helleborism, were accustomed to employ the black
hellebore also as an auxiliary in the treatment of chronic diseases*
160. In the time of Hippocrates the black hellebore was scarce-
ly or not at all known, or at least not yet designated by this
name ; for neither in his genuine writings nor in those of hig
predecessors or of his grandfather {Praenotiones Qxicae, and the
books De Fracturis and De articulw) is any mention whatever
made of this plant or of this name.
151. The only place where this name occurs {De victu acuLj
t xi, p. 44), although no one has ever doubted that Hippocrates
was its author, is certainly not a genuine work of his.^
' IIoAXol \a$6»rti row iWiSjpov xai Kcxf/avrsf avrdp iKaBap&titrav ftlv ov6iv oAa>f , <u(//cA^t|<ra»
a 9Ul¥ 9rroy rdw KadapBjfTuv. — (Aotius, quoting from Antyllud and Posidonicus, lib. iiL
eap. 122.
' For as every disease differs from every other in such a manner a? to demand a
*pecial medidneappropriate to its nature, to bo selected carefully from the great
store of the most diverse medicines, by which alone it can be cured quickly, safely,
and permanently, so all the other remedies less adapted to the disease present, are
either useless, or contrary, or hurtful.
> It is more than probable that the book under the title of D« victus ratione in
612 MEDICAL HISTOBIGAL DISSKBTATIOir
152. It follows of necessity, therefore, that this new plant (the
black hellebore) which was employed as a purgative, was eiUier
discovered or named * some time after Hippocrates ; for it is
both mentioned in the pseudo-Hippocratic writings of those phy-
sicians who were his immediate successors, and is described by
' Theophraatus with the addition of the word "/»ia«« " to distinguish
it from the original hellebore (veratrum album) which for so
many ages, until the discovery of this new plant, had been the
morbi* acutit, which has generaUy been alleged to be Hippocatic, was written hj
three or four diHerent authors. The first part was by Hippocrates Himf^if^ fg^ ^
called Liber de Ptisana (see Athenaei Dipnosoph., lib. il p. 67, also Caelius Aureliaoni
and Plinj) and it contained nothing except the use of ptisan ("nihil cootiDabat vm
ptisanae usum**—aee Plia, Hist fiat^ lib. zriii, sect 16, and lib. zzii, sect 66). TU
book seems to have begun at the words : SokUi 61 fiol ^la ypo^c tiwat (L c, pc 7)
and to have gone on to the words : <irpi^<u( 5so>^cay, but no fiArther. What foUowt
immediately, from the words: it ir\np9^(JL c^ pp. $6 — 116) is doubtless an
addition (in whicli the discourse concerning ptisan is suddenly broken off) apparantlT
by the same author who wrote the prologue to the beginning of the book upoo
ptisan. This addition certainly contains many excellent obaervations respectiiv ths
diet in acute diseases, but it is plain they are of a more recent date ; for here (L e,
p. 42) we observe a scrupulous selection of ** the internal vein in the flexure of ths
elbow to be opened in pleurisy ,** and in that part of the text (p. 44) which particu-
larly engages our attention at present, not only are black hellebore and peplium rs-
commended as purgatives, and a subtle distinction made between the effects of eacb
but several aromatic seeds are added to the formula of the purgative medicine oo
account of their pleasant odour, an artificial luxury only met with in more recsot
times, as history teaches us. Moreover, in this place (p. 44, also p. 8) many other
cathartics (aAXa voXAa rc> orqXdrwy) are alluded to, which could not have been done
before the time of the reign of the Ptolemies ; for it was only then that in ooosequence
of commerce having extended to near and distant nations, the number of medidnas
was increased, kings themselves having in those days (within 300 years before oar
era) devoted themselves to the study of medicine. As to the peplium which is alluded
to here, it was not, if I am not mistaken, known to Theophrastus a hundred yean
after Hippocrates ; and this spurious addition to the book on ptisan could not have
been written at that time for this reason, that the peplium is mentioned along with
the black hellebore. This is, moreover, confirmed by the resemblance this i^itjco
bears to the first book J)e mulierum morbia which is certainly peeudo-EUppocntic.
The author of this book (probably the same person) expresses the same idea in the
same words: irinXtov <^va<Zif dvai Karap^fifTtKdv. — Finally, they reproadies and vitu-
peration addressed to other medical men, because the employed too few medicaieflL
the acrimonious partisanship for a particular sect, the abstruse ratiocinations cooeeni-
ing the nature of things, the later dogmas respecting the artificial clasaificatiaD of dk-
eases and their names, the scrupulous selection of some particular vein to be opened
in a certain disease, — all these things, which are vehemently discussed by the anooy-
mous author of the afore-mentioned prologue and addition to the book on ptisttL are
nowhere to be found in the genuine writings of Hippocrates.
* Perhaps Hippocrates himself had already begun to employ this plant (as seems
to be implied towards the end of his hook J)e vulnnibui capitis^ t. xii, p. 128: rvrtT*
Xpfl Tfiv Karto KotXlitP ivoxad^ai ^apftdKio^ 5, ri j^oXtiir ^Y'h )> ^^^ if 80 t/ had noi VH ft'
ceived its distinctive appellation.
OK TfiB HSLLSBORISK OF TUE ANCIENTS. 6lS
only evacuant medicine, and which therefore, as might be ex-
pected, was known by the simple name only.*
158. But it remains to be inquired whether or not the black
hellebore of the ancients is the same as our helleborus niger.
And this is a question of no small difficulty to decide if we stick
to Sarrazin's text' of Dioscorides, which is that commonly fol-
lowed; but if we bring to our aid the different readings of dif-
ferent manuscripts, and examine the thing critically, it appears
from the text thus restored that it is the same plant as our own ;
it would then read thus : *'E;cf i it rm ^Jaa* x^*% wXmrmt^ wp§9^
tfu^fff^ iXmrvfti ii^ — %m: ir»Xvr^iiiTTt^m^ xm fu XtifT^^a »m cl«rtr^«;(^t**
tfttiXti P^»)^t* tifh it Afvx« iftwi^^vifm, rtu i\ Txilfutrt ^•^•siJv,^ W (f
9&T€» xm^iAi Mnx^ ifUtH' — fZ'^t i* iieuTi XS'wrm^ /uXmfMj •Itfti iwi r<f«f
jupmxitv M^ftf*,M§vi il^rnftif»tj £f jukI n ^^jT*-/*. that is to say, " its
leaves are green, like those of the plane-tree, but less, more di-
vided, blacker, and slightly rough, the stalk short, the flowers
white, purpled, like a rose; the seed resembles that of the car-
thamus; — the roots are small below, black, depending from a
head like an onion, and these are the parts used in medicine."
154. With this restoration of the text it will be seen that
Dioscorides' description of the plant corresponds pretty strongly
to our helleborus niger. For our hellebore has also rosaceous
flowers with white petals, the external surface of which is cov-
ered with red coloured spots, like little clouds, which grow pur-
* See above § 10—16.
* Materia Med^Vh. iv, cap. 161.
' Hie words wpdv r& rod v^povSvMov which exist in the ordinary text may be left
oofc; they are not to be found in some manuscripts.
* Samzin's text has r^ax^t ; but with Serapion {J)e Simpl ) we may read ^pa^yt^
fir the stalk of hellebore, if it have any, is very short, but not rough.
* I have restored the word poim^ri^ which is to be found in some manuscripts in
place of fforpvbiSiit which we find in Sarrazin's text, but which has no sense. In
this rendering, ^oiottSfit 1 am fully borne out by Avicenna's Arabic version of tiiis pas-
sage, (lib. ii, De medieamentU simpl. Art. Charbak Aawati: j J»J| &JuCP i<(> Kajw<J
that is: "similar in its form to a rose." That the word 0orpvtaSn, on tlie conteiry
was not to be found originally in the text, appears from this, that it does not exist in
a certain edition of the book, as the marginal notes of Sarrazin attest; that it got
bto the text at a very early period (perhaps from some marginal correction which
was intended to supply the word /loSoiiSi) that had been almost ef&ccd by the in*
Jury of time) may be suspected from the same place in Avicenna, who immediately
afterwards adds the version of this spurious word 0oTpvu>in (which has no sense if it
refer to the flowers), and renders it " the fruit of the botry," following some copy of
IMoeoorides which he employed, and "vv Inch witliout doubt had received from the
margin into the text, in place of the genuine l>0iott6n„ that unmeaning substitute
614 HSDICAL HISTORICAL PI8SSBTATI0N
pie as the flowering advances. Bellon moreover asserts that he
has found on Mount Olympus the helleborus niger with reddish
flowers.'
155. But Theophrastus of Eresus, describes this plant' still
better (according to Scaliger's and my own reading^), in these
words : T£ fuXtiuv lut kavX*? — fi^»X»* r^«i^»j pixXti9 i\ wXmrirxt'Tm^
fi4X«r <;^«f iv/A9Xt(, t00tf( it i» r%% fiQm nprn/uf09 rt xmi tittynipvXkm
w)iXvffi^%9 i* tZ fuiXm rmi Atwrmi xtu >^9otiM'<. That is tO say :
" the stalk is .very short, the leaf rather large and divided into
broad lobes, attached to the root itself, and spread upon the
ground ; the roots are numerous, small, and are the parts made
use of." Scaliger, however, in place of «-A«Tj«xjrr#», proposes
to read irXitrtturxtTw^ probably following Pliny ;* but he has no
reason for doing so, for it is quite right as it stands, and is analo-
gous to the Greek compounds wXmtuku^wHj irA«rtt»«f^#$, Trxmro^vxxH^,
&c., and the leaves of the black hellebore have in reality thai
form.
156. Finally, that the plant of the ancients is indubitably the
same as our own is not less shewn by this, that Avicenna
describes the black hellebore of Dioscorides under the name of
(>^l (3j j^^ and that Forskal, an eye witness, testifies that
in the East the helleborus niger goes by the same name to this
day.^
157. "It grows,'* says Dioscorides, "in rough, elevated and
dry places, and that which grows in those places is esteemed
the best; such is the case with the black hellebore of Anticyra,*
and it is the best.'' He also praises that which grew in Helicon,
Parnassus, and Aetolia, but prefers the Heliconian. Theophras-
tus likewise prefers this to the others ; he mentions that it grows
also in Boeotia, in Euboea, and in many other places. Rufus'
' Petri Bellonii, Ohservat. sing, et memorab. rerum in Oraecia, Afia, dx^ per
Clusium, Antwerp, 1689-8.
* Jliif. plants ^h. x, cap. 11.
' See above where I have criticised the text of Theophrastus, in referenoe to
Teratrum album, g 24 — 27.
* " Platano similia" says Pliny, Hut.nat^ lib. xx>', sect. 21.
* See Mat. Med. Kahirina, in the Appendix to Detieript animalitan in itinert
onentaliy p. 152.
' Such is the character of the country about Anticyra, as described by Pausaniot^
(Oraeciae deter ., Hanovioc, 1613, p. 682): rh H Spn rd iirlp WvrU^pw vtr^iiSn n
ayf wrij Ktii iy avroi^ yvtrni ft'iXitrra o iX'^iStfitT' " "£»' ft**** l*-^"T '^^'i y«i«rr^i ira^jp«iiv,
<tc. Ainoiig^ US it uls4) grows in places similar to those described by Dioscorides and
Pausanius.
In Oribttsius, L c, p. 249.
ON THE HXLLSB0RI8H OF THE AN0IBKT8. 615
also oommends that which grew in Lycestes, and above the
Aflcanian marsh. ^
158. According to Dioscorides, the preferable roots are those
which have swollen and fleshy fibres, a small medulla, and an
acrid burning taste.
159. The ancients believed that it purged by stool without
difficulty the black and the yellow bile, as also the pituita,^ and
that it was also useful in intermittent fevers.' They gave it in
chronic and hemicranial headache, in mania,^ in melancholia,^
in dropsy without fever,* in epilepsy,' in paralysis,^ in long-
standing gout," in diseases of the joints," in inflammation of the
liver,*** in chronic jaundice," in old aftections of the trachea. '*'*
Aretaeus'3 gave black hellebore in oxymel at the commence-
ment of lethargy, in order to cause moderate purging.
160. K they wished to purge strongly, they administered u
drachm (=72 gr.) of the root, if mildly, three oboli,** (= thirty
six gr. or four oboli (= forty-eight gr.) either in melicrat or in
decoction of lentils, or in broth. They mingled with it scam-
mony or salt.*** Others gave two drachms of the powder of the
dry root by itself^ in sweet wine, or in oxymel, or in decoction
of lentils, or in ptisan, i« or in chicken broth, if they wished to
purge gently ; but if they wished to cause a severe purgation,
they gave one drachm of the root mixed with three oboli of
scammony."
161. It was used externally in obscuration of the eyes;** in
difficulty of hearing it was introduced into the ears and kept
there for two or three days ;^* it was applied to swellings on the
' Adtius, lib. iii, cap. 27. Freind {Histoire de la medecine, ii, p. 167) ia wrong iii
mying that Johannes Actuarius -was the first to allege that the hellebore (the black
one, tor it is this that Actuarius is speaking of in the place referred to) acts without
difficulty ; for none of the ancient physicians (if except that insignificant Arabinii
aathor, Ayenxoer) considered it dangerous.
• Aetius, L c.
' Rufcus L c.,p. 261 — A^ttus, Lc
• Dioscorides, lib. ir, cap. 151. — CcUus, lib. ii,cap. 12 : '^veratrum nigrum aut atra
bile vezatis, aut cum tri^tatia insanientibus, aut iis, quorum nervi parte aliqua resoluti
sont"
• Pliny, L c, lib. xxv. sect 22. — Actuarius, Method, medend, lib. t, cap. 8.
• Dioecor., 1. c. " Curat. Acut^ lib. i, cap. 2.
' Diosoor., L c — Pliny, 1. c " Diosicor., 1. c
• Pliny, L c. »• PUny, I. c.
• Dioscor., 1. c. — Pliny, La " Decoction of pearl-barley.
*• Com Celsus, l.c, lib. iv, cap. 8. " Rufu-*, 1. c. p 261.
" A«liu3 1. c. " Pliny, L c
" PUuliis AegTneta,lib. vii, cap. 4. " Diuscor, 1. c
616 XEDICAL mSTOBICAL DI88EBTATI0K.
neck;' it entered inlo the composition of an ointmenty with
which the parts affected with scabies were covered ;^ it was bj^
[died, mixed with vinegar, to vitiligo, impetigo, and lepra ;^ it
was boiled with vinegar to make a gargle for toothache ;* it was
applied to the abdomen of dropsical persons, made up with flour
and wine,^ and finally it was used externally for callous fistulous
openings for two or three days.®
162. The seed, which is a more violent purgative than the
root (and went by the name of sesamaidesy was given for the
same purposes, but in a smaller dose than two drachms, in
melicrat.®
168. The black hellebore, with which the ancient physioiana
cured many chronic diseases, has also &llen into disuse in our
times (or other plants have been substituted for it), although it
is certain that it is an excellent and highly estimable medicine,
if it be exactly suitable and appropriate to the disease for which
it is administered.
ANALYSIS
or TRB B88AT ON
THE HELLEBORISM OF THE ANCIENTS.
Introduction, § 1.
Earliest medicinal employment of hellebore, § 4.
From the description given by the ancients of the white hellebore, does it foUov
that it is the same plant as our yeratrum album f § 22.
The efifects of both are not only similar, but absolutely identical, § 34.
Pftrts of Greece wliere the best hellebore grew, § 45.
Signs of its good quality, § 49.
Medicinal uses of yeratrum album, § 68.
Of the lesser treatment with yeratrum album, without preparatory treatmeni of
the patient^ § S6.
Helleborism, § 69.
When helleborism began to be practised, and how long its use was oootiDiied,
§72.
Of the seasons of the year, the diseases and the subjects to which th« ancients cou-
Hidered helleborism suitable or unsuitable, § 91.
Preparatory treatment for helleboriam, § 99.
Mode of exhibiting the yeratrum album for the purpose of inducing hclleborismf
§104.
* Pliny, L c. • Dioscor, L c.
* Dioscor^ L c • Dioscor., L c — Galen, L c.
* Dioscor., I c. ' See aboye, note to g 116.
* Dioscor, L c— Pliny 1. c.-^alen, Dt * Rufus, L c, p. 251.
Simpl. med/ae., lib. yl
HOH(EOPATHIC DOCTBINE OF MEBICIKE. 617
SnbBtanoeB tbat were mixed with the yeratrum ; sesamoides, § 112.
Eegimen to be employed to assist the emetic action of the yeratmm album, § 119*
Reme&8 employed in cases where the yomitiog did not take place properly, § 186.
T^«tttmflBt ot the b^ and seriouB symptoms occasioned by the action of veratnln,
|1«L
Condaabn, § 144.
Of the black hellebore, g 149.
SPffilT OF THE HOM(EOPATHIC DOCTRINE OF MEDICINE. '
It is impossible to divine the internal essential nature of dis-
eases and the changes they effect in the hidden parts of the body«
and it is absurd to frame a system of treatment on such hypo-
thetical surmises and assumptions : it is impossible to divine the
medicinal properties of remedies from any chemical theories ox
from their smell, colour or taste, and it is absurd to attempt,
from such hypothetical surmises and assumptions, to apply to
the treatment of diseases these substances, which are so hurtful
when wrongly administered. And even were such practice ever
80 customary and ever so generally in use, were it even the only
one in vogue for thousands of years, it would nevertheless continue
to be a senseless and pernicious practice to found on empty sur-
mises an idea of the morbid condition of the interior, and to attempt
to combat this with equally imaginary properties of medicines.
Appreciable, distinctly appreciable to our senses must that be,
which is to be removed in each disease in order to transform it-
into health, and ^ght clearly must each remedy express what it
can positively cure, if medical art shall cease to be a wanton
game of hazard with human life, and shaU commence to be the
sure deliverer from diseases.
I shall show what there is undeniably curable in diseases, and
how the curative properties of medicines are to be distinctly
perceived and applied to treatment.
^p ^p ^p ^p
What life is can only be known empirically from its phenomena
and manifestations, but no conception of it can be formed by any^
metaphysical speculations a priori; what life is, in its actual es*
sential nature, can never be ascertained nor even guessed at, by
mortals.
~ ... -
> This eesay appeared in a journal twenty years ago, in those momentous days
(March 1813) when the Germans had no leisure to read and still less to reflect upon
scientific matters. The consequence of this was that these words were not listened
ta It may now have more chance of being perused, particularly in its present len
hnperfect form. i^Reine Artneimittdlekre, 2terThL 1838.)
618 SPIRIT OF THK
To the explanation of human life, as also its two-fold oonditionSi
health and disease, the principles by which we explain other
phenomena are quite inapplicable. With nought in the woild
can we compare it save with itself alone ; neither with a piece
of clockwork nor with an hydraulic machine, nor with chemical
processes, nor with decompositions and recpmpositions of gaaea,
nor yet with a galvanic battery, in short with nothing destitute of
life. Human life is in no respect regulated by purely physical laws,
which only obtain among inorganic substances. The material sub*
stances ofwhich the human organism is composed no longer follow,
in this vital combination, the laws to which material substances
in the inanimate condition are subject ; they are regulated by the
laws peculiar to vitality alone, they are themselves animated
just as the whole system is animated. Here a nameless funda-
mental power reigns omnipotent, which suspends all the tendency
of the component parts of the body to obey the laws of gravitt^
tion, of momentum, of the vis inerticBf of fermentation, of putre^
fection, &c., and brings them under the wonderful laws of life
alone, — in other words, maintains them in the condition of sensi'
biliiy and activity necessary to the preservation of the living whole^
a condition almost spiritually dynamic.
Now as the condition of the organism and its healthy state
depend solely on the state of the life which animates it, in like
manner it follows that the altered state, which we term disease,
consists in a condition altered originally only in its vital sensibi-
lities and functions, irrespective of all chemical or mechanical
principles ; in short it must consist in an altered dynamical con-
dition, a changed mode of being, whereby a change in the pro-
perties of the material component parts of the body is afterwards
effected, which is a necessary consequence of the morbidly altered
condition of the living whole in every individual case.
Moreover the influence of morbific injurious agencies, which
for the most part excite from without the various maladies in
us, is generally so invisible and so immaterial, * that it is im-
'possible that it can immediately either mechanically disturb or
derange the component parts of our body in their arrangement
and substance, or infuse any pernicious acrid fluid into our blood*
vessels whereby the mass of our humours can be chemically al-
tered and destroyed — an inadmissible, improbable, gross in-
' With the exception of a few surreal affections and the disagreeable effeeti
produced by indigestible foreign substances, which sometiiues find their way into
the intestinal canal
HOX(EOPATHIO DOCTBINE OF MEDICINE. 619
rention of mechanical minds. The exciting causes of disease
lather act bj means of their special properties on the state of our
life (on our health), only in a dynamic manner, very similar to a
apiritual manner, and inasmuch as they first derange the organs
of the higher rank and of the vital force, there occurs fix)m this
state of derangement, from this dynamic alteration of the living
whole, an altered sensation (uneasinesJ^ pains) and an altered
activity (abnormal functions) of each individual organ and of all
of them collectively, whereby there must also of necessity second-
arily occur alteration of the juices in our vessels and secretion
of abnormal matters, the inevitable consequence of the altered
vital character, which now differs from the healthy state.
These abnormal matters that shew themselves in diseases are
consequently merely products of the disease itself, which, as
long as the malady retains its present character, must of necessity
be secreted, and thus constitute a portion of the morbid signs
(symptoms) ; they are merely effects, and therefore manifestations
of the existing internal ill-health, and they do certainly not react
(although they often contain the infecting principle for other,
healthy individuals) upon the diseased body that produced them,
as disease-exciting or maintaining substances, that is, as material
morbific causes,^ just as a person cannot infect other parts of his
own body at the same time with the virus from his own chancre
or with the gonorrhoeal matter from his own urethra, or increase
his disease therewith, or as a viper cannot inflict on itself a fatal
bite with its own poison.^
Hence it i3 obvious that the diseases excited by the dynamic
and special influence of morbific injurious agents can be origin-
ally only dynamical (caused almost solely by a spiritual process)
derangements of the vital character of our organism.^
^ Hence by clearing away and mechanically removing these abnormal matters
acridities and morbid organizations, their source, the disease itself, can just as little
be cured as a curyza can be shortened or cured by blowing the nose frequently, as
frequently as possible ; it lasts not a day longer than its proper course, although the
nose should not be cleansed by blowing it at alL
* [These statements are not strictly correct, at least as regards the chancrous and
gonorrhoeal matters, for it is well known that chancres may be produced on different
pirts of the body of an individual by inoculation from his own chancre, and the
gononrhceal process may be excited in the eye by the incautious application of the
discharge to that organ by the patient himself]
* [Unfortunately for this vital or dynamic theory of Hahnemann, the examples he
has cited absolutely dUprove his position in regard to dynamic or spiritual causes of
disease. Since this essay was written, Ricord has immortalized himself by demon-
strating that the virus of chancres and the matter of gonorrhceas, are both capable of
620 SPIRIT OF TH8
We readily perceive that these dynamic derangements ot the
vital character of our organism which we term diseases, since
they are nothing else than altered sensations and functions, can
also express themselves by nothing but by an aggregate of
symptoms, and only as such are they cognizable to our observ-
ing powers.
Now as in a profession of such importance to human life as
medicine is, nothing but the state of the diseased body plainly
cognizable by our perceptive faculties can be recognized as the
object to be cured, and ought to guide our steps (to chose con-
jectures and undemonstrable hypotheses as our guide would be
dangerous folly, nay, crime and treason against humanity), it
follows, that since diseases, as dynamic derangements of the
vital character, express themselves solely by alterations of
the sensations and functions of our organism, that is, sohly by an
aggregate of cognizable symptoms, this alone can be the objed
of treatment in every case of disease. For on the removal of aU
morbid symptoms nothing remains bid health.
Now b€K^use diseases are only dynamic derangements of
our health and vital character, they cannot be removed by man
otherwise than by means of agents and powers which also are
capable of producing dynamical derangements of the human
health, that is to say, diseases are cured virtually and dynamically
by medicines.*
reacting, and of reproducing the^ diseasea upon the bodies from whence thej M
taken. It is now a general practice among surgeons, when a suspicioos ulcer is pr»
sented to them, to innoculate another part of the same individual with the matter, lor
the purpose of ascertainbg whether a chancre can be reproduced. This test is now
deemed conclusive. In these instances, surely no dynamic or spiritual influences cio
be recognized as causes of the maladies under consideration, but manifestly the o^
tual contact of morbid material substances with other healthy material stmctmnaiL
We cannot, therefore, with any degree of propriety term these causes or their efieete
upon the organism, either dynamic or vital Hahnemann labours under a nmilar er-
ror, in regard to the bites of vipers, as it is well known at present, that when rerf
much emraged, certain reptiles destroy themselves by their own bitesw] Am. P.
' Not by means of the pretended solvent or medianically dispersing, dearing-oal^
and expulsive powers of medicinal substances, not by means of a (bkx>d-p>iirifyiii|{^
homour-correcting) power they possess of electively excreting fimded morbific prio-
ries, not by means of any antiseptic power they contain (as is effected in dead, pa*
trifying flesh), not by any chemical or physical action of any other imaginable sort, m
happens in dead material things, as has hitherto been fidsely imagined and dreamt faj
the various medical schools.
The more modem schools have indeed begun m some degree to regard diseases aa
dynamic derangements, and also intended in a certain manner to remove them dyna>
mically by medicines, but inasmuch as they have failed to perceive that the senaibie,
and reproductive acthrify of life is ta modo et qualitate sosceptible of an
HOM(EOFATHI0 DOCTRIKB OF MEDICINE. 621
These active substances and powers (medicines) which we
have at oxir service, eflFect the cure of diseaj&es by means of the
same dynamic power of altering the actual state of health, by
means of the same power of deranging the vital character of
our organism in respect of its sensations and ftmctions, by which
they are able to effect also the healthy individual, to produce in
him dynamic changes and certain morbid symptoms, the know-
ledge of which, as we shall see, affords us the most trustworthy
information concerning the morbid states that can be most cer-
tainly cured by each particular medicine. Hence nothing in
the world can accomplish a cure, no substance, no power effect
a change in the human organism of such a character as that the
disease shall yield to it, except an agent capable of absolutely
(dynamically) deranging the human health, consequently also
of morbidly altering its healthy state.*
On the other hand, however, there is also no agent, no power
m nature capable of morbidly affecting the healthy individual,
which does not at the same time possess the faculty of curing
certain morbid states.
Now, as the power of curing diseases, as also of morbidly
affecting the healthy, is met with in inseparable combination in
all medicines, and as both these properties evidently spring from
one and the same source, namely from their power of dynami-
cally deranging human health, and as it is hence impossible
that they can act according to a different inherent natural law
in the sick to that according to which they act on the healthy,
it follows that it must be the same power of the medicine that
Qures the disease in the sick as gives rise to the morbid symp-
toms in the healthy.*
Hence also we shall find that the curative potency of medi-
cines, and that which each of them is able to effect in diseases,
expresses itself in the other mode in the world so surely and
palpably, and cannot be ascertained by us by any purer and
nitj of changes, and to regard the iimumerable yarieties of morbid Bigns that (infinity
of internal alterations only cognizable by us in their reflex) for what they actually are,
the only undeceptive object for treatment, but as they only hypothetiodly recogniie
an abnormal increase and decrease of their dimensions quoad quantitatem, and in an
eqvalljf arbitrary manner confide to the medicines they employ the task of changing
to the normal state this one-sided increase and decrease, and thereby curing them ;
they thus have before their view nothing but chimeras, both of the object to be cured
and of the action of the medicine.
* Ckxisequenily no substance, for example, that is purely nutritious. ,
* The different result in those two cases b owing solely to the differeooe of thft ob-
ject that has to be altered.
628 SPIRIT OF THS
more perfect manner than by the morbid phenomena and symp-
toms (the kinds of artificial diseases) which the medidnes deve*
lop in the healthy individuals. For if we only have before us a
register of the peculiar (artificial) morbid symptoms produced
by the various medicines on healthy individuals, we only require
a series of pure experiments to decide what medicinal symptoms
will always rapidly and permanently cure and remove oertain
symptoms of disease, in order to know, in every case beforehand|
which of all the difierent medicines known and thoroughly
tested as to their peculiar symptoms must be the most certain re-
medy in every case of disease.*
' Simple, true and natural as tbts maxim is, so much so that one Would have ii
gmed it would long since have been adopted as the rule finr ascertaining the curatif*
powers of drugs, it is yet a &ct that it has hitherto been far from being reoogniiedL
During the many thousands of years over which history extends^ no one fell upoD
this natural method of ascertaining the curative powers of medicine a priori and b«*
fore their application to diseases. In all ages up to the present times ii was nm^
gined that the curative powers of medicines could be learned in no other way thaa
from the result of their employment in diseases themselves (ab uiu in morfrti); it
was sought to learn them from those cases where a oertain medicine (more fireqaeatlf
a combination of various medicines) had been found serviceable in a particalar am
of disease. But even from the efficacious result of one single medicine given in hi
accurately described case of disease (which was rarely done), we never can know tht
case in which that medicine would again prove serviceable, because (with the ex-
ception-of diseases caused by miasms of a fixed character, as small-pox, meaalet,
syphilis, itch, <&&, and those arising fix>m various injurious agencies that always le*
main the same, as rheumatic gautf (be), all other cases of disease are mere individo-
alities, that is to say, all present themselves in nature with different oombinatioos of
symptoms, have never before occurred, and can never again occur in exactly the same
manner ; consequently a remedy in one case can never allow us to infer its efficaej
in another (different) case. The forced arrangement of these cases of disease (whidi
nature in her wisdom produces in endless variety) under certain nosological heads^ m
is arbitrarily done by pathology, is a human performance without reaUty, which leads
to constant fallacies and to the confounding together of very different states.
Equally deceptive and untrustworthy, although in all ages generally introduced, it
the determination of the general (curative) actions of medicines from special
in diseases, where in the materia medica — when, for example, here and there, in
cases of disease during the use of a medicine (generally mixed up with othefs)
there occurred a more copious secretion of urine, perspiration, the irruption of the
catamenia, cessation of convulsions, a kind of sleep, expectoration, Ac^ — the medi-
cine (on which was conferred the honour of having ascribed to it more than to tha
others in the mixture the effect produced) was instantly elevated to the rank of a diu-
retic, a diaphoretic, an emmenagogue, an antispasmodic, a soporific, an expectoraal^
and thereby not only was a fiEdlacium causffi committed by confounding the word
during with 6y, but quite a false conclusion was drawn a partimlari ad univertaUfkk
opposition to all the laws of reason, and indeed the oooditiunul was mode unoondi-
tiouaL For a subfttance that does not in every cose of disease promote urine and per-
spiration, that does not in every instance bring on the catenieuia and sleep, that does
not subdue all convulsions, and cause every cough to come to expectoratioD, canDot
HOH(EOPATHIG DOCTRINE OF MEDICINE. 623
If then we ask experience what artificial diseases (observed
to be produced by medicines) can be beneficially employed
against, certain natural morbid states ; if we ask it whether the
ehange to health (cure) may be expected to ensue most certainly
and in the most permanent manner :
1. by the use of such medicines as are capable of producing in
the healthy body a different (allopathic) affection from that ex-
hibited by the disease to be cured,
2. or by the employment of such as are capable of exciting in
the healthy individual an opposite (enantiopathic, antipathic) state
to that of the case to be cured,
S. or by the adminstration of such medicines as can cause a
rimHar (homoeopathic) state to the natural disease before us (for
these are the only three possible modes of employing them), ex-
perience speaks indubitably for the last method.
But it is moreover self-evident that medicines which act fie-
krogeneously and aUopaihically^ which tend to develop in the
healthy subject different symptoms from those presented by the
disease to be cured, from the very nature of things can never
be suitable and ef&cacious in this case, but they must act awry,
otherwise every disease must necessarily be cured in a rapid,
certain and permanent manner by any medicine whatsoever, be
its action ever so different Now as every medicine possesses an
action different from that of every other, and as, according to
eternal natural laws, every disease causes a derangement of the
human health different from that caused by all other diseases,
this proposition contains a self-evident contradiction {contradic-
ti> in adJ€cto\ and is self-demonstrative of the impossibility oi a
good result, since every given change can only be effected
by an adequate cause, but not per quamlibet cati^am. And
daily experience also proves that the ordinary practice of
prescribing complex recipes containing a variety of unknown
medicines in diseases, does indeed do many things, but very
rarely cures.
The second mode of treating diseases by medicines is the
employment of an agent capable of altering the existing derange-
ment of the health (the disease, or most prominent morbid
be said bj a penwn of sound reason to be unconditioually and absolutely diuretic
diaphoretic, emmenagogue, soporific, antispasmodic, and expectorant ? Indeed it ia
impoesible that in the complex phenomena of our health, in the multifarious combina-
tkxis of different symptoms presented by tlie inuuaierablo varieties of human dis-
eases, the employment of a roiuedy cou exhibit it^ pure, origitiaL medicinal eticct, and
eXMctly thodo derangements of oar healtli that we might expect Croiu it. These cai»
unly b shewn by meilicines given to persons m licalth.
624 8PIBIT OF THE
symptom) in an enantiopathic^ antipathic^ or contrary manner (a
medicine employed paUiatively). Such an employment, as will
be readily seen, cannot affect a permanent cure of the diseasei
because the malady must soon afterwards recur, and that in an
aggravated degree. The process that takes place is as follows:
According to a wonderful provision of nature, organized living
beings are not . regulated by the laws of imorganized (dead)
physical matter, they do not receive the influence of external
agents, like the latter, in a passive manner, but strive to oppose
a contrary action to them.* The living human body does* indeed
allow itself to be in the first instance changed by the action of
physical agents; but this change is not in it as in inorganic
substances, permanent ( — as it ought necessarily to be if the
medicinal agent acting in a contrary manner to the disease should
have a permanent effect, and be of durable benefit — ) : on the
contrary, the living human organism strives to develop by
antagonism,^ the exact opposite of the affection first produced in
it from without, — as for instance, a hand kept long enough in
ice-cold water, after being \idthdrawn does not remain cold, nor
' The expressed, green juice of plants, which is in that state do longer living,
spread upon linen cloth and exposed to tlie sun^s light, soon loses its ooloor and
becomes completely decomposed, whereas the living plant that has been kept in a
cellar deprived of light and thereby blenched, soon recovers its full green odoa^
when exposed to the same sun's light A root dug up and dried (dead), if buried in
a warm and damp soil, rapidly undergoes complete decomposition and destmckiaB^
whilst a living root in the same warm damp soil sends forth gay sprouts — Foaming
malt-beer in full fermentation rapidly turns to vinegar when exposed to a tempem-
ture of 96° Falir. in a vessel, but in the healthy human stomach at the same tempera,
ture the fermentation ceases, and it soon becomes conrerted into a mild notritioQi
juice. — Half-decomposed and stroog^melling game, as also beef and other flesh meMt^
partaken of by a healthy individual, furnish excrement with the least amount of
odour ; whereas dnchona-bark, which is calculated powerfully to check deoompon-
(ion in lifeless animal substances, is acted against by the intestines in sudi a "i^im^
tiiat the most fetid flatus is developed. — Mild carbonate of lime removes aU adds
firom inorganic matter, but when taken into the healthy stomach soar perBpiratko
usually ensues. — Whilst the dead animal fibre is preserved by nothing more certainly
and powerfully than by tannin, clean ulcers in a living individual, when tbej are
frequently dressed with tannin, become unclean, green and putrid. A band plunged
into warm water becomes subsequently colder than the hand that has not beeo m
treated, and it becomes colder in proportion as the water was hotter.
* This is the law of nature, in obedience to which, the employment of every medi-
cine produces at first certain dynamic changes and morbid symptoms in the 1Mb%
human body {primary or Jir$t action of the medicinet)^ but on the other hand, bj
means of a peculiar antagonism (which may in many instances be termed the sdl^
sustaining effort), produces a state the very opposite of the first (the weamdarf or
a/tfr action), as for instance, in the case of narcotic substances, insenaibililj is
produced in the primary action, sensitiveness to pain in the seooodary.
HOXCBOPATHIO DOOTRmS OF HEDICINS. 626
merely assume the temperature of the surrounding atmosplierei
as a stone (dead) ball would do, or even resume the temperature
of the rest of the body, no ! the colder the water of the bath was,
and the longer it acted on the healthy skin of the hand, the
more inflamed and hotter does the latter afterwards become.
Therefore it cannot but happen that a medicine having an
action opposite to the symptoms of the disease, will reverse the
morbid symptoms for but a very short time,^ but must soon give
place to Ae antagonism pervading the living body, which pro-
duces an opposite state, that is to say, a state the direct contrary
of that transient delusive state of the health effected by the
palliative (one corresponding to the original malady), which
constitutes an actual addition to the now recurring, uneradicated,
primary affection, and is consequently an increased degree of
the original disease. And thus the malady is always certainly
aggravated after the palliative— -the medicine that acts in an
opposite and enantiopathic manner — ^has exhausted its action.''
In chronic diseases, — the true touch-stone of a genuine healing
ait, — ^the injurious character of the antagonistically-acting
(palliative) remedy oft;en displays itself in a high degree, since
fix>m its repeated exhibition in order that it should merely
produce its delusive effect (a very transient semblance of health)
it must be administered in larger and ever larger doses, which
are oft;en productive of serious danger to life, or even of actual
death.'
There remains therefore, only a third mode of employing
medicines in order to effect a really beneficial result, to wit, by
* At A burnt hand remains cold and painless not much longer than whilst it remains
in the oold water, hut afterwards feels the pain of the bum much more severely.
' * llias the pain of a burnt hand is subdued by cold water quickly, it is true, but
only lor a few minutes, afterwards however, the pain of the bum and the inflamma-
tion become worse than they were previously (the inflammation or secondary action
of the cold water makes an addition to the original inflaonmation of the bum, which
is not to be eradicated by cold water). Tlie troublesome fulness of the abdomen in
Cises of habitual constipation, appears to be removed, as if magicaUy, by the action
of a purgative, but the very next day the painful fulness returns together with the
cooiAtpation, and becomes worse afterwards than before. The stupified sleep caused
bj opimn is succeeded by a more sleepless night than ever. — But that the state that
•obeeqoently oocors is a true aggravation, is rendered evident by this, that if we
again to employ the palliative {e, g, opium for habitual sleeplessness or chronie
of the bowels), it must be given in a stronger dose, €u if for a more severe
in order that it should produce its delusive amelioration for even as short a
period as before.
* Ab for instance, where opium b repeated ki always stronger doses for the sup-
of urgent symptoms of a chronic disease.
40
^26 SFIBIT OF THB
employing in every case sucli a one as tends to excite of itself
an artificial, morbid affection in the organism similar (homoeo-
pathic), best if very similar^ to the actual case of disease.
That this mode of employing medicines is and must of neces-
sity be the only best method, can easily be proved by reasoning,
as it has also already been confirmed both by innumerable
experiences of physicians who practise according to my doctrines,
and by ordinary experience.'
It will, therefore, not be difficult to perceive what are the
laws of nature according to which the only appropriate cure of
diseases, the homoeopathic, -takes place, and must necessarily
take place.
' I may adduce merely a few examples from daily ezperience ; thus, the buraiii^
pain produced by the contact of bofling water on the akin, is orerpowered Hid
destroyed, as in the case of cooks by approaching the moderately burnt hand to tht
fire, or by bathing it uninterruptedly with heated alcohol (or turpentine), wfakfa
causes a still more intense burning sensatioa This infidlihle mode of treatment b
practised and found to be corroborated by yamishers and others engaged in flimilar
occupations. The burning pain produced by these strong spirits and their dented
temperature, then remains dhne present, and that for but a few minutes^ whUst tht
^xganism, honuBopathically freed by them from the inflammation occasioiied by tht
bum, soon restores the injury of the skin and forms a new epidermis throQgfa which
the spirit can no longer penetrate. And thus, in the cowm of a few Aovrs, the injoij
caused by the bum is cured by a remedy that occasions a similar burning pain
(heated fdcohol or turpentine), whereas if treated with the ordinary cooling paUiatiire
remedies and salves, it is transformed into a bad ulcer and usually cootinuea to
suppurate for many weeks or months with great pain. Practised dancers know from
old experience that those who are extremely heated by dancing are very modi
relieved for the first moment by stripping themselves and drinking very oM water,
but thereafter infallibly incur a fiital disease, and they do not allow persons exoesaTely
heated to cool themselves by exposive to the open air or by taking off their clntfvet,
but wisely administer a liquor whose nature is to heat the blood, such as punch or
hot tea mixed with rum or arrack, and in this manner, walking at the same tune
gently up and down the room, they rapidly lose the violent febrile state indcioed by
the dance. In like manner no old experienced reaper, after inordinate exertion in
the heat of the sun, would drink anything in order to cool himself bat a glass of
brandy ; and before an hour has elapsed, his thirst and heat are gone and he fe^
quite well Ko experienced person would put a frost-bitten limb into warm water,
or seek to restore it by approaching it to the fire or a heated stove ; a]>|dyii^ to it
snow, or robbing it with ice-cold water, is the well-known homoBopathic remedy for
it. The illness occasioned by excessive joy (Cwtastic gaiety, trembling rnntlfinwuisi
and uneasiness, palpitation of the heart, sleeplessness) is rapidly and permanent^
removed by coffee, which causes a similar morbid affection in persons unaocnstomed
to its use. And in like manner there are many daily-occurring oonfirmatiaDs of the
great truth, that nature intends that men should be cured of their loDg^atanding
diseases by means of similar affections of short duration. Nations, fior centuries
sunk in listless apathy and serfdom, raised their spirit^ felt their dignity as men, and
again became free, after having been ignominiously trodden in the dust 1^ the western
tyrant
HOHCBOFATHIC DOCTRINE OF ICEDICINE. 027
The first of these xmmistakeable laws of nature is : the living
crganiam is incomparably less capable of being affected by natural
diseaaeSj than by medicines.
A multitude of disease-exciting causes act daily and hourly
upon us, but they are incapable of deranging the equilibrium of
the health, or of making the healthy sick ; the activity of the
life-susiaining power within us usually withstands the most of
them, the individual remains healthy. It is only when these
external inimical agencies assail us in a very aggravated degree,
and we are especially exposed to their influence, that we get ill,
but even then we only become seriously ill when our organism
has a particularly affectable, weak side (predisposition), that
makes it more disposed to be aflFected by the (simple or com-
pound) morbific cause in question, and to be deranged in its
bealth*
If the inimical agents in nature that are partly physical and
partly psychical, which are termed morbific injurious agents,
possessed an xmconditional power of deranging the human
health, they would, as they are universally distributed, not leave
any one in good health ; every one would become ill, and we
should never be able to obtain an idea of health. But as, taken
on the whole, diseases are only exceptional states of the human
health, and it is necessary that such a number of circumstances
and conditions, both as regards the morbific agents and the
individual to be affected with disease, should conjoin before a
disease is produced by its exciting causes, it follows, that t/he
individual is so little liable to be affected by such injurious agencies^
that they can never unconditionally make him ill, and that the human
organism is capable of being deranged to disease by them only by
means of a particular predisposition?
But it is far otherwise with the artificial dynamic agents
which we term medicines. Every true medicine, namely, acts
at aU times, under all circumstances, on every living, animated
body, and excites in it the symptoms peculiar to it (even in a
perceptible form if the dose be large enough) so that evidently
every living human organism must always and inevitably be affect^
by Uie medicinal disease and infected so to speak, which, as Ls well
loiown, is not the case with respect to medicines.^
* [Inniimerable £Eu;t8, of daily occurrence, eatablish the truth of this important
remark.] — Am. P.
* Even the pestilential diseaAes do not effect every one uncooditiooally, and the
oiber dJaeates leave many more individuals unaffected, even when all are exposed to
828 SPIBIT OF THE
All experienoe proves incontestablj, that the human body is
much more apt and disposed to be affected bj mediciDal agents
and to have its health deranged by them, than by the m<MrlHfic
injurious agencies and contagious miasms, or, what is the same
tMng, that the medicinal powers possess an absolute power of
deranging human health, whereas the morbific agencies possess
only a very conditional power, vastly inferior to the former.
To this circumstance is owing the possibility of the core of
diseases by medicines generally (that is to say, we see, that in
the diseased organism the morbid afiection may be eflbced, if it
be subjected to the appropriate alteration by means of medicine) ;
but in order that the cure should take place, the second natural
law should also be fulfilled, to wit, a stronger dynamic affection
permanently extinguishes the weaker in tfie living organising provid-
ed the former be similar in kind to the latter ; for the dynamic
alteration of the health to be anticipated fix>m the medicine
should, as I think I have proved, neither differ in kind from or be
allopathic to the morbid derangement, in order that, as happens
in the ordinary mode of practice, a still greater derangement
may not ensue, nor should it be opposite to it, in order that a
merely palliative delusive amelioration may not ensue, to be
followed by an inevitable aggravation of the original malady,
but the medicine must have been proved by observations to
possess the tendency to develop of itself a state of health similar
to the disease (be able to excite similar symptoms in the healthy
body), in order to be a remedy of permanent efficacy.
Now, as the dynamic affections of the organism (caused by
disease or by medicine) are only cognizable by the phenomena
of altered function and altered sensation, and consequently the
similarity of its dynamic affections to one another can only ex-
press themselves by similarity of symptoms ; but as the organism
(as being much more liable to be deranged by medicine than by
disease) must be more susceptible to the medicinal affection, that
is to say, must be more disposed to allow itself to be influenced
and deranged by medicine than by the similar morbid affection,
it follows undeniably, that it will be freed from the morbid
affection if we allow a medicine to act on it, which, while differ-
ing* in its nature from the disease, resembles it very closely in
changes of the weather, the eeasons, and to the infloeiioes of many other n^oriooi im-
' Without this diflerenoe in the nature of the morbid wffwtwn from tiMt of the
medkinal affection, a core were impo«ihle; if the two were noi marelj of a nmilar.
HOHCBOPATHIC DOCTBINE OF MIDICIKS. 629
fflxnilaiity of symptoms, that is to say, is homoeopathic ; for the
organism, as a living, individual unity, cannot receive two simi-
lar dynamic affections at the same time, without the weaker
yielding to the stronger similar one, consequently, as it is more
disposed to be more strongly affected by the one (the medicinal
affection), the other, similar, weaker one (the morbid affection)
must necessarily give way, whereupon it is cured.
Let it not be imagined that the living organism, if a new
similar affection be communited to it when diseased by a dose
of homoeopathic medicine, will be thereby more seriously de«
ranged, that is, burdened with an addition to its sufferings, just
as a leaden plate already pressed upon by an iron weight is still
more severely bruised by placing a stone in addition upon if, or
a piece of copper heated by friction must become still hotter by
pouring on it water at a more elevated temperature. No, our
living organism does not behave passively, it is not regulated by
the laws that govern dead matter ; it reacts by vital antagonism,
BO as to surrender itself as an individual living whole to its
morbid derangement, and to allow that to be extinguished
widiin it, when a stronger affection of a similar kind, produced
in it by homoeopathic medicine, takes possession of it.
Such a spiritually reacting being is our living, human organ-
ism, which with automatic power expels from itself a weaker
derangement (disease), whenever the stronger power of the
homoeopathic medicine produces in it another but very similar
a£Eection, or in other words, which, on account of the unity of
its life, cannot suffer at the same time from two similar general
derangements, but must discard the primary dynamic affection
(disease), whenever it is acted on by a second dynamic power
(medicine) more capable of deranging it, that has- a great resem-
blance to the former in its power of affecting the health (its
^mptoms). Something similar takes place in the human mind.*
bat of the same nature, consequently identical, then no result (or only an aggravation
of the malady) would ensue ; as for example, if we were to touch a chancre with other
dHUiGroiiB poison, a cure would never result therefrom.
' For example : a girl plunged into grief by the death of her companion, if taken
to tee a &mily where the poor, half-naked children have just lost their fiither, their
fole BOpport, does not become more sorrowful from witnessing this touching scene, but
k thereby consoled for her own smaller misfortune ; she is cured of her grief for her
friend, because the unity of her mind cannot be affected by two similar passions at
oooe, and the one passion must be extinguished when a nmilar but stronger passion
takes possession of her mind, and acts as a homoeopathic remedy in extinguishing
the first But the girl would not be tranquillixcd and cured of her grief for the loss
of her companion, if her mother were angrily to scold her (heteroyencnous, allopatbic^
630 SPIRIT OF THE
But as the human organism even in health is more capable of
being affected by medicine than by disease, as I have shewn
above, so when it is diseased, it is beyond comparison more
affectable by homceopathic medicine than by any other (whether
allopathic or enantiopathic), and indeed it is affectahle m the
highest degree^ since, as it is ali^eady disposed and excited by the
disease to certain symptoms, it most now be more liable to be
deranged to similar symptoms (by the homoeopathic mediciiie)
— just as similar mental affections render the mind much more
sensitive to similar emotions — ; hence only the smallest dose of
them is necessary and vseful for their core, for altering the dia-
eased organism into the similar medicinal disease, and a greater
one is not necessary on this aocoimt also, because the spiiitoal
power of the medicine does not in this instance accomplish its
object by means of quantity, but by potentiality and quality
(dynamic fitness, homoeopathy), — ^and it is not useful that it
should be greater^ but on the contrary injurious^ because whilst
the larger dose, on the one hand, does not dynamically over-
power the morbid affection more certainly than the smallest
dose of the most appropriate medicine, on the other hand it im*
poses a complex medicinal disease in its place, which is always
a malady, though it runs its course in a shorter time.
Hence the organism will be powerfully atfected and possessed
by the potency of even a very small dose of a medicinal sub-
stance, which, by its tendency to excite similar symptoms, can
outweigh and extinguish the totality of the symptoms of the
disease ; it becomes, as I have said, free troxn the morbid affec-
tion at the very instant that it is taken possession of by the
medicinal affection, by which it is immeasurably more liable to
be altered.
Now as medicinal agents do of themselves, even in larger
doses, only keep the healthy organism for a few days under
their influence, it will readily be conceived that a small dose,
agency), but on the contrary, her mind would be still more distresaed by thb atta^
of grief of another kind ; and in like manner the sorrowing girl, if we were to euae
an apparent but only palliative alleviation of her grieC by means of a gay entertam-
ment, would subsequently in her solitude sink into still more profound sadneat^ and
would weep much more inteasely than previously for the death of her friend (becaow
this affection would here be only of an opposite, enantiopathic character).
And as it is here in psychical life, so it is in the fiirmer case in organic life. Tlie
unity of our life cannot occupy itself with, and take in two general dynamic afiectiooi
of the same kind at once ; for if the (>ocond be a similar one, the first is displaced by
it, whenever the organism is more affected by the last
HOH(BOFATHIO DOOTRIKS OF MSDICINS. 681
and in acute diseases a yery small dose of them (sncli as they
must evidently be in homoeopathic treatment), can. only affect
the system for a short time, the smallest doses however, in
acute diseases, only for a few hours, for then the medicinal
affection substituted for the disease passes unobservedly and
very rapidly into pure health.
The nature of living organisms seems not to act otherwise in
the permanent cure of diseases by means of medicines than in
aooordance with these, its manifest laws, and thus indeed it acts,
if we may use the expression, according to mathematical laws.
T^hen is no case of dynamic disease in Ae world (excepting the
deadi struggle, and when it comes under this category, extreme
old age and the destruction of some indispensable viscus or
member), whose symptoms can be met toith in great similarity
among the positive effects of a medicine, which will not be rapidly
and permanently cured by this medicine. The diseased individual
ean be freed from his malady in no more easy, rapid, certain,
reliable and permanent manner, by any conceivable mode of
Heatment,' than by means of the homoeopathic medicine in a
small dose.
TREATMENT OF THE TYPHUS OR HOSPITAL FEVER AT
PRESENT PREVAILING.^
As all ordinary modes of treatment with emetics, blood-let-
ting, acetate of ammonia, elder-flower tea, juniper juice, cold
and warm baths, naphtha, musk, opium, camphor and cinchona
bark did so much havoc in this disease, and the somewhat more
appropriate remedies, chamomile, serpentaria, valerian, and mu»
riatic acid were but indifferent comforters, moved by purely
' Byen those strikiDg cures occurring in rare instances in ordinaiy practice take
place only by means of a homoBopathically appropriate medicine, which forms the
chief agent in the receipt, into which it may have been accidentally introduced. Fhy-
•idauB hitherto could not have ekoten the medicines homoeopathically for diseases, tm
IIm positive effects of the medicines (those resulting from their administnition to
healthy persons) have not been investigated by them, and accordingly remain un-
Imown to them ; and even those which have been known otherwise than by my wri*
tingB, were not regarded by them as serviceable for treatment, — and moreover, the
relation of the effects of medicines to the symptoms of the disease they resemble (Uie
homoeopathic law of cure), which is requisite in order lo effect radical cures, was un-
known to them.
* From the Allgem. Anzeig. der Leuttehen, No. 6, 1814.
882 TBBATKBier OF THE TYPHUS
philanthropic motiyeS) I here propose an efficacious mode of
treatment, in order to preserve perhaps from death by this pes-
tilence the remaining victims, if ordinary prejudices do not pre-
vent its employment.
This fever has two principal stages. In the first period (which
is all the shorter the worse the disease is to be) there are pre-
sent, full, increased sensation of the pains usually present, with
intolerable bad humour, sensation of heat in the body, and espe-
cially in the head, dry feeling or actual dryness in the moiUh,
causing constant thirst, bruised feeling in the limbs, restlessnesSi
&c. ; but in the second period^ that of the delirium (a metastasis
of the whole disease u]x>n the mental organs) no complaint is
made of all those symptoms — the patient is hot, does not desire
to drink, he knows not whether to take this or that, he does
not know those about him, or he abuses them, he makes irrele*
vant answers, talks nonsense with his eyes open, does foolish
things, wishes to run away, cries aloud or whines, without being
able to say why he does so, has a rattling in the throat, the
countenance is distorted, the eyes squinting, he plays with his
hands, behaves like a madman, passes the excrements uncon-
sciously, &c.
In the first period of the pains and consciousness, two vege-
table substances are of use and generally quite remove the dis-
ease at its commencement — the bryonia alba and the rhiu Uxd"
codendron.
We take a drachm of the powdered root of bryona, shake it
up with ten drachms of alcohol and allow it to stand for mx
hours so as to extract all its medicinal power. In the mean-
time we pour six drachms of the strongest pure alcohol into
each of twelve bottles, which should be of such a size that this
quantity does not fill them completely, and then we number
them. Into the first of these bottles, marked No. 1, we drop a
single drop of the tincture prepared as above, and shake it
strongly for three minutes; then from this bottle No. 1, we
drop a single drop into bottle No. 2, and shake it strongly for
the same length of time ; then again, from this we drop a sin^e
drop into bottle No. 3, and thus we go on until each bottle has
received a drop from the preceding one, so that bottle No. 12,
is impregnated with a drop from No. 11, and thereafter, like all
the preceding ones, is strongly shaken for three minutes.
It is this last bottle, No. 12, which contains the bryonia
tincture in the suitable dilution, and which may be successfully
employed in the first stage of the disease.
HOBPTFAL RYKR AT PRESENT PBSYAILINa. 688
li^ for instanoe, the patient complains of dizziness, shooting (or
jerking-tearing) paxTis in the head, throat, chest, a;bdomen, <bc.,
which are felt partumlarly on moving the part — ^in addition to the
otiier sjnnptoms, the hemorrhages, the vomiting, the heat, the
thirsty the noctiumal restlessness, &c., we give him on a piece of
sugar a single drop from bottle No. 12, in the morning, in
preference to any other time, for the fever tends to increase to-
wards night Improvement takes place in the course of four and
twenty hours, and as long as the improvement goes on, we give
him no other medicine, nor even repeat the same (Hie ; for none
of the medicines here recommended can be used oftener than
once (in the dose of a drop) — seldom can they be given a second
time with advantage.
In this interval, until it is time for giving the second medi-
cine, we may, in order to satisfy the desire of the patient for
medicine and to quiet his mind, give him something innocuous,
e. y. a few tea-spoonfuls of raspberry juice in the course of the
day, or a few powders of milk-sugar.
If now, the amendment produced by the single dose of bry-
onia goes off in the course of two, three, or four days, that is to
say, if the patient then complains of sJiooting pains in one or other
part of the body^ whilst the part is at rest; if the prostration and
anorexia are greater, if there is harassing cough or such a de*
faiUty of certain parts as to threaten paralysis, we give a single
drop of the tincture of rhus toxicodendron, prepared in the
same way as the above and diluted to the same degree, so that
one drop of the tincture prepared with a drachm of the powder
of the leaves and ten drachms of alcohol, is added to a botUe
containing six drachms of strong alcohol and mixed by being
shaken strongly, and from this one drop is added to a second
bottle and so on, until the last of the twelve botties has been
impregnated by a drop from No. 11, and, like all the previous
ones, has been strongly shaken, just as was the case in preparing
the diluted tincture of bryonia.
Of this highly diluted tincture of rhus toxicodendron we give
in the last-mentioned case, or if the symptoms I have described
occur at the very commencement of the attack, we give, at its very
eommencement, a single drop from bottle No. 12, on sugar, and
no more, nor any other medicine as long as the improvement is
manifest and continued, unless it be (on the days when he is
getting no medicine) some of the above mentioned innocuous
substances.
684 TBSAnfBKT OF THS TTPHUSy ftc
Neither of the medicines can be used in a lower dilution or in
a larger dose ; they are too strong.
No domestic remedies of any kind, perfumes, pure wine, herb-
teas, clysters, fomentations or the like should be used any more
than other medicines, if we wish the case to turn out sucoesa*
fully. We should only put upon the patient the amount of
bed-clothes he feels agreeable, and keep him neither too warm
nor too cool, and we should let him drink or eat what he has
a fancy for ; he never wishes for anything that will not do him-
good.
The whole disease will generally be removed by a single drop
of the second or of the first medicine (according as the one or
the other is indicated, without the addition of any other). JBui
rhus is suitable mare frequently than bryonia^ and hence can be more
frequently used at first and alone^
If, notwithstanding, the disease should pass into the aboTO-
described stage of delirium and mania, then hyoscyamus niger
meets all the indications of the case.
A tincture &om the leaves of this plant should be prepared,
(the extracts of it are generally of indefinite strength or quite
powerless) and diluted in the above-described manner, but only
through eight bottles, and a single drop from the last bottle. No.
8, given upon sugar, and during the following days of ameliora-
tion only the above-described innocuous things given instead
of medicine, for then reason, strength, tranquillity, appetite, Ac.
usually return completely, although they might have seemed
to be almost entirely lost, and the patient an inevitable prey of
death.
This medicine also should not be given oftener than one
single time ; a single drop of the tincture diluted in this manner
almost always suffices.
Nothing particular need be administered for local infiamma-
tions or swellings, nor yet for eruptions, twitchings, long-con-
tinned constipation, diarrhoea, anorexia, vomiting, hemorrhages
or cough that occur in this disease. Those symptoms which
arise fi'om the main disease also go off simultaneously with its
disappearance, under the use of the remedies I have directed to
be given.
But there sometimes occurs a third state, a sort of lethargy of
the internal common sensorium, a kind of half-paralysis of the
mental organs. The patient remains indolently lying, without
sleeping or speaking ; he scarcely answers whatever we may do
ON THB TBEATMENT OF BUBN8. 685
to induce Iiim to do so, lie appears to hear without understand-
ing what is said or without iJlowing it to make any impression
on him (the few words he says he whispered but not irrelevant) ;
he appears to feel almost nothing, and to be almost immoveablei
and yet not quite paralysed.
In this case a remedy is useful that previously used to be em*
ployed in large doses for purposes not very clearly defined;
I mean Xhe sweet spirit of nitre. It must be so old, that is to sayi
80 thoioughly sweetened that it no longer reddens the cork of
the bottle. (It then contains in a concrete form, nitrous oxide,
respecting whose powjer the experiments of Dr. Beddoes give us
important hints).
One drop of this is to be shaken up with an ounce of water,
and given by tea-spoonfuls so as to be consumed in the four and
twenty hours. In the course of a few days this state passes into
health and activity.^
ON THE TREATMENT OF BDRNS.^
It 18 to be regretted that Professor Dzondi, of Halle, should
have recommended as the only sure, efficacious and best remedy
for bums, a means of the injurious nature of which all who
have much to do with fire are perfectly convinced. Has he then
instituted comparative experiments with all remedies recom-
mended for this purpose, that he can now with any degree of
truth vaimt his cold water as being the only sure, the best
remedy ? In such injuries the question is, not what shall give re-
Uef for the first few moments, but what shall most speedily render
the burnt skin entirely destitute of pain and heal it. This can
only be determined by comparative experiments, not by specu-
lation. But it has already been settled by observations, which
may easily be repeated, that it is exactly the opposite of cold waier
> [In the introduction of the proving of rhuB toxicodendron (R. A. Bl Is pt. ii, p^
S58), Hahnemann refers with satis&cUon to his success in the treatment of this epi>
demic of typhus. — " Of 188 patients whom I treated for this affection in Leipzic, I
did not lose one, which excited a great sensation among the members of the Ruadaa
Qoremment then occupying Dresden, but was taken no notice of by the medical aii>
tboritiea."]
* From the Allg. Anz. d. D^ No. 166, 181 6. In reply to Professor Dsondi*s recom-
mepdatJon of cold water in the same journal, Na lOi.
686 OK THE TREATMENT OF BUBITO.
that heals bums most rapidly. For with the true physidon the
object should be to heal, not to relieve for a few moments.
Slight bums — ^for example, when a hand has been scalded
with hot-water of from 180^ to 190° Fahr.— heal without any
application, in the course of from twenty-four to forty-eighi
hours ; but they take a somewhat longer time to do so if we
employ cold water in order to give relief at first For such alight
injuries hardly any remedy is requisite, least of all one like cold
water, which delays the cure. But for large severe bums, the
best remedies are not so generally known, and the public re-
quires some instruction on that subject ; it is in these that cold
water especially shews itself to be the most wretched palliative
and in some cases the most dangerous remedy that can be con*
cdved. Comparative experiments and obee^ations will, 1 1«-
peat, convince every one most conclusively, that the exact
opposite of cold water is the best remedy for severe bums
Thus the experienced cook, who from the nature of his occupa-
tion must so often happen to bum himself and must conse-
quently have learned by experience the remedy for bums, never
puts his hand that he has burnt with boiling soup or grease into
a jug of cold water (he knows from experience the bad conse-
quences of so doing), no, he holds the burnt spot so near to the
hot glow of the incandescent coals, that the burning pain is
thereby at first increased, and he holds it for some time in this
situation, until, namely, the burning pain becomes considerably
diminished and almost entirely removed in this high tempera-
ture. He knows, if he does so, that the epidermis will not even
rise and form a blister, not to speak of the skin suppurating
but that, on the contrary, after thus bringing his hand near the
fire, the redness of the burnt spot, together with the pain, will
often disappear in a quarter of an hour ; it is healed all at oncei
quickly and without any after-sufferings, though the remedy was
at first disagreeable. To this method he gives decidedly the
preference, because he knows from experience that the use of
cold water, which at first procures for him a delusive alleviation,
will be followed by blisters and suppuration of the part, lasting
for days and weeks.
The maker of lackered ware and other workmen who use in
their business alcohol and etherial oils, and who have to do with
boiling linseed oil, know from experience that the most rapid
and pennanent way to cure the most severe bums and to get rid
of the pain, is to apply to them the best alcohol and oil of tur-
OK THS TBEATMSNT OF BUBKS. 687
pen^e, substanoes which on a sensitiye skin (as that of the
mouth, the noee, the eyes) cause a pain of burning like fire, but
in oases of burning of the skin (the slightest, more severe, and
even the most serious ones) act as a most incomparable^ remedy.
True, they know not the rationale of this cure — ^they only say,
^One bad thing must drive out another "; but this they know
tram multiplied experience, — ^that nothing will make the burnt
spot painless and cause it to heal without suppurating, except
rectified alcohol and oil of turpentine.
Does Professor Dzondi imagine that it would never have oo.
oarred to these workmen to use cold water as a palliative reme*
dy immediately after burning themselves ? Any child who had
burnt itself would in its alarm fly to cold water ; it would not
require any advice to do so ; but the workman has repeatedly
tried it to his own injury, and experience, which in such cases
is always purchased at die expense of one's own suffering, has
taught and convinced him that the very opposite of cold water
is the surest, quickest and truest remedy for even the worst
bums: he has been rendered wise by experience, and in all
cases he greatly prefers the remedy which at first causes pain
(alcohol, oil of turpentine) to that which deludes by instanta-
neous relief to the pain (cold water).
Let Pro:^essor Dzondi only make upon himself, as he offers to
do, one pure comparative experiment, and he will be convinced
that he has made a grievous mistake in recommending cold wa-
ter as the only sure and best remedy for buma
Let him plunge both his healthy hands at the same instant
into a vessel full of boiling water, and retain them there for
from two to three seconds only, and withdraw them both at the
same time : they will, as may easily be imagined, be both equal-
ly severely scalded, and as the hands belong to one and the
same body, if one hand be treated with cold water and the other
with alcohol or oil of turpentine, the experiment will fiirmsh a
pure comparison and convincing result. This case will not ad-
mit of the excuse offered in that of the burns of two different
individuals, where the bad consequences that always result when
the hand is treated by cold water are sought to be ascribed to
impure humours, bad constitution, or some other difference in
the one so treated to the one that has been much more easily
cured by alcohol. No, let one and the same individual (best of
ei\ the professor himself, in order to convince him), scald both
^Homoeopathic.
088 OK THE TBEATMGBNT OF BITBK8.
his hands in the most equal manner before competent witnesBeOi
and then plunge one hand (which we shall call A) into his cold
water as often and as long as he pleases, but let him hold the
other hand (which we shall call 6) uninterruptedly in a yeflsel
full of warmed alcohol, keeping the (covered) vessel oonstantlj
warm. In this the burning pain of the hand B rises in a few
seconds to double its intensity, but thereafter it will go on dimi-
nishing, and in three, six, twelve, or at most twenty-four houn
(according to the degree of the bum) it will be completely and
for ever removed, but the hand, without the production of any
blister, far less of suppuration, will become covered with a
brown, hard, painless epidermis, which peels off in a few days^
and appears fresh and healthy, clad in its new skin.
But the hand A, which the Professor plunges into cold water
as often and as long as he pleases, does not experience the pri-
mary increase of pain felt by the hand B ; on the contrary, the
first instant it is as if in heaven ; all the pain of the bum is as
if vanished, but — aft«r a few minutes it recommences and in-
creases, and soon becomes intolerably severe, if cold water be
not again used for it, when the pains are likewise in the first in-
stants as if extinguished ; this amelioration, however, also lasts
but a few minutes ; they then return even in this colder water,
and in a short time increase to greater and greater intensity.
If he now puts his severely burnt hand into the coldest snow
water, he runs the risk of sphacelus, and yet afl«r a few honn
he can find no relief from the pains in water that is less cold. If
he now withdraws his ill-treated hand from the water, the pain,
instead of being less than it was immediately after the scald, is
four and six times greater than it was at first ; the hand be-
comes excessively inflamed, and swells up to a great extent with
blisters, and he may now apply cold water, or saturnine lotion,
lead ointment, hemp-seed oil, or any other of the ordinary re-
medies he likes ; the hand A, treated in this manner, inevitably
turns into a suppurating ulcer, which, treated with these ordi-
nary so-called cooling and soothing remedies, at length heals up^
aft<er many weeks or even months (solely by the natural powers
of his body), with hideously deformed cicatrices and tedioufli
agonizing pains.
This is what experience teaches us with respect to bums of
any severity.
If Professor Dzondi imagines he knows better than is here
stated, if he believes he is certain of the sole curative power of
Oir THE TRBATMENT OF BURNS. 689
cold water, which he lauds so much, in aU degrees of bumsj then
he may confidently undertake to institute the above decisive,
purely comparative experiment before competent witnesses. It
is only by such an experiment that truth will be brought to light.
What risk does he run if his cold water will procure as rapid
relief for the hand A as the warm alcohol will for the hand B?
But no I I pity the poor hand ; I know very well how it would
be I Let the Professor, if he is not quite so sure of the efficacy of
cold water in severe bums, perform but a small portion of this
experiment, let him dip only two fingers of each hand into boil-
ing water for two or three seconds, and let him treat the fingers
of hand A and those of hand B in the way above described, and
this little comparative experiment will teach him how wrong he
was to recommend to the public as the only, best and efficacious
remedy in all degrees of bums, cold water, an agent which,
though it is uncommonly soothing in the commencement, is
subsequently so treacherous, so extremely noxious. For severe
bums he could not advise any thing more injurious than cold
water (except perhaps the ointments and oils ordinarily used for
bums), and in slighter cases where no blister would rise if left
alone, blisters come on when they are treated with the palliative
cold water.
In the meantime, before Professor Dzondi can make known
the result of this decisive experiment upon himself it may be
useful for the public to know, that one of the greatest surgeons
of our times, Benjamin Bell* of England, instituted a similar
experiment for the instruction of the world, which was almost
as pure as the one I have proposed. He made a lady who had
scalded both arms, apply to the one oil of turpentine, and
plunge the other into cold water. The first arm was well in an
hour — ^but the other continued painful for six hours; if she
withdrew it an instant firom the water she experienced in it
more intense paio, and it required a much longer time for its
cure than the first.* He therefore recommends, as A. H. Eichter '
had already done, the application of brandy,* he also advises
*■ Heister already knew and had reoommended the treatment of burns by oil of
tnrpentiDe, which has recently created so much sensation in England: "expeditum
quoque hie esse solet terebinthinae oleum ; siquidem opportune ac saepius oorpori
iUmatur."
* See Phytisch'Medie. Journal^ herausgegeben yon Efihn, Leipzig, 1801, Jun,
8.428.
' Anafangigr, d. Wundarz^ Bd. i.
* Hie strongest alcohol heated is much more excellent in bums of yarious parts,
610 OK TBS TBSATMBNT OF BUBNa
that the part be kept constantly moistened with it* Kentish*
also greatly prefers^ and that very properly, ibe qpiiitooos re-
medies to all others. I shall not adduce the experience confir>
matory to this I have myself had.
From all this it appears that Professor Dzondi has made a
mistake, and that cold water, far from being a curative agent, is^
on the contrary, an obstacle to the cure of idight bumS| and oc-
casions a great aggravation of more serious ones, that in the
highest degree of such lesions, it even exposes the part to the
ri^ of sphacelus, if the temperature of ^e water applied be
very low (just as warm applications are apt to cause mortificar
tion of frost-bitten limbs), and that on the other hand, warm
alcohol and oil of turpentine are inestimable, wonderfully rapid,
perfectly efficacious, and genudne remedies for bums^ just as snow
is for frost-bitten limbs.
The adherents of the old system of medicine ought not longer
to strive against the irresistible efforts towards improvement
and perfection that characterizes the spirit of the age. They
must see that it is of no use doing so. The accumulated lumber
of their eternal palliatives, with their bad results, stands revealed
in its nothingness before the light of truth and pure experienca
I know very well that the doctor insinuates himself uncom>
monly into the affections of his patient, if he procures him a
momentary heavenly relief by plunging the seriously burnt
part into cold water, unmindful of the evil consequences result-
ing therefrom, but his conscience would give him a much higher
reward than such a deluded patient ever can, if he would give
the preference to the treatment with heated alcohol (or oil of tur-
pentine), which is only painfiil in the first moments, over all
traditional pernicious palliatives (cold water, saturnine lotioni%
bum salves, oils, &c.) ; if he could be taught by experience and
pure comparative experiments, that by the former means alone
is all danger of mortification guarded against, and that the pa-
tient is thereby cured and relieved of all his sufferings^ often m
eren where the epidermis has oorae off; bat in scalds of the whole body (pram
DO ooe ever recovered under the osual mode of treatment with cold water, sattmiine
lotions, bum-salves, or oils, all died generally within (bur days), we must oontenti
selves with ordinary spirits made very warm, or at least commence the
for the first hours with this, and consitantly renew this warm application, keepii^ te
jKitient warmly wrapped up in bed. Of all conceivable modes of treatment tl^ ii
the best
' Benjamin Bell's Syttem of Sttryeryt Vol. v.
> On JBunu, London, 1797.
ON THE TBEATM£NT OF BURNH. 641
kas than a hundredth part of the time required for the cure by cold
water, saturnine lotions, salves and oils.
So also the girl heated by dancing to the highest degree of
fever, and tormented by uncontrollable thirst, finds the greater,
refreshment for the first few moments from exposure to a draught
of air, and from drinking a glass of ice cold water, until she is
taught by the speedy occurrence of a dangerous or even fatal ill-
neas, that it is not what affords us the greatest gratification for
the first few moments that is for our real wel&re, but that, like
the pleasant cup of sin, it is fraught with evil, often with ruin
and death.
ADDITION TO THE FOREGOING ARTICLE.^
When ancient errors that should justly sink into oblivion are
attempted to be palmed off upon the world anew, he who knows
better ought not to neglect to publish his convictions, and there-
by to consign the pernicious error to its proper ignominious
place, and to exalt ike true and the salutary to its right position
for the wel&re of mankind. It was this idea that guided me in
No, 166 of this Journal,* where I displayed the inestimable
advantages of warm spirituous fluids for the rapid and perma-
nent healing of extensive bums, over cold water, which only
alleviates for an instant, but whose results are extremely per-
nicious.
The most convincing tests of the relative value of these two
opposite methods, viz., the curative (the really.healing) method,
(ihe employment of warm spirituous fiuids, such as alcohol or
oil of turpentine), and the palliative (alleviating) method, (the
use of cold water, &c.), are furnished firstly^ by pure compara-
tive experiments, where bums of two limbs of the same body
are simultaneously treated, the one by the one method, the other
by the other ; secondly^ by the expressed convictions of the most
unprejudiced and honourable physicians. One single such autho-
rity, who, knowing the worthlessness as facts of the favourite
pre-conceived notions of the age, dispossesses his mind of them,
and, rejecting the old pernicious errors from genuine conviction, is
not afraid to claim ibr truth its merited station, is worth thou-
sands of prejudiced upholders and combatants for the opposite.
Thousands of over hasty advocates of the pernicious employ-
* From the Allgtm. Anzeiger der DeuUchen, Na 204. 1816.
• [Sec above.]
41
d42 ON THE TBSATMSNT OF BUlUfa
ment of cold water in serious burns, mnst hold their peace be-
fore the expressed convictions of that most upright of practical
physicians, Thomas Sydenham, who despising the prejudioed
opinion that has prevailed universally from Galen's time till
now, marbi corUrariis curerUur (therefore cold water for buma)^
and influenced by his convictions and by truth alone, thus ex*
presses himself:^ As an application in bumti^ alcohol bears the bett
from aU other remedies that have ever been discovered^ for it effecti
a most rapid cure. Lint dipped in alcohol and applied, imme*
diately after the injury, to any part of the body that shidl have
been scalded with hot water or singed by gunpowder, will
do this, provided that as long as the pain lasts the spirit be re-
newed ; after that, only twice a-day will suffice." Let him who
can prove this to be &lse come forward !
Or, who can contradict one of the best and most enlightened
practical surgeons of our time, Benjamin Bell, when fix>m hia
extensive experience he alleges : ^ " One of the best appUoatiom
to every bum of this kind is strong brandy^ or any other ardenl
spirit; it seems to induce a momentary additional pain, but thia
soon subsides and is succeeded by an agreeable soothing aena*-
tion. It proves most effectual when the parts can be kept im-
mersed in it ; but where this cannot be done, they should be
kept constantly moist with pieces of old linen soaked in spirits.^
Kentish, who, as a practitioner in Newcastle, had to treat the
workmen who were often fearfully burnt in the coal pits, conai-
ders very carefiilly in his book^ all the claims preferred in fii-
vour of cold water and all other cooling remedies for bum8,and
he finds as the result of all his experience, contrary to the great
prejudice he felt in favour of these long used things, that under
their use no single person who had got a severe bum on a great
part of his body ever recovered, but that all were cured who
' Opera. Lipeiae, 1695, p. 848, (Edit Syd Soc. p. 255). " Amlrastis extos (Mfano-
vendus), quo casu omiiibtiB remedik, quotqnot adhoc inTenta liiere, hie liquor (qiiritai
vini) fiicile paliiuun praeriiutk cum curatiooem quam dto abeolvat ; — uempe ii UaUtk
spiritu vim imbuta partibus ab aqua ferrente, pulvere pyris, yel simili laests, quam
primum hoc iufligitur malum, applicentur, eademque dicto spirttu made&eta tubindt
repetantur, donee dolor ab igne peoitus eTanuerit^ et postea scdnm bit in die." That
cold eztenial applications to burnt parte render tbem liable, to inoreaae of pain% tfattk
fiucfa parts soon become altogether painless from the application of exteriMd beat m
he had often witnessed, is testified by the great obeerver, John Hunter, in hit wotk
On the blood and in/Uanmationf p. 218.
• SytUin of Surgery 1 3rd Edit Vol v.
' On Burnt, London and Newcastle, 1797, two Essays
09 THE TREATMENT OF BURN3. 64S
were treated by the speediest possible application and frequent
renewal of hot turpentine.
But no proof for the truth of this can be so strong as that
which is afforded by oomparatiye experiments performed simul-
taneously on one and the same body. In my former paper I
cii^ the case of a lady who got both her arms burnt, one of
which was treated by Bell with cold water, but the otlier was
kept covered with oU of turpentine ; in the first the pains per^
sisted for a much longer time and a much greater period was re-
quired for the cure than in the last, which was treated with the
volatile oiL
Another experiment of not less convincing character is related
by John Anderson.^ A lady scalded her face and right arm
with boiling grease ; the fiwe was very red, very much scalded,
and the seat of violent pains; the arm she had plunged into a
jug full of cold water. In the course of a few minutes oil of
turpentine was applied to the &ce. For her arm she desired to
continue the use of the cold water for some hours, because it
had formerly been of service to her in bums (she could not say
whether those had been more severe or less so than the present
one). In the course of seven hours her &ce looked much better
and was relieved. In the meantime she had oflen renewed the
cold water for the arm, but whenever she withdrew it she com*
plained of much pain, and in truth the inflammation in it had in^
ereaaed, ThefoUoumig morning I found that she had suffered greai
pain in the arm during the night ; the inflammxition had extended
above the elhow^ several large blisters had risen^ and thick eschars
hadjbrmedon the arm and hand. The face on t/ie contrary was
oomptetdy free from pain^ had no blisters, and only a little of the
q>idermis had become detached. The arm had to be dressed
for a fortnight with emollient remedies before it was cured."
Who can read these honest observations of illustrious men
without being satisfied of the much superior healing power of
the application of spirituous fluids to that of cold water, which
affords a delusive alleviation, but delays the cure ?
I shall not, therefore, adduce my own very extensive expe-
rience to the same effect Were I even to add a hundred such
comparative observations, could they prove more plainly, strong-
ly, and convincingly than is done by these two cases, that (warm)
spirituous fluids possess an inestimable advantage over the tran-
siently alleviating cold water in the case of severe bums ?
' JCeiUish*$ Beccnd U9ay en tntrnM, p. 48.
644 ON THE TBBATMENT OF BUENB.
How instructing and consoling, then, for mankind is the truth
that is to be deduced from these facts : that for aerious and for
the most severe injuries from burning^ thotigh cold water is very hurt'
Mfor them, spirituous applications {warm alcohol or oil of twrpa^
tine) are highly beneficial and capable of saving many lives.
These proofe will serve to guide the great numbers of man-
kind who require help, to the only eflTectual method, to the only
health bringing (sanative) remedy, without which, in the case of
extensive burns (that is where the greater part of the sur&ce of
the body has been scalded or burnt), delivery from death and
recovery is perfectly impossible, and has never been witneased.
This one single, and, as I have imagined, not unworthy object
of my essay, was evidently not perceived by Professor Dzondi,
as is proved by his violent letters to me ; he only perceives in
my remarks an attack upon his opinion. It is a matter of veiy
little interest to me to find that cold water which has already
been recommended ninety-nine times by others for bums, from
a predilection in &vour of this palliative whose effects are so in*
jurious, is now served up to us again for the hundredth time^
and I should feel ashamed to make use of a Journal so useful in
promoting the happiness of the people as this is, for the pap-
poses of merely personal recrimination and discussion. More-
over, as in the article I allude to I advised him to convince him-
self of the truth of my assertions by an experiment upon him-
self, my object was thereby to inform every one of the conditions
necessary to be observed in order to constitute a really con-
vincing pure experiment of this kind.
I avail myself of this opportunity to expose the disadvantage
of cold water (and other ordinary palliatives) in the treatment
of serious bums, and call the attention of the public to the only
effectual remedies, warm spirituous fluids, in order that they
may avail themselves of them in the hour of need. This is not
any mere idea of my own, but it has been clearly graved and irre-
frogably demonstrated by the observations of the most honour-
able and illustrious men of our profession (Sydenham, Ileister,
B. Bell, J. Himter, Kentish), and especially by the convincing
comparative experiments of Bell and Anderson.
I shall only observe further, that the burnt parts must be kept
moistened uninterrujitedly with the warm spirituous fluid, e, g,
warm alcohol, for which end the linen rags soaked in it should
first be simply laid upon the injured parts, and theu, in order to
prevent evaporation, and to keep all warm, covered with pieces
ON THB TREATKE^TT OF BURNS. 645
of woollen cloth or sheepskin. If a very large portion of the
sor&ce of the body is burnt, then some one will be obliged to
devote himself entirely and constantly to the external care of
the patient, removing the pieces of cloth or skin one by one,
and pouring with a spoon warm alcohol (or oil of turpentine)
over the linen rags upon the skin (without removing them), then
as aoon as they are dry, covering up the part and going on to
others, so that when the last part has been moistened and co-
vered up, it is time to commence again with the first part|
which, in the case of such a volatile fluid as warm alcohol, has
in the meantime generally become dry. This process must be
continued day and night unremittingly, for which purpose the
person engaged in performing it must be changed every two
hours for a fresh one. The chief benefit, especially in severe
and very serious injuries from burns, depends on what is done
within the first twenty-four hours, or in the worst cases, the first
forty -eight hours, that is, until all trace of the pain of the burn
is permanently removed. A basin should be at hand containing
very hot water, which should be frequently renewed, in which
some vessels full of alcohol should stand, of which the attend-
ant takes out the warmest for the purpose of wetting the rags,
whilst the rest stand in the basin in order to remain sufficiently
warm, so that there never shall be a want of warm alcohol for
the purpose of pouring on the rags. If the parts of the body
on which the patient is obliged to lie are also burnt, the raga,
dipped in warm alcohol, should be applied to them at the com-
mencement, and a layer of water-proof cloth spread underneath;
these parts can subsequently be wetted from above without
being removed. If the greater part of the body is burnt, the
first application must only consist of warm brandy, in order to
spare the first shock to the patient, which is the worst, the se-
cond wetting should be performed with stronger alcohol, and af-
terwards the very strongest alcohol may be used. And as this
operation must be continued uninterruptedly during the night,
the precaution must be used of keeping the candle (or lantern)
at a good distance, otherwise the warm spirituous vapour rising
from the skin might readily catch fire, and prove destructive to
the patient
If the burn has been effected with gunpowder, the small black
particles should not be picked out of the skin before all traces
of the pain of the burn are permanently removed.
M6 OV THS VSNSBXAL DISEASE
OX THE VENEREAL DISEASE AND ITS ORDINARY IMPROPER
TREATMENT.!
As long as the defects of the constitutions of countries put
difficulties in the way of matrimony, as long as celibacy shall
be considered £E^hionable and marriage as a political yoke, in
place of being regarded as the most honourable connexion of the
two sexes for their mutual moral and physical perfection, but
especially for the development of the really human and of the
divine and immortal in them ; as long as the notable difference
of both sexes shall be viewed merely as an object of sensuality,
and nothing more dignified is seen in a union with the opposite
sex than a mere animal copulation, and not a mutual communi-
cation and fusion of the excellencies of both to constitute a more
noble whole, so long will the all-powerful and sexual passion
thus unnaturally separated from moral duty seek its gratifica-
tion in the arms of common prostitution, and as a necessary con-
sequence not fail to contract the destructive lues, and so long is
the extinction of such a communicable virus not to be thought
of
It is the duty of the physician to cure patients ill of this dis-
ease who trust themselves to hin care, as the object of medicine
(like that of legislation) is not so much the prevention of the
evils incident to himianity as the correction of those which exist
Medicine should therefore prove itself to be really the helpful
art it professes to be in this disgraceful and destructive malady,
if it would act up to its pretensions. Its services should be
rendered with all the more facility and certainty in this case, as
the venereal disease is one of those happy few that remain
always the same with respect both to their origin and nature
(and consequently cannot be mistaken at its commencement),
and the specific remedy for which {mercury) was discovered by
a lucky hit in domestic practice shortly after the invasion of the
disease, now 323 years ago. We might therefore have expected
that physicians would at all events in this disease have acted
judiciously, and in this long period of time have learned the
way to cure this disease radically, easily and permanently,
although their treatment of all other diseases might have re-
mained, as indeed it has, mere subjective and objective delusion;
w^hich might to a certain extent be excused, since almost all
> From the AliffrmL Anx, d. />., Na 211, 1816.
AND ITS OBDIKABT XMPBOPSB TBSATMENT. 617
otiher diaeaaes differ so widely firom each other and among them-
selves, and the appropriate remedy for each several case re-
mained an eternal problem until homoeopathy solved it
Bat no ! physicians have mistaken even this so easily cogniz-
able venereal disease, and a fallacious and pernicious treatment
of it is the consequence of this mistake. Up to this hour almost
all the physicians of the habitable globe, in Pekin as in Paris
and Philadelphia, in London as in Vienna, in Petersburg as in
Berlin, have bungled the venereal disease from its commencement,
and have regarded the local removal of the chancre as the main point
of the treatment of syphilis^ and the simultaneous employment of
fnercury as a mere accessory ; and it is publicly taught that if the
chancre have existed but for a few days, its mere local destruc-
tion is all the treatment required.* And yet there can be noth-
ing more inappropriate, nothing more pernicious than this
procedure.
I shall in the first place show its inappropriateness. The
analogy with other miasmatic exanthematous diseases would
lead us to infer that the venereal disease arises only by infection
by means of corporeal contact. Now all infectious diseases have
this character in common, that on the part of the body where
the virus was first applied, at finst no alteration is perceptible,
although the inoculation may have taken place. If we scrape off
the epidermis on a child's arm till we come to the sensitive cutis
vera, and rub thereon either the matter of small-pox or the
lymph of cow-pox, for the first five days there will be no change
at all perceptible on this spot ; it is only afi;er the fourth day in
the case of cow-pox inoculation, and much later in that of
small-pox inoculation, that a change begins to appear on the
inoculated spot, and it is only on the seventh day Uiat the per-
fisct cow-pox vesicle is formed on this spot, amid febrile symp-
toms, and the small-pox pustule on the twelfth or fourteenth
day. Neither of them appears before the internal infection and
^^t^^m.^ » ■ ..III ■!■■■■ ■■» » . ■ I ■_-■,■ m^ ■■ I ^■^^■^ ■ MMIIMMMM.. ■ ■ ^W^Nl^M
* Tlie boldest propoimders of this erroDeous doctrine were Qirtaouer and A. F.
Becker. The former says {Treatise on the venereal dieeaee, G5ttingen, 1808, pi 216),
"Beoent dmocres must be only locally cored, burnt or driren off The poison must
be destroyed at the commencement on its seat, for then it has not yet had time to
be ab8orbed"(l) — and Hecker roundly atverts {On Ike venereal dUeate^ 2d editico
pi 67), ** In the chancre the poison lies as it were out of the system,** ** therefore it
yields (pb 180) to a mere external treatment (by desiocatiYe and corrosiTe remedies)
wUhamianyill effeeii* (f), and if it date from not more than twelve days (p. 182), it
mart "only be treated with external, local means.** Almost all other authors incline
to the same opinion, though they do not express themselves so distinctly — Hunter,
Bell Schwediaur, dc
648 OK THE VENKREAL DISEASE
flevelopment of this disease is completed in the s^tem. So it is with
the measles and other acute exanthematous diseases : namdjf^
the part whereon the infecting virus was first brought does not pnh
duce the eruption peculiar to each disease^ before the whole orgammk
has undergone a change and is completely infected. And on the
other hand, the perfect production of the specific eruption is an
infallible proof of the completed internal infection and developmaU
of the miasmatic disease in every case. The cow-pox prevaik
throughout the body as soon as the cow-pox vesicle is produced
in its perfect form with its red, hard areola, at the part wheie
it was first introduced, and so it is with other inoculable diseases.
But ^m the moment when the miasm has taken, and the whole
living organism has become aware of (has perceived) the pre-
sence of its action, the poison is no longer only local at the point
of inoculation ; a complete infection would still occur, even
though the seat of inoculation should be cut out. At the very
moment when the inoculation has taken, the first general attadc
on the system has occurred, and the full development of the
disease is in all probability not to be avoided by the destmcticm
of the inoculated part.
In the case of the bite of the mad dog, where the system was
predisposed to be afiected by the miasm,' we possess undeniable
observations to show that even cutting out^ and removing the
bitten part does not aflbrd any protection fix)m the oocurrenoe
of hydrophobia.
Small-pox would still be developed, even though at the mo-
ment the inoculation was efiected the inoculated part were cut
out.
So far is the miasm from remaining local when once it has
been inoculated in the body. When that has taken place, the
complete infection of the whole system and the gnuiual dfr
velopment of the miasmatic disease in the interior cannot be
prevented by any local treatment
But the disease can only be considered as completely de-
' Fur in many of those bitten by the rabid dog the poison does not infect ; of
twenty persons bitten, usnally from eighteen to nineteen escape without injury, ewm
though they do not use any antidote whatever. Hence the undeserved reoommctt-
dation of so many pretended preyentitive remedies ; they may all easOy protect, if
the poison ha^t not taken in those bitten, as u so often the case.
* A girl of eight yenr^ ol<l, in Scotland, was bit by n mod dog on the 21«»t of March,
1792; a siir«;eon iinmciiintoly cut tlic piece cleimout (kept it suppurating and gave
mercury till slight snlivaiion was produced), and, notwitlistanding, hydropholMi
liroke out, and death followed the fortieth diiy after tlie bite. — TTie new Lohdam
Medical Juumai, VoL u.
AND ITS ORDINABT IMPROPER TRBATKSNT. 649
Teloped in the whole organism when the perfect pock has ap*
peared on the seat of inoculation.
Thus the miasmatic exanthematous diseases indicate their
completion in the interior by the occurrence of one or more
shut boils of smaller or greater size.
Thus the pustula maligna appears on the part that has been
touched (some four days previously) by the blood of a cow
which has died of malignant anthrax, and in like manner the
oow-pock or small-pock appears generally and primanly on the
part inoculated or its vicinity, and the same is the case with the
itoh of wool-manufacturers.
The last-named disease belongs to the chronic exanthematous
dkeases (like the venereal disease), and in it nature also pro*
duoes the itch vesicles, at first in the neighbourhood of the part
that was originally touched by the itch-virus, e. ^., betwixt the
fingers and on the wrist, if the hands (palms) were first infected
As soon as the itch vesicles have made their appearance this is
a sign that the internal itch-disease is already AiUy developed.
For at first there is actually no morbid change observable on
the infected part, no itching, no itch-vesicles. Usually from
nine to twelve or fourteen days after the application of the itch-
virus there occurs, along with a slight fever, which is not no-
ticed by many persons, the eruption of the first itch vesicle —
nature requires this time, in order to complete the full infection,
that is to say, the development of the itch-disease in the interior
thioughout the organism. The itch-vesicles that now appear
are hence no mere local malady, but a proof of the completion
of the internal disease. The itch-miasm, as soon as it has con-
taminated the hand, remains no longer local the instant it has
caused inoculation, but proceeds to alter the interior of the
organism and to develop itself into this peculiar disease until
the entire infection is accomplished, and then only (after several
days) does the eruption produced by the internal malady appear
on the skin, and that at first in the vicinity of the original point
of infection. These itch-vesicles are an abnormal organ pro-
duced by the inner organism upon the skin, designed by nature
to be the external substitute of the internal disease, to take the
latter upon itself, to absorb it as it were, and so to keep it sub-
dued, slumbering and latent. That this is the case is evident
from this, that so long as the vesicles remain on the skin and
continue to itch and discharge, the internal disease cannot make
its appearance, and from this also, that whenever it is partially
650 ON THX YXNXBEAL DIBllfll
destroyed on the skin, without an j pierions core being eflfected
of the internal itch disease (especiallj if it be of someirhflft long
standing and have attained to anj extent) by means of the in*
temal employment of its specific remedy, sn^Aur^ this internal
disease then bursts forth rapidly, often in a fiightfiil nuumerf in
the form of phthisis, asthma, insanity, dropsy, apoplexy, amau-
rosis, paralysis, and it not unfrequently occasions sadden deatb.
A very similar proc^bss is observed in the case of the venereal
disease. On the spot where the venereal vims was first nibbed
in (e. g. during an impure coitus), fi>r the first daySi in like
manner, nothing morbid is observable. The vims has indeed
first come in contact with the living fibres at that part^ bat at
the moment that the inoculation has taken place, that is^ when
the living body has felt (perceived) the presence and action of
the poison, that same moment it is no longer only local, it is
already the property of the whole orgamsm. From that instant
the specific (venereal) alteration in the interior advances on-
wards until the venereal disease has completely developed itself
in the interior, and it is only then, that nature, oppressed bj
the internal malady, produces the abnormal organ, ike cAonei^
which it has formed for the purpose of keeping in subjectiott
the internal disease, in the neighbourhood of the part primarily
infected.' In the neighbourhood, I say, for it does not always
arise on the seat of the primary application of the yiras^ it
sometimes appears on the scrotum, &c., sometimes, though more
rarely, only in the groin, in the form of inguinal bubo, which is
also a kind of chancre.
In order to subdue and form a substitute for the internal
venereal constitutional disease, nature produces the chancre;
for as I have seen, chancres remaining untouched for as long as
two or three years (certainly enlarging gradually in that time)^
do not permit the more general venereal disease to break oat
As long as the chancre remains uninterfered with, no venereal
affection, no symptoms of syphilis are to be met with on any
other part of the body.
It is very probable that the infection during impure centos
takes place in the first seconds, and then no washing or deans-
iDg of the genitals is of any avail, nature from that time pro-
ceeds uninterruptedly in her course, altering the whole internal
organism in the manner peculiar to this disease. But from the
* At first m a Teside, whidi increaees in a few lioun and growa into an nkflr
vUha haidbaae.
jUTD m OBDINABY IXPBOPEB TBIATXKNT. 861
moment of the primary local infection, nature requires in our
daySy aeyeral, usuallj seven, ten or fourteen days, not unfire-
quently three weeks, there are even some instances of its requi-
ring five, six, seven or eight weeks before it has completed the
development of the venereal malady in the interior, and it is
only then, as a sign of the completed internal general venereal
diHease, that the chancre appears on the skin, and this chancre,
the evidence of the now internal affection, is designed by nature
to assume, as it were, the palliative office of substitution, reliev-
ing and keeping in subjection the latter.
For the fbst thirty or forty years after the occurrence of the
venereal disease, that is, from Uie year 1493 until the first third
of the following century, this infecting virus was much worse
than it is now ; nature then strove much longer before it allowed
the completion of the general internal disease in the organism ;
often several months elapsed after the local infection before the
chancre then burst forth. At that time too, the opposing
action of the body and the general ill state of health before its
i^ppearance, as the signs of the development*of the venereal dis-
ease going on in the interior, were much more distinct and strik-
ing^ than now-a-days, when the infecting virus is much milder.
The venereal disease pursues the same course even yet, for
ainoe that period it has only decreased in violence, but its na-
ture is not altered. Even at the present day there is, immedi-
ately after the infection, absolutely nothing abnormal to be per-
oeiTOd on the spot : the change only goes on in the interior, and
a general feeling of illness is felt by sensitive individuals for
some days or weeks, until the thorough alteration of the organ-
iam is effected by the venereal poison, and it is only aft;er this
that the chancre is produced by nature on the suitable spot, and
IS the in&llible sign of the perfect development of the venereal
disease in the entire organism, and the silencer of the internal
malady. Aft;er the breaking out of the chancre the previous
feelings of debility and fisitigue, the dulness of the sensorium
' Ptainig (wer the testimoDy of several physicuns of that time, such as 0. Torella,
K.lfMa, A. Ferro, P. Hanschard, I would merely refer to the description in Luinni
OdUtHo 9eripL de morho ffollieo, Venet 1666, i i, given by R Fraacatorius at p.
ISS and 178, and by Fallopius at p. 667, of the sufferings of those then infected be-
§an the outbreak of the chancre (then called earies\ and it is astonishing to find
How generally ill and miserable the infected crawled about for months, without the
■Kgfatfet change being observable on their genital organs, until at length after the
iitenial development of the venereal disease was completed, the chancre buret firth
k fuU liiiy, and the general state of ill health moderated, and, as it were, retired.
9oZ OK THE VEKEBEAL DISKASS
roz^irjine, the depresrion ot the spirits, the earthr oomplexion
with rjiue borders round the eves, &c., go off The internal
vener«^ disease then remains as it were enohiiined (latent) and
concealed, and can never break out as syphilis, as long as its
external substitute and silencer remains uninterfered frith on
its sear: but when the in-dwelling venereal disease is oom-
pletel V destroyed and cured by the sole internal employment of
the best mercurial preparation, then the chancre heals up of
itself without the aid of the slightest external remedy : if how-
ever it iij driven off bv external means, without curio? the in-
temal malady, the latter inevitably bursts forth in the fonn of
syphilis.
From a consideration of this mode of the production and of
this nature of the venereal disease, and of this true signification
of the chancre, which are founded on incontrovertible observa-
tions, what plan of treatment of this disease would suggest itself
to any person endowed with common sense? Certainly none
other — for I have a high idea of sound unprejudiced common
sense — than the following: " Treat the venereal affection of the
whok system hy €ie htsi internal remetly until it is completely eradi"
cated^ that is to say^ until the thoroughly cured organism no longer
requires any viru1/*,nt chancre^ arty external silencer and substitute
for the now nnnihihUid internal venereal disease, and from Oie
period of the completed internal cure, it must become a healthy ulcer^
without any assistance/rom ivithout, and rapidly heal up of its oi/*n at'
cord, v:it/iout leaving Miind the slightest ty-are of its previous existence,^*
Thus, I imagined, plain common sense would advise and car^
fiilly warn against meddling witK the chancre by any local ap-
plication, either before or during the internal treatment, that
might cause its premature disappearance, for it is the only certain
sign of the indwelling venereal disease, and it only can, by its
persistence, infallibly demonstrate to the patient and to the phy-
sician, that the cure of the disease throughout the organism is
not completed, whilst on the other hand, by its perfect sp<mtaneous
healing under the internal exhibition of mercury (without the
employment of any sort of external remedy), it gives the most
iir^ragable proof that the cure is completed, and that nature
^ ft m wnrtfay of remaric that any^ chancre btimt off ^withuut Uic preliminary cam
gf iha ■dftnal diMaae^ alwaiva Immm behind it a certain amount of redne*M and
aa Ibqg aa th« atarior is not dentniyud ; a bubo must tb«
» of wibetitutioD, and keeps the uiterml
AND ITS OBDDTABY IUPBOFEB TBSATMSNT. 858
no longer lequirea this subetitutive organ for an in-dwelling ve-
neieal malady, since it has been completely healed and annihi-
lated by the medicine given internally.
But as experience moreover incontrovertibly teaches us, that
when the chancre is driven off by local means, and nature is
thus deprived of the silencer and substitute of the internal ve-
leieal disease by external desiccative or corrosive applications,
it then invariably happens that either an inguinal bubo soon
oeours, or after a few months the general venereal disease (sy-
philis) breaks out; we might have imagined, that physicians
would have had the sense to perceive the importance oi pre*
serving the chancre inviolate, and without disturbing it by any
external remedy whatsoever, have made it their duty to employ
only internal treatment, with the best antivenereal medicine,
nntil the system was completely cured of this disease.
But no I — In spite of all these loud speaking fsu^ts, proving
the true nature and signification of the chancre, almost all the
physicians and surgeons of the habitable globe have gone on
ngarding it as a purely local and at first insignificant ulcer con-
fined to the outer surface of the skin, and have exerted them-
selves to dry it up and destroy it by local means as rapidly as
possible, and have even considered this destruction of the chancre
as the chief object of their treatment, just as though the venereal
disease proceeded from it (the chancre) as its source, just as if the
ohancre were the originator and producer of the venereal dis-
ease ; whereas it is only an evidence of the fully developed in-
ternal malady, which they might have inferred from this, that
the consequence of the local destruction of a chancre * performed
ever so early, and even on the very first day of its appearance,
was always a subsequent breaking out of syphilis ; and they
might also have learned this from the incontrovertible experience,
that not a single patient escapes syphilis if his chancre have been
only locally destroyed.^
* John Hunter's TreatUe on the venereal diteoMe^ p. 661 — 558 (Leipzic edition).
* Hunter, op.dt, 681. **Not one patient oat of fifty will escape syphilis if the
diaDcre be only locally destroyed." — So says Fabre also {LettreSf supplement a son
tnUi de$ maladieg venerienneB, Paris, 1786) — ** A chancre always causes syphilis if
It be only treated with eztcmal remedies." Let it not be supposed that these local
Inrltatiing oorrosiye remedies caused a recession of the virus from the chancre into the
inlerior of the body, and thus produced the syphilis. Nol a chancre destroyed locallr
vittKNit employing any irritant remedies, produces the same result ''Petit (so
Flabve, loc. eit) excised a portion of the nympb» of a woman on which some
i bad existed for some days ; the wound healed, it is true, but the syphtm
664 ON THE YEVEBfiAL DISEASE
Now, as the in-dwelling venereal malady can never break out
as long as the chancre, undisturbed by external applications, re-
mains on its seat (however long it remains there) and as the ve-
nereal disease at every period, whether it has broken out as
syphilis or betrays its hidden existence merely by the presence
of the chancre (or the bubo) can only be radically cured * by the
use of (the best preparation of) mercury (when the chancre heals
up spontaneously without the aid of external Temedies) I would
ask if it be not very foolish, nay, sinful, to destroy the chancre
by external desiccative and corrosive applications, seeing that
thereby, not only is no part of the venereal disease removed, but
we deprive ourselves of this conclusive sign of a perfect or im*
perfect cure, which should be our guide during an internal mer-
curial treatment : nay, more, what is much worse, we even cause
the outbreak of the syphilis, which had hitherto continued to Ue
latent and enchained in the interior, and as long as the chancie
existed could never burst forth, but would have been for erer
healed and destroyed had we medicinally treated the diseaae
solely by the use of the internal remedy, whilst the chancre still
existed until its cure was completed, that is to say, until Ae
chancre had disappeared without the aid of an external remedy I
"But," say these medical men, "we give mercury internally
whilst we dry up or bum off the chancre." '
I would ask — ^in a sufficient or insufficient manner? (It must
have been insufficient if the syphilis, as usually happens, breaks
out afterwards.)
" Oh, we give it in a sufficient manner," they reply.
Possibly: but how can they tell during their treatment whether
their internally administered mercury sufficed for the cure, as it
is only the healing of the chancre that has remained untouched|
under the influence of internal remedies alone, that can give us
the sole certain proof thereof ; but the chancre has been burnt
off by them before or during the treatment.
broke out notwithsUndiiig." And this might naturally have been expected, as the
venereal duease exists completelj in the body before the cfaaaoe appear^ and ii
only prevented bursting forth by the presence of the chancre on the skin.
' Fritie On ike venereal dUeaae, Berlin, 1790, and SauL Hahnemann, /mfmcrtaa
for eurgeoM reepeeUng venereal dUeaeee. Leipaig, 1789, g 278—284, 290— 29S, 614,
686, [vide antea, p. 72, et seq.] wherewith, although they contradict tbemselTee^ tlie
other better writers agree, as Schwediaur, Hunter, BelL
' The worst kind of physicians advise nothing more to be done than destroy ii^ the
chancre, e, g. Girtanner, Dreaiiee on the venereal dUeaee, Oftttii^fen, 1808, p. 215,
Hecker, On the venereal dieeaee. 2d edit pp. 67, 180, 182.
AND ITS OBDIHABT DfPBOPSB TREATMENT. 656
Had their employment of meroury sufficed for the perfect core
of the interoal venereal disease, they had not needed to bum off
the chancre, this would and must have disappeared ^ at the same
time that the internal malady was eradicated without the simul-
taneous employment of any external remedy whatever I
But it is just because they know that their internal treatment
does not suffice for the extirpation of the internal malady, oon*
sequently also not. for the spontaneous healing of the chancre;
it is just for Uus reason, that they bum off the chancre to give
their treatment the superficial appearance of having cured every-
thing (the poor patient is deceived ; he cannot help believing
himself to be cured) ; they give at the same time — ^if diey wish to
do the thing thoroughly — mercury internally without knowing
(ance the chancre, the guiding sign, is gone) how much or how
long they require to give it, ' and this they do under the idea
that even though the patient may not be thereby thoroughly
emedy they have at least advanced the treatment of the disease
as fiur as it will go.
But this is a mere delusion. For they torment the patient by
boming off his chancre, which is of no use, but is of the greatest
injury, as it is certainly followed by the breaking out of syphilis,
and they at the same time harass him by giving him an inde-
finite quantity of meroury by the mouth without avail. For the
venereid disease cannot be half or three quarters cured ; it must
either be quite cured (and in that case not a trace of it is left),
or it is not at all cured ; even though it be treated until it is al-
most cured (but not perfectly eradicated) it is no^ o^ aU cured;
what has been done for it is equivalent to nothing, for in the
course of time it in£EJlibly spreads round about again and reaches
' See Fritie and Hahnemann, op. cU.
* Thidj often attempt to justify thcmselTes by saying that thoy pushed the inteniAl
•dnUDistratioo of mercury until the appearance of the mercurial fever, whereby thej
obtained a certainty of cure being effected. But what do they usually call mercurial
farcr t Something that is not the least like it, and that affords no proof whatever of
an internal cure; looseness and falling out of the teeth, ulceration of the mouth,
swelling of the cheek and neck, violent pains in the belly, salivation f No I not every
violeDt assault with useless mercurial preparations as is now the fiishion (calomel
with or without opium) can deserve that appellation ; these remedies very seldom
pfodnoe that peculiar febrile state which can still serve as the sign of the internal
core, when some mischievous hand has burnt off the still more convincing chancre.
U it only the purest, moat perfect, and hence most efficacious sesquiozyde of mercury
that produces it in venereal dUeases, whereby the chancre (if it be still present)
spoDtaiieously heals witliout the aid of an external remedy, shewing that the internal
diseaae has been completely eradicated.
656 OK THE YENBXAL DISSAflB
the same extent and again plants itself just as finnlj as if nothing
at all had been done for it
Therefore what is the certain consequence of this local drjing-
up and often very tedious, often very painful burning off of the
chancre, whereby a portion of the genital organ is destroyed,
and of the blind employment of internal mercurial remedies?
That the patient is deceived into believing himself cured, and
that his lesser evil (chancre with latent internal venereal disease)
is changed into a greater I Now, either a bubo (a now much
more troublesome substitute for the indwelling venereal diseaae)
or (where no bubo has appeared, or if it have, has been driven
off again) after a few (3, 4, 6, 9) months syphilis breaks forth.
And i^ after it has broken out, (as it inevitably must if the
patients were not assailed with unhelpful mercurial preparations
so violently that there was a struggle betwixt life and death,
when if they did not go the way of all flesh, some few of them
were thereby freed from their tvenereal disease) the physician be
asked if the ulcers on the tonsils, the bluish pimples on the fiMse,
extending even into the hairy scalp, the round copper-coloured
spots on the skin, &c. be not remains of the venereal disease
that was thought to be cured, he usually seeks to get out of the
scrape by alleging: "That he certainly had thoroughly cured
him on the former occasion, there was then nothing more to be
seen about him" (he had burnt off the chancre and removed
from sight the proof of the existence of the indwelling disease ;
this he calls a cure)— "the patient must certainly have caught a
fresh infection during these four, siic, or nine months, whence
this venereal ulceration of the throat, &c. has arisen."
Thus the poor betrayed sufferers must^ in addition to their
misfortune, bear the doctor's disgrace, because they knew not
how syphilis can and must arise.
It can only proceed from the uncured indwelling venereal
disease, whose external substitute and suppresser (the chancre,
which, as long as it exists imdisturbed, prevents the outbreak oif
the syphilis) has been destroyed locally by the physician, and can
consequently no longer hinder its outbreak ; and even though
our patient may be conscious of having had several suspicious
connexions since the removal of his former chancre, but got no
chancre therefrom, yet he has not been infected anew, and the
syphilis that lias broken out must be derived indisputably from
the chancre that was formerly burnt oS, consequently from the
bad treatment of his former venereal disease. For it has never
AND ITB ORDINABY IMPBOPEB TBSATMENT. 667
oocorred that syphilis has been produced without a previous
(destroyed) chancre, Hhere is no authentic instance on record of
such a case having happened.
Did the patients, whose syphilitic symptoms the physician
attributes to a new infection, know this, they having in the
meantime contracted no fresh chancre (which has been driven
away), they would know how to reply to the physician when he
trial to transfer his disgrace upon them, whose treatment he
hae bungled.
But as patients ai^ ignorant on this subject, they alone have
to bear the injury and the disgrace ; the doctor subjects them to
a new course of mercury, and if this be not pushed by him to a
much more violent and serious extent than the former one
during the destruction of the chancre was — if, I say, the patient
be not assailed imtil his life is endangered with the ordinary un-
serviceable mercurial preparations, a radical cure of the disease
will not be effected even with this second course ; the patient
gjBtB rid of his ulcers in the throat for example (for each of the
primazy symptoms of syphilis is easily removed even by small
quantities of a bad mercurial remedy, whereby the disease is
not radically cured) but after a few, or after many months, a
new syphilitic symptom appears in their stead — and after a third
and a fourth similar, imperfect mercurial treatment, a third and
a fourth affection appear in succession, and at length the affec-
tions of the joints and the agonizing nocturnal pains in the bones^
for which the useless mercurials, decoctions of woods and baths
are no longer of any avail ; and the patient is left in the lurch,
that is to say, to suffer his tortures.
Thus, from an insignificant primary malady (for the original
venereal disease still accompanied by chancre may be readily
cured by the internal use of the best mercurial preparations),
there arises a sucession of sufferings and morbid alterations of
many years' duration, often on account of the health-destroying
treatments attended with danger to life, and all this— ^om t/ie crigi-
n(Ulo<xddestnu:tiono/ ^ecAancre which was designed by the bene-
ficent Creator to be the constant preventive of the breaking forth
of the syphilitic malady and the sure monitor of the physician
as to whether the internal treatment is complete (if it heals up
of itself), or the disease is not yet radically cured (if it remains
unaltered on its seat).
* Hunter, op. cit p. 487, Bays : ** Probably not in one case out of 5 0," i. e,
in DO caae.
42
658 ON THE Y£KKBJEAL DISIA81, 4a
It is only by the discretion of the patients themselTeB that
physicians can ultimately be improved. Let eyery one that is
infected immediately dismiss the physician who wishes to com-
mence the distructive plan with him, of treating the chancre by
local remedies, though he bestow on the remedy he would em-
ploy externally the mildest and most seductive of names, eren
though he should call it cooling, sedative, alleviating, emollient^
relaxing, descutient, purifying or healing ; all these fine appella*
tions serve but to disguise the enemy. The chancre, being the
most important witness of what takes place within, must on no
account be touched or treated with any kind of external zeme-
dies by whatevemames they may. be called.^ The patient ought
only to be allowed to wash the genitals occasionally with tepid
river- water or warm cow's milk.
- On the contrary, let him choose a physician, who, fidly alive
to the extreme importance of the chancre, leaves this quite
alone, and understands how to conduct the internal treatment
alone in a masterly way ; that is to say, eradicate it by means
of the best mercurial preparation that is capable of doing ao^
given internally without the production of salivation, in such a
manner that the chancre heals up of its own accord, without
the aid of the slightest external remedy.
'^en and then only can the patient be sure that his disease is
cured.
The best mercurial preparation for effecting this, is the dark-
coloured pure sesquioxide of mercury, of which a small portion
rubbed with a drop of water on the palm of the hand by means
of the point of the finger, nms into minute globules of metallic
mercury which are observable either with the naked eye or with
a lens. My mode of preparing it will be found in many books.
This only is the most innocuous and most powerful preparation
wherewith the venereal disease of all degrees may be cured,
' And should the patent have allowed himself to be seduced and have pennitted
the external driving off of his chancre, and should there arise, as usoaUy happens^ in
the place of it a bubo, let him remember that this has the same Mgnifi<»Bi>5^ j^ 1^
chancre, and is a substitute lor the internal malady, and that if allowed to stay there
undisturbed it also prevents the outbreak of the syphilis. Therefore he sbouid not
allow this at least to be driven off by external remedies (inunctions of the blue ouit.
ment beneath the bubo, called /nc/toiu, and the application of matfy other tha»
which physicians term resolving the bubo), for after a few months the syphilb fiiUowB
inevitably ; but he should rather let himself be only treated by the best memirial
preparation, only inwardly, until the bubo, without the aid of external remedies and
without fnctioDs, disappears spontaneously when the internal malady is cured ; and
it is only thus tliatbe can be certain of his complete recovery.
HOTA BKNS FOB XT BBYHWBBS. 059
without aaUration, if the general state of the patient's health be
not very much broken up and weakened.
I^ however, the patient have been mistreated by a physician
by having his chancre or the subsequent bubo driven off by ex-
ternal remedies, and the syphilis have consequently broken out ;
if it be already present, after several long-continued, fruitless
treatments with bad mercurial preparations, in a high degree,
the general health that has been ruined by such violent treat-
ment must first be restored, and the accesssory ailments usually
present must first be removed before the master in his art can
employ even the best mercurial preparation to effect the perfect
core.
In such master-pieces of treatment, where the malady has
taken such deep roots, and the chancre having been previously
driven off serves no more as a loadstar ; there is nothing to
shew that the treatment has accomplished a perfect cure, but
the closest observation for the arrival of the period, when, after
the complete restoration of the patient, some fresh symptoms
present themselves that are only peculiar to the action of mer-
cury, but which are quite new to the patient in the course of
his venereal complaint, and have scah^ly ever been experi*
enced before, but among which neither salivation, nor toothache,
nor ulcers of the mouth, nor pains in the bowels, nor diarrhoea
are to be found.
NOTA BENE FOR MY REVIEWERS.'
I have read several false criticisms on the second part of my
Pure Materia Medtca^ especially on the essay at the beginning of
it, entitled '* Spirit of the Homoeopathic* Medical Doctrine."
' From the 8d Part of the Beine Arzneimittellehref dated February, 1817.
• What an immense amount of learning do not my critics display 1 I shall only
allude to those who write- and print twmopathie and homopatky in a place of hommh
pathie and homeopathy, thereby betraying that they are not aware of the immense
^BfiiBreDoe betwixt &/idr and 5/ioiey, but consider the two to be synoDymona. Did they
ten never hear a word about what the whole world knows, how the infinite difference
betwixt &fiM6(rio( and huoiovvfi once split the whole Christian Church into two paitr,
impoMible to be re.united ? Do they not understand enough Greek to know that
(aloiie and in combination) o/idy means ccmimm, identical, the tatne (e. p. tU hjidv Xix't
inpoSalvot, Iliad 3.) but that H^ioiov only means similar, retemhling the object, bui
never reaching it in regard to nature and kind, never becoming identical with it f
The bom«Bopathic doctrine never pretended to core a disease by the eame, the
800 NOTA BSNS FOB KT BSVIXWXBa
Now I could easily settle them here after the traditional man-
ner of writers, and expose them in all their nakedness. But I
shall not do so. I do not wish to burden myself with the sin
of immortalizing these follies and their perpetrators, and piefisr
not to reveal the weaknesses of my contemporaries to an
assuredly more discerning posterity.
I shall only say tliis much in a general way.
Perversions of words and sense, incomprehensible palaver,
which is meant to appear learned, abuse and theoretical scepti-
cal shakings of the head, instead of practical demonstrations of
the contrary, seem to me to be weapons of too absurd a character
to use against a fact such as homoeopathy is ; they remind me
of the little figures which mischievous boys make with gun-
powder and set on fire in order to tease people-— the things can
only fizz and splutter, but are not very effective, are on the
whole very miserable affairs.
By such tricks, the pitiful character of which recoils on their
authors, homoeopathy cannot be blown up.
My respected bretiiren on the opposition benches, I can give
you better advice as to how you should set about overthrowing*
if possible, this doctrine; which threatens to stifle your art, that
is founded on mere assumption, and to bring ruin upon all your
therapeutic lumber. Listen to me I
Your attempts against the systematic exposition of the
doctrine, entitled the "Spirit of the Homoeopathic Medical
Doctrine," have as you perceive, proved unsuccessful. You had
better leave it alone 1 Spirits such as this is, are no subjects for
joking with. It is said there are spirits whose appearance has
left behind a life-long disquiet in the conscience of the wicked
and of those who act contrary to their knowledge of what is
right and which nightly torment them, for their neglect of
identical power by whicli the disease was produced — this has been impressed npoD
the unreasonable opponents often enough, but, as it seems, in vain ;~iio I it only eure>
in the mode most consonant to nature, by means of a power never exactly oofrea
ponding to, never the tame as the cause of the disease, but by means of a medicm
that possesses the peculiar power of being able to produce a nmilar morbid slata
( 'fimtuv waBos,)
Cannot those persons feel the difference betwixt ** identical^ (the same) and
**9imilarr Are they all homopathieaUy labouring imder the same malady of stu-
pidity { Should not any ome toko ventwru to ttep forward 09 a reviewer of the ** Spirit
of tbs HomcBopathio Medical Doctrine" have at least a rudimentary idea of the
meaning of the word ** Horn : op thy,**
KOTA BENB FOR IfT BEYIEWSRS. 661
acknowledged and jet neglected duties I Mark this; otherwise
you may not be able to silence the judge wit^n jou, which has
wakened to speak to you in unmistakeable accents !
No I there is another and an infallible method of overthrowing
this doctrine, if that is possible to be done.
This doctrine appeals not only chiefly, but solely to the verdict
of experience— "repeat the experiments," it cries aloud, ** repeat
ihem careAiUy and accurately, and you will find the doctrine
confirmed at every step " — and it does what no medical doctrine,
no system of physic, no so-called therapeutics ever did or could
do, it insists upon being "judged by the result."
Here, then, we have homoeopathy just where we wished to
have it; here we can (come on, dear gentlemen, all will go on
nicely) give it the death blow from this side.
Take one case of disease after another, note it down according
to the directions given in the Organon, specially in respect of
all its discernible symptoms, in so exact a manner that the
founder of homoeopathy himself shall be unable to find &ult
with the minuteness of the report (of course any case selected
must be one for which a homoeopathic medicine is to be found
amongst those medicines whose peculiar symptoms are known)
and administer the most appropriate homoeopathic medicinal
substance that can be discovered, pure and unmixed, for the
case of disease in question, in a dose as small as this doctrine
directs; but, as is expressly insisted on, taking care to remove all
other kinds ofmedimial influences from tlie patient^ and if it do not
give relief, speedy, mild and permanent relief, then, by a publi-
cation of the duly attested history of the treatment according to
the principles of the homoeopathic system strictly followed out, you
will be able to give a public refutation of this doctrine which so
seriously threatens the old darkness.
But I pray you to beware of playing false in the matter I — all
roguery comes to light and leaves an unfavourable stigma behind it
as a warning,^
K then, following your conscientious example, every other
equally conscientious and careful medical experimentalist meets
* As a warning example in point, I would refer to the notorioiis (exquisitelj re-
corded) Ustory of a disease which Kotzebue was said to have had, and of which be
was Baid to be miraculously cured by means of the excitement theory method. It
was, however, as was poon phewn a pure invention ; invented in order to serve the
purp<ifie:9 of the excitement-theory of that time, and the disgrace of the deception i^
still and will ever be attached to the name of its author.
602 SOTA BKHS FOB XT BXTJEWMSOL
with the same result — ifaU thai Ae homoeopathic doctrine pnmi$e$
fnym being faitl^uUy followed out does not take place — then homodo-
pathj is as good as lost, it is all up with homiBopakhj if it does
not i^w itself efficacious, remarkably efficacioas.
Or, gentlemen on the opposition oorporaticm benches, do joa
know any other and more potent method for suppressing this
accursed doctrine, with its truths^ that cut into the very soul <^
the dogmatists of ancient and modem times, well-armed though
they be — ig^iea inest ilUs via et coeUstis origo — which, as it is
asserted for certain, only needs to appeal to impartiality and
sound human reason, in order to find an entrance into the unoor-
rupted understanding, and can point to the in£dlibly beneficial
effects that result fix)m a fidthM following out of its precepts^
and is thus enabled to triumph certainly over all obduracy ;—
' Hie tmth of this, the ool j ratiooal doctrine of medicine, mart seiae npoo tbi
ooDTictioDs of these gentlemen if they ponessod but a spariL of reason, and it iSA ao
to a certain extent^ as we maj obsenre here and fliere in their writings, from flw
piteoas lamentations caused hj their appniienskin of the speedy overthrow of tht
antiquated edifice of their oorporatioQ.
But, see, they feel their brains so stofEed foil of the hondred tbnnsand fiuadfal
ideas, insane maTims, systems and dogmas and the load of ereilasting practical
trash, they are no longer capable of laying aside this useless fufuiUire, in order tea,
with freedom of mind to practise impartially a system so simple as hooMBopathy k,
for the benefit of mankind. They feel theoiselves, I say, so incapable of doing this^
that the ill-humour this causes distorts not only their mind, but also their leatare%
and can only find vent in impotent abuse of the better way that they can nerer
attain.
I am almost sorry for them ; for the old frlsehoods so often paraded before then
as truths hover incessantly before their memory as though they stall were trutfaa;
the fictions presented to them as articles of fiiith, and testified to by illustrious and
great names, have been so often dunned as important and proper things into their
ears, that they continue still to resound there ; the illusory doctrinal maxims and the
suppositions, a priori explanations, definitions and distinctions of the schoola, oOered
to them as axioms, have been so often read by them again and again in print, and
custom has habituated their whole mode of operations to such an easy-going routaoe
readiness, that they are unable any longer to resist the pressure of those accustomed
things that have become their second nature, and they must, in spite of themselres^
continue to think and act in the same way — (at the very first view of the patient
some particular anatomical seat in the body occurs to them as the undoubted seat of
the disease, some nosological name for the disease presses itself upon them, they
already feel at their finger ends the elegant compound prescription, which they wiU
dash off upon the nearest piece of paper) — so that even if they wished seriously to
reform and lead a new medical life in simplicity and in truth, wcirthy of the Allseo*
ing Maker of our mind that he has created to enable U9 to administer to the relief of
sick and sufiering humanity, tkey are note incapable of doing $0.
Such is the character of the self-styled critic* of the refiinned system of medicine
and their aiders and abettors ; how can their rriticiKnis be other than they are i God
have mercy on their poor souls I
IfOTA BXNB FOB KT BSVnBWSBS. 688
do yon, gentlemen, I repeat, know any more effectual mode ol'
Buppieflsing this doctrine 7
YesI apparently you think you do.
Continue then to exalt the common-place twaddle of your
school to the very heavens with the most fulsome praise, and to
pervert and ridicule with your evil mind what your ignorance
does not pervert ; continue to calumniate, to abuse, to revile :—
and the unprejudiced will be able plainly to comprehend on
whose side truth lies.
The improved (homoeopathic) medical doctrine will stand out
in more prominent relief and appear to greater advantage
against the ibil of this nonsense, and ( — ^for who can entertain a
doubt respecting the feeling for truth inherent in the better part
of mankind? — ) will dispel the nocturnal darkness of antiquated
stupidities, for it teaches how to afford certain benefit in diseases,
where hitherto mere incomprehensible learned palaver, at the
bed-side of the late lamented, sought in vain to hide the damage
done by pint and quart bottles full of unsuitable mixtures of
nnknown, life-destroying drugs.
And what do you say when you see the author and first
teacher of homoeopathy, together with his genuine disciples,
oure without suffering and permanently, a much greater propor*
tion of patients, and such as are suffering from the worst, the
most tedious complaints, with few, mild tasteless medicines?
Can your so-called art do the like? Does not such a result
laugh to scorn your miserable theoretical scepticism, and the
impotent routine of your cut-and-dry system ?
If you really wish to do as well, imitate the homoeopathic
practice rationally and honestly I
If you do not wish this — well then, harp away — we will not
prevent you — harp away on your comfortless path of blind and
servile obedience in the dark midnight of fanciful systems, se-
duced hither and thither by the will-o'-the-wisps of your vene-
rated authorities, who, when you really stand in need of aid,
leave you in the lurch — dazzle your sight and disappear.
And if your unfortimate j)ractice, from which that which you
intended, wished and promised, does not occur, accumulates
within you a store of spiteful bile, which seeks to dissipate itself
in calumniating your betters — well then, continue to call the
grapes up yonder, which party-pride, confusion of intellect,
weakness or indolence prevents your reaching, sour, and leave
them to be gathered by more worthy persons.
684 EXAMINATION OF THR 80UR088 OF THE
Continue, if it pleases yon, enviously to slander the sublime
art, but know that envy gnaws in vain at adamantine truth, and
only consumes the marrow of the bones of its possesaor.*
EXAMINATION OF THE SOURCES OF THE COMMON MATERIA
MEDICA.^
Next to a knowledge of what there is to cure in each particu-
lar case which presents itself for treatment, there can be no
more necessary knowledge for a practical physician, than an
acquaintance with the curative implements^ to know, namely,
what each of the remedies can certainly cure.
Twenty-three centuries have been spent in fruitless labour to
discover the way by which the end of this knowledge may be
reached ; and not a step has been gained by all the efforts.
Had the millions of physicians .who during this long space of
time occupied themselves with the subject, only discovered the
way to the knowledge of how this end (the discovery of the healing
properties of each medicine) was to he attained^ then had much,
almost everything been accomplished ; for then would this way
have been capable of being pursued, and the zeal and exertions
of the better class of physicians must have soon won a consider-
able territory of knowledge, so that what still remained to be
investigated would also soon have been within our grasp.
But observe, that not one, as yet, ever trod the patB that surely
and certainly leads to this end. All the paths hitherto trodden
were, consequently, as one century was forced to say of those
of another, mere ways of error. These we shall examine some-
what more closely.
The Jirst source of the Materia Medica hitherto extant is mere
guess work and fiction, which attempts to set forth the general
therapeutic virtues of drugs.
Exactly as the text ran in Dioscorides, seventeen centuries
ago: this or that substance is resolving, dissipating, diueretic,
diaphoretic, eminenagogue, antispasmodic, caihartic, &c., — so runs
it now in most recent works on Materia Medica. The same de-
scription of the general virtues of particular drugs, whidi do not
turn out true ; the same general assertions, which did not hoid
* Av'»va i3e.roir, AesclivL, JiStfiien., 829.
' From the Beine ArmeimiUelUhre^ part iil
COmOK MATERIA MBDICUL 605
good when put to the trial at the sick-bed. Experience declaredly
that such a medicine very seldom performs, in the human bodj,
what these books allege respecting its general therapeutic
virtues ; and that when it does, this happens either fix>m other
causes, or it is a merely palliative passing effect (primary action),
which is certainly followed by the opposite, to the greater detri-
ment of the patient
If a medicine prized for its diuretic, diaphoretic, or emmena-
gogue qualities, when given by itself alone, had, m special ctr-
cumsianceSj and in one out of many cases, seemed to have had
this effect, should it, on this account, be pronounced as abso*
lutely possessing these qualities, that is, would it deserve the
title of an unconditional diaphoretic, emmenagogue, or diuretic?
In that case, we should dignify with the name of an honest man,
one who only occasionally acted honestly ; and on one who
only lied on rare occasions, we should bestow the honourable
name of a truthftil man, a man of his word I
Are our conceptions to be thus perverted and reversed?
But these rare instances do not prove that a certain effect will
take place even in rare cases ; for not in one case out of a. hun-
dred were the substances given alone, but almost always in com-
"bination with other medicines.
How few physicians are there who have given a patient but
one single simple substance at a time, and waited for its sole
operation, avoiding altogether the concomitant use of all other
medicinal substances I It is nothing but a mixture of various
medicines that ordinary practitioners employ I And if they
ever give a simple substance, for example, in powder, they are
sure to order also some herbal infusion (another kind of medi-
cine), or medicated clyster, or embrocation, or fomentation of
some other kind of herbs, to be used along with it. They never
act otherwise. This inherent vice clings like pitch to the ordinary
practitioner^ so that he never can rid himself ofiL He is in straits
before and behind, and he cannot rest, and is not at ease, if this
and that, and a score of other drugs, are not prescribed into the
bargain.
And for this they have plenty of excuses.
They maintain that this or that medicine (of the peculiar and
pure effects of which, however, they know nothing) is the prin-
cipal ingredient of their compound prescription, and that all the
effects must be attributed to it. The other substances were
added for different objects, some to aid their principal ingredient,
M5 XXAHIHATION OF THX 80UBCB OP THX
Bonie to oonect it, others to direct it to this or that pait of the
body, or to give it the necessary instmctioiis <m its paasags
(their own peculiar operation being all the time nnknown); wm
i£ the drugs were intelligent beings, endowed with well-diqpoaed
wills and complaisant obedience, so that they wonld prodnee
jnst that efSdci in the body which the doctor ordered them, and
not a particle more !
Bat do these accessory snbstances cease, on your command,
to confuse and to counteract, with their own peculiar and oif*
known medicinal influence, the action of your principal, and to
produce, in accordance with the eternal laws of their own inh€S^
ent nature, effects which cannot be surmised or predicted, and
can only be discovered and brought to our knowledge by pnie
experiment?
Is it not foolish to estimate the effect of on^ force, while other
forces of another kind were in action, which often contnbnted
mainly, though in common with the rest, to produce the leBuH?
It would not be more absurd if some one were to try to per*
auade us that he had discovered a good article of nutriment in
kitchen salt; that he had ordered it to a man half-starved,
and that he had no sooner eaten of it than he was invigorated,
satiated, and strengthened, as if by miracle ; that the ounce of
conmion salt was the basis and chief ingredient of the nutri-
tious receipt prescribed by him, which he had caused to be
dissolved, lege artis^ in quantum satis of boiling water as the
excipient and vehicle, then he had added as a corrective, a
good lump of butter, and, as an adjuvant, a pound of fine
cut rye-bread. This mixture (soup), after being properly stirred,
he caused to be taken at once by the Seanished patient, and
by it his hunger was completely appeased ; — aU die latter in-
gredients were merely accessaries in the prescription, the chief
ingredient was the ounce of salt This was prescribed by him
as the basis of the whole receipt ; and see I — ^in his hands it
had, when prepared accurately according to these directions,
always exhibited the most beneficial results.
I^ in the kitchen Materia Medica, the virtues, of saturans^
analepticum^ restaurans^ reficiens^ nutriens should, firom these cir-
cumstances, be ascribed to the article Sal culinare^ it would
not be more childish and absurd than the conduct of the
physician who should arbitrarily ordain one substance to be
the basis of his diuretic^ then add two, three, or four other
powerful (unknown) medicinal substances (with the sage object,
COMMOK MATSBIA MEDIOA. 667
forsooth^ of serving as corrigens^ dirigens, adjuvans^ excipiens\
ftnd order the patdent to walk up and down the room while
taking the mixture, drinking in the meantime largely of warm
Back-whey, made of Bhine-wine well sweetened with sugar, and
then publish triumphantly the extraordinary success of the basis
he had prescribed : '' The patient has passed more urine than
UBuaL" In his ^yes the added substances and the regimen are
mere unimportant accessaries, and innocent of the result, in
drder that he may be able to ascribe to the substance which he
has constituted the chief ingredient in the receipt, and in which
(he knows not why) he takes the deepest interest, and whose
fsune h^wishes to extend, the sole honour of the effects produced.
Thus it naturally happens, when, by such arbitrary and wilM
praise of a medicine which some one has taken a fancy to, and
to whidx he was determined to attribute some definite curative
property, the undeserved and surreptitious attributes of diuretic^
emmenagogue^ resolvent^ sudorific^ expectorant^ antispasmodic^ are
insoibed in the willing Materia Medica, where they afterwards
figure as truths, deluding those that trust to it.
Thus this rare effect must be attributed to the action of all
these medicines which were used at once I How small a part of
the uncertain credit of being a diuretic, diaphoretic or emmena-
gogue, or any other sort of medicine, fidls to the share of each
individual ingredient in the receipt I
Consequently, the general theraputic virtues of drugs ascribed
to them by Dioscorides, and re-echoed by his successors, which
occupy the greatest share in Materia Medicas even of our own
day, as, for instance, that this or that medicine was diuretic, di-
aphoretic, purgative, expectorant, or a purifier of the blood and
humours, are quite unfounded.^
The assertion that this or that medicine is resolvent, discutient,
an exalter or depresser of sensibility, irritability, or the repro-
^ When no other virtue could be attributed to a medicine, it must be at leaet aa
€9Qeuant : evacuant in some way or other ; for, without an eyacuation — ^without an
cracuation of the morbific matter which their grossly material cooceptioiis of diseast
led them to seek in all diseases, they could not imagine that a medicine could aflSect
a cure. Since, then, the generation and existence of a disease was due to this hypo-
tiietical morbific matter, they bethought themselves of all the conceivable exits firom
file body by which this desperate matter could be driven out by medicines ; and the
medicine had to do them the fovour, to take upon itself the cffice of expelling this
imaginary morbid matter from the numerous vessels and fluids, and of clearing it
away by means of the urine, sweat, expectoration, or alvine discharge. These were
the principal effects they hoped and expected firom their remedies : this was the pari
all the medicines in the Materia Medica had to play.
068 SXAMINATION OF THE SOUBOXS OF THE
ductive function, rests upon baseless hypothetical assumptions
alone. It was in itself a false and hypothetical assumption^ des-
titute of proof and of reality, that it was necessary direeily to
perform these operations in diseases at all. How then, in the
name of reason, could it be ventured to ascribe these in them-
selves nugatory virtues to individual medicines, without proof)
irrespective altogether of the fact they were i^ost never pre-
scribed singly, but almost always only in combination with
others ? Thus every such assertion is a palpable lie.
What was ever seen dissolved or resolved in the interior of the
human body by medicines? By what fistcts was such a power
of dissolving living parts of the organism proved to be possible
by drugs ? Why is irrefragable evidence of the manifestation
of this power by some substance not brought forward ? Or
why, since it is impossible to observe such mechanical and chemir
eal effects of a drug in the undiscovered and undiscoverable pene-
tralia of the organism, has not a sense of shame restrained men
from publishing such inventions as truths and dogmas, and,
with unblushing brow, falsely ascribing such actions to medi-
cines, since error in the most serious and important of all earthly
vocations, the healing of the sick, must have the most grievous
consequences ; and falsehood here is the greatest crime, being
nothing less than high treason against humanity ?
And what is there, even in the hidden internal parts of the
living body, to dissolve or dissipate, which the human organ-
ism, when acted on by medicine proper for its recovery, cannot
itself, when necessary, dissolve ?
Is there anything actually present in the body to be dissolved
from without, as the opinion implies ? Has not our Sdramering
proved that the swollen glands, which had always hitherto been
considered to be obstructed, had, on the contrary their vessels
greatly dilated. Has it not been established by experiment on
healthy peasants, that by the persevering use of Kampf 's clys-
ters there may be produced in and evacuated from their bowels
the same abominable evacuations which Kiimpf, on hypothetical
grounds, assumed to exist in the body of almost all patients
affected by chronic disease, in the form of stoppage, infarctus,
and accumulations ; although he had at first, by his compound
herbal decoction, administered in the form of several hundred
clysters, brought on the imnatural condition of the bowels which
produced these secretions, and then got them evacu.ated, to the
horror of all beholders ; and, unfortunately, the rest of the pro-
COMJCOK MATSBIA KBDIOA. 669
&Bsion were almost without exception his followers, and in their
mind's eye they now saw in almost all patients nothing but ob-
structions of the smallest vessels of the abdomen, infarctus and
accumulations, took the senseless herb-mixture of Kampf to be
really dissolving and dissipating, and clystered the poor patientSy
for the sake of an hypothesis, with the greatest vigour and per*
severence, almost to death, so much so that it was a sin and a
shame.
' Now, supposing that these imaginary cases were indeed
real, and that there could be something to dissolve and dissipate
in the diseased human body, who has ever seen this dissolution
or dissipation effected by the direct action of the medicine when
the patient recovers, so that the vital force, which before presid-
ed over all the operations of the organism, had remained, in
this instance, a passive spectator, and had allowed the medicine
to work^ unaided, upon the supposed obstructed and indurated
parts, as a tanner operates on his hides?
By means of calomel, according to the history of a case,' a
chronic vomiting that occurred after meals was removed. The
cause of this vomiting was represented as nothing less than an
induration of the stomach and pylorus ; this the narrator of the
case avers with the greatest effrontery, without adducing the
slightest evidence in support of his position, only that he might
attribute in this manner an unconditional resolvent power to
calomel, and assume the honour to himself of curing a disease
which is as rare as it is incurable. Another writer,^ rants in the
same imaginative strain about pressure on the stomach, cramps
in the stomach, eructation and vomiting in his patient being due
to some organic disease of the stomach, scirrhus, indurations and
tumours, and believes that as these were removed by drinking
for a length of time decoction of triiicum repens (and at the same
time preserving a well-regulated diet and regimen?), that he
has fully established that this herb can cure scirrhus of the
stomach, of the existence of which in his case there was not the
slightest proof But pressure of the stomach, eructation, and
vomiting after meals, even when of long standing, are by no
means rare maladies, and are often easily curable by an im
proved diet and regimen, and, alone, aflbrd no proof of indura-
tion or scirrhus of the stomach or pylorus. This disease is ac-
liufflandi Journal, 1815, Decx, pi 121.
' Id UufelandiyfounuU, 1813, p. 68.
670 XXAMINATIOK OF THB 80UBCB OF THB
oompanied by much fncre serious symptoms than preasuiey emo-
tation, and mere vomiting are.
This is however the highly commendable way in wbidi a
medicine is raised to the nndeserv ed honour of being a resolving^
dissipating, &c. remedy, namely, by blind conjectore and bold
assumption of the presence of an important internal maladji
never seen or capable of being proved to be there. '
The second source of the virtues of drugs, as ascribed to them
in the materia medica, has, it is alleged, a sure foundation, viaL,
their sensible properties^ from which their action may be inferred.
We shall see, however, what a turbid source this is.
I shall spare the ordinary medical school the humiliation of
reminding it of the folly of those ancient physicians who, deter-
mining the medicinal powers of crude drugs from their siffnaturtf
that is, from their colour and form, gave the testicle-shaped
Orchis-root in order to restore manly vigour; the phaMus wi-
pudicus, to strengthen weak erections; ascribed to the yellow
tumeric the power of curing jaundice, and considered hypericum
perforatum^ whose yellow flowers on being crushed yield a red
juice {SL JohrHs blood) useful in haemorrhnges and wounds, &a;
but I shall refrain from taunting the physicians of the present
day \nih these absurdities, although traces of them are to be
met with in the most modem treatises on materia medica.
I shall only allude to what is scarcely less foolish, to wit, the
attempts, even of those of our own times, to guess the powers
of medicines from their smell and taste.
They pretended, by dint of tasting and smelling at drugs, to
find out what effect they would have on the human body ; and
for this they invented some general therapeutical expressions.
All plants that had a bitter taste should and must (so they
decreed) have one and the same action, solely because they tasted
hitter.
But what a variety even of bitter tastes there are ! Does this
variety not indicate a corresponding variety of action.
But how does the bitter taste obtain the honour awarded to it
by the Materia Medica and practical physicians^ that it is a
proof of the so^xUkd stomachic and tonic powers of drugs, and an
evidence of their similar and identical action, so that, according
to this arbitrary axiom, all the amara possess no other medicinal
action but this alone f
Although some of them have, besides, the peculiar power of
producing nausea, disgust^ oppression of the stomach and enu>
COXXOK MATERIA HSDIOA. 671
tations in healthy individuals, and consequently of curing,* ho-
moeopathically, an affection of a similar nature, yet each of them
possesses peculiar medicinal powers quite different from these,
which have hitherto been unnoticed, but which are often more
important than those ascribed to them, and whereby they diffet
extremely from each other. Hence, to prescribe bitter-tasted
things without any distinction, the one in place of the other, as
if they all acted in the same manner, or thoughtlessly to mix
them together in one prescription, and under the name of bitten
(eaOracta amara) to administer them, as if they were indubitably
identical medicines, haying only the power of strengthening and
improving fche stomach, betrays the most wretched, rudest
routinisml
And i^ as this dictatorial maxim of the authorities in materia
medica and therapeutics would have us believe, the bitterness
alone is sufficient to prove that everything tiiat tastes bitter
(amara/) is absolutely and solely strengthening, .and improves
the digestion, then must colocyntk, squHb, boletus laricis, the
thick-barked, much-abused angustura, eupcUoriumy mponaria^
myrica gale^ lupina^ lactuca mrosa, prussic acid, and upas-poison^
all be entitied, as bitters, to rank among the tonic, stomachic
medicines.
From this any one may easUy see how irrational and arbitoary
the maxims of the ordinary materia medica are, how near they
are to downright £Edsehoods I And to make fiilsehoods the basis
of our system of treating the sick-what a crime!
Cinchona was found to have a bitter and astringent taste.
This was quite enough for them in order to judge of its inward
powers ; but now all bitter and astringent tasting substances and
barks must possess the same medicinal powers as cinchona bark.
Thus was the action of medicines on the human frame deter*
mined, in the materia medica, in the most unthinking and hasty
manner from their taste alone I And yet it must and ever will
bo fidse, that willow-bark, or a mixture of aloes and gall-nuts,
have the same medicinal properties as cinchona bark. How
many such Chimin factitios, which were to answer all the purposes
of the true cinchona bark, have been publicly recommended by
celebrated physicians, manufactured and sold, and administered
with the greatest confidence to their patients by other physicians I
Thus, the life and health of human beings were made depen-
dent on the opinion of a few blockheads, and whatever entered
their precious brains went to swell the materia medica.
678 EXAXINAnOK OF THE 8OUB0B OP THE
In the same xnaDner a number of inconceivably diwimihr
Bmells were jumbled together in one category, and all chrigtened
aromatks^ in order that under this name a similar m<Miirinal ao*
tion might conveniently be invented for them. Thus they wera^
without the slightest hesitation or consideration, one and all
pronounced to be exaUers of the forces (excitants), strengthenen
if the nervesj deobstruents, &c.
Thus the most imperfect, the most deceptive of all the aenaeB
of civilized man, that of smell,* which admits of the ezpreasicxi
by words of so few perceptions of sensible differenoes — this
should suffice to determine the dynamic properties of a medicine
in the human organism, whilst all our senses iQgetheri employ*
ed with the utmost care, in the examination of a medicinal sub-
stance with regard to its external froperties^ do not give us any,
not even the ^ghtest information respecting this most important
of all secrets, the internal immaterial power possessed by n^
tural substances to alter the health of human beings ; in other
words, respecting their true medicinal and healing power, which
is so extremely different in every active substance, firom that ni
eiv&rj other, and which can only be observed when it is taken
internally, and acts upon the vital functions of the organism 1
Must mavflower, mint, angelica, arnica, sassafras, serpentaria,
sandal, coriander, chamomile, rosemary, necessarily have the
same medicinal action, because forsooth, it pleases the olfftctoiy
organ of the respectable teachers of materia medica*to discover
that they all have an aromatic smell ?
Can a materia medica composed of such a jumble of fliggimiUr
medicines, all highly important, from the very variety of their
action, shew aught else than intemperate presumption and dis-
honest, ignorant self-complacency?
No art, be it ever so mean, has been guilty of such wanton
fictions ^-ith respect to the uses and powers of its materials and
tools. The agent to be employed was, at all events, always tried
upon smaller parts of the object it was intended to work upon,
in order to ascertain what alterations it was capable of effecting,
beibre it was employed on a large scale in the precious work,
where an error might be productive of serious injury. The
cotton bleacher tried the effects of chlorine, which is so destruc-
tive to vegetable matters, in the first instance on a small portion
' Preciwly the ino«t powtrfiil nwdidDes, beUadoona, digitalit^ tmrter emccic;
Die, 4»^ hare little or no bmelL
GOKMON MATERIA XSDIGA. 678
of clotb, and thereby avoided exposing all his stock of goods
to danger. The shoemaker had previously convinced himsell
of the properties of the hempen thread, that it was stronger in
the fibre, ^t when it was exposed to damp, it filled the hole»
in the leather by its expansion more completely, and resisted pu*
trefiiction more powerfully than flax, before he preferred it to
the latter for stitdiing all his shoes ; and that, after all, was but
cobbler's work !
But in the arrogant medicine of the common stamp, the medi-
cines— ^the tools of the healing art — are employed without the
least hesitation in the most important work which one man can
perform for his brother man — ^a work whereon life and death|
nay, sometimes the weal or wo of whole femilies and their de-
scendants depends, namely, the treatment of disease ; and the
acquaintance with thes^ remedies being derived solely from
their deceptive outward appearance, and from the preconceived
notions and desultory classifications of teachers of materia
medica, there is the greatest danger of deception, of error, and
of fitlsehood. But even then, as if to conceal the effect of each
individual one, several remedies are given mixed together in
one prescription, with no anxiety as to the inevitable result I
So much for the unfounded allegations respecting the general
therapeutic virtues of the several medicines in the materia me-
dica, which are all elevated to dogmas, on a foundation of blind
guess-work, preconceived ideas, extraordinary notions and pre-
sumptuous fiction. So much for this second impure source of
the materia medica, as it is called, hitherto in use I
Chemistry^ also, has taken upon itself to disclose a source at
which the general^ therapeutic properties of drugs are to be as-
certained. But we shall soon see the impurity of this third
source of the ordinary materia medica.
Attempts were made a century ago by Geofirey, but still more
fi^uent have such attempts been made since medicine became
an art, to discover, by means of chemistry, the properties of re-
medies which could not be known in any other way.
I shall say nothing about the merely theoretical fidlacies of
Baume, Steftens, and Burdach, whereby the medicinal properties
of medicines were arbitrarily declared to reside in their gaseouF
and certain other chemical constituents alone, and at the same
time it was assumed, without the slightest grounds, (m mere con'
jecture, that these hypothetical elementary constituents possessed
43
^ 674 EXAMIXATIOK OF THE 80UBC£S OF THE
certain medicinal powers ; so that it was really amusing to see
the fecility and rapidity with which those gentlemen could cre-
ate the medicinal properties of every remedy out of nothing.
As nature, trials on the living human organism, observations
and experience were all despised, and mere fimcy, expert
fingers and overweening confidence were alone employed, it is
easy to conceive that the whole afifair was very soon settled.
No ! I allude to the earnest aspirations, and the honest exer-
tions of those of the present day, to arrive, by means of vegeta-
ble and animal chemistry, at a knowledge of the real pure
action of medicines on the human frame, in which| as was deeply
felt, the materia medica up to that period was miserably deficient
True it is that Chemistry — ^that art which reveals to us such
astonishing miracles, appeared to be a much more Ukdy source
for obtaining information with respect to the properties of
drugs, than all the idle dreams, and learned salti viortali of an-
cient and modern times, which we have just been considering ;
and many were infatuated with this expectation^ yet, chiefly
such as either did not understand chemistry (and sought much
more fix)m it than it could give or possessed), or knew nothing
about medicine and its requirements, or were ignorant of both
the one and the other.
Animal chemistry can merely separate from animal substances
such inanimate matters as shew a different chemical action with
chemical rc-agents. But it is not these component parts of ani-
mal tissues, separated by auimal chemistry, on which the medi-
cines act when they derange the health, or cure tlie diseases of
the living organism, either tlirougli their elementary part^, as
the chemist would have us believe, or directly upon them.
The fibrine, coagulable lymph, gelatine, organic acids, salts and
earths, separated from muscular substances by chemical opera-
tions, dill'er toto oj^lo from the living muscle, endowed with irri-
tability in its perfect organized state in the healthy and disea^iied
individual; the matters separated from it have not the most
distant resemblance to the living muscle. What information
respecting the nature of the living organism, or the changes
which the difterent medicines are capable of effecting on it
when alive, can be derived from these separated inanimate por-
tions? Or is the process of digestion (that wonderful transmu-
tation of the most dissimilar kinds of food for the purpose of
promoting the perfect development of the living individual in
all the variety of his organs and humours) rendered in the
OOVMOK MATERIA 1C8DICA. 675
slightest d^ree comprehensible from the discovery of a little
soda and phosphatic salt in the gastric juice? Can even the
material, not to speak of the dynamic, cause of a morbid diges-
tion or nutrition be understood by what chemistry finds in the
gastric juice, so that a sure method of treatment could be found-
ed thereon? Nothing could be more futile than any expecta-
tion of this kind.
In like manner, in the chemical constituents shewn by vege-
table chemistry to exist in plants, even in such as possess the
most powerful medicinal properties, there is nothing either tc>
smell or taste which can express or reveal those so varied ac-
tions, which, experience shews us, each of these medicinal sub-
stances is capable of performing, in altering the state of an indi-
vidual, whether in health or disease.
The water or oil, distilled from the plants or the resin ob-
tained from it, is certainly not its active principle ; this only
resided, invisible to the eye. in those parts now extracted from
it — ^the resin, the oil, the distilled water ; and is in itself per-
fectly imperceptible to our senses. Its effects are manifested to
our senses only when this distilled water, this oil, this resin, or,
still better, the plant itself is taken by the living individual,
and when they act dynamically on the susceptible spiritual-ani-
mal organism, in a spiritual manner.
Moreover, what medicinal action do the other parts which
chemistry extracts from plants indicate, the vegetable fibrine,
the earths, the salts, the gums, the albumen, &a, which, with
few exceptions, are found almost uniformly in all plants, even
those most opposite in their medicinal effects ? Will the small
quantity of oxalate of lime which chemistry shews us to exist
in rhubEurb-root, account for this medicine producing in healthy
individuals such a morbidly altered sleep, and such a curious
heat of the body without thirst, and for its curing similar mor-
bid states ?
What information can all these parts, though analysed ever
so carefully by chemistry, give us, relative to the power of each
individual plant, virtually to alter the health of the living hu-
man organism in the most peculiar and various manners ?
The chemist, Gren, who knew nothing about medicine, in his
Pharmacology, which is full of the most reckless assertions,
thus holds forth to physicians : " The knowledge of the princi-
ples contained in medicines, which chemistry gives us^ can
alone determine the efficacy of remedies."
676 EXAMIVATIOK OF THX SOUBCXS OF THS
Knowledge indeed! And what knowledge does chemistry
give us with respect to the inanimate, speechless, component
parts of medibines? Answer: It merely teaches their chemical
signification, it teaches us that they act so and so with chemical
re-agents, and hence are called gum, resin, albumen, mucus,
earths and salts of one kind or another ; — ^matters of vastly lit*
tie importance to the physician. These appellations tell us no-
thing of the changes in the sensations of the living man which
may be effected by the plant or mineral, each differing from
the other in its peculiar invisible, internal, essential nature;
and yet^ forsooth, the whole healing art depends on Ais alone I
The manifestations of the active spirit of each individual reme-
dial agent during its medicinal employment on human beings^
can alone inform the physician of the sphere of action of the
medicine, as regards its curative power. The name of each of
its chemical constituents, which in most plants are almost iden-
tical, teaches him nothing on this point
That calomel, for example, consists of from six to eight parts
of mercury, united by sublimation to one of muriatic acid — that
when rubbed up with lime-water, it becomes black, chemistry
can teach us ; but that this preparation can cause in the human
being the well-known salivation with its peculiar odour, of this
(rhemistry, as chemistry^ knows nothing ; this no chemistry can
teach us. This dynamic relation of calomel to the human
organism can only be learned from experience, derived from its
medicinal employment, and from its internal administration,
when it acts dynamically and specifically on the living organ-
ism: and thus it is only actual experiment and observation
relative to the action of medicinal substances on the living hu.
man subject that can determine their dynamical relation to the
organism, in other words, their medicinal properties; but this
chemistry, in whose operations merely inorganic substances are
brought to act upon one another, can never do.
Chemistry can indeed give us the useless information, that
the leaves of belladonna are very similar in their chemical com-
position to cabbage and to a great many other vegetables, as
they contain albumen, gelatine, extractive matter, green resin,
vegetable acid, potash, calcareous and siliceous earths, &c. ; but
if, us Gren asserts, the knowledge of the principal constituents,
so far as they are known to cbeinihtry by means of its re-agents^
that is, chemically, suflices to determine the medicinal proper-
ties of substances, it follows that a dish of belladonna must be
COMMON KATSBIA HEDIGA. 677
JQSt as wholesome and innocent an article food as one of cab-
bage. Is that what the chemist means ? And yet the chemis-
try which presumes to determine the medicinal properties of
natural sabstances from their chemical composition, cannot
avoid asserting that the same medicinal powers are possessed
by substances which are proved by analysis to consist of the
same constituents ; it cannot consequently help declaring cab-
bage and belladonna to be equally innocent vegetables, or
equally poisonous plants ; thereby sliewing, as clear as day, the
absurdity of its presumption, and its incompetence to judge of
the medicinal powers of natural substances.
Do Gren and his followers not perceive that chemistry can
only give chemical information with respect to the presence of
this or that material component part of any physical body, and
that these are consequently to chemistry merely chemical sub-
stances? Chemical analysis can tell us their action with chemi-
cal re-agents, and this in its proper domain ; but it can' shew us
neither in its dissolving nor digesting alembics, neither in its
retorts nor yet in its receivers, what dynamical changes any
single medicine, when brought in contact with the living organ-
ism, can produce.
Each science can only judge and throw light on subjects
within its own department; it is folly to expect from one
science information upon matters belonging to other sciences.
The science of hydrostatics enables us to determine with pre-
cision the specific gravity of fine silver in comparison with that
of fine gold ; but it presumes not to fix the difierent commercial
value of the one in comparison with that of the other. Whether
gold have twelve, thirteen, or fourteen times the value of its
weight of silver in Europe or in China, hydrostatics can never
tell ; it is only the scarcity of and the demand for the one or
the other, that can determine their relative mercantile value.
In like manner, indispensable as a knowledge of the particiihir
fonn of pUints is to the true farmer, and Hie power of distinguish-
img them by their external appearance^ which constitutes botany^
yet botany will never teach him whether a given plant is suit-
able or the reverse as for his sheep or swine, nor will it inform
him what grain or what root is best for making his horse
strong, or for fattening his ox ; tiie botanical systems of neither
Toumefort, nor Haller, nor Linnaeus, nor Jussieu, can tell him
this ; pure, careful, coniparative tiials and experiments on X\\v
different animals themselves can alone give him the requisites
information.
678 EXAMINATION OF THK 8DUBCB OT THK
Each science can decide on such mattera only aa are toiMn 0$
awn province.
What does chemiBtrj find in the native magnet and the arti-
ticial magnetic rod? In the former it disooveis nothing but m
rich iron ore, intimately combined with silica and a small quan-
tity of manganese ; in the latter, nothing but pore iron. No
chemical re-agent can discover, by the most minute chemical
analysis, the slightest trace of the mighty magnetic power in
either the one or the other.
But another science, natural philosophy, shews in its experi-
ments the presence of this wonderful power in the native mag^
net and magnetized steel, as also its physical relation to the ex-
ternal world, its power of attracting iron (nickel, cobalt), the
direction of one end of the magnetic needle towards the north,
its deviation from the north pole in different decenniums and in
diSferent regions of the globe, at one time towards the west, at
another towards the east, and the variety in its dip in diflfereni
d^rees of latitude.
IBfThe science of natural philosophy, then, is capable of telling
d(Hnething more respecting the magnet, and of discovering moie
of its powers, than chemistrj can, namely, its magnetic power
in a natural philosophical point of view.
But the knowl^e of what is worth knowing about the mag-
net, is not exhausted by chemistry and natural philosophy;
neither of these two sciences can detect anything in it beyond
what belongs to their own province. Neither the range of the
chemical nor that of the physical sciences can inform us^ what
mighty, what peculiar, what characteristic effects the magnetie
power is capable of producing on the health of the human body,
when brought into contact with it, and what curative powers
peculiar to itself it possesses in diseases in which it is suitable;
o{ this chemistry and natural philosophy are equaUy ignorant ;
this subject they must both abandon to the experiments and ob-
2>ervations of the physician.
Now, as no science can pretend to that which can only be ex-
plained bv another science, without rendering itself ridiculoosi
I hope that medical men will gradually have the sense to see
that the proper province of chemistry is merely to separate the
ohemical constituents of substances from each other, and to
•M>iubine iheiu together ag:tin. (thfts ononlniy ucfitu'ctii aid to phar^
.H^'xif) ; I hope that they will comniecce to see that medicines
«l«i m»t exist tor chemistry as medicines^ (i. e^ powers capable of
OOXXOK ICATSBIA XXDICA. 679
d jnamically altering the health of an individual), but merely in
80 far as they are chemical substances (i. e., in so &r as their
component parts are to be regarded in a chemical light) ; that
chemistry, consequently, can only give chemical information
with respect to medicinal substances, but cannot tell what spirit*
ual, dynamical changes they are capable of effecting in the
health of the human being, nor what medicinal and curative
powers each particular drug possesses, and is capable of exer^
cising in the living organism.
Finally, from Hie fourth impure source flowed the clinical and
special therapeutic indications for employment {ab usu in morbis),
into the ordinary materia medica.
This, the most common of all the sources of the materia
medica, whence a knowledge of the curative powers of medi-
cines was sought to be obtained, is what is termed the practice
of physic, namely, the employment of medicines in actual diseases^
whereby it was imagined that information would be obtained
with respect to the diseases in which this and those in which
that remedy was efficacious.
This source has been resorted to from the very beginning of
the medical art, but has, from time to time, been relinquished,
in order to try and hit upon some more profitable mine for the
knowledge required but it was always had recourse to again, as
it (jpppeared the most natural method of learning the action of
medicines, and their exact uses.
Let us grant, for a moment, that this were the true way to
discover their curative virtues ; one would, at least, have ex-
pected that these experiments at the sick-bed would have been
made with single, simple drugs only ; because, by mixing seve-
ral together, it would never be known to which among them
the result was to be ascribed. But in the records of medicine,
we meet with few or no cases in which this so natural idea was
ever carried into execution, viz., to give only one medicine at
once in a disease, in order to be certain whether it could pro-
duce a perfect cure in that disease.
It accordingly happened, that, in almost every instance, a
mixture of medicines was employed in diseases ; and thus it could
never be ascertained y?>r certain, when the treatment was success-
flil, to which ingredient of the mixture the favourable result was
due ; in a word, nothing at all was learned. If, on the contra-
ry, this medicinal mixture proved of no avail, or, as usually
happened, did harm, just as little could it be learned, from this
KXAMINATION OF THK fiOUBflSS OF THE
result, to which of all the medicines the bad result was attribu*
table.
I know not whether it was an affectation of learning which
induced physicians always to administer medicines mixed to-
gether in prescriptions as they are called, or whether it was their
anxiety which made them &ncy that a single remedy was too
powerless and was not sufficient to cure the disease. Be this as
it may, the folly of prescribing several remedies together has
prevailed from the remotest antiquity ; and immediately after
Hippocrates' time diseases were treated with a mixture of medi-
cines, instead of with one single medicine. Among the many
writings falsely attributed to Hippocrates, of which the greater
part were written under his name, shortly after his death, prin-
cipally by his two sons, Draco and Thessalus, as also by their
sons, Hippocrates the third and fourth, and among those works
fabricated by the Alexandrians Artemidorus Capiton and his
kinsman Dioscorides, in the name of Hippocrates, there is not
one practical treatise in which the prescriptions for diseases do
not consist of several medicines, just as in the prescriptions of
their immediate followers, those of more modern times, and
those of the physicians of the present day.
But that from the employment of mixed prescriptions, it can-
not be ascertained what each individual remedy is capable of
effecting in diseases, consequently, that no materia medica can
be founded thereon, was first commenced to be perceived by
physicians of later times, whereon several zealously set about
prescribing in a simple manner, in order to ascertain experi-
mentally in what diseases this or that medicine was efficacious.
They also published cures which were said to have been effected
by a single simple remedy.
But how was the execution of this apparently rational idea
carried out ? We shall see.
In order to do so, I shall just run over what is to be found
on this subject in the three volumes of Ilufeland's Journal for
1813, 1814 and 1815, and shall shew that the power of curing
such and such diseases has merely been attributed to single
drugs, without their having been employed simply and alone.'
* It is true ooe angle indiTidual in aU these three Tolumes, Eb«fs, institiited es-
periinenta with ooe single remedy only, in various diseasen {HuftlaiMt* Jo»rmtd^
September an<l October 1818.) — With aintenic ulmie. But wliat M»rt uf cxpcrinioot^ ?
Such OH oi»uld tliruw no light (hi the curative |M)\vcri of this s^ubhtuiice. In the HfnA
place, the cases of intermittent fever in whidi he employed arsenic were not minutoly
and then the dose was such that it must have dune much man harm than
OOMXOV MATXRIA MXDIOA. 681
Oonsequently, this is a new piece of fallacy in the place of the
old one with its acknowledged composite prescriptions.
That ulceration of the lungs has been cured by pheUandriwn
aqwUkvm is pretended to be shewn in the history of a case
(Hn^Jand^B Joumcd^ August, 1818), whereby it appears (p. 110)
that tus9cUigOj senega and Iceland moss were used at the same
time. With what right can the advocate for this mode of treat-
ment (which was so complex) exclaim, in conclusion : — *^ I am
(xmvinced that the man owes the recovery of his health to this
remedy ahne " t
JSkuJi was the sort of convictions that were produced by the im-
pare source of the virtues ascribed to simple medicinal substan-
ces in the materia medica !
In like manner {ibid,, February, 1813), a case of inveterate
syphilis, which would not yield to various mercurial prepara-
tions, (it was, in fact, a mercurial disease I) was cured in four
weeks by ammonia^ along with which nothing, actually nothing,
was employed— except camphor and opium I — Is that nothing ?
An epilepsy {ibid,, 1813, March) was cured in 14 months by
valerian alone, nothing else being used at the same time — but
oleum tartari per deliquium, tinctura cohcynthidis^ and baths of
accTus calamus^ mint, and other aromatic substances (pp. 52, 68).
Is that nothing?
In another case of epilepsy {ibid,, p. 57) velerian alone effected
a cure, but there were employed, besides, an ounce and a half
ci pomegranate leaves. Is (hat notliing ?
good. However, hk candid acknowledgmeDt of the harm it did ii infinitely more
praiseworthy than the many allegec] cases of cure recorded by others, in which
anenic in the Urgest doses %» taid to have done nothing but good, and never the
least harm. Ebers affirms that the doses he administered were so smaU, that, in
most cases, they did not amount to one grain. To one patient he only gave 2'9thB
of a grain within the 24 hours (p. 56), and her life was put in danger, whereby it
may be perceived that even this minute dose is capable of producing the most fearful
eflbcts. /Tonet^fy-observing physicians have long known this ; but Ebers, led astray
by the materia medica, fancied that 2-9th8 of a grain in 24 hours was a very small
dose of arsenic. Pure experience tells us it is a manstroug^ a most unJuttifitUUe dom
m dUeaaet I When was it ever shewn that arsenic should be employed in doses of a
grain, or even of a tenth of a grain, in diseasei f Many experiments with small and
ttill smaller doses (more and more diluted solutions) have shewn, that one drop
vlucfa mntains the dedllionth of a grain of arsenic in solutiun, is, in many cases, much
f09 tirong a dose, even when arsenic is exactly suited for the case of disease. Had
he known this he would not have been astonished that his 2-9ths of a grain put hb
patient's life in peril Thufs from these trials, whicli are otherwise evidently ver}'
hfloest, nothing can be leamt> not even what arsenic cannot curt; for the moostroos
doaet effectually prevented any good effect Ihxn taking place.
882 SXAXINATIOV OF THS BOUBCMB OF THE
MadnesBy with nymphomanict, is said to have been eared by
arinking cold water ahne {xbifL^ 1814, Jan). But infusion cf vor
Urian and tinchira chiruB WhyttU (p 12) were very pmdantly
administered along with it, in order that the action of the oold
water should be so oompletely masked as to be unieoognisable;
and the same happened in the case of another patient, who used
these powerful adjuvants only less frequently (p. 16).
Tymon {ihid.^ 1814, Aug. p. 88) professes to have foond fttei^
ing to syncope a specific in hydrophobia. But, see 1 he gives aft
the same time 800 drops of laudanum^ in clysters, every two hours^
and rubs in a drachm of mercurial ointment every three houre*
Does this prove venesection to be the only true remedy for hydro-
phobia t
In like manner (ihid.^ 1814, April) a venesection, followed by
an hour of syncope, is said to have cured, solely and specifically,
a case of hydrophobia ; at the same time (p. 102), however,
there were only administered strong doses ofopium^ Jameses poiuh
der^ and calomel till scUivation was produced Is that nothing?
If the case (ti«., 1816, July, p. 8—16) is to be a proof of the
elBScacy of bleeding to sjmcope in already developed hydropho-
bia, as the author would have it, canJOwavks should not have
applied, and still less should mercurial ointment have been rubbed
in every two hours, and large doses of calomel and opium given
until violent salivation supervened. It is ludicrous when the
author adds (p. 20) that '^ the calomel was scarcely necessary."
This art of surreptitiously obtaining for a &vourite remedy the
merit of a cure, when the other equally powerful drugs em-
ployed might at all events claim a sh£u*c, is an established custom
with ordinary physicians ; it being particularly requested that
the courteous reader will shut his eyes, and allow the author to
designate all the secondary means employed inactive.
A case of tetanus is reported {ibid,, 1814, Sept, p. 119) to
have been cured by cold water effusion ahne. It is true opium
was at the same time employed ; '* as, lunuever^ the patient himself
attributed the amendment to the effusion alone, to the effiision should
the cure be ascnbed" This is what I call a pure source at which
to learn the virtues of drugs !
In a similar manner (ibid, 1815, Sept, p. 128) the healing
power of potash in croup is established ;* but along with it were
' One case, in which potash is said to have been efficacious when administered
akne was that of a child in the country, which the author did not ^ee, and which,
fttim the descriptioo akme, he $uipteted to be thb disease.
OOHXON MATERIA KXDIOA. 688
uiaed other yeary powerful substances ; for example, at the oom-
mmioemeiit of the (supposed ?) disease two children were relieved
bj salt of tartar in an mjusim of senega root. Is what properly
pertains to two substances to be ascribed to the action of but
one^ the potash ? According to what hitherto unheard-of sys^
tern of logic?
In like manner, graphites {ibid,^ 1816, Nov., p. 40) is said to
have cqred a large number of old fistulous ulcers, and yet corro^
five subKnuUe was in the mixture I The explanation in the note,
that sublimate had already been tried in vain, is of no avail
here : it was not given aJcne^ but in combination with opium, a
quantity of decoctions of various wpods^ and the fitvourite china
Jbctitia; it was consequently greatly or completely destroyed
by the astringent parts of these accessory medicines, just as
other metallic salts are thereby destroyed and decomposed, and
consequently it could not develop its curative powers in such a
mixture. Still less can the apology, in the same note, for the
addition of the mercurial to the graphites be received, " that the
sublimate was merely to serve as an adjuvant here." Were this
the £Etct, then must medicines act agreeably to the commands ci
the prescribing physician, not according to their natural powers,
no 1 they must do exactly neither more nor less than what the
physician commanded and permitted them to do. Can arro-
gance and presumption be carried fieurtherthan this? What
man of sound intellect can attribute such slavish obedience to
medicinal substances, which act according to eternal laws ? Did
the author wish to see whether graphites could prove efficacious
by itself and to convince his readers of this, he ought to have
given it alone: but if he add to the graphites corrosive subli-
mate, this must perform what corrosive sublimate can and from
its very nature musty not what the prescribing physician pleases
that it shall or shall not do. Here again we have a case from
which nothing can be learnt Graphites is represented as having
alone proved serviceable, and yet that tremendously powerftd
medicinal substance, corrosive sublimate, was used along with it.
The cure of a case of fixmd pulmonary consumption by means of
duxrcoal powder is, if possible, still more unfounded. Here
the limewood charcoal was never employed cdone, but always in
eofgumction with foxglove. So then the foxglove in the mixture
has no action ? None at all ? and yet a medicine of such mighty
power! Do the authors of such observations deceive them-
selves, or do they mean to make game of us?
684 SZAMnCATIOK OF TEE SOUBCB Or THE
Angelica root is said (tMi., 1816, April, p. 19) to have cmed
a drapMy^ properly speaking an unknown case of disease with
swelling. {The quid-pro-quo-^wisig pathology collects together
all diseases having the most distant resemblance in this respeol
under the name of " dropsy J*) But no 1 iincturt {^opiunij neiher^
and, finally, calamus, were used in addition to the tincture of
angelica. Can any rational man lay to the account of the angeli-
ca alone the issue of this case?
No one will deny that the mineral water of Driburg has g^real
medicinal powers ; but when the cures related in Hvifdamd^t
Journal, 1815, April, pp. 75, 80, 82, are ascribed to it alone, we
must declare these statementB to be Mae, as so many other strong
medicines were used along with it\ nor can the pretended cure of
a case of cramp in the stomach with frequent vomiting by this
water (p. 85 to 98), nor that of hypochondriasis and hysteria (p.
94 to 97), prove anything in fitvourof the Driburg water, partly
on account of the ambiguity and vagueness of these two names
of diseases, but principally on account of the constant employ*
ment of other medicines at the same time. Were we to reoeive
these cases as proo& of the efficacy of the mineral water, we
might, with equal justice, give to a single man the credit of
having alone lifted a large rock, without reckoning his many
active co-operators and the helpful machines employed. It
would be ridiculous to ascribe to one only that which was done
by all in conjunction.
These are a few samples from among the multitude I might
adduce from the writings of the more modem physicians, sam-
ples of nominally simple treatment of diseases, each of which
was said to have been cured with one single remedy — in order
to obtain at last a knowledge of its true powers, — ^but along
with which there was always employed some medicine or other
more powerful than itself; and although the physidan should
protest ever so vehemently that ** that one medicine" to which
he would fain attach all the glory of the cure, '* ahne did iiy he
firmly believes" '* the patient himself ascribed the good efifects to
this remedy alone," '' to it alone he entrusted Ae cure, " ''he only em-
ployed the second medicincas an adjuvant," or, "it had once befine
been employed without effect;" yet all these shufflings will not
avail to persuade a rational man that the cure was owing to
that medicine alone to which the partiality of the physician
would award the honour ot* the cure, if any other— even one
single other remedy — ^have been used in the treatment It must
€X>XMON MATERIA MSDIOA. 686
erer lenudn nntrae that the cure is due to this rejnedj alone ;
and the materia medica which shall ascribe such a curative
powmr to this remedy, on the authority of such an impure ob-
server as this, propagates &lsehoods which must inevitably be
firaught with the most unhappy consequences to humanity.
I will not deny that the cures of which I have just adduced
examples did appro<ich towards simplicity. They certainly
oame nearer, much nearer to the treatment of a disease with one
single remedy (without which mode of proceeding we can never
be sure that the medicine was the real instrument in effecting
the cure), than those of ordinary routine practitioners, who
make it a glory to adminster to their patients several complex
prescriptions, one after the other, or even to prescribe daily one
or two fresh mixtures.
But to have approached merely nearer to the adminstration.of
single remedies implies that the true mark has been actually
and completely missed. Were it not so, then might we congrm-
tolate a person on his good fortune whose number in the lottery
differed by a single cipher from that which won the highest
prize; or a sportsman whose shot has gone within a hair's
breath of his game ; or a shipwrecked mariner who would have
escaped shipwreck had he been a single finger's breadth fitrther
from the &tal rock.
What credence do the assertions in the ordinary materia
medica deserve with respect to the virtues of drugs ah xjlsu in
morins f What shall we say to the alleged powers of drugs in
this or that disease, when we know that the materia medica has
obtained its information thereupon from such observations;
sometimes indeed merely from the titles of the recorded obser-
vations of physicians who scarcely ever treated with one single
remedy, but generally with a mixture of drugs, whereby as
much uncertainty existed as to which among them the result
was to be ascribed to, as if, like the routine practitioner, they had
prescribed a great hotch-potch of medicines 7 What shall we
say to the curative powers ascribed with so much confidence by
the materia medica to simple medicinal substances, seeing that
these were almost never employed singly ? We can say naught
but this : among a thousand such allegations and commendations,
scarcely one deserves credence, whether they refer to general
therapeutical, or to clinical or special therapeutical matters.
Hence it is undeniable, that to ascribe any powers to a medicinal
substance which was never tested pui-ely^ that is, unless along with
tf66 SXAIOKATIOK Or THE SOUBCOBB OF THE
othersj consequently migkL as well have been never ieskd at afl^ u Ie>
&s guilty ofdeoeption cmdfal&dwod, .
*< What if all phjsiciaDS were to agree from this tiine heooe-
forth to tarn over a new lea^ and to prescribe in eyerj diacjue,
only one single simple medicine? Would we noft^ by tUi
means, ascertain wbat each medicine is capable of coiingr'
This will never happen as long as a Hufeland livesi, who ooii-
Biders the statements of the ordinary materia medica tboo^
derived &om the impurest sources, to be truths, and aerkNiBly
defends the employment of a mixture of many medicines in dis-
eases, imagining that '* one medicine cannot suffice for all the
indications in a disease; several must be given at once^ in older
to meet the several indicaticma."
This statement, as pernicious as it is well mean^ rests upon
two perfectly erroneous premises, the firsts whereby it is taken
for granted '* that the baseless declarations with respect to the
virtues of simple drugs in practical works, and in the materia
medica compiled firom them, are weU founded ; and consequently,
that they were recUly capable of meeting the indications preaenled
by the case in which they were prescribed," (which, as we have
shewn, and shall again shew, is Mae) ; — the seamcL " that several
medicines should be prescribed at once in order to satisfy the
several indications in a disease, for this reason, because a single
medicine can do little more than respond to a single indication,
but not to several or many."
But what does the ordinary materia medica know about the
vast sphere of action of a simple medicinal substance, that ma-
teria medica which, from impure observations of the result of
the employment of severed medicines in one disease, attributes to
a drug whatever powers it has pleased the physician to ascribe
to a simple ingredient of the mixture ; which never subjected
the powers of a simple medicinal substance to a pure trial, that
is, on a healthy individual not affected with any symptoms of
disease ? Does that mixture of fidsehood and truth which the
materia medica has scraped together from prescribers of oom*
pound medicines, in diseases of which merely the pathological
name, but no accurate description is given, — does this comprise
the whole extent of the sphere of action which the Almigh^
has bestowed on his instruments of cure? No! He has im-
planted in his healing instruments undiscovered (but certainly
discoverable) miracles of his wisdom and goodness, in order that
they may prove beneficial and helpful to his beloved duldien
OOXXOK MATBBIA XEDIOA. 687
of mankind, in a &r greater measure than was ever dreamt of
by the short-sighted materia medica of the old school.
But though it is certain that a single medicine at once is
always sufficient for the rational and appropriate treatment of a
disease, I am far from advising the medical world, on that account^
to prescribe simply, that is, a single medicine in each disease,
in order to ascertain what medicine is useful in this, what in that,
disease^ so that thereupon a materia medica, or treatise on the
virtues of drugs ab usu in morbis, should be formed.
Far be it from me to advise anything of the kind, notwith-
standing that this idea might seem, and has seemed, to ordinary
physicians, to promise the best results.
Nol not the slightest useful addition can be either now or
ever made to our knowledge of the powers of drugs, with re-
gard to their f4sus in morbus, from observations on cases of dis-
ease even with single medicines.
This were just as foul a source as all the others above men-
tioned, hitherto employed. No useful truth, with respect to the
curative powers of each individual medicine, could flow from it
I shall explain myself
Such a mode of testing medicines in diseases were only possi-
ble in two ways. Either a single drug must be tried in all dis*
eases, in order to ascertain in which of them it is efficacious ; or
all drugs must be tried in a particular disease, in order to ascer-
tain which remedy can cure it most certainly and most perfectly.
And, first, with regard to the latter of these ways ; and from
it DMiy be inferred what reliance can be placed on the former.
By an infinite number of trials of all imaginable simple
substances used in domestic practice, in a weU-defined disease,
which shaU constantly present the sam^ characters, a true, certainly
efficacious, specific remedy for the greater number of individuals
and their friends suffering from the same disease might certainly
be discovered, though only casu fortuito.
But who knows how many centuries the inhabitants of
deep valleys were forced to suffer from their goitres before
accident, aAer thousands of drugs and domestic nostnmis had
been tried in vain, put it into the head of an individual, that
roasted sponge was the best thing for it; at all events it was
not until the thirteenth century that Arnault of Villeneuve
notices its power of curing goitre.
688 KXAMiNATioir or thi soubcbs of thx
It is well known that for many years after its first inYasion,
the venerecd disease was treated in a most imsucoessful manner
by the physicians of the schools, by starvation, by purgatives,
and other useless remedies, which had been employed to com-
bat the Arabian leprosy, until at last, after many attempts and
repeated trials of an innumerable multitude of things by em-
pirical physicians on many thousands of patients who sought
their aid, rnercury was hit upon, and proved itself specific in
this dreadful scourge, in spite of all the violent theoretical op-
position of the pedantic physicians of the Arabian school.
The intermittent fever endemic in the marshy regions of South
America, which has a great resemblance to our own marsh ague^
had long been treated by the Peruvians, probably after innu-
merable trials of other drugs, with cinchona bark^ which they
found to be the most efficacious remedy, and which was first
made known by them as a febrifuge to Europeans in the year
1688.
The bad consequences resulting firom blows, fidls, bruises and
strains were long endured, ere chance revealed to the labouring
classes who principally suffered from such accidents, the specific
virtues of arnica in such cases ; at least Franz Joel was the
first who, in the sixteenth century, makes mention of its virtues,
and, in the eighteenth century, they were more particularly
described by J. M. Fehr and J. D. Gohl, after they had become
generally recognised.
Thus, after thousands upon thousands of blind trials with in*
numerable substances upon, perhaps, millions of individuals, the
suitable, the specific remedy is at last discovered by accident In
order to discover the remedies for the few maladies mentioned
above, there was no necessity for the employment on the part
of indolent man, of that reason and mature knowledge which
the Almighty has given to him, in order to enable him to free
himself from those inevitable natural and other evils involv-
ing his health — ^the vast multitude of diseases; — in fact, no
true medical knowledge at all was required. Mere experiment*
ing with all imaginable substances which might come into the
head or hands was undoubtedly sujfficient (to be sure after the
lapse of perhaps hundreds of years) to enable him to discovery
by accident, a suitable remedy, which never afterwards belied
its specific power.
These few specifics in tJiese few diseases constitute all the truth
tcfiic/i is contained in the volumifious materia medica in common use;
OOimON MATIBIA IfSDIOA. 689
and these ttre, for the most part, I may say, almost entirely,
derived from domestic practice.
"But if specific remedies, which were always serviceable in
Hie above diseases, were discovered in this way, why could not
8ome remedies against all the remaining innumerable diseases
be difloovered by similar experiments?"
Because all other diseases only present themselves as indivi-
dual cases of disease differing from each other, or as epidemics
which have never been seen before^ and will never be seen again
in exactly the same form. The constant specific remedies in
these few diseases were capable of being discovered by means
of trying every imaginable medicinal substance, only because
the thing to be cured, the disease^ was of a constant chamcter; —
they are diseases which always remain the same ; some are pro»
duoed by a miasm which continues the same through all generations,
such as the venereal disease ; others have the same exciting causes,
18 the ague of marshy districts, the goitre of the inhabitants of
deep valleys and their outlets, and the bruises caused by falls
and blows.
Had it been possible, by blind trials of all imaginable sub-
stances, to discover accidentally the suitable (specific) remedy
for each of the innumerable other diseases, then must they all
have been as constant in their nature, have appeared always in
the same manner and in the same form, have shewn themselves
to be always as identical in their character, as those few diseases
we have mentioned.
Only for a want of a constant character can ive suppose a supply
of a cofistant character.
That it was requisite, in order to find out empirically the
proper remedy, that all diseases, for which the specific was sought
should be identical and preserve an invariable fixed character,
appears not only to have been surmised, but to have been deeply
felt by the medical community of the old school. They imagined
that they must represent to themselves the various diseases of
humanity in certain fixed forms, before they could hope to dis-
cover for each a suitable, trustworthy remedy, and this (as they
knew no other better — scientific — way of finding the fitting me-
dicine in diseases) by means of experimenting on them with all
possible drugs, — ^a method which had succeeded so well in the
few fixed diseases above alluded to.
This undertaking, to arrange all other diseases in a certain
44
990 BXAldNATIOK OF THS dOCSCBS OF THI
£xed classification, appeared to them at first certainljVeiy plau-
sible and practicable.
In order to set about it, they conceived the idea of considering
all those from among the vast array of diseases, which bore any
resemblance to each other, as one and the same disease ; and
having provided them with a name, and given them a place in
their nosological works, they were not deterred, by the constantly
occurring differences in their appearance, from declaring them
to be definite forms of disease, which they must always have
before them, in order thereby to be able to discover, as they
flattered themselves, a particular i^medy for this disease.
Thus they collected the infinite variety of diseases into a few
arbitrarily formed classes of diseases, without reflecting that na-
ture is immutable, whatever false notions men may form of her.
In like manner, the polyhedrical kaleidoscope held before the
eye arranges in one illusory picture a number of external veiy
different objects, but if we look behind it into nature, we dis-
cover a great variety of dissimilar elements.
It is no excuse to say that this arbitrary and unnatural amal-
gamation of diseases of nominally constant character was framed
with the good intention of thus discovering for each separately
a sure remedy, by means of trying on them the large number of
known drugs, or by accident. As was to have been expected^ there
were found in this way no sure remedial agents for these arti-
ficially classified diseases; for we cannot imagine any leal
weapons to combat figments and phantoms of the imagination !
All the uses and virtues^ therefore^ which the Tnateria medioa
ascribes to d^erent medicines, in tfiese surreptitious and fictttums
kinds of diseases, cannot maJce the slightest pretence to certainty.
What advantage has been gained in so many centuries, with
all the host of new and old medicines, over the artificial noso-
logical classes of diseases, and names of diseases ? What remedies
have been found that can be relied on? It is not now as it was
long ago, — ^2800 years ago,— that by the employment of all the
vanous drugs in the innumerable cases of disease which occur
in nature, some are, it is true, much altered, generally, however,
for the worse, and but few are cured by them ? And was it
possible, even in this enormous space of time, that it could be
otherwise, that it could be improved, as long as the old system
remained as it was, with its imaginary thing to be cured^ and fma-
fjinary mrtues of the instruments for effecting the cure, and its
ignorance of their true, pure action? How could reidly useful
OOXXON MATSBIA XXDIOA. 691
traihs spring fix>m the employment of the latter against the
former 7
Let it not be alleged, " that not unfrequently many a severe
disease — which some called by one, others by a dinerent patho-
logical name— ^was cured as if by miracle, by a simple domestic
remedy, or by some medicine or prescription which accidentally
fell into the hands of the physician."
No doubt this sometimes happened ; no well-informed man
would deny it But from this we can leam nothing but what
we all know already, "that medicines can cure diseases;" but
from these casus fortaiti nothing is to be learnt ; as yet they oc-
cupy an isolated position in history, altogether useless for prac-
tice.
Our congratulations must only be bestowed on the sufferer who
reaped advantage from this rare godsend, and was cured quickly
(and lastingly ?) by tlus accidental remedy. But from this won-
derful cure nothing at all is learned ; not the slightest addition
has thereby been made to the resources of the healing art.
On the contrary, these very chance causes ofa/ccidental cures, when
Ihey have occurred to physicians, have done most to fill the materia
medica luith/alse seductive declarations respecting the curative actions
{^particular Tnedicines ab usu in morbis.
For, as the ordinary physician seldom or never describes the
case of disease correctly, and, indeed, considers the circumstan-
tial description of a case of disease in all its symptoms as useless,
if he cannot bestow on it a pathological name (the illusory re-
presentation of a disease above alluded to), so he does not &il to
apply some illusory pathological name to his chance case, which,
together with his prescription, or the single remedy in the mix-
tore to which alone he ascribes the cure, straightway finds its way
into the materia medica, which, moreover, is incapable of making
use of anything but mere pathological names of diseases in its
. account of the uses of medicines.
He who, thereafler, is inclined to regard a case occurring to
himself as the same pathological species of disease (and why
should he not? the schools teach him to do so), has nothing to
do but to resort immediately to this magnificent receipt, this
splendid specific, at the bidding of its first recommender, or by
the advice of the materia medica. But he certainly has, under
the same illusory pathological name, a case before him vastly
different in the detail of its symptoms, and hence happens what
was inevitable, the medicine does no good ; it does harm, as
might have been anticipated.
692 XXAXINATIOK OF THJB SOUBOKS OF THS
This is the impure^ this is the unhaJhwed source ofaU Ae deda-
rations respecting the curative virtues of medicines ab usu in morbis
in the ordinary viateria medico^ wherisby every imiUUar w led
astray. '
Had the so-called observers — what thej almdst never did —
communicated to the world those cases of lucky chance cureSi <miy
describing minutely the case of diseasCi ufith all its symptoms^ and
mentioning the remedy employed, they had at least written
truth ; and the materia medica (iBnding no pathologitial name
attached) had not been able to glean any liesfiom them. They
had, I say, written truth, which, however, would only have been
useful in one single way, namely, to teach every fiiture physician
the exact case of disease beyond which the remedy, in order to
prove useful, shoidd not be employed; and thus no fidse, and
consequently unsuccessftil, imitatkni would have occurred. From
such an accurate description it woidd have been evident to all
future physicians that Uie same, the exact same^ case of diaeaae
never recurs in nature, consequently could never again be cored
miraculously.
Thus we would have been spared all the many hundred delu-
sive accounts of the curative actions of particular drugs in the
ordinary materia medica, whose truthfulness and honesty has
hitherto consisted, and still consists, in this, that it has fatthfuOy
re-echoed whatever authors have chosen to invent with respect to the
general tfierapeutical virtues of drugs, aivd has accepted^ as genuine
coin, their alleged special therapeutic powers ab usu in morbis,
ascertained from accidental cases qfcut^ by associating the spe-
cific pathological name of a disease bestowed on his case by the
so-called observer, with, as the curative power, the presumed
single medicine to which, among all the drugs employed in the
compound prescription, the physician chose principally, if not
entirely, to entrust and ascribe the successful result
So turbid and impure are Oie sources of the ordinary jnaieria
ivedica, and so null and void its contents I
Vfhat a liealing art, with such ill-understood medicines /
From the circumstance that constant remedies have already
been discovered for those diseases, few though they be,^ which
have a constant character, one might infer, that for all
* To be mire this was only effected by blind trial* of aU imagimible dn^ ; lor
hitherto a scientific mode of makii^ such discoveries has been entirely
medicine. !
OOXXOK KATEBIA MSDICA. 698
of a constant oharacter^ constant (specific) remedies might be
founcL
And aoooidingly, since the only trustworthy way, the homceo-
pathic, has been pursued with honesty and zeal, the specific re-
medies for sevend of the other constant diseases have already
been discovered.^
In order to treat successfully the other cases of disease occur-
ring in man, and which, be they acute or chronic, differ so vastly
among each other, if they cannot be referred to some primary
disease which is constant in its character, they must each be
regarded as peculiar diseases, and a medicine which in its pure
* In this homoBopftthic way, from a oonaideratioo of the symptoms of the smooth
SMrbt/NMT, with bright erjaipelatoiis redness of the skin, whidi formerly prevailed
iD Sorope from time to time, as a contagioiw epidemic (but has been alinost iotallj
tappbated by the purpwra mUiariM, which, in 1800, came from the Netherlands into
oar ooontry, and has been improperly confounded with BcarUifever, by physician^
ifho knew not the latter disease), I found the specific curative and prophylactic re*
mady hr tfab tme, smooth scarlet-fever in the smallest doses of belladonna^ which hat
the power of producing a very similar fever, with a similar lobster-red colour of the
skin*
Soi, also, from a thorough consideration of the symptoms presented by ihe purpura
siltttfrtt just mentioned, in the particular character of its purely inflammatory fever
witk ai^toiaing anxiety and restlessness, I found that aconite must be the specific re*
mady (oooaaionally alternately with raw ooflfee) ; and experience has confirmed tha
tmth of the remark.
Hie symptoms of eroup are to be found in the pure materia med^ca, among the
symptoms produced by burnt tponge and hepar eulphurU ; and see! these two
jlteraately, and in the smallest doso, core this frightful disease of children, as I fini
dboovered.
No known medicine is so capable of producing a state mmilar to that of the epidemic
hooping-cough as the tundew ; and this disease, which, notwithstanding all the
emtioiis of allopathic physicians, either becomes chronic or terminates fatally, is cured
in a iiw days in a certain and safe manner, as I first shewed, by the smallest portion
of a drop of the dedllionth dilution of the juice of droeera rotundifolia.
What physician before me, and before the publication of the ** Pure MaUria Me-
dUOf" was able to cure radically the constitutional and local sycosic condyloma >n]S
disease t They were content with removing the morbid growths by the cautery, ;he
knife, or the ligature, as often as they appeared externally, but none succeeded in
euring the disease. The symptoms of tkt^a oeeidentalis taught me, however, that
it must cure this disease ; and, behold 1 a very rmall dose of its highly diluted juice
actually cures the internal disease, so that the external growths vanish also, bhewing
iht core to be radical
With an infinity of empirically chosen drugs the allopathist attacks the autumnal
dysentery, but with what miserable success I The symptoms of corroHve 9ublinuit$,
however (vide the " Pure Materia Jfedica "), resemble so cluiely those of tliis diseaM;,
that this medicine must be its specific remedy ; and experience convinced me, many
years since, that a single dose, consisting of a 6niall portion of a drop of the trillionth
dilution of mereuriut eublifnatus corroHvw is sufficient to produce a rapid and ann-
plete cure.
694 KXAMIKATIOK OF THI SOUBCBS OT THB, ko.
effects on the healthy body shews symptoms similar to those of
the case before us, must be administered.
This improved healing art, i. e., the homoeopathic^ draws not
its knowledge from those impure sources of Ae materia medica
hitherto in use, pursues not that antiquated, dreamy, fidse path
we have just pointed out, but follows the way consonant with
nature. It administers no medicines to combat the diseases of
mankind before testing their pure effects ; that is, observing what
changes they can produce in the health of a healthy man — this
is pure materia medica.
Thus alone can the power of medicines on the human health
be known ; thus alone can their true importance, the peculiar
action of each drug, be exhibited clearly and manifestly, without
any fallacy, any deception, independent of all speculation ; in
their symptoms thus ascertained, all their curative elements lie
disclosed ; and among them may be found a signalization of all
the cases of disease which each fitting (specific) remedy is capable
of curing.
According to this improved system of medicine, cases of dis-
ease, in all their endless variety of appearance (if they cannot
be traced back to some more profoundly rooted primary disease
of constant character), must be regarded in every instance as
new, and never before seen ; they must be noted,exactly as they
present themselves, with all the symptoms, accidents and altered
sensations discoverable in them ; and a remedy must be selected
which, as has been shewn by previous experiments of its action
on perfect health, is capable of producing symptoms, accidents,
and altered sensations most similar to those of the case under
treatment ; and such a medicine, given in a very small dose,
cures, as experience teaches, much better and more perfectly than
any other method of treatment.
This doctrine of the pure effects of medicines promises no de-
lusive, fabulous remedies for names of diseases, imagines no ge-
neral therapeutic virtues of drugs, but unostentatiously possesses
the elements of cure for diseases accurately known (that is, in-
vestigated in all their symptoms ; and he who will take the
trouble to choose the remedy for a disease by the rule of the
most perfect similarity will ever find in it a pure inexhaustible
source whence he may derive the means for saving the lives of
his fellow-men.
LEiPtpio, April, 1817; and
CdTHKN, January, 1825.
ON THB UKCHARITABLENES3 TOWABDS SUICIDX. 696
OK
THE UNCHARITABLENESS TOWARDS SmCIDE&*
The propensity to self-destruction always depends upon a
disease which is to a certain extent endemic in England, but in
many other countries it prevailed epidemically, so to speak,
more some time since than now, but it by no means affect^ the
very worst characters, but often otherwise honest, well-con-
ducted individuals. It is generally the friends of the individual
— ^who do not pay attention to his corporeal disease, that often
passes rapidly into this mental disease — and his medical atten*
dants, who know not how to cure the suicidal-malady, that are
to blame for the catastrophe.
By their unsteady, shy, anxious look, by the despondency
they display in their words and deeds, by their restlessness, that
increases at certain times of the day, by their avoidance of things
that were formerly most agreeable to them, and sometimes by
their inconsolable lamentations over some slight corporeal ail-
ments, the patients betray their internal malady. This most
unnatural of all human purposes, this disorder of the mind that
renders them weary of life, might always be with certainty
cored if the medicinal powers of pure gold for the cure of this
sad condition were known. The smallest dose of pulverized
gold attenuated to the billionth degree, or the smallest part of
a drop of an equally diluted solution of pure gold, which may
be mixed in his drink without his knowledge, immediately and
permanently removes tliis fearful state of the (body and) mind,
and the unfortunate being is saved.
ON
THE TREATMENT OF THE PURPURA MILIARia^
Almost all of those, without exception, who are affected by the
red miliary fever (falsely called scarlet-fever) that is oflen so fatal,
will not only be rescued from death, but also cured in a few
* From the AUgffn. Ameig der DeniBrhtn^ No. 144. 1819.
* From the A 11 gem. Anseig. der De\it§chen, No. 26. 1 82 1
696 Oir BISFENSING BT THE PHTBICUJr.
days by aconite given alternately with tincture of raw coffee.
The expressed juice of the fresh aconite-plant should be mixed
with equal parts of alcohol, and diluted with a hundred times
its quantity of alcohol, until the last dilution is in the octillionth
degree. Of this a small portion of a drop is to be given for a
dose when there is mcrtaaing resihsmeas^ anxiety and heat ef the
bodj/j all acids being careftilly avoided; and tohen there are
mtreasing pains (in the head, throat, &c) combined with a dispo-
sition to weepj a small portion of a drop of the tincture of raw
coffee diluted to the millionth degree.
The one will usually be necessary when the other has acted
for from sixteen to twenty-four hours.^ Not oftener.
Besides this nothing should be done or given to the patient —
no venesection, no leeches, no calomel, no purgative, no cooling
or diaphoretic medicine or herb-tea, no water compresses, no
baths, no clysters, no gargles, no vesicatories or sinapisms*
The patients should be kept in a moderately warm room, and
allowed to adapt their bed coverings to their own feelings, and
to drink whatever they like, warm or cold, only nothing acid
during the action of aconite.
• • « •
But even should these remedies be prepared and administered
as directed, where is the practitioner who would refrain fix>m
giving something or another from his routine system, thus ren-
dering the treatment nugatory ?
ON
PREPARATION AND DISPENSING OF MEDICLNES BY THE
HOMEOPATHIC PHYSICUN.
I. Representation to a person high in authority.'
*' Nan debet cui plus licet quod minas est nno lioere."
Ulpian, lib. 27, ad Sabinum.
The complaint of the Leipzic apothecaries " that by dispensing
my medicines I encroach upon their privileges," is untenable for
the following reasona
' [" Every twelve, sixteen or twenty-fuur hours, mcoording as tbe one or the other w
in licHted." ' (R. A. M. L., ItUrod to BelL, pt i, p. 16.)]
^ Written in 1830. fir^t published in Stapfs <xtlU*ction in 1829. [The subject of
thkt mid the two following esisays is mvt of so much interest to the English homcBo*
pHthist as bis right to prepare and dispense his own medidiies has nerer yet beeo
L BBFBS8XNTATI0N TO A HIGH OITIOUL. 697
Mj system of medicine has nothing in common with the ordi*
nary medical art, but is in every respect its exact opposite. It
is a novum quid^ to which the standard of measurement hitherto
applicable to the dispensing of medicines is completely unsuit*
able.
The old S3rstem makes use of complex miictures of medicineif
each ooniaining several ingredients in considerable quantity. The
oompounding of these prescriptions, which in general consist of
several medicinal substances, demands skilful, often laborious
work and time, neither of which the ordinary practitioner can
devote to this purpose, as he is occupied with visiting his
patiente, and does not possess the skUl required for compounding
these various, often heterogeneous, substances, and therefore
must be glad to have at hand an assistant in the apothecary,
who relieves him of the toilsome, time-wasting preparation of
the medicines ; in a word, who undertakes for him the dispensing
business. For where the laws relative to medical affairs speak
of preparing the medicines^ and of dispensing^ they always and
invariably imply thereby the compounding of several medicinal
substances in one formvXa or prescription. Nor can the state
medicinal regulations imply anything else thereby, for hitherto
all the prescriptions of doctors for their patients have been as a
rule compound recipes, that is, consisting of several medicinal
ingredients mixed together; and up to the present day the treat-
ment of patients, as taught in our universities, colleges and
hospitals, consists solely in urriting prescriptions, which are direo*
tions to the apothecary relative to the different medicines he is
to bring together in one formula, for hitherto patients as a rule
have only been treated with compound prescriptions, the com-
pounding and mixture of which was entirely left to the
apothecary.
Tbia right to prepare compound medicinal formulas for the
physician was conceded to the privileged apothecary by the laws
relating to medicine solely on this account, that none unconver-
sant with this work or having a bad stock of medicines might
make a bungle of the prescriptions, because the physician who
questioiied, but the papen themselyes are well worth perusal, and oould not have
been with propriety omitted from this collection, llie tirst is a remonstniice
addratsed to the chief magistrate, in reply to an aocosation, brought aganist him by the
TiPipric apothecaries, of dispensing his own medicines.]
' When the medicinal laws speak of simple remedies, they make use of the words
timplieia and tpecie*^ and by the expression, medieint9 and medicamMnUt they always
mean eomp€fm%d mediciiiea.
698 oir DisPBiraiNa by ths phtbiouk^i
is engaged in practice would have often neither the skill to make
these often elaborate mixtures himself, nor the great time often
requisite to devote to their preparation.
All the royal mandates of this kind refer to this dispensing
and preparation of drugs {compound medicinal Jbrmtdas) which
ezclusiyelj appertains to the privileged apothecaries.
But their exclusive privilege is entirely limited to this^ but does
not refer to the sale of the simplida (simple drugs) otherwise
there could exist no druggists in the kingdom, for thej are not
prevented by any law at present ftom selling simples to every
one.
The only right and privil^e belonging to the apothecary,
exclusively to mcJoe up the mixtures ordered in prescriptions oontainr
ing several medicinal ingredients is not in the slightest degree inter-
fered with by the new method of treatment called homoeopathy,
the exact opposite of the ordinary medical art hitherto practised,
for this new system has no prescriptions that it could give to
the apothecary, has no compound remedies, but gives for e^ezy
case of disease only one single, simple m^icinal substance, in
an unmedicinal vehicle, therefore it does not compound^ and
consequentiy, does not dispense. Its practice is, therefore, not
included in the prohibition to dispense contained in the laws
regarding medicine.
Now, as every art admits of improvements in the course of
ages, which must be welcome to every civilized state, the medical
art also can and must advance farther on the way to perfection.
If, then, by the ordination by an All-wise Providence there
arise the art of curing diseases (more easily, surely and perma-
nently) without compound remedies, without mixtures of medi-
cines, and if there be now physicians who know how to treat
every disease efficaciously by means of one single, simple remedy
(simplex), this cannot be prevented by any privilege referring
to the preparation of compound prescriptions ; the new healing
art advancing nearer to perfection cannot thereby be obstructed
in its beneficent progress, for it is open to the physician for the
purpose of curing diseases to make use of every simple power
in nature which is best adapted to this end ; for example, the
employment by himself of electricity, of galvanism, of the
magnet, and so likewise of every kind of simple agent; and in
this the scientific physician has never yet been, and can never
be, fettered by any regulations of medical police.
For where in a syllable to be found in all the royal ordinances
I. B1FRB81NTATI0K TO A HIGH OFFICIAL. 699
relating to medicine that distinctly forbids physicians to admin-
ister simplicia with their own hands to the patients?
And as long as no such distinct prohibition for the practi-
tioner exists in the laws, as long as no privilege granted to the
apothecaries refers to their exclusive administration of the smt"
plicia^ as long as it is allowed to the ignorant dealers in roots and
herbs in the weekly market to sell for money to those who seek
their aid, simplicia^ medicinal roots and herbs, so long must it be
allowed to the scientific physician skilled in all the knowledge of
nature, its forms, and its phenomena, and entrusted with the
care of human maladies, to administer gratuitously to his patient
the simple remedy which he considers will prove most efficacious
for the disease,^ Ats, as I shall shew, cannot be done by the apor
ikecary.
Such is exactly the case with the new method of treatment of
which I am the founder, which is something quite different from
the ordinary mode of treatment. In my treatise upon the ho-
moeopathic system, all prescriptions^ all compound medicinal m^x*
turesBie prescribed, and I inculcate that only one single, simple
medicine at a time is to be given in every case of disease,' and
I never treat a patient in any other way than this.
According to this improved method of treatment, I require
for the cure of even severe diseases, that have hitherto been
considered incurable, only the smallest possible doses of simple
substances, either solutions of some minerals and metals in pure
alcohol without the addition of any acid (preparations that are
known to me alone, but not to any chemists, consequently, not
to any apothecary) or equally small doses of vegetable and ani-
mal substances — always only one dose of a single, simple medi-
cament— doses which are so small that they are quite undetect-
able by the senses, and by every conceivable chemical analysis,
in their ordinary unmedicinal vehicle (sugar of milk).
This inconceivable minuteness of the doses of simple medici-
nal substances in this new system of medicine quite sets aside
all possible suspicion of a hurtful size of the dose of simple me-
dicine given to the patient.
Incapable of being taught that the great curative power of
such small doses of simple medicines, that shews itself in the
beneficial effects of their administration, depends upon a plan of
' See the Organon of Medicine, 2d edit 1819, § 297, 298, 299— [Wde fifth edition,
272, 278, 274.]
700 Oir DI8FSNBIKG BT THB PHTHIOIiJf.
sdection for the cases of disease for which they are adapted
hitherto unknown and peculiar to the homoeopathic art^ whereof
the ordinary system of medicine never dreams^ the apothecary
ridicules the nullity of such small doses, since all his senses, as
well as the best chemical analysis, cannot enable him to deteol
any niedicinal substance in the vehicle (sugar of milk).
I^ then, even the apothecary, with all his jealous animosi^
against the new healing art, cannot detect anything medicinal or
poisonous in the remedies of the genuine homoeopathic physi-
cian, nor anything that could appear medicinal, not to mention
too strong or injurious, how completely satisfied may the go-
vernment which is concerned for the wel&re and health of the
community be with respect to the effects of such efficacious re*
medies given in such small, such inconceivable doses, as those
homoeopathy administers to its patients ! It may be infinitely
more satisfied than with respect to the trade of the apothecary,
where the very same medicines which the homoeopathic physician
employs in such inconceivably small doses are unhesitatingly
sold by the apothecary in quantities upwards of a million times
greater, to every one (citizen or peasant), to persons who do not
know what damage these things may do when employed im-
properly ; his only limitation being that he shall not sell arse-
nic, corrosive sublimate, opium, and a few other things, to
strangers.
I take leave to draw the attention of the medical police of
the state to this subject
Moreover, the homoeopathic physician cannot employ the
apothecary as an assistant in the practice of his new art The
medicinal doses of such a physician are so minute, so impercep-
tible, that if the apothecary had to put it into the vehicle al-
luded to according to the directions of the physician (which the
physician himself can do in a minute without waste of time),
the homoeopathic physician, if he did not himself see the ope-
ration performed, could not, either by the aid of his senses or
by that of chemistry, determine whether the apothecary gave
the medicine he ordered, or some other, or none at all.
This impossibility on the part of the homoeopathic physician,
to exercise control over such an act of the apothecary, renders
it impossible for the physician of the new school to avail him-
self in his treatment of an assistant, be he who he may. In this
case he can trust to himself only ; he alone can know what he
has himself done.
I. BXPBISSNTATION TO ▲ HIGH OFFIOUL. 701
And jet this unoommon minuteDess of the dose of all dyna-
mically-acting medicines is indispensably necessary in this new
art, which is excellent for the treatment of every disease, but
which iB'tndispevisabk for the cure of the serious chronic diseases
which have hitherto been abandoned as inisurable, and it is jq
indispensably necessary, that the cure of these diseases is impos-
sible without that minuteness of dose.
Now if the spirit of the laws relating to medicine is really di-
rected chiefly and before everything else to the salus jmbHca^
and if the diiseases most worthy of commiseration and hitherto
abandoned as incurable can only be transformed into health by
means of this new method, as, for instance, the cases I have
cured testify, which have roused to bitterness the envy of many
of the ordinary practitioners, then it surely cannot be doubted
that the sanitary police will prefer the welfare of the suffering
public to all unfounded private claims, and will afford its pro-
tection to the new efficacious healing art, but that it will not
lorce upon the new system as its assistant the art of the apothe-
cary, which was originally instituted for preparing the medicinal
miscJtwrea of the ordinary system, from prescriptions containing
many strong ingredients ; such an act could only be obstruodve
and never advantageous to homoeopathy.
I am correct in ^ying, '^ unfounded private claims," and I
add that these claims are *' insignificant and unmeaning." For
how much would an apothecary be entitled to if (as the homoeo-
pathic physician himself does without waste of time) to the ve-
hicle of three grains of sugar of milk he were to add, for ex-
ample, one drop of an alcoholic solution of a grain of tin, rhu-
barb or cinchona bark, diluted to more than the millionth de-
gree ? According to aU scales of apothecaries' charges hitherto
framed, which are all calculated only according to the weight of
the ingredients of the ordinary formulas, and the trouble (which
does not exist in the new system) of compounding the ingre-
dients, for making up any such homoeopathic prescription, I
say, he is entitled to just — nothing.
If then for the preparation of homoeopathic medicine he were
entitled to nothing, it is to be feared that if the Leipzic apothe-
caries stUl persist with their untenable proposition, there may
be some secret motive at work which determines them to force
their services, contrary to their interests, on the homoeopathic
physician. I would fidn hope that this is not done with the in-
tention of throwing an insuperable obstacle in the way of the
702 OK BISPSNSIKG BT THS PHTSIOIAK.
recently developed and highly important new healing art, for
which nothing can be a substitute^ as some of the practitioners
who are envious of its success would seem to wish.
The true homoeopathic physician, moreover, does not in the
least infringe on the rights of the apothecary as a dealer in
drugs, for he cannot charge the patient anything for such an in-
conceivably small dose of the simple medicine which no chemi-
cal analysis can detect in the vehide ; he can only, as is proper,
be paid for the trouble he expends in investigating the morbid
state, and in choosing the most efficacious remedy, which is
much greater in this new beneficent system of medicine than
nnder the old system.
Now, as the new system has nothing in common with the me*
thod of treatment hitherto practised, which consists in the giving
of compound prescriptions, for the preparation of which the
apothecaries are alone privileged ; as the new system bears no
resemblance to this, seeing that it never treats with mixtures of
ponderous, massive doses of medicines, but with inexpressibly
small and subtle doses of always smiple medicines pr^Mired in a
manner which is in some respects not attainable by the apothe-
caries, regarding which, consequently, the art of the apothecary
with its old privileges, can have no privilege ;* I therefore make
the following suggestion with all respect, but with a thorough
conviction of its justice:
** To keep the Leipzic apothecaries within the limits of their
privileges, and to notify to them that their rights do not extend
to a new method of treatment which has never before been prac-
ticed, which, far from dispensing, that is, making up prescrip-
tions of the ordinary kind composed of several powerful medi-
cines (the preparation of which belongs of right to the apothe-
cary), or requiring them for its treatment, on the contrary, only
requires inexpressibly small doses of simple medicines (which
the apothecary laughs at), consequently, only simpUcia^ which no
ruler ever yet forbade scientific physicians to administer to their
patients, and which consequently are, as we may naturally sup-
pose, not prohibited in any regulations of medical police."
* Pure human reaaoo is the roice of Gkxl I No goyernment erer yet pennitted
the sock-mill to extend it« right of monopoly to the pereon who can extract — what
the mill cannot do--pure starch from wheat without the employment of any machine
(the starch-maker) ; no government ever allowed the old privileges of the art of
printing to bterfere with the development of divine lithpgraphy, which also multi-
plies a thousand fold thoughts upon paper, and does this modi more rapidly and
easily hut without the artificial compoeitioo of mastive types.
n. THX HOlKBOPATHISr AND LAWS ON DISPENSING. 706
This concession I look forward to with all the more confi-
dence and tranquillity, seeing that this new system has, on ac-
count of its inmiense importance, already gained a public cha-
racter, and already in all countries where German is spoken,
men are arising who know how to estimate it as a great benefit
for suffering himianity.
Finally^ as regards what relates to my disciples,^ I must state
that I am in no way connected with them, and as the subject is
quite irrelevant I shall refirain from touching on it. I do not
consider any as my followers, who, in addition to leading an ir-
reproachable, perfectly moral life, does not practise the new art
in such a manner, that the remedy he administers to the patient
in a non-medicinal vehicle (sugar of milk or diluted alcohol)
contains such a small subtle dose of the medicine, that neither
the senses nor chemical analysis can detect the smallest abso-
lutely hurtful medicinal substance, indeed not the slightest trace
of any thing medicinal at all, which pre-supposes a minuteness
of dose that must indubitably dispel all anxiety from all officers
of state who have to do with medical police.^
a— THE HOMCEOPATHIO PHYSICIAN IS PREVENTED BY NO EXIST-
ING LAWS RELATING TO MEDICINE FROM HIMSELF ADMINI-
NISTERING HIS MEDICINES TO HIS PATIENTa'
J No homoeopathic physician dispenses ; according to the prin-
ciples of his art it is impossible for him to dispense.
To dispense means to mix together and to compound several
medicins^ substances, as the apothecary does.
At the period when the word " dispense " was first used in a
medical sense, the pharmacopoeias under the name of dtspensor
toria, contained only compound medicinal formulas, as, for ex-
ample, the first dispensatorium that appeared in Germany, pub-
lished at Niimberg in 1651.
> ["Id the very bitterjand abusive complaiot of the apothecaries, which was
drawn up by a Leipzig advocate,**)say8 Stapi^ ** malicious iuaiouataoDs were made re-
garding Hahnemann's disciples.**]
* ["And what," exclaims StapC was the result of this representatioD which
Hahnemann addressed to a high personage in the state, in consequence of a com-
plaint made against him, b^ the Leipzig apothecaries regarding the dispensing his
own medicines ? — The fatherland lost thereby one of its most illustrious sons ! *
' Sent to tlie Authorities of State in 1821, first published in Stapf's Collection
ID 1»2V.
704 ON DI8PSNSING BY THE PHTBIGUJN.
At the same time, the laws regarding medical affairs ordered
that the apothecary alone, and no one else, should oompoiind
the various kinds of medicine according to the formulas c^ such
a book (dispensalorium), or, according to the prescription of the
physician, into a uniform mixture (to dispense) for the treat-
ment of the sick.
In that alone consisted, and still consists, the apothecaries' pri-
vilege, and no apothecary has any other privilege.
The laws regulating medicine give to these mixtures of me-
dicines the names of medicines, medicaments^ and composiia^ but
the several medicinal substances and ingredients they do not
term either medicines or medicaments, but simpUda and species.
When therefore, the medicinal regulations forbid tjxe phy-
sician to administer himself medicines and medicaments to his
patients, in other words, to dispense, they cannot thereby mean
any thing else than to prevent him compounding medidnal
mixtures from various medicinal ingredients ; but they nowhere
forbid him giving simpUcia to his patients.
They also forbid the apothecaries to dispense of themselves,
or to make up and give out medicinal mixtures (medicaments)
for patients, without the physician^s prescription. Hence the
apothecary dare not prepare for patients without the doctor's
prescription any medicines (composita, medicinal mixtures, me-
dicaments), but he is permitted to sell to any one simple medi-
cinal substances (excepting those that act too violently in large
dose), without the doctor's prescription ; whence we perceive
that the giving the simplicia cannot constitute dispensing, other-
wise the apothecary would not be permitted to sell the simplicia.
But it is only permitted to the apothecary to sell simple medi-
cinal substances; he has no privilege for this sale; otherwise
there would be no druggists, who, also sell simple medicinal
substances to every one.
Therefore the apothecary is not justified in preventing the
physician from administering, himseli^ a simple medicinal sub-
stance to his patients.
The medicinal regulations never call the common sale by the
apothecary dispensing, consequently it cannot be said of the phy-
sician who administers a simple medicinal susbtance for the relief
of his patients, that he dispenses, because he does not compound
for them any so-called medicines and medicaments, in the legal
sense, that is, any composita consisting of several ingredients. In
his unprivileged sale the apothecary gives to any one for money
IL THB HOHCaOPATHiaT AND THE LAWS ON DISPENSING. 706
not only the crude simple medicinal substance, but also the sim-
ple preparations therefrom : he gives the buyers tincture of rhu-
barb, anise sugar, peppermint lozenges, &c., without let or hin-
drance, rightly ttJcing for granted that the alcohol used in
preparing the tincture and the sugar in the lozenges are not to
be looked upon as medicinal substances, but as unmedicinal ve-
hicles, in the former case for the rhubarb, in the latter for the
anise or peppermint oil, consequently, that these simple prepa-
rations are not to be regarded as medicinal mixtures, nor their
sale as dispensing.
But to be consistent, tie must allow that when the physician gives
a simple medicinal svistance mixed with sugar to his paMents, ^is
aiso cannot he considered dispensing.
Hitherto, however, this has almost never been the case.
From the most remote periods physicians were traditional^
directed by their teachers, by their colleges for instruction in
the art of prescribing, in their hospitals, and by their medical
authorities, to treat their patients by prescribing medicines (com-
posita) in receipts fix)m the apothecary's shop, and the apothe-
caries were directed to compound ^ose medicinal mixtures
called medicines and medicaments par exceUence, fix)m a variety
of ingredients in considerable quantities, which was called
dispensing.
But there unexpectedly arose — since all that is imperfect in
the world gradually advances inevitably towards its perfection
— an entirely new system of medicine, called by its foimder
Homoeopatht/y and taught in the book entitled Organon of Medi-
cine. This system of medicine, which, as the book teaches, is
much more consonant to nature, and as its results shew, is much
more successftd, is the direct opposite of the ordinary treatment.
According to this new system, medicinal substances are era-
ployed for diseases in which the ordinary method gave exactly
the opposite, but these were never given as in the ordinary
method, in mixtures, but a single medicinal substance (simplex)
only was always given for each case of disease, and that in such
an extremely small dose, that the ordinary physician of the old
school and the apothecary regard it as an unimportant nothing,
for the former was accustomed to employ in treatment only large
doses of medicine, but with entirely opposite aims, which could
not do much good ; and the latter was accustomed to comjiound
only large doses of several medicinal ingredients, and to trans-
form them into medicaments. Whilst, for instance, the ordinary
45
7fll6: ■ : > ;0H PISBBNSINO BY THE PHYSICUK.
phyoicHaB esnplojm the tineture of rhubarb in drachm doaes, in-
trodjciced into a formula along with other medicinea, for the pur-
pose: of , causing \pt^^in^, the homoeopathic physician gives a
smfkU part of a drop of the quadrillionth dilution, and for the
very opposite object, 'namely for the cure of morbid diarrhaas^
for which the old-school physician prescribes large doses of
opitun, often in vain, whilst the homoeopathic physician employs
this same tincture of opium more appropriately for the opposite .
state, and permanently removes continued constipation with a
small part of a drop of the billionth dilution.
With this new, much more beneficent healing art, the homoeo-
pathic physician does not interfere with any apothecary's
privilege, nor does he break any existing medicinal regulation-
No medicinal law has ever alleged that the physician must
not give to his patient a single medicinal substance.
No privilege gives to the apothecary the exclusive right that
Ive (done shall sell, unhindered, to every one, simple medicinal
substances in large quantities, at hap-hazard (often to the great
injury of the patient), whilst the physician dare not give to his
patients, with a scientific purpose, the same simple medicinal
substances in such small doses that the patient can only pay for
the physician's skill, not for the remedy, because the latter, on
account of its minuteness, has no commercial value, but on ac-
count of this incredible minuteness, must be given by the phy-
sician himself, and cannot be left to any assistant.
According to the principles of his lurt, which prove the em-
ployment of any mixture of medicines whatever for the cure of
disease as contrary to sound reason^^ it is impossible that the
homoeopathic physician can ever administer a medicinal mixture
to his patients, consequently it is impossible that he can dis-
pense, and so encroach upon the apothecary's privilege.
HI. How MAT HOMCROPATHY BB MOST CKRTAIlfLT KRADICATSD ?^
In no way more certainly than by the authoritive command-
ment, " Thou shalt not dispensed I have only a few observations
to make on this subject. Although it were undoubtedly desira-
ble that there was a method of more certainly curing the sick than
can be done by the ordinary system of treatment, yet homcpopa.
> Organon of Medicine, % 297-299, [yide last edition, g 272. 2741.
* From the AUgem, Ameig, der DtuUcKen, No. 227. 1825.
in. HOW MAY HOMCBOPATHT BE ERADICATED? 707
thy granting it fulfilled this desirable end, could not be tolerated, —
First, because from its practice the apothecaries would suffer
80 much ;
Second, because the large number of physicians instructed
according to the old system would see themselves too strikingly
placed in the shade if homoeopathic treatment in their neigh-
bourhood did much more than die prevailing system of medicine,
was able to do.
These two classes of professional men endangered by homceo*
pathy, the apothecaries and the physicians who practise and
teach the old system of medicine, have consequently done all
they could in order to prejudice the public against this treat-
ment ; they have tried to ridicule it, to malign it, and publicly
to insult its practitioners in every way.
^ut as the &me of several remarkable homoeopathic cures of
diseases, hitherto incurable, spread among the public, and the
latter, as it always does, paid more attention to the facts than to
the calumnies respecting the new art by its opponents, a differ-
ent plan was had recourse to. Those who sought relief for their
maladies at length no longer paid any attention t^ the invectives
and pasquils, anonymous and otherwise, that appeared in the
journals that lent themselves to this purpose, they did not re-
gard the bitter attacks in Jorg's Oritische He/te, nor Heinroth's
theoretical sophisms in his Anti-organoTij nor Kieser's nor Spren-
gel's writings — they looked to what had actually been effected
here and there, and in many places, and embraced with increas-
ing fervour the new healing art that did such great things.
All these manoeuvres did homoeopathy no harm ; they were
unable to effect its suppression in the slightest degree. It raises
its head more joyfully than ever. Accordingly some persons
gifted with a greater amount of worldly wisdom have already
abandoned these useless counter-mines, and have hit upon the
happier expedient of endeavouring to obtain its suppression by the
laws of the land, in order thereby to annihilate it
It is a main point for the homoeopathic physician, in order
that he may undertake and accomplish the cure of serious dis-
eases with certainty, that he should himself select his remedies,
prepare them himself^ and administer them to the patient with
his own hand, otherwise he is as little able to effect anything
certain and excellent of its kind as the caligrapher would be if
he were not allowed to select his own quills and cut them him-
self or the painter if he were forbidden to prepare iais own
708 ON DISPENSINa BY THE PHY8ICIAK.
colours, and was obliged to get every tint he used prepared by
a colour-mixing institution established by govermnent.
As little would the homoeopathic physician be able to perform
a masterpiece of a cure, indeed he would not be able to cure at
all, if he were prevented preparing his own curative agents^
the preparation of which demands so much care and such ex-
treme delicacy, but must let them be made by the apothecary,
whose chief endeavour is and must be to annihilate a system of
treatment that is exciting such attention, which not only is un-
profitable to him, but as it undeniably demands infinitely fewer
drugs for the accomplishment of the greatest cures, must one
day open the eyes of the world, and render his business, which
is only profitable by the amount of drugs disposed of to patients,
useless.
Thus the homoeopathist would naturally not be able to dia.
any good with his medicines prepared by the apothecary, heaven
only knows howl for no supervision can be exercised ovar
him (seeing that one white powder of sugar of milk looks, tastes^
smells and reacts chemically exactly like another, whether it
contain nothing #r whether it contain the minute homoeopathio
medicine or some medicine quite different), and he must natural-
ly cease to be a homoeopathic practitioner if he were to be pro-
hibited and forbidden by law to prepare his own remedies.
This it is that the institute of apothecaries and those physi-
cians brought up in the old system who are not able to equal
the horaoDopatbists in their cures, so earnestly desire for the new
school, in order to destroy the practice of the homcBopathists,
consequently homoeopathy itself and they are, as we hear,
attaining their object, inasmuch as they prosecute legally the
homoeopathists who give their own medicines to their patients,
on the strength of the laws that forbid the physician to dispense
his own medicines ; they avail themselves of the worldly arm
of the judge to paralyse for ever the hand of the homoeopathist.
In this they were an dare successful, for the judge, as a man
not belonging to the profession, acting upon the maxim cuUibet
in arte sua credendum, imagines he must listen to the opinion of
the medical authorities on the subject, and make their reasons
and deliverances his oum. It is only a pity that in this case he
does not hear the calm, well-weighed allegations of impartiality,
but only the embittered, fiery zeal of the adverse medical authori-
ties, consisting of doctors deeply imbued with the learning of
the past, whose traditional high position, together with that of
m. HOW HAT HOMCBOPATHY BE BRADIOATED? 709
their antiquated school, must, as they are aware, decline if homceo-
pathists be at liberty to exercise their art freely. This adverse
party will undoubtedly win the day if the judge does not per-
oeive partizanship in their so-called estimation of homoeopathy,
or if he attends to the interested insinuations of his family phy-
sician, who as a physician of the old school trembling for the
renown of the time-honoured faculty, takes great pains to join
in the cry of the complainants and of the medical authorities,
** Crucify him, crucify him ! "
If the judge, I repeat, do not estimate all this partizan talk at
its true value, and do not himself fulfil the sacred duty of a wise
impartial appUcatio legis ad facia^ do not himself examine the
law and its exact meaning with impartiality, then it is all tip
with the poor homcEopathists, — ^he will be condemned, as a dis-
penser, of having infringed upon the apothecaries' privilege,
and he will be compelled to abandon his profession. Such a
verdict is as laudable as that of the town magistrate, who, when
his friends the inn-keepers of the place, endowed with the ex-
clusive right to feed guests with dishes made in their kitchens,
brought an accusation against a man, '' that he* had encroached
upon their privilege and fed persons," condemned the latter to
punishment and the costs, in spite of all the representations of
this benefisK^tor to the effect, " that there was a great difference
betwixt the way he fed and that in which the inn-keepers fed^
and that though the latter might have the exclusive right to
dispense their composite dishes, and to set them before their
guests for money, yet that he had merely, during a period
of general scarcity, distributed gratuitously to those who required
it only simple articles of food, namely, bread to him who stood
in need of bread, meat to him who wanted meat, or uncooked
vegetables to him for whom they were suitable."
The homoeopathic physician is in the position of this benefec-
tor. In the midst of the dearth of relief for diseases, where
allopathy is of no use, he administers simple things, to cure one
thing this, to cure another that, whatever is most suitable for
each, and this he does gratuitously.
On the other hand the apothecaries' privilege runs as follows :
"that no one shall prepare medicines or medicaments^ that is,
dispense them, except the apothecary, from the prescription of
the physician — therefore that the physician shall not dispense
medicines, nor the apothecary prepare (dispense) medicine of
his own accord for patients, without the prescription of a legally
qualified physician."^
710 ON DISPENSING BT THB PHTBICUM.
But the words medicine and medkament are tiAwr emplojed in
any laws relative to medicine, except as signifying a medicinal
mixture composed of several medicinal ingredienffi, and the prtpara-
Hon of this ahne is exclusively entrusted to the privil^ed apoihe-
cary, who is to prepare it according to the presaiption of a
Intimate physician, that is, to dispense ; and in like nuinner
the physician of the old school is enjoined to prescribe several
medicinal ingredients in his recipe which are to be mixed
together by the apothecary. Thus Professor Gruner in the
prefiu^ to his Art of prescribing, says expressly, that a prescrip-
tion must consist of several medicinal ingredients to be united
together, for a single medicinal substance written down does not
constitute a prescription, — and for this reason every candidate
for a medical degree must shew by his certificates that he has
attended the lectures of a professor on the art of prescribing, and
in order to shew that he is thorough master of it| so as tobe aUe
to write prescriptions for a patient to be made up at the labora-
tory, he must at the bidding of the examine write extempore
prescriptions for any diseases named to him ; otherwise (and if
he gives expression to his thought that diseases may also be
cured with simple things) he will be rejected, <u has happened
more than once.
Thus it is certain that according to law the prescription must
direct several medicinal ingredients to be united together, so as
that they shall constitute one medicament, in the dispensing of
which the apothecary's privilege solely and alone consists.
On the other hand, the homoeopathic physician gives his
patient notldng hut one simple substance, he never mixes several
together, nor can he do so consistently with his doctrine and his
conviction, consequently he cannot employ in treatment any
mixed by the apothecary. It is therefore impossible that he can
encroach on the business of compounding medicines, in which alone
the apothecary's privilege consists, if fie always gives his patient only
a simple medicinal substance. Then who could accuse the homoeo-
pathic physician of interfering with the right appertaining to
the apothecary exclusively of preparing medicinal mixtures
(medicines, medicaments), seeing that he has no medicinal ingre-
dients to mix, and that he mixes none himself consequently he
does not dispense ?
Simple medicinal substances {species, simplicia) are not termed
medicines or medicaments by the medicinal laws of any land, on
the Cs^ntrary these terms are used in contradistinction to one
lU. HOW XAY HOMCBOPATHT BB BBAfi^ATSD ? 711
another. Medicines or mecUcanienta are, in the ^kii)er.«nd' spirit
of these laws, ofUy compounds and miociuTyss <>f' ieverM^^fiiMdi^^
ingredients prepared from the physician^ s preseriptum bfthje*apot^-
cary^ and mingled together into a com|)<>M!fe. ti^AoJb(caQed^-b}r4he
laws medicine and medicamefnt\ whioh is flufficfenil^^ olmotiiB
from this, that the same medicinal laws that (y>nfer^h^;f>r»iiife-
gium excbmvum on the apothecary, whereby heoMainstiieng^t
to prepare medicinal mixtures according to the {)hysi^ii%^'^-
scription, that is, to dispense medicines {medicameni^faiA^iie^ctby
he is at the same time forbidden to dispense* tT^edfioeriiM^^ V^thcMt
the physician's prescription, <that is, to prepare^his own ^leoord
mixtures of several medicinal ingredients for tfaepublib^4hai1;he
same medicinal laws, I say, allow himtodealinsimple^n^AiciBal
substances, to sell to any one that asks for* them^Hrhubi|rb,
cinchona bark, jalap, aloes, castor, asafcetida,- viklerian,'^'imd^ all
other simpUda and species that are not dangerous-in smaQ -qiMir-
tities — ^whence it is obvious that the laws which -foytidth^^^X)-
thecary to dispense medicines of his own accoid,' do /not under*
stand by the term ^^ medicines^^ {medicaments), simple slifoetancep,
and do not consider that the giving of sirnple^ n/iiedicmal^thfihgi
should be regarded as dispensing medicinesi-otherwiiae tb^
would not have allowed the apothecary to spti; them. -They,
however, universally allow the apothecary to <id this -a^a-regu^
lar retail seller of drugs, just as they appoint &e druggists ^
wholesale dealer in drugs. . ^ .^ . j ... - ^ •'
But i^ in order to suppress the homoeopathic phyjjibian, pof^
secuted as he is by the old school of medicine fti^ ih^ apo!die*>
caries^seeing that he cannot be accused of practisii&g. the ^x>*
thecaries' business of mixing medicines (di8pensing)~^it is sought
to indict him as a seller of simplicia — an accusation that could
not be brought under the category of the prohibited dispensing
(compounding simplicia into a medicament) — be it known that
the homoBopathic physician does not get paid by the patient for
his simple remedy (for medicines and medicaments in the sense of
the medicinal laws they are not, as we have shewn), nor can he
be paid for them, as they are so minute, so inconceivably deli-
cate, that it is impossible to attach a commercial value to them
on account of their incalculable minuteness I No! he does not get
paid for diem, he can only justly demand for his skill and trouble
the fee that cannot be refused to any legitimate physician.
But in order to prevent his escape if possible, the apothecaries
and allopathic physicians sophistically allege, " that the homoeo-
path also makes up mixtures, and thereby encroaches on the
712 CONTRAST OF THB OLD AND THB KXW
apothecary's privilege, seeing that he umtes his medicinal sub-
stance (simple though it be) with sugar of milk." But sugar of
milk is not a medicinal ingredient, it is a mere vehicle and
recipient for the simple medicinal substance of the homceopathic
practitioner, just like the cane sugar in peppermint lozenges, in
anise-sugar, in sugared worm-seeds and many other similar non-
medicinal things prepared and sold by the apothecary to the
public, which no medicinal regulations forbid hJTn to sell on the
ground of their being mixtures of medicines or their sale coming
under the head of dispensing, and which, in spite of the sugar
in them as a vehicle, remain simple things {simpUcui.)
Or shall the apothecary alone be allowed to give to the public
a medicinal substance mingled with sugar, but when the scientific
physician does the same for the purpose of curing disease, shall
it be forbidden, not allowed, punishable ? Is there a judge who
could pronounce such a sentence ?
And is there a judge, who, after a careful consideration of the
above truthful representation, could, with the slightest semblance
of justice, so misapprehend and distort our medicinal regulations
that lay down so clearly and so accurately the definition of
dispensing medicines, as to interpret them to condemn the
homoeopathic physician, who gives his simple substance (never
any mixtures) gratuitously in order to relieve his patient, of dis-
pensing and infringing on the apothecaries' privilege (which
only refers to the compounding of medicaments consisting of
several ingredients) ? Could any impartial judge help acquitting
him according to the letter of these plain and unanimous laws?
Let any one point out to us a single passage in any code of medi-
cinal laws which forbids Vie legitimate physician to administer a
simple medicinal substance in order to relieve his paiient 1
COXTRAST OF THE OLD AND THE NEW SYSTEMS OF
MEDICINE.^
As long as accurate observation, unwearied research, and
careful comparison have failed to demonstrate really constant
original ty]>es of disease for the amazing number of morbid
phoiiDinena and ca^cs of disease occurring in the human subject,
which nature appears to produce in endless variety and very
' Prom the RexM Arzneimitte/Uhre, part iv, 2d edit 1825.
SYSTEMS or MEDIGIKS. 71S
dissimilar to one another, so long will it be manifest that every
single morbid phenomenon must be homoaopathicallj treated,
just as it presents itself, according to the array of symptoms that
nhcw themselves in every case, by which means however they
will all be infinitely better removed than by all the routine
treatment that has hitherto prevailed in ordinary practice.
The adherents of the old school of medicine imagined that
they would best succeed with the treatment of that great variety
of morbid, phenomena, if they arbitrarily drew up upon paper a
list of types of disease, which should represent and include
within them all the cases of disease that were met with at the
dek-bed. They gave the name of pathology to this work of
diirirs.
Seeing the impossibility of efficaciously treating every case of
dbease according to its individuality, they imagined that their
bnsiness was to select from the apparently infinite variety of
different morbid phenomena which nature displays, a number
of diseased states, all resembling each other in having some par-
tiealar prominent symptom in common, as fundamental forms,
and, having assigned to them general symptoms that were of
not unjfrequent occurrence in diseases and bestowed on them
special names, to give them out for constant, distinct diseases,
^t always remained the same. The collection of these forms
of disease manufactured by themselves, they asserted to consti-
tute the whole range of the world of disease, in other words,
paiholoffy, in order that they might be able to lay down special modes
fif treatment for these their imaginary morbid pictures, and this
constituted the science of therapeutics.
Thus they made a virtue of necessity, but they did not con-
sider the evil that must arise from this perversion of nature,
ihey did not reflect that this arbitrary procedure that did vio-
lence to nature, after having grown old by being propagated
through thousands of years, would at length come to be regarded
88 a symbolical, unimprovable work.*
The physician who was called in to a case, to determine, as
the rules of his art enjoined, the nosological name of the disease
* It ifl only a pity that this fond dream is dispelled when we look at the Yarions
ifilemfl of pathology with their different names and diaHimilar descriptions of diseafle»
jA^ai we look at the hundred and fifty definitions of feyer, and the yery yanons
modes of treatment in the many works on therapeutics, which all lay equal daim to
idUlibility. Which of all of them is right f Is not the unnatural, unreal, apocry-
phal character of all apparent f
712 GONTRABT OF THB 010) AND THK HIW
apothecary's privilege, seeing that he umtes his medicinal sab-
stance (simple though it be) with sugar of milk." But sugar of
xnilk is not a medicinal ingredient, it is a mere vehicle and
recipient for the simple medicinal substance of the homcBopathic
practitioner, just like the cane sugar in peppermint lozenges, in
anise-sugar, in sugared worm-seeds and many other similar non-
medicinal things prepared and sold by the apothecary to the
public, which no medicinal regulations forbid him to sell on the
ground of their being mixtures of medicines or their sale coming
under the head of dispensing, and which, in spite of the sugar
in them as a vehicle, remain simple things {simpUcia.)
Or shall the apothecary alone be allowed to give to the public
a medicinal substance mingled with sugar, but when the scientific
physician does the same for the purpose of curing disease, shall
it be forbidden, not allowed, punishable? Is there a judge who
could pronounce such a sentence ?
And is there a judge, who, after a careful consideration of the
above truthful representation, could, with the slightest semblance
of justice, so misapprehend and distort our medicinal regulations
that lay down so clearly and so accurately the definition of
dispensing medicines, as to interpret them to condemn the
homoeopathic physician, who gives his simple substance (never
any mixtures) gratuitously in order to relieve his patient, of dis-
pensing and infringing on the apothecaries' privilege (which
only refers to the compounding of medicaments consisting of
several ingredients) ? Could any impartial judge help acquitting
him according to the letter of these plain and unanimous laws?
Let any one point out to us a single passage in any code of medir
cinal laws whicJi forbids the legitimate physician to administer a
simple medicinal substance in order to relieve his patient I
CONTRAST OF THE OLD AND THE NEW SYSTEMS OF
MEDICINFJ
As long as accurate observation, unwearied research, and
careful comparison have failed to demonstrate really constant
original tyjx^ of disease for the amazing number of morbid
phenomena and cases of disease occurring in the human subject,
which nature appears to produce in endless variety and very
' From the RetM ArmeimitielUhre, part iv, 2d edit 1826.
SYSTEMS or ICSDIGIKS. 71S
Hi»rinti1ft.T to one another, so long will it be manifest that every
single morbid phenomenon must be homoeopathically treated,
just as it presents itselJ^ according to the array of symptoms that
shew themselves in every case, by which means however they
will all be infinitely better removed than by all the routine
treatment that has hitherto prevailed in ordinary practice.
The adherents of the old school of medicine imagined that
they would best succeed with the treatment of that great variety
of morbid, phenomena, if they arbitrarily drew up upon paper a
list of types of disease, which should represent and include
within them all the cases of disease that were met with at the
8iek*bed. They gave the name of pathology to this work of
theirs.
Seeing the impossibility of efficaciously treating every case of
disease according to its individuality, they imagined that their
business was to select from the apparently infinite variety of
different morbid phenomena which nature displays, a number
of diseased states, all resembling each other in having some par-
ticular prominent symptom in common, as fundamental forms,
and, having assigned to them general symptoms that were of
not unfirequent occurrence in diseases and bestowed on them
special names, to give them out for constant, distinct diseases,
that always remained the same. The collection of these forms
of disease manufactured by themselves, they asserted to consti-
tute the whole range of the world of disease, in other words,
pathology^ in order that they might he able to lay down special modes
of treatment for these their imaginary morbid pictures^ and this
constituted the science of iherapeutics.
Thus they made a virtue of necessity, but they did not con-
sider the evil that must arise from this perversion of nature,
they did not reflect that this arbitrary procedure that did vio-
lence to nature, after having grown old by being propagated
through thousands of years, would at length come to be regarded
as a symbolical, unimprovable work.*
The physician who was called in to a case, to determine, as
the rules of his art enjoined, the nosological name of the disease
' It ifl only a pitj that this fond dream is dispelled when we look at the Tariow
•jBtema of pathology with their different names and diaHimilar descriptions of disease^
when we look at the hundred and fifty definitions of feTer, and the Tery yariow
modes of treatment in the many works on therapeutics, which all lay equal claim to
infiillibility. Which of all of them is right f Is not the unnatural, imreal, apooy-
phal character of all apparent t
714 OOHTRABT OF THE OLD AHD WKW
his patient laboured under, must take for granted, in referenoe to
some symptoms that the pathological works describe as belong-
ing to this form of dis^ise, that they are merely accidentally
absent in his patient, that they might Yerj weU be there, although
they are not — ^the remaining often very nnmerons and serious
sufferings and symptoms which the patient was really affected
with, but which do not occur in the definition of the nosological
name in the pathological work, he must^ so the roles of his art
required, regard as unessential, as accidental, as unimportanti
as wild, exuberant of&hoots, so to speak, — symptoms of symp-
toms— ^which he need not pay attention to. .
It was only by such extraordinaiy capricious adding-to the
actual morbid state, and equally capricious paring-down of it^
that the adherent of the arbitrary old school succeeded in con*
cocting the list of diseases, recorded in nosological works, and
in practice demonstrating that his patient laboured under one
of the diseases in this nosological system, of which nature never
thought when she made him ilL
'* What do we care," say the medical teadiers and their booka^
*^ what do we care about the presence of many other diverae
symptoms that are observable in the case of disease before us,
or the absence of those that are wanting ? The physician should
pay no attention to such empirical trifles; his practical tact, the
penetrating glance of his mental eye^ into the hidden nature of
the malady, enables him to determine at the very first sight rf
the patient what is the matter with him, what pathological form
of disease he has to do with, and what name he has to give it,
and his therapeutic knowledge teaches him what prescription he
must order for it"
Thus then were prepared from that human piece of manufiM>-
ture termed pathology those deceptive pictures of disease which
were transferred lege artis to the patient, and fiJsely attributed
to him, and this it was that rendei^ it so easy for the physician
to recal to his memory without hesitation a couple of prescrip-
tions which the clinical therapeutics (of the prescription pocket-
book) had in readiness for this name.
* What booest man not endowed with ckunroyanoe ooold boast of poapcawng a
mental eye which ahould enable him to penetrate throogh fle^ and bone into d»t
hidden essential nature of things that the Creator of mankind alone anderatands, of
which mortal man would hare no conception, lor whidi he would have no wcrd% if
it were laid open to him t Does not sik^ pretension reach the climax of boastfiil
charlatanerj and mendadotis delusion ?
SYSTEKS OF KSDICIKIL 716
But how did the prescriptions for these names of diseases
originate? Were they communicated by some divine revelation ?
My dear sir, they are either formulas prescribed by some cele-
brated practitioner for some case or other of disease to which he
has arbitmrily given this nosological name, which formulas
consist of a variety of ingredients, knovm to him no doubt by
name^ that came into his head and were put by him into an
elegant form by the aid of that important art which is called the
art of prescribing {ars formulas condnnandi recteque concipiendi)^
whereby the requirements of chemical skill and pharmaceutical
observance were attended to, if not the welfare of the patient ;
—one or several receipts of this kind for the given case, under
the use of which the patient at least did not die, but — ^thanks to
heaven and his good constitution I — gradually recovered. These
are therefore receipts taken from the writings of illustrious
practitioners; or they are formulas which, at the request of
some publisher who well knew how capitally prescription-
manuals sell, were fabricated in a garret, off-hand, for the patho-
logical names, by some willing soul in his pay, who was well
skilled in the ars formulas condnnandi^ and who was guided in
his labour by the account of the virtues that the lying works on
Materia Medica have liberally attributed to the several medi-
cinal substances.
But if the physician found the disease in his patient too un-
£ke any of the pathological forms of disease to permit him to
give it a definite name of this sort, it was admissible for him,
according to his books, to assume for the malady a more remote
and concealed origin, in order to establish a treatment thereupon
(on this assumption). Thus, supposing the patient at some
former period had sufiered from pain (no matter what kind) in
the back, his disease was instantly ascribed to concealed or sup-
pressed hemorrhoids —if he had had a tense abdomen, mucuous
excrements, anorexia alternating with bulimia, or even only itch-
ing in the nose, his disease was called a worm disease ; or if he had
occasionally had pains (no matter what kind) in the limbs, his
disease was pronounced to be concealed or immature gout, and
against this fancied internal morbific cause the treatment was
directed. If there were attacks of pain in the abdomen, spasm
must be to blame for them ; if there were frequent determina-
tion of blood to the face, or if the nose bled, the patient was de-
cidedly too full-blooded ; if the patient grew very thin during
the treatment, as he naturally would, marasmus had to be com-
716 OONTRAST OF THE OLD AND NEW
hatted ; if he was at the same time of a very sensitive dispositioii,
nervous wealcness was the enemy to be attacked; if he suffered
fix>m cough, then concealed catarrh or a tendency to phthisis
was in the back ground ; if the patient sometimes felt pains in
the right side of the abdomen, or even only in the right shoulder,
it was undoubtedly concealed inflammation or hidden in*
duration of the liver that was to be taken into considera-
tion. An old cutaneous disease or an ulcer on the 1^ mosti
in order that the treatment should be directed against it, be at-
tributed either to some herpetic humour or to some serofulous
virus, and a chronic prosopalgia must of course be ascribed to
the cancerous virus. After having in vain treated first this
then the other &ncied hidden morbid state according to the
directions of the clinical books, and after all the mineral waten^
which are said to be useful in some indefinite manner for every thing^
had been visited, nothing else remained but to view the case as
one of in£eux^tus of the abdomen and obstruction of the minntd
vessels of that part according to the idea of the formerly cele-
brated Kamp^ and torture the patient, in KampPs &shion, with
injections into the colon of hundreds of his absurd mixtures of
vegetable decoctions, until he had got enough of them.
In consequence of the ease with which conclusions relative to
the essentia nature of diseases were come to, there could, thank
heaven ! never be any lack of plans of treatment whereby the
days of suffering of the patient might be fiilly occupied (for there
are prescriptions in plenty for all names of diseases), as long as
his purse, his patience, or his life lasted.
" But no! we can go to work in a more learned and sagacious
manner, and investigate and conjecture upon the maladies that
afflict mankind in the depths and concealment of abstract views
of life, as to whether, in the case before us, the arterial, the
venous or the nervous system, the sensibility, the irritability or
the reproductive ftmction suffer qnantitively more or less (for we
purposely avoid considering the infinite variety of gualitivt
affections fix)m which these three expressions of vitality may
suffer, in order not to burthen ourselves to a still greater ex-
tent with the labour of research and conjecture) ; we merely makt
a guess as to whether these three expressions of vitality are in a
state either of excessive depression or excessive exaltation. If
we are of opinion that the first, second or third of them is suf-
fering from one or other of these states of too high or too low,
we may boldly proceed to manoeuvre against it^ according to the
grSTSlCS OF KSDICIKE. 717
plan of the new iatro-chemical sect, whicli found out, Hhat
nitrogen, hydrogen and carbon alone constituted the souls of
medicinea, that is, the only active and curative thing in them ;
that, moreover, carbon, nitrogen and hydrogen could at pleasure
regulate and screw up or screw down (potentize and depotentize)
the irritability, the sensibility and the reproductive function,
consequently (if the premises are correct) the whole vitality,
and therefore they were capable of curing all diseases.' — "Kb
only a pity that they are not yet agreed as to whether external
agents act by means of their similarity or their contrariety to the
oompotent parts of our organism!"
But in order that medicines should really contain these elemen-
tary principles, which, as £eu: as was known, they had not hitherto
possessed, they were one holiday evening formally ascribed to
them at the desk, and, in a system of materia medica specially
created for this purpose, it was decreed how much carbon, nitro-
gen and hydrogen each medicinal substance should henceforth
contain.
Could medical caprice go further, or trifle more sinfully with
human life?
But how long shall this irresponsible playing with human
life still' last ?
After three and twenty centuries of such a criminal mode of
procedure, now that the whole human race seems to be awaking
in order powerfully to vindicate its rights, shall not the day
begin to dawn for the deliverance of suffering humanity which
has hitherto been racked with diseases, and in addition tortured
with medicines administered without rhyme or reason, and with-
out limit as to number and quantity, for phantoms of diseases,
in conformity with the wildest notions of physicians proud of
the antiquity of their sect ?
Shall the pernicious ji^lery of routine treatment still con-
tinue to exist?
Shall the entreaty of the patient^ to listen to the account of
his sufferings, vainly resound through the air unheard by his
brethren of mankind, without exciting the helpful attention of
any human heart?
Or can the so remarkably different complaints and sufferings
of each single patient indicate anything else than the peculiarity
of his disease? If not, what can this distinct voice of nature,
which expresses itself in terms so appropriate to the various
symptoms of the patient, what can it mean if not to render his
718 CONTBAST OF THB OLD AMD THS NSW
morbid state as cognizable as possible to the sympathizing and
attentive physician, in order to enable him to distinguish the
very minutest shades of difference of this case firom every other?
Would beneficient nature, that makes such efforts for our pre-
servation, by her extremely wise, simple, and wonderful arrange-
ment for enabling the patient to reveal to the observer, by words
and signs, the great variety of his altered sensations and morbid
actions, have enabled him to do this so utterly in vain and with-
out object, and not in order to furnish a clear and accurate de-
scription of his morbid state in the only conceivable manner so
as not to lead the practitioner astray 7 The disease, being but a
peculiar condition, cannot speak, cannot tell its own story ; the
patient suffering from it can alone render an account of his dis-
ease by the various signs of his disordered health, the ailments
he feels, the symptoms he can complain o^ and by the altera-
tions in him that are perceptible to the senses. But the pseudo-
wisdom of the ordinary physicians thinks all this scarcely worth
listening to ; and even if they listen to it, they allege that it is
of no importance, that it is empirical and expressed in a very
tmleamed manner by nature, that it does not coincide with what
their pathological books teach them and is, therefore, not^avail
able for their purpose, but in place thereof they put forward a
figment of their learned reveries as the picture of the internal
(never ascertainable) state of the disease, in their folly substitute
this delusive pathological picture for the individual state of each
case of disease as nature faithfully delineates it, and direct their
medicinal weapons against this trumped-up phantom of their
imagination, the production of what they call their practical tact.
And what are these weapons of theirs ? Large doses of medi-
cines ; that is, be it observed, powerful substances, which, where
they do no good, must and really do injure the patient (seeing
that the peculiar and sole nature of all medicines in the world
consists in their capability, when brought in contact with the
living sensitive body, of morbidly deranging it, each in its own
peculiar way), which must accordingly make the patient worse,
if they have not been selected for remedial purposes with the
utmost care that their peculiar properties shall be adapted to the
morbid state ! These medicinal substances, which m tiiemselves
are injurious^ often very injurimis (and only useful in the cases for
which they are suitable) and which are unknown in regard to
their peculiar, true action, were so blindly resorted to, or in
obedience to the mandates of the mendacious book called ma-
STSTSMS OF MEDICIKS. 719
teria medica, mingled together (if the mixture was not taken
ready-made from the reoeip^book) as though they were drawn
at hap-hazard from the wheel of fortune or rather misfortune,
taith no correct knowledge or rather no knowledge at all of their true^
peculiar effisctSj and they served but to increase the tortures of
the patient already suffering from his disease, with this barbar-
0118 oUa-podrida fuU of disgusting smells and tastes (one spoon-
fbl to be taken every hour!). Was such a procedure beneficial
to him ? oh Gt)d I no, prejudicial to him. The usual result of
Buoh an unnatural and Mae mode of treatment pursued during
every hour of the day, must be visible aggravation of his state,
aggravation which the ignorant patient is made to believe is the
malignant nature of his disease. Poor, unhappy wretch I what
else than to make bad worse can be done by such powerful
noxious substances raked together, according to the whims of
the prevalent medical school, taken at blind hazard and admin-
istered in an inappropriate place ?
And in this homicidal manner have practitioners gone on
acting in despite of the truth that speaks trumpet-tongued for
our information, because, since the remotest times, it has been
the habit with their profession to torture methodically suffering
humanity in this unnatural manner for their money — ^to their
iiyuryl
What human heart in whom the smallest spark of the G-od-
implanted monitor, conscience, still exists, but must shudder at
such abominable behaviour ?
In vaiu, in vain dost thou seek to silence the audible, terrible
voice of the incorruptible judge in thy conscience, of that sacred
tnbunal of God's justice that holds its seat in thy bosom, by the
miserable excuse that others do so likewise, and that such has
been the practice since the most remote ages ; in vain dost thou
seek to stifle its still small voice by atheistical ridicule, wild
pleasures, and goblets of reason-obscuring, intoxicating drinks.
The Holy One, the Almighty lives, and eternal unchangeable
justice lives with him.
* * ♦ «
Now, as the internal operations and processes of the living
human organism cannot be inspected, and, as long as we are
merely men and not God, cannot be perfectly known to us, either
in the healthy or yet in the diseased state, and on that very ac-
count all deductions from the exterior respecting the interior are
deceptive, and as the knowledge of disease can be neither a
720 CONTRAST OF XHX OLD AND THE NEW
metaphysical problem nor the product of fimtaslic specolatioiiY
but is an af&ir of pure experience by the aenaee, becauae diaeMe
as a manifestation can only be apprehended by obserrsdon ;
therefore every unprejudiced person must at once peroeiYe thal^
as careful observation finds every individual case of <iiwHM» to
differ firom every other,^ no name borrowed fix>m a pathological
system of m^m's fiibrication which fidsely alleges diaeaaes to
possess constant unvarying characters^ should be attached to
morbid states^ which in reality differ so much among themselvesy
and that there can scarcely be any hypothetical rq^reaentatioii
which we can form to ourselves respecting any one disease, that
shall not be imaginary, delusive and xmtrue.
Diseases are nothing more than alterations of die healthy, le-
gular state of health, and as an alteration of thia sort conaisla
merely in the occurrence of many accidents, morlMd symptoma
and perceptible divergences from the former healthy state, aee-
ing that after the removal of all these aoddents and aymptoma
nothing but health can remain ; so there can be for the physician
no other true view of diseases which shall enable him to discover
what should be the aim of his treatment, and what there is to be
cured, save and except what is peroeiTed by the aenaes of the
observable alterations of health in the patient
The honest physician, therefore, whose conscience forbids him
with superficial haste to invent a delusive picture of the malady
to be cured, or to consider it as one of the forms of disease al-
ready existing in pathological works ; whose earnest desire it is,
in one word, to investigate the peculiar charact^ of the disease
before him, in order to be able to restore the patient with cer>
tainty, — the honest physician, I say, will observe his patient
minutely, with all his senses, will make the patient and his at^
tendants detail all his sufferings and sjrmptoms, and will care-
fully note them down without adding anything to or taking
anything firom them ; he will thus have a Mthfid genuine picture
of the disease, and along with that an accurate knowledge of all
there is in it to be cured and removed ; he will.then have a true
knowledge of the disease.
Now as diseases can be nothing more than alterations of the
healthy, regular state of health, and as every alteration of the
health of a healthy person is disease, therefore cure can be no-
* With the exoeptkn of such diseaaes as are caaaed bj a miasm of ooDslaDt
character, or by ao always idenrtca] cause.
SYSTEMS OF MBDICINB. 721
thing than transformation of the irregular state of health into
the regular and healthy state.
If^ then, as cannot be denied, medicines are the agents for
earing diseases, they must possess the power of effecting an al-
teration in the state of health.
Now as there can be no other alteration of the sound state of
health than this, that the healthy person shall become sick,
therefore medicines, inasmuch as tliey possess the power of heal-
ing, consequently of altering the health of man, the healthy as
well as the sick, must, in their action upon the healthy, produce
many symptoms, morbid sufferings, and divergences from the
healthy state.
Now admitting, what likewise cannot be denied, that, in order
to cure, the main business of the physician consists in knowing
beforehand the medicine from which a cure is most certainly to
be expected, he must, seeing that a cure by medicines takes place
only by reason of an alteration effected in the state of the health,
at)oye all things know beforehand, what alterations in man's
health the several medicines can effect, before he selects one of
them for administration, if he do not wish to be guilty of a cri-
minal inconsiderateness, and an unpardonable attack upon human
life ; — ^for if every powerftd medicine can make the healthy sick,
an ignorantly selected, consequently an unsuitable, medicine
must necessarily render the patient worse than he was.
The most zealous efforts of one who devotes himself to the
eore of diseases (a physician), must hence before all things, be
directed to obtain a foreknowledge of those properties and ac-
tions of medicines by means of which he may effect the cure or
amelioration of every individual case of disease with the greatest
oertainty, that is to say, he must, before commencing the prac-
tice of physic, have previously obtained a thorough knowledge
of the peculiar alterations in the health of man the several me-
dicines are capable of effecting, in order to be able to select, in
every case of disease, the health-altering medicine most suitable
for Meeting a cure.
Now it is impossible that the alterations in man's health which
medicines are capable of producing, can be known and observed
more purely, certainly and completely, by any other method in
the world, than by the action of medicines upon healthy indivi-
duals ; indeed there is no other way besides this conceivable,
in which it were possible to obtain experience that shall be at all
of an accurate character respecting the real alterations they are
46
722 OONTBAST OF THE OLD AND THE KXW
capable of effecting in man's health. For the ictioa they shew
with chemical re-agents, reveals only chemical properties^ which
are no clue to their power over the living human organism. The
alterations they produce when given to animalsi only teach wha(
they can do to them each according to its natuiei but not what
they would effect on man, endowed as he is with an organization
of a perfectly different character, and with very different poweia
both of mind and body. Even when given in human diaeaaea
in order to ascertain their effects, the peculiar symptoms which
were solely due to the medicine can never be distinctly reoognisedy
never accurately distinguished, amid the tumult of the morbid
symptoms already present, so as to admit, of our asoertaining
which of the changes effected were owing to the medicine, which
to the disease. Hence not the slightest claim to a knowledge
of the true, pure action of the various medicines can be made by
the ordinary materia, medica, which has scraped together its
£Eibles respecting the virtues of drugs, from the confused use of
mixed medicaments in diseases, its descriptions of which are often
not more lucid than the pathological names bestowed upon them.
The simple natural way alone remains for us, in order to aa-
certain clearly, purely and with certainty, the powers of medi*
cines upon man, that is, the alterations they are capable of
effecting on his health — the only genuine and simple natural
way, viz., to administer the medicines to healthy individuals
who are attentive enough to notice upon themselves what each
individual medicine is capable of producing in and on them of
a peculiar morbid and altered character, and to make a careftil
record of the complaints, symptoms and alterations in their cor*
poreal and mental state produced by its administration, as the
peculiar alterations of man^s health this medicine may henceforth
be expected to produce ; for whilst the action of a medicine
lasts (provided violent moral emotions and other injurious in*
fluences from without do not intervene) all the symptoms that
occur in a healthy individual must be the effects of the medicinCi
seeing that its influence alone dominates over our state of health
at that period.
The physician must possess the most perfect knowledge pos-
sible of the pure alterations in the health produced on the healthy
human body by the greatest possible number of single medicineSi
before he ventures to undertake the most important of all voca-
tions, namely, the administration of medicines to a sick person
for his disease, to a suffering fellow-creature who appeals to our
SYSTSMS OF MEDICIKB. 723
most sacred sense of duty to relieve him, who demands all our
compassion and all our zeal, to enable us to rescue him, for these
medicines if given improperly are firightful substances, and are
attended with injurious effects, and not un£requently with danger
to life.
In this way alone will the upright physician act in the most
important matter of conscience that can be, in gaining a know*
ledge of the pure effects of medicines, and in investigating the
ease of disease committed to his care, according to the distinct
indication and obvious requirements of nature, and in this way
alone will he act in accordance with the dictates of nature and
conscience, even though he know not as yet what morbid symp^
toms, artificially produced by medicine on the healthy individual,
nature has destined for the eradication of any given symptom
in natural diseases.
' This problem he cannot solve by any speculative a priori re-
aeareh, nor by any fantastic reveries — ^no I he can only solve
this problem also, by experiment, observation, and experience.
Now it 13 not merely one single observation, but all experi-
ments and observations careftdly conducted demonstrate in the
most convincing manner (to every sensible individual who will
be convinced) that among medicines tested as to their pure
effects, that one alone, which can produce in the healthy indi-
vidual a similar morbid state, is capable of transforming a given
case of disease, rapidly, gently, and permanently into heal^
indeed^ tliat such a medicine mill never fail to cure die disease, Tne
place of the natural disease in the organism is occupied by the
artificial somewhat stronger medicinal disease, which now alone
oecupies the vitality, and in consequence of the minuteness of
the dose of the medicine which produced it, runs but a brief
course before being extinguished, and the body is then left with-
out disease, that is, quite well and (homoeopathically) cured.
If then, beneficent nature shews us, in the homoeopathic
method of treatment, the only sure and infallible way by which
we can remove easily and permanently the totality of the symp-
toms in a patient, that is, his whole morbid state,' and by which
we are able to make him well at will ; if every instance of treat-
ment conducted on this plan shews lis the most un&iling cure ;
who could remain so perverse, and neglect to such a degree the
good of himself and of humanity, as to refuse to tread in this
' After the removal of all his ailmeote, BymptomB and the morbid changes in
his feelingd, can anything besides health remain t
7j(4 THS MSDICAL OBSIBYEB.
jMuii of truth and nature, bat stick to the indefensible, antiquated,
porelj imaginaiy phantoms of diseases and modes of treatment^
xo theminalion of the sick?
I know full well that it requires heroic courage in order to
cure oorselyes of prejudices grown almost into mental infirmitiefli
whidi have become sacred to us on account of their hoaiy age,
and that it demands a Tcrj uncommon strength of mind to
eradica&e from our memory all the absurdities that have been
imprinted upon our jouthful susceptibilities as oracular detir-
etances^ and to exchange them for new truths.
Ru Ae oat-foariind wiih which a consciousness ofading rigid
c :nnw uv f'fxar^ Aeje vidUnifSS over ourselves a thousand-fMI
Do old, antiquated untruths become anything better--do they
becocue truths — by reason of their hoary antiquity? Is not
truth eternal, thoi^ it may have been discovered only an hour
igo ? Do^ the novelty of its discovery render it an untruth?
Waes there ever a discovery or a truth that was not at first
novel?
THE MEDICAL OBSERVERS
(a fragment.)
lu order to be able to observe well, the medical practitioner
ivquiivs to possess, what is not to be met with among ordinary
phv^oians even in a moderate degree, the capacity and habit of
av^cing cjirefuUy and correctly the phenomena that take place
tu natural diseases, as well as those that occur in the mo^
^vl slates artificially excited by medicines, when they are tested
:ttvu tho healthy body, and the ability to describe them in the
^^^ appropriate and natural expressions.
lu or\ler accurately to perceive what is to be observed in pa-
^g^l»^ wo should direct all our thoughts upon the matter we
^x^ in hand, come out of ourselves, as it were, and attach our
l^t«k A^ to speak, with all our powers of concentration upon
j^ # \>l\Wr that nothing that is actually present, that has to do
« fhNutlw/MMtf ^rm«Mii<<€^Mre,ptiT,2iidedit 1886.
THB HBDICAL OBSBBYSR. 726
with the subject, and that can be ascertained by the senses, may
escape us.
Poetic &ncy, &ntastic wit and speculation, must for a while be
Buspended, and all overstrained reasoning, forced interpretation
and tendency to explain away things, must be suppressed. The
duty of the observer is then only to take notice of the pheno-
mena and their course; his attention should be on the watch,
not only that nothing actually present escape his observation,
but that also what he observes be imderstood exactly as it is.
This capability of observing accurately is never quite an in-
nate &culty ; it must be chiefly acquired by practice, by refin-
ing and regulating the perceptions of the senses, that is to
say, by exercising a severe criticism in regard to the rapid im-
presdons we obtain of external objects, and at the same time the
necessary coolness, calmness and firmness of judgment must be
preserved, together with a constant distrust of our own powers
of apprehension.
The vast importance of our subject should make us direct the
energies of our body and mind towards the observation ; and
great patience, supported by the power of the will, must sustain
U0 in this direction until the completion of the observation.
To educate us for the acquirement of this &culty, an acquain-
tance with the best writings of the Greeks and Romans is useful,
in order to enable us to attain directness in thinking and in
feeling, as also appropriateness and simplicity of expressing our
sensations ; the art of drawing jfrom nature is also useful, as it
sharpens and practises our eye, and thereby also our other
senses, teaching us to form a true conception of objects, and to
represent what we observe, truly and purely, without any addi-
tion from the fancy. A knowledge of mathematics also gives us
the requisite severity in forming a judgment.
Thus equipped, the medical observer cannot fail to accomplish
his object, especially if he has constantly before his eyes the
exalted dignity of his calling — as the representative of the all-
bountiful Father and Preserver, to minister to His beloved hu-
man creatures, by renovating their systems when ravaged by
disease. He knows that observations of medical subjects must
be made in a sincere and holy spirit, as if under the eye of the
all-seeing God, the Judge of our secret thoughts, and must be
recorded so as to satisfy an upright conscience, in order that
they may be communicated to the world, in the consciousness
that no earthly good is more worthy of our zealous exertions
720 THE MEDICAL OBSSBVBBb
than the preseryation of the life and health of our fellow-
creatures.
The best opportunity for exerciaing and perfecting our ohBerr-
ing fecultj, is afforded by instituting experiments with medi-
cines upon ourselves. Whilst avoiding all foreign medicinal
influences and disturbing mental impressions in this important
operation, the experimenter, after he has taken the medicine,
has all his attention strained towards all the alterations of health
that take place on and within him, in order to observe and cor-
rectly to record them, with ever- wakeful feelings, and his senses
ever on the watch.
By continuing this careful investigation of all the changes
that occur within and upon himself the experimenter attains
the capability of observing all the sensations, be they ever so
complex, that he experiences from the medicine he is testing,
and all, even the finest shades of alteration of his health, and of
recording iu suitable and adequate expressions his distinct con-
ception of them.
Here alone is it possible for the beginner to make pure, cor-
rect and undisturbed observations, for he knows that he will not
deceive himself there is no one to tell him aught that is untrue,
and he himself feels, sees and notices what takes place in and
upon him. He will thus acquire practice to enable him to make
equally accurate observations on others also.
By means of these pure and accurate investigations, we shall
be made aware that all the symptomatology hitherto existing in
the ordinary system of medicine, was only a very superficial
affair, and that nature is wont to disorder man in his health and
in all his sensations and functions by disease or medicine in such
infinitely various and dissimilar manners, that a single word or
a general expression is totally inadequate to describe the mor-
bid sensations and symptoms which are often of such a complex
character, if we wish to portray really, truly, and perfectly the
alterations in the health we meet with.
No portrait painter was ever so careless as to pay no attention
to the marked peculiarity in the features of the person he wished
to make a likeness of, or to consider it sufficient to make any
sort of a pair of round holes below the forehead by way of
eyes, between them to draw a long-shaped thing directed down-
wards, always of the same shape, by way of a nose, and beneath
this to put a slit going across (he face, that should stand for the
mouth of this or of any other person ; no painter, I say, ever
THE MEDICAL OBSEBVSR. 787
vent about delineating human faces in such a rude and slovenly
manner ; no naturalist ever went to work in this fashion in de-
oeribing any natural production ; such was never the way in
which any zoologist, botanist, or mineralogist acted.
It was only the semiology of ordinary medicine that went to
work, in such a manner, when describing morbid phenomena.
The sensations that differ so vastly among each other, and the
innumerable varieties of the sufferings of the many different
kinds of patients, were so far from being described according to
their divergences and varieties, according to their peculiaritieai
the complexity of the pains composed of various Idnds of sen-
sations, their deglrees and shades, so far was the description from
being accurate or complete, that we find all these infinite varie-
ties of sufferings huddled together under a few bare, unmean-
ing, general terms, such as perspiration, heat, fever, headache,
9ore-throat, croup, asthma, cough, chest-complaints, stitch in the
side, belly-ache, want of appetite, dyspepsia, hachache, coxalgia^
hcemorrhqidal sufferings, urinary disorders, pains in the limbs, (call-
ed according to fismcy, gouty or rheumatic), skin diseases, spa^sms^
convulsoins, &c With such superficial expressions^ the innu-
merable varieties of sufferings of patients were knocked off in
the so-called observations, so that — with the exception of some
one or other severe, striking symptom in this or that case of
disease — almost every disease pretended to be described is as
like another as the spots on a die, or as the various pictures of
the dauber resemble one another in flatness and want of
character.
The most important of all human vocations, I mean the obser*
vation of the sick, and of the infinite varieties of their disordered
state of health, can only be pursued in such a superficial and
careless manner by those who despise mankind, for in this way
there is no question either of distinguishing the peculiariti^
of the morbid states, nor of selecting the only appropriate re-
medy for the special circumstances of the case.
The conscientious physician who earnestly endeavours to ap-
prehend in its peculiarity the disease to be cured, in order to be
able to oppose to it the appropriate remedy, will go much more
carefully to work in his endeavour to distinguish what there is
to be observed ; language will scarcely suffice to enable him to
express by appropriate words the innumerable varieties of the
symptoms in the morbid state ; no sensation, be it ever so pecu-
liar, will escape him, which was occasioned in his feelings by
728 HOW CAK SMALL DOBES OF JLSTKSVATKD UEDHCafE
the medicine he tested on himself; he will endeayoar to convey
an idea of it in language by the most appropriate exju-easion,
in order to be able in his practice to match the accurate deUnei^
tion of the morbid picture with the similarly acting medidnei
whereby alone, as he knows, can a cure be effected.
So true it is that the careful observer alone can become atrue
healer of diseases.
HOW CAN SMALL DOSES OF SUCH VERY ATTENUATED MEDI-
CIXE AS HOMEOPATHY EMPLOYS STHX POSSESS GREAT
POWER ?•
This question is asked not only by the ordinary allopathio
physician, who thinks he cannot go fisur enough widi the huge
quantities of medicines he prescribes, but the b^inner in ho-
mcBopathy also ignorantly puts the same question.
To doubt, if it be possible that they can have the requisite
power, seems to be of itself very foolish, because they are ac-
tually seen to act so powerfully, and manifestly to compass the
object intended, and this they may be seen to do daily.
And what actually takes place must at least be possible !
But even when the hostile scoffers can no longer deny the
effect that lies before their very eyes, they seek, by means of
£Use analogies, to represent what is actually occurring, if not as
impossible, at least as ridiculous.
" K a drop of such highly attenuated medicine," so they talk,
"can still act, then the water of the lake of Greneva, into which
a drop of some strong medicine has &llen, must display as mxich
curative power in each of its separate drops, indeed much more,
seeing that in the homoeopathic attenuations a much greater pro-
portion of attenuating fluid is used."
The answer to this is, that in the preparation of the homoeo-
pathic medicinal attenuations, a small portion of medicine is
not merely added to an enormous quantity of non-medicinal
fluid, or only slightly mingled with it, as in the above compa-
rison, which has been devised in order to bring ridicule upon
the affair, but by the sHcrn.<<ion and triturattoi^ there ensues not
' Frmn ttMt Rtine AnauimUielUkrr, pL ri, l«t. edit 1827.
Aa HOMCBOPATHT XICFLOTB STILL POiSBBSS GBBAT POWISR. 726
only the moet intimate mixture, but at the same time — and this
is ^e most important circimistance — ^there ensues such a great^
and hitherto unknown and undreamt of change, by the deve-
lopement and liberation of the dynamic powers of the medicinal
substance so treated, as to excite astonishment.
In the above thoughtlessly adduced comparison, however, by
the dropping of one drop of medicine into such a great lake,
there can be no question of even its superficial admixture with
all parts of a body of water of such extent, so as that every
part shall contain an equal portion of the drop of medicine.
There is not the slightest question of an intimate mixture in
such a case.
Even only a moderately large quantity of water, for instance,
a hogshead of water, if we attempted to impregnate it in its en-
tirety^ in a mass, with a drop of medicine, could never, after any
length of time, or by any imaginable stirring about, be equally
mixed — ^not to mention that the constant internal changes and
nninterrupted chemical decomposition of the component parts
of the water, would have destroyed and annihilated the medi-
cinal power of a drop of vegetable tincture in the course of a
few hours.
In like manner, a hundred weight of flour taken as one whols
massj can by no mechanical contrivance be mixed so equally
with a grain of medicine as that each grain of flour shall obtain
an equal portion of the medicinal powder.
In the homoeopathic pharmaceutical operations, on the con-
trary, (admitting they consisted merely of a common mixture,
which they do not), as only a small quantity of the attenuating
fluid is taken at a time (a drop of medicinal tincture shaken up
along with 100 drops of alcohol), there ensues a imion and equal
distribution in a few seconds.
But the mode of attenuating practised in homoeopathy effects
not only an equal distribution of the medicinal drop through-
out a great proportional quantity of unmedicinal fluid (which is
out of the question in the above absurd comparison), but it also
happens — and this is of infinitely greater importance — ^that by
the syjccussicni, and trituration employed, a change is effected in
tJie mixture, which is so incredibly great and so inconceivably
curative, that this development of the spiritual power of medi*
oines to such a height by means of the multiplied and continued
trituration and succussion of a small portion of medicinal sub-
stance with ever more and more dry or fluid unmedicinal sub-
780 '< HOW (UOr SHALL DOBBS OF A!lTBinLfcJB» lUUMgllia
ftances, deserves inoontestaUy to be reckoned amoffig Ae greaiai
discoveries of this age.
The physical ohanges and developiiient of power that may be
produced by tritunUion £rom sabstances in nature, which we
call matter, have hitherto only been surmised from some cir*
oumstances — ^but the extraordinary effects in the way of de-
veloping and exciting the dynamic forces of medunnes it oaa
produce, have never been dreamt o£
Now with respect to the development of physical forces from
material substances by triturcUion, this is a very wonderful subr
ject. »
It is only the ignorant vulgar that still look upoti matter as a
dead mass, for from its interior can be elicited incredible and
hitherto unsuspected powers.
All new discoveries of this sc^ are usually met by denial
and incredulity from the great mass of mankind, who have nei-
ther adequate acquaintance with phy&dcal phenomena nor with
the causes of these phenomena, nor the capacity to observe for
themselves, and to reflect upon what they perceive. They see,
for example, that when a piece of steel is strongly and rapidly
rubbed against a hard stone (agate, flint), an operation that is
termed striking fire, incandescent sparks fly off (and kindle the
tinder or punk they fallen): but how few among them have
careftilly observed and reflected upon what really takes place
there. All of them, or at least almost all, go on thoughtlessly
lighting their tinder, and almost no one perceives, what a
miracle, what a great natural phenomenon thereby takes place.
When sparks are thus struck with sufficient force, and caught on
a sheet of white paper, then we may see, either with the naked
eye or by means of a lens, usually small pellets of steel lying
there, which have been detached in a state of fusion from the
surface of the steel by the smart collision with the flint, and have
£Edlen in an incandescent state, like small fire balls, in the form
of sparks, upon the paper, where they cooled.
How I can the violent friction of the flint and steel (in the
operation of striking fire) cause such a degree of heat as to fuse
steel into little balls. Does it not require a heat of at least
' [What follows appeared in 1826, in tbe Aliff. Am. d. D^ No. 194, and was intend-
ed as a reply to a oarrsfpondent of that Jonmal, who endeaToared to show tbe oo-
thingnesH of hoDMBopathy by some of those calculations respecting the minoteoess ol
the dose, which to this day constitute the stereotyped arguments of the opponents
of the system. In the i2. ^ M. L. this is abridged, I have restored it to iis original
fonn.]
As HOXCBOFiTHT EXPLOTS flTiLL poesmaRSiT PO^mR. 781
8000^ of Fahrenheit's thermometer in order to melt steel?
Whence comes this tremendous heat? Not out of the air, for
this phenomenon takes place just as well in the vacuum of the
air-pump I therefore it must colne from the substances that art
rubbed together ; which is the &ct
But does the ordinary individual really believe that the cold
steel which he draws thoughtlessly from his pocket to light his
tinder, contains hidden within it (in a latent, confined, undev^*
loped state) an inexhaustible store of caloric, which the blow
only develops, and as it were, wakes into activity ? No, he does
not believe it, he has never reflected, and never vriU reflect, upon
the phenomena of nature. . And yet it is so. And yet his steel,
which when at rest is cold, contains-^whether he believe it or
no — an inexhaustible store of caloric, which can only be released
hj friction. An inexhaustible store of caloric, I repeat, which
is not calculable by the cyphers of any of tiiose arithmeticians
who seek to limit nature and render her contemptible, by
applying their multiplication table to the phenomena of her
illimitable forces. The great natural philosopher, ^unt Bum*
ford,^ teaches us how to heat our rooms solely by the xapid mo*
tion of two plates of metal rubbing against one another, without
the employment of any ordinary combustible material whatever*
No further proof is required to convince the reflective that xof
tural bodies, and especially metals, contain an inexhaustible
store of caloric concealed within them, which however can be
called into life only by means of friction.
The effect oi friction is so great, that not only the physical
properties, such as caloric, odour,' &c., are thereby called into
life and developed by it, but also the dynamic medicinal powers
of natural substances are tiiereby developed to an incredible
degree, afcxt that has hitherto escaped observation. The founder of
the homoeopathic system was the first who made this great, this
extraordinary discovery, that the properties of crude medicinal
substances gain> when they are fluid by repeated succussion with
immedicinal fluids, and when they are dry by frequent conti-
nued trituration with unmedicinal powders, such an increase of
medicinal power, that when these processes are carried very fiur,
> Count Rumford's treaUso oa caloric fills the first diviuoo of the 4th VoL of hia
works, which have been published by the Weinuur Induttris-Comptoir.
' Hom^ ivory, booe, the calcareous stone impregnated with petroleum, Ac^ have of
themselves no smell, but when filed or rubbed they not only emit an odour but aa
eztrexiicly fetid one, hence the last-mentioned substance has obtained the name of
Stinkstone, though when not rubbed it has no smelL
782 HOW OAK SMALL DOSES OF ATTSKUATED XXBIOHnB
•ven substances in wHich for centuries no medicinal power has
been observed in their crude state, display under this manipu-
lation a power of acting on the health of man that is quite
astonishing.
Thus pure gold, silver and platina have no action on the hu*
man health in their solid state^ — and the same is the case with
y^etable charcoal in its crude state. Several grains of gold
leai^ silver leaf or charcoal may be taken by the most sensitive
person without his perceiving any medicinal action from it All
these substances present themselves to us in a state of suspended
animation as &r as regards their medicinal action. But if a
grain of gold leaf be triturated strongly for an hour in a por-
celain mortar with one hundred grains of sugar of milk, the
powder that results (the first trituration) possesses a considera-
ble amount of medicinal power. If a grain of this powder be
triturated as strongly and as long with another hundred grains
of sugar of milk, the preparation attains a much greater medi*
einal power, and if this process be continued, and a grain of the
previous trituration be rubbed up as strongly and for as long a
time, each time with a fresh hundred grains of sugar of milk
until, after fifteen such triturations, the quintillionth attenuadon
of the original grain of gold leaf is obtained, then the last at*
t^nuations do not display a weaker, but on the contrary, the
most penetrating, the greatest medicinal power of the whole of
the attenuations. A single grain of the last (quintillionth) at-
tenuation put into a small, clean phial, will restore a morbidly
desponding individual, with a constant inclination to commit
suicide, in less than an hour to a peaceftd state of mind, to love
of life, to happiness, and horror of his contemplated act, if he
perform but a single olfaction in the phial, or put on his tongue
a quantity of this powder no bigger than a grain of sand.^
' [In ooDDexioo with thid subject I may be permitted to adduce a few puints bearing
OD the questioD of the dose of paid. In the first place we learn from the 4th part of
the R, A. M. L. and the Chr. Kr. that this substance was proved upon healthj indi-
viduals in doses of from 100 to 200 grains of the first trituration (one to two grains
of pure gold). Then, with respect to the doses to be administered in disease, we find
it stated in the introduction to gald in the second edition of both these works (pob*
lished respectively in 1825 and 1835, probably a repetition of what appeared in the
1st edition of the R, A. M. L^ published about 1820) that Hahnemann had cored
several {mehre) individuals suffering from suicidal melancholia with from S-lOOtlis to
9-lOOths of a grain of gold for the whole treatment He also mentions in these
places that he had found a smaller quantity, viz : l<10000th part of a grain of gold
not less powerful, especially in caries of the nasal and palatial bones, from the abunc
of mercurials. In the essay of which our text is a translation (published in 1625) be
AS HOHCBOPAXHY SMPLOTS 8TILL POSSESS GBSAT POWSB. 788
From this we perceive that the preparations of medicinal sub-
stances of trituraiion, the fSEtrther the development of their pow-
ers is thereby brought and the more perfectly capable they are
thereby rendered for displaying their power, become capable of
answering the homoeopathic purpose in proportionately smaller
quantities and doses.
Medicinal substances are not dead masses in the ordinary
sense of the term, on the contrary, their true essential nature is
only dynamically spiritual — ^is pure force, which may be in-
creased in potency by that most wonderftd process of trituration
(and sixcussion) according to the homoeopathic method, almost
to an infinite degree.
In the same way liquid medicines do not become by their
greater and greater attenuation, weaker in power but always
more potent and penetrating. For homoeopathic purposes this
dilution is performed by well shaking a drop of the medicine
with a hundred drops of a non-medicinal fluid ; fix)m the bottle
so shaken a drop is taken and shaken up in the same manner
with another hundred drops of immedicinal fluid, and so on.
This result, so incomprehensible to the man of figures, goes 86
&r that we must set bounds to the succussion process, in order
that the degree of attenuation be not over-balanced by the in-
creased potency of the medicine, and in that way the highest
attenuations become too active. If we wish, for example, to
attenuate a drop of the juice of sundew^ to the dedUiontii, but
idiake each of the bottles with twenty or more succussions from
a powerful arm, in the hand of which the bottle is held, in that
case this medicine, which I have discovered to be the specific
remedy for the firightful epidemic hooping-cough of children, will
have become so powerful in the fifteenth attenuation (spintuali-
zation) that a drop of it given in a tea-spoonful of water would
endanger the life of such a child ; whereas if each dilution-bot-
ftties that a qaintillionth (16th dilutioo) was the prqwratioD he then generally used ;
in the aame essay as it i4>pean in the 6th part of the R, A. M, L^ (pobUshed in 1827),
and in the introduction to goldin the It, A. M, L., (published in 1826), he reoom*
iqiiids a quadrillionth of a grain (12th dilation) for a dose. In the Chr, Kr^ (pub-
lished in 1886) he of course adrises the dedllionth (30th dilution) to be given in
every case. The following, then, was the state of Hahnemann's practice in reference
to the dose of this remedy at different periods. About 1820, 1st or 2d attenua-
tion ; in 1826, 12th or 16th attenuation; in 1827, 12th attenuatioo; in 1886, 80th
attaouation.]
* Dro9era roi%tndifolui, a plant, which, along with its Tarious spedes^ grows on
moist meadow-grofBid, aiid'is Tery oomoos to iheep
784 HOW cAir aiCALL doses or attxnuatbd mmdicssEj kc.
tie were shaken but twice (with two strokes of the arm) and
prepared in this manner up to the decillionth attenuation, a su-
gar globule the size of a poppy seed moistened with the last at-
tenuation cures this terrible disease with this single dose without
endangering the health of the child in the slightest degree.^
But these homoeopathic medicinal attenuations ( — pity there is
no more appropriate word in any language to express what takes
place in the process, as this phenomenon was never heard of
before its discovery — } these attenuations are so £Bur fix)m being
diminutions of the medidnal power of this grain or drop of the
crude medicinal substance keeping pace with its extreme fiuo-
tional diminution as expressed by figures, that, on the contrary,
experience shews them to be raUier an actual exaltation of the
m^cinal power, a real spiritualization of the dynamic property,
a true, astonishing unveiling and vivifying of the medicinal
spirit
But there are various reasons why the sceptic ridicules these
homoeopathic attenuations. Itrst, because he is ignorant that
by means of such triturations the internal medicinal power is
wonderMly developed, and is as it were liberated from its ma-
terial bonds, so as to enable it to operate more penetratingly
and more freely upon the human organism ; secondly^ because
his purely arithmetical mind believes that it sees here only an
instance of enormous subdivision, a mere mcUerial division and
cUminiUion, wherein every part must be less than the whole — as
every child knows; but he does not observe, that in these spirit-
ualizations of the internal medicinal power, the material recep-
tacle of these natural forces, the palpable ponderable matter, is
not to be taken into consideration at all; thirdly^ because the
sceptic has no experience relative to the action of preparations
of such exalted medicinal power.
li^ then, he who pretends to be a seeker after truth will not
search for it where it is to be found, namely, in experience, he
will certainly fail to discover it ; he vdll never find it by arith-
metical calculations.
> [In the vereioo of this passage as it stands in the i?. A. M. L^^be decilliooth al
tenuation prepared with twenty soccussioas to each bottle is spoken of as endanger
ing the life of the hooping-ooogh patient, and from this drcmnstance and the &ct that
it is uot stated that such a preparation did endanger the life of any patient, but only
that it would {wQrde) endanger it, we are, I think, justified in inferring that Hahne-
mann did not actually ob^erre any such case, but that be merely supposed that it
would occur, which his theoty of the increase of potency in bomoBopathic medica-
loents by the pruceeees of trituratiefi and snocokiwo wouid lead him tu do'J
ON THE DCPBSGNATION OF GLOBULES WITH MEDICINE. 735
ON THE IMPREGJfATION OF THE GLOBULES WITH
MEDICINE.*
If we add to the mode of procedure recommended by the
esteemed author of this letter, that the globules, from 5 to 600
of which should be in each little bottle, and fill it only about
half full, should be moistened with fix)m three to four drops of
the alcoholic medicinal dilution, and not shaken in the corked
up bottle, but rather stirred about in it with a silver or glass
pin, and the bottle kept uncorked until by the evaporation of
the alcohol they become dry and no longer adhere to each
other, so that each globule may be taken out separately ; in this
way the homoeopathist possesses indisputably the most conve-
nient process for having his medicines always of the same good
guality and ready for immediate use.
The medicated alcohol that evaporates whilst the globules are
thus stirred for about an hour, is no loss for the globules that
that are thus dried in the bottle, seeing that, strictly speaking,
for the purpose of moistening 600 of the smallest globules a
single drop would sufl&ce, and consequently in this desiccation
by the evaporation of the superfluous medicated alcohol, they
do not undergo any diminution whatsoever of their medicinal
power, as I have been superabundantly convinced by employ-
ing them in practice.
With this little alteration the process recommended by my
esteemed and patriotic correspondent deserves the thanks of
every homoeopathic practitioner, for it is the most perfect that
has been proposed, as my own experience convinces me.
It is only in this form that the homoeopathic medicines can
be sent to the most distant parts without any alteration of their
powers, which is impossible to be done in their fluid form ; for
in that case the medicinal fluid, which has already been suffi-
ciently potentized during their preparation (by two successions
at each dilution), receives an enormous number of additional
' From the Arekiv der Aom. Heilk^ Vol yiii, pt 2, p. 162. 1829. [This article
ftppean as a note appended to a oommunicatkn from M. Korsakofi^ a RuBslaii
iMmkBopathic dilettante, suggesting the use of little tubes for holding the globules
ready made, such as tho»e at present in almost universal use for pocket cases. He
proposed that the globules should be saturated by pouring upon them two or three
dropd of the medicinal dUutioo, and shaking the bottle seTeral times etroi^ly.J
7S6 allopathy:
successions during the transport, and they are so highly poten-
tized during a long journey, that on their arriyal tiiey are
scarcely fit for use, at least not for susceptible patients, on
account of their excessive strength, as many obeervaticHis go
to prove.
The manu&cture of little bottles from glass tubes by means
of the blow-pipe, as our author directs, is a real improve-
ment, as they can be prepared in this way much more easily,
neatly and completely (with scarcely any constriction of the
neck) than they can be obtained in ordinary glass manu&ctories.'
ALLOPATHY:
A WOBD OP WARNING TO ALL SICK PEBSONS.*
Allopathy, or the method of treatment of the old school of
medicine, boasts, that for two and a half milleniums it has pos-
sessed the art of removing the cause of the diseases entrusted to it^
and thus — ^in opposition to homoeopathy, which cannot do this —
ikat it alone effects cures of the cause^ and heals in a rational
manner.
I^ however, the allopathists would remove the cause of
chronic diseases, which constitute much the greater number of
all diseases, it must previously be known to them. But it has
in all ages been completely unknoum to them, and they went
alpaost beside themselves, when the new discoveries of homoeo-
pathy shewed them that all chronic diseases depend solely and
alone upon three chronic miasma, whereof the whole of the old
school of medicine had not hitherto the most distant idea.
* [Hahnemann, as we learn from his writings, used globoles of Tarioos ^^^^
Iliose for administratioo by the mouth he usually describes as of the sise of a poppy-
seed ; he states them to be of the weight of 800 (Introd. to Betladonna and to Aco-
nite, R, A. M. jL, pt L) or 200 {Chr. Kr. pt i, p. 188) to the grain, and be says that
1000, many more than lOOO^i^. A. M. X., loc dt) or 800 (OrgaikOf^ § odzzzv, note)
of them are sufficiently moistened by one drop of alooboL Those for olfiustioii he
usually states to be (»f the siie of a mustard seed (Or^ttnon, p. 9, note) ; and he
elsewhere {Organon, § oclxxxriii, note) states that 10, 20, or 100 may weig^ a grain
These globules were to be made by the oonfectioDer of sugar (Or^ofum, g oclzzzr.
note, Chr. Kr^ pt i, p. 187X and his latest mode of moistening them was to put them
into a small glass or porcelain cup, to pour upon them a few drops of the medidna]
dilution, to let them stand thus a minute, and then to empty them out on blottii^
paper, so as to dry them before puttii^ them into a bottle for future use.]
* Published as a pamphlet Leipsic^ 1881.
A WORD OF WARinKG TO ALL SICK PEBSONa 7B^
Now, as during all this long period they knew not the origi-
nating cause of all chronic diseases, it follows that hitherto they
have treated away at an unreal cause, that therefore they could
not remove the fundamental cause which was unknown to them,
and consequently, that they could not really cure chronic
diseases.
The resuU also proved this ; for if we except the diseases de-
rived solely from the venereal chancre-miasm, in which mer-
cury, which had been empirically discovered by non-medical
persons, was no doubt efficacious, the whole array of physicians
of the old school, with all their medicinal apparatus, could cer-
tainly aggravate all other chronic maladies, and make them in-
curable, but they were incompetent to restore to health one
dironio patient For, by the force of medicine to transfer the
patient from one chronic disease into another and worse
malady of different appearance, and then, as is usually done, ta
imagine that this took place accidentally, and that the physician
was perfectly innocent of the appearance of this new sad state,
is to delude one's seli^ and cannot be termed curing, nor restor-
ing to health, but deceiving and ruining the patient
The physician of the old school erroneously alleged the vari-
ous, often purely imaginary, characters and phenomena of
chronic diseases, to be their cai^sc (whereas they are but the pro-
ducts and expressions of that cause), and they treated now for a
chiU, catarrh and rheumatism, anon for the gout, congestion in
the portal system, haamorrhoids, obstructions in the lymphatic
vessels, indurations, morbid matters in the juices, impurities,,
excess of pituita in the primsd visB, weakness of the stomach
and digestive organs, nervous debility, spasm, plethora, chronic
inflammation, swelling, and so on. They imagined these con-
ditions to be the cause (causa) of the chronic diseases, which had
to be removed, and the diminution or suppression of these by
means of the treatment hitherto prevalent to be cures of the
cause.
But when by the force of their medicines they succeeded in
diminishing or dispelling one of these characters or states, there
naturally always came in its stead another morbid phenomenon
(another product of the original cause). How then could the
first state have been the fundamental cause when its removal
was followed by no true cure, no restoration of health — when
in place of the one that had been driven away, another morbid
phenomenon and that always of a worse kind, made its appear-
47
738 ALLOPATHY :
ance? Whence was originaUy derived the apparent morbid
character and its attendant phenomena? whence proceeded the
patient's liability to get cold, catarrh, rheumatism, gout, conges-
tion of the portal system, hemorrhoids, obstruction in the
lymphatic vessels, indurations, mucosities and impurities in the
prima3 viao, the apparent acridity in the blood, the weakness of
the stomach and digestive organs, the febrile state, the nervous
debility, spasm, plethora, chronic inflammation, swelling, aod
so forth ? Whence did these actually and originaUy come, since
they are nothing more than single glimpses of the probable
chjuwjter of the disease, and only single expressions (symptoms)
of the undwelling malady, the combatting of a single one of
which (under the false title of cause) with medicines, is truly
nothing else than (blameworthy) symptomatic treatment^ which
these gentlemen with unwarrantable pretension allege to be
rational treatment of tlie cause f But what, then, was the proper
and real original cause of these varying, secondary maladies and
phenomena, whose removal would constitute a irue causal trtai-
menti a radical^ permanent cure^ a real rational mode of practice?
Of all the many thousands of physicians of the old school, none
knew it, nor will they now deign to leam^ it from homoeopathy,
but yet to this day they assert that their bimgling treatment
which never conduces to the advantage, but invariably to the
aggravation of the chronic diseases, is rational treatment.
A more ludicrous pretension, and, as the universal, ine\'itable
result teaches, one more fraught with injurious consequences to
humanity, there never has been I In the first place, as regards
their treatment of diseases of a rapid course (acute diseases),
experience shews, that patients affected with such maladies, who,
without any allopathic interference, were left entirely to their
unaided vital force, recovered on an average much sooner and
much more certainly than when they gave themselves up to the
treatment of the old school of medicine, under which many died
whO; without its unhelpful operations, would have lived, and
after which many long remained in a wretched state, and
usually at last died miserably of the consequences of the fine
treatment, who without these medicinal onslaughts on their
lives, would much sooner have recovered and would much more
certainly have been preserved.
The reason of this was, that allopathy attributed a false
' Is it much less shameful Dot to know a thing, than to refuM to learn it I
▲ WORD or WARNING TO ALL SICK PERSONS. 789
oharacter to the acute diseases it had to cure, in order that they
might conform to the plan of treatment once adopted for them.
Thus we see that in inflammations of the lungs and acute pleu-
risy, the allopathists pre-supposed an excess of blood (plethora),
of inflammatory blood, as the fundamental cause, and they did
nothing but diaw off blood, and go on drawing off blood, from
the veins, when— as homoeopathy teaches and practises — they
ought merely to have removed the] morbid irritation of the
arterial system by means of the few internal medicines suited
for allaying it (and eradicating all the inflammatory character
of the blood), in order to extinguish the entire, seemingly fatal
disease in a few hours, without it being at all requisite, accord-
ii^ to their old destructive routine treatment, by venesections
and leeches, to rob the patient of this innocent, indispensable
life's-juice, and, consequently, of all his strength, which after
this mistreatment he could either, as was most usual, never
r^ain, or only after a long indisposition.
It is incomprehensible how the allopaths can consider it a
great sin, if, in inflammatory diseases, e. g., pleurisy and inflam-
mation of the lungs, blood be not drawn of^ and that repeatedly
and in large quantity, as they most injuriously, according to
their stiff observances and agreeably to their art which has
grown grey in gross material ilbtions, make it an invariable rule
to do, and would wish to make it the same for better physicians.
But if this is an efficacious sort of method, how can they recon-
die it with the &ct that of all that die in a year, a sixth part oi
the whole number dies under them of inflammatory affections,
as their own tables prove I Not one twelfth of these would have
died had they not Mien into such sanguinary hands, had they
been btUkft to nature^ and kept away &om that old pernicious
art
Hundreds and thousands more die miserably every year — ^the
most promising youths of the country, in the bloom of their age
— of wasting, consumption and suppuration of Ihe lungs ! You
have their death on your consciences I for is there one among
you that has not laid the seeds for it by your fine mode of treat-
ment, by your senseless bloodletting and your antiphlogistic
appliances in a previous inflammation of the lungs, which must
thereby infallibly turn into pulmonary consumption, and prove
fatal? This irrational, antipathic, barbarous mode of treating
inflanunation of the lungs by numerous venesections, leeches
and debilitating substances (termed by you antiphlogistics),
74tt AldJOTAJHT:
yf 1^ lcflti» (ikenraae lerer), genenkl Bw«illn]^ <iLiJW i .
ai]f»fni»sfek«D of tbe liU3^! Tmlj an exoelkm. piiuimtBC
^^oncrtlr dMaxnrisqi vbailw&le the flower of m«nt m\ !
OftD i^bai be cnXksd evtiing, eosixig xstioDBlh'. tfOBtaHHi of
Qs tbe oliier band, ao pstaeot eared by bamoBcniirr ii
nlib v^xyidesf ol rafttditj) from eren tbe moit
taon i^ line loxi^ viU be Icmnd vbo died tberooGftr of
mA ffopgfmtafjn of liie lun^ ibr it com tbe flBemm^:
ftial iauflajnwartaopg of tbe laii0 in tbk war anlv.
liie dnjo^eroos sKflidd ecmmKition of tbe eiieiibaiiip
tose(l»er wltb the wxomfunymg paans, by meuff of b isv*
bttt appropruit^ internal Tnodirinail agents, often -witbiii ilt
twentj'IciQr boQia, and allova tbe patient^B strengtb ii>
tinaifeetod by avoiding all eracnatiotiB of blood md mD
litttting antiphlogistic remedief ; Ibr it knows idua "die ;pinB-
<;iaiia of tbe aj>cient icbool do not jet know, and, bIb! do na
widb to know, tbat violent acate inflammatiane of "Ae cbeB |bb£
of otber parta) aie nothing but exploaiana of an fnraiittii iiiaiiw
miaam (paora) that liea bid in tbe inteiior (no one fmt ±nac
pHora ever geta inflaiaination of the limgE!) and it know? boir
thai, after isubiuing the inflamm&torr exchezneni of xbf; cmnilft-
tion, it ha« to take care that the psora be cured wii^om los -d
time by meanis of appropriate antipgonc medicineB, bo xhai t
iihall not e0tabli)$h itJi Heat in the luugs which ii can bc* eamk
<Jej$troy ; and thu» the homoeopathic curer of the acnle puhnauaiT
infiammatir/n may all the more readily aooomplish, sinoe be bv
not waited the vital forces (so indispensable for p^^ducing ibe
re-action to the autipsoric remedy to be employed) bj taj^pn^
uff the blood and by anti jmthic cooling remedies, as u mva'raih
'U/fvt by Qvt aWypatliist.
Moreover the allopathist does not treat the oti^r diseases of
ra|iid course (acute) according to their several pecoliaritaes, ae
the homwopathist does, but he treats them aooording to the
pathological denomination introduced in the old schoo), upon
one and the same plan of treatment that has once been laid
down in the book. Thus all epidemic intermittent fevers, diffier
they ever so much among each other, are not cured by him
with tbe medicine specifically adapted for each individual inter
mittent ^ it are invariably merely sujypressed by strong,
tl^ doses of cinchona bark, repeated often for
▲ WORD OF WARNING TO ALL SICK PERSONS. 741
weeks together; ttie patient^ fiotvever, does not get weU; by this
process he indeed loses all the alternations of rigour and heat
(this they call getting well), but he becomes more ill, in another
way than he was while he still had the fever, with the insidious
bark disease which has been forced upon him, and which often
lasts for years.
And in like manner these physicians, who arrogate to them-
selves the title of rational practitioners, have in their books ready-
made, fixed names for the acute diseases that. attack mankind,
either singly (sporadic) or generally prevalent (epidemic) or
infectious (contagious), and for each name they are pleased to
bestow on the prevailing disease they have also a certain defined
plan of treatment (only varied from time to time to suit the
&shion), which this fever, that is oft^n quite unknown or that
iias never appeared in the same form, must be content with,
whether it do good or harm. Those whom a giant's constitu-
tion does not help through must infallibly succumb under such
treatment.
Very differently does the homoBopathist act : he judges of the
prevailing disease according to its peculiarities and phenomena
(its individuality) without suffering himself to be led astray to a
wrong mode of treatment by any pathological systematic nomen-
clature, and by attention to the present state, complaints and
ailments of the patient, he generally, by means of the suitable
(specific) remedy, brings about the desired recovery.
But I must return to the immeasurably more numerous, long-
lasting (chronic) diseases of mankind, which, under the old
system of physic, have hitherto made the world a very vale of
tears, in order to shew how infinitely inferior, in such diseases
also, the injurious Allopathy is to the beneficent Homoeopathy.
Without knowing (from the earliest time till now) the true
and only cause of chronic diseases, Allopathy violently attacks
the patients with a number of medicines given in large doses in
rapid succession, often continued for a long time, in order —
agreeably to the misapplied saying of the conmion people, " much
helps much " — to conquer the disease by physical force. And
by the power of what medicines do they seek to accomplish
this? By such as (although the old school physicians alas I know
it not) invariably have powers of quite a different kind, and
produce effects on the human health of quite another character
than what are suitable for the cure of the disease.
7^ ALLOPATHY :
Hence the inedicineB they usuallj employ in these diseases
are appropriately termed aUopatfUe («ax«S«, aUenOf ad rem turn
pertinenliay unsuitable)^ and their mode of treatment is justly
denominated Allopathy.
But how did it happen that they could make use of such
inappropriate («aa«7«) medicines, to the injury of they patients?
Evidently firom no evil design; but from iffnorance I They employ
them b^sause they know not their r^ properties and real
effects upon the human body; and nK^reover, because it is a
custom introduced among them to administer them in such
diseases, because it stands so printed in their books, and because
when they were students it was long so taught them ex ea Aedm.
But how did it happen that in the employment of these me*
dicmes among patiente during the many centuries that this system
of medicine has existed, they should not gradually have noted
in these medicinal substances what peculiarities each individually
possessed, and what were the effects of each upon the health of
man, so that at length they might have so gathered what each
was adapted to as a curative agent ?
To this it will suffice to reply, that these physicians of the old
school possessed and do still possess a most approved method of
guarding and preserving themselves from the knowledge of the
peculiar mode of action of each individual medicine, and thereby
rendering it imperceptible to their eyes and observation.
Every one of their young physicians, namely, on undergoing
his examination for the high degree of Doctor of their art, must
prove by the certificates of the professors that he has diligently
attended the lectures on the art of prescribing^ and must by the
extempore writing of prescriptions, that is to say, of recipes
composed of several different medicinal substances for the names of
diseases given him by the examiner (like contifinti), demonstrate
that he is perfect master of the noble art, essential to allopathy, of
always prescribing for the patient, lege artis, several medicinal in-
gredientSj mingled in one prescription, and, consequently, of care-
fully and entirely eschewing the employment of a single simple
medicinal substance.
Thus even to this day every prescription composed of several
different medicinal substances, betrays the prescriber to be with'
out dispute an allopathist, one of the many thousands belonging
to the unimprovable old school of physic !
Here 1 would ask my readers on their consciences to tell me,
how it were possible that these physicians, although during
A WORD OP WARNINa TO ALL SICK PEBSONa 74ft
these many centuries their numbers must amoimt to millions,
could detect and learn the peculiar properties of each of the
single medicinal substances while constantly using such mix*
tures of drugs?
If we should give one of the mixtures according to their pre-
scription even to a quite healthy person, quite free from all
morbid symptoms, would we from the effects that result from
such a mixture, even though it should consist but of two * differ*
ent ingredients, ever be able to decide with certainty which of the
affects that ensue are to be attributed to the one, which to the
other ingredient ? Never 1 — in all eternity, never !
Now, as even in trying a mixture of only two different medi-
cinal substances upon a healthy person^ we can never satisfactorily
observe the special effects of a single one of the two upon the
human health — since the mixture can only manifest a middle
action of both the two together ; how, I should like to know,
can it be otherwise than quite impossible to distinguish the pe-
culiar powers and special action of each of the several ingre-
dients in an artistic prescription, when it is given to patients,
that is to say, to persons already suffering from a number of
alterations of health ?
Who can fail to perceive from all this, that, besides that the
physicians of the old school never seriously set about making
experiments with simple medicines on healthy individuals — who
can fail to perceive, I say, that they all^ from the remotest times
until noWy must remain up to the present day perfectly and thorovghly
ignorant of the countless^ special^ pure, real effects and powers of
eoich individual medicine^ consequently of all medicinal substances (if
we except the few most palpable phenomena of many medicines,
that they display even when mixed, and that cannot remain
^-^^— I I I ■ I ■ II J J , _ I ■ Mil ■ -^m ~~t
' AooordiDg to that old so-called art of mudicine, eo repugnant to oommoD senae^
there should be more than two, at least three, different things in an artistical pre*
f cription ; apparently, in order that the physician who prescribes lege artis, from the
QM of such prescriptions foe diseases, may be deprived of all chance uf ascertaining
which of the difiiarent ingredients was useful or which did harm, and may also never
Me or be taught by experience what particular effects each of (he several ingredienta
of the prescription, each simple medicinal substance therein produces on the human
health, in order to be able to employ it with certainty in diseapes. Thus a bad job
always betrays itself by this, that its author seeks to keep us in the dark. When,
however, now and then the conscience of the good gentlemen was troublesome, when
of late a ray of the homosopathic truth struck upon their eyes, we have seen theot
put but two ingredients in their prescriptions, while they asserted that they now
prescribed quite nmply ; just as if a compound eould ever make a simple !-*In all
eternity, never 1
744 ALLOPATHY :
concealed even from ordinary persons, e. 9., that senna-leaves
porge, opium stupifies, mercury causes saliyation, ipecacuanha
excites vomiting, cinchona bark suppresses the type of inter
mittent fevers, and a few more of the same kind.)
. Thts^ therefore^ is an art the professors 0/ which have and with 90
have no knoiuledge ofaM their tools I
Among the very meanest of arts there does not exist one such
as this I The medical art of the old school alone gives an un-
heard of example of the kind !
And yet these gentlemen boast so loudly, notwithstanding
their incredible irrationality, of being the only rational physi-
cians, and, in complete ignorance of the original cause of all the
innumerable chronic diseases not of a venereal character, of
alone being able to perform cures of the cause I Perform them
— ^with what ? With tools whose pure actions are quite unknown
to them, with medicinal substances (prescribed in mixtures),
from a special knowledge of which they have introduced into
their system, as I have shewn, the most effectual arrangements
for preserving themselves ?
Was there ever a more ridiculous pretension? a more re-
cherche piece of stupidity ? a more complete negation of a cura-
tive system ?
Of this stamp, dear sick people, are all the ordinary physicians.
Of such alone do the medical authorities of all civilized lands
consist. These alone sit on the medical jur gment-seat, and con-
demn all that is better, w^hich, whatever advantage it may be
of to mankind, is opposed to their antiquated system I * These
alone are the superintendents and directors of the countless hos-
pitals and infirmaries, filled with hundreds and thousands of
patients pining in vain for health I Of such alone are the body
physicians of princes and ministers of state. Of such only are
the ordinary profeasors of medicine in all universities ! With
such routine practitioners alone, of great and small degree, do
our towns swarm, from the celebrities who knock up two pairs
of horses daily in swift-rolling gilded chariots in order to pay
visits a couple of minutes' duration to sixty, eighty, or more
patients, down to the crowd of low practitioners, who, in worn-
^^^— — — ^" ■ I ■■ »■ ^^^^^ 11 I 1 ■ ■■» ■-■ »^w^—i ^1^ ■ ■ ■ ■ ■ ■■■!-■■ .11 I I ■ ■ M I — ^^fc^
' What woDder i» it that they, with insolent pride in their principles transmitted
to them from the dark middle ages, zealously strive to suppress, by the worldly ann
of the lawj^ivcr whose favoured huuse-physicianit they are, the new medical art«
which by its deeds of cure surpasses all their lut^llcol ^romiies, and leaves their anti-
quated system of treatment fxt behind !
A WOBD OF WABKDIO TO ALL SICK PEBSONS. 746
Out clothes, must exert their legs to pester their patients with
fiequent visits and numerous prescriptions, with but scanty re-
numeration for their fruitless and hiurtful efforts, which are cer-
tainly much better paid in the case of the high and mighty ones
of their tribe.
If this innumerable host of doctors of the old school were
fnereij useless, and merely not profitable to their patients, even
that would be bad enough ; but they are unspeakably hurtful
and ruinous to sick mankind. Without knowing it, without for
an instant dreaming of it — without even willing it, they produce
incalculable mischief (although in chronic diseases this is not so
obvious) by their furious assaults upon the patients with large
doses of powerful, almost invariably unsuitable drugs, which
they continue often for a great length of time, repeating them
daily (often, indeed, several times a-day), and when this na-
turally does no good, they continue them in increasing quan-
tities, and thus they not unfirequently pimish the patient without
cessation for years, now with this and now with that powerful
medicinal mixture, unless they procure for him (and for them-
selves too) a kind of respite in the fine season, which they term
the bath-season) by sending him to some mineral water or other,
or still better to two in succession, which may just then happen
to be the most feshionable, ordering him either to swallow daily
no inconsiderable quantity, or to take daily at least one bath of
several minutes' duration, for weeks together. And yet each
draught of a mineral water, and each bath of it that is taken is
a strong dose of a strong medicine !
What will the reflecting public say when they learn that the
physicians of the old school of medicine have never in twenty-
five centuries learned to know, that every medicinal substance,
almost without exception, taken in one single dose, requires se-
veral daySj sometimes even weeks to expend its full action on
the human body, as innumerable careful observations, expe-
riences, and experiments have taught and satisfactorily proved
to the accurate observer of nature, the homoeopathic physician ?
What will the hitherto deluded world say to this, that the phy-
sicians of the old school, as a proof that they yet know nothing
respecting this most indispensable truth, still go on to this day,
giving their drugs to patients day after day in several doses a-
day, each dose of which is disturbed in its action by the one that
speedily follows it, so that from their ignorance no dose is al-
lowed one hundredth part of the time requii'cd for the comple-
746 ALLOPATHY :
I
tion of its action — an oyer-loading of the body outside and in
with the same medicinal mixtoi^Twhere&om only injoiy to the
health can be effected, but never anything good, appropriate^
beneficial I
The refiective, unprejudiced reader wUl find a difficulty in
solving the riddle of how in all the world the great crowd of
physicians could for so many centuries stick to such a disastrouB
treatment of chronic patients?
The ordinary hurtful mode of treatment of the old school
physicians here alluded to would be incredible, did it not with
them depend on the grossest ignorance of the true process of
nature, I mean of what experience shews to be the relation be-
tween the substances called medicines and the human body, that
is to say, did it not depend even at the present day on the
wretched indefensible superstition of these men (call^ phyai*
cians), thai drugs, even in large, oft-repeated andincreased doaeSj are
one and all per se and absolutely ir^aU cases wholesome things.
The smallest approach to accuracy in observation, had they
been capable of it, would have convinced them that this was
radically false, and that the reverse of it only was true, namely :
thai all things thai can he termed medicinal are, per se, hurtfvi
substances, injurious in general to the heaiUh of man, which can only
become wholesome where ecuch exactly corresponds in its injurious
power to the case of disease specially adapted for it, and where it is
given in appropriate dose and at theproper time.
This truth, so indispensable to enable us to cure, I was the
first to declare to the world. The allopathists, taken by surprise,
seemed at first to admit it, just as if they had long been fiuniliar
with it ; but the result shewed that they still remained enchained
in their own blindness, and that this heaven-bom truth could
find no entrance into their mechanical heads.
Had it been otherwise, it had been impossible that they could
persist to the present day in their quackish treatment of chronic
diseases, without endeavouring to ascertain the peculiar powers
of each several medicine in altering man's health, in cramming
their chronic patients, to their destruction, with a variety of
these unknown drugs in admixture, in giving large, frequent
and generally increasing doses of these important substances,
continued for a great length of time, happen what might, if they
had known or appreciated and kept in view this incontrovertible
truth : that medicines are in themselves hurtful substances, in-
jurious in general to the health of man, and can only prove
A WOBD OP WAENING TO ALL SICK PERSONS. 747
beneficial where each exactly oorresponds in its injurious effects
to a case of disease specially adapted to it, and where they are
given in appropriate dose and at the right time.
The mischievous effects to chronic patients that lie in this
their blind treatment, in this overloading of them with strong
unknown drugs, will be perfectly obvious to every reflecting,
unprejudiced person, who knows that every medicine is a disease^
creating substance^ consequently every powerful medicine taken day
after day in several and increasing doses will in&llibly make
any, even healthy persons, ill, — at first obviously and perceptibly
00, but when longer continued their hurtful action is less appa-
rent,* btit all the more profoundly penetrating^ and productive of
permanent injury, in this way, because the ever active-life-
sustaining power silently endeavours to ward off the injury with
which these frequent assaults threaten life itself, by internal
eounter-operations by means of the construction of invisible pro-
tections and barriers against the life-invadiug medicinal enemy,
— ^by the formation of morbid alterations in the organs, in order
to exalt the function of one, and render it intolerably sensitive
and hence painful, and the others again insensible and even in-
durated, whilst it deprives the other parts (that in their healthy
i^te were easily excited to action) of their irritability, or even
paralyses them ; in short it brings about as many corporeal and
mental morbid alterations as were requisite for warding off the
danger to life from the hostile attacks of the constantly reiter-
ated medicinal doses ; that is to say, it effects in secret innimier-
able disorganizations and abnormal organizations, so that a per*
sistent permanent derangement of the health of the body and
mind is the consequence, — ^for which there cannot be a more
appropriate appellation than cYiiomc medicinal disease — an inter*
nal and external crippling of the health, whereby, if the power-
fill drug have only been used some months, the nature of the
individual is so permanently altered that even should all medi-
cine thereafter be discontinued, and the system be subjected to
no further loss of humours and forces, yet this morbid metamor-
phosis in the interior cannot be again removed nor re-tnms*
formed into health and the normal condition by the vital force
under two or three years.
' -
I * Least of all perceptible if the dosea be not increased, in which caae the allopa-
thic physician seeks to persuade himself and his patient by saying, *'his nature has
become habituated to this medicine, therefore the dose of it must be increased," — a
radically wrong notion, leading to the patienCs mm 1
748 ALLOPATHY :
Thus, for instance, the vital force of our organism, that is
always exercising a preservative function, protects the sensitive
parts of the palm of the hand of the pavier (as also of the work-
er among fire, the glassblower and the like) against the scratch-
ing and lacerating sharp angles* and points of the paving stoneS)
with a hard, homy covering, to protect the skin with its nerves^
blood-vessels and muscles, from being wounded or destoyed. But
should the man fix>m this time forth cease to handle rough stones,
and take nothing but soft things in his hands, at least a year
must elapse ere the vital force (for no surgical or other art can
do this) brings about the removal of this homy skin, which was
formerly constructed by it on the workman's hands^ for their
protection against the continued action of the rough stones.
Equally protective does our preservative power exert itself to
rescue life at least, if it can do no more, by the formation of or*
ganic and dynamic barriers in the interior, against the injurious
and inimical assaults of long-continued doses of strong allo-
pathic medicines, that is, by the establishment of permanent al-
terations of our organisms, which always form a persistent medi-
cinal disease that often lasts for years, that is not capable of
being cured and removed by any human art, and that can only
be changed back again to the normal state in several years by
the vital force itself provided all medicines are discontinued and
the requisite strength of constitution still remains.
If, therefore, a psoric patient suffering from chronic non- vene-
real affections, in place of being cured homoeopathically in a
gentle, rapid and permanent manner, is assailed by physicians
of the old school by the long-continued use of a variety of strong
drug?, incapable of removing the chronic miasm, as the allo-
pathic medicines are, and, as usually happens, given in increas-
ing doses during a long period, as is the case in all their ordina-
ry modes of treatment, we may readily conceive into what a
sad and at length incurable state he must fall by such senseless
attacks on his system, and how relentlessly he must be assailed
in order that, without the very slightest diminution of his origi-
nal psoric malady, permanent organic malformations and changes
of the finest, most delicate parts of the organism, of those parts
most indispensible for life and well-being, may be developed,
and, as a consequence of them, new, permanent bark, opium,
mercurial, iodine, prussic-acid, arsenical, valerian, foxglove, and
other nameless chronic medicinal diseases, which all unite and
become fused (complicated) into one many-headed, intolerable
A WORD OF WARimrO TO ALL SICK PERSONS. 749
monster of disease, for which there is and can be no remedy on
earth, no antidote, no restorative medicines in nature.
I^ in addition to such bungling treatment to which the name
of rational is applied, powerful debilitating practices are employ-
ed, as is usually the case when the old school physician ima-
gines the disease to lie in some corruption of the blood (dyscra-
da) that must be removed, or in fiill-bloodedness (plethora),
(such treatment he terms treatment of the cause), and he henoe
from time to time taps off the blood (wherein the life of man
chiefly resides) by venesections and leeches, or reduces the sys-
tem by repeated warm baths, or when he, in his efforts for years
to expel an imaginary morbific substance (the favourite matter
of the material mind of allopathic physicians), robs the diseased
body and utterly wastes its most nutritive juices with so-called
mild, blood-purifying (?) laxatives, then these insidious medi-
cinal diseases produced secundum artem by such admirable
modes of treatment, become, on account of this pitiless robbery
of the vital force, so incurable, that recovery is not to be thought
of, and a miserable death can alone releal^e the patient from the
maltreatment of his physicians and firom his nameless torments.
Be not too anxious, I advise you, to insist on the dissection
of the corpses of those you have done to death I You would
not do it did you know what you thereby revealed to him who
knows the truth I Besides some rare congenital malformations,
and perchance some results of the deceased's dissipation, what
of an abnormal character do you encounter, that is not chiefly
the product of your injurious operations, of your medical igno-
rance and your therapeudc sins of omission and commission ?
There is displayed not what vxis present before your treatment, as
you would fain persuade the relatives, hut what was produced by
your treatment — the incurability of the deceased was rwt before but
after your treatment. It avails you nothing, that you thereby
gladly take the opportunity of making a display of your subtle
anatomical terminological learning, neither can it be concealed
from those who have any knowledge, that this is no test of abili-
ty to cure. The result of such autopsies is not the enriching of
pathological anatomy, but the revelation of hideous therapeutic
anatomy, to your disgrace — in spite of all your plausible sophis-
tries!
But even should these last mentioned debilitating processes
in the treatment of chronic (psoric) diseases have been avoided,
yet the most perfect^ imaginable healing art can never remove
760 ALLOPATHT :
these chronic mediciiial diseases produced firom bad treatment by
the long-continued use of large doses of strong medicines un-
suitable for the disease, nor indeed those that are developed by
a single simple medicament employed for a length of time in
frequent) large doses; for* where are remedies to be found that
can undo the organic mischief that has been affected ? But stUl
less can antidotes be thought of for persistent (chronic) maladies^
the consequence of medicinal mixtures. It is manifestly impos-
sible for the very best healing art to remove such vital injuries^
for as certainly as the preservative power alone can produce in
us organic permanent malformations and alterations for our pro
tection and delivery, be it from the chronic miasms^ or the in-
imical attacks of large, long-continued doses of the strong, im-
suitable medicines of the ^opathists, so certain is it that this
life-preserving power alone can again remove these malforma-
tions and alterations in our internal parts that were first pro-
duced by itself, and restore again the normal state, but it can
only do this after years, and provided the vital forces still
suffice. *
It only in the case of a very robust, undebilitated, youthful
constitution, and under other &vourable circumstances, that it is
possible for the vital force (alone), gradually (in two, three, four
years) to remove the organic degenerations which itself toil-
somely erected to ward off the attacks of inimical medicinal
forces, and to restore the healthy state, provided the psora that
still remains at the root of the evil be at the same time homoeo-
pathically cured, for this can never be overcome, never extin-
guished by our vital force alone, and still less by the senseless
bungling treatment of allopathy that plumes itself upon its
superlative wisdom.
But if the patient be already advanced in years, if his spirits
be depressed by sorrow, vexation, fear or want, or if in addition
he has been weakened by venesections, leechings, purgations
and the like, he can look for nothing with certainty but the sure
advance of death — ^the inevitable lot of those who can boast of
having employed many of the most distinguished physicians of
the old school and a variety of the mineral waters, foolishly
prescribed for them j none can ever help them more.
f ; : : ; : -~
' Those intemal malformations, abDormal organizations and disorganicatiaiis pro-
duced by nature for our protection against the yiolenoe of chronic miasmatic disease
(psora), it can most rapidly remove and reconstruct with the assistance of the cure of
the psora by homceopathy, but those caused by the ii\juriou8 misuse of medicines, it
has much more difficulty in curing.
A WORD OF WARNING TO ALL SICK PERSONS. 751
Subjectively it may be a more cruel deed to stab one's enemy
in the back firom revenge, but objectively it is more cruel to un-
dennine the system of a patient who sought our aid, and who
might easily and certainly have been relieved from his natural
disease by the appropriate remedies, so that life at length be-
comes intolerable to him, by secret instruments of destruction
(wrong medicines, in scarcely legible prescriptions, forced upon
him for half or whole years together, in several, often increasing,
doses daily), so that he must hopelessly and irremediably drag
out his wretched existence in constant misery, without having
the power to die, and envying the poniarded Ck)rsican his rapid
death.
At the contemplation of this heart-breaking fact, of how dif-
ficult is it for a patient to escape &om the destructive hands of
those quacks who foolishly pride themselves on their old Mse
art, and make a mighty display of incomprehensible pedantry,
who lie in wait for customers in order to entice them into their
toils by all manner of quaddsh expedients, I cannot forbear firom
aftectionately beseeching my modest colleagues, the important,
philanthrophic homoeopathists (0/ TnuUa mecum pejoraqud pasai
durale et vosmet rebus servate secundis/) to suffer for a short
time the unmerited pressure firom above, but in the meantime
not to waste our divine art, so infidlibly serviceable in natural
unspoiled diseases, on those irremedial patients who have been
destroyed to their very inmost marrow, not to receive at any
price those patients who have been injured to the verge of in-
curability by the allopathic exterminating art, nor, by \mder*
taking such impossibilities, to expose themselves to the scornful
laughter of the renowned physicians of the old school, who
have already taken the greatest pains to make them utterly in-
curable for hard cash. First let them be again restored by these
high-titled destroyers of health to the former state of natural
disease they were in before these medical onslaughts on their
life were perpetrated, if they are able to do it 1
On the contrary I beseech my homoeopathic colleagues to be
contented for the present with patients who have not been de-
stroyed by the physicians of the old school, even though they
be the poorest among the people, and laden with the most severe,
chronic, natural diseases, and to be satisfied with the smallest
remuneration for their labour, if these poor people can prove to
them that their poverty has prevented them applying to other
(allopathic) physicians, and consequently being ruined by im-
762 ALLOPATHY :
proper drugs. Though their income may be small they will yet
have the unspeakable joy of certainly and rapidly re-establish-
ing their patients' health, and thus putting flaunting allopathy
to shame, which is incapable of curing, but can only aggravate
diseases and render them incurable with a wilderness of drugs —
as a warning to the befooled publia The homoeopathic medi-
cal art can alone transform into health, as if by magic, all
natural diseases not ruined by allopathic art, provided there re-
main a tolerable amoimt of vital force, and this it does with-
out prating about rationality and treatment of the cause.
Before homoeopathy, that gentle, safe healing art so consonant
with nature, was discovered, no well disposed and honest phi-
lanthropist could forbear pitying the innumerable crowd of the
old-school physicians, as they groped about in midnight dark-
ness with their dreadfully learned ignorance, whilst their zeal
in treating natural diseases, in place of serving to benefit them
or bringing about the desired cure, only ruined them or render-
ed them incurable. For who among them could unravel the
confusion of so many (wouldbe profoundly learned) baseleas
hypothetical doctrines and unnatural therapeutic maxims and
modes of treatment with drugs whose peculiar action was un-
known, given in senseless mixtures and repeated large doses ? —
who among them could separate the fidse from the true, and re-
duce their mode of practice to a method of treatment that should
be consonant with nature, and lastingly beneficial ? They were
then fully as much to be pitied as those patients whom they
injured and continue to injure to an infinite degree with their
antiquated unimproved method. But since the light of the
doctrine that is alone consonant with nature, of restoring health
and well-being rapidly and certainly in unspoiled, natural dis-
eases by small quantities of properly prepared, mild specific
medicines, has appeared, and has shone throughout Europe in
marvellous deeds, those who paid no regard to it but condemn-
ed and persecuted it are not to be pitied ; they deserve for their
obstinate adherence to their antiquated homicidal mode of treat-
ment naught but contempt and abhorrence, and unprejuclicod
history will brand their names with a stigma on account of
their scornful rejection of the real aid which they might have
afforded their much-to-be-pitied patients, had they not impious-
ly closed their eyes and ears against the beneficent truth 1
OVBB ASD PBBVBirriOK OF THK ASIATIC CHOLERA. 768
CAUSE USD PREVENTM OF THE ASIATIC CHOLERA.'
jPreliminary.
A receipt has been given to the world, which proved so effi-
cacious in IHinaburg in the Asiatic cholera, that of ten patients
but one died. The chief ingredient is camphor^ which is in
ten times the proportion of the other ingredients. But not a
tenth — ^nay, not one in a hundred of the patients would have
died had the other ingredients, which were but injurious and
obstructing, and the venesection been left out, and the camphor
been given alone, and always at the very commencement of the dis-
eaae^ for it is only when given abme, and at the first invasion of the
dia^zae that it is so marveUously usefuL But if physicians come,
as usual, too late to the patient, when the fevourable time for em-
ploying the camphor is past, and the second stage has already
set in, when camphor is useless, then they may use it in vain ;
Aeir patients will die under its employment Hence every one,
the instant any of his friends take ill of cholera, must himself
immediately treat them with camphor^ and not wait for medical
aid, which, even if it were good, would generally come too late.
I have received many communications from Hungary from non-
medical persons, who have restored their friends, as if by magic,
by giving camphor the instant they became ill
Where the cholera first appears, it usually comes on in the
commencement in its first stage (with tonic spasmodic charac-
ter) ; the strength of the patient suddenly sinks, he cannot stand
upright, his expression is altered, the eyes sunk in, the face
bluish and icy cold, as also the hands, with coldness of the rest
of the body ; hopeless discouragement and anxiety, with dread
of sufibcation, is visible in his looks; half stupifled and insen-
sible, he moans or cries in a hollow, hoarse tone of voice, with-
out making ^ny distinct complaints, except when asked ; burn-
ing in the stomach and gullet, and cramp-pain in the calves and
other muscles ; on touching the precordial region he cries out ;
he has no thirst,. no sickness, no vomiting or purging.
lu the first stage camphor gives rapid relief but the patient's
friends must themselves employ it, as this stage soon ends either
in death or in the second stage, which is more difiicult to be
* From the Archiv.f, horn, Heilk^ yd. zi, 1881.
• 48
754 CURB AND PBEVEKTION OF THK ASUXIQ CHOLERA.
cured, and not with camphor. In the first stage accordingly, the
patient must get, as often as possible (at least every five minutes)
a drop of spirit of camphor (made with one ounce of camphor
to twelve of alcohol), on a lump of sugar or in a spoonful of
water. Some spirit of camphor must be taken in the hollow of
the hand and rubbed into the skin of the arms, legs, and chest
of the patient ; he may also get a clyster of half-a-pint of
warm water, mingled with two full t^easpoonfuls of spirit of
camphor, and &om time to time some camphor may be allowed
to evaporate on a hot iron, so that if the mouth should be closed
by trismus, and he can swallow nothing, he may draw in enough
of camphor vapour with his breath.
The quicker all this is done at the first onset of the first stage
of the disease, the more rapidly and certainly will the patient
recover; ofbeu in a couple of hours,' warmth, strength, con-
sciousness, rest and sleep return, and he is saved.
If this period of the commencement of the disease, so favour-
able to recovery and speedy cure, by the above indicated em-
ployment of camphor, has been neglected, then things look
worse ; then camphor is no longer serviceable. There are more-
over cases of cholera, especially in northern regions, where this
first stage, with its tonic spasmodic character, is hardly observ-
able, and the disease passes instantly into the second stage of
clonic spasmodic character ; frequent evacuation of watery fluid,
mixed with whitish, yellowish, or reddish flakes, and, along
with insatiable thirst and loud rumbling in the belly, violent
vomiting of large quantities of the same fluid, with increased
agitation, groaning and yawning, icy coldness of the whole body,
even of the tongue, and marbled blue appearance of the arms,
hands and face, with flxed sunken eyes, diminution of all the
senses, slow puJse, excessively painful cramp in the calves, and
spasms of the limbs. In such cases the administiation of a drop
of camphor spirit every five minutes, must only be continued so
long as decided benelit is observable (which with a remedy of
such rapid action as camphor, manifests itself within a quarter
of an hour). If in such cases decided benefit is not soon per-
ceived, then no time must be lost in administering the remedy
for the second stage.
* Tbere were casoB of patients for whom camphor had not been employed, who
hail apparently died in the fir^t stage and were laid out for dead, in whom a finger
was rieeii lo move ; in these some caniphor-.spirit mLxed with oil and introduced inu>
the moutli, recalled tie appaiently dead again to life.
CUBB AND P&SY£NTION OF TH£ AaiATIC CHOLERA. 755
The patieDt is to get one or two globules of the finest prepa-
ration of copper^ (prepared fix>m metallic copper in the mode
described in the second part of my work on Chronic Diseases),
thus cuprum ^^ X, moistened with water, and introduced into
his mouth every hour or every half-hour, until the vomiting and
purging diminish, and warmth and rest are restored. But noth-
ing else at all must be given beside ; no other medicine, no herb
tea, no baths, no blisters, no fumigation, no venesection, &c.,
otherwise the remedy will be of no avail. Similar good effects
result from the administration of as small a portion of white
hellebore {veratrum dlhum^ ^°® X) ; but the preparation of copper
is much to be preferred, and is more serviceable, and sometimes
a single dose is sufficient, which is allowed to act without a
second being given, as long as the patient's state goes on
improving.*
The wishes of the patient of all kinds are only to be indulged
in moderation. Sometimes, when aid is delayed many hours,
or other and improper remedies have been administered, the pa-
tient fiJls into a sort of typhoid state, with delirium. In this
case, bryonia ^ X, alternately with rhus tax. ^ X, proves of
eminent service.
The above preparation of copper, together with good and
moderate diet, and proper attention to cleanliness, is the most
certain preventive and protective remedy ; those in health should
take, once every week, a small globule of it {cupr. ® X) in the
morning &sting, and not drink anything immediately after-
wards, but this should not be done until the cholera is in the
locality itself, or in the neighbourhood. The health of the indi-
vidual will not be in the least disturbed by this dose. I shall
not, but any other homoeopathic practitioner may, tell where
the above medicines may be procured, excepting the camphor,
which, like the alcohol, may be had at every chemist's shop.
Camphor cannot preserve those in health from cholera, but
> If the dear and scarce (frequently fiilsified) cajeput oil be actuallj so serviceable
in the Asiatic cholera that out of ten scarcely one died, it must owe this quality to
its camphor-like property (it may almost be regarded as a fluid camphor) and to the
circumstance, that from the copper vessels in which it is imported ftom the Eai>t
Indies, it takes up some portion of copper, and hence, in its unpurified state, it is of
a blue-greenish colour. It has, moreover, been found in Hungaiy, that those who
wore next the skin of their body a plate of copper, were exempt from infection ; as
trustworthy intelligence from that country informs me.
* Similar afifections resulting from immoderate repletions of the stomach, with
indigestible nutriment, are best removed by a few cups of strong oofibe.
756 OK TEX XODX OF PBOPAGATIOK[
only the above preparation of copper ; but when the latter is
taken the vaponr of camphor mnst be avoided, as it suspends the
action of the copper.*
CoiTBEK, lOtb SepCcmber, 18S1.
APPEAL TO THIKKINO PHILANTHB0PIST8 RSSPECTDrO
THE MODE OF PROPAGATION OF THE ASIATIC CHOLERA.*
Two opinions, exactly opposed to each other prevail on this
59ubject. One party considers the pestilence as only epidemic, of
atmospheric-telluric nature, just as though it were merely spread
through the air, from which there would in that case be no pro-
tection. The other party denies this, and holds it to be commu-
nicable by contagion only, and propagated from one individual
to another.
Of these two opinions one only can be the right one, and that
which is found to be the correct one will, like all truths, exer-
cise a great influence on the welfare of mankind.
The first has the most obstinate defenders, who adduce the
fact that when the cholera has broken out at one extremity of
the town, it may the very next morning be raging at the other
extremity, consequently the infection can only be present in the
air; and that they (the physicians) are in their own persons
proofe of the non-contagious character of cholera, seeing that
they generally remain unaffected by it and in good health,
although they are daily in personal communication with those
dying of cholera, and have even tasted the matter they ejected
and the blood out of their veins, lain down in their beds, and
> [In the first VoL of the Bibl. Homctopatkique we find Um ibUowitig eztraet of
m letter from Hahnemaiui to the Editor :
** Cupntm as a prophylactic against cholera, has generallj ^ewn itself eflVcadoos
wherever it has been employed, and where its action has not been disturbed by gnMS
dietetic iaults, or by the ^mell of camphor (whidi is its antidote). The best booicBopa-
thic practitiooers hare also found it indispeuNblc m the second stage of the fiihy
developed disease, alternated, if the symptoms nidicate this, with vtratntm albmm, X.
1 have also advised the alternation of these two substances from week to week as a
|>rcventive against the disease.
** I learn from authentic sources that at Vienna, Berlin and Magdeburg, tbowandt
«»f fiuuiUes by following my instructions respecting the treatment by camphor, have
«. urcd, often in icM than a quarter of an hour, those of their members who were
uttiickcd by the epidemic, and that so efTectuuUy, that their neighbours knew nothing
alx^ut it, and etill less their medical attendimts, who oppu!<e with all their might thii>
treuUiit'Ut, HO f^iniple, bo mpid, and 90 amttantly certain in iU effcU,"]
' PublUhed as a pamphlet Leipzic, 1881.
OF THB ASIATIC CHOLERA. 707
BO forth. This foolhardj, disgusting procedure they allege to
be the eay)€rime7Uum crucis^ that is to say, an incontrovertible
proof of the non-contagious nature of cholera, that it is not
propagated by contact, but is present in the atmosphere, and for
this reason attacks individuals in widely distant places.
A fearfully pernicious and totally false assertion I
Were it the &ct that this pestilential disease was uniformly
distribured throughout the atmosphere, like the influenza that
recently spread over all Europe, then the many cases reported
by all the public journals would be quite inexplicable, where
small towns and villages in the vicinity of the murderously preva-
lent cholera, which, by the unanimous efforts of all their in-
habitants, kept themselves strictly isolated, like a besieged for-
tress, and which refused to admit a single person from without
— inexplicable, I repeat, would be the perfect exemption of such
places from the ravages of the cholera. This plague raged
fiercely over an extensive tract on the banks of the Volga, but
in the very middle of it, Sarepta, which had strictly and un-
deviatingly kept itself secluded, remained perfectly free from
the cholera, and up to a recent period none of the villages
around Vienna, where the plague daily carries off a large num.
ber of victims, were invaded by cholera, the peasants of these
villages having all sworn to kill any one who ventured near
them, and even to refuse to permit any of the inhabitants who
had gone out of the villages to re-enter them. How could
their exemption have been possible had the cholera been distri-
buted throughout the atmosphere ! And how easy it is to com-
prehend their freedom from it, seeing that they held aloof from
contact with infected individuals.
The course followed by the cholera in every place it traversed
was almost uniformly this : that its fury shewed itself most viru-
lently and most rapidly fetal at the commencement of its inva-
sion (evidently solely because at that time the miasm encoun-
tered none but unprepared systems, for which even the slightest
cholera miasm was something quite novel, never before expe-
rienced, and consequently extremely infectious); hence it then
infected persons most frequently and most fatally.
Thereafter the cases increased, and with them at the same
time, by the communication of the inhabitants among each
other, the quantity of diluted miasm, whereby a kind of local
sphere of cholera-miasm exhalation was formed in the town, to
which the more or leas robust individuals had an oppDitunity of
758 ON THE MODE OF PROPAGATION'
becoming gradually accustomed and hardened against it, so that
by degrees always fewer inhabitants were attacked by it and
could be severely aflFected by it (the cholera was then said to take
on a milder character), undl at last all the inhabitants were al-
most uniformly indurated against it, and thus the epidemic was
extinguished in this town.
Did the miasm only exist in the general atmosphere, the cases
oould not be less numerous at last than they were at the com-
mencement, for the same cause (said to be the general atmos-
pheric constitution) must have remained identical in its effects.
The only fact brought forward by Hufeland against my proofi
(viz., that on board an English ship in the open sea, about the
latitude of Biga, that had had no (?) communication with the
town, two sailors were suddenly seized with the cholera) proves
nothing, for it is not known how near the ship came to the in-
fected town, Riga, so that the sphere of the miasm-exhalation
from the town, although diluted, might yet have reached and
infected the sailors, who were still unused to the miasm, especial-
'y if they,as is often the case, were rendered more susceptible to
it from intemperance.
The most striking examples of infection and rapid spread of
cholera take place, as is well known, and as the public journals
likewise inform us, in this way : On board ships — in those
confined spaces, filled with mouldy watery vapours, the cholera-
miasm finds a favourable element for its multiplication, and
grows into an enormously increased brood of those excessively
minute, invisible, living creatures, so inimical to human life, of
which the contagious matter of the cholera most probably con-
sists— on board these ships, I say, this concentrated aggravat-
ed miasm kills several of the crew ; the others, however, being
frequently exposed to the danger of infection and thus gradually
habituated to it, at length become fortified against it, and no
longer liable to be infected. These individuals, apparently in
good health, go ashore, and are received by the inhabitants
without hesitation into their cottages, and ere they have time to
give an account of those who have died of the pestilence on
board the ship, those who have approached nearest to them are
suddently carried oflF by the cholera. The cause of this is un-
doubtedly the invisible cloud that hovers closely around the
sailors who have remained free from the disease, and which is
composed of probably millions of those miasmatic animated
beings, which, at first developed on the bnad marshy banks of the
07 THE ASIATIC CHOLERA. 769
tepid Ganges, always searching out in preference the hnman
being to his destruction and attaching themselves closely to him,
when transferred to distant and even colder regions become
habituated to these also, without any diminution either of their
unhappy fertility or of their fatal d»9tructiveness.
Closely but invisibly environed by this pestiferous, infectious
matter, against which, however, as has been observed, his own
individual system is, as it were, fortified by the loDg resistance
of his vital force to its action, and by being gradually habituate
ed to the inimical influence surrounding him, such a sailor (fly-
ing fix>m the corpses of his companions on board) has often gone
ashore apparently innocuous and well, and behold ! the inhabi-
tants who hospitably entertained him, and first of all those who
came into immediate contact with him, quite unused to the
miasm, are first most rapidly and most certainly attacked with*
out any warning, and killed by the cholera, whilst of those who
are more remote, such only as are unnerved by their bad habits
of life are liable to take the infection. Those who are not de •
bilitated, and who have kept at some distance from the stranger
who is surrounded by the cholera miasm, sufSsred only a slight
attack from the miasmatic exhalation hovering about in a more
diluted form ; their vital force could easily ward off the weaker
attack and master it, and when they subsequently came nearer
it their system had by this time become somewhat habituated
to the miasm, retained the mastery over it, and even when these
persons at length approached nearer or quite close to the infected
stranger, their vital force had thus gradually become so fortified
against it, that they could hold intercourse with him with per-
fect impunity, having now become completely uninfectable by
the contagious principle of the cholera. It is a wonderfully
benevolent arrangement of Qtod that has made it possible for
man to fortify himself against, and render himself unsusceptable
to, the most deadly distempers, and especially the most fatal of
them all, the infectious principal of cholera, if he gradually
approaches it ever nearer and nearer, allowing intervals of time
to elapse in order to recover himself, provided always he have
an undebilitated body.
When first called to a cholera patient, the physician, some-
what timid as yet, as is but reasonable, either tarries at first in
the antechamber (in the weaker atmosphere of the miasmatic
exhalation) or if he enter the patient's room prefers keeping
at some distance, or standing at the door, orders the nurse in
760 OK THS MODE OF PBOFA0ATIOK
attendance to do this or the other to the patient, he then prudent-
ly soon takes his departure promising to return again shortly ;
in the meantime he either goes about a little in the open air, or
goes home and has some refreshment His vital force, which
at the first short visit at some distance from the patient, was
only moderately assailed by the diluted miasm, recovers itself
completely in the meantime by this recreation, and when he
again comes into the patient's room and approaches somewhat
nearer to the patient, it soon by practice comes to resist more
powerfully the more concentrated infectious atmosphere that
exists closer to the patient, until at length, from frequent visits
and a nearer approach to the patient, it attains a mastery over
the assaults of the miasm, so that at last the physician is com-
pletely hardened against even the most poisonous cholera
miasm at the bedside, and rendered quite uninfectable by this
pestilence ; and the same is the case with the nurse who goes as
cautiously and gradually to work.
Both the one and the other then boast, because they can come
into immediate contact with the patient without any fear and
without any ill consequences, that they know better than to call
the disease contagious ; it is not^ they say, the least catohing.
This presumptuous, inconsiderate, and perfectly untrue assertion
has already cost thousands their lives, who in their ignorance, and
quite unprepared, either approached the cholera patient suddenly
or came in contact with these cholera physicians (who do not treat
with camphor) or the nurses. For such physicians and nurses,
fortified in this manner against the miasm, now take away with
them in their clothes, in their skin, in their hair, probably also
in their breath, the invisible (probably animated) and per-
petually reproductive contagious matter surrounding the cholera
patient they have just visited, and this' contagious matter they
unconsciously and unsuspectingly carry along with them through-
out the town and to their acquaintances, whom it unexpectedly
and infallibly infects, without the slightest suspicion on their
part of its source.
Thus the cholera physicians and nurses are Vie most certain and
frequent propagators and cominunicators of contagion far and
wide; andyet amazement is expressed, even in the public journals,
how the infection can spread so rapidly the very first day, from
the first cholera patient at the one end of the town to persons^
at the other end of the town, who had not come near the
imtient!
And thus the flame for the sacrifice of innocent persons breaks
OF THl ASIATIG CHOLSRA. 761
ont in all comers and ends of the town, lighted up by the sparks
of the black death scattered in every direction by physicians
and their assistants I Every one readily opens the door to these
plague-propagators ; allows them to sit down beside him, putting
implicit fidth in their confidently declared assurance : *' that it
is ridiculous to cfiU the cholera contagious, as the cholera pesti-
lence is only diffused epidemically through the air, and cannot,
therefore, be infectious" — and see I the poor cajoled creatures
are rewarded for their hospitality with the most miserable
death.
To the very highest people of the town and of the court the
oholera angel of death obtains access, in the person of the physi-
cian who gives this evil counsel, enveloped by the fresh miasm ;
and no one detects the concealed, invisible, but, for that reason,
all the more dangerous enemy.
Wherever such physicians and such nurses go (for what all-
seeing eye could perceive this invisible danger on these healthy
miasm-bearers?^wherever they go, their presence communi-
cates the spark, and mortal sickness bursts forth everywhere,
and the pestilence depopulates whole towns and countries I
If physicians would but take warning, and, rendered unin^
fectable by taking a few drops of camphorated spirit, approach
(ever so quickly) the cholera patient, in order to treat him at
the commencement of his sickening ^dth this medicine {purCj
unadulterated camphorated spirit) which alone is efficacious, and
which most certainly destroys the miasm about the patient, by
giving him, as I have taught,* every five minutes one drop of it,
and in the interval assiduously rubbing him on the head, neck,
chest, and abdomen with the same medicine poured into the
hollow of the hand, until all his giddy faint powerlessness, his
suffocative anxiety, and the icy-coldness of his body has disap-
pea«Ki, and given place to reViving animation, tnmquiUity rf
mind, and complete return of the vital warmth — if they would
but do this, then cv^ry patient would not only be infaUihly re-
stored within a couple of hours (as the most undeniable facts
and instances prove), but by the cure of the disease with pure
camphor, they would at the same time eradicate and annihilate
the miasm (that probably consists of inniunerable, invisible
living beings) in and about the patient, about themselves, even
in the clothes, the linen, the bed of the patient (for these all
- Citre and Prevention of the Aiiatie Cholera, — [See preoediz^ article.]
702 ON THS MODS OF PBOPA0ATIOKy &C.
would be penetrated by the yaponr of the camphor if it were
employed in this way) in the very furniture and walls of the.
apartment also, and they themselves (the physicians uid nurses)
would then cany oS none of the contagious principle with
them, and could no longer infect persons throughout the town**
But these physicians, as we see, despise this; they prefer
going on killing their patients in crowds by pouring into them
large quantities of aqua-fortis and opiimi, by blood-letting, and
so forth, or giving the camphor mixed with so many obstructing
and injurious matters, that it can scarcely do any good, solely
to avoid giving the simple, pure (efficacious) solution of camphor,
because the reformer of the old injurious system of treatment
(the only one they know), because /, from conviction, recom*
mended it in the most urgent manner in all countries of Europe^
They seem to prefer delivering over all mankind to the grave-
digger, to listening to the good counsel of the new purified
hewing art
But who can prevent them acting so, as they alone poasess
the power in the state to suppress what is good?
However, bountiftd Providence has provided a beneficent
remedy for this state of things (for these physicians are protected,
even in their ill-deeds, by antiquated injurious laws).
Thus, the cholera is most surely and easily and almost mira-
culously curable, but only in the first couple of hours from the
commencement of the sickening, by means of the employment
of pure camphor, and that before the physicians in larger towns
that are summoned can attend. But on their arrival they may
even then, by the employment of unadulterated camphor-spirit^
if not cure the cholera completely (for the lapse of a few hours
generally makes it too late to do so) yet annihilate the whole of
the contagious principle of this pestilence on and about the
patient, and adhering to themselves and the bystanders, and
cease to convey the miasm with them to other parts of the town.
Hence the families of non-medical persons, by means of this
employment of camphor, cure the members of their fisunilies by
thousands in secret (the higher classes alone, must, on account of
their station, be under the necessity of calling in the physician,
* The sprinkling of suspected strangers on their arrival, and of suspected goods
and letters with camphor spirit^ would most certainly destroy the cholera miasmi ia
them. Not a single fad goes to prove that chlorine annihilatPB the miasm of cholera ;
it can only destroy odorous effluvia. But the contagious matter of the Asiatic cho-
lera is fitf from being an odorous effluvium. What good then do the fumigations
with chlorine^ which is here perfectly useless^ and only hurtful to man*s healths
BXMARKS OK THB SXTRXMS AITBNUATION OF, &C. 768
who, in defiance of the philanihropio refonner of the healing
art, and his efficacious system of treatment, not nn£requentlj,
with his improper remedies, dispatches them to Orcus).
It 18 members of a family alone that can most certainly and easily
mutually cure each other imth camphor spirit^ because they are able
instantaneously to aid those taken iU.
Will physicians ever come to comprehend what is essential,
and what will at once put a stop to the devastation and depopa-
lation of two quarters of the globe?
Dixi et nlTEvi anrniam !
OOTHBr, the 24th October, 18B1.
REMARKS ON THE EXTREME ATTENUATION OF HOMCEO-
PATHIC MEDICINES.^
L The essay of this intelligent and unwearied and honourable
investigator and promoter of our art, incontestably corroborates
the following truths that some observations of my own had
already hinted at, viz., 1, that the development of the powers of
medicinal substances by the process peculiar to homcBopathy,
may be assumed to be almost iUimiUMe ; 2, that the higher their
dynamization (dematerialization) is carried, the more penetrating
and rapid does their operation become ; 8, that, however, their
efiEects pass off so much the more speedily.
All this is in strict accordance with my own experiments,
though I have not carried (hem so far ; one of them I may only
allude to, namely, that once having prepared a dynamized
attenuation of sulphur up to XXX (90th dilution), I administered
a drop of it on sugar to an aged, unmarried lady, who was sub-
ject to rare epileptic attacks (one every 9, 12, 14 months), and
' [These remarks occur io the form of postscripts appended toa paper by Qraf voo
Kofsakofi^ published ia the 11th and again in the 12th VoL of the Archiv, /. honu
Seilk. In this paper the author mentions that he bad diluted medicines up to the
160th, 1000th and 1500th attenuation, and that he had found them even at that
degree of dilutioo quite efficadous. He starts the idea that poanbly the material
<fif]8k» of the medicinal substance attains its limit at the third or sixth dilution, and
that the subsequent attenuations obtain their medicinal properties bj a kind of infee-
tko or communication of the medicinal power, after the manner of contagious diseases^
to the non-medicinal vehicle ; and in corroboration of this notion he relates seyeral
experiments, in which he says he communicated medicinal pr(^)erties to laige quan-
tities of unmedicated globules, by shaking them up with one dry medicated globule.
He likewise remarks that by diluting medicines highly, and by employing such
infMted globules, the force of the primary action of the medicines, or their tendency
to produce homcBopatluc aggrayations, declines whilst the reactioo of the oiganism,
or the cnratiTe action of the mediciiie, coatiaxulXij inoeases.]
764 BEHABSB OSr THB EXTBXHX ATTINUATIOK OF
within an hour afterwards she had an epileptic fit, and since
then she has remained quite free fix>m them.
The opponents of homoeopathy, obstinately attached to their
old system, who seem to have made a resolution not to allow
themselves to be convinced of this wonderfril development of
the powers of crude medicinal substances, which however mani-
fests itself to every unprejudiced person who honestly puts the
matter to the test, and which gives to the practice of homoM>-
pathy that tranquillizing certainty and trustworthiness in the
treatment of diseases with highly dynamized attenuations of
medicines in the smallest doses, whereby it vastly surpasses
every other method of treatment, — our opponents, I say, on
being informed of these extended experiments and observations
of the author of this treatise, who has rendered such service to
our art, can do nothing more than, as they have hitherto done,
remain standing in amazement below the steps of the outer-court
to the sanctuary of these health-bringing truths, and announce
by a sceptical smile their inability to avail themselves of these
beneficent revelations of the nature of things for the welfiure of
their patients. They wore the same sceptical smile when I some
thirty and odd years ago pointed out the efficacy of the millionth
part of a grain of belladonna in scarlet-fever ; they can now also
do nothing more when they read of the dematerialization of
sulphur up to the thousandth potency, that it still displays a
powerful medicinal action on the human body. Their Boeotian
smiling however will not stay the ef^le-flight of the new bene-
ficent healing-art, and in the meaiUime they remain as they
deserve to do, deprived of its blessings.*
However, it must be borne in mind, that the chief use of these
experiments, was to demonstrate how high medicinal attenua-
tions might be potentized without their action on man's state of
health being reduced to nothing, and for this, these experiments
are invaluable ; but for the homoeopathic treatment of patients
it is advisable, in preparing all kinds of medicines, not to go
higher than the deciUionth attenuation and dynamization (X),
' Ooe might applj to thete geotlemen GoetWt words:
** Damn erkenn' ich die gelehrtOD Hemn !
Was ihr iiicht tastet, steht euch MeOen fern;
Was ihr oicht fiisst, das fehit euch gam and gar;
Was ihr nicht rechnet, glaubt ihr, sei nicht wahr ;
Was ihr nicht wagt^ hat fOr euch keiu Gewicht ;
Was ihr nicht mflnzt, das, mcint ihr, gcltc nicht."
{Faust, 2ter TbeiL)
, HOH(EOPATHIC KEBICHnES. 766
in order that homodopathio physicians may be able to assure
themselves of uniform results in their practice.'
IL I can scarcely believe that the carefully discriminating
Graf von Korsakoff can regard the subdivision and dynamization
peculiar to homoeopathy as complete at the millipnth and bil-
lionth development [8d and 6th dilution], and incapable of any
further disembodiment and spiritualization of the^r medicinal
powers to an even greater degree by further trituration of the
dry and further succussion of the fluid attenuations — the occur-
renoe of which cannot be doubted — or that he actually looks
upon them as weaker, as he seems to imply. Who can say that
in the millionth or billionth development the small particles of
the medicinal substances have arrived at the state of atoms not
susceptible of further division, of whose nature we can form not
the slightest conception? For if the living human organism ,
shews an ever stronger reaction to the more highly dynamized
attenuations when they are used medicinally (as experience
teaches, and as the author himself admits), it follows that such
higher medicinal preparations must be regarded as stronger,
inasmuch as there can be no standard for measuring the degree
of dynamic potency of a medicine, except the degree of the
reaction of the vital foroe against it.
Thus much, however, is deducible from his experiments, that,
since a single dry globule imbibed with a high medicinal dy-
namization, communicates to 18,500 unmedicated globules, with
which it is shaken for five minutes, medicinal power fully equal
to what it possesses itself without suffering any diminution of
power itself it seems that this marvellous communication takes
^ [In 1829 he wrote to Dr. Schrater that (^BrU, Jour, of Horn,, Vol r, p. 898) :
" I do not approve of jour dynamiring the medicmee higher (m ibr instanoe, up to
XII and XX, (86th and 60th dttutioDs]). There must be some cod to the thing, it
. cannot go on to infinity. By laying it down as a rule that all homcBopathic remedies
be attenuated and dynamized up to X [80th dil.], we have a unifonn mode of proce-
dure in treatment of all homoeopathists, and when they describe a cure, we can reptet
it, as they and we operate with the same tools. In one word, we would do wdl to
go forward uninterruptedly in the beaten path. Then our enemies will not be able
to reproach us with having nothing fixed — no normal standard." In 1888 he speaks
more fiivourably of the higher attenuations, such as the 60th, 160th, and 800th dilu-
tions {Orpafumt % coLxzxvn, 2d note,) ascribing to them a more rapid and penetra-
ting, but likewise a shorter actioiL Again in 1888 {Chr, Kr^ part v, prefiioe), he
speaks approvingly of the 60th dilution. As a rule, he seems to have used chiefly
the 80th dilution, still we find from the cases sent to Dr. Bflnninghausen, which I
give fiurther on, that he occasionally gave other preparations, and in the letter of
which a &c-6imile is given in this work, he desires Dr. Lehmann to send him the 8d
trituration of certain medicines, whether for therapeutic use or for further dilution it
is impossible to say.]
766 CASSS TLLXJBTRATPnt OF
«
place by means of proximity and contact, and is a sort of infec-
tion, bearing a strong resemblance to the infection of healthy
^rsons by a contagion brought near or in contact with them —
a perfectly novel, ingenious and probable idea, for which we aie
indebted to the Grirf.
The conununication or infection appears to take place by
means of the power which is perpetually spreading around, like
an exhalation or emanation fix)m such bodies, even though they
are dry, just like those globules the size of a mustard seed that
had previously been moistened with a fluid medicine which we
employ for the cure of patients by ol£Biction. A globule of this
kind, e. ^., of staphisagria X, which, in the course of twentj
years, had been smelt several hundreds of times after opening
the bottle in which it was, for a certain symptom that always
recurred of the same character, possesses at this hour medicinal
power of equal strength as at &rat, which could not be the case
did it not continually exhale its medicinal power in an inexhaust-
ible manner.
The supposition of our author that dry globules that have
been impregnated with a certain degree of development of
power can be further dynamized and their medicinal power in-
creased in their bottles by shaking, or carrying about in the
pocket, like medicinal fluids further shaken, is not boi^e out bj
any fact, and will appear to me incredible until it \a supported
by proper experimental proofs.
On the whole we owe many thanks to this ingenious and in-
defatigable investigator for his present valuable communication.
C&ru£N, 80th May, 1882.
OASES ILLUSTRATIVE OF HOMffiOPATflIC PRACTICFJ
Many persons of my acquaintance but half converted to hc-
moeopathy have begged of me from time to time to publish still
more exact directions as to how this doctrine may be actually
applied in practice, and how we are to proceed. I am astonished
that after the very peculiar directions contained in the Organon
of medicine more special instruction can be wished for.
I am also asked, " How are we to examine the disease in every
' From the Heine ArzneitniiUUehre, pt ii, 3d. edit 1838. [The cases here given
originally appeared about 1817 in the first editioo of the R. A. M. L^ but the notes
and most of the preliminary matter are of the date we have given, and we may there-
fore consider the whole to represent Hahnemann's opinion and pnctioe, wHh the 6Z-
eeptioQ of the dose in these two cases, of the latter period.]
HOMCEOPATHIC PBAOTICE. 767
particular case ?'' As if special enough directions were not to
be found in the book just mentioned.
As in homcBopathy the treatment is not directed towards any
supposed or illusory internal causes of disease, nor yet towards
any names of diseases invented by man which do not exist in
nature, and as every case of non-miasmatic disease is a distinct
individuality, independent, peculiar, diifering in nature from all
others, never compounded of a hypothetical arrangement of
symptoms, so no particular directions can be laid down for them
(no schema, no table), except that the physician, in order to
efi^t a cure, must oppose to every aggregate of morbid symp-
toms in a case a group of similar ntedicinal symptoms as exact
as it is to be met with in any single known medicine, for this
doctrine cannot admit of more than a single medicinal substance
(whose effects have been accurately tested) to be given at once
(see Organon of medicine^ % 271, 272).
Now we can neither enumerate all the possible aggregates of
symptoms of all concrete cases of disease, nor indicate a prwri
the homoeopathic medicines for these (a priori undefinable) pos-
sibilities. For every individual given case (and every case is an
individuality, differing from all others) the homoeopathic medical
practitioner must himself find them, and for this end he must
be acquainted with the medicines that have till now been in-
vestigated in respect of their positive action, or consult them for
every case of disease ; but besides this he must do his endeavour
to prove on himself or on other healthy individuals medicines
that have not yet been investigated as regards the morbid al-
terations they are capable of producing, in order thereby to in-
crease our store ofhiomn remedial agents,* so that the choice of
a remedy for every one of the infinite variety of cases of disease
(for the combatting of which we can never possess enough of
suitable tools and weapons) may become all the more easy and
accurate.
That man is far from being animated with the true spirit of
the homoeopathic system, is no true disciple of this beneficent
doctrine^ who makes the slightest objections to institute on him-
self careful experiments for the investigation of the peculiar
effects of the medicines which have remained unknown for 2600
years, without which investigation (and imless their pure patho-
' Before the diBOoyery of Homceopathy, mediciiial subBtaoces were known only in
respect to their natural history, and besides their names nothing was known re^^uxl-
ing them bat their presumed qnalitieB, wfaioh were either imaginary or altogether
fiOee.
768 CASM8 JLLVSOLATPrm ow
genetic action on the lieahhy indiyidiial bss pfevioofll j been
aBcertained) all treatment of diaease moat cootinae to be not only
a£x>liah, bnt even a criminal operation, a dangeiona attack upon
homan life.
It is aomewbat too much to expect ns to work merelv for the
benefit of snch self-interested individoals as will contribute no-
thing to the complete and indiq)enaable building np of the in-
dispensable edifice, who only seek to make money by what has
been discovered and investigated by the laboors of othersi and
to famish themselves with the means of squandering the income
derived firom the ci^ital of science, to the accnmolation of which
they do not evince the slightest inclination to contributeL
All who feel a tme desire to asnst in elucidating the peculiar
effects of medicines— onr sole instroments, the knowledge of
which has for so many centuries remained uninvestigated, and
which is yet so indispensable for enabling us to cure the sick,
will find the directions how these pure ejq)erim^itB with medi*
ones should be conducted in the Org^non qfrnedictne^ § 118 — 142.
In addition to what has been there started I shall only add,
that as the experimenter cannot, any more than any other human
beinj^ be absolutely and perfectly healthy, he must, should sli^t
ailments to which he was liable appear during these provings of
the powers of medicines, place these between brackets, thereby
indicating that they are not confirm^ or dubious. But this
will not often happen, seeing that during the action upon a pre-
viously healthy person of a sufficiently strong dose of the me-
dicine, he is under the influence of the medicine alone, and it is
seldom that any other symptom can shew itself during the first
days but what must be the effect of the medicine. Further, that
in order to investigate the symptoms of medicines for chronic
diseases, for example, in order to develop the cutaneous diseases,
abnormal growths and so forth, to be expected from the medi-
cine, we must not be contented with taking one or two doses of
it only, but we must continue its use for several days, to the
amount of two adequate doses daily, that is to say, of sufficient
size to cause us to perceive its action, whilst at the same time
we continue to observe the diet and r^imen indicated in the
work alluded to.
The mode of preparing the medicinal substances for use in
homoeopathic treatment will be found in the Organon of medicine,
§ 267 — 271, and also in the Chronic disecises. I would only ob-
serve here, that for the proving of medicines on healthy indivi
duals, dilutions and dynamizations are to be employed as high
HOKCKOPATHIC PRACTICE. 7«»
as are used for the treatment of disease, namely, globules mois-
tened with the decillionth development of power.
The request of some friends, halting half-way on the road to
this method of treatment, to detail some examples of this treat-
ment, is difficult to comply with, and no great advantage can
attend a compliance with it. Every cured case of disease shews
only how that case has been treated. The internal process of
the treatment depends always on those principles which are al-
ready known, and they cannot be rendered concrete and defi-
nitely fixed for each individual case, nor can they become at all
more distinct from the history of a single cure than they pre-
viously were when these principles were enunciated. Every
case of non-miasmatic disease is peculiar and special, and it is
the special in it that distinguishes it from every other case, that
pertains to it alone, but that cannot serve as a guide to the treat-
ment of other cases. Now if it is wished to describe a compli-
cated case of disease consisting of many symptoms, in such a
pragmatical manner that the reasons that influence us in the
choice of the remedy shall be clearly revealed, this demands de-
tails laborious at once for the recorder and for the reader.
In order, however, to comply with the desires of my friends
in this also, I may here detail two of the slightest cases of ho-
moeopathic treatment.
Sch — , a washerwoman, somewhat above 40 years old, had
been more than three weeks unable to pursue her avocations,
when she consulted me on the 1st September, 1815.
1. On any movement, especially at every step, and worst on
making a fklse step, she has a shoot in the scrobiculus cordis,
that comes, as she avers, every time from the left side.
2. When she lies she feels quite well, then she has no pain
anywhere, neither in the side nor in the scrobiculus.
S. She cannot sleep after three o'clock in the morning.
4. She relishes her food, but when she has ate a little she feels
sick.
5. Then the water collects in her mouth and runs out of it,
like the water-brash.
6. She has frequently empty eructations after every meal.
7. Her temper is passionate, disposed to anger. — ^Whenever
the pain is severe she is covered with perspiration. — The cata-
menia were quite regular a fortnight since.
In other respects her health is good.
Now, as regards Symptom 1^ beBadonnOj chiruiy and rhv$ tooci-
49
770 CASKS ILLUSTBAHTX OT
eodendrtm cause sHootmgs in the scrobicnliifl, but none of them
<mZy on motion^ as is the case here. Pulsatilla (see Sjmp. 387)
oertainly causes shootings in the scrobiculus on TnaVing a BeJse
step, but only as a rare alternating action, and has neither the
same digestive derangements as occur here at 4 compared with
6 and 6, nor the same state of the disposition.
Bryonia alone has among its chief alternating actions, as die
whole list of its symptoms demonstrates, pains from nwvemefU
and especially shooting pains, as also stitches beneath the slemum
(in the scrobiculus) on raising the arm (448), and on making a
fidse step it occasions shooting in other parts (520, 574).
The negative symptom 2 met with here answers espedaUy to
hryonia (558?); few medicines (with the exception, perhaps, ci
ntix vomica and rhus toxicodendron in their alternating acticHi —
neither of which, however, are suitable for the other symptoms)
shew a complete relief to pains during rest and when lying;
bryonta does, however, in an especial manner (558, and many
other bryonia-symptoms).
Symptom 3 is met with in several medicines, and also in
bryonia (694).
Symptom 4 is certaiQly, as fiu* as r^ards '' sickness after eat-
ing," met with in several other medicines {ignatia, nux vomica,
mercurius^ ferrum^ belladonna^ Pulsatilla, caniharis), but neither so
constantly and usually, nor with relish for food, as in bryoi\ia
(279).
As regards Symptom 5 several medicines certainly cause a
flow of saliva like water-brash, just as well as bryonia (282) ; the
others, however, do not produce the remaining symptoms in a
very similar manner. Hence bryonia is to be preferred to them
in this point.
Empty eructation (of wind only) after eating (Symptom 6) is
found iu few medicines, and in none so constantly, so usually,
and to such a great degree, as in bryonia i^bb, 239).
To 7. — One of the chief symptoms in diseases (see Organon
of Medicine, % 213) is the " state of the disposition," and as bry-
onia (778) causes this symptom also in an exactly similar man-
ner— bryonia is for all these reasons to be preferred in this case
to all other medicines as the homoeopathic remedy.
Now, as this woman was very robust, and the force of the dis-
ease must accordingly have been very considerable, to prevent
her by its pain firom doing any work, and as her vital forces, as
has been observed, were not consensually affected, I gave her
one of the strongest homosopathic doses, a full drop of the pure
HOXCBOPATHIC PRACnCK. 771
jttioeof bryonia root^* to be taken immediately, and bade her
come to me again in 48 hours. I told my firiend E., who was
present, that within that time the woman would be quite cured,
but he, being but half a convert to homoeopathy, expressed his
doubts about it Two days afterwards he came again to ascer^
tain the result, but the woman did not return then, and, in fact,
never came back again. I could only allay the impatience of my
fiiend by telling him her name and that of the village where
she lived, about three miles off, and advising him to seek her
out and ascertain for himself how she was. This he did, and
her answer was : " What was the use of my going back? The
very next day I was quite well, and could again commence my
washing, and the day following I was as well as I am still. I
am extremely obliged to the doctor, but the like of us have no
time to leave off our work ; and for three weeks previously my
illness prevented me earning anything."
W — e, a weakly, pale man of 42 years, who was constantly
kept by his business at his desk, came to me on the 27th De-
cember, 1816, having been already ill five days.
1. The first evening he became, without manifest cause, sick
and giddy, with much eructation.
2. The following night (about 2 a. m.) sour vomiting.
8. The subsequent nights severe eructation.
4. To-day also sick eructation of fetid and sourish taste.
6. He felt as if the food lay crude and undigested in his,
stomach.
6. In his head he felt vacant, hollow and confused, and as if
sensitive therein.
7. The least noise was painful to him.
8. He is of a mild, soft, patient disposition.
Here I may observe : —
To 1. That several medicines cause vertigo with nausea, as^
well as Pulsatilla (3), which produces its vertigo in the evening also
(7), a circumstance that has been observed fix)m very few others..
To 2. Stramonium and nux vomica cause vomiting of sour and
sour-smelling mucus, but, as fisir as is known, not at night
Valerian and cocculus cause vomiting at night, but not of sour
stuff. Iron alone causes vomiting at night (61, 62), and can
' AccordiDg to the most recent deyeloptnent of our new system the ingestioD of a
single, minutest globule, moistened with the dedllionth (x) potential deyelopment
would haye been quite adequate to effect an equally rapid and complete reooyery •
indeed, equally certain would haye been the mere oUactioo of a globule the aiie of a
mustard seed moistened with the same dynamization, so that the drop of pure juiot
gtyen by me m the abore case toa robust person, should not be imitated.
772 CASKS ILl^ySTBATIYK, &C.
also cause sour vomiting (66), but not the other symptoms
observed here.
Pulsatilla^ however, causes not only sour vomiting in the eve-
ning (349, 356) and nocturnal vomiting in genjeral, but also the
other s3^mptoms of this case not found among those of iroiu
To 3. Nocturnal eructations is peculiar io jpulsatiUa (296, 297).
To 4. Feted, putrid (249) and sour eructations (301, 302) aj-e
peculiar to pulsatiUa,
To 5. The sensation of indigestion of the food in the stomach
is produced by few medicines, and by none in such a perfect and
striking manner as hj puUatiUa (321, 322, 827).
To 6. With the exception of ignatia (2) which, however, can-
not produce the other ailments, the same state is only produced
hy puhatllla (39 compared with 40, 81).
To 7. Pulsatilla produces the same state (995), and it also
causes over-sensitiveness of other organs of the senses, for ex-
ample, of the sight (107). And although intolerance of noise is
also met with in nux vomi4:a^ ignatia, and aconite, yet these me-
dicines are not homoeopathic to the other symptoms and still
less do they possess symptom 8, the mild character of the dis-
position, which, as stated in the preface to pubaiillaj is particu-
larly indicative of this plant.
This patient, therefore, could not be cured by anything in a
more easy, certain and permanent manner than by pubatilla,
which was accordingly given to him immediately, but on account
of his weakly and delicate state only in a ver^^ minute dose, i c,
half-a-drop of the quadrillionth of a strong drop of pulsatilla.*
This was done in the evening.
The next day he was free from all ailments, his digestion wa*^
restored, and a week thereafter, as I was told by him, he
remained free from complaint and quite well.
The investigation in such a slight case of diseas^e, and the
choice of the homa'opathic remedj' lor it, is very speedily eflected
by the practitioner who has had only a little experience in it,
and who either has the s^-mptoms of the medicine in his memory,
or who knows where to lind them readily ; but to give in writiug
all the roiisons y/ro and con (which would be perceived by the
mind in a few seconds) gives rise, as we see, to tedious prolixity.
For the convenience of treatment, we require merely to indi-
* According to our present kiK»wleii^^ and c xjxTit nc\ the ^anie oljeot would have
U'tfU attained by takuig <«e of tbe smallest jrli.bulos «if pul^atiUa x (decillicaith
p.»u,*iK\v and with equal ceruunty a pinglc ol&cti'ii of a g%.»bulo the sire of a mustard
6eod cf the mme potency of pulaatilli.
TWO CASES PROM HAHNEMAKN'S NOTE BOOK. 773
cate for each symptom all the medicines which can produce the
same symptoms by a few letters {e. g,, Ferr., Chin., Rheum, Puis.),
' and also to bear in mind the circumstances under which they
occur, that have a determining influence on our choice and iii
the same way with all the other symptoms, by what medicine
each is excited, and from the list so prepared we shall be able
to perceive which of the medicines homoeopathically covers the
most of the symptoms present, especially the most peculiar and
characteristic ones, — and this is the remedy sought for.
TWO GASES FROM HAHNEMANN'S NOTE BOOK.^
Case I.
Julie M. a country girl ; 14 years old ; not yet menstruated.
12th September, 1842. A month previously she had slept in
the sun. Four days after this sleeping in the sun, the frightful
idea took possession of her that she saw a wolf, and six days
thereafter she felt as if she had received a great blow on the
head. She now spoke irrationally ; became as if mad ; wept
much ; had sometimes difficulty in breathing ; spat white mucus ;
could not tell any of her sensations.
She got Belladonnaj^ weakened dynamization, in seven table-
spoonfuls of water ; of this, after it was shaken, a tablespoonful
in a glass of water, and after stirring this, one teaspoonful to be
taken in the morning.
16th. — Somewhat quieter ; she can blow her nose, which she
was unable to do during her madness ; she still talks as much
nonsense, but docs not make so many grimaces while talking.
She wept much last night. Good motion. Tolerable sleep.
She is still very restless, but was more so before the Belladonna.
The white of the eye full of red vessels. She seems to have a
pain in the nape of the neck.
From the glass in which one tablespoonful was stirred, one
teaspoonful is to be taken and stirred in a second glassful of
water, and of this from two to four teaspoonfuls (increasing the
dose daily by one teaspoonful) are to be taken in the morning.
20th. — Much better ; speaks more rationally ; works a little ;
recognises and names me ; and wishes to kiss a lady present
She now begins to shew her amorous propensities ; is easily put
' Communicated by letter, dated 24th April, 1S43, to Dr. Von Bdoninghausen, and
published in the Neues Archivj Vol. i. 1844.
* [Dr. R tells w that whenever the dilutioii is mi iodieated, it is imdentood thai
the 60th dilution was administered.]
774 TWO cim vbok
mapMrion, and takes tfaingi in bad pari; aleepa weD;
▼erj often; beoomes angrjaboot a trifle; eats more than naoal;
wben die comes to her senses she fikea to play, but only jnst as
a little child would.
BeOadannOj ag^oboleof ahig^ier potencjr: seren tabie^XMin-
Ibis shaken in two passes, 6 teaspoonfidsfiom theseeond^aas
eailj in the morning.'
28tL— On the 22d, 23d and 24, very much excited daj and
ni^ ; great lasdTioasnesB in her acticms and wovds ; she polls
np her dothes and seeks to tonch the genitals of ochen ; she
leadil J gets into a rage and beats every one.
HyoKyamuB X% seven tableqKxynfblSy hc^ one table^xwofid
in one tnmblerfhl of water ; in the morning a teaqxxmfoL
5th October. Forfiyedaysshe would eat nothing; complains
of belly*ache; for the last few days leas malicious and leas las-
drions; stools rather loose; itching all over the body, especial-
ly on her genitals ; deep, good.
Sacch. Lactis for seven days, in seven tableqxwnfiils, Ac
10th. — On the 7th, fit of excessive anger; she aoo^t to strike
every one. The next day, the 8th, attack of fiight and fear, d-
most like the commencement of her illness (fear of an imagina-
ry wolf;) fear lest she should be burnt Since then she has be-
come quiet, and talks rationally and nothing indecent for the
last two days.
Scuxh, Lcuctis, kc.
14th. — Quite good and sensible.
18th. — The same, but severe headache ; inclination to deep
by day : not so cheerful.
New sulphur (new dynamization of the smallest material por-
tion) one globule in three tumblers ; in the morning one tea-
q)oonful.
22d. — Very well ; very little headache.
Sulphur^ the next dynamization in two tumblers.
She went on with the sulphur occasionally imtil November,
at which time she was and still remains a healthy, rationd,
amiable girL
Case IL
O — ^t, an actor, 33 years old, married. 14th January, 1843.
For several years he had been frequently subject to sore throat,
* [The meaninfl^ of tbew directioiif>, which ki not verr ohTioQ^ wems to be that the
globule shall be dif^olreJ id fieven tablespoonfuU of water, and of this a tablespauo
lol is to be stirred iu a Mxxad tiiniiJw of water, aud ir «au iIms secund glaaa a t«a-
^KXNifiil is to be giTen fur ax suoces^ve moniiiig&J
HAHNXXAim'S KOn BOOK. 775
as also now for a montH past. The previous sore throat had
lasted six weeks. On swallowing his saliva, a pricking sensa-
tion ; feeling of contraction and excoriation.
When he has not the sore throat he suffers from a pressure in
the anus, with violent excoriative pains ; the anus is then in*
flamed, swollen and constricted ; it is only with a great effort
that he can then pass his &ces, when the swollen hemorrhoidal
vessels protude.
On the 15th January, he took, in the morning before break-
fsist a teaspoonful of a solution of one globule of belladonna X^
then the lowest dynamization, dissolved in seven tablespoonfuls
of water, of which a tablespoonM was well stirred up in a tum-
blerful of water.
15th. — ^In the evening aggravation of the sore throat
16th. — Sore throat gone, but the affection of the anus returned
as above described ; an open fissure with excoriative pain, in-
flammation, swelling, throbbing pain and constriction ; — also in
the evening a painful motion.
He confessed having had a chancre eight years previously,
which had been, as usual, destroyed by caustics, after which all
the above affections had appeared.
18th. — Merc, viv, one globule of the lowest new djmamization
I, (which contains a vastiy smaller amount of matter than the
usual kind), prepared in the same manner, and to be taken in
the same way as the belladonna (the bottle being shaken each
time), one spoonful in a tumberful of water well stirred.
2()th. — Almost no sore throat Anus better, but he still feels
there excoriation pain after a motion ; he has however no more
throbbing, no more swelling of the anus, and no inflammation ;
anus less contracted.
One globule of mere. viv. (^\q) the second dynamization of the
same kind ; prepared in the same way, and taken in the morning.
25th. — Throat almost quite well ; but in the anus, raw pain
and severe shootings; great pain in the anus aft^r a motion ; still
some contraction of it and heat
SOth. — In the aft;emoon, the last dose (one teaspoonful)* On
the 28th the anus was better; sore throat returned; pretty se-
vere excoriation pain in the throat.
On globule in milk-sugar for seven days ; prepared and taken
in the same manner.
7th February. — Severe ulcerative pain in the threat. Belly-
ache, but good stools ; several in succession, with great thirst
In the anus all is right
776 TWO CAS88 FBOH HAHHEHAKN'S HOTE BOOK.
Hulphur \ in seven tablespoonftils, as above.
18th. — Had ulcerative pain in the throat, especially on swal-
lowing his saliva, of which he has now a large quantity, espe-
cially copious on the 11th and 12th. Severe contraction of the
anus, especially since yesterday.
He now smelt here merc,^ and got to take as before tmtc. v, 'j^,
one globule in seven tablespoonfuls of water, and half a spoonftil
of brandy.
20th.— Throat better since the 18th ; he has suffered much
with the anus ; the motion causes pain when it is passing ; less
thirst
Milk-sugar in seven tablespoonfuls.
3d March. — ^No more sore throat On going to stool a blood-
less hsemorrhoidal knot comes down (formerly this was accom-
panied with burning and raw pain), now with merely itching on
the spot.
To smell acid, nitri. and then to have milk-sugar in seve
Almost no more pain after a motion ; yesterday some blood
along with the motion (an old symptom). Throat well ; only a
little sensitive when drinking cold water.
Olfaction of ocic?. nitri, (olfaction is performed by opening
small bottle containing an ounce of alcohol or brandy where
one globule is dissolved, and smelt for an instant or two.
He remained permanently cured.*
* [The following account of an illness with wbich Hahnemann was attacked, which
he gives in a letter to the same correspondent, dated 28th April, 1833, will be read
with interest
"Although I kept myself very calm, yet the annoyance I received from ♦ ♦ ♦ ♦ ♦
may have contributed to bring upon me the suffocative catarrh, that for seven dajn
before and 14 days after the 10th of April [Hahnenuiun*s birthday], threatened to
choke me, with instantaneous attacks of intolerable itching in the glottis, that would
have caused spasmodic cough, had it not deprived mo of breath altogether ; irritation
of the fauces with the finger, so as to cause sickness, was the only thing that restored
the breathing, and that but slowly ; there were besides other severe symptoms — ^very
great shortness of breath (without constriction of the chest), total loss of ap|)etite for
food and drink, disgust at tobacco, bruised feeling and weariness of all the limbs,
constant drowsiness, inability to do the least work, presentiment of death, Ac The
whole, neighbourhood proved their great affection for me by sending so frequently to
inquire how I was, that I felt quite ashamed. It is only within these four days that
I have felt myself out of danger ; I obtained relief by two olfactions, of ci^. er. X**
first, and then of calc; amhra too was of use. And so the Great Protector of all
that \f> true and g<.K)d will grant me as much more life upon this earth as seemcth good
to hid wisdoiiL ]
GENERAL INDEX.
Abscess of periniBinB, S2 ; of labi% S6 ;
of antrum, 148
Absorption of goDorrboMl matter, 18.
Aocideotal discoyeries of medidnal pow-
en,687.
AeonitCy pathogenetic effects oi, 291 ; the-
rapeutic uses o^ 291 ; in purpura mi-
liiuis, 482, 693.
Aoticms of medNmefl, jninuuy and ae-
ooodarj, 266.
Acute diseases^ terminate in recovery or
death, 411 ; allopathic treatment o(
T88.
Adulteratiaas of drugs, 484^
iEfiouLAPius in the baUnca, 410.
AetctUu8 in asthma, 297.
^a^AwM,pathogenetic effects o( 271; in
imbecility, 271.
Jff^ariciu, pathogenetic and tiierapeutic
ft&cts o(, 803.
Aggravations, medicinal, 473, 474.
Agues, remedies in, 260 ; different kinds
0^628.
Air, things that spoil the, 176.
Allopathy, on, 736; derivation of the.
word, 742.
Alterative treatment of syphilis, 112.
Ammonia^ in gooorrhosa, 23 ; in syphilis,
12a
Anatomical school, the, 422.
Anatomy, uses o^ to medicine 428.
Atumane^ pathogenetic and therapeutic
effects o( 293.
Animal fnagnetUm, therapeutic uses o(
464.
Animal requirements, on the satisfaction
of our, 227.
Animals, dead bodies o^ should be buried,
226 ; 6i^>eriments on, value to thera-
peutics, 265, 721.
Anticyra, celebrated for its white helle-
bore, 584 ; and for its black, 613 ; some-
times implied hellebore^ 596.
Antidote for poison, there is no universal,
828.
Antidotes to some drugs, 322
ApothecariuH, attack on Hahnemann by
the, 696; privileges of the, 698, 710.
Apothecary system, origin of the, 429.
Arnica, in giddhiess, 268 ; pathogenetic
effects of; 268 ; in dysentery, 269 ; dose
of, for children, 269 ; in glandular swel-
lings, 269; vinegar the antidote to,
826 ; case of poisoning by, 826 ; in coo-
tmued fever, 880; bad efiects o( in a
febrile influenza, 889.
AneniCf pathogenetk effiscts ct, 288 ; the-
rapeutio uses of, 288 ; in hych^pbobia,
289 ; in a febrile disease, 6 64k
Asthma, case of spasmodic, 817.
Attenuaticm of medicine, on the ettreme,
768; Korsakoff's ideas respecting,
763 ; disapproval of excessive, 764,
Attenuations used by HAHKEXAxii at dif-
ferent periods, 765.
Balaanu in gonorrhcsa, 26.
Barik, in syphilis, 118 ; production of ague
by, 267, 616 ; enormous consumption
o^ 846, 478, 486, 519.
Batha in gonorriiGea, 28.
Bed-sores, prevention ot 207w
BeUodonHa, in hydrophobia, 161, 278 ;
pathogenetic effects o^ 278 ; therapeu-
tic uses o^ 278 ; duration of action o^
276 ; history of the discovery of its
prophylactic power in scarlet-fever,
878 ; dose ot, in scarle^fever, 879 ;
preparations of; 880 ; dose of; as a pro-
phyhictic, 881 ; action of; increased fay
adds, 382 ; probably prophylactio of
measles, 882; in the first stages of
scarlet-fever, 888 ; oontra-indicatiolB
for its use, 884 ; on the power of small
doses of; 886: in scarlet-fsver, 488,
698.
Bklloste's pills, 114*
Bite of mad dogs, 1 68.
Bitters, observations on, 671.
Black's mercurial preparation, 3, 118.
Bleeding, in syphilis, 126 ; bad efiecta oC
687.
Botanical affinities of plants no guide to
their therapeutic action, 257.
Bougies, in stricture, 49 ; elastic, 49 ; best
shape o^ 60 ; bom, 62 ; medicated, 62.
Brandy in lying-in women, 176.
Brown's Elements of Medicine, obBwa>
tiiQDS on, 860, 646.
T78
OSHXBAL INDEX.
•S2 ; fjiiiptooM it ii iDdkated lor, MS ;
B the tji^oid ferer, fdloving dieted
766.
Biiboei»76; non-Teoereal, 80; ordmuy
UmtmoA oC 80; treatmeoi ci, 84 ;
opening oC 86 ; in infimta, 146.
Boriftb in cfamtlieB, erib ol^ S82.
Bnnia, treatmoit oC 460, 466, 648, 626,
626, 6U ; Dunx oo, 666 ; bud effBcto
of eoU water in, 666; koi tpiriU and
turpentine in, 686 ; Bbuaxdi Bbll oo,
666, 642; Bmbib on, 686; KxmBH
00,640^642; 8ti«hhamoo,642; A«-
1IB80H on, 648.
Bntdiei's AapB, on the cuurtmclion o^
226.
Obbinet-makefB, defonnttj o^ 18L
CtOomel m typtaH^ 110.
Cmmphar, m MOiraiiQn, 128; pnthoge-
netic effects oi, 296 ; thenpeotie nsea
oC 296; the antidote to opium, 828 ;
caeeofpniwniiy by, 828 ; the antidote
to eantharis and 9quiU, 824 ; the anti-
dote to coeeulut, 826 : the antidote to
megereum, 829 ; in febrile infhimia,
886; in the firtt stage of cbolera, 768;
fomigatioDS in cholera, 764 ; prophy-
lactic and curatiye of dK>lera, 762.
CakolatioDs of the quantity of medicine,
in bomoBopathic doses, 728.
Candles, danger of many lighted, 177.
Candidate for the degree of II D., to a,
662.
Oemnabie, pathogenetic effects o( 298.
CantharU in gleet, 42.
Caries, Tenereal, 188.
Oises of chancre in a woman, 70 ; of sy-
philitic phthisis, 96 ; of syphilis, 186 ;
of mercurial disease, 149 ; of oolico-
dynia, 804 ; of spasmodic asthma, 817 ;
of continued fever, 380 ; of remittent
ieyer, 381 ; of febrile influenza, 882;
of periodical and hebdomadal diseases,
841 ; of hebdomadal hematuria, 842 ;
of paralysiB cured by cold, 368, 462 ;
of scarlet-feyer that led to the disco-
yery of prophylactic, 876 ; of scarlet-
feyer, 881 ; illustrative of homcsopathic
practice, 760 ; of gastrodynia cured by
brtfimia, 770 ; of gastric derangement
cured hj puUatilloy 771 ; of nympho-
mania cored by belladonna and kyoe-
cfumui, 778 ; of venereal sore throat
md aHorein aDoa curau, lyy
wmlpkmr and nitrie meid, 774 ; ofaofib-
calive catMih cored faj eojfim, eal-
tarea and aai6ra^ 776.
Caaea, node of taking down, 448.
Oatanh, caae of saflbcatiye^ 776.
Ganse, treatment Of the, 682.
OHMfietin atrietore, 68.
Gotainty in medical ptaetiee, 807.
Cesspools, oGoatmctioD of , 220 ;
oi;22a
OaBc iriiy eateo by pregnant
186.
OAaMoaitila, pathogcnetie efleeta oC 267;
in the after-eaffermga of acaikt-fevcr,
886; in toofthacfae, 667.
Chaiicra,66 ; evil of baraii^ 01^69,647:
in the female, 68, 70; felse, 71
Charooal fires^ miwholeoomenesa oC 179,
Chemistiy, valoe oC to thetrnpeatiei^ 249,
424, 648, 678.
Ckm'r}f4mtrd water, pathogenetic eftcti
of; 298; therapeutic one of; 294.
ChlorosiB combined witii syphOia, 126.
Cholera, Asiatic, core and preyention oC
768 ; eompAor in the first stage o^ 768 ;
etqmtm m the second stage ct, 766 ;
verairum album in, 765 ; ce^jeput oil,
in, 766 ; copper plaiee in, 755 ; bryonia
and rhut for the consecutive fever ci,
766 ; preventives for, 755 ; success of
honuEopatfaic treatment of; 756 ; mode
of propagation o^ 756 ; proofii of its
contagiousness, 757 ; miasm, probably
consisting of animated beings, 757 ;
mode of becoming habituated to^ 759 ;
camphor, prophylactic and curative ci,
761 ; chlorine not destructive to, 762.
Chordee, 14 ; dironic, 87.
Chronic diseases, insufficiency of the old
system in, 414 ; the test of a system
of medicine, 625; allopathic treat-
ment o^ 741.
Cieuta, pathogenetic effects of, 271.
Cinchona,m a hebdomadal discaae, 841 ;
enormous consumption of; 845, 478,
485, 519; external employment o^
467; on a proposed substitute for,
476 ; habitat of; 479.
dtrie acid the antidote to ttramonium,
827.
Climate, 815.
Clinical experience as a meanf< of ascer-
I taining the powers of drugs, 679, 687.
osNSRAL nmix.
779
OocetUtu, pathogenetic eflEbete of 271 ; in
malignant typhus, 271 ; camphor the
antidote to, 825 ; case of pownning
bj, 826.
OooxBuaN on the seat of gonorrhooa, 11.
Coddling, bad effects oi^ 191.
Cofft€^ cure of uterine hemorrhage by,
186; injurious e£kcts of, on children,
282, 406 ; pathogenetic effects of, 271 ;
therapeutic uses oj^ 271; antidote to
opium, 272 ; bad effects of, in nervous
patients, 810 ; increases the action of
camphor t 824 ; the antidote to vera
trrnn, 827; on the effects oi^ 891;
purely a medicinal substance, 892;
primary action ol^ 898; headache
caused by, 896, 408 ; bad effects o^
899 ; secondary action o^ 401 ; re-
moval of bad effects ot, 406 ; medi-
cinal uses o^ 407 ; palliative action o(
408 ; in purpura miliaris, 696.
Cold and heat, medicinal action oi^ 468.
Colioodynia, case o( 306.
Condylomata, venereal, 73.
Confectionery, unwholesomeneas of^ 288.
Oonium, pathogenetic effects o(, 270 ; in
indurated glands, 270 ; in cancer, 270 ;
Contrast of the old and new systems,
712.
Corpse-washers, use ci, 222.
Commve wMimate, in syphilis, 108 ; in
dysentery, 698.
Cow-pox, course o^ 647.
OrocttSy pathogenetic and therapeutic
action of, 298.
Croup, Immt sponge in, 698.
Curative mode of treatment, the, 468,
618.
Cure, requisites to effect a, 448.
Cures, on wonderful, 417.
Dead, inspection of the, 222.
Debility, on direct and indirect, 869.
Diet, in gonorrhoBa, 21 ; during mercurial
treatment, 182 ; conversation with my
brother on, 182; and regimen, 808,
476 ; prevailing errors respecting, 810 ;
bad effects of a too rigid, 810 ; Hif-
Poc&ATES on, 814.
Dietetic regulations cannot be too sim-
ple, 314.
Dietetics, absurdities of modem, 182.
Digitalis, pathogenetic effects ol, 279;
therapeutic uses o( 280 ; long lasting
action o( 280.
Dihients in gODonhcBa, 22.
Disease, good moral effects of, 182 ; in-
creased susceptibility to the action ol
medicines in, 464 ; definition ol. 720.
Diseases, slight, do not require medidae,
471 ; with lew symptoms, treatment
of; 471.
Dispensatories, origin oi^ 429.
Dispensing by physicians, enactments
against, 480.
Dispensmg medicines, on, 696; what
constitutes, 697, 708.
Dissecting rooms, pracautions respecting,
228.
Ditches, dangers attending the diyiiig
up o^ 218.
Doses, minuteness of the homcBopathic,
699; to be used in all cases of disease,
764 ; disapproval of excessive atten-
uation of the, 766; to be used in
proving drugs, 768.
Drotera, in catarrh and cough, 294'; in
hooping cough, 698 ; mcrease of power
oi^ by excessive suocussion, 788.
Dry gonorrhoea, 18, 80.
Jhd&xmara, in syphilis, 1 18 ; pathogene-
tic effects o^ 272 ; therapeutic uses
oi; 272.
Dynamic action of medicines, 466.
Dysentery, commve tublimOU in, 698.
DzoNDi, Professor, on bums, 636.
EUctrieUy, medicinal effects of; 468.
Empyema cured by a sword thrust, 18L
Enantiopathic system, 261, 624.
Epidemics, protection from infection by,
166 ; prevention o^ 212.
Erysipelas combined with syphilis, 126.
EuLxa's proficiency in mathematics pro-
moted by his blindness, 182.
Examinations for the doctor's degree,
nature of the, 742.
Exciting causes of disease, 440.
Experience} the medicine of, 486.
Experiments on the human body with
drugs, 268.
External appearance of plants, value of
to therapeutics, 264.
Famine a source of pestOenoe, 224.
Favourite remedies, 581.
Fever, mercurial, 62, 188, 666 ; phuM
for eradicating a, 208; on the treat-
ment of a, 666, 631.
Fevers, on continued and remitteDt» 829.
780
aiBKBBAL mVESu
FieldJiospitda, on llie ^xnfltraBtkn o(
•Fig-wartai 78.
ffuh-markets, on tho C(n8tnietiono( 226.
Ilowen m a room, evils o( 176.
Food neoeflsaij toman, on Uie, 89L
Foreign drugs, scarcity of^ 484 ; on sub-
stitntes for, 506.
FBEDxaiGK HAHMSMAirN, Dotioe df 286.
Friction, effects of, on steel, 780.
FUctioos, mercurial, 106.
Friend of health, the, 156.
Frost-bite, treatment oi, 468.
Fruit, danger of exhalations from, 177.
FomigationB, mercorial, 106; uaeleas-
nees o^ 178.
Galen's Bystem, 421, 692.
^kmtboge, carbonate of potash the anti-
dote o^ 826.
Gangrene of prepuce, 67.
Gastric derangement cured hypvUatilla,
•771.
Gastrodjnia cured by 6ryofMa, 770k
General remedies, 525, 664.
Oeum in intermittent, 298.
GiETANNBR oo Venereal disease, 6 et teq.
Glands, effects of pressure on enlarged,
175.
Gleets 89.
Globules, on the medication of^ 736 ; va-
rious sises used by Hahnkhann, 786.
Oold, in suicidal mania, 695, 7tS2; pow-
ers developed in, by trituration, 782 ;
doses of, employed by Hahnemann,
782.
GoDorrhcea, in the male, 11 ; in tiie male,
treatrr ent o^ 20 ; a local disease, 23 ;
in the female, S3 ; in the female treat-
ment o^ 86 ; secondary, in the male,
89 ; secondary, in the female, 44w
Good in hurtful things, 180i
Gourmand, picture oi a, 228.
Gout combined with syphilis, 126.
Grave, fatal results from opening a, 222.
Gttaiae in syphilis, 117.
Hahnemann's discoveries, reception they
met with from the profession, 866.
Hahnemann's son, notice of, 235.
Hallee, his services to medicine, 423 ;
on veratrum, 576.
Hardening the bxly, on, 191.
Health, things capable of deranging the,
441.
Heat and cold, medicinal action o( 468.
IfdUbcre, bUnk, dato^oD of, 611 ; onr
hdUhomu nigtr, 618 ; medicmal effects
o( 615 ; seeds o( 616,
Hellebore^ white^ our verairvm albtan,
676; symptoms produced by, 661;
habitat of, 684; best kind k, 564;
best season for collecting, 686 ; medi-
cinal uses of^ 686 ; mode of admhiis-
tration of, 689, 690 ; sabetanees mixed
with, 602; doseof;600.
Helleborism of the andeots, 417 ; diMer-
tatioQ OQ the, 669; when it waa prac-
ticed, 691 ; ancient aathors on, 691 ;
seasons for practising, 596 ; diseases
contra-indici^ing it^696; diseases for
wfaieh it was indicated, 696 ; prepara-
tory treatment for, 698.
Hellebonu niger^ pathogenetic effects of,
292; therapeutic Oses of, 292.
Hematnria, case of hebdomadal, 848»
Hemlotk in syphilis, 120.
He par ndphurU, for the bad effeds of
mercury, 162 ; in itch, 449 ; in cronp,
698.
HippooaATSS, dietetios of 814; tfanple
practice o^ 821, 420; homcBopatfaic
principle enundatod by 460.
Hoffmann's theory of disease, 636.
Homoeopathic doctrine, spirit of the, 617.
Homoeopathic principle, ancient bints
respecting the, 460.
Homceoputhic system, first enunciation
of the, 265 ; explanation of the, 626.
Homoeopathy, Hahnemann's account of
his discovery of^ 512; derivation of
the word, 659 ; and homopathy, diffar-
ence between, 659 ; mode of disprov-
ing, if false, 660 ; discovery of speci-
fics by, 692 ; how it may be eradi-
cated, 706.
Hooping-cough, drosera in, 698.
Hospital, on the construction of a fever,
205 ; fever, treatment of; 631.
HuFELAND, his Opinion of Hahnemann,
850; letter to, 511; an opponent to
simplicity in medicine, 686.
Humidity, bad effects of, on children,
230.
Humoral pathology, 587.
Hunter 8 experiments with gonorrfaopa,
20 ; mode of treating stricture, 52, 63.
Hurtful things, good in, 180.
Hydrocyanic acid, pathogenetic efiects
of, 298.
OBNXBAL INDKX.
781
Hydrophobic tympUnm o( 168; BO0-
trums for, 169, 389; beUathnna in,
161, 278; hyoacjfomui in, 161; caaea
o^ 161 ; chronic, 162 ; pioportioii of
bitten persons affected bj, 162, 890;
arsenic in, 289 ; not preyented by ex-
cising the bitten part, 648.
HyQ9cyamu8^ in h7dr(^)bobiA, 161 ; pa-
thogenetio e£Eect8 o^ 276 ; therapeatie
iiaes o( 276; duration of action oi^
276; in toothache, 668; in ^phua»
684.
IgnaHa^ pathogenetic effects o^ 27.9;
therapeutic uses (d^ 279 ; viMgotr the
antidote to, 827 ; caae of poiaoning
by, 827 ; in continued fever, 880.
Infimts, syphilis in, 144.
Infection, protection against, 167.
Influenza, an epidemic of febrile, 882b
Injections, in gonorrhcaa, 21, 26, 86 ; in
gleet, 43
Inoculation of gonorrbooal matter; 21.
Inaane, on the treatment of the, 248.
Insanity, action of tobacco in, 277.
Instinct of the atomach in 'n^lfn'Wft, 887.
Inundations, treatment of^ 218.
Ipecacuanha^ therapeutic uaeao^ 281;
in scarlet fever, 876 ; external use oC
467.
Irritations, incompatibility of two simi-
lar, 447«
Itch, venereal, 92; treatment o( 449;
infection by, 649.
Joiners, deformity o^ 181.
ILkmpf's clysters, 689, 668.
Kkyskk's drag^ in syphilia, 114.
Kitchen materia medica, 666.
Klock£mbring, insanity ot, 248 ; cunoya
preacriptioQ fer hia ovn malady by,
246.
Korsakoff, his tubes fer globule^ 786 ;
his mode of saturatix^ globules^ 786 ;
his ideas Tespecting the transmissioD
of medicinal pover. 708.
KoTZEBUB, satire o( against KuHnoDf-
BUNo, 248 ; pretended Goie o( 661.
Lanes, evils o^ 226.
Lead^ pathogenetic effects o( 287.
Lb Daean^s bougies, 62.
Ledutn^ in syphilis, 118; pathogenetic
effects oi^ 282; therapeutic uses o(
282; doseo^ 288; in a febrile influe-
ensa,841.
Liberality, oa profwaiona], 862.
Liberthusm, fi^y o( 329.
Lifrhtaing, cure of paralysis by, 18L
LimMoater in gononrboBa, 21, 86.
Lijuurdi insdrrfaous taatide, 89; iB.8f<»
phUi8,12a
Lobeliain syphilis, 118.
Xo/tum temuUntunif pathogenetic effaote
o( 299 ; therapeutic uses of; 299.
Lues venerea, 88.
Lunar causiie in stricture, 62.
LuTHxa, comparison of Habnxkavn wklv
621.
Lying in state, evils o1^ 222.
Magnet, norik pole of the^ in toothachab
«6a
Man, on the reason of; 486.
Manufectoriea, regulations for, 226.
Marshes, on the drying up oC 217.
Masked syphilis, 90.
Materia medica, aouBces of the commoOt
426, 601, 664.
Medical observer, qualification fer a, 724.
Medicinal agents absolute in their power,
627.
Medicinal diseases, production o( 747;
incurability of some, 749.
Medicinal substances used as food, 891.
Medicine of experience, 436.
Medicine, on the necessity of aregenenb-
tion, 611.
Medicines, on the administration of; 819 ;
primary and secondary actions o( 898;
sources of their ascribed virtues, 426^
601, 664 ; not unconditionally whdba-
some, 407, 461 ; on the pathogenetie
effects o^ 461 ; mode of aacertaining
their powers, 462, 721 ; thdr curative
powers, on what dependent I 621;th9
homoBopathic practitioner has a tiijaX
to administer bis own, 704
MaLAMTOs, empbymant of wfuirum bj,
67L
Mklanctbok, Hutbland compared wifti
621.
Mercurial fever, 62, 188, 666.
Merewrkd oifUment, 102; uncertainly
o( 108 ; on the rubbing in of, 467.
Mercurial preparationa^ 98.
Mercurial trc»tment^ on the cvdinaiy,
664.
Mercurioui §olubili8, preparation q( 9i
161 ; in syphilis, 181, 666, 668.
Mercury, to obtain pure, 4; effects of
tbo.aboM.o^ 189.; antidatfi to thaof
782
OXHSBAL INDSX.
fecto ci, 161 ; oompand with ijpht-
h^fS6; patbogenetie eflecteoi;287;
kk the Uad dJaeme, 288; conflicting
opiniooB respectiiig the actioQ (< 848;
best prepftimtiao o^ 888, 868.
ifemmtm, therapeutic uses << 484.
Methods of treatii^ diaeaae, 488, 62S.
Mezertttm^ in sjphilia, 118; eamfkmr
the antidote io^ 829 ; caae of poiaoD-
ing by, 829.
Milttary ferer, diflRerent from acaiiet-
ferer, 480; symptoms oC 480, 896 ;
treatment of; 896.
MUUf^liwn, in hemorrhage, 289.
IGzed method of treating syphilis, 118.
Moderatioo, advantages ci, 28a
MoMtare, bad cfieeto oC 178.
Horbific agents noi absolute in their
power. 827.
Hame, treatment of the, 622.
Kasal bones, venereal affections, oi;97.
Hbtore, healing power oi, 488.
Haftnre's processes of healing disease noi
worthy of imitation, 488.
Hervons debility^ on, 643.
KnOral ao/Zt, in gonorrfaoBa, 26.
Kight stools in a room, danger oC 178.
mtraU ofmercyrjf in syphilis, 118.
JfUre in gonorrhcBa, 26.
A^itre, tpiriU of, in typhus, 636.
Nodes, venereal, 187.
KoD-mercurial remedies Cor syphilis, 116.
Hon venereal gomonhflBa, 20.
Nostrums, for hydrophobia, 169. 889;
for toothache, 666.
Nota bene for the reviewers, 669.
Hursery, picture of an unhealthy, 230.
NtOmeg, pathogenetic eflfecto oi, 808;
therapeutic uses of, 303.
Nux wwnico, pathogenetic effects, oi; 278;
therapeutic usee of, 278; in a case of
spasmodic asthma, 318 ; in a febrile
disease, 664; in toothache, 667.
Nymphomania, case of; 761.
Obedieuce of patients, 308.
Old clothes, regulations Cor dealers in,
213.
Oleander, in palpitation, 282.
Onydkia, venereal, 92.
Ophthalmia, gonorrfwBal, 16, 32.
Ofivwi, pathogenetic effects of; 2?3;
palliative use of; 283 ; in mania, 288 ;
^ the mercurial disease, 286; the
fg^BAM to c— ifAor, 828; in remil-
I
I
tent feren, 882 ; in aariet-ferer, 874:
in sleepiness, 488.
Ordinary treatment, exposure of ^
827, 662, 884.
pALUks on AcXMorv, 676.
Pklliative mode of treatment, on the,
466,619,624.
Pklliativai^ disadvantages oC 287, 488;
when they are to be used, 468.
P^>er-mills,rqgnlationB lespecting, 218.
Panlysia, case oC cured bycold, 868,482.
Paimpfaymusis, 86.
PmriMt in cramps» 271.
PUhoiogy, uses d; to medicine, 498;
definition oi;7l8.
Periodical diseases^ cases oC 841.
PncmL's poetical talent jncremsd by
MindnesB, 182.
Pmup^s bougies^ 62.
Philosophy, old womenTs, 174^
Phimosis, 64 ; chronic, 70.
Fhthifls, venereal, 96.
Physical properties of planls» valne o< to
therapeutics, 264.
Physician on thecfaoieeof afinnily, 288;
qualifications of a good, 240.
Physicians, portraits of &ahionable, 288,
629.
Physiology, uses o( to medicine, 424.
Phtson and Sogeatu, dialogue between,
200.
Fkytalaeea, pathogenetic effects of, 298.
Pimples, venereal, 92.
PixirK's mucilaginous mercury, 114.
Pldtt on hellebore^ 676.
Post-mortem evaminatifsw^ what they
teach, 749.
Foioih in gonorrhoBa, 36.
Prefiice to the Thesaurus medicamimmi,
344.
Preputial gonorrhcea, 18.
Prescriptions, absurdity of complex, 320,
846,412, 426, 498, 624, 742; apolcjgy
for complex, 321, 426, 623, 686;
source of; 716.
Preservative operations of nature, 748.
Principle, on a new therapeutic, 249.
l^rinciples of medicines, supposed active,
716.
PrisoDB, arrangement of, 212.
Privies, clearing out o^ 220.
Prophylactic for scarlet fever, Jahi on.
366 ; McxLLxa on the, 367 ; histofr
of the discovery of the, 874.
aXKERAL IKDRZ.
788
FhMtrito gliiid,iiidi]ratioo ofthe^ 54
Ptotectioa agaioBt infeeCiaii, l&l,
Proring of medidiiefl, obligatorj oo all,
768; dilutioiis to be iwed in the, 768.
Plroiimftta Tenereal sjmptooii^ 90.
PnmtM padu§ in agae, 294.
Pftychiod hamoBopathy, 629. .
Ptyaliam from mercmial ointment, 104.
PuUatilla, in toothache, 667 ; in a case
of gastric derangement, 772.
Purgatives in goDorrfaoBa, 26 ; injnrioiiB
effects of; 189 ; on the treatment by,
688.
Purpura miliaris, symptoms o( 481, 696 »
aeanite in, 488, 698, 696 ; cofee in,
696; treatment oC 696.
Pmtula maligna, infection by, 649.
Rabies canina, 168.
Bag gatherers, regulations respecting,
212.
Bed preeipittUe in stricture, 62.
Refutation of Baowx's doctrines, 860.
Regimen and diet in disease, 476.
Regimen iar patients subject to helle-
borism, 605.
Repetition of the dose, on the, 472.
Reviewers, nota bene ibr my, 659.
Rhagades. venereal, 91.
jRhododendron, pathogenetic eflfocts o(
282 ; therapeutic uses of; 282.
Bkubarb in diarrhoea, 808.
Bhus radieans in erysipelas, 295.
Bkue toxicodendrcnit in typhus, 684 ; pre-
paration o^ 686 ; in the typhoid fever
following dudera, 755.
Rumford's mode of heating houses, 781.
SabadiUa, pathogenetic eflecta oi; 802.
Salivation, prevention ot, 127.
8ambueu8j patliog^etic effects of; 295 ;
therapeutic uses of; 295.
Sartaparilla in syphilis, 118.
Scarlet fever, announcement of a pro-
phylactic for, 866; prophylactic for,
the reception it got, 865 ; on the cure
and prevention of, 869 ; history of an
epidemic of; 870 ; persons chiefly lia-
ble to 871 ; Ple.ncu's description of,
871 ; symptoms of, 871, 481 ; treat-
ment of, 874 ; opium in, 875 ; ipeea-
euMana in, 876; diet in, 876; pro-
phylaiis of, 876 ; history of the dis-
covery of the prophylaotie llor, 877 ;
sappreBsion of the first germs o( by 6sl-
iadonna, 888 ; treatment of the after
Bofleriqgsof; 884; observations on the,
479 ; oomparisoQ of; with purpura mi-
liaris, 481 ; beUndannm in, 488, 698.
Schools, promotion of infectious diseases
by, 226.
Sdurriius of the prepuce, 71.
Scorbutus combined with syphilis, 126.
Scrofula combined with syphilis, 126.
Seat of goDorrhcea, 12.
Sensible properties of medicines as a
source of the knowledge of their the-
rapeutic action of; 254, 670.
SequelsB of gonorrhoBa, 87.
Sesamoides, 602
Ships, regulations for, 219; diet for, 219 ;
ventilation of; 220.
Show, worth of outward, 200.
Sick, the visiter of the, 164.
Signature of medicines, 502, 670.
Signs of the times in medicine, 566.
Simplicity of medical practice, oo, 807.
Single remedies should be given al m
time, 820, 848, 469.
Small doses, on the power o( 885, 728.
Small-poz, communicated by Ibul linen,
208 ; and cow-pox incompatible, 448.
Smell, therapeutic action of drugs judg^
ed of by their, 672.
SooEATis and Phtson, a dialogue, 20a
iSo/ofium fu^mim, pathogenetic efliBcts oC
272; therapeutic uses o^ 278.
Scdvent remedies, oo, 540.
Sore-throat, a stocking in, 175.
Sources of the common nmteria medioa,
664.
Spanish collar, 65.
Speculative systems of medidne, value
of; 488.
Spirit of the homoeopathic doctrine, 617
Spoilt food, sale o^ 226.
8guill, pathogenetic effects o( 299 ; the-
rapeutic uses of; 800.
Stimulants, reooarks on, 854.
Stomach, instinct of the, 182.
Stoves, proper regulation oi, 179.
Stramonium, Klookenbedco's prescrip-
tion of, 246 ; pathogenetic effects of,
276 ; therapeutic uses o^ 277 ; vine-
gar the antidote to^ 827 ; case of poi-
soning by, 827.
Strangury, chronic^ 87.
Stricture of the tnethiB,46; pmiilmr.
7U
GSNXBAL INDEX.
47 ; spannodic^ 48, 68 ; from flricqhM^
68.
Subetitutes, objections to, 476, 606, 68a
Saoeuaaioo, effectB o^ 728.
Suicidal mania, gold in, 696, 782^
Suicides, on the uncharitable feeling to*
wards, 696.
Sword-thrust) cure of empyema by a, 181.
Sycosis, thtya in, 698.
Symptoms, treatment o^ 417, 626 ; dis*
eases only discoveraUe by an obeer*
nation of the, 448.
Syphilis, 87, 284 ; diagnosis of. 87 ; pro-
duced by destroying the chancre, 668.
Syphon, Hahnemann's injecting, for go-
norrhoea. 21.
Systems of medicine, yarioos, 421.
Tailfiring, removal of de£Drmity by, 180.
Taste, therapeutic action of dn^ judged
uf by their, 670.
Teething diseases, remarks on, 284, 641 .
Testicle, swelled, 31 ; induration of^ 88.
ToKOPUBAOTUS on hellebore^ 674.
TTieories on Medicine, value o^ 490.
Thuja in syoosis, 698.
TobaccOj pathogenetic effectn of) 277 ;
therapeutic u«)9 of, 277.
Tonsillar ulcers, venereal, 98.
T<M)tbache, nostrums fur, 666 ; treatment
of; 667.
Town-walls prejudicial to health, 224.
Trees, unwholesomeness of) 178.
Tripper, origin of tlie word, 11.
Trituration, efiEects of; 728.
Typhus £e?er, odour of the miasm oi,
207 ; treatment of; 631.
Uoat's mercurial preparation, 2.
Ulcers of the urethra, 17 ; venereal, 91.
Uterine hemorrhage cored by coffee^ 1 86.
Uva wn in urinaiy •^fr^npft 282.
Valerian in irritability, 269.
Vaugirard, tieatment of syphilitic iofiuita
at, 146.
Venereal disease, infection by, 660.
Venereal diseases, treatise on, 1 ; obeer-
vatiooson, 646.
Venereal sure-throat and fiasuie in the
anus, case of; 776.
Venesections in gonorrhoea, 24.
Veratrwn album, pathogenetic o^ 800,
681 ; then4)eutic uses o^ 800; inacaae
of colicodynia, 306 ; coffee the antidote
to, 827, Cl08 ; cases of poisoning, by,
327 ; in the water-colic, 634 ; the ishUe
hellebore of the andents, 676 ; treat-
ment of bad effects of; 607 ; in cholera,
766.
Vienna Faculty, absurd decrees of; 606.
Vinegar not a universal antidote. 323 ;
the antidote to anUcOy 826 ; the anti-
dote to sframomtoTi, 827; the antidote
to ignatia, 827.
Viola in skin diseases, 281.
Visiter of the sick, the, 164.
Wallachs, their treatment of syphilis.
107.
Walnut'htuks in syphilis, 118.
Wann baths in gonorrhoea, 24.
Warts, venereal, 78, 136t
Water, supply of to towns, 218.
Water-cohc, veratrum in, 634.
Weather, influence of, on disease, 316
Workhouses, regulations for, 817.
Worm diseases, on so-called, 642.
Wounds in syphilitic subjects, 88.
Yew, pathogenetic effects of; 290 ; thera-
peutic uses of; 290.
LANB MEDICAL. LlBRiRY
To avoid One. this book should be returned
an or belore the date laat aiaiuped below.
DEC!» W?
"wFORB, CftUF 94305
X568 Halinemann, Samuel, i
L6d The leaser writings of
18S2 SBBuel Ualinemann, ""O"
13260
jAjli^iShJr.
mjj
:em^zi:::-^
Live Music Archive
Librivox Free Audio
Metropolitan Museum
Cleveland Museum of Art
Internet Arcade
Console Living Room
Open Library
American Libraries
TV News
Understanding 9/11