II. ON THE PRESENT STATE OF HOMEOPATHY IN GERMANY.

BY DR. A. MÜHRY, OF HANOVER.

(Extract of a Letter to Dr. Forbes.)

HOMEOPATHY has undoubtedly taught us, that however high an estimate medical men may have before formed of the healing powers of Nature, these must be rated much higher still. This fact may indeed render us more modest, but need not depress us into spiritless unbelievers. If, on the one hand, we ought to feel ashamed that the curative powers of Nature, aided-by nothing at all (ein reelles nichts)-should sometimes achieve as much as we are able to do ourselves, the history of homoeopathy has, on the other hand, shown this system to be inadequate to the wants of human society; and has brought into stronger light, not merely the nullities (nichtigkeiten) of medicine, but also, as a secondary result, its positive utility.

I think I am right in affirming that the history of homoeopathy can be better traced in Germany, where the system originated (fifty years ago), and where its development took place, than in England, where it has not been practised more than from ten to fifteen years. It appears to me, likewise, that the changes wrought in homeopathy have not been sufficiently taken into account in your essay; and hence it may here be of some use to point out some of the principal epochs of the system.

Samuel Hahnemann published his Organon' of Medicine in the year 1810, but had begun to make his system known before that time. I think with you that he was a sincere believer in the truth of his doctrine. It is but just, however, to remark, that, at least once previously, he had deceived the world, by selling at a high price, under the name of pnoeum, a nostrum which consisted of nothing but borax. This is a fact undenied even by his adherents. He had before this published a pharmacological dictionary (Apotheker Lexicon'), and his system was altogether the offspring rather of Pharmacy than of Medicine, properly so called.

Among others, the following retractations and retrogressions have been made in the original doctrine of homoeopathy, by various adherents. At first it was deemed requisite to administer medicines only once a week or once a fortnight. At present scarcely a single homœopathist adheres to this; but, on the contrary, now frequently orders them several times daily. A contradiction was also recognized in the assumption of a force-creating power (potenzirung) of remedies by attenuation-a greater efficacy in less attenuated remedies. At the present day there is often administered a drop of unattenuated and unpotentialized tincture (termed elementary, or mother tincture [Urtinctür]). Originally, the abstraction of blood, emetics, aperients, mineral waters and baths, were all proscribed: now they are often acknowledged as useful. Hahnemann's later doctrines, as promulgated in his Chronic Diseases,' met with few adherents: he had become inconsistent, and became more so still when he recommended camphor in very large, unattenuated doses against cholera. His successors became more and more divided, modifying the system in various ways, until its original meaning was almost entirely lost. This became apparent at a congress of homoeopathic physicians, which took place at Magdeburg, either in 1836 or 1838. Their confession of faith attests how much reform and reaction the doctrine of numerous homœopathists had suffered. A fraction of the school has even laid aside the name of homœopathy, substituting for it that of "Specific Medicine " This sect is numerous

in South Germany, in the Grand Duchy of Baden. These still hold fast to the principle" similia similibus," as explanatory of the curative process, but they no longer give the remedies after the original method. They busy themselves in experimenting with medicines upon healthy persons, but in large doses, and from this they look forward to grand results, which are, however, not perceptible as yet. They likewise attend to the physiological relations of the diseased body, and they have amongst their body some most able and respectable men. For at least ten years past this "Specific Medicine" has supported a journal.

We may regard the homoeopathists as sincere; but it is true that their number has augmented less by adoption of the original doctrine than of its modifications. They bear the original name wrongly, being no longer true homœopathists. The majority have even resumed a great portion of the allopa thic medicines.

I do not hesitate to say that, although men of worth are to be found amongst them, there prevails, generally speaking, both within and without the profession, a low opinion of the standard of their intelligence. In Germany no man of undoubted eminence has ever become a convert to the system. Only once has an instance like that of Professor Henderson occurred: Dr. Kopp, of Hanau, unexpectedly published a volume of Practical Observations,' descriptive of a series of homoeopathic cases and cures of his own witnessing. He thus stamped himself a homeopathist. A few years afterwards another volume of the Observations' appeared, communicating a further series of cases and cures,-but of an allopathic nature. The author thus declared himself reconverted, and he has remained so ever since.

With us in Germany there are in almost every largish town one or more homœopathists, who are perhaps consulted in chronic cases, after various methods had been previously tried, and where it is thought that homeopathy, at any rate, can do no positive harm. True it is, that cures are sometimes thus effected, and these create a sensation; whilst the cures accomplished by ordinary medicine pass unnoticed. A large proportion of homeopathists have recently adopted the hydropathic method of treatment. I am not cognizant of any town where homoeopathy is exclusively practised.

If homœopathy has taught us that our curative control over the course of disease is far below what we rated it at, it has à fortiori, though unintentionally, taught us that our apparatus medicaminum" possesses less merit than we imagined, and that it need no longer continue as gross and rude as the instruments of an "armentarium chirurgicum" of old. It has, however, at the same time enabled us to mark with greater distinctness those diseases in which our remedies really effect the cure. Such are, for example, intermittent fever, scabies, syphilis. These it was that first showed the insufficiency of homœopathy; and you will find that in the statistic bulletin of Dr. Fleischmann these diseases are omitted.

On thing certain is that, through means of homœopathy, Medicine has undergone, is undergoing, and—as in your treatise you predict-will, in the future, yet further undergo a rigorous scrutiny. It appears to me, however, that rational scientific medicine has, in some degree already passed this ordeal; and if it can never claim the exactness of chemistry and mechanics, it may yet hope, in point of accuracy, to reach the standard attained by modern Physiology.

June, 22d, 1846.

Yours, most sincerely,

A. MÜHRY, M.D.

* I may here mention that, besides the Homeopathic Hospital at Vienna, there is also one at Leipsic, which can, however, with difficulty maintain itself.

III. REPORT ON THE HOMEOPATHIC TREATMENT OF ACUTE DISEASES IN DR. FLEISCHMANN'S HOSPITAL, VIENNA, DURING THE MONTHS OF MAY, JUNE, AND JULY, 1846.

BY GEORGE W. BALFOUR, M.D. EDIN.

(In a Letter to Dr. Forbes.)

Vienna, August 14th, 1846.

MY DEAR SIR,-I shall now proceed to lay before you the results of my inquiry into the practice of homeopathy, prefacing them with a short account of its present state in Germany, where it is now become quite fashionable, and nowhere more so than in Austria. Even travelling physicians are now chiefly chosen from among its followers, who are, consequently, far from being insignificant in numbers. No young physician settling in Austria, excluding government officers, can hope to make his bread, unless at least prepared to treat homoeopathically, if requested; and many, after attempting to do so, return to Vienna to make themselves acquainted with this new method. Many older men also attempt, by thus conforming to the foible of the day, to recruit a failing practice. Thus homœopathy is studied, not for any beauty or truth to be found in its doctrines, but from necessity, for a livelihood. Many continue to practise both methods, not eclectically, but according to the wish of the patient, believing in neither, leaving inquiry to others, and stumbling blindly on. Others, confident in homoeopathy, merely use ordinary medicine, or, as it is termed, allopathy, in so far as occasionally to give a laxative, or, where the relatives urge it, to bleed-all by way of placebo; and I believe there are few, except the older and better established practitioners, who would not give such a placebo if requested. Nay, the inclosed recipe will show that even they are not altogether free from blame in this respect, or else that they have found their guiding principle in many cases false. The gentleman who gave me it (an allopathic physician) told me he might have procured many such.

While thus, from force of circumstances, everywhere increasing their domains, homœopathists are far from sitting idly down, content in following the footsteps of their first great master. Imbued with the progressive spirit of the age, they also strive after improvement, and while professing to retain "similia similibus" as their fundamental principle, are endeavouring to advance their method, and give it a more permanent and dogmatic character. Seeing, as it would seem, that the above-mentioned principle does not suffice for every case, they change the name of homoeopathy to Specific Medicine. These men are dissatisfied with Hahnemann's work on the Materia Medica, on account of the imperfect nature of the observations, and look upon it as an enormous and almost unreadable catalogue of symptoms, more fitted for the memory than the intellect, and thus not only rendering the practice of homœopathy more difficult for his own followers, but throwing an almost insurmountable obstacle in the way of physicians who think otherwise, and often preventing those very intellects best fitted to become leaders in the reformed practice from ever studying it. (Esterreichische Zeitschrift für Homöopathie, 1 Band, 1 hft. s. 4-5). Accordingly they have commenced a careful re-proving of all the medicines, with the view of obtaining, not a mere catalogue of symptoms, but a collection of medicinal diseases. A journal (the above-quoted) is also published in Vienna, with the view of giving publicity to these provings. This shows them to be in earnest in their endeavours to simplify their method and render it more practicable, as any one will be more inclined to confess, after having looked into Jahr's Codex, the best of the day. Who can wonder

sented to us in dispensary and hospital patients; also in cases of latent inflamination, revealed only by the scalpel-cases in which Nature had been stealthily prosecuting her deadly work. But it might, perhaps, be said that there is no sufficient evidence to prove that such cases would have had a better issue had they been placed under orthodox treatment. Some years ago I was called to a patient who had been ill four days. He had been seized suddenly --the symptoms were those of peritonitis. For reasons which it is needless to state, not a single active measure had been employed. He had been confined to bed, taken diluents, and very trifling medicines. When I saw him the belly was tympanitic, with complete constipation and sickness. The pain had lessened, but there was tenderness; the voice had become husky; there was full evidence that the usual effusions had occurred in the peritoneum. I thought the case all but hopeless, but I practised some moderate depletion. Some alleviation ensued, but nothing more. He was not laid prostrate by the remedies, and, as a proof of it, he lived to the seventh day from the attack. He was a strong healthy man of 50. The necropsy showed the extensive adhesions, &c., of sthenic plastic peritonitis. Do you doubt that if, at the onset, the patient had been bled, leeched, and taken opium freely (with or without calomel), he would have had a far better chance of recovery? I have said, we must act up to our lights." Now, one has repeatedly seen cases begin in a way closely similar, and after, or because of certain remedies, yielding, as to the most essential points, in two or three days-nay, in a day;— the inflammation stopping before fibrin has been effused. I don't believe there can be a greater sceptic in these matters than I am; yet even my Pyrrhonism is overcome when I see the marvellous change induced at the onset of an inflammation by a bleeding, a poultice, and an opiate. Even if it be maintained that the symptoms only are abated, e. g. the pain and tenderness, and the vomiting and constipation, and the rapid pulse, and hot skin, and scanty secretion, but that still the essential disease, the pathological lesion, the causa causans, the vitium vitians, goes on a certain course, and stops only when Nature thinks proper-still I say, thank God for the lancet and opium! patient is lapped in balmy slumber, and I am quite at ease as to the issue of the malady.

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Take another instance. I was called up in the night to a lady, who I found had been ill several days. She had been treated with very mild remedies for what appeared to be hepatic congestion. She was very feverish, and breathed in a way that gave me the impression, when I first set eyes on her, that she was suffering from pneumonia; but I listened to the chest, and failed to find any sign of inflammation within the thorax. The pulse had an irritable character, and there was slight delirium; and, in the absence of proof of local disease, it was decided to try an expectant method, on the probability of the case turning out to be one of fever. The next evening things were rather worse. Again Ï explored the chest, and this time listened where I ought to have listened before, but where I had been deterred by a blister, which had been placed over the region of the liver. There I found crepitation and bronchial respiration. The case was clear. It had been occult pneumonia, which had possibly begun in a part more removed from the surface. Then came a terrible antiphlogistic visitation; all the great guns were fired: the patient recovered perfectly. Relief and abatement of disease ensued at once; but a check was not at once given to the hepatization, which involved two thirds of the lung. The most decided improvement in the signs, both physical and rational, was coincident with mercurial stomatitis. I do not deny that I have known hepatization consequent on neglected pneumonia get well without active treatment; but it has been in a prodigiously longer time than when antiphlogistic remedies had been employed.

Bear with me, if I narrate one more case. A young lady had been ill for many months. For several weeks she had been under a homoeopathic practitioner,

who was, of course, treating her symptomatically. She got worse, and ordinary medicine was again appealed to. We found an enormous collection of fluid in the left pleura, pushing the heart far over to the right side. We practised very moderate depletion, chiefly with a view to favour absorption; blistered largely; and exhibited diuretics. The case is now under treatment; and, as I have repeatedly seen in like cases, the fluid has been traced receding in proportion as the excretory organs have acted freely, and the discharge has continued from the blistered surface. The heart has resumed its proper habitat, and the symptoms (especially the dyspnoea) are greatly mitigated; but the case will probably end in phthisis.

If one were at a loss for instances in which art interfered with advantage, when Nature was doing nothing, or rather doing mischief, I doubt if any instance could be more striking than the cure and relief of many of the diseases of children by lancing the gums. On the expectant method a child may, after many days of suffering, and after incurring perils in various organs, at last recover when the tooth has pushed its way into the light; but all the pain and jeopardy might have been spared by one or two free incisions.

The efficacy of medical treatment is, I think, evidenced by the short time requisite for the cure of diseases, which, cured by Nature, occupy a far longer period. Within the last six months I have watched two cases of subacute pleuritis, both well marked by the auscultatory signs. In both there were reasons, from the peculiar constitutions of the patients, for avoiding general blood-letting and the stronger medicaments. They both recovered; but I have no doubt, from my experience in similar cases, that a more active treatment, not violent, would have reduced the disease in at least half the time. Whether it would have been ultimately a gain might be questioned; but such instances show the power of art over morbid processes.

Time does not allow me to touch on the reasonableness of the antiphlogistic treatment-as, for examples, the influence of venesection on the action of the heart, arteries, and capillaries, to say nothing of the blood; the operation of opium on the neurotic element of inflammation-of mercury and antimony on the excretory actions; and the close correspondence between the effects of such agents and the processes which appear to be instrumental in resolving diseases which are cured spontaneously.

But what shall we say of fevers and the exanthemata? Only what nine tenths of eclectics would affirm, viz. that the less heroically they are treated the better. And why? Because neither theoretical nor empirical therapeutics have suggested remedies that appear to tell on the essential part of the disease, that is, the poison in the blood. At least, I know of none, unless it be chlorine in scarlatina and typhus, when accompanied with putrid symptoms. Yet we cannot but hope that, when the pathology of the blood has reached a development approaching to that of the tissues, we shall have remedies equally direct and appropriate.

I am not fond of arguments from final causes; but can it be doubted that the various medicines we possess were, as such, a part of the plan of the universe, designed to have relation to morbid states of living organisms, as much as esculent matters to healthy conditions? What! were diseases planned? It would seem so; and that it was no less needful that men should depart from the stage of life than they should enter upon it. Disease and death are as natural as health and life. And lest it should be objected to this view, that if diseases were intended to sweep men from the earth, antagonists would not be provided for them in the form of medicines, I may remark that this is only one of a multitude of illustrations of the fact that it has pleased Divine Providence to order the world upon a system of checks and counter-checks. Few things show this more strongly than the predatory instincts of one set of animals, and the provisions in a weaker set for eluding and guarding against the attacks of the former.