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Part I, containing the symptoms of the Disposition, Mind, and Head. This work is of priceless value; and I for one could have wished that the subsequent parts had been fashioned, bulk notwithstanding, on the same plan. It is arranged in sections with certain general headings. The symptoms as they occur in the original provings are arranged under these, the medicines being placed in alphabetical order. To each section is appended a minute analysis of its contents, the medicines being arranged as to precise character, circumstances of aggravation and amelioration, and concomitants. The finding of the required medicine is thus rendered certain and easy.
After an interval of nine years, there appeared a volume called on its cover "A Repertory; or systematic arrangement and analysis of the Homoeopathic Materia Medica. Parts I and II, containing Preface; Introduction, by Drs. Drysdale and Atkin; Eyes, by Dr. Dudgeon; Ears, by the same; and Nose and Smell, Face and Neck, Teeth and Gums, by Drs. Drysdale and Stokes." On its title page, however, it is styled "A Repertory of the Materia Medica Pura: forming vol. ii of the Pathogenetic Cyclopaedia." In the preface we are informed that a special committee of the society was formed in 1853 "for the purpose, if possible, of devising a plan for completing the Pathogenetic Cyclopaedia in a less voluminous form than that adopted in the first volume." The result was the work whose first instalment was now published. A third and fourth part appeared in the course of the same year, containing "Mouth and Tongue; Throat; Appetite, Taste, and Digestion; Acidity, &c.; Nausea and Vomiting; and Stomach;" by Drs. Drysdale and Stokes. 1861 saw a fifth part, concluding the Stomach, and adding thereto the Abdomen, by Drs. Drysdale, Stokes, and Hay ward. Then its progress was arrested, until in the present year we received from Dr. Nankivell the sixth part now before us.
A good deal of difference appears in the arrangement of this second volume of the Pathogenetic Cyclopaedia. The sections are commonly six in number. The first comprises "Character," "Pains/' "Degree, Locality, and Direction of Pains;" the second, "Conditions of Pains;" the third, "Concomitants of Pains;" the fourth, "Course and Progress of Symptoms;'' the fifth, "Peculiar Symptoms;" the sixth, "Anatomical Regions." Some modifications have been introduced into subsequent portions of the work (as, for instance, in Part VI, "Stools and Diarrhoea" take the place of "Pains "); but substantially this is the order adopted.
But the distinguishing feature in this repertory is that every symptom is given entire under every aspect in which it could possibly present itself. This had already been noted by Jahr as desirable and even necessary; but renounced as impracticable, since he had calculated that if, upon an average, only four points of view of each symptom were given, the number of necessary repetitions is so great, that for a repertory worked on this plan, forty-eight thick octavo volumes would be required. The difficulty has been surmounted in the English Repertory by the use of cypher. A system of symbols has been devised for the various elements of the symptoms—Roman numerals for *' pains" and English for their "conditions,'5 English letters for their "degree, locality, and direction," and Greek for their "concomitants," and so forth. By means of these a whole symptom may be expressed within the compass of little more than the abbreviations of the medicines ordinarily used in repertories. Thus—in Chapter "Teeth and Gums," Phosphorus; "continued tearing and boring of one molar tooth, worse by touch or chewing," appears as "Mo. Pho. I* Vs. VI*. 11—60." Accordingly, the 600 pages which were required in the first volume for the "Disposition, Mind, and Head" have sufficed in the second for all the categories of Hahnemann's scheme from "Eyes" to "Stools."
I am not disposed to pass any criticism on this adoption of cypher. It has unquestionably hindered (to say the least) the acceptance of the work; and yet complaint would probably have been greater still if any approach to Jahr's forty-eight volumes had been made. Dr. Nankivell, in the article to which I have referred, has well shown that the cypher is not an essential part of the repertory, that the latter can be used while it is ignored. It is only essential to the completeness of the view of each symptom in every place where it is found; and such completeness must often save greater trouble than that involved in mastering the meaning of the symbols.
I have too little practical acquaintance with repertorymaking to criticise Dr. Nankivell's work.* My one thought is to congratulate English-reading homoeopathists that in it our best index to the Materia Medica is resumed. I hope that the Hahnemann Publishing Society will now find workers to press on the undertaking to its conclusion. When Dr. Allen's complete collection of the Materia Medica itself shall have been published, the two will stand side by side and complementary, to represent Hahnemann's homoeopathy as it now stands. Whether the homoeopathy of the future may not be something better is a point on which I have opinions, but which I will not here discuss.
[note By De. Deysdale.—It has been a subject of regret for some time that my esteemed friend and colleague, Dr. Hughes, does not fully share the opinion of Dr. Dudgeon and myself on the supreme importance of having an accurate and complete catalogue of the symptoms of our Materia Medica. The Cypher Repertory purports to be this and nothing more; and, moreover, it is, as yet, the only practicable plan aiming at that object. But in recommending it I decline to allow myself to be placed in the above a posteriori category; nor do I admit that Hahnemann is rightly placed therein. On the contrary, he belongs to the a priori category, for the knowledge of the special symptoms is essential to the a priori method, just as semeiology is an essential part of pathology. The proper division of parties seems to me to be that given by Dr. Hughes in his paragraph on the a priori method, viz. with those who follow it in a broad, general, and more or less vague manner, and those who adapt it, not only to genera, but also to species and individuals, leaving out the a posteriori altogether as a mere abuse of the homoeopathic principle. It is only those persons in the second division who will ever obtain the full benefit of the homoeopathic law, and that only through the means of an accurate catalogue of the symptoms of a sufficiently large and sufficiently well-proved Materia Medica. With respect to the preference of Dr. Hughes for the plan of the Pathogenetic Cyclopcedia, it is not shared by Dr. Dudgeon himself, who is now occupied, in conjunction with Dr. Stokes, in supplementing it with an analysis after the manner of the Cypher Repertory,,]
* The following remark has been communicated to me by one well qualified to express an opinion:—" In the concomitant pains of stool there is no collective of pains before, during, or after stool. So, to find all the pains before stool, wc have to look through all varieties and classes of pains occupying twelve columns. This is a serious omission. Also here, and in some other rubrics, there is a heading ' Fains so stated,' with complete adjuncts of conditions and concomitants; a useless and misleading heading, instead of which we should always have a 'collective.'"
THE TREATMENT OE TYPHOID EEVER BY COLD BATHS.
The cold-bath treatment of diseases attended by increased temperature has become such a recognised therapeutic method, and its results have been everywhere found to be so successful, that no system of medicine can afford to neglect this mode of treatment.
As representatives of progressive medicine, it is our duty to avail ourselves of every improvement in therapeutics, whencesoever it may come. As long as our treatment of diseases remains imperfect, so long shall we seek to diminish its imperfections by all the aids that accident or science may offer to us. The success of our treatment of typhoid and other febrile diseases attended by a great rise of temperature is not so absolute as to prevent us desiring some adjuvant to the merely medicinal treatment that may diminish still further the percentage of our fatal cases; and such an adjuvant is apparently offered to us in the now fashionable cold-bath treatment of fevers.
One of the earliest accounts of this treatment will be found in the Lancet of December 31st, 1870, where Dr. O. Fehrsen gives an account of the treatment of the feverstricken soldiers of the French and German armies in the Stadtkrankenhaus of Dresden.
A paper by Dr. C. Liebermeister, of Basel, in No. 31 of Volkmann's Sammlung klinischer Vortrage, gives us a detailed account of the treatment pursued in the Basel Hospital, and some historical account of the treatment, which we are happy to be able to lay before our readers en resume.
Until a very recent period it was generally supposed that fever was in some manner a wholesome effort of nature to throw off some morbid materies from the system. This opinion was held by the most illustrious names in medicine, as Asclepiades, Campanella, Van Helmont, Sydenham, Stahl, Boerhaave, &c.
Since it has been shown that the increased temperature in fever is owing to a more rapid combustion of material, and as in febrile diseases the appetite and digestive system are usually deficient, it is evident that the temperature can only be kept up by the consumption of the tissues of the body; hence the febrile process began to be looked upon as something the reverse of wholesome.
But it has now also been satisfactorily shown that the increase of temperature in the organism is accompanied by destruction of the organs themselves, and it has been found that when the temperature rises above a certain point, this destruction is complete and unmistakable, so that the integrity of the organs cannot be restored, and the patient must die. The destruction or disorganisation varies according to the organ. In all organs it is a real parenchymatous degeneration that accompanies this extreme temperature; the liver, heart, kidneys, brain, are each disorganised in their several manners.
This having been recognised as the inevitable effect of a certain elevation of temperature, it seemed desirable to check the tendency to elevated temperature in fever, and so prevent the disastrous effects that are owing to increased temperature alone.