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BINZ AND ANSTIE ON BROMIDE OF
The articles by Binz and Anstie in the January number of the Practitioner are very instructive. After the great experience with it of late in the imperfect and unsystematic way usual, it appears to be a salt of not great power, probably not more active as a poison than common salt; and its more obvious action seems to be as a mild narcotic acting chiefly on the reflex action of the spinal cord, with slightly hypnotic power. It is for these purposes chiefly given and with the usual results of a fashionable drug used by unscientific, merely professional hands, at first unduly lauded, and then producing the customary disappointment. But there are some things that remain and it is singular to look at what these are. The drug was first introduced by Dr. Locock on account of its supposed primary action in depressing the sexual nerves and function. But in Binz's paper here, p. 10, we find the experiments of Laborde thus narrated. He took ninety-four grains each time.
"Within an hour he felt a general sensation of wellbeing and of calm which incited to sleep; the latter, however, was but half established, so to speak, and in this half sleep there soon came on, especially if he was lying on his bed, a more or less intense sexual excitement, according to the circumstances—an excitement which was habitually accompanied by erection and emission; this act, of which there is always perfect consciousness, almost always wakened him. . . . Finally, sleep is definitely established, but with more difficulty or less rapidity than when emission does not take place."
To this Binz remarks only, "Thus K. br. is also an aphrodisiac. What manysidedness I"
And on this Anstie makes no remark at all except apparently inadvertently in a parenthesis which is very significant in spite of him; for, as usual, Anstie evades the difficult points in pharmaco-dynamics. He dares not give the true explanation of the many homoeopathic actions of medicines, so he keeps discreet silence. The conclusion of Binz is that the whole therapeutic action of K. br. has been exaggerated, and that it is of very little value, and that the good it happens to do is solely on account of the potash it contains. Hereupon Anstie writes an article intended to confute that dictum by the English experience. The main body of this is, we find, little more than a transcript of Bi. Reynolds' well-known articles on the use of it in epilepsy, in some cases of which he pronounces it curative in doses of four to forty grains daily. On this Anstie gives the result of the experience of himself and Dr. Hughlings Jackson, and, alas! they both agreed that neither of them had ever seen an example of a cure of epilepsy by it. It can mitigate the number and severity of the fits, as anybody now knows, but cure never.
Both of them have great doubts if it has any effect as a hypnotic in the miscellaneous forms of insomnia. Anstie then says for himself, "As regards sleeplessness from emotional causes (with the exception of the insomnia produced by sexual excitement with exhaustion), I am not convinced on the whole that K, br. is distinctly remedial" (p. 22).*
This is very remarkable indeed. The original discovery of K. br. was empirical from its calming sexual excitement and the diseases arising from it, and of course it was assumed such influence was from its primary action. But now by more extended proving it turns out this is one of its true specific actions and is really homoeopathic. At the same time, the really slight narcotic action or reflex actions in the healthy were turned to account allupathically, and after twenty years' experience it is confessed to have failed to cure by means of them; whereas the only action which still holds its ground as curative, as admitted involuntarily by Anstie, is the homoeopathic action. This is of the more specific character only discovered by long proving, for the specific susceptibility is not always developed, and thus the careless, unsystematic, haphazard proving does not reach it. There is another specific action now found, viz., the rash or acne on the skin, and on this R. Reynolds gives a most significant remark, "the rash or acne on the skin which is occasionally seen is not determined by the quantity of the Bromide that is taken. I have seen it after a few doses of five grains each, and it has been absent in many cases where thirty grains have been taken three times daily for six or even twelve months."
* To the above testimony of Anstie may be added what he says on Neuralgia :—" It is singularly efficacious, but in a comparatively limited number of cases; the majority of these are instances of some form of sexual worry." VOL. XXXII, NO. CXXVIII. APRIL, 1874. S
Thus it is not one of the common actions which may be produced at will by merely giving enough of it, but it is one of the peculiar actions which requires the presence of the special susceptibility to bring it out—one of the idio-dynamic class as named by Dr. Madden, and it is in them that the more specific curative actions of medicines lie, and as such is almost independent of dose. We have repeatedly verified the curative effect of K. br. in this form of acne to two or three grain doses. Thus the only two diseases in which K. br. holds its ground as a really curative drug are the two in which the specific and homoeopathic actions are synonymous.*
Besides these two no doubt there are other diseased states in which K. br. is truly curative, and if they are closely studied we have no doubt they will be also found to be homoeopathic. The analysis of Dr. Clouston's experience in a lunatic asylum shows the merely palliative action of the drug in epileptic fits, and no cure is reported, although there was some permanent amendment in some cases, while others were actually worse after the palliative effect had subsided.
To weigh the real value of the drug when used for its merely primary or allopathic action we need be in no difficulty. We are quite ready to acknowledge the degree in which it may "do good" to the patient by calming reflex spinal irritation for the time even. No doubt there are circumstances where such a drug may benefit the health by warding off the immediate evils of the succession of fits, and in default of true cures this is not a means to be despised or withheld. The best way to picture the matter to ourselves is to compare it to the effect of a mild purgative like Rhubarb or Aloes in constipation; by means of this from time to time we can ward off many serious evils, although we do not cure the tendency to constipation, and in default of that the occasional purgative is a smaller evil than the manifold secondary disturbance from inaction of the colon.
* See vol. xxviii, p. 807, of this Journal.
But we should not be satisfied with that, and always aim at the radical and true specific cures. But as long as men are hindered by subsidiary personal motives from fairly and philosophically discussing all the possible actions, homoeopathic as well as other, of medicines, it is impossible that there can be any important or philosophical discussion of the subject between ourselves and the adherents of the dominant school. And yet the time has surely gone by when our opponents can afford to treat us as unworthy of professional courtesy when almost every improvement that has oflateyears been effected in old-school therapeutics has been merely a "crib" from the practice of the school they despise in words but in fact sincerely admire, if imitation be a sign of admiration.
ON THE NAIVETE INHERENT IN GERMAN HOMOEOPATHY* A CRITICAL MEDITATION.
By Dr. J. Kafka, Prague.
The attentive observer is sometimes disagreeably surprised when, in speeches, magazine reports, new books, or original articles, he gets to hear or read expressions, opinions, and views which are in direct antagonism with the judgment, experience, and aims of the modern school, betray a character of mere childish innocence, nay even of inconsiderate rashness, and expose themselves, partly through one-sidedness, partly through false conclusions, or mere deficiency of the judicial faculty; and all this from men at whose hands he expected energy, solidity, conscientiousness and scientific progress!
* Allg. Somoeop. Zeitung, Bd. lxxxvii, No. 25.
It is really sorrowful and disheartening to see how those who are rich in experience and natural gifts (and to a certain extent belong to the class who give the tone), yet partly venerate tradition, partly disallow, intentionally or unintentionally, the progress of modern times, get into contradiction with themselves, or with the positive experience of others, and thus damage, whether they know it or not, that very homceopathy whose banner they fancy they are waving aloft.
In my report of this year's assembly of the Central Homoeopathic Society at Vienna (No. 12 of this serial) I expressed my astonishment that the president, Dr. Gerstel, spoke in favour of maintaining the "conservative standpoint" in homceopathy.
Before he reached this stage in his peroration he had expatiated on the "value of practical medicine," and said that it is therapeutic medicine alone that gives value to the theoretic studies, which (apart from the collateral sciences) consist essentially, mainly, entirely, of nosology (including diagnosis) and the knowledge of the Pharmacopoeia.
Of Hahnemann's own "Arzneimittellehre" which he most truly called "Monumentum are perennius," he said, en passant, that this treasury of science first received its infinite appreciation, nay its very consecration to the service of therapeutics, through the method at the same time discovered by Hahnemann on the path of experience and observation how this real knowledge of the action of medicines should be brought into combination and due appreciation with the permanent positive sciences, pathogenesy and pathology, i. e., with diagnosis, in order to the real cure of the patients.
This practical point of connexion between pathology and materia medica, this nucleus of therapeutic science, is the fundamental law of healing discovered by Hahnemann, "similia similibns." It is, said Gerstel, the electric spark which elevates medicinal action to the rank of curative action in the morbid organism. So far I am in full accord