which he has devoted much thought and attention. But I regret that I am utterly unable to assent to the two leading theses he propounds.

I. Dr. Berridge's first point is, that we do wrong to reject any symptom furnished bond fide as an observed effect of a drug; and that our emendations of Hahnemann's pathogeneses should be limited to the correction of clerical and printer's errors.

So far as the reports of provers are concerned, I for one have no objection to the position Dr. Berridge takes up. I admit the uncertainty of tracing effects to cause, and would not reject any of the former which occurred while the latter was operating, if the observer warranted them. Should any special element of uncertainty exist, I would (with Hahnemann) bracket, but not expunge. But since Dr. Berridge's remarks are elicited by my examination of Belladonna-symptoms which Hahnemann has cited from authors, I must understand him as referring to contributions from this source. Here I cannot admit that bona fides is any sufficient guarantee of correctness. The qualities we should require, were we unable to verify the quotations, would be (1st) industry, care, and discrimination on the part of the citer; and (2nd) that he should have access to the originals he uses, and should excerpt for himself and not through another. But where we ourselves could examine the originals, we should not be left to infer from such considerations the value of the symptoms cited: we should have to determine their future estimation from the facts we elicited.

Now what Dr. Berridge advocates amounts to this, that we should ignore the latter mode of proceeding altogether; and act as though the sources of Hahnemann's citations were as hidden from us as the day-books of his provers. Such a shutting of the eyes to facts seems self-condemned, and needs weightier arguments than Dr. Berridge has adduced if it is even to receive consideration. But, indeed, one of the strongest arguments against it is furnished by Dr. Berridge himself in this very letter. He tells us that he has "strong proof" that Hahnemann

"employed an

amanuensis who was careless ;" and thinks it most probable "that he had not when he compiled his Materia Medica access to the original sources of some symptoms, but only to copies thereof, or perhaps to brief and imperfect notes which he may have taken years before when an allopath." Dr. Berridge advances this to exonerate Hahnemann from carelessness; but surely the burden must be shifted to our own shoulders if, believing thus, we make no attempt at verifying citations so made when the opportunity is

afforded.

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Dr. Berridge, however, himself counsels reference to the originals, but only for the purpose of correcting printer's or clerical errors. Let us see what would be the result of such limitation, in the instance which he himself brings forward. The symptom of Cuprum, "heaviness of axillary glands," is a clerical error. "Schwere " has been written in mistake for "Schmerz;" the real axillary trouble was pain." But Dr. Berridge goes on to tell us that this symptom is taken from "a case of poisoning by the application of Sulphate of Copper to a wound on the back of the hand. Swelling of the hand followed; a lymphatic vessel was felt painful and inflamed a great way up the arm, and there was pain in the axilla." He admits that this last symptom is "unwarrantably separated from the remainder of the group;" but, it having been furnished bond fide, would correct the clerical error, and retain it. What is the result? The impression made on every mind by seeing "pain in the axillary glands" in the pathogenesis of Cuprum must be, that this symptom resulted from the internal administration of the drug; and it would be used therapeutically in accordance therewith. Now, a statement calculated to produce an erroneous impression is a falsehood; and if that impression is to lead to action, it is an injurious falsehood. Had Hahnemann wilfully made such a statement, the deception and wrong would have been his. I maintain that they become ours if, knowing the statement to be misleading, we allow and retain it.

But Dr. Berridge tells us that symptoms, however doubtful their origin, may be "confirmed by clinical

experience." I cannot admit that such symptoms as the above, which are radically false, can be confirmed by any evidence whatever. But I take exception to the kind of confirmation suggested, even in the case of symptoms which in themselves are merely doubtful. The argument implied is, that since similia similibus curantur, the fact of a morbid condition having disappeared under the use of a drug makes it certain that the drug might cause such condition on the healthy subject. But this argument only appeals to those who believe in similia similibus; it has no force with others. And, since we all begin by being of these "others," it is most unwise to put forth pathogeneses having no better support than such a (to them unwarrantable) assumption. With ourselves, moreover, it does no more than establish a presumption. Even if we may so assume the universality of similia similibus, we get no proof that in the case in question the symptom was actually produced by the drug,— which is the statement we make. Pathogenesy-pharmacology is a science by itself, and should stand upon its own ground. Its relation to therapeutics is a separate question, and one which requires pure facts for its decision.

I think that Dr. Berridge is mistaken in supposing that Hahnemann relied upon this kind of "confirmation." He regards the incorporation of the "Observations of Others" with his own in the third edition of the Mat. Med. Pura as his endorsement of them, " doubtless as having been confirmed by his clinical experience." But Dr. Hering has lately told us that Hahnemann effected this incorporation at the instance of his disciples, and against his own better judg

ment.

II. And now as to the question of the admission of "clinical symptoms as such; i.e. of symptoms which have disappeared in sick persons under the administration of a drug. The answer will be somewhat different according to the nature of the list into which the admission is claimed. If it is a Materia Medica like Hahnemann's, a pure collection of pathogeneses, then I think we must follow his example in excluding them utterly. This, of course, applies to such a work as that forthcoming under the management

of Dr. Allen: But in monographs upon medicines, like those of Dr. Hering and of the Hahnemann Materia Medica, clinical experience must be inserted; and it is only a question of expediency how it should be done. Dr. Hering prefers to include symptoms cured by the drugs with those caused by them in one list; those who have contributed to the Hahnemann Materia Medica have judged it better to keep the pathogenetic effects pure for use according to the homoeopathic method, and to insert their therapeutic applications hitherto in notes or commentary or appendix. What Dr. Berridge says about the usefulness of "clinical symptoms" is merely what we all recognise as the value of the usus in morbis, and does not touch the question of the arrangement of our material.

Dr. Berridge has some remarks upon a third point,—my omission of some of Hahnemann's symptoms on the ground that the provers were not healthy. I have no difference with him in what he says on this point. I have excluded, in my treatment of Hahnemann's pathogenesis of Belladonna, no symptoms on this ground merely; e. g., I have admitted symptoms observed upon Greding's epileptics, Lambergen's and Ollenroth's cases of mammary cancer, and Wiedemann's children with whooping-cough. I have only rejected such as were too closely connected with the existing disease, as the rage of maniacs and the convulsions of epileptics, or those occurring (as in Sauter's cases of hydrophobia) in the very paroxysm of the disorder, in which it is impossible to separate idiopathic phenomena from the effects of a drug administered. I must maintain that in this, and in the rest of my dealings with Hahnemann's citations, I could not have done otherwise than I have. Dr. Berridge applauds reference to the originals. What could I do, when I had them before me, but correct, expunge, or mark as doubtful, whenever the facts so directed? And for those symptoms to whose sources I had no access-what remained but that, seeing the frequent laches which had been detected in their fellows (to say nothing of the "careless amanuensis," the "brief and imperfect notes," &c.), I should mark them as not to be much depended upon until verified. Such is the extent

of "purification of the Materia Medica" which I advocate and practise; and I am at a loss to understand the hostility with which it is greeted by those who should prize a reliable pathogenetic collection above all medical treasures.

ON SOME CASES OF HÆMOPTYSIS.

By Dr. HERBERT NANKIVELL.

(Read before the British Homœopathic Society.)

MR. PRESIDENT AND GENTLEMEN,—I do not intend tonight, as you will already have gathered from the title of my paper, to deal with the medical and therapeutical aspects of hæmoptysis, including under that term all possible varieties of the disease, but rather from a practical point of view to give a classified résumé of certain cases thereof which have come under my notice during the last few years, and of the treatment which has been adopted in these cases.

I. In the first class I would place all those cases in which the hæmoptysis occurs without cough, excluding, of course, all cases of esophageal, gastric, or nasal hæmorrhage from this category. The hæmorrhage in these cases occurs from the mucous membrane of the gums or mouth, or the pharynx, or of the pharyngeal district of the larynx, superior or exterior to the vocal cords. This hæmorrhage is usually chronic; it is periodical, occurring either during the night or in the early morning before rising. So far as my experience goes, it has been confined to the female sex, and is influenced considerably for the worse on the arrival or departure of the menses. Pure blood is seldom expectorated; generally speaking, the sanguineous discharge is a dirty blackish fluid like sloe or black currant juice mixed with saliva, or mucus from the pharynx. There is, as I have said, no cough, and the extrusion of the blood