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A REVIEW OF HAHNEMANN'S 'INSTRUCTION FOR SURGEONS RESPECTING VENEREAL DISEASES/*

By W. B. A. Scott, M.D. Edin.

None of the writings of Hahnemann appears to me better calculated to induce practitioners of the old school to give at least a hearing to the great master's doctrines than the treatise on venereal diseases by the discoverer of homoeopathy. In the year when this work was first published (1789) Hahnemann had not as yet thrown down the gauntlet to the adherents of the old system (if, indeed, an incoherent mass of heterogeneous theories deserved the name of a system), nor had he reached the doctrine of infinitesimal doses which is still believed by many ignorant persons to be the essence of homoeopathy, and which, from its startling, and, at first sight, paradoxical character is, doubtless, apt to deter many inquirers from the very threshold of the investigation. We have here simply a learned, modest and ingenuous treatise on a too common disease, in which the author is shown to be at least on a level with the highest authorities of his own day in etiology, pathology, and diagnosis; while, in respect of treatment, he has anticipated nearly all the improvements which have since his time been gradually and in spite of much opposition introduced into the soi-disant "regular" practice. This being the case, it is surely worth while at least to pause and consider whether it may not be possible that the man who, in 1789, "with something of prophetic strain," preached amid the scorn of his contemporaries the doctrines universally received in 1873, may not in 1810 (the year of the publication of the Organon) have taught much which the future will confirm, and which it will one day be the acknowledged reproach of the present age to have condemned unheard. If a traveller should find on his * Leipzig, 1789. Translated by R. E. Dudgeon, M.D., in Hahnemann's Letser Writing/.

arrival at each successive stage of his journey that it, as well as those preceding, has been accurately described by one who has previously traversed the same route, surely such a discovery would afford at least a prima facie ground for believing that his predecessor's descriptions of the stages which still lie before him are worthy, if not of blind and implicit confidence, at any rate of careful examination. And this appears to us to be no inapt parallel to the case of Hahnemann and his opponents of the present day. One by one most of our founder's doctrines have established and maintained their ground, some even during his own lifetime, but the greater part since his decease. Bloodletting, mercurial salivation, the monstrous treatment of gastric acidity by the antipathic administration of alkalis (compare Drs. Ringer and Buckheim), prescriptions compounded of as many ingredients as the famous dish in Aristophanes, the practice of suffocating a fever-patient in a hot and airless room, and denying him even the cup of cold water which he craves, "heroic" treatment generally, large doses, the "reducing " system, together with many other absurdities against which Hahnemann entered his honest and courageous protest in a minority of one, are now, happily, things of the past; and the once celebrated treatises which extolled them have been deservedly relegated in vicum vendentem thus et odores. But while this is the case, the wise old physician who alone, or all but alone, protested against these modes of procedure more than three quarters of a century ago, in the midst of obloquy, derision, and neglect, has been studiously ignored by the very men who have obtruded on the world his discoveries as their own, and who may be said to hold their fame, wealth, and professorial chairs on the all but expressed condition of ignoring or vilifying the genius the results of whose labours they pirate. The professional forefathers of the" regular" school acquired for themselves an unenviable notoriety by abusing Harvey and Jenner, and some still living took part in the disgraceful persecution of Dr. Elliotson by the authorities of a college well known for the loudness and frequency of its professions of unlimited toleration; but, to do the "regulars " of the

present day justice, it must be acknowledged that, in these instances, they are now doing their best to (metaphorically) build the sepulchres of the prophets whom their fathers blasphemed. A harder fate has befallen Hahnemann. While his doctrines and discoveries have been shamelessly plagiarised, being in most cases adopted no less generally than those which deservedly rendered the names of Harvey and Jenner immortal, his fame has been left unvindicated save by his professed disciples; even the tardy tribute of posthumous praise has been denied him, and his conscientious followers are held up to scorn by the very men who disingenuously practise what They honestly profess, and labour under the reproach of belonging to a school ab initio condemned by the "regulars," no notice being taken of the very essential qualification that what the homoeopathic school was condemned for in initio is, in most respects, precisely what the "advanced regulars" now find it conducive to the gaining of university chairs, public confidence and remunerative practice loudly to proclaim as discoveries of their own. We propose, therefore, to give a short notice of Hahnemann's treatise on venereal diseases, an able translation of which by Dr. Dudgeon may be found in that gentleman's edition of Hahnemann's Lesser Writings.

To begin with the preface. There is little to notice here beyond Hahnemann's liberal acknowledgment of indebtedness wherever such was due (in which the vast extent of his reading becomes apparent) the modesty which leads him to compare his own labours not to "stone blocks" in the temple of science, but rather to "small stones to fill up intervening spaces," and to disclaim all pretensions to high reputation; and the ingenuousness with which, in an age and country fertile in occult remedies and secret modes of cure, he details every step, not only of his treatment, but even of the method of preparing the celebrated " mercurius solubilis" which still goes by his name in treatises on chemistry. It may, perhaps, be worth while to remark in passing that here (p. 6) and elsewhere he uses the term "white precipitate'' in the sense of a mixture of calomel and corrosive sublimate, not in that of the amido-chlorido of mercury which is its present acceptation. The directions he here gives for the preparation of his "soluble mercury," though minute and indicative of the most conscientious patience and care, need not be further referred to, as they were subsequently superseded by a more convenient method.

N.B.—It may be as well to state, for the benefit of any allopathist who may condescend to read these pages, that the "mercurius solubilis" does not derive its name from being soluble in water (which it is not), but from its free solubility in many organic acids. This explanation may appear superfluous; but Hahnemann was a good deal stronger in chemistry than most of his opponents, and the same may without either vanity or the profession of anything beyond the most superficial attainment be said of many of his successors.

In his introduction Hahnemann more than once gives some occasion of triumph to his adversaries, as he expresses his agreement with Hunter in some doctrines which subsequent experience has shown (we think conclusively) to be erroneous. These are, (1) that the virus of syphilis and that of gonorrhoea are identical; (2) that the sole difference between syphilis and gonorrhoea, consists in this; viz. that in the latter the virus is brought in contact with portions of the body devoid of epidermis, while in the former it is inoculated on cutaneous surfaces. (Hahnemann's own meaning would have been better expressed by saying that in gonorrhoea, which he regarded as a purely local disease, the virus merely acted locally on a sensitive surface, but that in syphilis it was absorbed into the system. He himself maintains that, even in the urethra, gonorrhoeal discharge may convert an open fissure into a chancre; (3) that there is no such disease as congenital syphilis, properly so called; and that neither the milk, semen, breath, perspiration, nor urine of a syphilitic patient is capable of conveying the disease either in its primary or secondary form. Now, it has of late years been pretty clearly shown, (1) that, in spite of Pope's well-known line, "time " never has " matured a clap to pox;" (2) that pure gonorrhoeal matter taken from a patient not labouring under coexisting syphilis will not by inoculation produce a true chancre; (3) that a primary chancre may exist on a mucous as well as on a cutaneous surface (e. g. in the urethra, and, in some disgraceful cases, on the lips, &c.), the failure to recognise which may have occasioned Hunter to imagine he was dealing with pure gonorrhceal matter, when in reality the patient from whom he procured it had been simultaneously affected with a urethral chancre; (4) that cases of true congenital syphilis do really occur; that is to say, cases where the foetus has been infected in utero or the ovum by the semen, when no local symptoms (as chancres) were present in the maternal passages, such as might have caused inoculation to take place during parturition; (5) that a mother may thus be infected through her own child; and (6), though this is less certain, that, in rare cases, syphilis may possibly be communicated to an infant from a syphilitic wet-nurse. Let us, therefore, freely concede to our opponents that on these points Hahnemann was not better informed than Hunter, but shared the errors of the most distinguished pathologist of his age, whom the allopathic sectarians (with much presumption) claim as a professional father. It appears, in fact, that, for once, the founder of homoeopathy was not materially in advance of the highest authority among his medical confreres. Our opponents are heartily welcome to make the most of this concession; they need all they can get.

These views of Hunter which Hahnemann was led to adopt were the cause of his following a somewhat unfortunate method in laying out the plan of his subject. He divides his treatise into two parts; the first part he subdivides into two classes, and each class again into two divisions; the second part is distributed into five divisions, or sections. In the first part he treats, in the first class, of "idiopathic local venereal affections on secreting surfaces of the body destitute of epidermis;" of this, the first division deals with primary gonorrhoea, and the second division with its sequelse; in the second class, he treats of "idiopathic local venereal affections on parts of the body

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