Page images

venereal preparations (§§ 541—562) in the very terms in which they are spoken of by the chief authorities of the present day, and although he would now be censured by many for condemning mercurial inunction in toto, he is unquestionably right in asserting that we can never be sure how much of the drug really enters the system by this method. In fact, the present advocates of this mode of administering Mercury chiefly employ it in the case of infants, when it is often difficult to administer it otherwise, and who, strange to say, seem less liable to ill effects from an overdose of this drug than adults. . He directs that buboes, if opened at all, be opened by means of Polassafusa rather than by the knife; a point insisted upon at the present day by Professor Erichsen in all cases where the integuments are much thinned or undermined (Science and Art of Surgery, 4th edition, p. 530). His remarks upon the nature and treatment of the ordinary local and constitutional symptoms occurring during the progress of the disease, or as sequelae (§§ 636—647), might be transferred with little if any alteration to the pages of a treatise on a similar subject published at the present day. Especially valuable and striking are his remarks upon the prevention of the disagreeable effects of Mercury, Part II, 3rd division, cap. iii, in particular § 600, where he inculcates the frequent necessity of a tonic treatment, and this at a time when contemporary practitioners, with the Montpellier school at their head, sought to avert untoward consequences by means of hot baths, starvation, violent purgatives and bloodletting.

It is worthy of remark that in § 448 Hahnemann admits the occurrence of syphilitic affections of the lungs, although even in much later times the possibility of syphilis attacking the internal viscera was strenuously opposed even by Sir Astley Cooper, and it is only quite recently that the syphilitic origin of visceral gummata, &c., has been fully recognised. Dr. C. B. Ker, in an able article on syphilis (Brit. Jour. Horn., Ap., 1873), has called attention to this. We must also add that the infecting character of venereal condylomata, which Hahnemann maintained in opposition to Hunter, has been now fairly established!

Our task is done; we have shown that in this treatise Hahnemann plainly appears to be on no question of pathology inferior to the leading pathologists of his age; while on some points (e. g. the infectious nature of venereal condylomata) he was in advance of Hunter; and in his assertion of the venereal source of some pulmonary affections he was in advance even of so much more recent an authority as Sir Astley Cooper. We have shown how closely his treatment of gonorrhoea and constitutional syphilis, as well as of the true or Hunterian chancre, approximated to that of the most advanced school of the present day. The error, if it is an error, of identifying the virus of syphilis with that of gonorrhoea he shared with Hunter; and the chief points in his practice which contrast with that of the present " regulars'' are (1) the universal prohibition of the employment of caustics in cases of chancre; and (2) the adoption of soluble Mercury in preference to other mercurial preparations. With regard to the first of these, few now venture to cauterise even a soft chancre without the simultaneous internal administration of Mercury, thus plainly admitting the great risk of constitutional infection attendant on this mode of procedure; and as regards the second point our increased knowledge of chemistry has no doubt enabled us to prepare many other forms of the drug free from the impurities which led Hahnemann to reject them; but it would still be well worth the time and trouble of any courageous surgeon attached to one of our larger hospitals to give a trial to the Merc. sol. He need not run any very great risk if he takes the simple precaution of prescribing the drug under some other name.

We should have liked to dwell shortly upon Hahnemann's remarks on the mercurial fever—the first of the "drug-diseases " which seems to have attracted his notice— in which we may clearly see the germ of the system which twenty-one years later attained such a splendid development

in the Organon. The words "the mercurial fever

by extinguishing the venereal irritation through the instrumentality of the specific irritation excited," § 387, acquire a peculiar interest when read in the light of Hahnemann's subsequent discoveries, and there are many passages scattered throughout this treatise which must, to the homoeopathic reader, clearly enough indicate the dawning of the universal law of cure upon the mind of his great master. But we have already encroached too far upon the space due to the more valuable communications of our colleagues, and must now draw our article to a close.

Before concluding, however, we must express our hope that none of our remarks upon the adoption of the doctrines of Hahnemann into the " regular " practice will be misunderstood. We rejoice even at their unacknowledged adoption, and esteem it a happy thing that suffering humanity should now enjoy the beneficial results of our founder's discoveries, even though they should ever remain in ignorance of their benefactor, who has long since passed beyond the reach of earthly censure or applause. So long as the true doctrines are received and acted upon, we count it a very small matter whether their votaries are ostensibly followers with us or not. While by their daily practice they pay the highest of all possible compliments to our system, we can afford to smile at their harmless vituperation, and to disregard the favourite witticism of some among their number, that " a homoeopathist must be either a knave or a fool." We have no wish to return railing for railing, and we have neither the skill nor the inclination to rival our opponents' proficiency in the objurgatory dialect of the stableyard and the fish-market. Nor is it our desire to lay to the charge of the bulk of the dominant party the ribaldry of a few comparatively obscure provincial practitioners, or the disingenuousness of some deservedly eminent medical teachers. We gladly believe that many, especially among the junior members of the "regular" school, who, without acknowledgment of indebtedness, practise our system, do so in pardonable ignorance of its true discoverer, as all information upon this head was studiously withheld from them during their hospital and collegiate course. With all such it is our wish to co-eperate in perfect cordiality, recognizing no spirit of emulation or rivalry save that of which shall best serve the interests of suffering mankind. With those alone do we refuse to associate who knowingly parade our doctrines as discoveries of their own, and for the sake of money, position, or fame consent to vilify or ignore the real author. Such among our opponents can expect nothing at our hands save indignant exposure and richly merited contempt.


By J. H. Nankivell, M.R.C.S., York.

(Continuedfrom Vol. XXXI, p. 427.)

Upper Extremities. "Trembling of the hands and arms; pains in the arms and fingers; numbness and lameness of the left arm, which scarcely permits the hand to stir. The arms hang down powerless as if paralysed by blows. The arms feel chilly and insensible."

Trembling, numbness, lameness, as if paralysed; these terms seem to fall naturally into one category and mark the depressing power of the drug when large or often repeated small doses of it have been taken. In such a state of things the muscles lose their tone, and are in the first stage of automatic uncontrolled action. The vasomotor nerves have failed to keep up their full influence on the arteries they supply, and thus in a morbid circle the nerves themselves cease to receive that quantum of blood which is required for the exercise of normal healthy functions: hence we arrive at a stage when a form of anaesthesia obtains and but little power is left in the affected extremities. The " clinical observations " of Aconite do not afford us any confirmation of the above signs or symptoms, but doubtless theyhave been met with in practice, and been combated with Aconite. I have not any case in point to record from my own experience.

"Tearing in the arms from the shoulders to the wristjoints and the fingers, scarcely even felt except during movement, with blueness of the hand during the paroxysm of pain. Pain as if contused in the shoulder-joint (also the hip-joint) after sleep, as if he had been lying on too hard a couch; the pain is felt only during movement. Pain in the shoulder, it feels as if it would drop. Swelling of the deltoid muscle, which when touched feels painful as if bruised. Stitches in the shoulder and the upper arm (they are sometimes drawing)."

In the first sentence we have a remarkable symptom, viz. venous engorgement accompanying acute pain; an opinion of Rau's may throw some light upon this point: he maintained that Aconite influenced the arterial but had no direct action on the venous system, and that the result was a stasis in this portion of the circulating vessels and hence a passive engorgement of the capillaries. Aconite seems to elect the upper extremity for some of its most marked effects ; thus we find "Sense of contusion of shoulder-joint and even swelling of deltoid," but Bonninghausen has recorded "a laming pain in the arms and bones without swelling." The symptoms in their entirety bear a close resemblance to those of chronic rheumatism as affecting aged people.

"Drawing pains in elbow-joints, weight and debility of the forearms as far as the fingers, which feel as if gone to sleep when taking hold of anything. Pain in the forearm as after a violent blow. Drawing (with sense of tearing and sticking) in the forearms and their bones; movement excites the pains. Feeling of lameness in the right forearm and hand, especially when writing, going off by moving the part strongly."

It has been before remarked, that the expression " as if gone to sleep" or " numb tingling" is one of the most characteristic symptoms of Aconite, and the expression "compare with Arnica " is constantly suggested during our study by such phrases as" after a blow." We may be pretty sure if this description of a pain by a patient had led us into the routine of giving Arnica and the effect if

« PreviousContinue »