remark about the symptoms. But I have not observed Kali bichromicum good in stringy and tough leucorrhoea, nor are there uterine symptoms to warrant us to expect that, and I doubt the propriety of using it there from analogy with the bronchial tough mucus. In fine, though I agree with nearly all that Dr. Lippe says of the practical sphere of the action of Kali bichromicum, yet he has added nothing to what was known before, and, strangely enough, every pathogenetic symptom he quotes as having guided him is found in my arrangement, except that one from Marenzeller [ear, No. 9] which he quotes verbatim three times over in this short paper. From all this it appears to me most likely that Dr. Lippe (probably from the same difficulty felt by myself and others) has not been in the habit of using practically my arrangement, but has merely referred to it for the purpose of criticism, and being struck by the great apparent discrepancy in the ear symptoms between it and Arneth's, comes at once to the conclusion that wrong is done to the practitioner, and injustice to Dr. Arneth by the omission. Dr. Arneth, himself, is not the one to agree with him, as he was of Watzke's opinion respecting the Hahnemannian schema, and merely gives his register as a simple catalogue of paragraphs contained in the foregoing provings, which are to be judged of according to their merits. As far, therefore, as Dr. Lippe is concerned, we have still to look for a commencement of real criticism of new plans of the Hahnemannic schema, for he is still in the mental position we all were in, (I was, certainly,) of not doubting that it was necessarily the proper form, and an essential part of Homœopathy. It is only since the reflections and discussions of many minds have been brought to bear on the subject that it becomes apparent, that though serving very well for practice in many ways it is incapable of giving a complete and correct view of the action of drugs. If we took the symptoms of any disease, say typhus fever, and cut them into lengths, and arranged them in that form without leaving any indication of their progress, course and connection, who would recognise the disease? Let Dr. Lippe look at the subject from

that point of view, and he will then begin to understand the object to be attained by new arrangements of the Materia Medica, as well as the difficulty of attaining it. And he will no more confound the careful new placing of some and omission of other symptoms which can be explained and justified years afterwards, with the arbitrary abridgments and curtailments of a mere copyist anxious to shorten as much as possible the wearisome list of apparently superfluous and useless symptoms.

ON THE NATURE AND TREATMENT OF
DIABETES.

By RICHARD HUGHES, M.R.C.S., L.R.C.P., Ed., (Exam.).

(Continued from p. 121.)

The dietetic treatment of diabetes must always be of high importance. But it is not, in the nature of the case, and by the confession of its advocates, curative. Sometimes indeed under its use Nature, relieved of much of her burden, asserts her recuperative power, and when the patient returns to his usual regimen, he finds it unattended by its pristine consequence. But too often the diabetic regimen proves but a continuous and most irksome palliative; the least abatement of its rigid restrictions is followed by an increase of the malady, and the patient at length succumbs under pulmonary disease, carbuncle, or simple exhaustion of the powers of life. Until we can do more than cut off the supplies—until we can attack the morbid process, we cannot consider ourselves in a position to cure diabetes.

Let us endeavour to estimate our resources for effecting this end.

And first, what has traditional medicine during the three thousand years of its history discovered in the way of curative means for this malady?

We cannot take a better account of the state of medical knowledge up to the year 1857 than that contained in Dr. Watson's classical Lectures on the Principles and Practice of Physic, (4th ed.). He believes" that the regulation of the diet constitutes by far the most important part of the treatment." Of other remedies he mentions only, the hotair bath, opium, iron, and kreasote.

The

Since the hot-air bath may be used in conjunction with specific treatment, and in the form of the Turkish bath is so accessible to our patients, it may be well to cite the account, given by a diabetic himself, of the benefit resulting from its use. "The urine is reduced more than one half, and does not contain much sweetness, but sometimes tastes salt, with a mixture of bitter. My stools, which were dry and like balls packed together, are now quite natural. pains in my limbs are entirely removed. My spirits, which were very much depressed, are now revived and cheerful. The unpleasant aching of my kidneys, of which I spoke little lest I should be cupped in my loins, is now removed, only I feel weak there. I am cured of the pain in my stomach, and the circuitous working of the wind in my bowels, which formed lumps in my belly as it passed, resembling those formed by the cramp. I have likewise got rid of the palpitation at my breast, which was accompanied with a sort of dread. My breathing is much improved; perspiration in a great measure restored; and my skin, which was dry, is now become moist. I sleep well at night, whereas I could not sleep more than two or three hours out of the twenty-four. My thirst, which was excessive, has ceased to be troublesome." This man, however, was not cured. The sp. gr. of his urine remained above 1030°; and six months afterwards, a wetting brought on pulmonary disease, a return of diabetic symptoms, and death.

Of Opium, Dr. Watson says, "It is a treasure to us in this disorder. It quiets the nervous irritability of the patient, allays many of his most distressing sensations, and restrains in a remarkable manner the morbid profluvium from the kidneys. But it does not banish the sugar itself." It is probable that these results follow from the well-known

physiological influence of the drug upon the nervous centres. But if Opium has ever done anything towards the cure of diabetes, it has been in virtue of its homoeopathicity to the symptoms. Dr. Coze, of Strasburg, resolved to determine its physiological action in this sphere, and acccordingly injected fifteen grammes of muriate of morphia in distilled water into the internal jugular vein of a rabbit. On examination, the quantity of sugar in the liver was found more than doubled, and likewise that contained in the arterial blood. The urine was not examined.*

"Steel is sometimes singularly beneficial in repairing the strength, and enlivening the spirits." If this is all that can be said, we cannot look to this metal as a remedy for diabetes.

Kreasote has more in its favour. Dr. Watson succeeded in keeping a bad case alive for a twelvemonth by its use, conjoined with a diet as exclusively animal as she could bear. The patient was eight years old, and took one minim of the drug three times a day. She regained her lost flesh, strength, complexion, and spirits, and grew considerably. But at length she suddenly sank under an obscure affection of the chest. A brother of this little girl's manifested unequivocal signs of the same complaint; and in him it appears to have been equally checked by the same method of treatment. "I have frequently," says the Doctor, "prescribed the Kreasote with similar results. The late Dr. McIntyre told me that he had found the Kreasote very useful in diabetes. I must however acknowledge that, in common with others, I have sometimes been totally disappointed by it." I may add, while on the subject of Kreasote that our own Trinks, in commenting on two fatal cases of diabetes occurring in his practice, remarks that "Kreasote seemed to exert most powerful effect on the morbid activity of the kidneys."+ It did not cure, however, and there is nothing in its pathogenesy to lead one to expect that it would.

One other point of practice referred to by Dr. Watson,

* British Journal of Homœopathy, vol. xix.

+ Ibid., vol. ix.

is rather curious. "I have found," says he "(acting upon a suggestion of the elder Dr. Latham's) that distilled water acidulated with phosphoric acid, appeases, more than most things, the painful sensation of thirst from which diabetics suffer." The same recommendation is given by Pereira in his Materia Medica on the authority of Dr. Paris. The facts I have to bring forward relative to the curative power of Phosphoric acid over the disease itself give much interest to this practical observation.

So far Dr. Watson: and so far allopathy at large. I know not of any additions made since the date of his fourth edition to our knowledge of the treatment of diabetes. The publications of Dr. Pavy and Dr. Harley are both

more recent.

But all Dr. Pavy has to say is that with the exception of Opium, no drug he has tried seems to exert the least influence on the disease. Dr. Harley recommends sedatives for the cases he believes to depend upon exalted glycogenetic action, and tonics for those where defective assimilation is regarded as the essential fault. This is little more than Dr. Watson's Opium and Steel in another form: and does not appear to meet with much more success.

We pass, then, from what chance and theory have done. in three thousand years, to see what has been accomplished in little more than half a century by investigation guided by inductive principle. I think the conclusion we shall come to will be, that while diabetics have to thank traditional medicine for their palliative diet, they must look to homœopathy for their curative drugs.

Beginning with Hahnemann himself, we find that from his survey of the hundred or more substances proved by him, he concluded that Argentum and Scilla were the two medicines which could safely be recommended for diabetes. Whether by "diabetes" he meant simply diuresis, or whether he intended the true glycosuria, we cannot positively affirm. But since he never tested the urine of his provers, he left out in his comparison of drug symptoms with disease the very symptom which, according to his own principles, is here characteristic and determining. Argentum and Scilla may be homœopathic to diabetes insipidus; but in the