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the conviction of the necessity of large doses or after? We ask this because the hypothesis stands so absolutely alone in Hahnemann's doctrines, that it looks like something not belonging to them at all, and thrust in awkwardly. There is no doubt that the pathogenesis of Camphor gives a striking picture of the first stage of cholera, so that the remedy is really and truly homoeopathic; but if so, why did not Hahnemann prescribe it in his usual dose—the 30th dilution t Is the reason of this, perhaps, that he first became aware of the wonderful power of Camphor in cholera from his correspondents in Poland and Hungary or from newspaper articles detailing its efficacy, that he was convinced by these reports that massive doses of the remedy must be used, and that he could not well claim the remedy to be merely homoeopathic to the disease without at the same time saying as usual "that the suitable dose cannot be too small," unless he could assign some valid reason for its administration in big doses, besides its homoeopathicity. The cloud of microscopic organisms and the necessity for their destruction—Camphor being assumed to be their poison—was such a satisfactory reason for the large doses, that it would be irresistible to Hahnemann at this period of his life, when altogether oblivious of his former denunciations of hypotheses, he was spinning them in quantities in his Coethen hermitage. Whether the idea which about that time was "in the air" that Camphor was inimical to microscopic germs of disease in general and which was soon after this formulated into a regular system by Raspail, had anything to do with Hahnemann's hypothesis of the origin of cholera and his antidote for its supposed cause, must of course remain for ever unknown, but they certainly seem to have some sort of connection with one another. It is significant that he scarcely alludes to the homoeopathicity of the drug to the disease, while he speaks so decidedly about the power of Camphor to destroy the invisible germs on which he supposes cholera to depend. But whatever the true explanation may be, we must always look upon it as a happy inspiration of Hahnemann's that amid the thousand and one remedies proposed and given for the cure of cholera he was able to point to Camphor as the one remedy capable of combating the terrible onslaught of the pestilence. Whether Hahnemann's hypothesis about minute living organisms being the cause of cholera be true or not, we must wait for the report of the experts M. Pasteur has sent out to Egypt to search for the cholera microbe, and perhaps they may fail to couvince us even should they assert that they have captured a real live micrococcus.

When, however, Hahnemann believed that the disease had advanced to a stage when Camphor was no longer indicated, he directed Cuprum or Veratrum album to be given, or, as he says in the same letter to Peschier, the two medicines in alternation, and the experience of many of his disciples has proved the efficacy of these remedies.

Others, especially Drysdale and Russell, place most reliance on Arsenicum when the period for administering Camphor is past. Some surprising cures were effected in the Liverpool epidemic by arseniuretted hydrogen gas inhalations, even when the patieuts were completely collapsed.

Hughes {Manual of Therapeutics, vol i, p. 113) says that Aconite presents symptoms most strikingly resembling the collapse of cholera, a resemblance that was pointed out by Hempel many years ago, and he adds that Cramoisy found it of excellent service in that stage.

Sircar, who has had much experience of the cholera in India, lauds Hydrocyanic acid in those cases of collapse, when, "along with pulselessness, the respiration is slow, deep, gasping or difficult, and spasmodic, taking place at long intervals, the patient appearing dead in the intermediate time."

For the suppression of urine, threatening uremic poisoning, if Arsenic does not suffice, Terebinth and Cantharis may be used, or Kali bichromicum which Drysdale found efficacious in no less than twelve cases.

For the consecutive fever, which so often follows an attack of cholera, that has not been cut short by the above remedies, Drysdale found Phosphoric acid most frequently useful.

It is not intended here to give anything like full details respecting the treatment of all the different stages and accidents of cholera. These have been so fully treated of in works like Russell's History of Epidemic Cholera and Hughes's Manual, that we need only refer our readers to those excellent works for detailed information. The present writing is only meant to refresh the memory of those who, in the event of cholera again making its appearance among us, may be called on to treat the disease.

Before concluding, however, it may be as well to say something respecting the prophylaxis of cholera. Hahnemann recommends a small dose of Cuprum to be taken every morning during the prevalence of the epidemic, either alone or in alternation with an equally small dose of Veratrum {Lesser Writings, p. 848). He also mentions that the wearing of a small plate of copper next the skin has been found an efficient protection from the disease. Dr. Schmit, physician to the Duchess of Lucca, also testifies to the prophylactic power of such a copper plate worn over the pit of the stomach. During the various epidemics in this country similar copper plates were worn by many by the advice of homoeopathic physicians, and it is not known that any who wore them were attacked. Dr. Burq, of Paris, the distinguished inventor of the system he calls metallo-therapie, made a careful investigation of the liability of the Parisian artisans to cholera, and he found that those engaged in the manufacture of articles of copper and brass were nearly entirely exempt from the disease and that they were the only class of artisans who escaped. He, too, recommends as a prophylactic the wearing of a copper plate next the skin.

In view of these facts and observations, the wearing of a small copper disc next the skin over the epigastrium is to be recommended to those who may be exposed to the infection of cholera. If copper, as we have every reason to believe, exercises an antidotal influence to the cholera miasm, it seems highly probable that its prophylactic power may be obtained as well by the application of the metal to the skin as by taking it by the mouth. I have on several occasions observed decided copper symptoms produced by the metal so worn, such as painful sensations in the pit of the stomach and even a pustular eruption on the skin.

One word in conclusion. The extreme purging and vomiting that often constitute the chief features of cholera, render the administration of medicines by the mouth a doubtful mode of obtaining their effects. Perhaps the hypodermic method of giving the medicine may be found the best, especially as regards Arsenicum and Cuprum. Dr. Drysdale devised an ingenious method of giving arseniuretted hydrogen by inhalation, but the difficulties of this method are rather apt to deter practitioners from its frequent use. No such difficulties attend the subcutaneous injection of the dose of the appropriate medicine, which, therefore, is worthy of a trial should the cholera again visit us.

Nothing has been said here about the sanitary measures which ought to be adopted, such as flushing drains, cleansing dust-bins, and securing a supply of pure water. These have been sufficiently dwelt upon by the medical authorities of the old school, and should be carefully carried out wherever possible. But the best sanitary measures will not always ward off the disease, and in a large town it is not always possible to secure perfect sanitary conditions were these even certain to avert the disease, which unfortunately they are not.

EXPERIMENTAL INVESTIGATIONS INTO THE CAUSES OF DIPHTHERITIS AND THE PRACTICAL LESSONS DEDUCIBLE FROM THESE— AN Unsuccessful PRIZE ESSAY.

By Carl Franz Dominik Von Villers, M.D.

Preface.

The author has thought fit to retain the words of the question proposed for competition as the title of his essay, although in its composition this was not strictly attended to; indeed, he has in the commencement of the essay ventured to criticise the title, which as a homoeopathic practitioner he was bound to do. On this account also, the author before putting his pen to paper renounced all idea of gaining the prize offered by Her Majesty the Empress Augusta even should the judges, contrary to all probability, have agreed to allow the work of a homoeopathic physician to compete.

The essay is printed just as it appeared in the manuscript submitted to the judges; with only a few unimportant alterations, rendered necessary by the abandonment of its anonymous character, after the decision of the judges.

Suhtilior et praestantior ea est seientia, qua, quod aliquid sit et cur aliquid sit, una simulque cognoscitur; non separatim quod et cur sit.Aeistoteles.

Next to cholera, typhus and pneumonia, by reason of its very frequent occurrence and the greatness of its fatality over other diseases, hardly any disease more urgently demands from physicians and naturalists a more thorough investigation into its mode of origin, its course, and its pathologico-auatomical character than diphtheria.* This has been done with praiseworthy diligence, and the result is that the mode of origin and of propagation of the disease in question have been ascertained without doubt. The researches of KJebs, Pasteur, Tomasi, Cohn, and others, deserve the thanks of contemporaries and posterity.

But if we ask if any conclusions of use for therapeutic purposes have been drawn from these brilliant investigations, if they have enabled the practitioner to cut short the

* The author prefers the word diphtheria, which is adopted by many authors, for the reason that the Greek termination " trig" denotes inflammation of the organ to whose proper name it is affixed, whereas the appellation of the disease in question is derived from the word di^Bepciv, to tan, and the affected organ is only understood not expressed, and the termination " eta" serves to indicate the process. So SupQipiTa, diphtheria.

VOL. XLI, NO. CLXVI. OCTOBER, 1883. Y

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