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intellectual powers are unimpaired and his judgment matured, has devoted his attention to the materia medica, and invites all to join in bringing out a volume of it in the most complete form, containing twelve to fifteen medicines, to be followed, it is hoped, by others till we have a complete work worthy of our privilege as possessing a law of specifics. It is my opinion that by an earnest prosecution of a work like this we shall be doing far more for the true advance of homoeopathy than by all the working of societies, schools, and publications in semipopular ephemeral literature that are now boasted of so much as signs of progress. If we had a complete materia medica, a complete index to the same as a repertory, and a work such as the contemplated Therapeutic Repertory, which would show what our practice really is, little more would be wanted to convert the whole medical profession to homoeopathy.
Without further preface I propose to continue the discussion begun in the Edinburgh Congress on the plan of the proposed work.
The following three propositions were agreed to, viz.:— (a) "It shall provide a collection of pathogeneses in the way of provings, poisonings, &c., and these shall be corroborated by post-mortem results whenever possible." (b) "It shall provide an interpretation of these pathogeneses by way of commentary on the general and topical action." (d) "It shall furnish clinical confirmations of the general and local operation of each medicine by means of clinical cases or cures." All these, as well as the critical revision of the symptoms, were admitted to be so obviously essential that no further discussion is necessary on them. But proposition c, viz. "It shall provide a schema of these pathogeneses on the different organs, with indexes and concordances," elicited a variety of opinions, and met with so much opposition that it was only carried by the casting vote of the chairman. It is, therefore, evidently a question requiring more ample discussion. To begin the same I beg to put forward the following considerations.
In the first place, the question of the concordance may be at once put aside, for although it may be useful for any one studying the proving for a particular case in practice to be able to find at once the other medicines having the same symptom, yet that advantage is so far superseded by the Cypher Repertory which was not in existence when the Hahn. Mat. Medica was begun; and as the concordance would add much to the trouble of doing a medicine and somewhat to the cost of printing, it may be omitted. At the same time, if any striking resemblance of the more or less characteristic symptoms to other medicines occurs, that can be noticed in the commentary. There remains, then, only the question of the schema, which I cannot but consider the cardinal point in the arrangement of a medicine, and, in fact, the position taken by any practitioner in discussing the question becomes a kind of test of his own fidelity to homoeopathic practice. For he who shows an indifference to the schema or some equivalent mode of easy access to the minute symptomatology of the medicine unwittingly betrays the fact that he is little in the habit of adapting the symptoms to the case in hand, but rather of trusting to clinical and general indications, which might be quite as well learned and used empirically without any reference to the homoeopathic principle at all. For example, every homoeopathic practitioner prescribes Aconite daily, probably several times, on the general indications summed up as inflammatory fever, but how many consult the materia medica before doing so to see how far the minute symptoms correspond to the case in hand, and thus justify the differential diagnosis between it and other medicines for inflammatory fever? Nay, how many have ever in their lives studied the pure symptoms to discover the facts which justified Hahnemann in the pathological induction that Aconite was the homoeopathic remedy in inflammatory fever of any kind?
The mode of settling the question by voting at a meeting of practitioners who have not specially worked at the matter practically is not a likely one to attain to success. Accordingly, we see that the chief opponents of the schema, viz. Drs. Moore and Nankivell, in their laudable wish to obviate the difficulties and imperfections of the Hahnemannic schema if standing alone, must have had in their mind's eye a very imperfect picture of the superabundance of minute details, the apparent total want of sequence and connection of the symptoms, and the numberless perplexities which beset one when he endeavours to bring the proving diaries into any kind of coherent arrangement. The only kind of tangible suggestion I can gather from the remarks made by the speakers is that all the proving diaries should simply be printed as they stand, somewhat pruned of redundancies and repetitions; the same should be done with histories of poisonings, and the whole rendered accessible by a complete index.
To judge how far this would suit the wants of the real homoeopathic practitioner, let any one take up Watzke's Colocynth, which consists simply of the proving diaries describing the symptoms in the natural order of their occurrence, and imagine an index added referring to the individual symptoms by a number. Supposing, then, it was wished to know all the varieties of any symptom of this drug, say giddiness, we should have a list of ten, or twenty, or thirty referring to that number of sentences or paragraphs where giddiness is mentioned scattered up and down the proving. To hunt up all these would be quite impossible for the practitioner. Suppose, then, to obviate all that searching through the pages of the proving, pretty full details of each variety were given in the index, that would be so voluminous as to amount to a complete schema, and involve printing the whole proving over again.
This is, in fact, what has been done in several of the Austrian re-provings, and it is not the worst plan independently of the size and expense of the work. But it has also a drawback in a scientific point of view, for the schema is then made in the old form of a badly*done Hahnemannic one, where the symptoms are torn from their natural group-connection. The practitioner having first to refer to it, soon comes to shirk the trouble of referring to the symptoms in their natural connection scattered up and down in the proving diaries, and falls back on the exclusive use of a badly-made schema. To obviate these difficulties I proposed a combination of the schema and index; the schema, however, being made up of groups in their natural connection. This, I still think, affords the most feasible mode of meeting the difficulties, although it is not easy in all cases to carry out in practice. Still it is founded on natural laws, for if we prove medicines ourselves, or attentively study the proving diaries of the effects of moderately small doses, we soon see that a great many symptoms appear either quite isolated or in small groups, and independently of these the prover is in perfect health. Such symptoms and small groups there can be no objection to arranging in the Hahnemannic order of the schema and they require no index. Other larger groups can also be arranged in the schema and alluded to by the index and in other departments. Other larger and more narrative groups, again, and poisonings, may require a separate department, and be merely alluded to in the index. Thus we shall have no need of reprinting the proving twice over, and shall be able easily to find all the symptoms and groups in the accustomed order of the Hahnemannic schema.
Dr. Hughes objects to the use of the index, and thinks that natural groups can be broken up so as to avoid the need of it by adding the number of the scattered components at the end of each symptom. This is, however, just an index, and the only question is simply whether it is a better kind. In some cases the index can quite well be so given, but in the majority it would lead us back to the fatal dismemberment of groups which is the present defect of the Hahnemannic schema. I still maintain that single symptoms or small groups which occur alone in a proving are most valuable to stand alone in the schema; there can be no doubt about them being independent. But when once you begin to tamper with natural groups for mere convenience of arrangement, you are in danger of losing the whole meaning of the morbid picture.
In the very example given by Hughes in the proving of Belladonna we have part of a group of a poisoning given under delirium, and at the end we are referred to three other symptoms in the schema many pages distant, and what are these? Some trivial accessory, or some parts of the case which have no pathological connection with the delirium? Not at all, for one is temporary total blindness, the next suppression of urine, the third dry hot skin, with a scarlatina-like rash. In none of these three is there a counterreference to the first symptom, viz. delirium, and to the last there is an additional reference to a fourth symptom, viz. pulse 170. Surely this group should never have been divided. How is the busy practitioner to find time to piece it together and fifty other such when he studies a case.
No doubt the practical difficulties of arranging the incoherent details of the proving diaries in the above way will still be very great, and I do not believe that any a priori plan will ever be found which shall altogether obviate them. So they must just be combated in detail to the best of our ability in each individual case.
One great desideratum is to prune the narrative of much redundancy and repetition, and also to find as far as possible by internal evidence which symptoms really belong to the drug by the confirmation of one prover's symptoms by those of another. Here also no hard-and-fast line can be drawn. On the one hand, Hering seems to lay down the doctrine that all symptoms, from whatever source, should at once be incorporated with the schema, and leave it to time and the clinical experience of the general body of practitioners to distinguish the true from the false, which latter can then be expunged. To allow, as he says, the tares to grow up with the wheat till the time of final trial. Others, such as the American Institute of Homoeopathy, forbid its executive committee to publish the reported symptoms of any drug which has had but one prover. If a hard-and-fast line were desirable I would rather side with the latter than the former plan of Hering's. Indeed, I think we cannot well be too scrupulous or severe in refusing doubtful symptoms admission to the schema, and I consider Hering's plan quite impracticable for the verification of symptoms, and worse than useless, as it throws discredit on the true symptoms and damages the proving so much that it becomes valueless till sifted or even re-proved.
Of course I do not mean that single observations should