Who was this man Hahnemann? Let me quote from a contemporary and one opposed to his convictions in medicine: "No careful observer of his actions, or candid reader of his writings, can hesitate for a moment to admit that he was a very extraordinary man—one whose name will descend to posterity as the exclusive excogitator and founder of an original system of medicine, as ingenious as many that preceded it, and destined probably, to be the remote, if not the immediate, cause of more important fundamental changes in the practice of the healing art than have resulted from any promulgated since the days of Galen himself. Hahnemann was undoubtedly a man of genius and a scholar; a man of indefatigable industry, of undaunted energy. In the history of medicine his name will appear in the same list with those of the greatest systematists and theorists; surpassed by few in the originality and ingenuity of his views, superior to most in having substantiated and carried out his doctrines into actual and most extensive practice.

What thought this wonderful man of the value of medicine in the days preceding the birth of the law of similars? It was because of serious illness in his own family when, uncertain as to the methods to be employed for their relief, he thus expressed himself: "Eight years of scrupulously careful practice have shown me the nothingness of ordinary curative means; my sad experience has taught me but too well what may be expected from the advice of the greatest men. However, it is, perhaps, in the very nature of medicine, as many great men have already said, to be unable to arrive to a very high degree of certainty."

In the middle of the last century Sir John Forbes thus wrote: "The same truth, as to the uncertainty of practical medicine generally, and the utter insufficiency of the ordinary evidence to establish the efficacy of many of our remedies, as was stated above, has almost always been attained to by philosophical physicians of experience in the course of long practice, and has resulted, in general, in a mild, tentative, or expectant mode of practice in their old age, whatever may have been the vigorous or heroic doings of their youth. Who among us, in fact, of any considerable experience, and who has thought somewhat as well as prescribed, but is ready to admit that, in a large proportion of the cases he treats, whether his practice, in individual instances, be directed by precept and example, by theory, by observation, by experiment, by habit, by accident, or by whatsoever principle of action. -he has no positive proof, or rather no proof whatever, often indeed very little probability, that the remedies administered by him exert any beneficial influence over the disease? We often may hope, and frequently believe, and sometimes feel confident, that we do good, even in this class of cases; but the honest, philosophical thinker, the experienced, scientific observer, will hesitate, even in the best cases, ere he commit himself by

the positive assertion, that the good done has been done by him. When physicians of this stamp have met in consultation in any doubtful cases, and when they have chanced to be startled out of their conventionalities by the bold doubt, or bolder query, of some frank brother of the craft, has not the confession, like the confidence, been mutual?"

It was, then, following these years of skepticism and after years of careful, painstaking experiment, that Samuel Hahnemann gave to the world his principle of similia similibus curentur; and through all the years which have passed his followers have shown no abatement of their enthusiasm in their faith in this law of cure. You may, if you like, attribute to others priority in the thought of first ascertaining the effects of drugs on the human body before using them in disease, yet as Rutherford Russell has well said: "The inductive philosophy of Bacon and Hahnemann and the application of its truths were necessary to the establishment of this law." What is it to believe in a law and practice it? To believe or not to believe in a philosophical point of view, and apart from the theological acceptation of the term, signifies to give or withhold one's approval after having fully and seriously examined every new idea that bears the stamp of truth."

To practice it presupposes a thorough knowledge of the subject and a careful following out of its principles. What, briefly, are the essentials of the law of cure, for such we deem it to be?

First. That every drug should be thoroughly tested upon the healthy human body, and that facts thus elicited shall be supplemented by further experiments upon animals, and also by the results of poisoning when that is possible.

Second. That the conditions thus, occasioned are those which when present in diseased states will be cured by these same drugs.

Third. That the dose to accomplish this must be sufficiently minute to occasion no aggravation of the symptoms present. What are the advantages to be gained from using drugs in this way?

(1) Simplicity in form and administration, the single remedy its natural corollary.

(2) Precision.

(3) It assists nature, does not thwart or check her, and thereby fulfils that most important essential of all cures.

You may naturally ask what is the basis of its action, and I can do no better than to quote from a recent article by Dr. Villechauvaix: "To explain homoeopathic cures Hahnemann evolved a certain number of theories. At first he considered that the organism was much more sensitive to drug-action than to disease; that drug-action was absolute; disease action but relative. Then he concluded, that to induce a cure a slight aggravation

was essential. Later he argued that the drug-disease was substituted for the natural disease and in turn vanquished by the reactive powers of the organism. This is the 'substitution method,' borrowed by Trosseau from Hahnemann. These theories lack solid scientific foundation, and Hahnemann finally said that the law being an established fact, its explanation was of lesser moment. However, when this law shall be scientifically explained, homœopathy will become omnipotent in medicine and the most prejudiced mind will be forced to accept it."

I have purposely ignored certain features of homoeopathy as not germane to the subject. That homoeopathy is capable of curing tuto cito et jucunde is to us perfectly self-evident, but to the seeker after truth, this is a thing to be proven. As a recent editorial rightly has said: "Drug giving may or may not be a permanent factor in the art of medicine; that is an open question we who are homoeopathic specialists believe,and with the soundest reason, that it is a factor far yet from being outworn. Be that as it may, we repeat, drug giving is not synonymous with the art of medicine. It may rise or fall; the art of medicine only declines when the physicians' means of healing the sick decline in number or in power. Has this been the case in the last twenty years? Is there anyone who would seriously make a claim so instantly refutable? We need cite but a few shining instances in disproof. What of diphtheria, fatal twenty years ago, in from 40% to 60% of the cases attacked-today treated in hundreds of consecutive cases without a death? What of tuberculosis, whose mortality, in the city of Boston alone, has been reduced 50% in the last quarter century? What of the once incurable headache, now easily diagnosed as due to eye-strain, and as easily cured? What of the innumerable hay fevers, reflex coughs and their kin, disappearing promptly after removal of nasal growths and hypertrophies? What of the regaining of lost nervous balance, under the various forms of rest cure? What of the once lethal cyclone of 'peritonitis' cases, today recognized and relieved as appendicitis? What of the vastly more intelligent treatment of anemia, possible on the knowledge obtainable by the laboratory student' of today as to whether the case be one of chlorosis, leukemia, or primary or secondary anemia? We surely need not multiply proof. Even superficial study of that already adduced must convince any impartial investigator that the art of healing-the only true synonym of the art of medicine is not declining, but progressing; and that, with beneficent speed."

Let us admit from the beginning that in the cure of the sick many influences must be considered.

(a) Natural history of morbid processes.

(b) The recuperative energies of the organism.

(c) The favorable agencies of hygiene.

(d) The power of personal magnetism in the practitioner. (e) Suggestion and auto-suggestion.

(f) Faith.

(g) Courage.

(h) Drugs.

Here then is the problem which faces every fair-minded man, to apportion to each of these influences its due weight. It is not strange that there have been differences of opinion; no two cases are alike, as no two individuals are alike, and it does seem as though in certain carefully and well selected cases we should possess definite information as to how much or how little drugs are factors. It would not be difficult in functional diseases to determine this factor; but in self-limited diseases the problem is a diferent one. Homoeopathy has won its successes in the treatment of epidemic disorders, and we point with pride to those statistics so long ago offered by Fleischman in the successful treatment of pneumonia. The time is coming and is not far distant when such tests of the remedial power of homeopathic drugs as shall silence all doubt will be made. It is the truth that we seek; self-deception must not longer rule us, and suffering humanity will be the gainer. The weakness of homoeopathy lies in the crude and imperfect application of its principles, and in that most important defect, lack of entire faith in its adaptability. Polypharmacy in the minds of most of the new school is an anachronism, a thing not to be tolerated; and yet with us it is even now a menacing evil. This, gentlemen, is not homoeopathy; give it some other name if you wish to adopt it; but leave to us the single remedy and the approval of an honest mind. As Dr. Elbridge C. Price has well said: "Do not forget, however, that since the days when Hahnemann wrote his 'Organon,' the world has progressed, arts have become more vital and effective, and the ever-multiplying branches of science have evolved into varied systems of learning of which the sages of the eighteenth century could have no conception. Do not forget that it is quite possible for many of the unessentials which have grown up beside the vital law, to be proven to be without foundation in fact, and that it is un-Hahnemannian in men of today to refuse to recognize the demonstrable facts of science. And finally, do not forget that nothing ever yet has modified in the slightest the truth of that eternal verity, the law of similars, and, to judge from the sublime verdict of the ages, nothing ever will. Its roots dip deep beneath the dust of remotest antiquity, and its branches reach out into the empyrean of coming time, bearing its leaves to all the ends of the earth for the healing of all the unborn nations of all futurity."

THE HOME TREATMENT OF PULMONARY

CONSUMPTION.*

BY J. P. RAND, M.D., WORCESTER, MASS.

The advantages or disadvantages of the home treatment of pulmonary tuberculosis depend upon the location, the family and the patient. In a farming community, a rural village, or even in certain sections of a great city, under proper medical direction a patient can be cared for just as well, perhaps better, than in a sanatorium. I said under proper medical direction. And this brings me to the first essential to the successful management of these cases, and that is an intelligent, tactful, enthusiastic physician. In the first stages of consumption the patient is apt to be discouraged and depressed. He goes from one physician to another until he finds one too ignorant to diagnose his trouble, or too dishonest to tell him the truth who informs him there is nothing the matter with his lungs, that his cough comes from a little bronchial irritation, his weakness from indigestion, and that there is really no necessity for him to change his occupation or mode of living to recover. That is the kind of a diagnosis he wants, and that is the kind of medical advice he is after; and the honest physician who could make an early diagnosis is discarded for the ignorant optimist, who could hardly distinguish an emphysema from a pleuritic effusion. Deceived by false promises the poor patient fritters away his opportunities for real improvement, and ere he is aware has reached the stage when an observing layman would recognize his disease.

My experience is that it is difficult to make a truly incipient case appreciate the gravity of his condition or the necessity of immediate and persistent treatment. Later on when no one but himself has any hopes of his recovery he will squander his strength and bankrupt his family in his mad chase for specifics. as advertised in his weekly newspaper. But patients are not all alike. The great "white plague' is no respecter of persons, and ape and scientist are both stricken with this disease. It requires some force for a patient with tuberculosis to make the necessary effort to recover. Many of them are anæmic women and nerveless men who know absolutely nothing of physical labor. There is not a single healthful occupation to which they can turn; and even if they could, they could earn but little by it. The stimulus of satisfactory wages that crowns the toil of the ordinary laborer is denied them, and when they are compelled to give up their previous and only means of livelihood they become completely discouraged. There is no doubt but the

*Read before the Rutland Clinical Club, at the Massachusetts State Sanatorium, Jan. 12, 1906.