found degeneration of the retina, one again asks how mercurial treatment could have the power of regenerating the rods and cones, the nerve cells which are destroyed, and reëstablish the delicate functions of the most delicate organ.

No doubt that, in the matter of therapeutics, a priori deductions, however logical they may appear, and good commonsense, however indispensable it may be for a medical man, are not sufficient to judge the value of a remedy. Experiment has the last word, and observation is the only judge; but the experiment has been made only too often, and observation has given the verdict. Mercury has proved to be quite useless. It is also inert in other affections in which the absorbent effect attributed to this metal seemed to give it a certain right to be tried. I mean the chronic exudative inflammation of different parts of the uveal tract — iritis, irido-cyclitis, serous irido-choroiditis. Except when these affections depend upon syphilis, mercurial treatment is at least superfluous, if it do not exercise a bad influence. In fact, these ocular diseases are met with almost always in cachectic persons, in children, young anæmic girls, badly nourished, living in deplorable hygienic conditions, in women with irregular menstruation suffering from leucorrhoea or from uterine troubles. The treatment of these affections, the raising of the gen eral tone are here the highest necessity, and this is obtained in a way far different from hypodermic injection or inunction of mercury.

I have never had recourse to this heroic form of treatment, and moreover, in studying the reports of special clinics, in observing the patients who have been submitted elsewhere to treatment of this kind, I may assert that hygiene, combined if necessary with local treatment, and with a rational general medication directed against special lesions, always suffices to bring about a retrocession of the morbid process, and to save the organ of sight.

A friend brought me his young wife. She had gradually lost the sight of her right eye in the space of a few weeks. It was scarcely possible for the patient to recognize the movements of the hand; a large portion of the retina was no longer functionally active, and produced a scotoma in the visual field. The opthalmoscope revealed an optic neuritis of a most evident character, swelling of the papilla, serous exudation, in which the tortuous and gorged blood vessels were immersed. I did not hide from the husband the gravity of the affection. I explained to him that it depended probably upon a general disease, and that local treatment would not at all suffice, and I therefore sent him to the family physician. This colleague was a homœopathist; he gave infinitesimal doses of those remedies into which there does not enter an atom of mercury. Along with this, a state of hygiene, local and general, was strictly observed, and at the end of six months the neuritis had disappeared entirely, leaving the papilla sensibly pale. Vision, direct as well as indirect, has become normal, and things remain in this state still.

A UNIQUE CASE. - We extract the following from the British Medical Journal: "A nice point of law has lately been debated before a French court. The question was, whether an operation on a dead body by an unqualified person came within the meaning of the enactment forbidding the illegal practice of medicine? It appears that a pregnant woman had just died, the cause of death not being stated. The Cure of the village, who had been with her in her last moments, induced a neighbor, who was in the room, to perform Cæsarean section on the corpse, with a view of saving the child. The operation was successful, but the operator was brought before the magistrate and fined fifteen francs for having been guilty of illegal practice of medicine." — Med. Argus.

T

COMMUNICATIONS.

-:0:

THE SCALE EMPLOYED IN MAKING DILUTIONS AND

TRITURATIONS.

BY C. WESSELHOEFT, M.D., BOSTON.,

Chairman of the Committee on Pharmacy.

[Read before the American Institute of Homœopathy.]

The object of this paper is to discuss the process known among us as potentiation by dilution, its objects and its effects, and also to ascertain what is actually known about it, and what is theoretical. This will appear more clearly at the end of an investigation of the reasons why we have always made use of two definite scales, as they are called, of diluting drugs - the centesimal and the decimal scales, as if these two depended on some fixed and unalterable law of nature, from which we must on no account depart. Hahnemann finally adopted the centesimal scale as a standard, which, for no reason except that it was so ordered, was adopted as a law, till Hering and Vehsemeyer, probably, objecting to the vastness of expansion, or through some other reason discovered the law that the greater the mass of vehicle, so much the easier is the effect of the medicinal substance; according to which "law" decillionths, potentiated in the ratio of 1:10, are much stronger than decillionths made in proportion of 1:100. In the proportion of 1:1000 the billionths act easily and quickly, while in the proportion of 1:10,000 all effect soon ceases. This is quoted by Buchner from the Archiv., Vol. XIV.: 2, p. 134 Since that time the decimal scale has been adopted, never to be departed from. Whatever reasons or proofs Hering may have given of his law, I doubt very much if they were more than rather positive assertions.

Be that as it may, why do we dilute or potentiate? It is for the purpose of diminishing the virulence of very active or "poisonous" drugs. This was the very natural and rational motive of Hahnemann, originally underlying the introduction of the process. It naturally arose from the experience of the time when excessive doses of very active drugs led to disastrous results which physicians sought to obviate by increasing their doses. To obviate the danger of such practice, there arose the humanitarian principle, upon which homoeopathy is based, namely, that medicine to do any good, must first of all be made safe by removing the danger of excessive dosage. The finding of the principle of similars, under which the quality rather than the quantity of a drug came into play, made the reduction of dosage useful and efficient, which is deemed impossible as long

as medicines are used only as antagonists, though there is no real reason why this should be invariably the case.

Gradually it was thought that potentiation or, better, expansion of surface by dilution or trituration, not only served to diminish the force of very active drugs, but that it essentially served to develop the strength of not very active drugs; and even to cause ordinarily inert bodies to become medicinal. All this is perfectly rational on general principles, and is illustrated by numerous examples; of which the relation of undivided quicksilver to that metal in fine subdivision, is a familiar example which illustrates a rule without which physics, chemistry, pharmacy, and mechanics would hardly have an existence-corpora non agunt nisi soluta (sive comminata).

But we speedily arrive at a paradox as soon as we take into consideration the particular method pursued by pharmacists in preparing drugs for homoeopathic use. Here not only is the strength of every active drug diminished, and the latent powers of mild or inert substances developed, but now the decimal scale, with its very swift progressive diminution by ten, comes into play; this diminution was still more swift and beyond the powers of the mind to follow in its flight when the centesimal scale was in use.

The paradox by which we are now confronted is involved in the question Granted that dilution or expansion of surface increases drug-activity, do active drugs, like belladonna or arsenic, grow more active when diluted or expanded? Do weak drugs, like coffee or charcoal, grow more active under the process of equally progressive dilution involving constant diminution of substance with constant expansion of surface? Again: Is the medicinal power increased while the substance is diminished; and if so, in what ratio? Thirdly, is the medicinal power indefinitely increased as the substance is indefinitely or infinitely diminished? Fourthly, what is the relation or ratio of the power of an originally poisonous drug to the power of an orginally feeble drug when both have been carried to an advanced stage in progressive "potentiation"? Let us ask, for instance, what is the relation of arsenic in the 30th (supposing this were attainable) to coffee in the 30th ?

Those to whom homœopathy is a religion, will scorn as sacrilege the attempt at finding a solution to any of these questions. Those to whom it is a matter of knowledge lacking much in accuracy, will keep on trying to find some satisfactory restingplace for their minds, besides and beyond the clinical test which, even in its most reckless form, is made to support everything doctors do or think.

In order to solve one or all of the propositions just mentioned,

we should, to begin with, have a definite idea or conception of what goes on with a drug while being potentiated, and, above all things, we should know exactly, in the case of each drug, in what ratio its power increases at every step of progression. Does its power keep pace with it, or does it go ahead of it, or fall behind it? In other words, if a drug is expanded tenfold, is its power also increased tenfold-or is it increased more, or less, than tenfold? And what becomes of the developed force during progressive reduction of substance?

To answer these questions it should first be positively known at what rate the medicinal power of a drug increases by expansion of its surface. That such an increase takes place is known. with regard to matter in general. Chemistry would be an unknown science without this quality of matter, and chemical forces of matter are estimated by the proportion of their combinations, which take place almost exclusively during solution or under the influence of heat, pressure, etc., in substances in a state of solution or comminution. But medicinal power can not be calculated in that manner, and can only be assumed to exist. When, therefore, we dilute, i. e., expand the surface of a given quantity of a drug ten times, we may assume, without clear evidence, that its power has also been increased tenfold, but it might with equal right be assumed that its power would be increased twentyfold or only twofold, for there exists no accurate or even approximately correct method of determining this point. For argument's sake, let us assume that if a given quantity of a drug were diluted by ten times its quantity of a vehicle, its power would be increased tenfold; by adding ten parts more of vehicle its power would be increased twentyfold, and so on thirty times. The power of the whole of the original quantity expanded thirty times would then be three hundred (300) times greater; and if it were possible to introduce the whole quantity into the human system, its effect should, theoretically, be three hundred times greater than if the original quantity unexpanded had been taken into the body. Whether this is so or not we have not so far been able to ascertain, and we are all working with an hypothesis.

But in actual practice we never can, nor do we attempt to, use the whole quantity of a potentiated drug expanded by dilution through many stages, e. g., the whole of the tenth, twentieth, or thirtieth, but only a minute fraction of it, either at a dose, or for the purpose of making the next higher dilution; of this we again take a tenth part and so on, as far as we please. This, expressed in the simplest arithmetical form, would be perhaps made plain by considering the original quantity of a drug to be composed of two factors, the power and the quantity. In this instance we

have assumed that if the substance is expanded by ten, its power is also increased by ten; but this is merely a tacit assumption of very ancient date. We have no positive method of determining toxic force, or power, in a given drug, or means of expressing it in a true and intelligible formula. In reality the same drug probably varies in toxic power at different times of its production; likewise does the organism of the prover vary; in fact, we are confronted by a problem of an unknown quantity of resistance to a variable or wholly unknown quantity of force. If any there are who can furnish us with a reliable working formula regarding this relation, based on experimental research, I am unacquainted with them or it, and fear that nothing of the kind exists in therapeutics or toxicology.

If this is so, we are thrown upon our resources of deduction from general observations; that is, we assume a thing to be thus and so. This being the only course left open to us, we assume that the development of force by the scale of ten, is equal to ten at every step; or we may assume a variety of proportions or scales; but whichever we adopt, the formula will remain the same; namely, that the quantity and power divided progressively by any number, 10 or 100, and then divided by the same number, that is, if both power and quantity are multiplied by ten and then divided by ten, both are increased and diminished in exactly the same ratio. So that even if the power is developed tenfold at each step of the progression, and if we use only one tenth of this we lose nine tenths of what we have gained, and are, therefore, diminishing the power just as fast as we are diminishing the quantity.

This is perfectly plain under the hitherto assumed proposition of gain of strength by progressive potentiation, and this expression, therefore, becomes a very fallacious one, and cannot be applied practically to the medicines we are using. It has led to a misconception of the whole subject by holding fast the idea of potentiation, and dropping out of sight the idea of progressive loss of power with substance. Hence the fear of many, that the method might dangerously increase the power of a potentiated drug, amounts to a superstition. This has created endless mischief by introducing an element of mystery which our school has never shaken off, notwithstanding the protests of an Attomyr, a Grieselich, a Dudgeon, and a Skoda.

For all that, the simple method of dilution, and of using small quantities of drugs whose surfaces have been increased by dilution, wet or dry, has been the medicine of the past century, as it will be the medicine of the future. Expressed in a few words, this is the groundwork of our practice; it is this and nothing more. Unfortunately the simplicity of the principle has been