lost sight of, running on the one hand into mysterious excesses, and being on the other hand almost neglected by too many who, using crude drugs, forget that by reasonable dilution much more may be accomplished. Mysticism, uncertainty, flagrant skepticism, are the results; and the most prominent sign of stagnation is the remarkable phenomenon that homoeopathy has run aground high and dry on certain empty names and phrases. These names are the centesimal and decimal scale and the numbers of certain "potencies," between which nothing is thought to exist.

If any one were to use another "scale," or proportion of drug to vehicle, say 1:1 or 1:3, etc., or were to report a case cured with the 7th or 29th or 133rd potency, I would not dare to say that his standing in this society, or its rival, would be an agreeable one; he would find little credence; but eyes and ears would readily open to the statement that the 3rd, 10th 30th or 200th had accomplished a cure. We are creatures of habit.

I have shown elsewhere, and repeat here, that the progression by 100 is far too rapid for even very active drugs. The first centesimal, representing 1 of the drug, may possibly be more active than necessary; while the second, representing the Taboo, already is far too weak; for, as I have just pointed out, in this instance we are not using the whole but only 100 of the potentiated power. This in the third and fourth steps of progression, has vanished into nothing; it is useless to examine the scale further than that. It is simply self-deception to think that the thirtieth (and, ye gods! the CMS.) have any power left; and the deception lies in the idea, with which many are possessed, that they are really using something dangerously and materially powerful — a psychological state akin to idolatry. If they really were capable of forming an idea of the transcendental, etherial sublimity of a high dilution — they would not use it!

The decimal scale, although an improvement on the centesimal, and showing a tendency to return from mysticism to rationalism, is still open to the same objections; it goes ahead too fast. The interval between 10 and 100 is very great; so is that between 100 and 1000, and still the latter is only the third step in the scale of progression. The intermediate grades are lost. The may be unsafe or useless; the rooo of many drugs is very often already inert. A case reported cured with the third is very uninteresting, because it is perfectly natural and commonplace, while one reported cured with high dilutions has about it an air of irresistibly fascinating mystery.

And yet we are not getting along fast enough, because we are aground on certain unprogressive notions. There is much work yet to be done in weeding out flagrant errors of pharmacy,

which, though they will not be encouraged in the forthcoming pharmacopoeia, will, nevertheless, be practised. The work is most needed where therapeutics and pharmacy merge into each other; above all things, medicines want to be prepared so as to do the most good with the least danger to the patient, and, as before stated, if there is one fundamental principle upon which all physicians will stand united, it is that principle of expansion by dilution divested of all excesses and mysticisms. And now, having prepared the way by a somewhat elaborate preamble, my proposition can be briefly stated.

Admitting the axiom, that expansion of surface by wet or dry dilution is the simplest and most beneficial form of administering medicine, it must also be admitted that it has limitations: it may be carried too far, and it may not be used when it should be. There are many drugs which develop their active principle quickly and noticeably to a dangerous degree. Their active principle is not latent, but free, e. g., prussic acid, belladonna, arsenic. There are others whose active principle though free, is not dangerously so, e. g., chamomilla, coffee in ordinary quantities. There are still others in which the active principle is latent, i. e., not readily apparent when these substances are, in a crude state, introduced into the body.

To treat these different classes of medicinal substances according to one undeviating, arbitrary scale is an error, for, while the decimal or even the centesimal scale would be serviceable as applied to very active drugs of easily-liberated powers, this same scale often entirely invalidates the efficacy of the less active medicines of the second class, so that already in the third or fourth dilution we are dealing with inefficacious, because too highly diluted, material. For the sake of argument, it may be admitted that it makes no difference whether we suppose the force separated from the substance or not, in either case it is lessened by such fearful strides that only too soon nothing is left of either matter or force. Now, it can be successfully maintained, that this class of substances should be treated ac cording to a different scale making less rapid progress in its steps, so that the intermediate possibilities of effect are not lost, but open to trial between 1 and 1, etc. While it is pos sible that the rooo will accomplish what the will not accomplish for want of proper expansion, the opposite condition is more likely to prevail, e. g., that the will do what it is impossible for the 1 to do, on account of its too great dilution.

In one class of instances we have to make use of dilution chiefly for the purpose of reducing an excess of free power, while in the third class we make use of dilution for the opposite purpose, that is, with a view to the increase or development of latent force.

There are only three instances calling for a variation from the common standard of scales of diluting, but they would have to be increased many times to adapt them to different drugs to be classified according to their powers; but this is avoidable and unnecessary when we revert to the fundamental principle, that is, development of force by expansion of surface. This is the principle to be held fast; the scale, to which too much importance has been attached, is not the principle, and should be varied according to the substance to be expanded. This is the only method by which a very minute and safe amount of drugmatter can be made to accomplish all that can be accomplished by medicine when used for the purpose of developing the specific effect, and this effect may be expected, provided we do not transcend the limits of possibility.

How, then, shall we best utilize this principle of potentiation if the old scale proves inadequate? Change the scale, is my answer. But, it may be asked, would not a multiplicity of scales become necessary and create confusion? This is easily avoided without violating any principle or without becoming in the least inconsistent: It is to adopt a scale which shall obviate enormous intervals by a slower rate of progression. Such a scale would be in the proportion of 1:1, 1:2, 1:3, etc.

This would answer best for the drugs of medium power as well as for those which in their crude form are practically inert. It is easy to adapt it to the wet and dry dilution potencies. If, e. g., coffee or chamomilla is diluted in the proportion of 1:1, the first would be of the strength of the tincture; the second, of; the third, of of the original substance with a proportionate degree of power. The power, though reduced in equal ratio with the quantity, is not lost so soon as it would be in the decimal or, much more certainly, in the centesimal scale. By this method we simply preserve the intermediate degrees of potentiation which are absolutely lost in the use of the usual scales. As we are unable to determine for drugs in general, or for any drug in particular, the ratio of increase of strength, and only able to assume by generalization that expansion of surface increases and develops molecular drug-power, we are equally unable to determine at what stage of potentiation a potency may cease to be practically useful before the substance reaches the point of extinction, which is reached somewhere between the twentieth and twenty-fourth decimal. At all events, long before the thirtieth centesimal. Hence, to make sure that we are not simply losing the beneficial effects of a chosen remedy by too rapid progression, we should seek every opportunity of testing, in cases of disease, those intermediate grades of potencies which have hitherto been unused; for instance, the possible

grades between the third and fourth decimal, representing all fractional parts of substance and power between and 1. In potencies of the centesimal scale, the difference between probably very efficacious fractional parts; for instance, between the third and fourth centesimal, or between any other two numbers, is vastly greater than is the decimal scale, and hence the probability of loss of therapeutic value and opportunity is much greater.

This is easily obviated by the employment of scales of less rapid progression, of which that of the proportion of 1:1, 1:2, and 1:3, are advisable, although scales of still less rapid progression readily suggest themselves.

The application of this proposition in the scale of progression to very active substances, might be just the same as with substances of less easily-liberated power. With poisons the object of dilution is not potentiation, but depotentiation. If, e. g., we desire to use a very poisonous substance as a medicine, our first object should be to reduce it in quantity and power. Now, the proportion of 1:1 might be too slow. For example, grain of sulphate of morphia is far too bulky for our therapeutic purposes; gr. would be so still, and so would gr., especially if expanded in surface, as it would be at that stage of our proposed new scale. Hence, to obviate repetition, it is an easy matter to reduce all known dangerously active substances by the decimal, centesimal, or even any other scale of much more rapid progression, to the second or third decimal or centesimal potency, after which progression should be much slower, as would be the case in the scale of 1:1 or 1:2, because, after the third or fourth decimal the intermediate grades should not be lost, because they may lose us our patient.

But how does this apply to practically inert substances, charcoal, graphite, silica, etc. If much of our knowledge of the development of physical and toxic properties of drugs of known active nature, rests on assumption and, to say the most, on working theories, we must, one and all, freely admit that our knowledge of the laws of development of toxic and therapeutic powers of inert substaeces is much more deficient. But, if we may assume that the toxic properties of charcoal, for instance, are increased tenfold by a tenfold subdivision,* we must also take it for granted that in the process of potentiation it will share the same fate as active substances, namely, that its power will diminish in exact proportion with the substance; but we must

This means either that a quantity of charcoal has been expanded by grinding to ten times its original surface, or it may mean also that nine molecules of a medium (alcohol, sacch. lact.) have been interposed between every two molecules of charcoal. The latter is the case in an ideal, but practically unattainable trituration.

also bear in mind that its original latent force, whatever this may be, is very small as compared with the energy of very active drugs; and that hence it will be lost much more quickly than in the case of drugs of free energy which has to be controlled. And yet, it is to be hoped that some of our time-honored "antipsorics" may prove much more satisfactory when a scale is adopted which, while developing latent powers in one step, does not waste them in the next; but which acts as a slow and conservative method of retention.

One more explanatory remark brings me to the close. It would be an easily-refutable error to suppose that this method would lead away from the good old ways of high potentiation. Any one is free to continue this as heretofore, and he may consider himself perfectly safe in the use of the new scale, which is as endless as the older ones, and will surely lead to the remotest part of the universe if continued long enough.

I have used this scale for three years whenever I feared that my medicines were either too strong or too weak. Like other physicians, I felt that I was leaping or, rather, flying between extreme points; while, by adopting a rate of slower progress, I felt my way along cautiously, from point to point, without losing sight of intermediate ground, and without so much danger of missing therapeutic opportunities, which in the system of leaping progression, are hopelessly lost.

SOME SYMPTOMS PERTAINING TO THE SKIN, GLEANED FROM THE CYCLOPÆDIA OF DRUG PATHOGENESY; WITH

OCCASIONAL REMARKS THEREON.

BY JOHN L. COFFIN, M.D., BOSTON, MASS.

APIS MELLIFICA.

Prover No. I a. Dose, I drop. After two days, small elevations of the skin, like ants' bites, appear over the external end of the eyebrow; pain as if raw, and very sensitive to pressure. b. 2 dr. of 1st dilution. - Transient, smarting itching over the right eyebrow. Pricking itching in left eye, on the lids and round about the eye, mostly in the inner canthus. Burning like fire on small, well-developed spots on hands for several mornings. Itching of right eyelids, in fits, during the day.

d. 2 dr. 2d dilution. Itching of the eyelids. Painful vesicle, as tender as a boil, with red areola, suppurating in the middle, on the left side of the hairy part of the pubes, remains painful for several days. (This symptom occurred on the tenth day after taking the drug, and is the only symptom, with one