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many conveniences of the fine new surgical amphitheatre of the adjoining hospital in active use. The entire buildings of hospital, college and dispensary will be thrown open to the inspection of the members of the society. Both hospital and college are, in the largest sense, representative institutions; the one of the clinical side of Massachusetts homoeopathy, the other of its student side. Both are inseparably bound up with the welfare and progress of homoeopathy in our State. No Massachusetts homoopathic physician can afford to be, or should willingly be ignorant of the work these institutions are doing, or the fashion in which they are doing it. The bringing into close accord, as will be done by the October meeting, of our representative State society, with our representative State institutions cannot fail to have healthful result, in fostering that esprit de corps which is the greatest single factor in the success of any cause or movement. It is to be hoped that every member of the society will recognize the unique interest and importance attaching to the October session, and will make an earnest effort to aid, by his presence and cordial co-operation, what should be the occasion's signal success.

COMMUNICATIONS.

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THE TEACHING OF MATERIA MEDICA.

BY RICHARD HUGHES, M.D., BRIGHTON, ENGLAND.
Honorary Member A. I. H.

[Read before the American Institute of Homeopathy, Washington, D. C., June 1892.] I write under pressure of a grave anxiety, and I trust that those on whose work my comments bear will not repel me as one who interferes, but will receive my suggestions as the fruit of brotherly interest.

There are now, it seems, sixteen Homoeopathic Medical Colleges in the United States. Judging from last year's statistics these institutions may be expected to graduate some four hundred students annually, a large propotion of whom will, in the natural course of things persevere in the vocation thus entered on, and will, ultimately, form the bulk of our section of the profession in this country, and indeed in the world.

The teaching and training given in these Colleges is thus a matter of vital interest to all who have the welfare of Homœopathy at

heart, and it is only fitting that the American Institute, as the foster-mother of the method of Hahnemann in this new home beyond the sea, should exert over the several institutions some disciplinary control. This it has done, on the wise counsel of its Intercollegiate Committee, and all of us who watch its proceedings from this side of the water applaud and are made glad by what has been accomplished. It is necessarily, however, with the external aspect of collegiate work that the Institute dealsthe number of years to be spent in study, the courses to be taken, and so forth. I am inviting it to-day to look further within upon one branch of such work, and to influence it, not by the passing of binding resolutions, but by expression of opinion which will (I doubt not) have hardly less weight, and whose timely utterance may make a great difference in our future.

It will be admitted by all, that if there is one chair in Homœopathic Colleges more important than the rest, it is that of Materia Medica. I do not doubt that the governing bodies endeavour to obtain, and often succeed in obtaining the best men available to fill them. But from books that have lately been published, from articles I have read in our journals, and opinions I have seen expressed, I have grave doubts whether the subject is always taught in the best possible manner, and whether justice is done in the process, either to the master or to his methods. Let me explain.

It is recognised at the present day that any adequate treatment of a subject must be historical. Thus only can its rationale be understood; and a thing must be approached in its original form, and at its nascent stage if it is to impress with all its possible force. Now in the matter of materia medica, we homoeopathists have unique advantages in this respect. Hahnemann, after discovering, propounding, and to a great extent elaborating his therapeutic method, set himself to provide the means of carrying it out. The Organon (1810), was quickly followed by the Materia Medica Pura (1811-1821). The object of this work, and the meaning of its title, are defined by the author himself in his preface. "In the Organon" he writes: "I have taught this truth, that dynamically acting medicines extinguish diseases only in accordance with the similarity of their symptoms. He who has understood this will perceive that if a work on materia medica can reveal the precise qualities of medicines, it must be one from which all mere assumption and empty speculation about the reputed qualities of drugs are excluded, and which only records what medicines express concerning their true mode of action in the symptoms they produce in the human body."* Hahnemann's aim was thus to furnish a * Mat. Med. Pura, Dudgeon's Translation, Vol. 1, p. 3.

collection of the symptoms developed by drugs in the organism of their pathogenetic effects, which, on the principle of "likes to likes," might be used for cure of disease. "These are the precise qualities of medicines," he says, which a work on materia medica ought to reveal.

It follows that a teacher of the subject in a College dominated by the method of Hahnemann, should first of all ground his students thoroughly in the pathogenetic action of drugs. He may, indeed he should, communicate and discuss the uses of the several medicines in the traditional school; he should also recount the clinical applications which homoeopathy has made of pathogenesy, and the indications general and special, which experience has furnished for such uses. All this Hahnemann does in the prefaces and notes to each constituent of his Materia Medica, but it is kept in strict subservience and subordination to the main body of the work, which consists of the symptoms elicited by proving and poisoning.

Now is materia medica taught in this way in our Colleges? From the glimpses I get of its mode of presentation, it seems to me too often approached from the clinical side rather than the pathogenetic, the latter being made quite secondary. With other teachers there seems a deliberate purpose to obliterate the distinction between the two: a list of symptoms is taken indiscriminately from the two spheres of action, and it is said that the medicine "has," or sometimes (by a bold personification), "is" such or such of them, no account being given as to how it came to possess or represent them. By yet another class, a crowd of pathological notions are interspersed: Hahnemann's "psora" and "sycosis," Grauvogl's temperaments, Schüssler's tissue inanitions, are all assumed to be realities, and medicines are assigned to them accordingly. Daily there are those who would have their students remember only certain "characteristics" or "key-notes" of each drugsymptoms picked up anyhow and anywhere, and make their therapeutics consist of looking out for such features in idiopathic disease, and choosing its medicines accordingly.

What is the result of such teaching? It must be to make the practice of its recipients empirical rather than homoeopathic. It is possible that they may occasionally light upon true similia, and so effect cures. But the process is a haphazard one. There is no conscious application of the law of similars; and therefore no strengthening of belief in it, no sharpening of acumen in applying it. The central vantage ground it gives has been abandoned, and men are stationed instead on the old slippery soil of particular experiences. That it is so, appears from the kind of

repertories that are now in demand, and are so largely supplied. Formerly, a repertory used to be an index to the materia medica, and was employed for carrying out the rule similia similibus. Now it is a clinical guide, and is consulted with a view to learn what drug is reputed to "have" the symptoms of the case before us, regardless of the way in which it obtained them. Our publications of the kind are avowedly based upon such symptomatologies as Hering's, which do not profess to be pure pathogenesy, and are intended only for the well instructed practitioner. In this way, empiricism, which would be the exception in homoeopathic practice, is becoming the rule; the requirement of similarity between disease and drug-action is more and more rarely made; and our play is growing into that which "Hamlet" was when, by special desire, the part of Hamlet was left out.

What is to be the remedy for the disastrous drift? It lies, I think, in the direction which I have indicated: it is the better teaching of materia medica in our colleges; the founding this first of all on the pure pathogenetic effects of drugs. I would urge the making a clean sweep from our lecture-rooms of all text-books which do not keep those prominent and distinct. Where Hahnemann has proved any substance, let the teacher begin with his article upon it in the Materia Medica Pura, showing the book to his students, and encouraging them to consult and one day to obtain it. How few practitioners, how few writers on and expounders of materia medica (tell it not in Gath!) possess this work of the Master, or have ever seen it! And then, for later work done with such medicines, and for the many which lie outside the Hahnemannian list, there are two unexceptionable sources of knowledge. If the schematic form. be preferred, there is Dr. Allen's "Handbook," where our symptomatology is purged of the dross which encumbered it in his larger work, and where its curative applications appear only in notes. But it seems to me, (and I think Dr. Allen will agree in the opinion, that the true place of his book is found later, and that it should serve as a remembrancer rather than a primary source of information. The teacher should present drug-action where possible, as he should disease, in the form of clinical cases; and for this purpose he has the Cyclopædia of Drug Pathogenesy now complete and accessible to all, where provings and poisonings may be read in their original narratives. This work is avowedly prepared for the student, and it would be a grievous thing if, as far as he is concerned, the labor expended upon it proves to be labor in vain.

Thus grounded in drug-pathogenetics, the beginner will be ready with cleared vision to enter upon drug-therapeutics. He

will hear of the traditional use of medicines, he will learn those current in the school of Hahnemann, as one capable of perceiv ing their relation to the effects of the several substances on the healthy body. The law of similars will be his touchstone for the doings of the past, his instrument for further developments in the future. If he has to fill up gaps from the usus in morbis, he will do so with his eyes open, and know what he is about. He will be, I think, a more intelligent and more satisfied man: he will be, I am sure, a better homoeopathist.

DISCUSSION.

DR. T. F. ALLEN.-It seems to me that this paper of Dr. Hughes should not be permitted to pass unnoticed. I have listened very carefully to that paper from the beginning to end to find out the cause of Dr. Hughes' lamentation. I cannot understand why it is that Dr. Hughes assumes that in the homœopthic colleges of this world, all of which are contained in the United States, the homoeopathic materia medica is not well taught. I tried the coat on myself and it wouldn't fit. I know a good many of the teachers, and am familiar with their methods of teaching, and I must say that Dr. Hughes labors under some misapprehension as to the methods of teaching materia medica, and I think perhaps he has estimated the plan of teaching in our colleges from his reading of the American medical press. It would not be at all peculiar for a foreigner reading our literature to form a wrong estimate of our college work. As I understand the methods of teaching materia medica, and I have had considerable experience in that line myself some twenty years-I find that we cannot read a list of symptoms to our students as was done in the former time; that is now absolutely impossible. Let me state briefly my mode. I would take let us say one of the potashes. I would call their attention to the cases of poisonings, which I would read in detail from the Cyclopædia; then I would explain to them carefully the symptoms that might be expected to arise from such a poisoned condition of the system, and thus gradually build up the homoeopathic edifice. But I cannot recommend a better book to an allopathic physician to study from than this Cyclopædia; but to the young student something else must precede, or some additional explanation must be given. The allopath can read the history of the drug perfectly well and intelligently; the student will do better if you build up the drug for him by easy stages. Some such plan as this is in vogue I believe in every college of the land. So that I think all teaching of materia medica should begin not perhaps with the general history of the drug, but by a species of illustration so that

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