COMMENT ON DR. KRAUSS' COMMUNICATION. Our editorial in the September Gazette has drawn the usual fire from Dr. Krauss' pen. In the "security of the editorial chair,"-which security Dr. Krauss has endeavored to render insecure,--we venture a few remarks in behalf of our "peculiar state of mind." If Plato, Aristotle and Strabo* defined “both the noun and adjective" 2,000 years ago, and Hahnemann defined "his medical creation, the medical content of homeopathy." why should we wait another 2,000 years before venturing a new definition? It is evident to anyone who has read the Organon what Hahnemann meant by the homoeopathic method of cure without having to read Dr. Krauss' effusive elucidation which we referred to in our editorial. Have we actually "mistaken and misstated the point at issue, the teachings of Hahnemann and of homoeopathy"? Dr. Krauss maintains that homeopathy is what Hahnemann told us it was, and attempts to force down our throats the definition as he, Krauss, has interpreted it from Hahnemann's writings. As a treatise on Hahnemann's idea of the homoopathic method of cure Dr. Krauss' paper in the journal of the American Institute of Homœopathy is very commendable. What we ventured to suggest in our editorial was that the noun, homeopathy, to-day might better be construed to apply to the study of similar affections in its broadest sense, rather than merely to the application of this study to therapeutics. For so doing we endeavored to bring out that much has been learned regarding the relation of similar affections since Hahnemann's day, and that consequently the application of this study to therapeutics must to a certain extent have been influenced by these advances. As a result of this, our views concerning the homœopathic method of treating disease must differ in detail from the views held by Hahnemann. Consequently the concept of homoopathy as expressed by the editor of the Gazette differs from Hahnemann's conception of homoeopathy as portrayed by Dr. Krauss. Now Dr. Krauss appears to be disgusted that anyone should dare to differ with Hahnemann, or rather with Krauss himself. Far be it from us to attempt to pacify him on this point. His communication has too clearly demonstrated that his and our attitudes are irreconcilable. When he remarks: ... "the laboratory workers have given us not only no homœopathy but have given us nothing, and I am safe in saying, will give us nothing unless they will radically change their methods of experimental attack and procedure," he puts himself with one Dr. J. B. S. King† of the Medical Advance, in a class of physicians upon whose minds medical progress exerts no apparent beneficial influence. By this remark Dr. Krauss also furnishes an excellent autogenous illustration of the truth of his statement that "it is easier to make blanket criticisms . . . than critically to illuminate arguments." "He should examine the points of argument and prove wherein these discrepancies self-contradictory hypotheses . . . and necessarily negative results. . . consist." By this remark Dr. Krauss has placed himself so out of harmony with the ideals of the medical profession as a whole, so utterly incapable of comprehending the significance of laboratory and clinical research that a continuation of the controversy with him seems futile. CONRAD WESSELHOEFT, Assist. Editor. *That Plato, Aristotle and Strabo did so is news to us. These authors are not mentioned by Dudgeon in his "Lectures on Homeopathy," or by Hughes in "The Principles and Practice of Homeopathy." In Baas, "Grundriss der Geschicte der Medicin," we find no mention of their definitions of homeopathy. We would appreciate accurate references from Dr. Krauss on this point. Does Hahnemann himself quote the definitions of these ancients, and if so, where? For Dr. King's impassioned tirade against these same researches, and against the same editor of the Gazette, see the editorial in the Medical Advance for October, 1914, p. 1755. A COMPLAINT FROM A STUDENT OF MATERIA MEDICA. Editors of the New England Medical Gazette, GENTLEMEN: In the August issue of the Gazette you comment briefly and rather indifferently upon the fifth edition of Boericke's "Materia Medica and Repertory." I have been a student of materia medica for twenty-five years and the subject is still a favorite with me. Boericke's pocket book, of over eleven hundred pages, has been on my desk for study and reference for over a year and I recognize and appreciate its good qualities. It is up to date in some respects, and for the most part the remedies and their symptoms are well characterized; but why, under pretense of completeness or anything else, should any work on materia medica include such subjects as "Skim Milk" (p. 429), "Honey with Salt" (p. 472), "Cane Sugar” (p. 630), "Distilled Herring Brine" (p. 592), “Common Salt" (p. 508), etc., etc.? Such bosh has no place in a work on materia medica, homoeopathic or otherwise, and homeopathic physicians can expect but little consideration from men of science until such nonsense is put aside. Again, when salt and sugar, both freely soluble, are so common in our every-day food, what reason can be given for advising sugar in "Thirtieth potency and higher." and salt in "Twelfth to thirtieth and higher," as therapeutic agents? I do not question that sick people have made good recoveries while taking such so-called remedies, but it is asking too much to believe that there is any material relationship between such remedies and recoveries. I can match such cases easily by recoveries under mental therapeutics. In contrast with such attenuated doses of common food stuffs, note on page 412 the deadly Cyanide of Potash recommended in the 2x. "Decomposed Vegetable Matter" (chemical formula overlooked). included in carlier editions of the work under the title of "Malaria Officinalis," has only brief mention, p. 517, under Natrum Sulph. But with our present-day knowledge of malaria and the indefiniteness of such a substance as decomposed vegetation, what can a man be thinking about to allow such delusions to be perpetuated in print at all? The Repertory is well planned and well executed and is a useful indexguide to homoeopathic therapeutics. These are but a few of the observations I have noted during the year that I have used the book. The work contains several remedies, mostly unimportant, which are not to be found in Cowperthwaite, nor in Allen's Primer, but aside from the excellent repertory, it has but little advantage over these older works. Before the homeopathic school maintains a propaganda or seeks consideration of its claims to therapeutic superiority, might it not be advantageous to clear the dust from our own eyes and unburden ourselves of some of our extravagances and superstitions? Why damage a book containing so much that is good and useful by mixing in so much trash? Fraternally yours, Lexington, Mass., FRED S. PIPER. September 28, 1914. A REPLY TO DR. PIPER'S COMMUNICATION. In a letter to the Gazette published in this issue, Dr. Fred S. Piper has expressed his indignation at the inclusion of certain substances, which he evidently considers inert, in Boericke's Materia Medica and Repertory. He undoubtedly voices the sentiments of the great majority of the readers of the Gazette; nevertheless the materia medica section of the editorial staff cannot allow his utterances to pass without comment. His objection to the including of these substances in a materia medica for the use of the homoopathic members of the medical profession at large is to our minds somewhat biased, if not prejudiced. The book is not compiled for the high or the low potentists. It is compiled for ready reference for the use of any physician or medical student, and is a condensed form of our materia medica. Any such work would be considered to contain errors and omissions by each and every physician according to his own ideas on the subject. Based upon our massive volumes of provings the book is merely a brief of the essentials, which, according to the author's idea would appeal to the majority. The author may not himself have any confidence in the therapeutic efficacy of certain substances, but he includes them for the use of those who do. The book is in no sense a treatise, and should not be considered as such. Consequently Dr. Piper's remarks should not have been directed against this compact edition, but rather at our entire materia medica. Our materia medica to be complete must include all substances which have been proved, or which have been used with apparent efficacy in the treatment of disease, even though it be milk sugar exposed to moonbeams, providing always that the sources of such provings or "cures" be given accurately. In this case it rests with the individual student to judge for himself the accuracy and reliability of such observations. To the author of this little book in question the observations regarding cane sugar seemed to warrant his including it either because he has confidence in it, or because he deemed that a sufficient number of homeopathic practitioners do. That is, as we have already said, for the individual to decide. Furthermore, the book is written to sell, an element not to be overlooked. A homeopathic pharmacy may prepare medicinal substances for sale, and it is no discredit to the firm if they have no confidence in their efficacy, providing physicians prescribe them for what these substances are. It must be left to the individual, legally registered physician to select his remedies and prescribe as he sees fit. Dr. Piper, therefore, should have confined his remarks to those physicians who prescribe these so-called inert substances rather than to the author of this book or the book itself. To refer to common salt as "bosh" in a materia medica is very rash. Such a term from "a student of materia medica for twenty-five years" usually calls forth abusive language rather than intellectual discussion based on logic. The action of sodium chloride is included in most of the best and up-to-date pharmacological text-books, and in some it heads the list of the group of neutral salts. In sufficient dosage it is fatally toxic, and, moreover, it has a very definite action. To exclude it from a homeopathic materia medica would be a serious omission, because a homeopathic materia medica should contain all drugs having a definite pharmacological action. The argument that because we take it as a food is, to our mind, not well taken. Iron is as essential to the body as sodium chloride. Both are foods to a certain extent, and beyond that, poisons. A normal daily diet contains about 10 milligrams of iron, yet cases of chlorosis are reported to have been benefited by the 3x and higher. The modus operandi of iron in chlorosis is no longer considered by the best authorities to be brought about by its presence as a food (because chlorotics assimilate iron as well as healthy individuals). but by a stimulation of the hæmatopoietic organs. The administration of inorganic iron in very small quantities will produce a stimulation of the bone marrow where larger quantities of organic iron in combination with a diet have little or no effect. The fact that the bone marrow is diseased renders it more susceptible to this action of iron. This susceptibility of diseased tissue cells to drugs is no longer a "homoeopathic notion." Cantharidin, in a dilution which does not irritate normal tissue, has been shown to irritate tissue diseased with tuberculosis. Just because we daily partake of sodium chloride in our diet is no reason why it should not exert a beneficial action in disease. The question of potency is to be decided by the individual physician, and as yet the high and low potentists have much to learn before making sweeping statements and bold assertions. The men who venture to attack the homoeopathic materia medica should remember that those who live in glass houses should be careful about throwing stones. There is a possibility that the use of sodium chloride in the 12x is more justifiable than the use of some preparations of the toxalbumins, such as snake venoms and apium virus. These toxalbumins-not infrequently dispensed in alcoholic solutions--are precipitated by alcohol, and the alcoholic filtrate is absolutely innocuous, while the precipitate retains its full toxicity when redissolved in water. Moreover, they are readily broken up and rendered inert by oxidizing agents. Sugar of milk is such an agent when time enough is given, and especially when not kept absolutely dry. We do not mean to imply from the above that our homeopathic pharmacopoeia is at fault. The directions for making up apium virus explicitly state that it is to be triturated with milk sugar, but in certain homeopathic pharmacies these triturations are only carried to the sixth, eighth or twelfth decimal, and after that run up in alcohol. In regard to Lachesis and Crotalus we are definitely told to make dilutions with glycerin, which we know preserves these toxalbumins indefinitely. But we not infrequently see alcoholic "dilutions" of both these substances in the medicine-cases of homoeopathic physicians. The common method of further diluting solutions with alcohol as practised by many homeopathic physicians must often result in their prescribing alcohol from a vial with a deceiving label. How many triturations are kept absolutely dry by the active practitioners? It is not to be inferred that we think Dr. Piper is guilty of this practice. We merely venture to suggest that some who scoff at sodium chloride as an inert substance are perhaps guilty of prescribing inert substances themselves.* Dr. Piper's communication is well worth consideration by the homoeopathic school. His criticism of our materia medica should stimulate the readers of the Gazette to think over their own prescriptions, and we hope that he has opened a discussion too long dormant among our subscribers. The Gazette will gladly welcome any further communications on subjects connected with our over-prized, underestimated and much abused materia medica. CONRAD WESSELHOEFT, Assist. Editor. SOCIETIES. Massachusetts Surgical and Gynecological Society. The 83rd meeting of the Massachusetts Surgical and Gynecological Society was held in Pilgrim Hall, Wednesday, December 9, at 3 p. m., President Herbert D. Boyd, M. D., in the chair. About 200 were in attendance, including members of the Suffolk District Medical Society and the Poston Homœopathic Medical Society, who were invited guests. After the regular business session, the scientific session under the charge of Clara E. Gary, M. D., of Boston, was taken up, The first paper was by Stephen H. Blodgett, M. D., of Boston, who described the results of four years of investigation into the causes and the prevention of convulsions in maternity cases. The paper was, naturally, of a very technical nature, but it had interest for the general public in that the observation of over 1500 cases has convinced Dr. Blodgett that such convulsions can be anticipated by comparatively simple tests that a physician can make with his ordinary office equipment, and can be prevented by proper diet if taken in time. Besides making available the results of his observations, Dr. Blodgett urged all physicians to impress upon their patients the need of coöperation between patient and physician. Prevention, according to his conclusions, is a cure, undertaken after convulsions have developed, is doubtful. This paper was discussed by W. A. Ham, M. D., and Katharine French, M. D., and others. easy; The second paper was by A. J. Rongy, M. D., of New York City, on "Twilight Sleep in Maternity Cases." Dr. Rongy, who is connected with the Jewish Maternity and Lebanon Hospital of New York City, reported the use of Scopolamine-Hydrobromid Narcophen in a large number of cases and gave full directions as to details of administration, dosage, etc. The point brought out in this paragraph, though seemingly irrelevant to Dr. Piner's criticism, is nevertheless pertinent to the subject he deals with. It is not offered as a retaliation. Among Dr. Rongy's conclusions were:-Standard solutions are absolutely essential. No routine method of treatment should be adopted, each patient should be individualized. Facilities should be such that the patient is not unduly disturbed. This form of treatment is best carried out in hospitals, although there is no reason why it should not be accomplished in all well-regulated private houses. Pain is markedly diminished in all cases, while amnesia is present in the greatest number of cases. To condemn or advocate a given therapeutic measure without thorough personal investigation is truly unscientific, and not in accordance with the tenets of progressive American medicine. Dr. Rongy's paper was discussed by F. S. Newell, M. D., and Edwin W. Smith, M. D., The third paper was by W. H. Dieffenbach, M. D., of New York, entitled "Treatment of Uterine Fibroids by means of Roentgen Rays." Dr. Dieffenbach was the first physician in this country to use the Roentgen Ray in the treatment of Uterine Fibroids, and through all these years has watched with interest its scientific development. He reported a case of fibroid tumor cured by means of X-rays, including details of the method by which the treatment was applied. Dr. Dieffenbach predicts that this will be a valuable addition in the treatment of these tumors. This paper was ably discussed by Horace Packard, M. D., John P. Sutherland, M. D., and DeWitt G. Wilcox, M. D. The officers elected were as follows: President, Charles T. Howard, M. D., Boston; Vice-Presidents, Edward E. Allen, M. D., Charlestown; Mary A. Leavitt, M. D., Boston; Gen. Secretary, Harry J. Lee, M. D,, Boston; Assc. Secretary, Ernest M. Jordan, M. D., Boston; Treasurer, C. Y. Wentworth, M. D., Newton Highlands; Auditor, George B. Rice, M. D., Boston; Censors, N. H. Houghton, M. D., Boston; George E. May, M. D., Newton Center; T. M. Strong, M. D., Boston. At 7 o'clock one hundred and fifty members of the Society sat down to dinner at Young's Hotel. American College of Surgeons. The third convocation of the American College of Surgeons was held in the Memorial Continental Hall in Washington on November sixteenth at eight o'clock. The program for the evening was as follows: 7.30-Fellows and Guests assemble; 7.40-Governors assemble; 7.45-Candidates for Fellowship assemble; 8.00-Regents assemble with Honorary Fellows and Guests. Invocation by His Eminence James Cardinal Gibbons. Introductory Remarks by the President, J. M. T. Finney. Presentation of the Roll of Candidates for Fellowship. Conferring of Fellowships by the President. Introduction of Honorary Fellows individually by the Regents and conferring of Fellowships by the President. Fellowship Address by Edward H. Bradford. Concluding Remarks by the President. Adjournment followed by an informal reception to the Fellows and Guests by the Officers of the College. The President, Dr. J. M. T. Finney, in the course of his introductory remarks, announced that subscriptions to the endowment fund of one million dollars, which proposition has been presented to the College at its annual meeting, now amounted to approximately $250,000. He predicted that the full sum would be easily secured before the next annual meeting in 1915. The following named physicians were nominated to replace retiring members of the Board of Governors: Dr. Robert Abbe of New York, Dr. Amos W. Abbott of Minneapolis, Dr. E. Wyllys Andrews of Chicago, Dr. Edward W. Archibald of Montreal, Dr. Charles S. Bacon of Chicago, Dr. Samuel C. Baldwin of Salt Lake City, Dr. J. M. Baldy of Philadelphia, Dr. Willard Bartlett of St. Louis, Dr. Carl Beck of Chicago, Dr. E. H. Beckman of Rochester, Minnesota, Dr. Frederic A. Besley of Chicago, Dr. Arthur Dean Bevan of Chicago, Dr. J. F. Binnie of Kansas City, Dr. Dougal Bissell of |