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minded the patient of pieces of "lights" of some animal, by which I suppose we may understand the lung, which the shreds seemed to have resembled by reason of a sort of sponginess of texture, after the blood had been washed out. The surface was rough, suggesting to the patient before washing "a shred of fresh meat torn from a mass of the same."
No one can appreciate better than myself how much more satisfactory the report of this case would have been, could I have described this pathological product from personal inspection, but my first intimate acquaintance with the case was made about midway between periods. I was satisfied of the essentially membranous character of the morbid product, notwithstanding its somewhat unusual form. I had lately happened on Hale's record of Borax in such cases, and, as many a wiser head than mine has done before, doubtless, I prescribed without first verifying my diagnosis. I did not see the patient again till she had ceased to exhibit these shreds at her periods. Thus I was compelled to report their appearance from the patient's observations instead of my own. As an offset to this confession, however, I would say that since that time-the spring of 1874-I have become well acquainted with the lady, and have found her careful and accurate in her description of other things, very intelligent and conscientious, and possessed of a common-school education. I would also add that in my satisfaction as to the "membranous" nature of the case, I have been strengthened by the coinciding opinion of one of our best-known gynecologists. The menses in this case were regular as to time, and not remarkable in any way as to quantity or quality of the flow, other than as already mentioned. The patient had suffered in the way described at every period since the establishment of the menses, twenty years before. Borax was prescribed precisely as used by Hale; namely, treatment being begun between periods as with him, five grains of the crude powder in a tablespoon of water, three times a day till the menses appeared. Between that and the next period the same dose once a day the first week, twice a day the second, then three times a day till the flow appeared and so on. Seventy-two powders were given, and these, though not taken so rapidly as prescribed, were all taken within the next three months; since which (five years) she has never received or needed any more. The first period
after beginning treatment was to a remarkable degree less pain. ful than usual. At the second the "meaty shreds," which had been fewer and smaller than usual during the first period, made no appearance at all. Since the third she thinks she has as little pain as any one can and have any, at her periods, and has never seen a "meaty shred," unless it was once, nearly three years since, when she had some pain during menstruation, which she attributed to wetting her feet just before, and thought she saw some little shreds. She received no other medicine than this, and no change of diet or other habits was prescribed. Though urged to make a daily memorandum of all symptoms or changes in her condition during treatment which she could ascribe to the use of the medicine, there was nothing at its end which she could mention other than the curative result already noted, except that for a day or two at some time during treatment she did not have her usual appetite and felt a slight nausea. Her general health since that time has been at least as good as before, sufficiently good for the doing of her own work.
The score of years during which this lady had suffered so excruciatingly at her periods had not, as may be supposed, been spent without efforts to get relief. One male and one female gynecologist, the latter of the most note, perhaps, both of the allopathic variety, had tried surgical interference in vain. The most valuable knowledge which she had preserved from her consultations with them was respecting the power of whiskey, when used in considerable doses, to mitigate her suffering. This mitigation, however, was to a very unsatisfactory extent.
The second case occurred in the practice of a brother physician. In this, the patient being Mrs. P, there were the same violence of pain in paroxysms at every menstrual crisis, and skinny substances, which would not dissolve by washing, were discharged. The morbid product in this case, it will be seen, was of the ordinary membranous character. Borax was used in the same manner as was the crude in the former case. When I last heard from it, some two and a half years since, the remedy had been suspended for several months, after using it between three periods, for the reason that relief had been so nearly complete that the remainder of the complaint was not a sufficient reminder for the taking of the medicine.
P. S. It was suggested by the gynecologist, whose opinion concerning case No. 1 I have alluded to, that the membrane in that case was probably forced into the cylindrical form in its passage through the cervical canal, and that it was owing to some circumstance which gave it an unusual cohesiveness that it retained that form.
ERRORS IN HOMEOPATHIC PHARMACY.
BY S. WHITNEY, M. D., BOSTON.
THE popular homoeopathic theory of attenuations rests upon the hypothesis that all substances, when treated according to our method, may be brought into the liquid form, and can then be attenuated without limit, and that when globules are moistened with these attenuations they will retain some portion of the drug after the liquid has evaporated.
In opposition to this view, well-established facts of science show beyond question that this theory is a fallacy. In the nature of things, it cannot be true. To found, or pretend to found, a system of therapeutics upon such a basis seems preposterous.
Matter exists in three physical forms, -the solid, the liquid, and the gaseous. This fact should be kept constantly in mind as we proceed to examine our method of preparing medicines, for we deal with matter in each of these three forms.
For the purpose of diffusion or attenuation, we use only milksugar, alcohol, and water. Many of our drugs are absolutely insoluble either in water or alcohol, and can only be prepared by trituration. Other substances are prepared only in the liquid form, while others may be secured either in the liquid or in the solid form.
To medicate globules effectually, the drug must be in its liquid state, and its essential properties must be such that when the liquid has evaporated, it will itself remain attached to the globule.
It so happens that many of our drugs will not dissolve either in water or alcohol. There are others which will dissolve in water but not in alcohol, while some will dissolve in alcohol but not in water. Then again, there are other important remedies which can only be secured and administered in the liquid form, either in water or in alcohol, and as soon as the liquid menstruum
has evaporated, they assume the gaseous form and disappear. From these facts it appears evident that every physician, to be properly educated in his profession, should know the precise behavior of his drugs when submitted to any special mode of treatment.
That physicians of our school should frequently express disappointment at the failure of their prescriptions to produce the desired effect need surprise no intelligent person. The great error in homœopathic pharmacy arises from the very general notion that the behavior of all substances is the same under the same treatment. It is a common practice to dispense medicine in the form of medicated globules, using many times a medicine which, when the liquid portion has evaporated, takes on the gaseous form and escapes. In this case, as soon as the globule becomes dry, of course no medicine is left.
There comes into notice another question of wide significance. By our method of treatment, is there a limit to the divisibility of matter? Yes, unquestionably. By the process of trituration, in the usual manner, we cannot proceed beyond the first, or at most the second centesimal degree with any certainty; and with liquids, in most cases, not beyond the third of the same scale, and to accomplish even this there must be a strong affinity existing between the drug and alcohol or water in which it is placed.
Because we put one drop of a certain liquid with ninety-nine drops of another liquid and shake, this of itself is no proof that the one drop is equally diffused throughout the ninety-nine drops. In the third attenuation there are one million drops. It would need a vast amount of faith to believe that each of the million drops contained just the one-millionth part of the medicinal drop, no more, no less; yet this must be so if our theory is correct. Let us illustrate. Water and alcohol have a strong affinity for each other and mix intimately, until an equilibrium of forces is established, when this action ceases. Two liquids having no affinity for each other cannot be equally diffused, nor the condition of their molecules determined. In many cases the drop which was designed to medicate millions and billions of other drops may have passed out when the vial was emptied the first time. There is no reason for supposing that portions of the
original drop always remain behind while the rest of the liquid passes out, no matter how many times the vial has been filled and emptied, in the process of "carrying up."
Let us look at this matter from another point of view. Here is a drop of water which we place before us. This drop contains a certain number of molecules which together occupy a certain space. It is not within the power of man to make these molecules occupy a greater or a smaller space than they do now. A molecule is a molecule, pure and simple. It cannot be divided without changing its properties and making it into something else. The molecules, separated to a certain distance from each other, take on the gaseous form and behave like other gases.
As coming within the scope and purport of this communication, it may be said in relation to high and low attenuations, that the first centesimal is low and that the third is high. Beyond this last degree very few remedies extend. In proof of this let me give a further illustration. We start with one drop of medicine and carry this drop to the third attenuation; we now have one million drops. Our theory requires that the one drop shall now be present in equal proportion in each of the million drops, and not only this, but it must be present in every conceivable portion of each drop, so that a single drop of this million will medicate, say, fifty No. 1 globules. Here we have a single drop of liquid filling the whole space occupied by a million drops, equal to ten gallons by measure. Now, if this one drop were to assume the gaseous form, it would occupy a space equal to about two fluid ounces, or only seventeen hundred times greater than it · did in the liquid form; yet we pretend, and expect others to believe, that this liquid drop fills a space equal to ten gallons, or six hundred and forty times greater than it would in the gaseous form.
TREATMENT OF CERVICAL ENDO-METRITIS.
BY L. A. PHILLIPS, M. D., BOSTON.
THIS disease, oftener known simply as cervical leucorrhoea, is so common that all physicians in active, general practice must of necessity have more or less experience in its treatment. That it is not an easily cured condition is testified to by all who