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poor, at which nearly 1,000 were treated yearly. An effort had been made to establish a hospital to which the poor could resort and have homoeopathic treatment. In fact, its institutions, its societies, and its practitioners were prosperous, and exhibited as yet no sign of the much-wished-for decay. There being no prospect of its dying a natural death, the councillors of the great Massachusetts Medical Society in secret conclave determined to kill it: First, by declaring it arrant quackery; second, by expelling, as unprincipled men, any who practised it; and third, by forbidding members to hold any professional relations with these "charlatans" The result of this action is best seen in the growth of homoeopathy in New England since that performance. In Boston the number of homoeopathic physicians has increased from sixty to upwards of one hundred; in New England from five hundred to eight hundred. A medical school in connection with Boston University has been established, which, with thorough instruction in every department, has already graduated two hundred and fifty physicians; a hospital has been founded which has cared for upwards of 1,600 patients, and has secured of funds for running expenses, for land, buildings, and permanent funds, upwards of $250,000; and the dispensary has enlarged its work from 973 patients in 1871 to 11,862 in 1881. But this growth is not confined to New England. Twenty-six State medical societies and one hundred and. nine local societies exist in the United States, with a membership exceeding 2,000. Forty-two hospitals, with 1,600 beds, employ wholly homoeopathic treatment, while more than 100,000 poor patients are annually treated at homoeopathic dispensaries. Moreover, seventeen medical journals are sustained, and eleven medical colleges are educating at the present moment upwards of 1,300 students in homœopathic opinions and preparing them for homoeopathic practice. The success of these practitioners, the quality of their patrons, and the amount of charitable work performed would indicate that the "sordid wretches" and the scarcity of "infinitesimal globules" prophesied belong not to this generation. May the "death of homoeopathy" continue, in the future as in the past, to be confined to the realms of prophecy, until, at least, science shall given to humanity a better method of healing.




ABOUT three months ago, a much-honored colleague of Dover, N. H., sent me a printed set of principles governing a medical organization in that city. They were intended to harmonize medical creeds: that is, homœopathic physicians must cease to call themselves by that odious name, and those who never did call themselves so, remain what they were before; namely, doctors who practise anything and everything but odious homoeopathy. This is the way they did it:

"Dover, N. H., February, 1880. "We, the undersigned, assuming that entire liberty of thought and freedom of opinion are absolutely essential to real progress in the science and art of medicine,

"Resolve, First, That we will in no way approve, sanction, or hold allegiance to any organization, society, or name, which, by giving exceptional prominence and authority to any exclusive medical dogma or system of practice, tends to limit such freedom of thought or opinion.

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Second, That we will recognize, professionally, only such honorable and well-accredited physicians as in their medical associations and conduct conform to the spirit of the foregoing resolution."

The following is a copy of the essential portion of my reply to the much-honored colleague in Dover :

"Dear Doctor, The difference between the two societies is that the American Institute (and similar societies) will admit every physician regardless of method of practice, while your society will not, unless a physician has no preference for any method, or unless he professes to have none.

"The time will come when there will be even more and better methods of practice than we now have; and the time must come when all well-accredited physicians, regardless of their special methods of practice, will be allowed to join any general medical society.

"We have abolished creeds or confessions of faith in our Massachusetts State and local societies, as well as in the Institute of Homœopathy. You, of New Hampshire, do not object to any creed or method of practice or 'pathy'; you admit them all, provided those who make use of them agree not to name their methods of practice. You allow them to practise a distinct

method, to write papers concerning it, to discuss it; but they must not call it by its name, or out they go.

"We, on the other hand, do not propose to limit any man's practice, nor to prescribe or proscribe the name he chooses to call it by. If, in our societies, we limit our labors mostly or exclusively to a certain method of practice, to its improvement and possible perfection; it is because we are limited by time, strength, and ability to do the amount of work on hand; not because we proscribe, prescribe, or exclude other methods of curing which should be free to call themselves by any name or definition suited to their wants.


The principles upon which alone medical societies can be founded are:


Every society has the absolute right to define the limit and kind of scientific work it proposes to do.

"2. It has no right to attempt to limit or proscribe freedom of thought or definition of method of practice.

"This is perhaps what your programme of February, 1880, tried to express, but got hopelessly and inextricably mixed. Your first sentence proclaims freedom; your second sentence (first 'resolve') gives your sentiments of freedom a terribly black eye; consequently you do not see it, as I fear."



THERE is certainly an existent relation between the two diseases. Laryngitis accompanied by membranous inflammation may arise from the contagion of diphtheria, but it is just as much a product of measles, scarlatina, or typhoid fever, without exposure to diphtheria; of accidental irritation, as contact of acids, inhalation of steam, or pressure of a foreign body; of cut throat, occurring as a sequel; of contact of foul air and water; and no doubt of other causes. An influence which in one person produces croup may in another produce diphtheria; yet it is questionable if a person suffering from croup can communicate to another by contagia the membranous condition which in the second person will be distinctly diphtheritic.

Two or three years ago, a committee of the Royal Medical and Chirurgical Society defined diphtheria as a zymotic disease, accompanied by membranous exudation, and which may or may not be accompanied by croup. Croup, they say, is a term signifying a laryngeal obstruction in children, accompanied by febrile movement. There is nothing provisional in these definitions, but

their chief glory is their duality of expression. Yet beyond the power of definition there is very little to diagnose from. Once it was said that a mark of distinction was the contagiousness of diphtheria; but now we know that diphtheria is not always contagious. Again, it has been said that croup was merely a local inflammation, whereas diphtheria was a special constitutional affection; now we have come to look upon croup as both constitutional and local in its relations. The albuminuria of diphtheria was characterized as diagnostic; but albumen has been found in the urine of the patient suffering from croup. The manifestation of asthenia, and the sequelae of paralyses and great depression characterize some cases of croup as uniformly as is the rule in diphtheria. A difference in the character of the exudation has been claimed, but is abandoned. I had an opportunity some time since of examining several specimens of sputa and false membrane removed from the throats of children dying of croup and diphtheria. Microscopical observation revealed but one difference; and that was that in diphtheria the exudation is planted firmly into the tissues, while in croup it is a superficial coagulation of lymph on the mucous membrane. In diphtheria the deeper tissues are destroyed, so that the membrane could not be peeled off. Another and a beautiful characteristic, microscopically revealed, relates to the presence of micrococci. In any partially decomposed mucus they are to be found scattered through the substance. This is the case in the croupal membrane and sputa, whereas in diphtheritic membrane these organisms appear only in collections or nests.

It seems, however, from all of the present data, that this question of diagnosis resolves itself into one conclusive ætiological truth, which, briefly expressed, is as follows: Croup is due to a constitution supported by blood of a certain condition, being acted upon by a certain condition of the atmosphere, which condition owes its peculiar influence to impalpable germs which might or might not be diphtheritic in origin. That germs procreating croup might originate from diphtheritic deposit is not necessarily hard to believe. In point of fact, it may be held that such germs might and doubtless do arise from other diseases than diphtheria. Measles or typhoid fever may furnish them just as readily. Until we come to know intimately the character of these germs, we can only estimate their value; yet there is every probability that their origin is from one fixed state, wherever placed. Interwoven with this remains the self-evident fact that germs born of the diphtheritic membrane have, by virtue of their birthright, more potent ability to produce a given character in the laryngeal membrane; which membrane, because of this relationship, manifests a disposition to put on a diphtheritic aspect.

Therefore it may be truthfully said that beyond question, those forms of croup which are somewhat asthenic, and manifestly of a diphtheritic nature, are due to the malignity of the influence of germs but recently derived from the condition of diphtheria, and only one remove from that disorder.



[From advance sheets of “Diseases of the Eye,” sixth edition, now in press.]


THE more experience one has in granular or trachomatous conditions of the conjunctiva, the more one is inclined to prefer the milder to the so-called heroic treatment. Caustics and strong astringents are sometimes necessary, but their use should not be prolonged, and they may often be dispensed with to the advantage even of eyes that appear to tolerate them perfectly. Thus, I find myself of late years substituting a crayon of alum in cases where formerly I should have used a crayon of sulphate of copper.

Naturally, much depends upon the fact as to whether ciliary irritation exists to any great extent. If it does, caustic or astringent applications are not borne well, and do harm rather than good. Pain, photophobia, and lachrymation indicate ciliary irritation; and when considerable, contra-indicate astringents, apart from other considerations. In some of these cases one should carefully regard the condition of the iris. Atropine will sometimes be useful.

Recently, as an intercurrent application, I have found boracic acid, four to six grains to the ounce of water, serviceable. In acute or sub-acute cases the boracic acid, being a disinfectant as well as a very mild astringent, may be used freely several times a day. When used in a four-grain solution, in cases of even marked ciliary irritation, it is usually borne well, and is often decidedly beneficial.


It is advised to wash the lids of the child in a one per cent solution of carbolic acid directly after birth. Possibly boracic acid, which is a milder and safer antiseptic, and could be used in a much stronger solution, would be equally efficacious. At the Lying-in Hospital at Leipsic the following prophylactic treatment is adopted: The eyes of the infant are immediately washed out with water, a drop of a two per cent solution of Argent. nit. is instilled, and the eyes are covered for twenty-four hours with

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