If the requirements of practice can be met within these limits, the great gains are very evident.

1. The gains in a pharmaceutical sense are enormous.

2. Such limitation gives more time to examine the varied character of medicines as regards their doses, and more attention can be paid to the very important point of repetition.

This subject of the dose has lately been several times discussed by many of you. I shall not therefore further occupy your time, except in giving a few cautions which are necessary, in order to restrict the discussions to the actual question.

Let there be no misunderstanding as to the question I put. I have no desire to dogmatically confine the limits of the dose. I do not deny the curative power of medicines above the 3rd, but I maintain there is no evidence that they act better than those below the 3rd; and I invite those who are in the habit of using the higher dilutions to make the experiment which I for years have made, especially with such medicines as sul., sep., lyc., graph., carbo, cham., the employment of which has been much influenced by Hahnemann's later teaching. Also with the action of such as act energetically, such as ars., acon., merc., bell., &c.

While investigating the dose, it is needful to remember the altered circumstances in which we stand as compared with the early periods of homoeopathy. That was a time when an allopathy prevailed so violent in its resources, that the withdrawal of these had often a speedy and wonderfully happy effect on the patient who sought homœopathic advice; so that some considerable deduction must be made from the cures of that period. In the present time, the increasing knowledge of the natural course of disease calls for much more stringent proof of the action of a remedy, than what was formerly deemed sufficient to distinguish recoveries from cures.

If moderate proof is sufficient to establish the efficacy of material doses, greater proof is required for the action of fractional; and the evidence needed to prove the value of infinitesimals mounts in a quickly increasing ratio, as you pass from one dilution to another.

Clifton, Sept. 1871.

ON OVARIAN AND UTERINE DISEASE.

By Dr. JOHN MOORE.

I PURPOSE in the present paper to give a few facts observed by me in the treatment of ovarian and uterine disease during the last twenty years; and afterwards to draw a few inferences which will place the whole subject before us for discussion, with a view to ascertaining what class of cases it is in which surgery is required in addition to medicine, whether homœopathic or otherwise, administered internally; and also what is the nature of those for which homeopathy, pure and simple, suffices for the cure. The great practical importance of this subject and its attendant difficulties, seem to point it out as one appropriate for discussion at our meeting here to-day.

This

It was brought forward at the first Homœopathic Congress held in this country, at Cheltenham, in 1850, by Dr. MADDEN, who read a very able paper On Uterine Disease, detailing his experience at the Brighton Dispensary, which comprised reports of 180 cases. paper was subsequently published in The British Journal of Homœopathy for January, 1851. Much discussion arose upon it; and much difference of opinion was expressed as to wherein consisted the use and abuse of caustics in the cure of ulceration of the os and cervix uteri.

One year afterwards Dr. LEADAM published ten cases in The British Journal of Homeopathy, which were all cured without escharotics; though local applications, such as injections of calendula, &c., &c., were used in addition to purely medicinal treatment.

The editors, commenting upon both papers, regarded them as inconsistent with the strict letter of the Organon; but of the two, Dr. Leadam's as the most inconsistent, though it must be admitted-the mildest. Thus stood this vexed question twenty years ago; and the same differences of opinion and practice still exists to some extent in this country; but chiefly among homeopathists in America, where the high dilutionists assert that they

effect cures of uterine disease without escharotics; while a large number of homeopathic physicians employ the surgical application in addition to the purely medicinal

treatment.

It will facilitate our enquiry and discussion if we bear in mind that the subject embraces three classes of disease. 1st. Those in which the ovaries are chiefly or solely affected. (Pure ovaritis.)

-

are

2nd. Those in which the uterus is the seat of disease. 3rd. Those in which both ovaries and uterus involved; and which may be styled the complex class, comprising as it does those cases which are the most difficult to meet; and which need much careful examination before we are able to ascertain the right process of

cure.

Though complex cases do occur, on close examination it will be found that one organ is mainly and primarily affected, and the other secondarily and slightly; and the order of the plan of treatment must be the same. I shall now proceed to cases illustrating these statements; and I shall begin with those which are strictly ovarian. One case occurred in a married woman between 35 and 40 years of age, of fair complexion, and highly nervous temperament. Had never completed the full term of pregnancy; having twice miscarried between the fifth and sixth month, or a little later. It was on the occasion of her last miscarriage, or premature labour, that I was sent for. As soon as she had sufficiently recovered from its effects, I resolved to find out the cause if possible. Though most anxious for a family, she declined examination per speculum on the ground that Sir Chas. Locock and Dr. Ferguson had both examined her, and pronounced the uterus to be perfectly sound; and that debility alone was the cause of the premature labour. This reason was not conclusive, because there were no indications of very great debility. On going closely into the symptoms I found pain in the region of the left ovary, extending down the inner side of the thigh. From some previous experience I thought of phosphorus provings, which show it to have great influence on the sexual organs, both male and female, by its acting violently on the testes and the ovaries, producing profuse menstruation even after it had ceased for eighteen months; by various kinds of leucorrhoa-chiefly the reddish-&c.

On October 29th, 1850, I accordingly prescribed phosphorus 6 for a few days, thrice a day. She complained that the medicine irritated her, though she thought it did her good. I now gave two or three doses of chamomilla, and retained the phosphorus; but then gave No. 30. At my next visit she still complained of the medicine irritating her, though she felt the pain better. I now gave her phosphorus 100 (Jenichen), a dose only once in twentyfour hours. After this I heard no more of the irritation, but she steadily improved; and I continued this for about eight weeks the only intercurrent being nux; and on one occasion mag. mur. for a few days-for what reason I cannot remember. I returned on the 3rd February, 1851, to phosphorus 30. In March she was quite well, and on the 30th March, 1852, one year afterwards, gave birth to a son, born at the full time.

The other case to which I desire to draw your attention. is that of a married woman, æt. 40, who I was called to see in October, 1866. She was five-and-a-half months gone in pregnancy. On visiting her I found her threatened with a second miscarriage. The characteristic pains had commenced; but no hæmorrhage had appeared. By aid of belladonna and sepia it passed off. On inquiring into the causes I found each ovary increased in size to the extent of a large hen's egg; and it was a matter for astonishment how she could have become pregnant in such a state. I gave a very doubtful prognosis as to her being able to complete the full time under such circumstances; but advised her to undergo a course of medicinal treatment. There was no indication whatever of uterine ulceration, or of any form of disease of that organ. Regarding the ovaries as chronically inflamed, I prescribed bell. 1, mercurius sol. 3 and 3x, and bryonia 1 for a few weeks. She went on to her full time, and had a living child, which she nursed. She felt such slight inconvenience that she paid but little attention to herself; but after weaning she became anxious to be cured of her chronic disease, in order to avoid a repetition of her former troubles. She now suffered great pain at each monthly period, the return of which had been regular. Examination of the uterus did not discover any disease of that organ. Both ovaries were distinctly enlarged. By persevering in the line of treatment I shall presently describe, one (the left) has disappeared, and the right one is still slightly perceptible by

deep pressure, and apart from pressure, she suffers pain in it occasionally. She has never become pregnant again; and four-and-a-half years have elapsed since the birth of her only child.

The medicines I prescribed separately were mercurius sol. 3 and 3x, bryonia 1, kali bromid. O, k. hyd. Q, and iodineum Q, the latter dissolved in kali hydriod, thus, iodine gr. 1. k. hyd. gr. x. in 3 viij. aquæ, cochl. min. bis in die sumend; thus the dose of iod. became the 64th of a grain, this I continued for weeks with such intercurrents as appeared to be required, e. g., merc., or puls., or nux. I also used a liniment of iodine, 3 i. to Ol. olei. 3 i.

THE TREATMENT OF OVARITIS.

Remembering the various tissues entering into the structure of the ovaries and their appendages, viz., serous, mucous, and ligamentous membranes, together with the parenchyma, we are prepared to expect a variety of symptoms, some of which are very painful. Our medicines. must be chosen here, as elsewhere, in harmony with the totality of the symptoms. Though highly and purely nervous symptoms are often met with, yet we should be careful not to set down all, or indeed many, of the symptoms to neuralgia. The ovaries being, according to my experience, very frequently inflamed, or congested, when the derangement is styled neuralgic, I feel sure that if we treated such cases as inflammations, we should obtain more brilliant results. Note also that every month the ovaries and uterus undergo a natural congestion; and if not relieved by the proper secretions, there is laid the foundation for disease after an epoch of time. The kind of pain will point out the most homoeopathically selected medicine; and these will be aconite, or belladonna, or bryonia, or mercurius, phosphorus, iodium, pulsatilla, platina, colocynth, lachesis, conium, staphysagria, or cimicifuga.

As regards the indications for the medicines I suggest the following: When the ovarian pain shoots or extends towards the hip-mercurius, bryonia. When upwards to the side-pulsatilla, cimicifuga. When the pains shoot down the inner side of the thigh, phosphorus is most reliable; perhaps also staphysag. and colocynth. In bilious headaches, &c., &c., gelseminum. When numbness in the limbs, platina and colocynth. When accompanied by

D