his processes; but now he declares it to be something over and above this-a change, a liberation of the dynamic, a development of the spiritual, powers of the drugs, analogous to the production of heat by friction. Treated in this way, he affirms, "medicines do not become by their greater and greater attenuation weaker in power, but always more potent and penetrating"; there is "an actual exaltation of the medicinal power, a real spiritualisation of the dynamic property, a true, astonishing, unveiling and vivifying of the medicinal spirit."

These views were so little in accordance with those expressed in the Organon that we find scant further trace of them in the edition of 1829. In the note before mentioned, "refined" (verfeinert) becomes "potentised," as we have it now; and in the directions for proving medicines a note is added to § 129, saying that recent observation pointed to greater attenuation and potentisation rather than larger quantity as best giving the strength required for the purpose. This is all. In 1833, however, the pharmaceutical portion of the treatise has two new aphorisms (269, 270) embodying them. Its posological section remains unchanged, save in § 276. Here Hahnemann had said, in former editions, a medicine, even though it may be homoeopathically suited to the cure of disease, does harm in every dose that is too large, the more harm the larger the dose, and by the magnitude of the dose it does more harm the greater its homœopathicity." In the fifth edition he adds "and the higher the potency selected," which obviously changes the meaning of what has gone before, and makes dose a mere question of number of drops or globules. I mention all this to shew how entirely the doctrine of dynamization was an after-thought, and how little the Organon proper (with which we are immediately concerned) has to do with it.

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But what shall we say of the theory itself, in its bearing on Hahnemann's worth as a thinker? This must depend very much upon the stand-point from which we regard it. Was it a gratuitous hypothesis, at best a mere logical consequence of the other views of the originator? or was it an attempt to account for facts-these being in themselves genuine? Hostile critics assume the former position, and judge accordingly. We, however, cannot do this. Whatever our own preferences in the matter of dosage, it is impossible to read the history of homœopathy, still more to be acquainted with its periodical literature, without recognising that highly attenuated medicines have an activity sui generis. They show this in provings on the healthy as well as in the treatment of the sick; and not here and there only, but in such multitudinous instances as to make coincidence and imagination utterly inadequate as accounts of the phenomena.

The Hahnemannic processes certainly do develope virtues in drugs which in their crude state are altogether latent. Brimstone, oyster-shell, flint, charcoal, table-salt-these substances in mass have a very limited range of medicinal usefulness; but what cannot homoeopathy do, what has it not done, with sulphur, calcarea, silicea, carbo vegetabilis and natrum muriaticum, in the dilutions from the 6th to the 30th? In this form they are in our hands as well-tried agents as any on which ordinary medicine depends. Their potency is a fact to us: how are we to account for it? Hahnemann's dynamization, in the light of later science, must be held untenable; but to this day we have nothing to put in its place. And even if we had, we should not the less honour the philosopher who perceived the necessity of the explanation; who brought to light the hitherto unknown phenomena, and set us to work at giving a scientific account of them.*

I have now completed my exposition of Hahnemann's medical philosophy as contained in his Organon. But we are accustomed now-a-days to demand more of philosophy than that it shall be sound in method: it must also show its power in bearing fruit. Hahnemann's need not fear the challenge. There is a fine passage in Macaulay's essay on Bacon, in which he recounts the numerous gains to mankind which the science of the last two hundred years has contributed. If the writer of the "Novum Organum" could have looked forward, he says, he might well have rejoiced at the rich harvest which was to spring up from the seed he had sown. In like manner has even the immediate future responded to the impulse given by our Organist. Could he have foreseen the medicine of to-day, how much there would have been to gladden his heart. He lived in a time when heroic antiphlogisticism was in full force; when physicians "slew," as in Addison's day, "some in chariots and some on foot"; when every sufferer from acute disease was drained of his life-blood, poisoned with mercurials, lowered with antimonials, and raked by purgatives. He denounced all

* Dr. Gatchell, in a very interesting essay, brought before the Paris Congress of 1900 the views now entertained about the effects of solution, as substantiating Hahnemann's dynamization. In a complete solution of a complex body, he writes, there are no molecules, but only "ions" into which the molecules have dissociated. These ions are electrically active while the molecules are passive, and so a fresh force may be said to have been imparted to the original substance. These views may be helpful to our conceptions, so far as compound salts and solvent processes are concerned, but they hardly aid us for other substances and modes of preparation; and as a solution of one part in the thousand is considered a "perfect" one, we do not even for the salts get far on in Hahnemann's scale.-Dr. Gatchell's paper may be read in English in the Medical Era for April 1901.

this as irrational, needless, injurious; and it has fallen-never, we trust, to resume its sway. The change thus wrought even in the practice of the old school would be a matter for thankfulness on his part; but how his spirit would have bounded when he looked upon the band of his own followers! The few disciples made during his life-time have swelled into a company of over twelve thousand practitioners, who daily, among the millions of their clientèle, in their hundreds of hospitals and dispensaries and charitable homes, carry out his beneficent reform, making the treatment of disease the simple administration of a few (mostly) tasteless and inodorous doses, and yet therewith so reducing its mortality that their patients' lives can be assured at lower rates. He would see the Aconite and Belladonna, the Bryonia and Rhus, the Nux vomica and Pulsatilla, the Calcarea, Silicea, Sulphur, which he created as medicines, playing their glorious parts on an extensive scale, robbing acute disease of its terrors and chronic maladies of their hopelessness. He would see his method ever developing new remedies and winning new victories,-evoking Lachesis and Apis, Kali bichromicum, Gelsemium, and earning laurels in yellow fever as green as those which crowned it in the visitations of cholera. He would see his principles gaining access one by one to the minds of physicians at large, the proving of medicines, the single remedy, the fractional dose already accepted, and selection by similarity half adopted under other explanations and names. He might well feel, like Bacon, about the "Philosophia Secunda: which should end his Instauratio Magna. He had given its "Prodromi sive Anticipationes"; "the destinies of the human race must complete it—in such a manner, perhaps, as men looking only at the present would not readily conceive." The destinies of the human race, in respect of disease and its cure, are completing it; and will be yet more profoundly modified for the better as that completion goes on.

LECTURE IV.

THE KNOWLEDGE OF DISEASE.

Hitherto, in dealing with the three elements of the method of Hahnemann-the aspect it takes of disease, the mode in which it ascertains drug-action, and the principles on which it fits the one to the other-I have confined myself to exposition and vindication of Hahnemann's own deliverances on the subject, and these mainly as contained in his Organon. There is still, however, a criticism to be made on his positions from the standpoint of the medicine of to-day; and to this I must now address myself.

In the opening words of the definition of homœopathy which formed the starting-point of my first lecture, I said "Homœopathy is a therapeutic method." It is, I might have added, so described by its author. We find the name, the formula, and the full statement of it in the first edition of the Organon. "Hitherto," he writes in the Introduction, "the diseases of human beings have been treated not rationally, not on fixed principles, but according to various curative intentions, among others by the palliative rule contraria contrariis curentur. Directly opposite to this lies the truth, the real road to cure, to which I give the guide in this work: To cure mildly, rapidly, and permanently, choose in every case of disease a medicine which can of itself produce an affection similar (őμolov Tábos) to that it is wished to cure (similia similibus curentur)." Homœopathy is a therapeutic method; and it belongs, avowedly at least, exclusively to that part of the therapeutic sphere in which drugs are our instruments. "To cure". . . "choose in every case of disease a medicine." It gives no instruction as to the other resources of the physician's art-diet, regimen, temperature, climate, the use of water and electricity, and so forth. Some analogies among these, and even among psychical affections, to the operation of similars have been pointed out by various writers from Hahnemann downwards; but, whatever be their value, they at any rate find no place here. For our present purpose, homœopathy is a method of drug-therapeutics; and * Hahnemann's suggestions of the kind have been criticised by Dr. Dudgeon in his Lectures (p. 71-4), and by Dr. Sharp in his "Essays on Medicine" (1874), Essay VI. On the other side see Dr. Percy Wilde in the M.H.R. for 1896, p.p. 116, 149.

**

while it has the advantages, must also share the limitations, of its materials. These limitations are of several kinds, but are mainly imposed by the superior claims of other remedial measures. Similia similibus may be the best mode of choosing medicines, but medicines are not always the chief or the most appropriate means of treating the sick. Such a thought was hardly so familiar to the age of Hahnemann as it is to our own. The ordinary medical attendant was then in fact as in name an apothecary-one who served out drugs from a store; his only variation upon this theme occurring when he bled or blistered. Of the natural history of disease nothing was known, and the idea of trusting to it was before Skoda and Dietl unheard-of. Hygiene played as little part in the doctor's prescriptions as it did in the patients' lives; and the tolle causam on which we now lay so much stress was then directed only to those hypothetical morbid states-obstructions, spasms, altered humours, and so forth-which were assumed as the foundations of disease. With the advance of knowledge on these subjects a corresponding encroachment has been made on the sphere of drug-therapeutics; and homœopathy occupies a less prominent part in the practice of homoeopathists, not because they trust to it less as a guide to drug selection, but because they have less need of drug action itself.

In a lecture "On the Place of Drugs in Therapeutics," delivered at the London Homœopathic Hospital in 1895, which is readily accessible, I traced the progressive adoption of this position from Hahnemann himself through Carroll Dunham, Dudgeon, and Dake. In assuming it on my own part, I reminded my hearers of the potency of diet in scurvy and of regimen in lithæmia; and of the benefit of exposure to nature's influences as seen in Pfarrer Kneipp's system (to which might now be added the fresh air treatment of phthisis). I showed the wide range of the maxim tolle causam ("that royal road," as Hahnemann calls it), applying it to the abuse of the tea, coffee, tobacco and alcohol which-to say nothing of coca, kola and absinthe-play so large a part in present-day life; and also to the place occupied by reflex action in the etiology of disease. I recognised the aid brought to the healing art by surgery, by hydrotherapy, by electricity, by gymnastics and massage (I might have added, by heat and cold). I need not further enlarge on this subject. I only mention it here to show that I am not unmindful of the wide field of therapeutic work which lies outside the special plot of ground we cultivate; and of our right and duty, as physicians and not merely homoeopathists, to labour in it.

* See M.H.R.,xl. 14.