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PKEFACE.

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This notice of the Cold Water Cure originally formed the Appendix to the " Baths of Germany ;" that of Homoeopathy having been ap-^ pended to my " Observations on Continental

^ Medical Institutions and Practice," published

several years ago. These were, I believe, the ^ first accounts of the subjects given in this coun-

sa try by one of the profession, and from the large

^ share of attention which they subsequently at-

^ tracted, I considered that it would be doing a

service to republish my remarks in a separate form—without making them so diffuse as to form a book, but with such alterations as a more extended knowledge had shown to be requisite, \ for the advantage of those interested in having

an opinion as to the degree of estimation to which these methods of treating disease are entitled, free from the one-sided views which their

partisans are desirous of inculcating, but at the same time, without an undue depreciation of the effects which, when considered in their more extensive bearings, their introduction is likely to have on medical practice. Considerable additions have been made to the present combined editions; the.notes in the Appendix remaining as before.

13, Curzon Street, May, 1847.

THE

COLD WATER CURE.

Graefenberg, the head quarters of the practice of hydropathy, now consists of about thirty houses, scattered on the acclivity of a wooded mountain which rises above the small town of Freywaldau, containing about three thousand inhabitants, and in which an establishment has also been formed. The country is salubrious, the air pure and bracing, and the water is excellent. " Among the half-wild mountains in Silesia," observes Dr. Scoutetten in his report,*"

* Rapport a M. le Ministre de la Guerre sur l'Hydrothe-rapie. Paris, 1844.

B

^ HYDROPATHY.

" where the medicine of the schools is scarcely known, the inhabitants still restrict themselves, in the treatment of the diseases and accidents to which they are exposed, to the means which nature offers. Of these water necessarily plays the most important part, and, together with forced sweating, are employed in combating a multitude of diseases." These remedies, which, from time immemorial, had been popular in the district, were, however, more methodically and successfully applied by Vincent Priessnitz, originally a small farmer, who, it is said, when young, had his attention more particularly directed to the advantages of cold water from the circumstance of his speedy recovery, by this means, from the consequences of a fall, attended with two broken ribs, and also from the rapid healing of a crushed finger. He was thus led to treat patients and animals on the same plan, and in 1826 had acquired considerable reputation in the surrounding country, which he was accustomed to perambulate with a bag of sponges on his back, applying water ablutions and compresses, to which were, afterwards added, sweating, cold baths, and douches. The success attending the practice induced many patients

from other parts to resort to Graefenberg, and considerable opposition was made on the part of the local authorities before whom Priessnitz was cited to appear, and was prohibited from practising ; but on appealing to a higher. tribunal, and proving that he used no secret remedy but only pure spring water, he was authorised to receive patients; a physician was sent from Vienna to report upon the proceedings and the advantages of the treatment, and Graefenberg was ranked among the Austrian baths. In 1830 the number of patients amounted to only fifty-five, but in ] 838 to upwards of eight hundred, which number has since more than doubled, including many medical men.

The governments of Bavaria and other German territories likewise authorised hydropathy. At Breslau the professors of the university, and especially the celebrated anatomist Otto, greatly modified their practice by the more frequent employment of water. - At Dresden hydropathy was favorably received. The distinguished professors, Cams and Choulant, regard hydropathy as a powerful means, calculated to render great service in the treatment of disease, after the prevailing enthusiasm should be succeeded

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by an enlightened appreciation of its effects deduced from experience. Several of the first physicians of Munich, and especially professor Ringseis, considered the cold water treatment properly applied as a powerful resource against certain diseases which have resisted the ordinary methods, and at some of the restaurants of the latter city wine was so little in request, that water brought from Schoenbrunn was sold. The Duke of Saxe Gotha gave up a chateau for a hydropathic establishment, as did also the Prince of Saxe Meiningen (Liebenstein), and the Prince of Reuss.* A degree of reaction has, however, taken place in the public mind in Germany since Dr. Scoutetten published his report, and the number of patients at most of the establishments has greatly decreased during the last two years.

One of the largest of these establishments, which I'have twice visited, is Marienberg, (formerly a convent of dames nobles;) standing on an eminence overlooking the town of Boppart, in one of the most picturesque parts of the Rhine, and forming a conspicuous object from

* Rapport, &c.

the river. In the court-yard is a fountain of clear spring water with iron cups attached, for drinking, and an ascending douche, by which a fine continued stream of water may be directed against the eyes or other parts of the head. A statue to the virgin, to whom the building was formerly dedicated, stands as a memento of bygone times in a niche over the door. The apartments (on either side of spacious corridors) are neatly and conveniently fitted up, the price varying according to the accommodation. There is a large and cheerful reading-room, commanding a view of the Rhine, and supplied with newspapers and periodicals; adjoining is the refectory, where all the patients assemble at dinner. The baths are on the lower story, sunk in the ground. They contain clear water, about four feet deep, of the natural temperature, and are sufficiently spacious to admit of the bathers moving freely about. About 150 persons could be accommodated at the same time. The dinner consists of soup, roast or boiled meat, potatoes and other vegetables, cutlets, and plain puddings; the only beverage allowed being pure water, of which there is a plentiful supply of bottles upon the table. Bread and butter, and cold milk and

water, are allowed for breakfast; and the same for supper, with the addition of stewed prunes, pears, or other fruit.

Besides the douches in the house, there are, in an adjoining building, the Wellenbad, (wave-bath,) which is used in certain cases of local debility, and two or three douches in the environs ; one being at the Hermitage, in a picturesque situation at the foot of the Hunds-Driicken hills, about a mile and half distant, to which the patients must walk, and, having been douched, must also return on foot. The water of the douches falls from a height of from ten to twenty feet, through tin tubes, the diameter of which varies from two to three inches, so that a powerful column of water falls upon the part of the body exposed to its action. On the back, abdomen, and chest, the stream is generally made to fall obliquely, Marienberg is now under the superintendance of Dr. Hallmann, who was formerly commissioned by the Russian government to visit Graefenberg and report upon the practice. A few minutes' walk from Marienberg, and close to the river, is the more recent establishment, Mtihlbad, which can accommodate about fifty patients, and was, till last year,

under the superintendence of Dr. H. Mayo, but now of Dr. Burgess, in conjunction with Dr. Heusner, the proprietor.

The mode of life and method of treatment, do not materially vary at any of these places; but the coarse nature of the diet at Graefenberg is a just subject of complaint, the dinners being generally composed of beef done to rags, cucumbers in salt and water, acid sauces, and heavy dough puddings.

" It cannot be doubted," observes an author,* " that this wretched diet keeps the patients much longer under treatment than would otherwise be required, and that in many instances it obstructs the cure altogether." Priessnitz, however, is said to be willing to prove that his patients are able to digest, without inconvenience, substances which at other times would disagree with them, though doubtless the true reason is assigned by Dr. Johnson, that bad food is cheaper than good. Everything of a stimulating nature, as spirits, wine, coffee, tea, &c. is prohibited.

Although the external application of water is the most essential part of the treatment, the drinking copiously is equally enjoined. Some

* Hydropathy, by Edward Johnson, M.D.

persons drink as many as twenty goblets a day, though it is seldom that more than twelve are prescribed. In some instances it is deemed advisable to recommend the preliminary use of a few cool or tepid baths, previous to bathing in the water at its natural temperature. The usual mode of procedure originally adopted was as follows: Each patient is awakened at about five in the morning by an attendant, by whom the process of emaillottage^ or wrapping up, is performed. A blanket or woollen covering is first bound round, so as to envelope the whole body, the face only being left free; over this a second blanket is bound round the body. In a short time copious perspiration is induced; the window of the room is then thrown open to admit fresh air, and cold water is given to the patient at intervals, to supply the waste produced by the perspiration, and to prevent him from being weakened by its quantity. When the perspiration has continued for the period that is deemed sufficient, the coverings' are taken off, except the original blanket, a cloak being thrown over the patient and slippers placed on his feet; he descends quickly from his room to the bath, and first dipping his hands and face for a second or two, throws off

the blanket and plunges into the water at a temperature from 9° to 12° R., while the perspiration is still streaming from the pores of his skin.

The duration of the bath is only a few seconds in most instances; some persons, however, remain in for a longer period, in brisk motion, and rubbing the surface of the body. On quitting the bath the skin presents the same appearance as a boiled lobster. After having been dried by friction with a sheet, the patient dresses, walks about for an hour, drinking two or three glasses of cold water, and then goes "to breakfast with what appetite he may." The time between breakfast and dinner (at twelve or one o'clock) is occupied in walking, reading, drinking cold water, &c. At Graefenberg many of the patients were formerly subjected to a repetition of the sweating and bathing process in the course of the day; this is, however, not now the case.

It is well known that the impression of cold water or cold air to the surface of the body, throws the blood upon internal organs, which relieve themselves of the excess under the consequent reaction when the application of the cold is discontinued, and a glow, frequently

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with perspiration, is produced. The sudden passage of the body, while its surface is heated or in a state of perspiration, to a very cold medium, is generally considered, and very justly so, as highly dangerous; but in the cold water treatment, it is seldom found to be productive of prejudicial consequences, when under proper superintendence. On the contrary, a direct increase of bodily vigour and of the appetite is commonly experienced on leaving the bath. # It must, however, be borne in mind, that in these cases the heat of surface and perspiration are of a passive nature, and not produced by exercise, by which the whole body is heated and the circulation accelerated, in which state a person could not go into a cold bath without great danger. In fact, the practice is very analogous to that which was adopted by the Romans, who

* " The cooling of the body," says Liebig, " by whatever cause produced, increases the amount of food necessary. The mere exposure to the open air in a carriage, or on the deck of a ship, by increasing radiation and vaporization, increases the loss of fyeat, and compels us to eat more than usual. The same is true of those who are accustomed to drink large quantities of cold water, which is given off at the temperature of the body of 99'5. It increases the appetite, and persons of weak constitutions find it necessary, by continued exercise, to supply to the system the oxygen required to restore the heat abstracted by the cold water.

plunged into the baptisterium or cold bath, after leaving the vapour or hot one: and also by the Russians and other nations at the present day. " The heat of the vapour/' says an author who has treated of the subject, "to which the bather is exposed, is from 122° to 132° Fahrenheit. Sometimes, when there are no conveniences for a supply of cold water, a Russian will rush out from the bath, and plunge into the nearest stream, or even roll in the snow." Acerbi states, "that almost all the Finnish peasants have a small house built on purpose for a bath; the apartment is usually dark, with only a hole at the top. They remain for half an hour or an hour in the same room, heated to 167° Fah. The Finlanders will sometimes come out naked and converse together or with any one near them in the open air. If travellers happen to pass by while the peasants of a hamlet or little village are in the bath, and their assistance is needed, they will leave the bath, and assist in yoking and unyoking, and fetching provender for the horses, or in anything else, without any sort of covering, while the travellers sit shivering with cold, though wrapped in good wolfskin. The Finnish peasants pass thus instantaneously from an atmosphere of 167° Fah., to

one in which the thermometer is as low as 24° below zero, which is the same thing as going out of boiling into freezing water; and, what is more astonishing, without the least inconvenience, while other people are very sensibly affected by a variation of but five degrees, and in danger of being affected by rheumatism by the most trifling wind that blows."

" The Indians of North America/' continues the same author, " have also their fashion of bathing, which is not very dissimilar from that of the Russians. They construct a kind of stove, by fixing several small poles into the ground, the tops of which they fix together, so as to form a rotunda, and then cover it with skins and blankets, so accurately, that the external air is completely excluded. The space left for the introduction of the body of the person about to take the bath is closed as soon as he gets in. In the middle of this small apartment they place red-hot stoves, on which water is poured until a steam arises that produces a high degree of heat. The effect on the person enclosed is a speedy and profuse perspiration, which may be prolonged at will. Immediately after coming out, he hastens to the nearest stream, into which he plunges and bathes for 7

about half a minute; he then puts on his clothes, sits down, and smokes with great composure, and, what is of no little importance, with a thorough persuasion that the process will prove efficacious. The sudatory is often resorted to for the purpose of refreshment, or to prepare for the transaction of any business which requires unusual deliberation and sagacity."*

In these instances, the time the person remains in the cold is not sufficiently long for the production of its depressing effects, which can be better resisted in proportion to the previously high temperature on the surface of the body. Hence, a person whose body is moderately warm, or whose skin is in a state of passive perspiration, would experience less inconvenience and danger from going into a cold bath, than one whose skin is cool, or when its vital powers are depressed. The advantage of cold affusion* in fevers, when the heat of the body is steadily above the natural temperature, is well known, and is a further illustration of the same principle.

In Great Britain, the regulation of the functions of the skin by bathing, especially the use * Bell on baths, &c. Philadelphia.

of the tepid bath, has been more neglected than in perhaps any other country. Of late years, however, a greater degree of attention has been directed to this important circumstance, the number of public baths having increased in London within the last few years.

In fact, when we consider the extent of surface occupied by the skin, its varied uses, both as the chief organ of sensation, in which the ultimate ramifications of the blood-vessels and nerves terminate, and also as that in which the important functions of absorption, perspiration, and the secretion of the sebaceous matter, by which its surface is lubricated, are carried on; its analogous office to the lungs, in favouring the decarbonization of the blood, and its extensive sympathies with other parts, especially the mucous membranes of the air passages of the alimentary canal and the kidneys, we cannot fail duly to estimate the importance of bathing, as the means best adapted both for maintaining this organ in a healthy condition, and also of rectifying many disordered states of the economy ; and yet how seldom is it that baths are recommended in chronic diseases ! Can it excite surprise, that in individuals who pass months together without taking a bath, or perhaps even 7

without washing the surface of their bodies (as is the case especially with the poorer classes of the community) the functions of the skin should become materially impaired, its circulation torpid, its secretions obstructed and vitiated, frequently giving rise, by their re-absorption, to deranged states of the health, of which the cause is seldom ascertained, and which the practitioner vainly endeavours to remove by the internal administration of medicines. #

Even in private practice, where there would be no obstacle to the free use of baths, how seldom do they form part of the treatment, unless there should happen to be any existing disease of the skin! I am convinced, that in many instances the digestive powers become deranged, and the general health undermined, from a neglect to pay proper attention to the state of the skin; that a large proportion of the catarrhal, rheumatic, and nervous affections, so prevalent in the variable climate of Great Britain, might be traced to the same source; and that the tendency to these complaints, as well as to pulmonary consumption, would be materially lessened, were persons, while in health, accus-

* The baths for the poor recently established in London and some other large towns, will have a material effect in the prevention of disease.

tome.o to attend to the functions of the skin, by the employment of bathing and cold ablutions more frequently than is generally the case. Many people, it is true, who perhaps never take a bath, yet enjoy good health, for the influence of habit will often enable the body to support many things that are generally prejudicial. But, on the other hand, there is no doubt that many suffer from various unpleasant sensations and disordered states of health, which might be prevented by the more frequent adoption of the practice.

In the great majority of cases where hydropathy has been employed of late, a coarse sheet dipped in cold water and wrung out is applied, and over this other coverings are bound round the body. ,The application of the wet sheet causes a penetrating sensation of cold and shivering for a period varying in different individuals ; but the body soon becomes warm, and from evaporation being prevented the wet cloth acts as a fomentation, and the subsequent perspiration is much less profuse than when the blanket is employed. Where, however, the object is to reduce the heat of the surface, as in cases of acute disease, the wet sheet requires to be frequently renewed, before this degree of re-

action takes place. In these instances, the first impression is agreeable; the application generally allays irritation, reduces the frequency of the pulse, producing a tendency to sleep, and is thus a powerful antiphlogistic. As long as the skin is hot and dry, the application may be repeated, at first at intervals of a quarter of an hour, and afterwards at longer intervals, till a tendency to moisture appears. The cold water application has been strongly advocated by many practitioners in acute disease, and its modified adoption cannot fail to be beneficial in many instances—as affording the most efficient means of lowering the temperature of the body, being, in fact, but a variation of the practice formerly advocated and successfully practised by Dr. Currie, of cold affusion in fevers, the rule to be observed being that the surface of the body be steadily above the natural temperature^ and that the skin be not in a state of perspiration, though as regards the latter some exceptions might be allowed. Where, however, the feverish excitement depends upon inflammation of an important internal organ, there would in many instances be great danger from the frequent application of cold of an increase of the evil, in consequence of the blood being driven upon the

internal organs at a time when the power of re-action is weakened. Hence the cases to which this treatment would be most applicable would be simple fevers, the more severe forms of scarlet fever, and other exanthemata, angina tonsillaris, rheumatism, and lumbago. Hip or sitz baths—the patient being seated in the water, with his legs over the edge of the tub— are also of very frequent use, combined with the wet sheet and other means. When employed for a short time only, and frequently repeated, the action of the sitz bath is tonic and bracing, causing contraction of the blood-vessels, and is consequently useful in various states of relaxation. When used for a longer period, a re-action succeeds on quitting the bath, more blood is determined to the parts; it is then a powerful derivative remedy, and is used to relieve congestion of the brain, or of the thoracic and abdominal viscera, and piles, by causing them to bleed, as well as constipation and other consequences of this state. In some cases of nervous excitement, head-baths are employed, the patient lying with his occiput in a vessel of cold water. Compresses of wet linen covered with a dry cloth (exciting compress) are also very commonly recommended to be worn on the

epigastrium or round the body, as also on other parts, for the removal of abdominal disease, fixed rheumatic pains, &c. This is also a powerful derivative means, producing in most instances an eruption on the part. When the wet cloth is frequently renewed, and evaporation freely allowed to take place, it is one of the most efficient means in the reduction of inflammatory action, especially in the skin, joints, and other parts, and has from time immemorial been employed both in private practice and in public institutions. The dressing ulcers and wounds with a bit of linen or lint steeped in cold water, (as formerly recommended by Dr. Macartney,) has also been long employed in some of the London hospitals.

Shallow and half baths, frictions with the wet hand while in the water, or with a dripping sheet, are likewise employed in some instances, often as a preparatory means for the sweating process and cold baths ; sometimes tepid baths, or water with the chill off, is previously used. *

* Dr. Gully, in his recent work on the cold-water cure, advocates hot fomentations to the abdomen (which are commonly used in ordinary practice) as a means of allaying visceral irritation, of procuring sleep, relaxing the kidneys and bowels, of arresting bilious and nervous headaches, fits of asth-

It is not my intention to enter upon the consideration of the theories of disease which have been promulgated to some of the exclusive advocates of the cold ivater plan, nor to attempt to refute their one-sided assertions as to the inefficiency of other remedial means, which have stood the test of the experience of ages; but it may be admitted that the treatment employed in proper cases of chronic disorder, strengthens the nervous and muscular systems, gives tone to the body generally, and to the skin in particular; there is consequently a greater inclination and ability for exer-cise, a diminution of the undue susceptibility to atmospheric changes, and to morbid impressions on the nerves, which in a high state of civilization are so frequently productive of disordered states of health. The pure air, bodily exercise, plain

ma, tic, sciatica, spasm, infantile convulsions, continued vomiting, and of relieving acidity and flatulence, and also as a preparatory measure to the applications of cold water, in " old persons, delicate females, bloodless and greatly debilitated patients, especially those affected with bronchial and asthmatic disorder of the lungs," thereby " enabling the skin to react upon the cold wet sheet, when it would otherwise not have done so. Extreme congestion and extreme general weakness, may be thus coaxed as it were into commencing the attempt at self-restoration." A person must indeed be strongly pre-j udiced in favour of cold water to think of applying it in similar cases.

diet, the drinking freely of water, and consequent copious excretion of fluid, by means of the skin and kidneys, must tend powerfully to renew the mass of blood, and to eliminate noxious matters which sometimes remain long in the circulation and give rise to intractable diseases. A vitiated state of the blood, as the cause of disease, has in fact been more overlooked by English than by continental practitioners, though even abroad it is only of late years that due attention has been sufficiently directed to this point.

The extent to which the employment of active medicines in chronic disease has been and is still carried in the British dominions, is made a subject of just reproach by foreign practitioners. The public, however, is, in great measure, to blame for the practice, by encouraging the custom of remunerating the great body of practitioners, not according to the attendance, but in proportion to the quantity of medicine sent. To this custom may be ascribed that habit which many have acquired of dosing themselves and their families with active drugs on every slight deviation from a state of health. It is gratifying, however, to observe that of late

considerable alteration has been effected, both as regards the doses of medicine and the mode of remunerating professional services; though there is reason to apprehend that a long period must still elapse before the generality of the public and medical men will become aware that their true interest consists in the abolition of this system. The manner in which mercury is frequently used, or rather abused, (though not so much at the present day as a few years ago,) occasions the production and continuance of many nervous, dyspeptic, hypochondriacal, and other complaints, which are generally relieved for a time by the medicine, (in the same way that the dram of spirits or the dose of opium excites for a period those accustomed to their' use,) and this temporary relief often tends to keep the practitioner and patient ignorant of the principal cause of the intractableness of the complaint, either till recovery takes place in some instances from the medicine being discontinued, or, what amounts to the same thing, from the homceopathic regimen,—or from some accidental circumstance, as change of air, scene, &c., or till, in other cases, the general health is seriously impaired, and not unfrequently a

foundation is laid for the supervention of organic disease of important parts.

Eruptions, boils, or abscesses, are not unfre-quently induced during the water-cure, and these are generally considered by patients sa critical and evacuating morbid humours, though in the majority of instances they are but a consequence of the excitation of the skin by the process. In some patients, however, the perspiration eliminated has a strong fetid odour, and the cloths and compresses are not unfre-quently stained, and retain a bad smell. Dr 4 Schmitz mentioned to me a case which fell under his observation of a patient who had taken sulphur-baths seven years previously, but who had not used sulphur since that period. After she had been pursuing the cold water cure for some time, her room smelt of sulphur, a bracelet she wore became tarnished, and her linen was stained a yellowish colour. Other foreign matters have also been detected by analysis in the perspiration and urine of these patients.

A system which acts so energetically upon the constitution may well be enumerated among the heroic remedies, and as such requires much discrimination in the selection of cases.* As

with Cadet de Vaux's method of treating diseases by hot-water, as well as with many other methods and remedies which have been adopted for a time and have subsequently fallen into neglect, so also the too general application of the cold-water cure has been followed by accidents, and an aggravation of the diseases it was intended to remedy. With respect to this point, the author whom I have already quoted observes, u But no rational man can doubt that the possession of scientific knowledge would enable Priessnitz to be much oftener successful than he is, and would lessen the number of his failures. Certainly it would prevent his taking in, and submitting to a tedious treatment, many cases which such knowledge would have taught him at first were perfectly hopeless. There are many such cases in the establishment at this moment" *

" And I foresee," further observes this author, " that much evil will at first result, and many a life be sacrificed, from the apparent simplicity and innocence of the remedy, inducing

* Priessnitz now employs much milder means, which is a tacit acknowledgment of the impropriety in many instances of those formerly used.

persons to practise, both on themselves and others, (to the injury of both,) without the knowledge necessary to do so with success." *

It is generally acknowledged by the profession in Germany that this mode of treatment is calculated to be of service in some diseases. I shall content myself with briefly alluding to the principal complaints in which it has been found advantageous, as it is my intention in this place merely to give an aperpu of the method. A great number of works have been published of late years in Germany and France, as also in this country, by medical and non-medical persons in which its advantages and disadvantages are fully considered ; and as some among these authors are not prejudiced in favour of or against the treatment, a tolerably accurate idea may be formed from their perusal of its results.

Good air, exercise, plain diet, abstinence from stimulating food and drinks, and tranquillity of mind, have been repeatedly insisted upon r by medical men and others, as being the most essential means of preventing and obtaining the removal of the majority of diseases which a high state of civilization and luxury induces;

• Dr. E. Johnson.

HYDROPATHY.

and the former of these are more influential with the human race than with others of the animal creation ; for though a man be an omnivorous animal, and requires a variety in his food, yet by the too free indulgence of highly-seasoned viands and stimulating potations^ (the habit> of which generally becomes more strong at a period of life when there is a less disposition for muscular exertion ;) # not only is the appetite excited and a larger quantity of food taken than is required by the wants of the system, but there is also a greater demand upon the nervous energies; the quality of the blood itself, and consequently of the various secretions, becomes altered, which state of matters cannot long exist without derangement of the health manifesting itself in one way or another. This state of predisposition to disease, and several of the disorders to which it gives rise, might often be remedied by the exercise, early hours, and temperance enjoined as part of the water cure: but it is seldom that persons, so long as they feel themselves tolerably well, have the resolution to break through the chains of

* "An excess of food is incompatible with deficiency of inspired oxygen, that is, with deficient exercise." — Liebig Organic Chemistry

habit so far as to adopt even partially these precautionary means, by which the future assistance of the physician might be obviated; but they go on in their accustomed manner, dosing themselves at intervals with medicines to relieve their most urgent inconveniences; and it is not until the germs of disease become rooted in the system, and the symptoms are so strongly manifested as to indicate material interruption in the performance of important functions, that they are awakened to the necessity of sacrificing some of their accustomed enjoyments, and are forced to resort to other than merely palliative means for a restoration to health, which cannot at this period be effected solely . by hygienic measures, and which is more effectually accomplished by a combination of these measures with remedies which alter and improve the quality of the blood, and impart tone to the nerves, by their general and gradual operation, than by others which have a more directly exciting effect upon particular organs. Hence the reason why so many have recourse to mineral waters, and lately to the cold-water plan, which, though more disagreeable in its immediate action than mineral waters, may yet be applied to several of the

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diseases of which I have spoken when treating of these remedial agents; especially to some forms of long standing disorder of the digestive organs, particularly when arising from the causes which have been already referred to, viz. repletion, and a too luxurious and sedentary mode of life ; some gouty and calculous disorders, which are so often dependent upon the same causes, especially when occurring in the young or middle-aged of full habit and otherwise healthy ; inactivity of the skin; complaints arising from exposure to cold and suppressed perspiration,—such as fixed and shifting rheumatic pains and stiffness, which are sometimes so intractable as to resist mineral waters and other means, are likewise not unfre-quently cured by this treatment ;* and the undue susceptibility to atmospherical vicissitudes by which they were perhaps originally caused is often removed, as is also morbid excitability of the nerves, and its consequences, hysterical and spasmodic attacks; long standing intermittent complaints, either in the form of ague, neu-

* M. Bonnet, chief surgeon of the hospital at Lyons, says : ' The diseases in which the most complete cures are effected are chronic rheumatism, with or without swelling of the joints, nncl chronic engorgements of the womb."

ralgia, or irregular muscular movements, after having resisted other measures, have sometimes yielded to this treatment, than which few things could be more calculated to counteract the influence of habit by which similar complaints are so often kept up; syphilitic cases, particularly when of long duration, and when much mercury has been taken ;* as also relaxation of the system, and other derangements of the general health, may often be removed or mitigated by this plan of treatment.

Notwithstanding, however, the advantage which the water cure may be calculated to produce in some disordered states of the economy, it must not be supposed that it is either so generally applicable or so successful as some of its advocates would have it considered; and the exaggerated accounts of its efficacy which have been given to the world by interested or enthusiastic parties, are likely to do much harm by leading to ,its indiscriminate adoption in cases

* " The patients are most likely to derive advantage if young, and if the complaints have been induced by chills or cold. If they are of a feeble constitution, hydropathy is powerless. The study of general treatment, among which hydropathy must rank, is worthy of all the attention of prac -titioners."— Compte Rendu, &c;

to which it is but ill-suited. Thus, one nonmedical author, after extolling Priessnitz as " one of the greatest benefactors of mankind— one of the most astounding geniuses of this or any other age — a second Hippocrates — the founder of a system by which all curable diseases, and many declared by the faculty to be beyond the power of their art, are to be cured by the sole agency of cold spring-water, air, and exercise,"* fills his book with cases of cure of acute and chronic disorders, chiefly from the publications of practitioners of this method, who, like others interested in crying up any particular mode of treatment, would generally abstain from bringing forward instances which would cause the success to be questioned. What, in fact, are the majority of publications written by watering-place practitioners, but one-sided accounts of the virtues of the waters of their particular locality, without any reference to other remedies or other places where the waters may be of equal if not superior efficacy, in the very complaints of which the account is given ? The same may be said of many remedies which have at times been trum-

* Claridge on Hydropathy.

petted forth to the world, and though perhaps efficient in many cases, have nevertheless been subsequently laid aside, in consequence of their not answering the exaggerated expectations raised by their too enthusiastic advocates. It must also be borne in mind, in estimating the value of remedies, that it is not because a person gets well while pursuing a particular mode of treatment, that his recovery is a necessary consequence of the treatment, as the same result would very often occur under a different mode, or even where no treatment at all was adopted. The post hoc is, especially in medicine, very often mistaken for the propter hoc. On the other hand, some less partial observers, who likewise followed the practice at Graefen-berg, and whose works are favourable to the cold water treatment, state that many patients go away without any amelioration in their condition; and that a large proportion labour under no more serious ailments than might be remedied by a residence in pure air, by exercise and plain diet.

Nor can the accuracy of the diagnosis of cold water practitioners always be depended upon. 6C In a great many cases," observes a recent author, who passed a long period at Graefenberg, and

whose work is on the whole favourable to the eold water treatment, " the names of apoplexy, pneumonia, and serious fevers, have been applied to some symptoms, which a few applications of the wet sheet or frictions caused to disappear, and of which the cure resounded through the colony as a convincing proof of the omnipotence of the method."*

The ability and tact of Priessnitz is frequently insufficient to counterbalance the absence of medical knowledge as regards the discrimination of cases .to which the method is applicable. I have already adduced the testimony of Dr. E. Johnson, that many of the cases at Graefenberg are such as are not likely to be relieved, and the attempt is necessarily a failure. Another medical author who resided at Graefenberg says, " Chance furnished me with several opportunities of meeting, a month or two after their departure from Graefenberg, with persons whom I had seen give themselves up to all the exaltation of their enthusiasm, and I was quite surprised at the change which had taken place in their sentiments. A short time ago I met a young Russian officer, with whom

* Dr. Schedel. Examen Clinique de PHydrotherapie. Paris, ] 845.

I had dined several times at the table of Priess-nitz. * And how are your headaches ? said I after the usual salutation, recollecting his bragging, of which I had been a witness more than once; he replied, with some confusion, ' My pains are the same as before; and I should have done much better had I gone to pass six weeks at Teplitz, instead of losing six months at Graefenberg."' Another patient told me, that far from being satisfied with his journey, he believed he could date from that period the sufferings which now tormented him much more than those for which he had gone to Graefenberg. A lady who had taken care to avoid the ordinary excesses of Priessnitz's guests could not find terms sufficiently strong to express to me, how disagreeable is the time which follows an hydropathic treatment; the continual use of cold water had become to her a condition of her well-being, and when "she was obliged to limit it in some degree, she experienced the same inconveniences, as those which occur when one is suddenly deprived of a stimulant of which one has contracted a habit."

These instances would be found to be multiplied, if the truth could always be known. Many persons who feel themselves in better

c 5

health at the time of the treatment, or for some time afterwards while still under the influence of the stimulation, and have consequently spoken highly of it, would, after a period, and on attempting to return to their ordinary mode of life, find the amelioration not to be of so permanent a character as they had expected, though comparatively few would, like the Russian officer, be disposed to recant what they had previously said, and to acknowledge that their expectations had been too highly raised. This remark is equally applicable to the results of other methods which have been unduly lauded by particular individuals, but which an impartial experience in time reduces to their proper level. " De tout chose ilfaut voir la fin ^

" It is evident," observes the same author, " that the laws of prudence are violated each hour of the day at Graefenberg; and this truth is beginning to make its way in the world, for, dining one day at Neisse with several Prussian officers, I heard one of them say, that they were greatly indebted to Priessnitz, whose treatment had contributed to render promotion more rapid, by hastening the end of some of them, whose names he mentioned; which, however, did not prevent one of the guests from

maintaining that Priessnitz cured every kind of intermitting fever in three days. I then recollected the only two patients attacked with fever whom I had known at Graefenberg, and who were not yet cured at the end of a month or six weeks. One of them had given up the water, and had recourse to ordinary medicine. This assertion of the guest whom I have mentioned confirmed me in the opinion that Priessnitz is a favourite of fortune, such as is seldom seen; for, at the moment when at Graefenberg an intermitting fever was braving him by its obstinacy, a few leagues off a panegyrist was found of his sagacity and the infallibility of his method. After my departure from Graefenberg a lady died there; it was then the custom to ascribe the occurrence of death to the bursting of an abscess internally, but on this occasion also, the opening of the body gave the lie to the favourite explanation. When the relatives inquired what had been the cause of the fatal termination of the case, the answer which they received was, that the patient's neck was too short to allow her to live. Where could there be found another man who would dare thus to express himself? In what other place than Graefenberg would there exist a public

who, instead of perceiving in such an answer the proof of the grossest ignorance, and of an unblushing effrontery, would, on the contrary, discover that of a profound wisdom ? What, then, will be the end of this direction of peoples minds? What will become of hydropathy, when it shall no longer be in fashion, and when time has torn off the tinsel with which it has been covered? These questions present themselves spontaneously, when on casting an eye over the history of medicine, we see that so many systems which have enjoyed so great a degree of fame, are fallen into complete oblivion. It is a bad sign for hydropathy, that it counts at the present time among its most zealous advocates, people who but lately spoke with enthusiasm in favour of homoeopathy. Precisely, because its value has been exaggerated, it will not be able to avoid a reverse of fortune."*

Dr. Sehedel also mentions cases of intermittent fever which had been long (two months) under treatment by the cold water, and one case where the patient became tired of the treatment and had recourse to quinine, which

* Exposition des Methodes Hydriatriques, par Ehrenberg et Heidenhain, Docteurs en M6decine, Paris,

soon effected a cure. He likewise refers to cases of chronic rheumatism and analogous affections, where the treatment was not attended with success, though, according to the hy-dropathists, these complaints are always cured. One patient had been under treatment for chronic lumbago for several months in the establishment, and was not cured; and Dr. Schedel says that similar instances are not uncommon.

The Italians (as well as the English) have a proverb " Ogni rnedaglio ha il suo riverso ;" and on viewing the reverse side, as regards the cold water cure, from what has preceded, it wil\ be easy to perceive that the method is not so generally successful, and that some of the cases have a fatal termination, even while under the treatment, or within a short time afterwards. Some of the exclusive advocates of the method boast of the small number of deaths which have occurred in the establishments where it is practised, as compared with those which take place where a purely medicinal treatment is pursued} but the comparison is not a fair one, inasmuch as the number of those who would leave their homes, when in a state of health attended with danger, to resort to a water cure establishment, must be extremely limited. The great bulk of

the cases met with in these establishments is composed of persons labouring under various derangements of the health unattended with danger, which is most to be apprehended from the imprudent use of the remedy from which they seek restoration. " Of the patients who resort to Malvern," says Dr. Wilson in his work,* " for the treatment by water, air, exercise, and diet, seven out of ten labour under the interruption of more or fewer of the organs which minister to the digestion of food ;" f and in fact the same may be said of a large proportion of those frequenting the different baths in the summer season, where, out of a large proportion of invalids, the mortality is extremely small on the spot, though many may subsequently find their sufferings aggravated, or have their lives shortened, by an improper use of the waters.

Hence it will be perceived that much discri-

* The Dangers of the Cold Water Cure,

f " Let me relieve your mind," says the writer of a letter to Dr. Bushnan, u of the idea that a water establishment looks like an infirmary, and presents at every turn disagreeable pictures of ill health. The fact is just the reverse j the patients generally seem in good health, and are so for all social purposes ; the majority have only some trivial dilapidation of the system, indigestion, nerves, gout."

8

mination is required as to the cases in which the water cure is likely to produce benefit, or to merit a preference over other means of treat-. ment. An unbiassed opinion can only be formed on this point after minute inquiry into all the circumstances and peculiarities of individual cases; and those persons would often find themselves grievously mistaken, who from hearing the account of cases of gout, rheumatism, or any other disease being cured by this or any other exclusive method, were to infer that it is necessarily suited to all or even to the majority of cases of those diseases, which cannot thus be considered in the abstract, but each case must be examined separately in order to modify and adapt the treatment to it according to the varying circumstances and peculiarities. It is true, that as there may be several roads leading to one place, so also in medicine, the same disease may frequently be cured by or subside under different modes of treatment, and it consequently behoves both the practitioner and patient to select the one which is attended with the smallest amount of positive inconvenience, and which requires the least time. Now the cold water treatment is not only a very unpleasant process, but a long course is in most in-

stances insisted on by those who practise it, and a patient would not have much reason to congratulate himself upon his relief from an ailment, by a four, six, or eight months' residence at a water cure establishment, when by medical treatment, or by a properly directed course of mineral waters, he might have been cured in a much more agreeable manner and in half the time. # I do not say that this is generally the case, but it is not unfrequently so; and what I am desirous of advocating is, the necessity of a proper discrimination by unprejudiced practitioners, in the selection of the cases to which different means of treatment may be applicable with the greatest amount of benefit to patients. I have, in the volume to which this account formed the appendix, endeavoured to show that mineral waters, which

* Dr. Schedel says : " Four or five months is considered by the enthusiastic partizans of hydropathy as a short time of treatment " and Dr. Gully also says, " I constantly have patients applying to me, to whom I say, you would recover by retiring to a farm-house, having care of your diet, rising early, taking appropriate exercise, breathing pure air, &c.; and this would be required to be continued for eighteen or twenty-four months. What the water treatment can do for you is to curtail that period by one half or two-thirds, and so it is in these slighter cases."

have no ephemeral reputation, but which have been used in all ages, and appear to be specially bestowed upon man as a means of relief from a large proportion of the diseases to which he is subject, present the most natural, efficient and agreeable mode of treating the majority of chronic diseases. A foreign author observes upon this point: " The evidence of antiquity with regard to the efficacy of mineral waters, the experience of centuries which confirms this efficacy, the universal favour in which they are held among all civilized people notwithstanding the difference of medical theories, sufficiently demonstrate that they are of all remedies those of which the reputation is the most justly established. Nature bestows these remedies liberally upon us in order to invite us to have recourse to them in our diseases; she has consulted, as much as possible, our delicacy, our taste; she has tempered the virtues and the power of the waters, and has adapted them to different temperaments. We obtain from plants and minerals many medicaments, but they almost all require certain pharmaceutical preparations; whereas mineral waters are always naturally at our disposal; they contain sulphur, carbonic acid, and neutral salts, which are fre-

quently employed in the practice of medicine. Why, when found in nature's laboratory, should these substances not have an equal degree of power as when taken from that of the apothecary ? Most mineral waters are not harmless; they cannot be used with impunity in cases where they are counter-indicated, and every year there are persons who become the victims of their imprudence," *

These statements are further corroborated by the progress of chemistry, which has demonstrated the direct action of solutions of salts and other substances contained in mineral waters, in altering and modifying the condition of the blood, in which similar substances are also contained, and of the secretions, as well as upon the nervous system, which point I have more fully treated of in my works on the German and English mineral springs; but as it may perhaps be considered that, having directed much of my attention to these remedial means I might be prejudiced on this point, I will quote the author of the work to which I have already referred. " The medical treatment which approaches nearest to hydro-

* Patissier, Manuel des Eaux Minerales, Paris.

pathy is doubtless that of mineral waters. The analogy can, however, only be established between these means and a moderated hydropathic treatment, when the cutaneous stimulation is maintained within just limits, and that of the different secreting organs is not too active, though sufficient to eliminate from the economy and by the natural means, the nescio quid, the presence of which interrupts the harmony of the functions. That an actual elimination is sometimes established there can be no doubt, since I have seen in gouty patients very abundant chalky matter come out of the abscess. But between an elimination of this nature, obtained by means of a very painful suppurative inflammation, and the mild and, so to say, physiological elimination directed towards the natural, emunctories by the use of certain mineral waters, my choice would not be doubtful,

cc The duration of the cold water treatment , often requires several years in order to procure a result which would be obtained by mineral waters in a much shorter time, and certainly in a much more agreeable manner for the patient. But, besides, the length of treatment which tires out the patience, there exists a very posi-

tive cause of disgust, which leads many to renounce hydropathy, viz. that they often find their complaints become aggravated during a tolerably long period.

" Most of the chronic affections which hydropathy professes to cure may be treated by appropriate mineral waters, and others by sea-baths. Not only can cold water not be made to supersede the use of all other remedies, but its employment must often be superseded by warm water."

Again—" This identity of the action of mineral waters and of hydropathy, is only apparent, for the effect of mineral waters is generally less violent, milder, and less disagreeable. They act more especially by exciting the functional activity of the secreting organs, and not, like hydropathy, by irritating and inflaming the skin and cellular texture, so as sympathetically to provoke the action of the abdominal viscera. Hydropathy should be the less preferred to mineral waters, inasmuch as there are numerous well ascertained facts where water employed at an elevated temperature has been followed by much more advantageous effects than are obtainable from cold or tepid water. 0

In a recently published work,* I have subjoined to my remarks respecting the action of solutions of various substances, as met with in mineral waters, upon the blood and secretions, the opinions of some distinguished continental observers. Thus, M. Anglada says, " It is known that the continued use of alkalis weakens in a remarkable manner the plastic force of the blood, lessens the tendency to coagulation, and forms a less consistent clot. Must not this induce relaxation of the system, allay irritation, and have a sedative action upon certain organs, when overstimulated,—and ought they not consequently to be employed in numerous cases ? The free use of alkalis is said to produce too. great a thinness of the blood and disorder of digestion. This may be the case in some instances, but not generally, especially when they are required by disordered conditions, as when an acid diathesis prevails. At Vichy, large quantities of alkaline water are taken daily in cases of gout and stone."

A German author observes, upon the same point: " The neutral salts soluble in water which are found in the body cause expansion to

* Practical Observations on Mineral Waters and Baths, &c. 1846. Churchill, Princes-street.

a considerable extent of certain organic substances, and on the other hand, contract or draw others together. They have the property of dissolving some, of maintaining them fluid, and of modifying the combinations of others among themselves. The salts of the blood are the only active constituents which maintain the albumen —which of itself is insoluble in water—in a state of solution, and this twofold combination is again the only medium of dissolving fatty and other insoluble substances, and of carrying them along with it into the circulation."

" If we apply these facts to therapeutical and pharmaceutical principles, the conclusion is readily deducible, that the quantity and quality of saline combinations, especially as they occur in mineral waters, exert the most marked influence upon the qualities and fluidity of the blood, its physical and chemical nature, as well as upon its circulating, secreting, and excreting powers/' (Schwartze. Heilquellenlehre.)

This is a fact which common sense would lead any one to expect, and is daily evidenced by experience in pathological states. In cases of long-standing gout and rheumatism, for instance, I have had numerous opportunities of witnessing the effects of baths of thermal waters,

in producing a cure in some instances,—in others, a long cessation from the attacks, after the employment of them for a few weeks. Having already referred to these instances in my work on the i( Baths of Germany," I need not do more than allude to them here as contrasting with the time required under the cold water treatment, respecting which part of the subject I will again adduce the opinion of an impartial observer :—" The ordinary period of the hydropathic treatment of chronic gout is very often more than a year. Patients subjectea to the treatment are by no means to be considered freed from the disease—the cases of relapse in patients who had resided long at Grae-fenberg are numerous, and are fully verified. The enthusiastic partisans of hydropathy endeavour to explain this fact, which they cannot deny, by saying that the treatment was too short, and thus prolong their delusions."

" Experience proves that, on the contrary, water at an elevated temperature succeeds in cases where cold water has completely failed. Besides, the numerous cures of chronic rheumatism which we see effected by the thermal waters of Neris, Mont D'or, Baden,Wisbaden, Carlsbad, and the sulphurous springs of the Pyrenees,

sufficiently attest the efficacy of these means under similar circumstances.""

" It must not be forgotten that these waters are remedies composed by the mysterious hand of nature, in which are often combined the advantages of hydropathy and the power of medicaments of which the combinations escape us "*

Dr. Schedel mentions the case of one youngish patient who was two years and two months at Graefenberg. Indeed, it is scarcely to be expected that in the great majority of instances, the excitation of the surface by sweating and the drinking of cold water could produce those alterations which tend to cure and to prevent the recurrence of the disease, so speedily or efficiently as the absorption in a mineralised thermal water, . . . Baths of mineral water, I have said, in my work already referred to, have a twofold action. In the first place, from the prolonged and repeated contact of warm water impregnated with saline and gaseous substances, the texture of the skin is softened, the activity of its capillary circulation is increased, as well as that of its secretions, perspiration being not unfrequently produced; and, conse-

* De L'Hydrotherapie.

quently, the blood is drawn in greater quantity from internal parts, thus relieving states of visceral congestion. When tepid they have also a sedative action on the nervous system, the pulse becomes slower while the person is in the bath, and a tendency to sleep frequently supervenes. These effects, though in a less degree, are also produced by bathing in warm water, but a prolonged course of bathing in warm water would greatly relax and debilitate, whereas when baths of mineral waters agree, persons feel refreshed and strengthened by their use. The second and more important operation of baths of mineral water takes place by means of the absorption of a portion of the water which becomes mixed with the blood, and thus has a material effect in altering the quality of this fluid and of the secretions. It has been proved by the experiments of M. d'Arcy and others, that a single bath of the Vichy water suffices to render the urine alkaline. The tonic effects which result from baths of chalybeate water are manifested in many instances where persons are unable to take the water."

" Mineral waters," says Dr. Kreysig, " become mixed with the mass of humours, produce in them a specific action, and leave the body in

D

HYDROPATHY.

a modified condition: they often produce effects independently of any increase of secretion. Such are chalybeate waters, but in general an increase in the intestinal canal or cutaneous secretions accompanies their action. We should be, however, greatly in error, if these secretions were to be considered critical in all cases, and as the sole and even the principal effect of the waters, for they are frequently of very subordinate importance; they constitute the most superficial, though the most apparent and quickest effect. The Carlsbad waters very frequently cure the most obstinate swellings of the glands and of the viscera, without any notable evacuations." *

Mineral waters, however, like other remedies, are liable to failure, and in some cases it would be advisable to recommend the cold water cure in preference; though these cases must always form the exceptions to the general rule. A frequent reason of the non-success of a course of mineral waters is, that patients either do not follow the regimen which is so powerful an accessory to their efficacy, or, that on finding a degree of amelioration, they discontinue their

* Practical Observations on Mineral Waters.

employment too soon; or else, after the course is terminated, resume those habits of life which perhaps tended to induce the complaint. To the same causes are doubtless attributable many of the relapses under the cold water cure.

That hydropathy has been in many instances practised by incompetent persons, by whom abuses were perpetrated, is apparent from numerous failures, and the fatal results which have been brought before the public in the form of judicial inquiry. The chief dangers consist in the too perturbatory action, as in the forced sweating, and douches—in the undue excitation of the skin producing numerous and painful boils—and in the treatment being too prolonged, a degree of collapse sometimes succeeding the stimulation.

In some persons, especially those of advanced life and of feeble re-active powers, the Blood becomes impoverished from this cause ; and Dr. Schedel observes, that " livid eruptions often show themselves in persons of a certain age, presenting evidently the character of local scurvy." These results are, however, it is to be hoped, less frequent at the present day when milder measures have in great measure superseded the more energetic treatment.

d 2

Another source of danger which has been ascribed to hydropathy is the occurrence of insanity. Dr. Schedel states, that in the spring preceding his arrival two females had become insane at Graefenberg. A Mr. S. and his wife, both great partisans of hydropathy, informed him that they had visited an asylum some leagues distant from the establishment, the director of which told them that he had several patients in consequence of the hydropathic treatment. He also mentions the case of Baron S., attached to the person of the King of Hanover, who solicited leave of absence to undergo a course of the cold water systen, on which the king cautioned him, as several persons who had undergone this treatment had become insane. The baron, however, went; during the course he had several times an eruption of boils, and some time after his return actually became insane.

This result, however, like some of those above mentioned, would only be likely to arise from the abuse of the system, and not from its moderate use, in cases where it is indicated, according to the opinion of practitioners not too prejudiced in its favour.

The position of a water cure establishment is

a matter of great importance as regards the results of the treatment. It should be in an undulating or hilly country, and an agreeable locality, well wooded and supplied with shade, so as to present inducements to its inmates for walking exercise, without the monotony of a plain and uninteresting country; the water should be of the purest kind, and the supply abundant As there are now several of these establishments in England, those persons to whom the water cure is recommended, or who may be disposed to make trial of it on their own responsibility, need not undertake a long journey to Silesia or other parts of the continent. Malvern is perhaps the best position in England for an establishment of this kind; and there are now two, under Drs. Wilson and Gully, who have had extensive experience of the treatment. Dr Johnstone has also an establishment near Leamington. The great error, however, to be guarded against, as respects the practitioners of this or any other exclusive method, is the too indiscriminate applicability to which they are disposed, and the consequent depreciation of other modes of treatment, which must end, as indeed it has

done to a certain extent in Germany, in causing hydropathy to fall altogether into discredit, unless the practice be restricted within just limits.

NOTES

GERMAN ESTABLISHMENTS MOST ACCESSIBLE TO ENGLISH INVALIDS.

Rolandseck, one of the most agreeable positions on the Rhine, a short drive from Bonn, near the ruins of Godesberg and the Drachenfels, and opposite the island of Nonnenwerth. " The house, which is surrounded by a large garden laid out in parterres, extensive walks, leading through luxuriant meadows and wooded dells, is well sheltered on the north of the rock of Rolandseck, which towers above it. The establishment consists of three houses, and will at present accommodate about fifty patients." The accommodation is good— a well-selected library, music*roora, bowling green, &c. There is a full complement of baths of every description, one four and a-half feet deep and eighty feet in circumference; one of the springs by which it is supplied, Rolandsquelle, has for centuries

NOTES.

been celebrated for its salubrity. The diet is said to be good. The resident physician speaks English.*

Laubach, also on the Rhine, within half an hour's walk from Coblentz, amidst very pleasing scenery, and near the restored Castle of Stol-zenfels and the ruins of Lahnstein, on the opposite bank, and overlooking the mouth of the Lahn. Ems may be reached in about an hour and a half. " The accommodation consists of three large buildings, containing upwards of sixty apartments, and a spacious apartment on the ground-floor for exercise in hot weather, billiard-room, bowling-green, gymnastic apparatus, and reading-room. The stream termed Fons Carus has long been celebrated. The physician speaks English.V

Weilbach: about equi-distant from Wiesbaden, Mayence, and Frankfort ; possessing a cold sulphurous spring, described in the " Baths of Germany " Its position for a water cure establishment is good; the air in summer light and bracing. The baths are well appointed, and there is the addition of steam-sweating baths. Dr. H. Mayo now resides at Weilbach, and last year published a brochure on the cold water cure.

* Dr. Bushnarfs account.

Liebenstein, one of the most frequented cold water establishments, is considered one of the healthiest places in Germany; protected from north and easterly winds, while its well-wooded mountains and rich grassy valleys make it second to none in pleasing scenes and associations. The establishment (formerly appropriated to visitors to the mineral springs which have of late fallen into disrepute) contains, besides the saloon and lesser public rooms, seventy bed-rooms in the central portion, and thirty in each wing. The baths are well arranged, and attendance good. " No bath in Germany is so agreeably situate, in the midst of a park twelve miles in circumference, commanding fine and varied views of the Thuringian forest, and stretching over hill, and dale, and mountain. "

The Queen Dowager occasionally visits Liebenstein, which is also an agreeable summer residence, possessing resources for the recreation of persons in health.

d 5

HOMOEOPATHY.

' Quand l'absurde est outre, on lui fait trop d'honneur, De vouloir, par raison, combattre son erreur."

La Fontaine.

This doctrine was first promulgated about forty years ago, though it did not attract much attention till of late years. It originated with Dr. Hahnemann, a native of Saxony, who, after having resided in various parts of Germany, failing, it would appear, to succeed in practice, at length took up his abode in Leipsic, and instituted experiments on the action of medicinal substances upon himself and others. # Having,

* "About the year 1800, Hahnemann advertised a new salt, of which he claimed the discovery, and which he sold at the modest price of a louts d*or per ounce. The Society for the Promotion of Natural Sciences, desirous of becoming acquainted with this new substance, had it analysed by some of the most

HOMCEOPATHY.

in 1790, taken some bark, which produced, as he states, paroxysms of intermittent fever, he was struck with the circumstance that the substance employed for the cure of intermittents should occasion a similar disease in a healthy person. This led to the inference that substances which produce certain symptoms in healthy individuals, can remove those symptoms when induced by other causes ; hence a fundamental point of the doctrine, that diseases are cured only by medicines which have the power of causing similar diseases in healthy persons: Similia similibus curentur.

Homoeopathists consequently do not consider a knowledge of anatomy, physiology, or pathology, as contributing to the cure of disease, but restrict themselves to noting the different symptoms and to ascertaining the appropriate remedy, without regard to the organic changes, or other circumstances, by which the symptoms are caused, or whether they affect the

experienced chemists, who pronounced it to be nothing but common borax. He shortly afterwards advertised " an infallible preventive of scarlet fever;" but being disappointed by its sale, he afterwards confessed it to be nothing but a few grains of extract of belladonna dissolved in water."—Remarks on the Abracadabra of the nineteenth century, by Dr. Leo Wolf.

nervous, vascular, or other systems. For example, in strictly following the rules of homoeopathy, if a person have headache, whether arising from exhaustion, inflammation, or stomach derangement, the same remedy should be had recourse to, and that remedy must be a substance capable of causing headache in a healthy individual.

Medical doctrines are divided by Hahnemann, into the allopathic, or method in general use, of curing diseases by remedies of an opposite nature— contraria contrariis, —the antipathic, or palliative method, and the homoeopathic, the only true method; the principles of which are contained in his Organon> ou Exposition de la Doctrine Medicate Homoeopathique. This work contains an abundance of absurd reasoning, of extravagant and unfounded assertions; of some truisms, from which erroneous conclusions are drawn ; of exceptions to general principles and isolated examples, extracted from various works and adduced as the principles themselves, in order to corroborate the positions laid down by the author. Thus, to prove that many of the cures hitherto effected, have been so by the chance employment of homoeopathic means, several instances are brought forward, among

HOMOEOPATHY.

which are, that rose-water cures ophthalmy, only because it has the power of causing a kind of ophthalmy. In like manner bark cures 4ri-termittents, because it occasions these diseases; ipecacuanha arrests fluxions of blood, only because it possesses the faculty of exciting haemorrhage ; generous wines, in small doses, cure homoeopathically inflammatory fever; hyoscya-mus could not cure spasms resembling epilepsy, if it had not the power of exciting convulsions ; the same remedy could not have cured a case of mania from jealousy, if it did not occasion mania and jealousy in healthy individuals.

Again, the popular customs of using snow to frost-bitten parts, of putting a scalded hand near the fire, are adduced to prove the homoeopathic nature of the remedies to these accidents; vaccine is considered to act homceopathically in preventing small-pox, &c. These examples will suffice to show, that the style of argument adopted is opposed to established truths; for who ever heard of rose-water causing ophthalmy, of bark causing intermittents, of ipecacuanha exciting haemorrhage, or being employed to arrest it, of generous wines curing inflammatory fever, of hyoscyamus determining convulsions, mania, and jealousy ? If snow is used to

frost-bitten parts, it is used with friction, in order, as is well known, to bring the parts gra« dually to their natural state; whereas, if used on homoeopathic principles, it would be kept constantly applied; and, as may be imagined, with a certainty of aggravating the evil. So also with respect to the application of heat to scalded parts; and to prove vaccine a homoeopathic agent, it should be shown that it has the power torcure small-pox when already existing; which indeed it is asserted it would do, were it not surpassed by the small-pox in intensity.

, Medicines, then, are not considered by the homceopathists as direct remedies, but to act by giving rise to morbid symptoms, surpassing in intensity those of the disease against which they are employed, on the principle that two similar diseases cannot co-exist in the same individual: the original disease consequently yields, being overpowered by the artificial disease caused by the remedies: and this, on the discontinuance of the medicines, is in its turn speedily overcome by the powers of the constitution.

This proposition also contradicts itself, for, as Dr. Wolf observes, " How can it be reconciled

with common sense, that the vital powers are too weak and insufficient to remove any natural

disease or its symptoms, be they ever so trifling, without the aid of a homoeopathic drug, but are nevertheless powerful enough to remove the drug-sickness which is left after the natural disease is extinguished? Can any one comprehend that a power should be capable of overcoming a large obstacle, and should be incapable of removing at the same time a similar and comparatively much smaller one?"

The particular symptoms to which each me-dicinal substance gives rise, and against which it is to be employed, are ascertained by experiments made by the homceopathist upon himself or other healthy persons.

But it must not be supposed that these surprising effects are produced by the drachm, or grain doses employed by ordinary practitioners. According to Hahnemann, the effects of medicinal substances are two-fold, viz. primitive, as -the violent action produced by large quantities of certain drugs ; purgation, sweating, &c.; and secondary, or homoeopathic, in which the action is determined towards the diseased part; the active properties becoming more developed in proportion to the minuteness of the dose: in fact, homceopathists are cautioned against too minute a subdivision of the medicine, lest it

should become so energetic as to give rise to dangerous symptoms. I cannot, however, do better than extract one or two passages from the " Exposition," in order to illustrate this position.

"Besides, the homoeopathic medicament acquires, at each division or dilution, an extraordinary degree of power by the friction or the shock imparted to it, as a means of developing the inherent virtues of medicines unknown before me, and which is so energetic, that of late, experience has. obliged me to shake the mixture only twice, whereas formerly I prescribed ten shakes to each dilution."

" Gold, silver, platina, charcoal, are without action on man in their ordinary state, but from the continued trituration of a grain of gold with a hundred grains of powdered sugar, there results a preparation which has already great medicinal virtues. If a grain of this mixture be taken and triturated with another hundred grains of sugar, and if this process be continued until each grain of the ultimate preparation contains a quadrillionth part of the grain of gold, we shall then have a medicament in which the medicinal virtue of the gold is so much developed, that it will be sufficient to take a grain,

HOMOEOPATHY.

place it in a phial, and cause the air from it to be breathed for a few instants by a melancholy individual, in whom the disgust of life is carried so far as to incline to suicide, in order that, an hour afterwards, this person be delivered from his evil demon, and restored to his taste for life."*

Hahnemann also says, speaking of silex or flint, " This earth being reduced to a millionth degree of attenuation, a grain of the powder is to be reduced to the decillionth dilution. In fact, dilutions to the billionth or trillionth degree produce effects much too violent; that of the sextillionth degree may be; commenced with, but this, only suits robust persons ; in irritable subjects it is prudent to use only the decillionth dilution/'

Of kitchen salt, he says, *< A grain of salt is reduced to the millionth degree of attenuation; this powder is to be dissolved in diluted alcohol, and the division extended to the decillionth de-

* Dr. Balfour, in his report of homoeopathy in Vienna, (in the British and Foreign Medical Review, October, 1846.) says, " One practitioner often contents himself with allowing the patient to smell the remedy, waiting patiently for some weeks or so for the completion of the cure, not even permitting a second smell."

gree: carried to this degree of dilution, sea-salt is a powerful and heroical medicament, which can only be administered to patients with the greatest caution." These instances will perhaps suffice to exemplify the doctrine,

"We find homoeopathy," says Dr. Forbes, " maintaining that substances utterly powerless in a state of sensible bulk, can acquire astonishing power by mere subdivision. Can any proposition be submitted to human apprehension that seems more utterly improbable, more ludi* crously absurd ? To be called on to believe that the decillionth of a grain of charcoal or oyster-shell is capable of producing hundreds of the most formidable symptoms of curing, as by magic, the most inveterate diseases, while we might take ounces of the very same substance with no other inconvenience than from its bulk, seems so gratuitous an outrage to human reason, that the mind instinctively revolts from the proposition."— Homoeopathy, Allopathy, and Young Physic.

The action of imponderable agents, as light, electricity, &c, has been adduced by some ho-mceopathists to prove the action of infinitesimal doses of medicines; but it is evident that no similar comparison can be instituted; and in

*

HOMOEOPATHY.

order for the analogy to be maintained, it should have been proved by the homceopathists, that persons can see better in proportion to the , small quantity of light, and that they are more affected by heat or electricity in proportion to the smallness of the quantity of these agents applied.

Hahnemann says, "Let mathematicians explain to them how true it is, that if a substance be divided into any number of parts, its smallest particle will always contain something of this substance, and therefore it can never become a nonentity." On which Dr. Wolf remarks, " If this be admitted in a strict sense, does it follow; therefore, that the effect of these substances on the human body in any imaginable small quantity, must not only be perceptible, but still greater than when in quantities many million times larger? The thick fibres of a piece of meat are divisible into those which are so small as to be perceptible only by the best microscope. Does it follow from this, that the decoction of such a microscopic fibre will afford the patient as much or even more nourishment after a homoeopathic manipulation, than a strong broth made allopathically from some pounds of meat ?"

#

Homoeopathic remedies may therefore be considered analogous with the medecine expectante, with this difference, that in the latter the pa-, tients know that the physician employs no re- % medies, but trusts entirely to the efforts of nature for their cure; whereas the imagination of patients treated homoeopathically is acted upon, from their being led to consider the remedies employed to be of an energetic nature, as will be seen in the sequel. The cures so pompously announced by the homoeopathists, will in almost all cases be found to be simple recoveries by the efforts of nature after a longer or shorter period, as in the following, published by a homoeopathic physician.

" Madame C. V., aged thirty-six, affected with chronic gastro-enteritis, produced by grief and abuse of coffee: she had been treated by several physicians, and had been kept for three months on a milk diet; she had headaches, and menstruation had been suppressed seven months ; she was prescribed Pulsatilla, nux vomica, &c.; menstruation appeared in twenty-seven days, and in three months she was cured."

" Mademoiselle R. did not menstruate at her accustomed period, and was 'affected with a

catarrh; she was prescribed pulsatilla; menstruation occurred in the following month, and the catarrh was cured without any other medicament."

On looking over the history of several of the cases treated at the London Homoeopathic Institution, which were published in numbers, I find what might be anticipated, that they are very analogous to the above, viz., the ordinary slighter ailments usually met with in dispensary practice, which seldom require a long treatment, though most of these cases reported in the Homoeopathic Annals required two, three, or four months' attendance, before the patients were dismissed; and though the different globules prescribed are minutely stated, no mention is made of the attention to diet and regimen, the necessity of which is doubtless inculcated upon the patients, thus leaving it to be inferred that the recoveries take place from the globules— post hoc ergo propter hoc. The publication of these brochures, however, probably answered the purpose of an advertisement, for which it was intended. The great influence of the diet, &c, is, however, acknowledged in the most recent work on Homoeopathy as follows:—" If the homoeopathic physician possesses even an ordinary amount of

penetration, he will soon perceive that the remedies which are chosen nevertheless fail to effect a cure unless great attention be paid to the hygienic regimen and external means. The homoeopathist must therefore, after a few years, have his attention almost exclusively directed to hygiene" —Madden on Homoeopathy, 1846.

The only division of diseases by Hahnemann is into acute and chronic; of the former but little is said in the Exposition; although they may arise from exterior causes, as cold, excesses, &c, yet in many cases they depend upon apsoric affection, and almost all chronic diseases originate from sycosis, syphilis, or psora (vulgo, itch). This latter, especially, is the cause of innumerable diseases, which great truth it took Hahnemann twelve years to find out. In mentioning some of the evils produced by this miasm, I quote his own words : " This is the only fundamental and exciting cause of all the morbid forms, which, under the names of nervous weakness, hysteria, hypochondriasis, mania, melancholia, epilepsy, spasms of all kinds, rickets, caries, cancer, gout, haemorrhoids, jaundice, dropsy, amenorrhoea, hemoptysis, asthma, and suppuration of the lungs, sterility, deafness, cataract, and amaurosis, gravel, palsy, pains of

all kinds, &c, figure in pathology as so many separate diseases, distinct and independent one from the other."

" The modifications this miasm has undergone in its passage through millions of human constitutions, during several hundred generations, explain how it can assume so many forms." *

Abstinence from everything of a stimulating nature, as condiments, coffee, &c, is recommended ; even the smelling of delicate perfumes is prohibited, although the smoking of tobacco is allowed; which, considering Germany is the country whence homoeopathy originated, was an extremely politic measure.

The absurdity of a doctrine equally opposed to reason and every-day experience could not fail to be immediately apparent to the medical profession, as well as the injurious effects that might arise from its professors being allowed to practise on the credulity of the public, a large proportion of whom is always to be attracted by novelty, especially if it be clothed in the garb of unintelligibility and mystery. In order, there-

* It is scarcely necessary to recal to mind, that many persons, while actually labouring under the itch, are in robust bodily health. The homoeopaths of the present day do not, however, adopt this absurd dogma.

fore, to show the value of the pretensions of homoeopathy, the experiment was made in Germany, Russia, France, and Italy, of treating a certain number of patients in public institutions by homoeopathic means, and an equal number by the usual methods: the results are such as might have been anticipated.

A German homoeopathist, practising in Russia, was invested by the Grand Duke Michael with full powers to prove, if possible, by a comparison of facts, the advantages of homoeopathic measures over the ordinary modes of treatment; and a certain number of patients in the wards of a military hospital were entrusted to his care. At the expiration of two months, however, he was not permitted to proceed further; for, on comparing results, it was seen that within this period, out of four hundred and fifty-seven patients treated by the ordinary means, three hundre 1 and sixty-four, or three-fourths, were cured, and none died; whereas, by the homoeopathic method, tried on one hundred and twenty-eight patients, one-half only were cured, and five had died.

In order to ascertain and give publicity to the results, the Russian government caused a certain number of patients to be treated homoeo-

pattncally in one hospital, while in another an equal number of patients were merely subjected to regulated diet and appropriate regimen, without the exhibition of any medicine. The results were very similar in both instances, and the medical council appointed to superintend the experiments thus gives its official opinion:

" The medical council, after having attentively weighed the results of the experiments made according to the homoeopathic method, and compared them with those made according to the principles of the medecine expectante, finds that they greatly resemble the latter, and are probably based only on the vis medicatrix naturce; for the infinitely minute doses can produce no effect on the human body. The medical council is therefore of opinion, that the homoeopathic practice should be prohibited in sanatory establishments dependent on government, for the following reasons:

" 1. Acute disease^ require energetic means of treatment, which are not to be expected from homoeopathy

" 2. The homoeopathic treatment of external lesions and surgical diseases is altogether out of the question.

"3. Some slight affections get well while 7

under homoeopathic treatment, but similar affections disappear equally well, without any medical treatment, by the adoption of an appropriate regimen, good air, and cleanliness."

The homoeopathist who introduced the practice at Naples, was, as stated by Dr. Wolf, " an ignorant Bohemian barber, who enjoyed the patronage of the Austrian general, to whom he was particularly recommended by Hahnemann. The public as well as some talented young physicians, who adopted homoeopathy, awoke from their illusive credulity, but not until the general, with many other persons of distinguished rank, had died or were injured by this all-curing art."

At the time homoeopathy was in vogue at Naples, a commission was appointed, by royal order, to superintend the treatment of a certain number of patients during forty days; the patients were selected by the physicians, and a separate ward in the hospital was appropriated to them.

It was first determined by the commissioners to ascertain whether some of the patients would not get well without the employment of any remedy; ten were consequently set apart, and all recovered. One of them, had a gastric fever; the homoeopathic physician wished to give him a

drop of the tincture of St. Ignatius's bean, at the twelfth dilution, representing a quadrillionth part of the original drop. He protested against waiting, saying, that the delay might compromise the life of the patient. The physicians reassured him ; they reckoned upon a crisis occurring, which accordingly did take place in the night, and the patient was well in two days. Had the homoeopathic dose been taken, the cure would most assuredly have been attributed to it.

Several slight affections were treated honioso-pathically and recovered, without the commissioners being able to ascribe any of the recoveries to homoeopathy, as they would in all probability have recovered as soon by simple attention to diet. A third set of cases of a more serious nature, and requiring the assistance of medicine, were also treated by the homoeopathic method, which was found altogether powerless, none of them obtaining any advantage; the cases were longer under treatment than usual, and several of the patients became worse, requiring the employment of ordinary measures for their cure.

In a fourth series of experiments of homoeopathic remedies on healthy persons, no effects resulted from their administration. From these

facts, the commissioners deduced the following inferences: 1st, That the homoeopathic treatment produced no effect; and 2ndly, that it had the serious inconvenience, in several of the patients, of preventing the employment of remedies by which they might be cured.

On account of the statement of a Dr. Luz, a veterinary surgeon at Leipsic, that he had performed several surprising cures by the homoeopathic method on horses and dogs, trials were instituted on these animals in the veterinary school and hospital at Berlin. The experiments were conducted with the utmost exactitude, and in the presence of many students and horaceopa-thists; and though the cases were similar to those described by Dr. Luz, not one was cured, not one confirmed his statements even in the slightest degree.

. The experiments made in Paris to show how-far homoeopathy had claims to public confidence, also tend to prove that where any effects are produced, they are to be ascribed to the influence of the imagination.

First. Several medical students of the Hotel Dieu, chosen by a homoeopathic physician, were subjected to the homoeopathic regimen, and took at first one, then two, then ten, and at last eighty

globules at a dose, of the most active medicines prepared by the only homoeopathic chemist in Paris. In not one instance was the slightest effect produced.

Secondly. A number of pills made with inert substances, as flour, gum arabic, and starch, were given to patients who believed them to be homoeopathic remedies. I subjoin two or three of the results obtained.

Aphonia, of six weeks' duration, cured in a few hours by starch pills given homceopathically. A girl, aged twenty, was admitted on the 14th January with complete loss of voice, which had existed since the middle of November. She had experienced a similar attack in the preceding year, but had recovered in fifteen days. Menstruation was regularly performed. A few days' rest, and the usual hospital regimen, produced no effect; she was consequently placed in the department where the homoeopathic experiments were made, and was ordered two starch pills-; the first to be taken in the presence of the physician, the next when four hours had elapsed. A few minutes after the first pill had been swallowed, the following symptoms manifested themselves—anxiety, pain, and uneasiness in the region of the heart and thorax, perspiration, with

heat and eruption on the skin. . The second pill appeared to aggravate these symptoms, with the addition of hiccough. She afterwards fell asleep, and, on awaking, was astonished to find she could talk in a loud tone. The complaint did not recur, and she soon quitted the hospital.

A man, aged forty, was admitted about the same time as the preceding patient, complaining of sense of oppression on the chest. He had experienced an attack of hemoptysis a year before, and was exceedingly hypochondriacal. During the first few days no treatment was adopted, and he continued in the same state. Four starch pills, which he supposed to be homoeopathic remedies, were then prescribed; one to be taken regularly every six hours. Half an hour after swallowing each pill, the patient experienced anxiety, sense of oppression, spitting of blood. The pills were discontinued, and resumed on alternate days during a fortnight. Each time they were taken, they were followed by oppression, headache, acceleration of pulse, diuresis, and pains in all the limbs.

A girl, aged twenty-three, labouring under cough with hectic fever, and sleeplessness, was also treated by these inert pills, which she imagined to be homoeopathic. Each time after

taking a pill, the fever diminished, the cough was less fatiguing, and she slept better; she suffered more when she did not take it, and always requested to have her " calming pill."

The following case occuned to a physician at St. Petersburgh: " A lady, aged forty-eight, phthisical, had been treated by the homoeopathic method during two years, when I became her physician ; and as my efforts were unsuccessful she requested me to treat her homceopathically. I consented, and gave her two grains of sugar, assuring her she would experience the effects of this powerful medicine for six days. The following day she received me with an ironical smile, saying, c One may easily see, doctor, that you are not accustomed to handle homoeopathic remedies: that which you gave me was too. energetic; it caused so much disturbance, that I did not expect to outlive the night; however, its action is in the end salutary, for I have not felt myself so well for a long' time as I have felt to-day*. 1 "

Thirdly, Two physicians attached to an hospital experimented upon the infirmiers, or male attendants in their wards. One physician desired his infirmiers to note down every hour the sensations they experienced, after taking what

they supposed to be a homoeopathic agent They all experienced various sensations, of which the following is a specimen :

A young man in perfect health took eight pills, containing a minute portion of charcoal, and at the expiration of half an hour had noted the following symptoms: headache, confusion, imperfect vision, flushing of the face. On repeating the same dose, the symptoms recurred, with violent prespiration.

Fourthly, The other physician conducted his experiments differently: he took every morning six homoeopathic pills, and at the end of a certain period asked his infirmiers if they were willing to do the same; they consented, and did not experience the slightest effect.

Thus, in the former experiment, the individuals expecting to experience extraordinary sensations, from being required to note them down, do not fail to feel some, as would be the case with most persons under similar circumstances. On the other hand, those who saw no effect produced on their superior by the pills, also take them, and not expecting any particular sensations, do not experience any.

. I might adduce various other examples, but being desirous not to extend this account, I shall

e 5

content myself with briefly alluding to the experiments of Professor Andral at the hospital La Pitie.

A hundred and thirty individuals were treated by homoeopathic remedies in the presence of numerous witnesses. The regimen recommended by Hahnemann was strictly adhered to, and the prescriptions prepared by a homoeopathic chemist. The experiments were of two kinds; first, to ascertain whether symptoms can be produced in healthy persons by medicines which cure similar symptoms when arising from other causes. Bark was one of the first substances chosen, and its various preparations were taken by M. Andral, and ten other persons, at first in homoeopathic doses, which produced no effect; then in ordinary doses, which were gradually increased up to from six to twenty-four grains of sulphate of quinine per day. None of these persons experienced the least symptom of an attack of intermittent fever; the only effects produced by the large doses were slight indisposition and headache, in some whose stomachs were not so strong as the rest.

Aconitum, which, according to the homoeopa-thists, is of superior efficacy to blood-letting in febrile diseases, was tried, and produced no

effect. Sulphur was also tried by several persons, without any eruption being produced on the skin.

Thus the statement that remedies cause diseases resembling those which they cure, is an assertion utterly groundless.

The second kind of experiments was made to ascertain whether homoeopathic remedies would in any case afFect the progress of disease.

Several cases of intermittent fever were treated homooopathically. Some got well at the end of a certain period, which would in all probability have been the case, had no remedies been employed : in other cases no effect was produced, and, on the usual method of treatment being adopted, the patients got rapidly well. Similar results were obtained in treating febrile diseases and several chronic complaints, except that in some cases the patients got worse while under the homoeopathic system.

The homoeopathists in Paris having petitioned the Minister of the Interior to permit the estab lishment of dispensaries for the treatment of patients by the homoeopathic method, the minister requested the opinion of the Academie de Medecine on the subject. The reply of that body is made in the following terms:—

" Monsieur le Ministre,

" Homoeopathy, which presents itself to you at the present time as a novelty, is not a new thing. For more than twenty-five years this doctrine has wandered here and there ;—first in Germany, then in Prussia, afterwards in Italy, and now in France; seeking everywhere, though in vain, to introduce itself as a branch of medicine.

" The time of the Academie has been repeatedly taken up with the subject, and, moreover, there are but few of its members who have not sought to ascertain its basis, and its effects.

" With us, as elsewhere, homoeopathy has been subjected, in the first place, to logical examination, which has exhibited in it a formal opposition to the best-established truths, a great number of striking contradictions, and many of those palpable absurdities which inevitably ruin all false systems in the opinion of enlightened persons, but which are not always a sufficient obstacle to the credulity of the multitude.

cc With us, as elsewhere, homoeopathy has also been subjected to the trial of facts, and put to the test of experience. Observation, faithfully interrogated, has furnished the most cate-

gorical answers ; for if it be admitted that some examples of recovery have occurred while under the homoeopathic treatment, it has been ascertained that the success is justly attributable to the bias of a weak imagination on the one hand, and to the remedial powers of the constitution on the other. Observation has also shown the great danger of homoeopathy in frequent and serious cases of disease, where the physician may. do as much harm, and cause no less injury, by inactive measures, as by those which are directly prejudicial.

" Reason and experience are consequently united to repel a similar doctrine, and counsel that it should be left to itself and to its own resources."

Having heard of the existence of a homoeopathic hospital at Leipsic, the head-quarters of the doctrine, I had the curiosity to visit it when in that city, some years ago, and was directed to a small house in one of the suburbs, with an inscription on the outside denoting its destination. I had no difficulty in obtaining admission, and was accompanied through the house by the assistant Jiomceopathist, the principal being in the country.

HOMOEOPATHY.

From what I had previously heard, I expected to see at least from thirty to forty beds occupied by patients, and was somewhat surprised to find that the house only contained eight, of which but one was occupied by a phthisical patient, who had been for several months without any amelioration. There were, however, five other patients able to get about, viz. a case of chronic swelling in the foot; one of delirium tremens, which had also been a long time under treatment by arnica and hyoscyamus, in doses of the decillionth part of a grain, which I was gravely assured produced sound sleep ; a young girl, with no other complaint than deranged menstruation, who had also been some months in the house; a case of necrosis of the tibia treated by the internal exhibition of homoeopathic remedies; and a woman with a cutaneous disease, of a syphilitic nature, who had been treated with sulphur, carbon, gold, and other homoeopathic remedies, since the month of February, but with little advantage, as the disease appeared to me likely to be interminable under a similar system.

During my visit two or three out-patients presented themselves. One of these was a healthy boy, with tinea capitis, for which he had

been taking homoeopathic globules since February, the hair having been allowed to grow, and no external application having been used. The appearance of the patient's head did not afford any favourable evidence of the good effects of the treatment, and I should imagine the disease was much in the same state as when he first applied for relief.

The house-physician to this institution having become convinced, after a residence of several months, of the nullity and danger of homoeopathy, gave up the appointment, and published an exposition of the system pursued, with an account of the cases, which clearly show what had long been evident to the bulk of the profession and the public, viz. that the so-called cures were recoveries from ordinary ailments by the efforts of nature; the cases being frequently a long time under treatment, whereas by a proper medication and attention at the outset, they would probably have been cured in a few days; and that many of the more serious cases got worse for the want of efficient treatment.* When last at Leipsic, I heard that matters were going on indifferently with homoeopathy, the hospital having been turned into a dispensary.

* Ueber die Nichtigkeit der Homoeopathic On the nullity of Homoeopathy. Leipsic, 1840.

Most of the homceopathisls of the present day have abandoned some of the more absurd propositions of Hahnemann as untenable, and it must not be supposed that they always adhere in practice to the avowed principles of their doctrine. It has not unfrequently happened that persons who attributed their recovery to homoeopathy were treated allopathically without their being aware of it. The case of the late Duke di Cannizaro, shows how little trust is to be placed in the practice of homoeopathy. He was slightly indisposed, and was ordered some globules, one to be taken at stated intervals. Considering, however, that he would not be at home when the time for taking the third dose arrived, he took three doses at once and did not survive many hours, the substance being an active poison in a concentrated state. In fact, one practitioner in Leipsic, a professed homoeo-pathist, candidly acknowledged that he pursued both plans of treatment, and was accustomed to ask his patients by which method they would be treated. # The principles, however, are the

* " Many," says Dr. Balfour, in his recent report of homoeopathy at Vienna, '• continued to practise both methods, not eccletically, but according to the wish of the patient, leaving enquiry to otheis, and stumbling blindly on."

HOMOEOPATHY.

89

same, viz. expectation, and the influencing the patient's imagination by leading them to suppose that they are taking some extraordinary remedies. In the cases which are noised about and published as recoveries by the homoeopathic method, the advantages derived may be ascribed to the above causes, assisted by a more strict attention to modes of living and regimen ; and in many instances is only temporary, as in the case of a noble individual labouring under tic, who has been repeatedly said in the papers to be cured or greatly relieved by different methods of treatment, and who, it appears; subsequently had recourse to the water cure. It is in the nature of several complaints, especially those of a nervous character, to be better or worse at different times or seasons, and to offer complete intermissions during a longer or shorter period, especially when patients can be induced to adopt a regulated diet, and mode of living; and in these cases the amelioration is generally ascribed to the remedy which happens to be employed at the time. Homoeopathy in fact is now comparatively little heard of in most parts of northern Germany and in France, to what it was some years ago, and only required to be inquired into by the more enlightened portion of the public,

for the absurdity of its propositions to be apparent. During its whole progress it was never sanctioned by any individual of scientific eminence, or even who was held in estimation by the profession ; but has been principally taken up as a means of acquiring wealth, or a livelihood, by persons who had never been previously h^ard of, or who had failed to acquire practice in the usual way, by whom every means have been taken to puff it into notice, and keep public attention directed to it, such as the establishment of dispensaries, the publication of books, and of histories of alleged cures, addressed ostensibly to the profession, but which in fact are but a means of advertising.

"All the results," says a German author, " which have been obtained by the employment of medicines in homoeopathic doses, were founded, without exception, upon delusion, and were not in consequence of these means. If any one wishes to convince himself of the truth of this, he need only so administer these doses, that the persons are not aware that they have taken anything, and every physician would then see as little effect from them as I have seen after innumerable experiments. These infinitesimal powders, drops, and globules, are in

fact nothing more than the modernised moonstone of the ancient Phoenicians and Carthaginians. At that time, as at the present day, faith in them must produce a blind confidence, and if this be effected, it would not matter whether they were swallowed, or hung about the neck, or carried in the pocket as an amulet, the effect would be the same. The worthy Stieglitz very justly observes, that it does honour to the condition of German medicine, that notwithstanding all the noise and puffing, but very few medical men adopted this system; and that many of the younger physicians rather chose to support privations, than give themselves up to its absurdities; and even some of the homoeopathic physicians themselves can scarcely conceal a feeling of shame, when they find themselves in the presence of others who understand the matter."

" When homoeopathic physicians and patients assert that they have seen on themselves and others the most evident effects from these means, we must draw our inferences from the consideration of the particular proceeding which is accustomed to be followed. Every change which occurs in the organism after having taken an homoeopathic dose, would be considered as the

necessary consequence of it. Hence, minute attention is always more or less directed to the functions of the body, but this would give rise to a variety of symptoms even in very healthy persons, who would otherwise have experienced nothing. Any one who has a tolerably lively imagination, may make the experiment on himself. If I were to tell an excitable patient, he must attentively observe the pulsation of his heart and arteries, I may reckon to a certainty, that at my next visit I shall have to hear an account of the surprising symptoms which have been observed, respecting the heart's action." #

Alluding to the different medical theories which at various times have had their day, and after a longer or shorter period have sank into oblivion, the same author observes ; "Each system found its believers and adherents, the number of whom at first greatly increased, and then gradually diminished. The falling off usually took place when the charm of novelty had subsided. In proportion as the system ceased to be new, was the belief lessened in its infallibility, which was generally at first loudly cried up by the proposers, and the number of fortu-

* Psychiche Heilmittelehre, von Dr. Braunlich.

nate cures decreased in the same proportion, until the whole fabric of the system was carried away in the stream of time, and frequently left behind scarcely a trace of it in the history of medicine."

I will also subjoin a few apposite remarks made by a correspondent in the Medical Gazette, upon the subject,

" The importance of any pretended remedy for disease, exerts its influence on that great majority of the public who are necessarily incapable of judging of medical evidence, because they are ignorant of the extraordinary workings of the human mind, which exhibit themselves to medical men only, not in unhealthy indivn duals alone, but often in those who are apparently free from disease. Experienced medical men are alone capable of ascertaining the existence or non-existence of disease amongst the variety and complexity of symptoms which distinguish particular affections; and they alone can say with certainty, whether disease has actually existed, or if so, whether it is or is not actually cured by the remedy alleged to have removed it. For there is a strong inclination in mankind generally, to assist in propagating an imposition to which they have themselves

yielded, both because it makes them objects of interest to the public, and because it appears to justify them in having given it their confidence.

" Again, there are many cases where the complaint has existed only in the imagination of the patient, and in these it will be no matter of wonder if the homoeopathic globule in aid of said imagination should effect a cure. In chronic stomach disorders, also, many patients have recovered under an homoeopathic doctor, and thus been the means of exalting his fame, whereas, it would be easy to show, that such patients needed only .cautious diet, time, the abandonment of a habit of taking too much aperient medicine, and the observance of regular rules, to effect a cure—all of which even an oZd-fashioned doctor would, of course, have directed.

" A gentleman who had been out of health some time, and had paid but little attention to the direction of his medical attendant, was advised to consult an homoeopathic physician ; he did so, and remained under his care six weeks, the doctor making his visit as often as he pleased: he improved in health-—in short, was cured. 'Now,' exclaimed his friend, 'you henceforth

stand up in defence of homoeopathy.' c Not at all; I am more than ever convinced of its fallacy and humbug. I have followed the plan of diet, &c, which plan was often urged upon me by my former medical friend, but not one of the billionth powders or globules have I taken.'

" A gentleman had been for some time subject to acute inflammation of the membrana conjunctiva, and had been attended by a surgeon of great eminence in the metropolis, who on every occasion had succeeded in subduing it. On a recurrence of the complaint, by the judicious advice of friends, he was 'placed under the care of an homoeopathic practitioner, when, after being for six weeks shut up in a dark room, great attention being paid to his diet and manner of living r , he was cured again by the wonderful effects of the homoeopathic remedies I ! ! This, of course, stamped the faith of the family, and all became disciples of Hahnemann. Some time after, one of its members was found in a fit, and the doctor was sent for. What plan did he adopt ? He belonging to a school which professes to repudiate bloodletting as pernicious, and almost certainly fatal, himself immediately bled her, and that not in

an homoeopathic quantity, bat largely. She continued under his care for a few days, but not recovering, she was by the doctor's own desire sent into the country in this state, and handed over to her original medical attendant, who discovered, and was confirmed in his opinion by an eminent physician, that she had been suffering from epilepsy, arising from the overloaded state of her stomach and bowels. The results, of course, effected the moral cure of the whole family.

" I give you now a case of the mischief that may arise from adopting this harmless system. A lady of rank had occasional headaches, for which she was advised to consult an homoeopathic physician. She had for many years taken daily aperient medicine, but nevertheless enjoyed a very good state of health. Her old medical attendants were summoned to her assistance after about the expiration of twelve months of homoeopathic treatment. They found her labouring under congestion of the liver to an enormous extent, constipated bowels, and active peritoneal inflammation, all of which had existed for some days, and had not ' yielded to the means employed' by the homoeopathist; he by whose treatment these formidable symptoms

had been induced, willingly sneaked out of the responsibility ; true, her life was saved, but she has never enjoyed her former good health.

" I have often been amused at the contradictory tales which I have heard on the subject of homooopathic cures. For instance, I have been told that a noble duke has been, by these remedies, cured of his gout; and then I am compelled to hear, that the noble duke is laid up with gout at his country seat. A distinguished baronet, also, is cured of the gout, but I hear again that the senate-house has lost the valuable services of the worthy member, because— he is confined with the gout. A noble earl is cured of his most painful malady, tic-dou-loureux, by homoeopathic treatment; but by his friends I am assured that his sufferings are still very great. Another sufferer from this most

dreadful disease, the Marquis of A , first

stamped the fame of this system as a certain cure for tic-douloureux, but it is well known that the noble marquis is still desirous of trying every remedy which can be suggested for the alleviation of his sufferings, and it is a remarkable fact, that he has heaped honours and distinctions on many persons who have cured him

F

of his malady. It is often dinned in my ears, that a certain noble earl swears by homoeopathy, yet that noble earl flies to Malvern with all avidity, to follow the most dangerous system of hydropathy for his relief. These are curious contradictions, but not more curious than true, and is it not wonderful that the fact of any person abandoning a system by which he has sworn, to adopt another diametrically opposed to it, should not open the eyes of his friends, as to the extent of his faith in it ? The fact is, the public have not yet learned the necessity of inquiring what opportunities those persons have had, who profess to practise medicine or surgery, of perfecting themselves, not merely in the knowledge of remedies, but what is of infinitely greater importance, in distinguishing the character of diseases. How many are there in the ranks of the profession, men of honour and talent, who have not thought it beneath them to spend often half their lives in the drudgef y of public practice in hospitals and similar institutions, that they might obtain a competent knowledge of diseases, as distinguished from each other, and of applying remedies to each individual case! for after all, each case is

a particular disease, and cannot be treated in a wholesale manner, as these systems would induce us to suppose.

" How often do we hear these men, after they have obtained all the information in their power, and attained to stations of eminence, expressing their regret, that they have been prevented from devoting a still larger portion of their time in learning an art which is infinite in its extent and complexity ? I mean the art of detecting and distinguishing diseases under innumerable phases. This, in fact, is the foundation of the art of medicine, for when a disease is at once surely ascertained and detected, it is comparatively easy to find its proper remed}', and to cure it, if it is in its nature curable. The public, I repeat, make no such inquiries, but hearing that a case has been cured by an unusual remedy—brandy and salt, or mustard-seed, for instance—they immediately infer that these remedies, if applied by a certain individual, will cure every disease, and therefore this individual, whether young or old, male or female, learned or unlearned, is the person to be consulted, and is preferred to those who have devoted the best portion of their lives to the study of their profession." , 4

f 2 U

It is unnecessary for me to make much allusion to the works published by homoeopathists, as the degree of estimation to which they are entitled, and the value of the cases which they contain, will have been pretty effectually shown in the preceding account, as far as the public is concerned.

Is there then nothing good in homoeopathy ? Unquestionably — though the good resulting from homoeopathy is more of a negative than a positive character, and one advantage of its introduction into England is that it has tended to limit the too active medication in chronic disease, which has so long prevailed to the prejudice of a large portion of the community; and the suspension of this active medication, during the homoeopathic treatment, has not unfre-quently been a cause of the benefit which has followed : consequently, homoeopathy is not unlikely to be longer in fashion in England than it has been in the continental countries, where a different system of medical practice obtains. It has likewise led to more minute inquiry into the action of several remedies, and has thus tended to make the circumstance more frequently known, that much smaller doses of active substances (especially sedatives and other

remedies having a specific action) than had been previously supposed, are not unfrequently highly influential in the alleviation of certain disordered conditions of the system, when large doses have failed to benefit. It does not, however, follow from this, that the infinitesimal doses of the homceopathists have a positive action ; for it would be absurd to argue, that because an effect is produced in some exceptional cases by two, three, or four drops of a tincture, of which the ordinary dose is from fifteen to thirty, that a positive result should also ensue from the administration of the billionth part of a single drop. It is true, however, that in a few rare cases where there exists a high degree of sensibility, or a particular idiosyncrasy, that effects will result from inconceivably small quantities of active substances; every practi-' tioner must have experienced the unpleasant consequences which have followed the inadvertent addition to a medicine of a minute quantity of ipecacuanha or opium, when this peculiarity has existed. In like manner some persons are disagreeably affected by flowers or perfumes, or experience unpleasant sensations when a cat, a butterfly, or other animal, against which they have an antipathy, is in the same

room, even though they may not have seen it. # These, however, are exceptions, from which no general conclusions can he drawn, and these exceptions have been adduced in proof of the general action of homoeopathic doses, to which, as I have shown, not only reason but experience from trials conducted on a large scale is opposed. The only physician whose opinion is entitled to consideration, from his not being interested in supporting the practice of homoeopathy, who appears to have been convinced from some trials that he made of the special action of homoeopathic doses, is Dr. Millingen, who, in his " Curiosities of Medical Experience," has adduced half a dozen cases, which he conceives go to prove the fact. These cases, however, with one exception, merely corroborate, in my opinion, what has been advanced, viz., that because some slight ailments and symptoms subside after an homoeopathic dose, which the patients for the most part know to be something unusual, it is not to be inferred that it is in consequence of a particular virtue in the drop or globule which has been administered

* " Indeed, the action of homoeopathic remedies may be considered in a certain sense as idiosyncratic."—Madden, Op. Cit.

to them, as we have seen that analogous effects often occur after a pill or* liquid, composed of inert substance, but which the patient imagines to possess some extraordinary power. The fourth case is that of a young woman, to whom a homoeopathic dose of a preparation of nux vomica was given, in whom the peculiar symptoms that usually follow a large dose of strychnine were produced, though she had been led to believe the remedy prescribed was merely a dose of calomeL Now, when we consider that an ordinary dose of strychnine is only one-sixteenth or one-twelfth of a grain, it would not occasion much surprise, even admitting that an homoeopathic infinitesimal dose was actually given, (the quantity is not stated,) that the peculiar symptoms of this energetic medicament should be produced in an isolated case. The only fair test is to make experiments with this or any other homoeopathic dose on a number of individuals; this has been done by impartial persons, and also by homoeopathists themselves, subject to the supervision of others; and, as has been seen from some of the instances adduced in the preceding pages, the result has been always a failure. Homoeopathy has further tended to make more generally known

what may be effected in many disordered conditions of the economy, by a due attention to regimen, by the imagination, and the unaided powers of the constitution, and in this way likewise has rendered some service.

A good deal has been said by the homoeo-pathists in England about the homoeopathic hospitals abroad. The only ones of which I know are the one at Leipsic, of which I have spoken, and the one at Vienna, of the practice of which the following report is given by Dr. Balfour (in the British and Foreign Medical Review for October, 1846). The homoeopathic hospital is a private one in the convent of the sisters of charity in one of the suburbs, and contains fifty beds; and since 1845, has been under the care of Dr. Fleischmann. Hahnemann's empirical rules as to rubbings and shakings are disregarded — the diet is light and simple—no coffee, tea, or wine is allowed.

"In taking into consideration the adjuvants to the treatment, the religious character of the establishment must not be forgotten. The patients find themselves surrounded by all the consolations of religion, by everything which, in their opinion, tends to ensure^ in the event of death, a speedy passage of the soul to the

realms of bliss—their minds thus set at rest with respect to futurity, they are less gloomy and desponding, and consequently react more favourably upon the body than under the opposite circumstances. The severer their disease, the more closely do they grasp their rosaries and crucifixes. The superiority of the attendance is also one great advantage in favour of this hospital, independently of the important fact just stated, that the nurses are spiritual as well as temporal comforters. The comparative youth of the patients in this hospital must also be taken into consideration; out of three hundred and twenty patients, two hundred and forty-five were under thirty years of age, and only four above sixty. The circumstance of comparative youth under all kinds of treatment has an immense influence upon the ultimate result.''

66 Again—the patients are admitted and dis charged by the physicians without any control; so that, to say the least, it requires a man to be very conscientious to decide impartially between temporary improvement and perfect cure, especially when he recollects that the fate of his creed, and of his institution, depends upon the nature of his returns to government, which are

f 5

HOMOEOPATHY.

made monthly. Cases discharged apparently cured may apply for readmission, and be under some pretext or other refused, while,, to disarm suspicion, a few whose relapses are more manageable may be readmitted. I have seen at least one patient refused admittance, and that, too, the very day after his discharge, without any good obvious reason ; it was that of a boy with effusion into the right pleura, following scarlatina. There was also a general anasar-cous state of the body, which speedily disappeared, but the chief complaints remained obstinate, and after thirty-three days' treatment with bryonia, (second dilution,) he was dismissed, slightly improved. This is not the only case of effusion into the chest which has been dismissed unimproved during the period of my observation, yet this scarcely agrees with Dr. Fleischmann's returns, as out of twelve with exudation in the pleura during ten years, he says he hascured all but three, who died; and a physician of the general hospital assured me that many such cases, after having been dismissed by Dr. F., and subsequently refused admission, have applied to him for relief, which they have obtained by the use of purgatives and baths. Then again I may say, there are

hundreds of trifling cases admitted here which would not have been admitted into any hospital in England, and even of these comparatively trifling cases many remain, for weeks, nay, months, in the hospital, while more acute or more interesting cases are hurried out too often with the cure incomplete. When the patient recovers* the case is published as one of the triumphs of homoeopathy, whilst the many similar Gases, where even homoeopathic treatment has proved unavailing, are silently passed over, or are recorded as instances of the imperfection of the human* intellect"

cc The whole process of the admissions and discharge of patients is mysterious; still so much is certain, that most of those admitted have been previously visited at their homes by the assistant. I feel convinced that the great secret of Dr. F.'s great seeming success lies in the fact of the admissions and dismissals being uncontrolled, and there being no check on the diagnosis; rarely other than well-marked cases have the diagnosis written on the board at their bed-head, the others being left blank, and entered in his book, of course, as he pleases.

" Homoeopathic remedies are not exclusively trusted to,, for Dr. F. uses cold applications to

the head in delirium, and sometimes in headache ; cold washings of the body in fevers, and in arthritis cloths dipped in cold water, surrounded by oil-silk, applied to the affected parts. He also has for constipation clysters of warm water, or water mixed with a little salt; and in diarrhoea rice clysters. He told me that neither he nor any other homoeopathists ever gave emetics or purgatives, and yet I heard his assistant once order a woman a spoonful of oil.

Dr. F. does not adopt the similia similibus, one drug serving for a great many diseases.

" Two or three fatal cases are given in the report, and fifteen per cent; three out of nineteen having died," whereas Skoda's cases of pneumonia in the general hospital during the same time amounted to forty-five, the deaths three, being an average of 6.6 per cent., no blood-letting being employed.

" I think you will see," concludes Dr. Balfour, " by what I have stated, that the strength of the homoeopathists lies not in the greater rationality] or superiority of their practice, but is founded on the weakness of allopathy, that they do not help their patients, but, if they are strict homoeopathists, are for ever shut out

from helping them; that in their treatment of acute disease, their success depends entirely on the hitherto unrecognised powers of nature. All the magic influence of their infinitesimal doses of phosphorus, &c, being emulated, if not excelled, by the heroic virtues of the ex-tractum graminis."*

* An inert substance.

NOTES

ILLUSTRATIVE OF-THE

INFLUENCE OF THE MIND ON THE BODY.

The great influence exerted by the imagination and other mental faculties on the exercise of the bodily functions, and in the production and removal of disease, has not received from medical practitioners the degree of consideration to which its importance entitles it, notwithstanding the effects of this influence are daily seen in the practice of medicine, and the subject has occupied the pens of several eminent individuals, both in ancient and more recent times. It is not my intention to enter at any length into the consideration of this subject, which would suffice to fill several volumes, but I purpose adding

as a pendant ta the remarks already made, a few illustrations, by which it will be seen that this influence has not been over-estimated in the preceding pages.

The faculty which so frequently enhances enjoyment by anticipation,

" Whose might Gan make the desert heavenly fair, And fill with forms divinely bright, The dreary vacancy of air,"

and to which, when under proper control, the civilized world owes so large a share of its happiness, is also unfortunately instrumental in the production of much of the misery that exists,, by the gloomy foreboding of expected evils y or by -the ideal aggravation of present misfortunes. While on the one hand, the happy effects of a well-grounded confidence are daily brought under the observation of the medical practitioner in the recovery of patients under the most unfavourable circumstances; on the other, the direful consequences of this instrumentality are strongly exhibited during the prevalence of some epidemic diseases, which are known to affeet individuals in proportion to the degree of apprehension that prevails; whereas medical men and others, who under these circumstances

are not so liable to be influenced by the terrors of an excited imagination, are much less likely to be affected by the disease, or, if they are attacked, the termination is favourable in a large proportion of cases. In many instances, again, and especially after accidents and operations, though the circumstances appear to be most favourable for recovery, yet if the moral of the patients be so influenced as to make them apprehend an unfavourable termination, how frequently does it not occur that these prognostications are verified by the result! In like manner, predictions of the occurrence of disease or death at a certain period, by the hold they obtain on the patient's imagination, occasionally bring about their own fulfilment. It is said, that in the Sandwich Islands there is a sect who assume the power of praying people to death : " Whoever incurs their displeasure, receives notice that the homicide litany is about to commence, and such are the effects of the imagination, that the very notice is sufficient with these people to produce the effect." It is mentioned by Hearne in his Journey, that " Such is the confidence of the North American Indians in professors of the magic art, that they appear

capable of curing the most serious diseases without resorting to any physical means; and the feats of their malignity plunge individuals into diseases which often terminate fatally. One of these Indians, Matonabbi by name, conceiving that Hearne was in possession of supernatural powers, requested him to kill, by magic, a man against whom he entertained a deadly hatred. To oblige him, Hearne, without dreading any bad consequences, drew some figures upon a piece of paper, and gave it to Matonabbi, advising him to make it as public as possible. Mato-riabbi's enemy, who enjoyed perfectly good health, had scarcely heard of the paper, when he became melancholy, drooped, refused food, and died in a few days"

The two following cases are stated in a recent work.* "A weak-minded man, a clergyman, drinking wine in company, swallowed a bit of sealing-wax, when one of his companions seeing him alarmed, to increase his terror, jocularly called out, c It will seal up your bowels.' From that instant he became melancholy, and in a day,or two refused all nourishment. On being pressed to give a reason for this refusal, he said

- * Preservation of Heath of Body and Mind, by Forbes; Winslow.

NOTES.

he knew that nothing would go through him. He was, however, induced to take a cathartic, which operated freely; nevertheless, he could not be convinced but that his body was hermetically sealed, and with the exception of a little broth, which he was frightened into taking, he refused to swallow anything, and died in consequence."

"A young farmer, who detected an old woman breaking sticks from his hedge for fire-wood, seized her and threatened her with the terrors of the law. After some struggling she released herself from his grasp, and kneeling on the fagot in the bright moonlight, stretching her withered arms out to heaven, addressed him, already shivering with cold, in the following words— * Heaven grant that thou never mayest know again the blessing to be warm.' He complained of cold all the next day, wore an upper coat, and in a few days another. In a fortnight he took to his bed, saying nothing could make him warm, covered himself with many blankets, placed a sieve over his face, and from this single hallucination from fear of the cold air, he kept his bed upwards of twenty years, when he died."

The author of the "Anatomy of Melancholy"

thus expresses himself on the subject: " Sometimes & strong conceit or apprehension will take away diseases; in both kinds it will produce real effects. Men, if they see but another man tremble, giddy, or sick of some disease, their apprehension and fear is so strong in this kind, that they will have the same disease; or if by some soothsayer, wise man, fortune-teller, or physician, they be told they will have such a disease, they will so seriously apprehend it, that they will instantly labour of it. If it be told them they shall be sick on such a day, when that day comes they will surely be sick, and will be so terribly afflicted, that sometimes they die upon it."

Again, " As some are so molested by phan-tasie, so some again by fancy alone, and a good conceit, are as easily cured. We see commonly the toothache, gout, falling-sickness, and many such diseases, cured by spells, words, characters, and charms. All the world knows there is no virtue in such charms, but a strong conceit and opinion alone."

I need scarcely allude to the more common effects of the imagination and of moral impressions known to every one, as illustrated by the production of blushing, paleness, fainting, pri-

KOTES.

vation of appetite, disturbance of disgestion, and other functions ; # but it is too often overlooked, that similar impressions are very frequently instrumental in the production and keeping up of a large proportion of chronic diseases; hence, a cause of the intractableness of many of them under a treatment exclusively medicinal.

A great many of the disorders of the digestive apparatus met with in a metropolis like London are induced and kept up by anxiety, the worry of particular avocations, and the annoyances and perplexities to which the professional, mercantile, and trading classes of the community are especially subjected. Such complaints may persist, or be constantly recurring for an indnfinite period, deriving but temporary alleviation from medicine; but they not nnfrequently cease spontaneously, »if any circumstance occur to counteract the influence of the above-mentioned causes; as partial change of habits, a short residence in the country, the undertaking of a journey of pleasure, &c. The same may be said of the class of nervous disorders, many of which are occasioned and kept up solely by causes of a moral nature, as seen in the occurrence of some

* " Unquiet meals make ill digestions."

Shakspeare.

convulsive affections, viz. hysteria from mental emotion or antipathy, epilepsy from fright, &c. Deep sorrow, disappointment, and other analogous causes, are but too often the latent occasion of complaints which long resist the efforts of medicine, for the iritractableness of which no obvious reasons can be assigned, and by their depressing influence on the vital powers, are frequently productive of some of the most distressing organic diseases to which humanity is subject,

A large proportion of cancerous diseases originate in grief, disappointment, and similar depressing causes which interfere with the free capillary circulation, and alter the innervation of parts. Consumption is not unfrequently induced by the same influence, or by a combination of mental and physical causes, the operation of which being necessarily very slow and gradual, mostly escapes observation till the germs of disease are firmly engrafted in the system, and only await the action of an exciting cause to bring them into activity. The complaint termed nostalgia, or home-sickness, is likewise a striking example. In these cases the individual, torn away from his country to fight or labour in foreign lands, droops and pines away

without exhibiting the symptoms of disease of any particular organ, until a hope be held out of his speedy return, when the cure will sometimes be effected as if by enchantment.* Dr. Carrick, who had many opportunities of witnessing this disease, says of the Scotch labouring under it, "They get dull, will not eat, cannot sleep, or if they do, they dream but of friends and home; the disease is daily on the increase. There is but one cure; put them into a homeward-bound vessel, and let them tread once more their native shore. The same effect is also produced by disappointment in love; the female form cannot endure the worm that feeds upon the damask cheek. The concealment of her passion brooding among the ruins of her peace, produces a mental anguish, under which the body soon sinks."

With how much greater ease and lightness

* One of our most justly esteemed poets has thus alluded to this malady:

" The intrepid Swiss who guards a foreign shore, Condemn'd to climb the mountain cliffs no more, If chance he hear the song so sweetly wild, Which on those cliffs his infant hours beguil'd, Melts at the long-lost scenes which round him rise, And sinks a martyr to repentant sighs."

Pleasures of Memory,

7

are all the bodily functions performed, when the mind is free from care and we are in good spirits ! How languid, on the contrary, is the flow of the "nimble spirits in the arteries," when we are " besieged with sable-coloured melancholy !" and how much more liable are we under these circumstances to be affected by deleterious agencies of a physical nature ! In an advancing army, flushed with conquest, disease rarely appears; if, however, the same body of men be dispirited by defeat and on a retreat, disease to a great extent will not fail to manifest itself, should they be exposed to any of its more common causes. The British troops in Walcheren continued tolerably healthy, notwithstanding the deleterious influence of the climate, till circumstances occurred" to depress their moral. The same effects were seen on a larger scale on the retreat of the French from Moscow, and there is no doubt, that had the army been advancing with a prospect of good quarters, instead of being in retreat and undisciplined, it would have supported the privations consequent on the rigour of the season and scantiness of food 3 with the loss of a comparatively small number of men.

The power of the imagination and of faith is

constantly exemplified in the action of remedies, especially in diseases of a nervous character. Thus we see that many patients, and more especially nervous and hypochondriacal ones, often find themselves much better after first consulting a new medical attendants Fresh remedies, when first tried, are often attended with a remarkable amelioration, and not unfrequently arrest the attacks of epilepsy, neuralgia, &c. or mitigate their severity ; particularly if the patient had been led to expect great advantage from their administration. In these cases, however, as the novelty subsides, and the patient becomes more accustomed to the remedy, its good effects frequently cease to be manifest.

* Delille, in alli.ding to the effects of Mesmerism, says—

" Tous se felicitoient de leurs metamorphoses, La vielle Egl6 croyoit voir renaUre ses roses, Le viellard decrepit se ranimant peu-a-peu D'un retour de sant6 menacoit son neveu ; Le jeune homme a vingt ans, ride" par la mollesse, Se promettoit encore quelques jours de jeunesse. ***** Mesmer courut ailleurs porter son art aimable ; Chaque malade au fond de son appartement, Tout seul avec ses maux s'enterra tristement, Et des remedes vains implorant la puissance, II perdit le plux doux en perdant respGrance."

L'Imagination.

Patients who entertain an idea that they require a course of mercury, will often derive great benefit, and will actually feel a soreness of the mouth, accompanied with an increased flow of saliva, on taking pills composed of bread or other inert substances, provided they believe themselves to be taking mercury. It is stated in the "Dictionnaire des Sciences Medicales," that a physician gave a peasant a prescription for a .purgative, saying, u Take this." The man, on his return home, actually swallowed the paper, which produced a similar effect to what would have resulted, had he taken the remedy prescribed. He. returned in a day or two.to the physician, to say that the purgative had quite cured him. At the period of Corvi-sart's. lecturing on the diseases of the heart, many of the students became affected with pal-pitation and other symptoms of these diseases, and it is well known that when medical students and non-professional persons read descriptions of diseases, they often become affected with some of the symptoms; or, if they had previously any of the symptoms, about which they had been reading, these are almost constantly aggravated from their attention being mere strongly directed towards them. The power

G

of the imagination and mental impressions in producing hysteria is well known. Analogous influences, and an exertion of the will, also frequently prevent the recurrence of attacks of this disease. On the same principle are easily explicable the cures which have been performed from persons being placed on the tombs of saints ; by touching holy relics; by pilgrimages to particular places; as in those affected with St. Vitus's dance who were cured in the sixteenth century by a pilgrimage to a chapel dedicated to this saint near Ulm. I have given, in my work on Nervous Disorders, some cases of partial or total paralysis, in which the persons have continued helpless for years, and have ultimately recovered, either spontaneously or after some strong moral impression; but as it would be somewhat out of place to cite here detailed medical cases, I prefer illustrating the remarks which have been made, by a quotation or two from a* work.in general circulation:—"A large body of sailors resorted to Sadler's Wells theatre one night, and amongst them a man who was deaf and dumb, and had been so for many years. This man was placed by his shipmates in the front row in the gallery. Grimaldi was in great force that night, and although the

audience were in one roar of laughter, nobody appeared to enjoy the fun and humour more than this poor fellow. As the scene progressed Grimaldi's tricks and jokes became still more irresistible, and at length, after a violent peal of laughter and applause, which quite shook, the theatre, in which the dumb man joined most heartily, he suddenly turned to his mate who sat next him, and cried out with much glee— ' What a d—d funny fellow V— ' Why, Jack,' shouted, the other, starting back with surprise, 6 can you speak ?'—' Speak,' returned the other, £ ay, that I can, and hear too.' The man, who appeared an intelligent and well-behaved fellow, said, that in the earlier part of his life he could both speak and hear very well, and that he attributed his deprivation of the two senses to the intense heat of the sun in the quarter of the world from which he had recently returned. He added, that he had for a long time felt a powerful anxiety to express his delight at what was passing on the stage, and that after some feat of Grimaldi's, which struck him as particularly amusing, he had made a strong effort to deliver his thoughts, in which, to his great astonishment, no less than that of his comrades, he succeeded."

g 2

cc When Grimaldi, worn out by premature old age, was almost deprived of the use of his limbs, so as to be scarcely able to stand or walk, he was visited by a friend, and when, with much difficulty, he had descended from his bed-room to the parlour, his friend informed him, with great care and delicacy, that his son was dead.

" In one instant every feeling of decrepitude and bodily weakness left him, his limbs recovered their original vigour, all his lassitude and debility vanished, a difficulty of breathing, under which he had long laboured, disappeared, and starting from his seat, he rushed to his wife's chamber, tearing, without the smallest difficulty, up a flight of stairs, which a quarter of an hour before it had taken him ten minutes to climb. He hurried to her bedside, told her that her son was dead, heard her first passionate exclamation of grief, and, falling into a chair, was once again an enfeebled and crippled old

man.

'*

The following cases will likewise serve to illustrate the beneficial effects of moral impressions in certain diseased states of the system.

" At the siege of Buda, that city had suffered from the effects of a long conflict, and the inha-

"* Memoirs of Joseph Grimaldi.

bitants had experienced the miseries of fatigue, bad provisions, and anxiety of mind. The scurvy had also made great progress among the besieged; the place was on the eve of being surrendered to the enemy, when the Prince of Orange introduced letters to the men, promising them speedy assistance ; a medicine which was represented to possess wonderful efficacy, and to be almost beyond price, was forwarded for the use of the garrison. Three small phials containing this precious panacea were given to each physician ; this stratagem was completely successful. It was stated that three or four drops were sufficient to impart a healing virtue to a gallon of liquor. Invalids flocked in crowds to the physicians ; many who had not moved their limbs for a month before, were seen walking the streets perfectly well."*

At the time when Sir H. Davy was assisting Dr. Beddoes in his experiments on the inhalation of nitrous oxide, Dr. B. having inferred that the oxide must be a specific for palsy, a patient was selected for trial, and placed under the care of Davy. Previous to administering the gas, Davy inserted a small thermometer under the tongue of the patient to ascertain the

* Winslow, op. cit.

temperature. The paralytic man, wholly ignorant of the process to which he was to be subjected, but deeply impressed by Dr. Beddoes with the certainty of its success, no sooner felt the thermometer between his teeth, than he concluded the talisman was in operation, and in a burst of enthusiasm, declared that he already experienced the effects of its benign influence throughout his whole body. The opportunity was too tempting to be lost. Davy did nothing more, but desired his patient to return the following day. The same ceremony was repeated, and the same result followed, and at the end of a fortnight he was dismissed cured, no remedy of any kind, except the thermometer, having been used.

When the metallic tractors were in vogue for the cure of several complaints, by being applied to the parts affected, Dr. Haygarth tried the experiment o^ preparing tractors composed of other than metallic substances, but which were made to resemble the original ones, and equally advantageous results ensued from their application.

I will subjoin three other cases which appeared in the papers, and were considered as evidencing the special interposition of a super-

natural agency, having been cried up as miracles in the localities where they occurred.

" Miracle in the river Case. — Charlotte Beeby, late of Elstow, aged twenty-five, an inhabitant of Biddenham, has for the last five years been a cripple, with an affection of the back, the lower limbs being perfectly paralysed. The affection had resisted the treatment of many practitioners. Being acquainted with the episcopalian church doctrines taught by the Rev. Mr. Matthews of this town, she conceived that if she were baptized by that gentleman she would recover; Accordingly, the reverend gentleman, at half-past ten at night, in the presence of a hundred spectators, converts to his doctrines, proceeded to the river Biddenham, whither the diseased person was removed in a cart, as usual when moved about. Mr. Matthews, going into the river to support her, immersed her in the water, when she immediately said, ', Leave me go, I can walk,' and walked out of the water, and ran some little distance up a hill till she was exhausted, but she has retained the use of her limbs ever since."

Similar cases, occurring for the most part in females, are recorded from time to time, and are not unfrequently considered as miraculous cures

by those who are ignorant of their nature, which, I believe, I first explained in my work on Nervous Disorders, as depending upon a debility of the faculty of volition. These cases not unfre-quently continue for months or years, being often kept up by habit, unless circumstances occur which forcibly impress the mind, and excite this faculty to activity, as in the above, instance, as well as that of the thermometer placed under the tongue by Sir H. Davy, The case of the voice being restored in consequence of the impression produced by Grimaldi's antics, as also that which I have related under the head of homoeopathy, of loss of voice being cured by starch pills, which the patient supposed to be homoeopathic remedies, are of a similar nature, the affection being restricted to the muscles concerned in the formation of the voice in these instances. The paralytic patients formerly cured by being placed on the tomb of the Abbe Paris, laboured under a similar affection, of which I have given several examples in the work above referred to, but which being frequently mistaken by the patient's friends as well as by members of the profession, for a consequence of structural disease, is too often intractable under a purely medical treatment, and

the sufferings of the patients are indefinitely prolonged, when they might often be removed by a proper employment of psychical measures. In the following case, which is of an analogous nature, the limb was contracted, and could not be extended from the same cause, and there was besides anormal sensibility of the skin, which is a very ordinary concomitant of these complaints, . but which frequently leads practitioners into the error of supposing the disease to be of an inflammatory nature. Though to appearance alarming, these cases almost always recover sooner of later, unless, from bad management, or from long confinement, disease of some internal organ be induced.

Extraordinary Miracle. —The Union Catho-lique of Monday last, contains a letter dated Nice, the 9th October, 1842, which relates a most extraordinary miracle that had just happened in that town, and of which the writer was an eye-witness ! The circumstances are briefly-as follow :—« The young Countess de Maistre, twenty-one years old, daughter of the Governor of Nice, had for four months lived in almost continual sufferings, contractions, and spasms. The labours she had undergone in the convent of the Sacred Heart at Turin, where she was a

g 5

novice, had caused a swelling in her feet. Leeches, unseasonably applied, had injured the nerves, and this, which was at first only a slight inconvenience, became at last a distemper of a very frightful character. One of her legs became contracted, bent back, and fixed in a strained and unnatural position, (dans un Hat de flexion eocageree,) so that the knee became twisted, and the foot rested firmly and immove-ably on the hip. All this was accompanied by frightful suffering/ Being unable to fulfil the duties of the monastery, her mother brought her home early in last July, ' her life already despaired of, neither eating or sleeping, always in pain, able neither to walk nor sit, nor remain in bed/ She got worse every day in spite of the attentions of three excellent physicians. She had besides crises of convulsion; she would fall down on the ground, be covered with black marks, her eyes turned round in her head, and her arms grew benumbed. The day of her cure, four hours before the miracle, she was visited by two of the physicians, who examined the limb. The same evening the surgeon came to the house, and seeing her, could not help saying, ' There is no hope, I cannot work miracles/ " Such was the state of the patient which

7

we have described "pretty fully from the letter. In the rest of the case we must be more brief. A daughter of the Countess de Komar had a great devotion for a canon,, Dom Gaspard del Bufalo, who died in December, 1838, in the odour of sanctity, after having founded an order of Missionaries of the Precious Blood, and worked miracles of all kinds during a laborious course of evangelical labours in Piedmont and Italy. Mdlle. de Komar had, for some days past, persuaded Mdlle. de Maistre to join her in a Noveria, and incertain other devotions, towards this holy man. On the 8th October, at noon, in the midst of these devotions, Mdlle. Komar, ' urged to do so by a secret and irresistible power, commanded Mdlle. de Maistre, in a loud voice, in the name of God, and by the merits of his servant, to do her utmost to stretch out her leg. < Frances,' said she to her, 4 stretch out your leg, try, try/ The patient did so move her leg, and leaping from her bed, tnrew herself into her friend's arms, and cried out, c Nathalie, I am cured. 1 The physicians were at once sent for, and, on examination, they found . that. the knee, lately ossified, was now sound .and flexible. It was straight, smooth, white, and perfectly sound ; on being repeatedly

NOTES.

squeezed, it was perfectly free from pain, though the moment before she had not been able to endure the slightest contact of the linen. The cure occurred at half-past three, p.m. and all the rest of the day Mdlle. Maistre continued on foot, receiving visits from the chief people of the place. The next morning she heard three masses, kneeling, and received the blessed Sacrament with all her family. Afterwards she went to the hospital, and when the letter was written, she was going from bed to bed, visiting and consoling the sick. The particulars of this occurrence, with the depositions of the physicians, have been sent to Rome. The rumour of it has spread to Genoa, Turin, and through Piedmont, where it has caused the most lively emotion."— Morning Herald, Dec. 1842.

In the next case the cure was produced by the same means, being in consequence of the report of the former one. It was likewise headed—

"A Modern Miracle" —said to have been wrought at Plombieres, was also recorded in the Union Catholique: —"A young girl, who for some years had been confined to her bed, by a disease which baffled the skill of several eminent physicians, was deemed to be incurable. For the last four months her body appeared to be

dead ; she was incapable of moving either of her limbs, or even of raising her hand to take the light nourishment presented to her; she, nevertheless, preserved her intellectual faculties. For some time lately, she became still more debilitated, and was believed to be dying, and prayers were put up to God that he would put an end to her agony. At this period, the cure of the parish read an account of the miracle which had been performed at Nice, and commenced a neuvainei in the hope that the Deity might have the same benevolence towards his suffering parishioner. Nine congregationists communi-acted on Thursday the 10th ult., and on the 18th, mass was performed at the altar of the holy Virgin ; the young girls of the parish communicating in the name of the sick person. At the same time a pious woman repeated the mass to the poor girl, who was placed on her knees at the foot of the.bed. At seven o'clock she communicated ; at eight o'clock, and between the two elevations of the host, the long-suffering woman got up and seated herself on the bed> exclaiming, c O, I no longer feel ill; and if I continue thus, I am cured.' She had not spoken for a long time before, and she could bear no light in her eyes without enduring great pain.

After the mass, she remained for some time perfectly tranquil, and then getting up, suddenly spoke with all the force of a person in full health, saying, * I am cured—O, a miracle ! leave me alone, and I will get up and walk.' Astonishment filled the rninds of all present. As no others were at hand, they put a pair of wooden shoes on her feet, and she walked in them with all the steadiness of any other person. In a few minutes the room was filled with people, and all present,-with tears of joy in their eyes, joined in chanting the Te Deum. A mass of thanksgiving was performed in the church; the bells were rung, and the whole place was full of emotion. Those who were without faith became believers, and all joined in prayers to God."— Times, Dec. 15, 1842.*

Dr. Warren, of Boston, relates the case of a lady who had a tumour of the glands of the neck, of the size of an egg, which had lasted two years, and had resisted all the efforts for its removal,

* In many cases time effects a cure after the failure of every other means. Several years ago, I saw a young man who had suddenly lost his voice about five years previously, and who had no hope of its restoration. I stated my opinion that it was not unlikely to be restored at some time or other. This has since occurred, an interval of twelve years having elapsed between the attack and recovery.

so that an operation was proposed. To this the patient objected, but asked whether it would be safe to make an application which had been recommended to her, viz., touching the part three times with a dead man's hand. Dr. W. assured her that she might make the trial without apprehending any serious consequences. After a time, she again presented herself, and smiling, informed him that she had used this remedy and no other, and on examining the part, he found the tumour had v disappeared. The cure of scrofulous swellings and sores in former days, by the royal touch, is also attributable to the power of the imagination, on the absorption of parts.

Imitation and habit influence in a remarkable manner the actions of the economy in health and disease. How frequently do" we not see one person imitating the gestures of another, without being aware of the circumstance ? * Children, in whom the imitative faculty is- most strong, readily adopt the gestures and even the tone of voice of their parents or other persons with whom they are associated. The action of

* " It is certain that wise bearing or ignorant carriage is caught, as men take diseases one of another *, therefore let men take heed of their company.'*— Henry IV.>Part 2.

yawning, when we see others yawn, is a familiar example of the power of imitation. Muscular twitching of parts, squinting and stammering, are not unfrequently acquired by imitation, and are subsequently kept' up by habit for an indefinite period. St. Vitus's dance occurs in some children in consequence of their associating with others affected with this complaint, which is in many cases kept up for a long time by habit alone. The same may be said of epilepsy, and other nervous affections. It is a matter of common observation, that if one female have an hysterical attack, in a place where several are congregated, as in the ward of an hospital, or in any public assembly, others frequently become similarly affected, The mode adopted by Boer-haave, of arresting an epidemic of a convulsive nature, has been repeatedly quoted by medical writers, as illustrating the power of imitation and of moral impression over these disorders. A girl labouring under attacks of an epileptic nature was placed in the ward of a public institution, with other girls, who all became affected in a similar manner,' and the complaint continued to prevail epidemically, till Boerhaave assembled all the patients together, and heating before their eyes a number of iron rods, expressed

his determination to apply a" red-hot rod on the face of the first who should have an attack. None of them had any recurrence, and the epidemic ceased as if by magic. Epidemics of a somewhat similar kind have at different times been propagated by imitation over a considerable extent of country; as in the case of the \dancing mania, which extended so widely in the sixteenth century. Laughter is also frequently excited by imitation, and sometimes under circumstances but' little likely to occasion merriment. Wesley relates, that paroxysms of uncontrollable laughter occurred at some of his prayer-meetings. He himself, and some of his most zealous followers, could not resist the infection, but laughed as loudly as the rest. He accounts for the circumstance by ascribing it to the influence of Satan.

The power of habit is further seen in the facility with which persons, under certain circumstances, accustom themselves to bear with but little inconvenience extremes of temperature; to digest with facility articles of food which would cause an attack of illness to those less accustomed to their use; or to require but a small quantity of sleep. By this power the eye becomes enabled to discern minute objects in com-

parative obscurity. The ear of a North American Indian applied to the ground, can hear advancing footsteps at a distance that appears incredible to Europeans. After the loss of one sense the other senses become, by the habit of cultivation, extremely susceptible to impressions made on their organs. When a person is deprived of his hands, the sense of touch may become surprisingly developed in other parts of the body, as the feet. Many diseases are greatly under the influence of habit, especially epilepsy, hysteria, and others, which occur at periodical intervals. The paroxysms of an intermittent fever are sometimes kept up by habit. Abortion is liable to recur at a similar period of pregnancy from this influence. In these cases the disorders are often kept up until some circumstance occurs which tends to break the chain of habitual^recurrence. Moral impressions have frequently this effect, as seen in the cases related in the preceding pages. Change of scene and mode of living also have a beneficial effect in many instances. Some remedies, which have an energetic action, and other, means in which the patient is led to place great confidence, produce an advantageous result in some cases, while, in others which have resisted a. variety of remedial measures, time alone effects the cure.

It is unnecessary to, lengthen this work by any further examples of the influence exerted by the mind on the body, enough having been said to enable those who have perused it to form an estimate of the power of this influence; as also of the value to be set upon homoeopathy.

LONDON:

G. J. PALMER, PRINTER, SAVOY STREET, STRAND.

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