CORRECT OBSERVATION IN MEDICINE:

AN A D1) R E S S
DELIVERED BEFORE THE

MASSACHUSETTS .

HOMEOPATHIC MEDICAL SOCIETY,

AT THE ANNUAL MEETING IN' BOSTON,

Ai'Kir,, 1864.

By S. M. CATE, M.D.,
OF SALEM, MASS.

|)rintcb from tbr Socictn’s publications.

BOSTON:
PRESS OF JOHN WILSON AND SON.
 CORRECT OBSERVATION IN MEDICINE:

AN ADDRESS
DELIVERED BEFORE THE

MASSACHUSETTS

HOMEOPATHIC MEDICAL SOCIETY,

AT THE ANNUAL MEETING IN BOSTON,

ArRiL, 1864.

By S. M. CATE, M.D.,
OF SALEM, MASS.

/: • Z £0
* **/.;, <
|)rinteil from tbc jftfcutg’s |lnbIinrtions.

BOSTON:
PRESS OF JOHN WILSON ANI) SON.

18G6.
 «

'
 ANNUAL ADDRESS.

Correct Observation in Medicine.

Medical men, since the time of Hippocrates and Galen,

have toiled at their art or science, and recorded something
of the result of their investigations. The bulky volumes
of the old masters have gradually fallen into disuse, or
been supplanted by successive productions, supposed to
embody the more recent discoveries and improvements,—
except, perhaps, an occasional master-mind has reared so
high a monument of his genius as to carry his works
down over generations of smaller men.
All along in the history of medicine are found evidences
of the advancing growth of this science. Here and there,
back in the centuries, some great truth has found birth
and footing, and contributed its part in the structure of
medicine in succeeding time. Some of these truths seem
to have upheaved the medical world like a volcano, turn¬
ing and tearing the old deposits without pity, and leaving
the mind in wonder at the loss of the old comeliness as
well as at the roughness of the new-made landscape.
The laborers in the field of medicine in the past

\
classified the result of their labors and investigations,
both as to facts and fancies, according to the best plans
they could devise. It is these laborers who have produced
the material that fills the medical storehouses of to-day.
Recently, many of the falsities and hindrances of the
earlier days of medicine have been laid aside for truer
theories and better doctrines, so that the productions of
later times possess a value that the old writers do not
have.
The material in the works of the authors is arranged
according to certain nosological forms. Though often
embodying incongruous things, they have still some kind
of order, according to which the medical facts are assorted
and labelled. Inasmuch as the student cannot re-arrange
what he does not understand, here much of his life must
be spent. So, also, to the student of riper years, this same
store of medical facts is the pabulum to which he must
turn to repair the waste that time makes with his mem¬
ory, or to open the mind to the understanding of subjects
not before investigated.
In addition to the works of those who have passed away,
we have those of our contemporaries; and, through
periodical and quarterly issue, and the lectures and labors
of teachers, something of the living thoughts of the men
of our own time. And every man has his own individ¬
ual labor and experience,— his struggles, triumphs, and
failures, all burned or pressed into his mind, as lasting
and ever-present helps, or as significant and faithful
warnings.
By the general judgment of cultivated minds, many
statements of the medical authors of the earlier centuries
 5

in the history of medicine are now pronounced to be false.

As we retrace the history of the past, we come upon the
time when the stump of an amputated limb was dipped
in boiling pitch to stanch the flow of blood. When the
ligature was applied to the cut blood-vessels, the innova¬
tion met a most stout resistance, opposing the supposed
temerity of risking one’s life upon a single thread. And,
if we follow the returning path, we shall find the way
strown with like mementos of errors left behind. In
fact, a close examination shows, that there have been
periods of improvement, steps that mark the disappear¬
ance of old errors and the establishment of new truths.
For such reasons, the “ time honored” in medicine is
that which is the most crude, ill-digested, and false ; and
the more recent productions contain the most true and
reliable material for our use. Each addition of better
theories has been so much help to guide medical observ¬
ers in right paths. Each new and true doctrine that has
come to the hand of the profession discloses old errors
and falsities, and the paths to avoid them. They who
cultivated the medical field by false theories gathered
some wheat mixed with vast quantities of chaff. During
past centuries, many of the doctrines held by the schools
were false; and hence it is, that most of their labor is,
comparatively, of little value to us. Further proof of this
is found in the fact, that the most useful studies of the
medical man are among the authors of the last hundred
years, while research hardly goes back to the works
prior to that time, except to gather the material for a
history of the art, or to study its history among that
material itself. The text-books of our schools are from
 6

the men of the present century, or the last half of the

last century; and those hooks of older date are not com¬
mended as containing the most useful food for the stu¬
dent’s mind.
These facts show us, that the methods of medical obser¬
vation of the present time have a progressive face, ever
looking onward and upward for greater perfection and
more satisfactory fruit. And it is a hopeful indication,
that the medicine of the future will progress beyond the
medicine of to-day to a degree far exceeding the advance-
* ment of to-day beyond that of Paracelsus.
The improvement which has marked the advancement
of medical science has two noticeable, features: —
1. The accumulation of new material to the store of
facts; and —
2. The re-arrangement of the old material more in
accordance with the intrinsic relations of the facts them¬
selves.
Under the first head, we find that large and valuable
additions are constantly being made to our knowledge.
Many diseases, supposed to be new, may not be so; but
old diseases under new names, and more fully described.
There can be little doubt that diseases, like races in the
animal kingdom, sometimes die out; or that, in the prog¬
ress of events, new types and forms come upon the
stage to play their part in human destruction. Diph¬
theria seems to be an example of this kind; and, though
there may be discussion as to whether this is a new dis¬
ease, or a better description of an old one, still the
fulness of our present knowledge places it in the light
of a new discovery. Although the number of new and
 7

grave diseases which have been brought to the notice of

the profession within the past few years is small, yet
there has been a constant increase in our knowledge of
those of less magnitude, and especially of peculiar forms
of organic lesion. If we take the derangement of almost
any portion of the human body, and go into a careful
investigation of the different diseases peculiar to it, no
very long time will elapse before we shall discover
forms of disease nowhere described by medical writers.
Almost any of the recent monographs on the liver, the
lungs, the heart, the brain, or other organ, will show this
to be true.
The great amount of knowledge that can be gained by
the careful study of any one of the severe common dis¬
eases almost places it in a new light before the mind.
When we consider that Laroche has written, on yellow-
fever, a monograph of fourteen hundred octavo pages,
and left the subject with abundant room for the work¬
ing of others, it will be seen, that the knowledge yet to
be gained of diseases, now somewhat understood, is much
more than the knowledge we already have of them.
But the discovery of new facts, and the welding together
of old ones by their aid, so as to show the relation and
dependence of the whole, is a process by which old and
scattered material, with the help of the new, becomes a
new structure. The frequent discovery by pathologists
of small sacks or cysts (cysticercus celhdosce) in various
parts of the human body, as the liver, brain, eye, kid¬
neys, &c., containing together with serum a rudimentary
form of animal life, was a puzzle to them for many cen¬
turies. It was also known that man was sometimes in-
 8

fested with various kinds of entozoa, among which was

the tcenia solium. This subject lias received much atten¬
tion, and Kuchenmcister shows us that each one of these
cysts contains a tape-worm in a rudimentary form. If
the flesh of an animal containing these cysts is eaten, and
one of them enters the stomach undestroyed by cooking,
the head and neck (scolex) of the young tcenia, which
projects in an inverted fashion into the interior, is digested
or broken away. The head, being liberated, everts itself
through its hollow neck ; and, by means of four suckers
and a double circle of hooks with which it is armed, it
attaches itself to the mucous membrane of the intes¬
tines, and, firmly adhering, commences its growth. Seg¬
ments or joints begin to be developed from the neck, and
the first formed joints are always pushed farther and
farther downwards by those more recently formed. Thus
the joints farthest from the head are the most mature;
and, when they are ripe, freighted with thousands of very
minute eggs, they break off, and are expelled from the
body. Upon finding a lodgment on grass or fruit, or on
falling into water, they burst; and the eggs, dispersed
through the water, may be eaten or drunk by animals,
especially by swine. In the stomach of these animals,
the egg-shell gives way, and the embryo or minute glob¬
ular vesicle, armed with six microscopic booklets, makes
its escape. By means of these booklets, it seems to
penetrate the tissue of the intestines, and either actively
works its way, or is passively conveyed by the circulation
to its final resting-place in the muscular tissue. When
many of these eggs are eaten by a hog, and the vesicles
proceed as just stated, its flesh appears as though it
 9

were thickly filled with hailstones, and is known as measly

pork. Each one of these lumps is capable of growing
into a cyst, and contains the rudimentary tape-worm, in¬
capable of further development or change during the life
of the animal in which it is imbedded ; but, on the death
of the animal, it may go the round of metamorphosis
just described.
To prove that the taenia solium is developed from the
cysticercus celluloses, Kiichenmeister performed a crucial
experiment on a criminal condemned to death: he ad¬
ministered, during three days of his life, seventy-five cysti-
cerci. On dissection, forty-eight hours after execution,
he found ten young tesnies in the intestines, six of which
were destitute of their hooks; but the remaining four
were attached by them to the mucous membrane.
To prove that the cysticercus celluloses is produced
from the egg of the taenia solium, some pigs were fed
with segments of tape-worm, and subsequently killed.
The flesh was found filled with the cysticerci, in differ¬
ent stages of development, from the first commencement
to the perfect formation, in proportion to the amount
eaten and the time which had elapsed; while a pig of
the same litter, not so fed, was entirely free from this
formation.* Thus from experiments, simple in them¬
selves, but direct and conclusive, scattered and hitherto
inexplicable phenomena were brought into connected
relations; and the riddle was solved.
Beside this striking illustration of the complete eluci¬
dation of a previously obscure subject, there are many

* See British Journalof Homoeopathy, vol. xvi. page 81. Also Kuchenmeister’s
Manual of Animal and Vegetable Parasites.
2
 10

others that would illustrate this point; and still others

which only partially serve to do this, because we lack
some of the connections of the facts; and, lastly, there
are a large number of facts not yet understood or classi¬
fied. Of the first, the relation between the accirus scabiei
and the itch is a well-marked example. So the direct
relation between apoplexy and the thrombus that oc¬
cludes a small artery, thus cutting off the nourishment
from a small portion of the brain, causing it to soften
and become disorganized, and into which the blood is
injected from the bursting of a neighboring blood-vessel,
may be taken as an additional illustration.
The relation between lenticular cataract and diabetes
mellitus, and also the connection of a saccharine condi¬
tion of the blood with amaurosis, have not yet been so
established in the different steps as to be more than
presumptive truths. But the wide field that opens be¬
yond, containing the vast number of facts which as yet
have no intelligent interpretation, shows that much
remains to be done. Cancer is a most fearful example
of this kind. Through all the ages, cancer has been
known as a fact; but how it is produced no one has yet
been able to tell, and its cure is as much beyond man's
reach as a true knowledge of it is beyond his under¬
standing. Tubercle is another example of a medical
fact that is known most intimately in its course and
termination, but whose remote as well as immediate
cause, and also its cure, are still unknown.
Similar statements might be made with regard to our
ignorance of the cause and successive steps in the pro¬
duction of, or ability to cure, a large number of diseases.
 11

An analysis of certain phenomena, before classified

together, has occasionally shown, that what is often de¬
scribed as one disease was made up of elements having
general symptoms common to several different diseases.
Thus facts, already the common property of the profes¬
sion, have, from time to time, had more true assignment
of place, separating and re-arranging, according to the
best knowledge of the time. Each year witnesses the
bursting of some bundle of phenomena, whose separated
elements are thenceforth to walk abroad in the arena
of the mind in their own distinctness of individuality.
The limit to this process no one can now foresee. Thus
the various phenomena formerly denominated typhus or
typhoid fever have now come to be separated. A por¬
tion of the symptoms formerly , so classified are now
known to be produced by certain diseases of the brain.
Another portion are arranged under the head of pyaemia,
or the poisoning of the blood by the absorption of pus,
or other product of disease. The liver sometimes fails
to separate certain waste matters from the blood; and
the blood, in its journey through the system, carries the
noxious matter to remotest parts, producing a series of
phenomena closely resembling those just mentioned.
A saccharine condition of the blood, in an acute form,
produces similar symptoms. There can be little doubt,
that other organic changes or faults may produce symp¬
toms of a like nature, especially derangements of the
excretory organs of the body, of which the liver and kid¬
neys are the most important.
When other derangements, now studied as typhus,
are fully investigated, and placed in their proper dis-
tinct classification, each such separation becomes not
only a case of correct observation in medicine, but is
itself a help to further advancement in the same direc¬
tion. After all the cases that possess a marked distinct¬
ness have been separated, there would still be left the
peculiar gastric and intestinal catarrh, the progressive
stages of which mark the simple, uncomplicated develop¬
ment of the typhus or typhoid fever; and this disease
by itself has abundant claim on our study and labor, ere
it shall be wholly amenable to medical efforts.
Through the whole range of disease, the same sepa¬
rating process goes on. A close and individual study
of those affections of the internal organs, that have
always been enveloped in some obscurity, has opened
distinctions where only a mass of disease was seen before.
Within the life of three generations, the entire system
of the physical examinations of the organs of the chest,
of the stomach and abdomen, of the generative and
urinary organs, by physical signs in the living body, has
been made. By rules already established, and made
applicable to the different parts of the body, their patho¬
logical condition is often determined with a great degree
of certainty before the anatomist has done his office. By
such examination, and the disclosure of the particular
organ and tissue that is affected, the exact nature of the
disease is laid open to the mind.- What was formerly
classified as consumption is now separated into several
affections of the organs of the chest. Though each of
these distinct affections is understood and recognized,
consumption is still to be met with as before, the
“ opprobrium medicorum.” Nevertheless, until con-
 13

sumption can be ranked among- curable diseases, there is

much gain to the race in rescuing those who seem to
have consumption, but have not, from the doom their
former classification pronounced upon them.
The division which has taken place in the disease for¬
merly called dyspepsia may be considered quite illustra¬
tive of this point. The time was when almost all the
long-standing and obstinate diseases of the stomach and
bowels were studied and treated under the name of dys¬
pepsia. This big bundle of ailments got the respects of
the doctor in the gross. In fact, it was the most com¬
mon custom for the M.D.s to load and fire off the full
weight of the college wisdom at the name itself, leaving
the poor victim with his acidity, cardialgia, or colic,
wholly uncured.
For a generalization of still more undetermined ail¬
ments, the term scrofula has served its day. In the
language of a medical writer to his fellow-doctors, it was
made a sort of big bag, into which were pitched all
the obscure and endless ailments that the faculty cohid
neither understand nor cure, it is to be hoped, that many
of these diseased conditions are, or at some future time
will be, understood, arranged according to their real qual¬
ities, and cured, to the credit of the profession and the
comfort of the race.
The result of this process of analysis and separation
has been in all such cases, that the extraneous matter
which has been thrown off has left the unencumbered
disease standing in clearer outline, easier to be under¬
stood, and all the more likely to be mastered. This,
as well as the bringing together of apparently dissimilar
 14

phenomena, and pointing out their common origin and

relation, has helped to reconcile seeming contradictions,
and to lead on to greater improvements of the science.
The gathering of new facts, and the careful observa¬
tion of those already known so as to establish the rela¬
tion that belongs to each respectively, is among the
highest attainments of a good observer. Many facts
with regard to electricity were known to the world
before the time of Franklin and his contemporaries.
Franklin, in the Divine Providence, was led to gather
them in his mind; and then to observe, and by experi¬
ment learn, new facts, which served as links to establish
the relation, and mark the unity, of the whole pheno¬
mena. So too, no doubt, such facts as Jenner observed,
and which were made by him to show the connection
between grease in the horse and the small-pox, had been
seen for centuries; but none before had been able to
bring them into their true relations, and evolve their use.
So the method of the action of medicine in the cure of
disease had been observed as isolated facts for a long
period before the time of Hahnemann ; but it remained
for him to gather up the fragments, scattered through
the record, and, like Franklin, to forge the links that
formed the chain into a priceless whole. This was one
of the grandest examples of correct observation in medi¬
cine that the world has seen. It involved the gathering
of old facts for their proper classification, and the obser¬
vation of new ones direct from the hand of nature.
The parallelism between Franklin and Hahnemann as
correct observers, and as to the treatment they received at
the hands of the men of their time, is somewhat remark-
 15

ible. Franklin published his facts and experiments to the

world, showing that it was the same fluid evolved by the
electrical machine, and by the clouds as lightning.
Learned societies wrote volumes to show that Franklin
was wrong. His theories were reasoned upon: mathe¬
matics were brought to show that his facts and theories
were not true. The only reply Franklin would give,
was, “ Let them repeat my experiments.” So Hahne¬
mann gave to the world his facts and experiments with
regard to the law of cure, similia simUibus curantur.
The learned societies go on to this day" reasoning about
Hahnemann’s statement, and showing by mathematical
demonstration that his facts and conclusions are wrong,
giving an example of a method of observation not
worthy of imitation.
How could the facts given by Franklin be measured
or verified, except by the repetition of the only experi¬
ments that could have any bearing on the question ?
And how can the facts dependent upon the truth of
the homoeopathic law be determined, except by experi¬
ments competent to settle such questions'? What
amount of reasoning could have answered the question
as to the prophylactic power against small-pox of the
smallest part of a drop of matter taken from a cow
with a given disease? Volumes could be written against
the probability of it. The weight of the matter as
against the weight of the man would tax the mathe¬
maticians, and the difference^ would be so much that the
thing would be shown to be absurd. And then, again,
a child might swallow many times as much, and not die.
Under like rules, in another way, Hahnemann’s great
 16

discovery is attempted to be brought. Ilis facts are met

by fancies, and his deductions by reasonings upon other
subjects wholly inapplicable to the question in hand.
The result of doing for JIahnemann what Franklin in¬
vited his contemporaries to do for him, in repeating his
experiments, is presented you to-day in the life of the
thousands of homoeopathic physicians scattered over the
world. Each one of them has, more or less perfectly,
measured the facts and deductions given by Hahnemann
with the only measure that can come near the question,
and has judged from the only basis that can lead to just
conclusions. Each one stands before the world, having
many times repeated the experiments directed by Hahne¬
mann, and witnessed their verification. To each one, the
conviction of the truth of the homoeopathic law grows
stronger year by year. Each one knows also, that the
application of the law is not always well accomplished ;
and, when it is not, it must fail of its good fruit. But,
of this, more further on.

How can the principles already set forth in this address

be made useful to us in the practice of medicine accord¬
ing to the homoeopathic law ? Hr. Scott, in a Prize
Essay awarded by the Parisian Homoeopathic Society, in
1848, announces the doctrine that the homoeopathic law
is a law of cure, and not a law of disease ; and hence that
its application is in no way influenced by the pathologi¬
cal theories of any succeeding time. This idea, clearly
stated by Hahnemann, receives a masterly treatment at
the hand of Hr. Scott; and the doctrine seems to have
passed into a fixed form in the mind of the homoeopathic
 17

world. The confirmations of it are strong, as the point¬

ing out, by Hahnemann, the remedies for the treatment
of typhus fever, epidemic among the opposing armies
of his day, as well as the treatment of Asiatic cholera;
and, in both these fearful diseases, the successful course
was marked out without seeing a single case.
Of course, the pathology was only studied mentally:
no post mortem had given its light to him. This is
fully admitted, as also that Hahnemann had a most mar¬
vellous success in his own practice: still there is another
side to the question. All minds do not resolve the mass
of symptoms presented in disease into their original ele¬
ments, and recombine them in their natural order with
the rapidity so easy to Hahnemann. And he was not
always successful in this work; for he sometimes treated
cases without success, that were easily cured by other
methods. There are many men among us, who possess
the power of such rapid analysis and understanding of
cases of disease, that they seem to be hardly conscious
of the steps in the process by which their conclusions are
reached. Such men sometimes talk of symptoms, much
after the fashion set forth by Dr. Scott; but the less gifted
plodders admire more than they follow. But these men
go swimmingly on only so far as their powers extend.
The incurable diseases are still incurable to them as to
us below them.
That Hahnemann made a mental analysis of the phe¬
nomena presented in each case of disease, so far as he
could, we may be sure from his own writings. He tells us
to “ select a remedy that presents the most accurate pic¬
ture of the disease; ’’ and again, that “ the remedy should
3
 18

correspond to the most important symptoms of the dis¬

ease.” How can we form an accurate picture of a disease
in the mind, while we have no knowledge of the relation
of the different phenomena, as to which is cause and
which effect? And, again, disease is not always a unit,
but may have more than one focus: there may he more
than one point of departure from health. Thus one may
have pulmonary consumption and contract small-pox, or
a person with cancer may have Asiatic cholera: in fact,
there are many diseases to which man is liable that are
not affected by the presence of other disease in the sys¬
tem at the same time. In such case, no correct picture
of the disease can be formed, without separating, in the
mind, those symptoms that are proper to the disease
from those that are accidental to it. To do this, a correct
understanding of what belongs to each is necessary.
Such an understanding is reached only through a good
knowledge of the history of each disease and its acci¬
dents. Those diseases that are not understood can be
approached, but not mastered.
A correct theory with regard to any disease puts the
phenomena of the disease before the mind in their nat¬
ural order, so that each symptom finds its proper place ;
one as cause, others as successive steps, and others as
the legitimate fruit of all which has preceded. So also
in the presentation of any case to the mind that does
uot easily find a nosological arrangement: if the proper
relations of the symptoms can be understood, the value
of each will be known, and each assigned its place in
the selection of the remedy. In no other way is there
any certainty that accidental will not take the place of
 19

essential things, or that ailments from long-standing dis¬

ease will not be mixed with the symptoms of an acute
affection. But by such an understanding of each dis¬
eased action, both as to its external symptoms and its
essential nature, each symptom is weighed in the balance
of the mind, and receives that attention which its im¬
portance demands.
A successful prosecution of correct observation in
medicine leads us, then, to the cultivation and acquisition
of accurate knowledge concerning the history of all dis¬
eases which will bear a nosological arrangement, in order
that our minds may be stored with such knowledge as
will enable us to meet and minister to all the forms that
claim our offices. And when such knowledge is attained,
in some good measure, it requires of us also to approach
each case of diseased action reverently, that its interior
workings may open to our minds, and that thus we may be
able to analyze the case by itself, putting each part men¬
tally in its proper place, and making up an equation that
belongs to that case alone. Thus will the spell of names
be broken. The nosological arrangement will be used
as a means to conduct the mind to its work, and bring
the material for the occasion within the working grasp
of the mind; and also as suggestive of the things com¬
mon and proper to different kinds and forms of disease
of a similar nature: but here it will leave the mind to
work its way in the analysis and construction required.
But, if the cause is taken for the effect, or the mind rests
with the name, taking it for granted that all the things
that the name requires are in the case to which it can
be applied, and then a medicine is given only because it
 20

has been known to cure a disease of the same name, we

shall fall away from all observation but the most crude
and ill-digested, and may come, from failure in practice,
to denounce a law that we are too weak or too unfaith¬
ful to use aright.
But this part of our subject is of so much importance
that a few illustrations will be ventured upon. It is told
of Hahnemann, that a man presented himself to be
cured of sycotic warts. Hahnemann talked with the
patient, and gave him some dry powders. The patient
was cured in a short time, and an observing student
inquired of Hahnemann for the remedy: he told him
the symptoms, and referred him to the materia medica to
find it for himself. The student worked faithfully, but
failed, and at last purloined the secret from Hahne¬
mann’s record, when he went to him to know how
Chamomilla could cure sycotic warts: to which Hahne¬
mann replied, “ Do you see those general symptoms ? no
other remedy but Chamomilla produces them. How could
you give any thing else 1 ”
A man of later times relates that he cured a skin-dis¬
ease with a minute dose of Lycopodium. The Lycopo¬
dium was given because it corresponded with the gen¬
eral symptoms. A case of eczema that resisted a long
and careful course of treatment was cured, very rapidly,
with a few doses of Apis mellifica given to remove an
intervening dropsy. I have known most obstinate forms
of eczema cured with Phosphorus, when the corres¬
pondence between the symptoms produced by Phos¬
phorus on the skin and the skin-disease was not accurate;
but this form of skin-disease, and the one produced by
 21 .
Phosphorus, both agreed in being worse in cold, but better
or well in warm weather. So, also, I have seen violent
neuralgia of the face, arising from derangement of the
stomach, repeatedly cured, in the same patient, with An-
timonium crudum, although the patient at the time had
no sign of trouble of the stomach in any way. A true
understanding of the case came from a careful statement
by the patient of the preceding troubles, from which it
was seen that the stomach was the seat of disease, though
not then making any expression of it, except through the
neuralgia.
A little reflection upon these not very wonderful cases
will lead to the conclusion, that in each of them the cure
was accomplished by the exhibition of a medical power
of the exact measure of the diseased action. In the first
case the sycosis was only a symptom thrown out from a
general derangement of the system, and Chamomilla
cured the general derangement. In what that consisted,
the record does not show. The same may be said of the
second case; but here various organic derangements sug¬
gest themselves as forming a part of the general group.
The third case unfolds itself more fully by disclosing a
general derangement in which disease of the kidneys
was a most important element. At first the eczema was
kept up by certain uric acid salts, which were thrown
upon the skin, instead of their usual elimination by the
kidneys. A further extension of the kidney disease pro¬
duced the dropsy, which first brought the kidney affection
to notice, and determined the selection of the right rem¬
edy. The fourth case would have a similar interpreta-
I

tion with a slight difference. Cold, on some persons,

 . 22

without impairing the general activity, produces a de¬

rangement of the kidneys, by which a minute portion of
waste matter of a peculiar kind would be regained in the
system, which, on being determined to the skin, may
produce eczema. Phosphorus cured, because it corres¬
ponded to the various steps, stages, and degrees of the
process. The neuralgia and stomach trouble needs little
comment, except to say, that it illustrates a large class
of cases in which the real seat of the disease is at a wide
range from its expression; and also the principle that
the originating point should in all cases be most dili¬
gently sought, as of most vital importance to be under¬
stood, not only with serious and malignant diseases, but
also with more simple affections.
But, to illustrate in a general way, we will take scarla¬
tina, cured by Hahnemann with Belladonna, and suppose
the elements that entered into it could be represented by
the letters A, B, C, and 1). Inquiry into a case that
presents for consideration to-day may show that it has
the elements A, B, C, and D; and also another added,
not common to the comparing standard, debility, repre¬
sented by E., and to which Belladonna did not corres¬
pond. A careful investigation might show, that the
demands of the new combination of symptoms would be
met by Arsenicum, which had the new element, as well
as, in a good measure, the old combination. So, in other
cases, any extent of variation would be measured and
provided for; furthermore, any case may have certain ele¬
ments to-day that may be met with an appropriate power,
but to-morrow other elements may be added, or some
taken away, in each of which cases, each day must have
 23

its proper selection of remedy, or else it is the old work

of the routinist, applying a remedy of one name to a
disease of another name, without a careful investigation
of the nature of either.
This use of the homoeopathic law is both intelligent
and accurate. It is thus that each case comes to be
treated by itself, yet it has the converging influence of
the light from the past resting upon it, while all the
truths of the present are doing their best offices for the
work in hand.
The science of medicine, in such a view, is a subject
of very great magnitude. Man contains within himself
elements drawn from all the kingdoms of nature. All
the sciences go out from man, and return to him. All
minister to his use, as all in some way contribute to his
physical well-being. Each of the various substances that
enter into the human body, when without the body, have
their peculiar science and classification. A correct un¬
derstanding of man, physically, leads to an acquisition of
a good measure of knowledge of all these sciences.
Man is first to be studied in his normal state. All his
physical anatomy is to be exhibited to the eye of the
body, and all the vital operations of each and every part
are to be laid open to the eye of the mind. This, in its
fulness, is man in health. And, as opposed to its mani¬
fold harmonies, we have each and all its parts acting in
discordant and jarring ways; the story of all which is
found (as far as written) in the history of disease. The
breadth of this history has already been hinted at; and
we may add, that a well-digested understanding of it
demands some knowledge of all the sciences, and that
 24

even with such collateral helps disease will still present

such an amount of matter to be mastered as may well
stagger the stoutest courage. Under the pressure ol
such feelings, many men divide off their work, and
confine themselves to the investigation of some single
branch of the science, or to the understanding of some
single disease.
But notwithstanding the whole domain of science
underlies that of medicine, sustaining and nurturing it;
and the vastness of the range of thought, to which this
view invites the mind, makes the science of medicine
seem as insurmountable as the highest mountain tops,
and often as rugged and pathless, — yet patient toil has
discovered an opening pathway, or planted pilgrim rest¬
ing-places well up the craggy sides.
The best knowledge of medicine, the truest theories of
disease that our age affords, are but idle tools to the
mind till brought into use in the cure of disease. The
practical result always seems easy, when only the clear
truths stand before us; but, when brought down to their
application, difficulties often stand in the way of success.
We do not always get a correct statement of the facts
that belong to the case in hand: some misjudged notion
leads the patient and friends to mistake the case, giving
symptoms that do not belong to it, or withholding impor¬
tant facts for some supposed good end; and thus the
physician is misled by others. Or, again, the fault is
with the physician, who approaches the case with some
favorite theory in his mind, and, in hunting for mate¬
rial to confirm and strengthen it, collects his facts
and arranges them according to his peculiar wishes in-
 25

stead of according to their natural order, and thus mis¬

leads himself. Sometimes observations are taken from
some angular points, or from a wrong position with
relation to the facts: so a false picture is taken; and
all will bear me witness of the difficulty of throwing
off' a wrong impression, or ridding the mind of a false
picture of a case of disease, whether coming from any of
these, or from other causes.
We sometimes fail because we cannot command ne¬
cessary conditions ; and, again, because, after the disease
is rightly observed and understood, the right remedy lies
hidden in the bosom of the earth, or blooming in some
far-off wilderness.
13ut, with all these deductions, the progress of our
school of medicine is steadily on, year by year winning
its way to the favor of the people by its practical good
fruit.
Within the homoeopathic ranks are several divisions
or separate schools, who approach the law of cure from
different directions, and operate it in different ways. One
division looks to Hahnemann, and attempts to distil from
him and his Organon all the medical wisdom that the
world needs. Others take the law of cure to be true,
but attempt to tax all collateral and subsidiary helps,
turning them towards the law of cure, that, by enlarging
and deepening its foundations, and building a symmetrical
and normal structure upon it, the law may gradually
assert its conquering march over all the field of disease.
To the same end, other sections are working, but in an¬
other way. Theirs it is to command the power to estab¬
lish the similimum, under the law, in each case in hand,
4
 26

supposing that its broad mantle is already unfolded to the

widest demands of all human want. The end with both
is the same; namely, the more rapid and sure cure of
disease. To this common end may we all aim, leaving
each free to pursue the path that seems good to him,
only hoping that each will contribute his part to Correct
Observation in Medicine!