BY W. P. BAIRD, M. D., EVANSVILLE, IND.

In the majority report of the Central Bureau of the Materia Medica, it is recommended “that each prover who makes use of potencies in the provings, should make the trial with high potencies, afterward if necessary in his particular case proceeding to the lower dilutions and triturations, and even taking the crude substance and tincture if satisfactory results are not obtained with the attenuations.” In the same report it is also asserted that “although the subject of provings has been so ably reported upon by a former member of this Bureau, it is very much to be regretted that many of the reported provings are so imperfect as to be nearly useless.” The reason these provings are nearly useless, the Committee think, is because they are imperfect. Provers have not observed sufficient care in describing and locating the various symptoms elicited from the drug, while the attending circumstances, as age, temperament habit, constitutional peculiarities, &c.,, have almost in all instances been overlooked or disregarded.

That the foregoing may be one reason of the want of success which has attended the efforts of the physicians, when they have administered medicines which from the symptoms were peculiarity indicated, I think no one will deny. But this is far from being the only reason. Very many of our drug provings are imperfect, and therefore, useless; not so much from the desultory manner in which the symptoms are described, as from the circumstances that the provings themselves are often imperfect. The drugs have not been taken in sufficiently large doses to render the symptomatic as well as pathogenetic phenomena clear and decisive. We must know accurately not only the symptoms, but also the lesion of structure which the drug will effect, and the nature and character of that lesion. We must know the primary and secondary effects of the drug.

In the provings, shall drugs be taken in the higher potencies or in the lower and stronger preparations? Are the symptoms elicited from the potencies as valuable to the physician as those from the crude substance and tincture? Are not the symptoms obtained from the potencies rather calculated to deceive and perplex, than to subserve any useful purpose in our Materia Medica? These are important questions, and merit the thoughtful consideration of every well wisher of our science, for it is evident to every one that our provings, those detailed in our Materia Medica, and used now as our guide to practice, are too voluminous, and contain too much useless matter. Our drug symptomatology needs pruning. There is danger that our Materia Medica, like a thrifty and well-cultivated tree, may require to have the rubbish cleared away, and the supernumery twigs and branches lopped off by skillful hands, in order that it may produce available fruit, or that the fruit may be discerned. Where shall we begin the lopping off process? What shall we remove, what retain? In my opinion the lower dilutions, the crude drugs and tinctures alone should be used in the provings. Now let us see if our opinion is not borne out by facts. We appeal to those drugs the symptoms of which are already familiar to us, and whose curative power when given in a disease manifesting similar symptoms is well known to the profession. Let us for example refer to Tartar emetic. Now the most obvious symptoms of this drug when taken in moderate doses are nausea, vomiting, purging and secretion from the glands and from the bronchial mucous membrane; and it is found to be a most excellent remedy in certain diseases attended with like symptoms. But Tartar emetic would never produce vomiting and purging if token in the potencies, and the only effect would be that of an alterative, giving rise to no well marked symptoms. If this drug was not already proven, how should we find out by infinitesimal provings that it would be a remedy for nausea, purging, vomiting, &c. The same is true of Ipecac. In small doses of the crude drug, according to Dr. Wood, it is stimulant to the stomach, exciting appetite, and facilitating digestion. In larger doses it acts as a nauseant, and in still larger as an emetic and cathartic. But Ipecac is one of our most valued remedies in nausea, vomiting, in diarrhea, dysentery, &c. Opium furnishes a good example of the value of provings from larger doses. It produces profound sleep, a stertorous respiration, a dark suffusion of the countenance, a full, slow, and labored pulse, and an almost total insensibility to external impressions. In our Manuals I find opium recommended in just such conditions, and I can testify to its curative power in such cases. But when given in small doses, it produces no symptoms except those of general excitation of the system. Similar examples will readily suggest themselves.

I do not wish to be understood as ignoring entirely the provings from the potencies, but I do not think they are deserving of as much importance as some are inclined to give them. I have not myself been able to elicit any symptoms, perfectly reliable, from the trial of potencies. It has been a matter of astonishment to me, how so many symptoms could result from the use of a few pellets of the high potencies when I have read their details in the journals.

But I have found very many of these symptoms unreliable in practice, and calculated to perplex the practitioner in his search for the appropriate remedy. This may be obviated, I think, by proving our remedies from medicine doses of the crude substance and tincture.

The following conclusions may then be drawn in respect to provings.

1st. Drugs should be used in the lower preparations, and in moderated doses.

2d. The symptoms should be carefully noted both as to the time of their appearance and general character.

3d. The pathology of the drug, the lesions it causes, and the organs affected, &c., carefully noted.

4th. Drugs should be used for a long time in small doses, and the effect observed.

5th. The chemical change in the blood, as well as in the various excretions.

6th. The influence as to the amount of excretion and secretion produced.

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