BY AD. LIPPE, M. D., PHILADELPHIA, PA.

J'ai explore le coeur et les poumons avec le plus grand soin et j'ai constate ucune lesion organique.

Le coeur en particular est bien conforme, d'un Volume ordinaire et les valouses sont intactes. Ce qui existe chez M. le consultant c'est un appouvrissement du sang (chloro-anemia) et un erethisme nervue tres prononce a forme hypochondriaque.

Puisque M. le rend a Nice je l' engage a prendre les bains de mer pendant le mois d' Octobre, le regime substantial est absolument necessaire.

Tous les matins un petit verre de vin de Bugeaud (vin de quinquina et cacao).

Davant chaque repas, trois dragees de lactate de fer, exercises suffisant du corps et distractions.

PARIS, 30 September, 1862. B.

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I have examined the heart and lungs with the greatest care and I have found no organic lesion. The heart particularly is very perfect, of ordinary volume and the valves perfect.

What exists in the patient is an impoverished state of the blood (chloroanemie) nervous erethism, very much in the form of hypochondriasis. Inasmuch as the patient is going to Nice, I advise him to take the sea-bath during the months of October.

A substantial diet is essentially necessary. Every morning a small wine glass full of Bujeaud (the wine of Peruvian Bark and Cocoa). Before each meal three grains of Ferrum lacticum, sufficient exercise of the body and diversion of the mind.

PARIS, September 30th, 1862.

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The patient who obtained the above medical opinion had been under my care for more than ten years. He is about forty years of age. For many years he had been excessively engaged mentally and physically, he had generally taken his meals at irregular hours and then insufficiently and in great haste, he had lost much sleep and gradually began to complain at first, two years ago, of frequent inclination to sigh, then later of attacks of palpitation of the heart; his breathing became much impaired; when walking fast or when ascending any height he felt a fullness about the heart, pains in the heart; he had attacks of dizziness with fainting, entire prostration, intermittent pulse, a hacking cough, great sensation of numbness in the left arm and finally much loss of flesh and strength. His mental occupations tried him more and more, and while the remedies administered from time to time relieved him, it was thought indispensably necessary that he should leave his occupation and go abroad. Aconit., Pulsatilla, Lachesis, Natrum mur., Plumbum and Rhus had given him most relief, and when he left here there was no doubt that the hypertrophy had diminished. He improved as soon as he left home in June, 1862, was far less sea sick then on former sea voyages and gained in every respect. In October he suffered from palpitation of the heart more than for some time past, he took Lachesis and went to Paris to have another examination of his heart made so as to form a plan for the winter. The above medical opinion of an allopathic celebrity at Paris along with his advice of treatment were then obtained.

The celebrated Dr. B. gives a very flattering account of the condition of the patient's heart, and his no doubt well merited reputation as a skillful and experienced auscultator warrants fully the belief in the correctness of the report.

But now for his diagnosis. “An empoverished state of the blood.” When the previous condition of the heart came under consideration while diagnosticating this case, the auscultation and percussion had shown a different condition. The patient was carefully examined on the second day of October, 1861, and at that time the left side of the thorax was found to be considerably larger than the right side. The apex of the heart could not be found, but percussion showed the heart sound, to extend over a much larger space than usual. The rhythm was irregular and the beats of the heart were labored. A later examination in March, 1862, showed a much better condition of the heart. The apex of the heart was then found, the heart sound extending over a smaller space than it did on the former examination, the rhythm was more regular and the heart beat less labored. On both examinations the valves appeared to be in a healthy condition. For the sake of argument let us agree with Dr. B., that when he examined the patient, his heart was perfect and he suffered only from an impoverished state of the blood. The patient had until then been treated homoeopathically, and was now going to Nice. He was advised to take sea-baths in the month of October. The sea-bath is far more of a remedial agent than is ordinarily believed, and might in this case become beneficial provided a remedy became necessary for the full restoration of the patient's health. We fully agree that the substantial diet is essentially necessary, but now comes proof “that the allopathic practice in 1862 is not progressive.”

The doctor includes in the substantial diet, every morning a small wine-glass of Bujeaud (the wine of China off. and Cocoa) and before each meal three grains of Ferrum lac. Here we find in the first place two medicines ordered in alternation — a vital error in all schools of medicine. If the condition of the patient required China off., that same condition could not require Ferrum and vice versa. Under alternation of medicines I understand the administration of two or more medicines at intervals determined upon a priori. Such alternations are contrary to common reasoning. Two medicines can not be given for one and the same individual case, and how can any possible good result from giving one medicine in the morning and another through the day; and while the alternation of all medicines is objectionable, the alternation of nearly related medicines, and on that account antidotes to each other, is certainly not at all admissible. This is one of the great errors only to be corrected by a patient investigation and adoption of Homoeopathy. The alternate administration of China and Ferrum are as absurd as the former concoction of many medicines into one prescription. The great question Homoeopathy asks is,“ does there exist for each individual case one individual specific curative medicine?” Experience has taught Homoeopathy to answer this question in the affirmative. All Homoeopathists ask the question, “does there exist for each disease some specific medicines which in alternation or combination cure?” Experience has answered this question in the negative. But there still exist some physicians who pretentiously call themselves Homoeopathists who have never asked themselves the former true homoeopathic questions, and who contend that each case of disease is best treated by alternate remedies. To show them their errors I here take up the case in point, and call their attention to the differences between the medical properties and curative powers of China and Ferrum; they will perceive that both medicines are singularly similar in their effects and that they are at the same time singularly different, so that it is utterly impossible ever to remain long in doubt which of the two to give in a given case.

China and Ferrum have both great debility. The debility of China is caused by loss of fluids, and accompanied by over-sensitiveness of the senses and great nervousness, with great tendency to perspire. The debility of Ferrum causes one to feel as if he was paralyzed, accompanied by great restlessness in the limbs. China has pains which are caused and much aggravated by contact (touch). Ferrum has all its pains and disorders aggravated by rest and relieved by slow motion. China causes a yellow skin. Ferrum a dirty earthy color of the skin.

China causes great drowsiness during the day while sitting and after meals; and while asleep delirium.

Ferrum causes great desire to sleep from debility and without the ability to sleep.

China has a small, quick and hard pulse.

Ferrum has a full and hard pulse.

Both have heat with inclination to throw off the covering, but the heat of Ferrum is always accompanied by a dry skin. Both have a great tendency to cause perspiration. The Chin. perspiration is often greasy, while Ferrum causes perspiration mostly during sleep and during motion.

China has much chilliness with thirst but aggravation from drinking. Ferrum has coldness from want of animal heat. The intermittent fever of China is characterized by almost entire absence of thirst, and if any thirst is present it is before and after the chill and during the perspiration. Ferrum has great ebullitions of the blood which China has not, and the intermittent fever of Ferrum (consequent upon the abuse of Cinchona) is characterized by congestions to the head, by a bloated appearance of the face and a distended abdomen. Both have congestion of blood to the head but Ferrum has more distended veins which China has not.

The China headache is pressive, with sleeplessness aggravated by the least touch and caused by the least draught of air.

Ferrum has a hammering, pulsating headache.

The China headache is mostly in the temples, while that of Ferrum is mostly in the sinciput.

Both have bleeding of the nose, the blood of China is pale while Ferrum has coagulated blood in the nose.

Both have pale and earthy color of the face, but Ferrum has also red spots on the cheeks or bloatedness of the face and around the eyes, or fiery hot red face.

China has dry cracked black lips, while Ferrum has dry pale lips.

Both have want of appetite. China has a longing for something but does not know what it really wants, or a desire for acid fruit, while Ferrum has an aversion to sour things and meat.

The thirst, if any of China, is quenched by small quantities of water, while Ferrum has unquenchable thirst. China has bitter taste of food and drink while Ferrum has the taste so altered that every thing appears to be dry.

Ferrum has vomiting of food after eating which China has not. Both have diarrhea of undigested food or watery.

China has the diarrhea of undigested food mostly at night, and Ferrum soon after eating. China has watery diarrhea which looks yellowish, that of Ferrum is accompanied by burning in the anus. The diarrhea of China is mostly painless and often cured by eating fruit.

Both have profuse menstruation, but China has black clots which Ferrum has not.

Both have leucorrhea, that of China is serous, bloody or purulent, that of Ferrum white often acrid.

They differ mostly in their mental symptoms, and these will often at once decide which of the two medicines is indicated.

In China prevails hopelessness, indifference, sadness and peevishness, while in Ferrum irritability and variableness prevails.

But the advocates of alternate doses contend that they cure; so contend the blind Allopathists, but the question is the aggregate number of cures and the time in which the cure is brought about; that question when fully answered by statistics will show a vast superiority of true Homoeopathy. The alternators often resort to a practical question when their practice is assailed, such as this: “how can the only specific curative remedy be found in a case as this — say a child has diarrhea discharges green — and fever — there they (the alternators) say Chamomilla must be given for the green stools and Aconite for the fever. It is in exactly such cases that Homoeopathy cures quickly and the patient may slowly recover under this alternative treatment, especially when Chamomilla was really the true remedy. But such descriptions of diseases are as faulty as the prescription. The true Homoeopathist will make enquiry whether that child with green stools has pains before, during, or after the evacuations, how it demonstrates the pains, at what time of the day the stools are most frequent, and if, for instance, the green evacuations are more frequent in the morning hours, and the child then strains much, the case would likely be cured by Podophyllum, and neither Chamomilla nor Aconite nor both in alternation or combination would cure; the fever, if such was present, would yield under the above symptoms to Podophyllum without Aconite. But if the child with the green stools is extremely restless at all times, but worse at night, if it wants to be carried and will not lie at all, if the pains are very violent before each evacuation, if the abdomen is bloated, if the child has much fever with thirst, and especially if this fever manifests itself by one burning hot red cheek; if the child can not sleep, or when falling into a slumber starts up at once and then cries violently and is not at all to be pacified till it is carried about, then one dose of Chamomilla, in the proper potency, will be the only specific curative remedy. The green stools by themselves are as much an indication for Chamomilla as the fever is an indication for Aconite. Green stools are as often cured by Phos., Pod., Puls., Sulph., Dulc., Phos. acid, Stann, or Ver. as by Cham., and the fever alone is never an indication of Acon.

I might go on, ad infinitum, and show the necessity to obtain at first an accurate picture of a given case and not the name of a disease, and then show that Homoeopathy claims to possess for each individual case one individually specific curative remedy, with the proviso that because the homoeopathic Materia Medica is not yet finished, and while we feel the necessity of new provings and reprovings, the case may occur that one remedy does not prove sufficiently curative, and that yet a succession of remedies may become necessary, indicated by the changing condition of the case; but as new provings and reprovings of medicines are improving our Materia Medica, these successions of medicines will become less often necessary: While this succession of medicines is yet excusable, alternation or combination can never be admitted as homoeopathic practice.

But let us go back to the diagnosis — “the impoverished state of the blood.” In the modern physiological school, the great exponent of which is Prof. Virchow, we find him to say “disturbances in the components of the blood can be equalized in various ways; yet the means to accomplish this equalization are found not as much in the blood as in the various organs with which it stands in reciprocity, therefore mostly in the glands.” Then we ask, according to the physiological school are Ferrum and China the required tonics?

If the diagnosis is correct that the impoverished condition of the blood was solely owing to a want of iron in the blood, then the first question would be, how came it that the iron, the necessary component of our organism was no longer furnished to the system of the patient in the usual manner by food? And again if the supposed absence of iron alone caused this impoverished condition of the blood, was it advisable to supply to this by introducing into the stomach the absent metal in the form of the lactate of iron, would it not be more rational, according to the physiological. school, to supply this want by nourishment containing more iron than the nourishment formerly taken?

The want of iron in the blood can have but three principal causes. It is either not supplied by the ordinary means, the nourishment — food — or the iron taken in the food fails to be assimilated, or the secretion of the iron from the organism through the liver (and spleen) is in the excess of the supply, but in neither case can the supply of iron into the stomach cause a healthy equalization of supply, assimilation or secretion. As a palliative it may for a short time serve to deceive the patient and give him false hopes of returning health.

Virchow further contends, “it was a great error that medicines necessarily existed for diseases, either the disease was to be cured by one remedy or there were medicines wanted for the various stages of the disease. Only the better physicians of all times became convinced that it was proper to administer the same remedy for similar conditions in, various diseases, and for different conditions of the same disease different medicines. The disease does not indicate the remedy, but the condition. It is the question to know under what condition of a certain disease a certain remedy has to be chosen.”

Dr. B.'s choice of the remedies was for the supposed disease, a supposed want of iron in the impoverished blood, which being only a supposed condition, therefore was an error according to his own school, not to mention the alternation of Cinchona and Iron.

The doctor advises three grains of lactate of iron to be taken before each meal.

Dr. Bell, an English allopathic physician of note, contends that all medicines, but especially metals, should be administered in a very diluted condition and to prove his position gives as facts, that the absorption is principally regulated by the organic want and it is for that reason that inorganic substances are received in the organism only in very small quantities. The best example he says is Ferrum. The most efficient for chlorotic anaemic conditions are the natural Iron Springs, and the strongest of them contain only one grain of iron in eighteen ounces of water.

What conceivable indications Dr. B. had when he advised, in addition to nine grains of Ferrum lac. daily, the use also of wine of Cinchona, is impossible to imagine. If in this case the doctor knew that Andral and Gavarret say that the quantity of the volume of blood globules often becomes reduced from the proportion of 133 to 48, and that the blood globules increase in quantity from the day that Ferrum is administered, and when in this case the doctor thought that the impoverished condition of the blood and the diminished quantity of the volume of the blood globules constituted the disease, and that iron would increase the quantity, he certainly had no such reasons for advising the morning draught of Vinum Cinchonae. The logic that because Andral and Gavarret observed, that after the administration of iron in cases where the quantity of the volume of blood globules had become reduced the blood globules at once increased in quantity, now in a case of sickness where it was supposed that the same condition prevailed, iron would and should also restore health, constitutes one of the fallacies of Allopathy. Even should iron for a time have the effect of increasing the quantity of blood globules, does it follow that by that phenomena the re-establishment is learned?

Again, has iron no other effect on the organism than to increase the quantity of blood globules, and what does the doctor think becomes of the nine grains of iron daily administered, and which nine grains are not needed for, nor can possibly be converted into, new blood globules, and if these nine grains have to be continued to be administered for ninety days, what will then become of the excess of iron and of the liver (and spleen) which will have to make prodigious efforts to export said excess?

It becomes evident that the allopathic practice has not been progressive in 1862. Whether the patient so advised took the Iron and Cinchona I have not learned, but as I did learn that his health is steadily improving, I am sure he did neither take the Iron nor the Cinchona.