[A Lecture delivered at the Homoeopathic College of Pennsylvania, before the class of Oct. 14^th, 1864]

By AD. Lippe, M. D., Philadelphia, P.A.

The characteristic symptoms of Aconite have already been brought before you, and will enable yon to select and administer to advantage this much abused remedy. I will now proceed to caution you against the administration of Aconite and Belladonna in alternation, and I do so, because you will find this alteration recommended in the ordinary books on practice; yon will also find cases recorded in which Aconite was administered in alternation with Belladonna, and when you see practitioners follow this mode of prescribing, giving as a reason, that it has been done by others, and quoting precedents, you might perhaps also fall into the same error. To enable you then to resist this wide-spread mongrelism, and to give your reasons for disapproval, and also to prepare you rationally and understandingly to combat this violation of our principles as well as of the fundamental rules of practice, we will first consider the error of alternating medicines in general, and then show in what particulars Aconite and Belladonna are similar or differ.

The question of alternating medicine has been brought before the profession from time to time, and but very lately an interesting paper “On the Alternation of Medicines” was read before the British Homoeopathic Society by Dr, Drysdale, and published in the September number of the Annals of that society. As the paper expresses the opinion at present pendant among a large majority of the homoeopathic physicians in England, we will here take occasion while considering this subject, to allude to it. The learned author of that paper, Dr. Drysdale, whilst saying that he does not give a preference to the plan of alternation, yet the bulk of said paper treats of the cases in which it is allowable. Without entering more fully on the fundamental ideas of Homoeopathy upon which he bases his conclusions, and without here showing his misconception of Homoeopathy and his false position, or questioning the admissibility of the authorities he quotes, taking the doubtful assertions of Trinks in preference to the sound and long accepted teachings of Hahnemann, we will deal with the question only as it should present itself to us as Homoeopathicians.

The alternation of medicines can occur in two different ways, first an alternation a priori, as for example the prescribing of Aconite and Belladonna in alternation, each remedy to be administered after a specified lapse of time, whether this time is numbered by minutes, hours or days is immaterial, the principle remains the same. Suppose then, that yon are called upon to prescribe for a given case, and are, of course, believed to understand the homoeopathic law of cure, the fundamental principles and practical rules left us by Hahnemann, and, acknowledged as the unerring guide, by all true Homoeopathicians and also to know the effects of the medicines, how can you ever be induced to violate one and all of the practical rules, and by prescribing two medicines in alternation, give evidence of your want of accurate knowledge of the effects of either of them.

One of the great fundamental practical rules is, never to repeat the same remedy or give another medicine until the first dose administered has fully developed and exhausted its effects. A priori this knowledge is not in your possession. One dose of Aconite, for instance may develop and exhaust its effects in six, twelve, or twenty-four hours, or in one, two, three or more days or weeks, and in chronic cases may even act for a longer period of time; the symptoms then, according to which you have selected Aconite, although much diminished may not have entirely disappeared, but still they are certainly yet aconite symptoms, you must then repeat the same remedy Aconite, and probably with better results should a still smaller dose be given than the previous one. On the contrary, should the symptoms according to which you selected Aconite have disappeared, and others have shown themselves, in that case you have to take up a new, careful record of the symptoms, and select another remedy, again waiting for the effects of this second remedy, and neither repeating nor giving a new medicine until its effects are exhausted. This then is the only correct and reliable practice if we are guided by the practical rules. But, say the advocates of alternating medicines, in order that they may set aside these practical rules and the practice based on them, we can prove the correctness of our position by practical and clinical experience. We have cases reported by Dr. Cate [We quote from the Annals, pages 376, 377 and 381.] who brings forward inflammation of the mucous coat of the colon. When it extends to the peritoneal coat of the gut, he gives Mercurius corr. in alternation with Sulphur, corresponding to their specific action on their different tissues. Also in inflammation of the membranes of the brain threatening effusion, he finds Bryonia alternated with Hellebore, more efficacious than either singly. In the analysis of Tessier's Pneumonia. Cases by Dr. Bayes, we find several cases that improved rapidly under alternation of Phosphorus with Bryonia, though the latter alone was not doing as much good as usual. Dr. Drysdale says of Dr. Cate's reported cases, “But this is already recognized in Homoeopathy, without stepping into the doubtful regions of pathology.” If then in the above cases the doubtful regions of pathology do not help us and can not help us to select any curative remedy, how can Homoeopathy recognize such alternation based on nothing else than these acknowledged doubtful regions of pathology? Without in the least calling in question Dr. Cate's superior pathological knowledge and his ability to determine when the inflammation of the mucous coat of the colon extends to the peritoneal coat of the gut, or when the inflammation of the membranes of the brain threaten effusion, and without either calling in question Dr. Cate's superior knowledge of the specific action of remedies on different tissues irrespective of accompanying subjective symptoms; for argument's sake, considering the cases as he gives them, they do not in the least prove the correctness of the practice of alternating medicines. This practice never has been and never can be recognized by Homoeopathy because medicines cannot be selected solely according to pathological indications, and if they could be so selected, no two distinct pathological conditions could be observed on one patient at the same time. Not only do Homoeopathicians treat only the sick and not diseases, but even the progressive allopathic schools have taught this great principle in practice for some time. But will you ask “how then do patients recover under this treatment by alternation? Dr. Drysdale tells us “Upon the two principles - viz, the meeting of complications, and maintaining the susceptibility, rests the practice of alternation of medicines. And when used with circumspection, it is a practice that has proven useful, anti developed the powers of Homoeopathy.” In every case we have to treat, we meet with complications, and what is generally understood under complications, are the unaccountable, often apparently small and trifling symptoms, not belonging strictly to the pathological condition present to the so-called disease, the class of symptoms that generally guide us in the selection of the truly curative remedy; if we select a remedy according to these symptoms, there will be no need of maintaining the susceptibility. If, furthermore, we must use circumspection should this practice prove useful, we are much afraid that between the doubtful regions of pathology as a guide, and circumspection as a landmark, we shall lose our way; I would advise you once for all, to hold fast to certain fundamental rules laid down by Hahnemann, and guard against unmeaning phrases, which, with all circumspection, will lead you into doubtful regions. If a patient recovers under the treatment by alternate medicines, it is to be supposed that one of the medicines was homoeopathic to the case, that the frequent repetition would have done more harm and protracted the recovery, had not the alternated remedy, being similar and therefore an antidote in that capacity, suspended and modified the action of the oft-repeated medicine.

As no two morbid states can exist in the animal organism, whether they are similar or dissimilar, without either the recent morbid condition silencing, at least for a time, the former morbid state or uniting itself with it, forming a double-headed monster, so can never any two medicines develop their effects separately on the healthy or on the diseased animal organism, without necessarily interfering and interrupting the action of both or at least of one. The knowledge of the effects of medicines is based upon the provings of drugs, and if so, who can ever have thought of proving two drugs on one and the same person, at one and the same time? As for instance, Aconite and Belladonna. Aconite to be given and allowed to act, say for twelve hours, then Belladonna to be given and also allowed to act for twelve hours, and so they are given alternately, and what will be the result of this medication duetto? Will it end in a harmonious solution of the questions we asked of nature, viz,: how do Aconite and Belladonna effect the human organism? If the healthy organism will not give a satisfactory answer to our question, which it could only do if the two medicines did not interfere with each other and the development of the altered sensations of each respectively; how much less can we suppose that the organism when effected by disease, will, under the double action of alternate medicines, respond and be beneficially affected by them? As two medicines cannot be proved at the same time in alternation on the same person, and as two distinct diseases cannot exist in the same person at the same time, so cannot two medicines administered in alternation affect the diseased organism beneficially,

Secondly. An alternation a posterori, may be good practice in some few and rare cases, and in those, you will find that after the effects of the first dose of a well selected remedy have been exhausted, the patient may be quite in a different condition; and then after selecting another remedy and its effects being exhausted, you may find again, all the symptoms for which you prescribed it, have disappeared, and the case presenting precisely the same symptoms for which the first remedy was given, with the difference that they may not be quite so intense, then, of course, you return to the first remedy; if, when its action is exhausted, yon again find the same symptoms, though most likely less severe than yon found them before, when you selected the second remedy; yon will give it again, and so continue as long as recurring circumstances require it and till your patient recovers. To fortify his position, i. e.,” that alternation of medicines a priori is admissible, Dr. Drysdale quotes a case related by Dr. Hering and cured by alternate doses of Ignatia and Ruta because a liver-complaint and a jaundice both were present; the inference from this statement would be, that the two distinct diseases were present and demanded the alternation or the two medicines, one for each disease. The fact is this, Dr. Hering relates in the third part of Archive. vol. xiii, p. 68: “A very short time after I first became acquainted with Homoeopathy in 1822, I cured permanently, in a few weeks, a patient attacked with jaundice and liver diseases, by giving every third or fourth day the tincture of Ruta and Ignatia¹². In this case Ignatia was first indicated by the symptoms of jaundice, the patient, a lady, had suffered much from grief, and they disappeared under Ignatia, but other liver symptoms then appearing, Ruta was indicated and removed them, but the jaundice returning Ignatia was again given, and so the two medicines were taken in alternation, not for two distinct diseases, but for two distinctly different complexity of symptoms of one and the same disease of one patient. In 1822, very few remedies were proved, Dr. Hering had just become acquainted with Homoeopathy and he relates this case as one of alternation and success; the practice of alternating medicines was then scarcely spoken of. Dr. Hering could not have given in this case, Lachesis, which he did not prove until 1833 and was therefore unknown to him in 1822. This is a case of alternating a posteriori, and does not sustain Dr. Drysdale in his efforts to uphold that mongrelism. The quotation of this case does not give color to the habitual practice of alternation common to most physicians calling themselves Homoeopathicians in England, and we must be allowed to

draw the inference from this quotation, and their habits of alternating, that the author and those who sustain him are ignorant of progressive Homoeopathy and are unaware of all the developments following the fundamental ideas since the year 1822; in fact the advocates of indiscriminate alternations of medicines, give full evidence of their lack of” knowledge of our Materia Medica and refute the fundamental principles of the school to which they claim to belong. The appeal of this faction, to statements made in 1822, when Homoeopathy was in its infancy, are only applied to suit their faction's retrogressive assertions, and not to accept the fundamental ideas on which the homoeopathic practice was based then and has developed itself progressively and is still developing new truths. To quote what, since 1822, has been unsaid by the same witness, to accept his passing remark while he had but just become acquainted with Homoeopathy, but ignore what he has said during the forty-two subsequent years, is to say the least, a deplorable resort to perversion and misrepresentation of our cause.

If it even admitted that the alternation a posteriori, is at times, but very seldom, admissible, it will also be acknowledged that this only allowable alternation proves that we have not chosen the only curative remedy for the patient; and we have not chosen it because it was not known to us, and it certainly might not have been known to us as our Materia Medica is far from being complete. The alternation of Medicines can never be excused on the plea that two distinct diseases existed which can never take place; it is in contradiction with true homoeopathic practice as we have nothing to do with diseases or forms of diseases or pathological conditions, as indicating the curative medicine, we have but one patient who is sick, and we prescribe for the patient, not for the disease.

The practice of administering medicines in alternation is wrong, but to alternate Aconite and Belladonna is simply ridiculous, and to substantiate this assertion let us now investigate in what particulars these two remedies are similar and in what they differ, and when you know these differences which, in some instances as under fever, become opposites, it will be an easy task to decide which of the two medicines is homoeopathic in a given case; you will not remain in doubt, nor hesitate, and above all you will never alternate.“

We begin with the mental symptoms and follow the arrangement of symptoms adopted in our Materia Medica by Hahnemann.

Mind and Disposition. - Aconite has inconsolable anxiety with a restless nervousness and tossing about.

Belladonna has unconsciousness, the person does not hear or see anyone.

Aconite and Belladonna have both delirium.

The Aconite delirium is worse at night and has the character of ecstasy.

The Belladonna delirium is of a violent nature with great loquacity, violence, beating, raving, tearing of objects, spitting. Belladonna has also visions as soon as the eyes are closed.

Aconite has prediction of the time of death.

Belladonna has great cunning, forgetfulness or vehement talking.

Aconite has giddiness when rising to sit up, with vanishings of visions.

Belladonna has giddiness as if on a swing, or vertigo with unconscious falling down.

Head. - Both have congestion to the head with red face.

Aconite has heat in the head with perspiration of the head and red face.

Belladonna has heat in the head with congestion of blood to the head and pulsation of the arteries.

Aconite has fullness and heaviness in the forehead.

Belladonna has stupefying headache in the forehead with congestion of blood to the head and unconsciousness.

Aconite has more pain on the left side of the head.

Belladonna has more pain on the right side of the head.

Aconite has headache which is better when lying quiet, worse when raising the head or moving.

Belladonna has headache which is better when sitting up and worse when lying down.

Aconite has sensation of the brain as if moving to and fro.

Belladonna has boring with the head in the pillow.

Eyes. - Both have photophobia and photomania.

Both have inflammation of the eyes, but,

Aconite has inflammation with the eyes protruding and insufferable pain.

Belladonna has heat in the eyes with redness and swelling of the conjunctiva, with the eyelids turned over.

Both have dilated pupils, but those of Belladonna are immovable.

Aconite has inflammatory swelling of the eyelids.

Belladonna has bleeding of the eyelids.

Belladonna has further, a wild, staring look, sparkling, red, glassy eyes, and momentary loss of sight, especially when rising up in bed; and also paralysis of the optic nerve, all symptoms which Aconite has not.

Face. - Aconite has a red face.

Belladonna also, but with burning heat of the face.

Aconite has a pale face, especially when lifting the head up.

Belladonna has fair, bluish red (purple) and bloated face – puffiness of the face.

Aconite has dry lips which peel off.

Belladonna has cracked, bleeding lips, and hard swelling of the upper lip.

Aconite has perspiration on the side of the face on which he rests.

Belladonna has erysipelas of the face, also violent cutting pain in the face.

Teeth. - Aconite has pulsating toothache.

Belladonna has violent toothache aggravated by eating.

Mouth. - Both have dryness of the mouth and inflammation with dark redness of the throat; the Belladonna dryness is often without thirst.

Both have pricking in the throat during deglutition, but

Aconite has the same pricking when coughing.

Aconite has tingling in the throat.

Belladonna has sensation of constriction with desire to swallow, and when not swallowing, tearing, cutting in the throat, also swelling and sudden suppuration of the tonsils.

Aconite has white coated tongue.

Belladonna has a red tongue or tongue coated with mucus, or inflamed and swollen, preventing speech.

Appetite and taste. - Both have aversion to food.

Belladonna has lost taste.

Aconite has more violent thirst than Belladonna which has either hasty drinking with trembling or aversion to drink, even when burning thirst and dry throat are present.

Aconite has bitter taste of all food and drink, except water.

Belladonna has sour taste of bread.

Gastric symptoms. - Aconite has vomiting of bloody mucus.

Belladonna has vomiting of pure mucus or acid vomiting.

Aconite has vomiting of what has been drunk.

Belladonna has vomiting of bile and also empty retching.

Stomach. - Aconite has tensive, pressing pain, as from weight in the abdomen.

Belladonna has swelling of the pit of the stomach .

Abdomen. - Both have swelling of the abdomen with tympanitis, and sensitiveness of the abdomen to the touch, but Belladonna alone has painful clawing and tearing in the abdomen. Both have colic from flatulency, but under Belladonna the colon transversum is considerably inflated, is palpable to the touch, and the pain is relieved by stooping and external pressure.

Stool. - Aconite has white evacuations.

Belladonna has green evacuations.

Aconite has small evacuations with straining.

Belladonna has involuntary evacuations.

Urine. - Both have suppression of the urinary secretions.

Aconite has anxious urging to urinate.

Belladonna has involuntary discharges of urine.

Both have diminished red and fiery urine, but Aconite has also increased secretion of urine with very frequent micturition and much thirst.

Respiration. - Both have frequent and short breathing.

Aconite has it especially when rising from a recumbent posture and while asleep.

Belladonna has it with great laboring of the chest.

Aconite has constrictions of the chest.

Belladonna has sensation of a heavy weight on the chest.

Cough. - Aconite has dry short cough.

Belladonna has dry, hacking cough, during the night.

Aconite has expectoration of blood, or blood-streaked, of a thick, white substance.

Belladonna has very little expectoration except in the morning after rising, when a thick substance like pus, is coughed up.

Aconite has stitches in the chest when coughing.

Belladonna has stitches in the lumbar region, when coughing.

Aconite has cough caused by smoking tobacco.

Belladonna has cough caused by the least motion in bed at night, it has also sneezing after coughing.

Chest. - Aconite has stitches in the chest aggravated by breathing, coughing, and motion, even by lifting up the arms.

Belladonna has congestion to the chest, with pulsation in it.

Aconite has a hollow voice.

Belladonna has aphonia.

Aconite has palpitation of the heart, with anxiety.

Belladonna has violent palpitation of the heart reverberating in the head.

Belladonna has also inflammation and swelling of the mammae.

Back and neck. - Both have a stiff neck, but that of Belladonna is accompanied by swelling of the throat and neck.

Aconite has tingling in the back.

Belladonna has distended arteries of the neck (pulsation of the carotid arteries) also an acid smell from the perspiration of the neck and swollen glands of the neck.

Upper extremities. - Aconite has tingling of the fingers.

Belladonna has twitching in the hands.

Aconite has hot hands and cold feet.

Belladonna has cold hands and feet.

Lower extremities. - Aconite has loss of power of the hip and knee joint, (generally on the left side).

Belladonna has stitches in the hip joint (generally in the right), worse at night and when touched.

Skin. - Both have dry, burning skin.

Belladonna has alternate paleness and redness of the skin.

Aconite has burning hot swelling of the affected parts.

Belladonna has smooth, shining, scarlet redness, not circumscribed, with dryness, burning, and swelling.

Aconite has military scarlet eruption

Belladonna has painful exanthema.

Sleep. - Aconite has sleeplessness from anxiety, and continuous tossing about.

Belladonna has deep stupor like sleep.

Aconite has sleeplessness and delirium with closed eyes.

Belladonna has sleeplessness from visions passing before the eyes as soon as they are closed.

Both have starting from sleep.

Fever. - Aconite has great restlessness.

Belladonna has great indifference, low-spiritedness.

Aconite has agonizing tossing about, cannot be calm.

Belladonna has boisterous disposition - full of rage.

Aconite has fear of ghosts.

Belladonna has desire to flee.

Aconite has a full, hard, accelerated, sometimes intermitting pulse, and occasionally, a slow, small, thread-like pulse.

Belladonna has a quick, full, hard and tense pulse, and Occasionally, a small and soft, seldom slow, but when so, a full pulse.

Aconite has sensation of coldness in the blood-vessels.

Belladonna has pulsation of the carotid and temporal arteries.

Aconite has at the commencement of the disease, chilliness most violent in the evening after lying down, often with one hot cheek, and contracted pupils.

Belladonna has chilliness in the evening, mostly in the extremities, with hot head, also cold extremities with hot head.

Aconite has chilliness from being uncovered and being touched.

Belladonna has chilliness when moving.

Aconite has external chill with internal heat, anxiety with red cheeks

Belladonna has internal chilliness with external heat

Aconite has shuddering which runs from the feet up to the chest

Belladonna has shudders which run down the back.

Aconite has dry burning heat mostly extending from the head and face, with much thirst for cold drink.

Belladonna has dry burning heat, with perspiration only on the head.

Aconite has head, with agonizing tossing about.

Belladonna has heat with stupor, or heat with hot head, red face and delirium.

Aconite has continuous external heat, with desire to be uncovered.

Belladonna has hot forehead with cold cheeks.

Aconite has burning heat with chilliness at the same time.

Belladonna has internal or external heat, or both at the same time.

Aconite has long, lasting perspiration over the whole body, smelling sour.

Belladonna has perspiration while asleep, day and night, the perspiration begins at the feet and ascends.

Aconite has most perspiration on the covered parts.

Belladonna has perspiration only of the covered parts.

Generalities. - Aconite affects the left side more than the right side.

Belladonna affects the right side more than the left side.

Aconite has pains which are insupportable.

Belladonna has over-sensitiveness of all the senses.

Aconite has great and sudden sinking of strength.

Belladonna has congestions to various parts.

Aconite has diminution of almost all pains while sitting still, but at night and while in bed, it is unendurable.

Belladonna has aggravation and renewal of the attacks, from the least touch and motion.

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