THE American Institute of Homoeopathy commenced its Fifteenth Annual Session, in the Atheneum, at Brooklyn, N. Y., on Wednesday Morning, June 2d, 1858, at 10 o'clock, and was called to order by the General Secretary, D. S. Smith, M. D., Waukegan, Illinois.
Report of the Central Bureau. -Reports were presented by two several members of the Bureau, viz., B. F. Joslin, M. D., and W. E. Payne, M. D. Dr. Joslin, Chairman of the Board, presented a proving of Rumex crispus, and Dr. Payne, a limited proving of the same drug, together with a proving of Calcarea phosphorica. On motion, both reports were accepted and referred to the Com mittee on Publication.
S. M. Cate, M. D., Augusta, Me., Committee on Scarlet Fever, its Prophylaxis and Treatment, was not present. The Secretary stated, in reply to the call, that Dr. Cate's report was completed, and that he had been expecting it by mail to present to the Institute, but, from some cause unknown to him, it had not arrived. It might arrive before the close of the meeting.
The Institute met on Thursday morning, and was called to order by the Chairman, at a few minutes past 10 o'clock. The minutes of yesterday's proceedings were read by the Secretary, and approved. On motion, the special order of the morning was postponed, for the purpose of allowing B. F. Joslin, M. D., of New York, to read a paper on ”Impurities of an Attenuating Liquid“. which on motion of Dr. J. P. Dake, was laid on the table for further discussion
Dr. Bartlett's report on Intermittent Fever, which was the special order of the morning, was now taken up. Pending the discussion, the Chairman announced the following named gentlemen as members of the Central Bureau-
The discussion of the main subject was now entered upon, and continued, in an interesting and instructive manner, by B. F. Bowers, M. D., New York; C. J. Hempel, M. D., Philadelphia; T. W. Donovan, M. D., Staten Island, New York; W. H. Watson, M. D., Utica, N.; N. H. Warner, M. D., Buffalo, N. Y.; I. M. Ward, M. D., Newark, N. J.; L. Clary, M. D., Syracuse, N. Y.; J. P. Dake, M. D., Pittsburgh, Pa.; and F. R. McManus, M. D., Baltimore, Md.
Dr. BOWERS, in opening the discussion, said there seemed to be a peculiar propriety in discussing this subject, at this time, in this place, by this body. Circumstances, he said, of a public nature, had occurred in this city, which made it proper that there should be an expression of opinion, by the Institute, on the treatment of Intermittent Fever. Gentlemen standing high in the profession, in the other school of medicine, in the adjoining city, have expressed opinions on this subject, here, under oath, I will not say, intended to deceive, but certainly calculated to mislead the public mind. They say, in substance, continued the Doctor, that Intermittent Fever is easily and certainly cured by a few doses of Quinine; and that any physician who fails thus to cure it in about a week or ten days, at the farthest, is guilty of malpractice. This, said Dr. B. is not in accordance with the instructions I received as a student-it is not in accordance with my reading in the profession-it is not in accordance with my experience-it is not in accordance with the facts in the case. When the magnates of the profession, in the character of experts, advance such opinions, they should not be allowed to pass unnoticed. He said, the injudicious, indiscriminate employment of Quinine produced almost an unimaginable amount of evil. The remedy is often worse than the disease. Patients linger out a miserable existence, or suffer and die from various affections thus produced. He knew a physician at the West who, feeling impatient at the inconvenience attending a few paroxysms, determined to make short work of it, and took a large dose of Quinine; in the very next paroxysm, coma ensued, and death ended the disease. Dr. B. knew of an eminent physician and surgeon in the city of New York, who was hurried to his grave by Quinine, given to break his chills. Innumerable instances might be cited where disastrous consequences unmistakably followed the employment of this drug.
Dr. HEMPEL coincided with the opinion of Dr. Bowers, that Quinine is not adapted to all cases of Intermittent Fever. He found many cases of Intermittent Fever, in the northwestern part of Michigan, where Quinine seemed to be indicated, but could be cured only by Arsenicum; and this he found it necessary to give in doses of one-tenth or one-fifth of a grain, to be repeated every two or three hours during the apyrexia. These cases were characterized by great prostration, loss of appetite, sallow complexion, excessive headache, violent chills followed by burning fever and drenching perspiration, violent retching and often vomiting of bile, attended with oppression and anxiety; there was either very little thirst during the chill, or else the thirst was burning and unquenchable, in which case, drinking freely of cold water would excite vomiting of bile. Some severe cases of this character yielded to Arsenicum.
In the course of the disease, after giving arsenicum, he sometimes observed that edema of the lower extremities would make its appearance instead of the expected paroxysm. He regarded this as simply a feature of the disease, and not a medicinal aggravation ; and this opinion was confirmed by the fact that the edema yielded to a few more doses of the same remedy. He had often cured fever and ague, with arsenicum, 12 or 18, when the paroxysms had been suppressed for a time by massive doses of quinine, but had reappeared, as it often does from very trifling causes. Ipecacuanha 18 or 24 he had found efficient, when the paroxysms commenced with stretching and yawning; violent thirst during the chill; fever and sweat not corresponding with the violence of the chill; and when, during the chill, there was retching and sometimes vomiting. He always used china or quinine where the chill was attended with symptoms of congestion of the larger organs-the head, chest, abdomen,-causing headache, oppressive palpitation of the heart; violent cough, sometimes with spitting of blood; colic; backache, etc. In such cases, the continued use of the first decimal trituration of quinine, during two or three paroxysms, would often cure the disease. In such cases, however he had been obliged to use from five to ten grains, dissolved in four ounces of water, giving the whole during one period of apyrexia. In a few cases only, had he succeeded in arresting the disease by china in attenuated doses. But he had found five or ten drops of the tincture sufficient to accomplish the purpose, Patients who had been treated unsuccessfully by other physicians, with attenuated china, he had cured with a few grains of quinine dissolved in four ounces of water. He had also derived a great benefit from the alternate employment of aconite and bryonia, in both the middle and lower attenuations, where, during the chilly stage, painful and alarming congestions were present.
DR. DONOVAN agreed with the gentlemen who preceded him, that quinine could not be relied on as curative in the treatment of intermittent fevers. He thought Homoeopathists committed a very great mistake in going back to this treatment.
He did not believe a disease so protean in its character, could be controlled by any one remedy, in all its manifestations; and he, therefore, regarded the administration of quinine for all varieties of intermittent fever, as not only irrational, but as highly empirical. He admitted that quinine given in sufficiently massive doses would usually break the chill; but there was no end to the list of drugs which had the same power. Dr, D. objected to quinine, not because it ceased to control the chills as the system became accustomed to its stimulus; but it was because the effects produced on the system, especially when given in large doses, were often of serious character, involving organic lesions from which the patient never recovered In the treatment of intermittents, Dr D. stated that he had been most successful with the high potencies. To insure this result, however, he thought it highly necessary that a careful analysis of the symptoms should be made, so as to be sure of the remedy; and then not to repeat it as long as signs of improvement were obvious.
In the commencement of his practice, he used the lower attenuations, but had not found them to answer so well. He had frequently seen the chill arrested by the crude medicine, or the 1st attenuation, as by quinine; but in such cases he had always found the same tendency to a recurrence, as in the quininetreatment. In such cases he thought the drug did not act homoeopathically, but as a revulsive; and suggested whether a revulsive effect was not the more common operation of all crude drugs. He had found arsenicum of the 100 and 200th potencies, to be the most invaluable in these cases where a long course of quinine drugging has been employed. Natrum muriaticum of the 30th attenuation was another admirable remedy. He had used it successfully where there was severe pain in the head and limbs, with eruption about the month;-the symptoms requiring its employment resembling, in many respects, those indicating both arsenicum and mercurius. Lachesis also, he had found efficient in intermittents of females, where ovarian and uterine complications were present. Its sphere of action seemed to be between belladonna and nux vomica. There was another form of intermittent fever, of children, requiring other remedies. He had used arsenicum and rhus tox, and sometimes ignatia and china successfully; but he relied mainly on rhus, and generally gave it the 100th attenuation.
Dr. WATSON said that he had heard the remarks of the gentleman who had preceded him (Dr. Donovan) with the greatest pleasure, from the fact that his own experience in the treatment of this disease had been entirely at variance with that just related. When he first commenced practice, he had used the high attenuations, but they entirely failed him. The only remedies on which he now relied in the treatment of Fever-and-Ague were Arsenicum, Carbo vegetabilis, Cedron, Ipecacuanha, Nux Vomica, Quinine, Nitric acid, Sabadilla, Tartar-emetic and Veratrum. He administered belladonna, opium, or other remedies, whenever they seemed indicated as intercurrent remedies for any complications of the disease. He also employed the above remedies in different attenuations, from the first to the third, and prepared on the decimal scale.
DR. WARD had some experience, and had often failed in these cases. He, at one time, used quinine, but from failures, and disastrous consequences arising therefrom, he had abandoned its use altogether. He now used arsenicum with the best effects-it is now his main remedy. But in some cases he found unequivocal advantage in the use of natrum muriaticum.
DR. CLARY had cured many cases with the remedies generally employed in homoeopathic practice; but in other cases the results were unsatisfactory. It seemed to him that we need a wider range for the selection of remedies. If any new remedies are known to individual members of the profession, he would like to know what they are.
DR. MCMANUS said, he considered intermittent fever to be primarily a neuralgic condition; and secondarily, an organic one. While the disease was assuming the chronic form, the alternate action and reaction in chill and fever gave rise to internal organic congestion, particularly of the liver and spleen; and, indeed, in all the internal organs, but particularly those, which were highly vascular. Where such organic congestions occurred, it was necessary to continue a proper treatment, to remove or cure such conditions after the chills and fevers had been arrested. He considered intermittent fever one of the easiest of cure which we had to contend with, but the most difficult to select a remedy for. The great secret of cure was to be found in the applicability of the remedy selected. The matter of the attenuation of the remedy was not, in his opinion, one of so much importance, as its specific applicability. This has been satisfactorily established by the testimony of several members, some of whom report cures from the lowest, and some from the highest potencies.
Dr. McManus then referred to a case, in which he had given a series of remedies, and which had resisted them all; and was cured by his son with six doses of ignatia 30, given at intervals of two hours, in the apyrexial condition, and was cured thoroughly, no recurrence having taken place. Natrum muriaticum he considered one of the most valuable remedies, in intermittent fever. It applies to cases, where the paroxysm comes on generally about ten o'clock, A. M., the chill attended by violent headache and great sleepiness, and the fever attended by great headache; epigastrium very sensitive to the slightest touch.
Possessing, he said, as we do, by far the greater portions of the earth, over which this disease has range, it seemed to him peculiarity a duty of the Institute to furnish the world with the fruits of its experience in the treatment of this disease.
One case he would mention, in which the symptoms indicated arsenicum. He gave that remedy at the sixth, third, and even thirtieth degree, and all without apparent improvement. He then gave arsenicum at the 200th degree,-one dose, and there was not another chill for two weeks. The dose repeated, removed finally all traces of the disease. Generally, he had found the sixth, twelfth, and thirtieth degrees of remedies the best in chills and fever. But he was fully satisfied, that he, who employed arsenicum at a lower degree than the third decimal, did so at the risk of doing much harm, and without a reasonable prospect of traversing, with his remedy, the fine recesses of the organism occupied by the attenuated, yet potent marsh miasma.
There was another point to which he wished to call attention; that was the too great, or rather, to exclusive attention usually given to the paroxysms in intermittent fever. There are other features of the disease, as important as the chill, fever and sweat, which the physician must observe, in selecting his remedy. He never allows his patients to suppose that he is seeking simply to ”break the chills;“ but takes especial pains to show them the importance of having the stomach, liver, and nervous system in an improved condition also. The chills are often suppressed, and the parts named left, in a very unhealthy condition, by massive doses of drugs.
DR. WARNER said, he had had a good deal of practice with this disease. He relied wholly upon the high dilutions. He used quinine, when the chills and fever came together. Natrum muriaticum, and arsenicum had proved very successful in his hands.
DR. McMANUS' experience agreed very much with that of Dr. Warner, except so far as the high attenuations are concerned. He thought there was no disease easier to cure, if the remedy was selected with care, and strictly in accordance with the homoeopathic law. He did not think that physicians were careful enough in the selection of remedies, or in their adherence to the rules laid down by Hahnemann. The degree of attenuations he did not think of much importance, provided the remedy was well selected. Ignatia was indicated in thirst during the cold stage, and absence of thirst during the fever. He would regard the presence or absence of thirst, during the several stages of intermittent fever, an important, if not an infallible guide, in the selection of remedies.
On motion of Dr. Clary, the treasurer was directed to pay to Dr. A. S. Ball, of New York city, the sum of fifty dollars, the amount of his alleged claim on the Institute, and take Dr. Ball's receipt therefor, in full.
F. R. McMANUS, M. D., chairman of the committee on the treasurer's account, made a report of approval, which was accepted by the Institute; and the demands therein, against the Institute, were ordered to be paid.
J. P. DAKE, M.D., chairman of the committee on the selection of subjects to be reported upon at the next annual meeting of the Institute; and the designation of the committees, offered the following report, which was unanimously adopted:
W.E PAYNE, M.D., proposed the following amendment of Article IV. of the Constitution of the American Institute of Homoeopathy, which in accordance with a provision of the constitution, was laid over for consideration, at a future meeting.
The officers of the Institute shall be a President, a Vice President, a General Secretary, a Provisional Secretary, and a Treasurer, with such other officers as shall be designated by the by-law, to be chosen at such time and in such a manner, and for such period, and with such duties as those by-laws shall ordain.
The chairman appointed the following named gentlemen a committe of arrangements for the next annual meeting of the Institute, viz.: Samuel Gregg, M. D., Wm. Wesselhoeft, M. D., L. Macfarland, M. D., and David Thayer, M.D., all of Boston. Mass.
|The AMERICAN HOMOEOPATHIC REVIEW Vol. 01 No. 01, 1858, pages 40-46
|The American Institute of Homoeopathy, the Fifteenth Annual Session.
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