THE YEAR’S PROGRESS. ADDRESS DELIVERED BEFOKE THE Jirmwm Jitsfiluk af\ lf0innti|ml|ij, By the President, / - \/ J. C. BURGHER, M.D., OF PITTSBURGH, PA., AT THE OPENING OF ITS THIRTY-FIRST ANNUAL SESSION, AT PUT-IN-BA Y, JUNE 18th, 1878. PH I LA I) ELPHIA: SHERMAN & CO., PRINTERS. 1878. COMPLIMENTS OF AUTHOR. PRESIDENT’S ADDRESS. Fellow-Members of the American Institute of Homoeopathy: At the last meeting of the Institute, held at Lake Chautauqua, N. Y., in June, 1877, without solicitation on my own part, I was elected to preside over your deliberations at this session. Al- though your votes were directly cast for me, I understand full well that they were not intended for me alone, but may be in- terpreted also as an utterance complimentary to my more imme- diate colleagues, who have done so much for the advancement of homoeopathic therapeutics in the geographical section in which it has been my good fortune to reside. In their behalf, there- fore, I tender to you their thanks. As for myself, permit me, without either sanctioning the policy or indorsing the wisdom of your choice, to acknowledge my appreciation of the high honor conferred upon me by your sulfrages, and to thank you for this additional expression of your individual confidence and esteem. I trust that harmony will characterize your deliberations, and that they will be such as shall give weight, dignity and influ- ence to your proceedings, and make this session one of the most important in the history of this organization. With the kindest personal feelings and the most sincere professional regard for every member of the Institute, I enter on the responsible duties de- volving upon me, and shall endeavor to discharge them faithfully impartially, and to the best of my ability. In my efforts to pre- serve order and decorum, and to expedite the business of the session, I may reasonably anticipate your co-operation; I may need your indulgence. The by-laws of the Institute, among other duties, make it obligatory upon the President to “deliver an address at the opening of each session, on the progress of homoeopathy during 1 2 the year past, and make such suggestions as he may deem neces- sary for the Institute to take action on during the session.” Those of you familiar with the writings of that prince of ro- mancers, Sir Walter Scott, will readily call to mind his pen-pic- ture of Old Mortality, whom he represents as devoting his life to deepening, with his chisel and mallet, the inscriptions on the unpretending tombstones which marked the obscure graves of the whig martyrs of Scotland, who afforded a melancholy subject of history in the times of Charles the Second of England, and his successor. It is not stated in the narrative that Old Mor- tality originated any devices, or that he added anything to the inscriptions. His object seems to have been simply to restore what time had measurably obliterated. I find before me a ser- vice not unlike that of this rude Scottish sculptor, except, per- haps, that his task was self-imposed, and mine enjoined. History is but a “ plain unvarnished tale,” a narrative of facts, a record of events, and cannot be manufactured to order. The only originality the historian can claim, is his arrangement of facts and his style of expressing them. His “letters patent” are simply those of design or construction of language; the data and materials, like those of science, are the common property of all. I can neither hope to add to the earnest words of counsel spoken by my distinguished predecessors, nor to improve upon their recommendations and monitions ; while the events which have marked the gratifying progress of homoeopathy since our last session are as familiar to you as they are to the speaker. The antagonism with which homoeopathy was received by the profession, when first announced by its illustrious founder, still continues. But, while the hostility is equally unscrupulous, it is far less general, while many of the more progressive of those .nominally classed as allopathists tacitly recognize the law similia similibus curantur, and practice largely in accordance with it. Plans of treatment and methods of practice that have been taught and explicitly followed for ages, have been almost com- pletely set aside. Authors and teachers of erudition, long expe- rience, and acknowledged ability, have made shipwreck of their old medical faith, and, on trial, have found, in the use of small doses of homoeopathically acting remedies, better results than 3 they have ever obtained from their boasted “ heroic treatment.” The old school has enriched its pharmacodynamics by our phys- iological provings, modified its practice by substituting the small for the massive doses, and in not a few instances by employing the single remedy instead of the complex mixture. That our allo- pathic brethren are indubitably drifting into homoeopathy is con- firmed by the following admissions of some of their more promi- nent authors: Dr. S. W. Wetmore, late professor in the medical department of the University of Wooster, at Cleveland, Ohio, in an address read before the Buffalo Medical Association (allopathic), Septem- ber 4th, 1877, uses the following language : “After more than twenty-five years of earnest pupilage in the various departments of our science, I feel that I have but a smattering of each ; but this I do know, that there is certainly something in homoeopathy. As philosophical practitioners, we all treat diseases homoeopathically every day without giving it a thought of the homoeopathic law. He who ignores a doctrine, a drug, or a remedial measure, without giving it investigation, is unworthy of the name of teacher. It is true, I have been culpable of that which I criticize, but then I was blind ; now I see, and have the moral courage to say, peccavi. I positively knew nothing of that which I condemned; the measure and cause of my intolerance was my ignorance, as is the case of nineteen- twentieths of the physicians of our school throughout the globe to-day. He must needs be blind in more than one eye, who cannot see that its superstructure is something more than imagi- nation, faith, sugar pills, and delusion. It is seemingly unnec- essary to detail the great variety of cases I have treated by the law of similars; that there is multum in parvo, though that little be of spectroscopic dimensions, and that these medical infinites- imals hold sway over morbid conditions, administered in accord- ance with the law similia similibus curantur, more satisfactory than remedies given according to the principles of contraria con- trariis curantur. This result being the product of my own ex- perimentation, I am positive of my deductions.” At a meeting of the New York Medical Journal Association (old school), held June 15th, 1877, II. S. Dessau, M.D., read a 4 paper bearing the title, “The Value of Small and Frequently Repeated Doses,” a report of which appeared in the Philadelphia Medical Times of July 21st, and was printed in full in the Medical Record of July 28th, 1877. It is fair, therefore, to assume, that the sentiments and practice of the author stand indorsed by the profession, so far, at least, as to have been published in leading allopathic journals without comment, and received by the profession without protest. Other allopathic authorities referred to in the essay afford evidences of a similar appreciation of small doses, and, so far, furnish practical recog- nition of the advanced ground we hold in the domain of thera- peutics. Dr. Dessau says his attention was directed to this sub- ject by the admirable work of Sidney Ringer, M.D., entitled, A Handbook of Therapeutics. “From the frequency with which Ringer recommends small doses of medicines that we have been accustomed to use in much larger doses, in entirely different diseases, I was induced to give them a trial.” The following homoeopathic prescriptions of Dr. Dessau are fair samples of many more which might be quoted from his article, viz.: In the vomiting of infants, due to various causes, he found the Wine of ipecacuanha, in one-drop doses, every hour, of great efficacy. Fowler’s solution of arsenic, in the same doses, proved equally serviceable in the vomiting after a debauch, and in the morning vomiting of chronic alcoholism. In a form of bronchitis occur- ring in children, characterized by loud wheezing and asthmatic breathing, Tartar emetic proved the most efficient remedy. The strength of the solution used was from one to three grains of the drug to one pint of water, and of this solution a teaspoonful was given every hour or so. It was also of great service in bronchial catarrh, in the same doses, especially if accompanied by diarrhoea. In syphilitic cephalalgia, the one-sixtieth of a grain of Calomel, given every hour, acted like magic. In gastro- intestinal catarrhs in children, he used calomel successfully in doses of one-sixtieth of a grain. When the stools were of a mucous character, containing blood or not, Mercurius corrosivus was given with brilliant results, in a solution of the strength of one grain to sixteen ounces of water, a teaspoonful every hour. In retarded menses, one-drop doses of the Fluid extract of ergot 5 was used with success, and Pulsatilla in the same sized doses in dysmenorrheea. He lauds Aconite tincture, in drop-doses, for reducing the temperature; Belladonna, in facial erysipelas and sore throat; Extract of hamamelis in obstinate epistaxis ; and Tincture of cantharides in strangury, in drop-doses, hourly repeated. Sidney Ringer, M.D., the author of the Handbook of Therapeutics, referred to bv Dr. Dessau, is a prominent member of the dominant school of medicine, and fills the professor’s chair of therapeutics in University College, and is physician to the University College Hospital, of London, England. The work was published in London, in 1869, and has passed through six editions. It met with a rapid and extensive sale, both in this country and in Europe. Did time permit, I might give many extracts from the work, which would do no discredit to a treatise on homoeopathic therapeutics. In the sixth edition of this work, issued but a few weeks since, Phosphorus is intro- duced in these words: “This substance for many years had fallen into disuse, but, owing to its signal success in neuralgia, in the hands of homoeopathists, it has again recently risen to favor.” Several prominent homoeopathists are named as his authority for the remedial powers of different drugs. Dr. Fleischmann, of Vienna, is given as authority for the employment of Phosphorus in pneumonia, and Dr. Hughes for its remedial action in chronic inflammation of the rgeturn. Drs. Bayes, Brown, and Cooper, of London, are cited as authorities for the use of minute doses of several drugs in a variety of diseases and conditions. It is to be hoped that a future edition of this (to Dr. Dessau, at least) indispensable work, will contain more acknowledgments of infor- mation obtained at the expense of homoeopathists, and that it will meet with the same rapid sale and appreciative reception at the hands of our old-school brethren accorded by them to its prede- cessors. In the Medical and Surgical Reporter of Philadelphia, March 30th, 1878, p. 246 (allopathic to the core), Charles II. Hall, M.I)., closes an article on Corrosive Sublimate in dysentery in these words: “These cases are taken from my case-book to illus- trate the efficacy of small and frequently repeated doses of Mercury in this disease. There cannot be any doubt of the success, in the great majority of cases, of this method of treatment. I could 6 furnish records of many more successful cases treated in this manner. My success so far has been very gratifying. Ringer, who advises it in his book, deserves no credit for it except for popularizing it. Any one curious on the subject of his small doses, not only in this disease but in almost every other one of his recommendations, has only to refer to homoeopathic works and find that he has plagiarized. Take up any one of their works, even the domestic manuals of twenty-five years ago, and you will find Corrosive Sublimate put at the head of the list of remedies in dysentery. Although a regular physician of the strictest sect, I believe we should give credit even to irregulars where they deserve it.” The recent work of Drs. Burness and Mavor, bearing the title, The Scientific Action of Drugs on the Healthy System, etc., consists of illustrations of the physiological actions of drugs, and their homoeopathic applications in what the authors call “the restorative doses,” which, I need hardly say, must have appeared exceedingly small to the old-school physicians. This work received the encomiums of the leading medical journal of Europe, the British and Foreign Medico- Chirurgical Review, as both “original and important.” The editor of the Chemist and Druggist, of London, being more in- dependent of the praise or censure of the profession, and more familiar with the writings of homoeopathic authors than his allo- pathic contemporary, saw from whence was drawn the “ orig- inal” ideas incorporated in the work, and, in reviewing the book, pronounces it “homoeopathy disguised,” and adds, “Our theory is paraded with much display in the introductory pages of this book, and, when it is at last exhibited, we find it to be purely and simply the framework of the homoeopathic system of medicine.” The same may be said of Dr. C. D. F. Phillips’ book on Materia Medica and Therapeutics, and Dr. John Har- ley’s Old Vegetable Narcotics, of recent date. The great impor- tance of these works is, that they have introduced homoeopathy to allopathic physicians, whose prejudice has prevented them from examining works avowedly homoeopathic. Trousseau, Bar- tholow, Eustice Smith, and other allopathic authors, mention many other medicinal agents as valuable and reliable in small doses in the treatment of various disorders. One attributes to 7 them a substitutive action ; another the physiological action, antagonistic to that of the disease; another to differential action, etc. The Medical Record of December, 1877, contains a well- written article by Henry G. Piffard, M.D., of New York, in which he recommends the homoeopathic formula for preparing triturations in the decimal and centesimal scales, on account of their uniformity, palatability, and the smaller dose required. As another evidence that small doses are gradually superseding large ones in old-school practice, we may instance the general favor with which gelatin-coated pills and parvules have been adopted by the regular doctors, and their extensive advertisement in their medical journals. A certain New York firm of manu- facturing chemists, occupies four pages of Braithwaite's Retro- spect in advertising these preparations. These pills, or parvules, are guaranteed to be of uniform strength, to contain but one drug, and in the quantities named, as follows: Arsenic, r of a grain ; Gelsemium, of a grain ; Podophyllum, of a grain ; Strychnia, 6'0 of a grain ; Tartar emetic, of a grain, etc. I have quoted thus largely from old-school authorities for three reasons: first, to prove, by their own statements, that they now extensively use and recommend small doses, which they hereto- fore sneered at, ridiculed, and denounced as fraud and humbug; second, to show that the remedies used were given in accordance with the homoeopathic law; and, third, that homoeopathic physi- cians have used the same remedies in similar diseases for more than half a century. The remarkable transitions which we have briefly considered, are striking proofs of the growing apprecia- tion of the therapeutic principles enunciated by the immortal Hahnemann. The tendency among recent allopathic authors seems to be an effort to absorb or appropriate the much-derided formula, similia similibus curantur, without acknowledgment; and to explain, on some pathological theory or sweeping gene- ralization of differential action, the efficiency of small doses, when given according to the homoeopathic law. With such con- tributions to the medical literature of the old school before us, we may congratulate ourselves on the progress homoeopathy is making in that direction. The lines which separate the avowed practitioner of homoeopathy from those who do not openly ac- 8 knowledge their faith in it, are gradually becoming obliterated. This change is taking place from no diminished confidence in the law of similars, from no distrust in the Halmemannian method of obtaining a knowledge of the action of drugs, nor from any doubt of the efficiency of infinitesimal doses when pre- scribed homoeopathically on the part of those who advocate these principles, but from the tacit adoption of every one of them, by the representative class of that branch of the medical profession, which has been the loudest in its denunciations of them, and has repeatedly declared the practice of them a “ public fraud/’ and their advocates “ ignorant pretenders and unprincipled charlatans.” Having thus briefly traced the progress of homoeopathy in the old school, we will now notice some of the evidences of progress in our own. If the literature of a science is any measure of its progress, we have proof of this character most conclusive, grati- fying, and voluminous. As the scientific and practical character of our book and periodical literature will be presented by the committee on that subject, I merely make mention of it here for the sake of completeness. All our hospitals and dispensaries are in successful operation and in a prosperous condition, as will be shown by the report of the Bureau of Organization, Registration, and Statistics. Our numerous medical societies, State and sec- tional, have been well attended during the past year, and have furnished many valuable contributions in the various depart- ments of medical science. The accessions to our professional ranks since our last session, are three hundred and forty-six graduates from homoeopathic colleges, besides an indefinite number of converts from the ranks of the old school. A few years ago, homoeopathic physicians were seeking favorable places in which to locate; now desirable fields are awaiting their coming. In supplying the demand for homoeopathic physicians, good quali- ties and superior attainments must be exacted. The standard of medical excellence and moral worth, must be inexorably main- tained. The sentiment is rapidly and properly gaining favor, that at least four years’ study under a reputable preceptor, and three full courses of medical lectures should be required of every one before receiving the degree of M.D. The right to practice the “divine art of healing” should be granted to no one who 9 falls below the standard of moral worth, literary attainments, or scientific acquirements. Our ranks, filled with physicians of cul- ture and refinement, will challenge and receive both the respect and confidence of the public. To secure this, no member of this Institute should allow any one to enter upon the study of medi- cine under his tuition, until satisfactory evidence is furnished of the moral fitness and literary attainments of the applicant for the profession to which he aspires. Good qualities and superior attainments, rather than large numbers and inferior acquirements, are to be sought in supplying the demand for homoeopathic physicians. As one of the events of the medical history of the past year, it may be mentioned, that women have been accorded professional recognition, heretofore denied to them. They have in fact, cap- tured several strong medical outposts. The examinations of women for degrees, in the medical schools of France, Switzerland, England, and in this country, are reported to have been as rigid as those of their male associates, and, as a rule, better withstood. The wards of the Royal Free Hospital of London have been formally opened to women students, with the view of providing them with the necessary clinical instruction, and the same is true of the Homoeopathic Hospitals of Boston and Pittsburgh. The Boylston prize essay in this country was won by a woman, the judges being unadvised of the sex of the author until after the award of the prize. Thus women have, with commendable energy and perseverance, surmounted all the barriers to profes- sional recognition. Even in conservative Europe, a woman can now obtain a Fuji medical education, and secure a registered diploma in Great Britain, entitling her to practice medicine. We have the fullest confidence in their ability, and congratulate them on their success. I respectfully suggest that the chairmen of the respective bureaus of the Institute be hereafter elected by ballot, a majority of all the votes cast being necessary to a choice, and that the place and time of meeting be also decided in the same way. In all human affairs a time arrives when joy gives place to sadness. While the therapeutic principles we advocate have been steadily gaining ground, death has removed from our ranks some 10 of our distinguished colleagues, through whose labor this is in some measure due. Among these are numbered Mercy B. Jack- son, M.D., of Boston, Mass., the first woman admitted to mem- bership in this Institute; George W. Swazey, M.D., of Spring.- field, Mass., an ex-president and senior member of the Institute; Jacob Jeanes, M.D., of Philadelphia, Pa., an original member of this organization, ripe in years and full of honors ; and Mar- cellin Cote, M.D., of Pittsburgh, Pa., an early convert to, and able advocate of homoeopathy. A biographical sketch of these and other deceased members will appear in the necrological re- port which will be submitted during this session. I may as well notice here, as elsewhere (although you are all familiar with the facts), the recent correspondence of Drs. Wyld and Richardson, of London, which was initiated with the view of uniting the two schools of medicine, which they took upon themselves respectively to represent. Their efforts were not in- dorsed by either school, as might have been anticipated, and very properly resulted in a “ broad farce.” With regard to the action of our brethren in New York, following the ripple of excitement in England, to which so much ill-judged prominence has been given, I have but few words to say. I may be excused, I trust, for remarking, that their not over-judicious resolutions have not been received with any more favor, elicited any more applause, nor resulted to any more advantage to either school than that of the ill-advised concessions of our transatlantic amalgamers. That both succeeded admirably in conveying very erroneous im- pressions to the public at large, is evident. Properly understood, their declarations are such as most of us can indorse. There is no disposition in New York, England, or elsewhere, among homoeopathists, to yield up their principles, or abate, in the least degree, their well-founded and grounded confidence in the method of therapeutics enunciated by Hahnemann. But, having been misrepresented by the old-school faculty, and hence misunderstood by the public, we are under moral obligations to disabuse the minds of both, by correcting the misstatements on the one hand, and the misconceptions on the other. Having the impression that this is a fit time and occasion to reiterate our principles, to give voice to the belief and practice of the great majority of our profession in this country, I offer the following brief declaration: 11 The homoeopathic profession in this country (as elsewhere), with- out assuming more than is their right, claim to be physicians,— doctors of medicine. The science of medicine includes many branches, viz. : Principally, anatomy, chemistry, physiology, pathology, obstetrics, surgery, and therapeutics. The latter again is divided into general and special therapeutics. In these two divisions are included sanitary therapeutics, or hygiene ; chemical therapeutics, relating particularly to neutralizing and disposing of poisons, etc.; mechanical therapeutics, relating to surgery and obstetrics; and finally, the administration of drugs or remedies for the relief and cure of diseases in all of their multiplied varie- ties and multiform conditions. The entire domain of medical science, and all its collateral branches and sister sciences, are of vast importance in the practice of medicine, and belong as much to the homoeopathic school as they do to any other. Now it is not only clearly the province, but the duty of every homoeopathic physician to be familiar with and put in practice every branch of medical science ; and yet it is only in the latter (special thera- peutics or the administration of medicine) that the question of homoeopathy is involved, and it is both a duty and a pleasure to practice in accordance with the principles professed. I believe that I but speak your own sentiments when I declare that in the field of special therapeutics, that is, where internal remedies are applicable, our faitli in the homoeopathic law is undiminished. Each day’s experience confirms us in the belief that it is nature’s law of remedial action. While we have inscribed homoeopathy on our banner, and adopted for our guide the law similia simili- bus curantur in the selection of our remedies, we exclude nothing, but embrace everything, claiming the right of every physician to employ what in his judgment and experience is the very best means to relieve and cure his patients. We accept the teachings of Hahnemann, only so far as our experience and ob- servation have proved them to be correct, and reject whatever investigation has shown to be erroneous. His untenable hypo- theses form no part of the great truths implied in the compre- hensive word homoeopathy, which enlists every principle in the wide range of medical science, and every fact in the broad realm of observation and experience. 12 And finally, the American Institute of Homoeopathy is a medical republic, national in its character, scientific in its objects, and representative in its membership. It is composed of physi- cians from all parts of the United States, and admits to its councils accredited delegates from all state and local medical societies, medical institutions, hospitals, asylums, dispensaries, and medical journals conducted in the interest of homoeopathic therapeutics, and other departments of medical science. It claims for itself absolute liberty in every department of knowledge which pertains to medical science and art. All that is required of candidates for membership is satisfactory evidence that the applicant has pursued a regular course of medical studies, ac- cording to the requirements of existing institutions of this coun- try, backed by a good moral character and professional standing. No creed or confession of belief is required of its members, further than the tacit consent given by becoming such, to ad- vance its objects, and to comply with its established code of medical ethics, which neither enjoins nor forbids anything touch- ing the practice of medicine, but leaves to the physician unre- stricted liberty in the uncertain matters of medical opinion and practice. All engrafted side issues, or favorite theories con- cerning matters of secondary importance are left to the indi- vidual, recognizing only the vital fact that we should be true physicians. This liberty, however, is not license. The phy- sician who habitually prescribes large doses of quinine, or other drugs, gives opiates in alternation with a homoeopathic remedy, or administers emetics or cathartics in other than very exceptional cases, cannot be consistently regarded as a homoeo- pathician, whatever his pretensions. Homoeopathy is essentially a curative method of treatment; where fatal disorganization is present; it can, of course, only palliate. Even in cases strictly surgical, the value of the carefully selected homoeopathic remedy can hardly be over-estimated. The size of the dose does not in any sense make the prescription homoeopathic. Experience, however, has convinced all who have sufficiently investigated the subject, that when a drug is given that acts on the system in a similar manner to the disease present, or, in other words, is homoeopathic to the case, a comparatively small dose is absolutely 13 demanded to insure a prompt curative effect without producing an aggravation of the disease. The distinctive feature of homoe- opathy consists in the employment of remedies according to the law of similars. This is the true basis, the corner-stone, which constitutes the essential difference between it and all other methods of treatment. The law which guides in the selection of the remedy is, as before stated, independent of the question of dose—of the difference between the realists, who give com- paratively large doses, and of the transcendentalists, who advo- cate very high dilutions. It is not in the nature of things that a law explaining and connecting a series of facts can long be ignored. Never in the history of medicine in this country was there a time when the cardinal principles we advocate were so well received as now, not only by the public but by the profes- sion. The word homoeopathy is, perhaps, to many, no welcome sound, but the facts which that word expresses are received with a cordiality truly gratifying. Although the scientific practice of homoeopathy is probably limited to about one-eighth of the entire medical profession of this country, it empirically pervades the entire practice of medicine. In every direction the principles we advocate are covertly incorporated into standard allopathic works, and, amid many fruitless elforts to conceal the fact, are largely taught in an empirical way in allopathic medical schools. Based on therapeutic principles which differentiate it from all other methods of treatment, its open advocates have been professionally ostracized by the dominant school, although re- ceiving their titles from the same authority. The old-school channels of periodical literature, societies, hospitals, and dispen- saries having been closed against us, we have been compelled to establish medical schools in which to teach homoeopathy, pub- lish medical literature in elucidation of its principles, organize medical societies in its interests, and establish hospitals and dis- pensaries where the poor might receive the benefits of this thera- peutic method; and thus have we been forced to assume, by way of distinction, a seemingly sectarian name or form. Under this ban, if ban it be, we propose to pursue the even tenor of our way, until all distinctions of schools and methods shall have been effectually ground to powder between the upper and the nether millstones of the high and the low potencies.