ERUPTIVE FEVERS. 
P. P. Wells, M. D , Brooklyn, N. Y. 
The science whose object is the deliverance of men from 
disease, presents itself in two divisions : prophylaxis and thera- 
peutics, prevention and cure. Prevention is proverbially the 
better of the two. But physicians have not hitherto fully 
recognized the fact that the prevention of disease is their high- 
est function and most important duty. Nor when this duty 
has been performed by them, have their services always been 
adequately appreciated; for men are slow to estimate aright a 
danger which has been averted. Less study has therefore been 
hitherto given to the prevention than to the cure of diseases. 
The means of prophylaxis may be considered in two divi- 
sions : 
1. Those of a general character, constituting what is known 
as hygiene. 
2. Those of a specific character, or medicine. 
Much earnest attention has been given to the prevention of 
disease by general or hygienic measures, and so much has been 
accomplished in this direction, that the development of hy- 
giene or preventive medicine is justly regarded with pride by 
the Old School, as one of the chief attainments of modern 
medicine. It is almost wholly a modern science. 
The idea of preventing disease by medicines taken inter- 
nally by persons still in a 6tate of health is also modern. It 
has not received the attention which its importance deserves. world’s homoeopathic convention. 
2 
It is one of the honors which gather around the name of 
Hahnemann, that lie first suggested this idea and demonstrat- 
ed its value by its successful application in most important 
epidemic diseases, viz: scarlet fever and Asiatic cholera. 
And it is a marvel that his followers so greatly neglected his 
suggestion. The value of the specific prophylactic medication 
advised hy Hahnemann on the first appearance of cholera in 
Europe was clearly proved. He predicted the successful ac- 
tion of medicines before the disease had come under his own 
observation. Ilis selection of these medicines must have been 
in accordance with some law and not a result of accident. As 
a matter of fact, he recognized the law of prophylaxis in the 
law of similars. That agent which produced on the living or- 
ganism effects most like the phenomena of the natural disease, 
was its surest preventive. This was the law. The discovery 
of the preventive must therefore be made in the same way as 
that of the curative agent, viz., by a comparison of the phe- 
nomena of the natural and the artificial or drug-disease. 
This law of specific prophylaxis can be practically available 
only in diseases which occur in groups or epidemics. The re- 
quisite similarity can be known only after the examination of 
numbers of cases of the disease; for no epidemic disease dis- 
closes all its phenomena in any one case. For this reason it 
is obvious that, even if we could foresee sporadic attacks of 
disease, we could not apply specific agents to prevent them, 
according to this law; because we could not know in just 
wrhat combinations and proportions the morbid phenomena 
might occur. These might not be similar enough in any two 
successive cases to constitute the requisite specific doses like- 
ness of drug and disease. And even in epidemics this rela- 
tionship may be limited to the single one in which the great- 
est similarity has been observed. For epidemics, as they oc- 
cur in successive years, are not identically the same. They 
require different curative remedies, and for the same reason 
must require different preventive agents. 
We may not assume, then, an identity of prophylactics in 
successive epidemics bearing the same name. 3 
ERUPTIVE FEVERS. 
VARIOLA : ITS PROPHYLAXIS. 
In looking at variola and its relations to prophylactic, agents, 
attention is first arrested by the claim of vaccine virus to he 
regarded as the first in importance, by its almost universal use, 
and the confidence given to it by the medical profession and 
the general public. It is not now our object to examine the 
grounds of this confidence, or the results of vaccination, but 
rather to place it in a light where its protecting power may be 
more rightly estimated than it generally is. In the first place, 
it will be readily conceded that it, to some extent, protects 
those susceptible to the action of the variolous poison. In the 
second place, it is equally certain that this protection is but 
partial; and, in the third place, that it is very uncertain. 
That vaccination protects, is proved by the fact that, many 
who have been successfully vaccinated receive no damage from 
exposure to air charged with variolous poison, or from contact 
with those who have the disease. The writer was successfully 
vaccinated 45 years ago, and the operation has been repeated 
many times since, without result. He has, in this time, treat- 
ed many cases of small pox, and has, of course, been often in 
its presence; has handled patients in all states of the eruption, 
and never received the slightest injury. That the protection 
is partial, is proved by the numbers of those who, notwith- 
standing successful vaccination, have contracted the disease, 
and passed through all its stages and sufferings (in some cases 
with fatal termination), apparently unmodified by the sup- 
posed protector. That it is uncertain, is proved by the fact 
that those who have been vaccinated with success, and on 
whom the operation has been many times repeated after- 
ward, and always without result, have yet contracted the dis- 
ease in its severest form. The uncertainty is further proved 
by the case of one who was vaccinated in infancy, and many 
times afterward, without result, and who treated numerous 
cases of variola, sometimes four or five in one room, and con- 
sequently was fully exposed to infection, without taking the 
disease, till he was called to the hist of a series of 25 cases, 
which was contracted from the 24th. This was a very mild world’s homoeopathic convention. 
4 
case, there were not more than half a^dozen’-pustules in all, 
and yet he took the disease from thfs case, and in him it came 
in its utmost violence. Why was this % The attendance on the 
25 cases was continuous, the succeeding cases being contracted 
from those which preceded them, in an uninterrupted series. 
This violent example of the disease resulting from contact 
with the last and mildest of the series, where there had been 
immunity while attending the preceding members, all of which 
were more severe, goes far to illustrate and prove the uncer- 
tain character of this prophylactic, even after there had seemed 
to be an immunity secured to the person so constantly and so 
thoroughly exposed to infection. It would be easy to multi- 
ply such examples, and thus to show that the proper place of 
the vaccine virus as a protection against attacks of variola, is 
far below that assigned it by professional and popular estimate. 
Indeed, m view of this admitted partiality of the success which 
has attended its use, the uncertainty of the protection it af- 
fords, and the accidents which sometimes follow vaccination, 
there are those who, on the whole, seriously question its value, 
as a preventive of variola. 
After vaccination, medicines which stand in specific relation 
to epidemics of the disease may deserve a careful consideration. 
There are a number of those from which it is claimed protec- 
tion has been realized, where given internally ; e. g., Varioline, 
Vaccinine, Sulphur, Thuja, Tart. Antimon., etc. That either 
or any one of them will protect the exposed, in all cases, is not 
to be admitted. It is claimed for each that it has been suc- 
cessful in some cases. But in order to insure a uniform suc- 
cess from any one of them, it would be necessary that each 
recurring epidemic should be a specific repetition of those 
which had preceded it, and each should be, in its specific char- 
acteristics, like the characteristics of the effects of the drug on 
the organism. This identity of elements at each succeeding 
epidemic is just what the disease will not present to us. And 
in resorting to the internal administration of medicines for pro- 
tection, we must select for each epidemic that which, in its 
effect, is most like the characteristics of that epidemic. If 
each epidemic be carefully scrutinized as to its specific cliarac- 5 
ERUPTIVE FEVERS. 
ter, and the right agent be selected afterward, according to the 
law of similars, there, is, no doubt, much promise of good in 
its use as a protector of those who may be exposed to the 
dread infection. 
Trealvnent.—When, notwithstanding all endeavors for pro- 
tection, the disease is developed and becomes a subject of treat- 
ment, it is found exhibiting very various phenomena in the 
different periods of its progress, as, for example, in that of its 
invasion, eruption, suppuration, and desiccation; and there are 
two methods of dealing with the problem of cure, as presented 
by them. One, to find a single remedy which, in its patho- 
genesis, has produced symptoms like those of each of these 
periods, and which thus answers the requirements of the law 
of cure for the whole case, and for all cases. The other seeks 
a remedy for the peculiar phenomena of each period, as the 
case progresses. No doubt, if the remedy can be found which 
more than all others, has a pathogenesis like the different ele- 
ments of the succeeding periods of the disease, the difficulty 
of its treatment is reduced to a minimum. The cure will be 
speedy and safe. But it is quite another question whether 
such a remedy has been found. The claim of Thuja to this 
high distinction, set up by Wolf, of Berlin, has hardly been 
sustained by clinical success. Many cases have certainly been 
cured by it, with singular promptness and completeness, but 
in other cases it has seemed to fail. This want of success, it 
is true, may have been the consequence of the unskilful use 
of the remedy, as may happen in any other disease, and with 
any other remedy. Or it may have resulted from an imper- 
fect knowledge of wdiat should have been reasonably expected ; 
and the change of remedy, and the conclusion of failure, may 
both have been hasty and unwarranted. But it would seem 
to be quite as reasonable, in viewT of the ever-varying phenom- 
ena of successive cases, and the light of experience in dealing 
with other forms of disease, that the absolute specific for va- 
riola, in all cases, has not yet been found, and is not likely to 
be. Thuja may be of great value. That it is a specific for 
all cases, in all circumstances, and in all combinations of symp- 
toms, may be held as something more than doubtful. In all world’s homoeopathic convention. 
6 
tlie range of our knowledge of other diseases and other reme- 
dies, nothing like a universal specific for any form of disease, 
has been found. It was once supposed that Cinchona was 
such a specific for intermittent fever, Sulphur for psora, and 
Belladonna for scarlet fever. But experience has proved that 
these suppositions are not well founded. The more recent 
suggestion of Tartar emet. as such a specific for variola is one 
better sustained by reason of practice. The remedy has its 
place with others in the list of those which have cured the 
disease, and may be regarded as of value. The same may be 
said of Yaccinine and Yarioline. Both have been regarded 
by a limited number of practitioners, as specifics; both are 
said to have of the disease with singular prompt- 
ness, and both, in other instances, have as signally failed to 
do any good. 
There is no reason to suppose that the true homoeopathic 
treatment of variola will be found any exception to the gen- 
eral rule, which requires the adaptation of the remedy, which 
is to accomplish the cure, to the specific elements of the case 
to be cured. In order to find the one appropriate to a given 
case, reference must be had to the period of its development, 
and the phenomena present at the time of the first prescrip- 
tion. If it be at the beginning of the invasion, and the attack 
of average severity, there will be successive chilly shndderings, 
alternating with sensations of heat, great bodily restlessness, 
pain and throbbing in the head, with congestion of head, face 
and eyes, these last being watery and suffused; great pain 
in the back, which is sometimes accompanied by stiffness, 
hardly admitting of motion, or this sense of rigidity may be 
accompanied by a sensation as if the back were paralyzed, 
pain in the epigastrium, often severe, with nausea, retching 
and vomiting. If the case be a severe one, there will be early 
delirium, which will increase in violence as this period pro- 
gresses to that of eruption. The skin becomes hot and con- 
gested. The disposition of mind is desponding. In children 
especially, the brain affection, besides the brain, may show it- 
self bv coma, frightened starts in sleep, grinding the teeth, 
and convulsions, and these symptoms are present, especially in 7 
ERUPTIVE FEVERS. 
the evening and at night. The above is a fair picture of a 
case of variola, in the period of invasion. It is for this, of- 
tener than otherwise, that the physician is first called to 
prescribe. He may say “ variola,” and give a supposed uni- 
versal specific for the malady, and so save himself all trouble; 
or, he may, from these elements, seek the remedy best adapted 
to them, as a curative, according to the law of similars, which 
we may suppose he professes to obey. This may be more dif- 
ficult, hut, it is submitted, if the responsibility of the treat- 
ment be on him, the physician has no choice hut to overcome 
this difficulty. He has all the elements of the case, with which 
he has to work, when he has mastered those of this period. 
He cannot look forward to the periods beyond, not yet devel- 
oped, and therefore, with these, at this time he has nothing to 
do. 
Taking the symptoms of this period, as we have given them, 
we have a very complete picture of them in the pathogenesis 
of Belladonna, Bryonia, Rhus, Arsenic, and Antimon. tart. 
If the symptoms of cerebral affection predominate in the case, 
and are of a marked character, as given above, there can he no 
doubt of the similarity of Belladadonna, in its effects, to the 
symptoms of the case. If, on the other hand, the gastric ele- 
ments prevail, Bryonia will have the preference. Or, if the 
vomiting be very violent, with great prostration of strength, 
and cool or cold, damp skin, great anxiety and restlessness, 
Antimon. tart. wrill be called for. But, if with the nausea or 
retching and vomiting, there be severe pain in the epigastrium, 
of a burning character, with diarrhoea, Arsenic, will be better. 
This remedy will also be especially called for if in this period 
there be indications of the case assuming an adynamic charac- 
ter. Rhus may be called for by this last indication, in t-he ab- 
sence of other signs calling for Arsenic. It will have the 
preference if the restlessness and pain in the back predomi- 
nate. We may reasonably expect from either of these reme- 
dies a mitigation of the violence of the attack, provided it is 
rightly selected and given, and is not alternated with either 
of the others, or with any other, and, as a general result, the 
case will come to its second period in a condition more amen- 
able to the action of remedies appropriate to its phenomena.