ELCXE s IN Alii 1 *¥W" A UN EMA NX ACADEMY. in. E. BELCHER, M.D., President. \<>KTli- \v,i ,1 -T, DV KKiJ VI. ( F H0M(E0PATIiV, ' < "".'. L'KMY. '!:. ;^ ritiN !" ^§k X K W - Y O It K : ;■ ^ I f N N It Y L U I) \V I G 35 CENTRE-STRF F.T. ^//l i «r, 7 ■■*&? INAUGURAL ADDRESS BEFORE THE HAHNEMANN ACAD DELIVERED JANUARY 7th, 1857, BY GEO. E. BELCHER, M.D., President PUBLISHED IN THE NORTH-AMERICAN JOURNAL OF HOMCEOPATHY, FOR AUGUST BY REQUEST OF THE ACADEMY. The art of applying remedial means to the relief of disease is the accumulated result of the observations, researches, ac- cidental discoveries, and reasonings of ages. When at an early period, a sufficient collection of empirical facts had been acquired, it was in accordance with the nature of the human intellect, that some generalizing theory should have been pro- pounded ; not only to adjust in the understanding an idea of their relative importance and adaptation, but to satisfy also the innate desire for the discovery of some principle, which would explain facts already known, and cheer the intellect, by promising to it a more expanded field. Such was the case with the ancient Greeks, who with their keen perceptions and vivid imaginations, as illustrated in the writings of Hippocrates, made exact observations, that live as valuable lessons; but the theories, which were made subser- vient to their use, have, by subsequent investigations, been modified into more comprehensive ones. "When I speak of their imaginations, I do not refer to those fanciful powers, that, with scanty knowledge, conjure up be- 2 * Inaugural Address, loved dogmas, which further observation prove to be mon- strosities ; but to that divine power of the human intellect, which, whether free or latent, openly expressed or inwardly hidden, finding ----" Tongues in trees, books in the running brooks, " Sermons in stones, and good in every thing," inspired them to conceive in their minds, and form with their hands, from the unhewn stone, intellectual, moral and physical ideals of the image of man : and which inspires the human mind to create the whole, when only a part is seen; to gene- rate, from the conception of a germ of thought, a perfect form; to grasp, (when appreciating signs unexplained, and unper- ceived by other eyes,) the true expression of disease and its treatment, amidst the confusion of its history and symptoms : that power, which inspired Harvey, when he examined the human body, as others had {not) done before him, to shape in his mind and to demonstrate, to the dismay of authoritative dogmatism, the true circulation of the blood : which inspired Jenner, when he observed the milk-maid's sore, that many a doctor had doubtless seen before, to discover—in preventing the loathsome small-pox—an inestimable benefit. to man : which inspired Hahnemann, amid crude, confused, and hetero- geneous therapeutic dogmas, when he observed the effects of peruvian-bark on the human constitution, to propound and il- lustrate the great law of cure; which, as true principles always do, opens indefinite fields of labor, cheers the physician to study- man in health and disease, and medicines in their re: lation to both: that power, which has made immortal the la- bors of Hippocrates, of Sydenham, of Hufeland. To return, it was natural, so long as men differ in the pe- culiarities of their powers of observation, and in consequence of their observations being in different localities and seasons, that various dogmas should have been propounded: and that the medical observer should devotedly search for facts to sustain his created image of an immortal principle, whether true or false, and to batter down opinions which threatened to mutilate or destroy it—like the fond parent, who loves a defective child, and strives to see beauties in him and to make others see them too. As a conse- by Geo. E. Belcher, M.D. 3 quence, mind was rendered active, and new truths were discovered. Art culled truths from any source; and in proportion as science arranged and developed principles from them for practice, did Art cling to Science as her guide. But as in course of time, the Roman Empire, by its imperial fathers, took from its people their manhood, and made them merely obedient children; who were taught not to see and think, but to look with enervating awe up to authority, and to seek station and respectability by bending the knee to those who administered it: so, following in the wake, physicians, their minds from generation to generation becoming more and more stagnant, unfortunately found it easier to reason than to ob- serve ; more comfortable to settle down dreamily in the ho- norable beds their fathers had laboriously made, than to arouse themselves to examine, to think, to study, to improve; more satisfactory to their self-complacent minds, clogged by high-sounding, but useless and debilitating learning, to in- herit than to acquire; more respectable to sustain and acqui- esce in the impracticable views of titled dignitaries, than to discover new facts or advocate nourishing ideas, which dis- turbing the pampered theories of arrogant decrepitude, brought only sneers, suspicion and chilling contempt. Then dogmas supplanted the spirit of inquiry ; then, "the recognized teachings of the schools" fain made disgraceful all inquiries, which implied doubt of the infallibility of their leaders ; then, " to sustain the honor and dignity of the pro- fession," was to pay fulsome adulation and servile obedience to those who engrossed and controlled its honors; to know the diseases and treatment they taught; and with pitiable disdain, to question his motives who studied to be useful rather than regular. And, then, until the human mind began ti- midly to assume its rights, the physician's aspirations were to be the learned depot of other men's dogmas ; he knew what those dogmas taught, what diseases they recognized, what treatment they directed. He was satisfied, or would be, any how ; he would not, even for the love of filthy lucre, do more; he treated diseases "regularly," "rationally," and, after the manner of the noted Pharisee, thanked God he was not like 4 Inaugural Address, the humble empiric, who humanely sought from the accumu- lations of medical experience the means of cure, and branded him as quack. His learning not being appreciated by those who needed the physician, caused his wig to be big ; his suit of clothes to be peculiar; his cane to be held to his nose, snuffing the gold head of which, brought out respectable, rusty wisdom; and his contemptuous head to dignifiedly nod and shake; his words were learned, profound, tremen- duous; and he was happy, and his dignified eye, as if illu- mined by the moon, lighted up when he quoted the authori- ty of great names, or showed how some famous cotempo- rary thought as he thought; he loved to call a black and blue spot, ecchymosis, and a pain in the back, lumbago ; and when he would scornfully, at times, smother a practical sense of his own imbecility, he found peculiar satisfaction in sneer- ing at and scandalizing the good names of those who ques- tioned the perfection of his knowledge; and, continually narcotizing his conscience, he struggled to elevate the character of his profession, by obtaining laws, which made it illegal for pain to be relieved by any but himself. Unmerited respectability, with malignant jealousy then tyrannized over medical art— i ----" Like a cloud along the sky, "Which would not let the sunbeams through, " Nor yet descend in rain and end; "But spread itself, 'twixt heaven and earth, "Like envy between man and man, "An everlasting mist" Such was the dogmatic physician, who for over one thou- sand years obeyed authority ; who loved antiquity, and the diseases and treatment it taught; who despised the present, when its diseases did not correspond to what he was taught they ought to be; who spent his time in swallowing commen- taries upon some foggy writer, and spurned as beneath his notice the disgusting small-pox and the undermining measles. He indeed loved authority; measured the character of others by its standard; saw diseases as it saw them; and passed by on the other side, when the black death and other epide- mics more than decimated the population of the known by Geo. E. Belohee, M.D. 5 world, left their treatment to his overwhelming competitors, mountebanks and old ladies, and their description to poets and historians. Such was the degraded state of medical art, when me- dical authority taught what disease was, not how to observe it, and dictated corresponding principles of treatment. It was the natural consequence upon enervated intellects of the assumption that to treat a disease rationally, it was necessary to understand it perfectly; and not disease only, but also the laws of physical, moral and intellectual existence, and the causes of their disorders; and that the application of remedial means was to be governed by reason, based upon such know- ledge, not by further observation. Science then, uncorrected by elementary studies based on certain foundations, ceasing to be merely an aid to art, assumed authority to direct it; and discouraging those, who, feeling its deficiency, sought outside of its conclusions, further aids, haughtily forbade other investigations, limited observation—and thereby proved it- self recreant to its duty, and therefore impracticable and false. To understand perfectly the infinite laws of health and dis- ease, is to comprehend God ; and he who presumes at the bed- side to apply those laws safely, virtually assumes a divine prerogative. Assumption of the knowledge of what in the na- ture of things is an impossibility, is disturbed when question- ed, and loves to be admiringly and quietly obeyed : begets " blindness of heart;" which begets " pride, vain-glory and hypocrisy ;" which beget " envy, hatred, malice and all un- charitableness." Therefore it is not surprising, that all now left of physicians, who taught and obeyed authority, is the slime they trailed from pathless wanderings through miry bogs upon the fruitful earth; musty curiosities of unreadable nonsense: standard food for comedians: and records of bi- goted combinations and self-interested unions, to exchange such scientific investigations as they deemed respectable; to decide upon courteous rules between themselves and for them- selves ; to define the sources and limits of medical knowledge; to pass resolutions virtually denouncing the characters of those, who seeking every means of cure, obeyed higher laws 'than theirs; and to allay each others' mortifying heart-burn- 6 Inaugural Address, ings by counter-irritating confessions and morbid congatu- tions. Like comforts like. Similia similibus curanfiur. But again, following in the wake; as political and religious power became divided into smaller principalities, so medical authority, amid the din of surrounding activity, drowsily aroused by Arabic authors teaching it the diseases that prevailed at its own door and by the reclaimed study of Hip- pocrates, began to look, to think, to see ; and as it saw, it was confused ; and in its confusion, it was disruptured. But each separate division, however petty, became the empire of a separate dogma, and quarreled and encroached or was en- croached upon by its neighbor: and consequently men's minds again were active, new truths were again discovered, and medical science, so far as it kept in the path of, and aid- ed medical art, again progressed. Then, frigid facts, encrust- ed in decaying dogmata, were reached by the reviving sun of observation; and escaping, returned as the enriching dew from heaven, and nourished the fruits of the diligent cul- tivator. At the present day, the science* of medicine has in conse- quence, in many respects, progressed; and bearing in mind that science is "knowledge arranged and employed in the manner best adapted for the attainment of its ends," i.e. "for practice,"* we will briefly review its state. We find in all its elementary branches, a growth that could only have followed a truthful investigation. Anatomy and Physiology —the, first the empirical observer,, as it were, of the human frame in health; the second, its illustrator and expounder,— modestly acknowledging their imperfections, as modestly ex- ercise the noblest faculties of the human intellect, to learn the laws^of God in man ; and, acquiring therefrom wisdom, with cheerful assiduity and hopeful perseverance, renew their widening labors. Chemistry, which released from the con- trol of its vain, dogmatic and mysterious ancestor—alchemy —, has indeed discovered the philosopher's stone, and become the mathematical aid to medical art;—Chemistry has, avow- ing with exultation its boundless prospects, by inspiring and * Oesterlen's Medical Logic, page 12. Sydenham Society Publication!. by Geo. E. Belcher, M.D. 7 searching labors, developed more certain sighs of disease, discovered the atomic natures of old and also new remedies for the medical investigator, and given new ideas how to re- gulate diet for the preservation and restoration of health. Morbid anatomy, by its pains-taking and minute investiga- tions of the effects of disease, has enabled Pathology to com- pare with their results, its symptoms and phenomena; and, in consequence, to furnish more discriminating notions in re- gard to diagnosis, prognosis and indications for treatment. Even the Materia Medica of the school at present predomi- nant, in spite of an imperfect science of therapeutics, has dis- carded with some valuable, many more tra'shy remedies, and laboriously accumulated empirical observations from every source : and, as if anticipating the time when the effects of medicine on the healthy constitution will be the basis of its science, it has of late begun to gather in such knowledge. But in practice—in the art of adapting a proper means of cure—in the art of discriminating the action of remedies in their application to disease, the school assuming to be le- gitimate—probably because of its legitimate succession from its respectable progenitors—has not advanced at all in pro- portion to the progress it has made in the sciences above mentioned. Indeed, there is scarcely a doubt that legitimate physicians ofthepresent day have far less confidence than those who preceded them, in the means they use of aiding the restora- tion of health. Dr. Williams, in his able work on the " Prin- ciples of Medicine," in the introductory chapter, headed :*— " On the need of the study of general pathology, as the foun- "dation of practical medicine :" —says:-—" Compare the state "of the practice of medicine with that of anatomy, physio- " logy, chemistry—the great fundamental or preparatory stu- " dies. How minute, how precise, how connected and defi- " nite are these f Yet how loose, indefinite, uncertain, uncon- " nected, is the practice of our art. To the public it appears "altogether vague—without any acknowledged principles. " Is there any wonder then that quackery should triumph ? " that the public>how their want of faith in legitimate medi- * Page 13. (Bell's Medical Library, 1844.) 8 Inaugural Address, " cine by their ready belief in any novelty that is not legiti- " mate ? Thus, one year, St. John Long's plan ; another " year, homoeopathy," (which on the same page, he under- stands to propound " that the best cure for a disease is the " influence which caused it"); another Morrison's pills ; an- " other the water-cure—rules the fashion. The public may "show their ignorance by such credulity, but they show, " also, the want of something plain and trustworthy in "regular medicine. The public will not believe that the secret " of the art is with a faculty, which professes to follow ex- perience only." The last sentence hints at what he consi- ders the cause, i. e. the treating of the sick by experience only. He may be partly right in this respect; but does not the necessity, which compels the physician to trust to this, show there is need of correcting other deficiences in medical science ? And I would suggest that one, and no doubt the principal cause of the low state of medical art, is the theory, which makes a correct pathology the necessary basis of the art of cure. Dr. Marshall Hall (in his work on Diagnosis) says:—"The diagnosis of diseases constitutes the first part " of the office of the physician, in his actual visits to the sick. "With the diagnosis must be associated correct views of the " nature of the disease, or the pathology, and a just apprecia- " tion of the powers and condition of the patient, or, to use "a neglected phrase of great practical value, the " constitu- " tionP It is in this manner alone that we can be led to the " ultimate object of the physician, the correct appropriation " and adaptation of the remedies, or the therapeutics."* The physician is trained that to treat, or teach the treatment of disease, " he must know the healthy function of the organ or " organs, the history of development, the influence of other "organs, i. e. systems, the changes produced by disease, and " as far as possible, the action of all external or internal " agents."f Consequently when attending the sick, he is to exert all his knowledge of the history of his disease, of its symptoms, of the supposed effects of medicines previously used, in order to conclude in his mind what its nature is: having obtained a conclusion, he is taught upon that, to base * Page 149, 2d edition. + Stokes (and Bell's) Practice. 1840, p. 18. by Geo. E. Belcher, M.D. 9 by induction, a rational treatment. In other words, the phy- sician is proudly, and with contemptuous disapprobation of all other plans, virtually taught; that to treat disease correctly, he must comprehend the infinitely varied deviations from the infinitely complex laws of God in man, and upon the correct- ness of that comprehension depends his ability of deducing a proper indication. Having comprehended, his examination ends, for as Marshall Hall says, " the most perfect know- " ledge of symptoms would be entirely useless, Unless consi- dered as signs and indices of the internal disease."* If he err, either through lack of industry or unavoidable lack of knowledge, in obtaining a correct view of the disease, he can only ascertain his error by the injury it has caused his patient. On a proper theory of disease depends the success of treatment, says the legitimate school—so also, say others, who are not of the legitimate school. What ennobling qua- lity can be aroused in the mind of him, who goes to the sick-room with the impracticable idea of deciding the cor- rect nature of a disease, before he can prescribe ? Is it not natural that, while physicians stake their patients' safety upon their knowledge of disease, they should, seek- ing self-justification, be irritable as to any doubts of the correctness of their conclusions? that they should disagree? and be uncharitable toward any other theory of practice, of which they are, or would be ignorant ? What poignant suffering must be his, who guided by medical science as it now legitimately, rationally exists, discovers, after the use of means often too sadly powerful, that he had mistaken one disease for another? A neuralgia perhaps for an inflammation ? Can deductions, based upon the knowledge of disease, afford a ground of safety or of reasonable certainty, when the sciences, which support that knowledge, are conti- nually bringing and will continue to bring to light new truths, and are therefore continually changing men's views of its na- ture ? Can we found upon the best knowledge of disease, which can be acquired at the present day, any pathological indications that do without experiment, guide us to vary * On Diagnosis, page 28. 10 Inamgwal Address, treatment with the varying phases of different epidemics, or with the varying shades in the symptoms of the same epi- demic ? Practical medicine based upon pathological know- ledge, neglects the minute study of symptoms when it cannot explain them; and does not consider it important, when a condition of disease is diagnosed (rheumatism for instance) to ascertain whether the pains are aggravated from rest or motion, from cold or warmth, at evening, night or morning : do not these facts—these deficiencies in directing observation or in taking into view the totality of symptoms, which every practitioner of any school realizes at the bed-side, prove it as lacking in the elements for the foundation of scientific—of rational medical treatment? And what is the treatment, by induction, for instance of inflammation, that science teaches ? Perhaps, regarding the " increase of heat in the part" as " analogous to that of fire, and the blood," as " the fuel by which that flame is kept up,* it is to allay the tumult of inflammatory reaction, by taking blood, and thereby, so long as its effects may last, to palliate it. Suppose there is doubt whether that reaction be inflam- matory or irritative ? Can that doubt be settled, according to the physician's notion of what inflammation or irritation is ? which nption may, by new study or new investigation, dog- matically displace a notion previously held. Or shall he be guided by the plan of Marshall Hall ? who suggests in his truly scientific work on Diagnosis, as follows :—" In cases in "which it is doubtful whether the pain or other local affec- "tion be the effect of inflammation or of irritation, the ques- " tion is immediately determined by placing the patient up- " right and bleeding to incipient syncope: in inflammation " much blood flows ; in irritation very little. The violence " of the disease, the powers of the system, and the due mea- " sures of the remedy, are determined at the same time. " There is" he italicizes, " in my opinion, no single fact in "physic of equal importance and value, in the diagnosis of " acute diseases and the use of an important remedy."^ And what other indications are deduced ? To reduce the tumult * Quotation from Laurence: Watson's Practice, page 123 t On Diagnosis, page 26. by Geo. E. Belcher, M.D. 11 by Antimony, because of its powerful depressing effect: by Mercury, because as Dr. Farre says, it " destroys red blood as effectually as it may be destroyed by venesection : or by Colchicum, or Digitalis, or Opium,* which the diligent student is benignantly told, have a powerful influence over the pulse, &c, and consequently would be indicated scienti- fically : or, it may be, as inflammations more frequently oc- cur among the weak and debilitated, that they might be sometimes treated successfully by Quinine and Brandy—he can. find out when he comes to treat the sick—but to be very careful or they will do harm—they are improperly given, very dangerous indeed^—he can not be too careful: he must study to acquire a correct knowledge of inflammation. Indications, by induction, do indeed sometimes conijise ; and it is conse- quently no wonder, that their study is neglected by the prac- titioner. Again, in saccharine diabetes, science has within a few years past deduced, that its seat might be in the kidneys— again might be in the liver or stomach—again, in the me- dulla oblongata : and consequently the poor patients have been scientifically treated for diseases of the kidney, liver, or brain, according to the latest conclusions of physiological researches. Scientific deductions do therefore sometimes de- lude the practitioner. A fashionable notion, for the last two or three years, has been, to regard that protean cluster of morbid phenomena, rheumatism, as the effect of a preponderance of lactic acid in the blood : and therefrom has been deduced the treatment of curing by neutralizing the acid by Rochelle salts. Gout is owing to a preponderance of uric acid, as may be ascertained by careful diagnosis, and is to be cured by the same Rochelle salts. Wonderful cutting of the Gordian knot! Such a scien- tific horror of treating symptoms! Such a killing of two birds or rather two flocks of birds with one stone! Such a labor- saving indication to rational brains! Does the treatment by such gross routinism of diseased conditions, variable in pro- portion to the number who suffer, rank as high as the grossest * Watson's Practice, Lecture xiv. 12 Inaugural Address, empiricism? Can the profession, which complacently presents to the world the above record of scientific induction, complain that quacks, who reduce their science to a complicated mix- ture of legitimate, Indian, and matronly remedies, displace its members in the estimation of the public. Quackery is no doubt a public curse ; but its existence proves that legitimate, rational treatment is radically defective. So much for the present science of legitimate medicine, doubted by the public, doubted by itself. While all the other departments of medical science have improved as to their practical operations, it still eixsts as formerly, dogmatic and irritable. Degraded, by comparison, in its own estimation, it has so far trammelled medical art as to cause it to took up to its mechanical departments for the chief sources of its honor. Consequently the medical man, who can amputate a limb with tact, or dexterously extirpate an eye, assumes, by ge- neral consent, the head rank in his profession. The impossibility of fulfilling the aims of medical science, founded on pathological conclusions, the unsatisfactory results obtained by the effort, the instability of its inductions or de- ductions, the lack of elasticity in adapting its ill-jointed sys- tem to the varying diathesis or conditions of disease, cause its study " to be generally considered by students as the " heaviest, most repulsive, most tedious of all subjects."* Readily interested in anatomy, physiology, chemistry and pathology—and also in the more glittering and beneficial re- sults of obstetric and surgical arts, they regard the practice of medicine, as taught, as an enormous mass " of dry detail; " its science, mere glimpses into an unknown land ; its rules, " irregular tracks through a wilderness of confusion."f But medical art—practice—clinical medicine, tramelled, deluded, disappointed as it constantly is by imperfect indi- cations, unacquainted with and uninstructed in medicines, ex- cepting by their use and effects in disease has, its mind, so to speak, being trained by the more certain elementary sciences, investigated minutely the symptoms and phenomena of disease; and condescendingly trusting to empirical observations, has * William's Principles, p. 14. + ibid. p. 15. by Geo. E. Belcher, M.D. 13 sifted and gathered together the practical results of judi cious observers. The physician depends upon it for his com- fort, his strength, his satisfaction. Perhaps we can illustrate the value of medical science based upon pathological knowledge, by reviewing or referring to the influence it has upon the physician.— I do not mean the miserable person, who swallows any dogma, because he esteems the source from which it came : whose mind, weakened by his habit, makes him impracti- cable, inefficient, irritable, envious, jealous, malignant! He is an annoyance—a pest in any profession. Nor do I mean the man, whose ambition is to be "respec- table"—in the sight of other men: who respects the honor and dignity of his profession,—because he respects its honors and its dignities : who believes honesty is the best policy— if it is policy ; and who therefore fulfills his duties to the sick and strives to save life by any and every means—providing his standing in the profession is not endangered thereby. He is a bear in the medical Wall-street. But I mean the sincerely honest, plodding physician of the legitimate school. Trained by a preceptor, whose whole pro- fessional life is an ambitious effort to reconcile his science and his art, who avows with pride, that correct practice must be founded on the knowledge of disease; he goes to the bed- side, trammelled by the wish to sustain his science, and, to sa- tisfy his wishes, he makes it, if possible, submit to almost any contortion. He really imitates the practice, and abstractly believes the science of his preceptor; and he uses either, as they serve his purpose. Observing by practice, new shades and varieties of morbid conditions, uncertainty in legitimate indications, and in the effects of medicines in legitimate doses, he gradually acquires thereby a more discriminate knowledge of disease and of remedial action,—and as he does so, does he neglect his science. That worries him, confuses him, frightens him. He feels more at home, when he trusts to his acquired tact in examining phenomena, in weighing them, and in adjusting to them the accumulations of obser- vations empirical or rational (according to his notions), and of hints culled from books and journals, from conversations 14 Inaugural Address, with other physicians, from old ladies, from chance hits, newspapers, almanacs, advertisements—from any body or any thing. He becomes a gleaner, a picker-up of empirical or practical knowledge from any person and every field—and does not hesitate to own it—excepting from one, the sugges- tion of an idea of taking any thing.from that makes him ner- vous—vexes him. He acquires an art peculiarly his own, and has theories which he cautiously believes, so long as they suit his practice-. He dreads a new scientific induction in treatment, as a burnt child dreads the fire; and leaves its glory to some scientific professor. Feeling at heart, and at times discouragingly, that medicine is an uncertain—very uncertain science, he practically realizes that he has no law, and becomes a law unto himself. Like the mass of his con- temporaries, he is irritable and incredulous as to any radically new suggestion: and using his present acquirements as the basis, he seeks in the sick-room, like a right-minded man, to adopt any means that have to him a show of practical rea- son, to alleviate the sufferings of the sick. He boasts that he depends on his acquired experience—limited, as it necessarily is; and that he does not treat by books—in other words is not guided, aided, directed by the records of his science: and thereby he preaches to the world that it is defective, treache- rous, inefficient. The chemist, the physiologist, the pathologist, the mineralo- gist, all alike, know that when their art neglects its science, it neglects the sources of its truth. But of all the sciences, of all the arts, of all the professions, legitimate medical art is the only one at the present day, which boasts it has no rule, no fundamental principle. And, contrary to the practice of any other art, it gives no encouragement to acquire any pre- liminary knowledge of the remedies it uses ; and trusts the safety of the sick solely to the uncertain empirical knowledge of medicines, obtained by their good or bad effects, when ad- ministered during disease. Taking the ground that empirical observation—practical experience—is the foundation of medical science; and that science is perfect and true in so far as it meets the demands of its practitioners, and constantly sustains and encourages by Geo. E. Belcher, M.D. 15 them to make further investigations, rational or empirical: we will now examine the claims of Homceopathy. It propounds the theory, that like cures like. Similia simi- libus curantur. In accordance with the nature of man's constitution, it ad- vises the mourner to be comforted among those who mourn ; the joyful to seek relief among those who rejoice ; the intel- lectual student, - to find rest and vigor among those who think; the pious, to gain strength among those who are seeking the right, in a manner corresponding to his sincere desire; and the investigator of science, to be enlivened and enlightened among its investigators. Medicines will cause disease. Lead, for instance will h> duce colic and paralysis ; and imponderable fumes from lead will do it quicker than the pure metal itself. Morbid poisons, whether visible or dynamic, ponderable or imponderable, appreciable to the senses or inappreciable, will produce disease, as all will appreciate, whether the sufferer gets the itch or the ague. And medicinal and morbid poisons induce diseases, the diagnosis between which it is not always easy to decide. Can physicians diagnose, to a demonstration, without being in- formed of previous treatment, an intermittent kept up by over-dosing with Quinine, from that kept up by morbid cau- ses? Can he, in the same way, readily diagnose a mercurial from an idiopathic iritis ? Can he positively diagnose—espe- cially by any rational symptom—a lead from a bilious colic? Are not the phenomena of typhus-fever and drunkenness often very similar ? Is it not " of the utmost importance to appreciate the effects of" venesection, and to "distinguish them from those of the disease, in the course of inflamma- tions ?"* Does not honest lago sometimes find it convenient, when called to see a patient to express the fact, when he says that the greatest difficulty is to cure the diseases induced by " rascally poisons ?" Has it not occurred, that an intelli- gent physician has treated what he supposed was primary, * Marshall Hall, on Diagnosis, pages 110, 198-«202. 16 Inaugural Address, and afterwards discovered he was treating a medicinal dis- ease? Medicines or medicinal poisons, like morbid poisons, act specifically or directly on certain organs and systems of the body—in health as well in disease. Tartar-emetic will vo- mit, by its specific action on the stomach, a well man at least as promptly as a sick one. Homoeopathy is based upon the principle that in order to cure a disease directly, it is necessary to give a remedy which acts directly or specifically upon the organ diseased. The old-legitimate school adopt the principle in a general, not a discriminating sense; and classify various medicines, accord- ing to their specific actions, into narcotics, emetics, diapho- retics, cholagogues, sialogogues, &c. Homoeopathy goes still further, and teaches how to choose, to discriminate a proper specific remedy : for instance, a man has disease of the liver. In order to select, the physician is taught to compare all the symptoms of the disease, both general and local, and to adapt a^remedy, whose general and local effects are similar to it: and that a remedy is more applicable than another, because acting on the liver in the way and manner the disease does, it, of necessity, produces its effect on the exact seat of disease. This constitutes the basis of homoeopathic practice. The duty of the physician is to study the symptoms and pheno- mena of disease by the elaborate records and other aids of science, and to investigate the effects of medicines on the healthy constitution in the same manner. The art is to dis- criminate nicely, minutely the history, nature and phenomena of disease, also of medicinal action ; that they may by com- parison, be adapted to each other as exactly as possible. In other words the art is that of diagnosis and prognosis, in order that the nature and course of a disorder may be calculated upon, and, also beyond that, that a remedial means may be selected. The principle is shadowed forth in Marshall Hall's work on Diagnosis, thus.—" When experiments have been carefully " instituted, and the results collected by an assiduous obser- " vation, we may expect to become acquainted with the real " effects of those agents which we consider as remedies—both by Geo. E. Belcher, M.D. 17 "good and bad. An investigation conducted in this spirit "would, I feel convinced, lead to some important results. " We still want an essay on the morbid effects of remedies."* Hufeland, in his day the chief of old-school German phy- sicians, acknowledges the principle, thus.—The selection of remedies may be made-----" in an empirical way, i. e. " through the knowledge, acquired by experience, that such "or such a remedy has a particular relation and curative " power, as regards a certain organ or morbid condition of " the system; such are the effects of Cantharides on the uri- " nary organs, of Mercury on syphilis—specifica.—Also the " principle: " Similia similibus curantur," the knowledge of "medicines, which produce in a healthy state symptoms "similar to the disease, may be very well profited of, in order " to discover such remedies."f That the art of discriminating exact features in disease, or shades of symptoms, may be based upon careful observation, Homoeopathy, assuming that a perfect knowledge of disease is unattainable, teaches to decide an indication of treatment by comparing the totality of symptoms both of disease and medicinal action, and adapting them to each other. By the totality is meant simply all the symptoms, all the signs— those which are readily perceptible to the senses ; and those which are developed by scientific investigation. And the relative appreciation of these is that which sustains the art of the physician above referred to. A knowledge of dis- ease, obtained from any and every source, aids him, but does not control him in understanding the therapeutical drift of symptoms: and, in proportion to the perfection of his ac- quirements, is-he more competent to arrange his perception of them into a definite idea. But as scientific knowledge may not take in all the symptoms, that idea is modified in a man- ner by conscious or unconscious observation of other symp- toms, which cannot always be expressed :—inward knowledge may'grasp their meaning practically and efficiently;—and that inward knowledge constitutes the skill and ability of the physician. The physician is therefore great, in proportion as * p. 30. t Hufeland's Practiee, page 73. 2 18 Inaugural Address, he has the power, outwardly expressed, or inwardly hidden, of weighing nice shades in the expression of disease, and in the expression of medicinal action, beyond what science does elucidate. So the accomplished student of human nature, because by scientific cultivation of his faculties, he im- proves his power of observing more discriminatively the whole—the totality of conduct, grasps essential points of character by little turns or expressions in conversation, manner, &c. This is the quality of the human intellect which goes before science, before reason: it is purified and developed by them, and they in turn are enlarged and corrected by it: before which, as before a judicial tribunal, every theory is weighed in the balance: which culls the grain of truth from the chaff of error; which makes the practical man the highest order of man. Stunted and trammelled by natural infirmities; cramp- ed, smothered, and overwhelmed by cherished infirmities; its vitality aroused only by a sincere desire for truth, it ob- serves all things according to its individual power, and selects therefrom their essence, their quality, their strength. It is, indeed, the spirit of truth, of consciousness, of rectitude; and its power realized is that which exalts man above the beasts, above another, and which inspires him with the idea of God. Nourished by truth, it knows the truth by the vigor it ac- quires in comprehending and in developing it;—it conse- quently decides that science to be in truthful development, in proportion as it lays open to its view the totality of things. Taking totality as its foundation, it recognizes the compre- hensiveness of a theory, by its enlarging its range of obser- vation and investigation. It teaches the practitioner to neg- lect his science in proportion as its principles are false: and also to rest upon his science in proportion as its teachings con- stantly aid, correct, guide and enlarge the scope of its power —and that not with the irritability of impaired health, but with the conscious freedom of normal vigor. The homoso- pathist acknowledges his constant dependence upon the re- cords of his science, in cultivating, and pointing his powers of discriminating indications, and thereby extols his science by his art. The old-school, the legitimate physician proudly by Geo. E. Belcher, M.D. 19 boasts that his art is independent of his science, and thereby condemns his science. As to doses,—they are matters of observation—empirical, if you choose. As Hahnemann was lead on and confirmed in his belief of the principle, by cures with moderate and even ordinary old-school doses; that of itself is sufficient proof that they are not necessarily incompatible with the principle. But as it can be easily imagined, that a nauseous stomach would be sensitive to the influence of Ipecac, such doses would often aggravate injuriously. Reducing them, conse- quently, by dilution and trituration, led to the practical dis- covery that medicines have inherent, innate, dynamic powers. The proof is in their effects ; on the same principle that the existence of morbid poisons is proved by their effects. Ob- servation—further observation, may discover a more certain guide, than is known at present, by which the size or extent, and the repetition of doses may be determined, but the na- tural tendency of all who favor the principle, is, of course, to give medicines in such doses, as will act without causing per- turbation. In the legitimate school, alteratives are always given in small doses, because exciting reaction of the system against larger, precludes the sought-for effects from smaller doses: and this principle, so limited in the old-school, sha- dowed forth the idea, so compatible with nature's indication, so accordant with the comfort of the sick, that disease is more naturally, rationally, cured by means that do not disturb the patient's rest and quiet. In making the above imperfect statement of the main prin- ciples arising out of the law—similia similibus curantur— it will occur to any candid observer, that it aids, develops, and extends the scope of medical science and art. It makes a minute study of disease in all its details, and by all the means the elementary, or the collateral sciences, or empirical observation can produce, the basis of an examina- tion of the sick. It makes the effects of medicines or other agents upon the healthy constitution, a knowledge of which is obtained by the same means, the basis by which the scope of their actions can be ascertained. What other theory encourages such ex- 20 Inaugural Address, animations ? What other theory even furnishes a motive for such investigations ? It teaches the physician that as one part of his noble art is to discriminate the essential symptoms, explained or un- explained, rational or empirical, by which he may acquire a knowledge of the course of disease, its diagnosis, and prog- nosis: so another and more important part is to discriminate, by comparing the pathology and the extraneous symptoms of disease, with the pathology and extraneous symptoms of medicinal action. Pathology, unsafe as a foundation, be- cause always progressive, assumes its natural position as the principle elementary science of medicine; and aids empi- rical observation, by guiding it with the elaborated conclu- sions derived from previous experience and investigation. Can there be a nobler study for the human intellect ? Can the human understanding be better developed, than by the exercise of nicely discriminating the course, diagnosis and prognosis of disease, and of minutely scrutinizing shades of morbific and medicinal influences ? It discourages routinism in the diagnosis of disease, and in its treatment; because its essence is to define particular indications. It suggests new remedies, and the scope of their actions. Does any theory, heretofore propounded, do as much as this ? Its study necessarily assists the mind to grasp the results of purely empirical practice ; because it necessarily trains to discriminate. It corrects and extends the knowledge of disease; because its indications, as a rule, discourage any treatment, that per- turbs the system in its struggle against disease. It corrects the conclusions, so far as treatment is concern- ed, of pathology; because it requires over and above any scientific inductions, a nice symptomatic adaptation of re- medial to morbific influences. It aids the science of pathology; because while it studies the effects of medicines on man and animals, it can in- vestigate their phenomena, from the beginning to the ending of the diseases they cause: and so, by analogy, illustrate the effects of morbific influences. by Geo. E. Belcher, M.D. 21 It proves itself to be a development of science; because it requires a constant study of the accumulated records of disease in any and every manner; and because it as strong- ly requires a constant recourse to the accumulated records of medicinal action. Fellow-believers in the homoeopathic law of cure, this is a hasty review of the science, which teaches the art of di;. rectly acting by remedial agents upon disease. Whether it is exclusively true or not, is to be ascertained by observa- tion—empirical observation. Reasoning or authority cannot overturn it, nor sneers, nor ridicule ;—nor can it be establish- ed by reasoning or authority. Founded upon observation, observation can alone do it. And upon the honest endeavor of its disciples—having in view solely therelief of the sick— to adapt its teachings to practice; and that, with more safety and certainty than by any other theory, is its recognition by the medical world to be anticipated. There is one thing, gentlemen, which showrs that the whole profession is prepared for a radical change;—and that is, the growing skepticism of the legitimate school in regard to the efficacy of medicines as curative agents. We have been informed that pneumonia and typhus-fever, for instance, have been treated by them more successfully without than with medicines: and in our daily rounds, we hear the un- seemly boast, that the legitimate physician treats his cases of scarlet-fever better, if he gives nothing. Belief in medicine is innate—is not even confined to man: skepticism is therefore unnatural, and must be based on its improper or imperfect use. And we may reasonably expect that, in another gene- ration the learned and conscientious teachers of the predomi- nant school, who, by their position, are necessarily conserva- tive, will listen to a suggestion, which is founded upon and furthers observation. i