medical essays-第14章

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send　for　Dr。　Muhlenbein！

It　is　evidently　impossible　that　I　should　attempt；　within　the　compass　of　a　single　lecture；　any　detailed　examination　of　the　very　numerous　cases　reported　in　the　Homoeopathic　Treatises　and　Journals。　　Having　been　in　the　habit　of　receiving　the　French　〃Archives　of　Homoeopathic　Medicine〃　until　the　premature　decease　of　that　Journal；　I　have　had　the　opportunity　of　becoming　acquainted　somewhat　with　the　style　of　these　documents；　and　experiencing　whatever　degree　of　conviction　they　were　calculated　to　produce。　　Although　of　course　I　do　not　wish　any　value　to　be　assumed　for　my　opinion；　such　as　it　is；　I　consider　that　you　are　entitled　to　hear　it。　　So　far；　then；　as　I　am　acquainted　with　the　general　character　of　the　cases　reported　by　the　Homoeopathic　physicians；　they　would　for　the　most　part　be　considered　as　wholly　undeserving　a　place　in　any　English；　French；　or　American　periodical　of　high　standing；　if；　instead　of　favoring　the　doctrine　they　were　intended　to　support；　they　were　brought　forward　to　prove　the　efficacy　of　any　common　remedy　administered　by　any　common　practitioner。　　There　are　occasional　exceptions　to　this　remark；　but　the　general　truth　of　it　is　rendered　probable　by　the　fact　that　these　cases　are　always；　or　almost　always；　written　with　the　single　object　of　showing　the　efficacy　of　the　medicine　used；　or　the　skill　of　the　practitioner；　and　it　is　recognized　as　a　general　rule　that　such　cases　deserve　very　little　confidence。　　Yet　they　may　sound　well　enough；　one　at　a　time；　to　those　who　are　not　fully　aware　of　the　fallacies　of　medical　evidence。　　Let　me　state　a　case　in　illustration。　　Nobody　doubts　that　some　patients　recover　under　every　form　of　practice。　　Probably　all　are　willing　to　allow　that　a　large　majority；　for　instance；　ninety　in　a　hundred；　of　such　cases　as　a　physician　is　called　to　in　daily　practice；　would　recover；　sooner　or　later；　with　more　or　less　difficulty；　provided　nothing　were　done　to　interfere　seriously　with　the　efforts　of　nature。

Suppose；　then；　a　physician　who　has　a　hundred　patients　prescribes　to　each　of　them　pills　made　of　some　entirely　inert　substance；　as　starch；　for　instance。　　Ninety　of　them　get　well；　or　if　he　chooses　to　use　such　language；　he　cures　ninety　of　them。　　It　is　evident；　according　to　the　doctrine　of　chances；　that　there　must　be　a　considerable　number　of　coincidences　between　the　relief　of　the　patient　and　the　administration　of　the　remedy。　　It　is　altogether　probable　that　there　will　happen　two　or　three　very　striking　coincidences　out　of　the　whole　ninety　cases；　in　which　it　would　seem　evident　that　the　medicine　produced　the　relief；　though　it　had；　as　we　assumed；　nothing　to　do　with　it。　　Now　suppose　that　the　physician　publishes　these　cases；　will　they　not　have　a　plausible　appearance　of　proving　that　which；　as　we　granted　at　the　outset；　was　entirely　false？　　Suppose　that　instead　of　pills　of　starch　he　employs　microscopic　sugarplums；　with　the　five'　million　billion　trillionth　part　of　a　suspicion　of　aconite　or　pulsatilla；　and　then　publishes　his　successful　cases；　through　the　leaden　lips　of　the　press；　or　the　living　ones　of　his　female　acquaintances；does　that　make　the　impression　a　less　erroneous　one？　　But　so　it　is　that　in　Homoeopathic　works　and　journals　and　gossip　one　can　never；　or　next　to　never；　find　anything　but　successful　cases；　which　might　do　very　well　as　a　proof　of　superior　skill；　did　it　not　prove　as　much　for　the　swindling　advertisers　whose　certificates　disgrace　so　many　of　our　newspapers。　How　long　will　it　take　mankind　to　learn　that　while　they　listen　to　〃the　speaking　hundreds　and　units；　who　make　the　world　ring　〃with　the　pretended　triumphs　they　have　witnessed；　the　〃dumb　millions〃　of　deluded　and　injured　victims　are　paying　the　daily　forfeit　of　their　misplaced　confidence！

I　am　sorry　to　see；　also；　that　a　degree　of　ignorance　as　to　the　natural　course　of　diseases　is　often　shown　in　these　published　cases；　which；　although　it　may　not　be　detected　by　the　unprofessional　reader；　conveys　an　unpleasant　impression　to　those　who　are　acquainted　with　the　subject。　　Thus　a　young　woman　affected　with　jaundice　is　mentioned　in　the　German　〃Annals　of　Clinical　Homoeopathy〃　as　having　been　cured　in　twenty…nine　days　by　pulsatilla　and　nux　vomica。　　Rummel；　a　well…known　writer　of　the　same　school；　speaks　of　curing　a　case　of　jaundice　in　thirty…four　days　by　Homoeopathic　doses　of　pulsatilla；　aconite；　and　cinchona。　　I　happened　to　have　a　case　in　my　own　household；　a　few　weeks　since；　which　lasted　about　ten　days；　and　this　was　longer　than　I　have　repeatedly　seen　it　in　hospital　practice；　so　that　it　was　nothing　to　boast　of。

Dr。　Munneche　of　Lichtenburg　in　Saxony　is　called　to　a　patient　with　sprained　ankle　who　had　been　a　fortnight　under　the　common　treatment。　The　patient　gets　well　by　the　use　of　arnica　in　a　little　more　than　a　month　longer；　and　this　extraordinary　fact　is　published　in　the　French　〃Archives　of　Homoeopathic　Medicine。〃

In　the　same　Journal　is　recorded　the　case　of　a　patient　who　with　nothing　more；　so　far　as　any　proof　goes；　than　inluenza；　gets　down　to　her　shop　upon　the　sixth　day。

And　again；　the　cool　way　in　which　everything　favorable　in　a　case　is　set　down　by　these　people　entirely　to　their　treatment；　may　be　seen　in　a　case　of　croup　reported　in　the　〃Homoeopathic　Gazette　〃　of　Leipsic；　in　which　leeches；　blistering；　inhalation　of　hot　vapor；　and　powerful　internal　medicine　had　been　employed；　and　yet　the　merit　was　all　attributed　to　one　drop　of　some　Homoeopathic　fluid。

I　need　not　multiply　these　quotations；　which　illustrate　the　grounds　of　an　opinion　which　the　time　does　not　allow　me　to　justify　more　at　length；　other　such　cases　are　lying　open　before　me；　there　is　no　end　to　them　if　more　were　wanted；　for　nothing　is　necessary　but　to　look　into　any　of　the　numerous　broken…down　Journals　of　Homoeopathy；　the　volumes　of　which　may　be　found　on　the　shelves　of　those　curious　in　such　matters。

A　number　of　public　trials　of　Homoeopathy　have　been　made　in　different　parts　of　the　world。　　Six　of　these　are　mentioned　in　the　Manifesto　of　the　〃Homoeopathic　Examiner。〃　　Now　to　suppose　that　any　trial　can　absolutely　silence　people；　would　be　to　forget　the　whole　experience　of　the　past。　　Dr。　Haygarth　and　Dr。　Alderson　could　not　stop　the　sale　of　the　five…guinea　Tractors；　although　they　proved　that　they　could　work　the　same　miracles　with　pieces　of　wood　and　tobacco…pipe。　　It　takes　time　for　truth　to　operate　as　well　as　Homoeopathic　globules。　　Many　persons　thought　the　results　of　these　trials　were　decisive　enough　of　the　nullity　of　the　treatment；　those　who　wish　to　see　the　kind　of　special　pleading　and　evasion　by　which　it　is　attempted　to　cover　results　which；　stated　by　the　〃Homoeopathic　Examiner〃　itself；　look　exceedingly　like　a　miserable　failure；　may　consult　the　opening　flourish　of　that　Journal。　　I　had　not　the　intention　to　speak　of　these　public　trials　at　all；　having　abundant　other　evidence　on　the　point。　But　I　think　it　best；　on　the　whole；　to　mention　two　of　them　in　a　few　words；that　instituted　at　Naples　and　that　of　Andral。

There　have　been　few　names　in　the　medical　profession；　for　the　last　half　century；　so　widely　known　throughout　the　world　of　science　as　that　of　M。　Esquirol；　whose　life　was　devoted　to　the　treatment　of　insanity；　and　who　was　without　a　rival　in　that　department　of　practical　medicine。　It　is　from　an　analysis　communicated　by　him　to　the　〃Gazette　Medicale　de　Paris〃　that　I　derive　my　acquaintance　with　the　account　of　the　trial　at　Naples　by　Dr。　Panvini；　physician　to　the　Hospital　della　Pace。　　This　account　seems　to　be　entirely　deserving　of　credit。　　Ten　patients　were　set　apart；　and　not　allowed　to　take　any　medicine　at　all；much　against　the　wish　of　the　Homoeopathic　physician。　　All　of　them　got　well；　and　of　course　all　of　them　would　have　been　claimed　as　triumphs　if　they　had　been　submitted　to　the　treatment。　　Six　other　slight　cases　（each　of　which　is　specified）　got　well　under　the　Homoeopathic　treatment；　none　of　its　asserted　specific　effects　being　manifested。

All　the　rest　were　cases　of　grave　disease；　and　so　far　as　the　trial；　which　was　interrupted　about　the　fortieth　day；　extended；　the　patients　grew　worse；　or　received　no　benefit。　　A　case　is　reported　on　the　page　before　me　of　a　soldier　affected　with　acute　inflammation　in　the　chest；　who　took　successively　aconite；　bryonia；　nux　vomica；　and　pulsatilla；　and　after　thirty…eight　days　of　treatment　remained　without　any　important　change　in　his　disease。　　The　Homoeopathic　physician　who　treated　these　patients　was　M。　de　Horatiis；　who　had　the　previous　year　been　announcing　his　wonderful　cures。　　And　M。　Esquirol　asserted　to　the　Academy　of　Medicine　in　1835；　that　this　M。　de　Horatiis；　who　is　one　of　the　prominent　personages　in　the　〃Examiner's〃　Manifesto　published　in　1840；　had　subsequently　renounced　Homoeopathy。　　I　may　remark；　by　the　way；　that　this　same　periodical；　which　is　so　very　easy　in　explaining　away　the　results　of　these　trials；　makes　a　mistake　of　only　six　years　or　a　little　more　as　to　the　time　when　this　at　Naples　was　instituted。

M。　Andral；　the　〃eminent　and　very　enlightened　allopathist　〃　of　the　〃Homoeopathic　Examiner；〃　made　the　following　statement　in　March；　1835；　to　the　Academy　of　Medicine：　〃I　have　submitted　this　doctrine　to　experiment；　I　can　reckon　at　this　time　from　one　hundred　and　thirty　to　one　hundred　and　forty　cases；　recorded　with　perfect　fairness；　in　a　great　hospital；　under　the　eye　of　numerous　witnesses；　to　avoid　every　objectionI　obtained　my　remedies　of　M。　　Guibourt；　who　keeps　a　Homoeopathic　pharmacy；　and　whose　strict　exactness　is　well　known；　the　regimen　has　been　scrupulously　observed；　and　I　obtained　from　the　sisters　attached　to　the　hospital　a　special　regimen；　such　as　Hahnemann　orders。　　I　was　told；　however；　some　months　since；　that　I　had　not　been　faithful　to　all　the　rules　of　the　doctrine。　　I　therefore　took　the　trouble　to　begin　again；　I　have　studied　the　practice　of　the　Parisian　Homoeopathists；　as　I　had　studied　their　books；　and　I　became　convinced　that　they　treated　their　patients　as　I　had　treated　mine；　and　I　affirm　that　I　have　been　as　rigorously　exact　in　the　treatment　as　any　other　person。〃

And　he　expressly　asserts　the　entire　nullity　of　the　influence　of　all　the　Homoeopathic　remedies　tried　by　him　in　modifying；　so　far　as　he　could　observe；　the　progress　or　termination　of　diseases。　　It　deserves　notice　that　he　experimented　with　the　most　boasted　substances；　cinchona；　aconite；　mercury；　bryonia；　belladonna。　　Aconite；　for　instance；　he　says　he　administered　in　more　than　forty　cases　of　that　collection　of　feverish　symptoms　in　which　it　exerts　so　much　power；　according　to　Hahnemann；　and　in　not　one　of　them　did　it　have　the　slightest　influence；　the　pulse　and　heat　remaining　as　before。

These　statements　look　pretty　honest；　and　would　seem　hard　to　be　explained　away；　but　it　is　calmly　said　that　he　〃did　not　know　enough　of　the　method　to　select　the　remedies　with　any　tolerable　precision。〃　＇〃Homoeopathic　Examiner；　vol。　　i。　　p。　　22。　〃Nothing　is　left　to　the　caprice　of　the　physician。　　（In　a　word；　instead　of　being　dependent　upon　blind　chance；　that　there　is　an　infallible　law；　guided　by　which；　the　physician　MUST　select　the　proper　remedies。'）　〃Ibid。；　in　a　notice　of　Menzel's　paper。＇　　Who　are　they　that　practice　Homoeopathy；　and　say　this　of　a　man　with　the　Materia　Medica　of　Hahnemann　lying　before　him？　　Who　are　they　that　send　these　same　globules；　on　which　he　experimented；　accompanied　by　a　little　book；　into　families；　whose　members　are　thought　competent　to　empl