August 1st, 1856.

Patient was entirely given up to des pair, and used latterly large doses of Asafoetida in order to kill the pain, also without effect. Merc. v. 3....

30

August 4th. Patient reported that she had been relieved of the pain immediately, and that she had come to report it and thought she did not need any more medicine.

19. FEBRIS GASTRICA.-Ellen, an Irish cook, about twentyfive years old, dark complexion, good-natured, complained after hard working and lifting of soreness in and tenderness of the epigastrium; nausea; disagreeable taste; pressure in the forehead, worse in stooping; want of appetite; tongue furred and coated yellow; fever; small, quick, and frequent pulse; dry, hot skin; flushed face; great weakness. She suffered usually in the morning from cramp in the stomach. August 27th, 1856. Nux vom., ...; after some aggravation patient got well next day.

12

(To be continued.)

AMERICAN INSTITUTE OF HOMEOPATHY.

The Seventeenth Annual Meeting of the Institute, will be held in the city of Philadelphia, on Wednesday, the 6th of June.

Members of the Institute and others purposing to attend the next Meeting of the Institute, are requested to send their names to J. P. DAKE, M.D., Pittsburgh, Pa., together with the routes they wish to take, and the names of the Agents or Superintendents of such routes, that he may secure a reduction of

fare for them.

BY CARROLL DUNHAM, M. D., NEWBURGH, N. Y.

The symptoms which drugs produce upon the healthy organism vary according to the dose. They may be :--

1. CHEMICAL-depending on the chemical affinity which exists between the drug and the tissues of the body, and independant of vitality; or,

2. MECHANICAL (or revolutionary), consisting chiefly in violent efforts on the part of the organism to eject from its cavities the offending substance; or,

3. DYNAMIC, Contingent upon vitality and resulting from the relations of the peculiar properties of the drug to the susceptibilities of the living, healthy organism. These dynamic effects may be:

A. Generic-such as are common to all the members of a certain class of drugs and which serve to distinguish this class from others, but do not furnish means of distinguishing between different individuals of the same class. For example, Arsenic in certain doses produces vomiting and diarrhoea, with cold sweat and cramps of the extremities. These are dynamic effects of Arsenic but they are generic, since other

members of the class to which Arsenic belongs, viz. :—Cuprum, Veratrum, Tartar emetic, &c., in certain doses, produce identical symptoms; and were these remedies proved in such doses alone, it would be impossible to distinguish the pathogenesis of one of them from that of any of the others.

B. Specific-such as result from the dynamic action of the drug and are peculiar to it. They serve to distinguish a given drug from all others. For example, Arsenic, taken in different doses from those which produce the generic dynamic effects, produces vomiting and diarrhoea or tendencies thereto; but these phenomena are accompanied and characterized by conditions quite different from those which accompany the similar symptoms of Cuprum, Veratrum, &c., and are thus distinguishable from the effects of these drugs.

The Specific-dynamic symptoms may be again sub-divided into Central and Peripheral.

The Central symptoms appear speedily after the drug is taken, are generally the result of comparatively large doses and, in the case of many drugs, are confined to the alimentary canal and to the organs immediately connected with it.

The Peripheral symptoms appear more tardily, are generally the result of comparatively small doses, taken repeatedly or allowed to act without interruption for a long period, and appear in the bones, skin, glands, &c., and in the co-ordinated phenomena of life. They are often the manifestations of a dyscrasia or cachexy. Doses which produce central symptoms do not generally produce the peripheral (or at least not until after a long period has elapsed) and vice versa. For example, Mercury, in certain doses, produces well-marked and characteristic action upon the alimentary canal and its appendages. In smaller doses it produces, instead of these effects, a series of symptoms in the skin, bones, glands, &c.— the Mercurial cachexy. The former are what we mean by central specific dynamic symptoms. The latter are the peripheral symptoms. Arsenic, again, furnishes, according to the dose, examples of all of the above varieties of symptoms. In certain doses it developes chemical and revolutionary effects.

In smaller doses, as we have seen, generic dynamic; in still smaller doses, specific dynamic symptoms of the central variety. In yet smaller doses, it produces peripheral specific symptoms, which are those of the so-called "gradual poison. ing; as, for instance, in poisoning by exhalations of Arsenic from green wall-paper, in which the phenomena of vomiting and diarrhoea or the central specific symptoms do not appear, but, instead of these we have evidence of a distinct cachexy, in the skin and glandular symptoms, marasmus, &c.

Such are the varieties of symptoms produced by corresponding varieties in the dose. It is hardly necessary to say that they are not always to be distinguished with precision ; but the facility with which we are able to recognise them is in proportion to the completeness of our proving.

It unquestionably behooves the homoeopathic physician to have an exhaustive knowledge of the whole sphere of action of his drugs; but, as a prescriber, he must be familiar with the varieties and sub-varieties of dynamic effects which we have specified. This knowledge is to be attained in the first place only by drug-proving. The proving of drugs must then be so conducted as to produce in the greatest possible completeness and clearness, each of these varieties and sub-varieties. This, as has been shown, is to be accomplished by a skilful selection and succession of doses. It is not so simple and easy a matter as it might at first view appear to be: for,

First: The doses by which the corresponding varieties of symptoms are produced, differ widely in different drugs. For example, a half grain of crude Nitrate of silver or of Sulphuric acid produces chemical symptoms, while a half grain of Lycopodium or of Silicea produces probably no symptom at all. A grain of Arsenic produces generic dynamic symptoms, while ten grains of Natrum muriaticum may be inert. Forty drops of Bryonia tincture may excite a fair show of specific dynamic symptoms, while forty drops of tincture of Opium will produce generic dynamic symptoms or full narcotism.

Secondly: The susceptibility of different provers to the same drug is very different, and the degree of susceptibility

which each prover possesses is to be learned only by experiment. For example, one prover will take five hundred drops of Thuja without any effect; another, taking twenty drops, experiences violent specific symptoms.

Thirdly: The susceptibility of provers to different preparations of the same drug is very various and apparently capricious. One records characteristic specific symptoms from large doses of the crude drug, and is not affected by smaller doses; another is acted on by dilutions and not by any quantity of the crude substance.

The relative power of a drug and susceptibility of the prover being altogether unknown until ascertained by direct experiment, the proving of a new drug is therefore a matter of pure experiment in every particular, and it might at first view be supposed to be a matter of indifference in what manner or with what doses the experiment is begun; which variety or sub-variety of symptoms is first developed, whether we take heroic doses and develope chemical symptoms or small doses and produce peripheral dynamic symptoms; since in either case we should be able by subsequent experiments based on the first, to develope the complementary symptoms and thus complete our proving. Experience teaches, however, that this supposition is not sound, and for the following rea sons-Drugs vary not more in the intensity than in the permanence of their action upon the organism. Some drugs appear speedily to exhaust, sometimes by a single large dose, the susceptibility of the prover, so that no subsequent doses, whether large or small, produce any effect. Of others again, a single large dose developes some one generic or central specific symptom, and along with it induces such an exalted and distorted susceptibility that every subsequent dose, whether large or small, evokes straightway that one symptom or series of symptoms and none other. Thus the proving is in either case partial and incomplete-we fail to get those symptoms which are the most valuable of all to us, as being those which clearly characterize the drug and enable us to distinguish it from all other drugs, viz. :—the peripheral and cen