^v:^ 
 
HOMOEOPATHIC   PHYSICIANS
              OF  THE UNITED  STATES.

         PRESENTED TO THE AMERICAN INSTITUTE OF HOMQUOPATHT

                       BY B. F. JOSLIN, M. D.

Medical Brethren:—
  In  endeavoring to fulfill the duty  of addressing you on some
topics designated by our National  Society, I believe  it will be in
accordance with the  spirit of their resolution, to offer some thoughts
on The  Advancement  of Medical Science, and especially on
HOMCEOPATHY, CONSIDERED AS IMPROVABLE.

  Your  practice is a continual confirmation of the fundamental law
of therapeutics.  The verification of this law, however, by Hahne-
mann and his successors, are  already so numerous, that  compara-
tively little can be added to the extreme probability of its universality
by any new clinical observations.  It is not chiefly  in this direction
that you are to labor for the advancement of medical science; though
by  the  repetition of verifications you may promote its  diffusion
among those who hitherto remain skeptical.
  The law of cure, and some obvious  inferences from  it  being
established, but the curative property of the great mass of material
agents being still undiscovered, your more useful eflForts in advancing
the healing art will not  often be in searching for new principles, but
for new  facts—not for new methods of  employing known  remedies,
but for new remedies to be employed under the  guidance of princi-
ples with  which you are already familiar.  The  term new is not
here intended to exclude the hitherto undiscovered properties  of
drugs, partially proved.  Revealing the functions still latent in one 
2
HOMOEOPATHIC LETTER.
of these,  may be  virtually equivalent to creating a new remedy.
The provings and reprovings of drugs  constitute the great work
devolving upon the disciples of Hahnemann.
  The additions thus made can never shake  the  fundamental prin-
ciple of similitude, nor  the general principle of proving, which the
very terms  of that law of cure imply.  Thus  far, at least,  the
homoeopathic  system ranks  among  the branches  of  established
science.
  The same rank, however, cannot be accorded to many subordinate
generalizations, which ingenious theorists attempt to introduce into
the superstructure.  For example,  the  relative  importance of a
medicine to different  organs and functions, and  that of different
medicines to the same  organ or function,  can  never be exactly
determined till the provings of such medicine or medicines  shall
have been completed.   In the meantime, the classifications which
relate  to  these, and which convenience may require, are to be  re-
garded only as approximate, provisional and temporary.
  Still lower in scientific rank, and more vacillating, are systems
of therapeutics founded on pathological hypotheses or mere clinical
experience.   The bad success of other schools should  teach ours to
avoid squandering their time by eflForts in that   direction.   Such
systems require frequent reconstruction.
  The legitimate extension of  the  Materia Medica by provings, is
not liable  to occasion  similar oscillations throughout the fabric.
Real materials accumulate nearly in the ratio of the number of ex-
periments.   If  some unsound elements are unavoidably introduced,
they will, by a kind of interstitial and molecular growth, analogous
to nutrition  in  the human body, be ultimately eliminated  without
any sudden or general shock,  their places being supplied by others
which better stand the test of  enlarged experience.
  Thus, new symptoms  give to  the  Materia Medica  structure,  its
extension ; the verification of old ones, its solidification.   Original
provings effect the former; reprovings effect  both.  The repetition
of the experiments by different provers, will  determine the relative
frequency of recurrence of the  several genuine  symptoms,  and
consequently their relative adaptedness to the average human  or-
ganism.
  But no  genuine drug symptoms  are absolutely useless, however
rare the organisms to which  they are peculiar;  so  that few  Deed 
HOMOEOPATHIC LETTER.
3
 decline making contributions  to the Materia Medica  from fear of
 vitiating it with their idiosyncrasies.  Natural or acquired peculiari-
 ties in a portion of the provers, and in some of them a susceptibility
 which almost amounts to  disease, may be requisite for the ultimate
 completeness of the world's knowledge of the properties of medicines.
   The therapeutic utility of that part  of the Materia Medica thus
 developed, will not be limited  to a class of patients whose normal
 state is similar to  that  of these  sensitive  provers;  for a disease
 generates a sensibility to  the action of its appropriate remedy; and
 in many instances this remedy may remain  undiscovered,  until its
 morbific properties shall  have been developed by persons naturally
 more sensitive  to  its action than  the  patients  themselves in their
 normal condition.  There may be many symptoms of  a drug which
 a majority  of provers  may  be incapable of  experiencing as its
 effects ;  and if  by disease, a  great  number  of  these symptoms
 should be developed in their own persons, they might be dependent
 for their cure,  upon the labors  of a few whose constitutions or con-
 ditions at the time of  the provings had been  dissimilar to their own.
   Both  classes of persons above referred to as proper agents  for
 extending a Materia Medica Pura,  are  supposed to have  few symp-
 toms, except those produced by the proving, and to be capable of
 distinguishing  the former, and careful to reject them.
   There is another class  from  whom may be obtained verifications
 of  symptoms  previously  established.    These are patients.   The
 confirmations which they afford are of  two kinds, pathogenetic and
 therapeutic.  Both require great discrimination and  caution,  for
 distinguishing the effects  of the drug from the  natural progress  or
 retrogradation  of  the disease.
  Meagre descriptions of cases cured under  several remedies given
 in quick succession, contribute nothing to the  confirmation of the
 Materia Medica.
  If the symptoms of a  case  are  minutely  noted, their entire  re-
 moval under a  single remedy, tends to verify the pathogenesis, but
 not in the same degree as would the recurrence of an equal number
 of symptoms, in reproving by new provers.   Such cures afford col-
 lateral evidence in favor  of the Materia Medica; they fortify, but
without extending it.   To admit new symptoms on mere therapeutic
evidence, would be in some degree a return of the uncertain method
of the  empirical  school. 
4
HOMOEOPATHIC  LETTER.
  The use of patients  for pathogenetic purposes  is attended with
similar difficulties, and  requires similar precautions.   Yet the mor-
bific effects  of  medicines appropriate  for the cure, will afford fre-
quent opportunities of confirming the results primarily derived from
the healthy.  By marking in a Materia Medica or repertory, the
symptoms thus  confirmed, physicians might collect much concurrent
evidence.   Under a  symptom of  the former, or drug of the latter,
an oblique line  (1)  might be placed  for  every unequivocal  patho-
genetic confirmation,  and another  oppositely  inclined for every
unequivocal curative one.   The  number of marks would show the
amount of  confirmations.   Whenever they  mutually  intersected,
they would form an  approximation to a star, already in our  school
the conventional sign  that  the drug has been  observed to exhibit
both modes of action with reference to the symptom.
   The morbific effects of drugs are frequently observed to be the
same on the sick as on the healthy, even  to  the minutest particu-
lars ;  and it is  probable  that the  real morbific  effects are identical,
and that the principal  reason for not relying on such provings is,
the danger of introducing symptoms proper  to the disease  alone.
This danger would vary with the  knowledge and caution of the ob-
server.
   A similar danger  attends  therapeutic verifications, and is in one
respect greater,  viz.,  in  regard  to  critical days.  Many  accurate
observers have  noticed certain epochs  of  decline  or termination  of
diseases, especially those of a febrile character.  The more marked
of  these changes occur on the third, seventh,  eleventh, fourteenth,
or twenty-first  days.   Several partial crises are observed in the pro-
gress of the same  case, each  leaving it changed by the somewhat
sudden disappearance or mitigation of some of the symptoms.  Now,
if under a correct treatment, each of these changes is on the whole,
a favorable one, and the final result  happy, the several improve-
ments and the  final cure are  not attributable  merely to Nature; and
on the other hand, not merely to the medicines given  immediately
before the epochs of the several  changes.  If others  had been pre-
viously administered, they may have  equal claims as  the  cause  of
the improvement or  cure.  If the physician neglects the observation
of critical days, he may  draw erroneous conclusions in regard to the
curative influence of a drug.   The quotidian changes are generally
appreciated.  The before mentioned critical days are also, in regard 
HOMOEOPATHIC LETTER.
5
to some symptoms, and  in  some degree, days of exacerbation, and
their neglect might vitiate  the pathogenetic confirmations, though
usually less  than the  therapeutic.   To  prove medicines on  the
healthy is the great work which devolves on our school.
   Some allege as an objection to additional provings, that the pile
of materials  is  already inconveniently large.  In  regard to this,
they might best appreciate the influence of additions, by  means of
subtractions ; because, by making the latter, we  can  compare objects
with which we are already acquainted.   As an experiment then, let
any physician expunge at random, one-half of each paragraph of a
Materia Medica or repertory, or,  what is equivalent, systematically
avoid consulting the first or last half of each paragraph, throughout
the book.  The mere conception of such a  course must satisfy any
experienced and thorough practitioner,  of the impossibility of attain-
ing even a near approximation  to his  present success, without vast
additional labor.  Toward the true remedy, and often to  one only
analogous  to it, he would  approximate by a longer series of com-
parisons than that which now suffices for obtaining the similimum.
Such being the effect of curtailing our  present resources, we can on
this, as on many other subjects, reason from subtraction to addition,
and  from the past to the future.   It is presumable, that  the effect
of adding will be opposite to that of  subtracting, and that of future
contributions similar to that of former ones.  The effect of reducing
the number of  symptoms of a remedy  in a Materia Medica, affords
an argument in favor of reprovings ; that  of reducing  the number
of remedies appended to  a symptom  in a  repertory, an  argument
in favor of original provings.
   We are agreed as to the general mode of improving our Materia
Medica, i. e., by the examination of  morbific properties, and not by
the direct observation of curative ones, on which other schools rely.
This will always insure to ours an immense  advantage in the rapidity
and certainty of development, which will be proportional to the labor
bestowed.
   I  have hitherto referred to our fundamental principles,  which are
eternal, and our materials, which are cumulative.
   Is the science of medicine in all its comprehensiveness, to become
equally reliable, or improvable with equal certainty and  rapidity ?
This is not to be  expected.  Some  auxiliary branches, common  to
all schools, must, from their nature,  remain more uncertain  and 
6
HOMOEOPATHIC LETTER.
less progressive ;  and when the exclusive labor of cultivating them
shall devolve also upon the disciples of Hahnemann, you will, with
these sciences, inherit those difficulties which are necessarily inherent
in them; though  some difficulties will be more easily surmounted
with the aid of Homoeopathy ; and some of the problems which pre-
sent other difficulties, will  themselves sink into practical insignifi-
cance, in proportion as the great  truths of  our system  are  appre-
ciated.
  Many physiological and pathological  problems  are  of  such a
character as to present to those  homoeopatbists who  may attempt
their solution, elements of uncertainty similar to  those encountered
by  previous medical  theorists;  so that, considered  in relation to
some of these collateral or auxiliary topics, Reformed Medicine is
not destined  to be exempt from  slow  development.   Here lie the
same  rocks on which have  been wrecked so many  navigators of
other times, compelled by their position simultaneously to encounter
invisible under-currents, and unforeseen shifting of winds.   Or, to
speak less  figuratively, the  investigator  is  compelled to grapple
with a problem of  numerous and  uncertain elements.
  Now, if  a great portion of what all schools, our own inclusive,
allow to be medical problems, are for a long time  to remain without
solution, and some of  them ever to remain incapable of any that is
demonstrably true, is  this  a ground of  discouragement to the fol-
lowers of Hahnemann ?  Does it affect the certainty of reward for
your proper labors in  the advancement  of Medicine, considered in
its more important practical bearings ?  In this respect your position
is different  from  that of the physiological  schools.  With  them,
theories of the functions of the human  organism are  the foundation
of therapeutics.   They are working at  one  unfinished monument;
you  at  another.   Their alterations are in a  considerable degree,
fundamental, and  cause  dilapidations in the superstructure,  and
necessitate its frequent demolition and  reconstruction.   You build
on an immovable foundation, and every extensive alteration involves
progression.
  In proportion to your faith in this, will, cseteris paribus, be your
happiness and activity; for one of the most agreeable and effectual
incitements to labor, is the  certainty of success.
  You have not, like many of your allopathic neighbors, the gloomy
and paralysing skepticism which keeps them in  doubt, respecting the 
HOMOEOPATHIC LETTER.                    7
proper reply to such inquiries as the following: Is there such a thing
as therapeutic science ?   Is the world, considered as one complex
individual, advancing more and more toward maturity in medical
knowledge ?  Have we any means of  determining whether this  age
knows more than the last, or  whether the  next  generation will be
wiser than our own?  If all these questions had to be answered in
the negative,  the philanthropist  and lover of truth would be  left
without any stimulus to exertion  in the cause of medical science.
   The world,  in some of its aspects, is calculated to give this  dis-
couraging impression.  In general, the controversies of parties  and
sects seem incapable of settlement.  Many old divisions continue
for ages, whilst new ones  arise to occasion increased distraction of
the human mind.  If one sect or  another acquires in its turn a tem-
porary preponderance or popularity, this is due to the eloquence of
its champions,  or some fortuitous advantage, oftener  than to  any
new and conclusive demonstration of truth.
   No doubt  many  place our medical sect in the  same category.
But from what has been above stated, it is  evident that our method
of investigation, if compared with the modes in which many medical,
moral and political  theories have been developed,  would exhibit a
striking contrast favorable to Homoeopathy, not only with regard to
its inherent truth, but its  power of eventually gaining universal  re-
ception.
            I am respectfully and fraternally yours,
   New York, June Uh, 1855.                B.  F. JOSLIN.