REFORMATION IN THE Practice of Medicine BY THE Dosimetric Method of Practice. OR THE METHOD OF SMALL DOSES OF THE ACTIVE PRINCIPLES OF PLANTS, MATHEMATICAL- LY MEASURED AND SCIENTIFICALLY ADAPTED TO THE VARIED ABNORMAL CONDITIONS. With Biographical Sketch of Dr. Ad. Burggraeve. BY J. E. MACNEILL, M. D Revised and Reprinted from The Dosimetric Medical Review, July, 188g. Published by W. J. MORRISON, 43-47 Broad Street, New York. REFORMATION IN THE PRACTICE OF MEDICINE BY THE DOSIMETRIC METHOD OF PRACTICE. J. E. Mac Neill, M. D. The Dosimetric method in the practice of medicine, that is the method of small doses of the active principles of plants mathematically measured and scientifically adapted to the varied abnormal conditions, was originated by the illustrious and venerable Dr. Burggraeve, of the University of Ghent, some twenty years ago. The method so boldly and ably promulgated from a source so eminent, attracted the atten- tion of many of the ablest and brightest physicians in various portions of Europe, who very soon gave him their most earnest and loyal sup- port. Strengthened by the consciousness of the advantages of the new method over the old systems of practice in the saving of life and suffering, and in the maintainance of health and longevity, Dr. Burg- graeve, after years of effective labor in perfecting the method and in educating both the profession and the people up to it, assisted by his very able and earnest colleagues, is now rewarded by the knowledge that 11,000 of the most advanced and influential physicians in Europe and America are Dosimetrists (including one-fifth of all the physicians in France) with a clientage of about 20,000,000 of patrons and adhe- rents. The enormous and rapid extension of Dosimetry in compara- tively so short a time, sufficiently attests the great favor and popularity with which it is received wherever introduced. Its usefulness and success in the cure of disease and in the maintainance of health among its patrons is its own recommendation. Quietly, yet surely and rap- idly it is coining to be recognized as the only absolutely safe, accurate, scientific and reliable method of practice. The substances used in the practice of Dosimetry are the active principles of the plants, and are for the most part the crystalized alka- loids or the glucosides. The granules contain accurately weighed quantities of simple substances whose chemical composition is invaria- ble, whose effects are always the same, and are such that they can be calculated with great certainty in advance. The medicaments or granules used by Dr. Burggraeve and his followers are prepared exclu- sively by M. Ch. Chanteaud & Co., the eminent and skillful pharmacists of Paris, and are always uniform in strength and efficiency. From the first, M. Chanteaud has been an active co-laborer of Dr. Burggraeve, and is the founder of Dosimetric Pharmacy, the reliability of whose preparations has so greatly added to the wonderful effectiveness and marvellous success of Dosimetry. Each granule contains, according to its medicament, a half milligramme, one milligramme or one centi- gramme of the active substance, protected by sugar of milk. These quantities correspond to I3'o, 6TS and £ respectively of a grain English, and are administered in quantities of one or more, as may be required by the age or condition of the patient. They are rapidly dis- solved by the juices of the stomach and are absorbed within ten or fifteen minutes, so there is no possibility of an accumulation as some- times happens with pills and other preparations ordinarily prescribed in doses too large, or of medicines not readily absorbed or assimilated, thus avoiding all danger of any accumulative and dangerous effect, especially as there is in the Dosimetric treatment a lavage intestinale every morning by taking a small quantity of Sedlitz Chanteaud, which has the triple good effect of acting on the digestive tract, on the kidneys and on the skin. Dr. Burggraeve early established some simple rules of treatment, simple in form, but of the greatest value in practice. In each disease he distinguishes two periods, the first, or dynamic, presenting only functional disturbance ; the second, or organic, accompanied by a change of tissue. 2 It is in the first period that the Dosimetric physician uses the most active means possible to jugulate the disease; that is to cause it to abort. From this Dr. Burggraeve educed his rule to give to an acute attack an acute treatment and to repeat the small doses frequently until the desired effect was obtained, independently of the quantity of medicine administered; thus doing away with the idea of maxima and minima, which have been regarded as axioms, and which are as great hindrances to success as are the massive doses currently employed for certain drugs. Small doses facilitate the absoption of the medicine and make it certain that the needed quan- tity shall not be exceeded. The disease may be considered as a resistance to the remedy, or a resistance of the human organism in a state of disease to the remedy. The dose should therefore be adapted to the morbid resistance. The adaptation cannot be known beforehand. The organism and the condition of the patient can alone indicate it. The dosimetric physician has thus the route he is to follow clearly placed before him by the imperious indications of the facts in the case. He is in no danger of an imprudence by giving too much of the remedy, because be stops or gives it less frequently when the useful effect he aims at begins to be accomplished, and on the other hand he is not held back in his treatment by timidity, for he is guided by Dr. Burggraeve's invaluable rule to continue giving the remedy until a useful or sufficient effect is obtained, that is, a result which is sensib e to the patient or appreciable by the physician. One granule too few may prevent the desired effect; one granule too many, by increasing that effect, can do no harm. There can be no' exact treatment without an exact clinical knowl- edge and an exact remedy. The exact remedy can only be had in the alkaloids or active principles of medicinal plants. If the hesitation that some physicians manifest to the use of the alka- loids proceeds from the fact that they regard them as poisonous, this may be justified to some extent for the reason that in allopathic prac- tice examples occur frequently of poisoning by their use from an 3 incorrect estimate of their strength or from careless or inefficient prescribing. Not so, however, in Dosimetric practice, as, in all of the many hun- dreds of thousands of cases so treated since the foundation of this method, not a single case of poisoning has occurred or can be cited. In Dosimetry, poisoning is "materially impossible " says the eminent Prof. Laura, of Turin, and of the School of Medicine of Paris. This distinguished physician, teacher, and scientist, also says in his "Phar- maco Dynamic Comparee," recently published, that his life for twenty- five years has been devoted to the hospitals, to instruction, and to private practice. During eighteen years of this time he followed the rules of the regular school of medicine, but for the past seven years he has devoted himself to the study and practice of Dosimetry exclusively. He says that he is profoundly and seriously convinced that this new Dosimetric method is a grand progress in the science and art of medi- cine, that it restores to the physician an abiding faith in the curative powers of his art, while it spares him the dangers of an excessive treatment, and that it renders to suffering humanity services much superior to those of ordinary medicine. Within the ranks of Dr. Burggraeve's followers are already num- bered many of the most eminent physicians of Europe, who are con- stantly adding to the popularity of Dosimetry by their large and suc- cessful experience, patient research and valuable discoveries. Special consideration is due to Dr. Fontaine, of Bar-sur-Seine, who has deserved well of humanity, and especially of parents, in discovering a treatment as simple as it is infallible for croup, and in general for all those diphtheretic and contagious affections so prevalent and so fatal among children. Thus to the venerable and distinguished Burggraeve and to the incomparable system of practice he has given to the world, reinforced and perfected by and with the cooperation of his able and zealous colleagues, is due the homage and endless gratitude of many thousands of parents whose children under Dosimetric treatment have been spared the fatal ravages of these most dreaded and destructive scourges, diphtheria, croup, scarlet fever, yellow fever, cholera, etc., etc. 4 whose victims are annually numbered by the thousands in all parts of the world and before which physicians of the prevailing schools of practice, with their multiplicty of conflicting ideas and remedies, with their heterogeneous and infinitesimal doses alike stand appalled and powerless in the face of a victorious and vicious enemy with which they are unable to cope. How long will they continue the un- equal contest with their erroneous, inexact and unscientific ideas, remedies and methods against a foe so relentless and so well organized, while every consideration of humanity, professional honor and success calls upon them to equip themselves with the more modern, scientific and successful means placed at their disposal through the genius and unfaltering courage of the great Burggraeve? Dr. D'Oliveira Castro, of Madrid, another distinguished physician and scientist, in his interesting and instructive 11 Elements ofTherapeu- tics and Practice " (Republished in translation in 1888) conclusively attests the great superiority of Dosimetry over all other systems of practice in the successful treatment of all contagious and other diseases of childhood and adult life. Thanks to the Dosimetric granules so active despite their small size (but which bear no relation whatever to homoeopathic globules) the physician knows with mathematical certain- ty what he is doing for his patient. If he is called in time, the varied forms of pneumonia and the gravest attacks of pleurisy will give way in a few days. Typhoid fever will disappear in one or two weeks under early Dosimetric treatment, leaving none of its dreaded and tedious sequellse so common under the ordinary treatment, whilst all the eruptive mala- dies, small-pox, scarlet fever, measles, etc., being no longer influenced by feverish conditions or cutaneous irritations will follow their course without danger to the patient. The fact is worth something also that patients treated by the Dosimetric method escape the nauseating and excessive dosage of the allopathic system which is too often so serious a hindrance to their successful treatment. Thus, too, they may also escape the illusionary treatment of the homoeopathic school. The Dosimetric granules are elegant, easily taken and readily assimilated, 5 perfectly agreeing in all cases with the most sensitive stomachs, and are veritable "Arms of Precision" in the treatment of disease, the patient, young or old, scarcely realizing that remedies the most pow- erful and potent in the cure of disease are being administered. The "Expectancy Method" of treatment of the old schools-expecting the patient to recover or die before the physician recognizes exactly what the condition is or is to be, and therefore leaving him undecided as to the exact treatment required, or causing him to neglect the proper treatment-is utterly repudiated in Dosimetric practice. In Dosimetry treatment is commenced at once by remedies exactly suited to the existing conditions, and in doses exactly and scientifically adjusted thereto. No time is lost (often a factor of the greatest importance) in sending to a drug store for some nauseating mixture that the chances are will not be properly taken when obtained, and the risk is entirely obviated of not getting what the physician orders or the patient will not take whether suited thereto or not. The great majority of chil- dren instinctively refuse to take medicines as ordinarily prescribed. Adults, impelled both by reason and instinct, in a large proportion of cases are equally intractable. Aside from and in addition to this serious objection to the prevail- ing method of practice is the more serious objection, alas! too often fatal to the patient, of errors either in properly writing or filling the prescription. The chances assumed by the patient in thus taking medicines are, to speak within bounds, hazardous. They assume all the chances of errors by the physician in knowing or remembering or of correctly calculating or correctly writing the proper doses. Errors of this kind, more or less serious are of daily occurrence, either through haste, incompetence or carelessness. Again, the patient assumes all the chances of errors on the part of the druggist in correctly reading, understanding or filling the prescription. That serious and often fatal mistakes are made in this way, either through carelessness or incompe- tence is well understood by all. Again by taking the same prescription calling for different ingredients, to different drug stores, a resulting mixture of varying strength will be obtained in the great majority of 6 cases. This is unavoidable from the inseparable defects in the whole system of polypharmacy and of prescribing in accordance with the pre- vailing methods of practice. However competent the druggist may be it is practically out of the question for him to know the varying strength of medicines on his shelves, purchased of different dealers or manufacturers, at different times, prepared by different formulas and by different methods. Chemical changes and deterioration also of necessity take place in many drugs and preparations resulting from their age and the varying conditions of atmosphere and temperature to which they are of necessity subjected. None are so dull as not to be able to comprehend the fact that under these existing conditions the practice of medicine can never become an exact science or even claim an approach thereto. The Dosimetric method of treatment is prompt in action, decisive in results and entirely agreeable to the patient, factors that in them- selves often decide the question as between life and death. In a word Dosimetry combines all the merits and advantages (and many more) of the other systems of practice and rejects their disadvantages, errors and fallacies. Among intelligent classes it is rapidly becoming the pre- ferred and popular practice, because of its prompt and superior results. This is more especially the case in Europe, where it has longer been known, and where the most eminent and progressive phy- sicians have, by observation and experiment, become convinced of its great superiority over all other systems of practice, and are adopting it as the one common basis upon which the various conflicting schools and theories of practice can unite. In a word, quoting the eloquent remark of Prof. Laura," Dosimetric medicine is enjoined upon us as a duty." Since writing the foregoing, I have learned that some of the most distinguished physicians of the French Academy of medicine have pro- nounced in the strongest and most unqualified manner in favor of alkaloidal medication. I quote from the official reports, Feb. 3d, 1889: " Professor Germain See closed his communication upon the cardiac medicaments with the following conclusions: To fill the therapeutic 7 conditions, the essential principles of plants, that is to say, the alka- loids and the glucocides, have an incontestable superiority over the plants themselves. * * * In all cases we may do without the plant, which is an irregular mixture, dangerously variable. But we can never do without the essential principle, which is fixed and chemi- cally defined, and may be formulated with precision; the choice between the two cannot be a matter of doubt." At the same session of the Academy, Professor Laborde read a long communication upon alkaloidal therapeutics in which he arrived at the following conclusions: "1. In every medicamentous preparation taken from the vegetable kingdom, there exists one or several active substances through which it exercises its physiological and therapeutic action. " 2. When this active substance, if it have one, has been isolated, determined and chemically formulated-in which case it must be regarded as its proximate principle-it is this to which it would be reasonable for us to address ourselves, with a view to its therapeutic use, after having first subjected it to experimental, and then to rigid clinical tests. "3. In fact, whilst the proximate principle is always the same, identical with itself, invariable in its essential constitution, as in its funda- mental, physiological and medicamentous action, the substance of the entire plant is essentially complex and variable, not only in its compo- sition, but in its effects, and it does not and cannot result in actions which shall be other than multiple, diverse, undefined and unknown." -Denver, Col., June, 1889. 8 J. E. Mac Neill, M. D. PHYSICIAN AND SURGEON. TELEPHONE 131 Cor. Larimer anp 20th Streets. Dear Sir: Desiring to call your attention to a matter of vital importance to all, I take the liberty of mailing to your address a monograph entitled, "Reformation in the Practice of Medicine by the Dosimetric Method of Practice," recently published in the Dosimetric Medical Review, of New York City, which, it is hoped, will receive your most careful consideration. This method founded some twenty years ago by the venerable and illustrious Dr. Burggraeve, of Ghent, (one of the oldest and most eminent physicians living-for fifty years professor of surgery in the University of Ghent, and Surgeon-in-chief of the great Civic Hospital of that city), has stood the test of the most careful and extended investigation and practical experience in the daily practice of many of the most eminent physicians of Europe, and is now taking precedence over all other systems of practice wherever introduced, more especially among the more thoughtful and intelligent classes. Combining as it does all the advantages of the other methods or schools of practice and discarding their many defects and objectionable features, it affords to the sick from whatever disease or cause, benefits far superior to those obtained from any of the older methods. By a proper and systematic use of this method, adjusted to the requirements of individual cases, even while in apparent good health, longevity can unquestionably be greatly promoted, as is illustrated in the case of Dr. Burggraeve himself, a man now 83 years of age, but apparently in the prime and vigor of early manhood and daily performing prodigies of labor that would appall most men of half his years. Should you upon due consideration, decide to give this new method of practice your valuable influence and support, you will certainly never regret it and yours will be the consciousness and the satisfaction of having aided in the more speedy and wide-spread introduction of this great boon and blessing to humanity-the simplest, safest, surest, most scientific, most exact and reliable, and most satisfactory method of practice. Let me ask of you to carefully read the article sent you, which briefly explains the new Dosimetric method, in comparison with the other methods of practice. Very Respectfully Yours, THE LIFE AND WORK OF DR. BURGGRAEVE Adolph Burggraeve was born in Ghent in the year 1806. In early youth he gave remarkable evidences of a studious and reflective mind and great care was taken with his education. ■ Destined by his friends for the medical profession, he successfully pursued his studies in Bel- gium, and, on completing them, entered into the current practice of the so-called regular school in his native city. He soon developed as a physician those remarkable powers of mind which have since made him eminent, and was early called to the surgical service of the Civil Hospital of Ghent, of which institution he soon became the Chief Sur- geon. During this period of his career he instituted many new and important measures and wrote several profound treatises upon this de- partment of his art, to which, as it seemed at that time probable, he was to devote his life. But the mental energies of the maturing physician had already begun to work in a broader field of research and one which stands at the very gates of human existence. He had observed the too great 9 mortality present in surgical cases; he noted that nearly two-thirds of these patients died from purulent infection or traumatism, and he believed these conditions to be preventable. The introduction of anti- septic dressings soon took care of the former part of the work to be done. The remaining problem lay in the question of how to dispose of the factor of traumatism. This equation was finally triumphantly solved by Dr. Burggraeve, and it was during his studies to this end that Dosimetry was born. Dr. Burggraeve believed that traumatic fever was due to a stasis of blood in the capillary circulation, having for its primary cause a paralysis of the vaso-motor nerves controlling the circulation. He thought that, by restoring to these nerves their tone and im- proving their vitality, he would bring back the circulation to its nor- mal condition and put a stop to that stagnation of the blood which is at first a source of heat and then of inflammation, and thus becomes the origin of congestion, changes of texture, and finally of lesions. He recalled to mind a successful treatment of intermittent fever and cholera in Russia, in 1832, by Dr. Mandt, of St. Petersburg, des- cribed in a memoir upon Indian cholera, which was read in 1854 by Dr. Everard before the Royal Academy of Medicine of Belgium. The Academicians paid no attention to this memoir, they did not even discuss it, the cholera epidemic having ceased. Dr. Burggraeve, however, found in this memoir material for serious study, and he de- cided to apply Dr. Mandt's methods to all of the fever cases which came under his charge in the Hospital of Ghent. He, however, sub- stituted alkaloids for the substances of the plants which Mandt had used. He gave to his patients strychnine in small doses, repeated at short intervals, to give tone to the vaso-motor nerves, and thus to re- establish the circulation of the blood. At the same time with the strychnine he gave small doses of aconitine and veratrine, to lower the temperature and stop the fever. He thus made the discovery that it is sometimes possible to prevent the fever, very often to jugulate it, and always to check the fever syndrome. Encouraged by this success, he studied the effects upon himself and others of the different alkaloids which he thought suitable to introduce 10 into therapeutics, and thence followed the formulation of the Dosimetric method of medical practice which, during the twenty succeeding years became known in all the civilized countries of the world and received the highest endorsement from some of the best minds in the profession. The effect upon practicing physicians of the principles and methods advanced by Professor Burggraeve has been very strongly marked. Large numbers of them have frankly thrown aside the encumbered therapeutics and involved pharmacy of the old school and entered fully upon Dosimetric practice. Others have unavowedly adopted it and use it in their practice as their most powerful aid on occasions demanding- prompt, sure and energetic treatment. It has unquestionably modi- fied the practice of medicine everywhere and must soon become univer- sally recognized as the only efficient, safe and certain method of thera- peutics which has yet been given to the world. Meanwhile Dr. Burggraeve, now Professor Emeritus of the Ghent University at which he first pursued his researches, and a prominent member of the Koyal Academy of Medicine of Belgium, awaits, full of years and honors, the final and universal recognition of his labors. He is still working for the cause he has instituted and may fairly be re- garded as a living proof of benefits which are to be derived from his measures of treatment. Personally, he is thus described by Dr. Paul Bert of the Paris Faculty: "Dr. Burggraeve occupies one of the first places in the history of contemporary surgery, by his 'works and his innovations. Since he has taken in hand, as a physician, the rational and systematic Dosimetric method, I look upon him as the Belgian Hippocrates. He is a fine robust old man, of high stature, and with a firm, straight step ; his features indicate the predominance of the reflective faculties; the glance of his fine eyes, overshadowed by thick brows, penetrates far and deep; his forehead is that of a thinker who is not content with merely think- ing. In a word he is a man who unites great strength to great activity, and he reminds me of what Vicq d'Azyr said of Haller: 'Nature has treated him with the care which she has but rarely bestowed upon the men who honor the present century.' " 11 The distinguished physician, teacher and writer Professor Laura, of the School of Medicine, Paris, in a recently published work says: "My life for twenty-five years has been devoted, to the Hospitals, to instruction and to private practice. "During eighteen years of this time, I followed the rules of the regular School of Medicine, but for the past seven years I have devoted myself to the study and practice of Dosimetry exclusively. "I am profoundly and seriously convinced that this new Dosimet- ric Method is a grand progress in the science and art of Medicine. "It restores to the physician an abiding faith in the curative powers of his art, while it spares him the dangers of an excessive treatment, and renders to suffering humanity services much superior to those of 'ordinary medicine.' "