isW&t J THE DUTY OF THE STATE IN RELATION TO H0I(E0PATHY; INAUGURAL ADDRESS, DELIVERED BEFORE THE HAHNEMANN ACADEMY OF MEDICINE, On Wednesday, January 9, 1850, n v JOHN F. GRAY, M. D., President. PUBLI8HED BY ORDER OP THE ACADEMY, N E W-Y n kS&£J*6TON, D.^^ " ANGELL & ENGEL, PRINTERS, TRIBUNE BUILDINGS, No. 1 Spp.itce-st., corner of Nassau. Ti 5 0. \ / \ PREFATORY NOTE. The Homoeopathic physicians of the city of New-York and its vicinity, after several preliminary meetings, on the 28th day of November, 1849, organized themselves into an Association under the name ©f " The Hahnemann Academy of Medicine." The preamble of the Constitution declares the assent of its subscribers to the three following truths : 1. That the law propounded by Hahne- mann " Similia similibus curantur'"' is a fundamental truth in the theory of Medicine and the only safe guide in its practice. 2. That the best mode of ascertaining the effects of drugs is by provings upon the healthy organism. And 3, that there is efficacy in attenuated remedies. The object of the Association is stated in the Constitution to be " the advancement of the Healing Art by mutual consultations and by public and private teaching.'''' On the 5th day of December following, the first annual election for officers took place and resulted in the choice of the following gen- tlemen, who constitute the first ** Executive Council" of the Aca- demy. JOHN F. GRAY, M. D. President. S. R. KIRBY, M. D. Vice President. P. P. WELLS, M. D., Corresponding Secretary. JAMES W. METCALF, M. D., Recording Secretary. ALONZO S. BALL, M. D., \ HUDSON KINSLEY, M. D., C Trustees. JOHN A. McVXCKAR, M. D., ) 2 IV. PREFATORY NOTE. On the 12th day of December, the Academy was incorporated as a Scientific Society under the general law of this State, passed April 12, 1848, by the filing in the offices of the County Clerk of the City and County of New-York and of the Secretary of State, a certificate duly acknowledged by the Executive Council, in the form required by law. By the By-Laws of the Academy, the President is required to de- liver an inaugural address on the second Wednesday of January in every year. The following address was delivered in pursuance of that regulation on the evening of Wednesday, January 9th, 1850, at a public meeting held at the Hope Chapel, Broadway, in the city of New-York, and is now published by order of the Academy. ADDRESS. Gentlemen : One of the purposes of this Academy is the teaching of the science of Medicine ; and for the effective fulfilment of this purpose, it is proposed to' ap- ply to the Legislature of the State for the appointment of a Board of Examiners, who may recommend successful candidates to the State for the degree of Doctor of Medicine. The plan of the Academy does not contemplate the erection of another monopoly; the appointment of a Board of six or seven teachers, with the exclusive title of Professor, and the exclusive power to grant or sell the degrees; nor does it exact of its candidates that they shall have attended the lectures of its teachers, or those of any other incorporated college of teachers. It proposes that the Candidate, whether he come from this Academy, from any other institution of Medical learning, or from any private teacher of Medicine, shall be examined by an impartial Board, who shall not be pecuniarily interest- ed in the business of teaching ; and that the examination shall be so conducted as fully and fairly to test the knowledge of the Candidate and at the same time to exemplify the fulness and fairness of such test in every case. In the undivided opinion of the Academy, the great need of the State in respect to Medical education is the reformation of the present system of examination; not the creation of more monopolies, nor the invigoration of the pernicious system which already flourishes but too well, by the grants of larger sums of money than those that are already wasted on them from the coffers of the 6 ADDRESS. State; but the patient and faithful inquiry at the hand of each of the new aspirants for the honors of Medicine and for the sacred trusts of the sick-room, if he have the knowledge—so diversified and profound, so exact and entire—which those honors and trusts, the demands of the State and the wants of the sick, the wounded and the dying, require of him. If the examination be made a verity, if it be made by the Government what it should be, the demand for more knowledge will assuredly pro- duce the supply ; it will beget the industry and assiduity on the part of the student necessary to put him in indis- putable possession of his degree, and it will as certainly make the student find and follow the teachers, whether private or public, known to fame or awaiting in obscurity , the development of their career, who can give him the precious aids he must obtain. The force of this maxim, that the demand will create the supply, is fully shoWn by the results which have flowed from the " Staats Examen" or State Examination —a Board appointed in several, perhaps all of the German States for the examination of the doctors from the Univer- sities before permitting them to practise their profession. The theory of this Institution is, that the people require some other voucher for the qualifications of the young Doctor than the diploma given to him by the Professors of the university at which he completed his studies; be- cause, these Professors being engaged in a competition as to numbers with other schools would have a strong bias in favor of the candidate, however deficient in know- ledge Jie might be—a bias too strong for the safety of the sick. Accordingly, the Government constitutes a suitable number of Physicians, not Professors, a board of License, who are charged with the duty of making a rigorous in- vestigation of the candidate's qualifications, and who are compelled to keep a full record of the whole procedure in each case, under which each Examiner writes his vote, ADDRESS. 7 admitting or rejectiug the candidate. The whole is under the surveillance of the Government, and is carefully in- spected by the Ministry of the Public Health.' Since this excellent system—simple, upright and perfect in opera- tion—was adopted in Denmark and Prussia, now some fifty years, the most beneficial results have flowed from it on a large scale ; indeed, a new era in teaching Medicine and all its collateral sciences has broken upon Germany, and its benefits, especially in Physiology, Chemistry and Pathology, are felt by the whole civilized world. A some- what similar practice has been established by the Govern- ment of the United States for admission into the Army and Navy Medical service, with known and very striking results so far as these branches of the public service are concerned; but the demand as to numbers is too small for it to have any appreciable effect on our Medical Colleges. The Academy proposes to adopt this method of exami- nation and to require of its candidates not only a full knowledge of the various and opposing modes of practice in Allopathy, but also an equally intimate acquaintance with the theory and practice of Homoeopathy. In this requirement it supplies a manifest deficiency in the existing system of medical examination and instruction. The schools not only do not teach nor require an acquain- tance with the researches and records of Homoeopathy ? but they discourage such an acquirement on the part of students and refuse themselves to investigate them. Homoeopathy, right or wrong, has nevertheless taken a deep hold on the mind of the civilized world, and, whether the schools will or no, it must form a part, and that a most important one, of both public and private teaching in medicine. Already have we here in the State of New-York more than 300,000 popular adherents to this mode of practice, of whom 60,000 reside in the cities of New-York and Brook- lvn ; and this party includes in its ranks a very large pro- 8 ADDRESS. portion of the men and women of talent and education in the State—and of the regular graduated and licensed phy- sicians and surgeons of the State, not less than 300 are avowed practitioners of Homoeopathy, beside a considera- ble number who are privately testing it on themselves and their patients. A similar condition of the system exists in several of the States of the republic ; and in Pennsylvania there is a regularly incorporated school of Homoeopathy, which though organized upon the objectionable plan of the col- leges of the common practice, is in successful operation as to numbers and money, and serves at least to mark the truth of what we assert respecting the advancement of our cause in the public faith. In Germany the system steadily advances, as also in Russia, Italy, Spain and Great Britain and Ireland. In Vienna the hospital of the Sisters of Mercy with its enor- mous roll of patients, continues to employ our practice, after many years of uninterrupted experience. In Bavaria by an express decree of the Government, patients in all the public Hospitals and other charities, are permitted to have Homoeopathic physicians in at- tendance if they choose. In Russia the Government has, by an imperial ukase, provided carefully for the distribution of Homoeopathic remedies throughout its vast domains. The people of Great Britain have recently done very much for the new practice, by the founding of infirmaries in all the principal cities and towns, and by organizing a powerful association of the nobility and gentry, amounting to some 1,300 in number, for the publication of popular essays on the subject, and are now founding a large Hos- pital in London. The infirmaries appear to be well sup- ported by the liberality of the opulent, and they are dispensing remedies to the sick poor on a large scale. In Brunswick the Duke has promulgated a decree per- ADDRESS. 9 mitting medical men to practise Homoeopathy. This pro- ceeding was rendered necessary by the prosecution of the late venerable Dr. Miihlenbein for preparing his own remedies, instead of ordering them from the apothecaries, who enjoy a monopoly of their business by law. Having such a hold on the public faith, and being in ninety-nine cases in a hundred adopted and practised by members of the regular faculty here and everywhere, the Academy deems its claim on the Government of this State to grant it the ability to dispense the Degree of Doctor of Medicine a valid claim upon this ground alone. The system, too, has exhibited abundant testimony of its vigor and vitality. First promulgated in 1796, more than fifty years since, it has steadily though slowly ad- vanced, encroaching everywhere, step by step, upon the domains of Allopathy, receding at no point, ever gaining new adherents in the profession and never losing one by relapse or retrocession. At all points met by the same bitter antagonism in and out of the profession, it has withstood the irony, the ridi- cule and the erroneous statements of every kind which its ready and powerful opponents have brought to bear against its advances—ever patiently pointing to its bene- ficent fruits at the bedside of the sick, as at once the best possible reply to all a priori demonstrations of its fallacy, and the surest rejoinder to assaults of a baser character. One by one have the decrees of despotic governments against it been repealed; book after book, written to insure its speedy destruction, has disappeared from the face of society; associations formed and prosecutions undertaken for its extinction, by legal force and by volun- tary co-operation, have been all successively abandoned; and here to-day is Homoeopathy, bearing the same traits of vigorous development and giving the same promise of perpetuity as if not one of these decrees had been uttered, not one of these books of controversy publi.shed, 10 ADDRESS not a single association of exclusion formed or prosecution undertaken. As an additional presage of the permanency of our sys- tem, we may advert to the state of its literature, which, though marked in some few instances by glaring defi- ciencies, is on the whole in a prosperous condition. First, we have the preliminary Essays of Hahnemann, (one of which has, within a few months, been reprinted by the British Homoeopathic Association:) then the Organon, now in its seventh edition; and, lastly, his great work on Chronic Diseases, the fourth edition of which was issued in Germany in the 85th year of its author's age. Then follows the Materia Medica Pura, which is continually coming from the press, either entire or in abridgments, in every civilized country on the globe. The work on Acute Diseases, by Dr. Hartmann, has been rendered into French and English, and has in Ger- many passed through several editions. Jahr's Manual has had several German editions, four or five in English, and two or three in French ; and his last great work, the Symptomen-Codex, finished scarcely a year since, is already nearly exhausted. The parent Journal of Homoeopathy, (the Archiv,) published by Stapf, is now in the 27th year of its un- abated career. The British Journal of Homoeopathy, many copies of which circulate in the United States, has reached the 5th volume, and gives abundant promise, by its liberality and energy, of a long and useful course. In this country we have one quarterly Journal for the profession, issued in Boston, and the American Journal and several others for popular distribution. Besides these standard works of the school, and the Journals enumerated, we have a large number of works scientific and popular, which it is not necessary to cite, but many of which are performing tasks of much virtue ADDRESS. 11 for the aid of physicians and for the propagation of the cause. We put our claim for the power we seek also on another and a higher ground. We assert, on proofs which can be adduced in abundance, that Homoeopathy is an acknowledged part of the medical art of the present day ; that its truth has already been sufficiently admitted by able and leading men of the Old School, although many, perhaps all of them, have made reservations as to the universality of its application. In support of this position, I take the liberty to make use of a few of the quotations contained in a recent work.* The first quotation I shall make is from a well-known work called Austria and its Institutions, by Mr. W. R. Wilde, M.R.I.A., the talented Editor of the Dublin Quar- terly Medical Journal : " The present state of Homoeopathy in Vienna," he observed, "next claims our attention; and although I neither advocate that doctrine, nor slander its supporters, I deem it but the part of truth and justice to lay the following statement before my readers. " One of the cleanest and best regulated hospitals in the capital is managed on the Homoeopathic plan. The following circumstances led to its erection :—The rapid spread of this mode of treatment in Austria, and the patronage it received from many noble and influential individuals in that country, attracted the attention of the government several years ago, who, with their characteristic jealousy of innovation, then issued an order, forbidding it to be practised. As, however, this had not the effect of suppressing it, but as it seemed rather to gain strength from the legal disabilities under which it then labored, it was determined, in 1828, to test its efficacy in the military hospital of the Josephinum. With this view, a commission was nominated, consisting of twelve professors, all of whom, it is but fair to observe, were strenuously opposed to the Homoeopathic doctrine. Dr. Marenzeller, a veteran Homoeopath, and a contemporary of Hahnemann's, was appointed as the physician; and two members of the commission always at- tended him during his visit, and at the expiration of every ten days reported the progress of the cases under his charge. The only part • Truth* and (heir Reception, &c. 2d Edit. London, 1819. 3 12 ADDRESS. of the report published was that of Drs. Jaeger and Zang. It contains a very brief outline of the cases and their treatment, and expresses the surprise of these eminent professors at the happy issue of some of them. The commission, however, as a body, came to the conclusion, that from the result obtained from their investigations, it was impossi- ble to declare either for or against Homoeopathy. One of the twelve, however, subsequently stated his conviction of the efficacy of the sys- tem from those trials, and has since remained an open adherent of it." After giving an account of the establishment of the hospital, and a detail of its internal arrangements, Mr. Wilde proceeds— " In 1834, Dr. Fleischmann, the present physician, was appointed ; and in 1836, this hospital, along with all the others in Vienna, was ordered to be fitted up for the reception of cholera patients. " Dr. Fleischmann agreed to continue his charge, on the conditon that he was to be permitted to adhere to the Homoeopathic plan of treatment. To this the government assented ; and two district physi- cians (Allopaths) were appointed to report upon the nature of the cases taken into this hospital, as well as to observe their course and treatment. " Upon comparing the report made of the treatment of cholera in this hospital, with that of the same epidemic in the othef hospitals in Vienna at a similar time, it appeared that, while two-thirds of those treated by Dr. Fleischmann recovered, two-thirds of these treated by the ordinary methods in the other hospitals died. This very extraor- dinary result led Count Kolowrat (Minister of the Interior) to repeal the law relative to the practice of Homoeopathy; although with that inconsistency which not unfrequently distinguishes the Austrian gov- ernment, it at the same time enacted the strictest prohibition of all the works in favor of the system being published in Austria." Mr. Wilde gives an analysis of the cases treated at this homoeopathic hospital during a series of years, and then goes on to say— " Whatever the opponents of this system may put forward against it, I am bound to say, and I am far from being a Homoeopathic practi- tioner, that the cases I saw treated by it in the Vienna hospital were fully as acute and virulent as those that have come under my observa- tion elsewhere ; and the statistics show that the mortality is much less than in the other hospitals of that city. Knolz, the Austrian proto- medicus, has published those for 1838, which exhibit a mortality of ADDRESS. 13 but five or six per cent.; while three similar institutions on the allo- pathic plan, enumerated before it in the same table, show a mortality as high as from eight to ten per cent." Again, another author, Dr. Millingen, in his Curiosities of Medical Experience, after relating six remarkable ca- ses in which he had tested, and found most unlooked-for benefit from, homoeopathic remedies, put forward the fol- lowing :— " But the facts I am about recording—facts which induced me, from having been one of the warmest opponents of this system, to investi- gate carefully and dispassionately its practical points—will effectually contradict all those assertions regarding the inefficiency of the Homoe- opathic doses, the influence of diet, or the agency of the mind ; for in the following cases, in no one instance, could such influences be brought into action. They were (with scarcely any exception) experiments made without the patient's knowledge, and where no time was allowed for any particular regimen. They may, moreover, be conscientiously relied upon, since they were made with a view to prove the fallacy of the Homoeopathic practice. Their result, as may be perceived by the foregoing observations, by no.means rendered me a convert to the ab- surdities of the doctrine; but fully convinced me, by the most incon- testible facts, that the introduction of fractional doses will soon banish the farrago of nostrums that are now exhibited to the manifest prejudice both of the health and purse of the sufferer." At the conclusion of his experiments, Dr. Millingen adds :— " I could record many instances of similar results, but they would of course be foreign to the nature of this work. I trust that the few cases I have related will afford a convincing proof of the injustice, if not the unjustifiable obstinacy, of those practitioners who, refusing to sub- mit the Homoeopathic practice to a fair trial, condemn it without investigation. That this practice will be adopted by quacks and needy adventurers, there is no doubt; but Homoeopathy is a science on which numerous voluminous works have been written by enlightened practitioners, whose situation in life placed them far above the necessi- ties of speculation. Their publications are not sealed volumes, and any practitioner can also obtain the preparations they recommend. It is possible, nay, more than probable, that physicians cannot find time to commence a new course of studies, for such this investigation must prove. If this is the case, let them frankly own their utter ignorance 14 ADDRESS. of the doctrine, and not denounce with merciless tyranny a practice of which they do not possess the slightest knowledge." Dr. Fletcher, also, in his Elements of General Pathology, gave testimony as follows:— " Every day's experience furnishes us with examples of the truth of the Homoeopathic doctrines, at least in some instances, the several sub- stances operating in producing and curing each its own class of dis- eases, sometimes directly, and at others indirectly, or by sympathy. Do we not continually give purgatives in the cure of diarrhoea 1 as is erroneously supposed, for the purpose of carrying off some offending matter, the presumed cause of the discharge; and how often is aloe, one of the most common causes of piles, a means of effectually re- moving them when already present 1 Among the diuretics, also, can- tharides, as well as the turpentines and balsams, are not more effectual in removing gleet and catarrh of the bladder when present, than they are, under other circumstances, in occasioning thern; and among the diaphoretics, tartar emetic has, according to our personal experience, excellent effects in stopping a diaphoresis, effectual as it is, as every- body knows, when no such affection exists, in exciting it. The sweat- ing sickness was treated formerly by diaphoretics. Further, among the tonics, cinchona, the chief remedy of intermittent fever when pre- sent, is said to be capable of producing this when not; and it was, in- deed, from noticing this effect upon himself, that Hahnemann was first induced to prosecute and systematize the theory in question. Tartar emetic, also, in large doses (when it is rather to be considered a tonic, than either a nauseant, a diaphoretic, or a sedative), which, as every one knows, is one of the most efficacious means of combating inflam- mation in general where it exists, is almost equally sure to produce it when it does not. But the medicine which is most illustrative, in its various operations, of the, truth of the Homoeopathic doctrine, is mer- cury. The occasional effects of this- mineral in producing laryngitis, iritis, ptyalism, and numerous other inflammations and their consequen- ces, are abundantly well known; and what remedy is so effectual in removing, as generally acknowledged, the two former, and, as not long ago proved by Duncan and others, the latter also. Nay, the effects of mercury in curing lues venerea are dependent probably on its power, when no such disease exists, of producing one, if not identical with it, certainly very similar in its specific effects upon the throat, skin, bones, and other organs, to the one in question. Lastly, among the narcotic medicines, the effects of alcohol in removing, as well as exciting de- lirium tremens in all its degrees, have been alluded to, and are suffi- ADDRESS. 15 ciently well known. But not only medicines, but other remedial agents, furnish equally conclusive evidence of the truth, in certain cases at least, of the Homoeopathic doctrine. Thus, what is the blacksmith's remedy, when he has scorched his finger 1 is it not, holding it again to the fire, for the purpose, as he expresses it, of drawing out the heat 1 And what is Dr. Kentish's treatment of burns in general ? is it not by heated oil of turpentine, and other stimulant applications, for the pur- pose, as he presumes, of bringing the inflamed part gradually, not sud- denly, down to the line of health ? This is not the true explanation of the benefit so derived, but the benefit is, nevertheless, unquestionable. Again, the occasional effects of electricity in removing amaurosis, palsy of the tongue, &c, are no less certain, than that these diseases have often resulted from the same cause; and its effects, in either pro- ducing or removing nervous apoplexy, according to circumstances, were beautifully illustrated, on one occasion, by the late Dr. Currie, who found that by passing an electric shock through the head of a rabbit, he could alternately stupify and revive it, for an almost indefi- nite number of times. * * * * Upon the whole, Hahnemann's book is an original and interesting one, and displays more reflection in every page, than many of his decriers will evince in the whole course of their life and conduct for half a century." In harmony with the foregoing remarks, the following " also appeared in the Therapeutique of MM. Trousseau and Pidoux:— " Experience has proved that a multitude of diseases are cured by therapeutic agents, which seem to act in the same direction as the cause of the disease which they are employed to combat." In 1840, Professor D'Amador, of Montpelier, in one of his lectures, remarked,— " Gentlemen,—Now that we have come to this point, you would naturally demand what judgment I have formed respecting the practi- cal and theoretical value of this doctrine (the Homoeopathic). Practi- cally, Homoeopathy is one method more to be added to the existing methods, but a method generally superior to all the others. It is another, but more direct way, and one we can pursue with greater rapidity t safety, and even facility; and if you will allow me to make use of a comparison not destitute of justice, I find in the new medical system some analogy with those rapid paths opened by modem industry which will astonish future generations, after having excited the amazement of contemporary generations; these new paths do not obliterate the an- 16 ADDRESS. cient ones, but they lead us more quickly and better from one point to another; they act more quickly or better in less time. This is the con- dition of each successive discovery. Homoeopathy, in the great ma- jority of cases, admirably fulfils this condition of each competitor. " Theoretically, Homoeopathy is for us a doctrine congenial to vital- ism ; I may say, it is vitalism itself broadly applied to therapeutics. This new system of therapeutics applies directly to the vital forces in order to cure the disease, as the vital pathology studies those forces, in order to form a conception of its formation. The doctrine of vitality has always professed this great principle, that the vital forces being the original source of the disease, it was above all things necessary that the agent which was to destroy the morbid modification, should act on these same forces. In order to discover the complete truth, and to snatch the glory from Germany, the vitalism of Montpellier had only to find the mode of disengaging medicinal agents from the living forces that concealed them; and this is what Hahnemann has done by his grand principle of the attenuation of substances. By this great and beautiful discovery, he has vastly enlarged the sphere of vitalism, and what is more, he has thereby given to this doctrine a practical founda- tion beyond all cavil." Amongst later avowals of eminent Allopathists, regard- ing the claims of Homoeopathy to a respectful examina- tion, the most prominent and satisfactory have been from Dr. Forbes, Physician to the Queen's Household, and Editor of the British and Foreign Medical Review, the late Dr. Andrew Combe, Physician in Ordinary to the Queen, Dr. John Wilson, Inspector of Naval Hospitals and Fleets, and M. Marchall, one of the Examiners of the Faculty of Medicine in Paris. Dr. Forbes admitted, with regard to Hahnemann, that— " No careful observer of his actions, or candid reader of his writings, can hesitate for a moment to admit that he was a very extraordinary man. He was, undoubtedly, a man of genius and a scholar ; a man of indefatigable industry, of undaunted energy; surpassed by few in the originality and ingenuity of his views, superior to most in having sub- stantiated and carried out his doctrines into actual and most extensive practice. It is but an act of justice also, to admit that there exist no grounds for doubting that he was sincere in his belief of the truth of his doctrines, and that many at least among his followers have been, and are, sincere, honest, and learned men. ADDRESS. 17 While, as respects the system, it was allowed that— " Homoeopathy is an original system of medicine, as ingenious as many that preceded it, and destined probably to be the remote, if not the immediate, cause of more important fundamental changes in the practice of the healing art, than have resulted from any promulgated since the days of Galen himself. By most medical men it has been taken for granted, that the system is one not only visionary in itself, but that it is the result of a mere fanciful hypothesis, disconnected with facts of any kind, and supported by no processes of ratiocination or logical inference. And yet nothing can be further from the truth. Whoever examines the homoeopathic doctrines, as enounced and ex- pounded in the original writings of Hahnemann, and of many of his followers, must admit, not only that the system is an ingenious one, but that it professes to be based on a most formidable array of facts and experiments. * * We think it impossible to refuse to Homoeopathy the praise of being an ingenious system of medical doctrine, tolerably complete in its organization, tolerably comprehensive in its views, and as capable of being defended by feasible arguments as most of the sys- tems of medicine which preceded it. * * As an established form of practical medicine—as a great fact in the history of our art—we must, nolentes volentes, consider Homozopathy. * * Not only do we see all our ordinary curable diseases cured in a fair proportion under the ho- moeopathic method of treatment, but even all the severer and more dan- gerous diseases, which most physicians, of whatever school, have been accustomed to consider as not only needing the interposition of art to assist nature in bringing them to a favorable and speedy termination, but demanding the employment of prompt and strong measures to pre- vent a fatal issue in a considerable proportion of cases."* By Dr. Combe it was observed :— " Let us scout quacks and pretenders as we. may, Homoeopathy pre- sents too strong a prima facie case to warrant our dismissing it with ridicule and contempt. * * As a matter of theory, supported only by argument, Homoeopathy produces no conviction whatever in my mind of its truth, or even of its probability ; but as a question of fact, claiming to rest ' on the irresistible ground of its superior power of curing diseases and preserving human life,' and on the alleged experi- ence of able and honest men, as competent to judge as most of those who oppose them, I cannot venture to denounce it as untrue, because I have no experience bearing especially upon it to bring forward, and * British and Foreign Medical Review, Jan. 1846. 13 ADDRESS. we are still too ignorant to be able to predicate, d priori, what may or may not be true in the great field of nature. After the presumptive evidence which has been produced, if I were now in practice, I should hold myself bound without further delay to test its truth, by careful and extensive experiment." * The remark of Dr. Wilson concerning Homoeopathy, to which we have alluded, occurs in his Medical Notes on China, published in 1846. Speaking of cases of common atmospheric cholera which fell under his observation, he states— " In the cholera cases, the doctrine of the Homoeopathists, similia similibus curantur, is partly admitted. Whatever may be thought of the theory on which the practice is founded, there is no doubt that the practice is often highly beneficial. At the invasion of many febrile affections, involving important organs, and leading, if not speedily ar- rested, to dangerous, perhaps destructive lesions of those organs, it often acts with an absolutely curative effect." The avowal of M. Marchall on the subject occurred during the examination of a candidate for the degree of Doctor of Medicine, before the Faculty of Medicine in Paris, 27th July, 1847. The thesis of the candidate was a comparison of the effects of mercury on the healthy in- dividual with the symptoms of syphilis ; and the homoeo- pathicity of the medicine having been shown, M. Marchall congratulated the candidate on his mode of treating the question, and said— " He only regretted that, in place of referring to one medicine in particular, the question had not been put in a more general manner. He should have liked to have heard a discussion on this subject, viz., Is the law of similarity the true and absolute expression of the facts of specificity ] He wished other candidates would frequently give an op- portunity to the faculty of discussing those important therapeutical questions, for he was desirous of stating, that we found nothing satis- factory on this point in the usual course of instruction." He afterwards added— • Ibid. April, 1846. ADDRESS. 19 u With regard to specifics and their action, all we know we owe td the works of Homaopathists ; in those of physicians commonly called legitimate, from Hippocrates to our own time, we find absolutely nothing." Finally, the most recent, and one which will probably be considered the most striking instance of a clear and manly acknowledgment of the facts of Homoeopathy from an Allopathist, is furnished in the case of the late Mr. Liston. Mr. Ljston died on the 17th December, 1847, and in the obituary of the British Journal of Homoeopathy, published on the 1st of January following, a biographical letter from Dr. Quin appeared, from which I make the fol- lowing extract. " In the course of some clinical remarks delivered by Mr. Liston, in April, 1836, apropos of the case of a man admitted on the 17th of De- cember, with erysipelas occurring in the upper extremities, that emi- nent surgeon, in the most unequivocal manner, bears evidence in favor of the principle of Homoeopathy, and also gives testimony to the effica- cy of the Homoeopathic remedies even when administered in infinitesi- mal doses. I cannot do better than quote his own words, as used by him in the clinical lecture I have alluded to above.—' Erysipelas oc- curring in the upper extremity. Since 1 last spoke on the subject of erysipelas, we have succeeded in subduing the action of the vascular system, without either the use of the lancet or tartarized antimony, by giving small doses of the aconitum napellus, and afterwards of bella- donna. Two cases in which this treatment has been most successfully employed, have been accurately detailed in some late numbers of the Lancet. You have no doubt read them, as well as watched the cases themselves in the hospital. The first case was that of a woman, who, the first time she was in the hospital, was treated for erysipelas by an- timony, punctures, and fomentations. It was some time before she recovered, and her convalescence was exceedingly tedious. In the second attack, after subduing the inflammatory fever in some measure by antimonials, we administered extract of belladonna in very minute doses, and in two or three days she was quite well. The second case was that of a woman who had been much subject to the affection, having had successive attacks of it at intervals, seldom recovering from them under a fortnight; small doses of the aconite, followed by belladonna, were given her, and in the course of three days she was also convalescent. There has been another case lately here, of a man with small ulcerations of the leg, from the toes up to the knee, agirra- A 20 ADDRESS. vated by a scald, and who walked about until the leg became exceed- ingly swollen and red. He suffered besides considerably from fever. In this state he was admitted. We subdued the fever, and then ad- ministered the extract of belladonna, and in twenty-four hours the dis- ease had quite disappeared. Of course we cannot pretend to say posi- tively in what way this effect is produced, but it seems almost to act by magic; however, so long as we benefit our patients by the treatment we pursue, we have no right to condemn the principles upon which this treatment is recommended1 and pursued. You know that this medicine is recommended by the Homoeopathists in this affection, because it produces on the skin a fiery eruption or efflorescence, accom- panied by inflammatory fever. Similia similibus curantur, say they. They give, in cases where a good night's rest is required, those sub- stances which generally, in healthy subjects, produce great restless- ness, instead of exhibiting, as others do, those medicines termed seda- tives. It is like driving out one devil by sending in another. I be- lieve in the homoeopathic doctrines to a certain extent, but I cannot as yet, from inexperience on the subject, go the length its advocates would wish, in as far as regards the very minute doses of some of their medicines. The medicines in the above cases were certainly given in much smaller doses than have hitherto ever been prescribed. The beneficial effects, as you witnessed, are unquestionable. I have, however, seen similar good effects of the belladonna, prepared accord- ing to the homoeopathic pharmacopoeia, in a case of very severe erysip- elas of the head and face, under the care of my friend, Dr. Quin. The inflammatory symptoms and local signs disappeared with very great rapidity. Without adopting the theory of this medical sect, you ought not to reject its doctrines without due examination and inquiry. Such is the testimony of some of the great minds of the Old School and such their admission, that Homoeo- pathy forms an acknowledged part of the science of medicine at the present day. There should be no coercion on the part of the State in the matter of medical doctrines, for very obvious reasons ; but the State should undertake to aid in the advancement of Medical Science by measures which shall permit the conflict of opinions among the members of the profession to take place in the presence of the learners of that science—it should open a fair field and show no favor to any combatant in the lists. ADDRESS. 21 Such is not now the case. Nowhere in the State is there room for a chair of Homoeopathy, nor is there room in any Board of Examiners for the presence of a Homoeo- pathic physician. Our system is not only not taught to candidates of medi- cine and surgery, but their ears are filled to stunning with denials of its truth, and with entreaties and warnings not to examine nor test its pretensions. We contend that they should have a chance to hear the other side, an op- portunity to judge for themselves, before going to the diffi- cult and but too often dangerous task of their lives. As the case now stands, there is a kind of coercion of con- formity with the Old School, sustained by the State, which ought to be abolished. A Board of Examination should be created, which should be empowered, nay, commanded by law, to examine the candidate in all the existing methods of practice. The relation of the government towards the sick, is not justly that of a chooser of his physician—a judge of the values of discordant modes of practice—but it is that of an efficient witness that the men who bear its licenses are learned in the Art of Healing ; that they know the struc- ture and functions of the human body, the forms and pow- ers of medicines, and that they are well acquainted with all the various theories and practical results of their learned and skilful predecessors in the art. It is, to our mind, so self-evident that this constitutes the whole duty of the State in the matter of Medical Science, that we would not, if we could gain our petition, ask for powers which should enable us to exact conform- ity with our theory and practice, although we consider them of the utmost importance to the true honor, happi- ness and usefulness of the members of the medical pro- fession, and of inestimable value to the sick and dying. We hold that a forced conformity is as tyrannical and inexpedient in medicine as it is in theology, and that its 22 ADDRESS. fruits would be as injurious to personal progress in our art as they are in the other to personal purity in morals. To render the principles of any art operative in another, we must so convey them to him as that in perfect freedom he see their truth, and by a process of his own adapt them to his rational faculty, so that they become as much his property as if he had discovered them himself. It is thus, and only thus, that a pupil can be made a master; he must learn the principles so thoroughly, digest them so perfectly, that, under the affinities of his moral and intel- lectual life, they become assimilated to and a component part of his very being. A forced or external assent to principles which he has not so appropriated, fills his mind with vague fancies which fatigue and perplex him, even to the loathing of all research ; and it takes away from him the sense of capacity to perform, from himself, real exercises of skill in his art or profession ; it paralyzes alike his love of the objects of his art and his power of accomplishing them. That some ideas of the similitude or accord between the forces of remedies and the diseases which they cure, enter into the minds of medical men of the Old School, is shown from the quotations made by Hahnemann, from many of the older authors, and particularly from those of Hippo- crates, Dioscorides, Paracelsus, Stahl and Hoffman. Nothing is more frequently said by Allopathic physicians in conversation with Homoeopathists, than that they be- lieve there is truth, great truth, in the law similia simili- bus, but that they do not believe in the minute doses of the New School. Were this a fitting occasion for such a polemical essay, I think I could show from the various in- genious attempts of able writers of the Old School to ex- plain the specific adaptation of several of the drugs to the diseases they are known to cure without producing other sensible effects, that the Homoeopathic law of cure has been, and is more frequently (though perhaps not ADDRESS. 23 sharply) contemplated by the prescriber, than he is willing to admit, even to himself. If, then, the Homoeopathic method be a tacit part, as we have shown it to be, of the lucubrations of many of the leading minds of the Old School, can any sufficient reason be shown why a systematic knowledge of it should not be required of every student who comes to the State authorities for a diploma or testimonial that he is a thoroughly instructed physician ? If there be gross falla- cies in it, let him study it, that he may be able to defend himself and his patients from their influence ; but if haply, as a whole, it proves to be a better system than the domi- nant one, let him be enabled to apply its benefits with promptness, and without the terrible labor of suddenly acquiring a new art, under the distracting pressure of great peril and suffering. Were the Government a competent tribunal for the trial of the great question at issue between the two schools, it would be incumbent on us to show, by appro- priate testimony and argument, that Homoeopathy pre- sents the only philosophic guide in the choice of remedies, and that, consequently, it is the first real contribution to a rational art of healing. We believe it would not be diffi- cult to establish this proposition clearly and irrefragably, even before an enlightened non-professional audience. Indeed, this work has been repeatedly done for the pro- fession by Hahnemann and by several of his ablest dis- ciples, of whom we may cite Moritz Miiller of Dresden, Rau of Giessen, and Dr. Channing of this city. Dr. Chan- ning's essay is entitled " The Reformation of Medical Science demanded by Inductive Philosophy," and is devoted to the proposition that " Homoeopathy is the first successful generalization of the powers of the Materia Medica ;" and it is perhaps no more than a just tribute to the learning, the humanity and the genius of its gifted author, to say that this unanswered and unanswerable work is an honor 24 ADDRESS. to the cause he so thoroughly embraced, and to the medi- cal character of the country which gave him birth. The late lamented Gram, the founder of Homoeopathy in the Western world, published, on his first arrival in this country, in 1826, a brief but powerful pamphlet on this subject, from the German of Hahnemann, entitled " The Spirit of the Homoeopathic Doctrine," which no man of the Old School has attempted to answer. But, while maintaining with perfect truth and unani- mity the importance of Homoeopathy to the right under- standing of the Materia Medica, and to the safe adminis- tration of remedies by medical men of all sects and of all coming times, we found no claim on the Government on this ground, because we condemn any and all interference, direct or indirect, with the tenets of medical science or art, on the part of any Government, as a despotism in principle and a tyranny in practice, alike subversive of the rights of physician and patient, and detrimental to all freedom of inquiry and all sound medical education. As the final consideration of this branch of the discourse I will say that the Academy craves the aid of the State in the way indicated, that the members now living may raise the standard of medical education within their own ranks. It is our earnest wish to discharge a great duty toward our successors ; we wish, by placing before them stronger incentives to research than does the present system, to make them better students of it than we have been. As the usages of the profession now are, our system, which requires far more real knowledge for its just ad- ministration than does the old, must continue to be most imperfectly, nay, most culpably administered in this country. We lack, in all this most happy land, the painstaking pcrfectness of academic learning and of preliminary medi- cal learning, which our profession of both schools possess ADDRESS. 25 in Germany, and, in fact, throughout the Continent of Europe. This deficiency is sad enough in the Old School, but its effect in ours is a thousand-fold worse. The man of good strong preparation in Allopathic practice will, for reasons which it is needless for me here to cite, be as apt to follow as to lead in a consultation with a brother Allopathist of very slight literary and scientific attain- ments. Empiricism, in its higher sense, is the strong for- tress of Old School practice, and the ignorant physician has often as sharp a memory of practical results, both good and evil, as his abler colleague. Such is not the case with Homoeopathy. The Materia Medica must be read—nay, explored perpetually, to dis- cover the relation of accord or similitude between each case of disease and its suitable remedy ; no possible effort of genius nor conceivable strength of memory can be trusted in place of this eternal vigilance. And for the right, not to say dexterous, performance of this inevitable task an exactitude and extent of knowledge in the lan- guages is of the highest conceivable value. Moreover, as perfect a knowledge of Physiology and Pathology as the state of these sciences will admit, is ever necessary to the true Homoeopathist; for by these aids, and by these only, can he so appreciate the value of symp- toms as to be able to know which of them it is essential for him to cover by his remedy, in order to attain in each case the highest aim and end of his art. This kind of knowledge, though of use to the Physician of the Old School, and indispensable to the attainment of an exalted rank among his colleagues, is not indispensa- ble to his choice of remedies ; for his choice depends on the revolutionary and violent processes which drugs are capable of producing by classes or groups in common, such as vomiting, purging, stupefaction of the senses, '&c. &c.—not on the specific characteristics in detail which can only be disclosed by trials on the healthy and which 26 ADDRESS. form an important natural alliance with the characteristic symptoms of disease. Now, to trace this alliance, in a case requiring the skill of art, imposes, on the Homoeopa- thist, the deeply interesting task of reviewing the play of the functions in a healthy state and a study of them in an analogous disease ; and this review and study is not for the transcendental purpose of discovering the quantitative or qualitative changes in the vital powers of the sufferer, (an eternal ignis fatuus in the Old School on which it affects to found its indications of art,) but for the plainly practical purpose of selecting a specific counter-force which experience has shown to be a true, direct and un- failing remedy. Moreover, this knowledge is very important to enable the Homoeopathist to meet a dilemma of very frequent occurrence in the present imperfect state of the Materia Medica—namely, the cases in which the records of the Materia Medica do not afford him an apt and perfect similimum. Here he can attack but one wing of the disease at a time ; and Pathology alone can inform him upon which symptoms the safety of his patient demands of him to direct his first and strongest attack. These two departments of human knowledge, (Pharma- codynamics and Pathology,) are growing with enormous rapidity, and, without early and earnest training, the student of Medicine, without facility in reading the modern languages (especially the German and French), cannot keep such pace with their progress as to do the justice to his patients which the cause of Homoeopathy and of humanity will claim at his hands. Without the legal ability to examine candidates of Medicine and the consequent influence on teaching which such power con- fers, we cannot prepare our successors for the righteous discharge of the duties which Time, by removing us, will devolve on them; and our good cause must continue to suffer, as it now does, in the house of its friends. ADDRESS. 27 Gentlemen of the Academy ! At your request I have glanced at the manifold topics contained in your relations with the State as a body incorporated by one of its enact- ments ; as anl association of Physicians seeking, in an open, free and honorable manner, to do a lasting benefit to the next and succeeding generations, by effecting an organic change in the medical education of the State. The nature of the subject, to say nothing of my want of time and abilities, precludes its full discussion in the short space allotted to a single lecture : and I should quit it with very great dissatisfaction, did I not feel well as- sured that you wrould take ampler means to press your just claims on the attention of the Legislature during its present session. Permit me, gentlemen, before taking the chair to which you have kindly called me, to congratulate you on the vantage-ground which you have gained by your recent act of association. You have not only taken one impor- tant step toward insuring that the increase of practition- ers demanded by the popular growth of our cause shall consist of rightly qualified students of the whole science of Medicine, but you have brought yourselves into such personal relations as to forestall and heal the differences which invade the ranks of our profession of every school. You have, moreover, combined under such auspices and laws as to ensure a good result with respect to the prac- tical skill of each diligent member of the Academy, and also to produce a zealous and harmonious adherence to the great leading maxims of the Homoeopathic system. This trait of your association has given me more pleasure than I have words to express; it has made me proudly willing to stand here and avow and defend the public purpose of the Academy ; to show that you propose to aid in the propagation of a mild and beneficial reform in the art of Healing by means as free as the air we breathe or the waters we drink ; that you will teach the 28 ADDRESS. science of medicine by a competition which can have no other incentive and no other goal than to impart the greatest sum of knowledge in the most efficacious manner and at the least possible expense to the learner; and that you freely invite any regularly authorized physician or surgeon, who chooses to become a member of your Acad- emy, to take the chances, which his genius, learning and skill may give him, to win from you the classes whom your talents or the combined forces of your Institution may have drawn within its walls. With ineffable gratification do I say to all such, in your behalf, and to the student, and likewise to the world: Let him who merits it bear the palm ; that the interests of the sick, the needs of the bright young aspirant and the true honor and dignity of a liberal and learned profession, claim alike and together this your noble freedom of dis- cussion, this entireness of human right in the exercise of man's most sacred task, the transmission to others and to posterity of Truths which bear charity in their bosom.