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I 
 
PROGRESSIVE  MEDICINE.
  A SCIENTIFIC AND PRACTICAL TREATISE
ON
DISEASES OF THE DIGESTIVE ORGANS
AND THE
COMPLICATIONS ARISING, THEREFROM.
     CIKO DE StZZARA-VERDI, M. D.,

                 LATE
Acting Assist ant-Surgeon at Balfour Hospital, U. S. A.,
   Professor of Physiology and Pathology in the
    Cleveland Homeopathic College for Women.
                               "iG
1^
          " SlMILIA SlMILIBUS CURANTUR*"
When the art of preserving life is in question, neglecting to learn
             is a crime.—Hahnemann.
    PHILADELPHIA:
F.  E. BOERICKE.
         1885. 
WI
 v  4 2 4- p
X         Entered, according to Act of Congress, in the year 1880,

              By CIRO DE SUZZARA-VERDI, M.  D.,
        In the office of the Librarian of Congress, at Washington, D. C. 
                TO JOHN  F. GRAY, M.D.,





IN TESTIMONY  OF HIS ABILITY  AS A  LEARNED  PHYSICIAN, AND  HIS



  DEVOTION  TO UNALLOYED TRUTH;  AND  ALSO  AS AN  ATTESTATION



  OF THE COURAGE  WITH WHICH HE  HAS DEFENDED LIBERAL MEDICAL



  PRACTICE, THIS WORK IS RESPECTFULLY DEDICATED, BY





                                            THE AUTHOR.




New Brunswick, N. J., Jan. 1st., 1879. 
 
PREFACE.
  I have labored with the most earnest purpose to gather
together  all evidences,  practical and  scientific,  chemico-
physiological, medical and dynamical, in order to demonstrate
the rationality of the law of similarity.
  Second.—I intend to bring forward some clinical cases,
taken from my memorandum-book, as proofs of the success
of progressive medicine.
  Third.—I have adopted a systematic course of pathology
and physiology as the true and only basis on which a correct
and reliable diagnosis can be formed ; at the same time veri-
fying the specific curative action of medical agents  upon the
animal economy.
  In  support of my  axiom, I have examined and  brought
forward the opinion of eminent progressive scholars of medi-
cine, viz.:  Rasori, Voght, Magendie, Prout, Watson, Pareira,
Graves, Huffland, Hoffman, and many others, who are repre-
sentative members of the dominant—called by us Allopathic,
which, however,  they reject with indignation, preferring the
name Regular, or Rational—school of medicine.  We shall
not quarrel on account of names, but on account of princi-
ples and truth.
  Fourth.—Physiology is so necessary, and so intimately con-
nected with medicine, that I had constantly to  recur to it,
even  if seemingly tedious; for that is  the  basis on which
we can treat diseases successfully with the system of homoe-
opathy.
  Fifth.—I found chemistry and  physical  science also two
great supports of my subject, as they bring forward continu-
ally proofs in favor of our school of medicine, and sustain the
basis  of the law  of Similia similibus curantur. 
8
PREFACE.
  Sixth.—I endeavored (though I might displease some emi-
nent extreme parties  of  both schools) to treat my  subject
upon clinical ground, sustained by rational deductions from
science and from medical experience.
  It is needless to remark, that  he who dares to differ and
predicate new discoveries or new thoughts, must be ready to
meet fearlessly the indignation and contempt of those who
think that there  is nothing beyond what they know and teach
daily.
  There are surely men of both schools of medicine who are
open to conviction and truth, and are ready to  accept them
and adopt them, even though contrary to former teaching and
prejudices.  To  these true representatives of  the medical
profession I most respectfully look  for an impartial verdict.
                       [BY PERMISSION.]

IMPORTANCE OF  PHYSIOLOGICAL  KNOWLEDGE.

                  BY M. B. LUKENS, M. D.
                        Cleveland, Ohio.

  It is one thing to  obtain a  knowledge  of Physiology, and quite
another to make the best practical use of it.
  New discoveries are continually flaunted before us.  Theories are
glibly explained.  Yet everything seems to move on as usual.  Some
claim that the average duration of human life is gradually increasing.
If this is true we can account for it in the diminished number of violent
deaths—as in war—and in the smaller amount of poisons taken as medi-
cines.  Improvement in the treatment of disease alone is sufficient to
favorably affect the average duration of life.  This average at  pres-
ent is so far below the proper standard that  a crusade should be organ-
ized against existing  practices, which are considered highly civilized,
but which the physiologist knows to be detrimental to life.
  He who best  understands machinery most readily detects the points
where friction exists,  and supplies the oil, knowing that  by doing this
he insures better work and increased durability.  The human, the most
complicated of  machines, and infinitely the most valuable, ought to re-
ceive at least equal attention and study.
  Perfection in mind and body should not be considered the wild dream 
PREFACE.
9
of some enthusiast, whose aim is to carry out some impossible theory,
for our great prototype is  perfection—man, made in the image of his
Creator, to be reproduced in time, and the method of  its reproduction
should receive conscientious investigation.  This aim may be ideal—one
that can not be attained in this, or may be a score of generations;  yet it
is elevating and ennobling—physically, mentally,  and morally—to raise
the standard of thought and aspiration, and hence the standard of action.
  A knowledge of Physiology has this mission:  It is to  take  its place
among the influences, second to none, which  are  to  elevate the moral
condition of the world.   It will not displace other good agencies, but
will prove to be the strong backbone of all.   Physiological knowledge,
correctly directed, will diminish disease and  lengthen  life.   Who  is to
enforce and direct this knowledge ?  By  whom are the people  to be  in-
spired with a desire for instruction and learning, that their " days may
be long in the land " ?
   Down deep in the souls of  the masses will  be found  a willingness  for
instruction, and a seeking for the '' elixir of life." The parent would give
worlds for some power to restore his dying child to life and health, little
dreaming that the cause of his anguish lies within himself or his  ante-
cedents.
   For relief in all physical trouble the  mind turns to the physician.
The patient is satisfied with the removal  of  present suffering, and sel-
dom inquires into its cause.
   There is entirely too much importance  given to this individual dubbed
 "physician."   No one ought to accept the guardianship of the health
of the family or individual, unless he is a practical physiologist.  If he
is, he will look after the sanitary conditicns, and prevention will be  ex-
alted above cure.  It might  be safely said that all  practical  physiolo-
gists are physicians;  but all physicians are not practical physiologists.
   The present state of intelligence demands of the doctor removal of
 present pain ; so the supply is  in accordance with the  demand.  Every
 one you meet has a cure for whatever disease afflicts you;  and as far as
 they accomplish the object of removing pain they have as much moral
 right to recommend and use their remedies as hundreds who  have  ac-
 quired  a  legal right, by purchasing an "M. D."  as  an  affix to their
 names;  for all have the sane object in view, viz., to gratify the patient
 by removing or alleviating their pain temporarily.  Few pretend  to do
 more than this.  Teachers ask no more from the graduate.  In the  be-
 ginning of his career he sounds his key-note—relief.  He does not waste
 his energies in preventing disease; but when trouble overtakes his  fel-
 low-man is willing and even anxious to assist him (for a moderate fee).
 He is generally honest, and does his work to the best of his  ability, so
 as to gain a reputation as an expert in his-line, that he may be preferred
 above all competitors.
   It might be asked, "Is it not good  to alleviate pain?"   Most  as- 
10
PREFACE.
suredly.  It is also good to have appliances to extinguish fire after it
is under headway ; but it is better to prevent the fire or make the build-
ing fire-proof.   What is the building worth after the fire is put out ?
What is the body worth after a severe attack of disease ?  From ten to
twenty years of life  are taken away by every severe illness.  A wise
physician has said, " To cure a disease is to prevent it."  The conscien-
tious physician will look to this, and endeavor to get above the practice
of putting drugs into the stomach that he may the better put his hand
into the pocket.
  When we study life,  whether animal  or vegetable, we find it made
up of a succession of periods of growth  and decay.   From the deposit-
ing of the germ there is a gradually ascending series  to maturity, and
from thence a descending one till death.   Nature has, no doubt, affixed
a limit to each epoch, the extent of which  can never be exceeded and is
seldom attained.  In applying this law to human life it is impossible to
ascertain the precise  length of each epoch, or the  aggregate whole of
existence.  The greatest age ever attained  by  man must  fall short of
the years he might have reached had he  lived in  strict conformity to the
law of nature.  The  famous Thomas Parr, who lived one hundred and
fifty-two years, was,  no doubt, prematurely cut off in consequence of a
change in his usual manner of living.  It was found upon post-mortem
examination that his cartilages had  not  turned to bone, as is the case
with the very aged.
  All who die,  whether early or late, have had the elements of a more
enduring existence.  The length of the descending series depends upon
the length  of  the ascending series.   The  m Dre  slowly maturity is
reached, or the longer the first series, correspondingly longer will be the
last series; or in the  ratio of one of  the  former  to  four  of  the latter.
Our calculation here will not admit  of mathematical precision, but ap-
proximates to the truth.
   The length of life depends upon  the length of this period of youth.
During  this period the  material is accumulated  in  the  superstructure,
which by constant accretion in after life determines the relative power
of resistance.
   We know from experience, and  draw our conclusions from nature,
that the conditions of this period decide the state of after life.  Health
and longevity depend  mainly upon the prolonging of the  ascending
series.   Let physicians so deviate from  their accustomed line of action
as to give this feature  especial attention.   To promote healthy matur-
ity will best promote longevity.
   The most of those who have carried bad habits and appetites beyond
the period of maturity, remain unchanged during life; and, fortunately
for the race, the life of many is short.  Those who are diseased, physic-
ally or morally, acquired the first  taint of the malady during the ma-
turing  period, either before or after birth.  All that skill can do for 
PREFACE.
11
them is to retard progress, and palliate their sufferings, for which ex-
isting doctors have been especially educated.
  Drunkards, consumptives, nervous wrecks, and those with chronic
taints, can find rest only in the grave.
  Some of the  special means of promoting healthy growth are  the
food and the habits.  From the beginning of life the proportion of the
solid parts of the body is gaining upon the fluids.   Natural death oc-
curs when the structures become so consolidated that the fluid can not
permeate the capillaries sufficiently to maintain the functions of nutri-
tion and depuration. As the fluid  and solid portions are formed mainly
from the food and drink taken  into the stomach, it follows that the
character of the aliment has a  controlling  influence  in determining
when natural death shall take place.
  When an infant makes its appearance in the  world it is a soft,
pulpy, juicy thing, if the  mother has been properly nourished during
gestation.  If she has indulged to a great degree in food rich in bone-
producing elements, the child enters the world  through much tribula-
tion, with its bony parts advanced toward maturity far beyond the period
of its existence.   The fact seems to be well  established, that the food
which contains a large proportion of fluid as compared with its solid
matter, and a large proportion of  bulk as compared with nutriment, is
best adapted to sustain permanently  the organism, provided it contains
the requisite elements of nutrition.
  All stock-growers know that animals raised for  physical endurance
should not be fed with concentrated food while maturing.  Experience
has shown that it is not the best practice, if  they wish to produce a
constitution capable of resisting hardship.   So during the maturing
period they  are  not  allowed  the same food as the matured  animals
which are subjected to hard work.
  But how different with the  human young !  In the greater number
of families, as soon as they are able to sit alone they are placed at the
table and given the same food as  the parents  and grandparents.  Such
children, instead of having developed  and  fostered soft body tissue,
have  old people's tissue.   They become old  far beyond their years,
both physically and mentally.   They early develop a brilliancy which
is very pleasing to the parents; and shortsighted and ignorant as most
parents are,  they yield readily  to the delusion that they have the
smartest children in the world, who are destined to make their mark.
Such children usually do make  their mark.  There is a precocity of
both mind and body which is unfortunate for its possessor and for so-
ciety, for it makes the child a giant  and the man a dwarf.   It  pro-
duces manifestations of maturity at twelve, and symptoms of decay at
twenty.   If this forced production of a man propagate his kind, the
offspring will inherit an imperfect organization.
  If we examine the main sources of education—the  pulpit, schools, 
12                         PREFACE.
and colleges,—we find no provision made for the symmetrical develop.
ment of mind and body.   If we analyze and grant all they claim for
their respective spheres,  we will still find that the physiologist stands
alone to tight for the lives of the children.  The central thought of the
minister of the gospel is to induce the mind to reflect  upon the Cre-
ator;  to remind the people  that they have moral powers to improve.
His specialty is the soul.   Judging from  his preaching,  he knows
nothing about the body—the dwelling-place of the soul.  His business
is not to save the dwelling, but to have the tenant " up and dressed,"
ready to depart when called for.  He never tells how to keep the body
in  a  sound and healthy condition.   He never  says anything about
clothing, diet, dry feet, exercise, ventilation, etc.  That is left for the
doctors.  But when the tenement is fallen and the tenant has departed,
he pronounces encomiums over the wreck,  and attributes this physical
ruin  to a  wise and  benevolent though inscrutable Providence,  and
cheers the  living with the assertion that all is for the best.  The pul ■
pit, then, fails to supply  the need.
   We have been in the habit of looking upon the  common schools  and
colleges of  our country as par excellence for the education of the youth
of the land.  When  we  analyze their  methods of work and  see  the
effect upon the youth after passing through these educational mi'ls, we
are forced to an adverse opinion.  To preserve the body while the mind
is  being properly trained does not enter into the modern system of
fashionable education.  The art of keeping up the bone, muscle,  and
nerve of the pupil, so as  to  keep  pace with the brain-development,  is
yet to be learned and practiced.  The old Grecian and Roman  idea of
keeping the body strong and vigorous, whatever might  be the  state of
the mind,  is now  considered a relic  of barbarism, and no  more to
be brought into our  civilized  refined  educational processes than are
their  modes of  physical exercise,  the  Olympian games,  gladiatorial
contests, etc.
  The high-toned school  of the cities and larger towns, whose  machin-
ery runs in such perfect order, is certainly "a thing of  beauty," if not
"a joy forever."  If we  look only to the perfect  mental discipline,  to
the text-books  mastered, to the grace and elegance acquired, such  a
school is certainly a model, but to the more practical  observer, who
looks forward to the stern realities of life, who appreciates good health,
and believes that future usefulness depends as much upon a sound body
as upon a cultivated mind, the schools appear to  be conducted upon  a
false basis.   Follow carefully a student through  his whole  course, and
witness his graduation.   It should be a source of  great disappointment
to both himself and his friends, that, after spending weeks, and perhaps
months, in  preparing an oration or an essay, he  cannot  be  heard dis-
tinctly a score of feet from the platform.  I here place great stress upon
this failm-e, for it is indicative  of  physical weakness.  We rarely hear 
PREFACE.
13
the strong, sound, manly voice of the young man, which is a sure index
of great physical endurance.  We much more rarely hear the strong,
rich, round, manly voice of the  young woman, which points you  to a
body that is sound and healthy.  When we contemplate the outgrowths
of the modern and the most popular system of education, the truth is
forced upon the mind that the plan is radically wrong.   Education is
not conducted as if  the vigor, growth, and development of the mind
depend  upon  the vigor,  growth,  and  development of  the body; but
rather upon that old  idea advanced by Dr. Watts—"the mind is the
measure of the man."  This sentiment is practically false, for it is the
mind and the body which measures the man, the  body standing first.
It is better to be a  healthy hod-carrier or laundress than a  useless,
broken-down graduate of some school.
  A graceful blending of the two extremes is a natural and healthy con-
dition.  What is education for,  if not to make the whole being better ?
—and is it not folly to adopt that system of culture  as the one pre-emi-
nently proper, which  entirely neglects the one and gives undue attention
to the other ?  We should not demand less scholarly but greater bodily
attainments.  How far the young mind may be safely stimulated is yet
an open question.  No rule can be  laid down for  all cases.   Early in
life some minds show  wonderful  power,  and take instant leadership
among their fellows.   These may be healthy, and to check them would
be cruelly ruinous.   The precocious must be held in mild restraint,  and
their inclinations be bent and unbent by the master  hand of one who is
wise in forecasting the future, and who is also able  to encourage wisely
the dull and stupid.  That the mother may be this  one, wise to form,
govern, encourage, and restrain, the physician  should assert his mission,
to instruct her mind  with physiological knowledge  necessary for both
the physical and mental development of her offspring. 
 
PROGRESSIVE  MEDICINE.
PAET  I.
                   CHAPTER I.

     MAL-ASSIMILATION, INANITION, AND DECAY.

  Science has established that the source and develop-
ment of organic life, vegetable and animal, depends
upon the co-ordination of three forces mainly, viz., phys-
ical, chemical, and vital.  This  complex relation should
be clearly defined in all its bearings, in order to mako
our views comprehensible and acceptable.
  The subject is certainly of great importance to  ph}rsi-
cians, involving the great desideratum of life and  its
functions—disease and health.
  Firstly. What is vitality, and from whence does it arise ?
These questions may be answered by saying that vital
force arises from a process of decomposition and molec-
ular disintegration; and this act is produced by atomic
motion and molecular attraction.  Those dynamic activ-
ities form new compositions  and new organizations of
animal or vegetable  matter.  During  this dynamical
transition and separation of atoms, an attraction of mo-
lecular particles is set up from  an inherent static force,
existing in an undeveloped condition within the matter
itself, self-acting and with energy of its own. 
16
PROGRESSIVE MEDICINE.
   Molecular force has a different origin  from chemical
force: it arises from a  changing process of organized
matter, which sets  in motion the atoms that were in a
state of cohesion.   A molecular attraction takes place
by affinity, and a new activity goes on and develops new
forms; and therefore a  new  force springs up together
with the energy of  the molecular attraction and atomic
motion.  This  is the vital force.  As it increases with
physical action, it also takes a superlative part in organ-
izing matter into animal tissues.
   Can we suppose that this force is independent or pre-
existing?  I answer in the affirmative.  If we admit a
static  force, we must then  admit that  this form and
power exist in the  organic matter,  and it  only needs
the momentum or energy to bring it  out; such as heat,
moisture, motion, electricity, etc.  This  force appears
with the birth of a new combination. From the commotion
of atomic disintegration, motion and heat are two nat-
ural  results; and  molecular attraction forms new com-
pounds of organized matter.  The process of decompo-
sition, then, is unmistakably a physical law in order to
form  new  compositions.   It  therefore  changes  the
physical into  chemical, the chemical into organic mat-
ter, and  the organic into a higher condition, or  vital
force.  All these  changes have a perfect unity  of pro-
gressive or retrogressive action.  The first rising higher
and  higher, the latter  (retrogression)  descending to a
lower condition, and through this process of molecular
disintegration, new  organizations, new formations, and
a new life are reached.   And rational reasoning  demon-
strates beyond question that action  and  re-action have
a correlation of forces, so as to arrive at  a perfect uni-
formity  of development.  There is  a vegetable vital
force, and an animal vital force: the former continuous
and unchanging, the latter constantly forming  and de-
caying. 
   MAL-ASSIMILATION, INANITION, AND DECAY.   11

  Vegetative life has only the function of growth; ani-
mal life has growth, force, and repair.  It is therefore
conclusive that force is inherent in organic matter, wait-
ing only the necessary energy. This energy may pro-
ceed from various  sources, viz., physical, chemical, and
vital, in both vegetable  and animal life; hence it is evi-
dent that life springs from three forces—chemical, phys-
ical, and  vital. From  physical  commotion there  are
new organic compounds formed, i. e., oxidations, carbon-
iferous, sulphurous, or volcanic emotions,  and nitrogen-
ous.  These elementary forces go on forming new com-
pounds called minerals,  or alkaloid earths;  and  again,
when these compounds  become disintegrated, a chemi-
cal force arises, and this atomic metamorphosis sets in
motion a molecular affinity in  favor of this or that ele-
ment which may happen to predominate, i. e., oxygen,
carbon, or nitrogen.  Thus we perceive  that new for-
mations are constantly produced  by atomic and molecu-
lar activity.   If we proceed a little further, under the
influence  of  heat, light, and electricity, the  mineral
atomic cohesion of any substance must separate and come
asunder; and from this physical activity new results
take place, and a  gas or a cell is formed.   And once
more, this cell is joined by affinity to other  elementary
substances; hence a nascent  combination forms  a pro-
toplasma, a new birth, a new life, viz., a vital vegetable
cell is  formed.  One step further:  with a few more
elements, i. e., sulphur,  phosphorus, and nitrogen, from
the same source or matter arises the vital animal cell.
The vegetable substances are annualized by physiologi-
cal process, and changed into animal matter and tissues.
Through a combination of forces a proteine compound
results, and the pabulum vitse is established.   There-
fore, vegetable matter  must  change by decomposition
and disintegration, to  give  birth to a gas  (nitrogen)
rising from this process of fermentation. 
18
PROGRESSIVE MEDICINE.
   The heat, the atomic motion, disintegration, molecular
 attraction and affinity, all combined, a vital force  arises
 and new formations are developed, the final accomplish-
 ment of which is an animal cell.
   These preliminary steps will appear  tedious,  but
 without them I am afraid our subject would be indeed
 incomplete.   I am sure that these few pages upon gen-
 eral  laws  will strengthen our mode  of proceeding to
 physical and vital diseases.  And just at  this point of
 the subject we must acknowledge and adopt  the  great
 physiological truth from the. beginning, viz.,  that vital
 force is the life-giving power to all our organs, whether
 simple or complex.
   Nutrition and  inanition are two contrary processes.
 The former is  re-organizing; the  latter, the process of
 retrogression and decay.  The first  is a  physiological
 law;  the second, a pathological  phenomenon; and  yet
 the process of decay is a condition to  animal  metamor-
 phosis and life.  The process and law of  reproduction
 would not be required if there were no waste, unless we
 were  simply vegetative objects; and with that supposi-
 tion, we could  retain neither our nature nor identity.
 But as organic life is constituted, an equilibrium between
 organization  and  decay is a physical prerogative.   If
 waste in the  animal economy should  stop, plethora
 would arise;  but if nutrition should  cease, waste would
 reduce the organism to a condition of retrogression and
 dissolution.
  Unquestionably these great principles of life and  de-
 cay are  constantly and  uninterruptedly going on. for
 they accomplish the great object of uniformity of action
 and re-action.
  The subject is undeniably very interesting, inasmuch
as it divulges the great and wonderful paths leading to
life and vitality—from life  to death, and  from death to
life, from the mere elementary principles  of inorganic 
    MAL-ASSIMILATION, INANITION, AND DECAY.  19

matter rising to the highest summit  of creation—to  an
organized body; and more, and higher still, the crown-
ing touch of our Creator, i. e., to a sentient being.
Whereas when this great  uniformity of animal organ-
ization ceases, it descends at once to mere matter, and
loses energy and force ; and from an organized condition
it descends step by step to its primordial state.
   Nothing is lost!  Only the great physical combination
of force and activity has ceased, and the  elements  sepa-
rated into different gaseous forms.   Existence as a sen-
tient being is no more, because the receptacles of the
inflowing spiritual life, which is a constant gift from  its
Author  and Source,  have separated into  other forms.
Notwithstanding this process of transmutation, the ele-
mentary  principles  still remain, and return  to  their
original source.  But this  question would be pertinent:
i. e., What becomes of the energy of the nascent force?
As a force is intangible and immaterial, it returns whence
it came, to that Infinite  which no human eye  or knowl-
edge can ever fathom.
   We  have then reached the last phase of our subject.
Our inquiries can go no further, purporting  to disclose
the spiritual part of our nature.  It is proper we should
take another direction, more in keeping with our knowl-
edge, and let what is not in our province remain where
it belongs.  It is indeed a ludicrous sight, that of seeing
the vain folly and attempts to reach what is and will ever
be a secret, or an impossibility for man  to  discover, as
long as he has a mere human nature.
   Our inquiries have brought us to the problem of cor-
relation of forces as indispensable to a perfect organiza-
tion.   And from  this  grand  ensemble,  the beautiful
harmony of life arises and exists.  It  is obvious that
the principles  of life are  now better understood; and
we physicians particularly require this great knowledge
to enter in the arena of medical and physical science; 
20
PROGRESSIVE MEDICINE.
and at the same time to form proper conceptions of the
etiology of diseases in general.
  Hypotheses and theories rich in scientific style  can
easily be produced, but I doubt whether that would  be
the right way to sound  and practical principles—prin-
ciples that could be used for the benefit of mankind.
  The study of diseases must  be based upon rational
deduction from the knowledge of the human organism,
and of its  peculiar laws, which guide it in health, so as
to come to a proper understanding of the various patho-
logical complications that occur from time to time, thus
changing its physiological functions.
  The cases of vitiated  blood,  nervous and organic
diseases, sthenic and asthenic, strumous and lymphatic,
physical and functional, mechanical and dynamic, zymotic
and contagious,  infectious  and  malarious—these  and
many others, divided and subdivided by a nomenclature
comprehensible only to the physician, they are even to
him often perplexities of the  most intricate nature.
Are these changes from health to disease mere changes
in  the vitality alone  of  the economy?  No; diseases
generally are the  results  of disordered physiological
laws  and  functions; but as long as  the  vital force is
not seriously  attacked, the recuperative  power stands
against the invasion of morbid influences, and with won-
derful activity reproduces strength, and repairs waste,
wherever it is needed.  The wounds are quickly filled
with  healthy granulations, and changed from  organized
matter into  living tissues.  Is, then, all  this done by
vital  force alone?  Decidedly not:  it is the result of all
the forces together, which go to form physical organiza-
tion.   These  are indeed the primitive and  co-ordinal
principles of life; and should any interference, no  mat-
ter how slight in degree, with  any of them take place,
 the most serious consequences may be looked for.   And
 moreover, should the vital force be affected and lessened 
    MAL-ASSIMILATION, INANITION, AND DECAY.  21

in degree, or perverted, the tissues would be lifeless,
perverted, or disintegrated; and abnormal formations
often thus arise.
  In  curable diseases vitality stands  firm against the
enemy, although  even that may apparently diminish;
but it reacts upon the other forces, and the recupera-
tive power slowly re-establishes the disarranged equili-
brium. Unquestionably, during any physical disturbance
from  its normal  condition, the entire  organism suffers
more or less, but the stronger the vitality, the stronger
is the reorganizing force, and dissolution is prevented.
  And again, returning to the great pabulum vitae, as
the  principle by which alone  existence  can  be  sus-
tained, therefore, on this  point, Ave  must  extend our
inquiries, and enter at the  same  time  on the arena of
physical diseases, and review them one by one, with all
their  myriads  of symptoms in connection with  mal-
assimilation and inanition, as well as the  process of na-
ture's resistance to all morbid invasions and phenomena.
  Let us select the lymphatic system as the one more
prone to temporary or  permanent—superficial or con-
stitutional—disarrangements, either  from physical, or-
ganic, or functional causes.
  From the different pathological complications in the
nature of these kinds of diseases, the uniformity of the
physical laws and organic functions  are more or  less
disturbed from  their normality  of action,  and  thus
complications from mal-nutrition, lymphatic atrophy, are
produced.
  When the lymphatic system becomes involved in any
physical or functional change, the histogenetic process
becomes immediately affected, and the process of nutri-
tion and tissue-making is relatively and proportionately
diminished.
  This  abnormity soon brings about  waste, inanition,
and adynsemia.   And from  these conditions,  we  are 
22            PROGRESSIVE MEDICINE
engaged to extricate the human economy, and replace
it on its own equilibrium.   It is clear, therefore, that
our greatest  effort,  after understanding the functions
and laws that are employed in the  process of repair, is
to assist, rationally and agreeably to nature, the  great
work of vis-medicatrix naturoz, et vis-conservatrix naturce.
  The vis-conservative law we study in the first prin-
ciple of organic life; the second, or vis-medicatrix, we
must find in the proper treatment of diseases, and thus
return organic functions to their  normal condition and
activity.
  The causes and shades of diseases are so variable and
numerous  that  they  often escape the  attention of the
sufferer, and defy frequently even the skillful physician;
and thus diseases frequently remain in a state of latency,
undetected and uncured.  Some  are physical, some or-
ganic and functional:  some  are inherited,  others ac-
quired.   The causes are many, viz., atmospherical, diet,
occupation, inordinate  mode  of living, inheritance, and
neglect.
  Whatever the cause is, there must be a corresponding
loss of some of that indispensable harmony which is the
only true characteristic of normal action.  When the
equilibrium of physical law is lost,  there must be  also a
loss of force;  hence, physical debility  and general dis-
turbance.
  There are two great elements which form the impor-
tant process of physical force and  equilibrium, i.  e., the
nitrogenous and albuminous substances derived from
the proper articles of diet and converted by assimilation
into a proteine  compound, whose constituents furnish
the plastic elements of life.
  These nutrients are naturally allied with  a variety of
elements, i. e., carbon in the nature of amyloids, sugar,
and  cellulose; having dextrine as the diastase, or the
separating element of the different substances existing 
     MAL-ASSIMILATION, INANITION, AND DECAY.  23

 in the  starch; and  these are again classified by the
 physiologists as respiratory or calorifacient substances,
 partially  histogenetic,  but non-nitrogenous.   So that
 starch and albumen  are the elements of tissue-making:
 nitrogenous and saline  materials  are  those of blood
 making.
  By the process of molecular and invisible energy we
 have molecular motion;  and hence caloric or absorbed
 heat.  And part of the energy of absorbed heat is spent
 in pulling asunder the molecules of the  body from the
 attractive force  which binds  them together;  and from
 this  physical and chemical metamorphosis  we  obtain
 alcohol by  fermentation: C 02 ;  and by adding H O2
 (water), i. e.,  one more atom  of oxygen, we get lower
 still, i. e., acetic acid.  And so, conversely, we can raise
 vegetable matter, in the same  way, into a higher organic
 material.   So it is  plainly demonstrated  that we can
 raise or lower organized matter by the  addition of cer-
 tain  organic  constituents  and elementary influences.
 Apparently, then, the functions of absorption, secretion,
 and excretion depend upon several  factors, i. e., molec-
 ular motion, absorbed heat, evolution, and force.   These
 chemico-physical forces bring  about physiologico-vital
 function and nutrition.
  The chyme  and chyle are prepared by gastroenteric
juices.   These  functions  are partially  chemical  and
 physiological; they assimilate  matter  to be organized
 into animal  tissues.   The process of injestion  and ejes-
 tion takes place under the influence of two organic forces,
 centripetal and centrifugal, together with the  influence
of affinity, i. e., endosmosis and exosmosis.  This  whole
physical function means nutrition and repair.
  The lymphatic system bears a great influence upon
the process of histogenesis, while nitrogenous substances
are changed into blood.  The lymph becomes denser
and more viscid  as it progresses towards animalization; 
24
PROGRESSIVE MEDICINE.
 and finally it forms into a glandular apparatus through
 the whole economy.  The lacteals are the colaborers
 with the lymphatics in the metamorphosis of chyle into
 blood.   Each has an elective power, sui generis; but for
 that  I  refer to physiology.  Thus far we have  found
 that the vital force lies in all organized matter, sponta-
 neous and independent. And furthermore, the vital force
 pervades all functions, organic and physical; and there-
 fore it is possible that the majority of diseases proceed
 from some dynamical disorder, thus disarranging organ-
 ization.
   In consequence of this material disorder of functions,
 the sympathetic system of nerves must, in more or less
 degree,  suffer; hence the  vaso-motor  branches  excite
 plethora, or the reverse (anamiia), through two opposite
 results, i. e.,  excitability  or debility.  Thus the  pro-
 cesses of absorption and  secretion  are  changed, and
 soon a pathological condition takes place.
   The ganglionic system  controls  organic functions,
 and influences  the small  ramifications  called the vaso-
 motor, which are in reality a continuation of the nervous
 ganglia.  This system has a  superlative powrer over our
 feelings; and causes, when excited, a blush or a paleness
 during our emotional sensations, and these ramifications
 reach also the  capillaries,  the organs  of digestion,
 absorption, secretion, and all the internal  organic  func-
 tions.  It does  more: it  reflects  upon the organs of
 special sense, the brain, and organs of generation.  The
ganglia is the source from which they receive a supplv of
force.  These ramifications, with  millions of invisible
subdivisions, play an important part  in the  process of
organization, and in the equilibrium and harmony of the
human organism.
  The chemico-physiological function of digestion and
assimilation is often affected by its influence.
  It is not surprising  that this wonderful' phenomenon 
    MAL ASSIMILATION, INANITION, AND DECAY.  25

of physical  arrangement is often disordered from vari-
ous and innumerable causes, i. e., objective  or  subject-
ive,  structural or functional, inherited  or acquired.
The influence of a simple eruptive disease may make a
patient almost frantic with discomfort.  When  the skin
with its glandular apparatus, its capillary convolutions,
its  pigment,  the spongy porosity of  sudorific  glands,
and the groups of papillse and its neurolemma are in an
abnormal condition, obviously the  reflex action  must
carry with it a mischievous influence  upon the whole
economy, as well as upon the hepatic organ.
  The liver being one of the principal organs involved
in the  nutritive process, sharing greatly in  the  organic
metamorphosis of the  animal system, and  having the
purification of the venous blood, extracting  bile, sugar,
and fats, as  calorifacients, and its relation to the chylo-
poetic viscera, therefore  the  organ must naturally be
prone  to  abnormal  deviations from health in  a large
degree.
  In biliary troubles, either in retention or suppression,
the process of chylification must be impaired: its hydro-
carbo fluid (bile) is  a physical necessity to the  paristal-
tic movement of the muscular fibers of the intestines.
It does more: it prevents both fermentation of  the  ex-
crementitious matter and abdominal flatulence.   When
this carboniferous element is not present, or is  not  ex-
creted, carbonic acid, or sulphuretted hydrogen gas, are
sure to be formed in the intestinal  canal, showing the
beginning of decomposition of the egesta, which, if not
corrected, may produce unpleasant complications.  The
bile  renders faecal  matter of natural  consistency and
easily evacuated.  But when this hepatic fluid  does not
pass into  the bowels, the fsecal  matter  becomes hard,
lumpy, and of a clay color, showing imperfect digestion;
the color  often changes  to  different shades—black,
green,  brown, etc. 
26
PROGRESSIVE  MEDICINE
  The quality of the food used is indicated by the smell
of the fecal matter.  The nitrogenous food produces an
ammoniacal sulphuretted fetid odor; the vegetable food,
when undigested, is indicated by an odorless carbonic acid
gas.   When the bile is retained in the blood (retention),
then the danger is of biliary toximia (Icterus).
  Besides the objective influences causing hepatic com-
plications and disorders, the  dietetics  have an  imme-
diate relation to hepatic diseases.  Excessive nutrition
and alcohol produce fatty degeneration and hypertrophy
of the organ.  I believe an excessive amount of amyloid
and glucose  articles of diet to  be  factors  of amyloid
degeneration  of the liver, glucosuria,  and fatty dis-
integration.  Albuminuria  often proceeds  from mal-
assimilation of albuminous food.
  Organic diseases of the liver  are  dangerous, because
the whole process of nutrition is by them affected, and
therefore often incurable.
  Malarious  diseases, or excessive heat, frequently pro-
duce hepatic diseases, like atrophy and hypertrophy,
from which structural  changes,  other diseases, i.  e.,
heart, lungs, kidneys, and  portal circulation, are likely
to occur.
  In view of this endless chain of physico-vital relations,
certain pathological conditions are transferred from one
organ to another  by sympathetic and  anatomical rela-
tion, thus creating functional  and  structural changes,
and destroying the harmony  of physiological action.
   The influence of gastric digestion, and the process  of
 chylification—the organic  functions  of the liver—are
 two great sources of good or  evil.
   The hepatic organ is also exposed to other influences
 from various sources,  viz., nervous  irritability  and  de-
 bility—hyperesthesia  and  asthenia—and  even from
 anaemia.   These are all included in the happy expres-
 sion of  adynamia.  The  contrary of  these  asthenic 
    MAL-ASSIMILATION, INANITION, A YD DECAY.  27

conditions  are, phlogosis,  engorgements, stasis, acute
and  subacute biliary  disorders, etc.; and these again
may reflex back, as they frequently do, in a great meas-
ure upon the process of  digestion  and  assimilation.
In such instances the cause and effect are reversed.
  Facts favor the inference that grief, anxiety, dissipa-
tion, and meteorological influences, lower the vital and
physical forces; and that all devitalizing tendencies are
influential  in producing hepatic diseases.
  In taking a coup-d"ceil of the renal diseases, where the
nitrogenous constituents pass out—the urea, lithic acid,
and phosphates, sodium  lithates and bile—this physical
and organic  metamorphosis, if  in  any degree it should
be  interfered  with in its physiological functions,  the
effete  matters would  be  retained and carried  in  the
circulation;  and, indeed,  when such  is the case,  the
consequences  are  serious.   It is a well-known  fact,
that many cases of Bright's disease of the kidneys pro-
ceed from  mal-assimilation.
  And many renal  diseases  are the  sequel  of nervous
disarrangements,  hygienic  neglect,  dissipation,  sup-
pressed  perspiration, checked  eruptive  diseases like
scarlatina, measles, eczema, diphtheria, etc.; also, malari-
ous diseases and those of a proteinaceous nature.
  The old adage is as true to-day as  it ever was—Chi
va piano va sano, chi va sano va lontano—Moderate  and
regular habits are conducive  to  health, while indul-
gences, dissipations, exposures, etc.,  are the factors of
disease. 
28
PROGRESSIVE MEDICINE,
                   CHAPTER  II.

PROFESSORS  TROUSSEAU AND PEDOUX's  ANALYSIS  AND
   CRITICISM  OF  THE  HOMEOPATHIC  MATERIA  MEDICA
   AND THERAPEUTICS.
  These truly conscientious writers have thought proper
to review  the  different schools or systems of medi-
cine, from the time of Hippocrates to the  present  day.
They have criticised the  French, German, English, and
Italian schools, with discretion and justice.  The views
of Doctors Broussais, Pinel, Brettaneau, Hunter, Brown,
Rasori,  and Hahnemann, are fairly discussed. They
have declared themselves catholic in spirit and eclectic
in practice; that is to say, they believe there are many
important and useful principles  in all the schools  of
medicine.  They saw the difficulty, however, of adopt-
ing such a mixture of contradictory theories without run-
ning the  risk of perplexity and  failure;  and  so  they
contented themselves with  praising what they consid-
ered right and true, and disapproving what they thought
lacked practical support; but yet they suggested or put
forward nothing of their own.   It is  easy to  criticise
and pull down what others have built with great labor
and difficulty, and quite another  thing to raise a new
and solid structure of your own.  These gentlemen have
shown one thing,  however, and that is, that the various
schools belonging to  the " rational" or Allopathic sys-
tem of therapeutics, differ from each other as much as
they do from homeopathy; and for this reason I confine
myself to  the criticism  they have made  upon Hahne-
mann's theory of Similia similibus curantur. 
HOMEOPATHIC MATERIA MEDIC A.       20
  They say: " Homeopathy, considered as the general
idea upon which this science is based, does not certainly
deserve the ridiculous therapeutic distinction which ho-
meopathic physicians have imagined that it possessed.
When  Hahnemann found  the  therapeutic principle of
similia, upon  which he stated his argument, he only
demonstrated/acfe which were the results of experiments
of some of the most  eminent physicians of his time.
According  to  Hahnemann," say the Professors, " each
medical agent  must possess a particular morbid  action
upon the system; but any drug not possessing distinct
pathological properties is  not  considered  a medical
agent  deserving of our  attention.   Such propositions
are true,  but were  expressed and demonstrated  by
others  before  Hahnemann; and  they are  worthy of
scientific examination, being useful to  the science of
medicine.  The morbid action of medicines can only be
recognized by the application of them upon an individ-
ual in a perfect state of health."  This is so eminently
true that Empiricism and Rationalism are both precipi-
tated into a labyrinth of obscurity at the appearance of
these   facts.  Artificial diseases, produced by medical
agents upon a  healthy sj^stem, are recognized and care-
fully classified by their peculiar objective and subject-
ive symptoms, lesions, and sympathetic  complications,
which  each and  every agent is capable of producing
upon  the animal  economy.   And when Pedoux  said
that we "have no  orders  of symptoms, and no unity,"
he  has shown that he little understood Homeopathy
proper.
  Again they say: " The  science  of the physician is
reduced to purely experimental knowledge, namely, that
of the  true symptoms of a certain natural disease, and
those   belonging  to  a medical agent."  Homeopathy,
however, does not  reject  the  study of microscopical
pathology, and its pathognomonic  lesions produced by 
30
PROGRESSIVE MEDICINE.
natural diseases.  On the contrary, it inculcates upon
the homeopathic physician the necessity that medical
agents should not only give us the superficial symptoms
like those of a disease, but also similar pathological,
functional, and organic lesions, as well.  This knowledge
can only be expected to  be acquired from  toxicology,
accidental  poisoning, or  from experiments made upon
animals.
  These learned gentlemen state the following facts:
" When virus is introduced into  the  system, and finds
there  homogeneous  substances, it multiplies to  the in-
finitesimal, and infects  and assimilates  all  substances
with which it comes in  contact.  It goes so far that
even a single atom  of virus is apt to produce  similar
disease, such as vaccine  matter, syphilitic poison, mias-
matic effluvia, cholera, yellow fever, and, in short, all
contagious diseases."

           CHEMICO-PHYSIOLOGICAL ANALYSIS.
  The animal and vegetable kingdoms present us with
numberless forms, different from each other in  aspect,
construction, and function; but the origin of all is  the
same.  All organic  bodies differ from the inorganic, or
mineral, in the  various  compositions of their compo-
nents, their structure, their proneness to become isomeri-
cal, and the great tendency they have to become united
in, or  change mutually their preference for, one another.
  The opinion of chemists  is very much  divided in re-
gard to the vital forces which take part in the formation
of organic bodies.   Liebig compared  the vital force to
a dynamic power, which has an influence on the  organic
forces, like caloric.   It  is known that, with heat, they
increase or diminish the changing  affinities of  organic
bodies:  therefore  they  can  produce combination,  or
decomposition, which would not have taken place had
it not been for a change  of temperature.   Liebig also 
        CUEMICO-PHYSIOLOGICAL ANALYSIS.       31

affirms that the normal existence of organic bodies, of
whatever  being, are, as it were, in the midst  of two
contrary forces—the organic  and the force of affinity.
These two vital forces exist in equal parts and strength,
and thus maintain the  physical equilibrium  of either
the animal  or vegetable  kingdom.  But when such
equilibrium is disturbed by a prevailing influence of
either force, life becomes more or less deranged, as this
or that influence is prominent.  The return  of health
and vitality is the harbinger  of the re-established equi-
librium of the two forces.  Professor Liebig's  experi-
ments prove that the current of a liquid is not produced
by its want  of density, nor by its viscidity, nor by its
endowments with the  greatest  force of ascent in  the
tubes.   But the current is generally determined by the
liquid which has the greatest  affinity  with  the inter-
posed substance [this establishes the correctness of the
law of endosmosis] and " by the greatest rapidity of im-
bibition."—Professor Mateucci.
   A vesicle containing one  liquid being placed within
another liquid of a different  nature, may so act on the
one by which it is surrounded as to  exchange its own
contents for a like quantity of the fluid with which it may
be in contact.   This  explains  the law of circulation
and  nutrition.  (See " Physiology.")
   " Chemists  have tried," says Selmi,  in his valuable
work on Organic Chemistry, " with ingenious and arti-
ficial instruments to make mineral matter organic, in the
hope of bringing out living beings, and with the aim of
producing atoms, that may be, in  either  effects or  na-
ture, like  those  atoms which are  part  of the organic
tissue.  Their labor, so far, has been very little rewarded.
Chemists  have  converted cyanogen, ammonium,  and
carbonate of hydrogen into urea, which is found abun-
dantly in the urine, thus uniting  purely inorganic sub-
stances with means strictly clwrnical." 
32
PROGRESSIVE MEDICINE.
  Any one  who  has the least  knowledge of organic
chemistry will soon see that the gains from such chemi-
cal experiments have been small.  But Professor Selmi
says:  " It is to be hoped that they would  have better
success in their experiments and results, if they should
undertake a research into the combination of the car-
bonated and nitrogenized substances with metalloids."
As carbon and nitrogen  are the root  of all organic com-
positions, it is but reasonable to suppose that in both,
and particularly  in  the first, there  would  exist  the
power of imparting an organic force into all the molec-
ular groups.
  " Artificial morbid affections are to be placed in the
same list with natural diseases, and  they do not differ
from each other.  All natural diseases  can be more or
less imitated by morbid properties of medical agents, as
some  of  these  produce, approximately, symptoms of
scarlatina; others, those of apoplexy;  others, those of
syphilis; others, those of roseola; and others, those of
dysentery.  A disease produced by a medical agent pos-
sesses the power  of destroying the natural disease with
which it is most similar.  Such medical theory would
substitute an artificial disease for a natural one,  but the
artificial disease is only of short duration, and not ma-
lignant—on the contrary, perfectly harmless, disappear-
ing immediately after a certain effect is produced.  We
must acknowledge, therefore, that phlegmasia^ or inflam-
mations,  are cured by the application of irritants, which
produce  another  local inflammation, thus  substituting
the primitive phlegmasia};  but if it is  so with local in-
flammation, it is nevertheless not so in general inflamma-
tion.  But  Hahnemann,  fascinated  by  one truth, verv
soon exaggerated the  importance  of  his  discovery."
— Trousseau and  Pedoux.
  In my opinion this is  a perfect contradiction, without
a satisfactory reason; when acknowledging that a natu- 
        CHEMICO-PHYSIO LOGICAL ANALYSIS.       33

ral disease can be imitated and destroyed by an artificial
one.
  The learned Professors  again say: " After knowing
the course  and intensity of an inflammation, if  it were
possible to put in contact with the inflamed  tissues an
irritating  medicine, which Avould substitute the  existing
irritations,  a great therapeutic result  Avould certainly
have  been obtained."
  Such a result is seen in the treatment  of conjunctivitis
with  nitrate of silver, mercurial ointment, or alumina,
which are irritating substances.   These medical agents
are used daily by the Allopathic physicians.  They con-
tinue: "This fact once  established, Ave must study the
laAvs of the theory.  It is clear, for  example, that sub-
stances which destroy organic  tissues with  their chemical
or physical action—like lime, mercury, nitric  acid, ar-
senic, cuprum, lead, and many others—succeed admirably
in restoring those tissues, when in a morbid condition,
to a healthy state."
   Doctor Pinel, although not a Homeopathic physician,
merely because he lived before Hahnemann, seems  to
have  felt the necessity of treating diseases symptomat-
ically, without following the erroneous  theory of Brous-
sais and Rasori.  Symptomology does not mean treating
every symptom separately in all  cases, as Ave  have
groups of symptoms; and  from groups we form classes.
We have groups of miasmatic symptoms, and some for
specific  diseases; and  these  groups  are divided into
classes according to  the peculiarity of the miasm, the
organic and functional complications, or specific disease.
We  have  also medical  agents  which  produce sthenic
and asthenic inflammations, organic and  functional de-
rangements, etc. These groups are divided into various
classes.  When Professor Trousseau attempts to demon-
strate the fundamental errors of Homeopathy, he must do
so on some other ground than by his puerile demonstra- 
34
PROGRESSIVE MEDICINE.
tion that a medicine can produce certain pathological con-
ditions in one organ only, and at the same time admitting
that diseases like dysentery, roseola, scarlatina, syphilis,
etc., can be artificially produced by medical agents.
  If our learned professor admits the above as possible,
he  must undoubtedly admit that a great variety of
pathological phenomena  can be produced by each and
every medical agent, varying, of course, in intensity, in
lesion, in specific affinity for certain  organs and  com-
plications.   This is all  that Homeopathy claims; and it
has been so declared by all  her followers, Avhose state-
ments are based on practical facts.
  And,  I am sure, that  all  unprejudiced and  honest
inquirers Avill find  the assertion to  be true.   We ask
nothing more than  that  such men as Trousseau,  Avith
his candor and  his  love  of science., shall  analyze the
claims of the system of Sim ilia.
  Every work on Homeopathy, and every Homeopathic
practitioner, is  peculiarly solicitous to demonstrate, on
clinical  grounds, the efficiency  of the law of similarity
in the treatment of all diseases, excepting mechanical
and toxicological, in Avhich mechanical, surgical, and
chemical means have to be employed.
  And in consideration of the honest  opinion of Trous-
seau upon our system of cure, I have  given my answer
in a plain, and, I hope,  in a convincing manner.  I  have
based the whole Avork on clinical and analytical grounds,
to the best of my ability.
  All  the  authorities I have searched, of both schools,
have strengthened my belief that the day is not far off
when  the law of similarity will  be regarded as the true
and only law of therapeutics.
  The many cures of the hospital and private clinical
cases, often  authenticated by honest Homeopathic phy-
sicians, are unquestionable examples.   All morbid  influ-
ences are as invisible as they are imponderable. 
CHEMICO-PHYSIOLOGICAL ANALYSIS.       35
  Again they say:  " We do not deny  the divisibility
of matter, nor the possibility of its division; but how aro
we to determine its division being effective?"  I must
answer, How are Ave to determine the rotation of the
earth?  Yet the Avorld moves.   I will, however, give a
more  conclusive  answer: We must be  logical, and ac-
cept results as proofs of Avhat we cannot explain; but
still, I think that Ave Homeopathists can ask our brethren
to accept physiological and  pathological results, Avhich
they have  already  been candid enough to admit and
grant  to Homeopathy.  May I ask  the learned  pro-
fessors  how we are  to determine the effective power of
the luminous  bodies of the  sun?  Merely, they Avould
Avell answer, from  their effects.  How are we  to de-
termine the  amount of  morbid influence of miasma ?
From  its effects. The above  argument  ought to be
sufficient to any unprejudiced  mind, that we  cannot
determine results and effects merely by ponderability of
matter.
   Doctors  Trousseau and Pedoux also say: "We knoAV
that it is not the quantity of a morbid influence Avhich
determines the nature of a disease, nor  its intensity, but
the kind of poison  Avhich has produced the disease—
just as it is not the  quantity and the size of seed that
determine  its productiveness.   So it is Avith a medical
agent—not the  quantity, but the kind."
   I believe that this is sufficient to decide the question
of doses, for Avhich the Homeopathic school has been so
fearfully abused.  And,  lastly,  they  say: "All Homeo-
pathic remedies have  been tried  experimentally  upon
individuals in a normal  condition:   the  Homeopathic
physicians have had the courage, patience, and  perse-
 verance to prove the remedies upon themselves; and
 have, after manv experiments, succeeded in constituting
 the Materia Medica Pura from which  they have derived
 much valuable information regarding the specific proper- 
36
PROGRESSIVE MEDICINE.
ties of medical agents, of A\diich we in France are totally
ignorant.   Many therapeutic agents  are  only super-
ficially knoAvn to us, as also many diseases Avhich appear
under peculiar conditions.   In these Ave  are at a loss to
knoAv Avhat therapeutic means to use."
  The professors advise  that in  typhus, typhoid, and
other miasmatic diseases, Avhen  there are  present any
of the above  peculiar conditions, the diseases  should be
treated symptomatically.   We  are  indebted to Pro-
fessors  Trousseau and Pedoux  for their criticisms on
Homeopathy. Hahnemann's doctrine has never  been
better explained and represented.

             DISSOLVING ORGANIC  MATTER.
  Solid or liquid substances, Avhen they unite Avithout
chemical  composition with a liquid  which  takes the
office of a vehicle or  conveyance, do so in one of the
following  ways, namely, by dissolving, fluidifying, or
SAvelling the  organic substances Avhich  are used as
medical agents.   It is as much a solution  Avhen the
substance is  dissolved in  the  conveying  liquid, in a
state of perfect molecular  division, as it would be bv
becoming gaseous  or ethereal.   "The  solution," says
Professor  Selmi, "is only  the gasification of the atoms
in a certain  space  that has for vehicle a'liquid, and
which is completed by an absorption of caloric."  Bizio
says: " The dissolved substance does not lose strength
in dissolving,  in  its  special  quality, neither  does it
change  in the least;  and, moreover, it resembles  Avhat
Ave see in  vaporizing bodies."
  The two substances—of  which one is the dissolving
agent, the other the  dissolved  substance—in  mixing
become smaller  in volume,  or else they have  the con-
trary effect, and  become much larger; so much so that
the volume of the solution  very seldom  represents the
quantity, or real volume, of the  matter dissolved.  The 
THE ACTION OF CONTACT.          37
act of aggregation of the liquid and medical agent dis-
places a certain  quantity of heat equal to that which is
absorbed by forming a solution.  It is not unnatural
that  atoms  subdivided in such minute particles, not
only  attract to themselves a part of the precipitating
agents, but that they become  sometimes so powerful as
to dissolve a base from an acid, or a neutral salt into a
sub-salt.   This  sIioavs what poAver division and sub-
division can add  to  organic  matter.

               THE ACTION OF  CONTACT.
   Chemists  have observed that, in certain cases, two
substances mixed with a liquid react upon each other
in such a  manner as  to modify the effect of one sub-
stance by the  pressure  of  the other,  Avithout  having
this  substance  participate  Avith  its  element  in the
modification of  the first, and that it  does not  even
show any chemical affinity.  How do  Ave explain the
modification  of the  first  substance?  The  modifying
influence of the second substance upon the first is ac-
complished  by the action of touch, or contact.  Berse-
lius,  Avho Avas the first to call attention to this subject,
says: "Besides  the forces of cohesion  and affinity be-
tAveen molecular matter, there also exists a third force,
called  catalectic, or catalysis;  and  from this peculiar
force Ave  can  explain the action of touch or contact.
Catalysis  is a  peculiar  influence or force of  a  body
Avhich modifies  other bodies by mere contact, Avithout
itself undergoing any change."  This, in my opinion, is
sufficient evidence that  Dr. Algeidi Avas  correct Avhen
he Avrote a letter to Hahnemann, in Avhich he said: "The
combination of two medical agents has proved,  beyond
doubt, that their therapeutic action is increased without
either altering or neutralizing the other, provided such
agents are not incompatible."
   Another proof that Homeopathy is  based upon the 
38
PROGRESSIVE MEDICINE.
most scientific laws  of chemistry is the following:  the
atoms of an active body become much more effective in
their influence through the velocity of their movements,
and  the force with Avhich they move.  In other words,
atoms gain more active strength by rapid motion than by
the quantity of particles which such bodies may contain.
Here Ave have another conclusive and rational example:
Ave produce coagulation of a hundred thousand  parts of
Avarm milk in the space of half an hour, Avith one part
only of caseine, Avhich Avould be less than one  sixth of
the active  agent.  It is but reasonable that Ave should
attribute that wonderful phenomenon of coagulation to
the velocity of the molecular movement of caseine rather
than  to  the  quantity of  ingredients therein.  This
demonstrates, beyond doubt, hoAv much  rapid motion
of molecular  matter can accomplish.   Liquids, by  the
means of adherence, absorb and condense many ethereal
fluids. The power of condensation is exhausted to such
a degree as to become a Avondsrful phenomenon.   They
come to the  conclusion,  from the observation  of Pro-
fessor Hassenfratz, that the volume of a solution does
not represent the real volume of the  dissolving agent,
nor of the substance dissolved—having either dilatation
or contraction.   But it is to be  supposed, according to
the elementary laAvs, that caloric and motion will always
dilate an ingredient which is undergoing the process of
subdivision.

      •EFFECT  OF FRICTION UPON MEDICAL AGENTS.

  The first action of friction  is  to increase the volume
of organic bodies and produce  heat, and  thus  disinte-
grate solids.  Solids  and liquids both go  through  the
process  of  vaporization  when  acted  upon  by  heat.
There is a  great number of  substances which  become
decomposed and useless, if  exposed to heat and  light.
It has been observed that light produces  evaporization 
       DEVELOPMENT OF ORGANIC MATTER.    39

 of some organic bodies—for example, camphor; and it
 is well known that it discolors many substances contain-
 ing a coloring matter, by exciting the oxygen of the
 atmosphere to act upon them, or to become mixed with
 them, or else to neutralize the hydrogen contained by
 them.   It is well known that oxygen sometimes becomes
 attached to the atoms, like a  metal; and in that case,
 such atoms become  oxydized.   At other times, oxygen
 takes off the carbon and the   hydrogen; and it can do
 this without mixing itself with the  substances which it
 has decarbonized and dis-hydrogenized.  This shoAvs the
 error of keeping medical agents in the light and heat.
 In Homeopathy,  Ave  have a  rule that our medicines
 should be kept in a dark and cold room.

        THE DEVELOPMENT OF  ORGANIC MATTER.
  We can see, at the  first vieAv, that the developing
 force, par excellence, of the organic attitude of the princi-
 pal elements is hydrogen.  Hydrogen produces volatil-
 ity of the organic compounds: the more hydrogen, the
 more development, and the more volatility.  The quan-
 tity of water does not  diminish the organization  of the
 organic  bodies.  Water is a simple developing agent,
 and is neither an organizing nor  disorganizing  agent.
 The importance of water, in organic chemistry, is almost
 equal to that of carbon.  Water—in  dissolving, sub-
 dissolving, emulsionizing,  and gathering all the organic
 bodies—favors the reactions, modifies the quality, and
 prepares them to accomplish  the functions, to  Avhich
 the vital  force stimulates them.  Without Avater, Ave
 would have neither blood, lymph, nor  many other in-
gredients belonging to both the  animal and vegetable
kingdoms.  Finally, there would be neither organiza-
tion nor life.   The subdivision of the elements in favor
of organic atoms  brings  great changes, and these  are
produced by the formation of new substances contained 
40            PROGRESSIVE MEDICINE.
in the Avater.  This confirms the hypothesis that water
is a developing agent, if not an organizing one.

        ELECTRIC  IRRITABILITY OF THE  NERVES.
  1. Electricity is the only irritant Avhich can excite at
one  time  sensation, and  at  another time contraction,
according  to  the direction  in  Avhich  it  transverses a
nerve.  2. The  electric current alone, in passing trans-
versely across a nerve, produces no  phenomena due to
the  excitability of the nerve.  3. The electric current
has  no  effect  on the nerves; that is, it  neither causes
contraction nor sensation, Avhen its action on the nerve
is prolonged.   4. The  electric  current  alone  modifies
the  excitability of a nerve, and even  rapidly  destroys
it, Avhen the  current circulates in a certain  direction;
and can  preserve or augment  the  excitability, Avhen
passing in the opposite  direction.  5. Of all  the  irri-
tating agents, the electric current is  the only one Avhich
possesses  the poAver of reviving the excitability of the
nerves, for a  time, Avhen  they have  become  very much
enfeebled in respect to other stimulants.

  ANALOGY BETWEEN  ELECTRICITY AND NERVOUS  FORCE.
   These  differences betAveen  the  action Avhich elec-
tricity  exercises on the nerves, and  the action of other
irritants,  evidently  show  that the first  is more  simple
than the  last.  Hence arises the  analogy between  the
nervous force and the electric current, which  the earliest
observers of galvanism  faintly perceived.  But ought we,
from this analogy, to conclude that the nervous force is
merely an electric current?  Let  us be  cautious in as-
suming such  an inference—which is too  often adopted
as  one  of the best demonstrated  experimental truths.
It was  important to search for  the presence of an elec-
tric current in the nerve of a living  animal.  The most
conscientious  and best-established  conclusion, is this- 
ON THE SECRETIONS.
41
In the present  state of science, and Avith the means of
experimenting Ave noAv possess,  no sign of an  electric
current is found in the nerves of human beings or of
the lower animals.  What is the  relation existing be-
tween nervous  force  and electricity?   There exists
between  electricity  and  nervous force  an  analogy,
Avhich, if it  does not possess  the same  degree of evi-
dence, is, hoAvever, of the  same kind as those analogies
Avhich Ave know exist betAveen caloric, light, and  elec-
tricity.  The phenomena  which  Ave have observed in
electrical fishes prove that a link of the same nature
unites the  nervous force and electricity.  Electricity
is not nervous  force;  nor is  nervous force or caloric
electricity.   There is a beautiful analogy of the  tAvo
forces Avritten by Professor Mateucci.  The conclusion
of this interesting argument, that " two  forces  may be
alike, acting upon one another Avith advantage,  and yet
not the same," is a very important matter, and Avorthy
of attentive  study by all  Homeopathic students.  It is
Avell to knoAv it, and to  knoAv it scientifically.  Professor
Mateucci  goes on to shoAV Iioav electricity can excite
nervous force.  The  excitability of the nerves  can also
be  aAvakened, and sensation  of  muscular movements
determined, by  other agents as Avell  as  by electricity;
for example, by heat, and  by mechanical  and chemical
action.  In  all  these actions Ave can  only see  various
causes of molecular movement, etc.; and Ave  cannot say
that chemical and mechanical  force  and caloric are
either nervous   force  or electricity.  But  they  are
analogous in  their actions and results.

                 ON THE SECRETIONS.

  Bv secretions, Ave mean the different fluids Avhich are
formed in the organs at the expense of the blood.  These
fluids have  different actions in  the  animal economy.
Some  are destined to certain  functions, as the saliva, 
42
PROGRESSIVE MEDICINE
bile, pancreatic juice, etc.  Others are thrown out, like
perspiration, urine, milk, etc., because they  could not
remain in the  economy  without producing  much de-
rangement.   The secreted liquids have a variable com-
position.   Some are, as it Avere, evaporated on the sur-
face of the membranes  Avhence they come; such are the
mucus, perspiration, and the serum.  Others are the
saliva and the pancreatic  juice: these  latter are ac-
cumulated in particular ducts,  Avhich pour  them out
when needed.  Finally, some others  are immediately
placed, after being  secreted, in  particular  reservoirs;
such as the  bile, the urine,  and spermatic fluid.  All
these secretions are not formed by the secreting organs,
but by the blood itself.  This proof shoAvs that there is
no such thing as secreting membranes;  but that they
only perform the mechanical function  of eliminating
such fluids from the blood; and  these  once throAvn out
of the  general circulation  are  of no more use  to the
nutrition of the system, and are then received into the
membranes for other purposes.
  This idea  is not agreed upon by all physiologists.
They have taken out the kidneys of a dog, so as to pre-
vent the  secretion of urine  and  the  excretion through
the usual channel.  After a few days the dog  died, and
they found that the blood  contained urea; but  it has
been impossible to ascertain such phenomena in a case
of natural death, as undoubtedly  the kidneys  constantly
separate  the  urea from the blood.  First, the separation
of matter from the blood is  performed by filtration; and
second, by cell-action, etc.   Secretion  by filtration is
purely a  physical act, which is closely demonstrated in
the  case  of  the. lachrymal  glands.  This  mechanical
function is observed also in the serous, and  particularly
in the synovial membranes, and bursce mucosae.  As long
as the material secreted pre-exists  in the blood, it is
needless  to refer secretions to any other  principle' than
to the simple one of transudation and filtration.   This 
         THE SALIVARY GLANDS—CHYME.       43

law is well defined in the structure of the liver; that is
to say, four different vessels are engaged in the liver—
the portal vein, hepatic arteries, biliary duct, and  he-
patic veins.  The first tAVO are the afferent; the second
two, the efferent.  The portal vein brings the portal or
venous blood.  The arteries supply that organ Avith  the
necessary blood for nutrition, that is,Avith arterial blood.
The ducts carry off the biliary  secretions Avhich have
been separated from the blood.   The hepatic veins take
charge of the residue, and carry it back into the circula-
tion and into the  vena-cava.    Similar  processes take
place throughout the glandular system.

         SECRETION  OF THE SALIVARY GLANDS.
   There are, it is Avell knoAvn, three pairs of salivary
glands;  and although secreting similiar  fluids, yet they
are not the same.  The parotid fluid differs from  the
maxillary in density; and is  less alkaline, and contains
less lime.  It is so viscid and glutinous  that  it may be
draAvn into threads; but the sublingual is much like the
parotid  fluid.  Besides the  special juices, the mucous
membranes pour  forth a liquid of  a thick, tenacious
character, Avhich is alkaline in  its reaction.  The mucus
of the buccal mixed with  the submaxillary secretions,
accomplishes a transudation of  starch  into sugar Avith
facility,  Avhich it Avill not do Avhen mixed Avith the  par-
otid fluid.   The saliva of the mouth is  a compound of
the  secretions of the various salivary glands.  The  pre-
ponderating ingredients in the composition of the saliv-a
are sulphates, chloride of sodium, and potassium.   The
difference  betAveen the saliva of man and that of herb-
ivorous animals is only that the salivary-calculus of  man
contains a greater quantity of phosphates.

                      ON CHYME.
   Chyme  is the result of digested food.   In consistency,
color,  and chemical re-action, chyme varies with the na- 
44
PROGRESSIVE MEDICINE.
ture of food, in its chemical constitution and its quantity,
but under ordinary circumstances  presents  an acid  re-
action, for it is to be remembered  that the diurnal sup-
ply of hydro-chloric acid is about one-fifth of an ounce.
Pepsin is a very important agent in the accomplishment
of digestion. The following is an example : hydrochloric
acid has been kept in contact with albumen, without any
perceptible action, at an ordinary temperature;  but if
the same acid,-at  the same degree  of temperature, be
joined Avith an addition of pepsin, a solution takes place
with rapidity.   This is  sufficient  to  explain  the influ-
ence of pepsin upon the  digestion;  that is to say, by
replacing heat.  The acid alone cannot form a solution
Avithout an increase of temperature varying from 150 to
200 degrees.  The lactic acid, by  the  aid of" pepsin,
reduces the  food  to  a uniform pulpy mass,  called
chyme.  Of all  the acids, these  alone  are capable of
forming digestive fluids.

                    GASTRIC JUICE.
   Gastric  juice is  secreted by the internal coat of the
 stomach, and has the power of dissolving the ingredi-
 ents Avhich enter into that organ  and of changing them
 into chyle.  Physiologists and chemists, after many ex-
 periments upon dogs, etc., have come to the  conclusion
 that the acidity of the  juice is due to an acid identical
 Avith the lactic and ascetic acids.  Dr. Prout has demon-
 strated that the  free acid is hydrochloric acid.  This
 acid of the gastric juice and the soda of the bile are de-
 rived from common salt, which is present in the  food.
 We find  that there is a constant recurrent periodicity
 of digestion from the  mouth and the entire digestive
 track.  As to the particular usefulness of  this  juice
 upon the  ingredients of nutrition, Professor Spallazani
 believes  it to be  the dissolving  agent, Avithout which
 no perfect digestion would take place, and no molec-
 ular transformation of chyme  into chyle   could be 
PANCREATIC JUICE, ETC.           45
accomplished.  Thus Ave must regard the gastric juice
as one of the great principles of digestion, and an in-
dispensable substance in the  formation  of chyle from
the milky emulsion of chyme.

                  PANCREATIC JUICE.
  That fluid Avhich is called pancreatic juice is secreted
by  the pancreas, and  poured  into  the  duodenum to-
gether Avith the bile and gastric juice.   The secretion
of this gland  is similar  in composition to  that of  the
salivary glands, and its  structure is also  similar to  the
salivary glands; and hence it  is usually regarded as  one
of the group.  The juice itself is analogous to saliva,
being  viscid and  alkaline in  its reaction.  Its specific
gravity is 1.008.   It acts upon starch even  more ener-
getically  than saliva, transforming  it into sugar  and
lactic acid; and upon fats, by forming them into emul-
sion, so that they are readily  absorbed.   This  has been
proved by submitting fatty substances to  the  juice at
the temperature of 100°. HoAvever, the action of the
pancreatic juice  seems to be limited to the upper half
of the intestines.

                    ENTERIC JUICE.
  This juice has received but very little attention from
the medical profession in general; and, in  my opinion,
it is one of the most complicated, as Avell as one of the
most useful, in its character and function.  It is secreted
by Brunner's glands, the structure of Avhich has a  cer-
tain analogy to the salivary group.  These glands  are
found  in  the upper part of the  small intestines: they
are as small as a hemp-seed, and consist  of globules
with ducts communicating with a common outlet.  Their
secretion  possesses a more energetic power in forming
fatty  emulsion Avhen mixed with  bile and pancreatic
juice  than the pancreatic juice  alone.  In the opinion
of Dr. Schmidt, the intestinal juice, which they describe 
46
PROGRESSIVE MEDICINE.
as being invariably alkaline, exerts as poAverful an action
on  flesh, albumen, and other proteine bodies, as  that
which occurs in the  stomach itself.  The follicles  of
Lieberkuhnn are straight, narrow, cereal depressions of
mucous membranes, found all over the intestines.   They
are analogous in their  structure to the mucous follicles
of the stomach, Avhich secrete  pepsin; and it may be
presumed  that  they possess  similar functions.  Their
mouths open to the  intestines,  to  Avhich  they com-
municate  their  influence.
  There is another very important class of glands,  or
paches.  These are  circular spots of a Avhitish  color;
and, without any excretory ducts opening into the intes-
tines, they secrete some kind of fluid necessary  to the
intestinal digestion.   By some  it  is  denied  that these'
bodies are in any way connected  Avith intestinal diges-
tion ; but it is too absurd  to suppose that these little
glands  have any other  function  than that  of a fluid,
Avhich, like the mucus  of the mouth, possesses some in-
gredient  necessary for the  accomplishment  of di-
gestion.
                   SYNOVIAL FLUID.
  This  fluid  is furnished by  a particular  membrane
which forms the synovial  capsules of the articulations,
and is secreted for the purpose of facilitating the fric-
tion of articular surfaces.  This  fluid  has been analyzed,
and found  to be semi-transparent, greenish, viscid, and
filamentous, like  the  Avhite of an egg; greasy  to the
touch, and  saline in taste.   Left  to  itself it assumes a
gelatinous  consistency.  It becomes fluidified  after de-
composing  a fibrinous substance.  The synovial fluid of
man contains a great quantity of albumen, animal matter,
alcohol, a fatty substance, some soda, chloride of sodium
and  potassium, and phosphate and  carbonate of lime.
The knowledge of the different  ingredients composing
this fluid is of great importance to the physician, as they 
LYMPH, ETC.
47
have  considerable influence  upon the  diseases of the
articulation.
                       LYMPH.
  The lymph is  a serous fluid, very  abundant in  the
human economy, and is the result of the process of de-
composition of the blood;  or  in other Avords, it is a sepa-
rated constituent of the blood.  It is found in the white
corpuscles, or mixed with  chyle in the thoracic duct.
  The lymph, like all the other fluids, is secreted by the
capillaries;  and,  in its  composition, is like the blood
itself, except in the red  cells—the fibrine, albumen,  and
saline  constituents being apparently  the  same.  The
lymph collects all the albuminous matter throAvn out by
transudation from the blood,  as unnecessary or innutri-
tious ingredients.  These albuminous ingredients, being
allied to the lymph, form a glandular substance, Avhich
is called the lymphatics.  This structure is the counter-
part of the mesenteric or lacteal glands.  These lymph-
atics anastomose with each other, in various Avays, so as
to form plexuses and convolutions.  The action of the
lymph is to gather the albuminous substances thrown
out by the blood-vessels, which otherwise Avould go to
waste.  Receiving all these, they transmit them through
their Avindings in the glands,  and  then submit them to
the action of innumerable cells; and, as in the egg of a
bird, albumen disappears and muscular  tissue of a bird
arises, so here the serous portion disappears and fibrine
arises  in  its place.  This is carried forward into the
circulation,  to repair   the  great  waste  of  muscular
tissue.  The skin is  abundantly supplied with these
glands, or lymphatics.

           FLUIDS WHOSE  REACTION IS  ACID.
  The skin  contains tAvo  kinds of glands: one for the
removal of water, the other for the removal of oily sub-
stances.   Dr. Anselmino analyzed the vapors, or steam, 
48           PROGRESSIVE MEDICINE.
of the body, and found  the  folloAving features, namely,
the fluid itself is perfectly clear, and has no smell; but
when analyzed it was found to be composed of Avater
and carbonic acid.

              ANALYSIS OF PERSPIRATION.
  The skin permits Avater  and  saline and  fatty sub-
stances to escape from it in  quantities Avhich differ on
different parts of the human body.  The experience of
Dr. Berzelius gives us the following substances as com-
posing the human perspiration:  water, acetic and lactic
acids, chloride of sodium, potassium,  phosphates, and
oxide of iron.   The acetic acid is  the fluid Avhich acts
upon colored clothing.
  Whatever physical   circumstances promote surface
evaporation correspondingly promote the action  of the
skin.  Moreover, this membrane acts similarly Avith the
kidneys;  and this not only in regard to the Avater, but
also in regard to the solid matter, a certain  amount of
which is thrown off in  the space of twenty-four  hours.
Besides Avater secreted  by the sudoriparous glands, car-
bonic acid and nitrogen escape.   Their proportion is
variable and seems to  depend upon  the  nature  of the
food—carbonic acid increases Avith vegetable food, and
nitrogen with animal food.   Professor Draper says: "I
believe that the sudoriparous glands are the counterpart
of the malpighian bodies, and the sebiparous glands are
the counterpart of the  uriniferous tubes."  Besides ex-
ercising the functions  of exhalation and  perspiration,
they also exert a great absorbent action.   Liquids, as
Avell as gases, find entrance  through the skin.  If oxy-
gen, carbonic acid, and nitrogen are put in contact with
the skin,  absorption rapidly ensues.

              MILK AND ITS COMPOSITION.
   The proportion of water which exists in milk is about
nine-tenths of the whole amount.   The function of the 
CONSTITUTION OF MILK, ETC.         49
Avater is to remove from the system substances  which
are not of a vaporous or gaseous form, and Avhich cannot
escape through the lungs and regulate the temperature
by  evaporation,  and to impart fluidity to the  blood.
These are conditions as necessary to the infant as to the
adult;  and it should be remembered that  tAvo-thirds of
the Aveight of the body is water.
  The next most important ingredient of milk is caseine,
Avhich  is  the tissue-making,  histogenetic, or nutritive
element.  It is to be converted into the muscular, gel-
atinous, and other soft  tissues  of the infant.  What  is
meant by proteine bodies is caseine, one  of the  group
designated by Professor Draper as the neutral nitro-
genized bodies, of Avhich albumen, fibrine, and globuline
are the most prominent substances, and Avhich form the
so-called proteine bodies.   Of the whole group, albumen
is the most  important element; but  it will be seen in
physiology that the process of digestion converts the
other substances  into it.  Caseine, albumen, and fibrine
all present nearly the same  constitution, but differ from
each other in their physical properties.

                CONSTITUTION OF MILK.
   Goat's milk......Caseine, 80.....Sugar, 40......Butter, 40.
   Cow's milk.......  "    60.....  "   28...... "   40.
   Woman's milk....  "   32.....  "   36...... "   29.

  This  table  sIioavs hoAv often the  changing of milk
interferes with the process of nutrition.   Goat's milk,
in my  opinion, is the best substitute for  human milk
for  children.

   INFLUENCE OF AGE  ON  THE COMPOSITION OF MILK.

  The variations  in the composition of milk from its
normal  standard  depend  upon age  and bodily health.
Young females, from fifteen  to tAventy, yield a milk more
rich in solids than that Avhich is given at  thirty-five or 
50
PROGRESSIVE MEDICINE.
forty years. (See " Physiolgy.")  This is a very import-
ant subject to the physician, as he is often consulted by
his patients as to  his opinion in regard to milk most
suitable for children who cannot nurse.  The opinion of
the physician, in this  case, ought to be based  upon his
thorough knowledge of the composition of milk and its
changes, 
PREDISPOSING CA USES TO MENTAL DISEASES.   51
                   CHAPTER III.

     PREDISPOSING CAUSES TO MENTAL DISEASES.

  It is unquestionably accepted as a natural result that
all great efforts, either physical, organic, vital, or mental,
are more or less destructive to organic structure and
functions.  Such efforts are always followed by reaction,
loss  of equilibrium,  and harmony of  action.  Mental
efforts are not  exempt from  the  general law, which
produces  reaction, debility, irritability, spasmodic  or
tetanic  disorders, or  anaesthesia, partial  and  general
paralysis; in consequence  of Avhich disorders of circu-
lation  and  organic  functions must  unavoidably  and
frequently occur.
  On the contrary, if the  organization, or any of the
vital functions of the organic economy, should be inter-
fered Avith, either by Avant of proper nutrition (anaemia),
or hypernutrition (plethora), the reflex influences upon
the encephalon are those of a pathological nature, thus
disarranging the physical  phenomenon of life  and  its
modus operandi.
  Sleep brings rest  and restores the organic economy
to its normal condition.  Labor means action and mo-
tion, and if exhaustive, irritability, insomnia, and loss of
appetite generally folloAvs.
  The brain has various and complex duties to perform,
viz.: sensation, creative-poAver, and volition, and supplies
physical and vital  forces, besides the  general functions
of thought, Avhich must be controlled by the effort of the
great nerve centre.
  Mal-nutrition, continued  Avasting diseases, infectious, 
52
PROGRESSIVE MEDICINE.
malarious, zymotic, sthenic, asthenic, and many other
diseases, may  involve  the nervous  centre  to  such an
extent as to produce  mental aberration, hallucinations,
exhaustion, irritability, monomania, and finally  insanity.
These are proximate and predisposing causes.
  The exciting  causes may be thus mentioned:  Grief,
loss  of  property, loss of  friends and  relatives, fright,
great excitement, blighted affections,  poison, injuries,
dissipation,  excess  in venery, anaemia, and inanition.
The  remote and physical causes are inheritance, scro-
fula, renal  diseases,  epilepsy, chorea, retrocession  of
skin  diseases, hepatic structural disease, etc.
  It is necessary that Ave should return to our special
subject of inquiry, i. e., mal-assimilation  and inanition,
as amongst the factors  of mental derangement.  No
doubt that mal-nutrition is often  a cause  of  derange-
ment of the organism ; hence inanition, haematic change,
and  asthenia;  these Avould soon produce a dissolution of
the organizing process of  all the physical and vital func-
tions.   And if Ave  accept this as a true  axiom, Ave can
thus Avell accept the theory of anaemia  of the brain.
  A Avant of proper general  nutrition must exercise a
depressing influence upon neuro-plasty and mental force.
Starvation  and  plethora  reach,  though  through oppo-
site  causes, the same  unavoidable  end, i. e., mental dis-
ease.
  When the mental  functions are once incapacitated,
their normal,  physical, and vital condition  is seldom re-
covered.  The  brain has greater  and  more complex
Avork to perform than any other organ, and has no tem-
porary substitute to act in its place.   Act it must, sick
or Avell, as the energies of all the physical  and organic
functions depend upon it.
   Those Avho are more prone or predisposed to mental
metamorphosis  are literary  and professional  men gen-
erally;  and just here, they  may occupy our  attention
principally, because  they form a large number of our 
   PREDISPOSING CA USES TO MENTAL DISEASES.  53

daily  patients, suffering  from various nervous  affec-
tions.
  Though their occupations necessarily differ  or  vary
in character, those Avho perform the arduous mental
labor  of the  Avorld are the  metaphysicians, mathema-
ticians,  engineers, philosophers, historians, physicians,
lawyers, musicians, actors, statesmen, clergy, etc.
  This class of men, Avhose mental energies and resources
are put to the heaviest tasks, too  often neglect their
physical necessities, to a great and  dangerous extent.
In such cases, naturally, the vital  force must suffer from
such deleterious neglect and overwork, thus implanting
diseases, organic or  functional, on  some  parts of the
nervous system.  These  abnormalities may fall upon
the motory or sensory system, or the  triple system of
nerves, i. e., sympathetic, vaso-motor, and splanchic.
Disintegration of the cells, embolism, thrombosis often
occur.  The  Avorld owes much  and has received much
and untold benefits from this class of men; they have
raised the human family  above the  drudgery of mere
vegetative creatures; they have ennobled  us and  keep
us moving fonvard in the proper sphere Avhich God has
intended us to fill; and they thus enable  us to ascend
to that higher plane  of intelligence and culture which
the Infinite has  designed that Ave should  reach.  This
great and glorious Avork must Avear fearfully upon the
great centre, the brain; and so the nervous forces, cen-
tripetal and  centrifugal, must, pari passu, be renovated
and constantly nourished with the proper elements of
nutrition.
   Should it be surprising that the organs of repair are
at times affected by these great  mental efforts?  It is
obvious that the mental  phenomenon would, in such
cases, receive a doubly devitalizing  and depressing in-
fluence, i. e., one from an  over-use of mental faculties,
and another  from a want of proper nutrition and repair.
Inasmuch as all vital processes depend upon a state of 
54            PROGRESSIVE MEDICINE.
perfect physical equilibrium, it certainly is very evident
that the organs of alimentation must perform their duty
and be in a perfect physiological condition.
  Even Avere  nutrition alone rendered feeble and in-
sufficient, the  Avhole economy (brain included) must suf-
fer and finally become totally disabled.
  The morbid conditions that  naturally result from
either or both disorders, i. e., brain and digestive organs,
or, vice-versa, digestive organs  and brain, are obviously
unlimited, according to  idiosyncrasies and  diathesis.
Some may suffer only from mere hyperaesthesia, hyper-
aemia, etc., others from exhaustion and inanition.
  A large number of persons suffering  principally from
enfeebled digestion and  imperfect chylification, consti-
pation, and  torpidity  of  the liver, etc., are rendered
incapable of severe constant mental occupations; these
are often the products of the sedentary life of students.
LikeAvise renal troubles may supervene;  the  skin and
its functions often become altered and  throw  back the
excrementitious materials which ought  to  have been
eliminated.  The  secretions are changed,  and  hence
the lymphatics become  surcharged and  engorged, and
thus  caco-plastic elements and  neophites are formed
(hetero-plastic lymphoma or neuro-hetero-plastic).  All
persons that  pass their time  in  seclusion are  neces-
sarily  deprived  of the  needy  and healthful exercise
—fresh air and motion—excluding those elements that
are so important  to perfect  organic  metamorphosis,
Avithout which, sooner or later, life becomes  seriously
affected.
  And, to make matters Avorse, these people have supple-
mented artificial  substances for natural and life-giving
elements, in  the form of stimulants: as coffee, tea, liquor,
high condiments, and in this manner live on an artificial
stimulus whose reaction is sure to take place in debility
and  exhaustion.  Now, therefore, since Ave  have seen
the practical  folly  of substituting  artificial  agents,
we 
    HYGIENE, DIETETICS, AND THERAPEUTICS.  55

must  endeavor to correct these abuses and supply a
better and more rational proceeding.

                      HYGIENE.
  Firstly. We must  remove  the patient from a seden-
tary life, and give him  exercise in  the open air, plain,
nourishing food,  light,  heat, electricity, and  regular
hours for eating and for rest, also  salt-Avater baths,
cheerful company and sufficient Avork to preArent another
evil—the despondency that follows  idleness.

                     DIETETICS.
  Secondly. The dietetics must be prescribed according
to the idiosyncrasies of the individual.  If he is emaci-
ated and anaemic, he should have animal food and nitro-
genous  vegetables, containing  those  elements Avhich
the patient  requires.  The  diet  should be at times
amylaceous, mixed  Avith  succulent substances.  If he
requires  food for the nervous  system, give him fish,
eggs, wild game, and poultry.

                    THERAPEUTICS.
  Thirdly. The  therapeutical  agents must  also be
chosen  according to the constitution and  special re-
quirements.  In  these  cases  Ave  find adynamia the
superlative symptom and  then a neuro-phlogosis may
be found in some  organs, but generally there is anaemia
accompanied by asthenia.  Then our  remedies  must be
of a vital nature, reorganizing and  reinvigorating—
ferrum  phosph. et  per oxidum, ferrum  sulphuricum,
ferrum iodidi, etc.  And, again, our blood remedies are
natrum and kali phosphoricum or sulphuricum, magnesia
phosph., oxid. of manganum,  natrum chloricum.
  In cases of nervous debility our  remedies are phos-
phorus, cinchona, quinia,  zincum  oxidum, nux vom.,
strychia  ignatia, pulsatilla bryonia,  actea racem., arnica
mont, etc. 
56           PROGRESSIVE MEDICINE.
   And in those cases Avhere  there are complications of
the  digestive organs, so  called difficulty of the chylo-
poietic  viscera, podophyllum,  mercurius sol. or alkali-
zatum, aloes, rhei et natrum, Kissengen  Avater, sulphur,
arsenicum alb or alkalizatum (the liq. potassae arsenica-
lis),  bismuth, and  pepsine.  These remedies must be
changed according  to the many circumstances,i.e., age,
sex,  occupation, idiosyncrasies, and diathesis, but they
are  sufficient for all common  purposes; and  are in  a
measure the best remedies.
   The object is that  of logically inA'igorating  and sup-
plying the system with those elements  needed, and, at
the same time, disintegrating tlie carbonic acid through
the lungs, skin, or excretions.
   In all complications Ave must make  a  strong distinc-
tion  betAveen organic, sympathetic, and  functional dis-
eases.   The  differential diagnosis is of the utmost  im-
portance, as it Avill be obvious to every practitioner that
objective and subjective symptoms  form the train of
diagnostic signs, Avhich united  give shade, and form the
true type of the disease in question.   Causes and struc-
tural pathology are  indispensable diagnostics, as evi-
dences  of an undoubted nature  concerning the true
physically morbid condition  existing.
   For illustration, in diseases  of the  liA-er one of tAvo
disorders may be  presented under very similar signs
and etiological condition, i. c, suppression and retention
of bile.   The former is an organic derangement; the
latter is a functional'one.  The same  is the  case Avith
the kidneys; the evacuation of urine  may be  impeded,
should Ave therefore jump at the conclusion that Ave have
a mere case of retention, Avithout any further  inquiry?
  The  evidences are in  favor of the folloAving conclu-
sion: intellectual   occupations  favor diseases of the
nervous  and digestive systems, from  which those em-
ployed in mechanical labor  are entirely  exempt.  In
the  former  instance  sedentary  life  prevents  proper 
THERAPEUTICS.
57
oxidation and  elimination of carbonic acid; Avhile in
the latter it. favors  oxidation, organization, and elimina-
tions of the excrementitious material.   Nutriment  can-
not Avell  be assimilated and  organized  unless  done
through  the physical and  physiological  functions of
elementary  and mechanical forces, i. e., motion,  heat,
air, light, and  electricity.   And  undoubtedly  the  prc-
teinaceous compound cannot  become plastic matter
Avhen  the above  organizing  physical  principles are
Avanting.
  And  besides these  elementary  principles  of  life,
others equally as important are the elements of nutrition,
Avhich, notAvithstanding  their  possessing  all  the  con-
stituents  required, the art of preparing them  is surely
of great  import,  for it  develops their nutritive  con-
stituents, Avhile otherAvise it might destroy them  so as
to  become  useless as elements  of alimentation  and
repair.
  Cooking is an art that may prove either  salutary or
injurious, and the health and happiness of millions of
people depend to a great measure upon the knoAvledge
of this accomplishment.
  It is a Avell-knoAvn fact that a great deal can be done
by  a good nurse and cook.  The former is to knoAv how
to apply Avhat  the latter has studied Iioav to  prepare.
A judicious diet may be often the means of restoration
of the physical forces.  The same nutriment cannot be
used ahvays  for even the same patient; it must accord
Avith the nature of the disease and the requirements of
the system.   Even during  the  same  sickness  the diet
must be constantly and intelligently varied.
  The various lights and  shades of nervous^affections
change so frequently, and present themselves in so
many various forms, that the most skillful of diagnosti-
cians is often puzzled to recognize the old enemy in its
neAv garb.
  Empiricism  and mere routine  practice  should be 
58
PROGRESSIVE MEDICINE.
deprecated as dangerous  and umvorthy of the honest
and scientific physician.  Nothing is more imperatively
demanded than conscience and honesty in the physician.
There  are  no forced  boundaries, no forbidden path in
the acquirement of his knoAvledge and to his honest
convictions;  no school or teaching should debar him
from the privilege of inquiry and study of other theories
besides his OAvn.  Knowledge  has no line of demarca-
tion; it is a sea Avhere the most experienced navigator
may always find something to learn.
  Surely, notAvithstanding  a perfect liberty of action
and  conviction, care  should  be  taken that vagaries,
mysticism, and  follies  should  not misplace  the Avell-
knoAvn facts  and rules adopted by sound-minded men,
and tested Avith the crucible of experience and  practice.
The elements  of nutrition, then, must be  particularly
selected so as to accord Avith the principles of life and
repair.
  When oxidation  and decomposition  are impeded, or
partially  interfered Avith, the  process of combustion or
fermentation (heat, assimilation, and nutrition) becomes
difficult and  inefficient.  It is then necessary to measure
the physiological requirements of our patient.
   Knowing one's habit, diet, idiosyncrasies, and consti-
tution, Ave Avould  know, or should knoAv,  Avhat to pre-
scribe and Avhat to forbid.
   It is a general rule, that cases of  nervous ailment
require very light nourishing food; and at  times very
strong and in small quantities,
   Light food may be enumerated as follows: fish, eggs,
nitrogenous  and vegetable food, Avine, cream,  shell-fish,
broth, etc.
   Strong food—beef juice, soup of vegetable and shell-
fish, roast beef, game, eggs Avith  rum  and sugar and
 Avater, ale Avith yolk of an e^, coffee and  cream, cocoa
 and Avell done oatmeal, peas, beans, and lentils.
   The amylaceous, glucose, and succulent elements of 
THERAPEUTICS.
59
 food  Avould not  supply  the  requirements  of those
 diseases belonging to asthenia, inanition, or adynaemia.
   And it is proven that  nitrogenous and carbonaceous
 are the  most suitable nutriment for an exhausted  or
 emaciated  constitution.   Changes  are  necessary,  and
 oftentimes in favor of a  starchy  vegetable  diet; but
 this comes in as a substitute for producing caloric and
 fat.   Sago, rice, potatoes, turnips, corn  meal, tomatoes,
 barley, tapioca and fruits—these  must be cooked so  as
 to destroy the elements of fermentation, breaking every
 cell and preventing the descending tendency of these
 vegetables into carbonic acid.
   Add  coffee, tea, cocoa,  wines,  and  we  have all the
 substances  that  help nutrition and physical  metamor-
 phosis.
   These beverages have been instituted for the purpose
 of nutrition, by preventing tissue Avaste.  Nothing adds
 more  to an  intellectual Avorker  than a cup of coffee
 and cream.  It not only  supplies a stimulus, but it does
 more: it supplies  food by its  nitrogenous constituents,
 and prevents a quick Avaste of vital force.
   Tea, on the contrary, proves to be a respiratory fluid;
 increasing  respiration by acting  upon the vagi,  and
 pneumogastric nerve, thus eliminating carbonic acid  in
 greater quantity.  Tea is a stimulant Avhich possesses,
 in very small quantity, nitrogen  (thein), and helps the
 system to burn out carboniferous materials in the  form
 of carbonic acid.  Therefore the  indications of both
 remedies are, the former  to increase nutrition, the latter
 to increase ejestion; one to  support nature's debility,
 the other to enable her to  eliminate the poisonous ac-
 cumulations  (secretory ingredients) and perform that
 elimination.
   In conclusion, dietetic experiments have demonstrated
 that a smaller quantity of food is required Avhen these
fluids  are taken than Avhen they are not.  In old  and
infirm people, Avhere the desire for tea is so strong, the 
60
PROGRESSIVE MEDICINE.
Avaste and decay of the system is  thus lessened by its
use.   Coffee Avould be still better.
  Professor Liebig says: " With addition to oxygen and
Avater, they can yield tourine, Avhich is the nitrogenized
constituent  of bile.  In  their  complexity it is very
probable that they act as a part of food to the  exciting
and vivifying  of strong common soup, and  that coffeine
and theobromine are closely related in their composition
to nervous elements, and  therefore they are suited for
the repair and renovation of the exhausted brain."
  And here Ave stumble into the great question of tem-
perance.
  Are  spirituous  liquors  beverages  and a  physical
necessity?  As to their being beverages, in  the usual
acceptation of that terra, they certainly are not; they
are agents by which  certain beneficial results can be
produced Avhen  there is a physical necessity, i.e., in
sickness.   As elements of nutrition and  oxidation, there
are none superior Avhen the animal economy is tardy in
her  functions  of reorganization and  repair.    We are
informed  from experiments  made by good authorities
that plastic formation must go through  a  certain grad-
ual metamorphosis, and this is obtained  by a process
of fermentation, decomposition, and disintegration, so
as to again become organized into a  higher  state of
formation.  Thus  starch, sugar,  and  dextrine,  the
constituents  of  ATegetable  matter, Avill  by  fermenta-
tion become  plastic formations,  making  the so-called
protoplasma.
   And by a  continuous  process, Avith an addition of
oxj'gen, alcohol is formed; or Ave  may push the  vegeta-
ble disintegration of elements still  further, into acetic
acid, and  from that into yeast or mold.  Thus the vivi-
fying  principle of the vegetable matter  is,  par excel-
lence, the diastase  or malt, and  so  are albuminous
constituents,  Avhich exist in more  or less  degree in all
vegetable and starchy products, but which require heat 
THERAPE UTICS.
61
and moisture, together Avith molecular motion to bring
about atomic force and organization.
  The ferment, then, is  the result of a  condition, the
presence of the mold, the principle in Avhich  the force
exists, the latent force of the yeast or mold.
  There is, therefore, the principle of life in the matter
itself;  and this is the true vital force.
  There  is another question:  Is, then, fermentation
necessary to  organization?  Yes, to a certain extent.
All vegetable nutriments contain a diastase or germin-
ating principle that  converts their starch into gum and
sugar, and this is done through the developing process
of heat and moisture, hence the result is fermentation.
  The scales  of  progression can  be well  traced, i. e.,
the change from the elementary  or  physical  into the
mineral, from the mineral into the vegetable, and from
the vegetable into the animal.  The process of develop-
ment is physical; the result is a vital force.
  Alcohol is  the  offspring  of vegetable  decomposition,
produced by  a  physical  process  of disintegration,  of
caloric, and moisture Avith hydrogen.
  The purpbse for Avhich these stimulating agencies are
used is to invigorate the activity of the vaso-motor nerves,
and thus circulation ; these agents are to be used Avith
care, and only Avhen nature becomes enfeebled either by
sickness, age,  or exposure, and exhaustiAre labor.
  They are useful  in adynaemia,  in dyspepsia, and  in
scrofula, as  nutritive and vivifying  agents;  they are
truly restorative  of force, physico-vital.
  The  excess or abuse of these stimulants  produce
morbid  conditions  of   the stomach,  liver,  kidneys,
and  brain;  and  there  are many medical  substances
Avhich Avould produce structural diseases of the organs,
in much less  quantity and time  than liquors, and yet
they are considered inert.  EAren some  articles of diet,
were thev so much  indulged in,  Avould  produce some
morbid  effects upon  the system. 
62
PROGRESSIVE MEDICINE.
   And, therefore, Ave learn that these agents add force
 to assimilation and nutrition, and so they are necessary
 to the physician, but only as organizers of an enfeebled
 recuperative poAver of nature.
   They exhilarate the imagination by propelling more
 blood to  the  brain,  and thus  give  the  brain more
 nutrition.
   They break up inactivity of the nervous matter,  and
 they quicken action and reaction.  The poor sot's brain
 has often  been found to contain a minimum of alcohol,
 and even the lungs also.
   The  reactive  influence of this agent  is that of de-
 pression,  emaciation,  anaemia, and liquefaction of  the
 fibrinous  blood.
   There are medical agents which in large  doses Avould
 produce similar  effects to that  of liquor in excessive
 doses, i. e., cannabis,  opium,  belladonna, hyoseyamus,
 ammonia, and stramonia.  And for nervous irritability
 Ave  have   quinine,  nux  vom.,  strychnia,  phosphorus,
 ignatia, and many others.
   In virtue of the untold beneficial effects of folloAvin"-
 the laAvs of nature, and thus preserving health, I cannot
 pass  Avithout recommending the profession to study
 more faithfully the  advantages  that  Ave  may derive
 from employing  elementary  agencies  as the  physical
 found .ition of our  structure, which may prove the most
 logical and truest remedy when the organization is in
 an abnormal condition.
  Medical  science is not  entirely  speculative;  it  has a
 good deal of the practical, and is attained by unmistak-
 able knowledge of the  phenomena of life and  its pro-
 gression.                                         1
  When Ave adopt strychnia,  quinin, phosphorus, capsi-
cum  etc., Ave use them in cases of irritability or agitation
of the cerebrospinal svstem.  And these remedies  are
really capable of producing the same or similar results
it given in  a normal condition of the system. 
ARTISANS, MECHANICS,  AND LABORERS.    63
          ARTISANS, MECHANICS, AND LABORERS.

   These three classes are only made distinct by reason
 of the different kind of Avork they perform, and  the ar-
 duous labor required of them.
   Artisans are the  better class.  They require taste,
 skill, intelligence, discrimination, and ingenuity; they
 must  have  considerable  natural  abilities; they  must
 have knoAvledge of the selection of becoming colors, and
 blending of shades in  all those Avorks of Avoolen, silks,
 and tapestry generally.
   Their mental faculties are called  upon for a higher
 sphere of action than in the case of mere mechanics.
   The second class are the carpenters, carriage-makers,
 cabinet-makers,  tailors, shoemakers, blacksmiths, etc.
   The third class  consists of those that perform  only
 manual labor on streets, common roads, and farms;  also,
 as servants, hostlers, millers, drivers, etc.
   The manufactories employ generally a great many girls
 and boys of a tender age; and besides working all day
 at their trades, they go to night schools for instruction.
 They have no play,  no recreation, which is so necessary
 to young children.   This  deprivation of the natural ele-
 ments of groAvth, i. e., air, play, and exercise, puts, as it
 were, a check upon physical  development
  They consequently grow up  physically and intellec-
 tually feeble, and thus  they reach the age of puberty in
 a deteriorated physical and mental condition.
  Thev are  deprived  of that  physical exercise,  from
 which their secluded lives compel them to abstain, and
 which lavs the  foundation of  many diseases of which
 thev only too soon become the victims.
  Their physical development and force are unfavorably
affected in  early life; their  nutrition and growth are
thus ffrndunllv suffering from the neglect of the physio-
logical law;  and their intelligence is stultified by the 
64
PROGRESSIVE MEDICINE.
Avant  of  the  proper elements of vegetative force  and
neglected instruction.
  The men and women fare no better;  only, they, hav-
ing obtained their  groAvth, have an  etiological reason
for less proneness to physical disorganization.
  The dusty rooms  of the Aveavers; the heated and con-
fined air; the moisture from steam;  the poisonous ex-
halations from materials, paints, and the air infected by
many breathing lungs confined in a small space; the
attitudes of sitting,  bending, or stooping over looms and
tables or seAving machines  for hours; these and a vari-
ety of other causes  go far to produce those myriads of
invalids and cripples that fill  up our hospitals, dispen-
saries, and other asylums of charity.
  The tobacco and  cotton factories, Avhere constant dust
is floating, and pervading the Avhole atmosphere, invari-
ably  affect the lungs, stomach, skin, and, at times, the
sight.  Soap  and leather factories emanate effete gases
Avhich produce a deterioration of the animal economy;
they cause asthenic and  anaemic diseases.
  The match and india-rubber factories are also sources
of disorganization of the vital forces through the poison-
ous and infected atmosphere,  which is  continuously im-
pregnated Avith  mephitic  gases.  Is it not  to  be  con-
sidered   a very important  question—the  happiness,
health, and life of  thousands  of these  poor creatures?
Should not  the  medical profession, as the recognized
faculty, Avhose dictum is  accepted  upon  all hygienic
subjects, present these  evils  for consideration, and, if
possible,  abolition,  and  suggest  the means bv which
fresh  and pure air  could be therein  introduced?   The
process of ventilation, heiting,  and cleanliness should
be the first important object of every humanitarian and
sanitarian.
  It is  also  a  question  of economv.  Bv taking the
proper cautions  njrainst  these putrid  smells, mephitic
gases, and devitalizing animal exhalations,  thousands of 
      ARTISANS, .MECHANICS, AND LABORERS.    65

victims  Avould be saved, and  the sanitary bills  Avould
fall to one half of Avhat they are uoav.
   The diseases Avhich originate from such sources are
generally of a malignant and  infectious nature.  They
cause  diphtheria, dysentery, hepatic disease, cholera,
typhoid  fevers, consumption, adenitis, scrofula, eruptive
diseases, carbuncles, suppression of the menses, apep-
sia, renal  diseases,  abscesses,  and, finally, disarrange-
ment of all the  organic functions.  Dissolution or per-
version of the great phenomena of life  must  sooner or
later take  place  in  the  majority of cases;  hence caco-
plastic formations, lymphatic diseases, mal-assimilation,
cancer, atrophy,  and finally and conclusively, adynaemia.
   And, furthermore, the surroundings of these  estab-
lishments  are anything but salubrious: Loav grounds
Avith  stagnant Avater; Avater-closets near, and  unclean;
animals—like cows, pigs, and  horses—and their dung-
hills,  are  generally in  the immediate  neighborhood.
The people avIio live near these factories build shanties,
and  are  poor, unclean, and  ignorant; they throAv  the
slops before their dAvellings, and the  Avater they drink
is full  of animalculi.
   It is,  indeed,  from  these unhealthy  localities that
effete  poisons arise  and  infect the rest of  the tOAvn or
city.
   There are large numbers of poor girls Avhose  emaci-
ated countenances, Aveak frames, dejected looks, are Ha--
ing specimens of this barbarous and inexcusable neglect.
   Their  diet is oftentimes faulty and unhealthy, both in
quality and the Avay the food is prepared.  At this day
the question of sustenance  has become a  serious one,
and has  called to it the attention of all the  Christian
and civilized governments of the Avorld.
  The groAvth of population and the requirements of an
enlightened age have brought  to civilization an increase
of mnnv  necessities, Avhich in the orimitive condition of
man Avere not even knoAvn. 
66
PROGRESSIVE MEDICINE.
   Naturally, man in his savage state has  feAV cares and
 less necessities of  life, and none of those appendages
 that Aveigh so heavily upon many of us, which are called
 social duties and requirements.
   Political economy has become  one of the most  useful
 branches of our system of government: it is indeed the
 basis of national prosperity and greatness.
   To ensure remunerate labor  to the loAver classes, so
 that they may get sufficient means for subsistence, and
 thus keeping them from idleness and  debasing vices, is
 truly a herculean and  noble  task, Avorthy of the  most
 patient and generous of governments.   A neglect of this
 high duty on the part  of those on Avhom divulges the
 affairs of a nation brings  about disorganizations, con-
 spiracies, revolutions, and misery over the land.
   An honest simplicity of life and living is conducive to
 health and happiness, Avhereas the  corrupting and de-
 bilitating indulgence of extravagance and vice carries
 Avith it poverty, soitoav, and desolation.
   Undoubtedly a simple, good, healthful  food ensures
 physical and mental force, and renders us more capable
 of enduring  the vicissitudes  of life.   Poor diet,  cold,
 dampness, and  mephitic gases, Avith insufficient clothing
 and  unhealthy habitations, Avill  produce  suffering, dis-
 ease, and premature decay to  a frightful extent.   Good
 clothing is an imperative necessity, and must be suitable
 to the climate  in which Ave live, both in texture and
 style.
  This subject  calls our attention particularly to the
style of dress which fashion imposes upon our Avomen.
  Indeed, fashion, although  commendable as a source of
employment, proves often a very foolish  and injurious
institution, often inconsistent with common sense, ugly,
uncomfortable,  and  extravagant.
  What is more pernicious than a tight-Avaisfed and low-
necked dress, and with short sleeves?  What is  more
absurd and injurious than thin and high-heeled boots? 
HYGIENE AND DIET.             67
   And, again, the weight of most of this paraphernalia is
 confined to the Avaist instead of  the  shoulders.  Is it
 any Avonder that there are so many diseases of the
 uterus?  The trouble  lies  in consulting beauty  and
 taste, instead of comfort and health.   From tight-lacing
 and heavy clothing are derived  derangement of diges-
 tion, hepatic engorgements, painful  menstruations, sick
 headaches, and  nervous irritability  in the form of in-
 somnia, apepsia, and hysteria.
   Physicians, as the proper  guardians  of the public
 health, should  not  neglect to call the  attention  of
 parents to  these great abuses  and wants of the  first
 principles  of health.

                 HYGIENE AND  DIET.
   Having  pointed  out  a fcAV valuable   causes Avhich
 produce  much  suffering and  sickness,  Ave  have  hoav
 reached the preliminaries of demonstrating the remedy.
   Unquestionably, at the present day the majority  of
 people understand the evil consequences of an impure
 atmosphere.
   The paludal countries are constantly  giving us evi-
 dences of their  poisonous effluvia;  the  intensity of an
 Indian temperature  proves the deleterious effect  of a
 tropical climate; the humid atmosphere  of England has
 shown its  deAatalizing  influence by the absorption  of
 too much  animal heat, favoring scrofula, rheumatism,
 and consumption.
  The exhalations of the rice-fields of the Carolinas and
 Italy, and the valley of the Danube, are pestilential  in
 their nature, and fever and zymotic diseases of all kinds
 are disseminated at the cost of thousands of lives.
  AcknoAvledging at once that the rice-fields are neces-
 sities to the human family,as likeAvise are the manufac-
tories, yet, Avith   all  this, there  is no reason  why Ave
should not endeavor to diminish the evils proceeding
from human necessities. 
68
PROGRESSIVE MEDICINE.
  Rooms  crowded Avith  children, or  men  and AA^omen,
should be forbidden.
  Sehoolhouses should be built in accordance Avith the
most approved laAvs. of hygiene, and so should factories
and all institutions where a large assembly of people  is
expected to gather.
  By exercising energy, patience, and Avill, the authori-
ties of our cities Avould soon yield to reasonable plans
for improving the health of all.
  The millionaire, Avhose sole  ambition  is  to  leave his
name as a perennial memory to the Avorld, can do so only
by doing the greatest amount of good.   He is the only
true benefactor, avIio has in his poAver to relieve suffer-
ing and raise the IoavIv.
  Much evil is due to negligence, but much is also  due
to poverty and ignorance; and, Avorse than all, many of
our incorporated institutions, Avhose sole object  is to
get the largest percentage upon their capital, building
badly constructed dAvellings and large places of business,
in order to save a few thousands, by their avaricious-
ness are sending hundreds of  A-ictims to a premature
grave.
  The  appalling epidemics of yellow  fever, cholera,
small-pox, diphtheria, dysentery, typhoid  fevers,  etc.,
Avould become reduced in frequency and virulence.
  Was it economy to the  South to keep the fermenting
elements of yelloAV fever ?
  Is it economy  to the East  to have the yearly plague?
Can it  be, in  the name of simple common sense, that
our municipal governments  could be so short-sighted
and inhuman as  to see nothing and think nothing of the
science of hygiene?
  In ansAver, I regret to say, that much  fault lies in the
perfect  indifference  and  inactivity of  our plrysicians.
Would they only take the pains,  through the press, to
demonstrate the danger and Avickedness of such Avant of
the proper means to ensure  health they Avould greatly 
HYGIENE AND DIET.
69
save suffering,  and expense too; for sickness is more
costly than keeping a Board of Health.
  Again, that  people  must be  clad  according  to  cli-
mates  and seasons of the  year is an  unquestionable
human necessity, and at the same time a great and seri-
ous expense.
  The covering of the human body  comfortably, taste-
fully, and cheaply is one of the  greatest causes of happi-
ness Avhich Ave may candidly thank civilization and its
industries for.
  There is much  or little in  our modern discoveries,
accordingly as we  understand  their proper use.   Great
is the Avaste of food  and of clothing, and our  people
are truly improvident and Avasteful.   This is the impor-
tant part of economy, of  usefulness, and of comfort.
Many  people  cannot  be comfortable,  for the  simple
reason that they do not knoAv hoAV to be  comfortable.
Others suffer from Avants, even Avith the material in
their houses, just  because they  do  not knoAv hoAV to
make things  meet for the desired purposes.
  I  advocate that all  our public schools, high or low,
should have a cookery and a seAving department, so that
every young Avoman leaving the school should go Avith
at least the  most important knowledge of hoAV to keep
house and prepare her food, and hoAV clothing should be
made in order  to save Avaste and to make it suitable for
the  purpose  intended.  Leave the piano, the  Greek, and
the  Latin to those whose fortunes are  amply sufficient
to let them proceed with these intellectual pursuits, but
teach poor girls the practical things of life.
   The feeble and  nervous  should always dress warmly.
The plethoric and lymphatic do Avell Avith less clothing.
   And when these rules  are not  observed by  either,
both will surely suffer.  The fat and strong would prob-
 ably suffer  from  too  much  clothing, as the weak and
 delicate would from too  little.
   One more thing is absolutely necessary to be not only 
70
PROGRESSIVE MEDICINE.
mentioned, but  insisted upon  by all physicians, i. e.,
cleanliness of dress  and  of person.  Nothing is  ino.e
conducive to  health  than simple, Avell-cooked food and
good bathing.
  To insure a perfect immunity from loathsome and epi-
demic diseases, the great  cardinal conditions should be
obserA^ed: 1.  Good, healthful food;  2. Convenient and
sufficient clothing;  3.  Cleanliness; 4. Healthful dAvell-
ings, Avith proper ventilation and heating apparatuses.
  We cannot verify the old adage, "a sound mind in a
sound body,"  without following the first rules of health.
  Many home-spun articles are far superior in durability
and warmth to those made by  manufactories.  Fashion
and fineries should be more disregarded  than they are
by our  working people;  for  good,  well-fitting dresses
are not ahvays a la  mode, nor  is it desirable that  they
should be so.
  The shoes should be heavy and strong; rejecting the
miserable imitation of " the Yankee  make," as they are
made of poor material and still poorer shape.
  One pair of English manufactured  shoes will last as
long as three pair  of the " Yankee  make "; therefore
the heavy home-made  shoe is the  cheapest and the
best.
  The love of extravagance in luxuries generally  is an
American failing;  this causes often domestic dissensions
and unhappiness.
  The phrase is true, if not comely:  In our  prosperity
we often forget the rainy  days  that  are  to come.   We
are apt to think of the present  alone, and let the future
take care of itself.
  The enfeebling  evidences of extravagance  and fast
living  are visible  in the delicate constitutions of the
present generation.   Children  often  suffer for the fol-
lies of their forefathers.
  Work and  plenty go well together; as idleness and
miserable poverty are unavoidably linked to one another. 
HYGIENE AND DIET.
71
   Remunerative Avages is only what is due to honest,
 good labor; just as exorbitant  demands for Avork is an
 evil which does not enrich the poor, but makes them
 extravagant and vicious.
   Small remuneration  Avith continuous and secured em-
 ployment  is far more  desirable than  spasmodic high
 prices, Avhich  soon terminate either in bankruptcy to
 the employer or  discharge of  the employed.  Poverty
 is not an unnatural thing with us  all; it has  often its
 reAvard in sobriety, industry, and  happiness.   Wealth
 leads too often to extravagance, frivolities, loss of health
 and morals, Avith nothing but unhappiness  as the off-
 spring of it all.
   Food must be fresh, simple, and Avell cooked.   Health-
 ful diet is not only a source of enjoyment, but of nutri-
 tion and  physical  force.  It is  a great gift,  that of
 knoAving hoAV to live.  All nations err to some extent as
 to the proper articles of diet.
   The English and Germans are apt to adopt too heavy
 a diet and to eat too frequently.
  The Latin races, Italians, French, Spanish, etc., live
 on lighter diet than the Saxon race. This is done in con-
 sideration of Avarmer climates, and hence more  salubri-
 ous.  I believe they use too much vegetable and succu-
 lent articles and an insufficiency of nitrogenous animal
food.
  Their meats  are  mostly boiled,  Avhile  were  they
 broiled  they  Avould be more  nutritious.   But of the
many errors committed by national fancies and customs
in the mode of living, I  believe the Americans excel
them all.
  The principal  error in the American diet is the in-
dispensable pastry in  all shapes  and kinds.   Again,
there is the abuse of using hot breads, and  SAveetened
fruits called jellies, and upon  this the children feast.
Coffee or tea ad libitum is  taken Avith the heaviest meat
diet, rendering digestion more difficult and laborious. 
72            PROGRESSIVE MEDICINE.
  The fried meats and vegetables are always to be found
on every American artisan, mechanic, or laborer's table
—an indigestible  and  non-nutritious Avay of cooking.
And it is not surprising that gastric troubles arise, and
that the chylification is imperfect, bringing on mal-nu-
trition— emaciation,  hepatic  complications,  nervous
disorders, portal congestion, hemorrhoids, constipation,
disturbance of the menstrual period, melancholy, head-
aches, and  dyspepsia in a chronic and complicated  kind
is the result.
  Gastralgia,  enteralgia, cardialgia, and neuralgia are
oftentimes the products of a poorly selected diet; these
prepare the Avay to more serious  constitutional derange-
ments.   We have seen  before  Iioav  simply the phenom-
enon of organization  springs from  fermentation and a
feAV agencies  to favor its development.
  It Avould, perhaps, suggest that Avere Ave to study
better the  processes  of nature, Ave  Avould  still  more
understand its simplicity and its requirements.
  The fundamental law is constantly before  us—good
simple food, plainly and Avell prepared: this is all.
  These are conclusions Avhich I have arrived at through
experience and practical  observations.   Affluence and
rich, luxurious living, late  hours, and  indolence, on the
one hand,  and poverty,  want  of  cleanliness, thirst,
badly prepared food, etc., on the other, will,  sooner or
later, cause physical and physiological disarrangements
leading to final disorganization.
  Invariably  any  departure from what is purely neces-
sary to the equilibrium of the animal economy causes
disorder and  disintegration.   Therefore, the  remedy
which Ave can logically recommend is frugality,  Avork,
good clothing, good air, and good food.

      DISEASES ARISING  FROM IMPERFECT NUTRITION.
   It is Avell known to the profession generally that there
are many  diseases Avhose  origin  proceeds from mal- 
      DISEASES FROM IMPERFECT NUTRITION.     73

assimilation and innutrition, and  these occupy a large
space in the  medical literature, Avhether  they present
themselves directly  or not, organically or functionally,
b}7 inheritance or acquirement.
  The diseases of the digestive organs should always be
looked upon with even more apprehension and care than
they really are.  Such ailments are often dismissed with
slight notice and little thought.
  It is true  that  oftentimes  these  very much abused
organs are only temporarily and superficially affected ; yet
these ailments, slight as they often seem, bring about, in
the course of  time, a feebleness and  a proneness to dis-
orders—these slight  deviations  from  piudence in diet
are too often neglected and  made light of, Avhen, after a
feAv  recurrences, the  indisposition changes to a recur-
ring disease.   The complications, the symptoms, and the
degrees of these anormalities are so numerous that  it
Avould be an  impossibility  to enumerate them in any
short or uniform classification.
  Some people by sympathy  and reflex action  suffer
Avith sick  headaches, some  with a complication of the
biliary organ, others Avith eruptions, coughs, and nervous
diseases of all kinds and shades.
  They are often the origin of many physical and vital
complaints, and if allowed to po on, they disorganize the
animal economy, thus gradually preparing  the Avay  to
some  insidious, perverted physical or organic metamor-
phosis.
  Some of the principal and incipient symptoms of im-
perfect nutrition are the  following:
  The complexion  changes from a  clear  and health-
ful color into a  pale yellowish or greenish hue; the
activity and vivacity of the person changes into a lassi-
tude,   Ioav  spirits,  sadness, or irritability;  strength
changes into weakness, sleep into insomnia.   It affects
the mind and intellectual  faculties.  A  sensible per-
son is often changed into a peevish, notional, and ir- 
74
PROGRESSIVE MEDICINE.
rational individual, easily offended and fond of fault-
finding.
  Suspicion arises where perfect confidence existed, and
morbid desire for things which were  never thought of
beforehand if at all, Avere looked upon as absurdities.
  Women are prone to hysteria and sterility. Hypochon-
dria generally affects the male.  They suffer with  pal-
pitation, gastralgia, and enteralgia.   The appetite is at
times increased and at times destroyed.
  They complain of sour,  bitter taste, eructations, of
flatulency, malaise, and  constipation.   Leucorrhea, ir-
regular menses, hemorrhoids,  dysmenorrhea, ovaralgia
in AATomen.  Oftentimes, the ganglionic and splanchnic
system of nerves, and even the  v-aso-motor, are so af-
fected that  the correlation  of  functions is partially
suppressed.  The process of injestion and ejestion  be-
comes sIoav and sluggish, from engorgement  of the  ex-
cement system.  The great centre of nerves, the focus
of vital force, soon  becomes sympathetically disturbed,
circulation  becomes likeAvise  impaired, and the blood
loses  its  fibrinous element,  becoming  liquid  by   the
increase  of  serum.  Complications  of the lymphatics
naturally  folioav.
   The gastro enteric juices become weak  and  changed
in their constituents.  The salivary glands and the  fol-
licles  of the stomach may become  morbidly  affected,
thus changing the process of digestion.
   These  disorders change according to diathesis  and
idiosyncrasies of sex, age, temperament, occupation, cli-
mate, and food.   We also find cases of digestive troubles
caused by miasmatic effluvia,  or brought about by ani-
mal or vegetable mephitic gases.

                   CLINICAL, CASE I.
   Physiodl  Examination,—On auscultation I found his
lungs  perfectly sound.   The  heart's  functions were ir-
regular, although its structure Avas free from  disease. 
      DISEASES FROM IMPERFECT NUTRITION.    75

I found the liver, on percussion and palpation, to be
tender; no enlargement Avas  apparent either to the
touch  or  eye.   Kidneys  Avere  healthy, although the
urine had  a specific gravity of 1030  (phosphates).
  Semiology.—A young man, tAventy-seven years old, of
a nervous, bilious  temperament.   Complained of some
trouble, Avhich he could not Avell describe.  He  had been
a good liver.  He  slept badly and was restless and un-
comfortable ;  he had frightful  dreams, aAvakening con-
fused and  not knowing Avhere  he Avas.  He arose in the
morning Aveak and tired.  His energy of mind and agil-
ity of body had left him.  He had no desire for either
physical or mental Avork.  He complained of having
pain in the  cerebrum, Avith a  feeling of pressure and
heaviness. He had lost all desire for pleasure or mirth.
He avoided society, and even friends.  The  table had
lost  its charms  for  him,  he  had no desire  for food.
His  mouth Avas parched  and slimy and raised mucus
from the stomach.
   He used stimulants, under  the impression that they
Avould  produce  a change.  His physician suggested
tonics,  Avhich meant  stimulants  in  a  different form.
After a feAv months of this kind of uncertainty, and his
bitters (as he called his medicine) not having  ansAvered
the purpose, he  considered  himself in a rather critical
condition.
   To be  sure,  the treatment  at  the very first sight
Avas  unmistakably improper,  and the diagnosis  incor-
rect.
   His  skin Avas dry and impervious  to a great degree;
no Avonder that the urine Avas  charged with phosphate
of ammonia, and its specific gravity 1030.  The  excre-
mentitious matter  was charged with carbonic  gas.
   The stomach was not disturbed with any ferment of
acidity, but the intestinal canal Avas.   Air accumulated
at the ilio-caecal region, ascending upAvard through the
colon.   This is  the ilio-caecal dyspepsia  of Dr. Cham- 
76           PROGRESSIVE MEDICINE.
bers, he  having localized the  disease on the principle
of morbid anatomy.
  He Avas very despondent and neglected his business.
He  suffered  Avith cold  feet and  hands, although hot
flushes Avould sometimes take  the  place of chilliness.
His  pulse Avas Aveak, and regular  but frequent.  Eyes
dull, movements slow, tongue coated, Avhite at  the root
and  reddish on the edges, and breath offensive.
  His abdomen was inflated Avith gas, memory uncertain,
and unable to collect his  thoughts.  This great variety
of symptoms has nothing decided pathognomonic, and
would be tiresome and   uninteresting to  the  empiri-
cist;  but yet  they  are indicative  of constitutional
trouble someAvhere in the digestive organs, and it is the
duty of the physician to find the organ, or the functional
lesion of the  chylopoietic viscera.
  He Avas an inveterate  pipe  smoker, and a tea and
coffee drinker.
  He chewed tobacco when he did not smoke.  Ate hot
bread and pastry and  retired late.  Danced immoder-
ately and drank  cold drinks when  in  full  perspiration,
thus changing the temperature of the stomach and in-
testines perhaps ten to twenty degrees in a few minutes.
What could or would we  think of throwing ice-water on
a hot boiler ? But the young man thought himself evi-
dently stronger than red-hot iron.  This is a very sugges-
tive" discovery,  which leads us on  to the stomach as
the organ greatly abused.
  Etiology.—Looking over the principal objective and
subjective symptoms, we find, 1. Indulgence in the good
things of the table; 2. Use of cold  drinks Avhile his
Whole system Avas at a high temperature, causing decided
mischief; 3. Late hours and late eating; 4. Smokin^ an
old pipe and chewing tobacco.
  These  were  the  true and. evident causes  Avhich
brought  upon  him  disarrangement  of the digestive 
      DISEASES FROM IMPERFECT NUTRITION.    77

functions, besides a natural predisposition  to nervo-
bilious trouble.
  There Avere no real organic pathognomonic symptoms
characterizing the disease, but, as it has been said al-
ready, there Avere  unmistakable signs  of derangement
of the digestive organs.
  It Avas a case  of inertia, caused  by  overstimulation,
by indulgence and carelessness in food and drink, with
the prostrating influence of tobacco. This condition of
things deprived the  system of much vitality;  and the
absorbents became sluggish and inactiA-e and the juices
Aveak and Avanting in the proper elements of nutrition.
The results  Avere  mal-assimilation, mal-nutrition, and
inanition.
  Although the  symptoms Avere not as pronounced as
those of dyspepsia, the indications Avere  strongly that
Avay.   I  believe  it Avas a case Avhich could  be called,
Avith sufficient good ground, enteric dyspepsia.
  General Remarks.—Here, in these very cases, Ave must
proceed cautiously and patiently, for nothing Avould be
gained by heroic treatment.  These are generally dis-
orders of a chronic nature, trying the patience of both
patient and physician.   But Iioav could it be otherAvise?
These symptoms have been groAving gradually upon the
system, and, therefore, have become implanted there, and
their returning to a normal condition requires the same
sIoav process  of re-invigoration.  And  it is  clear, that
Ave must base our mode of procedure  upon the princi-
ples of organizing and  Aritalizing  the  proteine  com-
pounds.
  This patient not only disregarded many of the impor-
tant requisites necessary to insure  health  and comfort,
but deliberately  took opportunities of  disarranging the
cliemico-physiological  process  of  digestion, and thus
brought  about a  physico-vital disarrangement of the
whole system.
  It Avas not a  case Avhere  regulated diet alone Avas 
78
PROGRESSIVE MEDICINE.
 sufficient  to  bring about  a change.  It certainly  re-
 quired immediate  advice on the most important laAvs
 guiding the primary principles of organization, namely,
 1.  Rest of the digestive organs; and, 2. A strictly regu-
 lated diet on  sound physiological regulations.   There
 Avas evidently a loss of correlative, digestive functions.
   This  prolonged  loss of organic force could  not be
 regained,  except  by a patient, continuous, and logical
 treatment, based  on physiological principles, aided by
 medical advice.   This  gastric disorder had  brought
 about a general systemic  trouble, Avhich required con-
 stitutional treatment.
   Through the neglect of proper medical treatment, and
 the process of over-stimulation, much difficulty was put
 in the Avay of a speedy recovery.
   The  " regular doctor " had evidently put fuel  to the
 fire; he stimulated Avith quinia, stiychia, and liquor; he
 irritated by  acrid  bitter agents, i.  e., cathartics, etc.
 From  this mode  of irrational  treatment,  debility and
 inanition was slowly disorganizing every physiological
 function in the economy.
   Tnis case presented  a feebleness or asthenia from
 over-stimulation  and abuse in  diet; and  nothing but
 injury could be expected  from stimulants and cathartics.
   It is but practical  common sense  that Ave should re-
 ject an agency Avhicli will create  mischief  and increase
 the disease: it is pure logic that would suggest  other
 plans than those Avhich had  been used, more in conform-
 ity Avith the science of physiology.
   Medical  Treatment.—Having  considered the case as
 one of  asthenia, accompanied by adynaemia from mal-
 assimilation  and  nutrition, Ave are, therefore,  prima
facie, to accept it as one of nervous exhaustion, or Avant
 of  physico-vital  force; and from this  standpoint  we
 must proceed  by invigorating the phvsical  phenomena
 of nutrition  and life.   The  mal-assimilation  of the nu-
 tritive  elements Avas due to the disordered condition of 
     DISEASES FROM IMPERFECT NUTRITION.   79

the organism produced by hyper-nutrition and the rest
of the evils already pointed out.  Were, therefore, medi-
caments alone sufficient to add physico-vital force?  The
constituents of the  proteinaceous  compounds are not
changed or increased by drugs.   The histogenetic pro-
cess is not increased or returned to its normal condition
by medicaments.   Nutrition and  life are not considered
to be found in chemicals or drugs.
   Rut diseases can be diminished, and  even cured, by
proper medication, provided  it is assisted  by the vital-
izing principles of nutrition ; but those principles are not
obtained  by food  alone,  but  also by the employment of
those physical principles of which the animal economy is
in a great measure the recipient, and from Avhich many
constituents are continually received and others organ-
ized.  And Avith these preliminaries Ave surely can enter
the arena of medical science Avith a fair chance of doing
justice to our  responsibilities.
   In this  case I used remedies Avhich are Avell known as
organizers of physical force, i. e., nitro-hydrochloric acid,
phosphate of soda, phosphate of magnesia, kali sulphatis,
nux vomica, pulsatilla,  bryonia  alba, arsenicum, aloes,
ferrum peroxidum, or phosphatis pepsine, lycopodium,
and capsicum an.  These remedies Avere given at differ-
ent  times, changing from .the  mineral to the vegetable
medical agents.   The strength  Avas generally that of
3-10, although I  have  given  the  iron  in larger doses,
i. e., five  to fifteen drops four times a day.
   Hygiene and  Diet.—-The  physical  principles  are—
motion, air,  light, heat,  bathing  (Avater),  electricity,
early hours, and plenty of oxygen.
   The diet Avas  composed mostly of nitrogenous ele-
ments.    Light soup, mutton,  beef,  chicken,  and fish.
These ingredients should be so cooked as to retain  their
nutritious constituents.
   The vegetables Avere rice, peas, beans, barley,  sago,
and tapioca—rejecting potatoes, pastry, coffee, tea, rich 
80
PROGRESSIVE MEDICINE.
and carbonaceous food generally.  He could not  derive
benefit from stimulating liquids, for  he had already ex-
hausted their utilit}\
  The liquids Avere cream, milk, cocoa, pure Avater, and,
at times, some  good claret  at dinner.   These articles
were to be taken in small quantities at first, increasing
as the power of chylification increased.  In all  these
complicated cases the diathesis and idiosyncrasies of the
patient must hi taken  into consideration. Where there
are lymphatic engorgements and tumefactions Ave haAre
to use specific agents for that system, e. g., belladonna
aurum, mercurius,  iodidi-iodine,  barita-muriatica,  kali
broinidi et chloricum, mineral baths, etc.
  Symptomology alone Avould not go fir enough, but Ave
must select those remedies that, besides having a simi-
larity of  symptoms,  haA^e  also similar  pathogenetic
effects and  lesions.  To this  suggestion I  Iciioav many
physicians may object on theoretical grounds, but not
on practical experience.  We, syinptomologically speak-
ing, might treat headache,  pain in  the stomach and
back, irritability, apepsia, and insomnia Avithout looking
deeper into the cause of these symptoms;  then  Ave
Avould be no better than empirics ourselves. Pathology,
etiology, and semiology form the grand field of inquiry,
Avithout Avhich  no  sound diagnosis, and still  less the
prognosis of the case can  be satisfactorily made out.
The  success of the treatment  of all diseases, in  my
opinion, depends upon the thorough knoAvledge of these
factors.
                  CLINICAL CASE II.
  Physical Examination.—A young Avoman of four and
tAventy years of age, of a nervo-lymphatic temperament
and excitable idiosyncrasies.   Lungs sound; heart's ac-
tion irregular, but organically sound; kidneys and liver
normal.
  Semiology.—She  came to  me  some four years  a«-o
She complained of general malaise and  distress, feeble- 
      DISEASES FROM IMPERFECT NUTRITION.   81

 ness,  constipation,  headache,  flatulency; sometimes
 looseness of the bowels, mental depression, painful men-
 struation, desire to lie down, slept badly, urine greatly
 increased in quantity, Avith an unnatural Avhiteness and
 specific gravity only 1000-10; hemorrhoids, pain in the
 back, flushes of heat  and cold alternating, cough, and
 rumbling in the intestines.
   She Avas nervous  and Aveak; the slightest noise or
 domestic disarrangement annoyed her, and she  Avept
 easily; she feared that some malignant disease  Avas
 groAving upon her; she aAvoke in the morning unrested
 and chilly;  she looked pale  and haggard, anxious and
 excited; appetite normal, but felt depressed after eat-
. ing, and a heavy Aveight distressed her stomach;  flatu-
 lency and eructations relieved her.
   The colicky  pains Avere confined to the small  intes-
 tines,  Avith sympathetic  nausea  and vomiting; unpleas-
 ant burning at the stomach  Avith  expectoration of mu-
 cous fluid; mouth and tongue Avhite and slimy; cardiac
 irregularity, due to nervous Aveakness, approaching as-
 thenia;  hepatic  torpidity, leucorrhcea, yet the  uterus
 Avas perfectly healthy; dyspnea was, at  times, very
 distressing to her; yet  her  lungs Avere sound and the
 heart Avas only  functionally irregular.  These organic
 troubles, as far as I could fathom them, were simply the
 result of reflex influences.
   Her mother  confessed that her daughter was fond of
 candies, pies, coffee and tea, and had been allowed to
 indulge  in them  ever since she Avas a  child.
   She Avas a very diligent  student when she went to
 school, and perhaps had her brain packed with all sorts
 of scientific branches, weakening her intellect, probably,
 more than doing her any practical good.
   She studied late at night, and often had a good lunch
 of cake  and pie before going to bed, in consequence of
 which she awoke in the morning complaining of  a rest-
 less night and exhaustion. 
82
PROGRESSIVE MEDICINE.
  The mental faculties w.ere so depressed that I feared
mental aberration, in consequence of nervous  irritation
and anaemia.
  The sympathetic system was also much involved and
hysterical signs Avere prominent.
  Etiology.—1. On the diagnosis of the case I found
mucous irritability of the stomach and  its follicles, and
aphthous  ulceration.  In such a physical disorganiza-
tion  it is  easy to imagine an  altered gastric  juice and
peptones.  The hypersecretion  of  the mucous mem-
brane  of  the organ produced inanition and nervous
Aveakness, and from  such  complications  arose  mal-
assimilation and a perverted condition of the vital force
(adynaemia).
  2.  The muscular force and the cliemico-physiological
functions Avere in an abnormal state.  The animal econ-
omy  Avas put out of its normal functions to such an ex-
tent  that emaciation,  inanition, and anaemia  Avere  the
results.
  3.  The  mucosity undoubtedly extended to the  in-
testines, and  the  process of injestion and ejestion  Avas
retarded.
  This  pathological  condition of the digestive organs
threatened to form  cacoplastic neophytes, and  to be-
come enteric consumption.  The process of histogene-
sis being  in  a precarious condition, the lymphatic  ves-
sels  and glands Avere  enfeebled  and  sympathetically
affected.
  The defective proteine organization must, by necessity,
in time, have brought about  plastic  changes—hence
tumors, cancers, ulcerations, and hetero lymphoma or
atrophia lymphatica, and consumption scrofulosa Avould
havTe been the result, and might have taken place in
the mesenteric glands.   The drain of a  large amount of
secretion  must Aveaken  the whole  process of repair,
as Avell as imprudence in eating—pork, pies, and  hot
bread. 
     DISEASES FROM IMPERFECT NUTRITION.   83

  Hygiene.—Motion by Avalking every day, or driving,
any  action producing heat, together Avith the air and
light, rendered assimilation more probable.   In ad-
dition to the above, I ordered sheets for packing her
Avhole body, so as to  equalize circulation and diminish
the hyperemia of the abdominal regions.  Early hours
for retiring  and rising, although I required a frequent
recumbent position, so as  to rest the internal organs.
Gentle occupation, so as  to relieve the mind from dwel-
ling  upon the disease, and cheerful company for an hour
or tAvo at a time, for anything Avould have tired her be-
yond description if not used Avith great moderation.
  Dietetics.—The necessity to understand Avell the prop-
erties that Avill  build up the physical force and  func-
tions is so imperative that I cannot dAvell upon  it too
much.
  It noAv devolves upon  a physician  to secure the  best
means to re-establish  the recuperative power of nature
in the best and most  rational manner.
  As I have said before, these cases have their origin
from the very fountain of life, and from  that very basis
only can we expect to cure them.
  I have dAvelt at length upon the necessity of knoAving
exactly Avhat are the  elements Avanted and Avhat are the
functions  impaired, for it is only then that Ave can sug-
gest a treatment Avhich  might be expected to be at all
beneficial.   Oxygen,  motion, heat, bathing, rubbing,
and proper dietetics may be  the necessary means to re-
cuperate  the physical force.   One patient needs rest,
another activity.  One needs oxygen, another heat and
carbon.   One nitrogeuized food, another albuminous or
amylaceous.  One needs acids, another  alkaline.   One
metalloids, another mineral metalloids.   In this lies the
whole process of physical laAvs and medical success.
  At breakfast, cocoa with cream, or the yolk of an egg-
beaten in white sugar, Avith the addition  of Avater and a
little wine.  In  this she had dry buscuit—nothing more. 
84
PROGRESSIVE MEDICINE.
 At dinner, beef-tea, or  clam-broth, Avith bread  and no
 butter.  In the  morning  a small  quantity of  boiled
 hominy Avith cream, and at noon rice or  hominy.  Sup-
 per—clam-broth, plain rice-pudding Avithout eggs in it,
 sago Avithout eggs, and  black tea Avith milk in it.
   This diet was increased  in  quantity  and someAvhat
 varied; but  I abolished potatoes, all pastry, and  all
 sorts of stews and  fried things.   At times I allowed
 half a cup of strong coffee, with cream, as an  iuvigor-
 ator and nutritious element.
   Medical  Treatment.—Dr.  Chambers says:  " Practi-
 tioners of the  Homeopathic laAV fail  sadly in the  treat-
 ment of enteric diseases, because  the remedies do not
 act promptly and are not given intelligently, but only
 symptomatically, taking no notice of the pathological
 condition of the system  ; hence a long and unsuccessful
 treatment."  And he unbecomingly boasts of having
 cured a myriad of cases coming from practitioners of
 the Homeopathic school.  I do not doubt his Avord, but
 discrimination should be exercised as to the standing of
 those practitioners.   Unfortunately, there are many of
 the so-called Homeopaths Avho are not physicians in the
 full extent of the Avord; and there are many so-called
 rational school men Avho are anything but rational in
 their treatment of diseases.
   My impression is that Dr.Chambers could not assign on
 Avhat principle he himself practices.  He adopts reme-
 dies that have certain pathogenetic effects, and most of
 them act, I dare say, Avith all due respect to him, on the
 law of similarity.   Drs.  Chambers and Pavy have Avrit-
 ten Avell upon  the diseases of the digestive organs, but
 both have come short of the mark.   I could make long
 criticisms, but my aim is not to fight other men's ideas
 as much as to adopt what is good in them and  forget
the rest.
  My practical experience with diseases of this  nature
leads  me  to state frankly, and Avithout  any sectarian 
      DISEASES FROM IMPERFECT NUTRITION.    85

feeling, that a remedy which  has acquired a dynamic
force  has also acquired  atomic  force and molecular
affinity for the malady in  question, provided that the
remedy is rightly selected: by that  Ave  mean, patho-
genetically,  in large doses;  and,  dynamically, Avhen
prepared for medical treatment  and  morbid diseases.
There are only a feAv exceptions to this rule, and  they
are so feAv, indeed, that they come under  the  head of
anomalies rather  than of  medical diseases, and are
either  toxic  poisons, like  chemicals,  or  malarious
from  alluvial  soil, or  indigestibles in  the  stomach,
Avhich require ejection by an  emetic.  Faecal  obstruc-
tions may require a good lubricating agent, like oleum
ricinis.  But these are more mechanical  agencies  than
therapeutics.  Again, the question is  not  of doses, for
that matter  is entirely experimental in both schools, ac-
cording to the diathesis  and idiosyncrasies of the pa-
tient^ the  climate, the seasons, and the  type  of the
malady.  Such good authority as Dr. Chambers ought
to knoAv Avhat Professor  Prout said about blue mass:
" It is a most useful remedy in certain  hepatic diseases,
but  like  dram-drinking,  if often  used,  must be in-
creased, and leads  to  o\*cr-action and into  debility of
the liver, which is the focus  of its action."  Does not
every  Avell-informed  physician knoAv this,  that  blue
mass is capable of producing  a disease for Avhich it is
given by the rational school?  Do not podophyllum, blue
mass, aloes,  strychnia, rhei, and many others,  produce
effects upon the stomach and intestinal canal, liver, and
the absorbents similar to those for Avhich they are pre-
scribed?  Do  not quinia and belladonna,  phosphorus
and arsenic, bismuthand nutrum  muriaticum affect the
mucous follicles, the ganglionic system, and lymphatics
or absorbents similarly as the disease they are given
for?  But there is no desire on my part to  convince Dr.
Chambers of the fallacy of his statements Avhen he runs
down " siniilia."   It is enough that he  does a Avrong to 
86           PROGRESSIVE MEDICINE.
science; and true scientific  men should  be above sec-
tarianism.
  It Avould not take much trouble to shoAV the similarity
of mercurial irritation to pyrosis and gastro-hepatic and
gastro-intestinal disturbance.  Ipecac and strychnia are
Avell-knoAvn  remedies to act upon  the spinal plexus of
the nerves, and through  them affect the  ganglionic.
We could go  on ad libitum, getting  the physiological
effects from a pathogenetic basis.  The pathogenesis of
acids  and their chemical action demonstrate at sight
Avhere and how they should be used  according to the
laAv of similarity.  And again, the  action of the metal-
loids and metallic alkaloids upon the absorbents and lym-
phatics is  Avell known.   Give an alkaline Avater to people
that do not need that agent, and Avhat  Avould be  the con-
sequence? Dr Chambers could ansAver us too Avell.
  Dr. Chambers speaks of capillary congestion as a cause
of pain in the pyloric region, and suggests a process of
blistering and bleeding.  Hyperaemia is recognized b}T
thirst, quick pulse, and pain,  but  certainly the doctor
has not forgotten the beautiful blush  color  made by the
capillary ramifications  of the  stomach, and that condi-
tion is often produced by a sthenic disease and not by
a simple  phlogosis.  What then?  Is the hyperaemia
from  nervous  influence produced  by irritability to be
treated as phlogosis per se?   Surely, depleting has a
temporary influence, and Avill even  relieve neuralgia,
but this superficial and temporary relief has no curative
poAver.
   Our remedies, given according to the laAv of similar-
ity, proceed from the  pathogenetic effects of the same
upon any given point,  and they are truly specifics Avhen
Avell chosen.

   1$. Ipecac, 3-dec. grs. xxx.
      M. et devid.  chart, xx.

   Dose—One  poAvder every three hours. 
     DISEASES FROM IMPERFECT NUTRITION.   87

  An improvement Avas decidedly taking place.  I used
the remedy for five days.
  I gave her two days rest, and then gave—
  #. Antim. crudum, 3-dec. grs. xxx.
     M. et devid.  chart, xx.
  She used the medicine for fiATe days, and then came
to see me.
  I perceived an improvement, as the mucous discharge
had diminished and the pain had left her.  But there
Avas something more left, viz., hepatic trouble.
  #. Iris florentina, 3-dec. gutt. xvi.
     Aqua distill.,          f ii.
  j)ose—One teaspoonful every three hours.
  On the fourth day she came and told me she Avas better
every Avav.  Her boAvels had moved quite  regularly,
and the color of the faeces AA^as more natural.  Food did
not distress her, and her general appearance was better.
I prescribed
  $. Mercurius alkaliz. 3-dec. grs. xvi.
     M. et devid.  chart, xvi.
  #. Belladonna, 3-dec. gutt. xvi.
     Aqua font:        ? iisj.
  Dose—One powder alternately every two hours with-
a teaspoonful of the  liquid.  The  medicine lasted ten
days, and during  that  time she observed the  dietetic
and  hygienic treatment already mentioned, Avith  cold
applications upon the stomach and boAvels.
  I concluded by giving her liquor-potass arsenicalis,
five drops in ten teaspoonfuls of Avater, and of  this, one
teaspoonful  every four hours.   After  two months of
treatment she left me apparently well, although  she
Avill never be a strong Avoman.

                  CLINICAL CASE III.
   A young girl, seventeen years old, came to me in 1870,
for treatment of a chronic dyspepsia.  She Avas dejected 
88
PROGRESSIVE MEDICINE.
and had lost nearly all hope of recovery, from having
received no benefit  from the dominant school of allo-
pathy.
  Physical Examination.—On auscultation I found the
rhythmical action of the heart to be greatly disarranged.
The pulsations Avere irregular and quick, Avith a small
amount of organic force.  On palpation I found the epi-
gastric regions tender and bloated.  The liver Avas en-
larged  and painful.   The  abdomen  tympanitic,  and
boAvels Avere constipated.  She  suffered at times Avith
dyspnea, although the lungs Avere  sound.   Kidneys
Avere irritable, and the urine Avas Avhite and too light in
specific gravity.   Skin dry and impervious.  Uterus fee-
ble of action Avith  scanty menstruations.  Nervous  sys-
tem appeared entirely in a state of asthenia.   She Avas
of a nervo-bilio-temperament.
  Semiology.—She complained of burning at the pyloric
region, Avith pain at the base of the larger curArature of
the stomach approaching gastralgia.
  Food distressed her A-ery much; it  laid heavily and
undigested for some time in the stomach, and had often
to be ejected, Avhich Avas generally accompanied Avith a
large  quantity of mucus: then she felt better.  The
abundance of mucus undoubtedly prevented the  action
of the gastric juice and the formation or organization of
the peptones, thus the food fermented and  became al-
most offensive, causing pyrosis and offensive breath.
  She also  complained of a dead feeling in the boAvels,
Avhich conveyed the  idea of perfect torpidity and Avant
of muscular action (parystaltic) of the intestines.   The
constipation Avas often folloAved by free and diarrhoeatic
discharges,Avhich relieved her from that unpleasant sen-
sation of fullness, although she felt the effect of pros-
tration.  She slept badly and got up  in the  morning
unrested.
  She had  no desire for food and  felt  continually in a
state of  exhaustion.   Her tongue Avas  coated Avith  a 
     DISEASES FROM IMPERFECT NUTRITION.   89

slimy Avhite mucosity and Avas trembling and very pale.
She avoided society, although so young and  pretty, and
brooded upon her sad condition.  She had  spent much
time and money and taken gallons  of medicines, with
perceptible injury  to herself.  She Avas desponding and
suspicious ; had lost confidence  in  physicians.   She
Avept  frequently, and everything seemed to go, as she
expressed it, to her stomach.
  Her complexion Avas far from clear ;  it had a hue of
yelloAV tint deep in the skin.  The liver Avas unable to
go through the physical process of disengaging  the
biliary elements from the venous blood, hence biliary
suppression.  Having suffered for five long years, the
disease Avas making great headAvay into the economy.
The physical and physiological functions had lost vigor
and harmony.  Their influence upon the  absorbents
Avas established to an abnormal degree, debility  and
anaemia Avere disintegrating the very foundation of life.
There Avas  great mental debility and prostration.   She
became feeble and  indifferent to everything.  Hepatic
derangement, Avith  suppression  of  biliary  secretion.
The ductus communis Avas tumefied and engorged with
mucus.
  The lymphatic system Avas normal, except, perhaps,
a little hyperaesthesia from sympathy and  mal-assimi-
lation. Her nervo-bilio temperament predisposed  her
to bilio-nervous affections.  The alkalinity of the  secre-
tions of the salivary glands (cyanide of potassia)  was
insufficient, hence lactic acid in excess, and  irritability
of the stomach. The pneumogastric nerve, radiating
from the lungs and heart to the stomach, Avas exces-
sively  sensitive, and by reflex  action  caused  those
complications already enumerated.   Every sensation
carried a certain influence to the stomach—the focus
of the disease.
  Her morning indisposition sIioavcmI enervation;  she
Avas therefore unfit for any occupation;  but as soon as 
90
PROGRESSIVE MEDICINE.
she seated herself and commenced her allotted Avork she
became faint, preceded by trembling and a cold perspi-
ration.  And again, pain in her boAvels Avould soon pro-
duce a loose evacuation.
  Etiology.—1.  Indulgence in pastry and sweetmeats;
2.  Over-study  and late  hours;  3. Abuse of ATegetable
food, and not sufficient nitrogen, producing a  physical
Aveakness  of the chylo-poietic  A'iscera; 4.  Diminished
physical force,  and cliemico-physiological functions;  5.
Imperfect histogenesis.
  The over-indulgence in any lacteous and saccharine
materials deteriorated her health to  such an extent that
inanition Avas fast gaining ground.  And these unassimi-
lated  ingredients became fermented, hence flatulency,
eructation, and formation of gases in the intestinal
canal.   •
  These physical conditions Avere devitalizing and the
juices  became  changed and acidulous.  Her nervous
system gave  signs of asthenia; the blood  became im-
poverished, hence hallucinations, insomnia from anaemia
of the  brain.  Further,  neglect of exercise, air, and
bathing increased her physical difficulties.  Her style
of living in closed rooms, overheated by artificial Avarmth,
and her disregard of proper diet, if continued, Avould
have soon put  an end  to her life.   It being  beyond
question that the digestive organs and their juices Avere
seriously affected and perATerted, the problem Avas  pre-
sented  to us clearly and forcibly: Can Ave restore the
vis-vitae and  return to the system that which it has lost
during a series of indulgence, neglect, and imprudences
causing loss of physical force and normal action.
  This proposition is not to be lightly ansAvered.  The
complexity of the case is such that no hasty conclusion
should be arrived at before a  satisfactory examination
of that Avhich is favorable, and that  which is not.
   A cure, radical I mean, cannot be expected  short of
one to tAVo }rcars. 
      DISEASES FROM IMPERFECT NUTRITION.     91

   The re-establishment of a physical equilibrium and
vital harmony cannot possibly be accomplished, without
commencing the process of repair from the very founda-
tion.
  Evidently the starchy and saccharine materials Avere
not easily acted upon by the Aveak gastric  juice, and  it
passed the chyme into the intestines in an  unsatisfac-
tory or crude  condition, there to  become  chyle.   A
perfect chyle cannot be elaborated from  an imperfect
chyme, for the very reason that Ave cannot make  good
bread out of poor flour or badly prepared  yeast.   This
illustration is a practical Avay of delineating the bound-
aries of  the  two digestions.  The Avhole  histogenetic
process Avas  interfered with  by  this  mal-assimilated
chylification.    The  normal emulsion  Avas out of the
question;  it could not be produced or vitalized properly
from an  acidulous chyme.  Hence the  proteine  com-
pound Avas deficient in those elementary principles that
constitute perfect nutrition.
  If Ave have  reasoned upon our proposition correctly,
the solution,  or rather the proceedings necessary, are
clear and  Avell pointed out for  us  to  act  upon.  First,
proper nitrogenous diet; and the reason is obvious that
this nutrient Avas the only one neglected, and that it Avas
the only one in Avhich I could expect any vital result.
  Dietetics.—AlloAved: Eggs, beef-tea, cream, roast-beef
rare, mutton,  clams, cocoa, peas, lentils, birds and fish.
Not alloAved:  Potatoes, pork, hot bread or cakes, pastry
of any kind.  No coffee or tea, but Avine and  old ale.
  Morning meal:  Eggs, cocoa, toast, and oatmeal boiled
for six hours.
  Dinner:  At  first,  beef-tea alone,  Avith  bread  and a
Avineglassful of Burgundy. After the digestive organs
gave sufficient signs of improvement, rare roast beef, or
birds.
  Supper: Cocoa, and  a bird,  or clams.   This  is the
first stage of  the dietetic treatment, and  Avas folloAved 
92
PROGRESSIVE MEDICINE.
by larger quantity and variety; but no amylaceous food
or glucose Avas indulged in for a long time.
  Hygiene.—Bathing  every day  in tepid,  salt Avater.
Gentle exercise, as Avalking early in the morning.  And
even  these rules had  to be  changed according  to
strength.
  After a feAv months, I ordered her to go  roAving and
riding in the country.
  Medical Treatment.—It Avas imperative that I should
use a rational mode of procedure to reinforce the physi-
cal functions.   I became convinced that the therapeutic
success depended upon Avhich special system I  selected
for  operation.   The great depression of  the  central
force and all its collateral branches pointed  out to me
the basis of operation.   The emaciation, adynamia, in-
anition, and anaemia Avere four  points Avhich  had to be
relieved, supported, and reinforced.
  If the so-called Rational school ever errs, it  errs in
the management of these  cases, and the brilliancy of its
eclectic system of medicine falls far short of the mark.
The cathartics  and stimulants Avhich Avould  have  been
used  here,  Avould have had a most destructive and un-
scientific effect.  Physicians might  deny that such a
treatment  would  have  been adopted; but, if  so, they
would not  endorse  the  rules  of  eliminating the faecal
accumulations,  disengaging the absorbents by the same
process, and then toning them  up, like harp-strings, to
the normal condition  Avith the tonic-stimulant  process
of quinia, stryeiia, iron, and astringents.
  I have no desire to find much fault with the other
school, but  Avhen they assume the title of R itionals they
must stand the test and the criticisms. No doubt they
employ remedies  that, if given  in smaller doses and
under a different  principle, Avould succeed Avell, but
heavy doses promiscuously given Avith compounds Avill
never give them a compass  to steer  by, or a point  of
appui to go to with a reasonable amount of success.   A 
     DISEASES FROM IMPERFECT NUTRITION.   93

mariner would be equally at a loss Avere he to folioav
the currents that seem to lead him, or the Avinds that
swell his canvas, Avithout any surer  indications.  It is
my desire to point to remedies Avhich  have a peculiar
and specific influence upon the organs of digestion,  and
leaving out many collateral  remedies Avhich frequently
might be usefully employed.
  I treated this case with the folloAving remedies: Bry-
onia,  quinia,  phosphate  of magnesia, pulsatilla, igna-
tia, natr.  phosphoricum, lycopodium,  bismuth,  ferrum
phosph.; kali  sulphatis, carbo veg., pepsine, calc. phos-
phorica, manganine,  etc.   Noav Ave can detect easily the
relation existing betAveen disease and remedy.   It is, in
my opinion, the most reasonable acceptation of the  law
of similia.
                  CLINICAL CASE IV.
   Mrs H., tAventy-seven  years old, and a AvidoAv.   She
came tome in thespringof 1875, complaining of a chronic
dyspepsia.  After  trying  the rational  school  to her
heart's  content, Avithout the least  benefit, concluded
that  she Avould try  the neAV one.  She Avas a country
lady and had the benefit of pure air, as the place where
she lived Avas  healthy.
   Physical Examination.—Chest small and badly formed
(pigeon-breasted).  Respiration tAventy-four to the min-
ute, with a tendency to cough.  No organic disease of
the lungs existed.  Atrophy of the liver and painful on
pressure.   BoAvels constipated and  felt hard and  full.
Skin  dry, rough, and yellow.  Great emaciation.   Heart
normal, although at times its functions or rhythms Avere
disturbed.   Kidneys Avere normal, but passed urine fre-
quently and devoid  of solids.  Tongue coated  yellow
and corrugated.  Eructation and flatulency with tormina,
and, at times, diarrhoea.
   Stomach tender  on  pressure.   Face  wrinkled  and
prematurely old.  General appearance, that of atrophia
lymphatica with a scrofulous diathesis. 
94           PROGRESSIVE MEDICINE.
  Semiology.—I found her in .the most deplorable physi-
cal  condition.    Emaciation,  asthenia,  inanition,  and
anaemia.  She had been married several years, Avithout
issue.
  She Avas of a lively disposition, but changed into sad-
ness and despondency.   Her nights Avere  passed rest-
lessly, her food disagreed Avith her and  gaA^e her pain
in the stomach.   She took no  exercise, and had no ac-
commodation for  ablutions.
  Her diet Avas composed of the usual kind.  Pork, ham,
fried eggs and meats, pastry and hot bread, Avith poor
tea and coffee. She retired early and  arose early.  She
had more to do than her physical strength  could bear,
and consequently became often exhausted, and suffered
Avith severe headache and pain in the back.
  The signs Avere those of mal-assimilation and mal-nu-
trition,  Avith a tendency to heteroplastic  formations.
The result  of deteriorated blood  predisposed her to
tubercular formations, and the nucleoli of the liver Avere
shrunk  and  almost pervious.  The condition Avas alarm-
ing in the extreme.
  The   gastro-enteric juices Avere  peiwerted  to  poor
chylification, and  thus the histogenetic process Avas dis-
arranged.  The Avhole  lymphatic system shoAved atro-
phy.   The ganglionica and  A*asa-motor nerves Avere
excessively  Aveakened.   The only beacon light of this
fearful condition Avas a strong A'ital  force.
  Portal engorgement Avith hemorrhoidal tumors.  The
venous blood Avas impure and leucophemia Avas gaining
ground.  Suppression of biliary secretion from organic
difficulty.  The functions of the Avhole organizing  pro-
cess Avere deficient in physical and organic force.
  The Avhole process of life and repair AAras so disturbed
that chronic cachexiaAATas stamped in her face.  SheAvas
a sensible woman and retained much mental vigor, and
therefore her condition Avas  Avell knoAvn to her.
  Etiology.—1. Scrofulous diathesis; 2. Physically fee- 
     DISEASES FROM IMPERFECT NUTRITION.     95

ble, and particularly the organs of digestion and assimi-
lation; 3. Disregard of hygienic rules; 4. Indigestible
ingredients of diet.  1 know not of any directly exciting
causes.
  Hygienic Treatment.—I must confess that I Avas at a
loss Iioav to commence a treatment, as my prognosis Avas
unfavorable.   I had  no  faith  in a recuperative force,
hence I Avas afraid to use radical agents.
  HoAvever, I had no  alternative, so I ordered a tepid
bath Avith a tablespoonful of bicarbonate of potass, so as
to act upon  the absorbents, every other night.   Cold
Avater Avas out  of question, and the Avarm bath would
equalize circulation and temperature.
  Again, I Avanted to  act upon the emunctories  of the
cutaneous surface, so  as to assist the liver and kidneys
in removing the effete materials.
  1. Rubbing her Avhole person Avith  a rough toAvel;
and, 2. Walking or riding in  the open  air  during  fine
weather, morning, noon, and afternoon.   If not possible
to ride or Avalk, she Avas to Avork in the garden as much
as possible.
  This plan, if Avell considered, often brings about such
reaction as  to insure success.  Motion,  atomic  heat,
light, decomposition, and  repair, one  and all, move in
co-ordination.  The nervous force increases,  the blood
becomes richer, and the equilibrium and harmony is re-
established.
  These elementary  principles, blending, as  they do,
forces and physical laAvs, increase the great phenomena
of the vis-vitae and Avith it the secretions and  excre-
tions.
  Dietetics.—These nutrients, to be useful, must be Avell
chosen and Avell assimilated for the process of organiza-
tion and repair.  Oxygen is an indispensable element
to the metamorphosis of physiological functions.
  Nutrition  cannot take  place Avithout combustion and
heat, for this brings about functions and forces.  The 
96
PROGRESSIVE MEDICINE.
      liver, one of the principal factors of the organization,
      must be  stimulated  to  perform  its organic function,
      and this can only be done by the least carboniferous
      and nitrogenous food, and the greatest amount  of oxy-
      gen and pure Avater.
         And yet the case needed some animalized food; and
      Iioav to accomplish digestion Avas a  difficult question,
      considering the enfeebled condition of'digestion.
         I put my patient on cream, which she could get easily
      in the country, morning and night, with old bread and
      no butter; beef-tea at dinner, Avith a little brandy, sugar,
      and Avater.   I kept her on these nutrients for tAvo Aveeks.
      Then, I alloAved her oatmeal,  cocoa, and the yolk of an
      egg; at dinner, mutton  chops broiled, Avith bread, and
      a glass of wine.  At supper, clam  broth  with bread
      and a cup of black tea.  She gained steadily, her color
      changed from yelloAv  to Avhite, her pulse became full and
f      even, respiration fuller and twenty in a minute.  I kept
      her on the same diet, except Avith a little change in the
      quantity, and gave her peas, hominy, and rice.   Coffee
      disagreed Avith her.
         Medical Treatment.—I had very little  hope from the
      therapeutics; but I thought I Avould  use those agents
      Avell knoAvn to support the elementary principles of life.
      From my knoAvledge of the Rational school, I knoAv that
      aloes, mercury, rhei,  ipecac, quinia, cinchona, and stry-
       chia had been used ad libitum,  and I  therefore pre-
      scribed,
         JL Natrum phosph., 3-dec. grs. 1.
            M. et  devid. chart, xxv.
         Dose—One poAvder every four hours.  The medicine
      lasted her a Aveek, and then she came to see me.
         In addition to this I  applied hot fomentations to the
       liver at night.
         She returned improved and in good spirits.
         The diet Avas continued, as she became satisfied with
       it.   I found that her stomach was not quite up to her 
       DISEASES FROM IMPERFECT NUTRITION.     97

 general condition, so  I  ordered:  Jfc. Pepsin and hydro-
 chloric acid, to assist her digestion.
   Her improvement Avas quite  satisfactory, and yet her
 liver did not act Avell.
   Ii. Podophylum, 3-dec. grs., xxx.
     M. et devid. chart, xv.
   p. Nux vom.,  3-dec. gutt. xxx.
     Aqua distill.    f iv.
   Dose—One poAvder every two hours alternately with
 a teaspoonful of the liquid.
   On the fourth Aveek she came back smiling, and had
 gained in  strength and flesh.
   The baths Avere continued, as Avell as the diet and ex-
 ercise.  I gave her general  directions as to her mode of
 life and the following prescriptions:
   #. Bismuth subnitr., 1-dec. grs. lx.
     M. et devid. in chart, xxv.
   #. Sulphur, 3-dec. grs. lx.
     M. et devid. chart, xxv.
   Dose—One bismuth   powder  every three  hours.
 Next day the sulphur in the same way—alternating the
 day and the medicine.
   The Avoman Avas strong in mind, and adhered  to  the
 treatment and directions.  She left me.
   The other day, five years  after she first came to me, I
 saw her and she Avas Avell and happy.

                  CLINICAL CASE V.
  In the year 1869, Avhile I Avas practicing  in the Avest-
 ern states, among the agricultural people,  I was  called
 upon by a farmer, Avho Avas above the common average
 in intelligence  and mental  culture.  He  entered my
 office, and Avithout prelude  asked  me: " Doctor, Avhat is
good for Avorms? Ave  are all cursed  Avith  the devilish
things."  The question was a droll one,  indeed, and
surely  not easily ansAvered.  He stated that for tAvo
years he had noticed  that his children had Avorms, and 
98
PROGRESSIVE MEDICINE.
that they greAv pale and thin, and had lost that  liveli-
ness and mirth so natural to the young.  He had  given
them vermifuge for months, under  the  guidance of a
Rational  doctor.   It  had only a temporary relief, and
the parasites soon returned  as bad as ever.
  He Avas satisfied that the strong anthelmintics and
the Avorms Avould soon have a deleterious effect upon the
patients; so he concluded to see if a physician Avho Avas
not  of the Rational  school could think and  act Avith
judgment.
  I laughed at his jokes, but felt the force of  them.  I
took much interest in the case, and told him I could give
no ansAver Avithout seeing the children.
  Semiology.—The children Avere brought to me a feAv
days after this remarkable visit.  I found them emaci-
ated, pale, and listless, with sunken eyes, tumefaction of
the abdomen, offensive breath, itching at the anus, and
incontinence  of urine.  They  had a cough, voracious
appetites, itching of the nose, skin dry and rough, and
at night  great restlessness, raising themselves from bed
in a frightened condition, screaming and grinding the
teeth together.  At times they Avould Avake up almost
choked  to death.   In the morning  they found Avorms
craAvling in the bed.  They looked anaemic and starved.
The mother's constitution  Avas  of a nervous, irritable
character, having the most ungovernable temper; she
also suffered from the same disease.
  They Avere badly clad, and the locality Avas damp and
SAvampy; they had bilious, remittent, and  intermittent
fevers, caused by an endemic, malarious effluvia.   These
poor creatures  had constant looseness of  the  boAA^els,
from irritation caused by these parasites.
  The father brought me  specimens of the Avorms in a
bottle.   I found them to  be about  an inch and a half
long, Avhite. Avith a sharp pointed head, viz., ascaris ver-
micularis, and under  the microscope they  looked like
a shoemaker's bristle.  This parasitic disease  became 
      DISEASES FROM IMPERFECT NUTRITION.   99

 chronic, and  produced  considerable physical  changes
 from mal-assimilation and inanition.
   Etiology.—Their main diet was pork, milk, corn meal,
 pastry badly cooked, bread made  of poor flour,  and
 heavy.   Ham  and succulent and starchy, indigestible
 articles Avere  constantly in use.  They lived upon these
 farinaceous and carbonaceous materials, omitting beef,
 mutton, fish, eggs, and nitrogenous vegetables.
   The hygienic laAv Avas at nil,  privies, stables, styes
 for  hogs,  etc., Avithin a feAv yards of the house.  The
 poisonous  and infected  air,  Avith the Avater  thoroughly
 impregnated  Avith the  floating molecules of these  ex-
 halations, together Avith the  food, Avere the  true prox-
 imate causes.   Parasites generally spring from Aveak
 digestion,  mal-nutrition, and fermentations.  This Avas
 their condition.   Their  diathesis being leuco-phlegmatic
 predisposed them more readily to the disease.
   Hygiene  and Diet.—The principal object  in vieAV Avas
 to correct the proximate causes; therefore they Avere di-
 rected to use  nitrogenous food (and abolish pork  and
 starchy or  succulent vegetables),  i. e., beef-tea, mutton,
 eggs, fish,  poultry, coffee   and  tea  Avithout  milk  or
 sugar.
   I added  a little claret Avine if they did not desire the
 above beverages; the acid and alcohol Avere ingredients
 conduci\re  to  re-establishing the  process  of digestion,
 and  thus  preventing fermentations.  I forbade pork,
 milk, molasses, potatoes, fresh bread and pastry gener-
 ally.  I ordered baths in salt Avater three  times a Aveek,
 and  kept  the children out in the air  and  Avarmly
 clad.
  Medical  Treatment.—It is in such cases that any laAv or
 school of medicine is to be put aside;  the action of the
medicament must be sufficient to permeate the excre-
menta with its  morbific influence, and kill  the  parasite
and its ova.  It cannot  feed upon  the secretions that do
not  contain milky  emulsion or  saccharine "materials, 
100          PROGRESSIVE MEDICINE.
much  less upon such  things  as  oleum  terebinthinse
chenepodium, or santonine.
  $. Pomgranatum cortex, f ii.
    Aqua (tAVO pints), 0 ii.
  Boiled for tAvo  hours and  strained; one half Avine-
glass before meals.   This infusion Avas meant to act as a
medical wash of the stomach and intestines.  They took
the remedy for  seven days.
  I had the pleasure  of seeing an  improvement, and
directed that the remedy should be  continued a week
longer. They came  to see me  on the fourteenth day,
and their cheerful faces and brighter color Avere unmis-
takable signs of returning health.  The father reported
that the stools  Avere no longer loose or  clay colored,
but yellow and  of a certain consistency.
  Bunches of dead  parasites Avere seen  in  the faeces;
after this  the appetite  became more natural and the
sleep undisturbed.   I thought  it proper  to change the
remedy, as I did not  Avish the system to get accustomed
to it and thus lose  its influence.
  5L Pulv. Kousso, 1-dec. 3;  M. et devid. chart, xxx.
Dose—one powder every two hours to each child and
the mother also.  The same diet Avas continued.
  On the fourth Aveek they still reported progress; but
to insure a cure I ordered:
  #. 01. Terebinthinae, 3-dec. f; M. et divided in chart.
xxx. Dose—one poAvder every three hours. On the sixth
week they reported themselves Avell.  These were inter-
esting cases, and shoAved that Avhere strong, irritating, and
purging anthelmintic medicines had failed, a  judicious
diagnosis and light  therapeutic treatment,  Avith small
doses, succeeded beyond question.  The first and main
object  Avas to re-establish nutrition and physical force;
and secondly to starve the  parasite instead  of driving
them out by mere mechanical or chemical means.
  The  therapeutic  idea Avas to permeate  the intestinal
excretions Avith an offensive ingredient, mixed with the 
      DISEASES FROM IMPERFECT NUTRITION.   101

 fluids of the intestinal canal, but not sufficiently strong
 to cause  irritabilities or mechanical evacuations.   This
 process would have had the effect of gradually destroy-
 ing the imbedded parasites.
   The question Avith us is to use remedies by the laAv
 of similarity, but helminthiasis is one of the anomalies to
 Avhich Similia has no relation.  It is purely a parasitic
 disease, and not a dynamical one.
   We do not claim that Homeopathy will  produce ver-
 mine; neither can the Rational school claim any system-
 atic treatment.  Both employ a general treatment, tak-
 ing as points of direction the diathesis, idiosyncrasies,
 and predisposing surroundings.   The  small  doses  per-
 meate, together with the fluids, the faeces,  and enter in-
 to the mucous corrugations; and thus Ave explain the
 action of an infusion or a trituration, having  a decided
 advantage upon massive doses, Avhich, it is true, expel
 large worms, but never cure helminthiasis as a consti-
 tutional disease.

                   CLINICAL CASE VI.

   During my practice in Washington city,  in 1866-68, a
 lady applied to me for medical advice.  She Avas thirty-
 three years old, unmarried, and a clerk in the Treasury
 Department.
   Physical Examination.—The rhythmical  action of the
 heart Avas not normal, the systolic sound Avas short  and
 increased in force.
   No hypertrophy could be discovered.  Stomach  sen-
 sitive to the touch; no indication of ulceration.  Intes-
 tines bloated Avith gas.  Tongue  coated yelloAv, with a
 slimy fur.  Liver someAvhat enlarged, hard and tender
 on  the loAver lobe.   Lungs sound.  Kidneys irritable
 from  a  strong  ammoniated urine.  Uterus  perfectly
sound, organically and functionally.   Menstruation regu-
lar.  Respiration slow and labored.  Pulse full, bound- 
102           PROGRESSIVE MEDICINE.
ing up to sixty-five  to the  minute.  Physical develop-
ment generally good.
  Semiology.—She Avas of dark complexion and bilious
lymphatic temperament and diathesis.  Her appearance
Avas of a pale and faded hue and she had yelloAvish spots
on her face and neck.  Her habits Avere regular and her
occupation confined her to  the  office  from 9 A. M. to 4
p. m., and no  exercise Avas taken.
  She  complained of having lost strength, flesh, and
appetite.
  Her mind dwelt a good deal upon her physical condi-
tion, and she felt as though life Avas a burden to her.
 , She  had no ambition to Avork, no taste for amusements
or inclination to exertion.  In her former life she had
been actively employed in  domestic duties.
  Her family were healthy and she could not  recollect
that any members Avere subject to any particular constitu-
tional trouble.   The district she  lived in Avas healthy,
hilly, and in the north.
  There Avere no illusory symptoms, from the effect of a
morbid, imaginative,  or hysterical mind.- I could not
trace her trouble to malarious  diathesis or  idiosyncra-
sies.   She had  never been exposed  to any sudden
change of  temperature,  vexations, or  sorroAv.  No do-
mestic troubles, no blighted affection Avere  the cause.
She indulged in no  intemperance or late hours.  She
suffered with periodical frontal  headaches.  She was
chilly,  alternating Avith hot flushes along the spine.
  Head burning hot and heavy; cold feet and hands;
loss of appetite; eyes lifeless, pupils contracted; pain in
the back;  urine  scanty  and of a dark  color; specific
gravity—1020 to 1025, Avith a sediment of phosphate of
ammonia; eructations of sour, bitter taste; pain under the
scapula and in the region of the liver (not constant).
  She  was insomnious, taciturn, and  fond of solitude;
had lost all her  energy; felt drowsy, and yet could not 
      DISEASES FROM IMPERFECT NUTRITION.   1C3

sleep; sparks before her eyes, Avith vertigo and  nausea.
She had taken advice from some physicians of  the old
school, but they gave her cathartics, bitters or tonics,
which had neither permanent or curative effects.
  Etiology.—Gastro-hepatic  derangement.   The liver
was engorged with slow circulation and biliary reten-
tion, and the whole digestive tract was  affected by it.
The juices were acidulous and the assimilation Avas sIoav
and imperfect.  The chylopoietic viscera Avere perform-
ing their physical and organic functions imperfectlv.
The  absorbents were all torpid.   This  organic and
physical  condition had been brought about  by confine-
ment in  heated rooms  and boarding-house diet and
insufficient exercise—perhaps, also, loneliness and Avant
of friends and cheerful amusements.
  Biliary engorgement or retention is  most generally
followed  by great  nervous, sympathetic symptoms—as
depression,  irritability,  chills,  hot flushes, and mental
disorder  like hypochondria, or hallucinations.
  There  are three conditions by which  this great organ
can be affected: 1. Organically by malaria and the vicis-
situdes of debauchery;  2. By anaemia  and  feebleness;
and 3. Bv nervous irritability and reflex influences from
the digestive organs.  Minor troubles might be enumer-
ated, but they  come under the  same category of patho-
logical lesions.   The afferent and efferent functions are
often sluggish and  cause engorgement.  It is of the
highest importance  to knoAv the organic and  physical
conditions of the  liver before  medicating it.   Is it hy-
peraemia  or  biliary  engorgement,  or  both ?   Is this
pathological  condition  organic  or functional?  Is  it
from reflex influences, or idiopathic or pathognomonic of
the organ ?  Is it hereditary or acq uired ?  Is it neurosis ?
Is it malarious poison, or high living and hypertrophy,
or anaemia and atrophy?  In the first morbid condition
we have  both tumefaction of the liver and atrophy and
invariably joined with splenic complications. 
104          PROGRESSIVE MEDICINE.

  I must premise that I have no fancy for liver doctors;
nor do I consider  that  organ deserving of blame  so
often.  The  erroneous attacks upon it are frequent,
and often Avithout  a scintilla of reason.
  In mental depressions the functions of the  liver may
be affected  abnormally,  but  the  question  arises  Avith
the physician,  or  should arise—Is it  the  liver, or the
brain?
  If the first is decided upon, it  must be on  close and
unmistakable physical examination,  and careful diag-
nosis, and Avith Avhat pathological  condition the  organ
is affected.   If the  second is  decided upon,  then the
conclusion is, that the afferent  and efferent functions of
that organ are  morbidly affected by reflex influence  or
neurosis.
  In all cases of disease  of the chylopoietic viscera, or
stomach, generically  called  dyspepsia,  the liver is  in-
volved ;  but is it  sympathetically affected by mal-as-
similation  and inanition,  or are the functions of the
liver idiopathically  affected, and are the lesions organic
or  only  functional ?    In the  hot  climate  of India
there are the insidious  hepatic  disintegrations, a path-
ognomonic  condition  of the disease caused by destruc-
tive materia-inorbi.   There are, also, from various physi-
cal causes,  cacoplastic formations in the  organ itself.
  Noav, are  the  cathartics—drastic  cathartics—saline
cathartics, etc.—given so often by the Rational school,
the proper  agents to be so indiscriminately used Avhen
hepatic diseases  proceed  from sympathetic  influences,
either objective or subjective?  The liver, Avhen involved
Avith the faulty process  of chylification, suffers not only
from sympathy, but from inanition, and  consequently
produces acidulous greenish bile and  enfeebled organic
action.   Would cathartics be advisable to bring about a
forced action, temporary and reactive, or  retrogressive
and debilitating?   Would that be a rational treatment?
But invariably in  all cases of suppression  of  biliary 
     DISEASES FROM IMPERFECT NUTRITION.  105

secretion the remedy is  Avithout any  further physical
inquiry than a good cathartic, which, of course, pro-
duces a temporary mechanical action, at the expense of
organic reaction, and increased debility.  This  system
of purging Avith drastic cathartics is to be  deprecated
as supremely injurious, and producing incurable diseases
of the liver.  There are so many natural Avays of get-
ting at torpid organic functions Avithout these irritating,
exciting, depleting,  and debilitating  processes.  The
physical examination and  semiology Avere  sufficiently
suggestive  that Ave had a  case of  idiopathic  liver
trouble.
  I stated that the diagnosis pointed out the true con-
dition of the organ, which Avas biliary suppression.  It
is a physical disarrangement of the nucleoli, Avhich are
unable to act upon the infiltration of the biliary fluid,
and conduct it into the  little intercellular ducts for
exit by way of the ductus  communis.   The  impure
venous  blood  goes on to the greater circulation and
poisons the Avhole system.
  But, had  I made  my  diagnosis as  retention, then I
should have meant that the  organ had  performed  its
physical and organic functions, but that it or its  chan-
nels Avere obstructed, either by  Avant of force or by
tumefaction  from an  acute or chronic  inflammation,
hence  retention.   Had Ave  irritability, nervous excite-
ment, and agitation, from physical or mental disturb-
ance,  then  Ave  Avould have a contrary condition, i. e.,
hyper-secretion, colic, diarrhoea, vomiting, fever, jaun-
dice, high bounding  pulse, mania, suppression of urine,
and possibly red eruptions in spots throughout, Avith, per-
haps, other complications of a cerebral order.  But these
cases proceeding from other diseases are reflected upon
the liver by a physical co-ordination of forces and func-
tions, differing from  ordinary idiopathic liver diseases.
  This  condition of inactivity  of organic action Avas
brought about  by enervation, caused by general mal- 
106           PROGRESSIVE-MEDICINE.
assimilation and nutrition.  The constitution and blood
were enfeebled by these causes, and the nervous system
and organic functions became affected.
  Hygiene.—Bathing  in  salt, warm water, exercise in
the open air,  and light animal food, the amylaceous
predominating.
  Diet.—Leguminous—oatmeal, peas, baked potatoes,
milk,   spinach,  rice,  sago;   Nitrogenous — mutton,
chickens, and fish.  No  pastry or  hot bread, no beef,
no butter, and no .gravies.  Coffee and tea  forbidden.
Lemonade, claret, Avine and Avater.
  Medical  Treatment. — #.  Nitro-hydrochloric  acid;
pepsine.  The usual formula—one tablespoonful after
meals.
  Hot  fomentations to  the liver.  After  one week of
this treatment, I changed for:
  $. Nux-vomic, 3-dec. gutt. xxx.
     Aqua distill., f iii.
  #. Podophyl., 3-dec. grs. xxiv.
     M. chart, xii.
  Dose—one  teaspoonful every tAvo  hours, alternately
with one poAvder.  She took these remedies for a Aveek
longer.   Her appetite returned, the tumefaction of the
liver disappeared, the bowels became regular, the  skin
of  a normal color, the pulse returned to  a normal  con-
 dition, and  her nervous system gained its  force and
equilibrium.

                  CLINICAL CASE VII.
   A Mrs. Keith, a married lady  Avith three children,
 thirty  years  old, of  a lymphatico-phlegmatic  tem-
perament.  She had been  sick  for  several years, and
 had employed both schools  Avithout any prospect of
 cure.
   Physical Signs.—The lady  Avas Avell  developed, of
 broAvn complexion and blue eyes, having a tendency to
 fatness.  Heart sound, and the rhythms Avere perfectly 
      DISEASES FROM IMPERFECT NUTRITION.    107

regular; lungs healthy; menstruation regular; kidneys
normal, both structurally and functionally.
  Semiology.—When I first saAV her I found her lying
down, and suffering with cardialgia and  the most pro-
fuse pyrosis.  The pain extended spasmodically all over
the  stomach, and  Avas more common in the fall and
spring.   Excitement of any kind would bring on a par-
oxysm of pain, Avith pyrosis.  Exercise Avas impossible,
and  even singing Avas out of the question.
  She had eructations of sulphurated hydrogen, and an
offensive breath.  Food did not  distress her, and she
had  a good appetite.
  I  examined  the  saliva and the  contents  of  the
stomach, and  found  a great quantity of  ropy, exces-
sively acidulous  mucous  and  of  a  yelloAvish  color.
She  had  to keep  a handkerchief constantly upon her
pillow for cleanliness.  Night and day she Avas equally
affected.   I  became  quite anxious, as  she  Avas  very
desponding.
  The ganglionic system Avas excessively sensitive, and
she  Avas  very excitable and imaginative.  Her boAvels
Avere regular and Avere free from  any complications of
the liver.  She  Avas  very feeble  on  account of this
great loss of mucous.  I could not detect  any ulcera-
tions, but the hypersecretions seemed to proceed from
a physiological derangement of the secretions, i. e., sali-
va and gastric juice.  The alkalinity  of the  salivary
secretion Avas not normal, and her food  did not contain
a sufficiency of alkaline elements, hence the lactic acid
abounded, and, together Avith the gastric juice, produced
this  terrible irritability and hyperaemia.  But Avas not
the nervous system primarily the cause and secondarily
the effect?
  Etiology.—I considered it a case of irritability  of the
mucous follicles of the stomach, Avith a sympathetic ner-
a^ous  hyperesthesia, caused, in the  first place,  by  a
change  in  the constituents of the salivary  fluid, and 
108
PROGRESSIVE MEDICINE.
second, of the gastric juice.  The remote cause was a
predisposition  to  mucosities.  The  exciting cause an
abuse of saccharine articles.  The pathognomonic symp-
toms Avere  like  those of ptyalism by  some  irritating
substance.
  The disease Avas evidently one  of a  cliemico-physio-
logical nature, Avhicli brought about a  hyper-secretion
of the mucous membranes, the follicles,  and the salivary
glands; idiopathic and idiosyncratic to her constitution.
There Avas  no other appreciable cause to account for it.
  It  became organic as  it Avas alloAved  to become
chronic; and finally it produced a nervous hyperesthe-
sia, a natural consequence of a continuous drain  of the
secretions.   This demonstrates  forcibly the  usefulness
of a  differential diagnosis betAveen  cause  and  effect.
The pathognomonic  lesion Avas organic  and not func-
tional.  The nervous symptoms and the pain Avere sym-
pathetic.
  This pathological metamorphosis presented certainly
irritability and hyperaemia, but neither entirely inflamma-
tory or nervous.   Pyrosis Avas a symptom, a feature,
indicating a deep seated trouble in the  organs of secre-
tion ;  but not  the disease  itself.  To  treat  merely a
hypersecretion Avould be like treating a sick headache,
caused  by injesta, or  gastric crudities alone.  In this
case there Avas no indigestion, supposed to be the offend-
ing materia morbi, but an organic disease, as a phenom-
enon of irritability.
  Although Ave haA-e admitted hyperaemia  and hyper-
sesthesia, yet still Ave could not admit an anti-phlogistic
treatment or an antispasmodic one.
  There Avas neither  inflammation  or sthenia, per se.
The bleeding and blistering of the old  school, or the
hypnotic, Avould have proved an unfortunate delusion.
Looking at the  disease from  a  logical  point of vieAv, I
could only hope for success in a treatment on a cliemico-
physiological plane—the only one possible for relief and 
      DISEASES FROM IMPERFECT NUTRITION.    109

cure.  Antispasmodic medicines  and the  hypodermic
injections had been used, as Avell as the  astringent  ton-
ics, Avithout success.  The old school had exhausted its
science and eclectic theories, and  there Avas nothing but
true similia that  could possibly do  any good, on  the
basis of physiology.
  Therefore the practitioner of  similia should direct
the remedies he employs to be  cliemico-physiological
in their action.  I prescribed kali chloras 1-10, in  tAvo
grains poAvder, every tAvo hours.  The emotional  sys-
tem Avas engaged, therefore  I gave belladonna 3-dec,
alternately.
  Dose—One poAvder every alternate hour.
  Two days after I found her better.   The  pyrosis  Avas
less copious and the nervous irritability Avas diminished.
I recollected tAvo more  points of my  diagnosis,  ATiz.,
offensive breath and  sAveetish taste in the mouth.
  I ordered:
  fi. Kali chloras, 1-dec. 3 i.
     Aqua distill.,  f iv.
  #. Carbo vegetabilis, 1-dec. 3  i.
     Aqua distill.,        f iv.
  Dose—One teaspoonful of each every tAAro hours alter-
nately.
  She  Avent  on  with this treatment, and improved in
many respects.  The odor and 3-elloAvish color  of the
secretions Avas corrected, but  the pain in the stomach
returned at night.
  On the fourth Aveek I prescribed:
  #. Natrum muriat., 3-dec. 3 i.
     Aqua distill. ^ iv.
  ty. Bismuth subnitratis, 1-dec. 3 i.
     M. et devid. chart, xxiv.
  The  fifth  Aveek she  felt much  better, she Avent to
church and sang in the  choir during the service.  Next
day I Avas called to see  her.   She had suffered all night
Avith gastralgia and pyrosis. 
110           PROGRESSIVE MEDICINE.
  It was evident that she Avas not cured, although she
was  much improved.    The  Homeopathic treatment
Avhich had been used before had had no effect;  and the
laAv of similarity had been exhausted, and almost noth-
ing seemed to be left for her relief.  I prescribed the
folloAving remedy.
  #. Iris florent., 1-dec. 3 i.
     Aqua distill,   f iv.
  Dose—One teaspoonful every tAvo hours.
  The  result  was  surprising.   She expressed herself
very much relieved, and felt that I had found the right
remedy.
  Hygienic and Dietetic Treatment.—In  this case I had
little trouble in selecting the proper diet, because she
could eat  everything with  impunity; but yet  she Avas
only allowed cream, mutton  or beef broth, chicken broth,
rice, oyster  juice,  and  the like.  No vegetables Avere
alloAved, but old bread, crackers, and  rye bread Avere
advised.
  This case  suggested strongly the want of cyanide  of
potass in the salivary secretions, a necessary ingredient
to elementary digestion.  In former  prescriptions  I
have endeavored to supply it; in this last remedy, I only
found a neurotic to serve my purpose, and thus removTed
a ganglionic influence.
  She gained flesh and general health.   I believe this
treatment will meet with the approbation of the profes-
sion generally.

                 CLINICAL CASE VIII.
  This case, although similar  in many respects to the
preceding ones, has some  peculiar  points of its  oAvn,
which are to be found in the intensity  of the symptoms
and the complications connected Avith it.
  Unless our mirror is at fault and our light deceptive,
the most important features of the case are reflected in
a very suggestive  manner.   There are a great variety 
     DISEASES FROM IMPERFECT NUTRITION.  Ill

of symptoms, differing in shades and indications,  but
easily distinguished by the practiced eye.  The useful-
ness of taking into consideration all symptoms is to be
recommended, but the important point is to take in the
salient points of the true pathological conditions, thus
directing your attention  to them as  the unmistakable
signs of a certain physical  or  organic manifestation.
The minor  symptoms are generally sympathetic  and
secondary.
  Mrs. N., forty-eight years old,  of a  nervo-bilious  dia-
thesis, dark complexion, Avell-developed, and the mother
of three children.  She had enjoyed good health and an
easy, comfortable life.
  Perhaps her mode of living Avell, and a sedentary life
had predisposed her to gastric troubles; and, indeed, she
recognized that fact herself.
  Physical Examination.—Heart and lungs Avere  sound;
kidneys normal,  yet the urine was  scanty  and of a
heavy  specific gravity,  1000-30, Avith a  bilious cast.
Liver large and someAvhat hard and  torpid.   Stomach
very irritable.  BoAvels inflated Avith constipation. Skin
dry and yellowish.  Her mental faculties Avere blunted;
she  could  not arrange  thoughts  and  connect ideas.
Great and general prostration.
  Semiology.—I Avas called to see her very early in the
morning in  the fall of 1869.   I found  her in her bed,
suffering intensely from the  stomach and intestines,
gastro-enteralgia.  A great quantity of flatus had accu-
mulated in the stomach and boAvels.  She had nausea, and
her tongue Avas coated Avith a yelloAvish Avhite slime.
  The abdomen was tympanitic and the  stomach very
sensitive  to the  touch.   She  made  several efforts to
vomit, but unsuccessfully.  The spasmodic contraction
of the muscular coat of the stomach  and  bowels upon
the  inflated organs produced the  most  excruciating
agonies.   She was restless, and had been sick for eight
hours. 
112
PROGRESSIVE MEDICINE.
  The pressure of the gas upon the iliac veins obstruct-
ed the portal circulation, and consequently the systemic
circulation was altered.
  She was threatened Avith  syncopy; pulse  small; ex-
tremities  cold, Avith  a cold perspiration, threatening
collapse.  The nerA^ous system  Avas so agitated  and so
severely tossed about that the danger Avas a temporary
suspension of the great vis-vitae, and perhaps death.
  The   splanchnic nerves Avere particularly affected.
The contraction  of every capillary  Avas  so  materially
dangerous that the heart  Avas fluttering, jumping, and
relaxing at a fearful  rate.  The symptoms Avere  truly
alarming.   Respiration short and  quick; in fact she
could not inflate the lungs, as the diaphragm Avas unable
to move doAvinvards on account of the  great inflation.
The force from vis-atergo being disarranged, the Avhole
circulation Avas in a critical  state.
  She had been constipated for some weeks, and sour-
ness and  pyrosis Avere the  harbingers of the  present
condition.   Her digestion had been  poor  for years, and
she  had  suffered Avith  dyspepsia  every spring  and
fall.
  The  gas  Avas odorless,  because  of carbonic acid fer-
mentation.   The bitter, sour  taste indicated  a  sIoav
abnormal process of chymification and passing unpre-
pared chyme upon the process of the chylopoietic viscera.
  This  disarrangement of the stomach produced that of
the intestinal canal.
   The liver also  had  its  indirect  effect, by not passing
the bile into the intestines, hence inflation from fermenta-
tion.  It is a Avell-knoAvn  fact that bile has  a material
influence upon chylification, and upon the effete mate-
rials throAvn out as a Avaste, in preventing fermentation
by its pungent carboniferous fluid, Avhich is the result
of decomposition of the venous circulation, and, to some
 extent, is  mixed  with  a  nitrogenous element.  The
 hydro-carbon is absorbed, while the  yellow, nitrogenous, 
     DISEASES FROM IMPERFECT NUTRITION.  113

effete part of the bile goes out Avith the  faeces.  Noav,
then, the hydro-carbon is the glucose part of the biliary
secretion, and aids in the calorifacient process of intes-
tinal digestion.   The physical and  physiological func-
tions of this organ are Avell knoAvn.  These feAv lines  of
elementary principles will refresh our memory as to the
difference betAveen suppression and retention, and bring
it more forcibly in comparison Avith our  clinical cases.
We must folloAV the diseases appertaining to the diges-
tive  organs upon a physiological knoAvledge  of their
suppressed functions.   The link is Avell connected, and
the chain is so closely dependent upon CArery link being
sound, that mistakes are  often made by the best  of
physicians.
  Then comes the question, Avas not this mischief the
result of bad chymification in the first place, and the
liver and chylification secondarily affected?
  The tAvo processes are so dependent upon one another
that very rarely do Ave  have the stomach affected Avith-
out the enteric juices feeling the effect of it.  Yet there
are such cases, both gastric and intestinal being singly
disarranged;  then, of course, the difficulty is easily
recognized.   And just at this juncture comes the ques-
tion of nitrogenized and histogenetic  digestion,  and
hence, whether  the elements of nutrition, Avhich are
mal-assimilated, belong to the former or latter class;  in
other words, a\ hether Ave should prescribe this  or  that
kind of nutrients.  With this comes the  idiosyncrasies
of the diathesis  and predispositions  thereof, and again,
the exciting  causes.  With this strong diagnostic force
in hand, the probabilities are that avo  cannot  go far
astray from the true course of treatment.  It is obvious
that high-living individuals arc often  affected by  liver
complaints, because of  the large  amount of effete ele-
ments  in the  A-enous blood, Avhich  the organ is not
always able to filter through its cells. We have another
condition, and just the  opposite of the first, i. e., mal- 
114           PROGRESSIVE MEDICINE.
nutrition from improper  food, or semi-starvation.   In
those cases Ave haA^e also hepatic diseases arising from
organic debility caused by physical inanition.
  While Ave Avould do Avell to prescribe an abstemious
regimen to the former, Ave should prescribe a generous
one to  the latter.  While amylaceous food Avould  do
for the first, the nitrogenized  should  be given  to  the
second.
  Frequently we  have organic or structural diseases of
the liver, caused by climatic causes or constitutional rea-
sons ; but in the largest percentage, the hepatic regions
are affected by an imperfect process of alimentation
and digestion.
  It  is not ahva}Ts the liver that suffers, but the lungs,
heart, and kidneys.  Morbid cachexia of the nervous
system, gouty  affections, etc., often result from  mal-as-
similation and mal-nutrition.   Melancholia,  hysteria,
hypochondria, asthenia, and  even mental  aberrations,
epilepsy, helminthiasis, etc.   The last are the innumer-
able  cutaneous affections Avhich cause so much suffering,
and from Avhich none are exempt—neither  the gour-
mand or the beggar, the plethoric or the anaemic.
  Etiology.—1. The bilio-nervous diathesis  predisposed
her  to hepatic  complications.   Her  idiosyncrasies
Avere  lymphatic and  predisposed her to leucophemia.
She might have been classed amongst the hyperplastic
lymphoma.  She inherited a long life, and her constitu-
tion Avas strong and Avell developed.
  2.  High living and indulgence in luxuries and pastry.
  3.  Excessive use of coffee, late hours  and suppers.
  4.  Sedentary life and hot rooms in the Avinter.
  5.  Of late, mental anxieties, on account of financial
troubles of her improvident husband, Avas one  of the
principal exciting causes.   These and other minor
humiliations  produced  a  sympathetic  or  emotional
influence upon the delicate organs.
  Hygiene.—Nothing  could be  suggested except bath- 
      DISEASES FROM IMPERFECT NUTRITION.    115

ing.  Exercise, early hours  in retiring  and rising, and
a protective flannel around the stomach and bowels.
  Dietetics.—Mutton broth, beef-tea, oyster-soup,  but
not the oysters, clams, mutton chops, and chicken.  The
albuminous and amylaceous articles  of diet Avere for-
bidden, as she had the difficulty of an enfeebled  chyli-
fication.
  Medical Treatment.—The case Avas severe and required
immediate relief,  by Avhich I do not mean an entire
cure.
  #. Tinct. Assafcetida, f i.
     Aqua bulientis, f iv.
     M. Injection—one quarter at a time.
  p. Lycopodium,  3-dec. 3 i.
     Aqua distill., f ii.
  Dose—One  teaspoonful every fifteen minutes;  and
hot poultices  applied to the abdomen, Avith drinks of
hot water added.
  She soon became quiet, and slept for half an  hour.
Then a free evacuation of the boAvels took place.    She
Avas much relieved and the eructations from the stomach
Avere excessive.  But  yet at times she felt the  pains
coming back.  I gave another injection  Avith assafcetida
and a feAv doses of lycopodium and the hot drinks.  She
slept again  for  over an hour, and had another  large
evacuation with a great amount  of gas.  I made an ex-
amination and found the abdomen relaxed, no pain in
the stomach, and no pain on touching it, except that of
great soreness.  I  continued the hot fomentations.

  #. Merc, alkalizatum, 3-dec. 3 sj.
     M. chart, xv.
  #. Lycopod., 3-dec. 3 i.
     Aqua distill.,  ? ii.
  Dose—OnepoAA'der every hour alternately with a tea- 
116          PROGRESSIVE MEDICINE.
 spoonful of the liquid.  At the sixth hour she Avas con-
 valescent.
   I left her in the afternoon comfortable, and returned
 next day.   I found her still more  comfortable, and  she
 told me she had had several copious evacuations, Avhich
 relieved her very much.  I continued the treatment  all
 the second and third days.  On the  fourth, I gave her
 no medicine, nor  the fifth.  On the sixth  day, I com-
 menced my curative treatment on a cliemico-physiologi-
 cal basis. The first tAvo remedies I considered thoroughly
 Homeopathic, having dynamic effects upon the nervous
 system and secretions as well; but the main object Avas
 to remove  the offensive matter,  and add  agents  that
 Avould stimulate hepatic action and nervous  influence;
 this Avas accomplished.  There Avere many  other reme-
 dies indicated as Avell, e. g., colocynthis, aloes, nux vom.,
 camphora, belladonna, natrum carbon, etc.   The object
 of the  folloAving treatment Avas to aid the vis medica-
 tricae naturae on a logical  principle.  Have Ave not  ad-
 mitted  the  want of chymification, and the enteric  or
 chylopoietic derangement in consequence? We have also
 seen the effect of this mal-assimilation upon the liver,
 hence Ave can suggest remedies that have a direct and
 specific  influence upon those organizing processes.
  I prescribed:
  #. Acid hydrochl. dil.,  3 ii.
     Pulv.  pepsine,       3 ii.
     Aqua bulient.,      ^ ii.
  Dose—One teaspoonful every four hours, or after eat-
ing.
  #. Pulv. aloes, 3-dec. 3 i.
    M. chart, xxx.
  One poAvder every tAvo hours.
  She recovered entirely,  and  never aftenvards  had  a
similar  attack during my  residence there, which  was
four years in length. 
     DISEASES FROM IMPERFECT NUTRITION.  117


                  CLINICAL  CASE IX.
  Miss C, an unmarried young lady of twenty summers,
of a nervous, lymphatic temperament, of small stature,
gray eyes, and regular habits.  She complained of much
pain in the cardiac region of the stomach, and particu-
larly after eating.
  Physical Examination.—Heart sound.    Lungs in a
normal condition.  Kidneys irritable, Avith a heavy yel-
lowish shade of the urine.
  At times she found a Avhite  sediment at the bottom
of the vessel, Avith strong ammoniacal odor.   Stomach
tender to the touch.  Liver enlarged and rough, not
having that natural smooth surface of the normal organ;
tender on touch.   Conjunctiva of the eyes of a yelloAv-
ish color.   Skin rough and  dry, impregnated Avith yel-
lowish pigment.
  Semiology.—Constipation; very irritable; sad, gloomy
thoughts; insomnia; headache;  great exhaustion  and
Aveeping; pulse Aveak and compressible;  countenance
haggard;  tongue coated Avhite at the edges and slimy
yellow in the middle.  She had a voracious appetite,
and could eat at all  times.  She tasted her food after
eating for a long time; pain in the epigastrium.
  Flatulency and eructations annoyed her constantly.
She suffered Avith pain under the right scapular, short
breath, and cold chills running doAvn her back.  She was
so feeble that everything tired her beyond measure.
  Her menstruations Avere regular.   Urine of a heavy
specific gravity—1000-31.   Eructations Avere often sour
and bitter, and breath offensive. Her Avhole organism
was  affected by this  devitalizing mal-assimilation, and
the  physico-vital  forces  Avere  steadily  undermined.
She Avas  fat, but asthenic, and  inanition was threaten-
ing.
  The gastro-hepatic and enteric symptoms Avere those
of a se\Tere case of mal-nutrition.  The nitrogenizedand 
118          PROGRESSIVE MEDICINE.

non-nitrogenized  elements AArere both  equally  and im-
perfectly organized.   The blood became poor and serous
—the fats only Avere einulsionized and kept her looking
Avell—and so the  tissues Avere scantily repaired.   Ani-
mal heat and combustion, so  necessary for the  process
of decomposition  and composition, Avere at a Ioav degree.
Her Avhole economy Avas fast descending, as the blood-
cells Avere  losing the haematine, and becoming  inactive
and  Avasted.  Leucothemia Avould  soon  have  had the
supremacy, and cacoplastic formations, or some malig-
nant or devitalizing disease of a Ioav form Avould  have
been the unavoidable result.  Often dyspeptic people
are faf.
  Etiology.—She Avas indiscreet in eating, and  very
fond of pastry and molasses.  She indulged in the heavy
kind of badly-cooked food  prevalent in  the country—
sausages, pork, ham, and fried  cakes  and  meats; hot
bread and pies, ad libitum.   She took no exercise in the
open air, although she had some domestic occupations.
Slept on a feather-bed and in closed rooms.  Ablutions
Avere more of a novelty than a daily or  Aveekly duty.
  Pudding, potatoes, and candies Avere the delicacies in
which she found pleasure.  This sums  up the Avhole
history of the case.   It Avas idiopathic, and neither dia-
thesis  nor  inheritance  had anything  Avhatever to  do
Avith it.
  The enervation and the hepatic  complications  Avere
subjective symptoms produced by the same cause.  The
organic functions of the  liver Avere torpid in conse-
quence of too much alimentation; the cells Avere filling
Avith the fats from the alimentary canal, and the  abun-
dance of it acidulated the chyle, to some extent, and
the process of histogenesis Avas  consequently impaired
from an imperfect organization of proteine compounds.
  The symptoms of enervation  and excitability  were
obviously duo to the described condition  of her general
system.  A reflex influence Avas brought from the  sym- 
      DISEASES FROM IMPERFECT NUTRITION.   119

pathetic filaments to the ganglia, and from there to the
centre.  Both the centripetal and centrifugal forces Avere
in a stale of hyperesthesia.   In these cases Ave often find
the so-called sick headaches, menstrual disturbances, and
renal complications.  The gastro-enteric juices had be-
come enfeebled and acidulated.
  She had employed a  Rational physician (Allopath),
and therefore  took physics and  tonics secundem artem,
but the trouble Avas never removed.
  Hygiene.—Bathing and hot applications to the  liver
were ordered.  Walking and riding in the open air Avere
also obserAred.
  Dietetics.—This Avas the great general difficulty, for she
Avas young, had a good appetite, and Avas unruly.   Fish,
oysters,  clams, dry toast, old bread—no butter—mut-
ton, and chicken, Avith tomatoes, lettuce, or green  cab-
bage  Avith vinegar.  The acidity of which she  com-
plained Avas not from an over-abundance of gastrc juice;
it Avas the result  of greasy food, Avhich became butyric
acid.   She did not have the symptoms of gastritis from
a hypersecretion of gastric  acid, but more from  the
result of fats  and fermentation.  But if the food had
been of a proper  quantity and kind, the organizing prin-
ciple of the stomach might have been sufficient to perform
a normal digestion; but since the abuse of over-nutrition
the juice and peptones had been very much  enfeebled,
and hence the necessity of bringing  artificial agencies
to add the elements required.

  Medical Treatment.—

  #.  Hydrochlor. acid diluted, 3  i.
     Pepsine,         3 i.
     Aqua bulientis,  f iv.
  #.  Nux vom., 3-dec. gutt., xxiv.
     Aqua distill., s iv.

  Dose—Tavo teaspoonfuls of  the digestive agent  after 
120
PROGRESSIVE MEDICINE.
eating, and one teaspoonful of the nux every tAvo hours
between meals.
  The first agent to supply chemico-physiological prim
ciples; the second, to  act upon the nervous force dy-
namically.  Chemically alone, Ave cannot expect a per-
manent and a physical  cure, but by adding  simply the
material wanted, together Avith  our dynamics, the recu-
perative poAver of nature is frequently re-established.
  This treatment  Avas  continued for  one week, at  the
end of which time I saAv the patient much improved
and  the  ct^mification  re-established.  Nevertheless,
there was still much to be done.
  The liver and calorifacients had not yet returned to
their normal functions.
  #. Podophyl., 3-dec. grs., xxx.
     M. chart, xx.
  #. Natrum  phosphor., 6-dec. grs, xxx.
     M. chart., xx.
  Dose—One poAvder every tAvo hours alternate^.
  The secretions improved Avonderfully, and she left me
before the cure Avas finished.
  I  should have  continued Avith bryonia  and bella-
donna, and finished it with  quinia and pyro-phosphate
of iron.
  There are two remedies Avhich I would recommend.
viz., iris vers and collinsonia. 
121
PART  II.
                     CHAPTER I.

         IDIOSYNCRASIES AND PREDISPOSITION.

   In the preceding part I have endeavored, by useful
 and practical illustrations, to support (by clinical cases)
 the theories Avhich  I  advanced in my first proposition,
 i. e., that mal-assimilation and innutrition  are frequent
 causes of a pathological metamorphosis of organic life,
 Avhich sooner or later must bring about a more general
 disarrangement of the co-ordination of the physico-vital
 phenomena.
   And in this part Ave Avill study a neAV proposition and
 argument, i. e., the idiosyncrasies and predisposition of
 the feminine sex to diseases of this nature.
   Convinced that this is rather a virgin soil, touched only
 in relation to diseases of Avomen in  the nature of uterine
 and the sexual organs, I make a neAV departure and  take
 up other than the diseases of the generative organs,  Avith
 Avhich the present subject is disconnected,
   I shall touch only upon the diseases and symptoms
 proceeding  from mal-nutrition and the pathognomonic
 lesion^, structural and functional, of the organs of diges-
 tion, Avith the connecting and inseparable  chain of the
 physico-vital phenomena, i. e., the nervous system.
  It is Avell understood that social position, occupation,
nature, climate, atmosphere, domestic relations—-single
or married—have much to do Avith these diseases.  What
mi°dit be only a temporary inconvenience to a man might
easily  overcome a  Avoman, and might  produce great 
122         PROGRESSIVE MEDICINE.
nervous complications, either general or special, centric
or excentric; and these may be  spinal, cerebro-spinal,
cerebral  alone,  or ganglionic;  sometimes  circulatory
and  at  others  lymphatic.   These complications often
arise  in Avomen Avhile  men are almost  exempt from
them.   The  ganglionic  and  lymphatic systems  are
very  much  more  sensitive in  Avomen than  in men,
more  easily put out of equilibrium, thus complicating
diseases  to  a Avonderful  degree.  The  female sexual
organs  are  prone  to  have  a  reflex  action upon
her Avhole  organization.   Her  physical  development
and force  are  less enduring, and consequently more
easily disarranged and enfeebled, rendering  her organ-
izing  functions  difficult and  incomplete.   The  vital
force  seems to be a prerogative of the female  sex: it is
a fountain inexhaustible beyond comprehension.  This
is a relative and  co-ordinating force, an offspring  of
physical and physiological forces; but there is something
nascent and peculiar, because if it depended  upon the
machanical or dynamic forces it  AArould most certainly
decrease or increase, ascend or descend, according to the
physical  development and functions of those correlative
agencies.
   Although linked to a large degree Avith other forces,
the dynamic possess a peculiar  strength, located,  as I
belie\re, in the  ganglionic  system, as a focus  of supply
Avhen there is a necessity for its equipment.
   With  this acceptation Ave must  admit  an extraor-
dinary amount of  dynamic force existing in  the great
sympathetic system of the  female.  It is already  con-
ceded that the ganglionic system  is greatly developed
in Avomen as an idiosyncrasy of their sex.   In sensibility,
in intelligence, in brilliancy, in endurance of suffering,
in affection, in  hatred, in  quickness of perception, in
virtue, in vice, in morality,  in religion, in  generosity, in
avariciousness,  she excels  the  male, and therefore Ave
must admit that these qualifications characterize the 
       IDIOSYNCRASIES AND PREDISPOSITION.    123

emotional  of the sex as of a finer  and more sensitive
nature than our OAvn.  This Avord sensitive derives its
origin from  the sensory system of nerves,  and avIio
doubts that the ganglionic system is the nucleus where
a finer ramification of nerves branch off to furnish all
the organs, supervise organic functions and circulatory
apparatus.
  These ganglia are found in the cervicle at the base of
the brain (the largest), the cardiac ganglia, the lumbar,
the sacral, etc.  This peculiar dynamic force exists in
these ganglia and  its nervous filaments.  The recuper-
ative poAver of nature lies  mainly in these ganglia, and
the process of  nutrition and repair is supervised by this
dynamic  force, in connection, of course,  Avith other
forces.
  From  this point of vieAv Ave may study and reflect
upon the Avhole field before us in a  most scientific and
logical manner. In vTieAV of this I feel  justified in con-
sidering the subject for  a study  apart from  the other
sex.
  Wealth and comforts, Avith ease and  a sedentary life,
do not promote strength and health.   Our ancestors had
to work  much  more  than Ave.   The inventions of  the
present day—relieving people from many hard drudg-
eries—did not  then exist.
  The convenient  arrangements of the range and cook-
ing apparatus, the hot  and cold Avater constantly at
our disposal, the  Avashing and the  seAving  machines,
and all  the  paraphernalia of domestic  utensils  Avere
unknoAvn.
  Our ancestors had to  do all  their  Avork by  hand
and  endure  hardships  that  Ave have . not.   But all
this, hard as it appears, gave them  strength, fortitude,
and patience to bear, together Avith health and strong
constitutions.
  Dissipations  Avere feAv in comparison to Avhat Ave have
noAV.  Dancing, late hours, late dinners, and fashionable 
124          PROGRESSIVE MEDICINE.
life were limited to a small number.  The extravagances
of a large number of servants,  carriages, and horses
were not indulged, except by the richest people.  They
lived economically and in accordance Avith their means
and the laAvs of nature.
  Music, although very  commendable, did not occupy
the first place in a young lady's  education, nor should
the  symphonies  of Mozart,  or  the  tender  notes  of
Rossini, or the cantatas of a Stabat Mater, or the thrilling
operas of Verdi  drive out all study of Avhat is practical
and useful.   And Avhile  I touch upon these points I
believe that the  readings and teachings of this day are
not, Avhat Avould prepare young ladies for  the  hard
fight  of life,  and the  prosy and  unpalatable acqui-
sitions necessary for  Avives  and mothers.   The  rudi-
ments  of Latin,  Greek,  music,  mathematics,  algebra,
navigation, poetry, chemistry, etc., are deceptions of
knowledge.   Better be a good houseAvife  than a mere
varnished, unreal piece of Avhatnot.  Better be a  good
cobbler  than a  quack  doctor, or  a charlatan  of a
laAvyer.
  The  assertion, perhaps, may be questioned, but  it is
nevertheless  true, that in our days  of intellectual  race,
Ave  often forget the first principles of Avhat is really es-
sential to human happiness and comfort.  We are car-
ried away with astonishing inventions  and discoveries,
neglecting, hoAvever, those practical things Avhich  form
so vividly part of our existence, our morals, our religion,
and our character.
  Do not the above truths prove our flimsy, superficial,
and inconsistent interpretation of Avhat should be the
education of  the  young?  My opinion is, that  if more
goodness, charity, and  self-denial  should be instilled
with the true idea  of virtue, of duty  and moderation,
the real essence of nobleness of  human nature,  the
fruits of this  peculiar culture Avould be far superior in
quality and effects to the superfluous  and empty vaga- 
       IDIOSYNCRASIES AND PREDISPOSITION.   125

 ries of our present system of education.   This does not
 apply to those whose fortunate  lot affords  the  means
 and facilities for pursuing scientific and artistic  studies
 to a high degree of usefulness, but simply to the poor
 girls whose path in life is expected to  be arduous and
 practical.
   Progress and civilization have brought us many ad-
 vantages, many comforts, and many social improvements;
 yet the matrons of old had stamina and stoical principles
 of right, the correct idea of Avork, appreciation of fru-
 gality and honor, and devotion to their duty and their
 families, of Avhich  we  stand much in need in this pro-
 gressive century.
   As illustrations bring  fonvard the proofs and facts  of
 the subject in question, the  demonstration should be
 made  by separating the  sex into tAvo grand divisions:
 First,  those  in' affluence  and  comforts, and second,
 those  Avhom God has intended to labor for their daily
 bread.
   Nature seems to adapt itself  to circumstance,  and
 renders the human  system fit  for its Avork and  exi-
 gencies.  Those Avhom destiny has placed in the  labor-
 atory of activity become large in frame and strong  in
 health, and meet the  duties  of  their calling Avith pa-
 tience, perseverance, and contentment.  The peasantry
 of Europe are Avell knoAvn for their hardihood, and their
 offspring are gifted Avith remarkable physical strength;
 they are free from the  myriads  of ailments to  Avhich
 the people of affluence are constantly subject.
  They are particularly free from diseases of the di-
 gestive organs.  Nervous troubles are almost unknoAvn
 amongst them.   Their maladies are generally acute and
 serious.
  Their  simplicity of living,  their methodical habits
 of rest, Avork,  and food, their unexcited  imagination,
 etc., leave  them  a  freshness,  a modulated disposition
and  SAveetness of  temperament pleasant  to  behold. 
126
PROGRESSIVE MEDICINE.
True, their superficial beauty, perhaps, soon changes
for hardness and solidity of constitution and  form, but
they lose  nothing  of their physical force  and vital
vigor.
  The wives and daughters of artisans, tradesmen, and
mechanics  are not always living a life of simplicity;
they are generally congregated  in  toAvns and  cities;
they do not always possess the blessings of unalloyed
morality, rural primitiveness, and  frugality; vices  of
various  kinds  creep in amongst  them.   The  vanity of
dress, and the love of external appearances and embel-
lishments, destroy many homes Avhich  otherAvise would
be happy.
  These unfortunate weaknesses  lead them astray from
the path of duty and  honor, and  miseries, heart-aches,
poverty, and  domestic  quarrels  soon   ruin  the very
foundation of  their  existence.  The deceitful pleasing
attractions of amusements; the apparent easy and com-
fortable mode of living; the gay  street and stores, and
the beAvitching fashions carry them  into  many pitfalls,
which their country sisters are not exposed to.  The
comparison is too vivid and true,  and Avhile the country
girls Avork hard, dress unbecomingly, and live in secluded
houses, they lead a life of morality and modesty, Avhich
has for  its  reAvard  contentment,  cheerfulness,  comfort,
and,  above all,  happy homes and  pure consciences.
Would  any one change the rural country life  for the
many trials,  disappointments, and bitter tears of  the
poor city Avoman?
   The above is  one class of women, only situated dif-
ferently in  life, and hence  different  are the -conse-
 quences.
   We Avill noAV look at the affluent class, Avhom  fortune
 has favored with comforts and plenty, and therefore  it
 Avould  be  but logical  to suppose  them the fairies of
 the promised land.  On a superficial view of the  sub-
 ject it might appear very possible, but deeper researches 
       IDIOSYNCRASIES AND PREDISPOSITION.    127

soon undeceive  the observer and open his eyes to the
sad realities of an artificial life.
   This higher  and intellectual  class of women  have
also a certain destiny  to fulfill, namely, the education,
ornamentation, and  refinement  of society.  They ha\Te
to encourage industry and labor, fine arts, belles-lettres,
and literary societies and pursuits.  These are the Avives
and daughters  of our legislators, laAvyers, merchants,
bankers, doctors, and professors.  These  are they Avho
fill the fashionable  theatres, the Avatering-places, the
ball-rooms, hotels,  stores, millineries, etc.  These are
the elements that give tone and taste  to society, and to
them Ave are indebted  for much that  is  beautiful and
aesthetic.   It is also true  that they are not  only the
companions of our best men, but they are the motive
poAver of all our great exertions and enterprises; in fact,
they are the magnet to Avhich all our mental efforts are
attracted for admiration  and approval.  This is  good
and providential for the progress of the human family.
The benefits arising from this feminine influence could
not be  demonstrated.  It is a  mountain of good whose
volcano  throws  to the  surface fountains of  bless-
ings.
  From the silent atelier of the painter, and from the stu-
dent's  room, to the chemist's laboratory and the invent-
or's mechanical  apparatus, Avoman is  the motive  force
—the genius that supplies the  incentive element,  " the
poAver behind the throne," and her ambition is the true
spur to man's intellectual development.
  These tAvo great classes, although diverging  in  their
peculiar positions  and  occupations,  form the  grand
total of the   human  and social  family—both useful in
their  particular  departments,   and  both addicted to
indulgences  and vice, to virtue, industry, and moral-
ity.  The systems adopted must naturally be different;
and Avhile the higher class of Avomen seem to have gifts
that others have not, they have also relative  responsi- 
128
PROGRESSIVE MEDICINE.
bilities, duties, and trials that those in a lower sphere of
life can hardly appreciate.
  And now it is Avell that I should return to our medi-
cal subject; believing that much illness is the result of
deviations from a plain and simple mode of life, especi-
ally when replaced by the artificialities of society. This
previous comparison will sufficiently  demonstrate, the
force of my argument.
  It is not  ahvays the case that dissipations are inten-
tional, but  the false impressions and notions of Avhat is
good and healthy lead to them.  The  prevailing  idea
seems  to be that the  more food is consumed, the more
wines, liquors, and stimulants of various kinds are used,
the  more completely are life and vitality supplied Avith
the  elements of nutrition; but they  are  often disap-
pointed Avhen the results fall short of the mark.
  If oxygen is necessary for vitalizing  the  blood, they
add food, and hence  carbon.   If  they require motion,
heat, and decomposition, they add rest, indolence,  and
stimulants instead.   If they require mental and physi-
cal activity, they Avaste it on balls, fashions, novels, etc.
They  seek to devitalize, exhaust, and  neglect every
principle, every organizing function, hence nutrition and
physical force gradually descend to asthenia and inani-
tion, bringing Avith it adynaemia.
   Our present  knoAvledge of physiological laws  and
functions demonstrates the fallacy of  the  principle of
indulgence.  Nutrition  and  force depend  upon  the
agency of simple elements, but in connection Avith it, Ave
require physical influences from  the outside, i. e., air,
motion, light, electricity, and  Avater.
   So, really, life is  sustained  by two grand principles,
nutrition internal and nutrition external—one animal,
the other physical.   From these  tAvo  principles we re-
ceive the recuperative and repairing forces.
   Should the physical laws be guided differently, the
gourmand,  the  wealthy, and all  those that enjoy the 
      IDIOSYNCRASIES AND PREDISPOSITION.   129

riches of the country, Avould  be stronger and  healthier
in proportion.  Where could Ave find muscle enough to
Avork our coal mines, our railroads, our canals, our farms,
and our factories?  If force should be  adequate to the
amount of  food taken, or  of  stimulants drank, the rich
alone could perform manual labor.
   But the reverse happens to be the case.   The tem-
perate class, Avhose judgment and education have taught
them to use  what is right  and proper, and  to avoid
abuse are those avIio  are reAvarded Avith strength and
health.
   Women, above all,  are  those that should learn Avell
these principles, for they are, to a great extent, the basis
of social happiness and national strength; they are the
promoters of home comforts; the health  of future gen-
erations, and intellectual  development.   The rules of
hygiene particularly conduce, Avith  proper food, to en-
hance physical force.  Mentally,  Avoman is impression-
able,  easily excited, and imaginative,  therefore  it is
necessary to  inculcate these laws, in order  that she
might soon be capable of controlling her appetites  and
fancies;  and  the reAvard Avould  be physical  strength
and beauty.  Sensible Avives and  mothers are unsur-
passed blessings  to  society; they are  the very founda-
tions  of the happiness of future generations.
   The external influences of climate, occupations, asso-
ciations, and readings should not be  undervalued, for
truly  they have astonishing effects upon the morals and
character of the people.
  A physician practising  among young AAromen, no mat-
ter Avhat class, should inform himself  of the  surround-
ings that mould the habits and character of his  patients.
From this  source he  can gather untold  information,
Avhich might have a bearing, directly or indirectly, upon
the malady; it may even be the very  source  of the
evil.  It should be thought necessary to give advice to
young women, especially  upon the laAvs guiding the 
130          PROGRESSIVE MEDICINE.
periodical change, and its physical and physiological in'
fluence upon the whole organism.
  The women of the Avorking class are generally occu-
pied and kept aloof from any morbid, or imaginary, men-
tal troubles.  Exempt  from idleness,  from late  hours,
from too stimulating  food  and beverages, which, Avhen
constantly indulged in,  bring about retrocession  of the
natural forces and nutrition, this class enjoy generally
better health and more physical beauty than their  higher
born sisters.
  Happy is the man and Avoman Avhose time does not
Aveigh heavily upon their hands (rather say upon their
minds).   Occupation is the natural and necessary em-
ployment of the mental force;  it is the healthful stimu-
lus of mental activity, and here, asAvith all physical laAvs,
action brings about reaction, and a neAV force of physical
and organic vigor is  the result.   The supply is  peren-
nial:  the mental strength increases  in vigor  during
proper  employment  to a wonderful degree.  Action is
life, Avithout  activity it becomes extinct.  The elemen-
tary forces are at hand  for this grand and great purpose,
and  if Ave neglect to  use  them, to  appropriate their
beneficent agencies, it is our oavii fault if Ave suffer.
  In justice  to many good Avomen of  both  classes, it
must be said  that much is  done  by them daily  that is
noble, self-denying, and Avorthy of their generous and
high conception of the duty devolving on them  in  the
path of life.
  And to these noble women Ave oavc refinement of man-
ners  and of feelings,  culture,  mental  and social, and
many of the charitable institutions  are  living monu-
ments to their great and good Avork.   No social position
or Avealth alone can make a true Avoman.   Her orna-
ments are those of the heart.  Nobleness of nature  is
only shown by  noble acts; and a Avoman is  only supe-
rior to another in proportion to the amount of good she
does in  her sphere.   The attainment of high virtues pro- 
       IDIOSYNCRASIES AND PREDISPOSITION.    131

ceeds simply from a pure, generous, and sincere inspira-
tion, the fountain of Avhich is in the heart.   Happiness
springs from a succession of good  actions;  mental and
moral  acquisition, Avithout  these true foundations, are
mere meaningless names, without an object, Avithout an
emotion, hence, Avithout a result.   The aesthetic belongs
to Avoman as her right.  All degrading habits and Adces
should be eschewed by the pure heart, Avithout Avhich
the fragrance  and beauty  of  gentility  cannot be  at-
tained.  Drunkenness or gluttony cause  the neglect of
those  feelings  of a nobler nature. " A man's a man
for a' that," but  never a gentleman, or  a gentle lady,
Avithout expunging the  contaminating  influences of
indulgences in every phase of life.   It is only through
a strict accountability of action that Ave can impart mor-
ality and individual nobility of character.
  A noble act is always reAvarded by the consciousness
of having done right;  a mean, degrading act is punished
by  an  opposite  knoAvledge,  or  that  of having  done
Avrong.
  Inasmuch as Ave have reached  the intellectual quali-
ties and social influence, it  is to  be observed that the
training of the mind is as necessary, and as successfully
accomplished as that of the body.   Strength is imparted
only by strict observance of the laAvs regulating both;
both are connected by a strong link of relationship un-
avoidable,  and  each  reflecting  its peculiar influence
upon the other.
  But  it is only necessary for the most casual observer
to look out upon our  great century of progress to be
convinced of the gigantic  strides of intellectual force.
If perseverance  and strength  of Avill are  retained at
our command, Ave are capable of as  much intellectual as
muscular development.  And so it  is Avith all our links
of sociology.  Endeavor to do Avell, and  cast off the
Ioav, degrading, impoA^erishing, destructive  elements of
vice and neglect, and good will germinate. 
132
PROGRESSIVE MEDICINE.
  The refinement should not only be confined to man-
ners  and taste, but to thoughts, aspirations, and feel-
ings.   Educate the mind and the heart.   Surely good
qualities, like everything else that is good, spring from
its elements  or  nature, but that good, Avell employed,
can be increased to an inconceivable degree.
  Our chain of thought has not parted from the anchor,
which holds still to the subject of force  and  develop-
ment.  The mental are not separate from  the  physical
laws; and Avhat is the rule Avith the latter is also Avith
the former.
  Returning  to  our first proposition; Ave have  surely
seen the  effects of labor, and proper regulations  of life
compared with  those Avhose good fortune cast them
silver  and  gold, but  Avhose misunderstanding of life
develops only elements conducive  to  disintegration,
physical  and  social.
  The conclusion is noAV reached by actual  demonstra-
tion, namely: action brings back force and  life;  activ-
ity of mind and body develop  to  a Avonderful degree
their resources and strength; health of body, of mind,
and of thought  depend upon many agencies—1. The
true interpretation of nature's  Avants.   2.  Adherence
strictly thereto.
  The endoAvments of these  tAvo classes  of  women
must  depend upon their  amount  of physical force.
They  must acquire this before they are able to undertake
mental or physical labor; and this is  only done  by ex-
ercise, gymnastic or otherAvise, and  employment  of the
mind, Avhich is mental exercise.  These are  tAvo health-
ful  and  indispensable  principles.  Then  heat,  light,
diet, etc.
  In these lies the great fountain of life.   The young
ladies  should rise  early, walk,  and breakfast  early.
Then  mental  or domestic employment should  be their
choice.   At this very  point Ave  see  clearly the  connec-
tion  between physical and mental exercise or labor. 
      IDIOSYNCRASIES AND PREDISPOSITION.   133

And if this is not done, inertia, retrogression, and decay
are the results.
  It is needless to repeat here that from the act  of de-
composition that  life and force  spring  forAvard Avhich
are lying dormant in matter, put there by the great
Providential Entity; and that this can only be accom-
plished by applying the  proper agencies.
  And Avhen life has made its appearance Ave must sus-
tain it, repair it, and increase it by the same law.   The
equilibrium of this great principle is found  in properly
understanding the method of action and reaction.   Is a
young girldeA'oted to study and retirement?  She needs
physical action to bring back vital force.   Does a la-
boring  Avoman Avork  too hard?   She needs  rest, for the
physical Avaste is too great in proportion to the repair.
The tAvo opposite and yet parallel  cases of gaining or
getting Avhat is necessary to life are  plainly visible to
every one. The axioni is indisputable.  The great remedy
lies in teaching these fundamental Liavs; to cure evil Ave
must understand  from Avhat it arises, and  how it is to
be avoided. 
134          PROGRESSIVE MEDICINE.
                   CHAPTER II.

         PROXIMATE CAUSES OP MAL-NUTRITION.

  Almost every organ may produce a change in the di-
gestive apparatus by sympathy and reflex action.   And
so, vice-versa, the functions of digestion being impaired
the general system must suffer, and those organs Avhose
physiological relations are correlated and closely connect-
ed Avith the functions of organization, are the first and the
more predisposed to be  affected, i. e. the stomach, the
liver, the heart, and the kidneys.   The influence of the
mind upon the process of organization through the ner-
vous system is obvious.
  It is not intended to take up psychology, but merely to
endeavor to  demonstrate  the great variety of causes
Avhich  are capable of being, and may often be direct
causes  of adynamia, from Avant of  the proper agencies
of nutrition.
  It is  therefore well, that Ave should be very particular
in making differential diagnoses  betAveen  cause and
effect:  or betAveen idiopathic per se, as entirely discon-
nected Avith any other  organic reflex influence.   This
does not discourage symptomatology in the least, on the
contrary; Ave must  be very careful  in distinguishing
primary from secondary symptoms; the pathognomonic
from the subordinate and sympathetic symptoms.   And
in this  Avay alone can Ave take  the  picture, and receive
and study the impressions  so as to form a true concep-
tion of  it. It cannot be denied that symptomatology, even
with all its present imperfections, is one of the brightest
jewels  in the laAv of Similia. 
      PROXIMATE CA USES OF MAL-NUTRITION.   135

  The structural part of the brain is too well knoAvn  to
require any anatomical description.  Its spongy, tubular
filamentous  and cellular arrangement is all included in
the Avhite and gray matter—the former the sensory, the
latter the motory, and from the  unity  of these too,
there is a further arrangement, a great provision made,
namely  the ganglionic  system.   This beautiful distri-
bution of forces is indeed most providential, for the  or-
ganic functions must be intimately related Aviththe ner-
vous system as their demand is continuous and the supply
must be near and abundant.
  It appears, therefore, that the sympathetic system is
endowed Avith both sensation  and motion (vasa motor).
These electric  and magnetic forces are concentrated in
the knots that  supply  the  Avires of nervous filaments
with the requirements  for their Avork.  This blending
of the tAvo  forces in the ganglia is a happy provision,
thus preventing any jarring,  and at the same time giv-
ing to the system a uniformity of action indispensable
to physical and organic functions.
  Each spongiole is endoAved  Avith a peculiar and com-
plex  function.
  Every cell acts through the vivifying influence of the
dynamic forces, and these are elementary—light, heat,
motion, and nutrition.  The great centre mustreceiA^e a
sufficient quantity of the vitalizing principles to enable
it to supply its ganglia, the organs of special sense, and
the muscular system, Avith nervous fluid and blood.
  Every cell must move and  receive nutrition and  ra-
diate force, activity, and  life.  It is a rotary, physical
motion; receiving and giving,  equilibrated harmoni-
ously, so that the action  is smooth, imperceptible, and
perfect.  (Co-ordination of  forces.)
  And is it surprising that so many are Avanting in men-
tal vigor and health?   The difficulty of maintaining an
equilibrium among so many physical requirements is an
obvious reason for the  deficiencies  Avhich so frequently 
136          PROGRESSIVE MEDICINE.
occur.   The influences of climate, idiosyncrasies, inheri-
tance,  predispositions, occupation, social surroundings,
and education are so many strains upon the  great ner-
vous centre.   Illusions, hallucinations, delusions, men-
tal aberrations, lunacy—these mental deflections from
the normal functions are often present in a  greater or
less degree, and are  either  idiopathic or symptomatic.

                  CLINICAL CASE I.

  A young lady, tAventy years old, of a nervo-lymphatic
temperament, having indulged in all sorts of vagaries
from her childhood to the present time.   A feAv years
ago she entered a female school.   She Avas always very
delicate and excitable.
  She  had complained of shortness of breath, slight
cough, pain in the left side and  constantly feeling ex-
hausted or Aveak and trembling.   Her medical attendant
Avas  puzzled,  and held several  consultations without
much benefit to the patient.
  I  Avas requested, just about a year ago (June 15th,
1877),  to  go  as a  consulting physician to the patient,
whom  I found in a most miserable condition, both physi-
cally and  mentally.
  Physical Signs.—On percussion there Avas no dullness.
On  oral examination I found no crepitant  or  sibilant
rales.   Respiration  short, expiration  prolonged.  No
vesicular  or  labored respiration. Temperature rather
high over the lungs (99-200 and a fraction.)   Heart per-
fectly  sound, organically  and functionally; no valvular
deposit or enlargement.  I  could find no abnormalities.
Uterus sensitive.  Had vaginal  leucorrhea.   Kidneys
sound—urine  profuse and Avhite.   Liver torpid.  Night
SAveats.  Mentally, she seemed a sensible girl, Avith the
usual excitable temperament, but ATery taciturn. Very
thin.
  Semiology.—She looked emaciated, anaemic and  ady- 
      PROXIMATE CAUSES OF MALNUTRITION.   137

 naemic.  She had no appetite, but was not distressed by
 food Avhen taken—constipation.   Her countenance  de-
 noted great exhaustion  from  inanition.   Pulse very
 much enfeebled  in volume and irritable in action, and
 small and thread-like.   Flesh  hot moist and very white;
 capillary veins full.  She Avas very impressionable and
 easily affected.   She sighed  and moaned  and looked
 hysterical.  Hyperaesthesis was very great.   Complained
 of pain  on  the left side, and  had a constant, dry, hack-
 ing  cough.   Insomnia,  apepsia and  irregularity of
 menses.   She had been sick for months  and thought
 herself dangerously ill.  Hid been confined to her bed
 for over tAvo months and  could not Avalk across the
 room.   She Avas indulged  in  every fancy.   She had no
 vitality and  no force of will.
  She Avas completely discouraged and abandoned  her-
 self to notions and  despair.  I could not find any hered-
 itary trouble, for her father and mother Avere healthy,
 strong and Avell-to-do people.
  Etiology.—I could not find any organic disease, struc-
 tural or functional; there Avas general torpidity of the
 functions of organic life, consequently the organs were
 under a  general physical debility.
  I dated her illness shortly  after the time she entered
 school.   Her retirement to close quarters  after having
 been accustomed to fresh air and exercise had something
 of an influence over her.   Her companions might have
 predisposed  her to romantic  notions, fanciful love and
 unsatisfied desires.
  The uterine functions Avere suspended on account of
 the general  debility, and nutrition  Avas similarly im-
 paired.   Her Avhole character and idiosyncrasies Avere
 those of a hysterical girl, her disease existing in the
 emotional or ganglionic system.  There  was no indica-
 cation of disease  of the absorbents.  The mental force
had lost  its equilibrium and its vigor.
  Her  mind Avas morbidly predisposed and although 
138           PROGRESSIVE MEDICINE.
she Avas not a lunatic she Avas next  door to  it, partly
through indulgence on the part of her family.  And in
summing up the objective and subjective  symptoms Ave
find  no lesion, but a general disability, a curious phe-
nomenon of abnormal condition,  and, in my judgment,
referable to mental, emotional and uterine influences.
  My prognosis Avas unfavorable because of the state of
enervation and hyperaesthesis Avith a Avant of the Avill
and disposition to succumb to morbid notions.
  Hygiene and Dietetics.—Cold Avater shoAver-baths Avith
salt.  The idea Avas to re-establish equilibrium of forces,
physical and vital, by a shock, and a number of them
continued  every  other  day.  If that should  be too
severe Ave Avould try  sheets  and  sponging.  Air, light,
cheerful company, encouraging her to leave the bed and
room.
  Diet—Beef-tea, cream, clams, mutton, birds, fish, rice,
oat-meal, eggs, lettuce,  cocoa, Avine  Avhey, or  ale.  I
forbade potatoes, corn, pies, candies, coffee and tea. Early
rising and early retiring.  In this I included change of
locality and driving out.
  Medical  Treatment.—Nutrition here Avas an alterna-
tive of great importance, for she  could  not get enough
food and nutrition to  sustain  the  economy.   Since I
arrived at the conclusion that it Avas purely  a case of
adynaemia, I  certainly had  but  to act upon that de-
cision.
  It Avas necessary to restore  as much of the subordi-
nate and indirect symptoms as the primary, for they
Avere derived from the same origin.
  Her hyperaesthesis was a natural consequence, but a
stumbling stone to carry out  certain medical treatment,
to restore calmness in place of irritability.  The folloAv-
ing Avas my first prescription as  preparatory to a more
specific one:
  #. L 'ctucaria, 1-dec. gutt.  xxx.
     Aqua distill.,         ? iii. 
      PROXIMATE CA USES OF MAL-NUTRITION.   139

  Dose—One  teaspoonful  every hour  till  quiet  and
sleep were  produced, folloAved by  strong  acidulated
drinks, and beef-tea.  In a feAv da}'s she gave signs of
improvement,  by sleeping better; cough was better and
had gained strength and cheerfulness.
  Then I recommended to her attendant physician to
give her
  #. Phosphorus, 6-dec. gutt. xii.
     Aqua distill.,          ^ ii.
  The doctor  reported  improvement  in every respect;
in a few Aveeks  she left her room and Avent  out.  For
some reason the improvement did not continue and she
Avent back to her former condition.   I believe that her
medical attendant Avas not persevering enough and that
she  indulged  again  in her  favorite diet of pies and
candies, and did not keep up a  strict hygienic and die-
tetic regimen.

                  CLINICAL CASE II.

  A maiden lady, sixty-five years old, of nervo-bilious
temperament.    She Avas an only child, and therefore
very  much indulged  and  spoiled.   Her life had been
that  of  comfort and  indulgence.   Her family Avere
Ave al thy and disposed to enjoy the good things of  the
Avorld.  They  Ave re highly cultivated people, and this
good  lady had inherited a sensitive organization and in-
creased it by her peculiar training.
  She had met Avith many a sorroAV and disappointment,
inconsequence of Avhich she became morbid and con-
stantly given to  despondency.  After the death of her
parents she became an hypochondriac and closed herself
in the house for  a long time giving admittance to no one
—even her dearest  friends.
  Physical Signs.—There Avere no indications of structural
organic troubles. Lungs sound.  Heart perceptibly ex-
cited by nervous influences.  Liver rather large and tor-
pid.  Stomach sensitive.  Kidneys healthy. Temperature 
140          PROGRESSIVE MEDICINE.
normal.   Pulse small and quick.   Well developed;
rather stout.  Light eyes and complexion.  Small frame.
Subject to borborygmus, acidity and constipation, alter-
nating with diarrhoea.
  I found her reclining on a chair Avith her feet on the
bed—one of her legs being shorter than the other.
  Semiology.—I Avas called to  see her in regard to an
injury she had received months previous, having broken
the patella  by a fall on the ice.  She Avas treated for a
transA7erse  fracture of the intertrocanteric  line  of the
femor, Avhich  Avas a mistake.  HoAvever, she complained
of inability  to  stand, Avith  pain  in the  knee  joint.
As union had taken place there Avas nothing to be done
as to her former surgical case.  She might have had an
impacted fracture  of the head of the femor, intercapsu-
lar of cause,  with  a fracture of the  patella.   But the
perfect motion of  the head, Avhich she ahvays  had, did
not denote  any such injury.   The  shortening Avas due
to retraction  of the biceps femoris and ankilosis of the
knee joint.
  I found her despondent and  hopeless ef being able to
Avalk again.  She related to me some of her great sor-
roAvs, amongst Avhich, besides  the  loss of friends, there
Avas loss of  property.  She told me in the most touch-
ing manner of her lonely life:  of having lost all her re-
lations and from affluence, beauty, social position and
brilliant  company, she was reduced  to  comparatively
scanty means amongst strangers.   There Avere indica-
tions of mental troubles.  She Avas excessively irritable,
Avept easily and became uncontrollably angry  at trifles.
She suffered indigestion and biliary accumulations with
acidities in the primae vie which  altogether  produced
flatulency, bitterish, sour eructations—borborrygmus and
at times  bilious  colic.  She Avas anaemic and asthenic,
but had vital  force enough to supply a regiment of men.
Yet she was  coAvardly as to pain.  She  Avas  very im-
aginative and suspicious.   Capricious  and constantlv 
      PROXIMA TE CA USES OF MALN U TUITION.    141

changeable.  Nothing could ever suit her longer than a
a day or two.   Constantly complaining though at times
very cheerful and amusing.  Hysterical.  She could have
felt pain in her little toe, if she only thought so.
  These seeming light symptoms are of great importance
to us, so  as to locate the origin of the  trouble.  The
process of digestion Avas generally good, considering that
she Avas devoid of motion, air, and mental activity, thus
the phenomenon of the functions of organization Avas
partly imperfect.
  In point of fact, she had a small way for the process
of decomposition, and, hence reaction could but be cur-
tailed, physico-vital forces diminished to a great degree.
  The pabulum vitae Avas slowly  decreasing as the pro-
cess of organization and re-vitalizing principles Avere so
much decreased.  The palpitation of the heart was due
to a sympathetic influence,  either from the stomach or
from mental hallucinations.
  She Avas a great sleeper and there Avas much in that that
recuperated her enfeebled economy.  And Avhile at this
point let me say that, physicians should pay attention to
rest as a principle of cure in cases of enervation.  And
the rest must be complete, for Aveeks at  a time, Avith a
Avell selected diet and bathing.
  Etiology.—Predisposing causes Avere, inheritance, edu-
cation, and enervating habits.   Excitement, indulgence,
mental troubles, and Avant  of physical motion and men-
tal  employment.  The  principal part affected was the
ganglionic system.
   Treatment.—She had been Avell directed in regard to
hygiene and diet.   The only medical treatment Avas by
means of electro-magnetism. And although the ankilosis
was much  benefited as well as her general system, jet she
set  her will against any possibility of cure, so that  I
could never persuade her to leave her position or room;
and she Avas fully able to go out in a  carriage.  I learn-
ed that the force of the  will had much  to do with her
condition.  The treatment Avas unsuccessful. 
142
PROGRESSIVE MEDICINE.
                 CLINICAL CASE III.

  A Avoman forty-five years old had been frequently sick
and Avas well knoAvn as an invalid.   She Avas  well de-
veloped, of a nervo lymphatic, or leuco phlegmatic tem-
perament.   She had two  children and Avas  surrounded
Avith sufficient comforts for her  station in life.   A wo-
man of light complexion,  blue  eyes, and a large, portly
frame.  There Avas no appearance of any  constitutional
disease.
  Her physician  asked me in consultation, as he thought
the case very serious  indeed; I  found  her  confined to
her bed.
  Semiology.—As the  patient did not complain, but of
general sickness, Avithout pointing to any special organ
the examination  was superficial, and not as thorough as
I might have liked; however enough Avas ascertained,
to shoAv that she had  an  ulceration of the  neck of the
uterus and  uterine leucorrhea.  AfterAvards  I  ascer-
tained the ulceration by physical examination.
  I found her in a room all  closed, and  there Avas an air
of the mysterious Avhich struck me as the sublime of the
ridiculous.   Her  medical attendant Avas thoroughly de-
ceived by these fanciful appearances and cautioned me
to keep very quiet.  In  truth, there Avas a consummate
piece of acting going on,  and I  made up my mind that
Ave had a fine case of  hysteria.   Her attitude, the clos-
ing and shutting of the  eyelids, the long  sighing and
her  insomnia, denoted an hysterical  condition, with
hyperesthesia of the organs of generation.
  After he asked how she Avas, she took a long sigh and
answered, " Oh Doctor! I Avas very  sick all last night.  I
believe I would have  died, if it had not been for your
medicine."   Her  general  appearance Avas that of  a
person who had not suffered  much  physically.  When
my turn came, I asked her to open her eyes and to shoAv
me her tongue, in a civil  but firm manner.   Eyes Avere
clear, and tongue white  and tremulous.   Pulse  small 
      PROXIMATE CAUSES OF MAL-NUTRITION.  143

 and sIoav, indicating a Avant of force and volume.  Urine
 very Avhite and copious, specific  gravity  natural.  She
 complained  of palpitation and distress in  the stomach.
 Food did not digest easily and she ate very little.
   Temperature Ioav and  general  debility, indicating
 sorneAvhat asthma.  There Avere no complications of the
 liver, and her boAvels Avere regular, Avhen not  confined
 to her bed.
   Mentally she Avas afflicted Avith all sorts of hallucina-
 tions.   She suffered Avith uterine and vaginal leucorrhcea
 proceeding  from  ulceration,  general debility, arising
 from her phlegmatic temperament.
   There  Avas great flatulency and  sensibility in the
 ovarian regions.   At  times  she Avas cold and chilly.
 Aphomia Avith a feeling of suffocation.  She imagined
 herself a great inAralid and thought  that she Avas going
 to die.
   She spoke in a whisper and kept the room very dark.
 She had paroxysms of fainting, Avhich frightened every-
 body present;  but the faint Avould disappear and leave
 no trace of any physical trouble.  She imagined  every
 body Avas talking about her and her  recurring sickness.
. Etiology.—This  Avoman had  been sick  more or  less
 for years, and indeed proved to be  a great trial to her
 poor husband and  friends.
  Such cases are  rather rare in the  loAver path of life.
 Hard work and practical knoAvledge of the difficulties
 and troubles of life keep many a Avoman from becoming
 hysterical and  morbid.
  I was rather perplexed to find out the  cause of this
 condition of things on account of her sphere in  life.
  Her marriage  to an  indulgent   and  good  husband
 brought about affectations and deceptions too numerous
 to mention.   A  firm, strong  Avill  on his part; or a
 sense of honor and duty on hers Avould have savTed them
 a small fortune.   As  her physician left  the place, she
 came under my care for medical treatment.   The dis- 
144
PROGRESSIVE MEDICINE.
ease Avas hysterical and located in  the  ganglionic sys-
tem.   She cried easily, and Avould be  taken  sick at a
moment's notice.  Her idiosyncrasy was a tendency to
ovaritis and uterine catarrh.
  Hygiene and Dietetics—As indolence was  one of her
characteristics, I  advised  her  to do her  own Avashing
and house-work without hiring  a Avoman  to do it for her.
She  was ordered Avalking in  the open  air and  warm
bathing.  Diet:  good  meats and bread, leaving aside
the pies and hot bread, etc.
  Medical Treatment.—I took  it upon myself  to advise
her poor husband, but I found him too  weak for such
an undertaking.
  Nothing but a  firm, kind, unflinching Avill could con-
trol and really cure  such morbid phenomena:
  #. Belladonna 3-dec gutt. xii.
     Aqua distill.       fo  iv.
  Dose—one teaspoonfnl every 2 hours.   She got bet-
ter for a feAv Aveeks, but became sick again.
  I called upon  her, found her in the  same condition,
and  gave  her the  folloAving  remedies.   Pulsatilla,  ig-
natia, changing every Aveek, although I  had no idea of
curing her.  A great misfortune, the  death  of her hus-
band, took place  tAvo years after I kneAv her, and this
added to  poverty  and a  sense of the  injury  she  had
done him, cured  her completely of all her vagaries.
  This will serve  as an example of the many disarrange-
ments of the digestive organs  produced  by  morbid  no-
tions ;  and, Avhat  is  very strange  to find, such  a perfect
case of misanthropy in a Avoman in her condition of life.
Had she been a  lady born in  affluence she could not
have presented  a better  case of hysteria produced by
the  imagination.   Plenty  of Avork, good principles,
instilled early in life, and a stern, just,  and conscientious
husband will cure most cases of hysteria.
   The ulceration and hysteria were  treated locally by
nitrate of silver, and by 
      PROXIMATE CAUSES OF MALNUTRITION.    145

  Tjc. Nux moscata 1-dec 31.
     M. chart,  xxx
also 9. Borax 3-dec 3L
     M. Chart, xxx
  #. Sepia 3-dec 3U
     M. Chart,  xxx.
  £L Moschus 3-dec gutt. xii.
     Aqua distill.,      f iv.
  These Avere  given during three  Aveeks' attendance.
She improved and got better, although she had recurring
attacks.

                  CLINICAL CASE IV.
  A young Avoman, tAventy years old, of a bilio-nervous
diathesis, dark  skin,  black hair and eyes, and  hand-
somely developed.  She Avas the mistress of a gentle-
man, and lived  a life of ease and comfort, if such can be
found in degradation and vice.   When I made my first
visit she Avas considered very ill indeed.
  Physical Examination.—I  found her in a state of un-
consciousness.   Pale and utterly lifeless.  SIoav breath-
ing.  Pulse very small  in volume and  slow  in action,
indicating a partial suspension  of the influence of the
vaso-motor nerves.   Urine she passed in  bed.   No or-
ganic trouble of the heart or lungs  could  be found.
Liver normal.   Pupil contracted.   Tongue  could  not
be examined  as her mouth Avas firmly closed.   She had
clonic spasms, Avhen she screamed, fought  and rubbed
and tore herself, unless kept  from it  by main  force.
She Avas totally unconscious.
  Semiology.—She complained  before she Avas sick of
malaise, general  debility  and Avant of  appetite.  She
Avas  found  Aveeping, angry, unreasonable, and  excited.
This Avould pass off, to return again in a  feAv days.  She
had chills and headache and great nausea.  She became
suspicious of her lover, and feared that he Avould soon
leave her; then  she would  refuse  eating, and  fainting 
146          PROGRESSIVE MEDICINE.
would occur.  Her peculiar position in life, her dissipa-
tions, and -mental and emotional  excitement,  predis-
posed her to nervous diseases.   There Avere difficulties
in making out a correct diagnosis,  oAving to the resem-
blance of malarious  poison or of  uremic  metastasis.
She  did  not  improve  for  several days; therefore I
thought it necessary to have a  consultation.
  The consulting gentleman saAv at once in it a case of
malarious poison  from  the malarious district of Nor-
folk, Va.   I did not  agree Avith him, yet I followed  his
advice.   We gave her quinine  in large doses,  because
he thought  her life Avas in peril, and because Ave both
belonged to the rational school, and must  treat the case
secundum  artem,  happen  Avhat may.   In tAventy-four
hours she Avas Avorse, and  had  not  eaten anything  for
nearly a Aveek.  Adynaemia Avas threatening.  I consid-
ered it my duty to call the attention of my colleague to
the pathognomonic symptoms of irritation of the vulva
and the partial suspension of animation, and the internal
contractile  condition of every  fibre, and the wonderful
phenomenon of life without alimentation.  I  therefore
concluded that those few salient points were the beacon
lights of unusually intensified and hysterical conditions.
He immediately assented  to my opinion and changed
our treatment accordingly.
  Etiology.—She  had lost her virtue early in life, and
had  been exposed to seditions, temptations, and vices
ever since.   Her nervo diathesis and  bilious tempera-
ment predisposed her to Ariolent paroxysms of excite-
ment, and her diseases Avere mainly of a  nervous char-
acter.  Her over-indulgence in sexual pleasures debili-
tated her, and Avas an exciting cause  of her sensitive
temperament.  In connection  Avith this, Ave must  not
forget the food and drinks, Avhich such people  indulge
in at late hours of the night.   In conclusion, her Avhole
tenor of life Avas debilitating, corrupting, and disorgan-
izing.  No  Avonder that her system became the prey of 
      PROXIMATE CAUSES OF MALNUTRITION.   147

hyperaesthenia, enervation and exhaustion.  The uterus
and ovaries were peculiarly in a state of excitability,
and  hence  hysteria.  These  numerous  evils brought
about a reflex action to the spinal nerves, medula, and
brain.
  Mediccd Treatment.—I suggested an enema  of assa-
fcetida and  a  little Castile  soap—about tAvo  ounces.
The injection Avas  retained, and after a  feAv  hours she
opened her eyes and  spoke to the attendants, asking
them Avhat had occurred.
  She  had  knoAvn  nothing for tAvo Aveeks.  She took
three injections during twenty-four hours, and beef tea,
Avhich  she digested perfectly.   She slept a good deal,
and gave signs of twitching during her sleep,  but Avould
Avake  up, take  her  nourishment, and  then  go to  sleep
again.   Her Avhole system Avas  not only exhausted, but
gave evidence  of anaemia.   On the third day Ave used
belladonna and hyosciainus, and in a Aveek's time she
was up and  about,  although very feeble and nervous.
  Hygiene and Dietetic.—Warm bathing every night,
Avith salt, hard bed, no company, and a drive  out in the
open  air.   Her alimentation Avas composed  of cocoa,
cream, eggs, oatmeal, and fruits for  breakfast.  Dinner
—roast beef, generous Avine soup, mutton, chicken, and
sago.   Evening—cream and biscuits.   She was removed
into the country, where the quiet and pure air did the
rest of the cure. 
148
PROGRESSIVE MEDICINE.
                  CHAPTER III.

GERMINATING MALARIOUS ORGANISMS  AS DEVITALIZING AND
  DISORGANIZING CAUSES OF THE FUNCTIONS OF ORGANIC
  LIFE.

  Unquestionably any floating molecules arising from
a process of fermentation and decomposition contain-
ing a living germ, and a force  of development, as soon
as they touch a fertile soil, like the human economy, the
vegetative process  begins at  once,  and proliferation
extends to an unlimited degree.
  They  reproduce  their  oAvn  kind:  be  it torula from
the vegetable ferment, or azone from animal decompo-
sition ; both are virulent, mephitic, infectious influences,
often in the form of  a vapor or gas.
  There are A-egetable  decompositions Avhose ferment
disseminate carboretted  hydrogen gas, and  others,  sul-
phureted, Avith pestilential effects.
  The  animal decomposition Avhose  ferment  is  azone,
nitrogenous gas, or  ammoniated substances, produce a
variety of diseases  differing  from the vegetable kind.
From the  typhus and typhoid to the  bilious,  gastric
fever;  from the simple  intermittent to  the congestive
pernicious  fever; from light digestive difficulties to the
utter disorganization of the process of chylification and
nutrition.
  All kinds and all forms of ailments may proceed from
such morbific  influences, yet  the origin be the  same.
Dyspepsia,  hepatic  troubles,  splenic,   enteric,  renal,
nervous scrofulous,  eruptive  zymotic.   Every variety
of physical change  is possible in malarious infections.
Neuralgia,  asthenia,  metastasis, catarrhal,  pulmonary, 
      DISEASES FROM IMPERFECT NUTRITION.   149

uterine  diseases, mal-assimilation  and nutrition  Avith
leucothemia and adynaemia.
   Many are  the  ravages  of these  morbific floating
germs, and Ave have just had the experience of the un-
fortunate South in the form of yelloAv fever.  The Pon-
tine marshes  near  Rome and  the  valley of Lombardy
are sources of as virulent effluvial  exhalations that can
be found.  The rice fields of Lombardy or the Carolinas
predispose people  to the most disorganizing  diseases.
Also excessive temperature and moisture produce mor-
bid gases and dissolution of the animal economy.
   The eruptive diseases are often the results of climeric
influences—erysipelas, scarlet fevers, small pox, measles,
eczema, etc., as also choleraic and cholera, diarrhoeas
anpl dysentery either  connected  Avith  gastro-hepatic
trouble or idiopathic.  Even the hardihood of the  peas-
antry has, sooner or later, to succumb to these morbific
influences
   In those localities on the continent, Avhere this efflu-
via prevails, Ave find that the people suffer more or less,
at certain times of the year, and Avhen the Aveather is
favorable to these exhalations, from many forms of dis-
eases of the nervous system, the lymphatics and chylo-
poietic viscera.
   A good climate, containing  exhilarating  oxygen and
good Avater, Avith the genial atmosphere of  a temperate
nature  is  productive  of longevity,  cheerfulness  and
health;  all these  are  derived from air, light, motion,
electricity and heat: People  strive to acquire Avealth
too quickly, and in their haste consume their energies,
their happiness, and even their liATes.  Hoav much bet-
ter if they should seek a genial climate Avhere the ele-
ments  are superlatively conducive  to health and com-
forts.   Elementary changes and loss of their  equilibrium
brings about the most depressing, devitalizing and dis-
organizing consequences.
  Paleness and cachexia are stamped  upon  the faces  of 
150           PROGRESSIVE MEDICINE.
the people who live  in malarious districts.  They are
proverbially melancholic, losing the cheerful part of lile,
and a shadoAV of gloom overhangs their whole existence.
  The  gastro-hepatio and intestinal secretions become
changed and give at once the alarm.  During  the war
of the  rebellion  the diseases of  the alimentary canal
Avere perfectly fearful, decimating  the  army.   (Lieu-
teria).
  The rank and file Avere all attacked  alike.  We Avere
all  subject  to the same  depressing  and  devitalizing
climatic influences and had to suffer similarly.
  Tavo  great and different  physical changes  took place
in the liver suppression and retention of the  bile.  The
mal-assimilated food brings about an acidulous  contami-
nation in  the  secretions, and hence in the blood.  The
bile being an  element extracted from the venous blood
Avas naturally abnormal: Avhat could  be expected but
crude biliary secretions. And more: Avhen physical force
has become much impaired, the functions of organic life
and vitality becomes likeAvise crippled and loAvered, and
the organization is imperfect.  In one case there may be
retention from obstruction; in the other suppression
from organic difficulty either functional or  structural.
There  are degrees in deseases of more or less intensity.
All this may be simply hepatic, or combined with trouble
in the alimentary  canal.  It may be primary idiopathic, or
secondary and symptomatic from the  digestive organs.
  In effluvial diseases the Avhole gastro-hepatic and en-
teric canal is generally  affected.   Again the spleen be-
comes emrolved and then  Ave find in the morbid ana-
tomy an increase  of  the Avhite corpuscles in  the  spleen
as Avell as in the  general circulation.   The blood there-
fore is deteriorated and the results are Avell knoAvn.

                  CLINICAL CASE I.
   During the Crimean War Ave learned Iioav very limited
Avere the good results from the rational  school of medi- 
     DISEASES FROM IMPERFECT NUTRITION.  151

 cine, and hoAV many thousand died of a Ioav form of lien-
 teria or fevers.
   During the American Avar of the rebellion,  in  Avhich
 I Avas an officer, the same diseases prevailed among the
 soldiers, and thousands died of dysentery, diarrhoeas, and
 chicahominy  fever—a species  of typhoid  abdomin-
 alis.
   The records shoAv the mortality of the American Army
 during that Avar and the utter incompetency of  the Ra-
 tional School to  compete Avith  diseases arising from
 morbific gases.
   I shall not attempt to say Avhat the laAv of  similarity
 Avould have done, but  I feel sure, that many a true allo-
 path Avill agree Avith me,  that great mischief and actual
 harm Avas done by  the routine practice of medical of-
 ficers in the field.  They used indiscriminately and most
 empirically about four favorite compounds, and this Avas
 done in the  face of  the Avell knoAvn failures of such a
 treatment.
   And these Avere the folloAving—
   p. Comp. Cathart. pills.  U. S. P. $. Camph. et. opii
 U. S.  P.  #. Blue  mass.   #. Quinia sulph.   #. Anti-
 mony.  #. Tincture catechu et creta pr.  $. Acid Tan-
 nic et chinchona etc.  I shall forbear to make any com-
 ments upon this rational proceeding.
   Physical Examination.--Mrs. K., tAventy-seven years of
 age, a German Avoman—has one child.   She was confined
 to her bed.  On examination I found her very anaemic.
 Heart  made a sound  like  that  of a belloAvs Aveak and
 irritable.   Pulse  small and  quick. Temperature Ioav
 Avith a moist skin,  inclined  to Aveakening perspiration.
 Emaciation, exhaustion, respiration short and quick, but
 no disease iiiA-olving  the lungs could be discovered. Liver
 enlarged with constipation of the boAvels.  Tympanitis,
and dropsical effusion of the loAver extremities.
  Semiology .—She complained of chilliness every after-
noon from three o'clock until five, pyrexia, the head and 
152
PROGRESSIVE MEDICINE.
face Avere hot and then a free, hot perspiration complet-
ed  the crisis.  There Avere  regular intermissions and
the signs Avere those of an intermittent  form of feArer.
She Avas taken soon after the birth of her child and it
affected her  Avhole economy most  unfavorably, being
at the time, enfeebled by the process of parturition, the
loss of blood, and all its concomitants.
  The uterus Avas enlarged  and  tender on touch.  As-
thenia  and adynaemia  Avere depicted upon every fea-
ture.   She lived in a small house, situated on low ground
and surrounded part of  the  spring and fall seasons by
water.   They lived on  greasy, innutritious  and indi-
gestible German diet.  The process of chylification was
defective.  She Avas well-formed and young, but her life
Avas gradually ebbing   aAvay.  The urine Avas  of Ioav
specific  gravity.   Pupils rather large and lifeless.
  Etiology.—Naturally  Ave Avould conclude that malaria
Avas the main spring of the disease,  yet there  are other
considerations Avhich  are  of absolute  necessity  to
observe.  1.  Her mode  of living  being unhealthy and
innutritious;  2.  Change of climate  from  her native
country to a  debilitating malarious spot in this country.
3. Mental  troubles  on  account of  her destitution;  4.
Stagnant Avater  producing an  effluvial atmosphere;  5.
Wantof knoAvledge even of the first principle of common
cleanliness.
  No wonder that disorganization,  physical and  vital,
Avere  fast ending her life.
  Hygiene and Diet.—1st. Removal from the Ioav marshy
place Avhere she Avas in  to a high sandy soil.   2d. Bath-
ing in alcoholic baths.   She Avas too weak to use the
Avet sheet.  3d. Hard bed and airy, clean room.  Diet.—
Nitrogenous, with brandy and Avater, after meals.
  Medical Treatment.—
  #. Ars. Solution, 3 dec. gutt. xxiv.
     Aqua distill., f ii. 
     DISEASES FROM IMPERFECT NUTRITION.  153

  Dose—one teaspoonful  every hour during the  inter-
mission.
  This Avas purposely given so as to break the paroxysm
of the pyrexia and the chills, which together Avith the
hygiene  and diet succeeded admirably.  I folloAved by
  $. Ferrum phosphatis 3-dec grs., xxxvi.
     M.  Chart, xvi.
  Dose—one poAvder every three hours.   I continued
the diet.  The progress of the disease Avas  checked and
a change in the quality of the iron Avas  advisable.
  #. Ferrum  Peroxidum  1 dec gr., xl.
     M.  chart xxx.
  Dose—one poAvder four times a day.   In  the course
of tAvo months the woman Avas Avell.

                   CLINICAL CASE  II.
  A young girl of nineteen summers, perfectly healthy,
became suddenly affected Avith facial paralysis.  She
did  not  give the  usual signs of neurosis either from
anaemia  or toxymia,  nevertheless  she  Avoke up  one
morning Avith a crooked mouth.
  Physical  Examination.—Pupil  normal.   No pain in
the spinal column on percussion.  Locomotion perfect.
Digestive organs  in a healthy condition.    Heart and
lungs sound.   And Avith  all these favorable signs she
was  emaciated,  anaemic  and  extraordinarily  weak.
Something  Avas  destroying  the  nervous  force  and
the  blood.   She digested food but did not  assimilate
it.   There Avas a sort of mechanical function going on
Avithout  the poAver of organization.
  Semiology.—There is a  negative  diagnosis Avhich  is
often as  important  as the symptoms usually traced out.
The absence of neuro-phlogosis objectively was remark-
able—no pain, no  heat, no swelling; only  distortion.
There Avas a tonic contraction of the muscles of the face
caused by an affection of the fifth pair of nerves.
  On further examination it Avas found that  perfect an-
asthesia  of the Avhole left side of the face existed.  No 
154          PROGRESSIVE MEDICINE.
further trouble took place;  it Avas confined to the face.
  Etioloyy.—The cause Avas  traced to  night  exposure
in the malarious regions of Jersey City.
  Hygiene and Diet.—Removal from Jersey City for a
feAv weeks into the country.    Bathing  in Avarm  salted
Avater every night.   Nitrogenous  food and good port
Avine  at dinner.
  Medical  Treatment.—Electro-magnetic  current  was
passed over the medulla oblongata and branches of the
fifth pair.   In four Aveeks she  Avas well.  She took #.
Nux vom: 3-dec ten pellets every four hours.
  The idea that miasmatic and infectious poisons pro-
duce a great number of different maladies is correct.
  And this  is  according  to experience  and  science.
The vital force is suddenly struck doAvn before the phy-
sical  force  and functions  are  affected.   These  efflu-
vial poisons demolish, as it Avere, the  correlation of the
animal  economy.   When these exhalations  are  of a
mild degree of morbidity there are lighter forms of dis-
eases.  Moisture and carburated  hydrogen   produce
catarrhal affections, bronchitis,  conjunctivitis,  catarrhal
pneumonia,  phlegmasie  of the bladder  and   kidneys
and the like.

                CLINICAL  CASES III-IV.
  Not long ago I Avas sent for to see a gentleman forty-
five years old, and  his son of about nineteen.  Both
Avere  suffering  intensely from  gastro-enteric  troubles.
They were recent cases, and  the result of night expo-
sure.
  Physical Examinations.—The  stomach and  abdomen
Ave re  inflated, and  both tender to the touch.  Urine
scanty and  deep yelloAv.   Emesis  troubled them  fre-
quently, and the properties of the matter  ejected Avere
Avatery, sour and bitter.  Evidently it contained gastric
and biliary substances.  The  faeces contained carbur-
eted hydrogen,  and at times Averc very fetid, indicating 
       DISEASES FROM IMPERFECT NUTRITION.  155

 a change into a sulphurated or nitrogenous undigested
 matter.   The  bile Avas retained, hence the  abnormal
 faeces.
   Semiology.—Although both  had nausea,  a feeling  of
 distress  and emptiness in the stomach, Avith pain in the
 small intestines, and  gas, the father's symptoms Avere
 more intensified.   He had a  febricula,  great  exhaus-
 tion, and pyrexia  of  the  cerebrum.  The  son had no
 fever, no pyrexia cerebralis, and not even the same gas-
 tric exhaustive feeling.
   They  could eat nothing, although they had  a desire
 for food.  They Avere  very Aveak; and the  tongue Avas
 slimy, and yelloAvish in the centre.  Tympanitis, bor-
 borygmus, and pain.  DroAvsiness; face pale, and eyes
 denoting general  debility.  They had from four to six
 passages of Avatery dirty faeces every three  hours.
 During the intermissions  they felt  no better, and ex-
 perienced no relief from the evacuations.
   Etiology.—They Avere exposed to  a south-east Avind,
 full of moisture and nitrogen, and  to exhalations from a
 Avet, spongy soil, Avith a growing vegetation.  It struck
 them in  the gastro-enteric regions, and the consequence
 was just Avhat is described above.   Had the vegetation
 been on its decline, the  vegetable  decay Avould haAre
 added much more poison to the air,  and both or one of
 them might ha\re had typhus or typhoid fever.   Had  it
 been a paludal soil, instead of the  rocky, the alluvial
 malaria  Avould  have struck them down Avith  gastro-
 enteric fever, typhoid,  pernicious, or  intermittent fever.
  Hygiene and Diet.—I ordered a small Avood fire in the
house, complete rest, etc.  Diet—beef  tea, a  small quan-
tity of solid food, and burnt brandy, Avith toast.  Rice,
and rice  Avater to drink.
  Medical Treatment.—
    R. Ipecac. 3-dec. grs. xxx or sj.
      M. chart, xv.
    R. Mercurius alkalizat. 3-dec. grs. xxx or sj.
    M. chart, xv. 
156
PROGRESSIVE MEDICINE.
  Dose—One poAvder every tAvo hours each.
  They  improved to  a  certain  extent;  they had, at
longer intervals, hoAvever, the same  copious  choleraic
evacuations, Avith nausea.
  On the second day I ordered to the son—
  #. Podophylum, 3-dec. grs. xxx.
  Dose—M. chart. XAr.
  #. Lycopodium,  3-dec. gutt. xii.
     Aqua distill,  f ii.
  Dose—One teaspoonful every hour during  the day,
alternately Avith the powders.
  To the father I prescribed otherAvise, for he had
someAvhat different symptoms.
  p. Byronia alba, 3-dec. 3 ii.  (vial).
     —In pellets.
  Dose—Six pellets  every hour.
  #. Mercur. alkal., 3-dec. 3 sj or xxx.
     M. chart, xx.
  Dose—One poAvder every hour  alternately with pel-
lets.
  On the fourth day I gave them
  R\ Camphor, 3-dec. pellets 3 ii. (vial).
  Dose—Ten pellets every hour or tAvo accordingly.
  I must remark here that the given podophylum to
the young man had the desired effect, i. e., it decreased
the evacuations and increased the  biliary  secretions so
that he Avas free from borborygmus and pain.  It Avas
truly homoeopathic in its  pathogenesis  and  quantity.
(See symptoms.)
  In the case of the  old gentleman I finished the treat-
ment Avith nux  vomica and arsenic in order to relieve
the great depression  of the gastric  nen*e and change
the enteric  trouble.  The, feeling of a distressing empti-
ness Avas unmistakably caused by nervous exhaustion.
  It is Avell knoAvn that exhalations have some pathogno-
monic characteristics according to the nature of the gas
afloat. The often used terms " malaria" and " infection" 
     DISEASES FROM IMPERFECT NUTRITION.  157

are synonymous Avhen applied to  a  condition of a poi-
sonous atmosphere.
  A damp, cloudy air will chill the  body by absorbing
the  heat from it.  Hot, dry  air excites pyrexia and
phlogosis,  either  general  or local, objective  or  sub-
jective.  But the hot, moist air has  the most depressing
and destructive influences of all.  From the latter Ave
have hepatic, abdominal, and  Ioav forms of disease of a
pernicious,  malignant type.  It favors yelloAv fever.
In India and South America  the  most malignant forms
of disease exist, e. g\, yellow fever, cholera, small pox,
and other  zymotic diseases.   The contrary  is to  be
found in Russia and Japan: there the diseases have a
tendency to disorganize by the sIoav asthenic  process.
The  same in Scotland,  England, the Loav Countries,
etc.  In contradiction to this Ave  observe very different
effects from mountainous, cold, dry air Avhere the oxygen
abounds and the depressing carboniferous elements are
at the minimum.
  The study of climatology is an indispensable item to
all  physicians; for the knoAvledge of the peculiarities of
certain climates give us the key to  many causes of the
diseases existing.   From  this  knowledge Ave learn
Avhether Ave  live in a stimulating or depressing atmos-
phere ; in oxygen or in carbon; in  sulphurated or  car-
burated atmosphere;  in hydrogen, or  in  mephitic
exhalations of animal decay.  This makes  us quickly
perceive the supplies needed under the various circum-
stances.
  Nothing is of greater importance than the knoAvledge
of  the food, hygiene  and clothing  necessary under  the
different vicissitudes of life.
  The highly nitrogenous diet of the English would  not
do  well with the mild climate of Italy,  or  the   hot
countries of India and South America.  The carbonifer-
ous diet of the Russians and inhabitants of Switzerland
would not answer well in the United States of America. 
158
PROGRESSIVE MEDICINE.
  I endeavour to recommend  the  law of Similarity in
hygiene—i.  e.,  cold  water in cold  countries; warm
baths in Avarm  countries.   Cold apartments  in  a  cold
climate (60 to 65) Avould be healthier  and less  danger-
ous than in  that of 75 to  80  degrees.  Generally we
accept it for granted that by keeping in the Avarmth in
Avinter and the cold in summer, Ave are  obtaining the
comforts of life, and Ave seek no further proof than  that
of our immediate satisfied sensations.
  The general disregard of the principles of the elemen-
tary science,  Avhich guides our  physical and vital forces,
and more, all our physiological organization's undoubt-
edly one of the great  causes of a large number of  pre-
mature deaths. 
PHYSICAL AND MENTAL LABOR.       159
                   CHAPTER  IV.

             PHYSICAL AND MENTAL LABOR.

  Mechanical Avork is folloAved by a reneAval of forces,
physical and vital.   Composition and decomposition go
on in a perfect reciprocal relation;  the Avaste and supply
must, in a normal condition, be even.
  The organizing  process, also, must perform  its vital-
izing functions by  assimilation,  and by it nutrition
becomes feasible and complete.
  All physicists have observed  the  immediate relation
of mechanical force  Avith physico-vital force, and that
mental activity, motion and labor are indispensable to
their groAvth.
  We find this laAv Avell illustrated in  the animals  and
vegetables.    The motion of the sap is simply physical,
because it has only to supply groAvth  or vegetable  de-
velopment.   In animals  Ave have  more—i. e., a variety
of  co-ordinate  forces and correlative  functions con-
tinuously going on for the equilibrium of the  complex
phenomena of organic life.
  Minerals possess the power of  cohesion and affinity.
There is an elementary force which is the basis of mine-
ral formations, and its constituents are also elementary.
No mineral formation could be possible Avithout elemen-
tary constituents  and force.  We receive certain sup-
plies from both, Avithout them animal life Avould  be
equally impossible.
  The velocity of light, sound and electricity is  far
more rapid than the current of the blood or that  of ner-
vous force.
  Electricity being produced by  the process of  chemi- 
16jO
PROGRESSIVE MEDICINE.
cal and elementary decomposition, the action of attrac-
tion and repulsion is the natural condition of elementary
disturbance and disintegration.
  The oxygen runs from copper  to zinc, and after the
molecules of oxygen have been  exhausted therefrom,
they are  attracted, or  rather repelled, and return to
Avhence they came, to receive  a neAV supply of oxygen,
and then are expelled by repulsion, and go back again
to the negative pole.
  The Avind moves from a balmy air into a velocity of
sixty miles an  hour; it cools the earth, it forms currents
Avhich are either cold or hot; giving us  fair Aveather,
rain or snow.  It absorbs the moisture of the earth and
carries Avith it either health or disease.   Even the sea
is  excited  by  grand storms, and large fleets are thus
carried to their destinations.
  All things move and live.  Even the force of cohesion
is a motion, produced by affinity and attraction of homo-
genous bodies.  Physical motion is found  in this  laAv—
endosmosis is a process induced by affinity and capillary
attraction; and exosmosis after the parts have received
their nutrition.   This is a general physical law.
  These  feAv  illustrations  are taken  in order to give
more force to the argument.*
  Motion then is a sine  qua non of existence.  Electro-
magnetism, positive and negative,  exists  in the mole-
cules of the human organism.   This force is static and
strictly connected Avith the other forces.  It is increased
or diminished in accordance with the others.  Motion,
light, air and  elementary electricity set them all in ac-
tion, and  devclope them to an  incredible extent.  In
this way the current of the blood, mental vigor,  physi-
cal and vital forces are stimulated  and reneAved.  But
Avhen the equilibrium of this physical combination is by
some  accidental reason lost, the physiological functions
of the animal  economy  become gradually  disarranged,
losing  the organizing force—hence inanition and decay. ' 
PHYSICAL AND MENTAL LABOR.       161
  There is a necessary uniformity of action in these for-
mative agencies, Avithout Avhich no physical laAv can be
possible, and no animal organization could be attained.
  It is then of paramount importance that activity, me-
chanical as Avell  as  physical, should be promoted as a
great element of organization and decomposition.
  Action  and reaction  cannot  Avell take  place Avithout
it;  and assimilation, nutrition, groAvth and force, must
descend step by step until the organic functions cease
altogether, or in a measure, in order to supply the gene-
ral  economy with their support.
  The principles of vital  force are static, as has been
said, in the matter itself, and they only need a momentum
in order to throAv the Avhole economy into a natural ac-
tivity and develop its resources.
  1.-Exercise mechanically the  muscular system, and
then stimulate organic activity by air, light, heat and
motion.
  2. Develop by proper occupation the mental faculties,
and the result will be health, abundant and unceasing,
and longevity.
  The  truth that elementary forces are indispensable
to  the  process of animal life is undeniable.   Physical
Avithout, vital within.  The mental force is derived from
the general physical phenomena, and is a correlation of
all  the forces.  It is a third agency, higher in its source,
differing from and greater than all the others. It might
be  said that it touches the acme of spirituality ; and its
groAvth and progress are  similar to the first principle,
i. e.  the mineral.  From a mere elementary substance,
from the  smallest nucleus, springs this  great volcanic
fountain.
  As the  highest condition of vegetable decomposition
is alcohol, a spirit, a force which  is capable of  organiz-
ing and disorganizing; so is the mind  spirit-like, the
ethereal substance of animal life.
  Let the mind remain inert and it will retrograde into 
162
PROGRESSIVE MEDICINE.
a state of sluggishness;  just as  activity Avill make it
progressive  and strong.   In  the  first instance,  it be-
comes  dwarfed and defective in every Avay.  In the lat-
ter case, by proper culture, it develops  into beautiful
harmony, and is capable of ascending to the highest pin-
nacle of glory and greatness.
  The  employment of the mind and especially the organs
of sense is a physiological condition, conducive to a high-
er development, and necessary to retain force and iden-
tity.
  The  first motion of a child is automatic, but from that
to the  first  step, the  development of both body and
mind, is marvelous.  The  first condition is  simply me-
chanical.  The first step  is  endoAved with the  force of
the Avill (mental development).
  And the next  step is  firmer  and quicker  and  the
physico-vital forces go  on  abreast Avith the  general de-
velopment of the economy.
  When the age of action arrives Ave must  obey these
laAvs in a  modified and   sensible  Avay.  From em-
ployment in the open air, Ave obtain three great agencies
Avhichare: oxygen, hydrogen and nitrogen; and from
decomposition Ave disengage, carbonic and lactic acids,
ammonia and phosphates.
  A simple,  brisk Avalk promotes organic action, assimi-
lation,  and nntrition, and by means of decomposition, or-
ganization goes on pari-passu.
  In order to demonstrate  the physical  conditions and
agencies required in the accomplishment of a thorough
physiological action, Ave have taken air, motion, light,
heat, electricity, as so many factors of life giving agents
and Avhen these are  united  Avith  the proper nutrients
and Avater, the elementary principles of life are complete.
The gastric acid and peptones become  thoroughly or-
ganized, the absorbents act promptly, and the secretions
of the chylopoeitic viscera continue their functions until
they reach the final stage of organization by  being form- 
PHYSICAL AND MENTAL LABOR.       163
 ed into blood and tissue.  LikeAvise, the secernents se-
 lect the caloriticients for the necessary process of heat
 and combustion.
   In conclusion, mechanical, elementary and vital forces
 form the great combination of physiological activity.
 But an opposite condition of things present to us another
 series of phenomena Avhich are called  pathological dis-
 eases, being the natural result of a  deviation from the
 physiological process already demonstrated.
   The terms struma, or scrofula, indicate the idea of an
 abnormal condition, of some kind, of the lymphatic sys-
 tem.  This peculiar  organization  composes  the Avhole
 glandular apparatus of the animal economy.
   All the functions of absorption  and secretion are per-
 formed  extensively by the lymphatics.   The mucus
 follicles of  the stomach and  the secreting patches of
 Payer  and  Brunner's glands are all lymphatic glands
 Avhose functions are to assimilate and vitalize albuminoids
 fats, fibrin and blood.
   There are glands in the bronchi, in the  lungs, in the
 mouth, and  under the  skin;  eA^erywhere  Ave find in
 greater or lesser degree, in number and size, a glandu-
 lar apparatus.  This  is a complex system, having the
 greatest influence upon  nutrition  and life itself.
   Motion increases lymphatic activity, absorption, se-
 cretion, and  organic  functions complete  the physical
 metamorphosis.
   The effete materials must be eliminated by the excre-
 tions and remoA^ed entirely from the system in the form
 of carbonic acids, bile, urea, phosphates, ammonia, lactic
 acids,  and sulphurated  substances.  The   elements of
 nutrition must move on  from stage to  stage; from the
 primary to the  ultimate condition of complete organiza-
 tion.  From defective nutrition we get defective forms;
 and from an imperfect protein  compound arises an ab-
normal organization, and then a cacoplastic formation
invariably takes place  in some of  the organs, often in-
festing the Avhole economy. 
164
PROGRESSIVE MEDICINE.
   Having ascertained that motion, or labor, is a physi-
 cal necessity and a paramount physiological law of organ-
 ization, Ave shall noAV study carefully and logically the
 process and results of this laAv.
   Statistics prove beyond doubt that those who live in
 the country and labor in  the fields, are generally in the
 enjoyment of better health and constitutions than those
 wdio  live in cities.  Longevity is  certainly in their fa-
 vor.  But it must not be overlooked hoAvever that other
 factors are of great  usefulness in  the general result of
 the above  statement, viz,—air, light, heat electricity;
 also simplicity of living and  regularity of habits are all
 conducive to a healthful condition.  Excitement, physi-
 cal and mental, late hours, excessive  drinking and  to-
 bacco, and rich food are predisposing and exciting causes
 to  various  diseases.  From  these sources  we trace
 sthenic and asthenic  maladies  of different  type  and
 nature; complicated, or iodiopathic, as the case may be.
 A perverted plasma and  unassimilated lymph or albu-
 minoids,  produce  lymphatic  derangements;  crude
 lymph brings about physiological  and physical abnor-
 malities like adenitis, lymphitis, tuberculosis, etc.  Phy-
 sical and mental inertia  is an abnormal condition, hav-
 ing a tendency  of  devitalizing  the forces as Avell as
 extraordinary great labor.  All  things are well  that
 are Avisely conducted; all excesses are deleterious.
  1. Every  physician has  met Avith cases that are  not
 only difficult to treat, but very often embarrassing and
 unsuccessful; these  are  generally  morbid  mental dis-
 orders.
  The hysteria prevailing among the fashionable ladies,
 and the hypochondria of the idle  man, are, surely, evi-
 dences of diseases produced  by mental inertia.  For
 these there is  only  one remedy, viz.:  Avork or occupa-
tion from morning till night.   And in speaking of occu-
pation in this sense, it is  meant as a process of cure, a
natural, logical and unfailing means ahvays to be found 
          PHYSICAL AND MENTAL LABOR.       165

in some department and  pursuit  in  life.   The  lady
Avhose education and position have  placed her beyond
the drudgeries of mere mechanical labor, could not rea-
sonably be expected to  find pleasure and health in  a
hard manual employment.
  And so, vice versa, the hard Avorking Avoman could not
folloAv an intellectual  pursuit Avith  either pleasure or
success.   The day is not far distant, hoAvever, Avhen
mental diseases (dementia cerebralis) Avill be  treated on
physiological principles;  Avhile the blistering  and bleed-
ing; the narcotics and antispasmodics, Avhich have been
so freely and unadAdsedly used by the dominant school,
will only be looked upon as barbarous practices and as
decidedly injurious.
  2. It is already thought that the laAv of similarity, in
mental diseases, is par excellence the true theory of cure.
This  laAv of similarity is  not  limited to the morbid
influence  of  medical  agents, but extends  to  physio-
logical means,  or  a  natural  mode  of cure: as music,
singing,  reading,  cheerful company;  and finally, the
influence of a strong  healthful mind upon a Aveak dere-
lict one, Avhich  is an instrumentality serving for the
stimulation of those elements Avhich require to be gently
acted upon through a mental agency.
  The said two forces, one mechanical, the  other psycho-
logical,  are indeed  intended to  be mutually  related.
"A healthy  mind in  a  healthy  body."   Labor  must
therefore be considered under two conditions: mechan-
ically as a promoter  of force and health,  and mentally
as a developing necessity to keep a mind healthy. Any
deflection from these rules is truly unphysiological and
devitalizing.

                  clinical case I.
  A young lady twenty-one years of age, of a lympho-
phlegmatic  temperament,  had  become taciturn,  and
suffered Avith general vital  depression.  There AArere no 
166         PROGRESSIVE MEDICINE.
indications of any particular physical disturbance.  Her
relatives Avere  apprehensive as to her  condition, be-
lieving  that  she Avas on the road to physical  decline.
She Avas German, and had no inheritance of cachexia of
any kind.   She Avas  suffering Avith  a  constant  nervous
cough, Avantof appetite, great prostration and insomnia.
  Physical Examination.—Irregular rhythmical move-
ments  of  the heart, entirely of a  nervous type.  No
organic  disease  could be  detected.  The  lungs Avere
evidently in a normal condition, both on auscultation and
percussion,  yet  there Avas a  mucus  rale   entirely
laryngo-bronchial:  She raised  a Avhite,  tough  mucus,
having no purulency Avith  it.
  The liver Avas torpid, kidneys sensitive, and the urine
of a light  specific gravity and color.   The triplo-phos-
phates Avere not sufficiently  eliminated, denoting a want
of physical  activity.  Her  physical development Avas
good; her stomach and boAvels  Avere  disarranged, but
Avith no pain or organic difficulty.   She Avorked in an
india-rubber factory  Avhere ventilation Avas imperfect.
  Semiology.—The patient Avas very  nervous, and suf-
fered Avith the globus hystericus.   She had lost her
appetite and did not rest at  night.
  She had lost some  flesh and energy, and became some-
what morbid, imagining all sorts of  things.   Her cough
not only disturbed her, being nervous, but  irritated the
larynx,  and kept up  agitation of the mind.  There Avas
no nausea, but great depression of mind  caused by a
general vital debility. Pulse  eighty to  the  minute,
and quite  irregular.   There Avere indications of hyper-
aesthesis Avith asthenia.  The chylopoietic viscera did
not assimilate enough food for  the needed supply, in
consequence  of which  she Avas  on the  threshhold
of anaemia.
  Her voice Avas Aveak, her ideas sIoav, and she Avould cry
at the slightest provocation, and loved to be alone. She
had no desires or morbid appetites. 
PHYSICAL AND MENTAL LABOR.       167
   She Avas an enigma, constantly complaining of a gen-
 eral  lassitude, with an irritating  and annoying cough.
 She  had flushes  of  heat,  and Avas chilly  afterwards.
 The least thing frightened  her;  and she complained of
 short breathing and palpitation.  The  digestion Avas
 sIoav, but not  abnormal  in any of its functions.  The
 biliary torpidity, Avith a partial sluggishness of organic
 action, Avas due to the general condition  of  the system.
 She  Avas too Aveak  to  Avork in the debilitating atmo-
 sphere of the factory.
   Etiology.—The three great agencies—physical, vital,
 and mental—forming the great organic functions, Avere
 temporarily disordered, and thus the entire functions of
 organization Avere partially altered.
   As I have said before,  I could not trace any constitu-
 tional defect, either inherited or acquired.  The trouble,
 undoubtedly, Avas idiopathic, symptomatic, and  Avithout
 any structural  organic disease.
   She Avas not emotional—in fact, she Avas Avholly Avant-
 ing in  this respect.   Her  affections Avere  not at  all
 involved by love or disappointment.   There Avere  no
 causes  for ambition  or  aspiration; so that there Avere
 no traces of mental predisposition.
   In going further, the suggestive  suspicion of an im-
 pure atmosphere should not be  lightly considered.
 This, Avith other predisposing conditions—such as con-
 finement in close  quarters", standing in  one position,
 hot rooms in Avinter Avith an artificial moisture (steam),
 and, again, irregular meals  and insufficient rest, turned
 the organic  functions from their normality.
   These are the only causes Avhich Ave can  account  as
 the true factors of the loss of physico-vital equilibrium.
   In  analyzing  this short etiological revieAV, Ave soon
perceive that a depressing hot atmosphere, gases  of
sulphurated  hydrogen,  and  mercurial  preparations,
Avhich are  connected Avith rubber making, croAvded
rooms and  constant  moisture, Avere quite sufficient 
168
PROGRESSIVE MEDICINE.
cause to produce a physico-vital change, by sloAvly poi-
soning the very foundation of life.
  The extraordinary surroundings Avith Avhich this girl
Avas  obliged to live Avere such,  that  disorganization
would have  taken place sooner or later in some form.
  And Ave knoAv by experience how many structural
diseases these poor factory people are subjected to in
all departments, and even under the best sanitary regu-
lations.  She had  a good  home and country air,  two
elements of  protection.
  Medical Treatment.—In this case wTant of mechanical
activity Avas not the cause, but rather a poisonous at-
mosphere Avhich pervaded her Avhole economy.   And
this Avill prove that diseases may be very similar, while
proceeding from a different origin.
  R\ Belladonna, 3-dec. gutt. xii.
     Aqua distill., f ii.,      and
  fy. Aloes 3-dec. 3 i.
     M. chart, xx.
  Dose—One teaspoonful eA-ery tAvo hours alternately;
beef  tea  and  milk,  with  brandy,  as nutrients and  easy
of digestion.  I called on the fourth day, and although
she Avas someAvhat better, the trouble Avas  still  there.
I prescribed
  li. Pulsatilla, 3-dec. gutt. xii.
     Aqua font, f iii.
  IjL Bryonia alb. 3-dec. gutt.  xii.
     Aqua distill., f ii.
  Dose—One teaspoonful every hour alternately; and
ordered rare beef, mutton, clams,  cocoa, and eggs.   On
the eighth  day I  returned and  found  her  about the
same.  I ordered the folloAving:
  ffc. Potass. Bromidi, 1-dec. 3  i.
     M. chart, xx.
  p. Ferrum phosph. 3-dec. 3  i.
      M. chart, xx.
  Dose—One poAvder every tAvo hours alternately, Avith 
          PHYSICAL AND MENTAL LABOR.       169

bathing in salt and Avater;  sherry Avine after eating.  I
continued this  treatment  for  a Aveek, at  the  end of
Avhich the cough had ceased and the secretions become
natural.  Her sleep returned, and she Avas  thus restored
to health.

                   clinical case II.
   A married lady of thirty-five years of age sent for
me in  haste desiring my  advice professionally.   She
Avas out of health and did not knoAv Avhat Avas the cause.
She Avas intelligent, had all the comforts she Avished for,
and yet her health Avas failing.
   Physical  Examination.—Her general appearance Avas
good; both lungs and heart Avere sound.   The digestion
Avas imperfect:  the secretions Avere acidulous. She had
leucorrhea.  Kidneys Avere acting  normally and the
liver Avas organically sound, but functionally disturbed,
and its  secretions abnormal.   Physically she Avas deli-
cate and lightly built.
   Semiology.—She Avas pale,  movements Avere feeble
and pulse sIoav,  irritable and  asthenic; she slept badly,
having horrible dreams.  She had  lost all  her  former
interest in domestic duties.
   She had apparently lost flesh; her strength Avas fail-
ing her; noise, or even talking Avould  annoy her.   She
suffered Avith eructations  and looseness of the  boAvels.
Chylification Avas imperfect, and the intestinal digestion
gave her a good deal of uneasiness.
   Chilliness and trembling,|and coated tongue Avith Avhite
fur.   She Avas distressed more mentally than physically.
  She relinquished all social  pleasures and  considered
herself an incurable iiiA-alid.   And  yet  all the organs
Avere structurally sound, Avith, of course, a  degree of ab-
normality in their functions alone.  There  Avas an asthe-
nic condition of  the brain threatening dementia, hallu-
cinations  or  delusions, Avith great prostration.  These
were symptoms  of a serious character. 
170
PROGRESSIVE MEDICINE
  In  examining the  case  Ave find the secretions to be
changed, and hence  tissue changes must folloAV.   Phy-
sical or rather physiological change, brought about con-
ditions of vital  disorder  which reflected an influence
upon the brain.   The physical debility from chylopoietic
disturbance had  brought  on a  mental irritability and
debility through Avant  of nutrition.  There is a great
necessity of making a correct differential diagnosis in
these complicated cases,  because that  determines the
whole treatment.  The  great variety of mental disturb-
ances and their similarity  render diagnoses difficult and
complex.
  There are simple irritabilities  from  nervous excite-
ment, with perfect nutrition ; and there are irritabilities
and  debilities, produced by  a plethoric condition  and
others by anaemia and asthenia.  In these cases the
most  skillful physician may err in judgment.
  Etiology.—We have  to  consider: 1.  inheritance; 2.
education  and  acquired  habits;  3.  constitution; 4.
mental  and emotional disposition; 5. social manner of
living;  6. organic torpidity.
  There Avas no  taint of inherited mental disease.  The
second  point  had something to do Avith her  physical
Avant of development, because of indulgence in so-called
comforts; and  this  includes the  third  point, Adz., the
constitution.  The fourth point  is a matter  of consider-
ation, as there Avas a predisposition to  mental excite-
ment and  emotional paroxysms.  The fifth Avas an
exciting cause,  and  the digestive disarrangement Avas
the physiological  and primary  cause.  These agencies
diminished  the  general tone of her system, and Avere
eminently devitalizing.
   The  education  and habits are  cither conducive to
health or disease, and those  indulged in by her Avhen  a
child fostered  a physical debility, Avhich Avas folloAved
by enfeebled functions  of organization.   This gives us, 
         PHYSICAL AND MENTAT LABOR.       171

also, the true microscopic light of the causes of mental
and emotional symptoms.
  These  two cases are at variance  as  to  the  origin of
the illness, but the symptoms  and  general effects are
very  similar ;  only the  former Avas more subject  to
treatment than the latter; and it is Avell to notice that
diseases  proceeding from indulgence  in vice are less
amenable to medical influences, and are often entirely
beyond the  scope of therapeutics.
  Here there are the antipodes.  The first case a poor
working  girl, whoso  lot had  compelled her  to  work,
knoAving no rest and no comforts.  The other, a lady of
leisure, and surrounded  by luxuries, indulging herself
in fancies,  emotions, and dreams, until her system be-
came morbidly affected;  and,  strange  to say,  the same
results, viz., mal-assimilation, irritability, inanition, and
hvperaesthesis, were in both cases strongly marked.
  And although the symptoms Avere alike, the fountain
whence they came being different, the treatment—not
only  therapeutical, but  also  hygienic and dietetic-
must be different.  The  two  cases came, as  we have
seen, from a dissimilar source; consequently, the treat-
ment must be essentially opposite.
  In  the first  instance  the  patient required merely
physical  rest, nutritious food, wines, amusements, cheer-
ful company, activity of the mind, etc., with  invigorat-
ing agents and soothing  medicines, to re-habilitate the
system to regain its physical equilibrium.
 " In the second case Ave must  look more at physical
and elementary aid than either hygienic or therapeu-
tical.  Physical motion and mental rest.  Exposure to
all weather, if avcII  protected from taking cold. Simple,
nourishing  diet, but  no stimulants.  No  amusements
appealing to the  senses;  no  social  excitement;  air,
light, work, heat, and mental quietude.  This can only be
secured in the country, and  a  permanent cure obtained
by  a long  residence  and physical  employment  there. 
172          PROGRESSIVE MEDICINE.
Forbade her all stimulants and all emotions.  The first
patient, on the contrary, required stimulants, rich diet,
and mental activity.
  In the former instance the disturbance Avas mephitic,
over-action, and poor diet; in the latter, Avant of  phys-
ical  action,  mental hallucination, morbid  desires, and
dietetic  indulgence.   In  the  first the  physical  force
Avas  OArerAvorked  and the A'ital  poisoned; in the second
the mental and emotional forces Avere intensified to the
highest degree at the expense  of the physical.
  Hygiene and Dietetics.—In this latter  case there Avas
little to suggest as to hygiene, for she bathed frequently
and  used precautions Avhich Avere Avell knoAArn to her.
Yet  there  Avere  some things that  she neglected, e. g.
early hours  and  exercise, Avhich Avere  at once recom-
mended.  Her diet Avas changed for a simple beef-soup
strained and roast beef or mutton.  Eggs, bread, cocoa,
fish,  cream,  lentils, peas, tomatoes, etc.  Potatoes and
rich  pastry, or hot bread and cakes Avere forbidden.
  She Avas ordered early hours and exercise.  She Avas
sent into the country and reported every Aveek.
  Medical  Treatment.—The  difference  betAveen  these
tAvo  cases Avas this:  one had  exhausted vitality, and
physical debility Avas brought  about by those unavoid-
able circumstances folloAving poverty,  hard labor and
insufficiency of repair;  the other Avas  exhaustion  by
those agencies Avhich produce disorganization of the
phenomena of life and of those physiological metamor-
phoses that  are indispensable to the process of vis vita3
and the pabulum vita\
  Therefore in the second  instance the folloAAring thera-
peutical treatment Avas considered necessary:
  P Pepsine 3 i.
     Acid Hydroch: gutt. xx.
     Aqua bulient z iv.
  # Lactucaria 3-dec. gutt. xxx.
     Aqua distill., f ii. 
          PHYSICAL AND MENTAL LABOR.       173

  Dose.—One tea-spoon of lactucaria every hour during
the day; and the digestive  remed}*—one tea-spoonful
before meals so as  to aid the chyme in organizing.  I
saAv the patient four days after and I Avas pleased to find
an improvement.
  I continued by giving her
  R. Pulsatilla 3-dec, gutt. xxx.
     Aqua distill., f iii.
  And pepsine the  same.
  On the tenth day I found that  she Avas doing Avell
but that insomnia and irritability existed in the brain.
  I prescribed:
  R. Phosph., 6-dec, gutt. xx.
     Aqua distill., ? ii.     And
  R. Ferrum phosph., 3-dec, 3 i.
     M. chart, xii.
  Dose.—Qne tea-spoonful of the liquid alternately Avith
the poAvders.
  I continued this treatment for ten  days longer  mak-
in0* tAventy days of medical treatment: sac Avas so much
restored  that I considered that exercise,  open air, and
complete mental rest Avould accomplish the remainder.
  Supposing I had treated this case with cathartics and
opium, or  Avith antispasmodics and stimulants?  Could
those remedies supply an exhausted constitution?  Had I
treated her symptomologically alone, Avithout the proper
knoAvledge of the pathognomonic symptoms of her dis-
ease I should have treated headaches, leucorrhoea, chil-
liness, constipation,  trembling, insomnia, ill-humor, weep-
ing, and a myriad of secondary symptoms, omitting alto-
gether the  primary causes.
  I considered it logic to supply those elementary prin-
ciples of physical force Avhich she so much needed.
  I also considered it right and proper  to supply an
ingredient that Avould help the process of chymification,
thus rendering digestion easy and perfecting assimilation.
It Avas also necessary to take into due consideration the 
   174           PROGRESSIVE MEDICINE.

   asthenic and anaemic condition of the patient as being
   the result of this general disarrangement, and supplying
   phosphorus  and iron to the devitalized corpuscles of
   the blood.  And had she continued under my treatment,
   I should have given her  magnesia, phosph., natrum
   phosph. and kali chloridi in order to  supply alkalinity
   to the plastic force.

                     CLINICAL  CASE III.
     I desire to shoAv  clinically, that Ave are all predisposed
   to diseases peculiar  to climate,  seasons, food, mode  of
   liATing,  occupation, correspondingly Avith diathesis and
^  idiosyncrasis.
     Physical Examination.—A young Avoman tAventy-eight
   years of age, of a  bilious lymphatic temperament and
   subject  to pituitous secretions, Avhich denoted a consti-
   tutional Aveakness.
     Her physical development Avas good, her lungs Avere
   sound, heart regular but feeble, radial pulse, Aveak and
   small in \rolume.  She presented an anaemic condition.
   Uterus tender on pressure, menses scanty and colorless,
   liATer tender  and enlarged, stomach painful, boAvels tym-
   panitic and kidneys irritable.   Asthenia Avas apparent
   Avith apepsia and insomnia.  Great mental depression;
   and the pallor of her face  denoted a peculiar Avant of
   vitality and  plastic force (Adynaemia).
     Semiology.—This woman Avas  a seAving  mistress and
   employed her machine  constantly.  She Avas confined
   in small quarters, and in the Avinter, in hot rooms.
     Her business required her to go out  frequently  to
   seAV for families; and she naturally found a great variety
   of cooking and food; this predisposed her to dyspeptic
   or rather digestive troubles.
     She Avas fond of coffee and tea Avhich no doubt she
   drank to excess.  Her complexion had changed from a
   bright rosy  color to a greenish yelloAv.   She became
   easily exhausted.   Her stomach felt uncomfortable and 
           PHYSICAL AND MENTAL LABOR.       175

 sensitive. She had intestinal borborysms Avith constipa-
 tion.   Gaseous eructations, sometimes acidulated, some-
 times bitterish, of a sulphurated nature or (nitrogenous)
   The papillae of her  tongue  Ave re  prominent  and
 aptheous  patches Avere seen here and there.  She suf-
 fered Avith  head-aches  and pain  in  the back; Avith
 nausea and general malaise.   Her physician (a rational
 of the old  school) employed  evacuants or  cathartic
 doses of drugs in order to remove  the crudities  in the
 intestinal  canal  or  irritating  materie-morbi,   Avhich
 treatment Avas not curative, but, on the contrary, un-
 scientific and empirical, producing a physical debility of
 the enteric organs.   He succeeded admirably in pro-
 ducing  constipation  and irritability of mucous mem-
 branes, and exhaustion of the splanchic nerves, and thus
 she was constantly prone to relapses and repetitions of
 the troubles.
   Her mental  condition  Avas  no better  than the
 physical.  She had fears and delusions of the most
 ridiculous kind.  She had nervous prostration in the
 morning.  She had no appetite or desire for any kind
 of food.  Urine Avas scanty  (specific gravity 1030) and
 had an ammoniated  sAveetish  odor, Avith foam (ferment-
 ing), and a Avhite crystalized sediment stuck to the A'essel,
 Avhich proAred to be  urate of ammonia.
   She Avas often dejected and Avept Avithout much cause.
 Her nervous system gave evidences of  great Avant  of
 nutrition and  hence force; she had  lost control of her-
 self;  her emotional senses ran aAvay, as it Avere, like a
 Avatch Avithout the balance Avheel.
   The physician in attendance, a true allopath, told her
 she had a uterine disease, Avhich umvise prognostication
 frightened the  patient into an hysterical condition.
   It is true that there Avas an hyperaemic condition of
the uterus and ovaries, as there Avas  an irritability  of
the absorbents  and acidulated secretions; but certainly
there must be  a Avide difference, I ATenture to say, be- 
176
PROGRESSIVE MEDICINE.
 tween hyperaemia and phlogosis, as betAveen irritability
 and structural diseases of the organs.
   The exaggeration of the disease and the unguarded
 diagnosis given, Avithout the least pathognomonic lesion
 to bear out the Doctor's diagnosis, produced unnecessary
 alarm, and misguided  treatment.
   The exciting cause, I must acknoAAdedge, AAras strongly
 in favor of a uterine trouble, but  it Avas surely a simple
 case  of irritability  caused by.constant treading upon
 the seAving machine, and this irritability, (from motion,)
 caused a hyperesthesia  and hyperaemia of the uterus
 and ovaries.   These  Ave re the  predisposing causes:
 Confinement, Avant of air, and stimulating, indigestible
 diet.  The  treading  on  the machine, Avas the exciting
 and most direct cause. There Avere no physical remote
 causes of inheritance.  The  etiology of  the  case Avas
 sufficient to sIioav no organic lesion.
   There Avas no  pain indicating an inflammatory con-
 dition of either  the  uterus or ovaries; there Avas no
 fever;  none  of  the   pathognomonic  signs of uterine
 perimetritis.  In  its  place  I found asthenia, a running
 down of the physico-vital forces, anaemia and  inanition
 bordering on typhoid  fever.  She Avas cold and anaemic,
 with irritability  of the kidneys, as Avell as the uterus;
 she could not stand on her feet Avithout feeling a drag-
 ging doAvn sensation of the ligaments of the uterus.
  Her food  disagreed Avith her, having evidently an en-
 feebled gastric j'uice  and peptones,  hence  a  Avant  of
 proper chymification.  Her head-aches, hepatic engorge-
ment and gastro-enteric disorder, Avere all consonant Avith
the abnormal functions of digestion.
  The lympho-phlegmatic temperament Avas a physical
fault, Avhich predisposed her to catarrhal diseases,pelvis
cellulitis, follicular leucorrhea, lienteria, follicular dyspep-
sia ;  glandular diseases, tumors, polypus, ulcerations, etc.
and tc aH forms of asthenic diseases.
  And  from what has been  said, we can,  surely, de- 
          PHYSICAL AND MENIAL LABOR.         177

tect Avith sufficient accuracy these functional, organic and
general disorders.
   I failed to appreciate the diagnosis of my learned con-
frere as all the physical and vital signs of this case Avere
those of debility, apepsia and anaemia.
   Etiology.—Summing up our case's generalities, it is, I
would venture to say, one of common occurrence anions:
the  poor seAving  Avomen of all  countries.   It is one of
those Avell authenticated abnormalities of the digestive
organs.
   In conclusion, the symptoms Avere pathognomonically
those of progressive asthenia, involving all the functions
of organic life—the blood, the correlation of forces, and
the  organic structure and functions.
   1. Irregularities in the hours of eating and  rest.   2. A
great variety of food.  3. Sedentary occupation depriving
her of physical exercise, air, light, and hence physiological
metamorphosis; the organs and  their functions remain-
ing in a semi-state of inertia.   4. Posture by bending
the  body  over the  stomach and uterus.   5.  Strong
coffee, tea and spices.  6. Constant Avorry and disappoint-
ment.   The pathological conditions therefore Avere gen-
eral or systematic, functionally organic (not structural)
and a physical  predisposition to morbid groAvths  and
pituitous  secretions  Avith hyperlymphoma, and  l}'m-
phatic diseases general^.
   Hygiene  and Dietetics.—Doctor Chambers' treatment
by tonics and alternatives Avould haAre sadly failed alone.
Similia also Avould have been of little or only temporary
help Avithout  the adjuvants of the  laAv of hygiene  and
nutrition.  The system was to be re-invigorated so  that
the recuperative power of nature  could  be re-established
on the proper principle of organic  force.  Organization
cannot be re-established by medicines alone.  It is Avell
demonstrated that dynamical forces depend upon a
unity of agencies in order to form organic life.
  I ordered Avarm salt Avater baths every other night. 
178 .         PROGRESSIVE MEDICINE.

Perfect rest  in a recumbent position and  quiet in the
room, except the cheerfulness  necessary in every sick
chamber.
  Diet:  beef-tea,  oysters,  clam  soup,  Avine  soup,
brandy Avith her food, eggs, game, etc.; all  nitrogenous
food.   And as soon  as  she  Avas able I sent her in the
country for fresh air, exercise and simple food.  Coffee
and tea Avere forbidden.
  Medical Treatment.—I consider belladonna as a great
vital  invigorator,  stimulating glandular functions  and
organic action.   I therefore prescribed
  R. Belladonna, 3-dec. gutt. xl.
     Aqua distill., f iv.
  R. Podophyl., 3-dec. 3 i.
    M. chart., xxx.
  Dose—one teaspoonful of the Belladonna  and  one
powder every hour alternately.
  I called on the third day and found her urine clearer
complexion  better, pulse fuller, and less tenderness in
the stomach, boAvels and uterus.  I continued the treat-
ment.  On  the sixth day she Avas decidedly better. I could
see the influence of the proper dietetics upon the  blood,
yet her appetite and boAvels Avere not sufficiently improv-
ing so as to keep on Avith the treatment.  Changed for
  R.  Quinia sulphas, 3-dec.  3 sj.
    M. chart., xxx.
  R.  Aloes, 3-dec 3 i.
    M. chart., xxx.
  Dose—one poAvder ever two hours alternately.   And
noAV to justify  this  prescription, I Avould  refer to the
pathogenesis of quinia  upon the liver and spleen, and
upon  the caeliac plexus of nerves and hence portal cir-
culation.  The  second, or aloes, hardly needs any  patho-
genetic explanation, for every  homoeopathic phvsician
understands  the relation of the pathogenesis of  this
drug  to hepatic  torpidity and uterus.
  The patient improved. The liver acted under the effect
                                           / 
           PHYSICAL AND MENTAL LABOR.        179

 of the above agents, and the boAvels and stomach became
 invigorated by the dynamic force imparted by the quinia.
 I consider this drug well chosen for all  diseases of the
 chylopoeitic viscera, bilious and splenic troubles,  and
 that it is  only  through the laAV of similarity that this
 great object is obtained.
   I finished the treatment Avith phosphorus and ferrum
 oxydum,  the third  trituration.  I  used,   also,  secalae
 corn, and actea racemosa, Avith hot  applications  to  the
 uterus.
   R.  Secalae corn., 3-dec. gutt. lx.
     Aqua distill., f ii.
   R. Phosph., 6-dec  gutt. lx.
     Aqua distill., f ii.
   R.  Ferrum peroxid., 3-dec. grs. lx.
   Dose—one poAvder eATery tAvo hours alternately Avith
 the secalae.
   R. Actea Racem., 1-dec gutt. lx.
     Aqua distill., f ii.
   Dose—one teaspoonful every tAvo hours alternately.

                  CLINICAL CASE IV.

   Mrs. B., age forty-five years, of a nervo-bilious temper-
 ament.  She AVas married tAvice, and  her second husband
 Avas uncongenial to her in many things.   She Avas very
 sensitive, Avith refined manners and tastes, A'ery impul-
 sive  and  had  many Avishes and illusions  ungratified.
 She had no children.   Physically she Avas lightly formed
 —black hair, dark complexion, and of  a strong  Avilful
 temperament.   She complained of having  suffered for
years Avith a bilious dyspepsia, complicated Avith renal
 and  cardiac  troubles;  she  complained also of pain in
her back, nausea, and Avas frequently nervous,  despond-
ing and fretful, Avith  paroxysms of  hysteria.   She Avas
Arery active,  and imprudent in diet—drank ale, Avhich
ahvays disagreed Avith  her.  She  had periodical  head- 
180
PROGRESSIVE MEDICINE.
 aches, and eructations of a sour, bitter taste.  She led
 a  sedentary  life, had nothing  to do, and consequently
 Avas ahvays dissatisfied.   She Avas suspicious and imag-
 inative,  very economical, and at times  irritable  and
 weak.  She considered herself an invalid and a victim
 of bad fortune.
   Physical Examination.—Lungs perfectly sound.  The
 heart Avas quick in action and small in volume.  The
 rhythmical sounds of the heart Avere  irregular.   She
 suffered  from dyspnoeas  and  cardiac agitation.  The
 stomach and  liver Avere tender on touch; the liver Avas
 also organically enlarged, and hard, and gaATe indica-
 tions of partial suppression of the biliary  secretions,
 and therefore left an impure, venous blood to circulate
 through  the  economy.    The  kidneys  Avere suffering
 from the general condition of  things  and had  been
 secreting oxalic acid crystals.   The urine  Avas dark,
 heavy, unhealthy, and strongly ammoniacal.
   Skin of a pale yelloAvish hue; eyes dull arid Avanting
 in lustre; boAvels constipated.   The nerA-ous system was
 irritable,  Aveak and  lacking both physical and  vital
 force.  Nutrition Avas evidently imperfectly carried on,
 and the great centre gave signs of mental debility and
 insomnia.  She had horrible fits of temper, despondency,
 inability to form ideas,  or  put them together, giving
 rise to the most ridiculous notions, as to all sorts of
 domestic comforts and discomforts, Avhich she succeeded
 perfectly in doing.  Loss  of appetite, great prostration,
 nausea Avith eructations of a sour, bitter taste.  Weep-
 ing  and  scolding alternately.   This examination was
 made on my second visit.
  Semiology .—It  was some  five  years  ago that I was
 called to see  this  lady  who Avas thought to  be cither
dying or insane.
  Upon entering the  room I saw at a glance that things
Avere in a condition of disorder, although  quietness ex-
isted at the time. 
PHYSICAL AND MENTAL LABOR A      181
   The patient Avas  apparently asleep and I stopped to
 get some preliminary information from  the attendants.
 It Avas  but a moment, Avhen I heard her moaning and
 moving.  In approaching her, I Avas faced by two eyes,
 not the pleasantest to behold.    They Avere Avild, angry
 and Avicked.   I took her Avrist and asked how she Avas.
 The answer Avas, " None of your business," and this Avas
 soon folloAved  by a jump and an attempted grasp at my
 throat accompanied by an oath.   I disengaged myself
 quickly from the aAvkAvard position in Avhich I so unex-
 pectedly  found  myself, and,  after  receiving  several
 kicks and blows, I retired Avith the full conviction that
 she Avas not to be trifled Avith.   Her husband laughed
 at my  discomfiture, but the  affair  soon became  too
 serious even for fun.
   It took two  strong  men  to prevent  her  from doing
 much mischief to herself but, I believe, more to us; hoAv-
 ever, she made things lively for a time,and it Avas Avon-
 derful, Avhere that little  lady found so much strength !
 During this paroxysm I could only give her  something
 in order to stop her antics and prescribed
   R. Chloralum hydratis, 3 i.
      Aqua distill., f i.
   Dose—one teaspoonful every half hour  till  better,
 then every hour, prolonging the interval.  I found that
 smaller doses than those of the dominant school Avere
 better fitted for an irritable brain.   The danger of
 chloralum is in its uncertain action upon the economy,
 and particularly upon the brain  and  the blood, having
 the  tendency to disintegrate  its corpuscles.   It  has
 been ascertained  that it not only keeps the  blood from
 coagulation, like  ammonia,  but Avould soon liquify it,
 destroying its fibrinous elements.
  The collapse produced  by chloralum is due to  a sud-
den action of the  agent upon the dynamical  forces of
the cerebrum, causing  dyspnoea, and  cardiac paralysis
with a fall  of temperature, which is a pernicious efi'ect 
182           PROGRESSIVE MEDICINE.
in the  extreme to the animal economy.  It  is, par ex-
cellence, an adynamical agent, and therefore to be used
Avith care.   Its  action  upon  the  nervous  system is
primarily on the S3"mpathetic ganglia, and afterwards it
acts upon the cerebrum and heart. On the second visit,
I made my  physical examination already given; then
she had returned to her normal condition  of mind:  the
medicine was well indicated and diminished the cere-
bral hyperaesthesia and the storm Avas over.   Nature
resumed its calmness and sleep Avas sloAvly and com-
fortably obtained.
  She  had a small pulse, yelloAv coated tongue, pain oxer
the stomach and liver, both organs being irritable.  She
had no appetite, Avas very nervous, had irritation of the
vocal cords with  aphonia, great prostration and  mental
exhaustion.   Her head Avas light and painful.
  Etiology.—She  had gastro-hepatic  trouble caused by
drinking beer and from Avhich  effect  the chylopoeitic
viscera became torpid and inactive.  She  suffered Avith
renal irritability  caused by the same beverage and, I
may safely add, liquor.
  Truly, her physical organization predisposed  her to
nervous troubles, besides being  excited by stimulants.
Nothing  could be expected from such habits but  mal-
assimilation and mal-nutrition.  Her Avhole organization
Avas disturbed, and the process of organic function Avas
partially suspended.  The  splanchnic  and ganglionic
systems  of nerves Avere very sensitive and very much
irritated.
  There  Avas a general irritability of the Avhole nervous
system as a secondary result of overstimulation.
  Other predisposing causes Avere. 1. Great indulgence
and indolence Avhen a young girl; she Avas  capricious
and AAdiimsical.   2. Indigestible food, like  pastry, cakes,
and candies Avere used Avithout the least prudence.   3.
Sedentary life and novel reading.  4. The inactivity of
the mind led her to all sorts of morbid desires and fancies,
producing depression  of mind  and  discontentment. 
PHYSICAL AND MENTAL LABOR.       183
 4. Indulgence in strong coffee and tea, and highly sea-
 soned food.
   These Avere sufficient causes to enfeeble  the best of
 constitutions, and change the nutritive process into an
 abnormal condition.
   Had this lady been born a poor country girl, obliged
 to AAork in  the  fields for her daily bread, her delicate
 constitution Avould have been  stronger  and a better
 organization Avould have been the result.
   This case shows the evidence of mal-assimilation and
 inanition as the  result of a delicate constitution, abused
 by indulgence and vice.   When the great co-ordination
 of forces  has  been disarranged, no Avonder  that the
 physical economy loses that beautiful harmony of action,
 Avithout  Avhich  there  can be neither health nor lomr
 existence.
   It is obvious that our first step is to re-establish the
 physical equilibrium in a rational manner.
   Hygiene and, Dietetics—1. It Avas necessary to remove
 the proximate causes either  predisposing or exciting.
 2. Tranquilize irritability and  excitement, thus return
 the economy into a normal uniformity  of  action.  The
 former causes could only be overcome by folloAving a hcav
 course of life :  e. g. Employment of body and mind; ex-
 ercise in the open air;  proper light  and  nourishing
 diet; and above all, total  abstinence from  stimulants.
 This mode of procedure Avould,in time, bring back phy-
 sical vigor and physiological metamorphosis.   It Avould
 also increase dynamical  forces by elementary agencies
 acting specifically upon the nutritive functions.
   The return to  a normal condition of the impaired or-
 ganic functions,  can only  be hoped  for in the proper
 conception of Avhat elements are  needed, and Iioav to
 employ an equivalent of homogeneous agents  to bring
 this desirable idea into a practical form.
  I therefore ordered leguminous and nitrogenous diet,
e.  g., beef-tea,  cream,  chicken,  light  broth, oysters, 
184
PROGRESSIVE MEDICINE.
clams, fish, eggs, vegetables, peas, beans, lettuce, toma-
toes ; a Avoiding the starchy materials.
  Bathing in salt  and tepid Avater every day.  Mental
rest, cheerful company, good books to read, etc
  Medical Treatment.—In connection Avith the hygiene
and diet, medical agents Avere chosen according to their
therapeutical and  specific action upon this morbid phe-
nomena.
  I ordered a sinapis cataplasm to be applied upon the
back and front of  the  liver, because that organ Avas in
such a state of torpidity that  I  thought it physiolo-
gically right to excite a physico-vital reaction. To this
I added simply fomentation of hot hops  steeped  in
vinegar and Avater.   This  topical  indication Avill  be
easily  understood, Avhen Ave take in consideration the
physical influence  of heat and moisture upon the hepatic
regions.   I  cannot recommend  too  strongly heat upon
the liArer  and all  glandular structures.  The remedies
giA'en Avere as folloAvs:
  R. Podophyl., pelt.  3-dec.  3 i.
    M. chart., xxx.
  R. Capsicum, 5-dec gutt. xxiv.
     Cinchona, 3-dec
     Aqua distill., f ii.
  Dose—one powder every hour  alternately with one
teaspoonful of the  liquid.
  The  pathogeny  of capsicum  is Avell knoAAm to the
profession, and  it hardly requires  any revieAv.   It is
Avell knoAvn to produce spasmodic  cough, irritation of
the throat and tonsils, burning at the stomach and stimu-
lates the genito-urinary organs.  It has a strong influence
upon  the  vagi and pneumogastric nerves, and so also
upon  the cerebro-spinal  centres.   Its extraordinary
poAver  to  control capillary circulation,  also brings
excess of blood to any given  point, or Arice-versa, it
scatters any sanguine tumefaction, congestion and stasis.
It enables the  vis medicatrice naturae to remove con°;ela- 
           PHYSICAL AND MENTAL LABOR.       185

 tions  or  congestions, reducing SAvellings  as promptly
 and as effectually as belladonna.  Its influence upon the
 nervous system in all the  derangements of the sympa-
 thetic and vasa-motor systems and upon the ganglia of
 the .lymphatics, is important and decidedly therapeu-
 tical.   The cinchona adds to it those  properties which
 it requires  as an invigorator, i. e. blending the tannic
 acid  and thus strengthening capillary contraction and
 cellular force.
   Those  tAvo ingredients I consider homogeneous and
 correlated in action.   Of podophylum, I need not assume
 any neAV  discovery in regard to its action, as  it is Avell
 knoAvn by both schools.
   She improved Avonderfully under the treatment and
 in  a feAv days had almost regained her health.
   But I thought that an exhausted nervous sysiem and
 mental force Ave re conducive  to organic hyperaemia
 and lymphatic complications.  I therefore continued
   R.  Nux vom., 3-dec. 3 i.
     M. chart., xxx.
   R.  Natrum  phosph., 6-dec 3 i.
     M. chart., xxx.
   These  agents  had  certainly specific  action  upon
 the nervous  system  both sensory and  motor)7;  be-
 sides  the natrum  has a most  useful effect  upon  the
 cliemico-physiological elements of the gastro-enteric
 juices.  In folloAving this principle I succeeded in elimin-
 ating  much that  Avas effete matter, and aided the vis-
 medicatrice of nature in all its intents and  purposes.
 She Avas also ordered A'ichy Avater—one  tumbler morn-
 ing and night, in order to act gently but surely upon
 the elementary alkalinities of the juices and blood.

                   CLINICAL CASE  V.
  Mrs.  P., a married  lady, fifty years old,  of a  bilio-
lymphatic  temperament,  predisposed to  attacks  of
phlegmasiae. 
186            PROGRESSIVE MEDICINE.
  Had dark hair,  fair skin and large blue eyes, and
although her general appearance Avas that of a strong
person, yet she had delicate fibres, very impressionable,
but of a good frame.   She had had eleven children and
her numerous conceptions had left a diminished physi-
cal and vital force.  Her predominating idiosyncrasis
Avas decidedly phlegmatic  and prone to lymphatic dis-
orders.
  Taking  in consideration the rearing of such  a  large
family she shoAved considerable strength and Avas active,
fora person of her age and temperament.  Her nervous
excitability Avas derived from debility and exhaustion of
the general economy. Her domestic duties confined her
too much  to the house  and she Avas subject to all the
annoyances of housekeeping, etc ;  otherAvise she Avould
be placid, though her stamina lacked fibrinous force.
  When I saAv her she Avas suffering with great pain in
the stomach and boAvels.  She  had been an invalid for
tAvo years  and had had the advice  of several allopathic
physicians, among the  number Doctor Saver of NeAV
York. I found her paroxysms quite serious, and threat-
ening some sort of metastasis elseAvhere.  She Avas at
times in a state of collapse, and Avas very anaemic and
emaciated—her  general  appearance  indicated  great
physical disturbance.  She Avas often in agony.
  The antispasmodics and hypnotics had been used by
the Allopaths ad nauseam, and Avere found to be rather
hurtful.   She  tried the cathartic treatment with no bet-
ter effect.  She had had all  sorts of cataplasma and
tonics with the same result.    The disease was neA-er
reached because never understood.
  Semiology.—She suffered  great  pain,  spasmodic  at
times, but ahvays  continuous from  the  epigastrium
doAvn to hepatic and  enteric regions, and in turn,  up to
the heart.
  She had emesis of  a mucous stringy slimv acid  fluid
denoting mucous and follicular trouble of the stomach ■ 
PHYSICAL AND MENTAL LABOR.       187
the gastric juice became intensely acrid and increased in
quantity, and at the same time diminished the  annual-
izing principles (or peptones).  There Avas constipation,
due to suppression of  biliary secretions;  great  eructa-
tion and flatulency. She could not digest the smallest
quantity of food, and Avhen taken she suffered intensely.
But  even Avhen fasting she suffered  Avith eructations
and  borborygmus, shoAving  that a gas Avas forming in
the intestinal canal deA'oid of alimentary material; this
Avas  an unmistakable sign of the self-production of car-
bonated hydrogen gas, resulting from a Ioav and ferment-
ing condition of a mucous accumulation in the intestines.
This inflation and  muscular irritation produced contrac-
tions and spasms.
  It is a pathological condition, that absence of bile in
the  intestines alloAvs the faeces to degenerate into  fer-
menting matter; as the bile  is  not only a physiological
condition for the peristaltic movement, but also a  sub-
stance Avhich prevents animal  decomposition.  I found
the urine dark, offensive and  of an ammoniated  char-
acter;  its specific gravity  being  1030.  Pulse small;
heart's action regular, but feeble;  cold hands and feet;
circulation  deficient  and  decarbonization  imperfect,
hence defibrinated blood; serum and Avhite  corpuscles
abounding.   At times  she Avould be apparently better,
only  to  have a return of  those dreaded  paroxysms.
The  seasons of spring  and fall predisposed her to  these
attacks.  Her habitation Avas not desirable being near
a pond  Avhich Avas supplied  by  spring Avater  from
many  sources  in  the   neighborhood.   The vegetation
Avas  luxuriant and rank,   shoAving  moisture, Avhich
constant supply Avas  a  source of poison.  It Avas a
question  Avhether  her  trouble  originated  from   ma-
lirious  effluvia, caused by  vegetable  decay and  stag-
nant  water.   She  suffered   with  pyrosis  and general
exhaustion.
  Mal-assimilation and inanition Avere  undermining  the 
188
PROGRESSIVE MEDICINE.
physical force to a fearful degree.  It Avas, therefore, of
the utmost importance to re-establish a certain amount
of nutrition, for life Avas rapidly losing its recuperative
poAver.
  This  good lady had had  her share of troubles  and
anxieties.   Her  ambition  and pride had  succumbed
often to unavoidable mortifications Avhich rendered her
miserable, and produced mental irritability.  Her  will
overtasked  the  nervous system and reflected its influ-
ence upon the ganglionic system, and agitation and  irri-
tations  Avere the  consequences.  She had  experienced
the ups and doAvns of  an eventful life, and such people
are often invalids in their old age and suffer from ener-
vation and inanition.
  Her  menstrual change had  not been Avell directed,
and it  took place under many difficulties,  and conse-
quently left her Aveak and unable to keep herself  in a
normal condition; phlogosis of different types attacked
at times one organ, and  at other times produced a com-
bination of symptoms, almost indescribable;  the head,
heart, kidneys, and sympathetic system  Avere often dis-
ordered ; and the mind and disposition Avere  becoming
depressed  and irritable.
   The  organic  functions,  and hence vitalizing forces,
Avere deficient and unable to perform  their necessary
work  in the accomplishment of  the various physiolo-
gical metamorphoses  for the sustenance of the animal
economy;  in another Avord,  Avaste  Avas greater than the
 supply.  Several factors indispensable to life were dis-
 regarded,  not only by the patient, but by the physicians,
 i. e., oxidation, motion, air and light; therefore, the re-
 sult Avas an unavoidable chemico-physiological derange-
 ment of digestion  and assimilation.  The  sympathetic
 svstem Avas superlatively involved almost to a hysterical
 degree.  Her mental functions Avere impaired,  and she
 imagined  all sorts of evils.  Here, I am sure, Ave had
 suppressed biliary difficulties from Avant of organic ac- 
PHYSICAL AND MENTAL LABOR.        189
 tion, and blood, Avhich Avas Avatery, and Avhich had be-
 come impure, and  through its medium sent poison to
 the nearest eliminating organ, the kidneys.
   Etiology.—Remote causes:  A large number of concep-
 tions, mental anxiety and hard Avork.
   Proximate causes: these Avere links folloAving the pre-
 existing conditions and aided by change of life, exhaust-
 ed vitality and ganglionic irritability.  Hyperaesthesia
 and  disorder  of the  chylo-poietic viscera interfering
 Avith the process of histogenesis.  The  dynamic func-
 tions Avere all disarranged and enfeebled.  The gastro-
 hepatic disorder, caused a mal-assimilated chyme Avhich
 being throAvn in the intestinal organs, overcharged them
 with materials of a crude nature.
   3Iedical Treatment.—There  was a great complication
 of symptoms, pathological, sympathetic and  reflex, thus
 rendering the  case most difficult  to manage.  There is
 great difficulty in finding a medical agent that Avould cor-
 respond Avith all the objectiA-e and subjective symptoms,
 and so Ave must use those that are analogous to the gene-
 ral symptoms, and specific with the pathological ones, or
 with those derived directly from the lesion.
   The danger of prescribing symptomatically in a gen-
 eric sense, is that Avhile Ave are treating mere  effects,
 Ave are apt to neglect the salient points  pathognomonic
 of the disease.   An  Allopath Avould prescribe a concoc-
 tion irrelevant and illogical, of many drugs in a pint of
 water, shake them up  Avell, and each agent must do  or
 should do, just as the classification of his materia medi-
 ca says ;  a most illusory, A-ague, and dangerous practice.
   But on  the other hand, I believe  that  a mere Baby-
lonian Symptomologist Avould  do no better than his con-
frere, the  Allopath.  This  mode  of  treatment is surely
not rational medicine.  It appears to me that something
more tangible and more trustworthy should be the great
aim of all  true physicians, than simply speculations, de-
ductions,  and  illusions.    Let us base  therefore our 
190
PROGRESSIVE MEDICINE.
symptomology on  pathology, true and real, and from
that, extend it outwards to lighter symptoms  and cor-
ralated uniformity  of action.   Does this or that remedy
correspond in greater or lesser degree Avith the patho-
logical lesion and  symptoms  of the  disease?   Does it
correspond Avith the peripheral and  sympathetic signs
and organs?  Does it cover the pathognomonic indica-
tions first, Avith the collateral  complications also?  FeAv
indeed are the remedies that are thus knoAvn.  Some
cover objective symptoms, but not the subjective and
organic ; and some are  specifically pathogenetic, caus-
ing like morbid effects upon  some organs or forces, and
others have no morbid  relation to any special organic
disease, but  have caused, perhaps, some  general dis-
turbance.
  The specificity of  drug action is all important to the
disease and the physician.  " The greater the similarity,"
says Hahnemann,  " the  greater  the  homoeopathicitv of
the remedy,"—but yet, Ave should never forget the path-
ological or morbid  relation necessary  between drugs and
diseases.  I cannot agree Avith  Dr.  W. Sharp's Organ-
opathy, for there are many organs that are only sympa-
thetically affected, the remote cause of Avhich is physico-
vital, or  which is from  the general  systems,  or  from
the great centre of nerves, or the spine, or the lesser or
greater circulation and A'ice versa.  The organs' reflex
action upon the great centres is Avell knoAvn.   We may
have an hepatic trouble  from malaria, food, nervous  in-
fluences, and habits; could Ave cure  that liver Avithout
removing the causes? and yet there might not be any
signs but those  of the liver.  We may have palpitation of
the heart from either smoking, or  drinking coffee, or
mental excitement;  Avould the heart get Avell Avithout
removing the cause? and yet  the heart is the organ
that gives us the alarming symptoms.
  Organopathy as a system of medicine is a chimera.
We must therefore prescribe  specifically and generally, 
           PHYSICAL AND MENTAL LABOR       191

 only, Ave must select the drug that has, besides general
 symptom, the characteristic morbific feature  similar to
 the disease, in preference to unmeaning generalities.
   This poor lady had a mania for an  indiscriminate use
 of Avater; irrespective of age, temperament or disease;
 and at the very first glance, any medical eye could have
 seen the  fallacy of her theory  in  her  OAvn case; for, if
 Avater  had  had the charms of cure-all,  she  certainly
 Avas a living rebuke to that statement.
   Water  cure,  as a system, is a dream of  the  past.
 As an antipyretic,Avater may be successfully used; and
 it is also efficacious in certain zymotic diseases. In this
 case Ave had:  1. To  tranquilize the irritability of the
 nervous system.   2. To  re-establish organic  functions
 and the vigor  of the nervous system and plastic  force
 of the blood.  3.  To calm mental hallucinations.  4. To
 aid  digestion and assimilation  thus  increasing the vis
 medicatnce naturae.  5.  To disengage organic engorge-
 ment from crude matters and acrimonies.
   The support of hygiene and  diet Avere not to be had,
 as she Avas a perfect physician's invalid, therefore had
 tried all sorts of diet and hygiene.  A judicious medical
 treatment Avas the only thing to rely upon.
   The medical treatment Avas adopted on the  principle
 of specific medicine : i. e., I prescribed  assafaetida injec-
 tion for  the cholichy borborysmus  thus  relieving the
 intestinal  canal  from the accumulation of  gases  and
 materie-morbi—and gave her
  R. Belladonna, 3-dec gutt. xii.
     Aqua distill., f ii.
  R. Plumbum aceti, 1-dec grs. xxiv.
     M. chart., xii.
  Dose—one teaspoonful  of the  liouid every hour, alter-
nately Avith one poAvder.
  In a few days an improvement Avas decidedly taking
place, for the paroxysms were not so frequent and  the
continuous pain and gurgling were much diminished. 
192"           PROGRESSIVE MEDICINE.
  The diet was composed of beef tea, clam broth, bar-
ley Avater, eggs, broiled mutton and stale bread. Wines
(old port or  sherry)  Avere taken  as  a beverage  after
meals.  Cocoa and black tea Avithout milk.
  On the second Aveek I found that the medical agents
had exhausted their action and that it Avas necessary to
change them for
  R. Lycopodium, 1-dec. gutt. xxiv.
     Aqua distill., ? ii.
  R. Natrum phosph., 3-dec. grs. xxiv.
     M.  chart., xii.
  j)ose—one teaspoonful of the liquid alternately Avith
a powder every tAvo hours.
  The action of these tAvo agents is general in one, and
chemico-physiological in the  other.   At times I had to
relieve her  Avith the injections, but  these were only
given at long intervals of two or three days.
  And with  these   principal symptoms of  a gastro-
enteric nature, Ave  had also  to consider the sensitive
condition of the ganglionic and  splanchnic systems of
nerves.  In  this  lady we had  also anaemia, and a ten-
dency to  the  relaxation of the  whole physico-vital
forces and from this tendency, an organic inertia and
acidolous secretions  took place.    She became so much
relieved that  the  third week  she  was able  to  sit
in  a chair for  a feAv hours at a time.  She  Avas very
nervous  and everything, no  matter  Iioav trifling, dis-
turbed her  and  felt every  sensation  affecting her
stomach and boAvels.
  Her phlegmatic temperament  predisposed her to ex-
cessive mucous  secretions, Avhich formed part of the
borborysmus, being a source of fermentation;  this is a
great symptom of Ioav vitality.  I gave her
  R. Capsicum ann., 6-dec gutt. xxx.
     Aqua distill., s h-.
  R. Pepsine, 3 iv.
     Acid hydrochl., 3 sj.
     Aqua bulient.. ? iv. 
AND PHYSICAL MENTAL LABOR.       193
  These agencies Avere for  the purpose of re-enforcing
the process of digestion and assimilation.   The capsi-
cum acted upon the vagi, pheumogastric,  par-vagum
and solar plexus; and again, acted upon the vaso-motor,
thus exciting circulation, heat, and force by its irritating
elements.   Surely the pepsine  acted  chemico-physio-
logically.
  Dose, one teaspoonful of the pepsine after eating only.
The capsicum to be taken one teaspoon every  hour.
  All these  cases of Avant of force of the organic func-
tions, are to be attributed to a special time in a woman's
life,e. g., the climeric time; before, during and after it.
And there is the whole physical economy envolved, and
anaemia is as liable to occur as asthenia.
  She continued to  improve  sloAvly but from a right
source,  viz., an increased physical force.  Lycopodium
and nux came in order on the fourth Aveek.
  On the fifth Aveek  I prescribed
  R.  Quinia sulph., 3-dec 3 i.
      M. chart.,  xxx.
  R.  Arsen. alkal., 6-dec gutt. xxx.
      Aqua distill., f iv.
  Dose__one poAvder every tAvo hours alternately  with
one teaspoonful  of the liquid.  She took this preparation
for two Aveeks  making seven Aveeks of medical  treat-
ment.  Her improvement Avas all that could be desired.
On the eighth Aveek I gave her  ferrum peroxidum and
pepsine, which  she took for a month;  varying it at in-
tervals  Avith quinia and arsenic.
  She Avas completely cured, although she  will ahvays
be a delicate Avoman.  This is the sixth year since she
was thus attacked, and she  has had no recurrence of the
malady.   After she Avas convalescent I had her in the
air  the  greater  part of the time.  These are leading
cases which demonstrate that even  the most chronic
ailments can be much  benefited by a  treatment the
basis of which stands upon logic and the true principles
of what compose life and force. 
194
PROGRESSIVE MEDICINE.
  In this treatise I have endeavored  to folloAV step by
step the  inevitable consequences of mal-assiinilation
and inanition, through physical, chemical  and vital dis-
turbances.  I have  also tried to  trace the pathogno-
monic  symptoms of the disease and its sthenic and as-
thenic  conditions;  the  hyperemia  of certain organs
and  asthenia in others.  Hyperesthesia  in  certain lo-
calities and hyperaemia in others. It'is  of  the utmost
importance to  distinguish a general  systematic disar-
rangement from a local organic, or functional one.
  These pathological conditions might be placed in the
muscular, sanguineous, or nervous  system. The disorder
may be  centric or  eccentric, ganglionic  or lymphatic
It might'become a brain disease or psychological phen-
omena  may present  themselves  in  different degrees
or phases.  And again, and more  frequently the excer-
nent system is the part that becomes disturbed and in
connection Avith the secernent the histogenetic process
becomes dangerously impaired.
   The  tripods  of  life  are  dependent  upon a tripod
principle, i. e., physical, chemical and vital, and these
principles become deteriorated by mal-assimilation, in-
anition and  decay; or else  they  produce  sanguineous
metastasis,  phlogosis,  heteroplastic, hyperplastic  or
caco-plastic  disorders, Avhich are  maladies of far  more
dangerous character, threatening a perversion of plastic
organization, hence incurable diseases.
   And  more,  the  proteine  compound,  of fibrin,  albu-
men, and gelatin, once it becomes abnormal, the higher
growth and development is prevented or perverted, and
if  proliferation takes place, the very germ of the cel-
lular arrangement is, as it were, disseminating diseased
tissue.   Perfect organization  of  the elements  of nu-
trition is a sine-qua-non condition of the principles of
life, whence all  the  dynamic forces are  continually
reproduced  and  kept  in a  physical   state of  equi-
librium.   And  at  this  very point the  truth of  some 
           PHYSICAL AND MENTAL LABOR.       195

 great French medical observers is strikingly apparent,
 viz., that tuberculosis, catarrhal consumption, cancerous
 disorganizations, and many other similar anomalies, are
 the offsprings of a  protoplastic perversion Avhich ends
 in  hetero-plastic formations.  These abnormalities are
 not exclusively congenital, for they are often acquired
 by many and  various  causes, and surely mal-nutrition
 must be at the topmost, proceeding  from Avhate\Ter ex-
 citing or predisposing cause, remote or proximate.  I
 do not mean at the same time to undervalue  diathesis
 and congenital inheritance, but I am decidedly of the
 opinion  that  the  majority of diseases are  acquired
 either by exposures, confinements, occupations, effluvia,
 or traumatic causes.  If the process of  reproduction is
 not adequate  to the Avaste, or does not supply the ele-
 ments required, nutrition must be  at a loss, and the
 great phenomenon  of life in peril.   The vis-vitae and
 nisus  formations go through  a pathological metamor-
 phosis, and hence disease.
  From these axioms, as established principles, Ave must
 rationally accept, that, the true and  best therapeutics
 are based upon the elementary principles or formation
 of a perfect plastic matter; and to bring about a physical
 or physiological change, Ave must adopt those means of
 Avhich nature  is in need, and by Avhich the vegetative
 process of life is kept up.  Are Ave not to derive more
 hope from such a  natural source, than  from artificial
 agents Avliich are often uncertain  in their  influences,
 and oftener too superficially knoAvn for their direct thera-
 peutical effects.  The lymphatic system is the  process
 of physical development (tissue-making) from an  histo-
 genetic principle, the  materials of Avhich are  albumi-
 noids and  amyloids, these  must be  in  an  acceptable
 condition;  in other Avords, they must  be thoroughly
 assimilated for further organization by  the  lymphatic
vessels;  but Avhen, as  often happens,  in  diseases of
the digestive organs, such an assimilation is  not per- 
196          PROGRESSIVE MEDICINE.
 feet, either of the  nitrogenous nutrients or the  albu-
 minous,  Avhat  is   the   logical  conclusion ?   Three
 pathological  conditions   may  arise, \'iz.,  adynaemia,
 hetero-plastic formations  or  asthenia, and  these  may
 produce a variety of diseases:  malignant or not. Malig-
 nant,  organic, functional,  general  or systemic ;  also,
 leucothemia,  struma,  exanthem,  arthritis ;  hepatic
 troubles  and  consumption;  portal  engorgements;
 atrophies  and  hypertrophies;  neuralgic  and  renal
 diseases.   Scrofula,  spuria  or A'cra, and zymotic disor-
 ganizations.
   I often observed  that  phthisis proceeded from dys-
 crasia  in the blood, the result of mal-assimilation of the
 albuminoids  or nitrogenous  nutrients,  and this  takes
 place from lymphatic Aveakness or defective digestion;
 thus devitalizing the quality of the animal nutrition.
 The blennorhagies, pulmonic or  intestinal, tabes-messen-
 terica, gastrosities,  apepsia, adenitis and cretenismus
 originate frequently from the  above source.
   The ductus aquosi of the old Avriters conveys precisely
 the idea of obstructed channels, thus rendering absorp-
 tion defective and nutrition impeded; these lymphatic
 vessels pervade the  Avhole economy, and Ave can readily
 imagine  the results Avhen  such physical arrangements
 are disordered.
   Therapeutics  is  at  a  loss in  these  chronic  and
 constitutional cases, for  they require much time and
 acumen for the  process  of restoration.   The  first in-
 tention should be to ameliorate  the most salient difficul-
 ties and strengthen the  lymphatic  system ;  correct
 crudities and Avaste of animal  vigor and  pacify nerA-ous
 irritabilities or mental agitation.
   Then forAvard  to  a radical treatment  on the  basis
already described.
   I deem it desirable noAV to bring fonvard  a different
class of cases Avhich Avill demonstrate practically the
result of lymphatic diseases, inherited and acquired, and 
           PHYSICAL AND MENTAL LABOR.       197

 the predisposing and exciting causes, remote as Avell as
 proximate.

                   CLINICAL CASE VI.
   During the year 1869 I AATas called to see a lady thirty
 years of  age, Avhose  life had been mostly passed  in the
 country upon her father's farm.  Her domestic life  had
 not been a  happy one on account of family differences
 Avith a cross step-mother.
   She Avas very sensitive and high-minded, Avith a pur-
 ity of heart seldom found.   She Avas raised  among  the
 hills of Ohio, and it had not been her lot to come in con-
 tact Avith the hardships  and corruptions of the Avorld.
 Her step-mother Avas the reATerse:  she Avas a smart,  cal-
 culating, intriguing Avoman, Avhose heart and soul Avere
 devoted  to  one ideal son.   She  became harsh  to  the
 poor girl's father, Avhich Avas a great source of grief and
 productive of family-quarrels between them.
   These irritating circumstances Avere indeed preparing
 the  Avay  to  some  physical complications, as  it  finally
 proved.  Some  fifteen years before I saAv her, she took
 Avhat she called a cold, and Avas sick Avith an attack of
 pleuro-pneumonia resulting from it.   She had a very
 fair complexion—rosy cheeks, prominent  lips, light blue
 eyes, large head, and a  small  frame.  She had ahvays
 been  delicate,  and eminently  a small eater,  Avhich is
 rather unusual Avith diealthy country people.
   Physical Examination.—Her chest looked contracted,
 respiration 28 to 30 to  the minute,  temperature 100;
 pulse  110 to 120,  On percussion, I  found dullness  in
 both the  loAver half of the lungs Avith actual  tubercular
 infiltration.   She breathed only Avith the upper third of
 the lungs.  Auscultation  discovered  bronchial mucous
 rales, extending  doAvn to the smaller branches, the  bron-
 chioles.   The   bronco-pneumonic  difficulty gradually
increased. I also found  a cavernous  sound about the
lower half of the right lung Avhere the tubercles  were
breaking doAvn. 
198           PROGRESSIVE MEDICINE.

  The voice Avas tremulous, (aegophony) Avith a mucous-
ronchus audible even  at the  outside.  She coughed in-
cessanth', and the expectoration Avas of a muco-purulent
character.   She  suffered Avith night sAveats  and turned
against food.
  Her pulse  increased  from  ten  to  fifteen degrees
every afternoon, Avith full pyrexia,profuse perspiration,
and  increased cough.  She Avas much flushed and pros-
trated.   These paroxysms Avould  last till ten o'clock p.
m., and the temperature and pulse Avould return almost
to their normal condition about three o'clock in the morn-
ing, and  remain so till about  12 in., Avhen a certain  cli-
max had arrived, and both temperature and pulse Avould
rise again.
   Semiology.—The symptoms of consumption have been
so ably  described by those avIio have made  a specialty
of lung  diseases, that any attempt of mine  for such a
purpose Avould be futile and  pedantic.  She had regu-
lar evacuations of the boAvels, regular menstruation and
pain  in  the chest and insomnia.   She  improved in the
spring and during the summer months,  but the same
condition of things returned again, as soon as the ther-
mal temperature changed.  The idiosyncrasies of the
case  Avere:  1.   Infiltration  of the loAver half of the
lungs Avhich Avas  never extended above that line.   2.
A vomica, Avhich did not appear to increase  in size.   3.
Regularity of menstruation  to Avithin three Aveeks  of
her  death and natural evacuation  of  the  boAvels.   4.
The regular pyrexia and length of the disease being of
fifteen years  standing.  Her  mental faculties,  Avhich
Avere clear and good to the last, only gave evidence  of
slight delirium during the febrile  state.
  Etiology.—The causes Avere both  inherited and  ac-
quired.   Her  lymphatic diathesis predisposed her to
blennorhagia and  subacute hyperemia and  metastasis
of the glandular system.  Her unfortunate domestic
troubles  acted as an exciting cause; and an irritability 
          PHYSICAL AND MENTAL LABOR.       199

of the nervous  system  increased  ten-fold the hyper-
aemic predisposition of lung tissue.
  It is clearly perceptible that it Avas a case of hetero-
lymphoma Avith caco-plastic deposits in lungs; it Avas a
disease of the lymphatic vessels and glands, Avhich dis-
seminated its  acrimony to the lymph, hence  impure
blood, devoid of fibrin and containing an  excess of se-
rum and crude Avhite corpuscles.
  Medical Treatment.—It Avas  necessarily  symptomatic
and palliative.   I used lactuca Avith  some advantage,
and calcarea caustica to diminish the  excessive expec-
torations.
  Phosphate of arsenic Avas given  Avith much benefit ;
and also the liquor-potass-arsenicalis of the old school
in minute doses, viz., 6-dec one drop  to a teaspoonful,
to be taken every two hours.   Sponging  Avith salt and
Avater morning and night.
  I  used senegar,  tincture of  prunis virginiana, Avith
some benefit.   Belladonna and aconite  Avere  frequently
given during the pyrexia.
  She died, after a long illness, in peace and Avithout pain.

                  CLINICAL CASE VII.
  A young lady, tAventy-nine years old, of slight frame,
light complexion, and of a nervo-lymphatic  diathesis,
Avas obliged to work in a factory (India-rubber).
  She had blue  eyes, light hair and fair skin.    She did
not have  the pathogonmomic symptoms of struma, yet
she Avas of a delicate fibre and lacked-physical  and vi-
tal vigor.
  Her blood  Avas thin, and  her Avhole  constitution de-
noted a tendency to emaciation and adynaemia and lym-
phatic Aveakness.   She had  pronounced indications  of
consumption.  The  greater part of her life had  been
passed in the factory, Avhich Avas very close, Avhere the
air Avas mephitic Avith an accumulation of gases destruc-
tive to the animal economy. 
200          PROGRESSIVE MEDICINE.
  The nutrition Avas  defective caused  by a poor  diet.
Her business prevented her from taking  that exercise
so  necessary  to  the  process  of  re-organization  and
thorough decomposition.   Assimilation Avas imperfect
and the recuperative poAver of nature Avas  gradually on
the  decline.   No  Avonder that a principle of disorgani-
zation Avas implanted in her system.
  Physical Examination.—Chest  small  but regular in
shape; there Avas no depression visible.   Breathing ac-
celerated to 40 a minute.  Pulse 101 to  102.  Tempera-
ture high 99.^- under the axilla.
  On percussion I found dullness over both lungs, es-
pecially so over the right.  Auscultation revealed bron-
chial respiration  Avith  crepitant  rales,  and  decided
hepatization over the Avhole right lung, and tAvo-thirds
of the left-
  There Avas no sonorus-ronchus or vomica.  The voice
Avas feeble and metallic, rebounding against the  hard
tubercular surface  of the  lungs.   Expiration  difficult
and quick, having no volume of air to eject  and a very
little diaphragmatic force  to contract upon the chest,
in order to expel Avhat little air there Avas.   There were
Avheezing sounds  here  and   there.    Egophony  Avas
clearly perceptible.   Heart quick and feeble in action.
Liver sound and kidneys normal.  Skin moist Avith a sour
smell.   Offensh^e breath.  Pain on percussion.   Tongue
tremulous and Avhite.  Nails inverted.   Hands hot and
emaciated.
  Semiology.—Cough dry, and after  Avith  a great effort
she Avould raise a hard ropy mucous Avith a hard nucleus.
It Avas undoubtedly a glandular secretion looking like
crude albumen.  Under the microscope  I discovered
many nucleoli  of lymphatic  cells.   She  suffered  Avith
apepsia, insomnia, night SAveats and  constipation.   Her
menses  ceased.  Hyperaesthesis,  and  asthenia  Avere
prominent features of her temperament. Her mind Avas
constantly preoccupied Avith the  idea that she Avas be^- 
PHYSICAL AND MENTAL LABOR.        201
yond cure.  She had had a terrible love-disappointment
which preyed upon her mind constantly.
  The signs Avere unfavorable indeed, and the prognosis
could not be hopeful.  The Avhole physical economy AATas
sloAvly becoming Aveaker and inanition Avas  impending.
  She lacked not only physical force but vital and men-
tal, therefore I  Avas sure the case Avould end fatally and
to that  effect I gaA"e my undisguised opinion.   Diges-
tion and assimilation Avere disordered so that the pro-
teine compound Avas defective in quality and quantity,
and. consequently  the process of histogenesis Avas im-
perfect, reducing the system in force and development.
  Etiology.—The  predisposing  and proximate causes
Avere inheritance, poor diet, ovenvork in close, unhealthy
atmospheres, and physical inactivity in the pure air.
  The  exciting and remote causes Avere asfolloAvs: 1.
Inability in aiding the great process and metamorphosis
of decomposition and  re-organization;  this  alone Avas a
radical defect in the vegetative  Avork, hence adynaemia.
2. Mental excitability and unsatisfied desires.  3. Want
of proper bathing and disregard of exposure.   These
numerous physical deteriorations  increased to  a con-
siderable extent her liability to pulmonic consumption.
Atrophia and hetero-plastic lymphoma Avere the results
of an inherited and induced defective chylification and
hence histogenetic difficulty.
  Hygiene and Dietetics.—The case Avas too far advanced
and the pathological condition of the lungs  too Avell set
in to hope much  from any treatment.  I prescribed
bathing  in alumina baths, thus diminishing capillary
congestion and reducing  both temperature and night
SAveats.   The diet Avas generous—composed of beef tea,
clam  broth,  eggs, wine and eggs;  wine  soup, beef
steak, roast beef, birds—in fact mostly nitrogenous food.
Cream,  fruits and nitrogenous vegetables.   A hard bed
and driving in the country.
  Medical Treatment.—\\T hat shall  we  hope from our 
202
PROGRESSIVE MEDICINE.
 materia medica  in  these  desperate cases ?  I  Avish I
 could say much or even  considerable, but I regret to
 say that little can be expected, although much benefit
 and comfort can be  given  to the patient.
   R. Calc phosphorica, 3-dec.  3 i.
      M. chart., xxx.
   R. Senega, 1-dec. 3 sj.
      Aqua distill.,  f ii.
   Dose—one poAvder every hour alternately with a tea-
 spoonful  of the  liquid.  The cough diminished in fre-
 quency.   The  expectorations  Avere  less tenacious or
 ropy and more fluid.   There Avas a diminished disinteg-
 ration of  the nucleoli of  the  lymphatic glands.   The
 hygienic, dietetic, and medical  treatment all combined,
 Ave re conducive to a general improvement, but none the
 less the progress of the disease Avas checked to no ap-
 preciable  extent.   I gave her kali  arsenicalis, Bella-
 donna, Bromine, iodine, cod liver oil andBarita carbonica,
 phosphorus, etc.  But AA'ith the exception of temporary
 improvement  the patient  gradually greAv feebler  until
 her miserable existence ended.   I must say that she had
 the usual afternoon and  night pyrexia  Avhich  caused
 insominia.  The lactuca, belladonna and aconite relieAred
 all those symptoms.  And especially in this case, she being
 so young.   I am strongly inclined to believe that if she
 had been  raised in the country and  witli light  field
 Avork, early  hours, simple  good  diet, quietude of mind
 the probabilities Avould haA-e been an entire re-invigora-
 tion of the recuperative and plastic forces, hence more
 development and the atrophia lymphatica corrected to
 a great extent.

                 CLINICAL  CASE A'TII.
   Mrs. L., of Gambier, Ohio, forty-three  years  old, of
lympho-phlegmatic diathesis.
   She was large in  frame, had blue eyes, white skin,
large mouth and thick lips.  Blue  veins  Avere  visible 
          PHYSICAL AND MENTAL LABOR.       203

under  the delicate  skin.   She Avas \Tery  intelligent,
good natured and of a strong Avill.
  She  married late in life and  had no issue.  She had
been an invalid for many years and tried a great many
physicians Avith but little relief.
  Her general appearance Avas  good and strong, yet she
suffered  Avith cough,  night sweats, pain in the  chest
and general  exhaustion.  Her ambition and industry
Avere unbounded.  She lived Avell and had the comforts
of a home.
  The climate at Gambier is moist and changeable and
her life Avas very retired and devoid of air and motion.
All her Avork Avas in  close rooms, comprising domestic
duties.
  Physical Examination.—Her chest Avas avcII developed
and considerable  volume of  air seemed  to enter, yet on
long inspiration the lungs did  not  take up the normal
quantity of air that such an exertion Avould naturally
suggest, and  the  expansion of the chest seemed insuffi-
cient.   There Avas no diaphragmatic  respiration, but
prolonged expiration, as though the air inspired could
not easily be removed.
  Auscultation revealed moist crepitous ronchus over'the
bronchia  and bronchioles, Avhile over  the  rest  of the
lungs there Avas aegophony; the voice rebounding back
and a  sibilant sound Avas heard here and there, Avhich
are sure signs of  hard hepatization.  I  found this con-
dition particularly in the right lung, on  its upper third.
This indicated bronchial respiration.  There Avas also a
cavernous sound  in  one  spot, but I could not discover
any gurgling noise.   The loAver lobes Avere  hepatized.
On percussion, I found dullness under the axillae all the
Avay down to  the apices.   Supra-clavicular  dulness—
over  the  clavicle and over the upper lobes no  real
hepatization  could be discoA'ered,  yet there Avas  a
muffled sound not reassuring.
  There Avas  much bronchial expectoration of clear mu- 
204          PROGRESSIVE MEDICINE.

cous Avitti, at  times, a nucleus  of hard gray tubercu-
lar-looking substance in  the centre  of the expecto-
rated matter.   On  microscopic examination  I found
these little  hard  substances  to be a mal-assimilated
fibrino-nuclieted  lymphatic  granules,  leading  me to
believe strongly in their  proliferation by contact thus
disorganizing the  lung tissue and  glandular arrange-
ments.
  The temperature of the lungs Avas 99g.  Pulse, during
the afternoon,  Avas 112  to  120 and  hands and  feet
burning hot.  Her finger  nails  Avere turned iiiAvardly.
Heart sound; liver in good  condition,  kidneys normal.
Her digestive organs Avere in a state of perfect  torpid-
ity.  Night SAveats and arterial hemorrhage.
  Semiology.—I found her Avith a  dry hacking  cough
Avhich, by much exertion, brought about large bronchial
yelloAvish mucous  expectoration. This effort exhausted
her  very much.  She  Avas suffering  Avith apepsia, in-
somnia and  apyrexia from early in the  afternoon  till
midnight, Avhen she found some rest.  Great  mental dis-
turbance causing dreams and seeing all sorts of spectres.
Assimilation difficult, circulation  feeble; blood thin and
Avatery.   Her idiosyncrasis  Avas  hyper-lymphoma or
mal-assimilated albuminoids.   Menstruation regular at
times, and at others abundant and  painful.  At times
she suffered Avith  complete aphonia  for days, and it un-
doubtedly proceeded from great nervous debility of the
pneumogastric and pharengeal plexus.  The hemorrh-
ages Avere often serious and  enfeebling  vitality, Avhich
she  needed  to  a  great degree.  With  all these un-
pleasant prospects she Avas rather cheerful and kept up
a Avondcrful amount of courage.
  Etiology.—Inheritance and  crude  lymph.   Exciting
causes Avere only confinement to  the house.   No other
difficulty could be  traced than Avant of motion  and de-
composition.
  Jfcdicul Treatment.— The laws of dietetics and hygiene 
PHYSICAL AND  MENTAL LABOR.      205
as  re-invigorating and vitalizing elements  Avere  Avell
knoAvn to her and she had adhered to them faithfully.
  I have  no doubt  that  the  highly nitrogenized  food
and the  liquor diminished  the  progress of  decay and
kept up as it Avere an artificial force, and thus she Avas
under  the restorative principles of life,  minus a feAv
other agencies, which if they  had been employed earl}T,
organization Avould   have been  fully  established and
strengthened.   Air,  out-door exercise, and mechanical
labor in the garden AArould have  brought about results
of vitalization that no other means supply.
  The medical part of the treatment Avas palliative, for
it hardly  could be called curative in that stage of the
disease.
  R.  Calc. phosphorica, Ferrum  peroxidum, Liquor
potass.,  Arsenicalis,  Secalae  cornuta,  Natrum  phos-
phoricum, Senega, Prunis virginiana, Lactucaria, Phos-
phorus.
  Inhalations of carbolated lime, stopped the excessive
secretions.   I finally succeeded in  sending  her to St.
Diego, Cal., Avhere she could  enjoy  the  benefit  of  that
beautiful and thermal climate.
  AfeAv months after she reached her place  of destina-
tion I heard  tnat  she had improved Avonderfully  that
she had  groAvn  stout, coughed little and Avas generally
invigorated.

                  CLINICAL CASE  IX.

  A young man, thirty-one years old, of a delicate phys-
ical  development, Avhose  occupation Avas  packing and
drying tobacco in a  snuff factory, Avhere that material
Avas constantly  afloat and therefore inspired through
the nose  and lungs.   He sent  to consult me for a severe
sore throat.
  His  general appearance  presented at once  that  of
long physical suffering  and  complicated  disease.   He
had blue eyes, light complexion, and  Avas of a  nervo-lym- 
 206           PROGRESSIVE MEDICINE.

 phatic temperament, hence predisposed to those ailments
 of Emphatic constitutions.
   I found him lying in bed, Aveak and prostrated, suffer-
 ing from aphonia and night sweats; small, quick  pulse
 and general physical debility indicating vital disarrange-
 ment.
   Physical Examination.—There Avas nothing irregular
 in his physical construction; respiration regular, though
 too frequent (22 to the minute).  He Avas  greatly ema-
 ciated and feeble.  On auscultation I found respiration
 and expiration natural and no abnormal sounds percep-
 tible.  Percussion  did not  reATeal any pain or dullness.
 I could not discover any pathognomonic signs of phthisis
 either incipient or chronic  The heart's  action Avas
 quick and regular, but Avanting Arolume and firmness.
 His boAvels Avere constipated; liver inactiA'e  but not
 enlarged.  Stomach seemed to perform its  functions
 naturally; appetite capricious, a desire for coarse  food,
 like fried ham and potatoes.
   Semiology.—Ho  coughed  constantly  at night, and
 could get no sleep.  He said, "Oh!  Doctor: if I  could
 only sleep! "   He did not knoAv his condition; he thought
 it Avas simply a difficulty of the throat Avhich could easily
 be overcome.  He Avas a  poor man, and lh^ed in badly
 ventilated rooms, croAvded Avith  dirty children.   His
 food had ahvays been of an inferior quality and miserably
 cooked.  His ignorance of the proper rules of living and
 hygiene exposed him to discomforts and physical suffer-
 ing.  Undoubtedly his occupation Avas conducive to dis-
 organization of the respirator}' apparatus.
  I found him  expectorating  a large quantity of  ropy
mucous, containing  solid mucous membranes, Avhich had
the appearance of having been detached  by ulceration.
The urine Avas high in specific gravity and did  not con-
tain the usual amount of phosphates.  Hyperemia, Avith
a hot, burning skin.  Great thirst and a constant scrap-
ing of the throat.  His difficulty commenced a year or 
          PHYSICAL AND MENTAL LABOR.       207

so before and he had had some medical treatment from
the Allopathic school, Avhich he described as nauseous
and disturbing his stomach.
   Cod-liver oil and Avhiskey Avere also given, but Avith
no apparent  benefit.   He  continued  to Avork in the
snuff factory until  his  strength Avould alloAv him to do
so no longer.  No  regular diet Avas prescribed nor hy-
gienic rules; he Avas left to his sad fate.   His voice Avas
changed into  a hoarseness, mixed Avith some  sybillant
notes, strongly indicating a changed physical condition
of the larynx—he felt a lassitude Avhich denoted a deep
seated disease.
   The larynx, on examination  Avith the laryngoscope,
Avas  found Avith spots of ulceration through the mucous
coat, extending doAvn to the trachea, and perhaps  doAvn
even to the biforcation of the bronchi.   There Avere no
signs of tuberculosis in the lungs, though I suspected
such condition in the trachea and larynx.
   Etiology.—I could learn nothing of his inheritance, as
throAving any light upon the diagnosis of the case.  His
parents Avere all dead, and according to his account, died
young and not of consumption.   But as usual, Ave are
sadly disappointed if Ave place much reliance on  such
desultory accounts, for  they are generally disconnected
and  unsatisfactory.  It Avas  sufficiently  eA-ident  that
they Avere poor and belonged to that unfortunate class,
the loAvest strata of the human family, full of vices and
ignorance ; improvident and neglectful of the first princi-
ples  of life and its requirements.
  These  people leave the seed of their vices to their
offspring, there to  groAV and develop.  Unless  these
poor children of misfortune are removed early  in life to
salubrious climates  and better modes  of living, and
raised by education to understand  the importance  of
proper attention to the  rules of life, they are apt to die
youn0, Avith  sdme  discrasia implanted  by their  fore-
fathers and developed by their neglect. 
208          PROGRESSIVE MEDICINE.
   In this case, I should express my conviction that both
 inheritance and occupation Avere the tAvo principal fac-
 tors Avhich prepared the foundation of this pathological
 condition.  And besides, Ave had the  exciting causes  of
 poverty, Avant of hygiene, exposure, ovenvork and bad
 and  improperly  prepared  food.   We  could  classify
 these cases together Avith consumption, lymphoma, ra-
 chitis and scrofula in all their varieties and forms.
   Treatment.—In these cases of physico-vital disorgani-
 zation all authorities have found that our art is deprived
 of those very elements  upon Avhich Ave can build Avith
 any hope  of success. The  material  necessary to Avork
 Avith is  not any longer to be found or trusted.  The  or-
 ganizing principle being once  vitiated, the correlation
 of the physico-vital forces is impossible.
   I  prescribed baths of iodide  of potassium Avhich had
 the  beneficial effect of  stopping the night SAveats and
 the excessive expectoration—and besides I ordered:
   R. Kali  causticum, 6-dec gutt. xxiv.
      Aqua distill. * iv.
   Dose.—One teaspoonful every tAvo hours.
   He Avas kept on this  treatment for a Aveek, but Avith
 the  exception  of  having recovered a little  strength,
 Avhich I credited to the potassium,  no other improve-
 ment Avas  visible.
   In  my perplexity I gave  him the doubtful benefit of
 a change:
   R. Acid  nitricum 3-dec. gutt.  xxiv.
     Aqua distilt. f iv.
   Dose.—One teaspoonful every tAAro hours.
   With this I gave him baths of nitro-hydro-chloric acid.
For a Avhile his expectorations improved, his appetite
returned to its normal condition, his bowels moved reg-
ularly, and he slept better.  Like every physician Avhose
hopes from the very first are   disheartening,  this im-
provement kindled a spark of hopeful anxiety, that after 
PHYSICAL AND MENTAL LABOR.      209
all something  could be done with this young man.  In
connection with the treatment I gave him a generous
diet  composed  of the most nutritious elements, such as
roast beef, rare mutton, Q'-g^, milk  punch, clams, rice,
beans (black), generous soup, wine, black tea with cream,
three times a day, in  order to prevent the great Avaste
going on; finally I exhausted the  dietetic list.   The
treatment  benefited  him  only for  two  weeks,  after
which he became weak and despondent; the cough re-
turned as bad  as ever,  and in fact all his former bad
symptoms reappeared.  Ho suffered with great dyspnoea
and  pain  in the  trachea.   I relieved him with a feAv
drops of  hydrocyanic  acid in  milk.  Borax Avas also
given Avith temporary benefit.   He finally died suddenly.
  Of course my patient Avas too far gone when he came
into my  hands, and  there Avas no  time for  treatment
sufficiently  exhaustive  to pronounce  homoeopathy  a
failure, for other remedies  should have been tried before
reaching such a conclusion; yet I feel that these cases
defy all our art—at least mine.
  Rationally speaking,  does our case suggest to us that
there might have been a prophylactic medical  treat-
ment which might have produced a change in the phy-
sical predisposition of this man? Could our profession
offer any reasonable  hope of  disengaging the system
from those crudities  of perverted lymph and changing
them into a healthful organizing process?
  Unhesitatingly I ansAver, that the  majority of these
weakly constituted people, if the proper hygienic and
dietetic  rules  could  be enforced early  in youth, and
they removed into a salubrious country life, working on
farms in the open air, probably ninety per cent, would
be successfully cured and  the predisposition eradicated,
or so modified, that a long  life would  be secured to
them. 
210
PROGRESSIVE MEDICINE.
                   CHAPTER T.

               DISEASES OF CHILDHOOD.

    DEFECTIVE ORGANIC  AND VEGETATIVE FUNCTIONS.

  Organic force and its physiological functions depend
upon a triple cause or origin, viz.: physical, vital, and
mechanical,  and it is  obvious that  the   vegetative
cliemico-physiological functions are derivath'es of this
natural combination of the physical organization.   The
systems of absorption, secretion, circulation, excretion,
etc, are  all included  in this vegetative and primitive
vital action.
  We will find the division of the lymphatic system into
internal and external, useful,  being connected by anasto-
mosis of  large  plexuses.   This system is entirely con-
fined to  animals, for it is not  found in either birds  or
fishes.   It is sometimes irregularly developed in its
plexuses, but mostly  found in the tract of the absorb-
ents connected Avith the lacteals and lymphatic glands.
  These  absorbent vessels are found mostly on the in-
ternal surface of the  small intestines, and  visible only
by a poAverful microscope.   They are  found larger, as
they are  intended for stronger physiological functions.
  The age of infancy is unquestionably a period merely
of nutrition and groAvth Avith all its concomitants, acci-
dental or otherAvise, and disarrangements and diseases.
  This complex Avork is evidently accompanied by many
difficulties, the  organs of digestion and assimilation be-
ing taxed to the utmost in the process of organizing (or
preparing), assimilating secretions, and selecting the dif- 
DISEASES OF CHILDHOOD.
211
ferent requirements, and at the same time expunging the
materials Avhich have ceased to be useful and nutritive;
and it is also natural that the vital functions should be
heavily engaged in assisting in  this physico-vital pro-
cess,  hence the occasional  hyperaesthesia of the  ner-
vous  centre (brain) running oftentimes  into irritability,
hyperaemia, and asthenia.  Excessive nutrition is truly
oftener the cause of  diseases of the vegetative system
of infants rather than a Avant of it.  The Avatchful and
unwearied mother is  too frequently the innocent source
of implanting  obstructions to the groAvth of her child
by overtaxing his or  her digestive functions.
  The lymphatic system has such a material iufluence
in the process of physical organization, that I Avould
venture to say that in the majority of diseases Avhere
atrophy, asthenia,  anaemia, and  marasmus  exist, Ave
Avill   find  atrophia  lymphatica,  adenitis, hyper-lvm-
phoma or hetero-plastic lymphoma.  By these various
pathognomonic indications avo are able to trace the na-
ture of these abnormalities, originating from idiopathic,
symptomatic, acquired,  inherited,  predisposing, or ex-
citing causes.   And, furthermore, these pathological
differentiations lead us to a more intelligible knoAvledge
of these diseases and their treatment.
  At this peculiar  period of infantile life, avc may Avell
say that the animal economy is not guided  by the Liav
of equilibrium, as the process of nutrition must necessa-
rily be far in excess of that of Avaste, and therefore the
chylopaetic A'iscera must be strong enough to prepare,
assimilate,  select and separate the nutrients, in order
to retain the necessary physical  force for the  histoge-
netic process.  The fats, the acids, the urea, the triplo-
phosphates. etc, must be electively selected in order to
provide the plasma Avith those elements necessary for
the accomplishment  of the grand ensemble  of animal
life.
   We have clear and logical evidence that  all the or- 
212
PROGRESSIVE MEDICINE.
gans must be in a state of very great active turgescence
(orgasmus) and this must be continually  and promptly
removed by organic  force  and  activity,  and conse-
quently, it is easily understood that the process of chyli-
fication can be readily changed  from the normal into
an abnormal condition, both  in quantity and  quality;
and thus being subject to become  either a nutritious or
a non-nutritious element, from Avhich life and force are
attained;  or, vice-versa, debility, atrophy and decay.
  The lacteals and A'illi select, their formative elements,
and  the rest is  reabsorbed  by the  lymphatics to be
reorganized and carried again through their vessels into
circulation and contact Avith the glands, and there to be
acted  upon by a  lymphatic  fluid until  it becomes a
suitable element for tissue and blood.   These great
glandular arrangements act  physiologically upon the
albuminoids  and oils, so that these elements may be
properly prepared for general nutrition.  The pancreas,
Brunner's glands, Payer's patches, and  all the enteric
fluids  are  Avell   knoAvn to possess  this physiological
property. The superfluous material, of course, is taken
in charge by the excreting organs.
  The glandular  system in childhood is naturally larger
and  softer,  than in  advanced years and its  external
ganglia is easily felt by the naked hand.  This condition
remains as long as the system needs such a great amount
of nutrition, and decreases step by step as Ave  advance
in age, till the Avhole system reaches  the acme  of statu-
quo  and gradually  descends  into  inanition  and natural
decay.
  It is of much importance to be  able to diagnosticate
the various shades of lymphatic diseases and their path-
ological differences and general effects.  Hetero-plastic
lymphoma is detected  by general scrofula, and is the
physical result of  an acrid, ichorous lymphatic  fluid,
the true evidence of mal-assimilated albuminoids, Avhich,
form into the abnormal fluid above described, and is the 
DISEASES OF CHILDHOOD.
213
result of many pathological lesions, viz., eczema, ecthema,
scrofulous ophthalmia, tetters, marasmus, adenitis, acne,
lupus exedens et non-exedens, intertrigo, porriga, crusta
lactea,  otitis, tubercolosis, ulcers,  tumors,  etc   We
designate cases  of hyper-lymphoma in fatty lymphatic
persons, by  superfluous  animal tissue, added to easy
good  nature and indolent  disposition, Avhere  the ner-
vous system is in a certain sense, sIoav to act and lacks
vital force.
  If this  temperament or idiosyncrasis  is happily en-
doAved Avith strong nervous and sanguine force, it is un-
doubtedly an addition of great value; but of course an
excess of either, Avould predispose an individual to some
peculiar malady of its own peculiar kind, and thus lose
that equilibrium so necessary in a perfect organization.
  In  hyper-lymphoma  Ave  frequently   find a  serous
blood, leucophemia, and a proneness to tumors, catarrh,
pulmonary difficulties, Ioav fevers, etc.   We also often
find the reverse of this  condition Avhicli  is  known as
lymphatic  atrophy.   This abnormal condition may be
inherited or acquired; it may also be a mere constitu-
tional idiosyncrasies or a result of mal-nutrition, malarious
influences,  or other  diseases  peculiarly  devitalizing.
When such  condition is congenital, there  is  no doubt
of its being the result of an ichorous lymph—(hetero-
plastic) and hence  abnormal  lymphatic development
such as atrophia lymphatica, or marasmus;  and  in this
instance the  histo-genetic process is necessarily  abnor-
mal.   The  chyle may  be properly and  sufficiently
healthy, but  the moment it has to enter into a further
stage of animalization by entering  the lymphatic ves-
sels and glands,  it finds hardness, insufficient  vital and
physical force, and the fluid secreted becomes of a disor-
ganizing rather than  organizing nature.  This physical
defect changes the healthy chyle into an abnormal fluid
and from that, the blood becomes deficient in fibrin, in
iron, in  phosphates and naturally, the liquor  sanguinis
is feeble and serous. 
214          PROGRESSIVE MEDICINE.
  In cases of acquired disorder of the lymphatic system,
there is more hope, and less tendency to malignant and
incurable  disorganization.  It  may  be a temporary and
superficial derangement, in which with care and proper
hygienic and dietetic treatment a favorable change may
be produced.  It is  in this acquired atrophy that the
intelligent physician can prevent much mischief and re-
establish  a  physical equilibrium, and  thus conquer a
disease Avhich if neglected, or not intelligently treated
is sure to create organic hyperaemia and nervous asthe-
nia,  finally  ending  in  adynemia  and  constitutional
decay.
  The  principal  train  of  symptoms  are emaciation,
mental feebleness, enervation, apepsia, renal  troubles,
hepatic engorgement and atrophy; Aveak venous circu-
lation, rachialgia, curvatures, morbus coxalgia, and follic-
ular diarrhea, general cachexia.  In this  last instance
nutrition  is at  a high  degree of insufficiency.   The
chyle must be (as a sine-qua-non) deficient in those prop-
erties required by the general system: the nitrogenous,
albuminoids, calorificients, one and all, divested of proper
animalization, hence  mal-nutrition; and therefore the
physical metamorphosis Avill sooner or Liter retrograde
into a condition of general disorganization.
  Exciting causes are : Exposures, poor alimentation, un-
cleanLness, excess in eating, drinking spirits, excess in
venery" Avant of proper  hygienic rules, confinement in
prisons, bad Avater  and  abstinence  from  animal  food.
Also, sedentary  life, and living in  unhealthy low loca-
tions Avith effete exhalations.   There are likeAvise cer-
tain diseases Avhich invariably excite numerous gangli-
onic complications, A'iz., measles, intermittent fever, scar-
let fever,  typhoid  and typhus feArer; also chronic diar-
rheas or  dysentery; ship  fever, erysipelas, small  pox,
syphilis, gastro-enteric engorgements, mal-assimilations,
typho-malarious fever, and suppurating Avounds. There
are an infinite number of causes that are  liable to irri- 
DISEASES OF CHILDHOOD.
215
 tate this delicate ganglia, and its relation to the venous
 system renders it liable to communicate its morbid ef-
 fects to the venous circulation  as the lymphatic vessels
 end, Avhere the venous begin.
   It is unquestionably a physical disorganization, Avhich
 necessarily affects the pabulum vitae and plastic force.
   The lymphatics being divided into  plexuses are not
 only placed in different  parts of the digestive track as
 co-operating Avith the process of animalization of chyle
 and lymph, but  they occupy also an important place in
 the excretory apparatus as Avell as in the absorbent;
 they form  conclusively a process of injection and ejec-
 tion.  Through the apparatus of the skin the outside
 influences  are received.  Through it, Ave  receive the
 depressing and devitalizing influences from animal and
 vegetable  decay, viz., that of mephitic gases,  malarious
 effluvia from marshes of fresh or salt Avater; through it
 Ave receive the  morbific influences from meteorological
 changes—the ever increasing or decreasing elements of
 health and life: the  thermal temperature  giving us a
 genial atmosphere, or  a cold Avind, chilling  us to the
 very marrow and carrying Avith it dampness, Avhich ab-
 sorbs  animal  heat faster than  Ave  can re-produce it,
 thus  producing those  diseases peculiar  to  a  sudden
 change of air,  impregnated  with moisture.   Daily
 changes of temperature engender pulmonary  disorders,
 rheumatisms, neuralgia,  hyperaemia and  phlogosis, all
 of which have a tendency to lower organic force.
  We  have evidences of this  in that  dreadful scourge
 which rages in the south—the yellow fever, and in the
 meteorological influences in the  time of cholera, and
 typhus diseases.  We have evidences  noticeable in en-
 teric  troubles of children and all  these materie-morbi
 are brought imvardly by the  lymphatics.
  This, together Avith breathing infected  air, and the
everchanging  evaporization  of the body, predisposes
the animal economy to an innumerable number of dis- 
216
PROGRESSIVE MEDICINE.
arrangements and diseases.  An excessive evaporation
of the body caused by atmospheric heat or produced by
an undue amount of activity, predisposes one to pyrexiae
and phlogosis.   If, on the reverse, evaporization should
be suddenly checked, the urea,  the biliary matter, the
lactic and carbonic acids are not eleminated, hence Ave
have all  that  train of infantile  enteric disorder Avhich
every physician is acquainted Avith.  Thus it is an un-
deniable fact  that the lymphatics Avithout, as  Avell as
those Avithin,  have the  most intimate relations in the
function of absorption, secretion and excretion, besides
that of organization.
  These various  atmospheric  causes bring  about  an
irritability of the lymphatic vessels, a  change in the
digestive fluids becomes unavoidable, and hyperaemia
lymphatica Avith  pyrexia and turgescence follow.  En-
tero-mesenteritis takes place, Avhich is  noAv-a-days ex-
pressed in the generic term of cholera-infantum.  This
condition must bring  about an abnormal change in the
functions of the  chylopoietic viscera and therefore in
the nature of  the chyle itself.  The first condition is
generally that of plethora  lymphatica followed by irrit-
ability, asthenia and adynaemia Avith exhaustion.
  The derangement of this important  system reflects,
oftentimes, its poAverful influence back upon the nervous
system, the blood, and  the functions of the organs. And
therefore Ave have the  discrasie, the cephaloid troubles,
and organic maladies.   And in this  country Avhere the
meteorological  changes are so deleterious to health, Ave
are seriously  affected, and  particularly the children,
from these elementary causes.   The air of our cities is
liable to be impregnated Avith mephitic  gases; that of
the country Avith  malarious poison arising from veget-
able decay or  paludal  effete exhalations.   But on the
contrary in high mountainous air Avhere these poisons are
not to be found there are seldom such  diseases preva-
lent. 
DISEASES OF CHILDHOOD.
217
  The process of digestion and organization is obviously
attacked by all diseases proceeding from either malaria,
mephitic, or  effluvial exhalations.   The vital force is
at once struck at its very base, the  chemico-physiolog-
ical process is changed and the Avhole physical organiza-
tion becomes infected and  modified.   Is  there  any
great  difficulty  to  imagine  such metamorphosis? and
although Avell understood it is not ahvays in our  power
to change these conditions, and by a negative action  or
apathy great epidemics are produced and spread, which
become uncontrollable even by the best medical skill.
  The precursory symptoms are those of general  mal-
aise, Avant of appetite, insomnia, Avhite  coated  tongue,
dry  hot skin, hot breath, prostration, diarrhea, strong
and small  quantity of urine, Avant. of mental force Avith
irritability, the pupil becomes dull, the pulse quick and
at times irregular.
  The cardiac symptoms are either sIoav and regular in
action, or irritated by a quick jerking pulsation,   The
organs become  inactive,  and  the secretions are sIoav,
and limited in their functions.   Gastro-hepatic torpid-
ity,  and gastro-enteric inactivity  are necessarily the
prelude of a physical disorder.  And if these prelimin-
ary ailments are not either, by nature or artificial med-
ication checked, the  disarrangement  proceeds  further
and gradually affects organic action; the nervous centre
and blood are by progression sympathetically or vitally
subordinate to morbific influences Avhich disseminate ac-
rimonies crudities and disarrange further  organization,
assimilation, chylification and nutrition.
  The distinction  between simple dental irritation and
meteorological changes should be a sine-qua-non with the
physician.   And again, betAveen  over-nutrition, causing
plethora irritability, and  digestive crudities, or  insuffi-
ciencyof the proper food in  quality and quantity, are
also matters Avorthy of serious inquiry.  There must be
properly ventilated apartments, bathing, and  careful 
218
PROGRESSIVE MEDICINE.
attention to the bed and clothing.  Often times the ori-
gin of this infantile trouble is due to the Avant of the
first rules of hygiene and nutrition.  Another great con-
sideration for the general result is, Avhether the mother's
milk and diathesis is to be a source of strength and
health to the infant, or AAdiether an artificial nutriment
would be more advisable.
  1. Consumptive or scrofulous  mothers  should  not
nurse their children as any discrasia of the blood can be
communicated and increased by the daily process of nu-
trition.   Children of such parents should be nursed by
healthful Avet-nurses  and enjoy the strengthening reno-
vating physical influences of country air.
  2. An analysis of the milk should be made in all cases
Avhere  the infant  appears to ail  from abnormal nutri-
tion; there Ave may find the real  cause of the disturb-
ance.   The milk may be too rich in butter, or casein; it
may contain  a  strong lactic acid, or abound in case-
ous substances;  else not  contain a  sufficiency of al-
buminous substance.
  If the proteine compound is at all abnormal, the his-
togenetic process becomes impaired in its very first
principal of life.  In finding these difficulties  Ave must
have the remedy at hand.  1. A very suggestive one is
condensed milk; 2.  Experiments have proven  that  a
vegetable compound of nitrogenous food can  be safely
and scientifically supplemented (vide leguminous food);
3, Purely animalized food in the shape of mutton broth,
light beef tea; broth and  vermicelli; broth  and bread
Avell boiled and strained.  I have a strong faith in rice,
peas and lentils as substitutes for milk.
  These  artificial nutritions are more frequently a tem-
porary necessity, but sometimes it becomes an imperi-
tive one for months and even years.   We have a remedy
in changing animal to vegetable nitrogenous food, avoid-
ing the  amyloids and the carboniferous, adding only
the succulent by  giving the ripest  fruits with sugar. 
DISEASES OF CHILDHOOD.          219
Every physician should have a lactometre thus measur-
ing the amount of Avater.
  It should not  be  forgotten, that each diathesis has
an  idiosyncratic  inheritance, and that  idiosyncrasies
should not be alloAved to become the prominent feature
of the system, thus necessitating the loss of that equil-
ibrium so desirable to every economy.   The  tempera-
ment of the individual should be Avell understood, and
by  diet, hygiene and medicaments a change is possible.
But an acquaintance Avith physiology, is to kno\v the de-
ficiencies of nature and the remedy.
  This may possibly seem an assertion in the abstract,
but I insist that there is much in it Avhich the most su-
perficial observer of medical science can see at the very
first glance.
  All elementary, dietetic  and hygienic means have  a
direct influence  upon the development  of the  animal
economy, its temperament and idiosyncrasis.
  Those nations  that live in a southern climate must
live according  to the peculiarities of the climate,  and
their food,  clothing,  occupations and hygienic rules
be  subordinate to the physical  influences surrounding
them.  Every  means should be employed to increase
the ozone.  Nitrogenous  food may be necessary for a
certain infant, albuminous for another, and amylaceous
and succulent for a  third.   And, if this is true, Ave
should  prescribe the same  to  the mother or select a
nurse Avhose constitution  Avould not favor the tendency
or  possess a predisposition  to  any abnormal idiosyn-
crasies.   With such a system Avonderful improvements
may be brought  about in the metamorphosis of life and
groAvth.
  The change in the secretions, if not due to over-nu-
trition, certainly suggest that either the quality of food
or  the atmosphere is possibly the cause.
   Excess in any  one kind of alimentation, or  Avhen too
constantly used, is sure  to  become hurtful,  solely be- 
220           PROGRESSIVE MEDICINE.
cause other elements are necessary to supply the various
demands of the economy.  If an excess of albuminous
food should be  used an excess of lymph Avould be the
result, provided that albuminous nutrient Avas properly
assimilated.
  The excess of nitrogenous  food Avould  create other
disturbances and discrasia.  The amyloid and succulent
alone Avould likeAvise  disturb  the system,  if used in
great quantity, producing fats, heat, fermentations and
mal-assimilation at the expense of blood and tissue.
  Childhood, therefore, can be nourished  into groAvth
and strength, even if it should inherit certain  deficien-
cies in its OAvn organizing force;  and to these  Ave must
supply  a  patient and  untiring care  from their  very
birth up  to  tAvelve and  fourteen years of age, when
Avith the approximation to adult life, a neAV A'igor, as it
were, bursts forth, disengaging the system from all the
weaknesses  of the past.   And, furthermore, Ave  must
use a progressive treatment as the child groAvs by giv-
ing him more exposure,more amusements, more motion,
air, light  and electricity.  With  these and  the  above
suggestions,  I dare say, one  half of  the strumous,
phthisical, dyspeptics, and those of an anaemic condition
could be permanently rescued from a life of  discomfort
and an early grave.
  Sanitary science, at  the present day, should be the
acme  of  all the medical  schools,  as  preA'ention of
disease.    This is  as  necessary, if not more  so, than
medical treatment, after a disease is contracted.
  Bathing is eminently a great source of health.   Na-
tional baths should be established in every citv.  They
prevent morbific influences from invading and implant-
ing malarious  germs  in  the  system,  and  diminish
and equalize  the temperature of the  body;  at the
same time they stimulate excretion, and capillary activ-
ity  being kept up they assist the  system in the process
of ejection of the excrementa. 
DISEASES OF CHILDHOOD.
221
  In hot summer days  when  the  thermometer ranges
from 80  to 90 and 100 and the number of the deaths
of infant increases to a fearful mortality, the principle
of bathing them morning and night Avould diminish that
irritability produced by the excessive heat, and promote
the secretions and excretions, controlling therefore  all
that hyperaemia  and  hyperaesthesia Avhich children
are constantly suffering and giving alarming evidences
of danger, and I  feel  at  liberty  to say,  that these
natural means Avould prevent  many summer disorders
by preserving the the equilibrium of the vital forces and
organic functions.
  I do not intend to say that  such a system of treat-
ment Avould prevent all diseases of children, but I mean
to say, that the excessive  mortality Avould  be  greatly
diminished;  and  I also Avould  add, that medicaments
are often required and have a beneficial  effect  in re-es-
tablishing the equilibrium  in chemico physiological dis-
eases of the alimentary canal.  Medicines Avill stimulate
a torpid liver, a sluggish stomach;  Avill pacify  an irrit-
able nervousness, change excessive and acrid secretions
and  stimulate gastric  secretion.   These agents are—
Bryonia  alb., Ipecac,  Rheum, Cinchona, Acid hydro-
chloric  et phosph,  Aloes   calcarea phosph., et carbon,
Natrum phosph. and Bismuth.   If  the  circulation is
giving symptoms  of  pyrexia: Belladonna,  Digitalis,
Aconite, Stibium and Hyoscianmus.  If the nervous sys-
tem is  principally affected:  Secalae  corn., Cuprum, Pul-
satilla, Veratrum alb., Helleborus, ingn., Kali Bromidi,
Opium, Stramonia  and Musk.
  In follicular disease of  the  stomach and boAvels, di-
gestion and assimilation are comparatively abnormal;
the  peptones are  defective and the gastric juice  in-
sufficient;  then, Chlorine,  Hydrochloric acid,  Natrum,
Iris  Florentinae  are  indicated;  starch is almost insolu-.
ble  by the  weak  salivary juice   of  children, and is
not  turned  into  sugar; lactic and butyric acids are 
222
PROGRESSIVE MEDICINE.
formed from animal food in adults.   Natrum phosphor.,
calc phosph., kali carbon, etc., are all agents  that Avill
add the elements wanted  in  the salivary  and gastric
juice.
  The salivary juice aids the stomach in digestion in
the transmission of starch into sugar, and sugar into lac-
tic acid.   The acids Avhich proceed from fatty globules
(butyric) must be acted upon  by the alkalinity of  the
saliva.  And there is as it Avere, a double digestion  go-
ing on in the stomach, partly salivary and partly gastric,
" and this is doubtless one of the causes of  those differ-
ences Avhich have been noticed betAveen  natural and
artificial  digestion"—Draper.    Amylaceous  food is
acted upon only by the strong saliva of the  adult, there-
fore farinaceous substances containing starch  are indi-
gestible to an infant.
  If encephaloid metastasis should  take  place, which
often happens  from  dental or  enteric irritation,  use
belladonna,  stramonia,  kali bromidi,  helleborus, puis.,
etc.; but if the secretions are  abnormal and acrid, with
plephora, I find that, mere. sol. or alkalizatum Avill  do
well, and  also  ipecac and care  carb. or carb. veg.   In
hepatic metastasis, hot fomentation to the liver and in-
testinal canal, Avith belladonna, podophylum, aloes and
nitric or hydrochloric acids  And I find also camphora,
natrum phosphor., cinchona and quinia to be very bene-
ficial—(vide Burt's on Quinia).
  In the renal complications Avarm baths with terben-
thenae,  belladon, cantharidies, digitalis, cannabis sativa
are excellent.
  In general hyperaesthesia chamomilla, coffea, ignatia,
Pulsatilla, moscus, gelseminum,  kali  brom. should  be
used.
  The lymphatics and  sympathetic  systems are  fre-
quently directly or  indirectly  involved, and  in such
cases Avould suggest assafetida, belladonna, conium, au-
rum, arsenicum  alkalizatum, barita, iris florentina, san- 
DISEASES OF CHILDHOOD.
223
guinaria,  hyosc, spongia,  liepar  sulphur,  Scutellaria
kali iodidi.
  The stomach is histogenetic in its functions, chiefly
transforming  nitrogenous food into  blood; Avhile  the
office of the enteric digestion is to transmute the album-
inoids into tissue, the amylaceous, glucose and fats, into
respiratory  food, or chalorificients.
  Here, we enter  upon the chyle formation and  pan-
creatic  functions; these special functions are  too  well
known to require description.  The amylaceous glucose
and albuminous substances are variously acted upon by
the intestinal juices and changed into lymph and tissue;
others into fatty emulsion and chalorificients.
  The  excrement  system  is thus seriously  engaged,
while the secernent is equally  so (lacteals and villi)  in
changing the  lymph into liquor sanguini.   From this
Ave  can determine or  rather Ave should  be able to,
Avhether Ave have  gastric disorder or enteric, or both.
Enteric digestion is subordinate to the gastric in a great
degree; imperfect  chyme  cannot  be  acceptable  to
enteric  digestion,  hence imperfect  chylification must
take place.   Gastro-enteric diseases,  I venture to  say,
should be treated on a cliemico-physiological principle,
adopting, hoAvever, other means in addition to  the med-
ical agents for the full accomplishment of a logical and
successful treatment, and therefore Ave must add—air.
light, heat, bathing, etc.  These elements are indispen-
sable to a perfect physical organizing principle.
  From Avhat has  been said it is obvious  that every
physician has to make special examination of the di-
gestive  organs, their functions  and their peculiarity.
  It is  not sufficient  to knoAv only  that a child has
diarrhea or constipation, irritibility,  fever and  Avant of
appetite, but  it is of great importance to knoAv Avhere
the real morbid cause lies.  If the fault lies  in an in-
sufficiency of digestion or elements  of digestion, then 
224
PROGRESSIVE MEDICINE.
Avhat are they ?   And it is in these very cases that the
chemico-physiological treatment serves us so Avell.
  There are sporadic and symptomatic diseases of the
digestive  organs and in  such cases AAre have to adopt
first, those remedies thatAvill doaAvay Avith the primary
cause,  and second,  give  such remedies as will re-es-
tablish the  elements Avhich  the materie  morbi have
either destroyed or changed.
  The Tissue-Remedies of Doctor Schtissler are doubt-
less chemico-physiological  agents, and all the principal
and  indispensable  elements  in  the  formation of the
plasma.  When Ave find  the evacuations  abnormally
fetid Ave have formations of sulphurated hydrogen gas
from animal decomposition, the urine is generally scanty
and strongly  tainted Avith ammonia  and urea.   But if
Ave find odorless faeces, accompanied Avith much gas and
pain there is undoubtedly carbonic, butyric or lactic
gaseous fermentation,  proceeding from a  vegetable
principle—fats, starch or succulent matters, Avhich not
having been digested become fermented, acidulous and
deleterious to the animal economy; and Avith  it Ave fre-
quently find a  suppression  of  bile and an increase of
Avhite odorless urine.
  In the first instance Ave find the greatest benefit from
a change  of  food Avith  sodium  phosph., Hydrochloric
acid, bismuth, sodium chloricum, natrum carbonic, etc.
In the second  instance, carbo-veg. alcohol, animal diet,
hydrochloric acid,  kali carbon, magnesia phosphorica,
rhei-mercurius sol, hot water, etc  Also aloes and colo-
cynth.
  If exhaustion supervenes, and collapse is threatening
it is Avell  to prescribe  burnt brandy, camphora, bella-
donna, quinia, cinchona and chloride of ammonia, capsi-
cum, arsenic, phosphorus, sponging, opium, etc. 
DISEASES OF CHILDHOOD.
225
                   CHAPTER VI.

          DISEASES OF CHILDHOOD.—Concluded.

 atrophia  lymphatica.—Tabes—Entero—Mensenterica.

   This is a common disease  in children, particularly so
in those of a  scrofulous diathesis;  although at times it
may be the  result of other  influences  like  malarious
poisons, scarlet fever, measles, poor nutrition and on the
contrary over-nutrition and neglect of hygiene.
   There are several  nosological classifications of this
diease, according to its locality and  the organs it in-
volves, viz., Tabes—Entero—Mesenterica,  Tabes  Pul-
monalis, Tabes dorsalis, andgenerically called marasmus,
including Tuberculosis and  lymphatic tumors.   It is
the same disease only pervading different parts of the
body,  but  pathologically  and pathognomically  the
same.
   These classifications are very suggestive  to the phy-
sician.  The disease generally and  necessarily develops
in those organs that are in greater  use and greatly sup-
plied by the lymphatic vessels and glands.
   It is obvious that childhood favors entero-mesenteric
disorders  considering  that the alimentary canal is the
focus of the  A-egetative process, being constantly sub-
ject to turgescence lympho-sanguina and hyperaesthesia,
all centrally  located  in  that fountain  of  alimentary
activity, and hence its proneness to  sporadic hyperaemia
or symptomatic; to plethora, lymphatic  engorgement,
mal-assimilaiion  and nutrition, asthenia, adynaemia and
marasmus. 
226
PROGRESSIVE MEDICINE.
  These various shades of the disease may become dan-
gerous or even  fatal, but more  frequently it  proves a
propagator of  lymphatic  disorders  over  the Avhole
system.  It seminates the nucleos of constitutional  dis-
crasiae.    From  such  atrophy  and  hypertrophy we
have a sequel of pathological lesions too numerous to
mention.  It  is enough to MIoav the disease  in its in-
cipient stage to  see Avhat a myriad of complications it is
capable of producing.  My object is  only  to present
clinical cases as  evidences of my assertions.

                  clinical case  i.
  Delano  Ames, three  years old, of a lymphatico-nervo
temperament; his father  is very  small  in  stature and
anaemic, having all  the marks of  that peculiar  dia-
thesis.
  Physical Examination.—I found him generally  ema-
ciated,  with  small bones, narroAv  chest, large  head,
enlargement  of  the abdomen, prominent red lips, Avhite
skin, Avith fine light hair, large blue eyes, large mouth,
and Avith  the venous circulation very visible.
  Semiology.—Pulse 130 per minute; general and  con-
tinuous hyperaemia, Avith an afternoon pyrexia.  Tem-
perature  100.  He Avas continually asking for Avater or
meat;  very irritable and restless; pale exhausted coun-
tenence, Avith flushed cheeks in  the afternoon;  anaemic;
had lost the  poAver of locomotion.   There Avas no pain
in  pressing upon the abdomen, no glandular enlarge-
ment perceptible.  He suffered with partial  insomnia.
As  soon as he aAvoke he asked for meat and refused
everything else.
  He  had frequent  evacuations  of the boAvels   of a
greenish  yelloAv color, mixed Avith mucous and faecal
matter.
  The  evacuations often changed the  color to a broAvn
and Avhitish  clay, spongy, Avith an  unpleasant odor;
I took  note of the fact that he Avas ravenous for meat. 
DISEASES OF CHILDHOOD.
227
  The child had been sick for several months before he
was  brought to me, and his physician had  diagnosed
the case as one of helminthiasis.   Of course the treat-
ment proved not only a failure but  redounded against
the child's chances of recovery.
  Surely  helminthiasis  has a good many  symptoms in
common Avith many other  enteric diseases, but the sal-
ient points, and pathognomonic symptoms of this pecu-
liar  disease Avere certainly Avanting.   There  was no
dilatation of the pupil, no itching at  the anus, no grind-
ing of the teeth; he did not wake up  Avith a start, ap-
pearing to be frightened by something; not the peculiar
breath or stools; no Avhiteness around the  mouth, no
swalloAving in his sleep, no  choking sensations Avere visi-
ble.  The absence  of  these symptoms indicated any-
thing but helminthiasis.
  Etiology.—The symptoms and pathological condition
of the child did not arise from sporadic cause, but cer-
tainly from a Avell seated constitutional disease.  In my
examination of the case I could not find that the  trouble
could have been produced by either  Avant of proper diet
or hygiene, as the mother was an intelligent, careful and
wealthy AAToman.
  The teething Avas  out of question, and I could not
trace anything to malarious poisons or to meteorolog-
ical influences.  The true and only visible cause was an
inherited  scrofulous diathesis, Avhich Avas running into a
chronic discrasia.
  The mother was strongly built, but deaf, and of an
unusual large bony frame.   She had black eyes,  large
mouth, and a large intelligent head.
  She Avas inclined  to  plethora sanguina  with a  deep
red  corpuscular and  fibrinated  blood.  She was  very
lively and good-natured.   There Avas, if anything, a
good abundance of lymph Avith a strong, healthy consti-
tution to change it into  blood and  tissue.
  The father was feeble, and suffered with a  chronic af- 
228
PROGRESSIVE MEDICINE.
fection  of the laryngo-tracheal  track, and  looked as
though  laryngo-tracheal phthisis would sooner or later
be the result.
  He was predisposed to consumption, and leucothe-
mia; Avhereas his Avife Avas of a sanguine-lymphatic tem-
perament," with plenty of vital and physical force.  His
frame  and muscular development Avas  defective, and
emaciation  had shoAvn an evident  want  of nutrition.
The child inherited his father's idiosyncrasis.
  The objective  symptoms of marasmus Avere evident
in his physical development; the subjecth'e Avere prom-
inently observable in the  paroxysms of hyper-exiae, in
the abnormal faecal evacuations, in the SAvollen abdomen
thirst, hunger, emaciation, adynaemia,  exhaustion, tem-
perature  of the  body, mal-assimilation  and  nutrition.
It was  also  evident that a normal metamorphosis of
chyle was not going on; the proteine compound Avas de-
fective, hence crude lymph and poor blood, and  there-
fore the plastic force was insufficient.  The enteric and
lymphatic vessels  Avere secreting Aveak and abnormal
juices (Humorum-acremonia).
  The lacteals and villi had the absorption and transmu-
tation of  these juices, and  turned them into blood in an
imperfect condition; hence discrasia.   Adynaemia and
asthenia Avere natural consequences from the general
Avant of proper assimilation of the nutrients.   The lym-
phatics, Avere atrophic, Aveak and incapable of perform-
ing their  normal functions, and thus  the  Avhole process
of organization Avas interfered Avith.
  Such  being the condition of the patient I looked  dis-
mayed at  the negligence Avith Avhich the child had been
treated.   The  disease had already  Aveakened the pa-
tient greatly, -and I undertook  the care of it Avith  full
appreciation of the  difficulties and dangers attending it.
  It Avas an imperative duty to select a nutriment that
would be easily assimilated by the impaired and turges- 
DISEASES OF CHILDHOOD.
229
 cent organs—Avithout  wrhich  no favorable  progress
 could be expected.
   The medical treatment Avas likewise of great  impor-
 tance, so as to calm Avithout irritating, change Avithout
 causing  dangerous  metastic complications,and  results
 elseAvhere.
   Medical  Treatment.—The splanchic and  the  sympa-
 thetic  nerves were  in a state of  complete exhaustion.
 The absorbing and  secreting organs Avere deficient of
 nervous force.
   Orgasmus Avas substituted by asthenia and enfeebled
 circulation ; then again, by  subsequent  paroxysm of
 pyrexia.
   .Now this state of transitory phenomena Avere  gradu-
 ally destroying the vital force, organic function, and
 physical equilibrium.  It Avas necessary that Ave  should
 employ medicaments Avhich could have if possible, a
 specific effect  upon  the vaso-motory system  and thus
 allaying irritability, turgescence and pyrexia.
   I prescribed the following remedies:
   R. Atropa belladonna, 1-dec. grs. xxiv.
     M. chart., xxiv.
   R. Barita mur., 3-dec. grs. xxiv.
     M. chart., xxiv.
   Dose—One poAvder'every hour alternately.
   I  saAv him next day and  found that he slept better,
had  less irritability and better  pulse.   Yet the secre-
tions Avere  very unnatural  and I believed  a change or
stimulous upon organic action was necessary.
   R. Natrum phosph., 3-dec grs. xxx.
     M. chart., xv.
   R. Belladonna, 3-dec. gutt. xii.
     Aqua fort., ? ii.
   To be taken alternately every tAvo  hours.
   On the fourth day I saAv an improvement in the secre-
tions and digestion.
  The  faecal matter Avas more  yelloAv and natural—no 
230           PROGRESSIVE MEDICINE.

offensive odor, and less frequent.   He was quieter, and
the thirst and pyrexia had  abated.  At  the same time I
forbade meat  entirely, and put him on  cream, oyster
broth, clam soup,  beef  broth with rice, bread without
butter.
   On the seventh  day he Avas still progressing although
he had had  a relapse  for twenty hours.  I had  him
sponged in salt and Avater  tAvice a day.   Cold Avater in
the morning, tepid water at night.
   The belladonna  had done Avell, and it Avas losing its
effect perceptibly, so I gave him,—
   R. Pulsatilla, 3-dec. gutt. xii.
     Aqua distill., f ii.
   R. Merc sol., 3-dec. gutt. xxii.
     M. chart., xii.
   Dose—One poAvder to every two doses of the pulsatilla.
In another  word I gave him two doses  of pulsatilla to
one of Mercurius.
   He took the above for four  days, and  the progress
was continuous.  No more  thirst, seldom any noticeable
change  of  temperature, appetite more natural, stools
only about  four in  tAventy-four hours, more natural also.
The  eleventh day of treatment I ordered for diet, oat-
meal  boiled Avith  cream and  thoroughly  gelatinized—
no grains to remain undissolved, rice Avith cream, and
beef-tea  or juice,  with bread, cocoa and milk in the
morning.
   On the twelfth day I prescribed
  R. Bismuth subnitr.,  3-dec. grs. xxx.
     M. chart., xv.
  R. Calc sphosph., 3-dec. grs. xxx.
     M. chart., xv.
  Dose—one poAvder every tAvo hours alternately.  He
was kept on these  poAvders for three days.
  I alloAved him three  days Avithout medicines, so as to
exhaust the action of those taken.
  I saw him again on the eighteenth day.  He kept his 
             DISEASES OF CHILDHOOD.          231

own, but it was evident that more medical  treatment
was required.  I prescribed
  R. Liquor Potass-arsen., 3-dec gutt. xii.
     Aqua distill., | ii.
  R. Capsicum, 5-dec gutt. xii.
     Aqua, f ii.
  Under these medicaments he improved greatly.  The
debility left him, he commenced to Avalk and play, slept
well and ate regularly.
  On the tAventy-fourth day I changed his medicine for
  R. Ferrum peroxyd, 3-dec grs. lx.
     M. chart., xxx.
  R. Barita mur., 3-dec. grs. xxx.
     M. chart., xx.
  Dose—One powder every two hours, alternately.
  It is to be observed that aconite Avas not used because
there Avas no inflammatory condition.  There Avas  a
passive  hyperaemia but the tendency was to adynaemia
and asthenia.
  He took the above  remedies for two weefcs and by
that time he was playing in the open air.
  I gave him
  R. Aurum, 6-dec grs. lx.
     M. et devide chart, xxx.
  R. Magnesia phosph., 3-dec. grs. lx.
     M. chart, xxx.
  Dose—One powder every tAvo hours alternately.
  He took this medicine for eight days.  I consider this
not anti-scrofulous treatment but chemico-physiological,
Avhich expresses better our meaning.
  Finally I gave
  R. Kali'chloras, 3-dec. grs. lx.
     M. chart., xxxx.
  R. Ferrum  peroxyd, 3-dec. grs. lx.
     M. chart., xl.
  Dose—One poAvder every three hours  during the day.
  The  dietetic and hygenic  treatment remained  the 
232           PROGRESSIVE MEDICINE.
same.   Treatment was kept up for six months, and  the
result was a cure.

                  clinical case  ii.
   George Henderson, eleven  years of age, of a nervo-
lymphatic temperament. He Avas brought up in a healthy
country place.  His  mother and  father Avere healthy.
He had tAvo sisters  and both Avere healthy.   His diet
was Avhat is called country food: good deal of ham and
pork, fried meats and heavy unseasoned  vegetables,
like potatoes, squash, those abominations  called pies,
preserves, molasses,  hot cakes, bread  and teas.  The
buck-wheat cakes and the  griddle  and  pan cakes Avere
abounding on their table Avith sour cheese and cabbage,
etc. The bill  of fare  Avas surely an anti-dietetic one
par excellence, and particularly to a delicate  child.
   Physical  Examination.—Large  head,  narroAv chest
small stature for his  age, Avhite skin, blue  veins, large
mouth, large pupil.   Heart's action irregular and irrit-
able, its rhythms being abnormal without any organic
lesion,  its walls thin  and somewhat  dilated (dilatation
without  hypertrophy).  Respiration very irregular, pro-
longed expiration Avith a quick short inspiration shoAV-
ing a deficiency in  the pulmonary  expansion and  a
difficulty of contraction.  The expiration was diaphrag-
matic.   There Avas a  broncho-laryngeal cough Avith free
expectoration and mucous  rale; and  on  percussion and
auscultation it was discovered  that  the bronchioles were
getting  filled with a  muco-purulent secretion.  The air
cells could get but a  small amount of air, and  deoxida-
tion Avas therefore  imperfect; carbonization  avus pros-
trating the physical and vital  forces to  a great degree,
hence fever, quick  pulse,  agitation, high temperature,
insomnia, apepsia, hallucinations, etc.
  The  abdomen  Avas swollen  and  painful  on pressure
and adenoid prominences Avere clearly felt, upon a care-
ful examination.   The  joints of the  wrists,  elboAvs 
DISEASES OF CHILDHOOD.
233
knees,  and ankles Avere  all SAvollen  and painful.  His
legs  Avere  flexed  upon  the femor  and could not be
extended  Avithout much pain, and even then the hot
SAvelling  of  the  knee  (subacute  inflammation)  Avas
threatening serious lesion of the synovial membranes.
He had also tumefaction of the submaxillary glands and
finally  there Avas turgescence and ichorous condition  of
all the lymphatic system.  Structurally I believe the
Avhole  lymphatic system Avas hetero-plastic lymphoma.
  From these outlines Ave can imagine the complications
and threatening dangers to all the physical and organi-
zing principles.   It Avas a condition in Avhich life Avas
fundamentally undermined.
  Semiology.—I found him restless, exhausted and sleep-
less.   Pulse  115—temperature  102£.   Great  thirst,
constipation and Want of appetite and digestion.
  He passed  a small quantity of urine of a high specific
gravity; strongly  acid.  His tongue  Avas coated yelloAv-
ish Avhite of a slimy nature, and Avas tremulous and pale.
He complained of pain  in  the  joints and  abdomen.
Could  not bear the bed clothes  upon his stomach and
abdomen, and he lay constantly on one side.
  His  sleep Avas disturbed by visions, and gave signs of
encheohaloid hyperaestesia caused by excitability.   It
Avas an aggravated case and complicated with vital  de-
rangements.   The patient Avas  emaciated to the last
degree, and  asthenia and adynaemia  Avere   evidently
going  on to a fatal issue.
  The proteine compound was evidently disarranged  by
heterogenous elements, and the histogenetic  metamor-
phosis Avas imperfect  and insufficient.   The blood and
tissue  making process became contaminated by physical
mal-assimilation.
  The cervicle  and mesenteric  glands Avere similarly
tumified and turgescent.
  The pancreas sympathized Avith the entero-mesenteric 
234          PROGRESSIVE MEDICINE.
trouble and  their physical  relations were  similarly
affected.
  The red corpuscles Avere feAv  in  number and the
fibrin Avere lessened.  The  blood abounded  in  serum
and Avhite corpuscles, with a Avant of the plastic materials
like  iron, phosphated lime, sodium, etc.,  and thus the
mould was  radically changed and the principle of a
higher  development  (vital  and physical groAvth) Avas
partly vitiated.
  Etiology.—In  examining  these  conditions of things,
it was necessary  to retrace  our steps and examine the
soil from Avhence such a deteriorated constitution arose.
To a casual observer, I suppose, no one could  see any
indications of poor-health  in the  parents;  they Avere
Avell  developed  people,  and  apparently  enjoyed good
health, still, during the examination,  I found that the
mother had  been a delicate girl;  had  suffered greatly
with some glandular trouble, and  her  growth Avas sIoav
and late.  The other  children, although well, had some
peculiar features (idiosyncratic of a scrofulous constitu-
tion).   Red lips  Avith an  unnatural  Avhite skin, long
bones, large  hands and  feet.  There  Avas  an anaemic
condition of the blood, although there Avas not real ema-
ciation.
  The mother Avas a tall  Avoman, Avell developed and
quite fleshy:  yet, she Avas  lazy, tired  and  ahvays com-
plaining.   There Avas  a lack  of physico-vital   force.
She Avas of a sandy color, hair fine and dry, light life-
less  blue  eyes, large head,  thin  long neck and large
hands and feet.   There was nothing of that ruddy com-
plexion so common among healthy country people.
  And  indeed the necessity that  compelled her  to live
in the primitive style, facing  the storms of  country ex-
posure  and  Avork, the  fresh air,  activity, light, heat
and electricity, supplied the deficiency of her constitu-
tion,  and brought about those  metamorphoses  Avhich
were imperative  to the progress of the great phenom- 
DISEASES OF CHILDHOOD.          235
ena of physical development, and  Avithout Avhich, she
Avould have died of pulmonary tuberculosis.  The phen-
omena of composition must be equilibrated  by  decom-
position; and in reality, there  can  be no  composition
Avithout the proper amount of decomposition.  The pro-
cess of growth  springs from the physical activity of de-
composition,  and from it new forces and neAV formations.
  Her marriage Avas also a neAV  physical change, being
followed by  the act of procreation, thus  forcing the
organs into  a physiological  activity which demanded
physical and  vital organization and force.  This brought
about  the elements  of  plastic force, and  her whole
physical process received  that impetus, which  either
develops a static animal life, or else destroys the one
that  does not  possess  the  spring of growth.   The
motion and hence decomposition kept up an organizing
force due to  her country life.   The very germ of the
mother Avas imperfect and lacking  in those  elements in-
separable  from a perfect physiological condition, and
nothing, but the elementary principles of  nature sup-
plied the  elements of organization and force,  Avhich
Avere wanting  to a great degree, in the  very pabul-
um-vitae.
   Hetero-lymphoma, and  atrophia  lymphatica,  arise
from a defective proteine compound, hence proteinous
disease.   This is scrofula.   This patient Avas a type  of
the mother and inherited her idiosyncrasis. The gener-
ally faulty physical  organization rendered  the system
incapable  of assimilation and chylification, so that the
process of repair was not equal  to the necessities of
growth and  waste,  hence emaciation and  general ex-
haustion.  The causes from which  this physical trouble
arose, were  unavoidable defects in  the animal economy
and composition.   It was inherited and  hence  trans-
planted from mother to son.
   Exciting Causes.--These were only additional evils, but
mot' fundamental, and arose  from  the  diet which was 
236
PROGRESSIVE MEDICINE.
quite irritating and indigestible, of namely, boiled  po«
tatoes, ham, fried meats, hot bread and pies, hot cakes,
coffee, tea, and pastry generally.   These  things  could
not be assimilated  and a formation of gastric crudities
Avas unavoidable, and therefore the chyle Avas Aveak and
impure.
  Medical agents employed alone in these cases -will
have  no result, as  the question is more physiological
than simply locally pathological.  The cod-liver oil and
iron of the old school indiscriminately prescribed by the
so-called rational doctors (Allopaths) would always re-
sult in sad failure unless  accompanied by a systematic
hygiene and dietetic treatment.
  Medical Treatment.—I  considered  the case a danger-
ous one and treated him Avith much solicitude.
  R. Belladonna, 3-dec. gutt. xii.
     Aqua distill., f ii.
  R. Mercurius  Proto-iodid., 3-dec. grs. xxiv.
     M. chart., xii.
  Dose—one teaspoonful every hour, alternately with
one powder and a Avarm  bath every night.
  I kept the patient on these remedies for three days
with a light animal diet  composed of broth and cream.
  I found no improA'ement, but  rather some discourag-
ing symptoms of hallucination insomnia, much pain and
SAvelling in the abdomen, Avithout  appetite.
  I acknoAvledge  that I Avas  disappointed, yet I  kneAv
that a crisis must be  the result  of this profound  phys-
ical malady.   BoAvels constipated, high fever and still
painful joints.  He shoAved considerable bronchial irrit-
ation  Avith a  general  irritability of  the  symoathetic
system and abdomen.
  On the  fourth day I gaA^e nim
  R. Atropa belladonna, 6-dec gutt. xii.
     Aqua distill., f ii.
  R. Emplastrum Conii upon  the abdomen  with 
DISEASES OF CHILDHOOD.
237
  R. Aurum muriat., 3-dec. grs. xxiv.
     M. chart, xii.
  Dose—one poAvder every hour alternately with a tea-
spoonful of the liquid.
  On the fifth day I found him more comfortable.   He
had  had a better night,  less fever, no  hallucinations,
free  discharge of urine and boAvels; abdomen less pain-
ful and less sAvollen.
  On the sixth and seventh days the temperature Avas
99; pulse 100.   He had thirst, and the secretions Avere
better.  He perspired freely and  was  comparatively
comfortable.   The hemlock poultice Avas reneAved twice
a day  and gave  great  relief.  He  received the same
treatment till he reached the tenth  day and then he
had an exacerbation, temporary, and Avithout any ap-
parent cause.  I  changed  the remedies:
  R. Hysciamus 1-dec gutt. xii.
     Aqua distill., f ii.
  R. Kali iodidi, 3-dec. grs. xxiv.
     M. chart., xii.
  Dose—one teaspoonful every hour alternately with a
powder.
  On my return  I found  him better, the fever  having
left him, the boAvels moved and the glandular tumefac-
tion  Avas diminishing.
  I kept him on this treatment for several days, and on
the fifteenth day  I gave him
  R. Podophyl, 3-dec grs. xxx.
     M. chart., xv.
  R. Aurum mur., 3-dec. grs. xxx,
     M. chart., xv.
  It  suggested to  me, the  fever having left, and the
irritability of the brain being  overcome, that I had to
look  after the  secretions, and  in  podophylum Avith au-
rum, I had tAvo great remedies for both the absorbents
and the secretions.
  In tAvo or three days I  had the pleasure to see that 
238
PROGRESSIVE MEDICINE.
the faeces Avere more natural and the urine less acid and
less ammoniacal; the ichorous secretions were  carried
aAvay and were changed.
  The  digestion having  improved, the  diet given  was
more  generous and  solid,  viz.,  roast beef, beef steak,
mutton, eggs, Avine and cream, bread and cocoa, etc.
  I continued for some Aveeks with aurum, belladonna
and aurum, changing the medicines every Aveek.  On
the fifth Aveek I found nearly all  the  sAvelling  of the
joints gone  down, the abdomen retracted, and almost
natural,  the daily faecal discharges were  regular  and
natural, and so  I had him brought out in the open air
on a mattress, put in a Avagon and  thus I kept him go-
ing out every day during pleasant Aveather.
  His improvement was noAV rapid; his appetite raven-
ous and his general physical condition gaining rapidly.
  I gave him during the  sixth and seventh Aveek
  R. Calc phosphoric, 3-dec. gr. 1.
     M. chart., xxx.
  R. Ferrum peroxyd., 3-dec. grs. 1.
     M. chart, xxx.
  Dose—one poAvder every three hours, alternately.
  On the eighth Aveek I left him apparently Avell and I
only recommended generous diet, fresh air, exercise and
salt Avater baths Avith occasionally  iodized cod liver oil.
Here Ave havTe a real homoeopathic treatment and cure,
because, Avere Ave to give such remedies to a Avell  per-
son (in a larger quantity) Ave Avould surely produce  ir-
ritabilities of the gastro-enteric  canal  Avith pyrexiae,
irritability  and general physical   derangement.   The
plastic force Avould deteriorate through an histogenetie
interference.   I also  predicted  a return of the same
trouble (less in intensity)  as soon  as the AAdnter season
would compel the boy to be closed in the house.
   The prediction Avas fully A'erified.   He had a return
of the cough, the fever and  the SAvelling; but Avith the
same treatment in tAvo Aveeks he was Avell again. 
DISEASES OF CHILDHOOD.           239
  I gave him  several  other remedies, as magnesia
phosph., barita carbon, natrum phosph., ferrum, etc.

                  CLINICAL CASE III.
  John Bartlett, fifteen months old.  His mother  died
soon after his birth and he was brought up by the bot-
tle.  The surrounding incidents Avere unfavorable, the
mother being sickly during pregnancy and died of puer-
peral fever soon after his birth.
  Physical Examination.—I found  the child in the ex-
treme condition of emaciation. His lungs Avere sound;
the heart Avas  normal  organically and  functionally.
Stomach and boAvels retracted Avithout heat.   His  phy-
cal development demonstrated general atrophy.
  He had a  large head, blue  eyes, light hair and Avhite
skin,  with  a  prominent  venous circulation.   Pulse
140; temperature  100.  His  bones  were  very small,
and in  truth,  he had not groAvn since  he  was three
months old.   Asthenia and aolynaemia Avith turgescense
of the  lymphatic vessels and  glands Avere decided evi-
dences of the  disease, in consequence of Avhich great
hvpereasthesia  existed.   Perfect anaetnia and enerva-
tion threatened the very foundation of his life.
  I Avas called  to consult Avith another physician  Avho,
after six  Aveeks of treatment, acknoAvledged  that he
knew nothing  of the disease.   He treated the case for
cholera infantum,  under the  impression that  the fre-
quent  intestinal evacuations  were sure indications of
that disease.
  Semiology.—When I visited the child I  found him
lying in his crib,  looking almost like a  skeleton, and
more of a corpse than a living being.  Great exhaustion
had set in, Avhich was evinced by his  very posture.
  His  moans and feeble cries indicated great physical
enervation.   His legs Avere abducted, his arms throAvn
off his  body, eyes shut, quick respiration, and too feeble
to change his position.  The skin alone  covered the 
240
PROGRESSIVE MEDICINE.
bony structure—no fat or muscles could be seen.   He
constantly called for nutrition (the bottle) and the more
of the milk he drank the more he Avanted.  His boAvels
moved almost as frequently as he took nutriment.  The
unquenchable thirst caused by  the  hyperaemic  condi-
tion of  the  digestive  organs  demanded a  continuous
supply of fluids.  As soon as he had received the milk,
he  passed  it  off through the boAvels  in  a sour and
curdled condition.
  The fermenting of the milk in  the stomach  produced
carbonic acid, in consequence of Avhich the  child suf-
fered Avith flatulant colic.
  He Avould take nothing but milk, day and night, and
its  undigested  condition produced symptoms of chol-
erine, but there Avere not the usual severe symptoms of
gastro-enteretis of the  cholera infantum.
  On examination of the abdomen I found that it had
no glandular SAvelling, no pain, and no heat; on the con-
trary, there  was an evident condition of atrophy, in the
excernent system.
  The teeth Avere not visible; and the gums giving no
signs of irritation.  I found that the milk Avas good, and
the child was also Avell attended; the atmosphere Avas
hot, but there Avere no  extreme  meteorological diurnal
or nightly changes; the Aveather Avas of course a source
of exhaustive influence, but the true cause lay deep  in
the physical economy.
  Etiology.—Taking a coup aVceil of the physical condi-
tion of the  child, the objective appearances were  only
confirmed by  the  subjective symptoms—marasmus  or
entero-mesenteric atrophia.
  The mother Avas feeble at the time of conception, be-
ing herself of a scrofulous diathesis; the act of procrea-
tion did not improve the physical conditions Avith her,
as it did Avith our country matron Avhom Ave have studied
in a previous case.  The  country matron Avorked hard
and  had the  beneficial  influence of perfect physical 
DISEASES OF CHILDHOOD.           241
 metamorphosis  and reorganization,  while this  young
 wife was indulged, and lived in  the  depressing  atmos-
 pherical influence  of a  southern climate and a retired
 life.   The  hyperaemia-lymphatica Avas  inherited from
 birth, and therefore the proteine compound Avas actually
 in a state of retrogression, and the mal-assimilated chyle,
 prevented a normal process of histogenesis.   The fault
 Avas fundamental and physico-vital.
   Medical Treatment.—Doubtless milk Avas not the food
 for that feeble  baby.   The  caseine,  sugar, butter, and
 albumen were ingredients Avhich the  lymphatics  would
 not  thoroughly  annualize,  and  indeed,  before these
 nutrients reached the  lymphatics, they were converted
 into imperfect chyle.
   That emaciated child required animalized food (nitro-
 genous) Avith the triplo-phosphates to give plasticity to
 the blood.
   1. It was a case  of insufficiency in  the elements of
 nutrition—milk  ; 2, the  physical compound  (proteos)
 Avas deficient; and 3, physically unable  to organize  out
 of a Avatery fluid a  sufficient quantity of  the elements
 of  nutrition  and groAvth—(Histogeneses) hence  the
 disease in question.  It Avas suggested that the  bottle
 be given up, naturally enough this Avas acceded to Avith
 great reluctance on the part of the attendants, but it
 Avas an imperative necessity.
  R. Belladonna, 3-dec gutt. xii.
     Aqua distill., f ii.
  R. Cainphora, 3-dec. gutt. xxiv.
    Aqua distill., f ii.
  Dose—one teaspoonful of the liquid alternately every
hour and a Avarm bath Avith salt in it.
  Diet.—Beef tea, almost like blood; one teaspoonful
every tAAro hours.  Burnt brandy Avith Avater; one  tea-
spoonful every hour; rice Avater for a drink—at first he
refused it and cried for a long time;  then he  slept and 
242
PROGRESSIVE MEDICINE.
woke up refreshed.   The beef tea Avas given  Avithout
any trouble.  The brandy he liked.
  I called tAventy-four hours after, and I found  by a se-
rious struggle Ave had succeeded in making him take
the food.   His pulse  Avas better;  he slept two hours;
his evacuations Avere less frequent.
  On the third day I  found the pulse fuller in  volume,
less  in  frequency; the  temperature Avas  loAver,  the
thirst had diminished and he did not ask for the bottle.
Evacuations yelloAv, more solid, the carbonic gas inflat-
ing the  intestinal canal, and decidedly diminished;  and
the child rested day and  night.
  It Avas advisable to change the medicament  because
it Avas not covering all the physical troubles, his evacua-
tions being still too frequent Avith considerable fretting.
  R, Plumb, acetatum, 3-dec grs.  xx.
     M.  chart., xv.
  R. Quin. sulph., 3-dec. grs. xx.
     M.  chart., xv.
  Dose—one powder every hour, alternately, till six at
night, then
  R. Lactucasia, 1-dec gutt. xxiv.
     Aqua fortis, f ii.
  Dose—one teaspoonful every hour during insomnia
at night.
  Sixth day: The grandmother Avas very much encour-
aged as the treatment seemed  so successful;  Avith  a
few little  returns of excessive Avatery evacuations, the
case progressed favorably.
  I found my  patient looking better, taking notice of
his grandmother and  hating the doctor as usual.  The
evacuations were only about eight in tAventy-four hours;
the urine was deeper in color and less in quantity.  The
food became rather tiresome to the child, so I  ordered
rice  boiled in broth, and  clam  broth.   As  the child
needed  great invigoration I gave him phosphorus in
glycerine—one teaspoonful every tAvo hours. 
DISEASES OF CHILDHOOD.
243
   R. Phosphorus, 6-dec gutt. xx.
     Glycerine (pure), f iii. '
   R. Calc phosph., 3-dec. grs. xii.
     M. chart., xii.
   He took the medicines for two days Avith great bene-
 fit, but the evacuations became too frequent, so I  had
 to keep them under restraint.
   On the eighth day I prescribed the phosphorus Avith
 a change in the place of the  calcarea, viz.:
   R. Rheum et natrum 3-dec, grs.  xxiv.
     M. chart., xii.
   To be taken alternately Avith the phosphorus every
 tAvo hours.
   The diet Avas also changed.   I gave bread and broth
 boiled together for an hour,  and then strained.  I  sub-
 stituted milk  punch for the brandy omitting the sugar.
   The  tenth, eleventh and twelfth days the case  con-
 tinued to improAre and the nature of the secretions Ave re
 much better under the effect of the Rheum et natrum.
   Thirteenth  day:  I found him rather  cheerful,  and
 some indication of teething.  Before, he Avas physically
 unable  to form sufficient  phosphate of lime to produce
 bone and teeth; and this sign Avas indeed an evidence
 of the good  result of chemico-physiological principles
 which I adopted in the treatment.
   The  progress of the case  Avent on Avith very feAv in-
 terruptions, and the boAvels and the chylopositic viscera
 became thoroughly disengaged from those elements of
 disintegration  Avhich Avere reducing the economy to a
 state of dissolution.
   The dietetic treatment  Avas someAvhat A'aried.  I gaATe
 him  rice cooked in condensed  milk, Avith salt and  tAvo
 grains of calcarea phosphorica in it.
   He digested  light cocoa,  mutton broth  and bread,
 sago, and a  composition of peas,  beans and lentils,
 strained in the broth, or even milk.  The above three
vegetables are  Avhat is called nitrogenous vegetables or
leguminous food. 
244  .        PROGRESSIVE MEDICINE.
  I proceeded by giving
  R. Magnesia phosph., 6-dec gr. xxx.
  Dose—one poAvder every three hours.
  And  ended  Avith  Barita  carb.,  Ferrum peroxid,
Aurum  muriat. Calcarea  carbonica, quinia sulph., kali
arsenic, kali sulph., kali  chloras;   fresh  air, bathing
morning and night; cold Avater in the morning, Avarm
at night.  In six Aveeks the child Avas cured.

                  CLINICAL  CASE IV.
  A female  child, about eighteen months old, of nervo-
lymphatic temperament.  She Avas almost in articulo-
mortis.   She had been sick for four months and treated
by Allopathic physicians  in good standing.   She AA'as
well dosed and, most emphatically, empirically treated,
i. e., Dover's poAvders to make her sleep and  check the
excessive evacuations, bismuth  and pepsine, and gray'
poAvder, to  use their Avord, as  alteratives; ipecac and
rheum in large doses, chalk mixture, and astringents, and
thus it Avent on to a chronic stage.
  The child Avas treated for cholera infantum, and then
for marasmus; they had her at the sea shore and although
she improved someAvhat, the irrational treatment could
not aid  the  vis-medicatricae naturae in its efforts  against
the disorder.
  Physical  Examination.—Lungs sound, heart's  action
very irritable and feeble, pulse thread  like and very
frequent (140), temperature  low, breath  offensive, and
tongue  reddish on the  edges, Avhite in  the middle.  No
glandular enlargement Avas  perceptible  to  the touch,
heat, turgescence  undoubtedly existed.   Abdomen
SAvollen, and full of gas, painful on touch  and hot, eyes
sunken, features shriveled and  emaciated.   The liver
Avas  enlarged  and  slightly jminful.  The general ap-
pearance Avas, that of extreme exhaustion and.anaemia.
  Semiology.—The child Avas  in  her mother's  arms
where she Avas accustomed to be  carried around the 
DISEASES OF CHILDHOOD.            245
 room for hours, and thus she  Avas kept  comparatively
 quiet, but  the moment  the motion ceased the child
 Avould scream until the Avalking Avas resumed; she Avas
 moaning, but  evidently not asleep.  Every attendant
 Avas tired out, for they Avere on the go, day and night.
 The pulse indicated adynaemia, agitation,  hyperaesthesia,
 in the highest degree, with asthenia following.  She was
 ravenous for the bottle,  and what is more, had it to her
 heart's content.
   I Avas  soon satisfied that I had a case  of entero-mes-
 enteritis cronica  Avith hetero-plastic lymphoma.   She
 inherited a  scrofulous diathesis  from the  father and
 mother; both parents Avere delicate, nervous and feeble.
 She had a  passage every  fifteen minutes, Avhich Avas
 Avatery  and of a chalk color Avith curdled milk, some-
 times greenish and  sometimes  mucous, but there Avas
 no biliary fluid in the evacuations.  She had been over-
 fed and  kept on feathers in close rooms.  All the enteric
 juices Avere  ichorous, perverted  and irritating.   The
 physico-vital forces.Avere in the most critical  condition.
   Etiology.—In examining  the proximate and remote
 causes I found  that the father  Avas so nervous that his
 speech Avas often  affected, his  eyes  shoAved a Aveakness
 (or a specie of scrofulous ophthalmia). His digestive or-
 gans Avere Aveak and suffered Avith dyspepsia.   He had
 small blue eyes, light hair and a large head.
   The mother Avas a brunette, Avith piercing black eyes,
 Avhite  skin,  black hair and large mouth.  She Avas very
 careless  of her  diet and A'ery imprudent as to exposure.
 She Avas  of delicate health and scrofulous; she had lost
 tAvo brothers, one Avith hepatitis, another Avith consump-
 tion.   The  remote predisposing causes Avere inherited
 scrofula  and  a  ner\Tous idiosyncrasis.   The proximate
 and exciting causes Avere over-nutrition, Avant of air and
light, etc.  (Induced causes).
  The  pathognomonic symptoms of struma from entero-
mesenteritis Avere strongly  marked.   I could not find 
246
PROGRESSIVE MEDICINE.
that the  child's  disorder  had  commenced  Avith  any
plethora or enteritis;  in that case her  condition  Avould
have been the natural sequence of inflammatory dis
ease of the  intestines.   If there  had  been  any ple-
thora in the first  stage, it  was undoubtedly lymphatic
Avith turgescence and tumefaction.
  When an inflammatory condition is first developed, if
death  does  not take  place, it is folloAved by  asthenia,
adynaemia and atrophy-lymphatica to a greater or less
extent, and  disorganization is  the unavoidable result
Avhen such a morbid process is prolonged.
  The secondary lesions of distant parts or  organs, are
the results of reflex  metastasis, viz., the ameloid dis-
order, hepatic suppression, renal complications, serous
secretions  or pulmonic  irritability,  hyperaemia,  and
tuberculosis.
   The  idiopathic  causes  are  sudden  meteorological
changes, malarial poisons, insufficient  nutrition, abnor-
mal milk, Avant  of the proper  diurnal ablutions and
 cleanliness, and teething.
   Hygiene  and  Dietetics.— HaA'ing noticed  the great
 anxiety of the parents, and their lack of judgment and
 proper  conception of Avhat Avas required by the sick
 child, and their total  Avant of instructions by their for-
 mer  physicians,  I immediately  informed them of  their
 duties and desired adherence to my directions.  This
 mode of procedure  Avas  neAV  to  them and  decidedly
 difficult to carry out.
    1.  The child should be put in  her crib, on  a hard mat-
 tress, so as to remain  in an incumbent and comfortable
 position.  2.  The  room should  be Avell ventilated, and
 Avhen the child Avas aAvake to let  in all the light possible.
 3.  A Avarm bath at night and a cold one in the morning.
 4.  Not to move the  child from her bed, as  motion, I
 considered, a disturbing element to the  irritable intes-
 tines.
   Milk Avas at once set aside ;  mutton broth and beef 
DISEASES OF CHILDHOOD.          247
teaAvere to take its place, and at intervals burnt brandy
and sugar with water.
  Medical Treatment.—I ahvays consider  belladonna  as
the great invigorator of the cardiac circulation and  at
the same time ameliorating ganglionic irritability, par-
ticularly that of the splanchnic and vasa-motor nerve.
  R. Belladonna, 3-dec gutt. xxiv.
     Aqua distillata, f ii.
  R. Merc solubilis, 3-dec grs. xii.
     M. chart., xii.
  Dose—one teaspoonful every hour alternately with a
poAvder.
  On the second day I found  the child had rested bet-
ter; the  boAvels Avere more quiet, and contained more
faecal matter;  she passed more Avater, Avhich had more
color.
  Her  skin Avas Avarmer, pulse stronger and less agi-
tated;  her  general countenance Avas  better; still the
dangerous symptoms were yet existing  only in a less
degree.
  I  continued  the treatment  for tAventy-four  hours
longer.
  On the fourth  day I found  the patient very irritable
and the evacuations as bad as ever.   I suspected that
they deviated^ from my instructions: they acknoAA'ledged
to have given  the child some  milk and to nave taken
her out of her crib.  I Avas at last satisfied that my ad-
vice Avas not ill-judged and that they had fully tasted
the result of contrary doings. I, of course, repeated my
advice only in stronger terms, and left.
  R. Lactucaria, 3-dec. gutt. xxiv.
     Aqua distill.
  R. Rhei et natr. 3-dec grs. xxiv.
     M. chart., xii.
  Dose—one teaspoonful of  the liquid  every hour, al-
ternately Avith the poAvders.
-  Fifth day:—The patient Avas  more  comfortable.   It 
248            PROGRESSIVE MEDICINE.
 had passed a good night; the evacuations Avere only few
 in  number,  of  better  color and contained more faecal
 matter.   The child Avas  less ravenous  and  took what
 they gave her.   The diet Avas continued and  the medi-
 cal treatment also.
   Seventh  day:—I  found  the   child Avith a stronger
 pulse, a AA-arm body, and  faecal evacuations.   The pass-
 ages Avere less painful, but  they had an offensive odor.
 I Avas prepared  to find nitrogenous undigestible excre-
 tions, so I gave her
  R. Carbo-vegatabilis, 3-dec. grs. xxiv.
      M. chart., xii.
  R. Camphora, 3;dec gutt. xxiv.
      Aqua fort., f ii.
  These remedies Avere given on a therapeutical prin-
 ciple.  The Avell-knoAvn  effect  of carbo-vegetabilis, so
 far as Ave knoAv, is antiseptic, and prevents decomposi-
 tion and fermentation.  The camphora is an organizing
 element as its effects are curative in cases of svncope
 in Avant of organic function  in defective circulation and
 hepatic  torpidity.  It also affects  strongly the motor
 sensory system  of nerves.
  Eighth day:—I found  the secretions improved and
 the excretion not alarming; the  child Avas iioav gaining
 strength  and its  digestive organs Avere quieted  doAvn
 under proper therapeutical means.   Her tongue  Avas of
 a healthful red and the  flatulency  nearly gone.  The
 odor of the faeces changed for the better and  the vital-
 ity of the patient Avas considerably increased,  yet in-
 somnia Avas still  a great trouble.  I  prescribed for the
 ninth day
  R. Potass Bromidi, grs.  xxx.
     Aqua distill., ?  iv.
  Dose—one teaspoonful every hour at night until she
fell asleep.
  R. Arsenic alkalizatum,  3-dec. gutt. xii.j
     Aqua, f ii. 
ISEASES OF CHILDHOOD.          249
  Dose—One  teaspoonful every tAvo hours  during the
day.
  Tenth day:—The  child  Avas  still improving  and
laughed  and played.  Her evacuations  Avere yellow,
skin Avarm, appetite natural,  slept Avell  and cried but
little; no fever and very  little irritability.
  TAvelfth day :—Went on Avith the same medical treat-
ment; but I changed the  dietetic to condensed milk
Avith brandy, beef  broth Avith rice, and glycerine.
  Thirteenth  day:—Child  still  improving.    I pre-
scribed.
  R. Calc phosph. 3-dec. grs. xl.
     M. chart., xx.
  R. Pulsatilla, 3-dec gutt. xxx.
     Aqua, f iii.
  Dose—one poAvder  every hour alternately with the
liquid.
  Fourteenth  and  Fifteenth  days:—I continued  the
same treatment.  I found that the child's whole organ-
ism Avas in a state  of change; noAV  I considered that the
day of the crisis had passed and that the climax having
arrived  the disease Avas entirely under submission.
  Sixteenth day:—
  R. Magnesia phosph., 3-dec.  grs. xxiv.
     M. chart., xii.
  R. Belladonna, 3-dec gutt. xii.
     Aqua pura, f ii.
  Dose—one poAvder alternately Avith a teaspoonful of
the liquid.
  The infant was still very much  emaciated, and Avant-
ing animal heat which I  knew her imperfect  poAver of
organization could not yet supply.   I ordered
  R. 01. Morrhua, ^ ii.   One  half teaspoonful to be
given in brandy tAvice a day;  and also
  R. Ferrum peroxydum, 3-dec. grs. xxiv.
     M. chart., xii.
  Dose—one poAvder every three hours. 
250
PROGRESSIVE MEDICINE.
   I continued this treatment for one Aveek with percep-
 tible benefit.
   On the twenty-first day I gave her
   R. Liquor potass arsenic, 3-dec gutt. xxiv.
      Aqua distillata, ■z ii.
      And iodized cod liver oil (Fougera's).
   She improved under this  treatment; slept well, cut
 tAvo teeth, became fat and strong and ate regularly.   I
 alloAved cocoa in  the morning Avith condensed  milk
 meat at noon Avith rice and bread, yolk of an egg Avith
 Avater and  brandy (without  milk), beef broth and ver-
 micelli  or bread.
   On the thirtieth day I ordered
   R. Ferrum peroxidum, 3-dec. grs. lx.
     M. chart., xl.
   R. Calc phosph., 3-dec  grs. lx.
     M. chart., xl.
   Dose—one  poAvder alternately  every  three nours,
 changing with cod-liver oil.   The  seventh  Aveek  she
 was entirely cured.   Tavo  important remedies which I
 used in  these  cases are, ipecac and plumbum aceticum:
 the first in great irritability, the second in great spas-
 modic pains.   I also used oleum ricinis Avhen  great irri-
 tation and bearing down existed.

                   CLINICAL CASE  V.

             APllTEOUS DISEASE—THRUSH.
   A baby of a few days old  gave signs of pain in the
stomach.  He  cried  and  refused   to nurse.  He  Avas
born under very  unfavorable  auspices.  The  mother
Avhen pregnant lhred  for  several   months before  the
birth of the child on bread and tea, and a feAv potatoes
and pork.  She Avas very  poor and her husband made
her poorer and miserable.
  She came to my house  and there gave birth to this
child.  When born he Avas very small and emaciated; 
DISEASES OF CHILDHOOD.
251
 the cord Avas very small and indicated anaemia.  He Avas
 fully groAvn as far as the bony structure Avas concerned,
 but atrophy mesenterica Avas the prominent pathogno-
 monic feature.

   Physical Examination.—The lungs Avere  sound with
 feeble respiration.   The heart's rythins Avere irregular
 and feeble.   Large bones, small head and feeble  pulse.
 The navel retracted in a  very short time after birth,
 defective venous circulation  (cyanosis), tongue coated
 Avhite, Avhich in a  short time developed  in  aptheous
 form  (Thrush).  The mouth Avas hot and dry.  He Avas
 at times very pale,  at others, flushed and cyanotic.

   Semiology.—Tavo or three days  after birth the child
 refused to take the bottle.   He cried a great  deal and
 seemed to be in pain.  I thought it Avas colic, from in-
 digestible milk, and ordered lycopodium  and natrum
 carbonicum.   On the fourth  day the  child Avas appar-
 ently improved and nursed better.
   When I saAv him tAvo days after he presented  a neAV
 feature.   He Avas shriveled like an old man; his eyes
 were sunken; he Avas cold and mottled Avith bluish spots.
 His breathing Avas sIoav, he cried a good deal and dreAV
 up his knees  as though the abdomen hurt him. On ex-
 amination I found his mouth full of those white specks,
 indicative of thrush  or the premonitory symptoms of
 thrush.  He  vomited several times and  gave me the
 idea that  the disease Avas irritating the stomach, if it
 had  not reached it already.  I am convinced that he
 Avas born  Avith it and that it Avas due to a great consti-
 tutional debility, disarranged assimilation, and ferment-
ing principles, Avhich  always arise  from want of proper
physical organization; it, indeed, arose from  an  unor-
ganized  animal  chymification.    It  Avas  temporarily
checked by Avashing  the mouth Avith  a solution  of na-
trum bisulph. 3 i to f i of Avater. 
252
PROGRESSIVE MEDICINE.   .
  R. Soda Borax, 1-dec. grs. xxiv.
     M. chart., xxiv.
  Dose—one poAvder every tAvo hours.  The mouth Avas
washed  after  taking the bottle.   The child  improved
for  two  or  three days  longer but  the  mother felt
uneasy.    His  agitation,  cries  and apepsia,  Avith fre-
quent  passages,  gave  the  alarming pathognomonic
symptoms of  aphetous condition  of the stomach and
boAvels.   His  abdomen was SAvollen and passed  much
gas.  The  evacuations  were  mucous  Avith  streaks
of blood;  the pulse Avas thready  and the features
indicated exhaustion and adynaemia.  The  faecal mat-
ter Avas  covered Avith a white  aphteous matter.   The
treatment  demonstrated  from  the various  changes,
that it Avas Avell chosen; had not the great physical dis-
order prevented  nature from regaining sufficient vigor
to overcome the disintegrating process of mal-assimila-
tion, there Avould have been a hope of recovery.  All
alimentation was of no advantage  Avhen heterogenous
formations Avere originated  in the  animalizing  fluids
themselves—heteroplastic-lymphoma.  Proteous disease
was unchangeable and beyond human poAver.
  We must observe that this is different (pathologically)
from follicular stomatitis or enteritis, Avhich are  condi-
tions of much milder form, being  idiopathic, or sympto-
matic, from some other cachexia, hence fomenting  dis-
eases ; Avhereas inherited thrush is the result of animal
dissolution like  gangrene.  I changed milk for animal
food and gave him  sulphurous  acid, kali chloras,  sweet
oil, glycerine, etc., but only Avith temporary relief.
   He died at the end of a month, having  lived longer
than any one  could possibly imagine.  He died of star-
vation  and decay.    He Avas a perfect mummy after
death;  even the bones seemed to have shrh'eled aAvay
(Aphteous-Neonatorum).
   I luive seen a good deal of this disease  in Hospital
 children, Avhere the little unfortunates inherit all sorts 
DISEASES OF CHILDHOOD.          253
of constitutional taints.  Much can be done  for those
cases Avhich are idiopathic and available to treatment.
We are indebted to Dr. Berg, of Stockholm, who made
a microscopic research of the pathology of the disease
in 1842, and to Dr. Jenner, Avho has suggested the treat-
ment of sulphite of soda, Avhich being decomposed by
the acid  of the  saliva, it  becomes  sulphurous acid,
Avhich  destroys the parasites. 
254           PROGRESSIVE MEDICINE.
                   CHAPTER VII.

 ERUPTIVE DISEASES, SCROFULO-DERMA,  MAL-ASSIMILATION,
   GASTRO-HEPATIC AND GASTRO-INTESTINAL ACRIMONY.

   Efflorescence, pathologically speaking, is a significant
 term, full of meaning and closely  applied to its purpose.
•It indicates—to break out, and is applied  to floAvers in
 bloom; it is indeed, the  natural sequence of an inward
 fermentation  (zymotic diseases)  Avhich must sooner or
 later creep through the lymphatic absorbents, and make
 its Avay to the surface, or Avithin the  cutis vera and the
 outer surface.  There are many such diseases, of various
 intensity and  virulency.  Some are  spontaneous, idio-
 pathic ;  some  constitutional and inherited, and others
 symptomatic.
   They are the result of either \-egetable or animal de-
 cay; from  hydro-carbone or hydro-sulphurated exhala-
 tions,  or from arnmoniacal  and  nitrogenous  mephitic
 exhalations (animal decay).
   The  vegetable or animal fungi are either spontane-
 ously generated and  existing in the protoplasma,or else
 introduced by effluvial  gases  proceeding from alluvial
 soils or meteorological influences.
   These diseases may be indigenous, or brought  from
 other places.   They are  the offsprings of uncleanliness
 and neglect.   Sometimes  are  spontaneous,  external,
 uncomplicated Avith any constitutional disorder.  They
 disseminate rapidly  Avhere there is a prolific soil to in-
 vigorate groAvth, and climeric influences to assist them.
   Moisture alone  does  not ahvays produce  malarious
 diseases; for in highly rocky places the most destructive 
ERUPTIVE DISEASES.              255
effluvia is produced by the rain falling upon the hot
rocks,  Avhose crevices are full of fungi or auimalculi,
Avhich  being disengaged by  the influence  of the rain
produce malarious  gases;  although  moisture  Avith
vegetable decay forms combinations of gases poisonous
in the  extreme.  And again, A^ery dry atmospheres Avith
electric influences combined, decompose animal matter,
change animal fluids, and  neAV compositions are formed
Avhich are deleterious to organization and life itself.
   I find it necessary to confine myself to a certain class
of examinations Avithin the boundary of neAV cutaneous
diseases.  These are subdivided into genera, atrophia
and hypertrophy of the lymphatic vessels and glands
from Avhich these various eruptions often originate, and
also from  gastro-hepatic  and  gastro-enteric  crudities
with neurotic complications.  From these physio-organic
disorders  rise  mal-assimilations  and  proteinaceous
diseases.
   There are a feAv idiopathic eruptions Avhich are super-
ficial, and that create but  temporary disturbances, like
erythema solares  or simplex:  erysipelatous  inflamma-
tions from heat, cold, moisture, or chemical causes.
   The  second  class are generally of an inflammatory
character and they have a regular course, pathological
peculiarities, and  are not dispersed  through  certain
physical morbid phenomena.
   The third class are those that are inherited or pro-
duced by  certain  physiological disorganization, hence
constitutional cachexia; these  are generally chronic in
their nature and tendency.
   The anatomy and physiology of the cutis is as folloAvs:
1. Dermis, a cellular canvas, demise and fibrous, protect-
ing  the capillary vessels,  the lymphatics, the nervous
filaments, and papillae.  2. The organ of touch is formed
by the termination of the nervous system.  3. The
sudorific  apparatus.  The organs of secretion and ex-
cretion Avith the  sudorific canals.   This  apparatus  is 
256          PROGRESSIVE MEDICINE.
composed of glandular parenchyma or spongy secreting
glands, and the excretory  canals arise  among them as
conductors of the sudorific fluid, Avhich  are the channels
by which evaporation  takes place.   4. Absorbents;
these resemble the lymphatics.   5.  The mucous appar-
atus.  6. The pigmentum.
  It is manifest to the most casual observer that such a
variety of actions and effects must necessarily be sub-
ject to a great number of derangements.
  Doctor Plumbe observes " Of those  deviations  from
health Avhich Ave  find frequently, diseases of the skin
form no inconsiderable portion.   Debility is the charac-
teristic of a very large portion of these, Avhile repletion
and disorder of the digestive organs arising from irregu-
lar habits give occasion to many others."
  And this theory confirms much  that  Hahnemann has
said in his Avritings  on  Psora;  but  of course  he was
ridiculed and persecuted just because he had the  cour-
age to advance a neAV idea.   Much that is  obscure in
Hahnemann's  Avritings is due  to  German  mysticism.
They are on the one  side fond of the profound and the
inexplicable, Avhile on the other they are often practical
and materialistic; the tAvo extremes are real German
failings.
  According to Hahnemann, every born human being
had some kind of psora.   Had this great reformer said
that, in animal economy there Avas  a latency for  some
dyscrasia Avhich  exists  in the  ichorous juices of the
scrofulous  diathesis, the statement would  have been
accepted.
  But surely  every  child is not born Avith  a psoric
cachexia, nor scrofulous diathesis; it Avould be absurd
to suppose such a thing.
  Strumous diseases appear  under a variety of causes
and  pathological lesions, namely, Adenitis, mesenteritis,
ulcers, abscesses, ophthalmiae, cutaneous eruptions, mor-
bus  coxalgia,  tubercular consumption,  etc.  The dia- 
ERUPTIVE DISEASES.            257
thesis  of the patient, the predisposing idiosyncrasies,
and the exciting and enduced causes, are so many factors
in the nature, progress and result of the disease which
should not  be thought  of lightly;  and it is only Avhen
Ave make ourselves Avell acquainted Avith these sources
of the disease in question, that a logical treatment can
be arrived  at Avith any chance of reasonable success.
  These different  species  of  disorders  are  well  de-
fined  by pathological  descriptions, and from that and
a thorough knoAvledge of the origin of the malady Ave
are prepared for a successful attack upon the enemy.
  The acne simplex is an  eruption of the  sebaceous
glands (meaning the summit of an efflorescent disease),
has its pathognomonic symptoms  both objective and
subjective  different from the  acne  punctata, indurata
rosacea, yet the variety is  the offspring of the same
evil, namely, constitutional debility, and hence acrimony
of the fluids Avhich  remain  unorganized or mal-assimi-
lated, to be throAvn to the surface in some peculiar form
according to the diathesis and idiosyncrasies  of the in-
dividual thus affected.   This, hoAvever, is not the psora
of Hahnemann,  Avhich  is generally a parasitic disease
arising from vegetable or animal decay or the result of
fermentation of  either animal or vegetable matter, and
hence  animal or vegetable  animalcules, impregnating
the atmosphere and thus infecting the animal economy.
Psora might also arise from Avant of  cleanliness, from
Ioav and poor diet, and from inheritance.
  But  the  acne requires only a simple and hygienic
regimen, it seldom being necessary  to have recourse  to
any medicine.
  Although idiopathic  and simple eruptions are often
met and treated successfully, yet, at times they change
and become intensified and complicated by  some con-
stitutional taint  unforseen and unsuspected.
  In these peculiar cases even erythema, the  simplest
of all the inflammatory eruptive diseases, may meet with 
258
PROGRESSIVE MEDICINE.
some predisposing and latent dyscrasia and thus become
an eczematous  fermenting exanthema; and vice versa,
an eczematous eruption may terminate in a simple ery-
thema, so that Ave cannot Avell determine Avhere and hoAV
one disease Avill commence or end.   One form may com-
mence  from the simplest and end in a serious  kind of
exanthema simply  from a constitutional  cachexia.  But
these  two  genera  are merely  phlogosis, one  being
simply the  higher  grade of the other.  Eczema solares
and humidum  proceed as their names  fully indicate
from meteorological influences.
  We  have no  reason to accept the theory of Hahne-
mann "that all eruptive diseases proceed from a consti-
tutional psora or taint," as our present  knoAvledge  has
clearly proved the fallacy of such reasoning, and  given
us a differential pathology and diagnosis.  There  are
plethoric eruptions, or rather eruptions proceeding from
plethora, as Avell as from adynemia; and again there are
also eruptions  arising from  both  hyperesthesia and
asthenia, and are  indeed  constitutional—and yet they
are not parasitic in their nature, and therefore patholo-
gically speaking they differ Avidely from psora or  the
itch of Cullen.
  Even a simple eruption obstructs, often, the evapori-
zation  of the body and thus interferes Avith the normal
physiological process of the economy.
  The  idiopathic  cutaneous diseases are  classified as
folloAvs: sthenic and asthenic, neuro-sthenia, neurosis
or adynaemia.
  Women of great sensibility are prone to neuro-sthenia,
others  to  adynaemia.  These  often suffer Avith cutane-
ous irritabilities and  hyperaemia Avith  more or less of
some kind of eruptions, and the cure depends A'ery much
upon  a correct diagnosis, as the causes are  dissimilar,
consequently  the  treatment must  be different.   Fre-
quently such morbid conditions attack  the genital or- 
ERUPTIVE DISEASES.
259
gans, and Ave find Avomen, especially those of a nervous
constitution, suffering with vaginitis.
  Scrofula-Derma.—From  this  term  Ave at once  can
place the morbid trouble in the lymphatic system  and
the blood.
  The lymphatic absorbents of the dermis are frequently
involved in cutaneous diseases, hence the name of scro-
fulo-derma;  and these morbid conditions may be either
acute or chronic:  1. Plethora  lymphatica Avith  turge-
scence,  2. sthenic or asthenic  The nature or type of
the  diseases and their  peculiar classifications are the
true mode of learning  the pathogeny of morbid affec-
tions;  and it is  indeed particularly necessary in the
great vrariety of  cutaneous disorders.  Here is  a\ here
Hahnemann has  erred  in his great Avork on homoeopa-
thic practice.
  In these cases of scrofulo-derma Ave find a  condition
of hetero-plastic disease diffused through  the lympha-
tics, of  an ichorous, crude, mal-assimilated albuminoids
(Proteinaceous disease), and  all the vessels, glands, and
lymphatic ganglia are  thus either atrophied or hyper-
trophied, gh'ing those  pathological  eAadences in the
form of cutaneous  diseases,  and  besides  causing an
hyperaemic  condition of all the capillary A^essels  sur-
rounding them, thus an acute or subacute capillary con-
gestion is the result.
  Much has been said about faulty-nutrition, chyme, and
chylification, as the proximate principles of disorgani-
zation of the physical forces, phenomena and metamor-
phosis.
  Inasmuch as the  excernent  and  secernent systems
have the absolute endoAvment of organizing the elements
of nutrition, adding materials to the proteine compound,
it  must be  obvious to  us that Avhen those absorbents
and refiners secernent as itAvere, animalizingas the fluid
proceeds, Avhen these are feebly developed, or are sur- 
260
PROGRESSIVE MEDICINE.
charged Avith elements not assimilated, that  the  tissue
and blood must be naturally impure,—hence  scrofula.
  Lupus Exedence/rom the non-Exedence.—The former is
more  confined  to the head and face, and perhaps  less
intractable; Avhile the  latter extends  itself from  the
neck, shoulder and arm; it is more virulent  and has a
longer period.
  " Lupus exedence rarely attack the integuments of the
chest, or the extremities; these are more frequently the
seat of Lupus non-exedence."—Plumbe.
  The divided opinion  of medical Avriters  upon  this
peculiar  disease has been, Avhether it Avas  of a scrofu-
lous nature or  free  and disconnected  from  it.   The
question has been often discussed Avith more or  less
ability on both sides; but it  is noAV regarded as a dis-
ease proceeding from a strumous diathesis, although, it
may differ in certain objective manifestations, yet  the
pathognomonic  symptoms are those  of constitutional
taint someAvhere.   It is said  that many cases of lupus
occur in people of sound  health, and avIio have never
suffered  from any cutaneous  or chronic troubles Avhat-
ever.  These are not points  Avithout a  certain force to
the argument.   Lupus, therefore, is not per-se, a scrofu-
lous disease, although they admit that it  may be  con-
nected Avith scrofula and erysipelas or  syphilis; but it
is also argued, and  Avith a strong sense of  logic,  that,
even a pure, strong constitution may have subjective
predispositions or latencies, Avhich only require certain
exciting causes to  develop  some  of  the most unsus-
pected dyscrasia, such as, tuberculosis, Avhich afterAvards
develops into galloping consumption, cancers, malignant
tumors, ulcers, diseases of the bones, etc. The acrimony
of the gastro-enteric juices  is really the factor of this
malady; and these conditions may be inherited, excited
or induced.
   And Avhy is it that this lupus exedence is  to be found
more frequently in people from the age of childhood to 
ERUPTIVE DISEASES.
261
manhood, and seldom after forty?  It  is obvious that
the lymphatic diseases are more generally developed in
the tender age, and the age of development, than after-
Avards, Avhen the physical and organic functions have
fought the battle out, changed the ichorous secretions
and returned to a comparative normal  condition.  Are
not the young more prone to diseases of the alimentary
organs and the vis-vitae than older people?
  Surely many a delicate  person  if he can only reach
the other side of thirty or forty, is good for many years
after, and the reason is Avell knoAvn to physicians.  And
again, those people aat1io live on sour food, tainted meats,
and  breathe animal mephitic poisons  are  more prone
to these diseases  than those living in comfort.  And
Ave see also those  that indulge in  spirituous  liquors,
fermenting  Avines, rich, greasy, nitrogenous diet, suffer
Avith gouty dyscrasia—or lithiasis; as Avell as those Avho
indulge  in  delicacies, which  render digestion  and as-
similation  out of the  question.  They  thus  produce
accumulations  of  acidities in the primce vie, changing
healthy chyme into acidulous chyle and thus the pheno-
mena of physiological metamorphosis,  is  changed into
an unspeakable fountain of anomalies.  It is therefore,
in my opinion, a disease of a proteous nature, or hetero-
plastic lymphitis.

                   CLINICAL CASE I.
   Mr. B., age sixty-tAvo, of a nervo-lymphatic  tempera-
ment.  Small frame but apparently  Avell and Aviry.  He
suffered no pain and no debility.  He had a gray Avhite
cicatrix under his right eye extending  to the alae nasi;
it Avas a thin shining skin Avhich indicated a poor reticu-
lated structure of the cutis, and  its softness denoted a
Avant  of healthy  tissue  underneath.   The eyelid  Avas
someAvhat everted from the former corroding  attack of
lupus exedence.
   Physical Examination.—The  skin looked unhealthy. 
262
PROGRESSIVE MEDICINE.
 The heart Avas frequently functionally irregular and ex-
 cited ; lungs Avere sound but the  liver Avas  torpid, and
 the stomach  very delicate.   The  chylopoietic v-iscera
 was evidently disturbed in its organizing functions, and
 the animalization of the elements of nutrition Avas de-
 defective  in  the extreme.   He had a large head and
 small grey eyes.  I found a chronic enlargement of the
 cervicle and submaxillary gland.
   He Avas ahvays a good liver, and often  abused the
 privilege of the table; smoked and used Avines ad libi-
 tum.   The capillary circulation  was sIoav.  He kept
 late hours, and confined himself to  reading and intel-
 lectual pleasures.   Years before  he suffered agonies
 Avith a complete retrograde process of all the functions
 of alimentation; he became so much reduced  in his
 physical and vital forces that his life Avas  in eminent
 danger.
   Semiology.—After a  protracted illness of dyspepsia,
 Avhich nearly carried him to  the grave, he  found that,
 Avithout  any  preliminary symptoms, he  had a  small
 scaly eruption  under  the right eye, Avhich Avhen the
 little scab Avas removed, secreted an ichorous fluid, and
 that it had various  points as  large as a pin's head, hard
 and in clusters; he paid little attention  to  it until he
 found that it Avas extending and deepening.
   His  digestion Avas entirely out of order,  but not so
 much so  as it had been; hoAA-ever the  disease  made
 rapid progress and  became very alarming, ulcerating a
 large space under the eye.  He  lost  flesh and vitality.
   His appetite left  him and he became the victim of a
 morbid imagination.
   Insomnia soon set in, and he resorted to all the pana-
 cea of narcotics, Avithout avail, but rather Avith injury.
   Etiology.—Scrofulous diathesis Avith a malignant dys-
 crasia.   Predisposing cause, a sedentary life.  Exciting
causes, indulgence in the table, smoking and late hours.
When I saAv the gentleman he had had a return of it,
after twenty years of comparatively good health. 
ERUPTIVE DISEASES.             263
  The hygienic laAv Avas  thoroughly observed by him-
self.  I only added salt in the Avater he  bathed in  and
at times potassia, so as to add plastic force to the  blood.
  Medical Treatment.—
  R. Liquor Potass arsen., 3-dec. gutt., xii.
     Aqua distillata, ? iv.
  One teaspoonful four times a day; and locally  I pro-
scribed :
  R. Acid tannicum, 3 sj.
       "  benzoicum, 3 sj.
      Collodion, f ii.
  This application made a protective emplastrum, which
excluded the air.
  He recovered, but is liable to a return at any moment,
being a constitutional dyscrasia.

                   CLINICAL CASE II.

  This is a case  which is singularly interesting, being
rather rare in practice, namely, acute-bilious eruptive
fever.
  I met this case at Norfolk, Virginia, during the Avar.
  Physical Examination.—I found a large, well-developed
man Avith good lungs and heart.   I also found  an en-
larged liver painful to the touch.  His kidneys Avere ir-
ritable and urine scanty, with heavy sediments of lith-
ates and urea,  specific  gravity 1030—reaction acid, and
at the same time containing biliary pigmentum.  Pulse
130, large in volume and full in force.  Bowels constip-
ated, although he had  taken much  medicine for them.
Tongue coated yellow,  white  and slimy, conjunctiva of
a yellowish color.  Skin  dry and infiltrated Avith im-
purities, and here and there I found  red spots as large
as a five cent  piece.  He felt very sick and  complained
of restlessness and severe headache.
  Semiology.—Fever, thirst, constipation,  nausea,  hot
and cold  sensations alternating,  somnolence without 
264
PROGRESSIVE  MEDICINE.
rest  or  real  sleep; fever Avorse  at  night.   Dry skin,
headache, dispondency, flatulency, etc   These accom-
panied Avith  the  spots above described completed the
symptoms truly pathognomonic to hepatic congestion
folio Ave d by  capillary engorgements of the system, Avith
impurities  remaining in the  blood.    The  capillary
venous  circulation in the liver Avas  sIoav and the pro-
cess  of  freeing  the  excrementitious elements of the
venous  circulation Avas  imperfect, hence, biliary pig-
ment in the urine, skin, conjunctiva and stomach.
  The ductus communis Avas inflamed and  tumefied in
consequence, and  the bile  could not  freely pass into
the intestinal canal.    There Avas retention as Avell as
suppression, the latter as a physico-vital debility. The
debility of the organ disabled it for the Avork of purify-
ing the  blood from the bile and  other excrementitious
elements.
  Etiology.—The man had been exposed to all the vic-
issitudes of the life of a soldier, exposure to  heat and
cold, moisture and bad Avater and food.  These  causes
Avere alone sufficient  to bring about a certain amount of
physiological  disarrangement of the assimilating pro-
cess.  The liver suffered from anaemia and ichorous ele-
ments ;  its physical and vital feebleness prevented the
organ from  that  activity necessary  for the process of
purifying and eliminating the effete  materials from the
venous  circulation.  These  organic  disabilities caused
the fever, the eruptions and all the other complications.
  Medical Treatment.—A Avarm bath  accompanied by
draught of Avarm Avater.  Hot poultices to the liver.
  R. Natr. phosph., 1-dec. grs. lx.
     M. chart., xxx.
  R. Belladon., 1-dec. gr. lx.
     M. chart., xxx.
  Dose—one poAvder every hour, alternately.
  I must premise that the man had  taken calomel and
blue-mass ad libitum  with castor oil, etc. 
ERUPTIVE DISEASES.
265
  Diet.—Generous as soon as his appetite Avas restored
but during the fever I gave him barley  and rice Avater
with milk.
  Next day he had free discharges from the boAvels of a
greenish yellow color denoting a pungency and an acrid-
ity of the excrementitious elements sufficient to produce
some physical disorder.   He felt better; the pulse Avas
softer and less in  volume; he rested better, and the skin
gave  evidence  of moisture.   The urine was  heavily
laden Avith phosphates and ammonia,
  It Avas  evident that we were on a fair Avay to help
the vis medicatricae naturae to throAV out the invading
poisons.
  I continued the same  treatment during the second
day.
  On the third day I found the patient much improved.
Urine more  abundant and  lighter in color.   Tongue
partially clean.   BoAvels  continue to moAre.   Appetite
slowly returning.    Free  perspiration.   The headache
left him and the pulse Avas much  more natural.   The
spots Avere disappearing  and the  capillary congestion
visibly diminished.
  I kept up one bath a day and hot applications to  the
liver Avith occasional Avarm drinks.
  R. Natrum phosph., 3-dec.  gr. xxx.
     M. chart., xv.
  R. Bryonia alba., 3-dec gutt. xxiv.
     Aqua distill., f ii,
  Dose—one poAvder alternately with a teaspoonful of
the liquid.
  Diet.—Beef broth  Avith vermicelli.   Cocoa in  the
morning Avith toast.   In the  evening he was given ren-
net made in fresh milk.
  On the fourth day  all the  symptoms and the fever
Avith the portal and capillary congestion disappeared.
  I prescribed
  R. Aloes, 3-dec grs. xxx.
    M. chart., xv. 
266          PROGRESSIVE MEDICINE.
  Dose—one poAvder every two  hours.   One tumbler
of Congress Saratoga Avater morning and night.
  On the  seventh day I ordered rare beef or mutton
chops for dinner, port Avine, beef broth  Avith  rice, and
rice  Avith milk.   He did Avell and  the  case  Avas dis-
charged.
  In connection with this case I must add another.

                  CLINICAL CASE III.

  A boy of 12 years of age, of a bilio-nervous  tempera-
ment.   He had had several attacks of bilious  derange-
ments.
  His sister and  father suffered from organic disorder
of the  liver.  His mother Avas health)', and  Avas of a
lymphatic diathesis, and never  suffered Avith that dis-
ease.
  He came to me several times with digesth-e troubles,
connected Avith biliary complications.   The chylo-poi-
etic viscera Avas  obviously feeble, and assimilation im-
perfect, hence portal engorgement and synocal fever.
These light deviations were easily treated and remoA^ed
until he got Avet  during the predisposing month of Sep-
tember, and then he became dangerously ill.
   Physical  Examination.—I Avas called to see him after
a feAv days of sickness had elapsed, and I found him in
the folloAving condition:
   High feA'er, pulse 130, full, temperature 101, and skin
dry and full of  a yelloAvish pigment.  Perspiration  25
per minute. Urine very scanty and of a  broAvnish color,
with a sediment of heavy  phophates.   Lungs  were
sound.   Cardiac  excitement.  Stomach and  intestines
tender  and inflated.  Tongue heavily coated, broAvnish
white and dry.
   Liver enlarged and painful;  joints painful and covered
with reddish spots.  His Avhole body and face Avas also
covered  with them.  He suffered  from insomnia and 
ERUPTIVE DISEASES.
267
with great pain all over his body.  A few  days after
my first visit I was taken sick and another homeopathic
physician Avas  called.   He  pronounced it meningitis
and  spotted  fever,  on  the  ground  that  the patient
seemed to have  tenderness along the spine  as Avell as
the spots.  He attended him for a feAv days Avithout
success, Avhen I became convinced of his palpable error
of diagnosis,  and  took charge of the case  myself,  and
convinced him of his error and directed him to  pursue
my treatment as I Avas physically unable to attend.
  Semiology.—Great thirst.   Devoid of appetite.   Pain
all over  the  body, so much  so  that  he could  not be
moved Avithout suffering.
  All  his  joints  Avere  covered  Avith red  spots  and
SAvollen.  BoAvels constipated, and secretions (for faecal
matter) Avere  devoid of bile.   Urine scanty.   Skin dry.
High fever and Avorse about  four o'clock p. m. till mid-
night, Avhen it abated.  He Avas very fearful of his con-
dition, and cried and scolded.  His whole  nervous  sys-
tem Avas in a  state of irritability.
  Etiology.—The  predisposing  causes Avere: 1st.  Bil-
ious  temperament;  2d. The feeble  digestion  predis-
posed him to acrimonies of the excrementitious elements,
mal-assimilation and impure  venous blood: 3. Organic
debility of the liver.
  Exciting causes  Avere irregularities in diet and ex-
posure to cold.
  From the nature of the symptoms and the pathologi-
cal condition of the economy I pronounced it a  case of
bilio-rheumatic fever; accompanied by portal congestion
and capillary engorgement.
  Medical Treatment.—As the patient had  not been re-
duced by strong medicaments, I hoped that with a de-
cisive  homeopathic treatment and good judgment, the
case  Avould terminate  favorably.  I prescribed  aconite
and bryonia for twelve hours without the least benefit. 
268
PROGRESSIVE MEDICINE.
I continued the same treatment for tAvelve hours longer
without any effect either on the fever, spots or liver.
  On the third day I ordered a cataplasm of hot bran
over the liver followed by
  R. Mercurius dulcis, 3-dec grs. xxx.
    M. et devid  chart., xx.
  R. Belladonna,  3-dec. gutt. xii.
    Aqua distill. ^ iii.
  Dose.—One poAvder every  hour alternately with  a
spoonful of the liquid.
  On the next day he Avas someAvhat better.  The urine
Avas more abundant.   He  perspired, slept  better and
the fever Avas abated—pulse 120.  In connection Avith
the above, I ordered hot marsh-malvadraught, as a dilu-
ent of the acrid secretions, having  also  the medical
property of affecting rheumatic and various troubles.
  The fifth  day,  having exhausted  the  action  of the
above remedies, I prescribed
  R. Aloes, 3-dec grs.  xxx.
     M.  chart., xx.
  R. Rododendron, 3-dec. gutt. xxx.
    Aconite nap., 3-dec.  gutt.  xv.
    Aqua pura, 3 ii.
  Dose.—One powder every  hour alternately Avith  a
teaspoonful  of the liquid.  In connection I gaA'e him
half a tumbler full of Vichy Avater morning and evening.
  On the sixth day he had three  foetid  evacuations of
the boAvels.   The urine  Avas  clear,  pulse 100,  tongue
much improved, and the  spots disappearing.
  I left the case in charge  of the other doctor, Avith the
condition that he should pursue my course of treatment,
varying  only the remedies and giving magnesia phos-
phatis 3-dec.  and natrum phosphatis as the finishing
touch.  The  patient got Avell  at the end of four Aveeks.
                  CLINICAL CASE IV.
  Mrs. Van, age forty,  of a nervo-bilious temperament,
and of a delicate physical development.   She had had 
ERUPTIVE DISEASES.
269
three children,  tAvo of Avhom Avere living.  Her work
Avas that of a farmer's Avife—hard and  confining.  She
lived in the true rural and primitiA^e style—simple diet,
hard Avork, early  hours,  and a retired life.   She Avas
emaciated, feeble, and  had a difficult  digestion.   Her
appetite Avas poor and her boAvels Avere constipated.
She often suffered with hypochondriasis and paroxysms
of nervousness.
  Physical Examination.—Her complexion Avas preterna-
turally dark, the skin dry and furfuraceous.  Heart irri-
table but  healthy;  liver hard and rather contracted;
the  nutrition of the organs Avas imperfect.   Kidneys
normal.  Pulse  small, and asthenia and  adynaemia Avere
prominent features in her general appearance.
  Semiology.—Apepsia.   Heavy feeling at the epigas-
trium after eating.  Eructations, constipation insomnia,
headache,  Avant of  energy, and a  general  feeling  of
malaise.   Assimilation Avas  imperfect, and the  process
of histogenesis Avas greatly enfeebled.   Anaemic symp-
toms, namely,  small Aviry pulse, heart  quick  in action
and capillary circulation very feeble.   There Avas  par-
tial organic inertia of the functions of the liver.  She
complained of an itchy eruption over her face and arms,
and sometimes covering the chest.  She Avas very Aveak
and nerA'ous.  She had no fever.  Her tongue Avas coated
Avhite,  and covered with a  thick  fur,  and tremulous.
Her  general health Avas  apparently disordered.  She
had spots of a dark reddish color over her face, and they
Avere erysipelatous in  their nature.  They burned and
itched after going to bed.
  Etiology.—1.  Physical  feebleness. Her Avhole econ-
omy Avas beloAv the average of a normal stand of force
(inanition).   2.  Her Avork Avas  too exhausting  for the
recuperative process.  3.  Innutritious food.  4. Tea and
coffee ad libitum.   5.  Confinement to the  house.   The
origin of her pathological condition Avas Avant  of  pep-
tones and of digestion  and assimilation from  physico- 
270
PROGRESSIVE MEDICINE.
vital debility of the  economy, increased by overwork
and injudicious  diet.  This brought about  emaciation,
asthenia and anaemia (poverty of the blood and nervous
exhaustion).
  Taking the above description of the case, Ave cannot
fail in our diagnosis.  Anaemia and  neuro-sthenia, both
proceeding  from a general Ioav  vitality of the  Avhole
organizing process.  The liver AA^as  inactive from Avant
of physical force, being, like the rest of the system, an-
aemic.   The eruption proceeded from a capillary stasis
or inability to push vis-a frontis the circulating fluid,
and this Avas produced by portal and vaso-motor  debility.
Noav, it Avas evident that the excrementitious materials
could not be either  normal or thoroughly eliminated.
The functions of injestion  and ejestion Avere greatly
diminished,  so that the wdiole economy Avas in a state of
abnormal transition.
  Medical Treatment.—
  R. Belladonna, 3-dec. grs. xxxii.
     M. et fiat chart., XA'i.
  R. Quinia sulph., 3-dec grs. xxxii.
     M. chart., xvi.
  Dose—One poAvder every two hours alternately.
  Hygiene and Dietetics.—A tepid bath Avith salt every
other night.  Generous diet—beef, mutton,   old  port
Avine and vegetables.
  At the end of a Aveek she returned already improved.
  Second Aveek  I gave her nux 3-dec. and  lycopodium
3-dec.   She Avas evidently benefited by  the treatment.
The boAvels moved regularly, appetite Avas better, pulse
fuller and normal, and the tongue clear, the spots  having
disappeared.  Yet she  Avas  anaemic  and  therefore  I
prescribed  Iron peroxidi, 3-dec and aloes, 3-dec.  during
the week.   Diet and bathing the same.  On the fourth
Aveek I prescribed natrum phosph., 3-dec.  and  ferrum
peroxidum also the third trituration.
  She recovered completely. 
ERUPTIVE DISEASES.
271
                  CLINICAL CASE V.
  Mr. P., forty-eight years old, of a  bilio-nervous dia-
thesis, Avith  venous plethora,  namely, hemmorrhoidal
tumors and portal feeble circulation.   His constitution
denoted  feebleness of  the co-ordination  of  organic
functions, Avith adynaemia-.
  The peptones Avere defective in quantity and quality,
hence emaciation.
  The chemico-physiological process of digestion was
seriously  impaired, and  the  protean compound Avas
Avanting in animalization and force.
  He had large hands and feet and Avas anaemic
  He suffered  for  years  Avith  hemorrhoidal  tumors
and  fluxus hamorragic, which  confined him to his bed
for AA'eeks on account of the loss of blood.  His general
appearance Avas that of cachexia and scrofula.
  There was an evident lymphatic atrophy Avhich  in-
terfered Avith the functions of absorption and secretion.
The albuminoids Avere scantily and imperfectly assimi-
lated, hence  emaciation  and anaemia, and at the same
time the Avhite corpuscles were greatly diffused through
the  blood (leucophemia) seriously impoverishing  the
process of animalization.
   Physical Examination.—I found my patient  in bed,
looking fearfully emaciated and of a yelloAv-broAvn color,
Avhich gave me at once  the thought  of  disease of the
chylopoietic viscera, connected Avith  organic disease of
the  liver.  The liver Avas small, hard  and tender.  Ab-
domen SAvollen and tympanitic.  Stomach retracted and
tender on percussion.  Heart  quick  and agitated and
the  volume did not  indicate strength.   The skin  Avas
dry  and rough and filled with a  broAvnish yelloAv pig-
ment.  Eyes dull.  Tongue  heavily coated. Tempera-
ture very Ioav.  Inanition from  mal-assimilation.   He
suffered Avith an eczematous eruption and hemorrhoidal
tumors, etc. 
272
PROGRESSIVE MEDICINE.
  Semiology.—Weak pulse—90; temperature, 97. Apep-
sia, headache, insomnia, great exhaustion, cold extremi-
ties, pain  in  the back, eructations  of a soury bitter
nature, and unable to attend his business.  He had con-
stipation, urine  heavy—1029,  bilious  and scanty, and
hypochondriasis.  He was  miserable  generally and Avas
threatened with physical disorganization.   He had
small grey eyes, large head, intelligent, and of a scrofu-
lous diathesis.
  Etiology.—1. Physical debility and  hence  organic
derangement.   The  feeble  A-enous  circulation  predis-
posed him to engorgements and stasis of the portal cir-
culation, due to Avant of force;  the  Aaso-motor nerves
Avere also Avanting  in  activity.  2. The predisposing
causes Avere a  sedentary life, Avhen young, being a school
teacher.   3. Country heavy diet, Avant of proper bath-
ing, excessive smoking and sleeping on a feather bed in
a closed room.
  It Avas indeed a complex case as the pathognomonic
symptoms Avere organic and physical, nerA'ous and san-
guine.  There Avere  some organic troubles of the liver
and lungs, atrophy  and anaemia hepatica, also tuber-
culosis pulmonalis.
  Medical Treatment.—Could any heroic treatment have
availed  here ? Avould it haA-e been at all advisable to
prostrate  his  already small recuperatiA'e  poAver ?  I
believe any school of medicine Avould recognize and ap-
preciate  the  difficulties Avhich  Ave re  certainly  insur-
mountable  by such a treatment;  a treatment  that
demanded a stronger vitality and recuperative poAver.
  It Avas  obviously  a  difficult case  to treat, where
proper judgment Avould have to  be  exercised Avith the
utmost care.   1. Reviving general principles of vitality
and nutrition.   2.  Diminish  the  venous  and portal
sluggishness.   3. Lessen nervous irritability.   4. Excite
organic action. 5.  Increase the process of injestion
and ejestion.   On these five points  I began my plan of
treatment. 
ERUPTIVE DISEASES.            273
   R. Camphora, 3-dec gutt. xxiv.
      Aqua distill., f ii.
   Dose—one  teaspoonful every hour.
    Capillary Stasis.—The pathogenesis of camphor shows
 the symptoms of prostration, coldness, weakness of the
 cerebrum, burning  at  the  stomach,  irritability  of the
 genital organs, and  increase of biliary activity.   This
 remedy I found a great  agent  for vital exhaustion, or-
 ganic  enertia and vascular inactivity.  It acts at once
 on the heart, cerebrum, secretions and vascular system.
 At the same time I  ordered sheets wrapped round the
 body,  which  had been  previously  Avet  in  tepid  salt
 water.
   Hygiene and Dietetics.—Beef broth and rice, clam soup,
 oyster broth, birds, eggs and  Avine.   The sheets were
 left upon him until full  reaction took place; then he
 Avas to be rubbed and  covered Avith blankets.
   On my return next day I found that the patient had
 slept Avell,  and that  he  felt more comfortable.   His
 pulse Avas softer, sloAver and fuller.  The treatment Avas
 pursued Avith  the aim  of  producing a derivative action
 to the surface through the process  of ejestion of the
 excrementitious matter.
   The fourth day I found my patient sitting up and
 looking as though there were  two  great agencies at
 work, and he patiently aAvaiting the result;  one  inan-
 ition, the other  the inherent vis medicatricae naturae.
 Both existed,  and the  question Avas Avhether the dyna-
 mic force would be sufficient to kindle a feAv more sparks
 of vitality and  thus increasing, as it Avere, atomically
 the  physico-vital  forces.   These  are times when  the
 physician stands beAvildered looking on the great strug-
 gle  betAveen  nature's  process  of re-organization  and
 support, on the one  side,  and decomposition and decay
 on the other.
  In  this  condition of great physical transition, the
phenomena  of nature's resources are  most Avonderful
and often secure recovery. 
274          PROGRESSIVE MEDICINE.
   Medical Treatment.—
   R. Belladonna, 1-dec gutt. xii.
     Aqua distill., f ii.
   R. Phosphorus, 3-dec. gutt. x.
     Aqua distill., f ii.
   One teaspoonful alternately every tAvo hours.
   Here we have tAvo great agents:  belladonna the great
 vaso-motor  re-invigorator, and phosphorous, the vital
 force invigorator.
   I had a good opportunity of observing the effects of
 these tAvo agents, and indeed, I Avas fully convinced of
 their perfect medicinal restorative poAver.
   The  gentleman Avas noAV  on  the sixth  day  of  the
 treatment, and the line Avhich Avas so narroAvly separating
 life from death  Avas happily passed.   The belladonna
 and phosphorus together Avith a pre-existing hygienic
 and dietetic treatment brought about the vital re-action
 by forming neAV sparks  of life, and  so neAV elements
 of force Avere added to the ebbing vitality.  It is indeed
 a great source of satisfaction to feel that your  cares
 and anxieties have been so happily reAvarded.
   Eighth day.  Noav I considered the patient out of dan-
 ger, but  hoAV much strength he would gain was a'
 question beyond human calculation.
   Having been two  days on belladonna and phosphor-
 us I let the agents have their full  scope of  action upon
 the system.
   I omitted the  remedies, and gave him solid food—
 Beef-steak, roast  beef, Avine,  eggs,  game, etc., Avith a
 sponge  bath every night at the temperature of 75.
   Tenth day.   The impetus once given, together Avith
the anti-inanition dietetic treatment,  a great salient
point Avas obtained.   I ordered
  R. Phosphorus, 3-dec. gutt. xxiv.
    Aqua distill., f ii.
  R. Aloes, 3-dec grs. xl.
    M. chart., xx. 
ERUPTIVE DISEASES.
275
  Dose—one teaspoonful of the liquid, alternately with
the poAvder.
  The aloes I used for its specific action upon the hem-
orrhoidal veins and portal circulation.
  Fourteenth day.  The improvement  continued with-
out intermission.  He Avas able to go about the  house
and felt much invigorated.  I ordered him out to drive
in a soft cushioned carriage.  His digestion improved;
assimilation and histogenesis became more natural.  His
pulse became stronger, he slept Avell and his brain grew
stronger and more active.  He also improved in  looks;
the skin lost that yelloAvish broAvn color.  The capillary
circulation gave evidence of having become normal.
The liver and eczema both Avere  on the road to  recov-
ery.  The  lungs did  not trouble him, but the seed of
the  evil remained  permanently  located there.  The
boAvels moved regularly.
  Sixteenth day.
  R. Ferrum peroxidum, 1-dec. gutt.  lx.
     Aqua distill., f iv.
  R. Natr. phosph., 3-dec. grs. lx.
     M.  chart., xxx.
  These medicines he continued  for  tAvo wreeks with a
decided improvement.
  At the  sixth week I  gave  him Acid hydrochloric
and Magnesia phosph. at different times. I then  added
more of those elements of  Avhich the  system stood in
need: e. g. Quinia, Nux vom., Bismuth and Bryonia.
  During this time he had resumed business and looked
a different man.

                 CLINICAL CASE  VI.

  A young man, tAventy-four years old,  of  a fine phy-
sique, perfectly healthy, Avho took great deal of physical
exercise by boating, hunting and fishing.
  His trouble Avas a disease in the matrix of  the nails 
276          PROGRESSIVE MEDICINE.
groAving  normally for a short length, then dividing or
separating in tAvo, and thus becoming brittle and break-
ing off close, making the finger  look unnatural.   His
mother Avas a delicate, nervous Avoman, Avith more brain
than physical force to support it; she suffered for years
with cracked fingers at the tip, and at times Avith small
reddish spots on the body.  She Avas anaemic, and gene-
rally feeble.  Assimilation and absorption Avere difficult
and imperfect, hence her constitutional difficulty. I pre-
scribed for the young man
  R. Silicia, 3-dec. gr. lx.
    M. chart., xxx.
  R. Hepar. sulphur, 3-dec. grs. Ix.
    M. chart., xxx.
  Dose—one poAvder  every  three  hours  alternately.
In tAvo months he reported Avell.
  The mother I treated differently.  I gave her
  R. Natrum-phosph. et quinia sulph., changing for
  R. Ferrum peroxidi, 3-dec.  gutt. xxxx.
    Aqua distill., f iv.
  Dose—one teaspoonful every two hours  alternately.
Again,
  R. Magnesia phosph., 3-dec. grs. lx.
    M. Et fial chart., xxx.
  She improved in general health; and the cracks filled
up.  Her color became healthy as  her digestion im-
proved.
  R. Pujsatill., 3-dec. gutt. xx.
    Aqua distill., f  iv.
  R. Lycopodium, 3-dec. gutt. xx.
    Aqua distill., f iv.
  Hygiene and Dietetics.—Bathing in hot Avater and bi-
carbonate of potass tAvice a Aveek, I concluded the treat-
ment with fresh air, country  life and improved  diet.
  In her case the treatment Avas to supply those proper-
ties which Avere needed.  She had evidently lost much
of those substances that are necessary for the formation 
ERUPTIVE DISEASES.
277
of plastic materials, and the acrimonious secretions had
produced an indescribable change in the blood.  In her
son's case there Avas a natural  deficiency of the silicate
and sulphate of lime, and by adding the silica and hepar.
sulphur the case Avas cured on a physiological principle.

               CLINICAL CASES VII, VIII.

  Tavo  children were  brought  to  me  suffering from
crusta-lactea.  They suffered Avith intense itching Avhicli
produced much nervous excitement, debility and fever.
It is generally accepted that  the milk is the source of
this  evil;  its  fermenting principles,  its  caseine and
butyric acid being  so  many  elements predisposed  to
ichorous eruptions.
  Surely, the  elements  of nutrition  and the process  of
digestion and assimilation are deeply  involved in the
organization of the  animal  economy, thus a poor nutri-
tion can only have as a  result an  enfeebled physical de-
velopment;  but again  Ave  must  also admit  a certain
proneness of diathesis,  predisposing the system to im-
purities  and  accumulations  of   the  excrementitious
materials, and this  is  the  lymphatic diathesis.   The
idiosyncrasis of this system  Avhen largely  developed
is inArariably that  of increasing the absorbent process,
Avithout, at the same time increasing the ability of ejes-
tion, thus predisposing  to plethora lymphatica, adenitis,
and eruptive diseases.
  This theory is sustained by facts, and is based upon
practical  truth.  The  mother of one of the infants Avas
scrofulous, and the other having  happily more vitality,
Avas endoAved Avith a healthy lymphatic organization.
  In both cases the children suffered alike, although by
inheritance  the symptoms Avere  different.  One had a
defective and feeble organization, the other had abund-
ant force, both physical and vital.  The delicate child
and the strong one, both suffered from two extremes. 
278          PROGRESSIVE MEDICINE.
  It is  obvious, therefore, that the two  cases  should
have been treated differently; and for this very reason
it is that, an empiric treatment is in all schools of medi-
cine considered dangerous and unscientific.
  Medical Treatment.—For the first case, I prescribed
both for the mother and child,
  R. Calc phosphorica, 3-dec. grs. lx.
    M. chart., xxx.
  R. Ferrum peroxid., 1-dec. grs. lx.
    M. chart., xxx.
  Dose—one powder to the mother every tAvo hours al-
ternately.
  To the second I prescribed a vegetable diet for the
mother, and the folloAving prescription for the child.
  R. Graphite, 3-dec. 3 i.
    M. chart., lx.
  R. Kali carbonic, 6-dec 3 i.
    M. chart., lx.
  Dose—one poAvder  every three  hours alternately;
and to the mother Vichy water eArery morning.
  Hygiene and Dietetics.—To the delicate mother it is
hardly necessary to  say, a generous diet Avas prescribed
and deemed  as a part of the treatment : beef, mutton,
oysters, birds, nitrogenous vegetables, cocoa, milk punch
Avith Jamaica-rum, and salt Avater baths; and the folloAA'-
ing medicinal agents Avere from time to time given:
  R. Magnesia  phosphorica, 3-dec. 3 i.
     M. chart., xxx.
  R. Ferrum peroxid, 3-dec.  3L
     M. chart., xxx.
  Dose—one poAvder every two hours, alternately.
  And to the strong healthy mother the prescriptions
Avere reversed: vegetables, fish and light  animal food,
Avith plenty of exercise and ripe fruits. I gave her baby
  R. Calc. phosph., 3-dec. 3 i.
     M. chart., xxx. 
ERUPTIVE DISEASES.
279
  R. Natrum sulphur, 3-dec. 3 i.
     M. chart., lx.
  To be given first one, and when  that was exhausted,
begin Avith the other.
  These  children both were cured and the mothers'
health also improved.
  I sometimes found carbolic acid  glycerole, or zincum
oxydum glycerole good adjuvants for local applications;
they soften the scabs, prevent the itching, and keep the
air from irritating and causing more suppuration. 
280        PROGRESSIVE MEDICINE.
                  CHAPTER VIII.

              USEFULNESS OF ELECTRICITY*.

  From my experience, and that of many medical gentle-
men in Avhose field of practice electricity has been em-
ployed as a therapeutic  agent, I have no  hesitation  in
saying that  it is one of the greatest panaceas for diseases
of the organs of digestion and assimilation.   It imparts
force, motion,  composition  and decomposition.  It in-
creases heat, oxidation, circulation and organization. x  It
changes the juices, increasing absorptions and secretions.
It eliminates the materiae morbi through the excremen-
titious matter.   It extricates organic engorgement and
releases the organs from sanguineous stasis and torpidity
of action, thus  setting  a vis-a-tergo-physical force to re-
adjust physical equilibrium.
  Notwithstanding the quackery Avhich unfortunately
has been obscuring much of the virtues  of electricity as
a medical agent, haA'ing  diminished  its Avell  deserved
reputation on account of the ignorance Avith Avhich it
has been used and abused;  yet it retains its usefulness
in diseases Avhen properly applied.
  To secure success it  requires several points:  1. KnoAv-
ledge of its action, 2. KnoAAdedge of the disease Avhere it
should be applied, for it cannot be used in all diseases
indiscriminately, and  3.  The  proper current and its
strength.  It is indeed an agent of great ATalue in rheu-
matism (not inflammatory), in gout (not  acute), in neu-
ralgia, in apepsia, in jaundice (hicterus), and in paraly-
sis.   As electrolysis in surgical operations,  for tumors 
USEFULNESS OF ELECTRICITY.         281
 and polypus, in calcareous deposits in the joints, and
 in fact in all the cases of locomotor ataxia, asthenopia,
 diploplia, etc
   With  this agent, I  cannot refrain from mentioning
 another  Avhich is Avell-knoAvn and yet little used by the
 profession, namely, Avater.   In acute eruptive diseases,
 in fevers of an inflammatory type, in inflammatory rheu-
 matism,  pneumonia, bronchitis and  Aveakness of the di-
 gestive organs Avhere the excretions are  sluggish  and
 strongly charged Avith animal poisons producing either
 exanthem, or organic pathological conditions, it may be
 used Avith excellent results.   This agent is one of the
 best as an anti-pyretic and acts directly upon  the  dif-
 ferent A'essels, as well as  upon the process of injestion
 and  ejestion by quickening the activity of the absorb-
 ents and secretory organs.  It relieves general plethora,
 sanguineous  suggillations,  and equalizes  the physical
 Avith vital  forces as Avell as the  temperature  of  the
 body.
  With this agent Ave can combat yelloAv, typhus and
 typhoid  fevers,  scarlatina, measles, paludal fe\Ter, per-
 nicious fever and all malarial diseases.  The reason is
 obvious,  namely, that Avater  properly used disengages
 the animal economy  from the absorbed poisonous mole-
 cules of the effluvial  gases, and eliminates them through
 the  excrementitious matter in shape of  urea, biliary
 secretions, lactic, carbonic and uric  acids, and through
 the secretory and sudorific organs of the skin.
  The use of Avater is to be carefully estimated before
 subjecting a person to its influences.   We must  con-
 sider, 1. The general physical condition of the patient.
 2. His strength and idiosyncrasies. 3. The nature of the
malady and the reactive  force of the patient. 4. The
temperature of the Avater must  be according  to the pa-
tients constitution, nature of the disease, age, sex, hab-
its, season,  etc.   With these  preliminary steps  and
cautions, Avater  can  serve as a great medical  agent. 
282
PROGRESSIVE MEDICINE.
With it Ave must combine a suitable diet and medicinal
treatment.   I recommend these  two great agents par-
ticularly to the Homoeopathic physician, because ration-
ality  is his  only course.  I deem it necessary that the
study  of the  process of alimentation should have  a
distinct chapter devoted to it  in this wTork, because
the proper  dietetics is a thing of great importance to
the sick, and invalids, being the pabulum upon which
the recuperative process of nature greatly depends. 
EFFECTS OF MEDICAL AGENTS.        283
                  CHAPTER IX.

       THE  DUAL EFFECTS OF  MEDICAL AGENTS.

  This is not, perhaps, a theme totally new or altogether
unknown to  some of our Avriters on  materia medica,
and therefore I do  not presume  to  enter  fully or in
detail into  the subject; I  simply desire to  call the at-
tention of both schools to some salient points Avhich are
of great interest and usefulness to the practitioner of
medicine.
  The subject might have been broached, possibly, by
abler men than myself, had it not been for the fear that
they might be ridiculed. Let us Avalk forward, no mat-
ter if a feAv shallow-brained felloAvs cannot understand
us and therefore delight in  abuse and misconception.
  The  vagaries of both schools are so great  and their
intolerance of anything that is foreign to their teaching
is so overbearing that they Avould  even shut their eyes
to the grandest of discoveries were it to interfere Avith
their theories.  But it is  possible to show  that the
faults of both are glaring and easily visible.   One has
the fault of an endless symptomology, in Avhich if true,
one medicine Avould be sufficient for all the diseases that
" flesh is heir to."  The other is crude and  has tried to
simplify the practice by classifications AA'hich are con-
stantly at  variance  Avith the pathogenetic effects and
therapeutical results of medical agents; both are erring
in the main from the true  spirit of physicians, and are
therefore antagonistic, bitter and sectarian.   A unity of
action and generous effort in the great work of scientific 
284
PROGRESSIVE MEDICINE.
medicine would be more  becoming  and beneficial to
both.
  Why Hahnemann should have  thought  of a neAV
school, and the then dominant school should have ban-
ished a man Avho desired to shoAv them a neAV problem,
is really difficult to divine.  When we think hoAV little,
from a practical point of view, Ave have advanced, and
hoAV difficult is the progress of medicine, Ave should be
more forbearing  toward  one another, at least for the
sake of the human family.   With a liberal spirit for the
common  cause, Ave should go forAvard in one arduous
path, and  Avork our Avay with the well-settled truths,
that to heal the afflicted was one of the great missions
of the Redeemer, and  we should  follow  him Avithout
questioning or gainsaying.  It is our most solemn duty
to  accept  truth  and knoA\dedge,  for they  have been
given by the Omnipotent himself to those whose under-
standing has reached that degree, and Avicked  indeed it
unquestionably is to refuse to look, hear or be told. We
are surely  reaching another  inquisitorial phase  in our
medical history, but, thank God, there are men strong
enough on both  sides  to annihilate this assumed " non
possumus " of late days.
   It  is also unquestionably admitted  that the toxic
effects of  medical  agents Avere the first indications of
their  pathogeny upon  the animal economy, and from
that rough frameAA'ork  our books  on poisons Avere con-
structed.
   These morbific outlines Avere of such great interest
that from  them greAV the study of the agents in smaller
 and safer  quantities; by  the  varied and numerous in-
 teresting researches from all the  civilized Avorld, their
 properties and effects  upon  the  human system were
 ascertained.
   Inasmuch as the possibility of learning a great deal
 to our advantage in this field was demonstrated without
 a shadow of doubt, many a generous government estab- 
EFFECTS OF MEDICAL AGENTS.        285
lished institutions of public learning, free to all and at
public expense, since the benefit Avas  to be universal,
(a true  humanitarian idea) and thus  botanical gardens
and botanical chairs of learning Avere established, from
Avhich our materia-medica originated, and Ave Avere thus
able to arrange in some sort of scientific order, all the
mixed and unintelligible gibberish of the old alchemists.
  It was from toxicology that Ave have received our first
knoAvledge of the  nature and morbid effects of certain
agents upon the  animal economy.  And by  the use of
them in such quantities as Avould only produce temporary
disturbances, Ave  have  ascertained their modus  oper-
andi as medical agents.
  This mode of procedure  brought  about further in-
quiries, thus the physiological action of these agents
Avas  discovered, with perfect safety to  the system.
" Beck's Murray " says: " Medicines operate by exciting
to action the general system, or the  particular organs
on Avhich they Avork.   They have  further  than this no
specific influence or properties, but are adapted to the
removal of morbid affections, by producing excitement
(partial or general) Avith certain degrees of rapidity and
force.
  " When medicines are  thus determined to particular
parts, they are either directly conveyed, by  being re-
ceived into the blood, or their action is communicated
indirectly from the stomach by the medium of the ner-
vous system; and in both Avays important  local effects
are produced."
  But yet, these  gentlemen have never demonstrated
from Avhat principle these cures Avere expected or ob-
tained, except by stimulating, urging, pushing and forc-
ing nature to bring about  her vis medicatricae-naturae,
and  thus overcome the  morbid disorder that may be
disturbing physical harmony of action.   If stimulating
the physical forces alone Avas sufficient, then  the prob-
lem  Avould soon  be solved.  But  Ave  must have  drugs 
286
PROGRESSIVE MEDICINE.
AAdiose specific action upon diseases may be ascertained by
their pathogenetic similarity to  any given disease, and
thus they prove to be useful as therapeutic agents.
  " It Avould not be advisable to give opium Avhere quin-
ine is indicated Avith any reasonable degree of common
sense.   No one Avould dream of  administering camphor
for capsicum or belladonna, although they are all nervo-
stimulants;  they Avould bring about excitement both
physico-vital and physico-organic, but, perhaps not the
desired effects. Again the physiological school say you
must give a remedy that is fit or adapted by its knoAvn
properties  and effects  to  every  specific  disease.  Hoav
are Ave  to know Avhether  belladonna acts more specifi-
cally upon the vaso-motor nerves than camphor?  I an-
swer, because  it creates  a  rash and a  congestion;  it
stimulates all the capillaries, etc.; but these are some of
its pathogenetic effects, and Iioav are Ave to expect any-
thing else than an increase of the disease if Ave give a
medicine Avhich is knoAvn to produce similar mischief or
disorders.   'Never mind that,' says the physiological
school,  'do  not give camphor,  or  quinia Avhere  bella-
donna is the remedy.'   But poor Hahnemann, Avhen his
bright genius saAv the plain  and simple truth, and dared
to say 'the action of all medicines is on the principle of
similarity,' he Avas  treated as Galileo Galilei, Avhen he
dared say 'E pur si muove.' "
   But truth is as great  noAV as then.  The medicine
whose pathogenetic effects or symptoms resemble more
those of any given morbid affection (or natural disease),
is truly a remedy of confidence and to be relied upon in
neutralizing the morbid phenomena arising from natural
causes.
   And  I would further say, that  to substantiate this
truth, Ave need not Hahnemann's observations, but Ave
have only to refer to Allopathic authorities Avho recog-
nize the facts in their  own  Avay, but neglect  to teach
them as laAvs of similarit3% 
EFFECTS OF MEDICAL AGENTS.        287
   Doctor EdAvard J. Waring says: "Almost every drug
operates differently Avhen given in large and small doses.
Tartar-emetic for example, in doses ofl-12th to l-16th of
a grain acts as a diaphoretic and an expectorant; in doses
of \ to £ of a grain as a nauseant;  and if carried to  the
extent  of tAvo or three grains  it proves a  poAverful
emetic.  A very  similar series of effects is produced by
graduated doses  of ipecacuanha;  recent  observations,
indeed, tend to sIioav that this drug in very small doses
acts as a poAverful anti-emetic"
   " The  neutral salts  aperient in large  doses, and diu-
retic in small;  opium as a stimulant in small doses, and
a  narcotic in large ones;  and the oil of turpentine in
doses of fl. drm. i. to fl. drm. ii. acts as an  acrid irritant
of the kidneys and  genito-urinary organs, Avhilst in  a
dose of fl. oz. i., and especially  combined Avith castor oil,
it operates freely on the bowels Avithout producing any
renal or vesical irritation.  These  are but feAv examples
out of many Avhich might be quoted; but it may be  ob-
served, generally, that most of the medicinal substances
whose  operation  is mild  and beneficial  in small doses,
may be converted into poAverful  poisons  by  being  ad-
ministered in large quantities."
  But AA'hy has not this able physician gone on Avith his
subject and told his colleagues  the rest of the grand  dis-
covery, Avhich I premise by saying that it Avas  knowu
and taught by Hahnemann?   Why not  tell them more
of the  principles of affinity, polarity  and  attraction of
medical agents?  of  the atomic force and  molecular at-
traction?  And this brings us face to face Avith the facts,
that, a solution of a fluid is only  a larger extension of
its atoms.
  And that a disintegration of a solid from its cohesion
is only a separation of its atoms.   Matter,  therefore, be
it vegetable, metalloid or alkaline, is divisible into three
forms: gaseous, fluid and solid; in all three, there is  the
same Aveight and  number of atoms. 
288
PROGRESSIVE MEDICINE.
  The  only  difference  exists in the form or manner  of
division, i. e., solution,  trituration, decoction, etc  And
in support of this theory Ave  knoAv that the  only differ-
ence betAveen Avater  and steam is that the  latter  is
Avater SAvollen by heat  to 1800° to one cubic inch.  But
this is  not all; chemistry says " that from a simple and
great principle  of II.  C. and 0. N.  arises organized
matter," yet other  elements enter often, like sulphur
and phosphorus, and perhaps  many more  unknoAvn  to
us.   What  is important to knoAv is  not so much the
change of materials or  components as the change  of
shape  and  position of the molecules Avhich in reality
change the  nature and grand phenomena of organic
matter, the  illustrations  of  molecular structure thus
far studied have been mostly taken from those classes
of compounds long knoAvn in chemistry under the name
of acids, bases, and salts, and they Avere selected because
it was  Avith such substances that the old theory had al-
most exclusively to deal.  But, as  I haA-e already said,
the strongest evidence in faA-or of the neAV  theory is  to
be obtained  from a class of substances about Avhich the
old  chemistry kneAV almost  absolutely nothing.   The
class to Avhich I  refer is formed of the  compounds of the
elementary  substances and carbon.   The  number  of
of knoAvn compounds of this element is far greater than
that of all the other elements together, and these ex-
hibit a greater  diversity of their molecular structure,
which  is often highly complex.
  As a rule  they consist of a very few chemical ele-
ments besides carbon,  hydrogen, oxygen and nitrogen,
but the number of atoms  united  in a single molecule
may be very large, sometimes even exceeding  100.
  Carbon  is peculiarly  the  element of  the organic
world,  for,  leaving  out of view the  great  amount  of
Avater which living beings  ahvays contain, organized
material consists almost  exclusively  of carbonaceous
compounds.  . 
           EFFECTS OF MEDICAL AGENTS.         289

  Hence the substances, Avith exception of a feAv of the
simplest, Avere formerly called organic compounds; but,
although the cause Avhich determines the groAvth of or-
ganized beings is  still  a perplexed question, Ave iioav
know that the materials of Avhich they consist are sub-
ject to the  same laAvs as mineral matter, and the com-
plexity may be traced to the peculiar qualities of carbon.
But Avithin a feAv years Ave have succeeded in preparing
artificially a very large  number of Avhat Avere formerly
supposed to be exclusively organic products, and not only
this, but the processes Ave have discovered are of such
general application that Ave iioav feel Ave have the same
command of the synthesis (combinations) of  organic as
of mineral substances.
  The number of elements which  enter into the com-
position of organic compounds being so restricted, i. c,
C. 0. H., it  is evident that the immense variety of qual-
ities Avhich they present cannot be referred solely to
the influence of a simple radical C. 0.= Avhich they con-
tain.
  In the simple compound C. Q.» there are the elements
C. 0. H. N.  bonded together, but the last two, i, e., II.
N., neutralize each other.  There are then  compounds
in all single medical agents, the radical being the basic
substance, Avhich is represented by quantivalence, and
its variation changes the nature and the effect of the
element in use.
  The folloAving is an example: from ammonia gas can
be  derived  a large  class of compounds, in all  Avhich
nitrogen is trivalent.
  And similar preparations can also be made Avith phos-
phorus.
  But although  they all contain the same atoms as a
nucleus, the tAvo classes  differ from each other as Avidely
as if they Avere composed of different elements.
  " Returning noAV to our comparison," says Professor J.
P.  Cooke,  "betAveen H. 0.  N.  and  H.  0. N.  0.* Ave 
290
PROGRESSIVE MEDICINE.
shall  describe the  relation of the molecules in a feAv
words by saying that the acid and the alkali  had mole-
cules  of the same general structure, but differed in that
the radical of the alkali Avas  the  elementary atom (po-
tassium), while the  radical  of the acid was the atomic
group, N. O.2
  "And again, first butyric acid is an oily liquid Avith
whose smell Ave are only too familiar, since, Avhen formed
in rancid butter it imparts to this article of our food its
peculiarly offensive odor.   Further, as its name denotes,
it has the qualities  of an acid."  Utterly different from
this offensive acid  is  the  second substance, which Ave
call acetic  ether, a  very limpid liquid, with  a pleasant
fruity smell, highly  volatile;  yet  butyric acid  and
acetic ether, have  exactly  the  same composition and
the same vrapor density.

          ANALYSIS OF ISOMERIC  COMPOUNDS.
      f BY GRUNZWIEO, )             (BY LIEBIG,  )
      \ Butyric acid. J             \ Acetic ether, j
   Carbon,       54—51       Carbon,       51—47
   Hydrogen,     9—26       Hydrogen,     9—67
   Oxygen,       36—23       Oxygen,      35—86

   And this Avill add strength to   our  subject, Avhich is
 that  in order to change matter organic or inorganic it
 is only necessary to have a change of molecular arrange-
 ments.  From a nourishing, healthful  butter, Ave  haAre
 it changed into a poisonous, acrid acid;  and that true
 science has found that molecular movement and division
 give force and activity to  matter.  It is not shoAvn that
 artificial medical compounds can add, but on the  con-
 trary they often detract from the object  in vieAV.  All
 simple products are nevertheless compound elements,
 but then activity depends upon the radical  product, be
 it sulphur, or tannic acid,  or ammonia, atropine, caffein, 
EFFECTS OF MEDICAL AGENTS.         291
the active principle will be  the  predominating force
radical in the product itself.
  Thus simple  remedies,  well knoAvn  and Avell sub-
divided so as to separate their molecular activities, are
a  correct principle  based  upon  a  chemico-medical
ground.
  To return to  our study: Ave know the effect of  a cer-
tain medicinal dose.  The quantity, then, determines the
effects toxic, pathogenetic, stimulant (or physiologic),
dynamic.  The first Ave have nothing to do Avith.   The
other effects are sufficiently knoAvn to justify the  classi-
fication.
  But Avhy call this a hypnotic, that an  alterative, the
other an  emetic or  nervine, etc, Avhen Ave knoAv that
such cannot be  stated, except with only partial truth.
  Opium is  both hypnotic or soporific and  stimulant.
In coma produced by general  physical disorder opium
is almost a specific
  In coma from renal troubles opium  is also a  great
agent.  Why?  Because  opium's  pathogenetic effects
shoAv its sphere of action, e. g., brain, kidneys and  cir-
culation.  When those organs are  similarly affected by
disease, opium releases them  (in small doses)  from  the
morbid  influences.  We  never  forget,  hoAvever,  to
potentize  it, thus developing  its molecular activity.
  Having stated these  facts in the first part  of  my
work, I only apply them noAV  in support of the medi-
cinal and dual action of medical agents.
  In conclusion, it is an  undeniable fact, that Avhen a
large dose of any medical substance  is capable of pro-
ducing  morbid  symptoms,   Avith  similar  symptoms
(from natural causes)  a  small  quantity of the same
agent is sure to bring about  a reaction, thus  neutraliz-
ing the morbid phenomena.  This is called the law of
similarity.  Although in diseases  of the gastro-enteric
juices the question Avill be  met more  on  a chemico-
physiological ground. 
292
PROGRESSIVE MEDICINE.
  Unquestionably the  quantity necessary to produce
certain effects has been and Avill ahvays be a specula-
tive, open  question, according  to  idiosyncrasies  and
temperaments; but the curative principle must  invari-
ably be that of similarity, notAvithstanding.  This is an
infallible rule, and the  true beacon-light  in  the right
direction.  And it is undeniable that Similia can only
succeed in her claims by  shoAving practically that Avhat
has been stated is correct beyond question.
  Doses  must naturally  differ, for  the very nature of
the medical agents themselves demands a difference.
  Let us take quinia, for example, the king of antiperi-
odics, yet not ahvays successful.  One to five grains is
the dose ghTen by the dominant school.   I shall  find no
fault with them, for I use it myself in nearly the same
quantity.  It all depends upon the severity of the sym-
toms.
  And this very agent  in large  quantities produces,
according to  Doctors Waring  and Pareira, cinchonism.
They say " Within the  first  tAvo hours  xii grains of
quinia produces a marked excitement Avith tension and
throbbing head-ache, morbid sensibility of the eyes to
light, buzzing and ringing of the ears, vertigo, unsteadi-
ness of gait,  and  some  excitement of the heart,  a sense
of internal agitation and general  excitement; the  face
is flushed, the skin is warmer,  and the pulse and respi-
ration are  more  frequent, and massive  doses are often
folloAved by delirium.
  " Again the reaction sets in and  aphonia ensues, the
heart and  pulse  become feeble, and  the temperature of
the body falls.
  "Finally, a prolonged use of quinia may cause a dimi-
nution of the red globules, and an increase in the pro-
portion  of  fibrine and  Avater  in  the  blood  (Leuco-
phemia)."
  Noav, then, very little  more Avould give us the Avhole
outlines of the regular malarial  intermittent fever • and 
EFFECTS OF MEDICAL AGENTS.        293
just here Ave must stop and reflect that such symtoms,
such pathological  analogy betAveen  chills  and  fever
and the pathogenesis of quinia is a striking illustration
of the truth of what has  been asserted.   At the same
time some sceptical reader may say that all this is very
well and sounds right, but where are your infinitesimal
doses ?  Once  for  all, I reply, infinitesimal quantities
was a Hahnemannian idea,  which he connected Avith
therapeutics, but has nothing to do Avith the laAv, Avhich
he  only  folloAved by logical deduction from facts, indis-
putable then as iioav.
  While it cannot be admitted that infinitessimal doses
Of medicines are at all connected Avith the laAv of thera-
peutics of Similia, nevertheless it is true that by our neAV
process of division of molecular activity, a much  less
quantity of  medicine is required and  better results are
constantly obtained, and it is  perfectly proper that all
physicians  should  study  Iioav  to cure Avith the  least
quantity of  medicine, and not Iioav much they can give
with  impunity, forgetting  the  danger of re-action, fre-
quent failures, and  the  Avant of science connected
thereAvith.
  Thus one-tenth and five grains of quinia are perfectly
compatible Avith the above-stated law, because the medi-
cine is not a rank poison,  and it requires considerable
to produce any pathogenetic disturbances, and because
in malarial  diseases  Ave have a malarial  poison Avhich
requires  a  sufficiency of  the medical agent in neutral-
izing its morbific influences.  Although smaller doses
do  often ansAver  as Avell in the common simple  in-
termittents.
  My rule is to use 1-dec of a grain and  to increase it
gradually to one and five.
  The same may  be said of ipecacuanha.  In large
doses it produces either vomiting or  evacuation  of the
intestines, together Avith a gastro-enteric irritation.
  It  produces  irritation  of  the  nares, larynx  and 
294
PROGRESSIVE MEDICINE.
bronchi.   It affects the nervous system and has proved
a good anti-periodic at times.  The  dominant  school
uses it pretty much as the neAV school, except that with
a thorough  study of its pathogenetic  effects the neAV
school prescribes  with more knoAvledge and  better
success.  Subdivision is a mode, as Ave have already
demonstrated, to separate molecular matter and to bring
eATery molecule in connection Avith the part extended
to be  treated.
  Phosphorus and ammonia are two remedies frequently
used  in  phthisis,  pneumonia and  bronco-pneumonia.
Who can deny the effects of these tAvo agents upon the
air passages ?  What pharmaceutical preparations are
better adapted to each case is left to the general intelli-
gence of the physician.  There are  many  preparations
of ammonia, namely, carbonate,  chloride, acetate,  etc.
Phosphorus, likeAvise—phosph.  of ammonia, calcarea
phosph., kali phosph., etc
  These agents have been lately introduced in different
forms:  phosphites  and  sulphites  of  soda,  ammonia,
phosphites of magnesia and soda, or substances in which
potassium is the base.  These are great blood elements
and Avould soon disorganize the blood, producing anaemia
and phosphate  diseases.
  In small doses they  have been  found by Professor
Polli to be great remedies for all diseases arising from a
foment; Ave must not forget that in such conditions they
act as chemico-dynamics, because, although in large doses
they may disorganize the blood, they could  never  pro-
duce  a  zymotic  disease,  but the  effects  and results
would be similar.
  Astonishing as it may seem, the parallelism betAveen
alkaloid  substances  and acids is chemically true, as it
is chemico-physiological.
  The therapeutic  uses of  the  acids  taught by the
learned  Dr. Prout to his OAvn school and  colleagues,
were knoAvn to the practitioners of the new school and 
EFFECTS OF MEDICAL AGENTS.        295
used by them before they Avere even thought of except
as chemical  re-agents.   Indeed, it is a fact of great
therapeutical value that Avhere the phosphates of soda,
ammonia, lime and  potassa  are indicated as dynamic
remedies  (or physico-dynamic), that  phosphorus, or
phosphoric acid, nitric, sulphuric, hydro-chloric and ace-
tic acids are also indicated.   The analysis of isomeric
compounds opens our eyes to these  facts, namely, that
in a medical sense the base being either sulphur, nitrate
of potash, phosphorus or ammonia, these  Avould  be
three acthae substances in forming disease, and thus de-
termining their action.
   The prolonged uses of acids, mineral  and vegetable,
produce morbid influences Avell known, of physical or-
ganic disorganization, and although they differ in prox-
imate principles, they are nevertheless strongly related
by their ultimate elementary products.
   Their  pathogeny differs as to intensity, locality and
affinities.   They are chemico-physiological  agents of
great importance in therapia.
   " Sulphuric acid is a frequent refrigerant, cooling and
diminishing the temperature of the body through its
astringency upon the  capillaries.  It improves the tone
of the taxed mucous  membranes and stops  excess
of evaporization and extravasation of blood (or purpurea
hemorrhagica).  It acts upon the liver and kidneys like
all acids, promoting  oxidation  and ejestion.   It adds
force to the gastric juice, leaving to it its oxygen.
  These  symptoms, seemingly   so very  desirable,  are
soon changed (by a stronger  preparation of the agent)
into  pathogenetic symptoms, i. e.,  ulceration  of  the
throat, mouth, larynx, tharynx  and  stomach.  If con-
tinued, gastro-cnteritis Avould soon take place, and in ad-
dition the solids  of the body Avould become affected,
neutralizing the supply  of lime from the blood.
  Our second agent, hydro-chloric acid, acts more upon
the gastric juice and liver.   But this very  useful sub 
296            PROGRESSIVE MEDICINE.
stance would produce disarrangement of the same or-
gans Avhen in a healthy condition.
  Nitric acid is a poAverful escharotic and is mostly used
in malignant ulcers, in diphtheria and in gangrene.   It
is useful in syphilis, in glandular enlargements and tur-
gescence.   It is given  to promote absorption, and  im-
prove  cachexia.   It  is used  in all those cases  Avhere
kali-iod., iodine, chlorine and lime  are  used,  and even
creosote.
  It is unnecessary  to describe  every acid and its
peculiar  pathogenetic effects, for the profession is  well
aAvare  of their therapeutic influence.
  In small doses they a.re indicated in  all those  patho-
logical conditions  \vhich  Avould  be liable, in large and
continued  doses, to  be produced  and therefore their
pathogeny and  similarity of  symptoms in disease, are
the tAvo main indications of their medicinal agency.   In
typhoid  fever, sIoav  remittent  fever,  diarrhoea,  hemat-
emises, eruptive fevers, in phthisis, trachealis, in apep-
sia, in  glucosuria, in gastric fever, etc.  Their effects by
pathogenetic  doses  cannot be  denied to resemble  Ioav
specific diseases and to  be  excellent remedies Avhen
prescribed on their OAvn indications and symptoms.
  Classifications like heamatica, corrigentia, stimulantia,
tonica, seclantia, narcotica, antacida antiseptica, etc., etc.,
are empty expressions Avhich  are of great injury to the
student,  because Avhen he  learns these  by heart he
thinks he has all the materia medica and therapeutics at
his  finger's ends.  It  "will be seen by every good phys-
ician that eA'ery drug ought to be studied not only from
its toxic, but also  its pathogenetic, physiological,  gen-
eral, and  special  effects, its organic  and  systematic
affinities, and  then compared in diseases both general
and special.  By such a scale  of comparative  patholog-
ical studies of both natural and drug disease, surely the
resemblance betAA'een  the  natural and the  artificial
symptoms "will be striking and unmistakable indications
for the selection of the remedy. 
            EFFECTS OF MEDICAL AGENTS.        297

   No fair minded student of the science of medicine can
 fail to see  the strong analogy and natural logic of such
 an axiom.  Practical common sense is the leading feature
 of the huv of similarity.
   Veratrum viride is called by the dominant school the
 king of sedatives, similar to aconite, tartar-emetic, anti-
 mony, etc  Noav such a Avord as sedatiAre has not a signifi-
 cation corresponding Avith physiological uses and effects.
 But they say Avhat  Avould  Ave  think of an  agent that
 diminishes the pulse and the heart's action and  capil-
 lary congestion?  What Avould Ave  say  of a stimulant
 Avhich Avould have the same result  in the  course of a
 few hours?  IIoav is hysteria or spasmodic action con-
 trolled  by brandy, ammonia, capsicum, strychia,  nux,
 ignatia, etc
   We ansAver that the name of sedative  in  a medicinal
 dose is a misnomer; the result of the medicine is named,
 not the agency from Avhich that  result Avas obtained.
 Veratrum,  aconite, tartar-emetic, opium and  stramonium
 are stimulants (in small medicinal doses) and from  that
 the excited circulation, the  bounding heart, the throb-
 bing head are quieted  through the  effect of a stimulat-
 ing influence upon an excited condition  of the vaso-
 motor and cerebro-spinal nerves. The result is sedative,
 through an influence and agency of an active medicine,
 thus neutralizing the tremor and hyperesthesia of the
 nerves and blood  vessels.   Just so the  influence  of
 stimulants Avill  tranquilize  Avhen  hypersensibility and
 excitability exist, if such doses are used  as accord  Avith
 the strength  and nature of the remedy and the  indi-
 A'idual.
  Dr. Waring does not give an explanation of the ac-
tion of veratrum, in varying  doses, but  only in the
abstract, as a sedative  of great power, namely, a depres-
sant Avhicli diminishes  the arterial circulation.
  And as  parallelism  is not  mal-a-propos, I  beg the
liberty to  compare  Dr. W. II.  Burt's " Characteristic 
298
PROGRESSIVE MEDICINE.
Materia-medica on Veratrum," and Dr. Waring's action of
the drug; thus Ave get a good  idea of Avho  is the best
authority and most reliable Avriter.
  Dr. Burt says,  " Veratrum viride selects for its centre
of action the cerebro-spinal system, bringing its greatest
force to bear upon  the pneumogastric  nerve  and by
paralyzing its functions produces congestion and inflam-
mation in every  organ and tissue to Avhich it is  distrib-
uted.  This action can be better explained by saying
that the vessels  become engorged with blood by lacking
that propelling nervous force Avhich the agent has thus
paralyzed, and hence central, or cerebral, pneumonic or
cardiac stasis.
  " Diseases that call for these  remedies  must  have
their starting point in the cerebro-spinal nerves."
  The pathological  changes Avhich veratrum viride is
capable of producing are due to the microscopical re-
searches rendered by Dr. Adams.  This microscopical
examination of the brain revealed intense capillary con-
gestion.
  " The convulsive centre is located in a limited space on
the floor of the fourth ventricle in the pons-varolii." We
found great capillary congestion of the pons, and this
solves the problem why veratrum \Tiride is so valuable
in spasms of a congestive nature.  In puerperal convul-
sions that  have  for  their origin  some emotional cause
and  Avhen there  is some excessive cerebro-hyperaemia,
veratrum viride is, of all  remedies, the  first to be
thought of.
  The Doctor says  further, " aconite, although acting
on the same organs and tissues, spends most of its force
on the spinal filaments of the vaso-motor nerves of the
capillary blood vessels, so as to produce congestion in
every tissue in the body that contains capillaries (such
are the parallelisms of the two greatest agents of the
materia-medica)  Avhile veratrum  only affects the great
centre of circulation." 
EFFECTS OF MEDICAL AGENTS.         299
  Still another interesting comparative analogy exists
between veratrum A'iride and belladonna, and although
similar in their sphere of  action, yet the  pathogenetic
disturbances and  influences are totally opposite, and
the result may be looked for Avith considerable  confi-
dence.  Veratrum viride prostrates organic functions
and circulation, in its morbid action (sensible doses) by
its  paralyzing effects;  belladonna on the contrary pro-
duces the same morbid phenomena by an entirely differ-
ent train of symptoms, namely, by its stimulating and
exciting cerebral congestion.
  The  explanation  can  easily be arrived  at  Avithout
great difficulty, and is as folloAvs: Veratrum produces
inflammation  and extravasation, through the sudden
paralyzing influence of its toxic effect, and cuts off the
vitality from  Avhich the vessels  receive acthnty and
motion, namely the nervous force, thus producing  almost
 apoplexy.
   Belladonna  produces  an inflammation, turgescence,
 and  congestion, by exciting nervous force, thus causing
 hyperaemia of the blood vessels.
   As Ave do not accept  anything but facts, Ave are not
 troubled with delusions.  The way to  employ  these
 three  remedies  is  clear  and logical,  namely, by the
 general and  specific  laAV of similarity upon the  organs
 Avhose functions are morbidly affected.
    Their  duality  of action primary  and secondary, the
 first pathogenetic, the second therapeutic, will  accord
 with the  different  pathological lesions and symptoms
 belonging to each agent and disease.
    If Ave  have cerebral  congestion and great nervous
 tension, resulting from traumatic  reflex action, together
 with a tonic spasmodic contraction of the muscles from
 Avhich  circulation and  nervous  reciprocal action are
 wanting veratrum in small doses is the remedy.  But in
 congestion from an over-excitement of the nervous centre
 or sympathetic  system of nerves, belladonna Avould be
 the remedy. 
300
PROGRESSIVE MEDICINE.
   So the dual action of medicines is a Avell established
fact.  The only true Avay to find their right employment
is to  study their pathogenetic  influences, and the
morbid symptoms of the natural disease.
   In puerperal fever, in trismus, in cardiac paralysis, in
cerebro-spinal meningetis, in pneumonic hypostatic dis-
eases,  veratrum Avould release the equilibrium of cen-
tral circulation  by its influence upon  the cerebro-spinal
plexus, i.  e., the pneumogastric nerves.  Belladonna
acts more upon the sympathetic and  A'aso-motor nerves
when circulation is disordered by excitement.
   Glonoine, like \Teratrum, will release a decided neurotic
congestion  which proceeds from nervous tension and
spasmodic  irritability.
   Aconite-glonoine, A'eratrum viride are analogous, just
as opium, belladonna,  stramonium and hyosciamus are
similar.
   Carbolic  and Salicylic Acids.—Both these  substances
originate from carboniferous sources, and their isomeric
chemical compounds are strikingly suggestive as to their
relation  in a therapeutical  sense.  Their haAdng  de-
cidedly beneficial  medical effects is iioav unquestioned.
One is extracted  from coal tar, the other from charred
AvilloAV Avood.   Such carboniferous substances  are of a
pungent escharotic nature, depressant, exciting, stimula-
ting and irritating, affecting the Avhole general  system,
and  having decided effects upon organic functions and
physical and dynamic  forces.   They  are found in the
blood,  and  affect  the  absorbents very  greatly.   The
nervous  system becomes also sensibly  affected  from
centre to periphery.
  They affect the  brain, the organs of respiration, the
kidneys, the gastro-enteric fluids, and the  nervouu sys-
tem, Avith a great muscular relaxation, besides aphonia
joined  Avith considerable  irritation and excoriation  of
the  larynx,  tharynx,   trachia,  stomach  and  bowels.
Such are  the well knoAvn  generalities  of the  morbid
effects of these elements upon the animal economy. 
EFFECTS OF MEDICAL AGENTS.        301
  Hahnemann in his experiments calls the attention of
the profession to  the  modus operandi  of carbo-vege-
tabilis, Avhich, although used by the old school as an anti-
acid, and in dyspepsia, is otherAvise not used except as
a disinfectant in cases of putrefying Avounds or tumors.
  But our old observer Avent to the trouble of testing
the drug, and found it an antiperiodic and antiseptic
and an anti-zymotic   It  induced  cardialgia> great de-
pression of the organs of generation, paleness,  inter-
mittent pulse and Avant of proper oxidation.  And if
these  prominent  symptoms mean anything, I presume
they mean a general disorder  of the  co-ordination of
organic functions  and  physico-vital phenomena.  The
symptoms are those of a sIoav but  steady retrogressive
change in the general process of organization  and phy-
siological  activity.  The  blood  and  nervous system
become decidedly  devitalized and anaemic.  This devi-
talizing element suggested the idea that in zymotic or
fomenting blood diseases  it would  stop the disintegra-
tion and the  retrograde metamorphosis of physical Or"
ganization.
  When an effluvial or alluvial poison  has produced
typhus or typhoid fever Which have a tendency  to de-
stroy the organizing principles of life, i. e., the blood,
the nervous system, the gastro-enteric juices, and finally,
all that is organic in functions and repair, become as it
Avere, changed from the remotest nucleus to the protein-
aceous compound.   The plastic formations of the blood
become impossible, and hence, loss of corpuscles,  in-
crease  of fibrine  and  Water.   The saline principles
Avhich  form the viscid, gummy fluid thus holding  to-
gether the elementary principles of plastic matter, pass
off the body unassimilated, and  hence the  Avhole fabric
falls to pieces for AVant of building material.   In these
cases and in chronic diarrhoeas, ulcerations, diphtheria,
etc. our carbon vegetalis  or mineralis are agents of un-
questionable  affinity and force of action. 
302
PROGRESSIVE MEDICINE.
  Medicine to-day stands exactly  like  new  and old
chemistry; related,  and yet  distinctly  simplified;
changed Avhile the basis and the elements in use are
still the same.
  And  Avithout going into a dissertation of a chemico-
physiological nature, I should unhesitatingly pronounce
these tAvo  remedies as the most promising elementary
substances in the treatment of zymotic  disease,  be  it
scarlatina, measles, diphtheria, croup, infectious or con-
tagious diseases  like  cholera, yelloAv fever or  malarial
and insidious cerebral feA*ers, pernicious and congestive
inflammations,  either  cerebral, pneumonic, abdominal or
laryngeal.
  The pathological effects of carboniferous, exhalation,
in various  degrees Avill  coArer a ground Avith A\'hich Ave
can easily  compare  the pathological conditions and
symptoms of all the above diseases.
  The pathogeny of  these remedies is the guiding star,
the quality of their action exists in tangible  doses pro-
ducing  diseases  similar to those that have  been de-
scribed and in dynamic doses, destroying them  Avhen
present.
  The tAvo elements  differ  in intensity of action and
therefore must be given in different doses.  But I should
not hesitate to  recommend salicylic acid from one-tenth
to five grains, carbolic  from  three-tenths  to one-tenth
only (internally).
  And I feel that if I have  not convinced all my col-
leagues of both schools of the truth of duality on the prin-
cipal  of similarity, I  nevertheless  have opened a fair
field for dispassionate and scientific discussion upon the
broad basis, Similia similibus curantur.
  The great truth of the duality of action of medical
agents, could be even better and more practically illus-
trated by the primary and secondary action of alcohol.
  Every one  knoAvs  the exhilarating sensation of a
drink of champagne;  many  remember the sensation  of 
EFFECTS OF MEDICAL AGENTS.        303
suffocation, burning heat in the throat and stomach and
cerebral excitement of the first dose of strong wines or
spirits.  It excites the  pulse, it quickens the imagina-
tion  and  renders every capillary subject to receive  an
extra amount of blood from the great centre.
  And these temporary amenities  groAV in a degree ac-
cording to the use or abuse of the agent.   Hilarity is
Avell  knoAvn to Till and there is a greater  degree called
over-excitement. From these degrees Ave go on further
into  the field of excess and intoxication.  From a simple
exciter, in large doses it becomes narcotic;  it benumbs
the muscular  activity,  it decreases  organic functions,
and the heart becomes  sIoav  and Aveak in activity, and
full of venous blood.  The circulation is thus disturbed,
the brain becomes as if  narcotized, loses its force, and is
in a turmoil of disordered co-ordination; hence stupidity,
or vague and foolish hallucinations, etc.
  The nervous  system  becomes feeble and trembling,
and hyperaesthesia sets in,Avhich is demonstrated by Avant
of mental poAver, apepsia, agitation, fear,  excitement
and unreasonableness.
  The hair  becomes white, the nutrition is abnormal
and evanescent, having  no real stamina, either physical
or vital.  And  if continued it  results  in  (delirium
tremens), imbecility, and general adynaemia.
  In this short sketch Ave have, in a general sense, the
primary and secondary action of alcohol.  And  from
these outlines Ave  can  easily  select  our  agent for the
diseases in Avhich it is therapeutically indicated.
  We  cannot question  its great usefulness in certain
diseases either sthenic  or asthenic,  acute  or chronic
It produces (in  sufficient doses, and  continually used)
those very morbid conditions varying  in degree  and
character, according to the idiosyncrasies  of the patient.
  General Stimulants.—They exalt the sensibility of the
nervous system, the action of the muscular fibre, as well
as that of the mucous membrane.   They augment the 
304          PROGRESSIVE MEDICINE.
strength and frequency of the  heart's pulsations, give
vigor to  the  play of the  lungs, and raise the tempera-
ture of the Avhole body (primary action).  Modus oper-
andi :  " Amongst the  most important, if  not the most
important, of the actions  of alcohol, in a therapeutic
point of vieAV, is the influence Avhich is produced on the
circulating system.   That the administration of alcohol
increases  the poAver of the  heart, diminishes the  fre-
quency of its beat, and augments  the force of its con-
traction, under conditions of its debility, are facts Avhich
must be familiar to all who are in the habit of prescribing
it.   And there is nothing more striking and more satis-
factory than to Avatch the effects of the  remedy in those
cases of asthenic inflammation  Avhich are marked by a
rapid and Aveak pulse.  Under its use Ave see a  pulse,
abnormally quick, gradually  fall ;  Ave see an irregular
one  become  steady and regular; Ave see  delirium sub-
side* and  tongue, foul, dry or broAvn, assume a moist
and healthy character."—- Waring.
  Far as I  am from  considering any school of medicine
perfect, or consistent in all things, yet this is too great
a discrepancy from the antiphlogistic  treatment used
and  propounded by the Broussanian-school of France.
And it is so glaring a departure from old  theories that
even Dr. Waring says " Within  the last  five and tAventy
years a great  change has taken place  in the vieAvs of
the majority of medical practitioners in this country on
the  subject of stimulants in the  treatment of acute
diseases."
  And Avith this testimony, undeniable as  it is, I cannot
find  any  practical  explanation of  the  therapeutic
mode of action of alcohol.
  But  I  believe  that  facts cannot be  denied by  one
even prejudiced against a school, such as  a stimulant is
to be used  in inflammatory diseases, in sthenic diseases
and  in nervous affections.  Now on AAdiat  principle  can
such a remedy act, except that  of similarity in lesser or 
EFFECTS OF MEDICAL AGENTS.        305
greater degree?  In examining the diseases of alcohol-
ism, Ave find doubtless all the phases from its beginning
to its end^from mere excitement, hyperaemia cerebralis,
to violence and congestion of the  brain.  From simple
hilarity to agitation and convulsive movement doAvn to
prostration, asthenia and typhoid condition.
  It is not for Avant of candor that many of the great
thinkers do not  speak, but I  believe  they hold their
peace from fear of offending their  colleagues.
  The truth of the action of these remedies is too strong
to believe that it has escaped the attention and notice
of the able authorities of the old dogma.
  I should not do full justice to the Allopathic profes-
sion, if I should not give them credit for this great dis-
covery.  But at  the  same  time  I must  premise, that,
physicians of the new school fully recognize the import-
ance existing in the proper use of alcohol in diseases.
  And, it Avould also add much if Ave had  a distinct line
marked out Avhen and Iioav to use these  remedies.
  Tweedies says: " 1.  It sometimes happens that when
a patient in fever has  been progressing favorably, the
pulse becomes suddenly soft and  compressible, the skin
cool and damp accompanied by a feeling of considerable
exhaustion; Avith these symptoms, there need  be  little
hesitation in alloAving  six or eight ounces of Avine in
•twenty-four hours,  at  proper  intervals.  2. When the
symptoms  denoting sensorial disturbance, languor, Ioav
muttering delirium, tremor subsultus, are progressively
increasing, and if at the same time the patient lose his
strength from  day to day, the pulse  becomes soft and
skin cool.  3. Alcohol should be  used  Avhen the  fever
assumes the petechial character (typhoid, putrid,  mala-
rial, remittent, intermittent, continued).  4. And also
in cases of sudden collapse, some Avith stertorous breath-
ing, melancholy, mania, Avith  inclination to murder—
delirium, hallucinations." 
306           PROGRESSIVE MEDICINE.
  I should also add pneumonia, second stage of scarlet
fever, small-pox and diphtheria.
  In chronic diarrhoeas, and in suppurating wounds, etc.
  Alcohol  as a Remedy and as a Nutritious Substance.—
It especially arrests destructive  mal-assimilations,  so
that for a certain period, during the stay of alcohol in the
system, less urea,  less phosphates, less water are ex-
creted by the  kidneys; less carbonic acid by the  lungs,
and less digestion goes on in the alimentary canal.
  " But at the same time, they give rise  in the body to
defensive  re-action Avhich  is prominent first, and then
gives place  to the special action."
  So that if a  suitable quantity be taken, and  both ac-
tion and  re-action  are alloAved  to exhaust themselves
before  the  dose  be repeated, there will be a  positive
gain in vitality, " but  if such a large quantity be  taken
that the re-action is overpoAvered (or the forces  dimin-
ished) the body is not reneAved, because its effete parti-
cles are not removed."—Burt.
 
APPENDIX.
307
APPENDIX.
NUTRITIVE  CONSTITUENTS AND  ALIMENTATION.

  The nutritive constituents of the numerous articles of
diet,  their nature, proportions  and  agencies  in  the
great process of alimentation, is obviously a study in
Avhich every medical man is interested, and with which
he should be Avell acquainted, thus facilitating the selec-
tion of articles containing those properties Avhich the
physician considers necessary to supply the deficiencies
existing in the economy during a condition of transitory
physical  abnormalities.   At the very  first Ave can see
the difficulties in forming a correct diagnosis as to Avhat
is needed by the idiosyncrasis of the patients constitu-
tion, and the difficulty in selecting the materials Avhich
contain  the  true  elements that are required  by  the
economy Avhen in  a condition  which is considered out
of equilibrium.   Without this knoAvledge, our profes-
sion Avould be a sad failure indeed, in her very first
principles of restoration.
  I need not dwell long on this subject to persuade the
profession of  its usefulness;  in diseases, as a restorative
principle—in  health,  as  a  preventative  of   disease.
Mechanical, chemical, dynamic, or physical forces, depend 
308
PROGRESSIVE MEDICINE.
for  their equilibrium upon the elements of nutrition,
the manner of  preparing  them, the  best  articles  of
supply,  and when,  where  and how to use them.   To
this there are to be added other considerations which
are indispensable; such as climate, seasons, idiosyncrasies,
sex, age, occupation, temperament, etc.
  In  thermal  countries  certain  diet  is  admissible,
Avhereas, in cooler and  extreme northern latitudes the
opposite, in the nature  of the  ailments, Avould be  re-
quired.
  Food is the anchor of life, and Avithout it no hope, of
physical development can be secured; therefore it is an
absolute,  unconditional necessity,  and  superlatively
needed as a restorative  principle.   In  disease, there-
fore, it is of the greatest importance to knoAv Avhat the
physical economy has lost, and what  it requires; and
to seek for the articles which contain the necessary con-
stituent to re-establish  the lost physical equilibrium,
or to hold it in its normal  condition where no descend-
ing vital signs have taken  place.
  In describing the proximate constituents of the nutri-
tive elements  Ave  must observe;  1. The functions of
Avater;  2. Of albuminoid compounds; 3. Carboniferous
substances; 4.  Amylaceous (starch);  5. Glucose  (gum
and sugar);  6. Mineral salts; and 7. Nitrogenous  ele-
ments.
  The  proteinaceous  compound, fibrin,  albumen and
gelatin, is changed and  animalized in  the stomach, into
fibro-peptones,  albumino-peptones, gelatino-peptones;
these compounds are thus  metamorphosed by the pro-
cess of digestion through  a secretion of the follicles of
the stomach, being the true animal dia-stase juice, which
organizes the nitrogenous  elements and separates them
from the starchy cellulose  elements, just as  the dia-stase
by the enteric juice separates the starchy materials 
APPENDIX.
309
from the albuminous fat's, gluten and glucose (carbonif-
erous) compounds.
QUANTITY OF ALIMENT THAT WILL YIELD 1220 GRAINS OP NITROGENOUS MATTER.		NUTRITIVE EQUIVALENTS IN A DRY STATE.--PER 1000.			
Skim cheese, lb. 1-4 nitr.	1220	ANIMAL		VEGETABLE	
Lean meat, " 9 oun<					
White fish, "1.0 "					
Fat meat, "1.3 "	"		..331		. 81
Bread, "2.1 "	"	Beef........	..880		. 84
Rice, "2.8 "	"		..305		.100
New milk, "4.2 "	"	H. milk.....	..100	Rye..........	10(5
Potatoes, " 8.3 "	"		..237	Wheat.......	.119
Turnips, "15.9 •'		Yolk of egg. Eel......... Mutton.....	..305 434 ..773		125 138
				White Bread..	.142
			..833	Black Bread...	.166
			910		239
			..914		271
			..756		.283
		Pork...".....	893		320
		Veal........	..873		
  These tables show that red herring and ham in a dry
state yield nine times more nutritious material than the
dry matter of human milk, yet these do not shoAv that
all such elements can be appropriated, assimilated  and
utilized as products for the greatest nutrition.   Nitro-
gen is not all that is required by the human economy;
other materials equally important, if not more so, are to
be considered.
  Here we Avill divide starch as vegetable carbonaceous
from animal fat carbonaceous, the latter being much
richer in  carbon—2.s greater than  sugar.
  It appears that an adult requires 1.267 grains  of car-
bon, Avhich is to be obtained from amyloids, glucose and
fat  animal food  and 181 grains of nitrogen, to  be  ob-
tained  from  albuminoids and  meats  or animal food.
(Animal and vegetable nitrogenized food). 
310
PROGRESSIVE MEDICINE.
AVERAGE  PER CENT. OF NUTRITIVE  ELEMENTS  OF  ANIMAL

                    AND  VEGETABLE FOOD.
Bread.'.......

Beef.........

Fat Beef.....

Mutton......

Fat Mutton...

Wheat Flour.

Barley Meal..

Oat Meal.....

Rye Meal....

Indian Meal..

Rice.........

Peas.........

Arrowroot....

Potatoes......

Veal.........

Pork........

Butter.......

Beer.........

Yolk of Egg..

White of Egg

Skim  Milk...
 8.1

19.3

14.8

18.3

12.4

10.8

 6.3

12.6

 8.0

11.1

 6.0

23.0



 2.1

16.5

 9.8
47.4
66.3

69.6

58.4

69.5

64.7

79.1

55.4

82.0

18.8
3.6
3.C

4.9

5.4

3.7

0.4

0.4

2.0
2.3

5.1

4.4

4.8

3.5

2.3

2.0

3.0

1.8

1.7

3.5

2.5
3.2
 0.1

16.0

24.4

 4.0
87.0
30.7
5.4
1.0
0.7

4.7

2.3

2.0

0.2

1.3

1.6

0.8
 as starch,
   55.0
animal fat,
    9.0
animal fat,
   71.50
animal fat,
   12.25
animal fat,
   77.75
 as starch,
   75.50
 as starch,
   80.30
 as starch,
   77.80
 as starch,
   78.20
 as starch,
   85.35
 as starch,
   81.25
 as starch,
   62.65
 as starch,
   82.00
 as starch,
   22.50
animal fat,
   39.50
animal fat,
  122.25
animal fat,
  207.50
 as starch,
    8.70
animal fat,
   76.75
animal fat,
    9.90 
APPENDIX.
311
AVERAGE PER CENT. OF NUTRITIVE ELEMENTS OF ANIMAL
          and  vegetable food.—Continued.
	w <	W S P w P	■Si	S < o p oa	P	03 P 0Q	P.	w a o «
Skim Cheese......	44 68 74 66 74 15	4.8 13.2 21.0 2.7 18.9 8.8			6.3 16.4 3.8 26.7 4.1 73.3	4.9 2.4 1.2 1.8 3.0 2.9	animal fat, 15.75 animal fat, 41.00 animal fat, 9.50 animal fat, 69.55 10.25 183.25	24.8
Tripe..............								13.2
								21.0
				2.8				2.7
Ox Liver...........								18 9
Dried Bacon........								8 8
								
  It is clearly shoAvn that the amyloids, sugar and gum
amount to 70.05 per cent, and the fat 2.0, so that the
carboniferous vegetable matter (as  starch)  is  to  the
nitrogenous as 7 to 1; and  it is calculated  that from
two pounds to two-and-a-half  is the average  amount of
food required by an active adult.   Idleness does not re-
quire but one and one half pound per day.
  It is obvious that the quality of the food has a great
deal to do Avith the amount of nutrition received.  Two
pounds of bread Avill give sufficient carbon and nitrogen
for the maintenance of life, but by using it alone health
Avould be impaired.
  Cream  is rich in butter, yielding 13 oz. to 15 oz. of
commercial butter; it contains 34 per cent, of solid mat-
ter, 26.7 of Avhich is butter; specific gravity 1.013.
  Meats  differ very much in nutritive value according
to the proportion of fat or lean: it is  a common belief
that beef is the strongest kind of meat; but the lean of
all meats have nearly the same nutritive effect, provided
it agrees Avith the idiosyncrasis of the digestive organs.
Some cannot eat one kind of meat, but  eat another with 
312           PROGRESSIVE MEDICINE.
perfect  impunity.  There is a difference betAveen fat
and lean meats;  the former contain more solid (carbon-
aceous)  in place  of Avater, while the latter has only 28
or 29 per cent, of solid.
  The table on vegetable and animal nutritive elements
shoAv exactly Avhich are the  richest articles of diet, and
from it  Ave can select with sufficient accuracy the  qual-
ity of food most desirable for our purpose.
  And Avhen, from  our diagnosis, Ave can decide  what
our  patients  are in need of, we can soon refer to our
table for the selection of the elements of nutrition most
suitable to their Avants.


              ALIMENTATION IN DISEASE.
  In acute  inflammatory diseases, the febrile state in-
duces serious  changes  in the constituents of solids and
liquids. The interstitial fat disappears from the tissues,
which become soft and watery.   The muscles become
flabby  and pale, and lose  their  contractive energy.
Digestion is feeble or suspended, the  red corpuscles di-
minish  in number, and fibrinous plethora is soon engorg-
ing  capillary circulation.   The blood  suffers material
alterations; the  red corpuscles diminish, the  fibrin in-
crease  and  a pathological  tissue metamorphosis  takes
place.   The  phenomena of the  organism is  that  of
descending  to disorganization, and thus  pathological
products croAvd  the intertices  of  the tissue, and there-
fore the result is Avaste and struggle for eliminations of
the poisons and decayed tissue changes.  It  is the in-
tention of our efforts by a thorough knowledge of thera-
peutics to prevent the occurrence of changes  in the
structure or parts of organs, and to  favor  the natural
solution of the  pathological process going on  in the
economy, and at the  same time  to repair  the  general
lesions  in the organism, which the occurrence  of morbid
action has induced. 
APPENDIX.
313
  In this effort alimentation of a suitable kind becomes
of the highest importance.  Noav, then, the object is to
supply the patient Avith those nutritiATe substances that
he requires in his abnormal condition.   What Avould be
the proper alimentation  in  acute fevers or  inflamma-
tions ?  We certainly cannot prescribe a carboniferous
diet, neither a nitrogenous one entirely, for such nutri-
ment Avould increase heat, circulation and  carbonifica-
tion.  It is evident that Ave must use an amylaceous and
glutinous diet.   This compound Ave find in starch and
albuminous nutrients.  The  articles  that have these
elements are  rice, Avheat, flour, barley, rye  and meal.
These  ingredients  can  be combined Avith animal food
containing the  least carbonaceous and nitrogenous ele-
ments, and the greatest amount of gelatine, such as veal,
lamb, chickens (poultry) and  milk.  In a broth made of
lean veal, or chicken, and  rice or barley, Ave have a com-
pound suitable to conditions of  inflammatory diseases.
The Aveakest of vegetables—arroAvroot—Avhich has only
starch, can be used also by combining it Avith rich milk.
  The functions of amylaceous, cellulose, and  succulent
substances called hydrates of  carbon, are mostly calorific,
yet they have  a nutritious  effect in their starch, gum
and sugar.  However, the animal fat  is tAvice as great
as that of starch (2.5). But these substances have other
duties  to  perform  beside caloric, Avhich  is in fact the
final result of their oxidation; for after starch becomes
a glucose ingredient by physiological metamorphosis, it
goes on further and takes the form of various acid com-
pounds, as lactic acid, carbonic acid, butyric, lithic and
uric acid,  etc., which are found in  the perspiration.
Starch and sugar are also concerned  in the production
of fat.  Farinaceous materials and sugar are very fat-
tening articles  of diet.
  And again, in cases of emaciation, provided it is not
the result of  organic and  structural  disease  of the
stomach, Ave can often develop some neAV  plan of nutri- 
314
PROGRESSIVE MEDICINE
tion, based upon our knoAvledge of the various articles
of diet, and succeed, if any success is attainable, by us-
ing nutrients suitable to idiosyncrasis of the patient,
thus  increasing the  adipose tissues.   If the patient
should digest well  the animal fat, that Avould be more
apt to increase the adipose tissue, being stronger than
vegetable carbon.
   And  for this purpose Ave should  select Indian meal,
peas, Avheat, flour, butter,  milk,  barley,  rye, oat-meal
and succulent vegetables like tomatoes, potatoes, fruits,
etc., as articles of diet for those Avhose constitution is
needing fat and histogenetics.  But some albuminoids
must be intenvoven Avith the carboniferous in order to
proceed Avith the process of thorough reconstruction.
   Again,  these articles of diet knoAvn as leguminous
food, must be conjoint Avith the saline materials neces-
sary to the economy, namely,  phosphate  of lime,  sul-
phate of potass, and phosphate of magnesia; Avith these,
silicate and carbonate  of lithicum are often present.
   From some other articles Ave get phosphoric acid,iron
oxalates, etc., and oftentimes it Avould be  Avell if we
should  select those nutritive elements containing cer-
tain  amounts of alkaloids, or  salts, for these are  the
necessary elements for the plasticity of the liquor san-
guini.
  " The saline constituents of food are largely concerned
in the metamorphosis  of matter;  and, perhaps,  this is
the principal function, for  it is a speciality for these
substances to give a soluble form to  the plastic consti-
tuents of food and of the animal tissues.   They are,
therefore, concerned in the phenomena of digestion, ab-
sorption,  sanguinification, assimilation, disintegration,
and secretion.   In truth, they are the chief, if not  the
only, media for the transference of organic matter from
place to place in the animal body, being, in one Avord,
the purveyors of nutrient materials to the system, and
also the carriers of effete substances out of it, besides 
APPENDIX.
315
 Avhich, it  is very probable  that they are the  agents
 whereby liquid colloidal forms of nutriment are changed
 into solids or pectous (vegetable basis of jell}7), as in the
 formation of solid tissues from the blood, and conversely,
 the solid into liquid."
   In the case  of digestion and absorption, the  plastic
 elements of our food, as  albumen, fibrin, gelatin, etc.,
 are not of themselves  capable of dialysis by passing
 through the walls of the alimentary canal, and, therefore,
 absorption  must be assisted by  some  physical agent.
 This agent  is the highly diffusive acids and salts Avhich
 are secreted so  freely into  the stomach during diges-
 tion ; and they prove to be indispensable substances in
 the solution of the proteine compounds by converting or
 organizing them  into peptones,  changing the  molecular
 form of the constituents, and causing it to pass from  a
 thick,  viscid, unabsorbable colloid juice into a  highly
 diffusive fluid, thus facilitating dialysis by passing easily
 through the Avails of the alimentary canal.
   The colloidal fluid, after passing through the  process
 of  animalization, goes into  the  blood and  assumes  a
 crystalloid form,  and therein Ave find the crystals of the
 alkalinity of blood, thus the molecular metamorphosis
 takes place  from  the fluid colloid into alkaline crystals.
   The  phenomenon is rich in beauty, interest and use-
 fulness, and it is  not ended here; the blood  returns to
 the tissues, and there finding acids, it once more changes
 its molecular structure, and the crystals are diffused again
 for the purpose  of nutrition.  This does not exclude
 the process of the  laAV of endosmosis and  exosmosis,
 for those are  physical functions of molecular affinity;
 the effects of the salts are  to organize and  facilitate ab-
 sorption and secretion, thus reconstructing solid tissue.
 In this way, step by step, the physical metamorphosis
brings about a condition of pectous solid by the saline
constituents, and according to their nature and propor-
tion determine  the degree  of  hardness.   Again,  an- 
316
PROGRESSIVE MEDICINE.
other physical  and  organic  transition  takes  place,
namely, the removal  of effete materials and Avorn-out
tissue.  This is unquestionably affected by the agency
of saline substances, for during the process of oxidation,
acid compounds  are  produced  in the  shape of lactic,
acetic, chloric,  carbonic, phosphoric acids, Avhich,by act-
ing chemically on the  saline constituents of the animal
fluids, give them a solutive poAver upon plastic matters,
and thus enable them to remove the debris of worn-out
tissue or superabundant secretions like bile, urea, car-
bonic acidities of the  enteric juices, etc.
   Of the special function of each of the  many saline con-
stituents of food so far, little has been demonstrated, yet it
is a remarkable fact that the alkaline or basis, phosphate
of soda is invariably found in the blood, while acid-phos-
phate of potass is the  chief  constituent of the tissues.
The alkalinity of the blood  is  a physical necessity in or-
der to keep it  in a colloidal form, and  at the same time
adding  to  its  plastic metamorphosis.  What is  the
agency of this phosphate of soda ?  Tavo  great pheno-
mena and changes take place.  It assists in the oxida-
tion of organic matter, by absorbing and removing car-
bonaceous products,  changing them   in  the shape of
phosphoric,  carbonic acids.  If this  ingredient is not
 present in sufficient quantity, other carbonates perform
 that duty, and  thus the effete  matters of decayed tissues
 arc removed by the excretions.

 PER CENTAGE COMPOSITION OF MINERAL MATTER OF BLOOD.
	riips. ACID.	ALKALINES.	ALKALINE EARTHS.	MINER. ACIDS AND OXIDE OF IKON.
Pi<r..........	36.50 14.80 36.82 14.04 31.79	49.50 55.79 55.24 60.00 55.66	3.80 4.87 2.07 3.64 3.33	9.90
Doc-..........				24.54 5.87
Ox...........				22.32
				9.22
 
APPENDIX.
317
  The coav's milk gives,  according to Hardless, the
saline  matters  amounting  to  5-8  in a thousand—the
average 5.83,of which the individual constituents are as
follows:
  Lime, 2.88; phosphate of  magnesia, 0.53; phosphate
and peroxide of iron, 00.7; chloride of potassium, 1.63;
chloride of sodium, 0.29, and free soda, 0.43.
  The salts of potass, namely, carbonates, nitrates, sul-
phates and phosphates (called acid phosphates of potass)
are the chief constituents  of  the  fluid of tissues, and
have the opposite  function from the phosphates of soda,
namely, that of promoting the transudation of nutrient
matter, Avhile the alkaline phosphate of soda prevents.
  Alkaline earths: phosphates, lime,  magnesia,  carb.
barita: sulphur, silicea, etc., are perhaps the agents for
the consolidation of  tissue,  and pass into the condition
of pectous solid  and form  the calcareous deposits of
bone, teeth, tegumentary scales, egg-shell, nails, etc.
The saline constituents are exuded, according  to their
nature and proportion, thus determining the degrees of
hardness.

                CHLORIDE OF SODIUM.
  This is the common salt Avhich the nutrients or the
ingredients of diet do not supply or contain.   It has an
important part in  the structural functions of the animal
economy,  and must be supplied (an alkaline earth). It
is a large  constituent of every one of the secretions, and
forms about half the total Aveight of the saline proper-
ties of the blood.
  Unlike  the  phosphates,  it does not enter  into the
composition of tissue, but seems to be only a medium of
absorption and secretion.  And it is so necessary and
exact in its proportions that it is not possible  to alter,
to any large extent, its proportion in the blood.
  It cannot be  diminished or increased to a large extent.
This normal proportion of it in the blood is evidently  a 
318
PROGRESSIVE MEDICINE.
physiological necessity, which the condition of diffusion
imperatively demands.
  It favors  the elimination of the effete animal juices
and tissues through the agency of its free  acid (chloric
acid), existing in the gastric and muscular juices, which
are thus absorbed and secreted.
  Before Ave proceed  to other constituents  it is  Avell to
remark the  importance of alkalines and alkaline earths
in the human organism.  We cannot forget  that children
often become anaemic although fat, Aveak  although ap-
parently healthy.  And, perhaps, upon inquiry into the
constituents of the nutriment of milk, Ave Avill find  it
different in  carbonaceous and saline ingredients of some
kind.  Here lies before us a table Avhich points  out the
saline substances of the blood, and the functions of those
substances; from it we learn that a Avant of phosphate
of soda and free soda Avould disarrange the molecular
crystals, the colloidal viscidity,  and disturb the  exact
proteinaceous compounds of albumen, fibrin and  gelatin,
so that the phosphate of soda is  a constituent of great
\a\\\e in the colloidal  formation of the blood.
  We cannot pass by the usefulness of the other alka-
lines  and earthy alkalines and  the free mineral acids.
These are phosphates, nitrates and carbonates of potass.
These promote absorption  and  diffuse the nutritious
elements into  every  tissue, and, at  the same time, by
their diffuse properties or effects, favor  secretion  and ex-
cretion of the effete tissue and juices.  Noav, Ave have in-
deed  great use for these alkalines in all cases of inflam-
matory diseases  Avhere  fibrinous  accumulation  and
blood  disintegration  is threatened.  And, also,  in all
those malarious phenomena of diseases Avhere the  blood
is poorly oxidized and retains much of the  effete venous
carbonaceous constituents; the saline substances should
be properly increased through diet, baths  and remedial
agents; these agents  secure the solubility  of the  blood
and prevent fibrinous plethora and corpuscular  decay. 
APPENDIX.
319
  But there are difficulties in the AAray.  Often an article
of diet that is rich in alkalinity is also unfortunately
rich in carbonaceous  or nitrogenous substances, and
these Avould add too much caloric to an inflammatory
disease.  In that case Ave may seek a diet amongst the
vegetables,  as Avheat flour, oat-meal, barley  and milk
can be 'often used.  But in malarious diseases Avhere the
proteinaceous compound  has been seriously disturbed,
and the process of absorption and secretion equally  in-
terfered Avith, the excretions being sIoav and full of dis-
organized animal matters, it is obvious that a free  vent
to these physical and physiological functions should  be
given by a judicious increase of saline substances, and
at  the  same  time,  carbo-nitrogenous  alimentation.
These can be added in fluid drinks, in dietetics, and as
medical agents.   These chemico-physiological agencies
Avould aid the medical treatment in the great recupera-
tive process.  And  do not the new school give  often
natrum  mur.  in  intermittent  fevers ?    Carbo-veg.,
kali-carb.,  arsenicum  album, nitr.  acid and phosph.
These  are  physiological  remedies, and  are  aided  by
china, quinia sulphatis, capsicum alb.,  cetron, eupoto-
rium per., aconite, belladonna, gelseminum,  bryonia alb.,
etc.  These are medicinal agents Avhich contain sub-
stances of a toxic revulsive  nature, producing  a revul-
sion and re-establishing the equilibrium  of the system.
  But Ave must never forget to use agents, physiological
or medical, which Avill  act not only on the nervous cen-
tre, but also upon the absorbents and secretions, elimi-
nating, or  encouraging the  elimination of the excre-
mentitious  materials Avhich are encumbering and dis-
turbing the restorative process of nature.
  Amongst  these agents Ave may select  those  more
available to the idiosyncrasis of the disease.   1. Blood
remedies:  phosphate of  soda, ferrum peroxidum, per-
oxide of manganese and chlorate of potass.  2. Tissue
remedies: nitrate of potass, sulphate and phosphate of 
320           PROGRESSIVE MEDICINE.
potass,  together Avith the earthy alkaline phosphates,
namely, lime and magnesia, chloride-soda, carbonate  of
lime and barita, sulphur, silicea, etc.  After these be-
come oxidized  and produce  their effects upon the or-
ganism, they pass off as carbonic phosphoric, nitric, sul-
phuric, uric, lactic acids; they are  the oxidized rem-
nants passing off with  the decayed tissues as carbonic,
and uric, and lithic  acids.  3. The  therapeutic agents
Avhich Ave use take another line of action, namely, affect-
ing the nerArous centripital and centrifugal system; and
Avith these agents Ave modify organic  action,  increase
physical functions, divulge nervous and vital activity—
thus increasing absorption and secretion, and  also the
whole  process  of  assimilation, histogenesis, chemical
action, ejestion, circulation, oxidation, etc.  These  min-
eral acids are often substituted in the shape of already
oxidized substances,  as  acetate  of potass, nitric acid,
phosphoric acid, sulphuric (carbonic acid in the mineral
water), etc.  Also tinct. mur. of iron, chloride of gold,
argentum nitricum, oxide of iron, acetate of lead, ebr.
oxide of manganese (minerals).
   The subject must be retraced to the products of ali-
mentations ; and just here Ave will take the ATegetables.
GRAINS PER  POUND  OF CARBONIZED  NITROGEN.
GRAINS PER POUND OP
CARBON.	NITROGEN.
2.698	2.68
3.016	1.20
2.563	0.68
2.693	0.86
2.700	1.16
2.831	1.36
1.975	0.88
2.732	0.68
0.769	0.22
0.263	0.13
0.508	0.14
Split Peas....
Indian Meal..
Barley Meal..
Bye ileal.....
Second Flour.
Oat Meal.....
Bakers'  Bread
Rice.........
Potatoes.....
Turnips......
Carrots...... 
APPENDIX.
321
  The carbon of vegetables is confined in the starch
and sugar,  and is the equivalent to fat in the animal
food.
  From this list Ave can surely select our vegetable diet
in sickness—Avhether Ave  Avant nitrogenous   food  or
starchy and calorificient.  And Ave  perceive that  peas
have  the  greatest  amount  of nitrogenous  substances,
even beyond the reputed oat-meal.  Again, Ave can also
select those ingredients that contain more or less of the
alkalines and mineral alkaloids, as  elements necessary
to the animal  economy.  The proximate  elements of
100 parts of peas, beans and lentils  (per 100 parts).
MATERIALS.	W <	Eh < P	o o « 3	H P < vx	o H CQ	i p
	15 13	2.1 2.6 *8.'l 0.7 5.6 1.6 2.0	2.3 0.9 2.5 11.0 6.3 12.6 10.8 8.0	2.3 2.3 1.7 0.5 3.0 2.3 1.8	55.4 74.0 64.7 79.1 58.4 66.3 69.5	0.2
						
						
	14 13 15 15 15					0 4
						04
Oat Meal................						54
Wheat Flour............						3.6
						3.7
               ON CERTAIN BEVERAGES.
  All nations  have some national favorite beverage.
The  southern  nations  indulge generally in light acidu-
lated drinks; the northerners use a more carbonaceous
beverage  in the  shape  of  liquors.   But there  are
several vegetable infusions which are accepted by the
Avhole civilized Avorld as eminently healthful and nutri-
tious, namely,  tea, coffee, cocoa,  chocolate; beer  and
wines,  which  come Avithin  the  class  of fermented
articles.
  "The principal constituents of tea and coffee are 1.
A volatile oil  on which  their aroma depends.  2. An
astringent acid, of the nature  of tannic acid in tea, and
caffeine acid in coffee, Avhich give  them their bitter
styptic taste—an average of, 13 to 18 per cent, in  tea, 
322           PROGRESSIVE MEDICINE.
and  about 5 per cent, in coffee;  and 3. A  crystalized
nitrogenous substance of an alkaline nature called theine
in tea,  caffeine  in  coffee, and theobromine  in cocoa
(theobroma a crystalized principle of- both coffee  and
cocoa).
  "The physiological properties of these and of their
homologue, theobromine, are a nitrogenous  crystalized
substance."  The physiologists like Mulder, Liebig and
Lehmann, Avith infusion of  roasted coffee and caffeine,
Avent to shoAv that their chief influence on  the human
body was to retard the Avaste  of  the tissue; that Avhen,
for  example, an infusion of roasted  coffee (for three
quarters of an hour), Avas taken daily for a fortnight, the
amount of urea and  phosphoric acid excreted by the
kidneys Avas less by one-third than Avhen the same food
Avas taken Avithout coffee.  " Reasoning from these ex-
periments, it leads  us to say that  theine, caffeine and
theobromine are closely related in their composition to
nervous tissue, and that, therefore, they are suited for
the repair of nervous tissues and the renovating of ex-
hausted brain.
  " The vapor exhaled  from the  oil by the process of
distillation  (empyreumatic  oil) and  abstraction,  Avas
found to produce a stimulating action on the nervous
system.  It also operated upon  the  skin and boAA^els,
producing gentle perspiration, peristaltic  action, and it
removed the sensation (nervous influence) of hunger.
  " And, in conclusion, it has been ascertained that these
beverages lessen Avaste, and enable  the food to  go  fur-
ther in its nutritive action."
  Doctor EdAvard Smith's experiments and opinion dif-
fer  someAvhat from  the above, and coincide Avith my
opinion and experience.
  •' 1. Tea  promotes rather than checks  the  chemico-
vital function of  the  body,  for  directly  after it is
taken, the quantity of carbonic acid emitted  from the
lungs, and  the quantity of  air inspired are increased, 
APPENDIX.
323
and there is greater depth and freedom of respiration."
In this Avay, he thinks, it  promotes the  transformation
of amylaceous and fatty food into carbonic acid, and by
exciting free perspiration it acts as a cooling agent, less-
ening the  heat of the body.  Coffee, he says, " has an
opposite effect, for it lessens the waste of the tissues
and the action of the skin (increasing the heat of the
body) and promotes through its specific  influence upon
the cerebro-spinal system, the peristaltic movement of
the intestines."
  " And here Ave must admit that  coffee yields an ele-
ment called taurine (from taurus ox or the bile of ox),
Avhich  is a  nitrogenized  constituent  of the  bile, and
Liebig properly asks if coffee may not be concerned in
the production of bile."   And theine, he also states, is
related  to  kreatine—that remarkable compound found
in the muscular juice of animals, consisting of oxygen,
hydrogen, carbon and nitrogen.  (It has neither acid nor
basic  properties; by the  action of  strong  acid  it is
crystalized into kreatinine.)  We can noAV pretty Avell
define  the  differences of  their constituents, and hence
establish a point of their individual and peculiar action
upon the animal economy.   In a generic sense, I agree
with the general acceptation of these products as vital
stimulants or invigorators, but they certainly differ in
a special sense  in their action upon the human system;
their homological constituents are of the  same essential
nature; their effects are as well homological, or similar,
but yet act on different parts and  functions of the  or-
ganism.
  The  subject is clear for  our understanding of the
proper use of these articles of diet.  Coffee, then, should
be  used in all cases  of  emaciation  and  Ioav type of
diseases.
  In iriervation; in neuralgias;  in fevers like typhoid;
after surgical operations Avhere blood has been lost and
anaemia  is  threatened;  malarial  diseases;  in atonic 
324
PROGRESSIVE MEDICINE.
dyspepsia; in chronic eruptive diseases; in scrofula and
chronic constipations  from  atony of the  peristaltic
movement of the intestines.  In Avant of vital force ; in
mental debility and Avant of organic co-ordination, assimi-
lation  and vitalization.  In  diseases  of  Avomen  after
parturition;  in  marasmus;  phthisis  and  catarrhal
diseases.
  Cocoa is also a beneficial nutrient, containing  more
nutrition  in carbon and nitrogen than coffee;  the oto-
genous and nutritious  elements are far greater than
those of coffee; but it has  little effect in lessening the
metamorphosis of tissue, and less still upon the cerebro-
spinal or vaso-motor system.
  Tea, then, can be used Avhen Ave  desire  to promote
carbonification,  augmenting  respiration  (respiratory),
cooling the body and  disengaging carboniferous and
nitrogenized constituents, which are as  a surplus and
effete matter in the economy.  The coffee Avill add force
and nutrition like phosphate of soda; Avhile tea Avill dif-
fuse the nutritive elements through the  tissue, and en-
courage secretion and excretion like the alkaline salts
of  the  nitrate,  phosphates  and carbonates of potass.
And this is a good lesson to  prevent the indiscriminate
use of these  articles,  so eminently  and highly  nutri-
tious,  by those from Avhose study of dietery,  better
things should be expected.
  Fermented Liquors.—The process of fermentation is
too Avell-known to require an elaborate description.
  The simplest  form is that  of making bread  and Avine.
Starch and sugar are the tAvo requisite  substances in
the grape, and by the process of fermentation a molec-
ular disintegration takes place, and Avith the addition
of  atmospherical  oxygen and hydrogen, under a ther-
mal temperature,  wine is  the result (10  to 17 parts of
alcohol).
  But Ave go a step further if a spirituous liquid  is de-
sired, by  burning out totally the vegetable starch  and 
APPENDIX.
325
sugar,  and  thus getting  a  pure  carbonaceous  fluid
(alcohol) as  the  result (C. 0.2).   Should  Ave add one
more  atom  of ox}Tgen to  C. 0.2,  namely, C. O.2 and
H. O.2, we would have an acid (acetic) a product of an
excess of oxygen.
  Wine  and bread are tAvo great elements of physico-
vital force, and they stand at  the  head of the list of
nutritious materials.   But the alcohol and spirituous
liquor are eminently carboniferous, highly stimulant and
not nutritious in the least.  It is simply fuel to the ani-
mal economy by AArhich (if needed) much benefit can be
produced; this dangerous material  is diffusive in  help-
ing the general process of assimilation, organization and
nutrition.  It promotes stimulation and motion ; activity
of the organs is increased; circulation is strengthened,
and every organ  and capillary is  aroused to activity.
The brain gives evidence of  a neAV vigor through the
increased cephalic circulation; the heart becomes fuller
and more active, and the Avhole economy is throAvn in a
state of temporary agitation.
  And an element that can produce, almost  instantane-
ously, such results, is surely an element of danger; and
when abused, it proves so to the fullest extent.  Its re-
action is converse^ to what has been stated.  The car-
boniferous spirit burns as  it  Avere the tissues, changes
the juices,  disorganizes organic functions, interferes
Avith assimilation, prevents nutrition and a condition of
amemia, and inanition is  the result.  But are these rea-
sons sufficient for the inquiring physician to stop and
say, I Avill learn no more  of this fatal drug.   The man
who gives the arsenic, the opium, the chloroform, the
aconite,  the  atrophine,  etc., cannot  remain in such a
ridiculous state of uncertainty, he must move and find
the way  to use this  agent safely.
  Spirituous Fluids.—There  is  the same universal in-
dication  of  their  serving a profound physiological pur-
pose, and supplying a common want.  It is no argument 
326
PROGRESSIVE MEDICINE.
that because these things have been abused they serve
no purpose in man's economy but that of evil.
  On the contrary, the fact of their use in all times, and
that no saccharine liquid or juice of ripe fruit can be
exposed to the air Avithout spontaneous  and almost im-
mediate fermentation, are  striking evidences of design
for some useful purpose.
  They may not  enter into  the composition of tissue,
but they may stimulate the energies of the living frame
and rouse them into  increased activity.  There are not
only brick and mortar to be sustained in the  human
economy—there are rarer forms of matter, and  higher
manifestations of force, concerned in man's existence.
  The effect of alcohol is much diminished by the sub-
stances Avith Avhich it is associated in different spirituous
liquors.  Beer and ale, Avine, cider and sherry, have an
effect upon the  respiratory function by reason of the
saccharine and nitrogenous  matter which they contain
(calorificient constituents).
  Brandy and gin lessen  the respiratory action.   Rum
(Jamaica), beer and ale  are true restoratives, as they
sustain and increase the vital poAvers.   This is  due to
their combination Avith saccharine and nitrogenous ma-
terials Avhich the pure spirits do not possess—except in
carbonaceous combustible form.

FUNCTIONS OF  CONDIMENT,  PEPPER, MUSTARD AND  SPICES.

  These substances are not simply the adding of an
aroma  to  the food, Avhich makes  it more palatable and
agreeable to us;  but they have a  pungent, stimulating
action upon the salivary glands and gastric juice; they
excite  a greater amount of digestive  fluids, increase
nervous activity  and  capillary  action.  They make di-
gestion more easy, and assimilation possibly more com-
plete.   Herbs—like sage, rosemary, parsley and celery,
are very useful in animal broths and soups generally. 
APPENDIX.
327
  Indeed, the art of culinary science lies in the knoAvl-
edge  of how to make  food  digestable, palatable, and
agreeable to the eyes as Avell as to the olfactory.
  The senses must be satisfied, for much of appetite and
pleasure is thus cultivated and rendered serviceable  to
nutrition.
               SUCCULENT VEGETABLES.
  We have examined many of the articles of diet, their
value, uses, effects, and individual constituents, but there
are a few more of the succulent type that have not  as
yet been entered in the list of diatetics.   They are juicy
and cellular, such  as potatoes, carrots, beets, cabbage,
salad, cucumbers, mushrooms, tomatoes, pumpkins, egg-
plants, and turnips.  The class of succulent \7egetables
is a very large one, and  is valuable for both its nutritive
and saline constituents, by which it  is  at once a food
and a medicine.  These articles are so well known that
they do not require description.
  ARTICLES OF DIET  COMPARED AS  TO THEIR NUTRITIVE
       QUALITIES IN OTHER PROXIMATE ELEMENTS.
	P w <	is' p M P <	< P	P < so	W o « < 02
	72.0 51.0 72.0 53.0 39.0 15.0 24.0 74.0 74.0 63.0 52.0 78.0 78.0	19.3 14.8 18.3 12.4 9.8 8.8 7.1 21.0 18.9 16.5 16.0 24.4 18.1	3.6 29.8 4.9 31.1 28.9 73.3 66.8 3.8 4.1 15.8 30.7 *2.9	5.1 4.4 4.8 3.5 2.3 2.9 2.1 1.2 3.0 4.7 1.6 1.3 1.4	0.9
Fat Beef.............					74.50
					12.44
Fat Mutton...........					77.75
Pork................					122.25
					
					
Poultry..............					950
Ox Liver............					10.25
Veal.................					39.50
Yolk of Egg..........					76.75
White of Egg........					24.44
  The so-called starchy animal nutrients are the carbon-
iferous and fatty substances, as the starch of vegetables
corresponds with the animal fats (carboniferous). 
328          PROGRESSIVE MEDICINE.
  We have classified many articles of diet according to
their proximate constituents, and not Avith reference to
their ultimate or chemical principles, for there is a great
difference  betAveen  nitrogenous and  nitrogen-carbon-
aceous, and  carbon; as these classified elements are to
supply the economy in health and disease, therefore Ave
have to select those that contain elements that Ave think
the patient needs, according to sex, age, idiosyncrasis and
morbid affections.  And to  understand this important
matter of alimentation, it is also advisable to understand
the natural constituents of the blood.   We have studied
the amount of carbonaceous and nitrogenous material
Avhich  is  required to  sustain the equilibrium  of the
animal economy—from 2 Sbs. to 2\ fibs, of  solid food per
diem.  When at Avork in the field it even requires from
3 to Z\ fibs., the quality  of food—one of nitrogen to six
of carbon.   In idleness it requires 2.27 ozs.  of nitrogen-
ous food  and 19.61 ozs. of carbonaceous food.  In ordi-
nary labor, 4.56 ozs. nitrogenous, and 29.24 ozs. carbon-
aceous.   In  active labor, 5.81  ozs. nitrogenous food,
34.97 ozs. carbonaceous.
  This method of study takes us to the amount of Avaste
going on in  the body at rest and at Avork.  The estimate
of the carbon and nitrogen exhaled and secreted  is from
6 to 13| ounces daily.
  Average Excretion of carbonic acid by the lungs:

      7.85 ozs. daily Avhen the body is at rest.
      9.11  "    "  Avith moderate exercise.
     12.9   "    "  Avith considerable labor.

  Taking the average as represented  by 2 lbs, 2 ozs.,
i. e., 34 ounces  of food  in ordinary diet, there Avould
remain in the system for general repair of the wastes,
26.15 ozs.
   And taking the largest amount of Z\ lbs. or 56 ozs. of 
APPENDIX.
329
food, compared with 13 ozs. of loss: there Avould be 43
ozs. left to repair the Avaste.
  Now then, there is the amount of nitrogen excreted,
as urea amounting to 2.03 grs. to one pound Aveight of
the body (in  ordinary diet and no exercise, 3.04 grs).
Add to this 9.6 ozs. emitted daily by the skin and boAv-
els, or 28  grains per pound Aveight.  And with  a non-
nitrogenous diet and  no exercise,  it Avas  0.95 grs. per
pound Aveight or less than half, Avith the same diet  and
active exercise, 2.42 per pound Aveight or 364 grs. per
156 fibs.
  As we have the articles of diet whose proximate con-
stituents contain all Ave need for the  process  of nutri-
tion, and as a great number offer  themselves for  our
selection, it behooves us to knoAv Iioav much of that food
is required daily, to sustain life and equilibrium  during
the different phases of various occupations or idleness.
And this we have learned and more, namely, the amount
on an average of the excretions of carbonic acid through
the lungs,  as urea or nitrogen through the kidneys, and
excrementitious materials through the skin and bowels,
Ave have taken as the standard or the rule of the physi-
ological process going on daily in the human  economy.
   And Avith this before us could Ave fail, or go far from the
physical necessities, taking of course into consideration,
climates, occupation, idiosyncrasis,  age  and sex, in ob-
serving these rules?  And once more:  If in idleness
Ave require only \\ fibs, of food  to li  fibs., how much
Avould a person sick in bed require? or confined  to the
house?  I  should  consider 3 ozs. to 3\ ozs. per meal
sufficient for an adult;  and this food should be oneN. to
six C. in health; but in disease, this rule cannot be ob-
served.   The physician here  must  be guided  by the
nature of the malady and the needs  of the physical
 economy,  because we often require more than one  part
 of nitrogenous to six of carbonaceous articles.
   At other times Ave need more  of the carbonaceous 
330          PROGRESSIVE MEDICINE.
elements, i. e.: minerals and metalloids or alkalies, etc.,
magnesia, sulphur, phosphor, silica  perox.  manganese,
iron, natrum, potassium,  calcareous  materials, phosph.
and carbonate of lime.  These minerals exist in  large
proportions in the products of food, called constituents.
  Unquestionably the knoAvledge of the  proper constit-
uents of vegetable and animal food is of the greatest
importance,  in  order to  supply  patients  with  those
proximate physical principles so necessary to re-estab-
lish the physiological functions.
PERCENTAGE COMPOSITION  OP THE
                     THE  BLOOD.
MINERAL MATTERS OP
  Blood  is a  healthful article  of nutrition, and Avhen
fresh and fried with a feAv condiments to make it pala-
table, it is as good as liver or kidneys.  The blood pud-
ding of the Germans is good provided it  be used  at
once.  Ox blood is rich in alkalines and iron.  Sheep's
blood is equally rich.  The blood of  chickens  and tur-
keys is richer in phosphorus.
  This article comes in order Avithin the list of diatetics,
for in sickness Avhen digestion is almost nil, this ingre-
dient Avell prepared becomes as SAveet as  bread, brain
or ox liver.
  It has  the advantage of being almost needless of di-
gestion :  and its nutritive constituents approach nearer
than any other articles to the purest blood-making food.
COMPARATIVE LTST OP SALTS.
	Man.	Pig.	Fowl.	Sheep.	Ox.
Phosphate Acid......	31.79 57.66 3.33 9.22	36.50 49.80 3.80 9.90	47.26 48.41 2 22 2.11	14.80 55.79 4.87 24.54	14.04 60 00
Alkaline Earths...... Mineral Acids........					3.64 22.32
	100.00	100.00	100.00	100.00	100.00
 
APPENDIX.
331
   We can see at a glance that the blood of the  ox and
sheep is the richest in iron and alkalies, AAdiile  that of
fowls and pigs abound in phosphorus and alkalies. This
gives  the advantage of choosing for cases of anaemia
Avhere the blood has lost its red  corpuscle and its phos-
phate of soda or iron.  These constituents are the ap-
proximate mineral salts contained in the human blood.
   I have seen these various bloods used by the peasan-
try of Italy, and have myself tasted  them, and found
them very digestable and palatable.
   If Ave  admit that mineral  Avaters  are physiological
liquids, as containing many elements  Avhich the physio-
logical process requires, Avhy not select for the same
reason those articles of diet endoAved Avith the same
elements?
   In infancy, and from ten to sixteen years  old we re-
quire more food and more articles of high nutrition than
in adult life  and middle age.
   On an average infants  require three times as much
carbonaceous food and six times as much nitrogen as
adults.   Therefore, even in  time of  sickness Ave must
give children a more nutritious diet than older  people
for young children require a supply for both nutrition
and growth, Avhile an adult has only  to keep up the
equilibrium.

        COMPARATIVE  DIGESTIBILITY OF ANIMAL.
ARTICLES OF DIET.	now COOKED.	CHYMIFICATION.
Beef ....	Boiled...............	H. M. 2 45
Beef		3 00
		3 00
		3 15
		2 45
		2 30
F -Is	Boiled...............	4 00
		4 00
		
 
332           PROGRESSIVE MEDICINE.

  COMPARATIVE DIGESTIBILITY OF ANIMAL.— Continued.
ARTICLES	OF DIET.	HOW COOKED.	CHYMIFICATION.	
Ducks.................		Roasted..............	H. 4 5 5 2 2 3 3 3 1 1 1 1 2 3	M. 00
Pork..................				15
		Boiled...............		30
				30
		Boiled...............		15
Cheese.................				30
Eggs..................		Hard Boiled..........		30
E»gs..................		Fried.............		30
Pig's Feet..............		Boiled............		00
Tripe..................		Boiled...............		00
Brain..................		Raw................		30
		Fried...............		35
		Broiled..............		00
Oysters................		Stewed.............		30
				
COMPARATIVE DIGESTIBILITY OF VEGETABLES.
ARTICLES OF DIET.	HOAV COOKED.	CHYMIFICATION.
	Roasted..............	H. M. 2 30
	Baked................	2 33
Indian Corn Bread......		3 15
	Boiled............	4 00
	Boiled.............	3 30
Cabbage, with Vinegar..		2 30
	Boiled.............	2 30
	Boiled..............	2 00
	Boiled......	1 45 2 00
	Boiled...........	
	Boiled............	3 45
	Boiled...........	3 15
	Boiled.......	1 00 1 30
	Boiled...............	
  We see gelatinous articles of food are the most diges-
table, although not the most nutritious.
  This list sIioavs  that vegetables take nearly the same
time for digestion  that animal food does.   Apples, rice
sago, tapioca, and  barley are the most digestible of all.
Boiled cabbage, indian corn bread, boiled  potatoes and 
APPENDIX.
333
boiled beets are among the most  difficult of digestion.
We cannot ahvays combine the most nutritious and the
most  digestible, but we may approximate the two by
comparison.  But of course,  if digestion is  impaired
and the system  needs building up, the question will be
an intricate one, and surely one that requires good judg-
ment  and discretion.
  If Ave use highly nutritious  food, Avhich cannot well
be digested, assimilation is  impossible  and  nutrition
necessarily abnormal.  BetAveen the tAvo evils we may
better aim at securing good digestion, eATen if the  food
lacks  some of those constituents required by the system.
The medical treatment  then must supply the lacking
constituents  by medical  agents,  containing approxi-
mately constituents of nutrition, i. e.,  natrum  chlori.
potass, phosphates,  acids, ferrum, silica and  oxide  of
magnesia; by liquid food containing nitrogenous ele-
ments, namely,  coffee, tea, ale and beer; carbonaceous
Avines, Jamaica-rum, milk and cocoa; and among such  a
large  list Ave can select such as will further our aims in
any given case or difficulty.  But if nutrition is required
as a sine quanon Avith only the usual digestive debility
common and natural in sickness, Ave can  select the most
nutritious among some  of the most digestible articles,
either carbonaceous, nitrogenous or phosphorated.
  A  pound of cocoa made Avith  an  ounce   of ground
nibs contains  the  folloAving  proportions of  nutritious
matter:
NUTRITIOUS MATTER.
Nitrogenous..........
Fatty Matter—Carbon.
Starchy Extractive....
Mineral Matter.......
______Total Extracted

  Noav, it is very easy to solve Avhether a patient should
 96 ;2
218.8
 65.6
 17.5
398.1 
334           PROGRESSIVE MEDICINE.
have tea, coffee or cocoa, wines, beer, liquors, or succu-
lent fruits Avhich are various and nutritious, as orangeade,
expressed juice from prunes, peaches, raspberry, cherries
and  SAveet  quassia  or  tamarinds,  senna,  etc.  These
of course add  only  saccharine matters, but  yet  they
add  carbonaceous and  some starchy materials.   (Glu-
cose.)
  A reference to  Liebig food for children is here neces-
sary, because it Avas thought to be the  acme of perfec-
tion, and, perhaps, with some reason.
  The so-called " Farinaceous Food for Infants " is only
baked flour, sometimes SAveetened Avith  sugar.
  The flour must be baked  until  it acquires a  light
broAvn color, the  temperature  being about 400 to 450
deg. of F.   The granules of  starch are  thus disintegra-
ted,  and converted  into  a  soluble  substance, named
dextrine (diastase) Avhich by  further process of cooking
or boiling,  as  in  making pap, forms,  Avhen  properly
SAveetened,  a  very excellent food for  children.  The
value of this process consists in breaking up the indi-
gestible farinaceous matter (or  starchy) by baking, and
thus develop dextrine.
  Surely Ave cannot pass by this subject and  accept it
as laAv, merely because the great  Liebig gave it  to us,
as unfortunately  is generally the case  Avith the profes-
sion.
  In remembering ulterior matters  in regard to protein-
aceous compounds, Ave distinctly see that our chain  of
reasoning is not lost or merely  based on theories.
  The explanation  of Liebig's  theory is this:  " Dex-
trine is the diastase  of starchy food or  amyloids gener-
ally :" and Avhat does he mean by diastase?  "A vegetable
principle generally  allied to gluten," and therefore  a
viscid proximate constituent of Avheat  flour, which in
reality is nothing  but  albumen.   This is  the germina-
ting element which converts  starch into gum, sugar, and
therefore is a separating substance or disintegrating, 
APPENDIX.
335
which we see so plainby in making starch.   It converts
the adhesive  elements into separate agents, which there-
fore act  for  themselves  as nutritious  agencies;  whilst
when enclosed into cellulose chambers they must either
separate during the process of digestion by fermenting,
or else pass off unbroken and undigested.  This, in my
opinion, is  the first principle of the theory of Liebig—
none other could be accepted.
  The food Avhich Liebig recommended for infants is a
mixture of malt Avith wheaten flour and  milk, to which
a bicarbonate of potass has been added.  The prepara-
tion is made as follows:  One  ounce  of Avheaten flour
with ten ounces  of milk, boil it for three or four min-
utes, and then remove it from the fire and cool it doAvn
to 90 deg.  One ounce of  malt poAvder, previously mixed
with fifteen  grains of bicarbonate  of potash, and tAvo
ounces of Avater are then stirred into it.  The vessel
being covered, is allowed to stand for an hour and a half
at a temperature of about 100 deg. of F.  It is then put
once more  upon the fire, and  gently  boiled for a few
minutes.   Lastly, it is carefully strained, to remove any
particles of husk,  and is  then fit for the child's food.
The composition of the food  according to Liebig is as
follows:
		PLASTIC M.	CARBONACEOUS.
10 oz.	Milk.....................	0.40 oz. 0.14 oz. 0.07 oz.	1.00 oz.
	Wheat Flour..............		0.74 oz.
			0.58 oz.
			
		0.61 oz.	1.32 oz.
  The relation of the plastic to the carbonaceous being
as 1 to 3-8.  The effect of the malt is to transform the
starch into sugar or glucose.  This object being to pro-
mote  diastase, or separate the elements of the amyla-
ceous articles  (a ferment). 
336
PROGRESSIVE MEDICINE.
   Liebig's  extract of malt is another such preparation
 for the quick assimilation of starchy matters.  And it is
 a well-knoAvn fact that vegetable substances  are  often
 fermented, either for the purpose of increasing its glu-
 tinous matter, making it viscid and albuminous (called
 plastic elements), or else  to render  it more acid, as we
 do in making Avines or malt beverages.
   And thus  the diastase  or  dextrine develops all the
 gluten starch and sugar of the vegetable elements of nu-
 trition, and if Ave go on a step  further, Ave obtain, after
 fermentation, a solid or a liquid substance containing
 proportionately more gluten (plastic matter) than the
 original substance,  because  of the  transformation of
 sugar and starch into alcohol;  so that Ave return to our
 law of descent from C. 0.2 H. 0.2 adding C. 0.2 alcohol.
   Finally, it is conclusive that the diastase is a glutinous
 substance, and that it is through this gluten or albumin-
 ous constituent in the starch, that Ave have the ferment-
 ing principle, hence the separation of these elements
 from  the  amyloids   by  separating   their  constituents
 into starch-sugar, gum, dexterine, and forming an albu-
 minoid substance.  The albuminous or protoplasma (called
 by Liebig, plastic matter) is thus decomposed and devel-
 oped from its enclosure in the granules of starchy vege-
 table food.  Then the process of fermentation is really
 the process of decomposition and disintegration of the
 constituents held together in the cellulose of vegetables.
   And from this fermentation the  elements  are called
 into activity and a force (the nascent force) is thus es-
 tablished (into plastic force).  This, then, is the physio-
 logical principle for  fermenting  or fomenting vegetable
 matter; it is obviously to  call forward its plastic force.

                  LEGUMINOSE FOOD.
            {Prepared by Hermann Ilartensteine.)
  This is a compound of several  nitrogenous vegetables
namely: lentils, rye, barley, and wheat flour, and is con- 
APPENDIX.
337
sidered by good  authorities as a great discovery in
dietary, supplying elements of nutrition easily digested
and assimilated.   " The abundance of nutritious mate-
rials in these flours has been placed beyond a doubt by
the strictest  chemical investigations.  The nitrogen
contained in them Avas determined by Professor Kolb,
in Leipzig, and Professor Heck,  in Dresden.  The quan-
tity of fat and fatty substances (cholesterin, a consti-
tuent of the brain and nerve) besides  the biliary mat-
ter, Avas determined by myself1—Professor Beneke. The
analysis prove that the finest lentil-flour contains 24.83
per cent,  of nitrogenous  substances, and that fat and
fatty compounds amount to nearly 3 per cent.   Starch
is contained in the proportion of about 52 per cent., the
quantity of cellular matter is 8  to  10 per cent., that of
ashes, 1-3 to 1-5 per cent.,  Avith  0.012 to 0.15 per cent.
Avith phosphoric acid."
PROXIMATE  CONSTITUENTS OF LENTILS.
NITROGEN.	FATTY MAT.	STARCH.	ALKALINE EARTHS.	MIN. ACID.
24.83	3.00	52	1-03 to 1 5	0-012 to 1 15
  Accordingly pure leguminous flour approximates very
closely to beef in its nutritive value, and Avith a small
addition of Liebig's meat extract, Avhich increases the
phosphates, it is almost equivalent to  it.  By mixing the
same  Avith cereal-flour, i. e., rye, Avheat, and barley, the
various proportions of nitrogenous and non-nitrogenous
substances are produced.
    The  proportions  are  graduated according to its
strength of nitrogenous, or  starchy materials; mixture
No. 1, from 2 to 3 parts of cereals being the  strongest.
Mixture No.  2—33, rank as  nutrient beef and  coAV-milk;
mixture No. 3—1 to 3, 9, is  equal to  coAV-milk in its nu- 
338           PROGRESSIVE MEDICINE.

tritive value.   No. 4 has a proportion 1: 4, 8, being the
normal strength of food generally.   One to six is the
minimum and necessary strength of our food in health.
  Im^cstigations have shown  that these flours  contain
only 10 to 12-7 per cent, of chygroscopic Avater, Avhereas
beef contains about  75 per cent., and coav  milk 80 per
cent.  Therefore,  one pound  of these substances con-
tain 3| times as much solid substance as meat, and more
than 7 times as much as milk.
  It is sloAvly mixed Avith cold Avater and put on the fire
to boil for  half an hour, Avith  sufficient salt  to make  it
savory; they furnish a  soup Avhich is invaluable for the
sick and convalescents.  Dose—a large tablespoonful
to be put in a plate of animal broth.
  Noav, Ave can perceive the necessity of adding alkalies
to food, for the nutriment might not have  them in suf-
ficient quantities  for  the re-establishing of a  system
Avhose equilibrium and  mineral salt have been lost.
  It is one thing to provide a diet for a person in health,
another to  furnish  a diet Avhich shall rectify the missing
nutrients in the body in time of sickness.
  These tAvo preparations of  assimilating  constituents
to the animal economy are  to a great extent similar; for
both seek the same end.  HoAvever similar, they never-
theless differ materially in constituents proximate and
ultimate.  The difference exists in the amount of nitrog-
enous articles of diet.   In Liebig's preparation he uses
malt or barley, a starchy ingredient par excellence; and
to bring about diastase he adds heat and milk, tAvo great
elements of fermentation, thus developing the gluten or
nitrogenous element.   Then Avheat flour, malt, heat and
milk  are  the  ingredients  of Liebig's  food.   Harten-
steine's Leguminose  is a  mixture of lentils, Avheaten
flour, barley and  rye,  AAdiich  certainly  contain more
nitrogenous matter than Liebig's; and  Liebig's  there-
fore is inferior in plastic material.   He adds bicarbon-
ate of potash as a mineral or alkali  in order to suppy 
APPENDIX.
339
the  food Avith sufficient saline  material.    Harten-
steine takes his supply of salts from the animal food he
uses, as Avell as vegetable.   They.also contain much
more saline material and mineral acids.   But yet, if the
broth should  be  too rich as a nitrogenous liquid, milk
would  do as  well,  provided that we adopt  Liebig's
plan, i. e. to  add an alkali, and the best we will find in
the phosphates of soda, potash, magnesia or lime. These
preparations are  not confined to children  alone—inva-
lids of all ages and diseases  require a nutriment suited
to their complaints;  and Ave can prepare many articles
of diet Avhich Avould aid  in a great measure in supplying
the Avastes.
                CULINARY PRINCIPLES.

  It is hardly  necessary to say that man's mental  cul-
ture has given him the knoAvledge of providing  that
kind of food Avhich meets best his constitution, and  sup-
plies the Avastes Avhich are  continually going on in  the
system, and  he avIio  has not attained  this knowledge is
not above the loAver animals.
  The  great  desideratum, then, is to  select the  food
suitable  to  constitution, age, sex, occupation, climate
and seasons.
  A temporary fatness  may  be produced, especially  in
the young, by  the use of farinaceous food, but it  does
not last,  and is sure  to bring on disease or sickness.
  Man  is omnivorous  and must  be  fed  accordingly.
Any deviation from this rule is wrong.   Extreme lean-
ness comes from want of proper alimentation either  m
youth or old age.
  It is not the amount  that  is eaten which nourishes,
but the amount that is digested.
  An excess of food is as bad as a want of it. The rules
are the  following:  1. Take a hearty meal, but by no
means a  heavy dinner.   2. Vary your food as much  as
possible.   3.  See  that everything  that  you eat  or 
340            PROGRESSIVE MEDICINE.

drink is of a  good quality, Avholesome and  properly
prepared.  4. Take at least an hour after a hearty meal,
for mind and stomach cannot Avork at the same time.
5. Never eat Avhen angry, or tired, or Avhen heated, but
be as cool and gay as possible, for food being exposed
to a heat of 100  degrees F. in the stomach, AA'ould  fer-
ment instead  of  digesting.   6. Eat sIoavIv, at regular
hours, and  masticate  Avell, but do not bolt  your food.
7.  Always have at least one  dish of  vegetables for
dinner, besides meat, and some ripe fruit. 8. Be guarded
against  too hot food, for it Avould neutralize the gastric
juice; also, do not use ice-Avater or ice-cream after your
food, for it would stop digestion and absorption.
  Modes of Cooking  and Preparing Meats.— It  is, no
doubt, the great object of  culinary science to retain all
the nutritious elements in the articles of diet; more, it
teaches the  manner of  developing the nutriment in
them, and of rendering them accessible to digestion and
absorption.   Much  can be lost by improper cooking; in-
deed a poor cook is a source of great anxiety, for nothing
tastes good or is nutritious.
  1. To coagulate the albumen and blood of the tissues,
so as to render the  meat  agreeable to the eyes as Avell
as the taste.
  2. To develop flavors, and nutritious materials, and to
make the tissue crisp, as Avell as tender, and  therefore
more easy of mastication and digestion.
  3. To secure  a certain temperature, and thus to be a
means of conveying Avarmth to the system;  and render
assimilation perfect.
  4. To destroy parasites in the tissues of the meat; and
develop its minerals and albuminoids.
  5. Never cook your meat too  much, as it becomes in-
digestible  in  proportion to its  toughness;  the tissues
become hard and shriveled, the  blood dries and disor-
ganizes, its fats oxidize and become acrid; and this is
always the case in fried meats.  I have seen meats and 
APPENDIX.                 341
sausages cooked under hot ashes, and I can scarcely speak
too strongly in favor of this method.   They retain  all
the savory fluids as Avell as the nutritious ones.   They
keep the saline materials in the meat, and the fats are
not burnt or oxidized, and thus they are prepared SAveet
and digestible;  the  ashes add an alkali as a protection
from becoming  hard, shriveled  or  oxidized.   No one
Avho has not tested this method can have any idea of
the advantages it secures in cooking meats.
  And this is substantiated  by the common  practice  of
cooking chickens and game  Avith a  covering of lard or
or oiled paper, and  even Avith feathers, the  idea  being
to modify the intense heat Avhich Avould destroy the
constituents of the meats.
  Liebig says," that a temperature of 133 F. Avill coagu-
late albumen, and that the red coloring matters of the
blood and muscle are coagulated and destroyed at from
150 to  170."  His directions are that all cooking opera-
tions, in respect of meat, should  be  limited to 170°, and
that boiling meat should be introduced into the vessel
when the Avater is in a state  of strict ebullition, and that
the boiling should be kept up for a feAv minutes.  The
pot is then to be placed in a Avarm situation, so that the
temperature of the Avater is maintained at from 158° to
165°.   The effect of this is to  keep  the albumen in the
meat, and the crust Avhich forms on the outside does not
permit the juices to  escape, nor the Avater to penetrate
into the meat.
  The  meat thus retains its savory and nutritious con-
stituents.   But if the meat is  set on the fire Avith cold
water,  and then  slowly heated to boiling, the  flesh un-
dergoes a  loss of albumen and gelatine, (the solid and
savory juices)  and the soup  becomes richer ; the truth
is that Ave cannot have both  a  rich meat and  a rich soup
from the one piece of flesh or by  the same process of
cookinsr.
  Experience  has taught us the proper methods of cook- 
342
PROGRESSIVE MEDICINE
ing the various kinds of meat.  A good  cook will boil
beef, poultry, veal, mutton, and certain varieties offish;
but not game or a shoulder of mutton, venison, etc., for
meats differ obviously in their solidity and savory juices.
Those that are not highly flavored Avith nitrogenous and
saline ingredient cannot Avell bear boiling.
  Fresh-Avater  fish are best cooked  by broiling.  Salt
Avater  fish has sufficient flavor  to stand boiling; and
really  very rich fish, like eels, salmon, mackerel, stur-
geon, tunny-fish, and many others,  can be boiled to ad-
vantage.
  Frying and baking are not the best Avays of cooking
fish; these methods make the fish dry and indigestible.
  SteAving is a good system of cookery, because it is a
process that retains the nutriment  of the meat and ren-
ders it juicy and tender.  The meat loses little  of its
Aveight and is  often mixed Avith vegetables, Avhich en.
rich the food Avith their starchy constituents; it is an
economical mode of cookery, and requires little trouble
and experience.
  Time required for  Cooking Meat.—Most  people are
uncertain as to the time it takes  to  cook meats.  You
have often to consult the taste, for some  cannot eat rare
meat.
  The  general rule is that beef, lamb, mutton and game
may be  eaten  rather underdone—according to taste;
domestic  poultry must be Avell  cooked;  pork and veal
must ahvays be well done, and as dry as possible, other-
wise they prove uiiAvholesome.

                                     Time for Cooking.
     Beef, five pound piece.................... 1 ]ir_  30 m.
     Beef, ten pound piece ................... 2 "  30 "
     Capon, a large one....................... \ «  qq <.
     Chickens................................ 0 < <  45 <<
     Duck...................................0 "  55 "
     Goose, a large one....................... o <<  qq <<
     Goose, a small one....................... 1 ><  jjq <• 
APPENDIX.
                                       Time for Cooking.
      Mutton, five pound piece................. 1  < < qq
      Mutton, a large piece..................... 2  " CO "
      Lamb, a large piece...................... j  << qq ,,
      Partridge, Pheasant, and Prairie Hen......30 to 45 m.
      PiSeon.................................. 0 lira. 30 m!
      Pork, four pound piece...................2  " 30 •'
      Turkey, a large one...................... ! to 2 hrs.
      Veal, a large  piece.......................2 hrs. 00 m.
      Venison, a large piece.................... 1  <<  qq >>
         Of course, much depends upon the stove and heat.

   Soups.—These are fluid nutrients Avhich are extracted
 from vegetable,  animal  and fish.  Hence vegetable soup,
 or animal broth, or fish  soup.  At times they are mixed,
 i. c, (the vegetable  and  animal  products) so as to get
 the beneficial  aliments  of both ; both being required.
 And Avhen delicately  flavored,  they are  called " the
 vestibule of the  banquet."
   Hippocrates said " these extracts were invented be-
 cause they suited the invalids and sick."  But science
 has made them  eA'en suitable to people  in health, as
 they can be made so nutritious as  to take  the place of
 solid food.   The  Pot-au-feu of  the French peasant,  and
 the rich soup of the French soldier  are the chief rations
 on Avhich they subsist.
   All cooks are  also coimnced of the utility of strong
 soup.
   It  is  an economical  ingredient of diet: in  fact it is
 made of many remnants Avhich otherwise could not be
 used.  All  the Avaste fragments  are  thus utilized and
 made productive of nutrition.
   Liebig says :  " The  attractive substances  of flesh
 Avhen added to food, do  duty as true nutritive materials
 in the place of  those substances which are otherAvise
 produced from albumen." They cannot, perhaps, supply
 the place of albumen and fibrin in  the nourishment of
 tissues, but they  can replace the  secondary products of
albumen, Avhich are  concerned in the development of 
344           PROGRESSIVE MEDICINE.

force;  and as they are at once absorbed in  the circula-
tion, requiring no efforts  of digestion, they not only
create  force, but  they  also economise it.  They are,
therefore,  among  the  most valuable  constituents of
food.
  What are these constituents?  We knoAv of the phos-
phates existing in the  bones, of the gelatine Avhich in-
deed is largely extracted b} boiling, and the carbonates.
These  constituents are unquestionably great elements
in the  composition of the blood, except gelatine, Avhich
is a tissue-making element.
  The  most nutritious of all soups is obtained from cut
meats,  soaked for an  hour or so in an  equal Aveight of
cold Avater, and gradually raised to the boiling point.
After  simmering  for  about a quarter of  an hour, it
should be Avell pressed  and strained from the insoluble
muscular fibre.  In this Avay it retains the Avhole of the
soluble constituents of meat, amounting to about five
per cent, of the meat used ; so that a pint of this liquor
from a  pound of meat contains just four-fifths of an ounce
of meat extract.
  But if the boiling is continued for a long time, a little
gelatine  is  dissolved, but  the  strength of the soup  is
not materially increased.
  Coarser, but still good and highly nutritious soup can
be made from lean meat and bone; as the leg or shin
of beef.
  The  meat should  be  sliced in small pieces and the
bone Avell  crushed; then put the  whole in cold Avater
Avith salt added.  It should be heated  gradually  to the
boiling point.  After taking off all the scum, vegetables
should  be added and it should gently simmer five or six
hours.
  After standing a little time  to  settle, it  should  be
carefully poured off  and strained;  and Avhen cold, the
cake of fat Avhich forms upon the surface should  be  re-
moved.  In this manner  about four or fi\Te quarts of 
APPENDIX.
345
strong soup may be made from a shin of beef, Aveighing
six or seven pounds.
  This kind of liquor contains 600 grains of solid matter
to the pint, and of this 39 are saline.
   Chicken-Soup.—Roast or bake an old chicken until it
turns color, then put it in a soup-kettle Avith three pints
of Avater and put on a sIoav fire; remove the scum, add
a small  onion, some  spinach or lettuce, and salt; let it
simmer for about three hours.   Take out the chicken
and the vegetables, skin off the fat, strain and use. This
broth is excellent for dyspeptics, and easy  of digestion.
The chicken is served in a salad.
   Veal-Soup.—Procure two  pounds of lean veal.  Put
the meat in a soup-kettle Avith tavo quarts of cold Avater
and a little salt;  set it on a good  fire, and skin off the
scum as soon as it gathers  on the  surface.   When
skimmed add  a head of lettuce and  celery Avith a little
onion; simmer it for about three hours: strain and use.
This, as Avell as chicken broth, is excellent for convales-
cents.   It may be made richer by adding a little  beef.
   Vegetable Broth.—Scrape clean and slice  three carrots
and  three  turnips, some  celery and a little onion and
parsley; fry the Avhole Avith a little butter till it turns
rather yelloAv; stir and fry the Avhole about six minutes.
   When fried, add garlic, salt, pepper, two cloves and a
little nutmeg grated. Cover it Avith about three  quarts
of Avater.
   Keep it on a sIoav fire, take off the scum carefully, and
then simmer it for about three hours; strain and use.
We may add a feAv  beans or rice, and even peas.
   Bisque of Lobster.—There fish  soups are exceedingly
nutritious, and agree Avith people that are nervous, ex-
hausted and have lost  digestive force.    In  acute  dis-
eases, in tvphoid fevers, in all kinds of malarious fever
Avhere advnaemia and inanition are threatening the very
foundation of the organism, these elements of nutrition
are preferable to animal food.   They impart the phos- 
346
PROGRESSIVE MEDICINE.
phates of sodium and lime and phosphoric acid.   They
are nitrogenous and contain little fat, no starch  and no
sugar; one part of salts, although  some fish  have,  like
salmon, 5-5 of fat.  The statistics show that the Avhite
variety of fish give  eighteen of nitrogen and seventy-
eight of water.  Saline and  fatty materials 4. 0. per
cent.  It is indeed highly nutritious, and by the aid of
culinary  science, can be made in soup consomme,  sup-
plying the elements of force Avithout an oppressive load,
thus requiring little  digestive force.
  In these soups often times it is advisable to add some
of the shell  Avell powdered Avith the soft part; this is
found to add  a  savor and  render  it more  active  upon
the blood through its alkalies  and  phosphates.
  The Homeopathic physicians speak highly of sepia as a
medicine Avhich promotes an activity in the  portal cir-
culation  and  lymphatics,  particularly  upon nervous
ansemic Avomen. It acts upon  the absorbents and secre-
tions,  causing irritability  of  the mucous membranes,
constipation  and ovarian plethora or excitability.   No
doubt that  sepia stimulates the organs of generation.
The virtue of the drug  lies in its phosphate of lime and
magnesia.   These may  have traces of silicon, chloride
of sodium, etc.; and these  constituents are Avell-knoAvn
to exist in  all shell-fish. The consomme of fish is pref-
erable for invalids.
   Bisque  of Lobster.—This famous dish is made by boil-
ing  one or several lobsters; after they are  cooked re-
move the meat from the claAvs and keep the  flesh of the
claws and tail for a salad.
   The head, stomach, and  black Arein are throAvri  aAvav,
but the rest is kept  and pounded  together in a mortar
Avith some shell.
   All small claAvs, shell, green, Avhite, or yelloAv matter,
are  pounded together.
   Then  put  a  tablespoonful  of butter in a sauce-pan,
put it on the fire, and Avhen the butter is melted put in 
                     APPENDIX.                  347
the contents of the mortar; stir it with a wooden spoon
for about ten minutes, then add one pint of warm broth
(or the water in Avhich the lobster Avas first boiled), stir
it  about twenty minutes, and strain.  Put  the liquor
back on the fire, add about four ounces of toasted bread,
boil  it five minutes  and mash it  through a colander.
Put the  liquid on the fire once more, add one quart of
broth or the water in which the lobster Avas boiled, boil
it  gently for ten minutes and turn it into a soup-dish.
While it is boiling, pulverize  a  piece of the coral  (col-
ored shell), mix it  Avith a little  butter and  press it
through  a  fine  sieve and put it in the soup-dish Avith
crusty pieces of bread.
  When there is no coral in the lobster, mash up a hard
boiled egg  Avith butter in its place.  With the addition
of an egg and a  little butter, the beef broth can be dis-
pensed Avith, although the  soup is not so rich, but is
more fit for coiiA'alescents.
   Clam Soup.—This  is a very delicious and nutritious
liquor.   Boil the  clams  in Avater  half an  hour.  Take
them  out and  use the  flesh as folloAvs:  Chop up the
clams fine,  put  them  in  a sauce-pan  Avith  butter,  salt,
and pepper, and  let them boil for half an hour, adding
broth so as to make a rich gravy.
  Then take the Avater which Avas left, put it (pot-au-feu)
over the fire in a kettle, put rice in it as soon as  it boils,
and cook the rice to the  proper softness, then add your
clam-broth  mashed through a  colander.  It is a  savory,
pleasant and nutritious soup.  But to improve its nutri-
tion Ave may add half beef broth and half its oavti water.
  Julienne  Soup.—Scrape tAvo carrots and tAvo  turnips
and cut them in pieces;  put them  in  a sauce-pan Avith
about two ounces of butter,  three tablespoonsful of cab-
bage chopped fine, and  half an onion also cut  up; set
thfs on the fire and stir till about half-fried. •  Add broth
to make  it  as you wish—thin  or thick.  Boil gently till
done, salt enough and pepper, skim off the fat and serve. 
348          PROGRESSIVE MEDICINE.

To this Ave can add tAvo ounces of boiled rice after hav-
ing added the broth.
  Julienne  aux  Croutons.—Put some  croutons  in  the
soup dish, and Avhen the julienne is done, pour  it over
them and serve.   Remember to cover the soup for  five
minutes  so that the croutons  may become tender  and
thoroughly steamed through.   We may add barley or
rice instead, or croutons, as it pleases the taste.
  Jardiniere Soup.—It is like the julienne soup, to Avhich
is added  the top or eatable part of  a feAv asparagus, six
turnips,  red  radishes, and  two or  three  spoonsful of
green peas.  These are fried in butter and added to the
boiling soup.

       SOUPS  FOR THE  SICK AND CONVALESCENTS.
  Consomme  au  Lait.—Milk  may be used  instead of
broth when  delicate digestion, the  age  and constitu-
tion of the patient, or the idiosyncrasis  of the  disease
demand it.  Where the system requires a small  amount
of nutrition  and repair,  merely sufficient  to keep up
equilibrium, this preparation is Avell indicated.
  In acute diseases Avith plethora, like gout, rheumat-
ism, scarlet fever,  pneumonia, dysentery, gastric com-
plications or  bilio-enterio, troubles Avhere the chylifi-
cation is difficult;  in  children of tender  age, this  pre-
paration  is particularly  indicated.   In  Avomen after
childbirth  and  dyspeptics generally ;  after  surgical
operations Avhere a great quietude of circulation and of
nervous action is  required, it is useful to prevent any
undue excitement.  This is a good liquor to keep the
patient upon for several days.
  With milk, use  a little salt and sugar; it can be thick-
ened Avith arroAvroot, corn-starch, and  bread.  Dry some
slices of  bread, either  stale or fresh, in the oven, place
them in  the soup dish, pour boiling  broth over them or
milk, cover the dish and serve.
  Panade or Bread.—Take some  stale bread, "-rate it 
APPENDIX.
349
fine, and then thicken Avith it a good generous  chicken
broth.  Stir the bread for twenty minutes in the broth,
add a little butter, and let it boil for half an hour, until
the proper consistency is obtained.  We often add tAvo
yolks of eggs, beaten Avith tAvo tablespoonsful of cream;
an excellent soup for infants.   It is a  soup of consider-
able reputation in Italy for its nutrition and digestibility
and simplicity, yet containing all the constituents neces-
sary to an invalid or a child.
  Sago Soup.—Sago must be boiled  gently about an
hour, but it is prepared just like arroAvroot.
  Tapioca.—Is  prepared  like  arroAvroot,  and  boiled
about forty-five minutes.   To these avc  may add more
strength by having some peas, beans, and lentils boiled
in a little Avater, butter, salt  and  pepper; then mash
them through a colander into the soup.
  Puree Soup of Lentils or Split Peas.—The proportions
vary according to taste;  the more  peas  that are used
Avith a certain quantity of broth, the thicker the potage
AvilPbe, and vice-versa.
  Soak  one pint of peas in cold water over night and
drain;  put them  in  a  sauce-pan  with a feAv slices of
carrots, some turnips, Avith a little onion and salt. Cover
the vegetables Avith cold Avater, and boil them till done.
Drain and  then mash them through  a colander.  Return
the liquid on the  fire Avith sufficient broth to make  the
soup thick or  thin, and season it Avith salt  or pepper.
Boil the soup for ten minutes, stirring  in the meantime.
Turn  it into the  soup dish, over croutons, and serve
Avarm.
  Puree.—These  are made of nitrogenous vegetables;
they are boiled first in water, if dry, and  then  mashed
through a colander into the soup to proper thickness.
  These delicate  fluid foods, called  soups, are the very
best nutrients  for  the  sick; from  the variety given  a
selection is possible for a very large  number of^ cases
and variety of diseases.
?£RA?5 
 
INDEX.
Part I.
Importance of Physiological Knowledge,
Mai-Assimilation, Inanition, and Decay,
Trousseau and Pedoux's Criticism,
Predisposing causes to Mental Diseases,

                            Part II

Idiosyncrasies and Predisposition, .
Proximate causes of Mai-Nutrition,
Germinating Malarious Organisms,
Physical and Mental Labor,  .
Diseases of Childhood, .
Tabes Entero-Mesenterica,
Eruptive Diseases, Scrofulo-Derma, etc
Usefulness of Electricity,
The dual effects of Medical Agents,
Nutritive Constituents of Alimentation
Alimentation in Disease,
On  certain Beverages,  .
Culinary Principles,
Chapter I.
       II.
  "   III.
15
28
51
Chapter I.   121
       II.   134
  "   III.   148
  "   IV.   159
       V.   210
  "   VI.   225
  "  VII.   254
  " VIII.   280
  "   IX.   283
Appendix.   307
            312
            321
            339
Si
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