consultation would be a useless and unnecessary tax upon the patient; and in the latter case, such a consultation could be nothing but a sham and a fraud.

It is true that all through the controversy a few great minds, rather more catholic than their fellows, conceived it possible that there might be an element of truth even in what they could not understand, and of these I may mention Trousseau in France, the author of those classical lectures on clinical medicine which are among the most highly esteemed works of the profession; and Liston, one of the most eminent surgeons of his time, with Sir John Forbes, a firm opponent of homoeopathy as a system, in England. These are Trousseau's words :

The homoeopathic doctrine, considered in its general fundamental idea, certainly does not deserve the ridicule which the therapeutic applications made by the homœopaths have provoked."

And again :—

Experience has proved that many diseases are cured by therapeutic agents which seem to act in the same manner as the morbific cause to which we oppose them.

Sir John Forbes's opinion is expressed in the following terms:

No careful observer of his [Hahnemann's] actions, or candid reader of his writings, can hesitate for a moment to admit that he was a very extraordinary man, one whose name will descend to posterity as the exclusive excogitator and founder of an original system of medicine as ingenious as many that preceded it, and destined probably to be the remote, if not the immediate, cause of more important fundamental changes in the practice of the healing art than have resulted from any promulgated since the days of Galen himself.3

In a lecture published in the Lancet of April 16, 1836, Liston records the result of his treatment of erysipelas with belladonna, a method then as now in common use among homœopaths, and claimed by them as an instance of the application of the law of similars.' In this lecture he says:

I believe in the homoeopathic doctrines to a certain extent, but I cannot as yet, from inexperience on the subject, go to the length its advocates would wish in so far as regards the very minute doses of some of their medicines. The medicines in the above cases were certainly given in much smaller doses than have hitherto ever been prescribed. The beneficial effects, as you witnessed, are unquestionable. . . . Without adopting the theory of this medical sect, you ought not to reject its doctrines without close examination and inquiry.

But this contention of the axiomatic absurdity and utter impossibility of the rule can only hold good so long as we are prepared to deny that such a case of the cure of morbid symptoms by a drug producing similar symptoms on the human body in health ever takes place. Prove one single instance, and the a priori objection vanishes. If it can and does occur in one case, there is no special reason why it 2 Treatise on Therapeutics, ninth ed. vol. i. p. 274. 8 Brit. and For. Med. Review, vol. xxi. p. 226.

may not occur in two, or ten, or a thousand. The whole field of argument has changed, and instead of denying the rule as an impossibility, we can only say that its general application is not proved to our satisfaction. To that it may fairly be retorted by the homoeopaths 'Have you tried it?' It is now no longer a theory to be reasoned about in the abstract, but a question purely of experience. And questions of experience are about the most variable of things.

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Of late, therefore, the objection to homœopathy and through it to its professors has been remodelled, though our conduct towards the latter remains the same. The rule similia similibus curantur is now admitted by men of light and leading' in the profession to be partially true. In evidence of this may be quoted the following explicit statements from the preface by Dr. Lauder Brunton, F.R.S., to the third edition of his laborious Text-book of Pharmacology, Therapeutics, and Materia Medica. On page x thereof he says:

This rule [similia similibus curantur] was known to Hippocrates [to whom he elsewhere refers as the Father of Medicine] and the rule similia similibus curantur was recognised by him as true in some instances.

The only difference between them [those homeopaths who have discarded the absurdities of infinitesimal dosage, to be subsequently referred to] and rational practitioners lies in the fact that the latter regard the rule as only of partial appli

cation.

Once more:

It is not the use . . . of a drug which may produce symptoms similar to those of the disease that constitutes homoeopathy.

The preface from which these quotations are made received the unqualified approval of the Lancet (one of the two best known and most widely recognised organs of the profession), in a leading article on the 16th of April 1887.

But that this rule is no longer held to be absurd per se, there is ample evidence scattered piecemeal throughout our whole practical therapeutics, as exemplified more particularly in the standard works of Dr. Ringer, F.R.S., Dr. Phillips, and Dr. Lauder Brunton, F.R.S. The first-named holds the post of Professor of the Principles and Practice of Medicine at University College, London; the second is late Lecturer on Materia Medica and Therapeutics at the Westminster Hospital; while the third not only holds a like post at St. Bartholomew's Hospital, but is in addition an examiner in these subjects at the Royal College of Physicians, at the Universities of London and Manchester, and until recently at the University of Edinburgh. He therefore is in some sense an official judge of what constitutes the therapeutics of the present day.

Not to enter more than is absolutely essential into any technical matters, it may suffice to quote one passage each from their works on

therapeutics, giving in juxtaposition their statements as to the physiological effects of some drug upon the healthy human body, and certain indications for its use in disease.

To begin with Dr. Ringer. I quote his remarks upon amyl nitrite, a comparatively new therapeutic agent, from his Handbook of Therapeutics (eighth edition, 1880).

As an example from Dr. Phillips I will take aconite, and I quote from his Materia Medica and Therapeutics, 1886.

There is, however, frequently a harassing dry cough.

In toxic cases there is generally much restlessness.

'In the same stage of bronchitis it... alleviates the dry teasing cough.

'In membranous laryngitis it has relieved the hard dry cough.

'In several cases I have seen aconite quiet the disturbing restlessness or "fidgets" which affects men as well as women.'

Dr. Lauder Brunton shall bear testimony concerning ipecacuanha (Handbook of Pharmacology, Therapeutics, and Materia Medica, 3rd edition).

Physiological Action.

In some persons it has a peculiarly irritating action on the respiratory tract, so that almost infinitesimal quantities of the powder cause running at the nose and sometimes asthma.

When taken internally it is an irritant to the mucous membrane of the stomach and acts as a prompt emetic.

Emetine (the alkaloid) produces in dogs, both when injected under the skin and when administered internally, diarrhea, which is sometimes bloody.

Therapeutic Uses.

Ringer strongly recommends the spray of ipecacuanha wine in . . . bronchial asthma. It is used in catarrhs.

In small doses it is often useful in vomiting from various causes.

Ipecacuanha is very useful as an antidysenteric, especially in the acute dysentery of the tropics.

It would be easy to multiply such instances as these, but as my object is merely to show that we have abandoned the objection to homœopathy founded upon the absolute absurdity of the law of similars,' one instance is as good as a thousand. It may not be consonant with facts to assert that a particular association of phenomena is sufficiently common to enable us to state it as a general fact or law; but we have clear ground for stating from the one verified instance that such a law is neither impossible nor absurd.

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Therefore this proof of the fact that like sometimes cures like, coupled with the admission that the law is of partial application, shows that the question as between homeopathic' and other practitioners in reference to a particular rule of drug selection is no longer one of kind (as it would be were the doctrine attacked held to be a scientific nullity) but one of degree, viz. to what extent the rule is available as a therapeutic aid. But this by itself would not justify the ostracism of either party, because differences concerning the degree of application of any law are always liable to modification as the result of extended experience. Wherefore, from the point of view of medical practice the objection to mutual intercourse based upon the scientific absurdity of the law of similars' may be discarded, though, as we shall see, that law will recur as a source of objection with greater show of reason when we come to the domain of medical politics.

II. The next objection, based upon a matter of medical theory and practice, refers to the doctrine of infinitesimal dosage. Briefly stated, the principle amounts to this: that an organ in a morbid condition, or temporarily unbalanced, will respond to the stimulus of a much smaller dose of a given drug endowed with a special action upon it than would be requisite to influence it in health. On this principle, the 'homœopathic' practitioners are accustomed to subdivide their drugs on a decimal scale, and I am bound to admit that with some this principle is carried to, in my opinion, an absurdly ridiculous extent. But then let us remember that we smell by the contact of material particles with the sensitive nerve-network spread out on the nasal mucous membrane. How infinitesimal must be the particles a man leaves behind him as he journeys; yet they are sufficient to enable the bloodhound to track him by the smell, even through a confused trail of many mingled scents. So that here again the essential difference between the 'homœopathic' and the ordinary practitioner is a matter, not of kind, but of degree—a proposition which I will now endeavour to illustrate.

First as to the principle of small doses, witness Dr. Lauder Brunton in the preface above referred to:

We are not homoeopaths because we use small doses.

.

It is not the use of. a small dose . . . that constitutes homoeopathy.

The Lancet also, in a leading article in its issue on the 16th of April 1887, states:

The ordinary practitioner differs from the homœopathic in being free to use any drug which he knows to be of use in the case, and that in any quantity experience shows to be best.

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As to the disability of the homœopath' implied in this passage, I shall have more to say under the next heading. It suffices here to show that a small dosage is not necessarily peculiar to the 'homœopath,' of whom, indeed, Dr. Brunton says in the paragraph quoted just now, 'But the infinitesimal doses are so absurd that I believe they have been discarded by many homœopaths."

Now for practical facts. While, as Dr. Brunton testifies, we have on the part of many of the leading lights of 'homœopathy' a tendency to discard the extremes of smallness, and to return to a tangible, if diminutive, dose, we find the ordinary practitioner learning to utilise smaller and smaller doses of drugs; so that quantities are now commonly prescribed which would, forty years ago, have been regarded (and as a matter of fact are still so regarded by many veteran practitioners who were educated in the old school) as almost equally ridiculous with those of the 'homœopaths' themselves. Witness 'a third of a grain of grey powder,' ' a single grain of bichloride (of mercury) dissolved in a pint of water and a teaspoonful of this solution given each hour,' i.e. 1 grain for a dose;