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By Dr. E. A. Taylor. The medical profession seems beset with fallacies and the history of almost any doctor's professional career will show that at some time during his medical meandering he nourished and cherished a dangerous delusion, his favorite fallacy. To some this comes duuring the transition stage that marks the boundary between ignorance and wisdom, and the fallacy fades with the first flash of the light of trutuh, but with others the delusion that becomes their favorite fallacy, comes only after many years, when they are wearing the frosty crown of age's winter, and one might almost expect them to be free from error. If one seeks the motive for the promulgation and inculcation of these various fallacies, it will in most instances be found in an attempt to shorten and simplify the process by which we arrive at the correct selection of the remedy. With some, the favorite fallacy is that only the highest potencies are worthy of consideration forgetting or ignoring the fact that Hahnemann made most of his brilliant cures with the thirtieth and lower. Others again contend that the high potencies are delusions, and in so doing delude themselves, keeping alive this their favorite fallacy. A musty mistake that has clung to us with great pertinacity is the notion that all the ills and evils resulting from crude drugs are to be dissipated by nux vomica. That this remedy should correspond to the multifarious effects of a pernicious pharmacy seems to be too preposterous to demand attention were it not for the fact that it is so frequently met with. Seeing the futility of this fallacy, some have devised another one to supercede and supplant it, namely, that all crude drugs that have ever been taken must be antidoted by the highest potency of the same drug, before a medicine can be selected according to the totality of symptoms. Some have advocated the classification and application of remedies according to the temperament of the patient, claiming that the distinction between remedies having a similar pathogenesis is to be found in the personnel of the patient in the normal appearance not in the morbid perspective, not in the deviation from the normal, but in the established and permanent normal, not in the
totality of symptoms, but in the complexus of health. For example, nitric acid is said to be indicated in lean persons with dark complexion, black hair and eyes. At the same time Hering's Materia Medica tells us that it is followed well by calcarea carb, which is said to be indicated in those who are fat, fair and flabby. Hering tells us that these remedies follow each other well, hence we ask, did the patient change his temperament, or whence this incongruity. The explanation so far as Hering and the old masters are concerned, is found tersely expressed in the Guiding Symptoms under Bryonia where it says "Indicated in jight complexions but more in dark." It is like saying that gall stones are found most often in women, so they are, twice as often, but that does not say that all women have gall stones, or that men never have them. In both cases the symptoms must decide. The pernicious platitude that “Sulphur frequently serves to a rouse the reactive power of the system when carefully selected remedies have failed to produce a favorable effect” is a fallacy and should be stricken from the literature, and banished from the rostrum. It is the progenitor of that later and greater fallacy which says “When the best selected remedy fails to relieve or permanently improve" give the nosode that corresponds to the supposed diathesis. If you believe they are tubercular give tuberculinum, if syphilitic, syphilinum; if gonorrheal, medorrhinum ,etc. Let us be done with this foul-smelling fallacy forcver, and hereafter let us say when the best selected remedy fails select a better, remembering always that the totality of symptoms and the law of similars is to be our guide, and if we fail in selecting the right remedy, we must try again, but the trial must be in accordance with law, and not a pitiable panic ending in a wild stampede to sulphur or a nosode or to something supposed to relieve us of further responsibility when our first erroneous efforts fail. It is remarkable how many of our authors, teachers and recognized authorities have placed the seal of their sanction on some fallacy. With some it has been in the form of a special analysis of a remedy as a prelude to the study of its symptomatology as given in one of our “Materia Medicas."
Another puts it forth in an attempted classification of remedies according to what nerve centers are primarily effected.
Another, and one of the truly great and good men of our school, but who enunciated the fatal doctrine of liberty of opinion and action, in other words, medical anarchy also started the fallacy that "in the case of sulphur has been made the first and only successful generalization in the way of indication for treatment based on pathological anatomy.” Think of treatment based on pathological anatomy; what a fallacy! Turn the pages of another volume, one of the standard works containing a great numbe rof splendid lectures on Materia Medica and under kali hydr. you find the statement "he who would prescribe by the symptoms alone in this case must fail.” He is contrasting a belladona and a kali hydr. case of pneumonia and insists that the pathology of the case is an important item in selecting the remedy. The author says "Until you have proved that belladona has produced such a condition, you can not expect it to do any good.' Could there be a greater fallacy? One authority of international reputation is fond of speaking of remedies according to disease states to which they may correspond. For example, a remedy is useful in old “gouty" or "rheumatic" patients, etc. True, he minimizes the damage by emphasizing the statement that the symptoms must agree. But if the symptoms are there, the remedy will be indicated, whether the patient is gouty or not. The danger is that one will remember the gouty, rheumatic part of it, which is of no importance, and forget the more difficult to remember but all important symptoms. A favorite fallacy with some is that the totality of symptoms will not suffice unless you recognize the miasm present and apply your remedy accordingly. What possible difference can it make whether the condition present is syphilitic, sycotic or psoric so long as the symptoms agree. Another favorite fallacy with some is the attempt to give the signaficance of symptoms, to explain what particular structure or function is deranged. Some attempt to trace all of the symptoms to certain supposed phrenological centers in the brain, while others attribute them to physiological perversions of the various organic functions. Hahnemann says in a footnote to paragraph 10 of the Organon “In what manner the vital principle produces morbid indications in the system, that is how it produces disease, is to the physician a useless question."
I have endeavored to briefly refer to some of the favorite fallacies of the Hahnemannians. No attempt has been made to detail the endless chain of delusions that has emanated from the old school, or the transcendental sophistries of the mongrel homeopaths. It is enough for us to see and correct the error of ou rown way, and to that end, I suggest that we read again and again paragraph 18 of the Organon, which says “There can be no other indication whatever, than the ensemble of symptoms in each individual case to guide us in the choice of the remedy."
Note.-I. H, A., Chicago, Ill., 1905.
THE PHYSICIAN himself is at fault for the remissness of his patrons in paying their dues. Indeed, our profession has been brought under contempt through the adage: “As hard to collect as a doctor's bill.” Tradesmen are promptly paid the entire amount of their bills. The doctor would be, too, if he would only put up a little fight for it; but without a particle of business insistence, with childlike timidity, he humbly submits, without protest, to being paid at any odd time, in a haphazard way, at long intervals, and then, usually, only a part of his bill, instead of the whole of it. Eventually payments become more and more remote, while the amounts at each payment dwindle in proportion.- Dr. G. R. Patton, in Northwestern Lancet.
LAST DECEMBER Collier's Weekly published a list of twenty-two supposed cases of death and serious illness from "headache powders," which, on investigation by the Proprietary Association of America, were proven to have been mostly lies or gross exaggerations. Only six of the said twenty-two cases were discovered to have been bona fide cases of poisoning, and nearly all of these were due to overdoses. No sane physician will condemn a drug or medicine because an overdose results unfavorably, for if we did, we might better quit the practice of medicine than to treat patients with drugs so inert that overdoses will never do harm. Any drug or medicine which is safe if taken according to the directions on the package, is a safe remedy in the sense in which the word "safe" is used in medicine. - St. Louis M. and S. Journal.
URINARY TENESMUS FROM MALARIA.
By Dr. A. McNeil.
Miss H. E., aged twenty years; good flesh and color, has lived in a malarial region. Her trouble dates back to child. hood, but has become worse recently. Four months ago an eruption appeared on the back, worse when going to bed, wants but little bed clothing, “never cold,” menses normal and painless. The main trouble is an excrutiating urging to urinate, which is imperative and must be attended to immediately. No relief from urinating; it increases after urinating. She craves salt; uses more than most people. General twitching, especially in legs; acid sweat of feet. She dreams much of falling, of money, of snakes choking cats, of being pursued, crying during sleep. Hysterical with the bladder distress.
She has just returned from a three weeks' sojourn in a hospital, where the bladder was irrigated frequently; this seemed to increase the pain rather than give any relief. On February 3, 1905, I gave her natrum muriaticum 30th one dose. On the fourth she was better. February 5th not so well, so I gave her natrum muriaticum 100th. Improvement began and continued until April 12th. She then, owing to a change of symptoms, received one dose of rhus tox 30th, which relieved. She has remained well since.
Persons who have lived in malarial regions and whose systems have become poisoned by malaria have a malarial bias running all through their ailments. Symptoms of natrum muriaticum frequently appear, as in this case. Natrum muriaticum seldom fails to make a good beginning toward a cure, if it does not complete it.
Note:-1. H. A., Chicago, 1905.
CAMPHOR IN MORPHINISM.-Erlenmeyer, in La Tribune Medicale, states that when morphine is withdrawn from an habitue, camphor is an excellent remedy to support the heart, acting both as a vasoconstrictor and very energetic cardiac tonic. Southern California Practitioner.