and also the plates, which we can keep, and from which we can publish, from time to time, as we need them, any number of copies. We can put them in pamphlet form, have them permanent, and issue them all as a book. It will be something like the "League Tract Enterprise" of London. They require of us 2000 subscribers, or that we take that many papers, and we can dispose of them as we please.

The Committee appointed to secure a proper recognition of the services to materia medica of Dr. Allen in the TRANSACTIONS, report, that as Dr. Allen's name was suitably connected with the development of materia medica in the late exercises of the Institute, the Committee have no further recommendation to offer.

The report was accepted, and the Section adjourned.

THE INDICATED REMEDY IN SURGICAL
PRACTICE.

BY HOWARD Crutcher, M.D., Chicago, ILL.

THE subject of this paper may lead to the imputation of presumption upon the part of its author; but, disclaiming any such inference, I hope to direct attention to the practical value of certain clearly recognized facts.

In surgery, as in therapeutics, the problem always is the supplanting of pathology by physiology. The subject is a person presenting some defect of dynamic or mechanical character. In surgery we are dependent for our success not upon mechanical art alone, but upon the condition of the subject upon whom our skill is expended. We may adjust fragments of bone never so accurately; we may coapt tissues never so perfectly; we may do with the utmost skill and celerity all that our hands can do, and yet our work may end in dismal failure because of ulterior causes not apparent at the time of operating.

Alarming hæmorrhages, in some cases, defy the ordinary methods of control, because a hæmorrhagic diathesis taints the patient's tissues. I recall, with a shudder, one case where the simple removal of a small lipoma in a bloodless locality came near ending the patient's life. The flow of blood continued in spite of desperate means to suppress it. There seemed to be absolutely no forces in operation that could prevent the patient's speedy death. Whether or not it was a coincidence, I cannot speak, but the fact remains that Calcarea carbonica seemed to act promptly in arresting the bleeding, and it certainly produced surprising changes for the better in the patient after the removal of the tumor. Calcarea is not classed with the hæmorrhagic medicines, and I am not claiming such a place for it here, beyond its well-established power over constitutional conditions.

The value of our law of cure in the preparation of patients for

operative measures cannot well be overestimated. In fact, whereever such a course is possible, it is always advisable. The patient who has received the attentions of a careful Homoeopathic prescriber is a most happy subject for operation compared with one who has been neglected or perhaps injured by injudicious use of drugs. In plastic operations this is especially true. Last summer I quickly and skilfully repaired a lacerated perinæum by a secondary operation, and was greatly disappointed at the utter failure of my work. There were simply no healing powers in reserve, and the tissues seemed to irritate and destroy each other instead of uniting. A few months of careful treatment brought a complete change in the condition, and a later operation brought a perfect result. There is not, unfortunately, a rule to guide us in these matters, although a careful study of the constitutional symptoms will often indicate the proper course to follow.

That many surgical procedures are rendered unnecessary by the exhibit ion of the indicated remedy, there can be no doubt. Abscesses are time and again prevented by the timely action of the remedy; hæmorrhoids are cured without excision; bone diseases are healed; and numberless minor surgical conditions, which the traditional school would attack with the knife, are cured entirely by rational therapeutic measures. We ought to be most thankful that this is the case, for it places in our hands additional power for good, and means more than we can estimate for suffering flesh. It is refreshing to compare the Homoeopathic surgeon with his Old-School neighbor in certain lines. The former is taught to weigh carefully those higher forces of the organism which the Old School so systematically neglect or ignore.

In the matter of diagnosis and prognosis, the value of the appropriate medicine is incalculable. A case that has not yielded to constitutional measures when they are indicated, presents a warning that no careful surgeon will overlook. The case that will not respond to the indicated remedy is likely to prove a failure when subjected to operative measures. Especially is this true of cancers and other dangerous conditions. The reactive powers are measured by the indicated remedy, and if they do not in any degree respond to its action, the case is graver than it would be if the opposite condition obtained. If the patient should improve for a time and then relapse, the fact presents a valuable indication. The case of strangu

lated hernia indicating Nux vomica will recover more promptly, with or without operation, as the case may demand, than the case indicating Veratrum album. The case of appendicitis indicating Aconite or Bryonia is in better condition pathologically than the case calling for Arsenic. Following operation, Aconite is more favorable than Rhus, and Coffea is nearer the line of safety than Lachesis. If, after a surgical operation of consequence, Rhus, Arsenic, and Carbo vegetabilis follow each other in the order named, a fatal issue is practically certain. Arnica and Bryonia, generally speaking, are desirable indications in surgery; the conditions calling for them are relieved quickly, and the patient is soon well within the danger

line.

The Aconite patient is never mentally serene; he is always restless and fearful and apprehensive.

The Bryonia image is one of quietude, thirst, and sharp rebukes in the matter of pains from violations of the law of stillness.

Chamomilla is a raging storm of pain which angers the patient and causes him to threaten the discharge of present medical attendants; the patient roars and fumes and tries to do something unusual to frighten his surgeon into active measures for his instant relief.

The Coffea pain is overwhelming; the patient sinks under it, even to the point of shock and faintness; he is too much overcome to be ugly and unruly, as the Chamomilla patient is.

The Nux vomica patient is a lively eater; he is cross and hateful and revengeful; his mornings are a torment; bowels costive, stomach sour, slight frontal headache.

The Arsenic patient may be thirsty, or cross, or peevish, but there can be no doubt that he is very sick; that his vital energies are scattered and that his chances are at least doubtful.

The Carbo vegetabilis patient is dying; he may be saved by the remedy, but his cold, dry skin, blue lips and feeble cries for more air are sure indications of threatened dissolution.

These indications might be prolonged indefinitely, but enough have been presented to indicate the images we must carry with us to the bedside and have at our fingers' ends for use at a moment's notice.

WHAT THE HOMEOPATH SHOULD KNOW OF

DRUGS.

BY JABEZ P. DAKE, M.D., NASHVILLE, TENN.

THE quality and extent of knowledge that the physician accepting the Homœopathic principle, should possess concerning drugs, has been considered and discussed by every writer and teacher of materia medica from Hahnemann down; and yet the question seems not fully settled. In this brief communication I propose to do little more than to indicate the general bearings of the inquiry with some reference to practical duties on the part of the physician and teacher. In general I think the tendency has been to take too circumscribed a view of the part to be performed by the Homœopathic practitioner; as if his one and only duty were to make a comparison of the drug symptoms on the one side, with the symptoms of the case to be cured on the other, in order to discover a similarity. Such a view overlooks the fact that, the Homoeopathic physician, like all others, is liable to be called in cases of poisoning, where antidotes are needed, and to cases of self-limited or necessarily fatal affections which require only palliative measures. It needs no display of facts or argumentation to convince one that attendance upon such cases calls for a knowledge of drugs not especially needed in following out the Homœopathic principle, and that a knowledge quite different from that of ordinary symptomatology is necessary, to be used upon chemical, mechanical or antipathic principles.

We cannot imagine a physician who is entirely limited to the Homœopathic use of drugs. He may turn a deaf ear to calls in cases of poisoning but he cannot tell when he may have cases in hand demanding palliatives instead of Homoeopathic remedies.

Our friends, on the other side, have erred greatly and done our practitioners gross injustice in saying that the Homoeopath must and can go no farther in the use of drugs than the law similia bids him go, and that he is trespassing upon their domain whenever he