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CASE OF ATROPIA POISONING.

By CURTISS Ginn, M. D.

Suigeon, Deaconess Hospital, Dayton, O.

ILLIAM D., aet. sixty-seven.-Severe cataract removed by the combined method of extraction. Patient was subject to so-called "bilious" attacks and used to outdoor life. Nausea and violent vomiting promptly followed the extraction, causing some prolapse of the iris and a subsequent iritis of a mild character.

A few drops of a 4-grain to an ounce solution of atropia was dropped in the eye. In the course of an hour an acute, violent delirium made its appearance, accompanied by great dryness of the throat, constant urging to urinate and headache. His tongue also became so dry and clumsy that distinct articulation was impossible.

This condition began to leave him in four or five hours.

I had ordered that four or five drops of the atropia solution should also be instilled into his eye the same evening. This was done, and the same train of symptoms were produced in an aggravated form.

No means were used to counteract the action of the atropia, which began to pass away in six hours and the patient presented his normal mental appearance the next morning.

He had absolutely no remembrance, however, of his actions or feelings the preceding evening.

Upon investigation it was found that the druggist had given a four per cent. solution of atropia, instead of a 4 grain to an ounce, as ordered.

This same solution had been used a few days before upon a child four years of age, upon whom an iridectomy had been performed for prolapse of the iris following a punctured wound of the cornea.

In her case it produced no toxic symptoms whatever the little patient merely complaining of its smarting.

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AGGRESSION OR CONCESSION-WHICH ?*

By GEORGE G. SHELTON, M.D.,

New York.

HE subject that I have chosen for our consideration this evening is presented to the Society with the greatest hesitation. I fully appreciate its importance and recognize that it is a question upon which honest men may honestly differ, and I have tried to approach it in a spirit of perfect fairness, unprejudiced by personal affiliation or therapeutic belief.

The history of medicine, more than that of any other science, has been one of repeated experiment and disappointment. Successes have been followed by failures, and failure has stimulated new effort in the hope of new success. Good men have honestly battled for beliefs that were inevitably doomed from the outset, and other good men have, with a mistaken but honest purpose, conspired against truth. Dogmatism has limited growth, and the weapons of ridicule, hatred, and spite have been mistakenly used by men who believed that they were in the right to overthrow what they thought to be wrong; and so it will continue to be as long as human effort and human endeavor shall last. It is our duty, therefore, carefully to consider our own position and determine the relation which it bears to the progress of our science.

Amid the scenes of scientific, as well as political, unrest that marked the closing years of the eighteenth century, a young German physician, dissatisfied and disheartened, retired from a lucrative practice, resolved to seek the support of his growing family in Some way other than the practice of his profession. Wearied with the empiricism and bigotry of his confréres, revolting against the methods then in use for healing the sick, he moved into a small German village and became a translator of medical and other works, preferring to eke out in that way an existence for himself and his little family, rather than to practice medicine by the methods then universally employed. Gifted with a mind of unusual brilliancy, he utilized to the full the opportunities afforded by his new occupation to become conversant with the best medical literature of his time. It may have been an accident that prompted a medical publisher to apply for a translation of Cullen's Materia Medica, the classic of the

* Presidential address before N. Y. Hom. Med. Society.

subject at that time. It may also have been an accident that prompted Galileo to stop beneath the swinging lamp of Pisa, but from just such accidents have sprung the greatest achievements of scientific discovery; and in the pages of the Edinburgh doctor's work, Hahnemann first received the suggestion that led to the recognition of a great medical law.

One of the reasons, perhaps the principal one, that has prompted me to discuss our position as members of the medical school which was founded upon this discovery is the effort that is being made by some homœopaths and members of the old school to bring about a greater degree of harmony, and to accomplish, if possible, a complete union, to obliterate all sectarian differences and remove every name or appellation which may in any way distinguish one party from the other. Just how far this sentiment extends through the rank and file of the profession, it is difficult for me to say. That it has received encouragement from men high in the councils of both schools is true. That it is also prompted, in many instances, by the purest motives of true philanthropy is equally true. But it behooves us, standing as we do upon a strictly sectarian basis and practicing under a strictly sectarian name, carefully to scrutinize every effort that is made in this direction, and to ascertain, if possible, just what is meant by union and what such union would accomplish in furthering the advance of medical science.

There is, it may be said at once, no proposition more alluring both to the lay and to the medical mind, than the one so often printed in the press, applauded at the banquet, and taught by the lecturer, that the warfare which has for half a century been waged between the two great systems of medicine should be supplanted by union and peace. Nothing higher or holier can appeal to us than the sentiment that all quarreling and recrimination should cease, and that physicians of all schools should join hands and hearts, united by a common impulse, in the endeavor to find the best method for the alleviation of the diseases and sufferings of mankind. It is therefore but natural to ask, why should not such a millenium begin at once? Why should a single difference keep any two men or any two thousand men from attaining such a desirable end--an end which appeals to the noblest traits of human nature, since its realization would mean, in the abstract, the promotion of all that is good and true, in place of bitterness and strife? Back of all considerations of reconciliation, however, lies a more fundamental question. Whether differences can be adjusted, must

depend upon what they are-whether they are founded on inherently irreconcilable views of fact and principle or are merely excited by prejudice or other even less worthy motives. Let us consider, then, how the antagonism of the two schools came to be what it is what it was that has actually divided them..

At the time that Hahnemann first enunciated the "Law of Similia" and began his investigations of the effect of drugs upon the healthy, the medical profession was dominated by a spirit that was intolerant of any criticism. The methods in vogue were those that had been handed down from generation to generation, and were intrenched in the prejudices and supported by the conservatism of an age that was unwilling to admit the possibility of a superior method. The causes of disease were poorly understood; the finer distinctions in drug action and the ultimate effects of massive doses of medicine upon the human economy had scarcely been considered; pathology, as we understand it to-day, was a comparatively unknown science; and the microscope and test-tube, upon which all pathology is to-day founded, had no part in the daily work of the medical practitioner in the closing years of the eighteenth century. Positive, definite drug-effects were looked for and disease was treated as something from which the human body should be purged or in a state utterly at variance with which it should be placed. Hence violent methods were resorted to, in the vain hope that in this way tality was great was accepted as but the natural result of morbid A patient threatened with a fever was first purged and then bled, and, if the fever did not stop, there was more purging and more bleeding; and when the weakness increased and the patient succumbed, this result was held to be due to the providence of God, and not to the fact that the body had been robbed of the element that should have been conserved with the greatest Surgery was in the same condition. Imagine the incredulity of a Hufelin or a Cullen had he been told that a patient could be kept unconscious of pain for hours at a time, the innermost cavities of the body be opened with impunity, the peritoneum be cut and stitched, and the brain-cap be perforated. I do not say that men did not think and reason and strive to ascertain what diseases are, and what caused the morbid processes so common in the body, but the world was not old enough.

processes.

very

care.

the cause of the disease would be removed. That mor

Into such an atmosphere Hahnemann ushered his discovery of the resemblance between drug effects and morbid conditions.

Looking at the matter from our own point of view it would seem that any departure from existing methods would have been welcome; but the profession of medicine as a whole was perfectly satisfied with the methods and means in daily use.

This self-satisfaction, this professional complacency, Hahneinann had to meet; and if we are inclined to blame his confrères for not giving to his views the fair consideration which they deserved as scientific propositions, we should consider how opposed they were to everything then believed in--what a radical departure from all accepted modes of treating disease. This conservative prejudice then, this unwillingness of the medical mind to accommodate itself to the new conception and consider it scientifically, on its merits, was the first ground of a difference which naturally widened into a vast and impassable chasm. The gulf grew broader and broader as the years ran on, increased by the contention in results claimed upon the one side and disputed upon the other, the argument, in the absence of careful statistical records, becoming a matter of individual prejudice and opinion.

To come down to a more recent period, let us look at some of the causes that have accentuated this original antagonism of the two schools right here at our own doors. Nearly seventy years have passed since the first homoeopathic prescription was made in the city of New York. The same feeling pervaded medical minds. that had controlled the men of the eighteenth century, though perhaps their intensity had decreased. The old methods were still in vogue, but men had become bolder and had ventured to ask themselves if, after all, the inherited beliefs and hereditary methods, with the accumulated dust of centuries upon them, were all that could be found in the medical art. They had dared to ask whether letting out the life current reduced the morbid cause of fever, and whether the secondary effects of massive doses of drugs was not, in some instances at least, a substituted disease. Instruments of precisions were coming into use; and, as one after another of the old beliefs became discredited a general sense of distrust began to disturb the minds of thoughtful physicians. Still the old, unfair and unscientific prejudice against the disciples of Hahnemann was there and, essentially, the old bitterness.

Into this atmosphere, already surcharged with an almost personal animosity, came a band of men who not merely extolled the fundamental therapeutic law announced by the rejected German, but also advocated the administration of excessively minute doses