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who have introduced all the latest inventions of our ancient enemies, still turn out such good medical timber in a strictly medical sense, it gives the unqualified negation to the pessimistic cry that scientific education is destroying Homœopathy. The evidence is absolutely to the contrary. Homoeopathy has no dread of scientific investigation. Homœopathy is itself a science, and, therefore, has no fear of touching elbows with her sister sciences.

ADDRESS.

AN INTRODUCTION TO THE STUDY OF THE SALTS OF POTASH.

BY T. F. ALLEN, M.D., NEW YORK, N. Y.

I HAVE been invited to address you to-day on this subject for the purpose of introducing a discussion concerning the method of teaching materia medica, and what I may say should not be open to criticism so much as the method of presenting the subject, for in the haste of oral presentation, statements might be made which should be corrected in the quiet of the study. I have rarely written, fully, a lecture of this sort, feeling that an extemporaneous delivery serves to give a vitality to the subject which leaves a more permanent impression on the mind of the student; a few notes only to prevent the lecturer from straying too far afield are needed. I am quite aware that my reputation is chiefly that of a compiler of vast numbers of symptoms, but if you expect me to make a lecture by stringing together these symptoms you will be disappointed; my method, of gradual growth and development, resulted from the clearly recognized necessity of presenting to the student certain fundamental facts concerning the sphere of action of a drug which may serve as a frame-work for future study and observation as well as for the support of a few selected symptoms which every one must retain in his mind ready for immediate use.

A student becomes confused by large numbers of symptoms, and even if he succeeds in memorizing them is quite apt to attach the name of a wrong drug; he must be given a few positive facts concerning the drug so illustrated and vivified that a lasting impression results; after he has had experience with symptomatology it is different; then a discussion of comparative symptomatology and of exceptional applications of symptoms becomes interesting and in

structive.

The subject of the lecture before us embraces a group of drugs having a wide range of action on the body; they may well be termed "tissue remedies" in the widest sense of the name; some of these drugs are very complex, producing profound and diverse alterations of both function and nutrition; they constitute the type of the great family of the alkalies. There are certain family resemblances between all the members of this "alkali" tribe recognized by all students of pharmacology; features which grouped together make up the "alkali cachexia." Our friends of the physiological school seeking to exhibit an alkali, take little thought as to which alkali to select; an alkaline water is ordered too frequently in a very careless fashion; these waters contain alkalies in great variety and it often seems that the water showing the largest amounts of alkaline salts is preferred, and is taken in unlimited quantity, with no thought of their influence on digestion or on the blood and tissues. As a rule, they are devilish in their effects, insidious and disorganizing, profound tissue changes resulting often, quite out of proportion to the amount taken. I am of the opinion that more chronic disease, predisposing to most pernicious and incurable maladies, is produced by the almost universal habit of drinking alkaline waters than by any other of the numerous habits of the civilized world. They lay the foundations for tuberculosis, cancer, gout, with its numerous progeny, etc. These pernicious results may be noticed among the effects of all the alkalies; we find them in all states and stages in alkaline toxicology but they are most prominent and most profound in the salts of potash. These potash salts as a class produced a profound anæmia, increasing all secretions, especially the quantity of urine, while, at the same time, the elimination of the solid constituents is increased; the sufferer becomes emaciated as well as anæmic; the kidneys after a time become inflamed and degenerate; digestion becomes impaired early, for an alkaline stomach does not favor the assimilation of food; the patients are always tired and cold. In violent poisoning, headache, vertigo and even convulsions follow. In more chronic cases, the mucous membranes are affected by all the potash salts; catarrh is universal. (In kali bichrom. we notice not only catarrh with rather profuse and viscid secretions, but destructive ulcerations extending to the deeper structures, noticed also in kali chlorate.) The secretions vary in respect to amount and character. But perhaps the most important and serious lesion produced by these salts is the

paralysis of the heart. It seems that their action is chiefly on the motor-centres in the heart muscle. All victims of potash poisoning suffer from cardiac depression but not from respiratory failure; these salts do not affect the pneumogastric nerve as they do most other

motor nerves.

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Emaciation, excessive waste in the excretions, anæmia, a low, feeble pulse with threatening cardiac failure, are thus seen to be essential features of the potash disease. A negative point of great value is the absence of fever. I would have you never forget that only in the most exceptional cases can any potash salt be indicated when there is fever. How often do we hear some physician extol the virtue of Kali bichrom. in croup beginning with its earliest manifestations and "pushing" the drug to the point of nausea; such observations show ignorance of the essential nature of the drug, and an utter disregard of scientific and successful therapeutics. I would have you sear your memories with the notion "never exhibit any salts of potash where there is fever;" they are applicable only in a condition of weakness, soft pulse, coldness, general depression, never excitement; certainly not febrile excitement.

A study of the symptomatology of these drugs show that in general there runs through them a tendency to sudden and sharp pains (neuralgic like), a marked tendency to periodicity, decidedly characteristic in Kali carb. and, perhaps, in Kali bichromicum.

A comparative study of the various individuals of this group might now be made with interest and profit. I have been in the habit of including Causticum in this group as it has been considered a weak solution of caustic potash; but recent investigations at Columbia College in New York, have shown that this "tinctura acris sine kali" of Hahnemann, and which, as he thought, contained the alkaline principle or spirit separated from the potash, is really aldehyde. Symptomatically, it has always to my mind, belonged to the potashes; from end to end its features are similar even to the symptoms of cardiac paralysis; there is something remarkable in its origin as related to its symptoms and to the potash salts; but there is no potash in it, that seems certain.

A word about Kali carb. may not be out of place just here. The chest symptoms are marked and important; the severe, sharp pains in the sides are to be compared to some other drugs which also produce cough, such as Bryonia, Scilla, Asclepias, etc.; but the group

of symptoms belonging to the chronic Kali carb. is unmistakable. Given the potash generalities-weakness, coldness, emaciation—add the dry cough, the sharp pains and the aggravation at 4 A.M., and the selection of the remedy is perfectly clear, whatever the lesions may be. The further sensitiveness to cold, which is a general accompaniment of a potash constitution, amounting to intolerance of cold weather, is a very important factor. This patient is not affected by dampness, as the Calcarea carb. patients are, but only by cold. This condition-aggravation by cold in Kali and dampness in Calcarea— is so pronounced that by it I am accustomed to be guided in a choice of climate. When the patient's symptoms indicate Kali, I advise a warm climate, even damp; when Calcarea, always a dry climate, even cold. This beautiful air of Colorado is a paradise for Calcarea patients, but destruction for Kali patients.

The potash anæmia, emaciation and general cachexia favor the development of tuberculosis, which is apt to supervene in the progress of fibroid degeneration of the lungs. In these cases we will find fever as one of the symptoms consequent upon the advent of tubercular infection. The question often arises whether, in such a case, Kali carb, can properly be administered, and the answer must sometimes be affirmative; not that this drug can have any influence in arresting the progress of the tuberculosis directly, but that it becomes necessary, in order to arrest the chronic and pre-existing condition which has preceded and determined the tuberculosis, to ignore the symptoms which have developed with and in consequence of the tuberculosis and to study the case in its original aspect. When this has been done, and Kali carb. has been found similar to such a condition it must be prescribed, for it will arrest the farther development of the disease, and probably enable the patient to expel the tubercle-germ from the system, since this germ will find no fit soil for its development.

One very characteristic sign of a Kali carb. condition is the presence of a little sac-like swelling between the upper lids and the brows. This symptom, noticed by Hahnemann and emphasized by Bonninghausen, has proved quite valuable; it will now and then lead you to a Kali carb. prescription. Do not forget it.

A few words concerning the applicability of the potashes to diphtheria at first sight it would seem as though these preparations should be very homoeopathic; in a general sense, the low state,

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