Dr. Perry (Jour. de la Medorrhinum Hom., i. 48.) of Paris lately recorded a number of cases to prove the efficacy of olfaction. The diseases in which he has found it most serviceable are coryza, megrim, facial neuralgia, toothache, constipation. His mode of employing olfaction is to dissolve two or three globules of the medicine in a mixture of spirits and water in a small phial, and make the patient inspire the air in the phial through the nostrils. He finds, he says, this method very successful in constipation depending depending on inaction of the rectum. A patient so affected was made to smell at a solution of opium 6, at the period of the day when his bowels were generally moved, and if no effect resulted, to repeat the olfaction a quarter of an hour or half an hour afterwards. If no evacuation resulted, the olfaction was to be repeated in a few hours, or not till the next day.
Several homoeopathic practitioners have spoken in favour the occasional employment of olfaction, but few profess to think it a method suited for general application. The partisans of the high potencies, and among these more particularly Dr. Gross, profess to think highly of the olfaction of their favourite preparations, and possibly that may be the mode of administration best calculated to elicit the marvellous virtues of those transcendental remedies; but I do not know of any who habitually remedies; about I do not know of any who habitually employ the lower potencies who affect to believe that olfaction is ever preferable to ingestion, unless it be in some cases where the antidotal powers of camphor, nitrous ether, or smelling salts are requisite.
Dr.Mure (Doctrine de l’Ecole de Rio, p. 86.) speaks greatly in favor of the method by olfaction, but finding that in practice it caused great incredulity, he discovered, he says, a mode of securing the advantages of this method without shocking the prejudices of the patient. Over the uncorked phial containing the tincture of the required medicine in the appropriate dilution he reversed the patient’s empty bottle, and left it thus for thirty or sixty seconds, then he suddenly turned the latter bottle right, filled it with water, corked it quickly, and gave it to the patient to take. This method, he assures us, always succeeded admirably. I would receive this statement of Mure’s like his wonderful astronomical theory, cum grano salis.
Akin to the method of olfaction is the mode proposed and adopted by Dr. Drysdale, of administering arseniuretted hydrogen, which he adopted with apparently good results in the epidemic cholera that raged in Liverpool in 1849. He invested an apparatus for this purpose, of which a full description will be found in the British Journal of Homoeopathy, vol. viii., p. 152. A common milk-bottle, with a flexible tube provided with a mouth-piece inserted not its side aperture, is all the machinery required. The top aperture of the bottle is left open, to allow the free ingress of air, and into the bottle are put a few pieces of pure zinc, half an ounces of water, one drop of strong pure sulphuric acid, and five or ten drops of the 3rd dilution (aqueous) of arsenic. The hydrogen disengaged by the action of the acid on the zinc enters into combination with the arsenic in the drops, and the arseniuretted hydrogen thus formed is inhaled by the patient.
The method proposed by Hahnemann of rubbing in the medicines in solution, on sound portions of the skin, has excited very little attention among his followers. Kampfer n Allg. hom. Ztg., xxvi., No. 1 certainly alludes to it, but chiefly to claim for homoeopathy the cures performed by mineral baths, by tartar- emetic ointment in whooping-cough, by ranunculus-leaves in sciatica, by croton-oil in rheumatism, etc.
The mode of administering the remedy, whereby its action on the patient shall most certainly be ensured, is a subject which has occupied very little attention among homoeopathic practitioners. The frequent changes Hahnemann proposed have served as an excuse to practitioners to follow their own caprice in the matter, and to refrain from seeking any fixed rules upon the subject. Accordingly we find in the clinical records the utmost variety in the mode of administering the remedy. Some invariably give the globule dry on the tongue; others give them always dissolved. Some like Drs. Wurmb and Caspar, (Hom. Klin. Studien.) always give so many drops of the medicine in so much water. Some, again, profess to believe that the dry medicine is more suitable for chronic disease, s the dissolved for acute, whilst others are of exactly the contrary opinion. Some would confine the mode of olfaction to acute diseases, others would practice it in chronic diseases only. Some tell us that the ingestion is necessary where the disease is accompanied by obvious structural change, whilst the olfaction should be limited to neuralgic affections. Some see to have no rule at all for the mode of administering their remedies, but treat all cases indifferently; now with dry globules, now with powders imbibed with the spirituous, dilution, now with the globules or tinctures diluted with water, and anon they make use of olfaction in all sorts of cases. all are silent on the endermic method so strongly recommended by Hahnemann, unless we are to consider as such the advice of some to rub the medicine in on the seat of the pain or disease. This, however, is exactly what Hahnemann forbids us to do when we practise the endermic method, and it will more properly fall under consideration when I come to treat of the local employment of remedies.
Hitherto, then, it seems as though practitioners were guided, by caprice or convenience only, the in their mode of exhibiting their remedies, admit is very evident, from the unsettled condition of the question as to the best mode of administration, and the great success that seems to attend all modes, that it is a matter of very minor importance. I confess I have never been able to perceive the slightest difference in the mode of action of a drop or a globule of medicine, whether it were given at once on the tongue, or dissolved in a small portion of water; but I think few could have failed to not a great difference between the effect of a certain quantity, whether a globule or a drop, given at one dose, and the same globule or drop distributed over several doses, by being mixed with a certain quantity of fluid. In the latter case, the effect is invariably much greater. I do not, however, believe that any difference would be observed in the effects of a certain number of globules dissolved in a given quantity of water, the solution being consumed in a certain number at regular intervals, and in the effect that would result from the same number of globules, given in the same number of doses, at the same intervals, dry on the tongue. I am not in the habit of hesitating which of these two methods I will adopt, but am guided solely by convenience in preferring the one or the other.
In Germany, many of the homoeopathic practitioners are in the habit of using pieces of sugar, larger than the globules usually employed, for conveying the medicine, which they term rotuli or pastilles; and in this country large globules, from there to six of which weigh a grain, have lately been introduced by Dr. Norton, and are now pretty extensively used by practitioners. Their advantages in many respects are undeniable not the least is the facility with which they are dispensed.
When circumstances render it most convenient, I confess to a decided partiality to the method latterly proposed and adopted by Hahnemann in the treatment of chronic diseases, namely, to mix several globules in a certain quantity of water, and let this be taken at short intervals, every six, eight, twelve, or twenty- four hours, as the urgency of the cases or the susceptibility of the patient seems to require.
Of the method by olfaction I can say little from personal experience. I have occasionally employed it with success in the treatment of toothache occurring in my own person, and then I used the alcoholic solution of the remedy; but I confess I have never and had the courage to employ it in acute diseases, nor the impudence to use it in chronic ones. I cannot conceive a case in which it would ever present advantages over the other methods of administering the remedy.
The endermic methods proposed by Hahnemann has, I think, been unjustly neglected by his followers. We cannot deny the power of medicines to act through the skin; the rubbing-in and fumigations of the allopathic school, and the often marvellous effects of bathing in certain mineral waters are proofs sufficient of the power of the endermic administration of drugs.
The endermic method of administering remedies dates from remote antiquity. Thus Plistonicus, Dieuches, and Diocles, the immediate followers of Hippocrates, employed the veratrum album to excite vomiting, in the form an epithem. Dioscorides states that the black hellebore was applied to the abdomen of dropsical persons, made up with fluor and wine. Rufus mentions that in his time it was customary to excite emesis by footbaths of hellebore. Haller states the Berengarius the first to discover that mercury could act on the system through the skin, and Amatus the Portuguese saw dangerous symptoms follow the external use of arsenic. An expression used by Celsus shows us that practitioners who treated solely by means of medicines or ointments applied externally were common in his day. He says, namely: (Celsus, de Medorrhinum, lib. i. cap.l.) “Sanus homo, quiet bene valet, et suae spontis, est, nullis obligare se legibus debet; ac neque medico, neque iatralipta egere.” Here the iatralipta, or employer of external remedies, is distinguished from the medicus, or ordinary doctor. Recently the endermic mode of administering remedies has been revived by Drs. Lembert and Lesieur of Paris, who published a memoir on the subject in 1824. They recommend that the epidermis should be first remove, in order to apply the medicinal agent to the corium directly; and Dr. Ahrensen of Copenhagen published a treatise in 1836 on the same subject. q Dissertatio de methodo endermico, auctore A. Ahrensen, M.D.; Hauniae, 1836. Dr. Ahrensen’s book is well worth the attention of homoeopathists, at it contains many interesting facts relative to the physiological effects of remedies when applied to the denuded skin.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.