anything else which may possibly be beneficial or comforting to the patient. Still his practice was homœopathic, because these cases were the exception, and the exception proves the rule. And so, in the preface to one, if not all, of the Homœopathic Directories, we are distinctly told that, because a medical man inserts his name there, it does not mean that he exclusively practises homœopathy, but that he believes that the law of similars is true as a guide to treatment, and that he makes use of this guide as the chief mode of his treatment.

As we have already observed, the term homœopathy defines a precise method of drug selection; concisely, and in one word, expresses the relation subsisting between certain medicines and the morbid conditions they cure. It is a fact, which neither the Lancet nor any other party print can deny, that medicines which hold a homœopathic relation to diseases are becoming more and more frequently used in them. In proportion as this frequency increases is the vitality of the word homoeopathy strengthened. The physician who prescribes drugs homœopathically is-whether he likes it or not-to all intents and purposes a homœopathist. He is just as much so as was the man who followed the method of John Brown, a "Brunonian "; or he who adopted that of Broussais, a "Broussaisist." We never heard that to be a Brunonian or a Broussaisist was to involve oneself in professional ostracism on the ground of "adopting a name calculated to mark one from the great body of the profession."

While, then, we repudiate the name homœopathist as a professional appellation, we cannot, whether we would or not, deny its appropriateness as indicating a reliance on the therapeutic principle similia similibus curantur in the choice of drugs when prescribing for the great majority of all forms of disease.

How absurdly trivial, how utterly childish all this discussion about a name, must appear to every intelligent person outside the profession, it is difficult to imagine!

If the "head and front of our offence" is that we are homœopathists openly, and not, like many others, secretly -if the ethical irregularity consists in admitting how we choose our remedies, instead of denying that we choose them as we do-medical ethics must indeed be in a bad way. That many medical men are at this moment practising homœopathy, and denying, either directly or indirectly, that they are doing so, we are fully assured. For this breach of morals, medical ethics, as at present set forth by the British Medical Association, are mainly, if not entirely, responsible.

There is but one remedy for this state of things. That proposed by Mr. PEMBERTON will not do. It is absurd on the face of it. It would promote dishonesty. It would be of no service to any one. It would turn out to be a perfect sham. But, nevertheless, the remedy for the present disunited state of the profession did appear at Birmingham. The struggle at Birmingham was not one on behalf of homœopathy, but one for perfect freedom of opinion in the domain of medicine. It was decided at Birmingham that the possession of a legal title to practise medicine was pro tanto evidence of a capacity to think medically, and that, having this evidence of such capacity, a man had a perfect right to express and act upon such views as his reading and experience seemed to prove to him to be correct. Once admit the justice of allowing perfect freedom of thought and action in therapeutics, and all excuse for such resolutions as those which are kept up for the purpose of ostracising physicians who practise homœopathically, by the British Medical Association and other societies, is gone.

Let, then, these societies do away with these unjust restrictions, and, by admitting to their fellowship all members of the profession, whether they practise homœopathy or whether they do not, put an end, once and for ever, to the "huge blunder" they committed in excluding them.

These resolutions do not, as we have seen, preclude either the teaching or the practising of homeopathy. Their only result is to prevent either being done honestly and openly. They constitute a premium upon cowardice and falsehood, form an impediment to the progress of scientific therapeutics, are a stain upon the honour, and a scandal to the liberality of the profession of medicine.

A COURSE OF LECTURES ON PRACTICAL MEDICINE.

By R. DOUGLAS HALE, M.D.

Physician to the London Homœopathic Hospital.

LECTURE II.-Acute Inflammation of the Larynx and Trachea.*

GENTLEMEN,

I have now to speak about acute inflammation of the inlet, the janua vite to the respiratory apparatus. If we compare the size of the larynx with the thorax and the organs it contains, it appears a very small organ; but when we consider the complexity of its structure, the delicacy of its organisation, and how richly it is supplied with nerves and blood-vessels, and if, in addition, we think of the various functions it performs, we shall the better understand how important becomes a right understanding of the morbid changes to which it is subject. When, moreover, we consider its exposed position, its mobility, and the strain to which it is hourly subjected in the production of human speech and vocalization, and, in addition, the sympathetic connection which exists between it and the stomach-an organ itself exposed to such rough treatment by its omniverous owner-the wonder is that the larynx is not more frequently attacked with acute disease than it is.

Having only to speak about acute inflammatory affections of the larynx and trachea, I will not occupy your time by mentioning the various sub-acute and chronic affections and structural changes to which the organs of voice are subject. An entire course of lectures might be

* Delivered at the Hospital on Tuesday, April 20, 1875.

well employed in discussing these affections and their homœopathic treatment.

With regard to the diagnosis of chronic affections of the larynx, the laryngoscope has become of late years a valuable aid in enabling us to see various morbid appearances in the organ. I doubt very much whether it enables us, as homœopathists, to prescribe with greater accuracy or success than we are enabled to do guided by symptoms and an external physical examination. To those practitioners who treat laryngeal affections by topical applications, examination by the laryngoscope enables them not only to see the diseased surface, but also to apply their local remedy.

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A very striking instance, showing the value of the instrument, occurred not very long ago in Dublin. A patient, who had consulted several medical men account of complete aphonia, which had lasted for, I think, three or four years, and which nothing that they prescribed had in the least removed, at last consulted a gentleman who had been well trained in the use of the laryngoscope. This aphonia was cured almost instantaneously by the removal, with a forceps, of a polypoid growth, which was attached to the mucous membrane in close proximity to the vocal chords. If, for no other reason, one such example as this of the value of the laryngoscope, would prevent any man in his senses from undervaluing it as a valuable aid to diagnosis; but I wish to point out this consideration-that, inasmuch as our more specific application of drugs having an elective affinity for the morbid process, whatever it may be (with the exception of incurable malignant diseases), and administered in obedience to the law of similars, we do not, as a rule, require the aid of topical applications. The character of the cough, pain, tenderness on pressure, nature of the expectoration, and a study of all the symptoms which, combined, form a true picture of the case, enable us to select the medicine which, in its pathogenesis, reflects with the greatest clearness the symptoms of the natural disease.

Excuse this reiteration of a fundamental axiom, which is so strangely misinterpreted by those who have not, or will not, put it to the test in practice.

I would fain, in these lectures, avoid every approach to a controversial argument; but I must be permitted, in justice to homœopathy, emphatically to deny the state

ment which is constantly made-namely, that we ignore or neglect pathology.

So far from this being the case, there is no fact in physiology, histology, pathology, or morbid anatomy, that is not of as great value to us as to any other school of medicine. As diagnostic helps we employ the microscope, the test tube, the opthalmoscope, the laryngoscope. Our hygienic rules are precisely the same as those of all intelligent medical men; and the diet we prescribe, excepting the prohibition of coffee and medicinal condiments, differs very little from that prescribed by our allopathic brethren.

I now come to speak upon the immediate subject of this lecture-acute inflammation of the larynx and trachea, and, as in the case of bronchitis, I drew your attention to the disease occurring in childhood and infancy, so here I think it well to select the same period of life, because, during it, acute affections of the windpipe present their most striking manifestations.

Now, as touching the pathology of laryngeal inflammation in the child, we are met on the very threshold of the enquiry with the remarkable divergence of opinion among pathologists as to the true definition of that most serious form of disease called croup. The question to be solved is this: Ought the inflammation of the windpipe in the young child, having a catarrhal origin, manifesting all the symptoms, local and constitutional, of inflammation of the mucous membrane of the larynx and trachea, which becomes vascular and swollen, and sometimes oedematous, narrowing the inlet to the lungs, and, when accompanied by an exudation of plastic nature, ends in apnæa and death, be designated croup; or should that name be restricted to a morbid condition of the larynx, which is diphtheritic, and nothing else?

Very eminent authorities are at issue about the etiology of croup. Trousseau, Sir Thomas Watson, and others, draw a broad line of distinction between catarrhal laryngitis and true croup, restricting the name to a complication of diphtheria; whereas Niemeyer and Sir William Jenner adhere to, what I venture to think, the sounder view-that acute laryngitis in the child does not essentially differ from true croup, but that, under certain conditions, the morbid process may become diphtheritic.

Niemeyer's lucid definition is of such great practical

No. 6, Vol. 19.

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