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Homeopathic Materia Medica by Dunham


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In entering upon the general consideration of any subject involving a number of topics, it is expedient always to seek to obtain at the very outset a clear view of the scope and extent of the subject; to comprehend what it involves and to perceive what are its limits and what its relations with other kindred subjects. Let us begin our course by doing this with reference to homeopathy, the principles of which it is my duty to lay before you.


You all know that by homeopathy is generally understood that system of practical medicine, in accordance with which the physician seeks to cure his patient by giving him a remedy which has been known to produce in the healthy subject symptoms similar to those which the patient presents. It is a system claiming to be the only scientific system of medicine, inasmuch as it possesses a "law of cure" as it is termed; or, as it might be more correctly expressed, a law for the selection of the remedy in any concrete case of illness; the law expressed by the now familiar formula — "SIMILIA SIMILIBUS CURANTUR."


You will hear also that homeopathy is called the science of therapeutics, and I will add that it is the only therapeusis which exists possessing the elements of a natural science; that it is the only science of therapeutics. Now, by therapeusis or therapeutics, we mean the science of treating diseased persons by means of drugs.


We thus arrive at a view of the limits and scope of our subject, homeopathy. It is a therapeutics. It deals with the science and method of treating the sick by means of drugs. And this is its whole scope. As homeopathists strictly, and confining yourselves to the application of the science of homeopathy, you will perform your entire function when you accurately select and rightly administer a suitable drug to your patient.


But you will go forth from these halls as doctors of medicine. Shall you have no other professional duties toward your patients than to administer drugs to them? Assuredly you will. Then you must be homeopathists and something beside.


The injuries and accidents to which men are exposed, involving destructive injury to limb or tissues, may require the interference of the operative surgeon. As such you will act under the law of mechanics, guided by your knowledge of anatomy and physiology, and governed by the traditions and maxims of surgery. It is true that few surgical cases occur which do not sooner or later involve the entire organism in such a way that the patient's condition demands the co-operation of the therapeutist; and as you will combine in your own person the function of operative surgeon and therapeutist, you, who have when operating, acted outside of your office as homeopathist or therapeutist, will now select and administer a drug suited to the condition of your patient, in accordance with the therapeutic law. You will, thus, in treating this case, act in a double capacity. You will be both an operative surgeon and a prescriber of drugs. It is in the latter capacity only that you will be a therapeutist, that you will practice homeopathy. It is true that your possession of a science of therapeutics will make the intervention of operative surgery much less frequently necessary than it is deemed to be by our allopathic brethren, who have no science of therapeutics. For homeopathy gives us the means of curing many diseases formerly supposed to require mechanical treatment; and in so far your function as homeopathist will encroach on that of surgeon. Yet the two are in a scientific aspect entirely distinct, and may not be confounded, unless you would introduce confusion into your views of the principles of medicine.


So, likewise, as obstetrician, you are called upon to superintend the physiological process of parturition, to prevent accidents or to remedy them; to anticipate or to cure diseases that may complicate the process. Some of your interference will be mechanical, as when you turn the child or use instruments. Such interference does not come under the scope of homeopathy. It belongs to another department of science and art. Another kind of treatment for the abnormal conditions which may supervene during parturition, consists in the administration of drugs in accordance with the homeopathic law. In doing this you are acting of course within the limits of the science of homeopathy, being therapeutists. Thus in the practice of obstetrics you fill a double office; you are therapeutists, and as such, homeopathists, and may also be operative surgeons, exercising another art.


Here again homeopathy puts us in possession of remedial means which, in a great many cases, obviate the necessity of resorting to mechanical interference, because they enable us to prevent the occurrence of morbid states which lead to conditions requiring such interference; and thus the function of the homeopathic therapeutist circumscribes that of the operative obstetrician, as it is laid down in the text-books of the allopathists. And it should be our aim so to develop our therapeutic science as still further to circumscribe its limit and do away with the necessity for operative interference. For instance, if I may venture to spend a moment on this subject, homeopathy, as a system of therapeutics, educating our powers of observation and sharpening our clinical foresight, enables us to anticipate the recurrence of uterine haemorrhage as an incident of parturition, and so to prescribe that we prevent or control it; thus making the mechanical appliances so frequently resorted to by the allopathists at least so seldom requisite that some homeopathists have affirmed that the tampon, etc., can never be required. In the same way and to the same extent of rarest use or absolute disuse has homeopathy brought the entire apparatus of pessaries and supporters and bandages for the treatment of uterine disease. In these cases, as in other similar cases, it will be for you, in the exercise of a sound judgment, to determine whether the best interests of your patient demand that you shall act solely as operative surgeon, or solely as therapeutist, or whether you shall combine these functions. You cannot exercise this sound discretion aright unless you are fully instructed in both departments of science, unless you know all that can be effected by therapeutics from the stand-point of the homeopathist, and know also the resources and limits of operative surgery. The point which I wish to make is that as doctors of medicine you combine in yourselves the functions of therapeutist, surgeon and obstetrician; and that in the latter capacity you do not, cannot, and are not called upon to act as homeopathists, inasmuch as the homeopathic law applies only to the selection of drugs for diseased conditions.


Once more, hygiene is that department of medical science which includes the prevention of disease, and the removal or cancellation of material causes which induce or perpetuate disease. The advances of physiology and pathology, chemistry and natural history, within the last thirty years, have given to sanitary science a scope and importance which were not heretofore imagined. Many epidemic diseases have been shown to be dependent upon the conditions in which the individual, the family and the community live—conditions which by knowledge and care might be obviated, I refer in general to improper drainage of the soil, deficient ventilation, unwholesome food and drink, lack of light and heat, injurious occupations, improper social habits and relations. Surely the doctor of medicine can have no more important business than the prevention of disease by diligent endeavor,—whether as a public officer or as the medical adviser of a family or of an individual,— to modify unfavorable conditions, and thereby remove material causes of disease, and place those with whose care he is charged under circumstances most favorable to health. In doing this you will apply the principles of chemistry or of mechanics or of vegetable physiology; and although fulfilling one of your most important vocations, you, who will style yourselves homeopathic physicians, will not be acting within the scope of homeopathy; will not be applying its law of cure. You will, as hygienists, have nothing to do with homeopathy.


Furthermore, it has been ascertained by modern research, that certain diseases depend for their perpetuation, if not wholly for their origin, upon parasitic vegetable or animal growths, the removal of which by chemical or mechanical means is an essential condition of speedy cure. While you effect this removal by such means, you are fulfilling your duty as those intrusted with the care of the sick, just as faithfully and fully as when you administer, in accordance with the homeopathic law, the remedy which shall so change the vital processes of the patient as that his body shall no longer be a favorable nidus for these parasitic germs. But remember that when you seek the aid of chemistry or of mechanics to remove these parasites, you are not exercising your vocation as homeopathists, because you are acting as hygienists, not as therapeutists ; you are not combating disease by drugs. I lay stress upon these instances. I desire to show clearly, and impress upon your minds the fact, that homeopathy applies only to the treatment of the sick by means of drugs ; because, unless your minds are clear upon this point, unless you perceive plainly that as curators of the sick you have other functions beside that very important and essential one of administering drugs, you may err as many do who strive to apply the homeopathic law of cure to their every action as medical men; and to make it cover not only their treatment by drugs, but also the surgical, obstetrical, hygienic, chemical and mechanical expedients and procedures. They come into the dilemma, that either dreading to prove recreant to their guiding principle, which they cannot perceive to lead them in any of these procedures, they neglect something which is essential to their patient's safety or recovery, and thus fail of their duty as doctors ; or else, resorting to measures which their common sense and experience show to be necessary, they attempt to explain them in such a way as to bring them under the homeopathic law, and. thus make themselves ridiculous and bring ridicule upon the science which as therapeutists they profess and honor.


Remember, then, the scope and limits of homeopathy. It is the science of therapeutics, and concerns only the treatment of the sick by means of drugs. Do not misunderstand me, and think me to say, inasmuch as I am a homeopathist, that therefore I believe diseases are to be treated only by drugs. Being a science, the elements of which are natural phenomena, viz. : those of the sick and the phenomena of drugs in their relation to the living human being, homeopathy takes rank with the other natural physical sciences.


For the better understanding of our subject let us take a general view of the nature and elements of a physical science. The physical sciences are variously arranged. There are sciences of classification, and sciences which are pursued with a view to the practical application of the knowledge they afford us to the affairs of daily life. But all of them deal with the phenomena of the physical universe as we observe them by means of our senses, aided by the resources of art. Let us study for a moment the science of astronomy, the most perfect and least complicated of the physical sciences. It deals with the phenomena of the bodies which compose the universe. We observe these phenomena, which consist of the movements of the heavenly bodies in space and upon their axes; and our observation is assisted by whatever instruments the ingenuity of man has contrived for the purpose, every successive invention enabling us to discover some new feature of these phenomena. In observations of the movements of the heavenly bodies we observe their movements in relation to each other. This is obvious, since the motion of one body is perceptible only in relation to some other body. Our object is to understand the relations of the heavenly bodies to each other in respect of their phenomena, and then to be able to foresee and predict what will be their relations and relative positions at some future time. We accomplish this object when, by virtue of our studies of the phenomena of the heavenly bodies and their relations, we are able to foretell the occurrence of eclipses at definite times, and to indicate, years beforehand, the position of the heavenly bodies at a given time.


I ask you now to notice several facts respecting this science.


FIRST: In all its processes we never think of bringing in the question—What is the CAUSE of the motion of the heavenly bodies? Such a question must present itself of course to every reflecting mind; but its consideration belongs to the speculative or metaphysical sciences, and has nothing to do with astronomy proper, or celestial mechanics, —is certainly in no sense and to no degree a basis of it. Our opinions on this point may be most various; yet this variety will not prevent our perfect agreement in the processes and conclusions of astronomy when considering the relations of, say two heavenly bodies.


SECOND: Astronomy deals with two series of phenomena, viz.: those of the two heavenly bodies, or systems of bodies, under consideration. And this science reckons the effects of one body or system of bodies upon the other in accordance with some law or formula which is general, applying to all bodies, and which expresses the mechanical action of bodies upon each other as regards mass and distance; in other words, their mechanical relations to each other.


THIRD: This law or formula, expressing the relation of bodies to each other, was perceived in a single instance. The mind which perceived it formed at once the hypothesis that it was a general formula expressive of the relation which exists between all bodies. A vast number of experiments and observations having confirmed this hypothesis, it is now universally accepted as the law of the mechanical relations of bodies.


FOURTH: Observe that this law, which is a bare statement that bodies attract each other directly as their mass, and inversely as the square of their distances, is not based upon any theory of the nature of attraction — how it is that one body attracts another. Myriads of hypotheses on this subject might be framed, defended and overthrown, yet this formula would remain unshaken. It expresses the relations of phenomena which we observe, and nothing more—the relations therefore of what we know. For, what besides phenomena can we know—phenomena or things which are apparent to our senses, which may be seen and touched, smelt and tasted and heard. How disastrous would it be if in our science of astronomy the phenomena were limited by a law or formula based upon a theory of the cause of attraction. Phenomena we see and apprehend, and may be said to know, but the causes of them no man has seen or touched. Causes are hidden from our senses. We can reach them only by the action of the mind in hypothetic speculation. It must needs be that with every advance in observation a new hypothesis would spring up, overturning former doctrines of causation, and with them whatever laws or formulae might be based upon them; and if the central formula of the science rested on them, it would be overturned to give place for a brief interval to some as short-lived successor. Progressive knowledge would be impossible on such a basis.


FIFTH: Observe, finally, that one great object of the cultivation of this science is, that it affords us the means of prevision ; it enables us to foretell events within its domain. And this is true of all the natural sciences when constructed on a sound basis. It would, therefore, furnish a test of the soundness of a science so called. For, on ultimate analysis, every natural science (save those of classification) consists of two series of phenomena connected by a law expressive of their relation to each other. Now, in the application of the. science to the purpose of prevision the problem is this: Given one series of phenomena and the law of relation to find the other series of phenomena, to foretell what they will be. This problem is continually applied in astronomy, and the results uniformly attest the accuracy of the method.


In conclusion, then, this episode enables us to state understandingly the elements of a natural science. They consist of two series of phenomena (the result of observation) and a law which expresses a uniform and invariable relation between these series of phenomena. The phenomena must be susceptible of indefinite exploration, study and elaboration without disturbing the law of relation.


The law must be such as will enable us to foresee and predict future events. One series of phenomena and the law being given, we must be able to indicate the other series of phenomena; and this in advance of any observation of them or of any experiment.


Such must be the structure and the elements of the science of therapeutics, the only possible science the elements of which are capable of being developed independently by study and experiment and observation without detriment to the science as a whole, and which in its integrity will enable us to foretell the future, will put it in our power, having one series of phenomena and the law, to predict the other series.


Therapeutics being the science of treating the sick with drugs, it must deal with two series of phenomena, viz.: those of the sick and those of the drug as it affects the living human body; and it must present us with a law expressive of some constant and general relation between the phenomena of the sick and the phenomena of the drug as it acts on the human body. And by means of this law we must be able to foretell events. If we have the phenomena of the sick and the law, we must be able to tell correctly what shall be the phenomena of the drug which will cure the patient, even though no such experience has ever been had. Or, conversely, having the phenomena of the drug as it acts on the human body and the law, we must be able to tell what phenomena of disease that drug will remove, even though none such have ever been witnessed or experimented with. Now, gentlemen, homeopathy is just such a science of therapeutics. It has again and again submitted to this test, and has come forth triumphant. It possesses this law, which is not interfered with by the indefinite expansion of the phenomena with which it deals. I proceed to state it in detail in the light of what has been said.


The object of your study as medical practitioners is of course the patient—the sick person who sends for you. Your first care is to ascertain if he be really sick. He states perhaps that some organ is the seat of pain, that some function is not properly performed, or that the unusual appearance of some part of his body has attracted his attention and excited his alarm; and now he asks your opinion, advice and assistance. He wishes to know what ails him, what will be the issue of his sickness, and how long it will last, and finally he wishes you to assuage his sufferings and restore him to health as quickly, safely and gently as you can. The first question is this, Is the patient sick ? Is any organ or tissue in an unnatural condition? Is any function arrested, or performed in an unnatural manner? You compare the patient with your recollection of a sound and healthy man. Your knowledge of anatomy will enable you in this comparison to detect abnormal conditions of organs or tissues. Your knowledge of physiology puts it in your power to discern the abnormal performance of functions. In a word, you observe whatever of a material character is wrong with your patient. Where it is possible you assist your senses by instruments. The functions of respiration and circulation are inspected by means of the stethoscope; the tissues of the eye by means of the ophthalmoscope ; of the ear by the otoscope; the tissues and, to some extent, the functions of the larynx, by the laryngoscope; the renewal and waste of tissue, to some extent, by the thermometer; to some extent, by chemical examination, the excretions and secretions. These examinations, which are made by the aid of a comparison of the patient with our recollection of a standard, healthy, living human being, furnish us with the objective phenomena which the patient presents. Besides these there is another class of phenomena. Rarely are any tissues or functions in an abnormal state without the existence of some sensations in various parts of the body complained of by the patient, unless he be in such a benumbed condition that he cannot feel nor describe. Such phenomena, since they are perceived only by the patient, are called subjective phenomena; we cannot verify them. The patient may deceive us in stating them. He may not be capable of describing them so that we can understand him or get a distinct idea of what he feels, or, he may be dull or comatose and take no note of them. These objective and subjective phenomena together constitute that in which the patient differs from a healthy man. He wants to know what ails him, for the purpose of forming an idea whether and how soon he can get well. You form your diagnosis by means of your knowledge of the relation of phenomena to lesions of tissue; and you give your prognosis from your knowledge of the history of the course of diseases under treatment. You have not come to your duties as therapeutists until your diagnosis and prognosis have been made and pronounced.


This having been done, your great duty as curers of the sick lies before you. Is the case one in which it will suffice to order a change in the mode of life, abstinence from some hurtful article of food or drink, change from a noxious habitation to a more wholesome one, substitution of suitable for injudicious raiment, of a nutritious for a scanty diet, of a healthy for a baneful occupation ? If so, you will have done your whole duty when, from the stand-point of hygiene or sanitary science, you have cared for these things, and have placed the patient under the conditions which are requisite for the normal performance of the functions of the body and mind. But we will assume that, these things having been attended to, the patient remains ill; and that we need to apply to his organism some special stimulus which shall bring him back to a healthy condition. A drug is such a stimulus.


We are now in a position to apply the science of therapeutics. The phenomena of the patient with which we deal, are the subjective and objective phenomena of which we have already spoken. We include these under the general term " symptoms," and we consider that, practically, the aggregate of the symptoms constitutes the disease under which the patient labors. A great outcry has been raised against homeopathists because of their alleged exclusive attention to symptoms. It is affirmed that they prescribe on symptoms only, not taking cognizance of the disease, and this is made a reproach to them.


In part this reproach springs from the failure to start on a mutual understanding of the term symptom. The old school does not give it so extensive an application as we do. For we include among the symptoms of the patient every deviation from a healthy condition of mind or body which the physician can in any way discover or perceive, or which the patient makes known by his statement or complaints, or which the attendants of the patient have observed and can communicate to the physician. Now, this definition includes every possible deviation from a healthy condition of tissue or function whether objective or subjective, which it is possible to have. And what is called a disease in contradistinction to such an aggregate of symptoms, is simply an abstraction, a mental conception devised for the purpose of expressing this aggregate in a single phrase. For example, the patient has heat of skin, a hard, frequent pulse, rapid and short respiration, a quick, dry cough or cough with rusty sputa. These are objective symptoms which the physician may observe. The patient in addition complains of oppression of the chest, of sharp pains through the lung on coughing, or of rawness behind the sternum. The physician, by physical exploration of the chest, discovers, on percussing a certain part of the chest, dullness, or a fine crepitation. Let this collection of symptoms constitute all there is about this patient which is a deviation from his condition when in health. These phenomena, being the results of positive observation, are known; there can be no error or uncertainty about them. Now, if we wish to express to another physician the condition of our patient, it may be and is convenient to have a brief term which will include and imply the presence of these phenomena. But does it add anything to our knowledge if we designate this aggregate of symptoms by the name pneumonia or inflammation of the lungs ? The fallacy is that we are in danger of including under the given name cases agreeing in anatomical lesion, but differing in symptoms, and requiring different treatment.


It has been objected to the use of a collection of symptoms as the basis of a prescription, that, if we depend on symptoms alone, we may fail to discover the existence of latent disease. But if disease be really latent, not manifested by any symptom whatever, by any deviation from a healthy condition, why then it must be so completely latent, must lie so hidden, that in no way is it discoverable.


Let us remember that Hahnemann taught, and that we believe and teach, that the aggregate of symptoms, which we regard as identical with the disease itself, includes and comprises everything which the physician and attendants discover or have observed about the patient as different from his condition in health, and every deviation from health of which the patient is conscious. Let the physician avail himself of all the appliances of the modern accessory medical sciences, the most approved methods of research and observation; whatever he observes in any way in the patient which is a deviation from health, is a symptom in the sense of the homeopathist, and the aggregate of these symptoms constitutes for him the disease. I may say that the most recent and most enlightened writers of the old school, Virchow, Carpenter, Bouchut, express themselves much in the same sense.


These symptoms, then, these phenomena of the patient, constitute one series of the phenomena with which the science of therapeutics deals.


The other series of phenomena are those of the action of drugs upon the living body. Let us come to an understanding of what we mean by a drug. The condition of a sick person is this: The organs which, while the patient was in health, have been performing their functions regularly and normally, under the action of the general stimuli of light, heat, aliment, etc., on which we all depend, have in some way, through some cause, come to act abnormally. Now we seek for some special stimulus which is capable of modifying the action of the organism; and if we can hit upon that stimulus which will modify them in just the right way and to the right extent, we shall have the means of modifying the organism back from its perverted action to a healthy action. To hit upon this special stimulus, this is the therapeutic problem.


We gather from this statement that any substance whatever which has the power to produce in the living organism a definite deviation from its healthy, normal action, may come under the designation of a drug. Thus almost every substance in the world, provided it have the power, as most substances have, of producing a definite and constant modification of function and tissue in the organism, may be a drug, and may be used to cure disease if we only know how to use it. Those who deny the possibility of curing disease affirm that a pathological process once begun cannot be arrested;—why not as well as a physiological process ? As a matter of course, almost as early as men began to record observations of nature, in however rude a way, they began to note the effects produced upon the organism by natural objects taken into the system accidentally or by design. And these observations were the foundation of the science of pharmacodynamics, or the effects of drugs upon the living organism. Subsequently systematic observations and experiments began to be made, with a view of extending our knowledge of pharmacodynamics and making it exact. It was not however until a very recent period that these experiments were instituted on the proper basis and in the proper way to secure permanent and valuable results.


At first, and indeed until a very recent date, experiments and observations with drugs upon the human organism, were made in the case of sick persons in the way of endeavors to cure them. Now in this way we could not arrive at any certain knowledge of the action of the drug upon the organism, because of the organism being already in abnormal action under the influence of the cause of disease, whatever it might be.


When we add the modifying influence of the drug, the result would be a kind of action due to the combined influence of drug and morbific cause. Nor could we know how much or what deviation to ascribe to each of these influences. Such an experiment could give us knowledge of nothing save the action of the drug upon an organism already affected by disease, precisely as the subject of the experiment is affected. But when we consider how very rarely two identically diseased conditions occur, it will be very apparent that such knowledge would be of but little practical value to us. It would not afford us the constant quantities we seek. It was apparent to some of the most clear-headed of the earlier physicians, after the restoration of learning, that in no way could a knowledge of the properties of drugs in relation to the human organism be obtained except by observations of their action upon the healthy subject. Although this conviction was expressed with more or less clearness by several, and notably by Haller, it was reserved for Hahnemann both to demonstrate its truth, and to illustrate it by undertaking and accomplishing a gigantic series of experiments with drugs upon the healthy organism; experiments of which the results constitute the bulk of our materia medica; and which form the most splendid and enduring monument of scientific acumen and philanthropic devotion of which humanitarian science can boast.


The remarks which were made in relation to symptoms as compared with abstract conceptions supposed to be represented by them, apply to observations of the action of drugs; since the effects of drugs are really artificial diseases. The phenomena observed by the prover or his friends upon him, whether subjective or objective, constitute facts; constitute what we know about the action of the drug. Speculations about its mode of producing these symptoms are certainly interesting, and may lead to further discoveries, and certainly do stimulate to closer observation; but they are no part of the positive facts which constitute this second series of phenomena of our science of therapeutics.


We have now two series of facts or phenomena ; the symptoms of the patient and the symptoms produced by drugs upon the healthy. It is reasonable to believe that if we knew how to bring the latter action to bear upon the former we might arrest the morbid action of the organism; might modify it back to a healthy action, if, among all the drugs which act with such a variety of difference upon the organism, we only knew how to select the right one.


Wanted, then, a law of selection; a rule for selecting the right drug for each patient; a formula expressing the relation between the symptoms of the patient and the symptoms of the drug which would cure that patient, the law of the interference of symptoms.


This law, of which others had had vague glimpses, was discovered by Hahnemann to be the general law of therapeutics. It was expressed by the phrase "SIMILIA SIMILIBUS CURANTUR"; or "Likes are to be treated by likes." It is the law for the selection of the drug. It expresses nothing concerning the MODUS OPERANDI of the cure. It ventures nothing of hypothesis. It is as bare and as general a formula as that of celestial mechanics.


Discovered by accident, supported by multitudes of instances, established by direct experimentation and clinical demonstration, it interferes in no way with the growth of either series of phenomena,— either the phenomena or symptoms of disease, their causation and connection, or the phenomena of drug action; and yet it affords us the means of prevision that have already been most fruitful of blessings to mankind, as in the case of cholera in 1831.


Let us for a moment, in conclusion, suppose the science of therapeutics otherwise constructed, first on the rationalistic, and then on the empirical basis.


On the former, the symptoms are observed and a cause is assumed for their existence. The action of a drug is observed and a theory formed of the cause of its action. Here two theories come in to introduce two possible points of error. The science cannot progress, because advancing knowledge must continually change the hypotheses concerning the cause of symptoms and of drug effects upon which the treatment was based. Take for example the use of mercury in liver diseases. It was assumed from observation in disease that mercury increases the formation and discharge of bile. In certain diseases then, which were supposed to depend upon a diminished secretion of bile, mercury was administered. But subsequent experiments showed that mercury does not increase the flow of bile. Then all observations and conclusions based on this treatment must be thrown away as worthless, and we must begin again; and so on AD INFINITUM.


The empirical method simply records that A. has cured a patient sick with B., and concludes that A. is a remedy for B. But diseases occur alike so very rarely that the results of treatment based on such experience never agree. Nor does this method afford means of prevision, a defect which is fatal to its claims as a science. Nothing remains but the science as we have explained it, and of which we shall proceed to study in detail and in a practical way the different elements.


The subject of the next lecture will be: " Symptoms ; or, How to take the Case."