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How To Study Materia Medica Three Lectures
How To Study Materia Medica Three Lectures
MATERIA MEDICA
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Macsimund
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HOW TO STUDY MATERIA
MEDICA.
Three Lectures
BY
C. WESSELHOEFT, M.D.,
PROFESSOR OF PATHOLOGY AND THERAPEUTICS IN BOSTON UNIVERSITY
SCHOOL OF MEDICINE.
BOSTON :
i.
INTRODUCTION.
riences are like mine and those of many others, when, entering
upon medical studies, we were first confronted with ponderous
tomes filled with multitudinous descriptions of drug effects.
The question which then appals us is Shall we acquire the
:
daily life, the knowledge by which we live and have our being,
is the result of simple deduction from a priori data, while
only a small proportion of what might be termed the more accu-
rate branches of human knowledge is strictly based upon induc-
tive methods of obtaining information.
It may be said in behalf of "medicine." that of late years a
greater degree of general knowledge has been attained by purely
inductive research and experiment.
But I hear you say Are we not taught that the founder of
:
useful though small part of our materia medica that I now invite
your attention.
After this introduction I feel free to proceed, my mind being
no longer hampered by the thought that all is not understood
between us since though we may view the subject from dif-
;
that you will soon discover that when you have once learned one
of several ways to properly arrange your subject, you will not
only find it as easy as you seem to consider anatomy, physiology,
or chemistry ; but you will delight in materia medica as the
easiest of acquisition, provided you bring with you real fond-
ness and some preparatory training for study.
Now let me lead you directly into the subject. You have un-
doubtedly all heard the word "proving." To prove means to
test or to try a thing; in this case it means to try medicines
upon yourselves. As a method of studying the materia medica
there is no surer, no more practical manner of acquiring accurate
and trustworthy knowledge of the action of drugs upon the
(healthy) organism than to test them upon yourselves, as well as
upon animals.
If, before being prepared for it, you have unfortunately allowed
studied upon the animal, and in many instances upon the human
body. No investigator in the Old or in the New World nowa-
days thinks of getting at the truth according to the old way of
trying medicines on the sick or by studing obsolete treatises.
Whatever fault the opponents of Hahnemann may find, they
will no doubt acknowledge that his (inductive) method of experi-
mental research is the only profitable one.
Then let short provings upon yourselves and a few domestic
animals furnish you with the first rough outlines of a number
of drugs. If you make it a rule to investigate one during every
fortnight of your medical studies, you may easily acquire con-
siderable knowledge of fifty drugs, — a knowledge which will out-
weigh any thing that you may get from books. There are not
many authors of large books on drug pathogenesy who have ever
tried a single one, or who possess any practical knowledge of
proving. When you have obtained even a little of such experi-
ence, you will be surprised at the credulity with which book-
makers seize upon entirely unreliable material. Most authors
regard proving as an easy matter. To them it is take a drug,
:
you will still struggle in vain to master them, unless you are
shown some better way.
There are many ways of learning a lesson, or, as in our case,
a branch of science but whatever may be your mental habit,
;
II.
you will soon come upon families of plants and their genera.
Take up any family you happen to hit upon, and read over succes-
sively the different genera and tribes belonging to it, and you
will discover that there is scarcely a family group that does not
embrace one or more plants which are also contained in our
books on materia medica, be they old or new school.
Now write out all the names of plants which are known to
you as officinal, arranging them in groups according to botanical
orders. Let us suppose you had singled out the solanaccce, or
nightshade family ; now let your eyes glide leisurely clown the
very conveniently arranged list in " Gray's Botany," and you
will at once single out the following plants whose names are
familiar to us as those of medicines. There you find solanum
:
and nausea.
This list is long enough to illustrate my meaning. These
vegetable substances have close resemblances by virtue of their
family relation. They are not identical, but similar to each
other, as indicated by the broad rough outlines I have given.
They are much alike in general character, but differ in minor
details. By more careful comparison of other groups of effects
as produced on the various organs, you will readily perceive the
same conspicuous analogies. In noting these, remember always
that the differences, which are often slight, are differences never-
theless, and that those differences in their effects, even in the
rough outlines, are of equal importance with those external
differences in form upon which the distinction into tribes and
species is founded.
We make use of their differences therapeutically they point
;
let me remind you that details even are related in each group.
Do not take alarm at this long description the whole process
;
ica, yet you will desire to add lights and shadows, and more
details. Now, to obtain these, you come to the longer symptom-
lists. Let us suppose these were Hahnemann's, or Allen's, if
you have not got the New Cyclopaedia.
There are several ways of methodically arranging your mate-
rial for study ;
of these the following is one: // is to condense,
eitJier mentally or in writing, the long symptom-lists and narra-
tives. Supposing, then, you had before you Allen's Encyclope-
dia, from which you desire to learn all you can concerning, e.g.,
19
ally retentive memory, you will easily retain the principal features
of the group you have been reading; not only this, but much
more: you will presently be surprised that you have mastered
nearly the whole, because the group consists chiefly of repeti-
tions of the same symptoms, only expressed in slightly different
words.
Let us look at this specimen group. These are its words
(p. 76, vol. ii.) : "The whole head
is muddled for many days.
wrote it, it recalls at once the details. Moral Never copy from
:
one another, nor depend on others' notes for lectures not attended
personally.
If you have entertained the opinion that it is easier to study
materia medica by availing yourselves of some highly abridged
or condensed materia medica, I trust that you will now abandon
such notions. These abridged works, ponies, vade-mecums, etc.,
are in every sense like the beef-extracts and patent foods, for
which their proprietors claim that each teaspoonful is equal to a
pound of meat as a nutriment.
Take my advice, and do not abandon sound mental pabulum
derived from trustworthy sources, and good table board prepared
in honest kitchens.
Condensed materia medica and anatomically arranged symptom-
lists will be a dead-letter to you. They are useful only to him
who has formerly proved medicines, or who at least has studied
the whole pathogencsy of remedies, and to one who has experi-
ence in the practice of condensing. Just such is the skill which
our best students acquire by the practice of taking notes, which
I am glad to see is the rule among you. Therefore, do not fear
voluminous details or long symptom-lists with a little good-will
;
III.
ANALYSIS OF SYMPTOMS.
Hering, in his pamphlet on serpent-venom, compares the
study of the materia medica to learning the streets and alleys of a
large city. The stranger who has never visited a large city, first
notices and remembers the chief thoroughfares, and then the
smaller streets and landmarks. The plan I shall propose is
founded on the observation that each "symptom" or distinct
sign of a morbid ("pathological") condition is composed of
several parts. 1
Like a sentence or phrase of spoken or written
language, each symptom has what may be compared to the
parts of speech of a sentence, a subject, adjective, verb, adverbs,
prepositions, etc., whch are interdependent on each other.
Now, when we examine any carefully expressed and qualified
*'
symptom," we shall soon see that it is composed of parts,
which may be aptly likened to parts of speech. Every sign of
disease, or symptom, if expressed with tolerable perfection, is
capable of being parsed, or separated into its component ele-
ments, like a sentence in writing. Let me give you an example
at once :
1
Se.- B. llirschel's Grundriss der Humueopathie.
23
ways.
In thefirst place, you may take up the condensations of drug
effects you have noted down. Supposing you had before you a
condensed account of the effects of belladonna. This consists
of a moderately long list of "symptoms," some of which are
given with all their details and conditions, others are very briefly
expressed. It makes no difference whether they are anatomi-
cally arranged, or in what I have termed the narrative form.
Next, take an ample sheet of writing-paper (foolscap size is the
best), and divide it into four parts by ruling lines from top
to bottom. Over the first column write the heading, "Kind
of sensation ;" over the second, "Part affected ;" over the third,
"Time of occurrence;" over the fourth, "Conditions (under
which the sign occurred)." This the work of a few min-
is
( Dryness .......
Hoarseness, collection of mucus, frequent
Mouth, larynx.
spilling Mouth.
Tongue adhered 10 p late . . . . Tongue, palate.
Swelling, flatulence
pressure, in-
Stomach.
Abdomen.
Sinking UmLil. region.
Pimply exan'hema, suppurating slowly, dry
in a few flays . . • • . Face, skin.
Redness, burning fauces . . . . _
Fauces.
Heat <hat it glowed and became bro*nish
red in Face. [more walking.
moving head.
f Confusion in
Vision obscured . . ... Head.
Eyes.
I!y
Heller Irom collce.
|
|
No>e dry, sneezing
blown from
Gieat press re in
......
: mucus mixed with blood
Nose.
Stomach.
Increased pain in . . . . . . Forehead.
Injected condiiion of I Lids, conjunctiva
Pain with hiccough . . . . Low. partof larynx After eating.
Dilatation ol pupils, weariness of lids
Ringing in ears, sleepiness
Dulntss ol intellect.
.... .
Ol pupils: lids.
K.i is.
•
SUMMARY.
The
student will see from this that the parts principally affected are the head, mouth, throat, and
fauces; that the character of the affection points to the implication of the nervous system, as indicated
by spasm and hallucinations; that the mucous membranes are involved throughout their thickness, as
25
indicated by the nervous reflexes of throat and fauces, sphincters, etc.; that the optic nerve as well as
motor nerves of the eyes are involved in the effect; and that conditions of aggravation are chiefly mo-
tion, open air, etc. The brackets at the side indicate the different narratives from which the above list
has been condensed; it embraces the chief characteristics of the effects of Belladonna; but oth rr details
are containe 1 in the subsequent pages of Dr. .Hughes' Cyclopaedia,
pp. 526-546. It shows how to
condense many pages into a few, and how to arrange the symptoms analytically after having con-
densed ihem, which may be done mentally, but to greater advantage in writing.
This will, I trust, give you an idea of the plan proposed. The
symptoms have been taken from Dr. Hughes' Cyclopaedia, Part
III., p. 527 but, by way of illustration, I have added a couple
;