Most simple medicinal substances produce in the healthy human body not few, but on the contrary, a considerable array of absolute symptoms. The appropriate remedy can consequently frequently contain among its primary effects an antitype of most of the visible symptoms in the disease to be cured (besides many others which render it suitable for the cure of other diseases).

Now the only desirable property that we can expect a medicine to possess, is this, that it should agree with the disease-in other words, that it should be capable of exciting per se the most of the symptoms observable in the disease, consequently, when employed antagonistically as a medicine, should also be able to destroy and extinguish the same symptoms in the diseased body.

We see that a single simple medicinal substance possesses in itself this property in its full extent, if it have been carefully selected for this purpose.

It is therefore never necessary to administer more than one single simple medicinal substance at once, if it have been chosen appropriately to the case of disease.

It is also very probable, indeed certain, that of the several medicines in a mixture, each no longer acts upon the disease in its own peculiar way, nor can it, undisturbed by the other ingredients, exert its specific effect,-but one acts in opposition to the other in the body, alters and in part destroys the action of the other, so that from this combination of several powers that dynamically decompose each other during their action in the body, an intermediate action is the result, which we cannot desire, as we cannot foresee, nor even form a conjecture respecting it.

In the action of mixtures of medicines in the body, there occurs what, indeed, must occur according to the maxim of experience given above (viz.:-that a general irritation in the body removes another, or else suppresses it, according as the one irritation is analogous or antagonistic to the other, or provided the one be much more intense than the other)-the actions of several of the medicines in the compound partially destroy one another 46, and only the remainder of the action, which is not covered by any antagonistic irritation in the mixture, remains to oppose the disease; whether this be suitable or no, we cannot tell, as we are unable to calculate what actually will remain.

Now, as in every case, only a single simple medicinal substance is necessary; no true physician would ever think of degrading himself and his art, and defeating his own object, by giving a mixture of medicines. It will rather be a sign that he is certain of his subject if we find him prescribing only a single medicinal substance, which, if suitably chosen, cannot fail to remove the disease rapidly, gently and permanently.

If the symptoms be but slight and few in number, it is an unimportant ailment that scarcely requires any medicine, and may be removed by a mere alteration of diet or regimen.

But if-as rarely happens-only one or a couple of severe symptoms be observable, then the cure is more difficult than if many symptoms were present. In that case the medicine first prescribed may not be exactly suitable, either because the patient is incapable of describing the extent of his ailments, or because the symptoms themselves are somewhat obscure and not very observable.

In this more uncommon case we may prescribe one, or at most, two doses of the medicine that appears to be the most appropriate.

It will sometimes happen that this is the right remedy. In the event of its not being exactly suitable, which is most commonly the case, symptoms not hitherto experienced will reveal themselves, or symptoms will develop themselves more fully, that the patient has not previously noticed, or only in an indistinct manner.

From these symptoms which, though slight, now shew themselves more frequently and are more distinctly perceptible, we may now obtain a more accurate picture of the disease, whereby we may be enabled to discover with greater and even the greatest certainty the most appropriate remedy for the original disease.

The repetition of the doses of a medicine is regulated by the duration of the action of each medicine. If the remedy acts in a positive (curative) manner, the amendment is still perceptible after the duration of its action has expired, and then another dose of the suitable remedy destroys the remainder of the disease. The good work will not be interrupted if the second dose be not given before the lapse of some hours after the cessation of the action of the remedy. The portion of the disease already annihilated cannot in the mean time be renewed; and even should we leave the patient several days without medicine, the amelioration resulting from the first dose of the curative medicine will always remain manifest.

So far from the good effect being delayed by not repeating the dose until after the medicine has exhausted its action, the cure may on the contrary be frustrated by its too rapid repetition, for this reason, because a dose prescribed before the cessation of the term of action of the positive medicine is to be regarded as an augmentation of the first dose, which from ignorance of this circumstance may thereby be increased to an enormous degree, and then prove hurtful by reason of its excess.

I have already stated that the smallest possible dose of a positively acting medicine will suffice to produce its full effect. If, in the case of a medicine whose action lasts a long time, as for instance digitalis where it continues to the seventh day, the dose be repeated frequently, that is to say, three or four times in the course of a day, the actual quantity of medicine will, before the seven days have expired, have increased twenty or thirty-fold, and thereby become extremely violent 47 and injurious; whereas the first dose (a twentieth or thirtieth part) would have amply sufficed to effect a cure without any bad consequences.

After the expiry of the term of action of the first dose of the medicine employed in a curative manner, we judge whether it will be useful to give a second dose of the same remedy. If the disease have diminished in almost its whole extent, not merely in the first half-hour after taking the medicine, but later, and during the whole duration of the action of the first dose; and if this diminution have increased all the more, the nearer the period of the action of the remedy approached its termination-or even if, as happens in very chronic diseases, or in maladies the return of whose paroxysm could not have been expected during this time, no perceptible amelioration of the disease have indeed occurred, but yet no new symptom of importance, no hitherto unfelt suffering deserving of attention have appeared, then it is in the former case almost invariably certain, and in the latter highly probable, that the medicine was the curatively helpful, the positively appropriate one, and, if requisite, ought to be followed up by a second-and finally even, after the favourable termination of the action of the second, by a third dose if it be necessary and the disease be not in the mean time completely cured,-as it often is, in the case of acute diseases, by the very first dose.

If the medicine we have chosen for the positive (curative) treatment excites almost no sufferings previously unfelt by the patient, produces no new symptom, it is the appropriate medicament and will certainly cure the original malady, even though the patient and his friends should not admit that any amendment has resulted from the commencing doses,-and so also conversely, if the amelioration of the original disease take place in its whole extent from the action of the curative medicine, the medicine cannot have excited any serious new symptoms.

Every aggravation, as it is called, of a disease that occurs during the use of a medicine (in doses repeated before or immediately after the expiry of its term of action), in the form of new symptoms not hitherto proper to the disease, is owing solely to the medicine employed (if it do not occur just a few hours before inevitable death, if there have taken place no important error of regimen, no outbreak of violent passions, no irresistible evolution of the course of nature by the occurrence or cessation of the menstrual function, by puberty, conception, or parturition); these symptoms are always the effect of the medicine, which, as an unsuitably chosen positive remedy, or as a negative (palliative) remedy, either ill-selected or given for too long a time, and in too large doses, develops them by its peculiar mode of action to the torment and destruction of the patient.

An aggravation of the disease by new, violent symptoms during the first few doses of a curative medicine is never indicative of feebleness of the dose (never requires the dose to be increased), but it proves the total unfitness and worthlessness of the medicine in this case of disease.

The aggravation just alluded to by violent, new symptoms not proper to the disease, bears no resemblance to the increase of the apparently original symptoms of the disease during the first few hours after the administration of a medicine selected in a positive (curative) manner, which I formerly spoke of. This phenomenon of the increase of what seem to be the pure symptoms of the disease, but which are actually predominant medicinal symptoms resembling those of the disease, indicates merely that the dose of the appropriately selected curative medicine has been too large-it disappears, if the dose has not been enormously large, after the lapse of two, three, or at most, four hours after its administration, and makes way for a removal of the disease that will be all the more durable, generally after the expiry of the term of the action of the first dose; so that, in the case of acute affections, a second dose is usually unnecessary.

However, there is no positive remedy, be it ever so well selected, which shall not produce one, at least one slight, unusual suffering, a slight new symptom, during its employment, in very irritable, sensitive patients,-for it is almost impossible that medicine and disease should correspond as accurately in their symptoms as two triangles of equal angles and sides resemble each other. But this unimportant difference is (in favourable cases) more than sufficiently compensated by the inherent energy of the vitality, and is not even perceived except by patients of excessive delicacy.

Should a patient of ordinary sensibility observe during the duration of the action of the first dose, an unusual sensation, and should the original disease appear at the same time to decline, we are unable to determine with precision (at least not in a chronic disease) from this first dose, whether or no the medicine selected was the most appropriate curative one. The effects of a second dose of equal strength, given after the first has exhausted its action, can alone decide this point. From the action of this, if the medicine was not perfectly or exceedingly appropriate, there will again appear a new symptom (but not often the same that was observed from the first dose, usually another one) of greater intensity (or even several symptoms of a like character), without any perceptible progress occurring in the cure of the disease in its whole extent;-if, however, it was the appropriate positive medicine, this second dose removes almost every trace of a new symptom, and health is restored with still greater rapidity, and without the supervention of any new ailment.

Should there occur from the second dose also some new symptom of considerable severity, and should it not be possible to find a more appropriate medicine (the fault of which may however lie either in a want of diligence on the part of the physician, or in the smallness of the supply of medicines, whose absolute effects are known) in the case of chronic diseases, or acute diseases that do not run a very rapid course, a diminution of the dose will cause this to disappear, and the cure will still go on, though somewhat more slowly. (In this case also the energy of the vitality aids the cure).

The choice of the medicine is not inappropriate if the chief and most severe symptoms of the disease are covered in a positive manner by the symptoms of the primary action of the medicine, while some of the more moderate and slighter morbid symptoms are so only in a negative (palliative) manner. The true curative power of the predominant positive action of the remedy takes place notwithstanding, and the organism regains full possession of health without accessory sufferings during the treatment, and without secondary ailments thereafter. It is not yet decided whether it is advantageous in such a case to increase the doses of the medicine during the continuance of its employment.

If, during the continued employment of a curative medicine without increasing the doses (in a chronic disease,) fresh symptoms not proper to the disease should, in the course of time, present themselves, whereas the first two or three doses acted almost without any disturbance, we must not seek for the cause of this impediment in the inappropriateness of the medicine, but in the regimen, or in some other powerful agency from without.

If, on the other hand, as is not unfrequently the case when there is a sufficient supply of well known medicines, a positive medicine perfectly appropriate to the accurately investigated case of disease, be selected and administered in a suitably small dose, and repeated after the expiry of its special duration of action, should none of the above alluded to great obstacles come in the way, such as unavoidable evolutions of nature, violent passions, or enormous violations of regiminal rules, and should there be no serious disorganization of important viscera, the cure of acute and chronic diseases, be they ever so threatening, ever so serious, and of ever so long continuance, takes place so rapidly, so perfectly, and so imperceptibly, that the patient seems to be transformed almost immediately into the state of true health, as if by a new creation.

The influence of regimen and diet on the cure is not to be overlooked; but the physician needs to exercise a supervision over them only in chronic diseases, according to principles which I shall develop in the special part of my work. In acute diseases, however (except in the state of complete delirium), the delicate and infallible tact of the awakened internal sense that presides over the maintenance of life, speaks so clearly, so precisely, so much in conformity with nature, that the physician needs only to impress on the friends and attendants of the patient, not to oppose in any way this voice of nature, by refusing or exceeding its demands, or by an injurious officiousness and importunity.

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