Elements of therapeutics and practice according to the dosimetric system

Front matter

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Preface To The American Edition

This translation has been made for several laymen of New York and Boston who, having derived great benefit themselves from the daily use of the alkaloids as recommended by Dr. Burggraeve, are desirous of bringing this admirable book to the knowledge of the physicians of the United States.

The new method of treatment of disease described in this book is called Dosimetry— that is, the medicine of small doses mathematically measured. The granules contain accurately weighed quantities of simple substances whose chemical composition is invariable, whose effects are always the same, and are such that they can be calculated with great certainty in advance.

These substances are the active principles of the plants, and are, for the most part, crystallized alkaloids.

Dr. Burggraeve, an eminent professor of the University of Ghent, is the author of this new method of medical treatment. He was the chief surgeon of the Hospital of Ghent, and many years ago was deeply impressed by the great mortality among those who had been operated upon. He found that about two thirds of them died in consequence either of traumatism or of purulent infection. Later the antiseptic dressings of Lister reduced the mortality to fifteen and vi PREFACE TO THE AMEBIC AN EDITION.

* twenty per cent. Subsequently Dr. Burggraeve, by his alkaloido-therapeutic treatment, both preventive and curative, brought the mortality down to two and a half and five per cent, where it has since been maintained.

He judged that the traumatic fever was due to a stoppage of blood in the capillaries, caused by a paralysis or a fatigue of the vaso-motor nerves which control the circulation.

He thought that, by restoring to these nerves their tone and improving their vitality, he would bring back the circulation to its normal condition and put a stop to that stagnation of the blood which is at first a source of heat and then of inflammation, and thus becomes the origin of congestion, changes of texture, and finally of lesions.

He recalled to mind a successful treatment of intermittent fever and cholera in Russia, in 1832, by Dr. Mandt, of St. Petersburg, described in a memoir upon Indian cholera, which was read in 1854 by Dr. Everard before the Royal Academy of Medicine of Belgium.

The Academicians paid no attention to this memoir, they did not even discuss it, the cholera epidemic having ceased. Dr. Burggraeve, however, found in this memoir material for serious study, and he decided to apply Dr. Mandt's methods to the fever cases which came under his charge in the Hospital of Ghent. He, however, substituted alkaloids for the substances of the plants which Mandt had used. He gave to his patients strychnine in small doses, repeated at short intervals, to give tone to the vaso-motor nerves, and thus to re-establish the circulation of the blood. At the same time with the strychnine he gave small doses of aconitine and veratrine, to lower the temperature

PREFACE TO THE AMERICAN EDITION. vii

and stop the fever. He thus made the discovery that it is sometimes possible to prevent the fever, very often to jugulate it, and always to check the fever syndrome.

Encouraged by this success, he studied upon himself and others the effects of the different alkaloids which he thought suitable to introduce into therapeutics.

In his "Manuel di Pharmacodynamic " he describes, in a summary manner, the physiological and therapeutic action of the principal agents employed in dosimetry. He also established some simple rules of treatment, simple in form but of the greatest value in practice. In each disease he distinguishes two periods : the first, dynamic, presenting only functional disturbance ; the second, organic, accompanied by a change of tissue. It is in the first period that the physician should use the most active means possible to jugulate iiiQ disease, or cause it to abort. From this Dr. Burggraeve educed his rule to give to an acute attack an acute treatment, and to repeat the small doses until the desired effect is obtained, independently of the quantity of medicine administered, thus doing away with the ideas of maxima and minima, which have been regarded as axioms (especially when employing the alkaloids), and which are as great hindrances to success as are the massive doses which are currently employed for certain drugs.

Small doses facilitate the absorption of the medicine, and make it certain that the needed quantity shall not be exceeded.

The disease may be considered as a resistance to the remedy, or a resistance of the human organism, in a state of disease, to the remedy. The dose should viii PREFACE TO TEE AMERICAN EDITION.

therefore be adapted to the morbid resistance. This adaptation can not be known beforehand : the organism and the condition of the patient can alone indicate it. The dosimetric physician has thus the route he is to follow clearly traced before him by the imperious indications of the facts in the case. He is in no danger of an imprudence by giving too much of the remedy, because he stops it or gives it less frequently when the useful effect he aims at begins to be accomplished ; and, on the other hand, he is not held back in his treatment by timidity, for he is guided by Dr. Burggraeve's invaluable rule to continue giving the remedy until a useful or sufficient effect is obtained ; that is, a result which is sensible to the patient or appreciable by the physician. One granule too few may prevent the desired effect; one granule too many, by increasing that effect a little, can not do harm.

As Prof. Laura says, in his "Journal Dosimetria" : " Observation and experimentation are thus the two masters that never deceive. The experimental method has become the sovereign method in medicine."

There can be no exact treatment without an exact clinical knowledge and an exact remedy. The exact remedy can only be had in the simple ^principles of the medicinal plants, i. e., in their alkaloids. Dr. Burggraeve found that, by administering the necessarily small doses in a liquid form, there was a too rapid absorption by the mucous membranes of the throat, etc. ; he therefore adopted the form of the granule, and he applied to a well-known and very skillful pharmacist, M. Ch. Chanteaud, of Paris, to assist him. M. Chanteaud prepared the granules containing the different alkaloids. They are easily soluble, and are unalterable

PREFACE TO TEE AMERICAN- EDITION. jx

except when exposed to dampness. Each granule contains, according to the case, a half-milligramme, or one milligramme, or one centigramme of the active substance. These quantities correspond to y^-g-, and -£T, and about -§- of a grain English.

These granules are composed solely of the alkaloids mixed with and protected by sugar of milk. They are rapidly dissolved by the juices of the stomach, and are absorbed within ten or fifteen minutes, so there is no possibility of an accumulation, as sometimes happens with pills ; especially as there is, in the dosimetric treatment, a lavage intestinale every morning by taking a teaspoonful or less of Sedlitz Chanteaud (neutral sulphate of magnesia), which has the triple good effect of acting on the digestive tube, on the kidneys, and on the skin.

D'Oliveira Castro writes (in another book) that the dosimetric granules are of such purity and so regular in their action that too great praise can not be given to M. Chanteaud for the courage with which he devoted himself to the reform of Dr. Burggraeve, but still more for the constancy with which he has maintained the purity of his products.

There are, unfortunately, many imitations, and some very poor ones, now offered for sale both in Europe and America ; and their use would bring discredit upon dosimetric treatment. The sole agents in the United States for the Chanteaud granules are Fougéra & Co., of 30 North William Street, New York.

These granules do not deteriorate if kept from humidity. D'Oliveira Castro states that some of them which he had on hand for six years preserved intact all their organoleptic and therapeutic properties.

X PREFACE TO THE AMERICAN EDITION.

The hesitation which many physicians show to using the alkaloids in their general practice seems strange when we consider that, for their hypodermic injections, they employ exclusively these active substances that are chemically defined ; and that, for this purpose, they never use extracts, decoctions, or electuaries. Why should the cellular tissue be given the prerogative of a treatment by simple substances, easily absorbable, while the intestinal mucous membranes are rudely attacked by gross and irritating substances, whose absorption is often difficult ?

If their hesitation proceeds from the fact that they regard these alkaloids as poisons, this may be justified to some extent, for the reason that in allopathic practice there are numerous examples of poisoning by their use ; but not one case can be cited in dosimetric practice.

There are now in Europe more than three thousand physicians who use the dosimetric treatment ; many of them have done so for several years, and, in the thousands of cases which they have reported in the dosimetric journals, there is not one case of poisoning by the alkaloids. As Prof. Laura says: "In dosimetry, poisoning is materially impossible."

The dosimetric medicaments should always be given by small successive doses, proportioning the dose to the tolerance of the patient, and they are to be suspended or given less frequently as soon as the physicotherapeutic effect is obtained ; consequently, a toxic effect is never reached.

Dr. Burggraeve says it is only the abuse of these medicaments which provokes a toxic action.

Dr. D'Oliveira Castro shows elsewhere how a patient

PREFACE TO THE AMERICAN EDITION. xi

may take successively or at proper intervals more than sixty granules of aconitine without feeling the physiological effect, and still less any toxic effect, or more than toxic.

In order that therapeutics should derive the greatest benefit from the use of the active principles of plants, it was necessary that Dr. Burggraeve should teach the profession how to use them, not only without danger, but in the most profitable way.

He has thus deserved the title of Reformer of Therapeutics.

About fourteen years ago he founded a monthly journal in Paris, "Le repertoire universelle de mèdecine dosimétrique.''

It contains the report of cases treated dosimetrically by allopathic and other physicians in all parts of France and of some other countries.

There have subsequently appeared similar dosimetric journals in Italy, Spain, Portugal, England, and Holland, and very recently in New York.

Dr. Burggraeve has written many important books on the subject ; a list of some of them is given in this work ; and, although now in his eighty-second year, he is still an indefatigable writer and a hard worker.

A most useful book is the " Compendium de Mèdecine Dosimétrique," by Dr. Yan Renterghem, of Goes, Zealand. It is chiefly devoted to the therapeutics of the active principles of plants.

Prof. Laura, of the School of Medicine of Paris, has in press a treatise of " Pharmacodynamic Comparée." He says that his life for twenty -five years has been devoted to the hospitals, to instruction, and to his private practice. During eighteen years of this time xii PREFACE TO THE AMERICAN EDITION.

he followed the rules of the regular school of medicine, but for the past seven years he has devoted himself to the study and practice of dosimetry exclusively. This work, treating of comparative pharmacology, is the fruit of his professional career. He compares the results of his later years with the earlier period of his practice.

He says that he is profoundly and seriously convinced that this new dosimetric method is a grand progress in the science and art of medicine, that it restores to the physician an abiding faith in the curative powers of his art, while it spares him the dangers of an excessive treatment, and that it renders to suffering humanity services much superior to those of ordinary medicine.

The dosimetric method contains the germ of a perfection which time and science will develop from year to year. Happy are those who are young in the medical profession : they will see some marvelous things in therapeutics !

The present translation has been revised by Dr. Jules Grand, an eminent physician of the Ecole de Médecine de Paris, who has for some years followed the dosimetric practice. It has also been read and approved by the author, Dr. D'Oliveira Gastro, who is

Table Of Contents

PAGE

Introduction (Dr. Burggraeve's preface) 1

Prologue 7

Introduction

The work of Dr. d'Oliveira Castro, which received the grand prize of the Dosimetric Institute for 1885, is the complement of the prize essays of Dr. Laura and Dr. Van Renterghem. Prizes were awarded to each of these three works : to the first, in connection with therapeutics ; to the other two, in connection with materia medica. Together they form the ways and means of a well-adjusted medical budget. Practitioners will find in them all necessary directions for the treatment of acute and chronic diseases according to the dosimetric system. With such guides they should never have occasion to hesitate ; and they will escape the contradictions which the classic authors experience — of whom one might say, tot capita, tot census (as many opinions as there are individuals), if, like Julius Cresar, they give as an excuse the famous "Veni, vidi, vici" (I came, I saw, I conquered).

The adversaries of the dosimetric system decry the simplicity of its means: "Always strychnine! aconitine ! veratrine ! digitaline ! hyoscyamine ! " As if the dosimetric medicaments were like the allopathic ones. With the latter the prescription must constantly be changed, because for the natural malady it substitutes an artificial one, as the word allopathy indicates. Dosimetry has also been reproached with the charge that it merely regarded symptoms, as if disease were an entity for which there were specifics — mercury standing for syphilis, salicylate of soda for articular rheumatism, etc. 1

In dosimetry we regard the dominating and the varying — in other words, it is the treatment of causes and effects. If the first are often obscure, so that one might say, ' ' Felix qui rerum poterit cognoscere causas " (happy he who will be able to comprehend the causes of things) ; the second, the effects, are constant. Symptoms are the basis of treatment, as was well expressed by the celebrated author of " Symptomatology, or Morbid Conditions " — " It is so unusual to cure, while it is always urgent to relieve." By the dosimetric system suffering can always be relieved and fever subdued, and it is upon this "jugulation" that the system is based. Munaret has said of it that it is an old fashion of the Greeks renewed, for it dated back to Hippocrates. If one shall object, ' ' How can one fight with an unknown enemy % " the answer would be, we are doing that most of the time, and this is the cause of the differences which prevail among classic authors. Open the work of Prof. Spring, for example, and you will see that, where he believed he was making the history of the medical science, he was pronouncing a criticism which was the truer because it was unconscious, for Spring, as a professor, was faithful to the "magister dixit" and he died of variola, a victim to his convictions that this disease can only be combated in its symptoms. D'Oliveira Castro, on the contrary, proves that the poisoning of the blood in this disease may be combated, as the source of the trouble, by the sulphide of calcium as the dominant, and the defervescing alkaloids as the variant. That there are parasites, microbes, we do not deny ; but are they cause or effect ? In typhoid fever there are also proto-organisms ; will any one say that this fever can not be arrested in its evolution %

Where can these infinitely small organisms not be found ? An enthusiast on the subject of microbes set up his microscope on a street- corner in London, and for a penny allowed each new-comer to examine a drop of water which, to the naked eye, was pure and limpid.

INTRODUCTION. 3

Under the microscope it swarmed with monsters which attacked and devoured each other. It was a sermon to the crowd against water, as effective as Father Mathew's sermons against gin. Could not one tell an equally alarming tale concerning the liquids of the allopathic pharmacies, covered with mold and in active fermentation? Thus, to the microbes of the disease one must add the microbes of the remedy, while the alkaloids of the dosimetric system destroy both.

The duration of the treatment is not a matter of importance ; that which is important is, that the patient run no risks. In dosimetry crises are not recognized, because vital reactions are battles in which the results are uncertain and contain an element of chance.

These are the views which have guided Dr. D'Oliveira Castro in the composition of his book. Being addressed to practitioners, it is sparing of theories, preferring to go straight to the facts. Let us also believe that this book, as well as those of Laura and Van Renterghem, will be found upon the table of every physician who desires to succeed in his cases, cito, tuto, et jucunde (quickly, safely, and agreeably).

Dr. Burggraeve.

PROLEGOMENA.

LIFE— DISEASE— MEDICAMENTS— CURATIVE ACTION— THE THERAPEUTIC PLAN.