pose these 622 cases entirely struck out, the mortality in that hospital for these years would not be raised one per cent. Had we the means of ascertaining it, I have no doubt that in any other hospital, admitting the same number of patients, we should find an equal, if not greater proportion of simple diseases seldom fatal. But it is argued

"3. Another reason of the increased rate of mortality in Allopathic hospitals, is in the want of room to admit milder cases of disease. It must be obvious where there is more room for the admission of less serious cases, the annual mortality will be less." Very true, but the Allopathic Hospitals are considerably larger than the Homœopathic Hospitals, the latter therefore are disadvantageously circumstanced in this respect. This is a "reason" which makes the favourable results of Homœopathic treatment still more striking.

Dr. Routh next asks,—

"What if it should appear that, proportionally to their number of beds, they admit more patients, perhaps twice as many; will this not be evidence that they have a large number of milder cases ?" Not at all. But rather evidence that the cases, though severe, are more quickly cured and dismissed.

"Certainly, they seem to admit a large number of chronic cases." If so, how is it that the beds change their occupants so rapidly? Every one knows that chronic cases under the old mode of treatment, are tedious and difficult of cure.

Dr. Routh proceeds,

"4. An important element in hospitals towards increasing or diminishing mortality, is the degree of comfort of patients, and the ventilation of the building." If the old hospitals are deficient in these respects, it is high time that such defects should be brought under the notice of the governors of these hospitals.

"5. Another circumstance which will explain the different rate of mortality in Homoeopathic hospital returns, is in the class of patients admitted. In regard to Dr. Fleischmann's hospital, the patients are not the very poorest." Dr. Routh himself contradicts this statement further on (p. 68) where, in endeavouring to account for the large proportion of fever cases, he says, "Fleischmann tells us he admits the poorer classes." It is moreover the fact that his hospital is situated in a poor manufacturing district of Vienna, out of which it must necessarily receive the majority of its patients.

6. Sex is another circumstance which exerts a powerful influence on disease in general." But how this affects the general mortality of hospitals receiving both sexes indiscriminately is not suggested.

7. Age materially affects the cypher of mortality.

It is precisely between ten and forty that persons are most healthy and least likely to die. Between ten and forty, they

have 21 per cent. or rather less than one third too many patients and above forty, they have 6.8 per cent. or nearly one half too few patients. The proof of selection according to favourable ages is perfect." How perfect this proof is shall be shown by the following quotation from the British Journal of Homœopathy, [No. 40, page 347.] "We are not told whether or not Allopathic hospitals have a sufficient number of patients above 40,--but we can inform Dr. Routh that they have not. We do not however on this account charge these hospitals with an attempt at deception, but content ourselves with the simple fact that the missing aged poor Dr. Routh is in search of are not to be found in hospitals, either Homœopathic or Allopathic, but quietly engaged picking oakum within the walls of the poor-houses."

"Lastly," concludes Dr. Routh, "the Homœopaths prove too much. When we come to look at the Homœopathic mortality, as collected from some of their hospitals, we find it is considerably less than the mortality of any given population, including the healthy as well as the diseased. A 2 per cent, mortality

is a common occurrence. The Homœopaths thus prove too much, since their mortality, including their worse and most severe cases, is positively less than that of ordinary populations in most European countries, which average 2 to 24 per cent." It is sufficient to say in reply to this, that the mortality in the hospitals is what takes place during an average of less than a fortnight's treatment, while that of entire populations is the mortality in a year!

a

Such are the arguments "on the general mortality of hospitals" advanced by Dr. Routh to prove the "Fallacies of Homœopathy." They are repeated on "the mortality in particular diseases." For example:-on the table for pneumonia he observes that it is " result most favourable to Homoeopathic treatment.........to be explained by the selection of cases, the comfort of the patient in the hospital, the age, sex, &c." It will be remembered that the small number of deaths from all diseases was explained by the selection of mild cases; here we have the opposite complaint that too many cases of pneumonia are "selected!" "I find that in the two years 1848 and 1849 there were admitted into the General Hospital at Vienna 51,709 cases altogether. Of these 1134 were cases of pneumonia, or 2.1 per cent. Apply this test to Fleischmann's (comparatively very small) hospital, out of 6,551 cases, admitted between the years 1835 and 1843, there were 300 cases returned as pneumonia, or 4.5 per cent." I remark, 1st, That the exclusion of diseases of the skin and other chronic diseases from Fleischmann's hospital, which constitute a considerable class in the general hospital, renders this comparison, to a considerable extent, inapplicable. 2nd. That the comparison is defective in point of time. The years 1835-43 being compared with 1848-9. We all know how a disease like inflammation of the lungs varies in frequency in different years; and 3rdly. That the statement

proves how unfounded was the first charge of "selection" of a too large proportion of mild cases, and that in reality this hospital receives and cures a much larger proportion of severe acute cases than the Allopathic hospitals.

On the table for pleurisy, Dr. Routh says,-as before the advantage is in favour of Homœopathy........ There is reason to believe the cases are either not genuine or selected." What reason? "The number of cases admitted are at least double the number admitted in Allopathic Institutions." And yet it was pretended above that the general mortality from all diseases is reduced by the selection of too many mild cases, and the "rigid exclusion" of such serious ones as pneumonia and pleurisy are admitted to be! As to the cases not being genuine, the hospitals are constantly open to inspection; medical men are invited to witness the practice; Dr. Routh has visited them, he brings forward no sufficient evidence on which charges, so dishonourable to the whole profession, should rest; his assertions and insinuations are directly contradicted by an eminent Allopathic practitioner, who has also visited these hospitals, and who says that the cases he saw treated in Fleischmann's Hom. Hospital were fully as acute and virulent as any he had observed elsewhere.-Wylde's Austria, p. 277.

Dr. Routh's further objections are equally self-contradictory or altogether futile and frivolous. We have seen that he asserts that because the Homoeopathic hospitals have a larger number of patients annually in proportion to their number of beds, therefore their cases are not similar to those in the old hospitals. We infer that they are more quickly cured. On the other hand, he complains that the pneumonia cases remain on an average too long in the hospital: may we not rather conclude that this apparently increased time arises really from fewer of the cases dying? It is death which shortens the period for these cases in Allopathic hospitals. Again, from the fact that the cases get cured quickly, it is concluded that they are not genuine. Is not this again taking for granted the thing to be proved? Is it not much more reasonable to draw an inference in favour of the treatment from such speedy recoveries? What will be thought of attributing the cures to the "humility and gentleness" of the Sisters of Charity? Their "calm aspect of religion;"" the beauty observed in their persons," and "their melodious accents ?" What sort of a corner has Dr. Routh been driven into, that he must fight with such weapons as these? Does he feel his gallant ship sinking beneath him, that he is catching at straws?

The statistics are genuine. The very existence of a Homœopathic Hospital in Vienna is itself a convincing proof of the superior value of the new treatment. It was because Dr. Fleischmann, when the Asiatic cholera raged in Vienna, cured double the number that were saved under the old system, that the Emperor

removed the restrictions that had previously been imposed upon the practice of Homœopathy in his dominions, and established the hospital which has since been the principal school of Homœopathy for Europe. Had Dr. Routh's objections been sufficiently weighty to destroy our confidence and our hopes thus excited in Homoeopathy, we might indeed have greatly regretted it for humanity's sake, but we must have bowed to the conclusion. If, however, as I think my readers will by this time have been convinced, they have rather been "frivolous and vexatious," we may cheerfully dismiss them, and thankfully indulge our hopes that this improved method of treating all our bodily ailments will become increasingly beneficial to mankind. Hard indeed must that heart be that will not rejoice at such a prospect as this!

It appears then with respect to the principle of "like curing like," it is admitted to a considerable extent by our opponents, as indeed it was by Hippocrates himself, emphatically and deservedly recognised as the Father of Medicine; and that no reason has, as yet, been shown, sufficient to set aside the proofs in favour of its being received as a general rule of universal application.

That with respect to the efficacy of small doses, this is also admitted to the extent that it has been practically tested :-so far as the small doses have been tried, they have been found to act satisfactorily. Now as Dr. Routh himself contends that "we have no right to argue a priori," (page 12) we feel justified in asserting that a priori or theoretical objections to doses which have not been tried, are of no force, and may safely be disregarded, and at once rejected.

That with regard to the administration of medicines we learn from our opponents in the most conclusive and self-evident manner, not only the inefficiency, but the positively hurtful nature of the usual treatment by large doses; and that with regard to the statistics which speak so loudly and so unequivocally in favour of Homœopathy, we have seen that the objections brought against them are not of sufficient validity to shake our confidence in their truth.

In conclusion, the published statistics of Homoeopathy are important in themselves, and of value to medical practitioners, either as preliminary information, to induce them to study Homœopathy, seeing that by them at least a prima facie case for enquiry is made out, or as a confirmation to their own private trials on the subject, if the information come, as it no doubt often does, after that private examination has been made. Still the main reliance is to be placed upon what happens in our hands, and under our own eyes. Whatever charges of unfairness or fraud may be brought against other persons, we know whether we are sincere ourselves or not. The subject is too serious, and the consequences too important to each individual practitioner, to allow him to be careless in his own proceedings. He is almost necessarily cautious,

and awake to all the sources of fallacy to which he may be exposed. He procures the books and reads them, he obtains the medicines, and with intense interest tries them; he expects them to fail, he is almost sure he shall be able to prove that the thing is a delusion. He selects simple cases at first, both for his patient's sake and his own, the remedies apparently act beyond his expectation, at any rate the patients quickly recover, better and more speedily than if he had given them his usual doses. He reasons thus:—even if the medicines have done nothing, the patients have been gainers, they have been spared the taking nauseous physic, perhaps the loss of blood, or the pain of a blister, and they have speedily recovered; so that supposing it has been diet and regimen, it is evident that diet and regimen do better without drugs than with them. This point becomes settled, that drugging, and bleeding, and blistering are bad. By degrees more serious cases are tried; cases, such as croup, where diet and regimen are out of the question, seeing that if relief be not speedily afforded, death must ensue; and how does the conviction of the efficacious action of the medicines then flash upon the mind! When a violent paroxysm of croup passes off in an hour under the influence of mild doses of aconite and hepar sulphuris and spongia, without the warm baths, and emetics, and leeches and blisters, which before were considered indispensable; when an equally violent fit of tic doloreux yields in a few moments to the appropriate remedy; when inflammation of the brain yields. to belladonna, and inflammation of the lungs subsides rapidly under phosphorus; again, when hands covered with warts are cleared of them in a few weeks, without cutting and caustic, which did not remove them: when such universally fatal diseases as diabetes (sugared urine) are, if not absolutely cured, at least so greatly relieved, that life is prolonged for years; what further proof does he require to convince him of powerful medicinal action in the remedies employed? What then is the conclusion arrived at by the anxious but patient and persevering enquirer? That Homœopathy is a boon to mankind from the Giver of all good, and that it is his duty to embrace it, and to advocate its cause to the best of his ability.

Rugby, August 12th, 1853.

E. Thomas, Printer, 3, Bridge Street Row, Chester.