Homœopathy and natural therapeutics

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H O M ( E O P A T H Y AND N A T U R A L T H E R A P E U T I C S By

E.

K.

LEDERMANN, L.R.C.P.Ed., L.I~.C.S.Ed., M.D. (Berlin)

L.R.F.P.& S.Glas.,

MR. PRESIDENT, LADIES A N D GENTLEMEN, This paper deals with two forms of therapeutics. Any therapy which aims at curing and not merely relieving a patient constitutes a stimulus, given with the intention of obtaining ~ response. Therefore this paper deals with two forms of stimulation, the stimuli of the homceopathic remedies and those of natural therapy. The first part will be of a general character ; in it I shag define and describe the two systems, investigate the principles on which they are based, compare these and relate them to each other, and finally suggest the combination of the two forms o f treatment. I n the second main p a r t I shall deal with certain forms of natural stimuli in detail and again show their relationship to homceopathy. PART I DEFINITm~ OF HOMC~OPATHY Let us start with homeopathy. It consistsin the use of medicinal stimuli, chosen according to the law of similarity between patient and prover, usually given in potentized form. BASIC PRINCIPLES OF HOM(EOPATHY

These m a y be elucidated through a comparison with allopathic medicine. The allopathic school also uses medicinal stimuli, the first difference between the two schools lies in the principle, underlying the choice of the remedies : I n allopathy drugs are used specifically, i.e. the stimuli are aimed at certain parts, whereas in homceopathy the simillimum is matched to the whole patient. A second difference lies in the fact t h a t allopathic medicine is given in standardized quantity, whereas in homceopathy the qualitative aspect matters almost entirely, the quantities used show the greatest possible variations. The third difference is found in the temporal order of administration. Here, too, standardization prevails in allopathy (for instance " one tablespoon of the mixture--containing one drachm of the d r u g - - t h r e e times a day "), whereas in homceopathy the response to the stimulus is decisive in the administration of further stimuli. The principles of specificity and of quantitative and temporal standardization of stimuli will have to be investigated in the case of the system of natural therapeutics. I f natural therapy and homceopathy are to be combined, they must have the same principles in common. DEFINITION OF ~ATURAL THERAPEUTICS

Let us now define what is m e a n t by natural therapeutics. This system does not use medicinal stimuli as a m a t t e r of principle, but relies on those which are part of normal functioning of the body as air, water, sun, food, exercise. To these m a y be added certain auxiliary stimuli which help various functions of the organism in a mechanical way such as massage, manipulations, enemas. BASIC PRINCIPLES OF ~'ATURAL THERAPEUTICS

These stimuli arc not given primarily to the part where the disease shows itself, but, on the contrary, are mainly applied to those other parts and functions which arc not affected by the disease and therefore offer a good chance of response to the stimuli, a case of bronchial asthma m a y be treated with cold water applications to the skin, a skin condition with diet. The underlying

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conception is that the organism functions as one unit or who/e ; therefore the diseased part will benefit from any improvement in the functioning of any other part. The stimuli of natural therapy are used essentially in an unspecific way. We have found that homceopathy and natural therapeutics agree in this first principle, both do not recognize diseases, but only diseased whole patients. The quantity of the stimulus has to be adjusted to the patient's abihty o f response. The same dose of sun treatment or the same quantity of raw vegetables, given as the only food, would constitute a drastic stimulus to a patient who is not used to sunlight or raw vegetarian diet, whereas it would not be a stimulus at all to another one who is used to the sun and this particular form of dietary. In his case a fast may be needed in order to provoke a vital response. As we cannot standardize the quantity of the natural stimuli, the following discussion of them will mainly deal with their qualitative aspect. Temporal standardization of the application of natural stimuli is not possible either. Just as in homceopathy, so with the natural stimuli, the patient's response to the stimulus has to be watched, a new stimulus (which means here an alteration in the rdgime), is only called for when the patient's. whole condition demands it. TEMPORAL ASPECT OF DISEASE ACCORDING TO NATURAL THERAPEUTICS AND. HOM(EOPATHY

To judge the temporal aspect of disease, i.e. the progress of the patient as a whole, the following signs are considered important with a view to natural treatment : temperature and pulse, condition of hair and nails, of the iris, of the capillaries which can be examined with a special technique under the, microscope. The tongue is also an indicator of the patient's general health. Under allopathic treatment it often gets furred and patients complain of a bad taste, whereas under natural therapy it gets cleaner and the taste becomes. normal. To these objective signs the subjective feeling of well-being, which is physical as well as mental, has to be added as an important indicator of t h e patient's progress. As a first reaction to the change of rdgime we often find a headache, indigestion, or some general malaise. But we do not consider that these symptoms indicate that the patient should give up this form of treatment, we encourage him to persevere. The symptoms usually disappear in time and the patient reaps the benefit of the change. An intercurrent acute condition such as an attack of diarrhoea ortonsfllitis, occurring under natural therapy, is looked upon as a " healing crisis ", i.e. as an effort on the part of the body to rid itself of toxins. This. does not mean, however, that ever)" acute condition can be interpreted as a healing crisis, the future will tell whether the patient is better for having had such an attack. In homoeopathy we also allow the interpretation of an aggravation of the patient's condition as a good sign of reaction to the treatment. We distinguish between the aggravation which follows immediately after the application of the drug stimulus (which corresponds to the discomfort felt at the beginning of a new rdgime) and those reactions which occur in the form o f acute conditions (corresponding to the " healing crises " in the treatment o f chronic cases. Hcring formulated a law of the time, order and place of manifestation : " from above downwards, from within to without, in the reverse order of their starting ", and Kent drew attention to the same facts and maintained that a chronic disease spreads from without to within, from theless important organ to the more important ones, and that it must be driven back to the surface, if the patient is to regain health. That means we have to. expect acute skin conditions during the curative treatment of chronic diseases._ In homoeopathic literature we find frequent references made to the harmful effect of a suppression of acute conditions (like catarrhal discharges and skin eruptions). These are therefore considered as fulfilling a useful purpose.

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I n those conditions in which p a t h o g e n i c micro-organisms can be demons t r a t e d , Dr. J o h n Paterson holds the view t h a t a large o u t p u t of these is t h e sign of a good reaction on t h e p a r t of the body, whereas a small one indicates low v i t a l i t y . Dr. Pierre S c h m i d t , of Geneva, expresses a similar view in his article " Cure a n d R e c o v e r y ", in t h e following words : " I t m a y be found t h a t these v a r i o u s crises (meaning a c u t e conditions) in t h e life of an i n d i v i d u a l are n o t a succession o f f o r t u i t o u s ~etiological circumstances such as t h e u n e x p e c t e d i n t r u s i o n o f bacteria, b u t t h a t each m o r b i d m a n i f e s t a t i o n supervenes a t t h e precise m o m e n t a t which a rigorous d e t e r m i n i s m in the vital evolution calls for an a c u t e crisis in o r d e r to c o u n t e r b a l a n c e in a m e t a s t a s i s (meaning m o r b i d s u b s t i t u t i o n ) a n u n b a l a n c e d s t a t e of chronic t e n d e n c y , s o m e t i m e s impossible t o diagnose." The two systems, as we have seen, work on t h e same conceptions, therefore can be combined. B u t if I suggest t h a t t h e y s h o u l d be combined, one fundam e n t a l criticism has to be answered : it is unscientific to give more t h a n one stimulus a t t h e s a m e time, it spoils the case f r o m t h e scientific p o i n t of view, it m a k e s i t impossible t o assess t h e value of each p a r t i c u l a r stimulus. I a d m i t t h a t , b u t I still w a n t to j u s t i f y such a procedure. I f a new m e t h o d of t r e a t m e n t is discovered a n d has to be tried out, it is o n l y r i g h t t h a t no o t h e r interference is allowed a t the same t i m e in order to assess t h e value of t h e new t r e a t m e n t . B u t this stage of investigation is passed. The n a t u r a l stimuli h a v e p r o v e d t h e i r value since t h e beginning of medicine. T h e y were discussed in g r e a t detail in the works of H i p p o c r a t e s , a n d t h e homceopathic m e t h o d has p r o v e d its efficacy for m o r e t h a n 100 years. I t is therefore unn e c e s s a r y to p r o v e the value of these m c t h o d s in principle now. B u t w h y combine t h e stimuli ? I f y o u arc sure of y o u r homceopathic r e m e d y , w h y a d d t h e o t h e r stimuli a n d forego t h e g r e a t scientific satisfaction o f p r o v i n g t h a t t h e r i g h t r e m e d y , given in p o t e n c y , has a g a i n " d o n e t h e t r i c k " .~ The ideal of t h e scientific clear-cut e x p e r i m e n t is d e r i v e d f r o m t h e r e a l m o f physics. H e r e is a machine, e.g. t h e mechanic can u n d e r s t a n d t h e m e c h a n i s m o f functioning fully. If a m o t o r car does n o t run, t h e m o t o r car m e c h a n i c e x a m i n e s one p a r t of the car a f t e r a n o t h e r m e t h o d i c a l l y until he has f o u n d t h e t r o u b l e which he t h e n t r e a t s in a specific way. Life, however, consists of the co-operation of i n n u m e r a b l e p a r t s working together, b u t t h e workings of these we do n o t u n d e r s t a n d . Therefore we h a v e t o t r e a t n a t u r e in a different w a y f r o m t h e mechanic or the physicist in his l a b o r a t o r y . I t is true t h a t t h e a p p l i c a t i o n of t h e homceopathic stimulus is o f t e n followed b y i m p r o v e m e n t , a n d t h a t the p a t i e n t a p p e a r s to be cured, b u t who is b o l d enough to d e n y t h a t m a n y p a t i e n t s do n o t i m p r o v e , or n o t sufficiently, or t h a t t h e good progress m a y be only t e m p o r a r y a n d sooner or l a t e r followed b y a relapse ? This relapse m a y r e s p o n d to f u r t h e r homceopathic t r e a t m e n t , b u t will a p e r m a n e n t good result be a c h i e v e d this t i m e ? W e shall c e r t a i n l y n o t be satisfied, if only one organ seems b e t t e r , as homceopathic p h y s i c i a n s we m u s t p a y a t t e n t i o n to all t h e organs a n d functions. Therefore we m u s t give all t h e help t h a t is possible, h e a l t h becomes a n ideal, to be a i m e d at. T h e c o m b i n a t i o n of n a t u r a l a n d homceopathic stimuli effects b e t t e r results t h a n one m e t h o d only, t h e n a t u r a l stimuli p r o v i d e a g e n e r a l basis of t r e a t m e n t , t h e homceopathic ones t h e m o r e i n d i v i d u a l a p p r o a c h . I s this " general basis of t r e a t m e n t " m o r e t h a n j u s t c o m m o n sense, can i t be d e s c r i b e d scientifically, i.e. can t h e details o f t h e m e t h o d be o r d e r e d in a ~systematic w a y ? I will t r y to do so, give i n d i c a t i o n s for t h e use of t h e s e stimuli, will a t t e m p t to give a n a c c o u n t o f t h e i r effect on t h e o r g a n i s m a n d finally see w h e t h e r t h e y .can be r e l a t e d to t h e s y s t e m of h o m c e o p a t h y . B u t within t h e f r a m e w o r k of t h i s p a p e r I shall only deal with t w o t y p e s of n a t u r a l stimuli, t h o s e which I h a v e f o u n d m o s t f u n d a m e n t a l : a p p l i c a t i o n s t o t h e skin, a n d diet.

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THERAPEUTICS

PART I I SKI N

1. Functions Before discussing the various forms of skin stimulation, I propose to deal briefly with the part this organ plays within the organism. The skin does not only protect the body against the outer world, it takes part in the internal processes, the metabolism, through the excretory functions of the sweat and sebaceous glands. In addition to these functions, the German physicians, Much, Hoffmann and Memmesheimer have shown that the skin produces immuno-bodies and thus plays a very important part in infectious diseases. Any improvement of the skin will help the whole patient. When judging the skin's ability of response Kneipp has drawn attention to its texture. I f it is flabby and leaking with perspiration, we cannot expect a good reaction from it, whereas a firm skin with some pigmentation gives a better chance in the treatment. In hom~opathy we pay attention to the importance of the skin for the whole organism. We stress an alternation between skin eruptions and affections of internal organs in our drug pictures. For instance an alternation between asthma and skin eruptions is found in the following drugs according to K e n t :

Caladium, Croton tiglium, Hepar sulph, Kalmia, Ixtchesis, Mezereum, Rhus toxicodendron, Sulphur. A relation between skin eruptions and internal affections in general is particularly marked in Graphites, between skin and bowel in Calc. phos. (diarrhoea) and Rhus toxicodendron (skin and dysentery). T h a t suppression of skin eruptions is harmful, is a leading thought in homceopathy, Sulphur is often prescribed in these cases to bring the skin eruption out again. A large group of drugs is mentioned by K e n t under " suppressed perspiration ", another one under " suppressed perspiration of feet ".

2. Natural Skin Stimuli Having discussed the important functions of the skin, we can now deal with the various forms of natural stimulation of this organ. These stimuli are used in an unspecific way, they are applied in all kinds of dermatological conditions, but also in every other case where a response from the skin can be expected.

3.

Water

I shall start with water treatment. I t is used mainly in the form of baths, ablutions, and compresses. A compress consists of linen, rung out in cold, lukewarm or warm water, on which dry woollen material is put. The compress has to be wrapped around the patient tightly. I t is mostly applied to the trunk, but also to other parts of the body. H o t water produces passive hyper~emia, the cold water stimulus is given with the intention of producing active hyper~emia, the patient warms up in the compress. The response to the cold water stimulus is valued higher than to the warm water one, which is eventually weakening. In order to increase the response from cold water, one can use hot water first and follow it up with cold water. Apart from the temperature, the size of the area to which the treatment is applied, can be varied and thus the stimuli be graded. Examples of the distant effects of water treatment are cases of otitis media, treated with compresses, applied to the feet, in order to draw blood away from the head, combined with a body compress to help elimination, or cases of angina pectoris, treated with hot arm baths (the temperature should rise gradually !). Here the peripheral hypcr~emia relieves the spasm in the coronary arteries by reflex action. 4

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Relationship to Homceopathy. We saw that everything depends on the right choice of natural stimulus, right for the particular patient's constitution. Here homceopathy with its consideration for the patient's constitution can help. After having taken the case from the homeopathic point of view it will often be possible to say whether the particular patient will stand up to cold water applications or not, as the reaction to heat and cold is one of our principal methods of grouping. A Lachesis patient will do well with cold water treatment, a Phosphorus patient will not stand it. Thus homceopathy can help in finding the right natural stimulus, but natural therapy on its part may do the same for the discovery of the right homceopathic stimulus : body compresses, e.g. are used frequently to promote elimination through the skin, the patient perspires in them and the perspiration may bc oflbnsive. In such a case we should choose one of the remedies mentioned in Kent's Repertory under the heading " offensive perspiration ". The followers of homceopathy and those of natural therapy have to be traincd in the observation of such symptoms as odour of perspiration ; these are neglected by the allopathic physician, as they do not fit into his system of diagnosing illness. We feel justified in speaking of the elimination of toxins through the skin in such cases and claim that our treatment is therefore beneficial for the patient's general health. Our allopathic colleagucs may consider the term " toxin " vague and unscientific. We are not in a position to provide the chemical formula of the toxin. But even allopathic medicine uses this vague terra " toxic " in the description of feverish, eclamptic and dehydrated patients or in " toxic goitre " ! 4.

Air and Sun

We have already agreed that we are not justified in withholding any form of treatment for the sake of scientific experimental exactness. We shall therefore combine water treatment with other stimuli to the skin in the treatment of the same patient. These other stimuli are mainly those of air and sun. Here we are dependent on the climate and the surroundings. Ideal conditions are found in Switzerland. I do not think anybody could fail to be impressed by Dr. Rollier's work in I~ysin, sun and air are his main stimuli. Although he treats mostly cases of so-called surgical tuberculosis, his treatment is not specific for this disease, many obstinate skin conditions (like psoriasis) and all kind of other diseases heal under this treatment. The curative effect of these stimuli in cases of T.B. of the lungs is of course generally accepted, and it is only necessary to remind ourselves that we are not dealing with a specific treatment for phthisis. Dr. l%ollier exposes the skin gradually to the sun, thus making the stimulus gradually stronger. In this climate here we can do a great deal on the same lines, although we may have to use artificial light in place of natural sunlight. When judging the dosage of sunlight in an individual case the ability of pigmentation of the skin is the important factor. Relationship to Homoeopathy. The knowledge of different types of people, gained from the study of the homceopathic materia mcdica, will again help us in choosing the natural stimuli wisely. We know that a Pus patient, for instance, can stand cold air and needs it, whereas a Silica or Rhu8 toxicodendron patient is very sensitive to it. 1.~chesis and Glonoine cannot stand direct sun, although, I think, that applies mostly to exposure of the head, which should be shaded in any case.

5. Massage The last group of skin stimuli I want to mention is massage. I t can be carried out by rubbing the skin with a towel or brushing it in a dry state, often it is combined with hydrotherapy, the brushing being done in a bath. Finally massage is given with the hands. All variations of stimulation from

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light stroking to firm pressure (called friction massage) are at our disposal. Obviously the firm massage affects the underlying structure too, as does also water treatment to the skin. Firm massage is especially beneficial in fibrositis. Manual massage has a psychological as well as physical effcct. The touch of the hands conveys the influence of the practitioner's whole personality. Relatioruship to Homeopathy. The homccopathic drug pictures stress psychological as well as physical sensitivity. Kent's Repertory gives a large group of remedies under the heading " worse for rubbing ", a still larger one under " better for rubbing ". In a sensitive Phosphorus patient, for instance, massage will be of grcat help, whereas an irritable Cuprum patient cannot bear any touch or pressure. In conclusion of the discussion of natural skin stimulation let me quote Dr. Hube, Medical Director of the Priessnitz Hospital in Mahlow (Germany), who in his Manual of Natural Therapy for the General Practitioner, points out that " it is not ' the littlc bit of water ', the compress, the bath, the ablution which cure, but the natural recuperative powers, immanent in the body. These are released by the vital therapeutic stimuli." He goes on to warn the reader against the view that " a lot helps a lot " and asks him to use mild stimulation as a general principle. Such advice shows the same conception which we have as homeopathic physicians who prefer small doses which we call " potencies " DIET The next part of the paper deals with the dietetic treatment. This is combined with the various forms of skin treatment and the other methods used in natural therapy as enemas and exercises. Let us investigate the question whether we can apply the general principles, as laid down at the beginning, to the treatment by dict.

1. Specificity In orthodox medicine specific diets are prescribed for certain organic conditions as diabetes, nephritis, obesity. As we do not consider that this classification according to organs or parts of the body does the fullest possible justice to diseased people, we shall adapt diet as a form of treatment to the particular type of patient, i.e. to the whole patient and not to an organ lesion of a single part of his body. But we must not neglect the condition of the different organs, i f a patient loses albumen, for instance, through a deficiency of his kidneys or sugar through one of the Langerhans isles in the pancreas, such a condition is certainly important and has to be considered ill the dict. But the diagnosis of diabetes mellitus does not tell us whether we are dealing with a stout person who can obviously do with fewer calorics in his diet, or a thin one whose ultimate requirements may have to be judged higher.

2. Quantitative Aspect This brings us to the question of quantity. Here the position differs from the one met with under skin treatment. Is food a stimulus at all, does it not simply represent the fuel which the body necds, i.e. is the problem of food not simply a problem of quantity of protein, carbohydrate, fat, vitamins, mineral salts and water '.~ The orthodox school holds this view, it is clearly stated, for instance, in thc leading article in thc British Medical Journal of January 22nd, 1938, called " Dietetic Therapeutics ". Obviously the quantitative aspect is not to be neglccted and we must keep in mind the need for the various constituents. But we consider the official figure for protein requirement as far too high. This figure was given as 120 grammes per day by Volt and Rubner, as 100

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grammes by a committee of the Royal Society. Dr. Cole, in his article, " Diet in General Practice," published in the British Medical Journal on J a n u a r y 22nd, 1938, admits too, " that many people can maintain health on a much smaller allowance of protein than this ". For our purpose it is of special importance that Ragnar Berg has found the requirements for protein to be lower when there is a prevalence of alkaline elements in the diet--this being a characteristic feature of the vegetarian diet. But apart from the divergence of opinion as to the right quantity of food, the question arises whether it is at all possible to standardize the quantitative needs for food which we know is the aim of the scientist. I n order to decide this question, let us investigate the temporal aspect of life.

3.

Temporal Aspect

A machine is kept in motion by a certain quantity of fuel which can be standardized, but living cells show a rhythm of their own, different from the r h y t h m of a machine. I n the case of nutrition of the organism, we can distinguish between the digestive work to be done by the cells lining the alimentary tract and composing the glands attached to the tract, and the assimilative work, done by all the cells in the body. I n these vital processes food can be conceived as acting as a stimulus to the cells as well as the material to be burnt up or to be built up. These processes are named " metabolism " I n disease we want to modify the metabolism and we can do so by modifying the patient's diet. You see that we consider the phase in which the patient happens to be under dietetic treatment, we do not prescribe a routine diet, to be taken at certain times of the day, we avoid temporal standardization. We shall be prepared to find, not only different people vary in their requirements and ability of assimilation, but also the same person at different times, i.e., his organs can learn to make use of raw vegetables for instance, which proves that quantitative standardization is impossible. For what guidance could statistics give us, computed from a large number of cases which we would all judge differently ? Generally speaking, two phases follow each other under natural treatment, first elimination, helped by restriction of food, which enables the organism to overcome its disease without wasting efforts on digesting food and its detoxication, then building-up of healthy tissue.

4.

Different forms of die,tic treatment

As mentioned under skin treatment, the stimulus has to be adjusted to the ability of response and the seriousness of the case. The strictest form is a complete fast, the next step would be to give water only, the next addition would be fruit juices, then vegetable juices, then raw fruit and raw vegetables, then nuts, honey. A more permanent diet would include cooked vegetables, later additions still would be milk products, eggs, wholemeal bread and finally, if thought necessary, the other food articles.

5. Effects of the different forms of diet on the Organism During a fast the tissues of the body undergo catabolic changes, at the same time toxic substances which had been stored in the body are eliminated, mostly from the intercellular spaces. They appear especially in the urine, but are also eliminated by the various mucous membranes, a bad taste in the mouth and an offensive breath arc such signs of elimination, characteristic of a fast. The digestive organs are saved work and so are those glands, like liver and kidneys, which deal with detoxication of food. The raw fruit and vegetables diet supplies alkaline elements (mostly K) in the form of mineral salts and vitamins, especially vitamin C, some fruits supply sugar also. Bircher-Benner claimed that raw fruit and vegetables have a special healing effect because they contain the stored-up energy of the sun which

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charges the living cells with energy. The eliminative effect of raw vegetarian diet is less pronounced than of the fast, some people can build up tissue on it, although its protein content is low. So is its sodium chloride content. The vitamin content of cooked vegetables, especially in vitamin C, is smaller. than of raw vegetables. Many patients find cooked vegetables easier to digest, this diet represents generally a milder form of dietetic stimulation.

6.

Indications for the different forms of diet

As we do not aim at specific treatment of special diseases, the abovementioned plan, indicated in every case, has to be adjusted to the individual's ability to respond. I t may, however, interest you that certain conditions can be named especially where this form of treatment can be shown to be rational. A short discussion of these conditions will throw further light on the effect these forms of diet have on the organism : (a) An acute fever is an indication for a fast or the application of fruit juices and vegetable juices only. Prof. Eppinger deals with the effects of raw vegetable diet. He speaks of " transmineralization ", brought about by the substitution of Na by K. He points out that the relationship between the two elements is disturbed in m a n y inflammatory conditions, accompanied by fever, Von Noorden has described the effect of raw vegetable diet a s " anti-philogistic ". (b) In cases suffering from retention of fluid in the tissues the raw vegetarian diet can be called " anti-retentional " according to Dr. Barber (" Diet in Dermatology ", article in the Practitioners' Handbook, Diet in Health and Disease). This benefit arises from its diuretic effect, which is due to its lack in NaCl. I t is therefore especially indicated in cases of cardiac, renal and allergic (edema, but also in another large group of conditions, characterized by exudations from skin and mucous membranes (catarrh of various mucous membranes, weeping eczema, scurf, intcrtrigo), combined with a tendency to infections and general wasting. Czerny in Germany, described this form of disturbance of metabolism, found frequently in children, under the name " e x u d a t i v e diathcsis ". ]n all conditions where the tissues contain too much water, starch has to be reduced, as it holds water. (c) Lastly any lesion of the organs dealing with detoxication (like liver and kidney) would call for this rSgime, as it saves them work and helps them, if inflamed, through its transmineralizing effect. Relationship to Homeopathy. Hom(eopathy can confirm the important changes which NaC1 produces in the organism. Its drug picture contains the following features: disturbances of blood circulation (migraine, other vasomotor disturbances), fever, exudation on skin and mucous membranes. Hom(eopathy also stresses the importance of a whole natural product as against an artificially manufactured one. When giving Calc. carb., so invaluable in children, we do not follow the example of the allopathic school and use the pure synthetic product, but have the medicine prepared from the oyster shell. The same reverence for nature's laboratory is shown in natural therapy. Sugar, starch and vitamins are used as provided in the cells of the plants in place of manufactured products, although the scientist tells us that the chemical formulae and the caloric values are the same. Eliminative treatment, especially by diet, aids homceopathic treatment, as it makes the organism more sensitive to drugs. This fact is of great importance for the hom(eopath, as he relics on the patient's sensitivity to the right stimulus. Another reason why this type of diet should be combined with hom(eopathy lies in the effect of the vegetarian diet on the stoo/s. They lose their foul odour, the number of micro-organisms in the large bowel becomes greatly reduced, a tendency to acid reaction appears, lactic acid bacilli grow. The allopathic school pays little attention to the stool organisms unless an infection of the bowel with pathogenic organisms is suspected. But the hom(eopath,

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especially through the work done in this country, has found the bowel flora of great importance. Dr. John Paterson states in his article, " Sycosis and Sycotic Co ", t h a t " the non-lactose organisms found in the bowel are the result of a vital reaction on the part of the body tissues ", that " certain types of the non-lactose organisms are definitely related to s y m p t o m complexes ", and " that homccopathic remcdics possess power to alter the bowel flora ". Drs. Bach and Wheeler in their book Chronic Disec~es, pay great attention to diet and specify the right diet as consisting of raw fruit and vegetables to the largest possiblc degree, also of wholemcal bread, cereals, milk puddings ; m e a t and fish is not included to avoid the absorption of toxins. They do not credit this diet with the elimination of the established infection of the bowel with non-lactose fermenting organisms, but they consider it to be of greatest service as an addition to vaccines, their method of treatment. They also recommend exercise, massage, sunlight and electricity. These eminent homceopathic physicians interpret the processes occurring in the bowel as a manifestation of the state of the whole organism. Therefore any improvement here will help in the cure of the patient, and Drs. Bach and Wheeler recommend the same diet as used in natural therapeutics. Obviously, it is also of great prophylactic value. ~PsYCHOLOGICAL ASPECT IN NATURAL THERAPEUTICS

The importance of regulating the patient's habits, especially of food, has been recognized as of supreme importance since the beginning of medicine. The Hippocratic Oath contains the promise : " I will prescribe regimen for the good of m y patients according to m y ability ". The necessity of combining natural treatment with homceopathy is no new suggestion either, it is stated in The Organon of the Rational Art of Healing, by Dr. Hahnemann, and is therefore exactly as old as homceopathy itseff. Why then have these principles not been accepted and carried out ? We saw t h a t the principles of specificity and scientific standardization blind the allopath. But they should not prevent the homceopath from using this form of treatment. I think the main reason lies in the important psychological factors which are involved. The patient is told that his mode of living has largely contributed to his illness, t h a t it is not only the germ which has made him ill. He is therefore asked to change his habits. These are the expression of the person's personality like his handwriting. They constitute a manifestation of his character. The same diet sheet m a y suit a large number of people from the physical point of view, but only some will" take to it "psychologically. Therefore the task of the physician, who prescribes natural therapy, is not only to judge the body's ability of response to the stimulus, but also the mind's. " What is the patient ready for physically and psychologically ? " is the decisive question. Relationship to Hom(~opathy. The importance of the psychological factors is well-known to the homceopath. He often chooses his remedies accordingly. Mentals are classed highest in the choice of the simillimum and likes and dislikes for certain foods are considered very important. Dr. Buchinger, in his book Curative Fa~vting and its Auxiliary Methods, devotes a long chapter to homceopathy. He uses it mainly to help his patients to overcome the psychological difficulties of the fast and describes the use of Pulsatilla for the sensitive-depressed woman, Arsenicum alb. for the anxious patient, Nux vomica for the baxi-tempered one, Phosphorus for the hypersensitive, etc. He also uses homceopathy to help his patients over any physical difficulties, the " healing crises " ~AME FOR THE COMBINED SYSTEMS

I hope I have been successful in m y plea for the combination of homccop a t h y and natural therapy. I t is important to find a name for this combination,

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only t h e n will these diverse m e a n s of t r e a t m e n t r c p r e s e n t a u n i t y to our minds. Two t e r m s I will p u t to t h e discussion. " Biological Medicine " is t h e one chosen for these t r e a t m e n t s b y physicians on t h e Continent. This n a m e seems somehow p r e s u m p t u o u s to me, as e v e r y physician will claim t h a t his t r e a t m e n t is biological. The o t h e r n a m e is " Holistic Medicine ". I t was used b y Dr. J. C. Young in his p a p e r " I n d i v i d u a l P s y c h o l o g y a n d Holistic Medicine ". H e uses Gen. S m u t s ' expression " holism " to conceive a s y s t e m o f medicine in which " diseases m a y be defined as t h e dissolution of t h e whole into p a r t s or opposites ". This s y s t e m involves " t h e exercise of holistic vision ", of m a k i n g t h e p a t i e n t aware of his e n v i r o n m e n t , o f t h e cause of his suffering, of his responsibility in the t r e a t m e n t a n d p r e v e n t i o n of illness. Dr. Y o u n g p o i n t s out t h a t this holistic a t t i t u d e is n o t opposed to t h e a c c u m u l a t i o n o f specialized e m p i r i c a l knowledge, " on the contrary, it strives to give d e p t h a n d significance to t h a t knowledge " :FREEI)OM OF ACTION :In stressing awareness a n d responsibility, Dr. Y o u n g has a b a n d o n e d t h e a t t i t u d e of determinism, characteristic of n a t u r a l science, a n d has a d o p t e d t h a t o f f r e e d o m of action, e s t a b l i s h e d b y philosophy. I n our j u d g m e n t of people's m i n d s we m u s t n o t t a k e t h e view t h a t t h e y c a n n o t . h e l p their m e n t a l m a k e - u p , otherwise a pedagogic influence would be hopeless a n d impossible, b u t " d o c t o r " m e a n s " t e a c h e r ". Self-discipline is to be a t t a i n e d b y t h e p a t i e n t , cspccially in e a t i n g a n d a v o i d i n g of s t i m u l a n t s . This is m o r e difficult t h a n t h e swallowing of medicine, homceopathic or allopathic. P l a t o in t h e f o u r t h b o o k o f T h e Republic, refers to t h e p r o b l e m of certain sick persons. Socrates sums up their position a n d ours as doctors in t h e following words : " T h o u g h t h e y u n d e r g o r e m e d i a l t r e a t m e n t , t h e y do n o t h i n g b u t m a k e their a i l m e n t s g r e a t e r a n d more complex ; a n d t h e y are e v e r in hopes, when a n y o n e r e c o m m e n d s a n y medicine to t h e m t h a t b y these m e a n s t h e y shall soon g e t well . . . t h e y reckon tha~ m a n t h e m o s t hateful o f all who tells t h e m t h e t r u t h , n a m e l y t h a t till one a b a n d o n s drunkenness, g l u t t o n y , u n c h a s t e pleasures, a n d laziness, n e i t h e r drugs nor caustics, nor t h e use of t h e knife, nor c h a r m s nor amulets, nor a n y o t h e r such things as these will be of a n y a v a i l . " REFERENCES Bach, E. and Wheeler (1925), Chroniv Diseases. Barber, H. W. (1939), The Practitioner YIandbooks, Diet in Health and Disease. Bircher-Benner, M. (1933), Erndhrunyskrankheiten. Bircher-Benner, M. (1935), Didtetische Heilbehandlun~. Bircher-Benner, M. (1926), Grundz~ge der Erndhrunqstherapie. Brauchle.Grote (1938-39), Ergebnisse au~ der Gemeinschaftsarbeit von Naturheilkunde und Schulmedizin, 2 Bde. Buchinger, O. (1936), Das Heilfc~sten und seine Hilfsraethoden. Cole, L. (1938), Brit. Meal. Jour., 22rid January. Eppinger, H. (1938),- Wiener Klinisehe Wochensehrift, Ist Juli. Hahnemann, S. (1810), Organon of the Rational Art of Healing. Hay, W. H. (1934), Health via Food. Hippocrates, Genuine Works, translated by Francis Adams. Hoffmann (1927), Die nach innen gerichtete Schutz- und Heilwirkung der Haut (Esophylaxie) mit besonderer BerO~cksichtigung der Tuberkulose.

Itube, F. (1936), Ta~,chenbuch des Naturheilverfahrens. Kneipp, M y Water Cure. KStschau, K. (|934), Z u m Aufbau einer Biologischeu Medizin. MeCance, R. A., Widdowson, E. M., Shackleton, L. R. B. (1936), The Nutritive Value of Fruits, Vegetables and Nuts, Med. Research Council. Marmersheimer (1927), Hautreize und Huate~*ophylaxe. Paterson, J. (1933), British Homozopathic Journal, April. Paterson, J. (1937), British Homceopathic Journal, October. Pollak, J. (1927), Hautkrankheiten. Rabe, H. (1938), Herzerkran]cungen und KreislaufstSrunffen. Ragnar Berg (1932), Physiatrie Mai.

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Rollier (1922), Heliotherapy with special consideration of surgical tuberculosis. Schenk-Meyer (1938), Das Fasten. Schmidt, P. (1937), British Homoeopathic Journal, October. Young, J. C., Individual Psychology Pamphlets, n u m b e r l I.

DISCUSSION Dr. BENJhMIN said that one was at first struck by the title of Dr. Lcdermann's paper, " Homceopathy and Natural Therapeutics ", because one was rather in the habit of regarding homceopathy as essentially a natural therapy. What could be more natural than a remedy based on the law of similars .~ Dr. Ledermann qualified the term of natural therapy as being the application of the theories which he outlined in the paper. The most interesting part of the paper was the parallel he drew between the underlying principles of the similar, and the underlying principles of naturotherapy. He had not realized particularly with regard to naturotherapy, how very similar the principles were to those of homccopathy. With regard to the question of the skin one function which Dr. Ledermann did not mention was heat regulation. I f one had a patient with a fever which did not respond to the homceopathic remedy one knew that it was quite likely that the patient would be assisted by the application of one of the natural agents such as cold or warmth so as to obtain a surface erythema and eliminate some of the fever in the body. Another very important and interesting point was Dr. Ledermann's contention that each therapy could point to the stimulus to be used by the other. He pointed out, for instance, that a Phosphorus patient could not stand cold, whereas the Lachesis patient would. Dr. Benjamin found it difficult to realize how diet could be regarded as a stimulus ; perhaps Dr. Ledermann colfld enlarge on that point and also on the reason why a bad tongue and a bad breath were signs of elimination. One could recall people with these unpleasant characteristics who did not seem to eliminate anything very much. In acute fevers the use of fasting or fruit juice only was mentioned and he wondered whether it was necessary or advisable when treating the patient homccopathically. I t was hard to imagine anything more striking than the response of a patient suffering from fever to a well-chosen remedy. The method usually adopted was to leave it to the patient to take what he could and here the psychological aspect of one's patient counted very considerably. In this connection he was glad that Dr. Ledermann stressed the importance of " natural " therapy because although at times one thought it was better ibr a patient to have a vegetarian diet yet, if the patient had a passion for meat, one allowed him to have it because one felt that it would be better for him psychologically than putting him on a strict vegetarian diet. This was an interesting problem and one which had given him reason to think a great deal. Dr. Lederrnann talked of withholding starch where a patient's tissues held a superfluity of water. Starch in the raw took up water but when it was assimilated it was not assimilated as starch and did not appear as starch in the tissues. Dr. Ledeimann had given him a broader outlook on natural therapeutic methods than he had had before, but he did think that some of the methods were exceedingly unnatural, washing out the bowel seemed to be an unnatural proceeding. This type of paper was valuable, but perhaps Dr. Ledermann could add to its value by giving some notes on cases where he had put his principles into practice; he had studied these things carefully--it was a characteristic of the German mind to go into the physiological and psychological questions in practice and perhaps other nations missed a great deal by not doing so.

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Dr. C. E. WHEELER said that the paper lent itself to discussion. Dr. Ledermann had embarked on the difficult task of trying to persuade the inhabitants of these islands to think a little more philosophically. I t had been the British habit in medicine and in other things to concentrate on the practical course. " Does the thing work ? " and if it did not to bother as to why it worked. I t had made us the champion improvisers in emergencies of the world, but there was room for a little more consideration of general principles and gratitude was due to Dr. Ledermann for indicating the track. There were many points upon which one could comment. Our remote ancestors were vegetarians and the alimentary canal was developed on a diet mainly vegetarian which would give a certain bias in favour of such a diet if a change was necessary for a patient. Although diet was an individual problem . any change would probably be in that direction than away from it. Bach showed over and over again that it made all the difference, indeed the large intestine became acid, as it should under a strict vegetarian diet, and he was able to distil fmces in the ordinary laboratory without tile slightest difficulty and they were entirely odourless. He could distil the acid from the fzeces without the smallest difficulty. An endeavour was made to get a concentration sufficient to identify the acid, it belonged to the ordinary series of acetic acid, but so much turned upon the boiling point that one could not get it concentrated enough to get an estimation. What acid it was the workers were unable to determine except that it belonged to that series. One would think in a general way that patients were inclined to eat more protein and meat than they needed ; most adults ate too much. While growth was proceeding there was a great deal of construction to be done and a good supply was necessary, but one was inclined to overestimate the amount needed for day to day repairs. There was a doctor in Leeds who corresponded with him at one time who had a theory--which had been developed by Macdonagh-which turned everything into terms of energy and he said that the amount needed for tissue repair was very much smaller than was ordinarily given. The problem had been complicated by the fact that, as Sir John Orr had shown, the larger proportion of the inhabitants of this island were undernourished. They went through the growing period without enough to eat and consequently did not start right, but for those who had bad adequate nourishment during those early years there was a good deal more in these fasts than was realized. He believed that the Friday fast when practised strictly by the Roman Catholic community was a most admirable institution, although he never put a patient through 24 hours without allowing them to drink at least water. As far as food was concerned he remembered what a response one got if diabetic patients would fast one day a week. I f they had any power of response in the pancreatic cells an entire rest for the 24 hours seemed to give them a chance to pick up. An occasional day's fast would be very good for everybody ; whenever he was slightly unwell the first thing he did was to cut down the amount of food he took. Mr. Dudley Wright could give a series of experiences which were very unique with regard to the effect on general health of even prolonged fasts. Dr. Benjamin said that he did not see that diet could have such a profound influence, but another correspondent was a physician who never gave a drug at all. He had made a profound study of the effects of various articles of diet on patients' general health and his prescription would be so much more of this, that or the other, so much more carrots, potatoes and even nettles. Presumably he had a good deal of success because he reported cases which compared favourably with others which were published. Apart from vitamins there were proportions of mineral salts, varying enormously in different kinds of vegetables, which were essential to the wellbeing of the body. How often could one trace this or that effect to this or that ingredient and he could see why, when taken in the form of food, they would

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have an effect particularly when given in evenly divided doses. They were not present in large quantities (not strictly speaking potentized), but the relation with homccopathy was quite real. He agreed with Dr. Benjamin that ])r. Ledermann's distinction between the two therapies was a distinction without an essential difference. The whole essence was that they were based on the way in which life worked. Homceopathy cndcavoured to work along the lines on which the natural living tissue was endcavouring itself to work and that food couht do the same thing was shown by the fact that people had cravings for different foods. He was not sure that h~ would accept t h a t t h e o r y completely and allow a patient to have whatever he asked for, but with children their likes and dislikes had a real meaning and should be observed carefully. With regard to the skin being a possible source of antibodies, Hans Moclke, the German pathologist, held that view. He thought the skin was a great manufacturer of antibodies in general. The speaker felt, however, that the whole conception of toxin and antibody was ripe for reconstruction and he was not at all sure that the same theories would be held in 25 years' time as were current in these days. Moelkc regarded the skin as a source of resistance, and that might be the explanation of the fact that in using nosodes such as the bowel nosodes there was a percentage of cases which would respond better to the small dose injected into the skin than to the potentized nosode given to the body generally. ])r. FERGIE WOODS also thought that Dr. Ledermann tended to draw a distinction which was not quite good between h o m e o p a t h y and natural therapy. Natural therapy did include homccopathic medication and Dr. Ledermann tended to restrict it too much in his definition of homceopathy because he said it was a system of drugs. Homceopathy extended beyond the realm of drugs. To take one or two well-known instances : to cure frostbite one rubbed the part with snow, a popular method of curing a scald was to hold it in front of a fire until one could not bear the heat any longer, the instinct to press the part which had been hit was surely homceopathy. Homceopathy was a very widespread law and not confined to drugs. With regard to diet he did not see why it, or any other form of natural therapy, should not be used at the same time as homceopathy. There could not be any clash because they acted on different planes. They were body stimuli and had one thing in common--the saying that one must be worse before one was better. Unless there was an aggravation in chronic cases one was doubtful whether one had the proper remedy and those who tried natural therapy, fasting, high enemas and so on, would say that they always expected a reaction. Dr. Benjamin misunderstood a little what Dr. l, edermann meant when he said he did not think a bad tongue and foul breath were evidence of elimination. Dr. Ledermann said these things occurred under natural t r e a t m e n t ; it was well known that in a fast the tongue became very think and foul at first and then generally it cleared and the ideal was to go on fasting until that clearing was complete because that showed that food could be taken again with safety. Dr. Wheeler and Dr. Benjamin had said all he wanted to say. He had only to add his thanks and hoped that more would be heard from Dr. Ledermann in the near future. Dr. GREEN agreed with Dr. Templeton that natural therapeutics and homceopathy were two different things but one could say that they would work very well side by side and the lecture might induce some homceopaths to think a little more about natural therapeutics in treating their patients. In his own practice he had found in measles in children there was no need to give drugs if the patients had nothing but water for 48 hours. They got up much better than when they went to bed.

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H e would like to cross swords with Dr. W h e e l e r when he said t h a t our a n c e s t o r s were v e g e t a r i a n s . Relics of pre-historic m a n included a r r o w h e a d s a n d axe heads which were n o t used for ploughing l a n d a n d there was no d o u b t t h a t pre-historic m a n was a m e a t eater. W h e r e a p a t i e n t ' s ancestors were all m e a t eaters it would be r a t h e r a difficult a n d bold step to s u d d e n l y switch over to v e g e t a r i a n i s m . As one got older t h e less s t a r c h one could e a t ; the y o u n g e r t h e person t h e m o r e t h e y could eat. Dr. G. R. MITCH~]LL said t h a t Dr. L e d e r m a n n m e n t i o n e d when t r y i n g to r e l a t e n a t u r a l t h e r a p y to h o m c c o p a t h y t h a t one p a t i e n t liked h e a t a n d a n o t h e r liked the cold, a n o t h e r liked r u b b i n g a n d a n o t h e r was t h e worse for it. Did he m e a n t h a t a p a t i e n t who did n o t like h e a t should be g i v e n hot compresses or d i d he m e a n t h a t t h e one who liked cold got it, a n d so on ? I f so, it m e a n t t h a t t h e relief was local, if not, it was m o r e like t h e homceopathic principle. T h e PRESmENT agreed with Dr. T e m p l e t o n when he said t h a t he could n o t see a n y c o m p a r i s o n between t h e principles of t h e two systems, if n a t u r a l t h e r a p y could be called a s y s t e m because, so far, t h e r e were no rules. As a n a d j u n c t , yes, it was a g r e a t help ; for instance, h e a t a p p l i e d locally d i d help some conditions. On t h e question of food he believed in giving p a t i e n t s w h a t t h e y liked. H e d i e t e d for t h r e e y e a r s a n d was n e v e r well until he w e n t to a wise o l d Scot who said he was s t a r v i n g h i m s e l f a n d told h i m to e a t m e a t a n d he d i d a n d e n j o y e d it. On t h e question of h o t or cold food, he would n e v e r forget being called in to see a d y i n g child. H e asked w h a t food the child was being given a n d was t o l d so a n d so. On asking w h a t the child preferred the answer was " I c e cream ". He asked t h e little girl if she would like some ice c r e a m a n d she said yes, so she h a d it a n d he gave her Phosphorus a n d her life was saved.

Dr. T e m p l e t o n t e a s e d him when he said in discussions t h a t he h a d seen a p a t i e n t t h a t d a y , a n d it h a d h a p p e n e d t h a t he saw a child t h a t m o r n i n g whose m o t h e r said she w o u l d n o t t a k e milk. W h e n he asked her m o t h e r w h y she w a n t e d t h e child to t a k e t h e m i l k she said, " Because it is good for her ", b u t he t o l d her n o t to force t h e child t o t a k e it. These n a t u r a l likes a n d dislikes were v e r y helpful. A n o t h e r m a n said t h a t his child was keen on s a l t a n d fat, a n d he asked, " Is y o u r child so a n d so ! " a n d t h e m a n replied t h a t it j u s t d e s c r i b e d t h e child. H e prescribed Nitric acid a n d t h e child recovered. I t was a psychological fact t h a t people d e r i v e d good from w h a t t h e y liked. As a n a d j u n c t n a t u r a l t h e r a p y was v a l u a b l e , he h a d t r i e d it, he w e n t to Tring a n d benefited, so m u c h so t h a t he s t a r v e d himself for 12 d a y s , t h r e e times a year. T h e question of t h e psychological effect was v e r y i m p o r t a n t ; he r e m e m b e r e d a n old l a d y in t h e l a s t war who h a d t e a with his mother, who t a l k e d a b o u t t h e " lovely b u t t e r " which was m a r g a r i n e . Dr. L e d e r m a n n was a n e n t h u s i a s t , he h a d e n j o y e d his p a p e r , b u t he could n o t see a n y connection b e t w e e n t h e t w o s y s t e m s a n d it was a p i t y he h a d t r i e d t o connect t h e m . One was a s y s t e m of medicine a n d the o t h e r was not. Dr. L e d e r m a n n had said w h a t he t h o u g h t a n d his colleagues r e s p e c t e d him for t h a t a n d for having t h e courage of h;s convictions. R e p l y i n g to t h e discussion, Dr. ],EDERMA~.~ t h a n k e d t h e m e e t i n g for t h e i r r e c e p t i o n of his p a p e r a n d said t h a t in his lecture to t h e F a c u l t y a y e a r ago he h a d t r i e d to p r e p a r e t h e g r o u n d b y enunciating t h e principles he h a d e v o l v e d which included the practice of medicine, of H o m c e o p a t h y , of a l l o p a t h y , n a t u r a l t h e r a p y , principles which were t h e expression of how one looked u p o n life a n d disease (which was p a r t of life), a n d he would a s k those who h a d c o n t r i b u t e d to t h e discussion to r e a d his earlier p a p e r before a t t a c k i n g him on t h e question of principle. T h e principle was t h a t of holism, of how one looked u p o n t h e b o d y w h e t h e r a s a whole or in p a r t . I f one looked on it as a whole, t h e n w h a t he h a d said followed, t h a t H o m c e o p a t h y a n d n a t u r a l t h e r a p y were b a s e d on t h e same i n t e r p r e t a t i o n of h e a l t h or disease. H e d i d n o t k n o w w h e t h e r he h a d m a d e

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t h a t clear--the principle of holism as against mechanization, as against specificity. Was it natural to fast ? I t worked in practice. There was an immense literature on it. He would ask his critics to read the literature, a selection of which would appear in the printed paper. Many of the questions, " Do you put them on a fast, do you give them hot or cold," were details, there was not one rule a~d much study and experience were needed and the homceopathic remedy would be a guide. He did not. mean that the law of similars was used because the patient had an inflammation and wanted something cold that one gave something hot, he was not speaking about relating the law of Hahnemann to the law of natural therapy. One must not avoid the cold compress at all costs if the patient's remedy was P h o s p h o r u s but be more gentle in its application. He had a case of pneumonia in a woman a few days ago about whom he was very worried. The nurse gave her an enema and the result was a foul stool, that put him on to M e r c u r i e s and the patient did very well. The two methods helped each other. Dr. Templeton said that artificial sunlight was not natural, Dr. Ledermann replied, as he was not able to produce the climatic conditions existent in Switzerland, he had used artificial sunlight oll a boy with tuberculosis aud the patient had got well. That was the point, the boy got well on combined treatments. First they were physicians and then homoeopaths, allepaths or natural therapists. Those who said they would not use certain things were dogmatists. I n any case ultra-violet light is a natural stimulus and therefore its use i s ~ b y definition--part of natural therapy. The opposite to " natural " stimuli were "foreign " stimuli (foreign to the body), not " unnatural " stimuli ! I t had been proved that toxins appeared in the stools, and in the urine during fasting and eliminative diet. A lot of laboratory work had been carried out to find out what happened to a patient when hc was under natural therapy. This, again, was detailed work which did not come within the scope of the paper. These findings proved the existence of elimination which had been questioned by speakers in the discussion. He would stress that he did think of local applications, e.g. for a joint which was swollen one gave something warm or cool just as the patient wanted it but the main treatment was that aimed at the whole patient and it had been the subject of this paper. He was surprised that homceopathic doctors suggested that it was local treatment only, did not Hahnemann suggest t h a t what was done to one part affected the whole .~ There was nothing strictly local, the effect of what one did to the skin was not confined to the skin. Such a view would be against the conception of disease which the natural therapist had and which a homoeopath had. There were many other points ; the question of whether one used this, that or the other stimulus, depended on what the patient could tolerate and to which he could respond. He tlad tried to show how one method of diet constituted a greater stimulus than another, but they could all be graded with experience. Someone suggested that irritants should be avoided, but it was irritating to be ill and one wanted to get well and therefore would go through with the treatment and the physician had to have the courage to help his patient to stand it and be better for it. I t had also been said that massage must not hurt, some patients had to be hurt, e.g. cases of fibrositis, if they are to get well. I t was mentioned that starch only drew water when it was outside the body but in the Practitioner's ttandbook, Diet i n Health a n d Disease, there was literature on the action of starch, it made people catarrhal. A rational explanation for all these things was to be found in the literature. They also worked in practice and that was what mattered. The study of the capillaries and iris was a detailed point. He did not use the iris chart, to his mind it was foolish, it was the typical idea of dividing

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t h e b o d y into parts. I t was t h e s t r u c t u r e of t h e whole iris, t h e s t r u c t u r e of -the whole skin which gave an i n d i c a t i o n of t h e condition of t h e p a t i e n t to the t r a i n e d physician. H e h o p e d hc h a d answered all t h e questions. I t was e n t i r e l y a question of principle a n d of one's a t t i t u d e t o w a r d s life a n d t o w a r d s disease. H e w o u l d conclude with a q u o t a t i o n from K e n n e t h W a l k e r ' s book Meaning and Purpose wherein he said t h a t science should n o t be o v e r - e s t i m a t e d a n d he spoke of t h e medical m a n " whose vision h a d become so n a r r o w e d t h a t t h e y can see only a single m e a n s of curing ailments, a certain form of diet, a p a r t i c u l a r medicine, some electrical m e t h o d o f t r e a t m e n t , or a n ingenious operation. H e a l t h entails a balancing of all our functions as well as a d j u s t m e n t b e t w e e n ourselves a n d the outside world. I f this balance a n d a d j u s t m e n t is u p s e t it can r a r e l y be r e s t o r e d b y t h e use of a n y single r e m e d y ". DR. TE.MPLETON t h o u g h t i t was a g r e a t p i t y t h a t Dr. L e d e r m a n n h a d a t t e m p t e d to argue t h a t H o m c e o p a t h y a n d N a t u r a l T h e r a p e u t i c s were in a n y w a y r e l a t e d in principle (except in a v e r y wide sense such as t h a t each t r e a t e d t h e whole patient). H e could find no evidence in I)r. L e d e r m a n n ' s p a p e r to j u s t i f y this thesis a t all. H e (Dr. T.) was quite p r e p a r e d to consider t h e value of N a t u r a l T h e r a p e u t i c s on its own merits, or even in conjunction with, e.g. Homeeotherapeutics. H e t h o u g h t t h a t Dr. L e d e r m a n n was n o t q u i t e true to his own principles when he allowed Artificial Sunlight to e n t e r into his m e t h o d s when a t t h e s a m e t i m e he a r g u e d t h a t t h e use of artificial v i t a m i n s was to be d e p r e c a t e d . H e could n o t agree with t h e view t h a t food per se was a stimulus in t h e t r u e sense o f the word used b y t h e Homceopaths, nor in a medicinal sense. F o o d d i d set into m o t i o n metabolic processes a n d in t h a t sense alone could be claimed to a c t as a stimulus b u t t h a t was r a t h e r different from our use of t h e word. On t h e evidence p r o d u c e d he could n o t agree t h a t , e.g. t h e ingestion o f r a w vegetables p r o d u c e d elimination of t o x i n s a n d he would be i n t e r e s t e d to h e a r o n w h a t grounds such e l i m i n a t o r y p r o d u c t s were considered t o be toxic (specifically toxic) in the conditions of disease in which t h e y were a d m i n i s t e r e d . Dr. Wheeler had a d m i t t e d t h a t in his series of e x p e r i m e n t s he h a d failed to isolate t h e acid p r o d u c t so o b t a i n e d from t h e stools. These indeed m i g h t s i m p l y be i r r i t a t i v e p r o d u c t s for he was of t h e opinion t h a t r a w fruit a n d vegetables did i r r i t a t e r a t h e r t h a n s t i m u l a t e in t h e t r u e medicinal a n d c u r a t i v e conception, i.e. setting into m o t i o n n a t u r a l c u r a t i v e processes. H e would be i n t e r e s t e d also t o l e a r n how t h e condition of t h e capillaries ()f t h e iris, e.g. could be considered as a n a c c u r a t e measure of t h e s t a t e of t h e b o d y in h e a l t h a n d disease. Only a large series of a c c u r a t e l y described cases could be a c c e p t e d as p r o o f of such a m e a s u r e m e n t . I s o l a t e d cases were of l i t t l e value in this respect. H e could n o t follow how a c u t e conditions such as tonsillitis, etc., were to be r e g a r d e d as " healing " crises e x c c p t on t h e view t h a t a n y acute condition is t o be considered as a n a t t e m p t on t h e p a r t of t h e b o d y to t h r o w off, e.g. infection. B e t w e e n t h e a c u t e condition of" t h e p a t i e n t w i t h o u t t r e a t m e n t a n d t h e p a t i e n t u n d e r t r e a t m e n t , how was one to distinguish t h e significance of such " crises ". The a g g r a v a t i o n or t h e r e t u r n of old s y m p t o m s a f t e r a c c u r a t e H o m c c o p a t h i c prescribing cou/d be checked, b u t he could n o t see how t h e N a t u r o p a t h was able to check his findings. H e could n o t quite follow how Dr. L c d e r m a n n p r o c e e d e d to j u d g e his a p p l i c a t i o n o f h o t or cold when he h a d a g r e e d t h a t t h e p a t i e n t , e.g. t h e Phosphorus p a t i e n t , was worse for cold g e n e r a l l y or, if the p a t i e n t was worse for rubbing. Did he give t h e chilly p a t i e n t w a r m applications, or cold ? D i d he advise massage or n o t ? T h e n he a t t e m p t e d to show t h a t e.g. t h e condition of the sweat a f t e r N a t u r a l m e t h o d s was of v a l u e in choosing a r e m e d y . B u t surely this sweat was n o t t h e p a t i e n t ' s n a t u r a l sweat, b u t an artificially p r o d u c e d perspiration. One m i g h t surely as well j u d g e of t h e sweat a f t e r an a n t i p y r e t i c

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such as Aspirin, which was as inaccurate as judging the temperature after such antipyretic treatment. So, too, when discussing "sun r a y " treatment, Dr. Ledermann claimed that this was a general effect rather than a local, but in some cases he doubted this. He had seen psoriasis cases clear up completely with sunlight, both artificial and natural, and return as bad as ever when this was discontinued. Here at any rate the effect was surely local only. Massage, he was afraid, could not be claimed as a natural form of therapeutics. Essentially it should be soothing, but as given to-day it seemed t o him to " injure " the tissues rather than heal them and certainly as administered for fibrositis it was simply destruction of fibrous tissue. He believed, too, that therc was something in the old idea that the rubbing of joints did send the infection (if it be infection) " round " the system. Here it seemed to have a general but deleterious effect. Dr. Ledcrmann attempted to claim that thc small doses of the Homoeopatb were accepted by the Naturopath even in his treatmcnt of the skin, but was the homceopath essentially a small dose physician ? Surely not ! The dose was not the essential feature of the Homceopathic principle. This was tile law of similars and it was because Natural Therapeutics had no such law that he deprecated the attempt to link the two methods. Diet he had already commented upon, but with reference to the diet in fever he found difficulty in following why Dr. Lcdermann advised fasting and/or raw vegetables and fruit juices. There was an old adage : " Starve a fever " and that was founded upon the idea (which he believed to be justified) that in fever all natural processes such as the digestive were functionally out of action for the time being. The Homceopath believed in allowing the patient to be the dietitian, in other words to choose his own diet. I f he were thirsty for large drinks of cold water, he had large drinks of cold water ; if he was thirstless the homceopath did not believe in forcing fluid on him. And when one had the feverish patient who was " hungry " one tried to satisfy this craving. The homceopath believed that the sick organism was a better guide than the expert dietitian in these acute states. I n addition or primarily, in fact, the patient's desires were of ten direct guides to the choice of remedy. Hc deprecated the idea that homceopathy should be used, as it was by one expert quoted by Dr. Ledermann, simply to overcome the psychological " c r i s e s " of Natural Therapeutics. He thought the positions might be reversed with value to the patient, but then that might be Homceopathic conceit ! So he (Dr. T.) would reject the plea for combining in word or deed Homceopathy and Natural Therapeutics for the reason that they were founded on quite different principles. Only in the technique of dosage was there any resemblance. He did not say that they could not be used together with value, but he would of course require much more scientific evidence for the claims made, and would ask for some guide as to the administration, be it of sun or diet. No principles either for quantity or for time ha~t been proffered and that one would require to have, before one could even assess thclikely value of the method.