PSORA.

I think it necessary before proceeding to the doctrine of the third chronic miasma, the most important of all, psora, to premise the following general remark:

For the infection with the only three known chronic miasmatic diseases there is usually needed but one moment; but the development of this tinder of infection, so that it becomes a general disease of the entire organism, needs a longer time. Not until a certain number of days have elapsed, when the miasmatic disease has received its complete internal development in the whole man -not until then, from the fullness of internal suffering, the local symptom breaks forth, destined by a kind nature to take upon itself in a certain sense the internal disease, and in so far to divert it in a palliative manner and to soothe it, so that it may not be able to injure and endanger the vital economy too much. The local symptom has its place on the least dangerous part of the body, the external skin, and, indeed, on that part of the skin where during the infection, the miasma had touched the nearest nerves.

This process of nature, which repeats itself continually and evermore in the same manner in chronic miasmata, aye, - even in those which are acute and constant, - ought not to have escaped the penetration of physicians, at least not in venereal diseases, to the treatment of which they have applied themselves now for more than three hundred years; and then they could not have avoided drawing a conclusion as to the process of nature in the other two chronic miasmata. It was, therefore, irrational and unpardonably thoughtless of them to suppose that every chancre evolved by the organism after several days, often after quite a number of days, as the result of the completed internal malady, was a thing merely adventitious from without and situated on the skin without any internal connection, so that it might be simply removed by cauterizing, "so as to prevent the poison from the chancre (scilicet) from being absorbed into the internal parts, and thus from causing man to be afflicted with the venereal disease." Irrational and unpardonably thoughtless was this false idea of the origin of the venereal chancre, which caused the injurious practice of the external cauterization of the chancre, producing as its unavoidable, shameful effect, the breaking out of the venereal disease from the internal which has continued in its diseased state. This has been the case in several hundred thousands of cases these last three centuries. Just as irrational and thoughtless is the notion of physicians of the old school, even of the most modern times, that itch is merely a disease of the skin, in which the internal portion of the body takes no part. According to this groundless supposition, therefore, nothing better can be done than to remove this ailment from the surface of the skin, although the extirpation of the internal psora disease which causes the cutaneous eruption is necessary as an aid, and when this is cured also the cutaneous ailment, being the necessary consequence of the internal disease, will naturally disappear - cessante causa, cessat effectus.

For in its complete state, i.e., so long as the original eruption is still present on the skin so as to assuage the internal malady, the entire disease of the psora may be cured most easily, quickly and surely.

But when by the destruction of this original cutaneous eruption, which acts vicariously for the internal malady, it has been robbed then the psora is put in the unnatural position of dominating in a merely one-sided manner the internal finer parts of the whole organism, and thus of being compelled to develop its secondary symptoms.

How important and necessary the cutaneous eruption is for the original psora, and how carefully in the only thorough cure of itch, that is, the internal cure, every external removal of the eruption must be avoided, we may see from the fact that the most severe chronic ailments have followed as secondary symptoms of the internal psora after the original itch-eruption has been driven out, and that when, in consequence of a great revolution in the organism, this itching eruption re-appears on the skin, the secondary symptoms are so suddenly removed, that these grievous ailments, often of many years' standing, are wont to disappear, at least temporarily, as if by a miracle. See the before quoted observations of older physicians, Nos. 1, 3, 5, 6, 8, (9), 16, (17), (21), 23, 33, 35, 39, 41, 54, 58, 60, 72, 81, 87, 89, 94.

But let no one suppose that an internal psora, which, after the external destruction of the original cutaneous eruption, has broken out into secondary chronic ailments, can, through the re-appearance of such an itch-like eruption on the skin, come into just as normal a state as before, or that it can be cured just as easily as if it were still the original eruption and as if this had not been as yet removed.

This is not at all the case. Even the eruption following immediately after the infection has no such unchanging constancy and pertinacity on the skin as the chancre and the figwarts show on the spots where they first appear,[] but not infrequently disappears from the skin also from other causes [] than from artificial remedies used purposely for its destruction, and so also from other causes unknown.[]

So that the physician must not waste any time even in the original eruption, if he would complete the cure while the itch-disease is still entire, by the use of internal anti-psoric remedies. Such a respite can be expected still less in this secondary eruption, which has been brought out on the skin by any cause after the local extirpation of the eruption; for the second eruption is wont to be far more inconstant and changeable, so that it often passes away on much slighter provocation in a few days -a proof that it lacks much of the complete quality of the primitive itch-eruption, so that the physician cannot count on it in the thorough cure of the psora.

This proneness to change, in the itch-like eruption which has been called a second time to the skin, seems evidently to be caused by the fact that the internal psora, after the destruction of the original itch-eruption is unable to give to the secondary eruption the full qualities belonging to the primary eruption, and is already much more inclined to unfold itself in a variety of other chronic diseases; wherefore a thorough cure is now much more difficult, and is simply to be conducted as if directed against the internal psora.

The cure is not, therefore, advanced by producing such a secondary eruption through internal remedies, as has sometimes been effectually attempted (see Nos. 3, 9, 59, 89); or by its re-appearance through other unknown causes (see Nos. 1, 5, 6, 8, 16, 23, 28, 29, 33, 35, 39, 41, 54, 58, 60, 72, 80, 81, 87, 89, 94) or, especially, through the help of a fever (see No. 64, also 55, 56, 74). Such a secondary eruption is always very transitory, and so unreliable and rare that we cannot build our hope of cure on it, nor expect from it the advancement of any thorough cure.

[*] Neither of these ever passes away of itself, unless destroyed externally on purpose, or the entire disease is healed internally.

[*] E.g. *through cold, see No. 67 of the above-mentioned observations; through small-pox, No. 39; through warm baths, No. 35.

[***] See Nos. 9, 7, 26 (36), 50, 58, 61, 64, 65, in which observations it may be seen at the same time that after such disappearances of the original itch-eruption without appreciable cause just as many ill effects are wont to follow as when it has been driven away artificially through local applications.

But even if, by any means, such a secondary eruption might, after a fashion, be produced, and even were it in our power to retain it on the skin for a longer period, we cannot at all count on it for assistance in the cure of the whole psoric malady. [*]

It remains, therefore, an established truth, that the cure of the entire destructive Psora through antipsoric remedies is effected most easily only while the original eruption of itch is still present. From this it again appears how unconscionable it is of the allopathic physicians, to destroy the primitive itch eruption through local applications instead of completely eradicating this grave disease from the whole living organism by a cure from within, which at that stage is as yet very easy, and by thus choking off in advance all the wretched consequences that we must expect from this malady if uncured; i.e., all the secondary, chronic, nameless sufferings which follow it.

[] There was a time when, not yet fully convinced of this fact, I thought that the cure of the entire psora might be rendered easier by an artificial renewal of the cutaneous eruption effected through a sort of checking of the perspiratory function of the skin, so as to excite it homœopathically to the reproduction of the eruption. For this purpose I found most serviceable the wearing of a plaster mostly on the back (but where practicable also on other portions of the skin); the plaster was prepared by gently heating six ounces of Burgundy pitch, into which, after removing it from the fire, an ounce of turpentine produced from the larch-tree (called Venetian turpentine) was stirred until it was perfectly mixed. A portion of this was spread on a chamois skin (as being the softest), and laid on while still warm. Instead of this, there might also be used so-called tree-wax (made of yellow wax and common turpentine), or also taffeta covered with elastic resin; showing that the itching eruption evolved is not due to any irritation caused by the substance applied; nor does the psora first mentioned cause either eruption or itching on the skin of a person who is not psoric. I discovered that this method is the most effective to cause such an activity of the skin. Yet despite of all the patience of the sick persons (no matter how much they might internally be affected with the psora), I never could evolve a complete eruption of itch, least of all one that would remain for a time on the skin. What could be effected was only that some itching pustules appeared, which soon vanished again, when the plaster was left off. More frequently there ensued a moist soreness of the skin, or at best a more or less violent, itching of the skin, which in rare cases extended also to the other parts not covered by the plaster. This, indeed, would cause for a time a striking alleviation of even the most severe chronic diseases flowing from a psoric source; e.g.,* suppuration of the lungs. But this much could not be attained on the skin of many patients (frequently all that could be attained was a moderate or small amount of itching), or again, if I could produce a violent itching, this frequently became too unbearable for the patient to sustain it for a time sufficient to produce an internal cure. When the plaster then was removed in order to relieve him, even the most violent itching, together with the eruption present, disappeared very soon, and the cure had not been essentially advanced by it; this confirms the observation made above, that the eruption if evolved a second time (and so also the itching reproduced) had not by any means the full characteristics of the eruption of the itch which had originally been repressed, and was therefore of little assistance in the real advancement of a thorough cure of the psora through internal remedies, while the little aid afforded loses all value owing to the often unbearable infliction of the artificially produced eruption and itching of the skin, and the weakening of the whole body which is inseparable from the titillating pain.

The excuse of the private physician (for the physician at the hospital has no excuse at all) amounts to nothing. He will say, indeed: "If it is not known -and hardly ever does it become demonstrably known- where, when, at what occasion and from what person avowedly suffering from itch the infection has been derived, then he could not discover from the present, and often insignificant little eruption whether it was real itch; so he was not to be blamed for the evil consequences, if he supposed it to be something else and endeavored to remove it from the skin as soon as possible by a lotion of lead solution, or an ointment of cadmia, or white precipitate of mercury, according to the wishes of the aristocratic parents."

This excuse, as above said, amounts to nothing. For, first of all, no cutaneous eruption of whatever kind it may be, ought to be expelled through external means by any physician who wishes to act conscientiously and rationally. [*] The human skin does not evolve of itself, without the co-operation of the rest of the living whole, any eruption, nor does it become sick in any way, without being induced and compelled to it by the general diseased state, by the lack of normality in the whole organism. In every case there is at the bottom a disorderly state of the whole internal living organism, which state must first be considered; and therefore the eruption is only to be removed by internal healing and curative remedies which change the state of the whole; then also the eruption which is based on the internal disease will be cured and healed of itself, without the help of any external remedy, and frequently more quickly than it could be done by external remedies.

Secondly, even if the physician should not have presented to him the original, undestroyed form of the eruption, - i.e., the pustule of itch which in the beginning is transparent, then quickly filled with pus, with a narrow red margin all around it, - even if the eruption should consist only of small granules like the miliary eruption, or appear like scattered little pimples or little scabs, still he cannot for a moment be in doubt as to whether the eruption is itch, if the child or even the suckling only a few days old, uninterruptedly rubs and scratches the spot, or, if it is an adult, when he complains of the titillation of a voluptuously itching eruption (or even only a few pimples) which is unbearable without scratching, especially in the evening and at night, and when this is followed by a burning pain. In such a case we can never doubt as to the infection with itch, though in genteel and wealthy families we can seldom secure the information and the certainty as to how, where and from whom the infection has been derived; for there are innumerable imperceptible occasions whereby this infection may be received, as taught above.

[] See "Organon of the Healing Art*," fifth edition, §187-203.

Now when the family physician notices this in time, then without any external application, the simple dose of one or two pills as large as poppy-seeds, moistened with the potentized sulphur in alcohol, as described below, will fully and abundantly suffice to cure a child and to deliver it from the entire disease of itch, both the eruption and the internal itch malady (psora).

The homœopathic physician in his private practice seldom gets to see and to treat an eruption of itch spread over a considerable part of the skin and coming from a fresh infection. The patients on account of the intolerable itching either apply to some old woman, or to the druggist or the barber, who, one and all, come to their aid with a remedy which, as they suppose, is immediately effective (e.g., lard mixed with flowers of sulphur). Only in the practice of the barracks, of prisons, hospitals, penitentiaries and orphan asylums those infected have to apply to the resident physician, if the surgeon of the house does not anticipate him.

Even in the most ancient times when itch occurred, for it did not everywhere degenerate into leprosy, it was acknowledged that there was a sort of specific virtue against itch in sulphur; but they knew of no other way of applying it, but to destroy the itch through an external application of it, even as is done now by the greater part of the modem physicians of the old school. A. C. Celsus has several ointments and salves (V. 28) some of which consist merely of sulphur mixed with tar, while others contain also compounds of copper and other substances; these he prescribes for the expulsion of itch, and this he supposes to be its cure. So also the most ancient physicians, like the moderns, prescribed for their itch patients baths of warm sulphurous mineral water. Such patients are usually also delivered from their eruption by these external sulphur remedies. But that their patients were not really cured thereby, became manifest, even to them, from the more severe ailments that followed, such as general dropsy, with which an Athenian was afflicted when he drove out his severe eruption of itch by bathing in the warm sulphur baths of the island of Melos (now called Milo), and of which he died. This is recorded by the author of Book V. Epidemion, which has been received among the writings of Hippocrates (some three hundred years before Celsus).

Internally the ancient physicians gave no sulphur in itch, because they, like the moderns, did not see that this miasmatic disease was, at the same time and especially, an internal disease.

Modern physicians have never given sulphur only, and internally, to cure the itch, because they have never recognized the itch-disease as being also an internal and, indeed, chiefly internal disease. They only gave it in connection with the external means of driving away the itch, and, indeed, in doses which would act as purgatives, - ten, twenty and thirty grains at a dose, frequently repeated, - so that it never became manifest how useful or how injurious this internal application of such large doses, in connection with the external application, had been; at least the whole itch-disease (psora) could never be thoroughly healed thereby. The external driving out of the eruption was simply advanced by it as by any other purgative, and with the same injurious effects as if no sulphur at all had been used internally. For even if sulphur is used only internally, but in the above described large doses, without any external destructive means, it can never thoroughly heal a psora; partly because in order to cure as an antipsoric and homœopathic medicine, it must be given only in the smallest doses of a potentized preparation, while in larger and more frequent doses the crude sulphur [*] in some cases increases the malady or at least adds a new malady; partly because the vital force expels it as a violently aggressive remedy through purging stools or by means of vomiting, without having put its healing power to any use.

[] Here it is proper to subjoin the words of an impartial and even practical connoisseur of Homœopathy, the deep-thinking, many-sided scholar and indefatigable investigator of truth, Count Buquoy, in his Anregungen für ph. w. Forschungen (Leipzig, 1825, p. 386 sgg.). After assuming that a drug, which in a normal state of health causes the symptoms a, b, g, - in analogy with other physiological phenomena, produces the symptoms x, y, z, which appear in an abnormal state of health - can act upon this abnormal state in such a way that the disease-symptoms x, y, z, are transformed into the drug symptoms a, b, g, which latter have the peculiar characteristic of temporariness or transitoriness; he then continues: "This transitory character belongs to the group of symptoms of the medicine a, b, g, which is substituted for the group of symptoms belonging to the disease, merely because the medicine is used in an extraordinarily small dose. Should the homœopathic physician give the patient too large a dose of the homœopathic remedy indicated, the disease x, y, z may indeed be transformed into the other, i.e., into a, b, g but the new disease now just sits as firmly fixed as the former x, y, z; so that the organism can just as little free itself from the disease a, b, g, as it was able to throw off the original disease x, y, z. If a very large dose is given, then a new often very dangerous disease is produced, or the organism does its utmost to free itself very quickly from the poison (through diarrhœa, vomiting, etc*.)".

Now if, as experience teaches, not even the fresh itch-disease which is the most easy to cure of all, i.e., the internal, recently formed psora together with the external, recent eruption, can be thoroughly healed by external applications accompanied with large quantities of flowers of sulphur, it may easily be seen, that the psora, after it has been deprived of its eruption and has become merely internal and inveterate, having developed secondary ailments and thus having change into chronic diseases of various kinds, for the same reason can be just as little cured by a quantity of sulphur flowers, or by a number of baths in sulphurous mineral waters, or on the other hand by simultaneously drinking the same or a similar water; in a word, it cannot be cured by a superabundance and frequent repetition of this remedy, although it is of itself antipsoric. [*] It is true that many such chronic patients by the first treatment at the baths seem to get rid for some time of the symptoms of their disease (therefore we see an incredible throng of many thousands, suffering from innumerable different chronic ailments at Teplitz, Baden, Aix-la-Chapelle, Neundorf, Warmbrunn, etc.); yet they are not on that account restored to health, but instead of the original chronic (psoric) disease, they have for a time come under the dominion of a sulphur-disease (another, perhaps more bearable, malady). This in time passes away, when the psora again lifts its head, either with the same morbid symptoms as before, or with others similar but gradually more troublesome than the first, or with symptoms developing in nobler parts of the organism. Ignorant persons will rejoice in the latter case, that their former disease at least has passed away, and they hope that the new disease also may be removed by another journey to the same baths. They do not know, that their changed morbid state is merely a transformation of the same psora; but they always find out by experience, that their second tour to the baths causes even less alleviation, or, indeed, if the sulphur-baths are used in still greater number, that the second trial causes aggravation.

Thus we see that either the excessive use of sulphur in all its forms, or the frequent repetition of its use by allopathic physicians in the treatment of a multitude of chronic diseases (the secondary psoric ailments) have taken away from it all value and use; and we may well assert that, to this day, hardly anything but injury has been done by allopathic physicians through the use of sulphur.

[] Used in small doses, sulphur as one of the antipsoric remedies will not fail to make a brief beginning of a cure of the chronic (non-venereal and therefore psoric) diseases. I know a physician in Saxony who gained a great reputation by merely adding to his prescriptions in nearly all chronic diseases flowers of sulphur, and this without knowing a reason for it. This in the beginning of such treatments is wont to produce a strikingly beneficent effect, but of course only* in the beginning, and therefore after that his help was at an end.)

But even supposing that anyone should desire to make the only correct use of sulphur in this kind of disease, it will seldom be possible to do this with the same desired success as where the homœopathic physician finds a recent case of the itch-disease with its still existing eruption. Even when, owing to its undeniable anti-psoric effects, sulphur may be able of itself to make the beginning of a cure, after the external expulsion of the eruption, either with the still hidden and latent psora or when this has more or less developed and broken out into its varied chronic diseases, it can nevertheless be but rarely made use of for this purpose, because its powers have usually been already exhausted, because it has been given to the patient already before by allopathic physicians for one purpose or another, perhaps has been given already repeatedly; but sulphur, like most of the antipsoric remedies in the treatment of a developed psora that has become chronic, can hardly be used three or four times (even after the intervening use of other antipsoric remedies) without causing the cure to retrograde.

The cure of an old psora that has been deprived of its eruption, whether it may be latent and quiescent, or already broken out into chronic diseases, can never be accomplished with sulphur alone, nor with sulphur-baths either natural or artificial.

Here I may mention the curious circumstance that in general - with the exception of the recent itch-disease still attended with its unrepressed cutaneous eruption, and which is so easily cured from within [] - every other psoric diathesis, i.e.*, the psora that is still latent within, as well as the psora that has developed into one of the innumerable chronic diseases springing from it, is very seldom cured by any single anti-psoric remedy, but requires the use of several of these remedies -in the worst cases the use of quite a number of them- one after the other, for its perfect cure.

[] Recent itch-disease with its still present cutaneous eruption has been cured at times without any external remedy by even one* very small dose of a properly potentized preparation of sulphur and thus within two, three or four weeks; once a dose of 1/2 grain of carbo vegetabilis potentized a million fold sufficed for a family of seven persons, and three times a like dose of as highly potentized sepia was sufficient.

This circumstance need not astonish us when we consider that the psora is a chronic miasma of quite peculiar and especial character which in several thousands of years has passed through several millions of human organisms, and must have assumed such a vast extension of varied symptoms, -the elements of those innumerable, chronic, non-venereal ailments, under which mankind now groans,- and could transmute itself into such an indefinite multitude of forms differing from one another as it gradually ultimated itself in the various bodily constitutions of individual men who differed from one another in their domiciles, their climatic peculiarities, their education, habits, occupations, [] modes of life and of diet, and was moulded by varying bodily and psychic relations. It is, therefore, not strange, that one single and only medicine is insufficient to heal the entire psora and all its forms, and that it requires several medicines in order to respond, by the artificial morbid effects peculiar to each, to the unnumbered host of psora symptoms, and thus to those of all chronic (non venereal) diseases, and to the entire psora, and to do this in a curative homœopathic manner. [*]

It is only, therefore, as already mentioned, when the eruption of itch is still in its prime and the infection is in consequence still recent, that the complete cure can be effected by sulphur alone, and then at times with but a single dose. I leave it undecided, whether this can be done in every case of itch still in full eruption on the skin, because the ages of the eruption of itch infecting patients is quite various. For if the eruption has been on the skin for some time (although it may not have been treated with external repressive remedies) it will of itself begin to recede gradually from the skin. Then the internal psora has already in part gained the upper hand; the cutaneous eruption is then no more so completely vicarious, and ailments of another kind appear, partly as the signs of a latent psora, partly as chronic diseases developed from the internal psora. In such a case sulphur alone (as little as any other single antipsoric remedy) is usually no longer sufficient to produce a complete cure, and the other antipsoric remedies, one or another according to the remaining symptoms, must be called upon to give their homœopathic aid.

The homœopathic medical treatment of the countless chronic diseases (non-venereal and therefore of psoric origin) agrees essentially in its general features with the homœopathic treatment of human diseases as taught in the Organon of the Art of Healing; I shall now indicate what is especially to be considered in the treatment of chronic diseases.

[] I.e.*, occupations which called more fully into play one or another of the body, one or another function of the spirit and mind.

[**] I refrain from hinting through what exertions and through how many careful observations, investigations, reflections and varied experiments I have finally succeeded after eleven years in filling up the great chasm in the edifice of the homœopathic healing art, the cure of the innumerable chronic diseases, and thus in completing as far as possible the blessings which this art has in store for suffering humanity.

As to the diet and mode of living of patients of this kind I shall only make some general remarks, leaving the special application in any particular case to the judgment of the homœopathic practitioner. Of course everything that would hinder the cure must also in these cases be removed. But since we have here to treat lingering, sometimes very tedious diseases which cannot be quickly removed, and since we often have cases of persons in middle life and also in old age, in various relations of life which can seldom be totally changed, either in the case of rich people or in the case of persons of small means, or even with the poor, therefore limitations and modifications of the strict mode of life as regularly prescribed by Homœopathy must be allowed, in order to make possible the cure of such tedious diseases with individuals so very different. A strict, homœopathic diet and mode of living does not cure chronic patients as our opponents pretend in order to diminish the merits of Homœopathy, but the main cause is the medical treatment. This may be seen in the case of the many patients who trusting these false allegations have for years observed the most strict homœopathic diet without being able thereby to diminish appreciably their chronic disease; this rather increasing in spite of the diet, as all diseases of a chronic miasmatic nature do from their nature.

Owing to these causes, therefore, and in order to make the cure possible, the homœopathic practitioner must yield to circumstances in his prescriptions as to diet and mode of living, and in so doing he will much more surly, and therefore more completely, reach the aim of healing, than by an obstinate insistence on strict rules which in many cases cannot be obeyed.

The daily laborer, if his strength allows, should continue his labor; the artisan his handiwork; the farmer, so far as he is able, his field work; the mother of the family her domestic occupations according to her strength; only labors that would interfere with the health of healthy persons should be interdicted. This must be left to the intelligence of the rational physician.

The class of men who are usually occupied, not with bodily labor, but with fine work in their rooms, usually with sedentary work, should be directed during their cure to walk more in the open air, without, on that account, setting their work altogether aside.

Persons belonging to the higher classes should also be urged to take walks more than is their custom. The physician may allow this class the innocent amusement of moderate and becoming dancing amusements in the country that are reconcilable with a strict diet, also social meetings with acquaintances, where conversation is the chief amusement; he will not keep them from enjoying harmless music or from listening to lectures which are not too fatiguing; he can permit the theatre only exceptionally, but he can never allow the playing of cards. The physician will moderate too frequent riding and driving, and should know how to banish intercourse which should prove to be morally and psychically injurious, as this is also physically injurious. The flirtations and empty excitations of sensuality between the sexes, the reading of indelicate novels and poems of a like character, as well as superstitious and enthusiastic books, are to be altogether interdicted. [*]

Scholars ought also to be induced to (moderately) exercise in the open air, and in bad weather to do some light mechanical work in doors; but during the medical treatment mental occupation should be limited to work from memory, since straining the head by reading is hardly ever to be allowed, or at least only with great limitation and a strict definition as to the quantity and quality of what is read, i.e., in treating any of the more severe chronic diseases. In mental disorders it can never be allowed.

All classes of chronic patients must be forbidden the use of any domestic remedies or the use of any medicines on their own account. With the higher classes, perfumeries, scented waters, tooth-powders and other medicines for the teeth must also be forbidden. If the patient has been accustomed for a long time to woollen under-clothing, the homœopathic physician cannot suddenly make a change; but as the disease diminishes the woollen under-garments may in warm weather be first changed to cotton and then, in warm weather, the patient can pass to linen. Fontanelles can be stopped, in chronic diseases of any moment, only when the internal cure has already made progress, especially with patients of advanced age.

The physician cannot yield to the request of patients for the continuation of their customary home-baths; but a quick ablution, as much as cleanliness may demand from time to time, may be allowed; nor can he permit any venesection or cupping, however much the patient may declare that he has become accustomed thereto.

[*] Physicians frequently wish to assume importance by forbidding without exception all sexual intercourse to chronic patients who are married. But if both parties are able and disposed to it, such an interdict is, to say the least, ridiculous, as it neither can nor will be obeyed (without causing a greater misfortune in the family). No legislature should give laws that cannot be kept nor controlled, or which would cause even greater mischief if kept. If one party is incapable of sexual intercourse this of itself will stop such intercourse. But of all functions in marriage such intercourse is what may least be commanded or forbidden. Homœopathy only interferes in this matter through medicines, so as to make the party that is incapable of sexual intercourse capable of it, through antipsoric (or anti-syphilitic) remedies, or on the other hand to reduce an excitable consort's morbidity to its natural tone.

As to diet, all classes of men who wish to be cured of a lingering disease; can suffer some limitation, if the chronic disease does not consist of an ailment of the abdomen; with the lower classes there need to be no very strict limitations, especially if the patient is able to remain at work in his trade, thus giving motion to the body. The poor man can recover health even with a diet of salt and bread, and neither the moderate use of potatoes, flour-porridge nor fresh cheese will binder his recovery; only let him limit the condiments of onions and pepper with his meagre diet.

He who cares for his recovery can find dishes, even at the king's table, which answer all the requirements of a natural diet .

Most difficult for a homœopathic physician is the decision as to drinks. Coffee has in great part the injurious effects on the health of body and soul which I have described in my little book (Wirkungen des Kaffees [Effects of Coffee], Leipzig, 1803); but it has become so much of a habit and a necessity to the greater part of the so-called enlightened nations that it will be as difficult to extirpate as prejudice and superstition, unless the homœopathic physician in the cure of chronic diseases insists on a general, absolute interdict. Only young people up to the twentieth year, or at most up to the thirtieth, can be suddenly deprived of it without any particular disadvantage; but with persons over thirty and forty years, if they have used coffee from their childhood, it is better to propose to discontinue it gradually and every day to drink somewhat less; when lo and behold! most of them leave it off at once, and they will do so without any peculiar trouble (except, perhaps, for a few days at the commencement). As late as six years ago I still supposed that older persons who are unwilling to do without it, might be allowed to use it in a small quantity. But I have since then become convinced that even a long-continued habit cannot make it harmless, and as the physician can only permit what is best for his patient, it must remain as an established rule that chronic patients must altogether give up this part of their diet, which is insidiously injurious; and this the patients, high or low, who have the proper confidence in their physician, when it is properly represented to them, almost without exception, do willingly and gladly, to the great improvement of their health. Rye or wheat, roasted like coffee in a drum and then boiled and prepared like coffee, has both in smell and in taste much resemblance to coffee; and rich and poor are using this substitute willingly in several countries.

The like may be said concerning the expensive and so-called fine sorts, as well as concerning the cheap sorts of Chinese tea which so flatteringly allures the nerves and so secretly and inevitably infests and weakens them. Even when made very weak and when only a little is drank only once a day it is never harmless, neither with younger persons nor with older ones who have used it since their childhood; and they must instead of it use some harmless warm drink. Patients, according to my extensive experience, are also willing to follow the advice of their faithful adviser, the physician in whom they have confidence, when this advice is fortified with reasons.

With respect to the limitation in wine the practitioner can be far more lenient, since with chronic patients it will be hardly ever necessary to altogether forbid it. Patients who from their youth up have been accustomed to a plentiful use of pure [*] wine cannot give it up at once or entirely, and this the less the older they are. To do so would produce a sudden sinking of their strength and an obstruction to their cure, and might even endanger their life. But they will be satisfied to drink it during the first weeks mixed with equal parts of water, and later, gradually wine mixed with two, three and four and finally with five and six parts of water and a little sugar. The latter mixtures may be allowed all chronic patients as, their usual beverage.

More absolutely necessary in the cure of the chronic diseases is the giving up of whisky or brandy. This will require, however, as much consideration in diminishing the quantity used, as firmness in executing it. Where the strength appreciably diminishes at giving it up totally, a small portion of good, pure wine must be used instead of it for a little while, but later, wine mixed with several parts of water, according to circumstances.

Since, according to an inviolable law of nature, our vital force always produces in the human organism the opposite of the impressions caused by physical and medicinal potencies in all the cases in which there are such opposites, it may easily be understood, as accurate observation also testifies, that spirituous liquors, after having simulated refreshment and heightened vital warmth immediately after partaking them, must have just the opposite after-effects, owing to this opposite reaction of the vital force of the organism. Weakness and a diminution of the vital warmth are the inevitable consequences of their use - states which ought to be removed as far as possible from the chronic patient by every true physician. Only an allopath who has never accustomed himself to observation and to reflection, and who is unwilling to acknowledge the injurious effects of his palliatives, can advise his chronic patients to daily drink strong, pure wine to strengthen themselves; a genuine Homœopath will never do this (sed ex ungue leonem !).

[*] Even for men in quite good health it is improper and in many ways injurious to drink pure wine as a customary beverage, and morality only permits its use in small quantities at festive occasions. A youth cannot keep his sexual desires under control up to his marriage unless he altogether avoids banquets. Gonorrhœa and chancre are due to such excesses.

The permission of beer is quite questionable! Since the artifices of brewers in modern times seem to intend, by their addition of vegetable substances to the extract of malt, not only to prevent it from souring, but also and especially to tickle the palate and to cause intoxication, without any regard to the injurious qualities of these malignant additions which often deeply undermine the health when daily used, and which cannot be discovered by any inspection, the honest physician cannot allow his patient to drink whatsoever is called beer; for even in the white beer (thin beer) and the porter, which on account of their lack of bitterness seem so harmless, not infrequently have narcotic ingredients added to give them the much-liked intoxicating quality in spite of their diminished quantity of malt.

Among the articles of diet which are generally injurious to chronic patients are also all dishes containing vinegar or citric acid. These are especially apt to cause disagreeable sensations and troubles in those afflicted with nervous and abdominal ailments. They also either antagonize or excessively increase the effects of several medicines. For such patients also very acid fruit (as sour cherries, unripe gooseberries and currants) are to be allowed only in very small quantities, and sweet fruits only in moderate quantity; so also baked prunes as a palliative are not to be advised to those inclined to constipation. To the latter, as also to those suffering from weak digestion, veal which is too young is not serviceable. Those whose sexual powers are low should limit themselves in eating young chickens and eggs, and should avoid the irritating spice of vanilla, also truffles and caviare, which as palliatives hinder a cure. Ladies with scanty menses must avoid the use of saffron and cinnamon for the same reason; persons with weak stomachs should avoid cinnamon, cloves, amomum, pepper, ginger and bitter substances, which, being palliatives, are also injurious while under homœopathic treatment. Vegetables causing flatulency should be forbidden in all abdominal troubles and where there is an inclination to constipation and costiveness. Beef and good wheat-bread or rye-bread, together with cow's milk and a moderate use of fresh butter, seem to be the most natural and harmless food for men, and also for chronic patients; only little salt should be used. Next to beef in wholesomeness are mutton, venison, grown chickens and young pigeons. The flesh and fat of geese and ducks are even less to be permitted to chronic patients than pork. Pickled and smoked meats should be rarely used and only in small quantities.

Sprinkling chopped raw herbs on soups, putting pot-herbs into vegetables, and eating old, rancid cheese must be avoided.

In using the better quality of fish their preparation should be especially looked to; they had best be prepared by boiling and used sparingly with sauces not much spiced; but no fish dried in the air or smoked; salt fish (herrings and sardines) only rarely and sparingly.

Moderation in all things, even in harmless ones, is the chief duty of chronic patients.

In considering diet, the use of tobacco should also be carefully considered. Smoking in some cases of chronic diseases may be permitted, when the patient had been accustomed to an uninterrupted use of it, and if he does not expectorate; but smoking should always be limited, and more so if the mental activity, sleep, digestion or the evacuations are defective. If evacuations regularly only take place after smoking, the use of this palliative must be all the more circumscribed, and the same result must be obtained in a lasting manner through the appropriate antipsoric remedies. More objectionable yet, however, is the using of snuff, which is wont to be abused as a palliative against rheum and obstruction of the nose and insidious inflammation of the eyes, and which being a palliative, is a great hindrance in the cure of chronic diseases; it can, therefore, not be allowed with such patients, but must be diminished every day and at last stopped. An especial reason for this is also that in snuff the medicinal liquors (sauces) with which almost all snuff is medicated touches with its substance the nerves of the inner nose and injures just as if a foreign medicine were taken, which is less the case with the burning smoking tobacco in which the strength is disintegrated by the heat.

I now pass to the other hindrances to the cure of chronic diseases which must be avoided as far as possible.

All those events in human life which can bring the psora latent and slumbering within, which has hitherto manifested itself only by some of the signs mentioned above, wherein the patient varies from a state of health, so as to break out into open chronic diseases, these same events if they occur to a person already a chronic patient may not only augment his disease and increase the difficulty of curing it, but, if they break in on him violently, may make his disease incurable, if the untoward circumstances are not suddenly changed for the better.

Such events are, however, of very various nature, and therefore of different degrees of injurious influence.

Excessive hardships, laboring in swamps, great bodily injuries and wounds, excess of cold or heat, and even the unsatisfied hunger of poverty and its unwholesome foods, etc., are not by any means very powerful in causing the fearful malady of psora which lies in ambush, lurking in secret to break forth into serious chronic diseases, nor of great consequence in aggravating a chronic disease already present; yea, an innocent man can, with less injury to his life, pass ten years in bodily torments in the bastile or on the galleys rather than pass some months in all bodily comfort in an unhappy marriage or with a remorseful conscience. A psora slumbering within, which still allows the favorite of a prince to live with the appearance of almost blooming health unfolds quickly into a chronic ailment of the body, or distracts his mental organs into insanity, when by a change of fortune he is hurled from his brilliant pinnacle and is exposed to contempt and poverty. The sudden death of a son causes the tender mother, already in ill health an incurable suppuration of the lungs or a cancer of the breast. A young, affectionate maiden, already hysterical, is thrown into melancholy by a disappointment in love.

How difficult it is, and how seldom will the best antipsoric treatment do anything to relieve such unfortunates!

By far the most frequent excitement of the slumbering psora into chronic disease, and the most frequent aggravation of chronic ailments already existing, are caused by grief and vexation.

Uninterrupted grief and vexation very soon increase even the smallest traces of a slumbering psora into more severe symptoms, and they then develop these into an outbreak of all imaginable chronic sufferings more certainly and more frequently than all other injurious influences operating on the human organism in an average human life; while these two agencies just as surely and frequently, augment ailments already existing.

As the good physician will be pleased when he can enliven and keep from ennui the mind of a patient, in order to advance a cure which is not encumbered with such obstructions, he will in such a case feel more than ever the duty incumbent upon him to do all within the power of his influence on the patient and on his relatives and surroundings, in order to relieve him of grief and vexation. This will and must be a chief end of his care and neighborly love.

But if the relations of the patient cannot be improved in this respect, and if he has not sufficient philosophy, religion and power over himself to bear patiently and with equanimity all the sufferings and afflictions for which he is not to blame, and which it is not in his power to change; if grief and vexation continually beat in upon him, and it is out of the power of the physician to effect a lasting removal of these most active destroyers of life, he had better give up the treament [*] and leave the patient to his fate, for even the most masterly management of the case with the remedies that are the most exquisite and the best adapted to the bodily ailment will avail nothing, nothing at all, with a chronic patient thus exposed to continual sorrow and vexation, and in whom the vital economy is being destroyed by continuous assaults on the mind. The continuation of the fairest edifice is foolish, when the foundation is being daily undermined, even if but gradually, by the play of the waves.

Almost as near, and often nearer yet, to insurability are the chronic diseases, especially with great and rich men, who for some years, besides the use of mineral baths, [*] have passed through the hands of various, often of many, allopathic physicians, who have tried on them one after another all the fashionable modes of cure, the remedies which are so boastingly lauded in England, France and Italy, - all strongly acting mixtures. By so many unsuitable medicines, which are injurious by their violence and their frequent repetition in large doses, the psora which always lies within, even if not combined with syphilis, becomes every year more incurable, as do also the chronic ailments springing from it; and after the continuation of such irrational medical assaults on the organism for several years it becomes almost quite incurable. It cannot well be decided, since these things take place in the dark, whether these heroic unhomœopathic doses have added, as may be suspected, new ailments to the original disease, which ailments through the largeness of the doses and their frequent repetition have now become lasting and as it were chronic, or whether through abuse there has resulted a crippling of the different faculties of the organism, i.e.*, those of irritability, of sensation and of reproduction, and so (probably from both causes) there has arisen the monster of various ailments, fused into one another, which can no longer be rationally viewed as a simple natural ailment. In short, this many-sided disharmony and perversion of parts and of forces most indispensable to life present a chaos of ailments which the homœopathic physician should not lightly declare curable.

[*] Unless the patient should have little or no cause for his grief and sorrow, or hardly any incitement from without to vexation, and in consequence would need more particularly to be treated with respect to his mental disorder, by means of the antipsoric remedies, which are at the same time suited to the rest of his chronic disease. Such cases are not only curable, but often even easily curable.

[**] Every time the baths are used, even when the water is not in itself unsuitable to the ailment, they are to be considered as the use of large doses often repeated of one and the same violently acting medicine, the violent operation of which can seldom be salutary, and must often result in the aggravation of the morbid state, yea, even to the patient's utter destruction.

By such treatments, which are incapable of curing the original disease, but are exhausting and debilitating, the aggravation of the psora is not only hastened from within, but new artificial and threatening ailments are generated by such delusive allopathic cures, so that the vital force, thus attacked from two sides, often is unable to escape.

If in such cases the sad consequences of these indirect assaults of the old methods of cure were dynamic disturbances only, they would surely either disappear of themselves when the treatment is discontinued, or they ought at least to be extinguished again effectively through homœopathic medicines. But this is not at all the case; they do not yield. Very likely by these indirect, continuous and repeated assaults on the sensitive, irritable fiber by such injudicious medicinal disease-potencies, which are given in large doses frequently repeated, the vital force is obliged to meet this attack and to endeavor either to dynamically change these tender internal organs which are assaulted so mercilessly, or to reconstruct them materially so as to make them unassailable to such violent attacks, and thus to protect and shield the organism from general destruction. Thus, e.g., this force, which instinctively preserves life, beneficially shields the fine sensitive skin of the hand with a callous covering of hard, horny skin in persons with whom the skin is exposed to frequent injuries during hard labor whereby the skin is injured by hard, scratching materials or by corroding substances. So also in a long continued allopathic treatment, which has no true healing power with respect to the disease, no direct pathic (homœopathic) relation to the parts and processes concerned in the chronic disease, but internally assaults other delicate parts and organs of the body, in such cases the vital force, in order to protect the whole from destruction, dynamically and organically transmutes these fine organs; i.e., either makes them inactive or paralyzes them, or dulls their sensitiveness, or makes them altogether callous. On the one side the most tender fiber is abnormally thickened or hardened, and the more vigorous fibers consumed or annihilated -thus there arise artificially, adventitious organisms, malformations and degenerations, which at postmortem examinations are cunningly ascribed to the malignancy of the original disease. Such an internal state is not infrequent, and is in many cases incurable. Only where there are still sufficient vital powers in a body not too much bowed down by age (but where under an allopathic regime do we not find the powers wasted?) under favorable external circumstances, the vital force dynamically freed from its original disease by the careful homœopathic (antipsoric) treatment of a practiced physician, may succeed in gradually reasserting itself, and in gradually absorbing and transforming those (often numerous) adventitious secondary formations which it was compelled to form. Such a transformation is, however, only possible to a still energetic vital force, which has been in great part set free from its psora. Only however, under favorable external circumstances, and after the lapse of a considerable time and usually in only an imperfect manner, does the vital force succeed in this almost creative endeavor. Experience proves daily that the more zealously the allopath puts into practice in chronic disease his perverse destructive art (often with great care, industry and persistence), the more he ruins his patients in health and life.

How can perversions, introduced into patients in this manner frequently for years, be transformed in a short time into health even by the best, i.e., the true method of cure, which has never assumed to itself the power of directly influencing organic defects?

The physician has to meet in such cases no natural, simple psoric disease. He can therefore promise an improvement only after a long period of time, but never a full restoration, even if the vital powers are not (as is so frequently the case) altogether wasted; for where this is the case, he would feel compelled to desist from treatment even at the first glance. First the many chronic medicinal diseases which pass over the fluctuating state of health must gradually be removed (perhaps during a several months' stay in the country almost without medicine); or they must depart as of themselves through the activity of the vital force, when the antipsoric treatment has to some degree begun, with an improved manner of living and a regulated diet. For who could find remedies for all these ailments artificially produced by a confused mass of strong unsuitable medicines? The vital force must first absorb and reform what it has compulsorily deformed, before the true healer will in time see again before him a partially cleared malady similar to the original one, and which he will then be able to combat. [*]

[] On the other hand, the most dreadful diseases of every kind which have not been spoiled by any medical fatuity, in the families of farm laborers and other day laborers, on whom of course no ordinary physician presses his services, are quite commonly*, almost as if by a miracle, cured by the antipsoric remedies in a short time, and are transformed into lasting good health.

Woe to the young homœopathic physician who has to found his fame upon the cure of those diseases, of rich and prominent persons, which by a mass of allopathic evil arts have degenerated into such monstrosities! With all his care he will end in failure!

A similar great hindrance to a cure of far-advanced chronic diseases is often found in the debility and weakness into which youths fall who are spoiled by rich parents, being carried away by their superabundance and wantonness, and seduced by wicked companions through destructive passions and excesses, through revellings, abuse of the sexual instinct, gambling, etc. Without the least regard for life and for conscience, bodies originally robust are debilitated by such vices into mere semblances of humanity, and are besides ruined by perverse treatment of their venereal diseases, so that the psora, which frequently lurks within, grows up into the most pitiable chronic diseases, which, even if the morality of the patient should have improved, on account of the depressing remorse, and the little remnant of their wasted vital powers, accept antipsoric relief only with the greatest difficulty. Such cases should be undertaken by homœopathic physicians as curable only with the greatest caution and reserve.

But where the above-mentioned often almost insurmountable obstacles to the cure of these innumerable chronic diseases are not present, [*] there is nevertheless found at times, especially with the lower classes of patients, a peculiar obstruction to the cure, which lies in the source of the malady itself, where the psora, after repeated infections and a repeated external repression of the resulting eruption, had developed gradually from -its internal state into one or more severe chronic ailments. A cure will, indeed, also be certainly effected here, if the above-mentioned obstacles do not prevent, by a judicious use of the antipsoric remedies, but only with much patience and considerable time, and only with patients who observe the directions and who are not too aged nor too much debilitated.

[] One additional obstacle to the homœopathic cure of chronic diseases, and one which is not very rare but is still usually disregarded, is: The suppressed sexual instinct* with marriageable persons of either sex, either from non-marriage owing to various causes not removable by a physician, or where in married persons sexual intercourse of an infirm wife with a vigorous husband, or of the infirm husband with a vigorous wife has been absolutely and forever interdicted by an injudicious physician, as is not infrequently the case. In such cases a more intelligent physician, recognizing the circumstances and the natural impulse implanted by the Creator, will give his permission and thus not infrequently render curable a multitude of hysterical and hypochondriac states, yea, often even melancholy and insanity.

But in these difficult cases also the wise arrangement of nature is manifested in aid of our efforts, if we only make a good use of the favorable moment offering. For experience informs us that in a case of itch arising from a new infection, even when, after several preceding infections and repressions of the eruption, the psora has made considerable progress in the production of chronic diseases of many kinds, the itch which has last arisen, if it has only still kept its full primitive eruption unhindered on the skin, may be cured almost as easily as if it were the first and the only one, i.e., usually by merely one or a few doses of the appropriate antipsoric medicine, and that by such a cure the whole psora of all the preceding infections, together with its outbreaks into chronic ailments, is cured. [*]

Nevertheless it is not advisable to intentionally cause a new artificial infection with itch, even if the patient felt no repugnance to it (as is nevertheless, frequently the case) merely on account of the easier cure in that case of the old psora which had been several times renewed; because in severe chronic diseases of a non-venereal and therefore psoric origin, -as e.g. suppuration of the lungs, a complete paralyzation of one or another part of the body, etc.,- the itch miasma rarely retains its hold, and, as far as experience shows, it clings less when caused by an artificial inoculation than when it originates from an accidental, unintentional infection.

I have little further to say to the physician already skilled in the homœopathic art as to how he is to operate in the cure of chronic diseases, except to direct him to the antipsoric remedies appended to this work; for he will know how to use these remedies for this noble end successfully. I have only to add a few cautions.

First of all, the great truth is established that all chronic ailments, all great, and the greatest, long continuing diseases (excepting the few venereal ones) spring from psora alone and only find their thorough cure in the cure of the psora; they are, consequently, to be healed mostly only by antipsoric remedies, i.e., by those remedies which in their provings as to their pure action on the healthy human body manifest most of the symptoms which are most frequently perceived in latent as well as in developed psora.

The homœopathic physician, therefore, in curing a chronic (non-venereal) disease, and in all and in every symptom, ailment and disorder arising in this disease, no matter what seductive name these may have in common life or in pathology, will usually and especially look to the use of an antipsoric medicine selected according to strictly homœopathic rules, in order to surely attain his end.

[*] The same is the case, according to the merciful arrangement of nature, with syphilis, where, after a local destruction of the chancre or the bubo and after a consequent breaking out of the venereal disease, a new infection takes place. The new infection, while the chancre remains undisturbed, may be cured, together with the venereal disease sprung from the former infection, just as easily by a single dose of the best mercurial preparation, as if the first chancre were still present, -provided that no complication with either of the other two chronic miasmata, especially the psoric, has taken place; for in such a case, as has been mentioned above, the psora must first be removed.

Let him not think, while a well-chosen antipsoric medicine is acting and the patient some day feels a moderate headache, or else a moderate ailment, that he must give the patient at once some other medicine, whether an antipsoric or another remedy; or if perchance a sore throat should arise, that he must give another remedy, or another on account of diarrhœa, or another on account of some moderate pain in one part or another, etc.

No! the homœopathic antipsoric medicine having been chosen as well as possible to suit the morbid symptoms, and given in the appropriate potency and in the proper dose, the physician should as a rule allow it to finish its action without disturbing it by an intervening remedy.

For if the symptoms occurring during the action of the remedy have also occurred, if not in the last few weeks, at least now and then some weeks before, or some months before in a similar manner, then such occurrences are merely a homœopathic excitation, through the medicine, of some symptom not quite unusual to this disease, of something which had perhaps been more frequently troublesome before, and they are a sign that this medicine acts deeply into the very essence of this disease, and that consequently it will be more effective in the future. The medicine, therefore, should be allowed to continue and exhaust its action undisturbed, without giving the least medicinal substance between its doses.

But if the symptoms are different and had never before occurred, or never in this way, and, therefore, are peculiar to this medicine and not to be expected in the process of the disease, but trifling, the action of the medicine ought not for the present to be interrupted. Such symptoms frequently pass off without interrupting the helpful activity of the remedy; but if they are of a burdensome intensity, they are not to be endured; in such a case they are a sign that the antipsoric medicine was not selected in the correct homœopathic manner. Its action must then be checked by an antidote, or when no antidote to it is known, another antipsoric medicine more accurately answering its symptoms must be given in its place; in this these false symptoms may continue a few more days, or they may return, but they will soon come to a final end and be replaced by a better help.

Least of all, need we to be concerned when the usual customary symptoms are aggravated and show most prominently on the first days, and again on some of the following days, but gradually less and less. This so-called homœopathic aggravation is a sign of an incipient cure (of the symptoms thus aggravated at present), which may be expected with certainty.

But if these aggravated original symptoms appear on subsequent days still of the same strength as at the beginning, or even with an increased severity, it is a sign that the dose of this antipsoric remedy, although properly selected according to homœopathic principles, was too large, and it is to be apprehended that no cure will be effected by it; because the medicine in so large a dose is able to establish a disease, which in some respects, indeed, is similar to it; with respect to the fact, however, that the medicine in its present intensity unfolds also its other symptoms which annul the similarity, it produces a similar chronic disease instead of the former, and, indeed, a more severe and troublesome one, without thereby extinguishing the old original one.

This will be decided in the first sixteen, eighteen or twenty days of the action of the medicine which has been given in too large a dose, and it must then be checked, either by prescribing its antidote, or, if this is not as yet known, by giving another antipsoric medicine fitting as well as possible, and indeed in a very moderate dose, and if this does not suffice to extinguish this injurious medicinal disease, another still should be given as homœopathically suitable as possible. [*]

Now when the stormy assault caused by too large a dose of medicine, although homœopathically selected, has been assuaged through an antidote or the later use of some other antipsoric remedies, then, later on, the same antipsoric remedy -which had been hurtful only because of its over-large dose- can be used again, and, indeed, as soon as it is homœopathically indicated, with the greatest success, only in a far smaller dose and in a much more highly potentized attenuation, i.e., in a milder quality.

The physician can, indeed, make no worse mistake than first, to consider as too small the doses which I (forced by experience) have reduced after manifold trials and which are indicated with every antipsoric remedy and secondly, the wrong choice of a remedy, and thirdly, the hastiness which does not allow each dose to act its full time.

[] I have myself experienced this accident, which is very obstructive to a cure and cannot be avoided too carefully. Still ignorant of the strength of its medicinal power, I gave sepia in too large a dose. This trouble was still more manifest when I gave lycopodium and silicea, potentized to the one-billionth degree, giving four to six pellets, though only as large as poppy seeds. Discite moniti*.

The first error I have already spoken of, and would only add that nothing is lost if the dose is given even smaller than I have prescribed. It can hardly be given too small, if only everything ill the diet and the remaining mode of life of the patient which would obstruct or counteract the action of the medicine is avoided. The medicine will still produce all the good effects which can at all be expected from a medicine, if only the antipsoric was homœopathically, correctly, selected according to the carefully investigated symptoms of the disease, and if the patient does not disturb its effects by his violation of the rules. If ever it should happen that the choice has not been correctly made, the great advantage remains, that the incorrectly selected medicine in this smallest dose may in the manner indicated above be counteracted more easily, whereupon the cure may be continued without delay with a more suitable antipsoric.

As to the second chief error in the cure of chronic diseases (the unhomœopathic choice of the medicine) the homœopathic beginner (many, I am sorry to say, remain such beginners their life long) sins chiefly through inexactness, lack of earnestness and through love of ease.

With the great conscientiousness which should be shown in the restoration of a human life endangered by sickness more than in anything else, the Homœopath, if he would act in a manner worthy of his calling, should investigate first the whole state of the patient, the internal cause as far as it is remembered, and the cause of the continuance of the ailments his mode of life, his quality as to mind, soul and body, together with all his symptoms (see directions in Organon), and then he should carefully find out in the work on Chronic Diseases as well as in the work on Materia Medica Pura a remedy covering in similarity, as far as possible, all the moments, or at least the most striking and peculiar ones, with its own peculiar symptoms; and for this purpose he should not be satisfied with any of the existing repertories, - a carelessness only too frequent; for these books are only intended to give light hints as to one or another remedy that might be selected, but they can never dispense him from making the research at the first fountain heads. He who does not take the trouble of treading this path in all critical and complicated diseases, and, indeed, with all patience and intelligence, but contents himself with the vague hints of the repertories in the choice of a remedy, and who thus quickly dispatches one patient after the other, does not deserve the honorable title of a genuine Homœopath, but is rather to be called a bungler, who on that account has continually to change his remedies until the patient loses patience; and as his ailments have of course only been aggravated he must leave this aggravator of diseases, whereby the art itself suffers discredit instead of the unworthy disciple of art.

This disgraceful love of ease (in the calling which demands the most conscientious care) often induces such would-be Homœopaths to give their medicines merely from the (often problematic) statement of their use (ab usu in morbis) which are enumerated in the introductions to the medicines, a method which is altogether faulty and strongly savors of allopathy, as these statements usually only give a few symptoms. They should only serve as a confirmation of a choice made according to the pure actions of the medicines; but never to determine the selection of a remedy which can cure only when used according to the exact similitude of its homœopathic symptoms. There are, we are sorry to say, even authors who advise following this empiric pathway of error!

The third leading mistake which the homœopathic physician cannot too carefully nor too steadfastly avoid while treating chronic diseases, is in hastily and thoughtlessly -when a properly moderate dose of a well selected antipsoric medicine has been serviceable for several days,- giving some other medicine in the mistaken supposition that so small a dose could not possibly operate and be of use more than eight or ten days. This notion is sought to be supported by the statement that on some day or other, while allowed to continue its action, the morbid symptoms which were to be eradicated, had shown themselves somewhat from time to time.

But if once a medicine, because it was selected in a correct homœopathic manner, is acting well and usefully, which is seen by the eighth or tenth day, then an hour or even half a day may come when a moderate homœopathic aggravation again takes place. The good results will not fail to appear but may, in very tedious ailments, not show themselves in their best light before the twenty-fourth or thirtieth day. The dose will then probably have exhausted its favorable action about the fortieth or fiftieth day, and before that time it would be injudicious, and an obstruction to the progress of the cure, to give any other medicine. Let it not be thought, however, that we should scarcely wait for the time assigned as the probable duration of action to elapse, before giving another antipsoric medicine: that we should hasten to change to a new medicine in order to finish the cure more quickly. Experience contradicts this notion entirely, and teaches on the contrary, that a cure cannot be accomplished more quickly and surely than by allowing the suitable antipsoric to continue its actions so long as the improvement continues, even if this should be several, yea, many [*] days beyond the assigned, supposed time of its duration, so as to delay as long as practicable the giving of a new medicine.

[] In a case where sepia* had showed itself completely homœopathically antipsoric for a peculiar headache that appeared in repeated attacks, and where the ailment had been diminished both as to intensity and duration, while the pauses between the attacks had also been much lengthened, when the attacks re-appeared I repeated the dose, which then caused the attacks to cease for one hundred days (consequently its action continued that long), when it reappeared to some degree, which necessitated another dose, after which no other attack took place for, now, seven years, while the health was also otherwise perfect.

Whoever can restrain his impatience as to this point, will reach his object the more surely, and the more certainly. Only when the old symptoms, which had been eradicated or very much diminished by the last and the preceding medicines commence to rise again for a few days, or to be again perceptibly aggravated, then the time has most surely come when a dose of the medicine most homœopathically fitting should be given. Experience and careful observation alone can decide; and it always has decided in my manifold, exact observations, so as to leave no doubt remaining.

Now if we consider the great changes which must be effected by the medicine in the many, variously composite and incredibly delicate parts of our living organism, before a chronic miasm so deeply inrooted and, as it were, parasitically interwoven with the economy of our life as psora is, can be eradicated and health be thus restored: then it may well be seen how natural it is, that during the long-continued action of a dose of antipsoric medicine selected homœopathically, assaults may be made by it at various periods on the organism, as it were in undulating fluctuations during this long-continued disease. Experience shows that when for several days there has been an improvement, half hours or whole hours or several hours will again appear when the case seems to become worse; but these periods, so long as only the original ailments are renewed and no new, severe symptoms present themselves, only show a continuing improvement, being homœopathic aggravations which do not hinder but advance the cure, as they are only renewed beneficent assaults [*] on the disease, though they are wont to appear at times sixteen, twenty or twenty-four days after taking a dose of antipsoric medicine.

[*] These attacks, however, if the antipsoric remedy was selected fittingly and homœopathically and the dose was a moderate one, during its continued action take place, ever more and more rarely and more feebly, but if the doses were too strong they come more frequently and more strongly, to the detriment of the patient.

As a rule, therefore, the antipsoric medicine in chronic diseases continue their action the longer, the more tedious the diseases are. But vice versa also those medicines which in the healthy body show a long period of action act only a short time and quickly in acute diseases which speedily run their course (e.g. belladonna, sulphur, arsenic, etc.) and their periods of action are shorter, the more acute the diseases. The physician must, therefore, in chronic diseases, allow all antipsoric remedies to act thirty, forty or even fifty and more days by themselves, so long as they continue to improve the diseased state perceptibly to the acute observer, even though gradually; for so long the good effects continue with the indicated doses and these must not be disturbed and checked by any new remedy. [*]

[] The importance of avoiding the above-described two errors will hardly be realized by physicians. These great, pure truths will be questioned yet for years even by most of the homœopathic physicians, and will not, therefore, be practiced, on account of the theoretical reflection and the reigning thought: It requires quite an effort to believe that so little a thing, so prodigiously small a dose of medicine, could effect the least thing in the human body, especially in coping with such enormously great, tedious diseases; but that the physician must cease to reason, if he should believe that these prodigiously small doses can act not only two or three days, but even twenty, thirty and forty days and longer yet, and cause, even to the last day of their operation, important, beneficent effects otherwise unattainable. Nevertheless this true theorem is not to be reckoned among those which should be comprehended, nor among those for which I ask a blind faith. I demand no faith at all, and do not demand that anybody should comprehend it. Neither do I comprehend it; it is enough, that it is a fact and nothing else. Experience alone declares it, and I believe more in experience than in my own intelligence. But who will arrogate to himself the power of weighing the invisible forces that have hitherto been concealed in the inner bosom of nature, when they are brought out of the crude state of apparently dead matter through a new, hitherto undiscovered agency, such as is potentizing by long continued trituration and succussion. But he who will not allow himself to be convinced of this and who will not, therefore, imitate what I now teach after many years' trial and experience (and what does the physician risk, if he imitates it exactly?), he who is not willing to imitate it exactly, can leave this greatest problem of our art unsolved, he can also leave the most important chronic diseases uncured*, as they have remained unhealed; indeed, up to the time of my teaching. I have no more to say about this. It seemed to me my duty to publish the great truths to the world that needs them, untroubled as to whether people can compel themselves to follow them exactly or not. If it is not done with exactness, let no one boast to have imitated me, nor expect a good result. Do we refuse to imitate any operation until the wonderful forces of nature on which the result is based are clearly brought before our eyes and made comprehensible even to a child? Would it not be silly to refuse to strike sparks from the stone and flint, because we cannot comprehend how so much combined caloric can be in these bodies, or how this can be drawn out by rubbing or striking, so that the particles of steel which are rubbed off by the stroke of the hard stone are melted, and, as glowing little balls, cause the tinder to catch fire? And yet we strike fire with it, without understanding or comprehending this miracle of the inexhaustible caloric hidden in the cold steel, or the possibility of calling it out with a frictional stroke. Again, it would be just as silly as if we should refuse to learn to write, because we cannot comprehend how one man can communicate his thought to another through pen, ink, and paper -and yet we communicate our thoughts to a friend in a letter without either being able or desirous of comprehending this psychico-physical miracle! Why, then, should we hesitate to conquer and heal the bitterest foes of the life of our fellowman, the Chronic diseases, in the stated way, which, punctually followed, is the best possible method, because we do not see how these cures are effected?

But if these appropriately selected antipsoric medicines are not allowed to act their full time, when they are acting well, the whole treatment will amount to nothing. Another antipsoric remedy which may be ever so useful, but is prescribed too early and before the cessation of the action of the present remedy, or a new dose of the same remedy which is still usefully acting, can in no case replace the good effect which has been lost through the interruption of the complete action of the preceding remedy, which was acting usefully, and which can hardly be again replaced.

It is a fundamental rule in the treatment of chronic diseases: To let the action of the remedy, selected in a mode homœopathically appropriate to the case of disease which has been carefully investigated as to its symptoms, come to an undisturbed conclusion, so long as it visibly advances the care and the while improvement still perceptibly progresses. This method forbids any new prescription, any interruption by another medicine and forbids as well the immediate repetition of the same remedy. Nor can there be anything more desirable for the physician than to see the improvement of the patient proceed to its completion unhindered and perceptibly. There are not a few cases, where the practiced careful Homœopath sees a single dose of his remedy, selected so as to be perfectly homœopathic, even in a very severe chronic disease, continue uninterruptedly to diminish the ailment for several weeks, yea, months, up to recovery; a thing which could not have been expected better in any other way, and could not have been effected by treating with several doses or with several medicines. To make the possibility of this process in some way intelligible, we may assume, what is not very unlikely, that an antipsoric remedy selected most accurately according to homœopathic principles, even in the smallest dose of a high or the highest potency can manifest so long-continued a curative force, and at last cure, probably, only by means of a certain infection with a very similar medicinal disease which overpowers the original disease, by the process of nature itself, according to which (Organon, § 45, Fifth Edition,) two diseases which are different, indeed, in their kind but very similar in their manifestations and effects, as also in the ailments and symptoms caused by it, when they meet together in the organism, the stronger disease (which is always the one caused by the medicine, §33, ibid.) destroys the weaker (the natural one). In this case every new medicine and also a new dose of the same medicine, would interrupt the work of improvement and cause new ailments, an interference which often cannot be repaired for a long time.

But if any unfavorable effects are evolved by the present dose of medicine, i.e., troublesome symptoms which do not belong to this disease, and if the mind of the patient becomes depressed, if only a little at first, still increasingly, then the next dose of the same medicine, given immediately after the former, cannot but become injurious to the patient. Yet when a sudden great and striking improvement of a tedious great ailment follows immediately on the first dose of a medicine, there justly arises much suspicion that the remedy has only acted palliatively, and therefore must never be given again, even after the intervention of several others remedies.

Nevertheless there are cases which make an exception to the rule, but which not every beginner should risk finding out. [*]

[*] Still there has been of late much abuse of this immediate repetition of doses of the same medicine, because young Homœopaths thought it more convenient to repeat, without examination, a medicine which in the beginning had been found to be homœopathically suitable, and which had therefore in the beginning proved serviceable, and even to repeat it frequently without examination, so as to heal more quickly. We may declare it once, that the practice of late, which has even been recommended in public journals of giving the patient several doses of the same medicine to take with him, so that he may take them himself at certain intervals, without considering whether this repetition may affect him injuriously, seems to show a negligent empiricism, and to be unworthy of a homœopathic physician, who should not allow a new dose of a medicine to be taken or given without convincing himself in every case beforehand as to its usefulness.

The only allowable exception for an immediate repetition of the same medicine is when the dose of a well-selected and in every way suitable and beneficial remedy has made some beginning toward an improvement, but its action ceases too quickly, its power is too soon exhausted, and the cure does not proceed any further. This is rare in chronic diseases, but in acute diseases and in chronic diseases that rise into an acute state it is frequently the case. It is only then, -as a practiced observer may recognize- when the peculiar symptoms of the disease to be treated, after fourteen, ten, seven, and even fewer days, visibly cease to diminish, so that the improvement manifestly has come to a stop, without any disturbance of the mind and without the appearance of any new troublesome symptoms, so that the former medicine would still be perfectly homœopathically suitable, only then, if say, is it useful, and probably necessary to give a dose of the same medicine of a similarly small amount, but most safely in a different degree of dynamic potency. [] When the remedy is thus modified, the vital force of the patient will allow itself more easily to be further affected by the same medicine, so as to effect by it everything that may be expected of this medicine and in this ailment. [*]

To adduce an example: a freshly arisen eruption of itch belongs to those diseases which might soonest permit the repetition of the dose (sulphur), and which does permit it the more frequently, the sooner after the infection the itch is received for treatment, as it then approaches the nature of an acute disorder, and demands its remedies in more frequent doses than when it has been standing on the skin for some time. But this repetition should be permitted only when the preceding dose has largely exhausted its action (after six, eight or ten days), and the dose should be just as small as the preceding one, and be given in a different potency. Nevertheless it is in such a case often serviceable, in answer to a slight change of symptoms, to interpose between the doses of pure sulphur, a small dose of Hepar sulphuris calcareum. This also should be given in various potencies, if several doses should be needed from time to time. Often also, according to circumstances, a dose of Nux vomica (x) or one of mercury (x) [***] may be used between.

[] If it, e.g., has first been given in the 30th potency it will now be given in perhaps the 18th, and if a repetition should, be again found serviceable and necessary, it might afterwards be given in the 24th. and later perhaps also in the 12th and 6th, etc., if, e.g.,* the chronic disease should have taken on itself an acute character. A dose of medicine may also have been suddenly counteracted and annihilated by a grave error in the regimen of the patient, when perhaps a dose of the former serviceable medicine might again be given with the modification mentioned above.

[**] In cases where the physician is certain as to the homœopathic specific to be used, the first attenuated dose may also be dissolved in about four ounces of water by stirring it, and one-third may be drunk at once, and the second and third portions on the following days; but it should each time be again stirred so as to increase the potency and thus to change it. Thereby the remedy seeing to take a deeper hold on the organism and hasten the restoration in patients who are vigorous and not too sensitive.

[**] That the itch-patient during such a treatment must avoid every external application, however harmless it may appear, e.g.*, the washing with black soap, is not necessary to emphasize.

If I except sulphur, Hepar sulphuris and in some cases Sepia, the other antipsoric remedies can seldom be usefully given in immediately repeated doses. Indeed it is hardly ever needed in chronic diseases, as we have a goodly supply of antipsoric remedies at our disposal, so that as soon as one well selected remedy has completed its action, and a change of symptoms, i.e., a change in the total image of the disease, appears, another antipsoric remedy homœopathically appropriate to the altered case may be chosen to greater advantage and with a more sure prospect of hastening the cure, than if we take the risk of prescribing the former medicine which now is no longer altogether adequate. Nevertheless in very tedious and complex cases, which are mostly such as have been mismanaged by allopathic treatment, it is nearly always necessary to give again from time to time during the treatment, a dose of Sulphur or of Hepar (according to the symptoms), even to the patients who have been before dosed with large allopathic doses of Sulphur and with sulphur-baths; but then only after a previous dose of Mercury (x).

Where, as is usually the case in chronic diseases, various antipsoric remedies are necessary, the more frequent sudden change of them is a sign that the physician has selected neither the one nor the other in an appropriately homœopathic manner, and had not properly investigated the leading symptoms of the case before prescribing a new remedy. This is a frequent fault into which the homœopathic physician falls in urgent cases of chronic diseases, but oftener still in acute diseases from overhaste, especially when the patient is a person very dear to his heart. I cannot too urgently warn against this fault.

Then the patient naturally falls into such an irritated state that, as we say, no medicine acts, or shows its effect, [*] yea, so that the power of response in the patient is in danger of flaring up and expiring at the least further dose of medicine. In such a case no further benefit can be had through medicine, but there may be in use a calming mesmeric stroke made from the crown of the head (on which both the extended hands should rest for about a minute) slowly down over the body, passing over the throat, shoulders, arms, hands, knees and legs down over the feet and toes. This may be repeated if necessary.

A dose of homœopathic medicine may also be moderated and softened by allowing the patient to smell [**] a small pellet moistened with the selected remedy in a high potency, and placed in a vial the mouth of which is held to the nostril of the patient, who draws in only a momentary little whiff of it. By such an inhalation the powers of any potentized medicine may be communicated to the patient in any degree of strength. One or more such medicated pellets, and even those of a larger size may be in the smelling-bottle, and by allowing the patient to take longer or stronger whiffs, the dose may be increased a hundred fold as compared with the smallest first mentioned. The period of action of the power of a potentized medicine taken in by such inhalation and spread over so large a surface (as that of the nostrils and of the lungs) last as long as that of a small massive dose taken through the mouth and the fauces.

[] That a homœopathically potentized dose of medicine should ever fail of having an effect in a treatment conducted with care*, I think impossible; I have never experienced it.

[**] Even persons born without the sense of smell or who have lost it through disease, may expect equally efficient help from drawing in the imperceptible vapor (proceeding from the medicine and contained in the vial) through one nostril or the other, as those do who are gifted with the sense of smell. From this it follows that the nerves possessing merely the sense of touch receive the salutary impression and communicate it unfailingly to the whole nervous system.

Such medicated pellets kept in a stoppered vial retain their medicinal power quite undiminished, even if the vial be opened a number of times in many years for the purpose of inhalation; i.e., if the vial be preserved from sunshine and heat. This method of allowing the patient to be acted upon by smelling the potentized medicine has great advantages in the manifold mishaps which often obstruct and interrupt the treatment of chronic diseases. The antidote to remove these mishaps as quickly as possible the patient may also best receive in greater or less strength through inhalation, which acts most quickly on the nerves and so also affords the most prompt assistance, by which also the continuation of the treatment of the chronic disease is least delayed. When the mishap has thus been obviated most speedily, the antipsoric medicine before taken frequently continues its interrupted action for some time. But the dose of the inhaled medicine must be so apportioned to the morbid interruption that its effect just suffices to extinguish the disadvantage arising from the mishap, without going any deeper or being able to continue its operation any further.

If a homœopathic physician, scrupulous at the wrong occasion, should ask me bow he might fill up the many days after giving a dose, so that it may continue its action undisturbed during the above-mentioned long time, and so satisfy, without injuring, the patient who every day [] asks for his medicine, I reply with two words, that he should be given every day at the usual time for medicine a dose of sugar of milk, about three grains, which shall be marked as usual with continuous numbers. [] I remark here, that I consider the sugar of milk thus used as an invaluable gift of God. []

[*] No old established custom among the people, be it ever so hurtful, can be suddenly changed. So also the homœopathic physician cannot avoid allowing a new chronic patient to take at least one little powder a day; the difference between this and the many medicinal doses of allopaths is still very great. During this daily taking of a powder, following the numbers, it will be a great benefit to the poor patient who is often intimidated by slanderers of the better medical art, if he does not know whether there is a dose of medicine in every powder, nor again, in which one of them? If he knew the latter, and should know, that to-day's number contains the medicine of which he expects so much, his fancy would often play him an evil trick, and he would imagine that he feels sensations and changes in his body, which do not exist; he would note imaginary symptoms and live in a continual inquietude of mind; but if he daily takes a dose, and daily notices no evil assault on his health, he becomes more equable in disposition (being taught by experience), expects no ill effects, and will then quietly note the changes in his state which are actually present, and therefore can only report the truth to his physician. On this account it is best that he should daily take his powder, without knowing whether there is medicine in all or in a certain powder; thus he will not expect more from to-day's powder than from yesterday's or that of the day before.

[**] Chronic patients who firmly trust in the honesty and skill of their physician will be satisfied, without any after thoughts, to receive such a dose of sugar of milk every two, four or seven days, according to the disposition of each, and nevertheless retain a firm confidence, as, indeed, is only just and reasonable.

[***] There were some anxious purists, who were afraid that even the pure sugar of milk, either in itself or changed by long trituration, might have medicinal effects. But this is a vain, utterly unfounded fear, as I have determined by very exact experiments. We may use the crude, pure sugar of milk as a food, and partake of considerable quantities of it, without any change in the health, and so also the triturated sugar. But to destroy at the same time the fear to which utterance has been given by some hypochondriacs, that through a long trituration of the sugar of milk alone, or in the potentizing of medicines, something might rub off from the porcelain mortar (silica), which being potentized by this same trituration would be bound to become strongly acting Silicea(1), I took a new porcelain triturating bowl in which the glazing had been rubbed off, with a new porcelain pestle, and had one hundred grains of pure sugar of milk, divided into portions of thirty-three grains, triturated eighteen times for six minutes at a time and as frequently scraped for four minutes with a porcelain spatula, in order to develop by this three hours strong trituration a medicinal power either of the sugar of milk or of the silica or of both; but my preparation remained as indifferent and unmedicinal as the crude, merely nutritive sugar of milk, of which I convinced myself by experiments on very sensitive persons.

We cannot flatter ourselves that the antipsoric medicine given was rightly selected, or that it will forward the cure of a chronic disease, if it quickly and entirely destroys as if by a stroke of magic the most troublesome symptoms, old, great, continuous pains, tonic or clonic spasms, etc., so that the patient almost immediately after taking the medicine, fancies himself as much freed from sufferings as if he were already restored, and as if in heaven. This deceptive effect shows that the medicine here acts enantiopathically as an opposite or palliative, and that in the days following we cannot expect anything from this remedy but an aggravation of the original disease. As soon then as this deceptive improvement within a few days begins again to turn to aggravation, it is high time to give either the antidote to this medicine, or, when this cannot be had, a medicine which is homœopathically more appropriate. Very rarely will such an enantiopathic remedy do any good in the future. If the medicine which is thus antipathic at once in the beginning, i.e., which seemed so to alleviate, is inclined to reciprocal action, it is possible that when the aggravation from this dose takes place, a second dose of the same remedy may produce the contrary, and thus bring about a lasting improvement, as I have at least perceived in ignatia.

In such cases we may also successfully use, for the ailments following after a few days from such an antipathic remedy, one of the remaining medicines from the considerable store laid down in Materia Medica Pura, in the "Archiv der homœopathischen Heilkunst" or in the "Annalen." This may be done for a few days until the Psora-disease returns to its customary routine course, when a homœopathically selected antipsoric medicine is to be given to continue the Cure.

Among the mishaps which disturb the treatment only in a temporary way, I enumerate: overloading the stomach (this may be remedied by hunger, i.e., by only taking a little thin soup instead of the meal, and a little coffee); disorder of the stomach from fat meat, especially from eating pork (to be cured by fasting and pulsatilla); a disorder of the stomach which causes rising from the stomach after eating and especially nausea and inclination to vomit (by highly potentized antimonium crudum); taking cold in the stomach by eating fruit (by smelling of arsenicum); troubles from spirituous liquors (nux vomica); disorder of the stomach with gastric fever, chilliness and cold (bryonia alba); fright (when the medicine can be given at once, and especially when the fright causes timidity, by poppy-juice (opium); but if aid can only be rendered later, or when vexation is joined with the fright, by aconite; but if sadness is caused by the fright, ignatia seeds); vexation which causes anger, violence, heat, irritation, by chamomilla, (but if beside the vexation there is chilliness and coldness of the body, by bryonia); vexation with indignation, deep internal mortification (attended with throwing away what was held in the hand, by staphisagria); indignation with silent internal mortification (by colocynthis); unsuccessful. love with quiet grief (by ignatia); unhappy love with jealousy (by hyoscyamus); a severe cold (next to keeping the house or the bed) by nux vomica; when diarrhœa resulted, by dulcamara; or if followed by pains, coffea cruda; or if followed by fever and heat, by aconite, a cold which is followed by suffocative fits, (by ipecacuanha); colds followed by pains and an inclination to sleep, (by coffea cruda); cold with consequent coryza and loss of the sense of smell and of taste, (by pulsatilla); overlifting or strains (sometimes by arnica, but most certainly by rhus toxicodendron); contusions and wounds inflicted by blunt instruments, (by arnica); burning of the skin (by compresses of water mixed with a dilution of highly potentized arsenicum, or uninterrupted application for hours of alcohol heated by means of very hot water); weakness from loss of fluids and blood, (by china); homesickness with redness of the cheeks, (by capsicum).

But during the treatment of chronic diseases by antipsoric remedies we often need the other non-antipsoric store of medicines in cases where epidemic diseases or intermediate diseases (morbi intercurrentes) arising usually from meteoric and telluric causes attack our chronic patients, and so not only temporarily disturb the treatment, but even interrupt it for a longer time. Here the other homœopathic remedies will have to be used, wherefore I shall not enter upon this here, except to say that the antipsoric treatment will have for the time to be totally discontinued, so long as the, treatment of the epidemic disease which has also seized our (chronic) patient may last, even if a few weeks in the worst cases may thus be lost. But here also, if the disease is not too severe, the above mentioned method of applying the medicine by smelling a moistened pellet is often sufficient to help, and the cure of the acute disease may thus he extraordinarily shortened.

The intelligent homœopathic physician will soon note the point of time when his remedies have completed the cure of the epidemic intermediate disease [*] and when the peculiar course of the chronic (psoric) malady is continued.

[] Usually these epidemic intermediate diseases appear in the form of a fever (if they are not the permanent miasms, small-pox, measles, dysentery, whooping cough, etc.). There are fevers of various kinds, a continuous acute fever, or a slow remittent, or an intermittent fever. Intermittent fevers appear almost every year in a somewhat changed form. Since I have learned to cure chronic diseases and maladies by a homœopathic extirpation of their psoric source, I have found the epidemically current intermittent fevers almost every year different in their character and in their symptoms, and they therefore require almost every year a different medicine for their specific cure. one year they require arsenicum, another belladonna, another antimonium crudum, or spigelia, aconite, with ipecacuanha, alternating with nux vomica, sal ammoniacum, natrum muriaticum, opium, cina, alone or in alternation with capsicum, or capsicum alone, menyanthes trifoliata, calcarea carbonica, pulsatilla, one of the two carbos, arnica, alone or in alternation with ipecacuanha, and with these they were cured in a few days. I would not, indeed, except any one of the non-antipsoric medicines, if they are only homœopathic to the whole complex of the symptoms of the prevailing fever, in its attack as well as in its apyrexia (see von Bœnninghausen, Versuch e. hom. Therapie d. Wechselfiebers, 1833, Muenster), but I would almost always except cinchona; for this can only suppress its type in many large doses in a concentrated form (as quinine), and then it changes it into a cachexy of quinine, which it is difficult to cure. (China is only appropriate to the endemic intermittent fever in marshy regions, and even this can only be rightly cured by it in connection with antipsoric remedies.) Even at the beginning of the treatment of an epidemic intermittent fever, the homœopathic physician is most safe in giving every time an attenuated dose of sulphur or in appropriate cases, hepar sulphuris in a fine little pellet or by means of smelling, and in waiting its effects for a few days, until the improvement resulting from it ceases, and then only he will give, in one or two attenuated doses, the non-antipsoric medicine which has been found homœopathically appropriate to the epidemy of this year. These doses should however only be given at the end of an attack. With all patients in intermittent fever, psora is essentially involved in every epidemy*, therefore an attenuated dose of sulphur, or of hepar sulphuris is necessary at the beginning of every treatment of epidemic intermittent fever, and makes the restoration of the patient more sure and easy.

The symptoms of the original chronic disease will, however, always be found somewhat varied after the cure of such a prevailing intermediate disease. Also another part of the body will be found suffering, so that the homœopathic physician will choose his antipsoric remedy according to the totality of the remaining symptoms, and not simply give the one he intended to give before the intermediate disease appeared.

When the physician is called to treat such a prevalent disease in a patient whom he had not before attended as a chronic patient he will not unfrequently find, especially if the fever was considerable, that after overcoming it by the remedies which had been homœopathically specific with other patients of this kind, the full restoration to health does not follow even with good diet and mode of living: but incidents of another kind will show themselves (usually, called after-pains or secondary diseases) and these will gradually be aggravated and threaten to become chronic. Here the homœopathic physician will nearly always have to meet a psora which is developing into a chronic disease, and this will have to be cured according to the principles here laid down.

Here is a fitting opportunity to note that the great epidemic diseases: smallpox, measles, purple rash, scarlet fever, whooping cough, fall dysentery and typhoid, when they complete their course especially without a judicious homœopathic treatment, leave the organism so shaken and irritated, that with many who seem restored, the psora which was before slumbering and latent now awakes quickly, either into itch-like eruptions [] or into other chronic disorders, which then reach a high degree in a short time, if they are not treated properly in an antipsoric manner. This is due to the great exhaustion of the organism which still prevails. The allopathic physician, when such a patient, as is frequently the case, dies after all his unsuitable treatment, declares that he has died from the sequelæ*, of whooping cough, measles, etc.

These sequelæ are, however, the innumerable chronic diseases in numberless forms of developed psora which have hitherto been unknown as to their origin and consequently remained uncured.

Epidemic and sporadic fevers, therefore, as well as the miasmatic acute diseases, if they do not soon terminate and pass directly over into good health, (even when the epidemic and acute miasmatic part has found a homœopathic specific which has been rightly used against them), often need an antipsoric assistance, which I have usually found in sulphur, if the patient had not used shortly before a medicine containing sulphur, in which case another antipsoric suitable to this particular case will have to be used.

Endemic diseases, with their striking pertinacity, depend almost wholly on a psoric complication, or on psora modified by the peculiarity of the nature of the locality (and the especial mode of life of the inhabitants), so that, e.g., in intermittent fever originating in a marshy region, the patients, even after removal into a dry region, often remain uncured despite of all their use of china, unless the antipsoric treatment is especially used. The exhalation from swamps seems to be one of the strongest physical causes of the development of the psora latent within with so many persons [*] and this most of all in hot countries. Without an almost regular use of the best antipsoric method of cure, we shall never succeed in removing the murderous qualities of humid climates and changing them into passably healthy, habitable regions. Man may accustom himself to the extreme degrees of atmospheric heat, as well as to the most violent cold, and can live joyous and healthy in both extremes, Why should he not be able to accustom himself to marshy regions just as well as to the driest mountain regions, if there were not a hitherto undiscovered and unconquered enemy of vigorous life and lasting health, lying in ambush in marshy regions, i.e., psora? Wherever psora lies latent within (and how frequently is this the case?) it is developed into chronic diseases of every kind, especially those in which the liver is most affected, through stagnant water and the gases that emanate from damp soil and from swamps; and this is effected more surely, yea, unavoidably* by these causes than by any other physical power injurious to health.

[] When such an eruption appears in any quantity, it is called by writers scabies spontanea* (spontaneous itch) - a mere chimera and nonentity, for as far as history goes, no itch has arisen except from infection, and it cannot now arise again of itself without infection with the miasma of itch. But this phenomenon after acute fever is nothing else than the secondary eruption so often mentioned above springing from the slumbering and latent psora remaining within after the repression (or more rarely the gradual disappearance) from the skin of the original eruption of itch. This eruption frequently leaves the skin of itself and it has never been proved that it infected any other person with the itch.

[**] Presumably these exhalations possess a quality which as it were paralyzes the vital force of the organism (which in an ordinary state of health is able to keep down the internal psora which always endeavors to manifest itself) and thus predisposes to putrid and nervous fevers.

The latest symptoms that have been added to a chronic disease which has been left to itself (and thus has not been aggravated by medical mismanagement) are always the first to yield in an antipsoric treatment; but the oldest ailments and those which have been most constant and unchanged, among which are the constant local ailments, are the last to give way; and this is only effected, when all the remaining disorders have disappeared and the health has been in all other respects almost totally restored. In the general maladies which come in repeated attacks, e. g. the periodic kinds of hysteria, and different kinds of epilepsy, etc., the attacks may quickly be made to cease by a suitable antipsoric; but to make this cessation reliable and lasting, the whole indwelling psora must be completely cured.

The frequent request of a patient to have one symptom, which above others is troublesome to him, removed first of all, is impracticable, but the ignorant patient should be excused for his request.

In the daily written report during the use of an antipsoric medicine, the patient who lives at a distance should underscore once, for the information of the physician, those incident symptoms during the day, which after a considerable time or a long time he has now felt again for the first time; but those which he never had before and which he first felt on that day, he should underscore twice. The former symptoms indicate that the antipsoric has taken hold of the root of the evil, and will do much for its thorough cure, but the latter, if they appear more frequently and more strongly, give the physician a hint that the antipsoric was not selected quite homœopathically, and should be interrupted in time and replaced by a more appropriate one.

When the treatment is about half completed, the diminished disease commences to return into the state of a latent psora; the symptoms grow weaker and weaker, and at last the attentive physician will only find traces of it; but he must follow these to their complete disappearance, for the smallest remnant retains a germ for a renewal of the old ailment. [] If the physician should here give up the treatment and suppose what the common man (and also the higher class of the non-medical public) is apt to say: "It will now likely get right of itself*," a great mistake would be made; for in time there would develop, (especially when any important untoward events take place), out of this little remnant of this only diminished psora, a new chronic disease which gradually would increase unavoidably, according to the nature of diseases springing from unextinguished chronic miasms as shown above.

The cito, tuto et jucunde (quickly, safely and pleasantly) of Celsus, the patient may reasonably ask from his physician, and from the homœopath he can rightly expect this in acute diseases springing from occasional causes, as well as in the well-defined intermediate diseases prevalent at times (the so-called intercurrent diseases).

But with especial regard to the "Cito" (quickly), i.e., the hastening of the cure, the nature of the case forbids it, at least in inveterate chronic ailments. [**]

The cure of great chronic diseases of ten, twenty, thirty and more years' standing (if they have not been mismanaged by an excess of allopathic treatments, or indeed, as is often the case, mismanaged into incurableness) may be said to be quickly annihilated if this is done in one or two years. If with younger, robust persons this takes place in one-half the time, then on the other hand in advanced age, even with the best treatment on the part of the physician and the most punctual observance of rules on the part of the patient and his attendants, considerable time must be added to the usual period of the cure. It will also be found intelligible that such a long-continued (psoric) chronic disease, the original miasm of which has had so much time and opportunity in a long life to insert its parasitical roots as it were, into all the joints of the tender edifice of life, is at last so intimately interwoven with the organism that even with the most appropriate medical treatment, careful mode of life and observance of rules on the part of the patient, great patience and sufficient time will be required to destroy this many armed polypus in all its parts, while sparing the independence of the organism and its powers.

[*] So from the water-polypus which has several of its branches lopped off in time new branches will shoot forth.

[**] Only an ordinary ignorant practitioner can lightly promise to cure a severe inveterate disease in four to six weeks. He need not, indeed, keep his promise! What does he risk, if as a matter of course, his treatment only aggravates the disease? Can he lose anything? Any honor? No; for his colleagues, who are like him, do no better. Can he lose in self-respect? Should he yet have any to lose?

The strength of a patient under an antipsoric treatment, even if it should be continued ever so long, ought continually to increase from the very commencement of the correct treatment even to the restoration of health and of the normal state. The strength increases during the whole of the cure without the use of the so-called tonics, and the patients joyously rise up again of themselves in proportion as their life is delivered from its corroding enemy. [*]

The best time for taking a dose of antipsoric medicine seems to be, not an hour before going to bed but, rather, early in the morning while fasting. The medicine in the numbered paper [] (as also all that succeed) if it is desired that it should act but feebly, should be taken dry and allowed to dissolve on the tongue, or be moistened with two or three drops of water on a spoon, and by itself, without in either case drinking anything after it or eating anything within half an hour or a whole hour. [*]

After taking the medicine the patient should keep perfectly quiet at least a full hour, but without going to sleep (sleep delays the beginning of the action of the medicine). He must avoid during this hour, as indeed throughout the treatment, all disagreeable excitement, nor should he strain his mind immediately after taking the dose, in any way, either by reading or computing, by writing, or by conversations requiring meditation.

[] It is inconceivable how allopathic physicians could think of curing chronic diseases through a continuance of exhausting and debilitating treatments, without being restrained by their lack of success from repeating continually their perverse treatment. The amara* which they give between, together with the quinine, without being able to supply the strength lost, only add new evils.

[**] Numbering the powders continuously has the convenience that the physician when the patients render their daily report (especially those living at a distance) putting first the date and the number of the powder taken that day, can recognize the day when the patient took his medicine, and can judge of the progress of its action according to the report of the following day.

[***] If the medicine is to act more strongly it must be stirred in a little more water until dissolved before taking it, and in still more water if it is to act still more strongly, and the physician should order the solution taken a portion at a time. If he orders the solution taken in one or three days it must be stirred up not only the first time, but also the other two times, by which every part thus stirred acquires another somewhat higher degree of potency, and so is received more willingly by the vital force. To direct the use of the same solution for a greater number of days is not advisable, as the water, kept longer, would begin to putrefy. How a dose for smelling may be adapted to all degrees of strength, I have mentioned above.

The dose of antipsoric medicine must not be taken by females shortly before their menses are expected, nor during their flow; but the dose can be given, if necessary, four days, i.e., about ninety-six hours after the menses have set in. But in case the menses previously have been premature or too profuse, or two long-lasting, it is often necessary to give on this fourth day a small dose of nux vomica (one very small pellet, moistened with a high dynamization) to be smelled, and then, on the fourth or sixth day following, the antipsoric. But if the female is very sensitive and nervous, she ought, until she comes near her full restoration, to smell such a pellet once about every time seventy-two hours after the beginning of her menses, notwithstanding her continued antipsoric treatment. [*]

Pregnancy in all its stages offers so little obstruction to the antipsoric treatment, that this treatment is often most necessary and useful in that condition. [*] Most necessary because the chronic ailments then are more developed. In this state of woman, which is quite a natural one, the symptoms of the internal psora are often manifested most plainly [**] on account of the increased sensitiveness of the female body and spirit while in this state; the antipsoric medicine therefore acts more definitely and perceptibly during pregnancy, which gives the hint to the physician to make the doses in these as small and in as highly potentized attenuations as possible, and to make his selections in the most homœopathic manner.

[*] In such a morbid state of the menses nothing can be done in the cure of chronic diseases without the intermediate use of Nux vomica, which here specially reduces to order the disharmony arising in the functions of the nerves from so disorderly a flow of the menses, and so quiets this excessive sensitiveness and irritability, which put an insurmountable obstacle in the way of the curative action of the antipsoric remedies.

[*] In what more certain way could, e.g.,* the return of miscarriage, which is almost exclusively due to psora, be prevented, and, indeed, be lastingly prevented, than through a judicious antipsoric treatment before or at least during Pregnancy? In what more reliable way could the states of the womb, which are not infrequently dangerous, and sometimes fatal even in a proper presentation of the fœtus and in a natural labor, be removed in advance than by a timely antipsoric treatment during pregnancy? Even the improper presentation of the child has, if not always, still very often its only cause in the psoric sickness of the mother, and the hydrocephalus and other bodily defects of the child have surely this cause! Only the antipsoric treatment of the sickly wife if not before, at least during pregnancy, can remove in advance the mother's inability for suckling, as also in suckling prevent the frequent sore breasts, the soreness of the nipples, the frequent inclination to erysipelatous inflammations of the breasts and their abscesses, as well the hæmorrhages of the uterus during suckling.

[***] Nevertheless, the entire opposite frequently takes place, so that the wife who before pregnancy was always sickly, and uninterruptedly complaining, feels in unusual good health during every pregnancy and only during this state. And with such cases this time of pregnancy may very well be made use of for antipsoric treatment, which in such a case is directed against the symptoms of the morbid state before pregnancy, so far as this can be remembered.

Sucklings never receive medicine; the mother or wet-nurse receives the remedy instead, and through their milk it acts on the child very quickly, mildly and beneficially.

The corporeal nature (called the life-preserving principle or vital force) when left to itself, since it is without reason, cannot provide anything better than palliatives in chronic diseases and in the acute diseases springing thence which cause sudden danger to life, owing to the indwelling psora. These are the causes of the more frequent secretions and excretions of various kinds taking place of themselves now and then in chronic (psoric) diseases, as e.g., diarrhœas, vomiting, perspiration, suppurations, hæmorrhages, etc. All these are attended with only temporary alleviations of the chronic original malady, which owing to the losses of humors and of strength thereby only becomes more and more aggravated.

Allopathy has, so far, not been able to do any more than this toward a genuine cure of the chronic diseases; it could only imitate the unreason in corporeal nature in its palliatives (usually without an equal alleviation and with a greater sacrifice of strength). It caused therefore, more than the other, a hastening of the general ruin, without being able to contribute anything to the extinction of the original malady. To this class belong all the many, indescribable purgatives, the so-called dissolvents, the venesection, cupping, the applying of leeches now so insanely frequent, the sudorifics, the artificial sores, setons, fontanelles, exutories, etc.

God be praised, the homœopathic physician who is acquainted with the means of a radical cure, and who thus through the anti-psoric treatment can destroy the chronic disease itself, has so little need of the above mentioned applications, which only hasten dissolution, that he has on the contrary to use all care that the patient may not secretly use some of these appliances, following the old routine, diffused over the whole earth by allopathy. He can never yield to the request of the patient, e.g., that he has become accustomed to being bled so and so many times a year, or to be cupped, or to use purgatives or warm baths, and that he therefore needs them. Such things cannot be permitted.

The homœopathic physician who is a master of his art, and God be praised! there is now a not inconsiderable number of such masters in homœopathy, never allows a drop of blood to be drawn from his patient; he never needs any such or similar means of weakening the body, for such a course evermore remains the negation of curing. Only journeymen, half homœopaths still, I am sorry to say, use such a contradictio in adjecto (weakening while desiring to cure). [*]

Only in the one case, where, as in many chronic diseases, the delay in passing evacuations causes great trouble, he will permit (in the beginning of the treatment before the antipsoric medicine has had the time [in its after-effects] to produce improvement in this point) if the stool is not passed for three or four days, a clyster of clean, lukewarm water without the least admixture, also perhaps a second, if an evacuation does not result within a quarter of an hour. Rarely a third injection will be needed, after waiting a third quarter of an hour. This help which acts chiefly mechanically by expanding the rectum, is harmless when repeated after three or four days if it is necessary, and, as before mentioned, only at the beginning of the treatment - for the antipsoric medicines, among which in this respect lycopodium next to sulphur has the pre-eminence, usually soon remove this difficulty.

The inexcusable wasting fontanelles the homœopathic physician must not at once suppress, if the patient has had them for some time (often for many years), nor before the antipsoric treatment has already made perceptible progress, but if they can be diminished without totally stopping them, this may safely be done even in the beginning of the treatment.

So also the physician should not at once discontinue the woollen underclothing, which is said to prevent the taking of cold and the recommendation of which is carried very far by the ordinary physicians in default of any real assistance. Though they are a burden to the patient, we should wait until there is a visible improvement effected by the antipsorics which remove the tendency to taking cold, and until the warmer season comes. With patients who are very weakly, he should in the beginning change to cotton shirts which rub and heat the skin less, before requiring patients to put linen underclothing on their skin.

[*] This may well be pardoned with journeymen and beginners: but when they assume to boast of this noviceship and declare in public journals and books that the incidental use of blood-letting and leeches is indispensable, yea, that it is more essentially homœopathic, they become ridiculous and are to be pitied as tyros and as laboring under delusion; and their patients also are to be pitied. Is it laziness or a haughty preference for their old (although ruinous) allopathic routine, or is it lack of love for their fellowman which prevents a deeper entering into true, beneficent Homœopathy and an elevation into the troublesome but correct and useful selection of the remedy homœopathically specific in every case, and into that mastery of Homœopathy now no more rare?

For many easily perceived reasons, but especially in order that his delicate doses of medicine may not be interfered with in their action, the homœopathic physician can not in his antipsoric treatment allow the intermediate use of any hitherto customary domestic remedy, no perfumery of any kind, no fragrant extracts, no smelling-salts, no Baldwin tea, or any other herb teas, no peppermint confection, no spiced confections or anise-sugar or stomach drops, or liqueurs, no Iceland-moss, or spiced chocolate, no spice-drops, tooth-tinctures or tooth-powders of the ordinary kinds, nor any of the other articles of luxury.

So-called warm and hot baths for the sake of cleanliness, to which spoiled patients are usually very much attached, are not to be allowed, as they never fail to disturb the health; nor are they needed, as a quick washing of a part or of the whole of the body with lukewarm soap-water fully serves the purpose without doing any injury.

At the end of these directions for treating chronic diseases, I recommended, in the first edition, the lightest electric sparks as an adjuvant for quickening parts that have been for a long time paralyzed and without sensation, these to be used besides the antipsoric treatment. I am sorry for this advice, and take it back, as experience has taught me, that this prescription has nowhere been followed strictly, but that larger electric sparks have always been used to the detriment of patients; and yet these larger sparks have been asserted to be very small. I, therefore, now advise against this so easily abused remedy, especially, as we can easily remove this appearance of enantiopathic assistance; for there is an efficient homœopathic local assistance for paralyzed parts or such as are without sensation. This is found in cold water [*] locally applied (at 54° Fahrenheit) from mountain-springs and deep wells; either by pouring on these parts for one, two or three minutes, or by douche-baths over the whole body of one to five minutes duration, more rarely or more frequently, even daily or oftener according to the circumstances, together with the appropriate, internal, antipsoric treatment, sufficient exercise in the open air, and judicious diet.

[*] Water of this and a lower temperature has the primary power of depriving the parts of the living body partly of sensation and partly of motion, in such cases it therefore gives local homœopathic assistance.