§ 211–240

§ 211

This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being a decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician.

§ 212

The Creator of therapeutic agents has also had particular regard to this main feature of all diseases, the altered state of the disposition and mind, for there is no powerful medicinal substance in the world which does not very notably alter the state of the disposition and mind in the healthy individual who tests it, and every medicine does so in a different manner.

§ 213

We shall, therefore, never be able to cure conformably to nature – that is to say, homoeopathically – if we do not, in every case of disease, even in such as are acute, observe, along with the other symptoms, those relating to the changes in the state of the mind and disposition, and if we do not select, for the patient's relief, from among the medicines a disease-force which, in addition to the similarity of its other symptoms to those of the disease, is also capable of producing a similar state of the disposition and mind.[141]

[141] Thus aconite will seldom or never effect a rapid or permanent cure in a patient of a quiet, calm, equable disposition; and just as little will Nux vomica be serviceable where the disposition is mild and phlegmatic, Pulsatilla where it is happy, gay and obstinate, or Ignatia where it is imperturbable and disposed neither to be frightened nor vexed.

§ 214

The instructions I have to give relative to the cure of mental diseases may be confined to a very few remarks, as they are to be cured in the same way as all other diseases, namely, by a remedy which shows, by the symptoms it causes in the body and mind of a healthy individual, a power of producing a morbid state as similar as possible to the case of disease before us, and in no other way can they be cured.

§ 215

Almost all the so-called mental and emotional diseases are nothing more than corporeal diseases in which the symptom of derangement of the mind and disposition peculiar to each of them is increased, while the corporeal symptoms decline (more or less rapidly), till it at length attains the most striking one-sidedness, almost as though it were a local disease in the invisible subtle organ of the mind or disposition.

§ 216

The cases are not rare in which a so-called corporeal disease that threatens to be fatal – a suppuration of the lungs, or the deterioration of some other important viscus, or some other disease of acute character, e.g., in childbed, etc. – becomes transformed into insanity, into a kind of melancholia or into mania by a rapid increase of the psychical symptoms that were previously present, whereupon the corporeal symptoms lose all their danger; these latter improve almost to perfect health, or rather they decrease to such a degree that their obscured presence can only be detected by the observation of a physician gifted with perseverance and penetration. In this manner they become transformed into a one-sided and, as it were, a local disease, in which the symptom of the mental disturbance, which was at first but slight, increases so as to be the chief symptom, and in a great measure occupies the place of the other (corporeal) symptoms, whose intensity it subdues in a palliative manner, so that, in short, the affections of the grosser corporeal organs become, as it were, transferred and conducted to the almost spiritual, mental and emotional organs, which the anatomist has never yet and never will reach with his scalpel.

§ 217

In these diseases we must be very careful to make ourselves acquainted with the whole of the phenomena, both those belonging to the corporeal symptoms, and also, and indeed particularly, those appertaining to the accurate apprehension of the precise character of the chief symptom, of the peculiar and always predominating state of the mind and disposition, in order to discover, for the purpose of extinguishing the entire disease, among the remedies whose pure effects are known, a homoeopathic medicinal pathogenetic force – that is to say, a remedy which in its list of symptoms displays, with the greatest possible similarity, not only the corporeal morbid symptoms present in the case of disease before us, but also especially this mental and emotional state.

§ 218

To this collection of symptoms belongs in the first place the accurate description of all the phenomena of the previous so-called corporeal disease, before it degenerated into a one-sided increase of the mental symptoms[142], and became a disease of the mind and disposition. This may be learned from the report of the patient's friends.

[142] correction; original translation reads “physical symptom“, which is clearly an error as Hahnemann's words are “Geistes-Symptoms“

§ 219

A comparison of these previous symptoms of the corporeal disease with the traces of them that still remain, though they have become less perceptible (but which even now sometimes become prominent, when a lucid interval and a transient alleviation of the psychical disease occurs), will serve to prove them to be still present, though obscured.

§ 220

By adding to this the state of the mind and disposition[143] accurately observed by the patient's friends and by the physician himself, we have thus constructed the complete picture of the disease, for which in order to effect the homoeopathic cure of the disease, a medicine capable of producing strikingly similar symptoms, and especially an analogous disorder of the mind, must be sought for among the antipsoric remedies, if the physical disease have already lasted some time.

[143] 6th Edition footnote, missing in Boericke's translation: Which not infrequently appears alternating in periods, e.g. for several days tumultuous insanity or wrath, other days of profound, tranquil sadness follow, etc., also indeed only returning in certain months of the year.

§ 221

If, however, insanity or mania (caused by fright, vexation, the abuse of spirituous liquors, etc.) have suddenly broken out as an acute disease in the patient's ordinary calm state, although it almost always arises from internal psora, like a flame bursting forth from it, yet when it occurs in this acute manner it should not be immediately treated with antipsoric, but in the first place with remedies indicated for it out of the order class of proved medicaments (e.g., aconite, belladonna, stramonium, hyoscyamus, mercury, etc.) in highly potentised, minute, homoeopathic doses, in order to subdue it so far that the psora shall for the time revert to its former latent state, wherein the patient appears as if quite well.

§ 222

But such a patient, who has recovered from an acute mental or emotional disease by the use of these non-antipsoric medicines, should never be regarded as cured; on the contrary, no time should be lost in attempting to free him completely[144], by means of a prolonged antipsoric treatment, from the chronic miasm of the psora, which, it is true, has now become once more latent but is quite ready to break out anew; if this be done, there is no fear of another similar attack, if he attend faithfully to the diet and regimen prescribed for him.

[144] It very rarely happens that a mental or emotional disease of long standing ceases spontaneously (for the internal dyscrasia transfers itself again to the grosser corporeal organs); such are the few cases met with now and then, where a former inmate of a madhouse has been dismissed apparently recovered. Hitherto, moreover, all madhouses have continued to be chokefull, so that the multitude of other insane persons who seek for admission into such institutions could scarcely find room in them unless some of the insane in the house died. Not one is ever really and permanently cured in them! A convincing proof, among many others, of the complete nullity of the non-healing art hitherto practised, which has been ridiculously honoured by allopathic ostentation with the title of rational medicine. How often, on the other hand, has not the true healing art, genuine pure homoeopathy, been able to restore such unfortunate beings to the possession of their mental and corporeal health, and so give them back again to their delighted friends and to the world!

§ 223

But if the antipsoric treatment be omitted, then we may almost assuredly expect, from a much slighter cause than brought on the first attack of the insanity, the speedy occurrence of a new and more lasting and severe fit, during which the psora usually develops itself completely, and passes into either a periodic or continued mental derangement, which is then more difficult to be cured by antipsorics.

§ 224

If the mental disease be not quite developed, and if it be still somewhat doubtful whether it really arose from a corporeal affection, or did not rather result from faults of education, bad practices, corrupt morals, neglect of the mind, superstition or ignorance; the mode of deciding this point will be, that if it proceed from one or other of the latter causes it will diminish and be improved by sensible friendly exhortations, consolatory arguments, serious representations and sensible advice, whereas a real moral or mental malady, depending on bodily disease, would be speedily aggravated by such a course, the melancholic would become still more dejected, querulous, inconsolable and reserved, the spiteful maniac would thereby become still more exasperated, and the chattering fool would become manifestly more foolish.[145]

[145] It would seem as though the mind, in these cases, felt with uneasiness and grief the truth of these rational representations and acted upon the body as it wished to restore the lost harmony, but that the body, by means of its disease, reacted upon the organs of the mind and disposition and put them in still greater disorder by a fresh transference of its sufferings on to them.

§ 225

There are, however, as has just been stated, certainly a few emotional diseases which have not merely been developed into that form out of corporeal diseases, but which, in an inverse manner, the body being but slightly indisposed, originate and are kept up by emotional causes, such as continued anxiety, worry, vexation, wrongs and the frequent occurrence of great fear and fright. This kind of emotional diseases in time destroys the corporeal health, often to a great degree.

§ 226

It is only such emotional diseases as these, which were first engendered and subsequently kept up by the mind itself, that, while they are yet recent and before they have made very great inroads on the corporeal state, may, by means of psychical remedies, such as a display of confidence, friendly exhortations, sensible advice, and often by a well-disguised deception, be rapidly changed into a healthy state of the mind (and with appropriate diet and regimen, seemingly into a healthy state of the body also.)

§ 227

But the fundamental cause in these cases also is a psoric miasm, which was only not yet quite near its full development, and for security's sake, the seemingly cured patient should be subjected to a radical, antipsoric treatment, in order that he may not again, as might easily occur, fall into a similar state of mental disease.

§ 228

In mental and emotional diseases resulting from corporeal maladies, which can only be cured by homoeopathic antipsoric medicine conjoined with carefully regulated mode of life, an appropriate psychical behaviour towards the patient on the part of those about him and of the physician must be scrupulously observed, by way of an auxiliary mental regimen. To furious mania we must oppose calm intrepidity and cool, firm resolution – to doleful, querulous lamentation, a mute display of commiseration in looks and gestures – to senseless chattering, a silence not wholly inattentive – to disgusting and abominable conduct and to conversation of a similar character, total inattention. We must merely endeavour to prevent the destruction and injury of surrounding objects, without reproaching the patient for his acts, and everything must be arranged in such a way that the necessity for any corporeal punishments and tortures[146] whatever may be avoided. This is so much the more easily effected, because in the administration of the medicine – the only circumstance in which the employment of coercion could be justified – in the homoeopathic system the small doses of the appropriate medicine never offend the taste, and may consequently be given to the patient without his knowledge in his drink, so that all compulsion is unnecessary.

[146] It is impossible not to marvel at the hard-heartedness and indiscretion of the medical men in many establishments for patients of this kind, who, without attempting to discover the true and only efficacious mode of curing such disease, which is by homoeopathic medicinal (antipsoric) means, content themselves with torturing these most pitiable of all human beings with the most violent blows and other painful torments. By this unconscientious and revolting procedure they debase themselves beneath the level of the turnkeys in a house of correction, for the latter inflict such chastisement as the duty devolving on their office, and on criminals only, whilst the former appear, from a humiliating consciousness of their uselessness as physicians, only to vent their spite at the supposed incurability of mental diseases in harshness towards the pitiable, innocent sufferers, for they are too ignorant to be of any use and too indolent to adopt a judicious mode of treatment.

§ 229

On the other hand, contradiction, eager explanations, rude corrections and invectives, as also weak, timorous yielding, are quite out of place with such patients; they are equally pernicious modes of treating mental and emotional maladies. But such patients are most of all exasperated and their complaint aggravated by contumely, fraud, and deceptions that they can detect. The physician and keeper must always pretend to believe them to be possessed of reason. All kinds of external disturbing influences on their senses and disposition should be if possible removed; there are no amusements for their clouded spirit, no salutary distractions, no means of instruction, no soothing effects from conversation, books or other things for the soul that pines or frets in the chains of the diseased body, no invigoration for it, but the care; it is only when the bodily health is changed for the better that tranquillity and comfort again beam upon their mind.[147]

[147] 6th Edition footnote: The treatment of the violent insane maniac and melancholic can take place only in an institution specially arranged for their treatment but not within the family circle of the patient.

§ 230

If the antipsoric remedies selected for each particular case of mental or emotional disease (there are incredibly numerous varieties of them) be quite homoeopathically suited for the faithfully traced picture of the morbid state, which, if there be a sufficient number of this kind of medicines known in respect of their pure effects, is ascertained by an indefatigable search for the most appropriate homoeopathic remedy all the more easily, as the emotional and mental state, constituting the principal symptom of such a patient, is so unmistakably perceptible, – then the most striking improvement in no very long time, which could not be brought about by physicking the patient to death with the largest oft-repeated doses of all other unsuitable (allopathic) medicines. Indeed, I can confidently assert, from great experience, that the vast superiority of the homoeopathic system over all other conceivable methods of the treatment is nowhere displayed in a more triumphant light than in mental and emotional diseases of long standing, which originally sprang from corporeal maladies or were developed simultaneously with them.

§ 231

The intermittent diseases deserve a special consideration, as well those that recur at certain periods – like the great number of intermittent fevers, and the apparently non-febrile affections that recur at intervals like intermittent fevers – as also those in which certain morbid states alternate at uncertain intervals with morbid states of a different kind.

§ 232

These latter, alternating diseases, are also very numerous[148], but all belong to the class of chronic diseases; they are generally a manifestation of developed psora alone, sometimes, but seldom, complicated with a syphilitic miasm, and therefore in the former case may be cured by antipsoric medicines; in the latter, however, in alternation with antisyphilitics as taught in my work on the Chronic Diseases.

[148] Two or three states may alternate with one another. Thus, for instance, in the case of double alternating diseases, certain pains may occur persistently in the legs, etc., immediately on the disappearance of a kind of ophthalmia, which latter again appears as soon as the pain in the limbs has gone off for the time – convulsions and spasms may alternate immediately with any other affection of the body or some part of it – in a case of threefold alternating states in a common indisposition, periods of apparent increase of health and unusual exaltation of the corporeal and mental powers (extravagant gaiety, extraordinary activity of the body, excess of comfortable feeling, inordinate appetite, etc.) may occur, after which, and quite unexpectedly, gloomy, melancholy humour, intolerable hypochondriacal derangement of the disposition, with disorder of several of the vital operations, the digestion, sleep, etc., appear, which again, and just as suddenly, give place to the habitual moderate ill-health; and so also several and very various alternating states. When the new state makes its appearance, there is often no perceptible trace of the former one. In other cases only slight traces of the former alternating state remain when the new one occurs; few of the symptoms of the first state remain on the appearance and during the continuance of the second. Sometimes the morbid alternating states are quite of opposite natures, as for instance, melancholy periodically alternating with gay insanity or frenzy.

§ 233

The typical intermittent diseases are those where a morbid state of unvarying character returns at a tolerably fixed period, while the patient is apparently in good health, and takes its departure at an equally fixed period; this is observed in those apparently non-febrile morbid states that come and go in a periodical manner (at certain times), as well as in those of a febrile character, to wit, the numerous varieties of intermittent fevers.

§ 234

Those apparently non-febrile, typical, periodically recurring morbid states just alluded to observed in one single patient at a time (they do not usually appear sporadically or epidemically) always belong to the chronic diseases, mostly to those that are purely psoric, are but seldom complicated with syphilis, and are successfully treated by the same means; yet it is sometimes necessary to employ as an intermediate remedy a small dose of a potentised solution of cinchona bark, in order to extinguish completely their intermittent type.

§ 235

With regard to the intermittent fevers[149], that prevail sporadically or epidemically (not those endemically located in marshy districts), we often find every paroxysm likewise composed of two opposite alternating states (cold, heat – heat, cold), more frequently still of three (cold, heat, sweat). Therefore the remedy selected for them from the general class of proved (common, not antipsoric) medicines must either (and remedies of this sort are the surest) be able likewise to produce in the healthy body two (or all three) similar alternating states, or else must correspond by similarity of symptoms, in the most homoeopathic manner possible, to the strongest, best marked, and most peculiar alternating state (either to the cold stage, or to the hot stage, or to the sweating state, each with its accessory symptoms, according as the one or other alternating state is the strongest and most peculiar); but the symptoms of the patient's health during the intervals when he is free from fever must be the chief guide to the most appropriate homoeopathic remedy.[150]

[149] The pathology hitherto in vogue, which is still in the stage of irrational infancy, recognizes but one single intermittent fever, which it likewise termed ague, and admits of no varieties but such as are constituted by the different intervals at which the paroxysms recur, quotidian, tertian, quartan etc. But there are much more important differences among them than what are marked by the periods of their recurrence; there are innumerable varieties of these fevers, some of which cannot even be denominated ague, as their fits consist solely of heat; others, again, are characterised by cold alone, with or without subsequent perspiration; yet others which exhibit general coldness of the surface, with a sensation on the patient's part, or whilst the body feels externally hot, the patient feels cold; others, again, in which one paroxysm consists entirely of a rigour or simple chilliness followed by an interval of health, while the next consists of heat alone, followed or not by perspiration; others, again, in which the heat comes first and the cold stage not till that is gone; others, again, wherein after a cold or hot stage apyrexia ensues, and then perspiration comes on like a second fit, often many hours subsequently; others, again, in which no perspiration at all comes on, and yet others in which the whole attack consists of perspiration alone, without any cold or hot stage, or in which the perspiration is only present during the heat; and there are innumerable other differences, especially in regard to the accessory symptoms, such as headache of a peculiar kind, bad taste of the mouth, nausea, vomiting, diarrhoea, want of or excessive thirst, peculiar pains in the body or limbs, disturbed sleep, deliria, alterations of temper, spasms, etc., before, during or after the sweating stage, and countless other varieties. All these are manifestly intermittent fevers of very different kinds, each of which, as might naturally be supposed, requires a special (homoeopathic) treatment. It must be confessed that they can almost all be suppressed (as is often done) by enormous doses of bark and of its pharmaceutical preparation, the sulphate of quinine; that is to say, their periodical recurrence (their typus) may be extinguished by it, but the patients who suffered from intermittent fevers for which cinchona bark is not suitable, as is the case with all those epidemic intermittent fevers that traverse whole countries and even mountainous districts, are not restored to health by the extinction of the typus; on the contrary, they now remain ill in another manner, and worse, often much worse, than before; they are affected by peculiar, chronic bark dyscrasias, and can scarcely be restored to health even by a prolonged treatment by the true system of medicine – and yet that is what is called curing, forsooth!

[150] Dr. von Bönninghausen, who has rendered more services to our beneficent system of medicine than any other of my disciples, has best elucidated this subject, which demands so much care, and has facilitated the choice of the efficient remedy for the various epidemics of fever, in his work entitled Versuch einer homöopathischen Therapie der Wechselfieber, 1833, Münster bei Regensberg.

§ 236

The most appropriate and efficacious time for administering the medicine in these cases is immediately or very soon after the termination of the paroxysm, as soon as the patient has in some degree recovered from its effects; it has then time to effect all the changes in the organism requisite for the restoration of health, without any great disturbance or violent commotion; whereas the action of a medicine, be it ever so specifically appropriate, if given immediately before the paroxysm, coincides with the natural recurrence of the disease and causes such a reaction in the organism, such a violent contention, that an attack of that nature produces at the very least a great loss of strength, if it do not endanger life[151]. But if the medicine be given immediately after the termination of the fit, that is to say, at the period when the apyretic interval has commenced and a long time before there are any preparations for the next paroxysm, then the vital force of the organism is in the best possible condition to allow itself to be quietly altered by the remedy, and thus restored to the healthy state.

[151] This is observed in the fatal cases, by no means rare, in which a moderate dose of opium given during the cold stage quickly deprived the patients of life.

§ 237

But if the stage of apyrexia be very short, as happens in some very bad fevers, or if it be disturbed by some of the after sufferings of the previous paroxysm, the dose of the homoeopathic medicine should be administered when the perspiration begins to abate, or the other subsequent phenomena of the expiring paroxysm begin to diminish.

§ 238 6th edition

Not infrequently, the suitable medicine has with a single dose destroyed several attacks and brought about the return of health, but in the majority of cases, another dose must be administered after such attack. Better still, however, when the character of the symptoms has not changed, doses of the same medicine given according to the newer discovery of repetition of doses (see note to § 270), may be given without difficulty in dynamizing each successive dose with 10-12 succussions of the vial containing the medicinal substance. Nevertheless, there are at times cases, though seldom, where the intermittent fever returns after several days' well being. This return of the same fever after a healthy interval is only possible when the noxious principle that first caused the fever, is still acting upon the convalescent, as is the case in marshy regions. Here a permanent restoration can often take place only by getting away from this causative factor, as is possible by seeking a mountainous retreat, if the cause was a marshy fever.

§ 239

As almost every medicine causes in its pure action a special, peculiar fever and even a kind of intermittent fever with its alternating states, differing from all other fevers that are caused by other medicines, homoeopathic remedies may be found in the extensive domain of medicines for all the numerous varieties of natural intermittent fevers and, for a great many of such fevers, even in the moderate collection of medicines already proved on the healthy individual.

§ 240

But if the remedy found to be the homoeopathic specific for a prevalent epidemic of intermittent fever do not effect a perfect cure in some one or other patient, if it be not the influence of a marshy district that prevents the cure, it must always be the psoric miasm in the background, in which case antipsoric medicines must be employed until complete relief is obtained.